bluuebunny/crossref_metadata_2025 huggingface dataset:
QuitNic: A Pilot Randomized Controlled Trial Comparing Nicotine Vaping Products With Nicotine Replacement Therapy for Smoking Cessation Following Residential Detoxification
Authors: Bonevski Billie , Manning Victoria , Wynne Olivia , Gartner Coral , Borland Ron , Baker Amanda L , Segan Catherine J , Skelton Eliza , Moore Lyndell , Bathish Ramez , Chiu Simon , Guillaumier Ashleigh , Lubman Dan I
Published: August 2020

Introduction

The QuitNic pilot trial aimed to test the feasibility of providing a nicotine vaping product (NVP) compared with combination nicotine replacement therapy (NRT) to smokers upon discharge from a smoke-free residential substance use disorder (SUD) treatment service.

Methods

QuitNic was a pragmatic two-arm randomized controlled trial. At discharge from residential withdrawal, 100 clients received telephone Quitline behavioral support and either 12-week supply of NRT or an NVP. Treatment adherence and acceptability, self-reported abstinence, cigarettes smoked per day (CPD), frequency of cravings, and severity of withdrawal symptoms were assessed at 6 and 12 weeks. Results are reported for complete cases and for abstinence outcomes, penalized imputation results are reported where missing is assumed smoking.

Results

Retention on was 63% at 6 weeks and 50% at 12 weeks. At 12 weeks, 68% of the NRT group reported using combination NRT while 96% of the NVP group used the device. Acceptability ratings for the products were high in both groups. At 12 weeks, 14% of the NVP group and 18% of the NRT group reported not smoking at all in the last 7 days. Mean CPD among continued smokers decreased significantly between baseline to 12 weeks in both groups; from 19.91 to 4.72 for the NVP group (p < .001) and from 20.88 to 5.52 in the NRT group (p < .001). Cravings and withdrawal symptoms significantly decreased for both groups.

Conclusions

Clients completing residential withdrawal readily engaged with smoking cessation post-treatment when given the opportunity. Further research is required to identify the most effective treatments postwithdrawal for this population at elevated risk of tobacco-related harm.

Trial registration number

ACTRN12617000849392

Implications

This pilot study showed that smoking cessation support involving options for nicotine replacement and Quitline-delivered cognitive behavioral counseling is attractive to people after they have been discharged from SUD treatment. Both nicotine vaping products and nicotine replacement therapies were highly acceptable and used by participants who reported reductions in cravings for cigarettes and perceptions of withdrawal symptoms and reductions in number of cigarettes smoked. Some participants self-reported abstinence from cigarettes—around one in five reported having quit smoking cigarettes at 12 weeks postdischarge. The results have significant public health implications for providing quit support following discharge from SUD treatment.
USA and Empire in the 19th Century
Authors: Dierksheide Christa
Published: August 2020

During the course of the 19th century, the United States forged an empire on a continental scale and also made significant territorial gains overseas. While it had taken the British Empire a little over two centuries to settle the swath of land stretching between the Appalachian Mountains and the Atlantic Ocean, the fledgling postcolonial American nation managed to colonize a land mass several times larger in a fraction of the time. But all this expansion came at an enormous human cost, resulting in the death or removal of countless native peoples, the enslavement of millions of African Americans, and sectional tensions that led to the American Civil War. During the latter part of the century, Americans began pursuing an imperial project beyond the continent, waging war or initiating annexation projects in Santo Domingo, Cuba, Hawaii, Puerto Rico, and the Philippines. The sources collected here reflect the dynamism, contingency, and tragedy of American colonization efforts between 1776 and 1900.
Conquest of Mexico and Peru
Authors: Doebler Scott , Restall Matthew
Published: August 2020

The traditional, master narrative of the momentous collision of worlds in 16th-century Mexico and Peru centers on small bands of Spaniards, who quickly overwhelmed indigenous peoples in the Western Hemisphere with their superior technology and leadership. That narrative, rooted in the accounts and perspectives of the Spanish conquistadors themselves, has until very recently dominated the historiography of “the Conquest,” as it has long been known. The years since the 1970s have seen monumental shifts in how scholars approach the period of “the Conquest,” stemming from two distinct historiographic currents, which together have driven complex revisions to the master narrative of “the Conquest.” The first is New Military History (NMH), which emphasizes the study of war and society. New military historians focus on social, cultural, and gendered aspects of war, as opposed to the set-piece tactical battle histories, unit histories, and biographies of famous generals. Though still interested in battle itself, the NMH came to emphasize larger implications of war. While the NMH hardly engaged directly with the Conquests of Mexico and Peru, its development widened the pool of scholars considered “military” historians, made the study of warfare widely accepted, increased the field’s diversity, and pushed military historians to be more theoretical. As NMH blurred the lines between military, social, and cultural history, a second shift took place, known as the New Conquest History (NCH). The NCH developed primarily within colonial Latin American history. During the last quarter of the 20th century, scholarship focusing on Latin America increasingly studied indigenous peoples, African slaves and their descendants, and non-elite Spaniards, whose experiences in the Conquest period were largely ignored. The NCH gives indigenous-language sources particular attention, but also stresses newly found sources or the reinterpretation of familiar ones—be they written in Spanish or a native tongue, or a nontextual visual source—in order to reveal new protagonists and multiple perspectives on contact phenomena and Conquest moments. “The Conquest” is now seen as a protracted series of wars of invasion, resulting in slow and incomplete conquests of indigenous societies. Spanish-language literature published in Latin America is too vast to be included here. Instead we focus on English-language books and articles, which themselves will lead researchers into Spanish-language primary and secondary sources.
Speculations on the Generation and Movement of Komatiites
Authors: McKenzie Dan
Published: August 2020

