bluuebunny/crossref_metadata_2025 huggingface dataset:
The dynamics of frailty and change in socio-economic conditions: evidence for the 65+ in Europe
Authors: Sirven Nicolas , Dumontet Magali , Rapp Thomas
Published: April 2020

Background

The frailty phenotype for older people is defined as an increased vulnerability to stressors, leading to adverse health outcomes. It is acknowledged as a specific precursor of disability besides chronic diseases that allows for some reversibility in the loss of autonomy. Although the literature on the socio-economic determinants of frailty is emerging in cross-sectional settings, little is known about the dynamics of this relationship over time. This article examines the joint evolution of frailty and change in economic conditions for the 65+ in Europe.

Methods

Individual and longitudinal data from SHARE (Survey on Health, Ageing and Retirement in Europe) over the period 2004–12 has been used. The sample contains 31 044 observations from 12 002 respondents aged 65 or more. A fixed effect Poisson model is estimated in order to control for unobserved individual heterogeneity. Three types of explanative economic variables have been considered in turn: income, wealth and a subjective variable of deprivation.

Results

Our results indicate that individuals with worsening economic conditions (wealth and subjective deprivation) over time simultaneously experience a rapid increase in the frailty symptoms. Results also show that the nature of economic variable does not affect the frailty process in the same way. Subjective measure of deprivation seems to better evaluate the household’s financial difficulties than objective measure.

Conclusion

From a public policy perspective, these results show that policies fostering economic conditions of the elderly could have a significant impact on frailty and henceforth, could reduce the risks of disability.
Assessing predictors of respiratory tract infections in infants born to teenage mothers: secondary analysis of the Building Blocks trial data
Authors: Buchanan Emily , Cannings-John Rebecca , Lugg-Widger Fiona , Hood Kerry , Butler Christopher , Robling Mike
Published: April 2020

Background

Respiratory tract infections (RTIs) are estimated to account for 60% of infants’ primary care visits. There is limited research into risk factors for infant RTIs in those born to teenage mothers.

Aims

To identify risk factors for primary and secondary care RTI attendances, in infants of teenage mothers, and to identify risk factors associated with high primary care RTI consultations.

Method

Secondary analysis of a data set from the Building Blocks trial of special home visiting support in England containing 1510 infants born to teenage mothers recruited to the study. Maternally reported and routinely collected data were examined. Multivariable logistic regression models were performed to determine independent predictors. Primary care data analysis also focused on infant risk factors for RTI consultation.

Results

No independently predictive risk factors for infant RTI were identified in primary care. Lower maternal antenatal attendances (odds ratio = 0.96, 95% confidence interval = 0.92–0.99), infants born in autumn (vs. spring; 0.54, 0.36–0.80) and neonatal unit (NNU) admissions (0.51, 0.30–0.89) had increased odds of attending accidents and emergencies with an RTI. Male infants (1.52, 1.03–2.25), NNU admissions (3.21, 1.98–5.22) and birth season had increased odds of RTI-associated hospital admissions. High infant RTI primary care consulters were more likely to have an RTI-associated hospital admission (2.11, 1.17–3.81) and less likely to have breastfed (0.55, 0.38–0.78).

Conclusion

Risk factors previously found to increase the risk of an RTI infant admission in the broader population have been identified here. This study is one of the first to identify modifiable risk factors of high primary care RTI consulters.
LGBT WIDOWHOOD: THE ASSOCIATION BETWEEN PARTNER LOSS AND PSYCHOLOGICAL WELL-BEING
Authors: Noblitt Jessica A , Barrett Anne
Published: April 2020

Death of a partner – one of the most stressful events many people will ever experience – has profound effects on psychological well-being. However, research on widowhood focuses almost exclusively on heterosexual couples, with little known about these studies’ applicability to the LGBT population. Further, the few studies of partner loss among LGBT individuals are qualitative and many focus on gay men. As a result, little is known about the effects of partner loss in this population as a whole or among other sexual minorities, including lesbians, bisexuals, and transgender individuals. Addressing this issue, our study examines the association between partner loss and psychological well-being using data from the 2010 Aging with Pride: National Health, Aging, and Sexuality/Gender Study (NHAS) (n=2,322), the largest nationally representative sample of LGBT middle-aged and older adults. We use OLS regression to examine the association between partner loss and psychological well-being, measured as depressive symptoms, loneliness, and subjective mental health. Results reveal a significant association between partner loss and psychological well-being across all three measures. However, the association is significantly weaker in models controlling for current partner status. In models predicting depressive symptoms and loneliness, partner loss no longer reaches significance, though it remains significant in the model predicting subjective mental health. Results suggest that current partner status more strongly impacts psychological well-being than does partner loss, though further research is needed to identify how, for whom, and under what circumstances the negative effects of partner loss may linger.
DISTINGUISHED FACULTY AND RISING STAR EARLY-CAREER FACULTY AWARD LECTURES
Authors: Hancock Cynthia
Published: April 2020

The Distinguished Faculty Award acknowledges individuals whose teaching stands out as exemplary, innovative, or influential—or any combination thereof. The Distinguished Faculty Award lecture will feature an address by 2019 recipient Gayle Doll, PhD, of Kansas State University. The Rising Star Early-Career Faculty Award acknowledges new faculty whose teaching and leadership stand out as influential and innovative. The Rising Star Early-Career Faculty Award lecture will feature an address by 2019 recipient Katarina Felstedof, PhD, of the University of Utah.
VIEWPOINT FROM THE INTRAMURAL RESEARCH PROGRAM
Authors: Ferrucci Luigi
Published: April 2020

