bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral mucosal lesions in psoriatic patients based on disease severity and treatment approach
Authors: Olejnik Maria , Osmola‐Mańkowska Agnieszka , Ślebioda Zuzanna , Adamski Zygmunt , Dorocka‐Bobkowska Barbara
Published: August 2020

Background

This observational case‐control study was designed to investigate the frequency of oral lesions in psoriatic patients and to identify an association between mucosal involvement, the severity of the disease, and a form of treatment.

Methods

One hundred twenty‐seven patients diagnosed with psoriasis were enrolled in this study from November 2018 to September 2019. The oral mucosa evaluation was based on the clinical appearance, location, and morphology of the lesions. All patients completed a general medical history and a Dermatology Life Quality Index (DLQI) questionnaire. The severity of skin involvement was assessed using the Psoriasis Area and Severity Index (PASI) scale.

Results

The most common oral lesions in patients with psoriasis were found to be fissured (FT), white coated (CT), and geographic tongue (GT). A significantly lower prevalence of GT was evident in the group managed with a new class of biological drugs and smokers. There appeared to be no association between the oral manifestation and the PASI score. FT appeared significantly more often in patients that experienced an extremely large effect of psoriasis on their quality of life as determined by the DLQI questionnaire and smokers. Only 25% of patients presented normal oral mucosa.

Conclusions

Tongue lesions seem to be associated with skin psoriasis regardless of the treatment. The severity of the disease, according to the PASI scale, does not influence mucosal involvement. The type of treatment may affect the prevalence of oral lesions. Further investigations are required to confirm the influence of biological therapies on mucosal improvement.
Distinct microRNA expression profiles in saliva and salivary gland tissue differentiate patients with primary Sjögren's syndrome from non‐Sjögren's sicca patients
Authors: Sembler‐Møller Maria Lynn , Belstrøm Daniel , Locht Henning , Pedersen Anne Marie Lynge
Published: August 2020

Objectives

Increasing evidence suggests that aberrant expression of microRNAs (miRNAs) is involved in the pathogenesis of primary Sjögren's syndrome (pSS). The aim was thus to characterize the miRNA profile in saliva, salivary gland tissue, and plasma from patients with pSS and compare findings with those of patients having Sjögren‐like disease (non‐pSS). In addition, to correlate miRNA levels and clinicopathological features of pSS.

Methods

miRNA real‐time quantitative polymerase chain reaction was performed on saliva, plasma, and salivary gland tissue samples from 24 patients with pSS and 16 non‐pSS in 384‐well plates. T test was used for comparison of miRNA profiles, followed by Benjamini‐Hochberg correction. The discriminatory power of miRNAs was evaluated by receiver‐operating characteristic curves, and Pearson/Spearman correlation was used for correlation analyses.

Results

In saliva, 14 miRNAs were significantly differentially expressed between pSS and non‐pSS, including downregulation of the miR‐17 family in pSS. In salivary gland tissue of patients with pSS, miR‐29a‐3p was significantly upregulated. Plasma miRNAs did not differ between the two groups, although the miR‐17 family tended to be downregulated. The combination of miR‐17‐5p and let‐7i‐5p in saliva yielded an area under curve of 97% (CI 92%‐100%). Several miRNAs correlated significantly with one another and with salivary flow rates and histopathology.

Conclusion

Our findings indicate that the miRNA expression profile in saliva may enable to discriminate between pSS and non‐pSS patients. However, further validation in larger cohorts is needed as well as functional analyses of the miRNAs of interest.
Making and maintaining relationships through the prism of the dark triad traits: A longitudinal social network study
Authors: Rogoza Radosław , Danieluk Barnaba , Kowalski Christopher Marcin , Kwiatkowska Katarzyna , Kwiatkowska Maria Magdalena
Published: August 2020

Objective

We investigated how Dark Triad traits influence the development and maintenance of social relations.

Method

Participants completed the Short Dark Triad questionnaire and a measure of social relations at three time points: at the beginning of their first year in high school, 3 months later, and at the end of their first year. We investigated whether the Dark Triad traits are stable over time using Multilevel Modeling (N = 265; 59.6% girls), and how Dark Triad traits predict incoming and outgoing agentic and communal relations using Temporal Exponential Random Graph Models (N = 192; 60.4% girls).

Results

Overall, the Dark Triad traits were stable over a one‐year period. Narcissism did not predict an increase in communal and agentic relations in the short‐term, but predicted slightly less incoming communal and more agentic relations in the long‐term. In the short‐term, Machiavellianism predicted a small increase while psychopathy predicted a small decrease in the incoming agentic and communal relations. In the long‐term, however, neither Machiavellianism nor psychopathy was a significant predictor of any incoming relations.

