bluuebunny/crossref_metadata_2025 huggingface dataset:
The role of resistin on metabolic syndrome‐induced erectile dysfunction and the possible therapeutic effect of Boldine
Authors: Kara Erkan , Kahraman Erkan , Dayar Ezgi , Yetik Anacak Gunay , Demir Omer , Gidener Sedef , Atabey Nese , Durmus Nergiz
Published: July 2020

Background

Resistin is known as a potential mediator of obesity‐associated insulin resistance. The high resistin level disrupts nitric oxide (NO)‐mediated relaxation which is also important in erectile function. An antioxidant alkaloid, Boldine, is known as anti‐diabetic and protects endothelial functions.

Objectives

We aimed to investigate resistin expression in penile tissue in the presence of insulin resistance (IR) and the effect of Boldine treatment on erectile functions in the metabolic syndrome (MetS) rat model.

Materials and methods

Wistar rats were randomly divided into three groups: Control, MetS, and boldine treated MetS group. MetS parameters were assessed by serum triglycerides (TG), uric acid (UA), glucose, insulin levels, HOMA index, and waist circumference (WC)/tibia length (TL) ratio. To evaluate erectile functions, intracavernous pressure (ICP)/mean arterial pressure (MAP) ratio was performed during cavernous nerve stimulation. Protein expressions of resistin, endothelial nitric oxide synthase (eNOS), p(S1177) eNOS, and insulin receptor‐β were evaluated by Western blotting.

Results

TG, glucose, insulin levels, weight, WC/TL ratio, HOMA index and resistin expression in penile tissue were significantly increased and ICP/MAP values, and p (S1177) eNOS expression in penile tissue were decreased in MetS group. Boldine treatment enhanced ICP/MAP values, insulin receptor‐β and p(S1177) eNOS expressions compared with the MetS group.

Discussion and Conclusion

MetS caused a deterioration in erectile function accompanied by an increase in resistin expression and a reduction in eNOS enzyme activation in the rat penile tissues. Boldine treatment resulted in an improvement in erectile function, independent of resistin expression.
Pantoprazole, a proton‐pump inhibitor, impairs human sperm motility and capacitation in vitro
Authors: Escoffier Jessica , Arnaud Bastien , Kaba Mayis , Hograindleur Jean Pascal , Le Blévec Emilie , Martinez Guillaume , Stévant Isabelle , Ray Pierre F. , Arnoult Christophe , Nef Serge
Published: July 2020

Background

The effects of PPIs on human sperm fertilizing capacity were poorly investigated although these drugs are widely over‐used. Two publications retrospectively studied relationships between any PPI intake and sperm parameters from patients consulting at infertility clinics, but the conclusions of these reports were contradictory. Only two reports investigated the effects of lansoprazole and omeprazole on sperm motility and found lansoprazole to be deleterious and omeprazole to be neutral for sperm motility. The inconsistency of the PPI effect in the previous reports emphasizes the need for more basic research on human spermatozoa, taking into account the hypothesis that the different PPI drugs may have different effects on sperm physiology.

Objectives

Do PPIs, which are among the most widely sold drug in the word, impact negatively human sperm capacitation and sperm motility?

Materials and methods

The effects of PPIs on human sperm maturation and motility were analyzed by CASA, flow cytometry, and Western blot.

Results

We tested the impact of 6 different PPIs on human sperm motility and capacitation. We showed that pantoprazole, but not the other PPIs, decreased sperm progressive motility and capacitation‐induced sperm hyperactivation. We therefore investigated further the effects of pantoprazole on sperm capacitation, and we observed that it had a significant deleterious effect on the capacitation‐induced hyperpolarization of the membrane potential and capacitation‐associated protein phosphorylation.

Discussion and Conclusion

Our results indicate that exposure to pantoprazole has an adverse effect on the physiological competence of human spermatozoa. As the capacitation process takes place within the female tract, our results suggest that PPIs intake by the female partner may impair in vivo sperm maturation and possibly fertilization. Moreover, the absence of adverse effect by PPIs on mouse sperm emphasizes the need to develop reprotox assays using human material to better assess the effects of medication intake on sperm physiology.
Taking on the tweed suits: Reflections on the ‘How the other half lives’ and its critique of masculinist geography
Authors: McEwan Cheryl
Published: July 2020

In this commentary I explore the groundbreaking interventions of Jacky Tivers’ (1978) “How the other half lives” (Area 10:4, pp. 302–306). I highlight its contribution in focusing attention on two specific issues: the underrepresentation of women as producers of geographical knowledge and the exclusion of women’s issues as a focus of geographical inquiry. I argue that the paper broke new ground in the context of British geography by demonstrating the connections between the domination of the discipline by men and what was considered legitimate geographical knowledge, as well as by demanding that the latter be addressed through the explicit study of the geography of women and gender relations.
Effects of livestock grazing on plant species diversity vary along a climatic gradient in northeastern Iran
Authors: Rahmanian Soroor , Hejda Martin , Ejtehadi Hamid , Farzam Mohammad , Pyšek Petr , Memariani Farshid
Published: July 2020

Questions

(a) Do patterns of species diversity and composition differ between plots exposed to high vs. low grazing intensity? (b) Do these differences vary among three regions with different climates, representing a gradient from arid to sub‐humid conditions?

Location

Northeastern Iran.