Dr. Ferrucci will review accomplishments of the Intramural Research Program and make projections for the future
A MULTI-SITE PROGRAM TO PROVIDE GERIATRICS TELECONSULTATION TO OLDER RURAL VETERANS (GRECC CONNECT)
Authors: Hung William , Barczi Steven , Colon-Emeric cathleen , Rossi Michelle , Dang Stuti , Caprio Thomas , Espinoza Sara
Published: April 2020

Older Veterans living in rural areas often do not have access to geriatrics team care; rural frontline providers and teams may need support to address the needs of older adults with complex chronic conditions. GRECC Connect aims to link up geriatric teams at Geriatric Research, Education and Clinical Centers (GRECCs) and rural clinics to provide geriatric consultation remotely through clinical video telehealth (CVT) and other means. GRECC Connect is established in twelve GRECCs across the country with links to rural clinics in their catchment area; consultations led to identification and meeting of care needs of older adults with complex conditions, improving medication use and reducing older adults’ need for travel to long distances for consultation. In this presentation, we review the experience of establishing connections with rural clinics, impact on older adult care and adaptations needed to address local needs and contexts.
COGNITIVE FUNCTIONING AMONG BREAST CANCER SURVIVORS AND NON-CANCER PARTICIPANTS: EVIDENCE FOR SIMILARITIES
Authors: Pasquini Giancarlo , Small Brent J , Mogle Jacqueline , Sliwinski Martin , Scott Stacey B
Published: April 2020

Breast cancer survivors may experience accelerated decline in cognitive functioning compared to same-aged peers with no cancer history (Small et al., 2015). Survivors may show important differences in mean-level performance or variability in cognitive functioning compared to those without a history of cancer (Yao et al., 2016). This study compared ambulatory cognitive functioning in a sample of breast cancer survivors and an age-matched community sample without a history of cancer (n_cancer=47, n_non-cancer=105, age range: 40-64 years, M=52.13 years). Participants completed three cognitive tasks measuring working memory, executive functioning, and processing speed up to five times per day for 14 days. Results indicated no mean-level differences in cognitive performance on the three tasks between cancer survivors and those without cancer history (p’s>.05). Unexpectedly, women without cancer history showed more variability than survivors on working memory but not on the other two tasks. Across both groups, those without a college education performed worse on executive functioning (B=-0.05, SE=0.03, p<.05) and working memory (B=0.94, SE=0.36, p<.05) compared to those that completed college. Additionally, older age was associated with slower processing speed (B=31.67, SE=7.44, p<.001). In sum, this study did not find mean-level group differences in cognitive functioning between cancer survivors and age-matched women without a history of cancer. Contrary to hypotheses, those without a history of cancer were more variable on working memory. Results suggested similarities in cognitive functioning in the two samples and that education and age are important predictors of cognitive functioning independent of cancer history.
INNOVATING CAREGIVER EDUCATION: INCLUDING COOPERATIVE EXTENSION IN RURAL CAREGIVING EDUCATION
Authors: Struckmeyer Kristopher M , Bishop Alex J , Peek Gina , Tripp Paula , Gordon Sarah
Published: April 2020

Studies consistently report that caregivers under utilize resources, citing unawareness or inability to access programs as barriers to service utilization. Family and Consumer Science (FCS) educators within Extension have a unique blend of training that can help transform access to education for rural caregivers. Extension programming covers a wide range of topics, but few have implemented a curricular program or workshops to educate caregivers about caregiving issues. The current study involved a multi-state examination of innovativeness in caregiving program implementation among N = 216 FCS educators employed by the Cooperative Extension Service. Educators rated their perceptions of Extension’s receptiveness to change and personal factors. Results indicated that more urban areas (β = .19, p < .05), fewer years in their current position (β = -.23, p < .05), and greater leadership self-efficacy (β = .17, p < .05) predicted educator innovativeness to implement new caregiver education programming. However, when personal factors were added to the model, only years in current position (β = -.20, p < .05) remained significant. Subjective age (β = -.25, p < .01) and social support (β = .28, p < .01) were also found to significantly predict educator innovativeness. Despite previous research, these results indicate that personal factors may have a greater influence on educators’ innovativeness than organizational factors. These findings are critical when adopting and implementing a rural caregiver education programs through new organizational networks.
Treatment-Emergent Influenza Virus Polymerase Acidic Substitutions Independent of Those at I38 Associated With Reduced Baloxavir Susceptibility and Virus Rebound in Trials of Baloxavir Marboxil
Authors: Ince William L , Smith Fraser B , O’Rear Julian J , Thomson Michael
Published: April 2020

