bluuebunny/crossref_metadata_2025 huggingface dataset:
Material security and adherence to antiretroviral therapy among HIV-positive people who use illicit drugs
Authors: Mohd Salleh Nur Afiqah , Van Draanen Jenna , Nosova Ekaterina , Barrios Rolando , Milloy M.-.J. , Richardson Lindsey
Published: February 2020

Objective:

To examine the relationship between poverty, operationalized using a novel material security measure, and adherence to antiretroviral therapy (ART) among people who use illicit drugs (PWUD) in a context of universal access to HIV care.

Design:

We analyzed data from a community-recruited prospective cohort in Vancouver, Canada (n = 623), from 2014 to 2017.

Methods:

We used multivariable generalized mixed-effects analyses to estimate longitudinal factors associated with mean material security score. We then estimated the association between achieving at least 95% adherence to ART and overall mean material score, as well as mean score for three factors derived from a factor analysis. The three-factor structure, employed in the current analyses, were factor 1 (basic needs); factor 2 (housing-related variables) and factor 3 (economic resources).

Results:

Recent incarceration [β-coefficient (β) = −0.176, 95% confidence interval (95% CI): −0.288 to −0.063], unmet health needs [β = −0.110, 95% CI: −0.178 to −0.042), unmet social service needs (β = −0.264, 95% CI: −0.336 to −0.193) and having access to social services (β= −0.102, 95% CI: −0.1586 to −0.0465) were among the factors associated with lower material security scores. Contrary to expectations that low levels of material security in this population would lead to poor ART adherence, we did not observe a significant relationship between adherence and overall material security score, or for each factor individually.

Conclusion:

Our findings highlight the potentially important role of no-cost, universal access to HIV prevention and treatment, in mitigating the impact of socioeconomic disadvantage on ART adherence.
Registration timelines of antiretroviral medicines in Ghana and Kenya
Authors: Ashigbie Paul G. , Laing Richard O. , Wirtz Veronika J. , Nkrumah Nathaniel , Kemboi Anthony , Nwokike Jude
Published: February 2020

This study examines registration timelines of antiretroviral medicines (ARVs) in Ghana and Kenya, to assess whether prior reviews by the US Food and Drug Administration Tentative Approval or WHO prequalification (WHO/PQP) affect in-country approval timelines. Data were collected from online and national databases. Median in-country review period in Ghana was 9 months compared with 25 months in Kenya. ARVs with Tentative Approval and WHO/PQP status did not benefit from shorter in-country review periods.
Clinical Feasibility of Abbreviated Magnetic Resonance With Breath-Hold 3-Dimensional Magnetic Resonance Cholangiopancreatography for Surveillance of Pancreatic Intraductal Papillary Mucinous Neoplasm
Authors: Kang Hyo-Jin , Lee Dong Ho , Lee Jeong Min , Yoo Jeongin , Weiland Elisabeth , Kim EunJu , Son Yohan
Published: February 2020

Objectives

To determine the clinical feasibility of abbreviated magnetic resonance image (MRI) using breath-hold 3-dimensional magnetic resonance cholangiopancreatography (3D-MRCP) (aMRI-BH) for pancreatic intraductal papillary mucinous neoplasm (IPMN) surveillance.

Materials and Methods

In this retrospective study, 123 patients with 158 pancreatic IPMNs (pathologically proven [n = 73] and typical image feature with ≥2-year stability [n = 85]) who underwent conventional MRI (cMRI) consisting of contrast-enhanced pancreatobiliary MRI with conventional and BH-3D-MRCP were included. Two readers independently evaluated aMRI-BH protocols consisting of heavily T2-weighted, precontrast T1-weighted, and BH-3D-MRCP sequences. The diagnostic performance of aMRI-BH for detecting malignant IPMNs was assessed using the following criteria: category 3, presence of mural nodule 5 mm or bigger and/or main pancreatic duct (MPD) 10 mm or bigger; category 2, more than one of the following: cyst size 30 mm or greater, mural nodule smaller than 5 mm, thickened cyst walls, MPD of 5 to 9 mm, lymphadenopathy, and an abrupt MPD caliber change with distal atrophy; and category 1, none of the above. Categories 2 or 3 were considered positive results of surveillance. Interreader agreement of image features by intraclass correlation and κ statistics were analyzed.

Results

The total acquisition times of cMRI and aMRI-BH were 32.7 ± 8 and 5.5 ± 2.1 minutes, respectively (P < 0.01). Among 158 IPMNs, 33 lesions were malignant. The aMRI-BH presented a sensitivity of 100% and a negative predictive value of 100% for evaluating malignant IPMNs in both readers, with substantial interreader agreements (intraclass correlation or к values, range: 0.73–0.93 for cMRI and 0.57–0.94 for aMRI-BH) in significant imaging features based on revised Fukuoka guidelines, except for thickened cyst walls and lymphadenopathy (к values: 0.10 and 1.00 for cMRI and 0.13 and 0.49 for aMRI-BH, respectively).