Methods

We compared plots intensively grazed by sheep and goat (HG) to plots with low grazing intensity (LG), across three climatic regions: arid, semi‐arid and sub‐humid. Species diversity (expressed as Shannon H) was compared using linear mixed‐effect models. Dissimilarity analysis was used to estimate the compositional heterogeneity of different types of plots, reflecting the differences in species composition. Indicator Species Analysis was used to identify individual species associated with particular types of plots.

Results

The HG plots had lower values of Shannon H than LG plots, across all climatic regions. Further, the effect of grazing on species diversity varied between the climatic regions, with the most pronounced differences between the HG and LG plots in the sub‐humid region. Although no differences in species diversity were detected between the three climatic regions, compositional heterogeneity was the highest in the sub‐humid region and the lowest in the semi‐arid region, with the most pronounced differences between the HG and LG plots in the sub‐humid region. Indicator Species Analysis showed significant main effects of both climate and grazing on species composition, revealing species that respond to grazing in each of the three climatic regions.

Conclusions

Overgrazing was detected to reduce the diversity of species in all three climatic regions, even though its effect was most pronounced in the sub‐humid region. Therefore, the control of overgrazing or reduction of its intensity appears an effective management tool for protecting species diversity, applicable in areas with different climates.
Risk of squamous cell carcinoma of the lip and cutaneous melanoma in older Australians using hydrochlorothiazide: A population‐based case‐control study
Authors: Daniels Benjamin , Pearson Sallie‐Anne , Vajdic Claire M. , Pottegård Anton , Buckley Nicholas A. , Zoega Helga
Published: July 2020

Recent European and US studies reported increased risks of skin cancers associated with hydrochlorothiazide (HCTZ) treatment. Our study aimed to determine the risk of lip cancer and malignant melanoma among Australians prescribed HCTZ. We conducted a case‐control study nested within a population of veterans residing in New South Wales in 2004‐2015, using Australian Department of Veterans’ Affairs data linked with cancer registrations, hospitalisation and prescription dispensings. Among DVA healthcare card holders 65 years and older, we identified incident cases of squamous cell carcinoma of the lip and of cutaneous melanoma, each matched with up to 20 controls through risk‐set sampling. We estimated odds ratios (ORs) associating HCTZ use with each cancer using conditional logistic regression, adjusting for predefined confounders. For lip cancer (45 cases), ever‐use of HCTZ yielded an OR of 2.6 (95% CI: 1.4‐5.0) and high HCTZ use (≥25 000 mg) an OR of 4.7 (95% CI: 1.6‐13.7). For cutaneous melanoma (659 cases), ever‐use of HCTZ resulted in an OR of 1.2 (95% CI 1.0‐1.5) and high HCTZ use in an OR of 1.2 (95% CI: 0.8‐1.8). Our findings align with risk estimates from previous studies and provide further evidence that HCTZ’s photosensitising properties may promote carcinogenesis in sun‐exposed tissues.
Markedly increased prevalence of migraine headaches in adolescents with bipolar disorder
Authors: Mehrhof Sara Z. , Fiksenbaum Lisa M. , Bettridge Ariel M. , Goldstein Benjamin I.
Published: July 2020

Objective

There is substantial evidence of increased prevalence of migraines, and negative psychiatric correlates of migraines, in adults with bipolar disorder (BD). Given the paucity of data on this topic in youth, we investigated the prevalence and correlates of migraine in a large sample of adolescents with BD.

Method

The study included 165 adolescents with BD‐I, ‐II, or ‐not otherwise specified (NOS), diagnosed via the KSADS‐PL semi‐structured interview, and 89 healthy controls (HCs). Non‐migraine headache and migraine headache was evaluated using the validated ID‐Migraine 3‐item screener.

Results

Although the prevalence of non‐migraine headaches did not differ between adolescents with BD (24.2%) and HCs (32.6%; P = .15), migraine was significantly more prevalent among adolescents with BD (38.2%) compared to HCs (3.4%; adjusted odds ratio 14.76, 95% confidence interval 4.39‐49.57; P < .001). Within BD, migraine was associated with female sex, BD‐II/‐NOS subtype, less severe worst past functioning, higher past depression severity, higher self‐reported affective lability, higher body mass index, and less use of lithium and second‐generation antipsychotics.

Discussion

Migraine is much more prevalent among adolescents with BD compared to HCs; the magnitude of this association exceeds what has been reported in adult samples. Correlates of migraine in youth BD are similar to those found for adults, including the link with the depressive polarity of BD. Future prospective studies are warranted to evaluate temporal associations between migraine and mood symptoms, and to evaluate neurobiological and cardiovascular underpinnings of these associations.
On order and disorder during the COVID‐19 pandemic
Authors: Reicher Stephen , Stott Clifford
Published: July 2020

In this paper, we analyse the conditions under which the COVID‐19 pandemic will lead either to social order (adherence to measures put in place by authorities to control the pandemic) or to social disorder (resistance to such measures and the emergence of open conflict). Using examples from different countries (principally the United Kingdom, the United States, and France), we first isolate three factors which determine whether people accept or reject control measures. These are the historical context of state‐public relations, the nature of leadership during the pandemic and procedural justice in the development and operation of these measures. Second, we analyse the way the crisis is policed and how forms of policing determine whether dissent will escalate into open conflict. We conclude by considering the prospects for order/disorder as the pandemic unfolds.
A marine fungus‐derived nitrobenzoyl sesquiterpenoid suppresses receptor activator of NF‐κB ligand‐induced osteoclastogenesis and inflammatory bone destruction
Authors: Tan Yanhui , Deng Wende , Zhang Yueyang , Ke Minhong , Zou Binhua , Luo Xiaowei , Su Jianbin , Wang Yiyuan , Xu Jialan , Nandakumar Kutty Selva , Liu Yonghong , Zhou Xuefeng , Li Xiaojuan
Published: July 2020