The discovery of komatiites, first in South Africa and then in many other Archean greenstone belts, with MgO concentrations of 20–30% and eruption temperatures of more than ∼1600 °C, showed that some parts of the mantle were hotter in the Archean than they are now. Since their discovery there have been many speculative proposals as to how such magmas can form. At present melt is produced by mantle upwelling, because the solidus temperature gradient of the mantle is steeper than that of isentropic decompression gradient at depths of less than 300 km. In contrast, in the lower half of the upper mantle the solidus gradient is shallower than the isentropic gradient, and, therefore, isentropic upwelling cannot generate melt. At the base of the upper mantle limited melting can occur, either in the thermal boundary layer at the base of the upper mantle, or in the upper part of the lower mantle where the solidus gradient is steeper than the isentropic gradient. In both cases melting can occur at depths of more than 600 km, where Ca perovskite, CaPv, is a stable phase on the solidus. A surprising feature of the partitioning between melt and solid CaPv is that most trace elements are compatible in the solid. Partitioning into CaPv can, therefore, account for the low concentrations of such elements in komatiites. The temperatures required to generate such magmas in plumes need be no more than ∼50 °C above those of Phanerozoic plumes. The presence of komatiites in the Archean, therefore, requires plume temperatures in the first half of the Earth’s history to have been somewhat hotter than they are now, but does not constrain the average temperature of the Archean upper mantle.
Exploring evolution of maximum growth rates in plankton
Authors: Flynn Kevin J , Skibinski David O F
Published: August 2020

Evolution has direct and indirect consequences on species–species interactions and the environment. However, Earth systems models describing planktonic activity invariably fail to explicitly consider organism evolution. Here we simulate the evolution of the single most important physiological characteristic of any organism as described in models—its maximum growth rate (μm). Using a low-computational-cost approach, we incorporate the evolution of μm for each of the plankton components in a simple Nutrient-Phytoplankton-Zooplankton -style model such that the fitness advantages and disadvantages in possessing a high μm evolve to become balanced. The model allows an exploration of parameter ranges leading to stresses, which drive the evolution of μm. In applications of the method we show that simulations of climate change give very different projections when the evolution of μm is considered. Thus, production may decline as evolution reshapes growth and trophic dynamics. Additionally, predictions of extinction of species may be overstated in simulations lacking evolution as the ability to evolve under changing environmental conditions supports evolutionary rescue. The model explains why organisms evolved for mature ecosystems (e.g. temperate summer, reliant on local nutrient recycling or mixotrophy), express lower maximum growth rates than do organisms evolved for immature ecosystems (e.g. temperate spring, high resource availability).
Convergent Validity of the Central Sensitization Inventory in Chronic Whiplash-Associated Disorders; Associations with Quantitative Sensory Testing, Pain Intensity, Fatigue, and Psychosocial Factors
Authors: Hendriks Erwin , Voogt Lennard , Lenoir Dorine , Coppieters Iris , Ickmans Kelly
Published: August 2020

Objective

Central sensitization is present in different pain conditions, including chronic whiplash-associated disorders. In the absence of a gold standard method of assessment to determine the presence of central sensitization, quantitative sensory testing is currently understood as an optimal proxy. Laboratory sensory testing is, however, not feasible in clinical practice, and the Central Sensitization Inventory was developed as an alternative. The aim of the current study was to evaluate the convergent validity of the Central Sensitization Inventory in chronic whiplash-associated patients by determining the association between the Central Sensitization Inventory and quantitative sensory testing, pain intensity, fatigue, and psychosocial factors.

Methods

A total of 125 chronic whiplash-associated patients completed multiple questionnaires and were subjected to pressure pain thresholds and temporal summation.

Results

. The Central Sensitization Inventory showed a strong association with constructs of general psychopathology, anxiety, distress, depression, and somatization in chronic whiplash-associated disorders. Moderate correlations were found with fatigue and intrusive and avoidant phenomena after a variety of traumatic events. No significant association was found between the Central Sensitization Inventory and pressure pain thresholds and temporal summation, nor between the Central Sensitization Inventory and other pain measurements.

Conclusions

Overall, we found that the Central Sensitization Inventory is better in identifying the psychosocial factors related to central sensitization in chronic whiplash-associated disorders than the central nervous system adaptations. Thus, the convergent validity of the Central Sensitization Inventory appears to be only partially present in chronic whiplash-associated disorders.
Veteran Response to Dosage in Chiropractic Therapy (VERDICT): Study Protocol of a Pragmatic Randomized Trial for Chronic Low Back Pain
Authors: Long Cynthia R , Lisi Anthony J , Vining Robert D , Wallace Robert B , Salsbury Stacie A , Shannon Zacariah K , Halloran Stephanie , Minkalis Amy L , Corber Lance , Shekelle Paul G , Krebs Erin E , Abrams Thad E , Lurie Jon D , Goertz Christine M
Published: August 2020

Conflicts of interest: No potential conflicts exist for any author listed.Abstract

Background

Low back pain is a leading cause of disability in veterans. Chiropractic care is a well-integrated, nonpharmacological therapy in Veterans Affairs health care facilities, where doctors of chiropractic provide therapeutic interventions focused on the management of low back pain and other musculoskeletal conditions. However, important knowledge gaps remain regarding the effectiveness of chiropractic care in terms of the number and frequency of treatment visits needed for optimal outcomes in veterans with low back pain.