Conclusions

Our results shed new light on the dynamics of making and maintaining social relations through the prism of the Dark Triad traits.
Did Marketplace coverage really offer financial protection? Financial gains from the Affordable Care Act's private insurance policies among the previously uninsured
Authors: Zewde Naomi
Published: August 2020

While the Affordable Care Act successfully expanded health insurance access, the law's private insurance component drew far fewer participants than projected. This study investigates the attractiveness of Marketplace insurance relative to uncompensated care provisions for those who remain uninsured. Using restricted‐access Medical Expenditure Panel Survey data, I find that for one in four previously uninsured consumers, bankruptcy costs less than meeting the deductible of the subsidized benchmark policy. Marketplace insurance reduces spending in only the top 3% most catastrophic potential scenarios these consumers face, on average. Net financial gain is more common among individuals in poor health (11% vs. 1%) or with assets to protect (3% vs. <1%). High‐deductible insurance aims to protect wealth in catastrophic scenarios. However, hospitals substantially discount care for the uninsured in such scenarios. High‐deductible coverage might not be an effective driver of financial security for the uninsured, which may help to explain low Marketplace enrollment.
Low allergen content of commercial baby foods
Authors: Netting Merryn J , Gold Michael S , Palmer Debra J
Published: August 2020

Aim

Introduction of allergenic solid foods, especially peanut and hen's egg reduces the risk of food allergy development in early childhood. Ideally, parents will offer their infants home‐prepared foods; however, many rely on the availability of convenient ready to purchase infant foods. This audit aimed to assess the major food allergen content of commercial infant foods.

Methods

Infant foods available for sale in 2019 in Australia were the focus of this audit. The major food allergens investigated were peanut, tree nuts, hen's egg, cows milk, wheat, fish, shellfish, soy, sesame and lupin. Websites of infant food manufacturers and major supermarkets were used to identify ingredient lists of infant foods available for purchase. Where ingredients listings were unavailable this information was sourced directly from the product labels in the supermarket.

Results

Fourteen companies were identified, manufacturing over 251 foods specifically for the infants aged less than 1 year of age. Although there were many choices available containing wheat (27 products) and cows milk proteins (73 products), none contained peanut, tree nuts, sesame, shellfish or lupin.

Conclusions

Despite infant feeding advice encouraging early introduction to food allergens, of 251 commercial baby foods surveyed only 1% contained egg and none contained peanut, the most common food allergies in young Australian infants. This low food allergen content may be disadvantageous for infants fed mostly commercial infant foods as they are unlikely to be exposed to sufficient amounts of the major food allergens on a regular basis during infancy.
A dis‐ordered personality? It’s time to reframe borderline personality disorder
Authors: Brand Gabrielle , Wise Steve , Walpole Katherine
Published: August 2020

Accessible summary

What is known on the subject

Integrating strengths‐based, co‐produced, consumer‐driven resources into mental health workforce education has the potential to dissolve hierarchical mental health care relationships.

What the paper adds to existing knowledge

Humanities‐based pedagogy that draws from photography and multi‐voiced narratives is a powerful reflective learning tool to bridge clinical and human experiences of Borderline Personality Disorder (BPD).

The Depth of Field reflective learning methodology aims to provoke, prod, reveal and challenge assumptions and/or unconscious bias towards BPD and stimulate raw and reflective discussions that have the potential to inspire critical reflection and move health professionals towards more humanistic, recovery centred models of mental health care.

What are the implications for mental health nursing

At the core of co‐production in research, education and practice lies a reciprocal, transformational learning experience. This relationship needs to be further explored in order to reframe mental health education that honours and legitimizes consumers as experts of their own lives and recovery experiences.
The importance of historical ecology for interpreting evolutionary processes in plants of oceanic islands
Authors: Stuessy Tod F.
Published: August 2020

Oceanic islands and archipelagos are natural laboratories for investigating patterns and processes of evolution. Islands change with the course of time, resulting in a dynamic ontogeny over millions of years. The combined forces of tectonic plate subsidence and erosion from waves, wind, and rainwater bring about substantial geomorphological change over millions of years, until islands eventually disappear under the sea. Added to these long‐term natural changes to the environment of the islands are the changes caused by human activities in recent centuries. After humans reach a previously unpopulated island, they utilize the natural resources for their own survival, cutting forests for making houses, boats, and firewood. The size of the human population and the length of time on the island determine the degree of environmental impact. Evolutionary processes in plants of oceanic islands take place during ontogeny of the islands, resulting in population divergence, speciation, and hybridization. Due to the dramatic alterations suffered by many islands over millions of years, the present patterns of distribution and ecology of species within endemic groups may have little to do with the patterns when the species originated. Understanding these environmental changes is fundamental to infer a founder effect, reasons for levels of genetic variation within and among populations, and modes of speciation. Special caution must be exercised while making comparisons between groups located on islands of different geological ages and that have endured differing environmental modifications from humans. Examples are provided from the Juan Fernández Archipelago and Lord Howe Island.
Unit root testing with slowly varying trends
Authors: Otto Sven
Published: August 2020

A unit root test is proposed for time series with a general nonlinear deterministic trend component. It is shown that asymptotically the pooled OLS estimator of overlapping blocks filters out any trend component that satisfies some Lipschitz condition. Under both fixed‐b and small‐b block asymptotics, the limiting distribution of the t‐statistic for the unit root hypothesis is derived. Nuisance parameter corrections provide heteroskedasticity‐robust tests, and serial correlation is accounted for by pre‐whitening. A Monte Carlo study that considers slowly varying trends yields both good size and improved power results for the proposed tests when compared to conventional unit root tests.
Bioavailability, rheology, and sensory evaluation of mayonnaise fortified with vitamin D encapsulated in protein‐based carriers
Authors: Khan Wahab Ali , Butt Masood Sadiq , Pasha Imran , Saeed Muhammad , Yasmin Iqra , Ali Maratab , Azam Muhammad , Khan Muhammad Shahroz
Published: August 2020