Background and Purpose

Osteoclasts are unique cells to absorb bone. Targeting osteoclast differentiation is a therapeutic strategy for osteolytic diseases. Natural marine products have already become important sources of new drugs. The naturally occurring nitrobenzoyl sesquiterpenoids first identified from marine fungi in 1998 are bioactive compounds with a special structure, but their pharmacological functions are largely unknown. Here, we investigated six marine fungus‐derived nitrobenzoyl sesquiterpenoids on osteoclastogenesis and elucidated the mechanisms.

Experimental Approach

Compounds were first tested by RANKL‐induced NF‐κB luciferase activity and osteoclastic TRAP assay, followed by molecular docking to characterize the structure–activity relationship. The effects and mechanisms of the most potent nitrobenzoyl sesquiterpenoid on RANKL‐induced osteoclastogenesis and bone resorption were further evaluated in vitro. Micro‐CT and histology analysis were used to assess the prevention of bone destruction by nitrobenzoyl sesquiterpenoids in vivo.

Key Results

Nitrobenzoyl sesquiterpenoid 4, with a nitrobenzoyl moiety at C‐14 and a hydroxyl group at C‐9, was the most active compound on NF‐κB activity and osteoclastogenesis. Consequently, nitrobenzoyl sesquiterpenoid 4 exhibited suppression of RANKL‐induced osteoclastogenesis and bone resorption from 0.5 μM. It blocked RANKL‐induced IκBa phosphorylation, NF‐κB p65 and RelB nuclear translocation, NFATc1 activation, reduced DC‐STAMP but not c‐Fos expression during osteoclastogenesis in vitro. Nitrobenzoyl sesquiterpenoid 4 also ameliorated LPS‐induced osteolysis in vivo.

Conclusion and Implications

These results highlighted nitrobenzoyl sesquiterpenoid 4 as a novel inhibitor of osteoclast differentiation. This marine‐derived sesquiterpenoid is a promising lead compound for the treatment of osteolytic diseases.
Human skin models: From healthy to disease‐mimetic systems; characteristics and applications
Authors: Moniz Tânia , Costa Lima Sofia A. , Reis Salette
Published: July 2020

Skin drug delivery is an emerging route in drug development, leading to an urgent need to understand the behaviour of active pharmaceutical ingredients within the skin. Given, As one of the body's first natural defences, the barrier properties of skin provide an obstacle to the successful outcome of any skin drug therapy. To elucidate the mechanisms underlying this barrier, reductionist strategies have designed several models with different levels of complexity, using non‐biological and biological components. Besides the detail of information and resemblance to human skin in vivo, offered by each in vitro model, the technical and economic efforts involved must also be considered when selecting the most suitable model. This review provides an outline of the commonly used skin models, including healthy and diseased conditions, in‐house developed and commercialized models, their advantages and limitations, and an overview of the new trends in skin‐engineered models.
Mechanisms of artemether toxicity on single cardiomyocytes and protective effect of nanoencapsulation
Authors: Moreira Souza Ana Carolina , Grabe‐Guimarães Andrea , Cruz Jader dos Santos , Santos‐Miranda Artur , Farah Charlotte , Teixeira Oliveira Liliam , Lucas Alexandre , Aimond Franck , Sicard Pierre , Mosqueira Vanessa Carla Furtado , Richard Sylvain
Published: July 2020

Background and Purpose

The artemisinin derivative, artemether, has antimalarial activity with potential neurotoxic and cardiotoxic effects. Artemether in nanocapsules (NC‐ATM) is more efficient than free artemether for reducing parasitaemia and increasing survival of Plasmodium berghei‐infected mice. NCs also prevent prolongation of the QT interval of the ECG. Here, we assessed cellular cardiotoxicity of artemether and how this toxicity was prevented by nanoencapsulation.

Experimental Approach

Mice were treated with NC‐ATM orally (120 mg·kg−1 twice daily) for 4 days. Other mice received free artemether, blank NCs, and vehicle for comparison. We measured single‐cell contraction, intracellular Ca2+ transient using fluorescent Indo‐1AM Ca2+ dye, and electrical activity using the patch‐clamp technique in freshly isolated left ventricular myocytes. The acute effect of free artemether was also tested on cardiomyocytes of untreated animals.

Key Results

Artemether prolonged action potentials (AP) upon acute exposure (at 0.1, 1, and 10 μM) of cardiomyocytes from untreated mice or after in vivo treatment. This prolongation was unrelated to blockade of K+ currents, increased Ca2+ currents or promotion of a sustained Na+ current. AP lengthening was abolished by the NCX inhibitor SEA‐0400. Artemether promoted irregular Ca2+ transients during pacing and spontaneous Ca2+ events during resting periods. NC‐ATM prevented all effects. Blank NCs had no effects compared with vehicle.