Influenza viruses harboring treatment-emergent I38F/M/N/T substitutions in the polymerase acidic (PA) endonuclease exhibited reduced susceptibility to baloxavir and were associated with virus rebound and variable clinical response in clinical trials. US regulatory review of registrational trial data also identified treatment-emergent PA substitutions E23K in A/H1N1 viruses and E23G/K, A37T, and E199G in A/H3N2 viruses, which conferred reduced susceptibility to baloxavir, although to a lesser degree than I38F/M/N/T substitutions, and were associated with virus rebound. Although these non-I38 substitutions emerged less frequently than substitutions at I38, they represent alternate pathways to baloxavir virologic resistance and should be monitored accordingly.
Direct Determination of Coagulation Factor IIa and Plasmin Activities for Monitoring of Thrombotic State
Authors: Zhang Junhua , Zou Lihui , Liu Chengyang , Li Chuanbao , Wang Meng , Yang He , Wang Yan , Tan Zheng , Li Hexin , Su Fei , Zou Tong , Li Kang , Wang Xiaogang , Li Ying , Han Bingqing , Zhang Zhu , Zhai Zhenguo , Liu Xiangyi , Xu Xiaomao , Xiao Fei
Published: April 2020

Background

Current laboratory examinations for hypercoagulable diseases focus on the biomarker content of the activated coagulation cascade and fibrinolytic system. Direct detection of physiologically important protease activities in blood remains a challenge. This study aims to develop a general approach that enables the determination of activities of crucial coagulation factors and plasmin in blood.

Methods

This assay is based on the proteolytic activation of an engineered zymogen of l-phenylalanine oxidase (proPAO), for which the specific blood protease cleavage sites were engineered between the inhibitory and activity domains of proPAO. Specific cleavage of the recombinant proenzyme leads to the activation of proPAO, followed by oxidation and oxygenation of l-phenylalanine, resulting in an increase of chromogenic production when coupled with the Trinder reaction.

Results

We applied this method to determine the activities of both coagulation factor IIa and plasmin in their physiologically relevant basal state and fully activated state in sodium citrate–anticoagulated plasma respectively. Factor IIa and plasmin activities could be dynamically monitored in patients with thrombotic disease who were taking oral anticoagulants and used for assessing the hypercoagulable state in pregnant women.

Conclusions

The high specificity, sensitivity, and stability of this novel assay not only makes it useful for determining clinically important protease activities in human blood and diagnosing thrombotic diseases but also provides a new way to monitor the effectiveness and safety of anticoagulant drugs.
Spoken words as biomarkers: using machine learning to gain insight into communication as a predictor of anxiety
Authors: Demiris George , Corey Magan Kristin L , Parker Oliver Debra , Washington Karla T , Chadwick Chad , Voigt Jeffrey D , Brotherton Sam , Naylor Mary D
Published: April 2020

Objective

The goal of this study was to explore whether features of recorded and transcribed audio communication data extracted by machine learning algorithms can be used to train a classifier for anxiety.

Materials and Methods

We used a secondary data set generated by a clinical trial examining problem-solving therapy for hospice caregivers consisting of 140 transcripts of multiple, sequential conversations between an interviewer and a family caregiver along with standardized assessments of anxiety prior to each session; 98 of these transcripts (70%) served as the training set, holding the remaining 30% of the data for evaluation.

Results

A classifier for anxiety was developed relying on language-based features. An 86% precision, 78% recall, 81% accuracy, and 84% specificity were achieved with the use of the trained classifiers. High anxiety inflections were found among recently bereaved caregivers and were usually connected to issues related to transitioning out of the caregiving role. This analysis highlighted the impact of lowering anxiety by increasing reciprocity between interviewers and caregivers.

Conclusion

Verbal communication can provide a platform for machine learning tools to highlight and predict behavioral health indicators and trends.
Toxicity of canola-derived glucosinolates in pigs fed resistant starch-based diets
Authors: Lee Jung W , Wang Shenggang , Huang Yue , Seefeldt Teresa , Donkor Abigail , Logue Brian A , Woyengo Tofuko A
Published: April 2020

A study was conducted to determine effects of reducing hindgut pH through dietary inclusion of high-amylose cornstarch (HA-starch) on growth performance, organ weights relative to live body weight (BW), blood thyroid hormone levels, and glucosinolate degradation products of nursery pigs fed cold-pressed canola cake (CPCC). A total of 240 pigs (initial BW: 7.1 kg), which had been weaned at 21 d of age, were housed in 40 pens (6 pigs per pen) and fed 4 diets (10 pens per diet) in a randomized complete block design for 28 d. Four diets were a basal diet with CPCC at 0 or 40%, and with HA-starch at 0 or 40% in a 2 × 2 factorial arrangement. The diets were fed in two phases: Phase 1 from day 0 to 14 and Phase 2 from day 14 to 28 and were formulated to have the same net energy, standardized ileal digestible AA, Ca, and standardized total tract digestible P contents. Dietary inclusion of CPCC and HA-starch was achieved by a partial or complete replacement of corn, soybean meal, and soy protein. At the end of the study, one pig from each pen was euthanized to determine organ weights, blood parameters, hindgut pH, and glucosinolate degradation products. Dietary CPCC reduced (P < 0.05) overall average daily gain (ADG) by 15%; increased (P < 0.05) relative weights of liver and thyroid gland by 27% and 64%, respectively; and reduced (P < 0.05) serum tetraiodothyronine (T4) level from 30.3 to 17.8 ng/mL. Heart, kidney, and gastrointestinal tract weights; serum triiodothyronine level; and hindgut pH of pigs were unaffected by dietary CPCC. Dietary HA-starch reduced (P < 0.05) overall ADG, relative weight of thyroid gland, cecal, and colonic pH; but increased (P < 0.05) relative weight of colon; tended to increase (P = 0.062) serum T4 level. Dietary CPCC and HA-starch interacted (P = 0.024) on relative weight of thyroid gland such that dietary CPCC increased (P < 0.05) weight of thyroid gland for HA-starch-free diet (120 vs. 197 mg/kg of BW) but not for HA-starch-containing diet (104 vs. 130 mg/kg of BW). Dietary CPCC and HA-starch interacted (P = 0.001) on cecal isothiocyanate content such that dietary CPCC increased (P < 0.05) level of isothiocyanates for HA-starch-containing diet but not for HA-starch-free diet. In conclusion, dietary CPCC reduced growth performance, increased liver, size and interfered with thyroid gland functions of pigs. However, the negative effects of dietary CPCC on thyroid gland functions of nursery pigs were alleviated by dietary HA-starch.
Strangulated spigelian hernia with necrosis of the caecum, appendix and terminal ileum: an unusual presentation in the elderly
Authors: Ndong Abdourahmane , Tendeng Jacques Noel , Niang Fallou Gallas , Diao Mohamed Lamine , Diallo Adja Coumba , Ndichout Aicha , Dia Diago Anta , Nyemb Phillipe Manyacka Ma , Konaté Ibrahima
Published: April 2020