Conclusions

The aMRI-BH provided high sensitivity and negative predictive value to evaluate malignant IPMNs by using predetermined criteria, and aMRI-BH might be a potential tool for pancreatic IPMN surveillance with significantly lower acquisition time.
Gnomonious projections for bend-free textures: thoughts on the splay-twist phase
Authors: Chaturvedi N. , Kamien Randall D.
Published: February 2020

The Hopf fibration has inspired any number of geometric structures in physical systems, in particular, in chiral liquid crystalline materials. Because the Hopf fibration lives on the three sphere,

S

3

, some method of projection or distortion must be employed to realize textures in flat space. Here, we explore the geodesic-preserving gnomonic projection of the Hopf fibration, and show that this could be the basis for a new liquid crystalline texture with only splay and twist. We outline the structure and show that it is defined by the tangent vectors along the straight line rulings on a series of hyperboloids. The phase is defined by a lack of bend deformations in the texture, and is reminiscent of the splay-bend and twist-bend nematic phases. We show that domains of this phase may be stabilized through anchoring and saddle-splay.
Output-weighted optimal sampling for Bayesian regression and rare event statistics using few samples
Authors: Sapsis Themistoklis P.
Published: February 2020

For many important problems the quantity of interest is an unknown function of the parameters, which is a random vector with known statistics. Since the dependence of the output on this random vector is unknown, the challenge is to identify its statistics, using the minimum number of function evaluations. This problem can be seen in the context of active learning or optimal experimental design. We employ Bayesian regression to represent the derived model uncertainty due to finite and small number of input–output pairs. In this context we evaluate existing methods for optimal sample selection, such as model error minimization and mutual information maximization. We show that for the case of known output variance, the commonly employed criteria in the literature do not take into account the output values of the existing input–output pairs, while for the case of unknown output variance this dependence can be very weak. We introduce a criterion that takes into account the values of the output for the existing samples and adaptively selects inputs from regions of the parameter space which have an important contribution to the output. The new method allows for application to high-dimensional inputs, paving the way for optimal experimental design in high dimensions.
Baby cry recognition is independent of motherhood but improved by experience and exposure
Authors: Bouchet Hélène , Plat Aurélie , Levréro Florence , Reby David , Patural Hugues , Mathevon Nicolas
Published: February 2020

Neurobiological changes affecting new mothers are known to support the development of the mother–infant relationship (the ‘maternal brain'). However, which aspects of parenting are actually mother-specific and which rely on general cognitive abilities remains debated. For example, refuting earlier findings, a recent study demonstrated that fathers identify their own baby from their cries just as well as mothers. Here we show that this performance is independent not only of sex, but also of parenthood status. We found that mothers' ability to recognize their newborn from their cries increased rapidly within few days postpartum, with highly multiparous mothers performing better. However, both male and female non-parents could similarly recognize an assigned baby, even after a very short exposure. As in mothers, both the initial amount of experimental exposure to the baby's cries (learning opportunity) and prior experience of caring for infants (auditory expertise) affected participants' performance. We thus suggest that, rather than being female-specific or motherhood-dependent, the ability to recognize a baby from their cries derives from general auditory and learning skills. By being available to non-parents of both sexes, it may contribute to the caregiving flexibility required for efficient cooperative breeding in humans.
Competition for resources can promote the divergence of social learning phenotypes
Authors: Gilman R. Tucker , Johnson Fern , Smolla Marco
Published: February 2020

Social learning occurs when animals acquire knowledge or skills by observing or interacting with others and is the fundamental building block of culture. Within populations, some individuals use social learning more frequently than others, but why social learning phenotypes differ among individuals is poorly understood. We modelled the evolution of social learning frequency in a system where foragers compete for resources, and there are many different foraging options to learn about. Social learning phenotypes diverged when some options offered much better rewards than others and expected rewards changed moderately quickly over time. When options offered similar rewards or when rewards changed slowly, a single social learning phenotype evolved. This held for fixed and simple conditional social learning rules. Sufficiently complex conditional social learning rules prevented the divergence of social learning phenotypes under all conditions. Our results explain how competition can promote the divergence of social learning phenotypes.
Co-occurrence of beaked whale strandings and naval sonar in the Mariana Islands, Western Pacific
Authors: Simonis Anne E. , Brownell Robert L. , Thayre Bruce J. , Trickey Jennifer S. , Oleson Erin M. , Huntington Roderick , Baumann-Pickering Simone
Published: February 2020

Mid-frequency active sonar (MFAS), used for antisubmarine warfare (ASW), has been associated with multiple beaked whale (BW) mass stranding events. Multinational naval ASW exercises have used MFAS offshore of the Mariana Archipelago semi-annually since 2006. We report BW and MFAS acoustic activity near the islands of Saipan and Tinian from March 2010 to November 2014. Signals from Cuvier's (
Ziphius cavirostris)
and Blainville's beaked whales (
Mesoplodon densirostris
), and a third unidentified BW species, were detected throughout the recording period. Both recorders documented MFAS on 21 August 2011 before two Cuvier's beaked whales stranded on 22–23 August 2011. We compared the history of known naval operations and BW strandings from the Mariana Archipelago to consider potential threats to BW populations. Eight BW stranding events between June 2006 and January 2019 each included one to three animals. Half of these strandings occurred during or within 6 days after naval activities, and this co-occurrence is highly significant. We highlight strandings of individual BWs can be associated with ASW, and emphasize the value of ongoing passive acoustic monitoring, especially for beaked whales that are difficult to visually detect at sea. We strongly recommend more visual monitoring efforts, at sea and along coastlines, for stranded cetaceans before, during and after naval exercises.
Assortative mating and within-spouse pair comparisons
Authors: Howe Laurence J , Battram Thomas , Morris Tim T , Hartwig Fernando P , Hemani Gibran , Davies Neil M , Smith George Davey
Published: February 2020

Comparisons between cohabitating spouses have been proposed as an aetiological design method to reduce confounding and evaluate effects of the shared adulthood environment. However, assortative mating, a phenomenon where individuals select phenotypically similar mates, could distort associations. We evaluated the use of spousal comparisons, as in the within-spouse pair (WSP) model, for aetiological epidemiological research.