Vitamin D lost its functionality during processing and storage, thus, encapsulation with proteins is desirable to preserve bioactivity. The aim of the current study was to develop encapsulated vitamin D fortified mayonnaise (VDFM) using whey protein isolates (WPI) and soy protein isolates (SPI) as encapsulating materials in three different formulations, that is, 10% WPI, 10% SPI, and 5/5% WPI/SPI. Increased shear stress decreased the apparent viscosity along with significant effects on the loss modulus of VDFM. WPI encapsulates showed better results as compared to SPI. WPI based VDFM (M1) depicted the best results in terms of size and dispersion uniformity of oil droplets. Hue angle and total change differed significantly among treatments. The highest value for overall acceptability was acquired by M3 (5:5%WPI:SPI‐encapsulates) thus proceed for in vivo trials. Serum vitamin D level was significantly higher in the encapsulated VDFM rat group (58.14 ± 6.29 nmol/L) than the control (37.80 ± 4.98 nmol/L). Conclusively, WPI and SPI encapsulates have the potential to improve the stability and bioavailability of vitamin D.
Effect of laver powder on textual, rheological properties and water distribution of squid (Dosidicus gigas) surimi gel
Authors: Yang Rong , Xu Anqi , Chen Yanting , Sun Nan , Zhang Jinjie , Jia Ru , Huang Tao , Yang Wenge
Published: August 2020

In order to ameliorate the gel quality of Dosidicus gigas surimi, the effects of laver powder on gel properties, rheological properties, and water‐holding capacity (WHC) were investigated. Results indicated that the addition of laver powder could significantly increase the hardness, chewiness, and breaking force of surimi gels. However, the texture indexes and gel strength began to decline when additional amount exceeded 0.6%. Rheological results demonstrated that the addition of laver powder increased the storage modulus (G′) and viscosity of surimi, prolonged protein denaturation temperature in surimi gels. Moreover, the WHC of surimi gel was improved with the increase of laver powder. Further analyses in low‐field nuclear magnetic resonance revealed that laver powder could shorten the transverse relaxation time, enhanced the combination with water, and altered the distribution of different water categories. The proportion of bound water and immobilized water reached its maximum and minimum at 0.6% of laver powder, respectively. Correlation analyses showed that WHC of surimi gel was negatively correlated well with the proportion of loose‐bound water, but positively correlated with the strong‐bound water and free water. In conclusion, the results supported that 0.6% was the optimal additional amount of laver powder for the squid‐based surimi production based on the current ingredients of surimi products.
Interference of sanitizers, NaCl and curing salts on Listeria monocytogenes adhesion and subsequent biofilm formation
Authors: Silva D.A.L. , Tavares R.M. , Nero L.A.
Published: August 2020

Listeria monocytogenes, a well-known foodborne pathogen and the causative agent of listeriosis, has the ability to persist in food processing environments due to its high adhesion ability in different surfaces, playing an important role in the food industry. The aim of this study was to assess how the main stressing conditions, usually observed in meat processing facilities (sanitizers, NaCl, curing salts), interfere in L. monocytogenes adhesion and biofilm formation. The isolates, representatives of different L. monocytogenes lineages (n = 6) were subjected to four different sanitizers (S1: quaternary ammonium; S2: peracetic acid, hydrogen peroxide and glacial acetic acid, S3: biguanide polyhexamethylene hydrochloride, S4: hydrogen peroxide) to verify adhesion ability and susceptibility based on minimum inhibitory concentration (MIC). In addition, the isolates adhesion and biofilm were assessed up to 72 h under different conditions: sanitizers (MIC values), curing salts and NaCl (both at 5, 7·5, 10%), at different temperatures (4, 12 and 37°C). Despite the effectiveness of sanitizers, isolates presented higher biofilm development when compared to controls in the presence of quaternary ammonium (S1, 1: 1,024) at 4°C, over the tested time (P < 0·05). Furthermore, different responses were observed for the different L. monocytogenes strains tested, providing a better understanding of the persistence of this pathogen in the food processing facilities.
Niche overlap and diet composition of three sympatric coastal dolphin species in the southwest Atlantic Ocean
Authors: Teixeira Clarissa R. , Botta Silvina , Daura‐Jorge Fábio G. , Pereira Luiza B. , Newsome Seth D. , Simões‐Lopes Paulo C.
Published: August 2020