Spigelian hernia is a rare form of abdominal wall hernias. We report an unusual case of a strangulated spigelian hernia with necrotic contents of the caecum, appendix and terminal ileum in the elderly. An 84-year-old woman, with a history of eight pregnancies, was admitted for bowel obstruction evolving for 7 days. The computed tomography scan showed a strangulated right spigelian hernia. Surgical exploration with an incision centered on the mass confirmed the diagnosis with extensive necrosis of the caecum, appendix and 10 cm of the terminal ileum. A right hemi-colectomy with an ileo-colic anastomosis was performed. The post-operative course was marked by the death of the patient in intensive care due to multi-visceral failure. The occurrence of strangulation with necrosis of the caecum, appendix and terminal ileum in spigelian hernia is extremely rare. It requires early diagnosis and treatment to reduce post-operative morbidity and mortality.
Aeromedical Evacuations Within the French Armed Forces: Analysis of 2,129 Patients
Authors: Luft Antoine , Corcostegui Simon-Pierre , Millet Marianne , Gillard Jonathan , Boissier Jerome , Rondy Patrick , Bancarel Jérôme , Carfantan Cyril
Published: April 2020

Introduction

The doctrine of medical support during French military operations is based on a triptych: forward medical stabilization, forward damage control surgery, and early strategic aeromedical evacuation (Strategic-AE). The aim of this study was to describe the last piece, the evacuation process of the French Strategic-AE.

Methods

We conducted a retrospective cohort analysis using patient records from 2015 to 2017. All French service members requiring an air evacuation from a foreign country to a homeland medical facility were included. Data collected included age, medical diagnosis, priority categorization, boarding location, distance from Paris, type of plane and flight, medical team composition, timeline, and dispatch at arrival.

Results

We analyzed 2,129 patients evacuated from 71 countries, most from Africa (1,256), the Middle East (382), and South America (175). Most patients (1,958) were not severely injured, although some considered priority (103) or urgent (68). Diagnoses included disease (48.6%), nonbattle injuries (43%), battle stress (5.3%), and battle injuries (3%). 246 Strategic-AE used medical teams in flight, 136 of them in a dedicated Falcon aircraft. The main etiologies for those evacuations were battle injuries (24%), cardiovascular (15.4%), infections (8%), and neurologic (7.3%). The median time of management for urgent patients was about 16 hours but longer for priority patients (26 hours). Once in France, 1,146 patients were admitted to a surgery department and 96 to an intensive care unit.

Conclusion

This is the first study to analyze the French Strategic-AE system, which is doctrinally unique when compared to its North Atlantic Treaty Organization allies. North Atlantic Treaty Organization allies favor care in the theatre in place of the French early Strategic-AE. However, in the event of a high intensity conflict, a combination of these two doctrines could be useful.
Self-gravitating filament formation from shocked flows: velocity gradients across filaments
Authors: Chen Che-Yu , Mundy Lee G , Ostriker Eve C , Storm Shaye , Dhabal Arnab
Published: April 2020

In typical environments of star-forming clouds, converging supersonic turbulence generates shock-compressed regions, and can create strongly magnetized sheet-like layers. Numerical magnetohydrodynamic simulations show that within these post-shock layers, dense filaments and embedded self-gravitating cores form via gathering material along the magnetic field lines. As a result of the preferred-direction mass collection, a velocity gradient perpendicular to the filament major axis is a common feature seen in simulations. We show that this prediction is in good agreement with recent observations from the CARMA Large Area Star Formation Survey (CLASSy), from which we identified several filaments with prominent velocity gradients perpendicular to their major axes. Highlighting a filament from the north-west part of Serpens South, we provide both qualitative and quantitative comparisons between simulation results and observational data. In particular, we show that the dimensionless ratio Cv ≡ Δvh2/(GM/L), where Δvh is half of the observed perpendicular velocity difference across a filament, and M/L is the filament’s mass per unit length, can distinguish between filaments formed purely due to turbulent compression and those formed due to gravity-induced accretion. We conclude that the perpendicular velocity gradient observed in the Serpens South north-west filament can be caused by gravity-induced anisotropic accretion of material from a flattened layer. Using synthetic observations of our simulated filaments, we also propose that a density-selection effect may explain observed subfilaments (one filament breaking into two components in velocity space) as reported in recent observations.
The thermal-radiative wind in low-mass X-ray binary H1743−322 – II. Iron line predictions from Monte Carlo radiation transfer
Authors: Tomaru Ryota , Done Chris , Ohsuga Ken , Odaka Hirokazu , Takahashi Tadayuki
Published: April 2020