Using directed acyclic graphs and simulations, we demonstrated that the WSP model can reduce confounding if spouses are correlated for an unmeasured confounder, but that WSP comparisons are susceptible to collider bias induced by assortative mating. Empirical analyses using spouse pairs in UK Biobank found evidence that genetic association estimates from the WSP model are attenuated compared to random pairs for single nucleotide polymorphisms (SNPs) associated with height (shrinkage: 23%; 95% CI 20%, 25%), educational attainment (74%; 95% CI 66%, 81%) and body mass index (23%; 95% CI 14%, 32%) as well as for an alcohol consumption SNP (29%, 95% CI 5%, 46%). Some of these attenuations are likely to reflect effects of assortative mating because height and educational attainment are unlikely to be strongly influenced by the adulthood environment. In contrast, effect estimates of increasing age on coronary artery disease and systolic blood pressure were found to be concordant between random and spouse pairs.

Assortative mating is likely to induce phenotypic and genetic structure between an individual and their spouse which complicates the interpretation of spousal comparisons in an aetiological context. A further consideration is that the joint participation of non-independent spouses in cohort studies could induce selection bias.
GADL1 is a multifunctional decarboxylase with tissue-specific roles in β-alanine and carnosine production
Authors: Mahootchi Elaheh , Homaei Selina Cannon , Kleppe Rune , Winge Ingeborg , Hegvik Tor-Arne , Megias-Perez Roberto , Totland Christian , Mogavero Floriana , Baumann Anne , Glennon Jeffrey , Miletic Hrvoje , Kursula Petri , Haavik Jan
Published: February 2020

Carnosine and related β-alanine-containing peptides are believed to be important antioxidants, pH-buffers and neuromodulators. However, their biosynthetic routes and therapeutic potential are still being debated. This study describes the first animal model lacking the enzyme glutamic acid decarboxylase-like 1 (GADL1). We show that Gadl1-/-mice are deficient in β-alanine, carnosine and anserine, particularly in the olfactory bulb, cerebral cortex, and skeletal muscle. Gadl1-/-mice also exhibited decreased anxiety, increased levels of oxidative stress markers, alterations in energy and lipid metabolism, and age-related changes. Examination of the GADL1 active site indicated that the enzyme may have multiple physiological substrates, including aspartate and cysteine sulfinic acid, compatible with organ-specific functions. Human genetic studies show strong associations of the GADL1 locus with plasma levels of carnosine, subjective well-being, and muscle strength, also indicating a role for β-alanine and its peptide derivatives in these traits. Together, this shows the multifaceted and organ specific roles of carnosine peptides and establishes Gadl1 knockout mice as a versatile model to explore carnosine biology and its therapeutic potential.
Buckling of fiber metal laminated plates – numerical and experimental studies
Authors: Prasad Elluri Venkata , Sahu Shishir Kumar
Published: February 2020

Purpose

The purpose of this study is to study the buckling behavior of new aircraft material, i.e. glass fiber metal laminated (GFML) plates.

Design/methodology/approach

The first-order Reissner–Mindlin theory is used in the present finite element formulation to determine the buckling loads of GFML plates. A program is developed in MATLAB for analyzing the effect of different parameters on buckling loads GFML plates. A set of experiments was performed to determine critical buckling loads of GFML plates using universal testing machine INSTRON 8862 and compared with predictions using the numerical model.

Findings

The effects of various parameters such as aspect ratio, side to thickness ratio, ply orientation and boundary conditions on buckling loads of GFMLs are examined. With the increase of aspect ratio, the reduction in buckling load is observed, while the increase inside to thickness ratio decreases the buckling load of GFML plates. There is a slight variation in buckling load with the increase of ply orientation. The buckling load is significantly influenced by boundary conditions because of restraint at the edges.

Practical implications

These types of materials are used in lightweight structures such as aircraft, aerospace and military vehicles. The results reported in the present study can be used as design guidelines while designing fiber metal laminated (FML) plated structures.

Originality/value

For the first time, the authors have studied the buckling behavior of bidirectional woven FML plates using both numerical and experimental techniques.
The group matters: examining the effect of group characteristics in online brand communities
Authors: Liao Junyun , Wang Lu , Huang Minxue , Yang Defeng , Wei Haiying
Published: February 2020

Purpose

In an online brand community (OBC), consumers as a group occupy a dominant position, and their horizontal interactions are pivotal for the consumer–brand relationship. However, little is known about the effect of group characteristics on brands. To partially fill this gap, this study examines how group characteristics influence brand loyalty from the perspective of social identity theory. Specifically, by collecting data from an online survey, this paper investigates the effects of group similarity, group receptivity and group involvement on brand loyalty, the mediating role of community identification and the moderating effect of tenure in a community.

Design/methodology/approach

Data from 482 brand community members were analyzed using structural equation modeling.

Findings

The results show that group similarity, group receptivity and group involvement increase brand loyalty; furthermore, the effect is mediated by community identification. Moreover, group receptivity is more effective in fostering community identification of short-tenure members, whereas group similarity plays a more important role for long-tenure members.