Design

This pragmatic, parallel-group randomized trial at four Veterans Affairs sites will include 766 veterans with chronic low back pain who are randomly allocated to a course of low-dose (one to five visits) or higher-dose (eight to 12 visits) chiropractic care for 10 weeks (Phase 1). After Phase 1, participants within each treatment arm will again be randomly allocated to receive either monthly chiropractic chronic pain management for 10 months or no scheduled chiropractic visits (Phase 2). Assessments will be collected electronically. The Roland Morris Disability Questionnaire will be the primary outcome for Phase 1 at week 10 and Phase 2 at week 52.

This trial will provide evidence to guide the chiropractic dose in an initial course of care and an extended-care approach for veterans with chronic low back pain. Accurate information on the effectiveness of different dosing regimens of chiropractic care can greatly assist health care facilities, including Veterans Affairs, in modeling the number of doctors of chiropractic that will best meet the needs of patients with chronic low back pain.
Thoracic Zygapophysial Joint Thermal Neurotomy: A Cohort Revealing Additional Outcomes by Specific Joint Groupings
Authors: Speldewinde Geoffrey C
Published: August 2020

Objective

Thoracic spinal pain is common, and patients with this type of pain have limited therapeutic options. The cohort in this study received diagnostic intra-articular zygapophysial joint injections leading to thermal neurotomy to the medial branch nerves to demonstrate improved pain as well as physical and psychological function.

Design

A consecutive cohort from 2012 to 2018 with retrospective analysis of prospectively gathered data.

Setting

A private multidisciplinary pain clinic with referrals from primary care.

Results

Forty-six complete data sets from 39 patients were found using a pre-procedure and 3-month post-procedure questionnaire. Further follow-up results were found for the dual primary outcomes of duration of ≥50% relief using a numeric rating scale (NRS) for the entire group. The group was then divided into three subgroups of T1/2–T3/4, T4/5–T8/9, and T9/10–T12/L1. Success rates of 63% for ≥3 months of ≥50% relief and 46% for ≥6 months of ≥50% relief were found, for an average duration of 7.8 months. Group mean change in the NRS was 6.7, decreasing to 4.3 (P<0.0001). For the first time, there are data showing that the three groups of T1/2–T3/4, T4/5–T8/9, and T9/10–T12/L1 responded equally. Secondary outcomes of physical and psychological function using the Functional Rating Index (FRI) and the Depression Anxiety Stress Scale (DASS) all showed significant improvements with small to moderate effect sizes and with all achieving >36% improvement in scores.

Conclusion

This cohort demonstrates that there is a pragmatic diagnostic and therapeutic option available for patients with thoracic zygapophysial joint pain that can achieve 50–100% of pain relief in 63% of patients with improved physical and psychological function.
Staying safe while waiting for the vaccine: what we need to do
Authors: Nabarro D , Atkinson J
Published: August 2020

Societies are organizing themselves to keep the COVID-19 virus at bay for the foreseeable future. The World Health Organization (WHO) has proposed that every country implement a comprehensive set of measures to prevent infection, detect cases, interrupt transmission, control clusters, suppress outbreaks and reduce mortality. Throughout the world, four systems capabilities are emerging that are important for societies to get ahead of the virus and become COVID-19 ready. First: understand the pattern of infection locally and act on it effectively: assess the status of the outbreak; act rapidly and robustly to interrupt transmission. Second: enable people to be active participants in their own responses. Third: focus on the places where people are most at risk of infection. Fourth: assess the performance of responses to COVID-19 infection: detecting cases, interrupting chains of transmission, minimizing adverse consequences, protecting the most vulnerable and ensuring opportunities for sustainable livelihoods and well-being for all, leaving no-one behind. These four capabilities are being woven together within societies: successful weaving can be helped through focusing on three interlinked elements: making information available; assessing and reducing risk; and being able to suppress outbreaks rapidly. This means involving everyone in the response and having strong public health defences. Governments, authorities, public health teams, employers and community organizations make it possible for us to stay safe but, in the end, what happens is up to all of us, individually and collectively. If we are to live well with the threat of COVID-19, solidarity really does matter.
Treatment of psoriatic arthritis with biologic and targeted synthetic DMARDs: British Society for Rheumatology guideline scope
Authors: Tillett William , Allen Alexander , Tucker Laura , Chandler David , Ciurtin Coziana , Davis Charlotte , Dick Andrew , Foulkes Amy , Gullick Nicola , Helliwell Philip , Jadon Deepak , Jones Gareth , Kyle Stuart , Madhok Vishnu , McHugh Neil , Parkinson Andrew , Raine Tim , Siebert Stefan , Smith Catherine , Coates Laura C
Published: August 2020