We show the best current simulations of the absorption and emission features predicted from thermal-radiative winds produced from X-ray illumination of the outer accretion disc in binary systems. We use the density and velocity structure derived from a radiation hydrodynamic code as input to a Monte Carlo radiation transport calculation. The initial conditions are matched to those of the black hole binary system H1743−322 in its soft, disc dominated state, where wind features are seen in Chandra grating data. Our simulation fits well to the observed line profile, showing that these physical wind models can be the origin of the absorption features seen, rather than requiring a magnetically driven wind. We show how the velocity structure is the key observable discriminator between magnetic and thermal winds. Magnetic winds are faster at smaller radii, whereas thermal winds transition to a static atmosphere at smaller radii. New data from XRISM (due for launch 2022 January) will give an unprecedented view of the physics of the wind launch and acceleration processes, but the existence of static atmospheres in small disc systems already rules out magnetic winds which assume self-similar magnetic fields from the entire disc as the origin of the absorption features seen.
High resolution crystal structure of a KRAS promoter G-quadruplex reveals a dimer with extensive poly-A π-stacking interactions for small-molecule recognition
Authors: Ou Arnold , Schmidberger Jason W , Wilson Katie A , Evans Cameron W , Hargreaves Jessica A , Grigg Melanie , O’Mara Megan L , Iyer K Swaminathan , Bond Charles S , Smith Nicole M
Published: April 2020

Aberrant KRAS signaling is a driver of many cancers and yet remains an elusive target for drug therapy. The nuclease hypersensitive element of the KRAS promoter has been reported to form secondary DNA structures called G-quadruplexes (G4s) which may play important roles in regulating KRAS expression, and has spurred interest in structural elucidation studies of the KRAS G-quadruplexes. Here, we report the first high-resolution crystal structure (1.6 Å) of a KRAS G-quadruplex as a 5′-head-to-head dimer with extensive poly-A π-stacking interactions observed across the dimer. Molecular dynamics simulations confirmed that the poly-A π-stacking interactions are also maintained in the G4 monomers. Docking and molecular dynamics simulations with two G4 ligands that display high stabilization of the KRAS G4 indicated the poly-A loop was a binding site for these ligands in addition to the 5′-G-tetrad. Given sequence and structural variability in the loop regions provide the opportunity for small-molecule targeting of specific G4s, we envisage this high-resolution crystal structure for the KRAS G-quadruplex will aid in the rational design of ligands to selectively target KRAS.
Anterior Column Realignment: Analysis of Neurological Risk and Radiographic Outcomes
Authors: Saigal Rajiv , Akbarnia Behrooz A , Eastlack Robert K , Bagheri Ali , Tran Stacie , Brown Drew , Bagheri Ramin , Mundis Gregory M
Published: April 2020

BACKGROUND

Anterior column realignment (ACR) is a less invasive alternative to 3-column osteotomy for the correction of sagittal imbalance. We hypothesized that ACR would correct sagittal imbalance with an acceptable neurological risk.

OBJECTIVE

To assess long-term neurological and radiographic outcomes after ACR.

METHODS

Patients ≥18 yr who underwent ACR from 2005 to 2013 were eligible. Standing scoliosis radiographs were studied at preoperation, postoperation (≤6 wk), and at minimum 2 yr of follow-up. Clinical/radiographic data were collected through a retrospective chart review, with thoracic 1 spino-pelvic inclination (T1SPi) used as the angular surrogate for sagittal vertical axis.

RESULTS

A total of 26 patients had complete data, with a mean follow-up of 2.8 yr (1.8-7.4). Preoperative, sagittal parameters were lumbar lordosis (LL) of −16.1°, pelvic incidence (PI)-LL of 41.7°, T1SPi of 3.6°, and pelvis tilt (PT) of 32.4°. LL improved by 30.6° (P < .001) postoperation. Mean changes in PT (−8.3), sacral slope (8.9), T1SPi (−4.9), and PI-LL (−33.5) were all significant. The motion segment angle improved by 26.6°, from 5.2° to −21.4° (P < .001). Neurological complications occurred in 32% patients postoperation (n = 8; 1 patient with both sensory and motor). New thigh numbness/paresthesia developed in 3 (13%) patients postoperation; only 1 (4%) persisted at latest follow-up. A total of 6 (24%) patients developed a new lower extremity motor deficit postoperation, with 4 (8%) having persistent new weakness at last follow-up. Out of 8 patients with preoperative motor deficit, half saw improvement postoperation and 75% improved by last follow-up.

CONCLUSION

There was net motor improvement, with 24% of patients improving and 16% having persistent new weakness at latest follow-up; 60% were unchanged. Radiographic results demonstrate that ACR is a useful tool to treat severe sagittal plane deformity.
Radiological differences between subtypes of WHO 2016 grade II–III gliomas: a systematic review and meta-analysis
Authors: van Lent Djuno I , van Baarsen Kirsten M , Snijders Tom J , Robe Pierre A J T
Published: April 2020

Background

Isocitrate dehydrogenase (IDH) mutation and 1p/19q-codeletion are oncogenetic alterations with a positive prognostic value for diffuse gliomas, especially grade II and III. Some studies have suggested differences in biological behavior as reflected by radiological characteristics. In this paper, the literature regarding radiological characteristics in grade II and III glioma subtypes was systematically evaluated and a meta-analysis was performed.