Originality/value

This paper enriches the brand community literature from a group perspective and provides implications for how brand communities develop customer loyalty strategies.
The combination of artesunate and carboplatin exerts a synergistic anti‐tumour effect on non‐small cell lung cancer
Authors: Wang Zhu , Wang Qianqian , He Tao , Li Wen , Liu Yan , Fan Yuan , Wang Yanping , Wang Qi , Chen Jie
Published: February 2020

Carboplatin (CBP) is a widely used targeted anticancer therapeutic drug; however, multi‐drug resistance induced by the accumulation of CBP eventually causes diseases progression. The anti‐malarial drug artesunate (ART) also exerts anticancer effects in various cancers; however, the combined effect of ART and CBP on non‐small cell lung cancer (NSCLC) remains unclear. In the present study, the NSCLC cell line A549 was pretreated with various concentrations of CBP, ART and gemcitabine (GEM). 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyltetrazolium bromide (MTT) assays were conducted to detect cell viability. Cell apoptosis was evaluated by both flow cytometry and TUNEL apoptotic assay. The expression profiles of cell cycle‐related proteins and apoptotic proteins were determined by western blot. Cell clone numbers were visualized using crystal violet staining. Here, we found that both CBP and ART suppressed cell viability, and promoted cell apoptosis, and the combined application of ART and CBP at a lower concentration exhibited synergistic effects. Specifically, the combination of ART and CBP at a lower concentration suppressed cell clone numbers, promoted cell cycle arrest at the G2/M phase, and induced the expression of the cell cycle and apoptosis‐related proteins BAX, p21, p53, and Caspase‐3, while decreasing Bcl‐2 and Cyclin B1 expression. Based on these results, we concluded that combined application of ART and CBP exerts synergistic anti‐tumour effects on NSCLC by enhancing cell apoptosis in a mitochondria‐dependent manner.
Coenzyme Q10 supplementation: Efficacy, safety, and formulation challenges
Authors: Arenas‐Jal Marta , Suñé‐Negre J. M. , García‐Montoya Encarna
Published: February 2020

World population growth and aging are posing unprecedented challenges in sustaining the health of 9.1 billion people that will be occupying the planet by 2050. Although noncommunicable diseases such as cardiovascular and neurodegenerative diseases, cancer, and diabetes are among the top 10 global causes of death, they can be prevented by risk factor reduction, early detection, and adequate treatment. Since a healthy diet along with dietary supplementation could play an important role to reduce morbidity and cut off its associated health care costs, research in the food and nutrition area is required to find solutions to global challenges affecting health.

As a result of the healthy living trend, dietary supplements category is growing fast, leading to an urgent need for dietitians, physicians, and policy makers to broaden the scientific evidence on the efficacy and safety of a wide range of active ingredients. Coenzyme Q10 (CoQ10), as the third most consumed dietary supplement, and as a potential candidate for the treatment of various noncommunicable diseases that are among the global top 10 causes of death, has gained interest over years. Scientific evidence regarding mainly CoQ10 efficacy and safety, as well as formulation challenges, is addressed in this review.
The in vitro effect of VEGF receptor inhibition on primary alveolar osteoblast nodule formation
Authors: McLaughlin KI , Milne TJ , Zafar S , Zanicotti DG , Cullinan MP , Seymour GJ , Coates DE
Published: February 2020

Background

Vascular endothelial growth factor (VEGF) is a master regulator and is required for the effective coupling of angiogenesis and osteogenesis supporting both skeletal development and postnatal bone repair. A direct role for VEGF in intramembranous‐derived osteoblast growth and differentiation is not clear. We investigated the expression of primary alveolar osteoblast VEGF receptors and the subsequent effects on mineralization and nodule formation in vitro following VEGFR inhibition.

Methods

Primary human alveolar osteoblasts (HAOBs) were cultured in the presence of VEGF receptor inhibitors, exogenous VEGF or the bisphosphonate, zoledronic acid. VEGF, VEGFR1 and VEGFR2 mRNA expression and nodule formation following 21 days of culture. VEGFR1 protein expression was examined using immunofluorescence after 48 h.

Results

The HAOBs expressed high levels of VEGF and VEGFR1 protein but VEGFR2 was not detected. The VEGFR1/2 inhibitors, ZM306416 and KRN633, lead to a dose‐dependent decrease in mineralization. Treatment with zoledronic acid showed no difference in HAOB VEGF receptor expression.

Conclusion

VEGF/VEGFR1 pathway appears to be important for intramembranous‐derived osteoblast differentiation and maturation in vitro.
Ceramide/sphingosine‐1‐phosphate imbalance is associated with distinct inflammatory phenotypes of uncontrolled asthma
Authors: Kim Seung‐Hyun , Jung Hae‐Won , Kim Minji , Moon Ji‐Young , Ban Ga‐Young , Kim Su Jung , Yoo Hyun‐Ju , Park Hae‐Sim
Published: February 2020

Background

Asthma is associated with inflammatory dysregulation, but the underlying metabolic signatures are unclear. This study aimed to classify asthma inflammatory phenotypes based on cellular and metabolic features.

Methods

To determine cellular and metabolic profiles, we assessed inflammatory cell markers using flow cytometry, sphingolipid (SL) metabolites using LC‐MS/MS, and serum cytokines using ELISA. Targeted gene polymorphisms were determined to identify genetic predispositions related to the asthma inflammatory phenotype.