Sympatric species are expected to differ in ecological requirements to minimize niche overlap and avoid competition. Here we assess the trophic interactions among three coexisting dolphin species from southern Brazil: the franciscana dolphin (Pontoporia blainvillei), the Guiana dolphin (Sotalia guianensis), and the Lahille's bottlenose dolphin (Tursiops truncatus gephyreus). We evaluated temporal variation in carbon (δ13C) and nitrogen (δ15N) isotope values of bone collagen to examine potential dietary shifts resulting from increased fishing activity over the past three decades. We estimated the degree of niche overlap among these species and the contribution of potential prey sources to their diet. δ15N values were consistent among species and across years, while δ13C values increased for Guiana dolphins and decreased for bottlenose dolphins, suggesting changes in diet and/or foraging habitats through time. The similar δ13C and δ15N values and the high niche overlap between Guiana and bottlenose dolphins indicate that these species are primarily feeding on demersal prey. The franciscana diet is primarily composed of pelagic prey, resulting in a lower niche overlap in comparison with the other dolphin species. Our study provides further information about the foraging ecology of this unique dolphin community in southern Brazil with implications for its management and conservation.
Aetiology of superficial fungal infections of the foot in urban outpatients in mainland China: A multicentre, prospective case study
Authors: Yu Jin , Liu Wei‐Da , Tong Zhong‐Sheng , Yu Nan , Cao Cun‐Wei , Zhou Xun , Li Yu‐Zhen , Zhang Yu , Li Fu‐Qiu , Zhang Jun‐Min , Zhu Min , Yang Lian‐Juan , Abliz Palida , Wang Ai‐Ping , Ran Yu‐Ping , Li Ruo‐Yu
Published: August 2020

Background

In China, the prevalence of superficial fungal infections of the foot is high and recurrence is common. However, a prospective, large‐scale and multicentre study on the aetiology of superficial fungal infections of the foot is still lacking.

Objectives

To study the epidemiology of aetiological agents of superficial fungal infections of the foot in urban outpatients in mainland China, as well as to understand the aetiology features of the pathogenic agent.

Methods

The study was designed as a multicentre, prospective epidemiological survey. A total of 1704 subjects were enrolled from seven geographical areas in mainland China. For each subject, one mycological sample and one bacterial sample were collected. KOH wet mount examination and culture were performed at local laboratories. The bacterial results were only reported in those with positive mycology. Further morphological identification and, if necessary, molecular biological identification were conducted in a central laboratory.

Results

Of 1704 enrolled subjects, 1327 (77.9%) subjects had positive fungal culture results. The incidence of dermatophytes, yeasts and moulds was 90.1%, 8.1% and 1.1%, respectively. The most frequently isolated aetiological agent (fungus) was Trichophyton rubrum. Moccasin form was the most commonly reported clinical diagnosis of superficial fungal infections. The most frequently isolated bacterial genus in patients was Staphylococcus.

Conclusion

This study prospectively investigated the clinical and mycological features of human dermatophytosis in mainland China. T rubrum was the most frequently isolated fungus, and moccasin form was the most commonly reported clinical diagnosis of superficial fungal infections.
SarocladiumandAcremoniuminfections: New faces of an old opportunistic fungus
Authors: Pérez‐Cantero Alba , Guarro Josep
Published: August 2020

The generaAcremoniumandSarocladiumcomprise a high diversity of morphologically and genetically related fungi generally found in the environment, although a few species, mainlySarocladium kilienseandAcremonium egyptiacum, can also be involved in many human infections. Clinical management of opportunistic infections caused by these fungi is very complex, since their correct identification is unreliable, and they generally show poor antifungal response. More than 300 clinical cases involving a broad range ofAcremonium/Sarocladiuminfections have so far been published, and with this review we aim to compile and provide a detailed overview of the current knowledge onAcremonium/Sarocladiumhuman infections in terms of presentation, diagnosis, treatments and prognoses. We also aim to summarise and discuss the data currently available on their antifungal susceptibility, emphasising the promising results obtained with voriconazole as well as their impact in terms of animal infections.
Interventions for impacted maxillary canines: A systematic review of the relationship between initial canine position and treatment outcome
Authors: Grisar Koenraad , Luyten Jonathan , Preda Flavia , Martin Catalina , Hoppenreijs Theo , Politis Constantinus , Jacobs Reinhilde
Published: August 2020

Background

The objective of this review was to critically assess the existing literature on the relationship between the initial position of impacted canines and treatment outcomes.

Methods

We performed a systematic review of the available literature until February 2020 using the MEDLINE, Cochrane Central, Web of Science and PubMed databases. Prospective and retrospective studies (randomized controlled trials [RCTs], cohort studies, longitudinal follow‐up studies) considering impacted maxillary canines that were orthodontically and/or surgically treated, and clearly reporting the initial position using 2D and/or 3D classifications, were included if they assessed at least one of the following: treatment success, treatment duration, number of treatment visits, radiographic outcome, periodontal health, esthetics and/or treatment complications. The included studies were assessed for risk of bias according to the Cochrane guidelines.

Results

Seventeen studies were reviewed (2 RCTs and 15 non‐RCTs). The included studies enrolled a total of 1247 patients with an average age of 14.1 years and a total of 1597 impacted canines. Various causal relationships were detected between the success of treatment modalities and the initial state of the impacted canine (bucco‐palatal position, vertical position, canine angulation, root development).