The aim of this guideline is to provide an update on evidence-based recommendations for treatment of adult patients with PsA. The previous BSR guidelines for PsA were published in 2012 and since that time, there have been many new advanced therapies licensed for PsA. This update will provide practical guidance for clinicians on the optimal selection of advanced therapies taking into account different domains of PsA (arthritis, enthesitis, dactylitis, axial disease and psoriasis) and key associated comorbidities. It will also update guidance on treatment strategy including the use of a treat-to-target approach. The guideline will be developed using the methods and processes outlined in Creating Clinical Guidelines: Our Protocol. (1) This development process to produce guidance, advice and recommendations for practice has National Institute for Health and Care Excellence (NICE) accreditation.
ESTIMATION OF RADIOLOGICAL HAZARDS DUE TO NATURAL RADIONUCLIDES FROM THE ROSTERMAN GOLD MINE TAILINGS, LURAMBI, KAKAMEGA, KENYA
Authors: Wanyama C K , Masinde F W , Makokha J W , Matsitsi S M
Published: August 2020

Radiological hazards associated with naturally occurring radionuclides in materials from Rosterman gold mine were assessed by analysis of 30 samples. The gamma-ray spectrometric analysis of tailing samples reported an average activity concentration of 263 ± 13, 123 ± 6 and 84 ± 4 Bq kg−1 for 40K, 232Th and 226Ra, respectively. The average absorbed dose rate was 124 ± 6 nGy h−1, while the annual effective dose of 0.4 ± 0.02 mSv y−1 for indoor and 0.3 ± 0.01 mSv y−1 for outdoor were reported. The mean and range of radiological parameters (external and radium equivalent) calculated from the tailing samples were within the permissible limits and hence mining of gold at Rosterman has no significant radiological health implication on the miners and the surrounding population.
Effects of acetaminophen on risk taking
Authors: Keaveney Alexis , Peters Ellen , Way Baldwin
Published: August 2020

Acetaminophen, an analgesic and antipyretic available over-the-counter and used in over 600 medicines, is one of the most consumed drugs in the USA. Recent research has suggested that acetaminophen’s effects extend to the blunting of negative as well as positive affect. Because affect is a determinant of risk perception and risk taking, we tested the hypothesis that acute acetaminophen consumption (1000 mg) could influence these important judgments and decisions. In three double-blind, placebo-controlled studies, healthy young adults completed a laboratory measure of risk taking (Balloon Analog Risk Task) and in Studies 1 and 2 completed self-report measures of risk perception. Across all studies (total n = 545), acetaminophen increased risk-taking behavior. On the more affectively stimulating risk perception measure used in Study 2, acetaminophen reduced self-reported perceived risk and this reduction statistically mediated increased risk-taking behavior. These results indicate that acetaminophen can increase risk taking, which may be due to reductions in risk perceptions, particularly those that are highly affect laden.
Maths Sparks engagement programme: investigating the impact on under-privileged pupils’ attitudes towards mathematics
Authors: Ni Shuilleabhain Aoibhinn , Cronin Anthony , Prendergast Mark
Published: August 2020

In this paper we explore the attitudes of under-privileged secondary school pupils in Ireland towards mathematics and investigate the impact of attending a 4-week engagement programme on these attitudes. The pupils involved in this research attended schools recognized by the Department of Education & Skills as socio-economically deprived. Pupils attending these schools, known as Delivering Equality of Opportunity in Schools (DEIS), are 40% less likely than their counterparts in non-DEIS schools to pursue mathematics at a higher level in state examinations (Smyth, E., Mccoy, S. & Kingston, G., 2015, Learning From the Evaluation of DEIS. Dublin: Economic and Social Research Institute). However, little research has reported on these pupils’ experiences of and attitudes towards mathematics at senior secondary level. An engagement programme entitled ‘Maths Sparks’ was purposefully designed for secondary pupils from DEIS schools, with the aim of positively influencing their attitudes towards and confidence in mathematics. The programme consisted of weekly out-of-school workshops exploring extra-curricular mathematics topics, designed and delivered by undergraduate mathematics students. Questionnaires were utilized to evaluate pupils’ attitudes towards mathematics before and after their participation in the programme. Despite its relatively short time frame, qualitative and quantitative analysis suggests an increase in participating pupils’ attitudes towards, enjoyment of and self-confidence in mathematics due to their participation in the programme. Findings also suggest that while these pupils liked the subject of mathematics, their experience of learning the subject in school was not always positive and was sometimes hindered by the absence of higher-level mathematics as an option in school. The high-stakes examination content and teachers’ beliefs in the ability of their students also sometimes negatively impacted learners’ intentions to pursue mathematics at a higher level. Findings suggest that longitudinal mathematics engagement programmes, which focus on problem solving, involve extra-curricular mathematical concepts and are presented by undergraduate mathematics students, may provide a valuable way of positively impacting pupils’ intentions to pursue the subject.
Mathematics support centres’ online presence: provision in Ireland and the UK in 2018
Authors: Mac an Bhaird Ciarán , Mulligan Peter , O’Malley James
Published: August 2020

Mathematics Support Centres are available in the majority of Higher Education Institutions in Ireland and the UK. Whilst the online presence of these centres appears to be increasing, there is little research to date which considers its breadth or effectiveness. In this paper we consider the results of a survey on the online presence of support centres in Ireland and the UK. We discuss the opportunities that arise from such a presence, the challenges that exist and what the results of the survey mean for individual practitioners and the wider mathematics support community.
Cloning of the Rice Xo1 Resistance Gene and Interaction of the Xo1 Protein with the Defense-Suppressing Xanthomonas Effector Tal2h
Authors: Read Andrew C. , Hutin Mathilde , Moscou Matthew J. , Rinaldi Fabio C. , Bogdanove Adam J.
Published: August 2020