Results

In total, 137 patients with asthma and 20 healthy controls (HCs) were enrolled. Distinct cellular and metabolic profiles were found between them; patients with asthma showed increased expressions of inflammatory cell markers and higher levels of SL metabolites compared to HCs (P < .05 for all). Cellular markers (CD66+ neutrophils, platelet‐adherent eosinophils) and SL metabolic markers (C16:0 and C24:0 ceramides) for uncontrolled asthma were also identified; higher levels were observed in uncontrolled asthma compared to controlled asthma (P < .05 for all). Asthmatics patients with higher levels of CD66+ neutrophils had lower FEV1(%), higher ACQ (but lower AQLO) scores, and higher sphingosine and C16:0 ceramide levels compared to those with low levels of CD66+ neutrophils. Asthmatics patients with higher levels of platelet‐adherent eosinophils had higher S1P levels compared to those with lower levels of platelet‐adherent eosinophils. Patients carrying TT genotype of ORMDL3 had more CD66+ neutrophils; those with AG/ GG genotypes of SGMS1 exhibited higher platelet‐adherent eosinophils.

Conclusion

Patients with uncontrolled asthma possess distinct inflammatory phenotypes including increased CD66+ neutrophils and platelet‐adherent eosinophils, with an imbalanced ceramide/S1P rheostat, potentially involving ORMDL3 and SGMS1 gene polymorphisms. Ceramide/S1P synthesis could be targeted to control airway inflammation.
Perianal sepsis in neutropaenic patients with haematological malignancies: the role of magnetic resonance imaging and surgery
Authors: Ashkar Claudia , Britto Maneka , Carne Peter , Cheung Wa , Mirbagheri Naseem
Published: February 2020

Background

Perianal sepsis occurs in up to 10% of neutropaenic patients with haematological malignancy and is associated with significant morbidity and mortality. The management of this condition is challenging in neutropaenic patients due to its atypical pathophysiology. The aim of this study is to assess the role of magnetic resonance imaging (MRI) and surgery in neutropaenic patients with perianal sepsis.

Methods

A retrospective chart review was performed on all neutropenic patients with a haematological malignancy who had a diagnosis of perianal sepsis during the inpatient admission between 2008 and 2017. Patient characteristics, symptoms, haematological data, MRI result, surgical intervention, intraoperative findings and outcomes including recurrence and mortality were collected.

Results

Nineteen neutropaenic patients with haematological malignancy were treated for perianal sepsis, eight (42%) patients were managed conservatively and 11 (58%) were managed surgically. Nine patients underwent MRI, which identified a collection in 88% of cases despite severe neutropaenia. In patients with a collection identified on MRI prior to surgery, 80% had a drainable collection confirmed intraoperatively. Post‐operative complications included two cases of sepsis from a presumed perianal source and one death. A total of 82% of patients experienced symptom resolution after surgery compared to 88% of patients managed conservatively.

Conclusion

This study has demonstrated that MRI is a useful diagnostic tool in evaluating perianal sepsis in patients with haematological malignancy, even during periods of severe neutropenia. We found that both conservative and surgical management strategies lead to resolution of symptoms.
Meprin‐α (Mep1A) enhances TNF‐α secretion by mast cells and aggravates abdominal aortic aneurysms
Authors: Gao Ran , Liu Duan , Guo Wenjun , Ge Weipeng , Fan Tianfei , Li Bolun , Gao Pan , Liu Bin , Zheng Yuehong , Wang Jing
Published: February 2020

Background and Purpose

Abdominal aorticaneurysm (AAA) rupture is mainly due to elastic lamina degradation. As a metalloendopeptidase, meprin‐α (Mep1A) critically modulates the activity of proteins and inflammatory cytokines in various diseases. Here, we sought to investigate the functional role of Mep1A in AAA formation and rupture.

Experimental Approach

AAA tissues were detected by using real‐time PCR (RT‐PCR), western blotting (WB), and immunohistochemistry. Further mechanistic studies used RT‐PCR, WB, and enzyme‐linked immunosorbent assays.

Key Results

Mep1A mediated AAA formation by regulating the mast cell (MC) secretion of TNF‐α, which promoted matrix metalloproteinase (MMP) expression and apoptosis in smooth muscle cells (SMCs). Importantly, increased Mep1A expression was found in human AAA tissues and in angiotensin II‐induced mouse AAA tissues. Mep1A deficiency reduced AAA formation and increased the survival rate of AAA mice. Pathological analysis showed that Mep1A deletion decreased elastic lamina degradation and SMC apoptosis in AAA tissues. Furthermore, Mep1A was expressed mainly in MCs, wherein it mediated TNF‐α expression. Mep1A inhibitor actinonin significantly inhibited TNF‐α secretion in MCs. TNF‐α secreted by MCs enhanced MMP2 expression in SMCs and promoted SMC apoptosis.