Discussion

Evidence, though limited, suggests that a higher alpha angle, higher vertical position and more mesial sector of the impacted canine are related to less successful interceptive and active treatment solutions, prolonged treatment time and inferior outcomes.
Molecular, genomic and mutational landscape of oral leukoplakia
Authors: Farah Camile S.
Published: August 2020

Oral leukoplakia (OLK) and its more aggressive clinical variant proliferative verrucous leukoplakia (PVL) remain enigmatic disorders clinically and histopathologically. Despite decades of research into both, there has been only incremental advancement in our understanding of their aetiology and pathogenesis and only minimal improvement in effective management strategies. Currently, no specific prognostic genetic or molecular marker has been reported for leukoplakia. There is, however, an emerging body of evidence characterising the genomic and transcriptomic profile of OLK. Regardless of the significance of cellular and architectural features of OLK and PVL, it is clear from studies reported in this review that new emerging evidence points to the presence of premalignant molecular subtypes of leukoplakia which require further investigation. This up‐to‐date review explores the contemporary genomic, transcriptomic and mutational landscape of leukoplakia broadly, discusses concepts that may not be widely recognised or accepted and purposefully highlights studies with juxtaposed findings in an effort to challenge dogma. It also highlights the urgent need for a concerted international effort of original collaborative research which will only occur by pooling collective efforts, resources and intellect to define the molecular fingerprint of this enigmatic disorder, in the hope it will better inform diagnosis, stratification and treatment.
Care home staff's experiences and views of supporting the dietary management and choices of older residents with obesity
Authors: Thompson Juliana , Parkinson Mark , Collery Robyn
Published: August 2020

Background

Rising numbers of older people with obesity living in care homes is an international phenomenon. Addressing dietary management of residents with obesity is a cause of debate and controversy. On one hand, the ‘obesity paradox’ suggests obesity protects against morbidity in frail older people. On the other hand, obesity reduces functional status and restricts activity for this group. This paper considers care home staff's experience and views of supporting dietary management and choice for residents with obesity within the context of this controversy.

Design

In this qualitative study, 33 staff from seven care homes in the North East England participated in focus groups, and data were analysed using Braun and Clarkes's (2006) six‐phase thematic analysis approach.

Findings

Findings indicate that participants’ support of dietary management and choice for residents with obesity may be strongly influenced by the care home environment. Care priorities, dietary management approaches, care home life and family involvement in residents’ dietary intake facilitate and encourage weight gain, and as such, pose challenges for staff attempting to support weight management of residents with obesity.

Conclusion

Findings suggest that in the care home setting, nutrition policy, guidelines and service commissioning processes and staff nutrition education should include management of obesity. Furthermore, families should be supported to understand the implications of their own caring behaviours on residents’ nutritional status.
Counselling by general dental practitioners for coronectomy before referral – is it always appropriate?
Authors: Beaumont I. , Richards J.A. , Coyle M.J. , Finley B. , Beech A.N.
Published: August 2020

Aims

For the general dental practitioner (GDP) coronectomy may be a treatment option that is discussed with a patient prior to referral to a specialist in primary or secondary care for management of problematic mandibular third molars. The purpose of this study was to examine the variance between coronectomy prescription between GDPs compared to specialist clinicians when assessing cases for coronectomy using plain view radiographs.

Methods

An online survey was completed by 50 GDPs across the UK. This survey had also been completed by 25 specialist oral and maxillofacial or oral surgery clinicians of varying levels of experience from six different units across the UK and the Republic of Ireland.

Results

Results were compared and, whilst agreement between GDPs was higher in coronectomies prescribed, there was a significantly larger number of coronectomies prescribed in the GDP group.

Conclusions

The increased number of coronectomies prescribed by the GDP group compared to the specialist group could reflect a lack of experience in the regular assessment of mandibular third molars or a clinician being more aware of the litigious climate of dentistry when based in primary dental care.
The evolution of pediatric sedation and anesthesia patient safety: An interview with Dr Charles J. “Charlie” Coté
Authors: Firth Paul G. , Mai Christine L.
Published: August 2020

The career of Dr Charles J. Coté covered a period of major advances in pediatric anesthesia patient safety. Dr Coté (1946 ‐‐), Professor Emeritus in Anaesthesia at Harvard Medical School, helped develop pediatric sedation guidelines, conducted influential clinical research, edited a major textbook, and promoted pediatric anesthesia training fellowships in low‐ and middle‐income countries. Based on a series of interviews with Dr Coté, this article reviews the career of this Robert M. Smith Award winner through the lens of improvements in pediatric sedation and anesthesia patient safety.
Moyamoya disease in children and its anesthetic implications: A review
Authors: Giustini Andrew J. , Stone Sarah A. , Ramamoorthy Chandra
Published: August 2020

Moyamoya disease is a rare, progressive cerebral vasculopathy which most commonly presents in the first and fourth decades of life. The mainstay of treatment is surgical revascularization; without treatment, most patients experience ischemic or hemorrhagic strokes. This report reviews moyamoya disease, its associated conditions, surgical treatment techniques, and anesthetic management of patients with moyamoya disease.
High‐Frequency Spinal Cord Stimulation at 10 kHz for the Treatment of Nonsurgical Refractory Back Pain: Design of a Pragmatic, Multicenter, Randomized Controlled Trial
Authors: Patel Naresh , Calodney Aaron , Kapural Leonardo , Province‐Azalde Rose , Lad Shivanand P. , Pilitsis Julie , Wu Chengyuan , Cherry Taissa , Subbaroyan Jeyakumar , Gliner Bradford , Caraway David
Published: August 2020

Background

Spinal cord stimulation (SCS) has been shown to provide pain relief for chronic back and leg pain due to failed back surgery syndrome. But many patients with chronic back pain have not had major back surgery or are not good candidates for surgery, and conventional medical management (CMM) provides limited relief. We have termed this condition nonsurgical refractory back pain (NSRBP). Level 1 evidence does not yet exist showing the therapeutic benefit of SCS for NSRBP.