The Xo1 locus in the heirloom rice variety Carolina Gold Select confers resistance to bacterial leaf streak and bacterial blight, caused by Xanthomonas oryzae pv. oryzicola and X. oryzae pv. oryzae, respectively. Resistance is triggered by pathogen-delivered transcription activator-like effectors (TALEs) independent of their ability to activate transcription and is suppressed by truncated variants called truncTALEs, common among Asian strains. By transformation of the susceptible variety Nipponbare, we show that one of 14 nucleotide-binding, leucine-rich repeat (NLR) protein genes at the locus, with a zinc finger BED domain, is the Xo1 gene. Analyses of published transcriptomes revealed that the Xo1-mediated response is more similar to those mediated by two other NLR resistance genes than it is to the response associated with TALE-specific transcriptional activation of the executor resistance gene Xa23 and that a truncTALE dampens or abolishes activation of defense-associated genes by Xo1. In Nicotiana benthamiana leaves, fluorescently tagged Xo1 protein, like TALEs and truncTALEs, localized to the nucleus. And endogenous Xo1 specifically coimmunoprecipitated from rice leaves with a pathogen-delivered, epitope-tagged truncTALE. These observations suggest that suppression of Xo1-function by truncTALEs occurs through direct or indirect physical interaction. They further suggest that effector coimmunoprecipitation may be effective for identifying or characterizing other resistance genes.
Occurrence of the White Soybean Cyst Nematode, Heterodera sojae, and the Soybean Cyst Nematode, H. glycines, in Korea
Authors: Kang Heonil , Ko Hyoungrai , Kim Donggeun , Choi Insoo
Published: August 2020

Soybean cyst nematode (Heterodera glycines, SCN) is the most harmful pathogen of soybean (Glycine max (L.) Merr.) worldwide. In 2016, a new soybean-parasitic cyst nematode, Heterodera sojae (the white soybean cyst nematode) was found parasitizing the roots of soybean plants in Korea. To investigate the distribution and population density of H. sojae, 943 soil samples were collected from soybean fields in all nine provinces in Korea in 2017 to 2018. Cyst nematodes were detected in 343 samples (36.4%) from eight of the nine provinces, except the island of Jeju province. Among the 343 samples, H. glycines was found in 227 samples (66.2%), H. sojae in 95 samples (27.7%), and 21 samples (6.1%) were infested with both H. sojae and H. glycines. Wide distribution of H. sojae in soybean fields indicates that H. sojae is an important cyst nematode species parasitizing soybean together with H. glycines.
Novel Multiplex and Loop-Mediated Isothermal Amplification Assays for Rapid Species and Mating-Type Identification ofOculimacula acuformisandO. yallundae(Causal Agents of Cereal Eyespot), and Application for Detection of Ascospore Dispersal and In Planta Use
Authors: King Kevin M. , Eyres Gavin J. , West Jonathan S. , Siraf Clara , Matusinsky Pavel , Palicová Jana , Canning Gail G. M. , Bateman Geoff L. , Fraaije Bart A. , Dyer Paul S.
Published: August 2020

Eyespot, caused by the related fungal pathogens Oculimacula acuformis and O. yallundae, is an important cereal stem-base disease in temperate parts of the world. Both species are dispersed mainly by splash-dispersed conidia but are also known to undergo sexual reproduction, yielding apothecia containing ascospores. Field diagnosis of eyespot can be challenging, with other pathogens causing similar symptoms, which complicates eyespot management strategies. Differences between O. acuformis and O. yallundae (e.g., host pathogenicity and fungicide sensitivity) require that both be targeted for effective disease management. Here, we develop and apply two molecular methods for species-specific and mating-type (MAT1-1 or MAT1-2) discrimination of O. acuformis and O. yallundae isolates. First, a multiplex PCR-based diagnostic assay targeting the MAT idiomorph region was developed, allowing simultaneous determination of both species and mating type. This multiplex PCR assay was successfully applied to type a global collection of isolates. Second, the development of loop-mediated isothermal amplification (LAMP) assays targeting β-tubulin sequences, which allow fast (<9 min) species-specific discrimination of global O. acuformis and O. yallundae isolates, is described. The LAMP assay can detect very small amounts of target DNA (1 pg) and was successfully applied in planta. In addition, mating-type-specific LAMP assays were also developed for rapid (<12 min) genotyping of O. acuformis and O. yallundae isolates. Finally, the multiplex PCR-based diagnostic was applied, in conjunction with spore trapping in field experiments, to provide evidence of the wind dispersal of ascospores from a diseased crop. The results indicate an important role of the sexual cycle in the dispersal of eyespot.
Mating Type Idiomorphs, Heterothallism, and High Genetic Diversity in Venturia carpophila, Cause of Peach Scab
Authors: Bock Clive H. , Young Carolyn A. , Zhang Minling , Chen Chunxian , Brannen Phillip M. , Adaskaveg Jim , Charlton Nikki D.
Published: August 2020