Methods

Studies that addressed the relationship between conventional radiological characteristics and IDH mutations and/or 1p/19q-codeletions in newly diagnosed, grade II and III gliomas of adult patients were included. The “3-group analysis” compared radiological characteristics between the WHO 2016 glioma subtypes (IDH-mutant astrocytoma, IDH-wildtype astrocytoma, and oligodendroglioma), and the “2-group analysis” compared radiological characteristics between 1p/19q-codeleted gliomas and 1p/19q-intact gliomas.

Results

Fourteen studies (3-group analysis: 670 cases, 2-group analysis: 1042 cases) were included. IDH-mutated astrocytomas showed more often sharp borders and less frequently contrast enhancement compared to IDH-wildtype astrocytomas. 1p/19q-codeleted gliomas had less frequently sharp borders, but showed a heterogeneous aspect, calcification, cysts, and edema more frequently. For the 1p/19q-codeleted gliomas, a sensitivity of 96% was found for heterogeneity and a specificity of 88.1% for calcification.

Conclusions

Significant differences in conventional radiological characteristics exist between the WHO 2016 glioma subtypes, which may reflect differences in biological behavior. However, the diagnostic value of the independent radiological characteristics is insufficient to reliably predict the molecular genetic subtype.
Desire That Amounts to Knowledge
Authors: Hazlett Allan
Published: April 2020

I argue that desire sometimes amounts to knowledge, in the same sense that belief sometimes amounts to knowledge. The argument rests on two assumptions: that goodness is the correctness condition for desire (which is one articulation of the idea that we desire things under the ‘guise of the good’) and that knowledge is apt mental representation (which is a generalized virtue-theoretic account of knowledge). Desire that amounts to knowledge—or ‘conative knowledge’—is illustrated by cases in which someone knows the goodness of something despite not believing that it is good.
Early detection of ventricular dysfunction in juvenile systemic sclerosis by speckle tracking echocardiography
Authors: Civieri Giovanni , Castaldi Biagio , Martini Giorgia , Meneghel Alessandra , Milanesi Ornella , Zulian Francesco
Published: April 2020

Objective

Cardiac involvement is the most important cause of mortality in juvenile systemic sclerosis (JSSc). Recent reports in adult patients underline that traditional techniques of imaging are inadequate to assess the subclinical cardiac involvement, while speckle tracking echocardiography (STE) is able to identify ventricular dysfunctions in the early stages. The aim of our study was to assess the role of STE in JSSc.

Methods

Demographic, clinical and laboratory data were collected from patients with JSSc. Cardiac investigations performed at baseline (T0) and 18 (T18) and 36 months (T36) follow-up included electrocardiography, conventional echocardiography with measurement of the ejection fraction (EF) and STE with assessment of left and right ventricular global longitudinal strain (LV-GLS and RV-GLS). Cardiac parameters have been compared with demographic characteristics and disease severity, assessed by the Juvenile Systemic Sclerosis Severity Score (J4S).

Results

A total of 18 patients, 12 (67%) females, entered the study. At T0, electrocardiography was abnormal in three patients, EF was reduced in one, LV-GLS was abnormal in three (16.7%) and RV-GLS was abnormal in five (27.8%). At T18, EF remained stable while at T36 the result decreased in seven of nine patients. At the same time, LV-GLS also worsened (from −21.6% to −18.2%, P = 0.01). LV-GLS and RV-GLS at baseline showed a significant correlation with J4S (P = 0.012 and P = 0.02, respectively).

Conclusion

STE is more sensitive than standard echocardiography to identify cardiac involvement in JSSc. Over time, we observed a gradual worsening of LV-GLS, a sign of left ventricular dysfunction, that anticipated by several months the decrease of EF.
A Next-Generation Risk Assessment Case Study for Coumarin in Cosmetic Products
Authors: Baltazar Maria T , Cable Sophie , Carmichael Paul L , Cubberley Richard , Cull Tom , Delagrange Mona , Dent Matthew P , Hatherell Sarah , Houghton Jade , Kukic Predrag , Li Hequn , Lee Mi-Young , Malcomber Sophie , Middleton Alistair M , Moxon Thomas E , Nathanail Alexis V , Nicol Beate , Pendlington Ruth , Reynolds Georgia , Reynolds Joe , White Andrew , Westmoreland Carl
Published: April 2020