Conclusion and Implications

Taken together, these data suggest that Mep1A may be vital in AAA pathophysiology by regulating TNF‐α production by MCs. Knocking out Mep1A significantly decreased AAA diameter and improved AAA stability in mice. Therefore, Mep1A is a potential new therapeutic target in the development of AAA.
Transplantation of viral‐positive hepatitis C‐positive kidneys into uninfected recipients offers an opportunity to increase organ access
Authors: Graham Jay A. , Torabi Julia , Ajaimy Maria , Akalin Enver , Liriano Luz E. , Azzi Yorg , Pynadath Cindy , Greenstein Stuart M. , Goldstein Doctor Y. , Fox Amy S. , Weiss Jeffery M. , Powell Tia P. , Reinus John F. , Kinkhabwala Milan M. , Rocca Juan P.
Published: February 2020

The advent of direct‐acting antivirals (DAAs) has provided the impetus to transplant kidneys from hepatitis C virus‐positive donors into uninfected recipients (D+/R−). Thirty D+/R− patients received DAA treatment. Sustained virologic response (SVR12) was defined as an undetectable viral load in 12 weeks after treatment. An age‐matched cohort of uninfected donor and recipient pairs (D−/R−) transplanted during same time period was used for comparison. The median day of viral detection was postoperative day (POD) 2. The detection of viremia in D+/R− patients was 100%. The initial median viral load was 531 copies/μL (range: 10‐1 × 108 copies/μL) with a median peak viral load of 3.4 × 105 copies/μL (range: 804‐1.0 × 108 copies/μL). DAAs were initiated on median POD 9 (range: 5‐41 days). All 30 patients had confirmed SVR12. During a median follow‐up of 10 months, patient and graft survival was 100%, and acute rejection was 6.6% with no major adverse events related to DAA treatment. Delayed graft function was significantly decreased in D+/R− patients as compared to the age‐matched cohort (27% vs 60%; P = .01). D+/R− transplantation offers patients an alternative strategy to increase access.
The influence of ischemia and reperfusion time on outcome in heart transplantation
Authors: Jernryd Victoria , Metzsch Carsten , Andersson Bodil , Nilsson Johan
Published: February 2020

Ischemia/reperfusion may lead to graft dysfunction in heart transplantation (HT). The purpose of this study was to evaluate the influence of ischemic and reperfusion time on acute cellular rejection (ACR) within the first‐year post‐HT and on long‐term outcomes. Data were collected from 331 patients (mean age 49 ± 12 y, 28% females) who underwent HT 1988‐2016. Endomyocardial biopsies obtained within the first year after HT were graded according to the 2004‐ISHLT‐WF. We classified the patients by ischemic time </≥4 hours and further by reperfusion time </≥90 minutes. Primary endpoint was ACR ≥ 2R within one‐year post‐HT. A multiple logistic regression analysis was used to adjust for potential confounders. Secondary endpoint was long‐term survival. There were 56 (17%) patients who received donor hearts with ischemic time >4 hours, and of these, 31 (55%) patients had reperfusion with CPB ≥90 minutes. Ischemia >4 hours had an increased risk of ACR ≥ 2R during the first year (adjusted OR = 3.1, P = .016); however, an extended reperfusion ≥90 minutes reduced the risk (adjusted OR = 0.25, P = .024). The conditional probability of surviving 10 years post‐transplant, given that the patients already survived first year, was inferior for recipients with ischemia ≥ 4 hours and reperfusion <90 minutes, 59%, compared with the other groups 83%, P = .016. Prolonged reperfusion appears to reduce the risk for ACR ≥ 2R and improve long‐term survival.
Phenological shuffling of major marine phytoplankton groups over the last six decades
Authors: Chivers William J. , Edwards Martin , Hays Graeme C.
Published: February 2020

Aim

Phytoplankton form the basis of the marine food web and are responsible for approximately 50% of the world's photosynthesis. Changes to their ecology are, therefore, important: here, we examined seasonal patterns in ocean phytoplankton abundance for 45 taxa over 59 years collected from circa 410,000 km of line‐transect sampling at temperate latitudes.

Location

The North Sea.

Methods

For our analysis we used plankton abundance data from the Continuous Plankton Recorder (CPR) survey, sea surface temperature measurements from the Hadley Centre, UK Meteorological Office and wind speed data from the International Comprehensive Ocean–Atmosphere Data Set, NOAA.

Results

We found large differences in changes in the timing of peak abundance between the major phytoplankton groups. Late‐summer blooming dinoflagellates (n = 10 taxa) tended to show a large seasonal advancement, the timing of peak abundance for dinoflagellates as group advancing 39 days over these six decades. By contrast diatoms (n = 35) did not show any change as a group in their timing of peak abundance over the time series. Granger causality testing suggested a major driver of these phenological changes has been ocean warming in general but more specifically the rate of spring temperature rise as the most important factor. We also found differences in the timing of peak abundance of harmful algal bloom taxa, with some showing peak abundance earlier while others have moved later.

Main conclusions

There has been a fundamental transformation of the classic seasonal progression from blooms of diatoms to dinoflagellates, which lies at the heart of temperate marine food chains, as the classic bimodal diatom and dinoflagellate seasonal peaks are eroded to a more continuous, single, longer‐lasting phytoplankton peak. This phenological shuffling within and between major taxonomic groups is likely to have profound implications for the transfer of energy to higher trophic levels.
Endoscopic submucosal dissection/endoscopic mucosal resection guidelines for esophageal cancer
Authors: Ishihara Ryu , Arima Miwako , Iizuka Toshiro , Oyama Tsuneo , Katada Chikatoshi , Kato Motohiko , Goda Kenichi , Goto Osamu , Tanaka Kyosuke , Yano Tomonori , Yoshinaga Shigetaka , Muto Manabu , Kawakubo Hirofumi , Fujishiro Mitsuhiro , Yoshida Masahiro , Fujimoto Kazuma , Tajiri Hisao , Inoue Haruhiro ,   The Japan Gastroenterological Endoscopy Society Guidelines Committee of ESD/EMR for Esophageal Cancer
Published: February 2020