Scab (caused by Venturia carpophila) is a major disease affecting peach in the eastern United States. The aims of the study were to characterize the mating-type loci in V. carpophila, determine whether they are in equilibrium, and assess the population genetic diversity and structure of the pathogen. The mating-type gene MAT1-1-1 was identified in isolate JP3-5 in an available genome sequence, and the MAT1-2-1 gene was PCR amplified from isolate PS1-1, thus indicating a heterothallic structure. Mating-type loci structures were consistent with those of other Venturia spp. (V. effusa and V. inaequalis): the mating-type gene is positioned between APN2 encoding a DNA lyase and a gene encoding a Pleckstrin homology domain. Primers designed to each of the mating-type genes and a reference gene TUB2 were used as a multiplex PCR to screen a population (n = 81) of V. carpophila from various locations in the eastern United States. Mating types in five of the nine populations studied were in equilibrium. Among the 81 isolates, there were 69 multilocus genotypes. A population genetic analysis of the populations with >10 individuals (four populations) showed them to be genetically diverse. Linkage disequilibrium was found in five of nine populations with ≥4 isolates. A discriminant analysis of principal components indicated three genetic clusters, although extensive admixture was observed. Mating-type identification in V. carpophila provides a basis for understanding reproductive methods of the pathogen and can be a basis for further studies of the genetics of the peach scab pathogen.
Cognitive, Psychiatric, and Quality of Life Outcomes in Adult Survivors of Extracorporeal Membrane Oxygenation Therapy: A Scoping Review of the Literature
Authors: Khan Imad R. , Saulle Michael , Oldham Mark A. , Weber Miriam T. , Schifitto Giovanni , Lee Hochang B.
Published: August 2020

Objectives:

To perform a scoping literature review of cognitive, psychiatric, and quality of life outcomes in adults undergoing extracorporeal membrane oxygenation for any indication.

Data Sources:

We searched PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, and PsycINFO from inception to June 2019.

Study Selection:

Observational studies, clinical trials, qualitative studies, and case series with at least 10 adult subjects were included for analysis. Outcomes of interest consisted of general or domain-specific cognition, psychiatric illness, and quality of life measures that included both mental and physical health.

Data Extraction:

Study selection, data quality assessment, and interpretation of results were performed by two independent investigators in accordance with the PRISMA statement.

Data Synthesis:

Twenty-two articles were included in this review. Six described cognitive outcomes, 12 described psychiatric outcomes of which two were qualitative studies, and 16 described quality of life outcomes. Cognitive impairment was detected in varying degrees in every study that measured it. Three studies examined neuroimaging results and found neurologic injury to be more frequent in venoarterial versus venovenous extracorporeal membrane oxygenation, but described a variable correlation with cognitive impairment. Rates of depression, anxiety, and post-traumatic stress disorder were similar to other critically ill populations and were related to physical disability after extracorporeal membrane oxygenation. Extracorporeal membrane oxygenation survivors’ physical quality of life was worse than population norms but tended to improve with time, while mental quality of life did not differ significantly from the general population. Most studies did not include matched controls and instead compared outcomes to previously published values.

Conclusions:

Extracorporeal membrane oxygenation survivors experience cognitive impairment, psychiatric morbidity, and worse quality of life compared with the general population and similar to other survivors of critical illness. Physical disability in extracorporeal membrane oxygenation patients plays a significant role in psychiatric morbidity. However, it remains unclear if structural brain injury plays a role in these outcomes and whether extracorporeal membrane oxygenation causes secondary brain injury.
Normothermia in Patients With Sepsis Who Present to Emergency Departments Is Associated With Low Compliance With Sepsis Bundles and Increased In-Hospital Mortality Rate*
Authors: Park Sunghoon , Jeon Kyeongman , Oh Dong Kyu , Choi Eun Young , Seong Gil Myeong , Heo Jeongwon , Chang Youjin , Kwack Won Gun , Kang Byung Ju , Choi Won-Il , Kim Kyung Chan , Park So Young , Shin Yoon Mi , Lee Heung Bum , Park So Hee , Kim Seok Chan , Kwak Sang Hyun , Cho Jae Hwa , Kim Beongki , Lim Chae-Man ,   for the Korean Sepsis Alliance (KSA) Study Group
Published: August 2020

Objectives:

To investigate the impact of normothermia on compliance with sepsis bundles and in-hospital mortality in patients with sepsis who present to emergency departments.

Design:

Retrospective multicenter observational study.

Patients:

Nineteen university-affiliated hospitals of the Korean Sepsis Alliance participated in this study. Data were collected regarding patients who visited emergency departments for sepsis during the 1-month period. The patients were divided into three groups based on their body temperature at the time of triage in the emergency department (i.e., hypothermia [< 36°C] vs normothermia [36–38°C] vs hyperthermia [> 38°C]).

Interventions:

None.

Measurements and Main Results:

Of 64,021 patients who visited emergency departments, 689 with community-acquired sepsis were analyzed (182 hyperthermic, 420 normothermic, and 87 hypothermic patients). The rate of compliance with the total hour-1 bundle was lowest in the normothermia group (6.0% vs 9.3% in hyperthermia vs 13.8% in hypothermia group; p = 0.032), the rate for lactate measurement was lowest in the normothermia group (62.1% vs 73.1% vs 75.9%; p = 0.005), and the blood culture rate was significantly lower in the normothermia than in the hyperthermia group (p < 0.001). The in-hospital mortality rates in the hyperthermia, normothermia, and hypothermia groups were 8.5%, 20.6%, and 30.8%, respectively (p < 0.001), but there was no significant association between compliance with sepsis bundles and in-hospital mortality. However, in a multivariate analysis, compared with hyperthermia, normothermia was significantly associated with an increased in-hospital mortality (odds ratio, 2.472; 95% CI, 1.005–6.080). This association remained significant even after stratifying patients by median lactate level.