Objective

To compare 10‐kHz SCS plus CMM (10‐kHz SCS + CMM) to CMM alone for treatment of NSRBP in terms of clinical and cost effectiveness.

Study Design

Multicenter, randomized controlled trial (RCT), with subjects randomized 1:1 to either 10‐kHz SCS + CMM or CMM alone. Optional crossover occurs at 6 months if treatment does not achieve ≥50% pain relief.

Methods

Patients with NSRBP as defined above may be enrolled if they are ineligible for surgery based on surgical consultation. Subjects randomized to 10‐kHz SCS + CMM will receive a permanent implant if sufficient pain relief is achieved in a temporary trial. Both groups will receive CMM per standard of care and will undergo assessments at baseline and at follow‐ups to 12 months. Self‐report outcomes include pain, disability, sleep, mental health, satisfaction, healthcare utilization, and quality of life.

Results

Enrollment was initiated on September 10, 2018. Prespecified independent interim analysis at 40% of the enrollment target indicated the sample size was sufficient to show superiority of treatment at the primary endpoint; therefore, enrollment was stopped at 211.

Conclusions

This large multicenter RCT will provide valuable evidence to guide clinical decisions in NSRBP.
The HY5 and MYB15 transcription factors positively regulate cold tolerance in tomato via the CBF pathway
Authors: Zhang Luyue , Jiang Xiaochun , Liu Qianying , Ahammed Golam Jalal , Lin Rui , Wang Lingyu , Shao Shujun , Yu Jingquan , Zhou Yanhong
Published: August 2020

The induction of C‐repeat binding factors (CBFs) is crucial for plant survival at low temperatures. Therefore, understanding the mechanisms that regulate CBF transcription is vital for the future development of crops with increased cold tolerance. Here, we provide evidence for the existence of a LONG HYPOCOTYL 5 (HY5)‐MYB15‐CBFs transcriptional cascade that plays a crucial role in the cold response in tomato. The exposure of tomato plants to cold (4°C) increased the levels of HY5, MYB15 and CBFs transcripts. Moreover, mutations in HY5 or MYB15 decreased the levels of CBF transcripts. In contrast, overexpression of HY5 or MYB15 increased CBF transcript abundance. Crucially, the HY5 transcription factor activated the expression of MYB15 by directly binding to the promoter region, while both HY5 and MYB15 activated the expression of CBF1, CBF2 and CBF3. Taken together, these data show that HY5 can directly regulate CBF transcript levels, and also influence CBF expression indirectly via MYB15. The coordinated action of HY5 and MYB15 allows precise regulation of CBF expression and subsequent cold tolerance. These findings provide an improved understanding of the molecular mechanisms affording transcriptional regulation of CBFs, which can be exploited in the future to enhance cold tolerance in crops.
Anemia after kidney transplantation: Does its basis differ from anemia in chronic kidney disease?
Authors: Oruç Çiğdem , Canpolat Nur , Pehlivan Esra , Balcı Ekmekçi Özlem , Ağbaş Ayşe , Çalışkan Salim , Sever Fatma Lale
Published: August 2020

Background

Although similar factors play a role in both PTA and anemia in patients with CKD, additional risk factors exist in the pathogenesis of PTA. The present study aimed at comparing anemia and inflammation‐related parameters between RTx recipients and CKD patients and elucidating the risk factors of PTA.

Methods

This single‐centered, cross‐sectional study consisted of 68 participants: 48 were in the RTx group and 20 were in the CKD group. The CKD patients were comparable to the RTx recipients in terms of age, gender, and eGFR. Serum levels of EPO, hepcidin, and IL‐6 were measured by enzyme‐linked immunosorbent assays. The ratio of EPO/Hb was calculated to estimate endogenous EPO resistance.

Results

The prevalence of anemia was 46% in the RTx group and 30% in the CKD group (P = .23). RTx recipients had significantly lower Hb (P = .04), higher EPO (P < .001), and ferritin levels (P = .001), and higher EPO/Hb ratios (P < .001); however, CKD patients showed a higher frequency of absolute iron deficiency (P = .008). Neither hepcidin nor IL‐6 levels differed between the two groups. Hb level of RTx recipients was correlated with only eGFR (r = .437, P = .002) but not with any of the transplantation‐related factors, while Fe level was the only parameter to be correlated with Hb level of CKD patients (r = .622, P = .01).