Next-Generation Risk Assessment is defined as an exposure-led, hypothesis-driven risk assessment approach that integrates new approach methodologies (NAMs) to assure safety without the use of animal testing. These principles were applied to a hypothetical safety assessment of 0.1% coumarin in face cream and body lotion. For the purpose of evaluating the use of NAMs, existing animal and human data on coumarin were excluded. Internal concentrations (plasma Cmax) were estimated using a physiologically based kinetic model for dermally applied coumarin. Systemic toxicity was assessed using a battery of in vitro NAMs to identify points of departure (PoDs) for a variety of biological effects such as receptor-mediated and immunomodulatory effects (Eurofins SafetyScreen44 and BioMap Diversity 8 Panel, respectively), and general bioactivity (ToxCast data, an in vitro cell stress panel and high-throughput transcriptomics). In addition, in silico alerts for genotoxicity were followed up with the ToxTracker tool. The PoDs from the in vitro assays were plotted against the calculated in vivo exposure to calculate a margin of safety with associated uncertainty. The predicted Cmax values for face cream and body lotion were lower than all PoDs with margin of safety higher than 100. Furthermore, coumarin was not genotoxic, did not bind to any of the 44 receptors tested and did not show any immunomodulatory effects at consumer-relevant exposures. In conclusion, this case study demonstrated the value of integrating exposure science, computational modeling and in vitro bioactivity data, to reach a safety decision without animal data.
Using Positive Nudge to Promote Healthy Eating at Worksite
Authors: Montagni Ilaria , Prevot Frédéric , Castro Zoila , Goubel Baptiste , Perrin Laurence , Oppert Jean-Michel , Fontvieille Anne-Marie
Published: April 2020

Objective:

To assess the effect and transferability of a workplace food labeling intervention.

Methods:

Employees’ purchase of food items in cafeterias of an international company was monitored in six intervention sites (one in France and five in the United States [US]) where green-labels were displayed in healthy food items. One cafeteria in France represented the control site. Descriptive statistics were performed inter- and intra-site.

Results:

One year after the intervention, purchase of labeled items was higher in the French intervention site compared with the control (P < 0.001). This consumption was increasing 2 years after the intervention (P < 0.001). The percentage (+8.0% from T0 to T1) of sales of labeled items from the US sites confirmed the transferability of this intervention.

Conclusions:

Workplace food labeling using positive nudge can contribute to healthy eating habits among employees. This can be replicated in other worksite cafeterias.
Risk Factors for Retinal Detachment
Authors: Kriebel David , Sama Susan R. , Bradbury Michael , Buchholz Bryan , Curti Stefania , Daines Bradley , Deliso Kathryn , DeVries Rebecca , Fleckner Tara , Gore Rebecca , Mattioli Stefano , Shah Chirag , Wegman David H.
Published: April 2020

Objective:

The aim of this study was to investigate risk factors for retinal detachment or tear (RD/T), and follow up two studies that found increased risk from work-related heavy lifting.

Methods:

We conducted a case–control study including 200 cases of RD/T and 415 controls. Participants completed a questionnaire covering general health, vision, and physical exertion. Multiple logistic regression and propensity score matching was used to control confounding and estimate independent effects.

Results:

RD/T risk was increased by one lifting measure: current regular lifting of more than 30 lbs (>13.6 kg). In the population aged less than 65 years, the odds ratio comparing those with/without heavy lifting was 1.81, 95% confidence interval = 1.08 to 3.04.

Conclusion:

Occupational heavy lifting may represent a risk factor for RD/T, but further research is needed in populations with frequent heavy physical exertion to more precisely quantify the risk.
Whole-Process Emergency Training of Personal Protective Equipment Helps Healthcare Workers Against COVID-19
Authors: Tan Wenhui , Ye Yuying , Yang Yijing , Chen Zhu , Yang Xinglong , Zhu Caizhong , Chen Dong , Tan Junyuan , Zhen Cheng
Published: April 2020

Objective:

To develop an emergency training program of personal protective equipment (PPE) for general healthcare workers (HCWs) who may be under the threat of Corona Virus Disease 2019 (COVID-19) and evaluate the effect of the program.

Methods:

A three-stage training program was designed. The complete clinical workflow together with infectious disease ward was simulated. To verify the effect of the program, an experimental training with pre- and post-test was conducted before large-scale training.

Results:

Post-test scores were significantly improved when compared with the pre-test scores. Among all PPE, N95 respirator and protective coverall needed training most. Meanwhile, “proficiency level” and “mutual check & help” also needed to be strengthened as independent scoring points.

Conclusion:

This training program significantly improved the performances of participants. It may therefore be applied for general HCWs on a larger scale.
Dynamics of ATP-dependent and ATP-independent steppings of myosin-V on actin: catch-bond characteristics
Authors: Xie Ping
Published: April 2020

An analytical theory is presented for the dynamics of myosin-V molecular motor, where both ATP-dependent and ATP-independent steppings are taken into account. Specifically, the dependences of velocity, run length and unbinding rate upon both forward and backward loads and ATP concentration are studied, explaining quantitatively the diverse available single-molecule data and providing predicted results. The results show that the unbinding rate increases with the increase of ATP concentration and levels off at both low and high ATP concentrations. More interestingly, at an ATP concentration that is not very low, the unbinding rate exhibits characteristics of a catch-slip bond under backward load, with the unbinding rate decreasing rapidly with the increase of the backward load in the range smaller than about 2.5 pN and then increasing slowly with the further increase of the backward load. By contrast, under forward load the unbinding rate exhibits a slip-bond characteristic.
Subconcussive head impact exposure differences between drill intensities in U.S. high school football
Authors: Kercher Kyle , Steinfeldt Jesse A. , Macy Jonathan T. , Ejima Keisuke , Kawata Keisuke
Published: April 2020

Purpose

USA Football established five levels of contact (LOC) to guide the intensity of high school football practices. However, it remains unclear whether head impact exposure differs by LOC. The purpose of this study was to examine head impact frequency and magnitude by LOC in the overall sample and three position groups.