Conclusion and Implications

Artemether induced NCX‐dependent AP lengthening (explaining QTc prolongation) and disrupted Ca2+ handling, both effects increasing pro‐arrhythmogenic risks. NCs prevented these adverse effects, providing a safe alternative to the use of artemether alone, especially to treat malaria.
Contact dermatitis caused by glucose sensors—15 adult patients tested with a medical device patch test series
Authors: Ulriksdotter Josefin , Svedman Cecilia , Bruze Magnus , Glimsjö Jenny , Källberg Kajsa , Sukakul Thanisorn , Mowitz Martin
Published: July 2020

Background

Several cases of allergic contact dermatitis (ACD) to the glucose sensor FreeStyle Libre have been reported. Isobornyl acrylate (IBOA) and N,N‐dimethylacrylamide (DMAA) are known culprit allergens.

Objectives

To evaluate patients with suspected ACD to FreeStyle Libre in a standardized manner, present causative allergens, and assess patient‐reported implications.

Methods

A total of 15 patients with suspected ACD to FreeStyle Libre were patch tested with the Swedish baseline series and a new medical device series. IBOA and DMAA were tested at 0.1% and 0.3% in petrolatum (pet.). Readings were performed on day (D) 3 and D7. Background data, details on skin reactions, and associated implications were assessed using a questionnaire.

Results

Thirteen patients were sensitized to IBOA and four to DMAA. Two positive reactions to IBOA and one to DMAA were seen only at 0.3% concentration on D7. Median duration of sensor use before dermatitis onset was 6 months. Half the number of the patients took precautions in everyday life due to sensor‐related skin reactions. Six patients discontinued sensor usage.

Conclusions

Patients with suspected ACD to glucose sensors should be evaluated with a relevant patch test series containing IBOA and DMAA. Adding the 0.3% pet. concentration is recommended. The reading on D7 is necessary.
Outcomes following emergency colorectal cancer presentation in the elderly
Authors: Webster P. J. , Tavangar Ranjbar N. , Turner J. , El‐Sharkawi A. , Zhou G. , Chitsabesan P.
Published: July 2020

Aim

Colorectal cancer is predominantly a disease of the elderly and up to 30% of these patients will present as an emergency. We compared the outcomes of ‘elderly’ patients presenting to our unit with a colorectal cancer emergency over a 10‐year period with those of a ‘younger’ cohort.

Methods

A single centre retrospective review of colorectal cancer emergencies between 1 April 2007 and 1 April 2017 was performed. Patients were separated into two cohorts: ‘young’ (< 75 years) and ‘elderly’ (≥ 75 years). Data collected included demographics, disease status, treatment and outcomes.

Results

A total of 341 patients (< 75 years: n = 154; ≥ 75 years: n = 187) presented as a colorectal cancer emergency. Significantly fewer ‘elderly’ patients underwent curative surgical procedures (72% vs 49%, P < 0.0001) or received adjuvant chemotherapy (56% vs 21%, P < 0.0001). ‘Elderly’ patients had significantly more postoperative cardio‐respiratory complications (7% vs 36%, P < 0.0001), but despite this there was no significant difference in 30‐day mortality (7% vs 12%) and survival rates at 1 year (75% vs 74%) or 3 years (56% vs 49%). Elderly patients treated with best supportive care had a median overall survival of just 62 (range 1–955) days.

Conclusion

Patients ≥ 75 years presenting as a colorectal cancer emergency were significantly less likely to undergo emergency curative surgery or receive adjuvant chemotherapy than those < 75 years. However, the 30‐day mortality, 1‐ and 3‐year survival rates for patients undergoing curative surgery were comparable.
Statistically Induced Chunking Recall: A Memory‐Based Approach to Statistical Learning
Authors: Isbilen Erin S. , McCauley Stewart M. , Kidd Evan , Christiansen Morten H.
Published: July 2020

The computations involved in statistical learning have long been debated. Here, we build on work suggesting that a basic memory process, chunking, may account for the processing of statistical regularities into larger units. Drawing on methods from the memory literature, we developed a novel paradigm to test statistical learning by leveraging a robust phenomenon observed in serial recall tasks: that short‐term memory is fundamentally shaped by long‐term distributional learning. In the statistically induced chunking recall (SICR) task, participants are exposed to an artificial language, using a standard statistical learning exposure phase. Afterward, they recall strings of syllables that either follow the statistics of the artificial language or comprise the same syllables presented in a random order. We hypothesized that if individuals had chunked the artificial language into word‐like units, then the statistically structured items would be more accurately recalled relative to the random controls. Our results demonstrate that SICR effectively captures learning in both the auditory and visual modalities, with participants displaying significantly improved recall of the statistically structured items, and even recall specific trigram chunks from the input. SICR also exhibits greater test–retest reliability in the auditory modality and sensitivity to individual differences in both modalities than the standard two‐alternative forced‐choice task. These results thereby provide key empirical support to the chunking account of statistical learning and contribute a valuable new tool to the literature.
Mothers' Depressive Symptoms and Child Externalizing Problems: Aversion Sensitivity as an Underlying Mechanism
Authors: Moed Anat
Published: July 2020

Background

The mechanisms responsible for why depressed parenting undermines child development are poorly understood. One proposal is that depressive symptoms increase mothers' aversion sensitivity, thereby increasing the frequency of mothers' negative emotional arousal.

Objective

This study examined aversion sensitivity as a marker of maladaptive emotional processes occurring in depressed mothers to explain why mothers' depressive symptoms so consistently disrupt child behavior.

Method

During a 2‐year period, mothers' depressive symptoms and children's externalizing problems were measured repeatedly; interactions between mothers and their 4‐ to 11‐year‐old children were observed (Ndyad = 284).