Conclusion

In the present study comparing GFR‐matched RTx and CKD patients, lower GFR level appears to be the factor most strongly associated with anemia, and endogenous EPO resistance is among the contributing factors to PTA.
Host‐parasite dynamics in Chagas disease from systemic to hyper‐local scales
Authors: Pérez‐Mazliah Damián , Ward Alexander I. , Lewis Michael D.
Published: August 2020

Trypanosoma cruzi is a remarkably versatile parasite. It can parasitize almost any nucleated cell type and naturally infects hundreds of mammal species across much of the Americas. In humans, it is the cause of Chagas disease, a set of mainly chronic conditions predominantly affecting the heart and gastrointestinal tract, which can progress to become life threatening. Yet around two thirds of infected people are long‐term asymptomatic carriers. Clinical outcomes depend on many factors, but the central determinant is the nature of the host‐parasite interactions that play out over the years of chronic infection in diverse tissue environments. In this review, we aim to integrate recent developments in the understanding of the spatial and temporal dynamics of T. cruzi infections with established and emerging concepts in host immune responses in the corresponding phases and tissues.
Centralizing Government Communication? Evidence from Finland and Sweden
Authors: Johansson Karl Magnus , Raunio Tapio
Published: August 2020

How governments manage their communication is one crucial indicator of the balance of power within the cabinet and inside the executive branch as a whole. Existing research offers few insights into the process by which governments come to choose one form of communication over another and about the factors driving centralization. This article addresses this gap through a comparison of two countries, Finland and Sweden, examining not only the organizational forms of government communication but also the causal mechanisms at work. Combining theoretical lessons from studies in political communication, political science, and public administration, it develops a centralization argument, focusing on the centripetal factors facilitating coordination and control. Drawing on over 40 interviews with journalists and political or media advisors in the two countries and on government documents, the article offers clear evidence of a trend toward centralization, particularly in Sweden. This trend should be understood as part of a broader process whereby prime ministers and their offices establish stronger control of the entire executive branch.

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Hankivsky, Olena. 2013. “Gender Mainstreaming: A Five‐Country Examination.” Politics & Policy 41 (5): 629‐655. https://doi.org/10.1111/polp.12037

König, Pascal D., and Georg Wenzelburger. 2014. “Toward a Theory of Political Strategy in Policy Analysis.” Politics & Policy 42 (3): 400‐430. https://doi.org/10.1111/polp.12076

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Distilling the distinct contralateral and ipsilateral attentional responses to lateral stimuli and the bilateral response to midline stimuli for upper and lower visual hemifield locations
Authors: Monnier Anne , Dell'Acqua Roberto , Jolicoeur Pierre
Published: August 2020

A contralateral posterior negativity elicited by lateral oddballs (N2pc) and a bilateral posterior negativity elicited by vertical midline oddballs (bilateral N2) are ERP components reflecting attentional deployment that have been rarely compared. In different tasks, we explored to what extent they reflect similar underlying mechanisms of attention. We used a multiple‐frame procedure to present pop‐out color oddballs among distractors. A homogeneous condition contained only distractors (0 oddballs) and served as a control condition that was subtracted from oddball‐present conditions to isolate attention effects. The number of oddballs and the vertical hemifield containing them (upper vs. lower) were two critical factors. For the lower hemifield, the signal amplitude increased with the number of oddballs, otherwise had similar effects and scalp distributions, suggesting the bilateral N2 acted as a bilateral N2pc and likely reflected similar underlying generators. For the upper hemifield, component amplitude also increased with the number of oddballs, but the scalp distributions were positive and more centered, suggesting inverted generators across the two vertical hemifields. An ipsilateral positivity occurred about 50 ms after a contralateral positivity, similar in magnitude, producing a biphasic contra‐minus‐ipsi difference wave. Previously reported smaller negative N2pc components for upper hemifield oddballs likely reflected a negative lobe artificially created by the subtraction of a lagged positive ipsilateral response. The results compel us to argue for a systematic separation of data for upper versus lower hemifields in studies of visuo‐spatial attention, and the use of an experimental design permitting the separate estimation of contralateral and ipsilateral responses.
Participatory Transparency in Kenya: Toward an Engaged Budgeting Model of Local Governance
Authors: Muthomi Frankline , Thurmaier Kurt
Published: August 2020

Research about citizen participation in public budgeting is inconclusive regarding whether citizens actually influence budgetary priorities. In Kenya, emerging citizens’ participation models spawned by a constitutional mandate are excellent laboratories for evaluating the impact of citizens on county planning and budgeting decisions. Focus groups of citizens who have participated in planning and budgeting sessions in four Kenyan counties revealed their experiences, their perceived impact in public participation, and suggestions about how their county's participation could be improved. Analysis indicates counties vary in their performance and commitment to an engaged budgeting model whereby participating citizens are able to influence county priorities in the capital budget. Findings support the necessity of participatory transparency for citizens' influence; repeating participants in county budget forums are learning technical and legal aspects of county budgeting, and are beginning to influence the engaged budgeting processes. We argue that participatory transparency is a necessary condition for citizens to be able to affect priorities.
Land‐use legacies limit the effectiveness of switches in disturbance type to restore endangered grasslands
Authors: Price Jodi N. , Schultz Nick L. , Hodges Joshua A. , Cleland Michael A. , Morgan John W.
Published: August 2020