The Japan Gastroenterological Endoscopy Society has developed endoscopic submucosal dissection/endoscopic mucosal resection guidelines. These guidelines present recommendations in response to 18 clinical questions concerning the preoperative diagnosis, indications, resection methods, curability assessment, and surveillance of patients undergoing endoscopic resection for esophageal cancers based on a systematic review of the scientific literature.
Endocytoscopic intramucosal capillary network changes and crypt architecture abnormalities can predict relapse in patients with an ulcerative colitis Mayo endoscopic score of 1
Authors: Maeda Yasuharu , Kudo Shin‐ei , Ogata Noriyuki , Mori Yuichi , Misawa Masashi , Homma Mayumi , Nemoto Tetsuo , Ogawa Masataka , Sasanuma Seiko , Sato Yuta , Kataoka Shinichi , Kouyama Yuta , Sakurai Tatsuya , Igarashi Kenta , Ogawa Yushi , Kato Kazuki , Ichimasa Katsuro , Nakamura Hiroki , Kudo Toyoki , Hayashi Takemasa , Wakamura Kunihiko , Baba Toshiyuki , Inoue Haruhiro , Ohtsuka Kazuo
Published: February 2020

Objectives

Recent studies have suggested the necessity of therapeutic intervention for patients with ulcerative colitis at high risk of clinical relapse with a Mayo endoscopic score (MES) of 1. The aim of this retrospective cohort study was to demonstrate the impact of intramucosal capillary network changes and crypt architecture abnormalities to stratify the risk of relapse in patients with an MES of 1.

Methods

All included patients had an MES of ≤1 and confirmed sustained clinical remission between October 2016 and April 2019. We classified patients with an MES of 1 as “intramucosal capillary/crypt (ICC)‐active” or “ICC‐inactive” using endocytoscopic evaluation. We followed patients until October 2019 or until relapse; the main outcome measure was the difference in clinical relapse‐free rates between ICC‐active and ICC‐inactive patients with an MES of 1.

Results

We included 224 patients and analyzed data for 218 (82 ICC‐active and 54 ICC‐active with an MES of 1 and 82 with an MES of 0). During follow‐up, among the patients with an MES of 1, 30.5% (95% confidence interval 20.8–41.6; 25/82) of the patients relapsed in the ICC‐active group and 5.6% (95% confidence interval 1.2–15.4; 3/54) of the patients relapsed in the ICC‐inactive group. The ICC‐inactive group had a significantly higher clinical relapse‐free rate compared with the ICC‐active group (P < 0.01).

Conclusions

In vivo intramucosal capillary network and crypt architecture patterns stratified the risk of clinical relapse in patients with an MES of 1 (UMIN 000032580; UMIN 000036359).
Sleep and obesity among children: A systematic review of multiple sleep dimensions
Authors: Morrissey Bridget , Taveras Elsie , Allender Steven , Strugnell Claudia
Published: February 2020

The objectives were to systematically investigate the multiple dimensions of sleep and their association with overweight or obesity among primary school‐aged children. CINHAL, PsycINFO, SPORTDiscus, Medline, Cochrane, Embase, and PubMed databases were searched for papers reporting on an association between children's sleep and weight status. Studies on clinical populations, published in languages other than English, without objectively measured weight status, or where weight status was reported outside the outlined age bracket (5‐13 years) were excluded. A total of 34  248 citations were extracted from our systematic search protocol, of which 112 were included for detailed review. Compared with sleep duration, of which 86/103 articles found a significant inverse association between sleep duration and measured weight status, few studies examined other dimensions of sleep, such as quality, efficiency and bed/wake times, and relationship with weight status. Where studies existed, variation in defining and measurement of these dimensions restricted comparison and potentially influenced discrepancies across results. Overall, the findings of this review warrant the need for further research of the outlined dimensions of sleep. Future research would benefit from clarity on definitions across the different dimensions, along with the use of valid and reliable tools.
Caring for a family member with intellectual disability into old age: Applying the sociocultural stress and coping model to Italian and Greek migrants in Australia
Authors: Walker Ruth , Belperio Irene , Gordon Sally , Hutchinson Claire , Rillotta Fiona
Published: February 2020

Background

Little is known about how older parent caregivers from culturally and linguistically diverse (CALD) backgrounds experience caring for their family member with intellectual disability into late life.

Method

In‐depth semi‐structured interviews were carried out with N = 19 family caregivers aged 50–91 from ten Italian and four Greek families. The Sociocultural Stress and Coping Model was used as a framework to interpret their experiences.

Results

A number of stressors including the need to make sacrifices, physical and emotional demands, uncertain futures and challenges associated with “the system” were identified. While family members play a key role in providing support, changing values around filial responsibility were evident.

Discussion

Further attention needs to be given to CALD families to address challenges associated with caring for their family member with intellectual disabilities as they age. This study also challenges assumptions that CALD families prefer to keep caring within the family long‐term.
Perceived healthiness of food items and the traffic light front of pack nutrition labelling: choice‐based conjoint analysis and cross‐sectional survey
Authors: Anabtawi O. , Swift J. A. , Hemmings S. , Gertson L. , Raaff C.
Published: February 2020

Background

Although traffic light labelling (TLL) is designed to aid the selection of healthier choices, consumers often have to make trade‐offs between (un)desirable attributes. With the current emphasis of public health on sugar reduction, the present study aimed to investigate the relative influence of sugar on the perceived healthiness of products.