Results

Results demonstrated that mothers' aversion sensitivity mediated the relation between mothers' depressive symptoms and child externalizing problems in the next assessment.

Conclusion

Aversion sensitivity may underlie depression‐related parenting problems. It has the potential to clarify why depressive symptoms predict dysfunctional parenting and, as a result, developmental problems in children.

Implications

Aversion sensitivity has the potential to elucidate how and why depressive adaptations to a large number of personal and social circumstances reduce parenting competence and predict developmental problems in children.
A Brazilian pandemia/monium: A researcher’s search for a ‘New Normal’
Authors: Cortese Coelho Magdalena
Published: July 2020

This is the narrative of a Brazilian PhD candidate during the first four months of COVID‐19 in Brazil. Her trajectory and feelings are expressed in evocative autoethnographic format, juxtaposed with the main feminist debates and concerns taking place in Brazil during the pandemic. As scenario, an unprecedented worldwide sanitary crisis and local economic, political and social crises, challenging activists, feminists and the researcher herself in posing new questions to understand the world, her country and herself during/after crises. Her own feminist lenses cannot read ‘New Normal’ comfortably.
Significant improvement in portal‐systemic liver failure symptoms and successful management of portal‐splenic venous hemodynamics by the combination of interventional radiology and pharmacotherapy
Authors: Ishikawa Tsuyoshi , Hamamoto Kaori , Sasaki Ryo , Nishimura Tatsuro , Matsuda Takashi , Iwamoto Takuya , Takami Taro , Sakaida Isao
Published: July 2020

This study describes a case of hepatitis C virus‐related decompensated cirrhosis with portal‐systemic liver failure and refractory encephalopathy. It was successfully managed with a combination of interventional radiology and pharmacotherapy, to improve hepatic function, including hyperammonemia and to control portal‐splenic venous hemodynamics with hepatic venous pressure gradient (HVPG) monitoring. A man in his late 50s presented with a Child–Pugh score of 13, Model for End‐Stage Liver Disease‐sodium (MELD‐Na) score of 19 and blood ammonia level of 185 μg/dL. He underwent balloon‐occluded retrograde transvenous obliteration (BRTO) followed by partial splenic embolization (PSE) and non‐selective beta‐blocker (NSBB) administration. BRTO induced drastic changes in the portal‐splenic venous hemodynamics, resulting in dramatically improved hepatic function and reduced hyperammonemia. However, the procedure resulted in increased HVPG from 13.6 mmHg at baseline to 23.5 mmHg at 1‐month post‐BRTO, accompanied by ascites retention and development of portal hypertensive gastropathy. Thereafter, PSE was performed, followed by NSBB administration, to control the elevated portal venous pressure following BRTO. Postoperatively, the patient's ascites and portal hypertensive gastrophy improved after splenic artery embolization, which eventually disappeared after the additional administration of NSBBs 1 month later. The HVPG finally decreased to 16.9 mmHg; the Child–Pugh score, MELD‐Na score and blood ammonia level improved to 7, 11 and 22 μg/dL, respectively, after all therapies. BRTO significantly improved the symptoms of portal‐systemic liver failure with refractory encephalopathy. PSE and NSBB administration could contribute to additional amelioration of hepatic function and successful management of complications induced by portal hemodynamic changes following BRTO.
Caudocranial transseptal approach for placement of endocardial left ventricular leads
Authors: Sinno Mohamad C. , Carrigan Thomas , Hays J. Christian
Published: July 2020

Cardiac resynchronization therapy (CRT) is associated with improvement in the quality of life, hospitalization rates, and mortality in patients with left ventricular dysfunction and evidence of the right ventricle‐left ventricle (RV‐LV) desynchrony. Implant failure rates and patient outcomes have improved with the advent of quadripolar leads, yet alternatives to traditional coronary sinus (CS) LV lead placement is sought for in a subset of advanced heart failure patients with difficult CS anatomy, phrenic nerve stimulation or in nonresponders. Endocardial left ventricular pacing (EnLVP) in chronically anticoagulated patients has been reported as an alternative using different approaches, techniques, and tools with acceptable short and long term adverse events. We present a case of successful EnLVP achieved for CRT using standard techniques and commonly available tools in a patient on chronic direct oral anticoagulation with recurrent heart failure admissions who failed traditional epicardial LV pacing.
External Validation of the Skilled Nursing Facility Prognosis Score for Predicting Mortality, Hospital Readmission, and Community Discharge in Veterans
Authors: Burke Robert E. , Canamucio Anne , Medvedeva Elina , Manges Kirstin A. , Ersek Mary
Published: July 2020

BACKGROUND/OBJECTIVES

Prognostic tools are needed to identify patients at high risk for adverse outcomes receiving post‐acute care in skilled nursing facilities (SNFs) and provide high‐value care. The SNF Prognosis Score was developed in a Medicare sample to predict a composite of long‐term SNF stay, hospital readmission, or death during the SNF stay. Our goal was to evaluate the score's performance in an external validation cohort.

DESIGN

Retrospective observational analysis.

SETTING

We used a Veterans Administration (VA) Residential History File that concatenates VA, Medicare, and Medicaid claims to identify care trajectories across settings and payers for individual veterans.

PARTICIPANTS

Previously community‐dwelling veterans receiving post‐acute care in a SNF after hospitalization from January 1, 2012, to December 31, 2014. Both VA and non‐VA hospitals and SNFs were included.