Conclusions:

Normothermia at emergency department triage was significantly associated with an increased risk of in-hospital mortality and a lower rate of compliance with the sepsis bundle. Despite several limitations, our findings suggest a need for new strategies to improve sepsis outcomes in this group of patients.
A Time-Phased Machine Learning Model for Real-Time Prediction of Sepsis in Critical Care
Authors: Li Xiang , Xu Xiao , Xie Fei , Xu Xian , Sun Yuyao , Liu Xiaoshuang , Jia Xiaoyu , Kang Yanni , Xie Lixin , Wang Fei , Xie Guotong
Published: August 2020

Objectives:

As a life-threatening condition, sepsis is one of the major public health issues worldwide. Early prediction can improve sepsis outcomes with appropriate interventions. With the PhysioNet/Computing in Cardiology Challenge 2019, we aimed to develop and validate a machine learning algorithm with high prediction performance and clinical interpretability for prediction of sepsis onset during critical care in real-time.

Design:

Retrospective observational cohort study.

Setting:

The dataset was collected from three ICUs in three different U.S. hospitals. Two of them were publicly available for model development (offline) and one was used for testing (online).

Patients:

Forty-thousand three-hundred thirty-six ICU patients from the two model development databases and 24,819 from the test database. There are up to 40 hourly-recorded clinical variables for each ICU stay. The Sepsis-3 criteria were used to confirm sepsis onset.

Interventions:

None.

Measurements and Main Results:

Three-hundred twelve features were constructed hourly as the input of our proposed Time-phAsed machine learning model for Sepsis Prediction. Time-phAsed machine learning model for Sepsis Prediction first estimates the likelihood of sepsis onset for each hour of an ICU stay in the following 6 hours, and then makes a binary prediction with three time-phased cutoff values. On the internal validation set, the utility score (official challenge measurement) achieved by Time-phAsed machine learning model for Sepsis Prediction was 0.430. On the test set, the utility score reached was 0.354. Furthermore, Time-phAsed machine learning model for Sepsis Prediction provides an intuitive way to illustrate the impact of the input features on the outcome prediction, which makes it clinically interpretable.

Conclusions:

The proposed Time-phAsed machine learning model for Sepsis Prediction model is accurate and interpretable for real-time prediction of sepsis onset in critical care, which holds great potential for further evaluation in prospective studies.
Beneficial Effects of Vasopressin Compared With Norepinephrine on Renal Perfusion, Oxygenation, and Function in Experimental Septic Acute Kidney Injury
Authors: Okazaki Nobuki , Iguchi Naoya , Evans Roger G. , Hood Sally G. , Bellomo Rinaldo , May Clive N. , Lankadeva Yugeesh R.
Published: August 2020

Objectives:

To compare the effects of restoring mean arterial pressure with vasopressin or norepinephrine on systemic hemodynamics, renal blood flow, intrarenal perfusion and oxygenation, and renal function in ovine septic acute kidney injury.

Design:

Interventional Study.

Setting:

Research Institute.

Subjects:

Adult Merino ewes.

Interventions:

Flow probes were implanted on the pulmonary and renal arteries (and the mesenteric artery in sheep that received vasopressin). Fiber-optic probes were implanted in the renal cortex and medulla to measure tissue perfusion and oxygen tension (Po
2). Conscious sheep were administered Escherichia coli to induce septic acute kidney injury. Vasopressin (0.03 IU/min [0.03–0.05 IU/min]; n = 7) or norepinephrine (0.60 μg/kg/min [0.30–0.70 μg/kg/min]; n = 7) was infused IV and titrated to restore baseline mean arterial pressure during 24–30 hours of sepsis.

Measurements and Main Results:

Ovine septic acute kidney injury was characterized by reduced mean arterial pressure (–16% ± 2%) and creatinine clearance (–65% ± 9%) and increased renal blood flow (+34% ± 7%) but reduced renal medullary perfusion (–44% ± 7%) and Po
2 (–47% ± 10%). Vasopressin infusion did not significantly affect renal medullary perfusion or Po
2 and induced a sustained (6 hr) ~2.5-fold increase in creatinine clearance. Vasopressin reduced sepsis-induced mesenteric hyperemia (+61 ± 13 to +9% ± 6%). Norepinephrine transiently (2 hr) improved creatinine clearance (by ~3.5-fold) but worsened renal medullary ischemia (to –64% ± 7%) and hypoxia (to –71% ± 6%).

Conclusions:

In ovine septic acute kidney injury, restoration of mean arterial pressure with vasopressin induced a more sustained improvement in renal function than norepinephrine, without exacerbating renal medullary ischemia and hypoxia or reducing mesenteric blood flow below baseline values.
Volume Infusion Markedly Increases Femoral dP/dtmax in Fluid-Responsive Patients Only*
Authors: Vaquer Sergi , Chemla Denis , Teboul Jean-Louis , Ahmad Umar , Cipriani Flora , Oliva Joan Carles , Ochagavia Ana , Artigas Antonio , Baigorri Francisco , Monnet Xavier
Published: August 2020

Objectives:

To evaluate the preload dependence of femoral maximal change in pressure over time (dP/dtmax) during volume expansion in preload dependent and independent critically ill patients.

Design:

Retrospective database analysis.

Setting:

Two adult polyvalent ICUs.

Patients:

Twenty-five critically ill patients with acute circulatory failure.

Interventions:

Thirty-five fluid infusions of 500 mL normal saline.