Methods

This longitudinal observational study included 24 high school football players during all practices and games in the 2019 season. Players wore a sensor-installed mouthguard that monitored head impact frequency, peak linear acceleration (PLA), and rotational head acceleration (PRA). Practice/game drills were filmed and categorized into 5 LOCs (air, bags, control, thud, live), and head impact data were assigned into 5 LOCs. Player position was categorized into linemen, hybrid, and skill.

Results

A total of 6016 head impacts were recorded during 5 LOCs throughout the season. In the overall sample, total number of impacts, sum of PLA, and PRA per player increased in an incremental manner (air<bags<control<thud<live), with the most head impacts inlive(113.7±17.8 hits/player) and the least head impacts inair(7.7±1.9 hits/player). The linemen and hybrid groups had consistently higher impact exposure than the skill group. Average head impact magnitudes by position group were higher duringlivedrills (PLA (41.0-45.9g) and PRA (3.3-4.6 krad/s2) per head impact), whereas other LOCs had lower magnitudes (PLA (18.2-23.2g) and PRA (1.6-2.3krad/s2) per impact).

Conclusion

Our data suggest that LOC may influence cumulative head impact exposure in high school football, with players incurring frequent head impacts duringlive, thud, andcontrol. The data indicate the importance of considering LOCs to refine practice guidelines and policies to minimize head impact burden in high school football athletes.
A Mini Review on Current Clinical and Research Findings for Children Suffering from COVID-19
Authors: Li Xiao , Qian Kun , Xie Ling-ling , Li Xiu-juan , Cheng Min , Jiang Li , Schuller Björn W.
Published: April 2020

Background

As the novel coronavirus triggering COVID-19 has broken out in Wuhan, China and spread rapidly worldwide, it threatens the lives of thousands of people and poses a global threat on the economies of the entire world. However, infection with COVID-19 is currently rare in children.

Objective

To discuss the latest findings and research focus on the basis of characteristics of children confirmed with COVID-19, and provide an insight into the future treatment and research direction.

Methods

We searched the terms “COVID-19 OR coronavirus OR SARS-CoV-2” AND “Pediatric OR children” on PubMed, Embase, Cochrane library, NIH, CDC, and CNKI. The authors also reviewed the guidelines published on Chinese CDC and Chinese NHC.

Results

We included 25 published literature references related to the epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19.

Conclusion

The numbers of children with COVID-19 pneumonia infection are small, and most of them come from family aggregation. Symptoms are mainly mild or even asymptomatic, which allow children to be a risk factor for transmission. Thus, strict epidemiological history screening is needed for early diagnosis and segregation. This holds especially for infants, who are more susceptible to infection than other age groups in pediatric age, but have most likely subtle and unspecific symptoms. They need to be paid more attention to. CT examination is a necessity for screening the suspected cases, because most of the pediatric patients are mild cases, and plain chest X-ray do not usually show the lesions or the detailed features. Therefore, early chest CT examination combined with pathogenic detection is a recommended clinical diagnosis scheme in children. The risk factors which may suggest severe or critical progress for children are: Fast respiratory rate and/or; lethargy and drowsiness mental state and/or; lactate progressively increasing and/or; imaging showed bilateral or multi lobed infiltration, pleural effusion or rapidly expending of lesions in a short period of time and/or; less than 3 months old or those who underly diseases. For those critical pediatric patients with positive SARS-CoV-2 diagnosis, polypnea may be the most common symptom. For treatment, the elevated PCT seen in children in contrast to adults suggests that the underlying coinfection/secondary infection may be more common in pediatric patients and appropriate antibacterial treatment should be considered. Once cytokine storm is found in these patients, anti-autoimmune or blood-purifying therapy should be given in time. Furthermore, effective isolation measures and appropriate psychological comfort need to be provided timely.
Epigenetic dysregulation ofACE2and interferon-regulated genes might suggest increased COVID-19 susceptibility and severity in lupus patients
Authors: Sawalha Amr H. , Zhao Ming , Coit Patrick , Lu Qianjin
Published: April 2020

Infection caused by SARS-CoV-2 can result in severe respiratory complications and death. Patients with a compromised immune system are expected to be more susceptible to a severe disease course. In this report we suggest that patients with systemic lupus erythematous might be especially prone to severe COVID-19 independent of their immunosuppressed state from lupus treatment. Specially, we provide evidence in lupus to suggest hypomethylation and overexpression ofACE2, which is located on the X chromosome and encodes a functional receptor for the SARS-CoV-2 spike glycoprotein. Oxidative stress induced by viral infections exacerbates the DNA methylation defect in lupus, possibly resulting in furtherACE2hypomethylation and enhanced viremia. In addition, demethylation of interferon-regulated genes, NFκB, and key cytokine genes in lupus patients might exacerbate the immune response to SARS-CoV-2 and increase the likelihood of cytokine storm. These arguments suggest that inherent epigenetic dysregulation in lupus might facilitate viral entry, viremia, and an excessive immune response to SARS-CoV-2. Further, maintaining disease remission in lupus patients is critical to prevent a vicious cycle of demethylation and increased oxidative stress, which will exacerbate susceptibility to SARS-CoV-2 infection during the current pandemic. Epigenetic control of theACE2gene might be a target for prevention and therapy in COVID-19.