Temperate native grasslands in Australia have been decimated across their range since European colonization (>200 years ago), and the few remaining remnants are mostly fragmented and degraded. Changes in disturbance type, particularly the removal of Indigenous fire and the introduction of livestock grazing, resulted in the local extinction of fire‐dependent and grazing‐sensitive native species, and led to an increase in exotic species. Recently, native grasslands have been acquired to improve the reservation status of the threatened community and management strategies have been implemented that involve the removal of livestock grazing and the reintroduction of fire or other biomass reduction methods. Here, we examine if the change in disturbance type—a disturbance switch—improves the native composition of grasslands. We review literature that reports instances where there has been a change in disturbance type to examine how grasslands respond to disturbance switching. We found mostly no change in native and exotic species richness when management changed from stock grazing to fire (at least in the short term, ≤10 years). Positive outcomes for other disturbance shifts (grazing → mowing, or cultivation → grazing) occurred when the disturbance type was accompanied by seed addition, or in landscapes where dispersal from nearby remnant sites was possible. This suggests that seed‐ and/or dispersal‐limitation may limit passive restoration outcomes in fragmented landscapes. It is necessary to determine the longer‐term impacts of switches in disturbance regimes, and whether recovery thresholds have already been crossed.
Hemodialysis using a low bicarbonate dialysis bath: Implications for acid‐base homeostasis
Authors: Sargent John A. , Yamamoto Tadashi , Yamakawa Tomoyuki , De Waal Desirée , Gennari F. John
Published: August 2020

The low bath bicarbonate concentration ([]) used by a nephrology group in Japan (25.5 mEq/L), coupled with a bath [acetate] of 8 mEq/L, provided an opportunity to study the acid‐base events occurring during hemodialysis when flux is from the patient to the bath. We used an analytic tool that allows calculation of delivery during hemodialysis and the physiological response to it in 17 Japanese outpatients with an average pre‐dialysis blood [] of 25 mEq/L. Our analysis demonstrates that addition is markedly reduced and that all of it comes from acetate metabolism. The added to the extracellular fluid during treatment (19.5 mEq) was completely consumed by H+ mobilization from body buffers. In contrast to patients dialyzing with higher bath [] values in the US and Europe, organic acid production was suppressed rather than stimulated. Dietary analysis indicates that these patients are in acid balance due to the alkaline nature of their diet. In a larger group of patients using the same bath solution, pre‐dialysis blood [] was lower, 22.2 mEq/L, but still in an acceptable range. Our studies indicate that a low bath [] is well tolerated and can prevent stimulation of organic acid production.
Leisure physical exercise and creatine kinase activity. The Tromsø study
Authors: Bekkelund Svein Ivar
Published: August 2020

Creatine kinase (CK) is an enzyme catalyzing energy reaction in muscle cells and has proven to modify cardiovascular risks. The influence of skeletal muscle activity on CK concentrations is a potential study confounder but is mainly reported in connection with sport activities. This study investigated the association between leisure physical exercise and CK and estimated the effect of physical exercise on the CK values. CK and leisure physical exercise defined as intensity, frequency, and duration subsets were measured in the population‐based Tromsø study. Comparisons of CK at different exercise levels, multivariate analyses, and relative differences in CK between “never exercise” and “heavy exercise” (moderate or hard exercise ≥2 hours per week) subgroups were analyzed age‐ and sex‐stratified in 12 796 men and women. CK increased significantly with higher levels of physical exercise intensity and frequency in both sexes analyzed by ANOVA. In a multivariate analysis, CK was independently associated with heavy exercise after adjusting for age, BMI, and blood pressure; OR 9.38 (95% CI 5.32‐16.53), P < .0001 in men and OR 5.20 (95% CI 2.53‐10.69), P < .0001 in women. The differences in CK between physically inactive and participants performing heavy exercise varied between 3.1% (women) and 6.4% (men) and was also larger in participants ≥50 years. In conclusion, CK was positively and independently associated with increasing leisure physical exercise in a general population. CK values associated with exercise were approximately twice as high in men than women, but exercise altered CK only modestly.
Scaling up Deliberation: Testing the Potential of Mini‐Publics to Enhance the Deliberative Capacity of Citizens
Authors: Suiter Jane , Muradova Lala , Gastil John , Farrell David M.
Published: August 2020

This paper tests the possibility of embedding the benefits of minipublic deliberation within a wider voting public. We test whether a statement such as those derived from a Citizens’ Initiative Review (CIR) can influence voters who did not participate in the pre‐referendum minipublic deliberation. This experiment was implemented in advance of the 2018 Irish referendum on blasphemy, one of a series of social‐moral referendums following the recommendations of a deliberative assembly. This is the first application of a CIR‐style voting aid in a real world minipublic and referendum outside of the US and also the first application to what is principally a moral question. We found that survey respondents exposed to information about the minipublic and its findings significantly increased their policy knowledge. Further, exposing respondents to minipublic statements in favour and against the policy measure increased their empathy for the other side of the policy debate.