Methods

A choice‐based conjoint analysis (CBC) survey was designed to assess the relative importance of the macronutrients commonly used in TLL, as well as the rescaled utilities of three attribute levels (red, amber and green), which involved 858 participants aged ≥18 years, who were recruited from the general population of Nottingham. An additional cross‐sectional online survey was completed by another 901 participants to assess public knowledge about the intake recommendations underpinning the TLL.

Results

Usable data for CBC analysis showed that, when deciding upon the healthiness of items, sugar was significantly the most important macronutrient (mean 0.34, 95% confidence interval = 0.32–0.35) among the 641 participants. Red labelling was significantly more influential than green across macronutrients. In the substudy, 13.3% of participants correctly identify the maximum recommended intake of free sugars. Moreover, 42.8% of the total sample could not identify whether the sugar information on TLL refers to the total or free sugar content.

Conclusions

Despite a lack of knowledge about the recommendations underpinning the TLL criteria, decisions made by participants concerning the healthfulness of food products were significantly influenced by sugar content. TLL appears to guide consumer beliefs in the absence of deep knowledge. The dominance of sugar in decision making is unsurprising in the current public health climate.
Improving assessment of child development: Results of a quality improvement intervention in general practice
Authors: Alexander Karyn E. , Mazza Danielle
Published: February 2020

Aims

Parents' Evaluation of Developmental Status (PEDS) is a validated tool used to assess child development that has not previously been tested in Australian general practice. We examined the effect of a Quality‐Improvement intervention in a single general practice in Melbourne, Australia, that aimed to use this tool to improve the documented assessment of child developmental surveillance during vaccination visits.

Methods

Mixed methods incorporated audits of clinical records of children aged 1–5 years, before and after intervention, written questionnaires and a focus group (informed by the theoretical domains framework and Capability, Opportunity, Motivation‐Behaviour (COM‐B model)) with clinical and non‐clinical staff.

Results

After 6 months, developmental surveillance more than doubled and was documented in more than one in three visits (34.1%). Almost one in five (18.6%) vaccination visits included the PEDS tool. Overall, the tool was positively received with staff expressing high levels of comfort asking parents to complete it (92.8%), increasing development of professional skills (71.4% staff) and confidence (55% clinicians) detecting developmental delays. Thematic analysis of the focus group transcript revealed underlying barriers arising from the practice environment, staff capabilities and motivation.

Conclusions

In a whole of practice Quality‐Improvement intervention that applied PEDS training and implementation, including the receptionist in the medical team more than doubled documented rates of child developmental surveillance during vaccination visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance.
After an end‐of‐life decision: Parents' reflections on living with an end‐of‐life decision for their child
Authors: Sullivan Jane E , Gillam Lynn H , Monagle Paul T
Published: February 2020

Aim

Parents' role as end‐of‐life decision‐makers for their child has become largely accepted Western health‐care practice. How parents subsequently view and live with the end‐of‐life decision (ELD) they made has not been extensively examined. To help extend understanding of this phenomenon and contribute to care, as a part of a study on end‐of‐life decision‐making, bereaved parents were asked about the aftermath of their decision‐making.

Methods

A qualitative methodology was used. Semi‐structured interviews were conducted with parents who had discussed ELDs for their child who had a life‐limiting condition and had died. Data were thematically analysed.

Results

Twenty‐five bereaved parents participated. Results indicate that parents hold multi‐faceted views about their decision‐making experiences. An ELD was viewed as weighty in nature, with decisions judged against the circumstances that the child and parents found themselves in. Despite the weightiness, parents reflected positively on their decisions, regarding themselves as making the right decision. Consequently, parents' comments demonstrated being able to live with their decision. When expressed, regret related to needing an ELD, rather than the actual decision. The few parents who did not perceive themselves as their child's decision‐maker subsequently articulated negative reactions. Enduring concerns held by some parents mostly related to non‐decisional matters, such as the child's suffering or not knowing the cause of death.

Conclusion

Results suggest that parents can live well with the ELDs they made for their child. End‐of‐life decision‐making knowledge is confirmed and extended, and clinical support for parents informed.
Understanding teenage fertility in Peru: An analysis using longitudinal data
Authors: Favara Marta , Lavado Pablo , Sánchez Alan
Published: February 2020

Reducing the prevalence of teenage pregnancy remains an elusive goal for public policy in Peru. We use longitudinal data from the Young Lives Study in Peru to investigate on an extensive set of early circumstances and life changes that might be the risk factors for teenage childbearing—about one out of five girls in the sample was a teenage mother. The use of longitudinal data allows us to reduce the methodological concerns common to this type of analysis. According to our results, growing up in a poor household, being raised in a single‐parent household, leaving school at or before age 15, performing badly in school at age 12, and having the first sexual relation at or under age 16 are the key risk factors for early childbearing. From a time‐varying perspective, we uncover the importance of changes in the characteristics of a child and household that occurred prior to childbearing. Among other factors, we find that improvements in self‐efficacy and education aspirations during adolescence are associated with a decrease in the probability of early childbearing. Risk factors identified are considerably more relevant—in most cases, only relevant—for girls. From a policy perspective, our results suggest that initiatives aimed at improving school attendance, sexual education, and socioemotional competencies among adolescents might be effective tools to reduce the high rates of teenage pregnancy in Peru.