MEASUREMENTS

We calculated the five‐item SNF Prognosis Score for all eligible veterans in our sample and determined its discrimination (using a receiver operating characteristic curve) and calibration (plotting observed and expected events).

RESULTS

The 386,483 veterans in our sample had worse physical function, more comorbidities, and were more likely to be treated for heart failure, but they had shorter index hospital lengths of stay and fewer catheters than the original Medicare cohort. The SNF Prognosis Score had similar discrimination (C‐statistic = .70; .75 in the derivation cohort) and calibration at low to moderate levels of risk; at high levels, calibration was poorer with the score overestimating risks of adverse events.

CONCLUSION

The SNF Prognosis Score has reasonable discrimination and calibration, and it is simple to calculate using an admission SNF assessment and a nomogram. Future work embedding the score into practice is needed to determine real‐world feasibility, acceptability, and effectiveness.
Examining directional changes when walking with an intravenous pole: A comparison of turning methods with and without stopping
Authors: Hachigasaki Reiko
Published: July 2020

Aim

This study aimed to examine safer turning methods by focusing on and comparing gait and turn methods in relation to stopping when executing a turn while walking with an intravenous (IV) pole.

Methods

The study participants included 33 healthy men. A situation was recreated in which an IV drip was placed in the peripheral vein of the left forearm of the participants and the IV pole was maneuvered using the left hand. A series of six movements was executed, including turn left and right, stopping. Gait was measured (by observing turning motion, stride, walking speed and head tilt angle), and subjective assessments were performed.

Results

Compared with walking normally, walking with an IV pole and executing turns resulted in a decrease in the walking speed, an increase in the time required for walking, a decrease in the stride and a forward tilting in the head angle. Turning left without stopping was mostly accompanied by a spin turn, and the probability of the pole legs coming into contact with participants' legs (15.2%) was higher than that in other assessed movements of walking with a pole. In the subjective assessment, turning left without stopping displayed a lower sense of security (p < .05) than turning left with stopping.

Conclusions

When turning while using an IV pole, the pole itself poses a risk of falling. Therefore, momentary stopping and checking the safety of one's footing is a preventive measure against falling.
Altered Structural Brain Networks Related to Adrenergic/Muscarinic Receptor Autoantibodies in Chronic Fatigue Syndrome
Authors: Fujii Hiroyuki , Sato Wakiro , Kimura Yukio , Matsuda Hiroshi , Ota Miho , Maikusa Norihide , Suzuki Fumio , Amano Keiko , Shin Isu , Yamamura Takashi , Mori Harushi , Sato Noriko
Published: July 2020

BACKGROUND AND PURPOSE

Recent studies suggest that the autoantibodies against adrenergic/muscarinic receptors might be one of the causes and potential markers of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The purpose of this study was to investigate the structural network changes related to autoantibody titers against adrenergic/muscarinic receptors in ME/CFS by performing a single‐subject gray matter similarity‐based structural network analysis.

METHODS

We prospectively examined 89 consecutive right‐handed ME/CFS patients who underwent both brain MRI including 3D T1‐wighted images and a blood analysis of autoantibodies titers against β1 adrenergic receptor (β1 AdR‐Ab), β2 AdR‐Ab, M3 acetylcholine receptor (M3 AchR‐Ab), and M4 AchR‐Ab. Single‐subject gray matter similarity‐based structural networks were extracted from segmented gray matter images for each patient. We calculated local network properties (betweenness centrality, clustering coefficient, and characteristic path length) and global network properties (normalized path length λ, normalized clustering coefficient γ, and small‐world network value δ). We investigated the correlations between the autoantibody titers and regional gray matter/white matter volumes, the local network properties, and the global network properties.

RESULTS

Betweenness centrality showed a significant positive correlation with β1‐AdR‐Ab in the right dorsolateral prefrontal cortex. The characteristic path length showed a significant negative correlation with β2‐AdR‐Ab in the right precentral gyrus. There were no significant correlations between the antibody titers and the regional gray matter/white matter volumes, and the global network properties.

CONCLUSIONS

Our findings suggest that β1 AdR‐Ab and β2 AdR‐Ab are potential markers of ME/CFS.
Comparison of In Vitro Inactivation of SARS CoV‐2 with Hydrogen Peroxide and Povidone‐Iodine Oral Antiseptic Rinses
Authors: Bidra Avinash S. , Pelletier Jesse S , Westover Jonna B , Frank Samantha , Brown Seth M , Tessema Belachew
Published: July 2020

Purpose

To evaluate the in vitro inactivation of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) with hydrogen peroxide (H2O2) and povidone‐iodine (PVP‐I) oral antiseptic rinses at clinically recommended concentrations and contact times.

Materials and Methods

SARS‐CoV‐2, USA‐WA1/2020 strain virus stock was prepared prior to testing by growing in Vero 76 cells. The culture media for prepared virus stock was minimum essential medium (MEM) with 2% fetal bovine serum (FBS) and 50 µg/mL gentamicin. Test compounds consisting of PVP‐I oral rinse solutions and H2O2 aqueous solutions were mixed directly with the virus solution so that the final concentration was 50% of the test compound and 50% of the virus solution. Thus PVP‐I was tested at concentrations of 0.5%, 1.25%, and 1.5%, and H2O2 was tested at 3% and 1.5% concentrations to represent clinically recommended concentrations. Ethanol and water were evaluated in parallel as standard positive and negative controls. All samples were tested at contact periods of 15 seconds and 30 seconds. Surviving virus from each sample was then quantified by standard end‐point dilution assay and the log reduction value of each compound compared to the negative control was calculated.