Measurements and Main Results:

Changes in femoral dP/dtmax, systolic, diastolic, and pulse femoral arterial pressure were obtained from the pressure waveform analysis using the PiCCO2 system (Pulsion Medical Systems, Feldkirchen, Germany). Stroke volume index was obtained by transpulmonary thermodilution. Statistical analysis was performed comparing results before and after volume expansion and according to the presence or absence of preload dependence (increases in stroke volume index ≥ 15%). Femoral dP/dtmax increased by 46% after fluid infusion in preload-dependent cases (mean change = 510.6 mm Hg·s–1; p = 0.005) and remained stable in preload-independent ones (mean change = 49.2 mm Hg·s–1; p = 0.114). Fluid-induced changes in femoral dP/dtmax correlated with fluid-induced changes in stroke volume index in preload-dependent cases (r = 0.618; p = 0.032), but not in preload-independent ones. Femoral dP/dtmax strongly correlated with pulse and systolic arterial pressures and with total arterial stiffness, regardless of the preload dependence status (r > 0.9 and p < 0.001 in all cases).

Conclusions:

Femoral dP/dtmax increased with volume expansion in case of preload dependence but not in case of preload independence and was strongly related to pulse pressure and total arterial stiffness regardless of preload dependence status. Therefore, femoral dP/dtmax is not a load-independent marker of left ventricular contractility and should be not used to track contractility in critically ill patients.
Evaluation of the Risk Prediction Tools for Patients With Coronavirus Disease 2019 in Wuhan, China: A Single-Centered, Retrospective, Observational Study*
Authors: Liu Fang-Yan , Sun Xue-Lian , Zhang Yong , Ge Lin , Wang Jing , Liang Xiao , Li Jun-Fen , Wang Chang-Liang , Xing Zheng-Tao , Chhetri Jagadish K. , Sun Peng , Chan Piu
Published: August 2020

Objectives:

To evaluate and compare the efficacy of National Early Warning Score, National Early Warning Score 2, Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment on predicting in-hospital death in patients with coronavirus disease 2019.

Design:

A retrospective, observational study.

Setting:

Single center, West Campus of Wuhan Union hospital-a temporary center to manage critically ill patients with coronavirus disease 2019.

Patients:

A total of 673 consecutive adult patients with coronavirus disease 2019 between January 30, 2020, and March 14, 2020.

Interventions:

None.

Measurements and Main Results:

Data on demography, comorbidities, vital signs, mental status, oxygen saturation, and use of supplemental oxygen at admission to the ward were collected from medical records and used to score National Early Warning Score, National Early Warning Score 2, Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment. Total number of patients was 673 (51% male) and median (interquartile range) age was 61 years (50–69 yr). One-hundred twenty-one patients died (18%). For predicting in-hospital death, the area under the receiver operating characteristics (95% CI) for National Early Warning Score, National Early Warning Score 2, Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment were 0.882 (0.847–0.916), 0.880 (0.845–0.914), 0.839 (0.800–0.879), 0.766 (0.718–0.814), and 0.694 (0.641–0.746), respectively. Among the parameters of National Early Warning Score, the oxygen saturation score was found to be the most significant predictor of in-hospital death. The area under the receiver operating characteristic (95% CI) for oxygen saturation score was 0.875 (0.834–0.916).

Conclusions:

In this single-center study, the discrimination of National Early Warning Score/National Early Warning Score 2 for predicting mortality in patients with coronavirus disease 2019 admitted to the ward was found to be superior to Rapid Emergency Medicine Score, Confusion, Respiratory rate, Blood pressure, Age 65 score, and quick Sepsis-related Organ Failure Assessment. Peripheral oxygen saturation could independently predict in-hospital death in these patients. Further validation of our finding in multiple settings is needed to determine its applicability for coronavirus disease 2019.
The efficacy and safety of pioglitazone in psoriasis vulgaris
Authors: Chen Pengfei , Chen Xiubing , Lei Lei , Zhang Yang , Xiang Jianjun , Zhou Jinxia , Lv Jun
Published: August 2020

Pioglitazone may have potential benefits in the treatment of cutaneous and metabolic derangements of psoriasis, but its role in the treatment of psoriasis remains in debate. We therefore conducted a meta-analysis to evaluate the clinical efficacy and safety of pioglitazone in psoriasis vulgaris (PsV).

We performed a comprehensive search in database of PubMed, Web of Science, Cochrane library, Embase and China National Knowledge Infrastructure (CNKI), and Wan fang database through March 2019 to identify eligible studies. Randomized controlled trials that have evaluated the effect and safety of pioglitazone in PsV were included. Treatment success was defined as ≥75% reduction in psoriasis area and severity index (PASI) score after treatment. Weighted mean differences (WMD), relative risks (RRs) and the corresponding 95% confidence intervals (CIs) were pooled to compare the clinical efficacy and safety between different groups.

Six randomized controlled trials (n = 270) were included. Meta-analysis showed that pioglitazone was associated with a remarkable reduction in PASI score in patients with PsV (weight mean difference: 2.68, 95% CI 1.41–3.94, P < .001). The treatment success rate in the pioglitazone group was higher than in the control group (RR 3.60, 95 CI 1.61–8.01, P < .001). Compared with control group, pioglitazone was not related to a pronounced increase in total adverse events (RR 1.180, 95 CI 0.85–1.63, P = .33). Moreover, the risk of common adverse events in the 2 groups were similar, such as elevated liver enzyme, fatigue, nausea, weight gain.

This meta-analysis suggested pioglitazone is an effective and safe drug in the treatment of patients with PsV.