Results

After the 15‐second and 30‐second contact times, PVP‐I oral antiseptic rinse at all 3 concentrations of 0.5%, 1.25%, and 1.5% completely inactivated SARS‐CoV‐2. The H2O2 solutions at concentrations of 1.5% and 3.0% showed minimal viricidal activity after 15 seconds and 30 seconds of contact time.

Conclusions

SARS‐CoV‐2 virus was completely inactivated by PVP‐I oral antiseptic rinse in vitro, at the lowest concentration of 0.5 % and at the lowest contact time of 15 seconds. Hydrogen peroxide at the recommended oral rinse concentrations of 1.5% and 3.0% was minimally effective as a viricidal agent after contact times as long as 30 seconds. Therefore, preprocedural rinsing with diluted PVP‐I in the range of 0.5% to 1.5% may be preferred over hydrogen peroxide during the COVID‐19 pandemic.
RAISe‐ing awareness: Person‐centred care in coercive mental health care environments—A scoping review and framework development
Authors: McKay Katherine , Ariss Jessica , Rudnick Abraham
Published: July 2020

Accessible Summary

What is known on the subject?

In mental healthcare environments, there are times when people are forced into care (i.e. to take medications or be hospitalized) when they may not want it.

It is difficult to understand how person‐centred care (i.e. supporting patients to lead decisions about their care) can occur within coercive settings.

There is a gap in the literature about this topic as few studies have explored it.

What this paper adds to existing knowledge?

This paper examines the research publicly available to better understand if person‐centred care can exist at times when people are forced into mental health care.

The paper develops a conceptual framework, RAISe (Relationship, Agency, Information, Safe environment), for understanding this matter in order to help people apply this concept in practice

In certain situations, with caring and respectful approaches, with and for patients, it is possible to provide person‐centred care at times when mental health care is forced.

RAISe identifies ways in which this can be done by clinicians while working with people.

What are the implications for practice?

These person‐centred approaches need to be applied across mental health systems so that people in forced mental healthcare scenarios continue to experience dignity and respect.

This is particularly important for nurses who are often the ones providing direct care to patients in these environments.

Introduction

Person‐centred care (PCC) is founded on a theoretical premise that the person who the care issue pertains to directs the decisions relating to them. This can raise ethical challenges when mental health care is forced.

Aim

This paper reports on how PCC is provided in coercive mental healthcare environments and its outcomes, where reported.

Method

A scoping review methodology was utilized to search the literature in English until December 2019 (inclusive).

Results

Twenty articles were included in the review. The information found was diverse and addressed different aspects of PCC in coercive mental healthcare environments.

Discussion

Overall, this area is understudied. Despite ethical challenges, there are opportunities to provide PCC in coercive mental healthcare environments. A novel conceptual framework, RAISe (Relationship, Agency, Information, Safe environment), is presented to assist in applying PCC in these environments. Further research investigating how to employ these practices across systems should occur.

Implications for Practice

This review acknowledges the challenges of providing PCC in coercive mental healthcare environments, while suggesting that this type of care can still be delivered in general as well as specific ways. This is especially relevant for nurses who provide direct care within these environments.
Comparative phylogeography of two Agarophyton species in the New Zealand archipelago
Authors: Huanel Oscar R. , Nelson Wendy A. , Robitzch Vanessa , Mauger Stéphane , Faugeron Sylvain , Preuss Maren , Zuccarello Giuseppe C. , Guillemin Marie‐Laure
Published: July 2020

Molecular studies have reported the coexistence of two species of Agarophyton in New Zealand: the newly described A.transtasmanicum with an apparently restricted distribution to some sites in the North Island, and the more widespread A.chilense. Here, we compared the distribution, genetic diversity, and structure of both Agarophyton species throughout the archipelago using sequences of the nuclear Internal Transcribed Spacer 2 (ITS2) marker. Agarophyton chilense’s distribution was continuous and extensive along the North and South Islands, Stewart Island, and Chatham Island, and the genetic clusters were mostly concordant with boundaries between biogeographic regions. In contrast, specimens of A.transtasmanicum were collected in four sites broadly distributed in both the North and South Islands, with no clear spatial structure of the genetic diversity. Populations, where the species co‐occurred, tended to display similar levels in genetic diversity for the two species. Demographic inferences supported a postglacial demographic expansion for two A.chilense genetic clusters, one present in the South Island and the eastern coast of the North Island, and the other present in northern South Island. A third genetic cluster located on the western coast of the North Island had a signature of long‐term demographic stability. For A.transtasmanicum, the skyline plot also suggested a postglacial demographic expansion. Last, we developed a new molecular tool to quickly and easily distinguish between the two Agarophyton species, which could be used to ease future fine‐scale population studies, especially in areas where the two species coexist.
Why should syntactic islands exist?
Authors: Asoulin Eran
Published: July 2020

Sentences that are ungrammatical and yet intelligible are instances of what I call perfectly thinkable thoughts. I argue that the existence of perfectly thinkable thoughts is revealing in regard to the question of why syntactic islands should exist. If language is an instrument of thought as understood in the biolinguistics tradition, then a uniquely human subset of thoughts is generated in narrow syntax, which suggests that island constraints cannot be rooted in narrow syntax alone and thus must reflect interface conditions imposed on the output of the computational system and its mapping to external systems.
tepR encoding a bacterial enhancer‐binding protein orchestrates the virulence and interspecies competition of Burkholderia glumae through qsmR and a type VI secretion system
Authors: Peng Jingyu , Lelis Tiago , Chen Ruoxi , Barphagha Inderjit , Osti Surendra , Ham Jong Hyun
Published: July 2020

The pathogenesis of the rice pathogenic bacterium Burkholderia glumae is under the tight regulation of the tofI/tofR quorum‐sensing (QS) system. tepR, encoding a group I bacterial enhancer‐binding protein, negatively regulates the production of toxoflavin, the phytotoxin acting as a major virulence factor in B. glumae. In this study, through a transcriptomic analysis, we identified the genes that were modulated by tepR and/or the tofI/tofR QS system. More than half of the differentially expressed genes, including the genes for the biosynthesis and transport of toxoflavin, were significantly more highly expressed in the ΔtepR mutant but less expressed in the ΔtofI‐tofR (tofI/tofR QS‐defective) mutant. In consonance with the transcriptome data, other virulence‐related functions of B. glumae, extracellular protease activity and flagellum‐dependent motility, were also negatively regulated by tepR, and this negative regulatory function of tepR was dependent on the IclR‐type transcriptional regulator gene qsmR. Likewise, the ΔtepR mutant exhibited a higher level of heat tolerance in congruence with the higher transcription levels of heat shock protein genes in the mutant. Interestingly, tepR also exhibited its positive regulatory function on a previously uncharacterized type VI secretion system (denoted as BgT6SS‐1). The survival of the both ΔtepR and ΔtssD (BgT6SS‐1‐defective) mutants was significantly compromised compared to the wild‐type parent strain 336gr‐1 in the presence of the natural rice‐inhabiting bacterium, Pantoea sp. RSPAM1. Taken together, this study revealed pivotal regulatory roles of tepR in orchestrating multiple biological functions of B. glumae, including pathogenesis, heat tolerance, and bacterial interspecies competition.
Achalasia subtypes can be identified with functional luminal imaging probe (FLIP) panometry using a supervised machine learning process
Authors: Carlson Dustin A. , Kou Wenjun , Rooney Katharine P. , Baumann Alexandra J. , Donnan Erica , Triggs Joseph R. , Teitelbaum Ezra N. , Holmstrom Amy , Hungness Eric , Sethi Sajiv , Kahrilas Peter J. , Pandolfino John E.
Published: July 2020

Background

Achalasia subtypes on high‐resolution manometry (HRM) prognosticate treatment response and help direct management plan. We aimed to utilize parameters of distension‐induced contractility and pressurization on functional luminal imaging probe (FLIP) panometry and machine learning to predict HRM achalasia subtypes.

Methods

One hundred eighty adult patients with treatment‐naïve achalasia defined by HRM per Chicago Classification (40 type I, 99 type II, 41 type III achalasia) who underwent FLIP panometry were included: 140 patients were used as the training cohort and 40 patients as the test cohort. FLIP panometry studies performed with 16‐cm FLIP assemblies were retrospectively analyzed to assess distensive pressure and distension‐induced esophageal contractility. Correlation analysis, single tree, and random forest were adopted to develop classification trees to identify achalasia subtypes.

Key Results

Intra‐balloon pressure at 60 mL fill volume, and proportions of patients with absent contractile response, repetitive retrograde contractile pattern, occluding contractions, sustained occluding contractions (SOC), contraction‐associated pressure changes >10 mm Hg all differed between HRM achalasia subtypes and were used to build the decision tree‐based classification model. The model identified spastic (type III) vs non‐spastic (types I and II) achalasia with 90% and 78% accuracy in the train and test cohorts, respectively. Achalasia subtypes I, II, and III were identified with 71% and 55% accuracy in the train and test cohorts, respectively.

Conclusions and Inferences

Using a supervised machine learning process, a preliminary model was developed that distinguished type III achalasia from non‐spastic achalasia with FLIP panometry. Further refinement of the measurements and more experience (data) may improve its ability for clinically relevant application.
White adipose tissue browning in critical illness: A review of the evidence, mechanisms and future perspectives
Authors: Alipoor Elham , Hosseinzadeh‐Attar Mohammad Javad , Rezaei Mahsa , Jazayeri Shima , Chapman Marianne
Published: July 2020

Observational studies suggest better clinical outcomes following critical illness in patients with overweight and obesity (obesity paradox). An understanding of the morphologic, physiologic and metabolic changes in adipose tissue in critical illness may provide an explanation. Recent studies have demonstrated the transformation of white to brown‐like adipocytes due to the “browning process,” which has been of interest as a potential novel therapy in obesity during the last decade. The characteristics of the browning of white adipose tissue (WAT) include the appearance of smaller, multilocular adipocytes, increased UCP1 mRNA expression, mitochondrial density and respiratory capacity. These changes have been identified in some critical illnesses, which specifically refers to burns, sepsis and cancer cachexia in this study. The pathophysiological nature of WAT browning, underlying mechanisms, main regulators and potential benefits and harms of this process are interesting new areas that warrants further investigations. In this review, we discuss emerging scientific discipline of adipose tissue physiology in metabolic stress, available data, gaps of knowledge and future perspectives. Future investigations in this field may provide insights into the underlying mechanisms and clinical aspects of browning that may further our understanding of the proposed obesity paradox following critical illness, which may in turn open up opportunities for novel therapies to save lives and improve recovery.