bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical features and patterns of psychopharmacological prescription in bipolar patients with vs without anxiety disorders at onset
Authors: Galimberti Cesare , Caricasole Valentina , Bosi Monica F. , Viganò Caterina A. , Ketter Terence A. , Dell'Osso Bernardo
Published: November 2019

Aim

Up to just over half of bipolar disorder (BD) patients report at least one‐lifetime anxiety disorder (AD). In some, anxiety represents the earliest psychiatric manifestation, prior to any mood episode. We sought to investigate prevalence of AD subtypes as first psychiatric manifestations and AD's relations with duration of untreated illness (DUI) and treatment among BD outpatients.

Methods

We recruited patients referred to the Centre for the Treatment of Depressive Disorders in Milan, diagnosed with BD‐I, BD‐II, BD not otherwise specified (BD‐NOS) and cyclothymia according to Diagnostic and Statistical Manual fourth edition‐text revision criteria. Several clinical characteristics were assessed through retrospective chart review and/or direct patient interviews. Based on presence/absence of an AD at psychiatric onset, eligible subjects were stratified into two groups (A+ and A−) and clinical features were compared between these groups and between BD subtypes.

Results

We analysed 260 BD patients (77 BD‐I, 122 BD‐II, 45 BD‐NOS and 16 cyclothymia). An AD was the first psychiatric manifestation in 69 patients (26.5%). BD‐II and BD‐NOS more frequently had an AD at psychiatric onset, with panic disorder being the most common AD. Among A+ vs A−, age at BD onset was younger, duration of untreated BD illness (DUI) was longer, and a mood stabilizer/antipsychotic was less often prescribed at psychiatric onset.

Conclusions

Considering BD in its longitudinal course, over one in four BD patients presenting with an AD at psychiatric onset belatedly access adequate treatment, with subsequent prolonged DUI and prospective worse outcome compared to patients with a mood episode at psychiatric onset.
The efficacy and safety of modified bortezomib‐lenalidomide‐dexamethasone in transplant‐eligible patients with newly diagnosed multiple myeloma
Authors: Okazuka Kiyoshi , Ishida Tadao , Nashimoto Junichiro , Uto Yui , Sato Kota , Miyazaki Kanji , Ogura Mizuki , Yoshiki Yumiko , Abe Yu , Tsukada Nobuhiro , Suzuki Kenshi
Published: November 2019

Objectives

Bortezomib with lenalidomide and dexamethasone (VRd) is a standard induction regimen for transplant‐eligible patients with newly diagnosed multiple myeloma (NDMM). However, some patients discontinue VRd because of severe adverse events, despite its high efficacy. We aimed to study the efficacy of modified dose of VRd (VRd lite) in transplant‐eligible patients with NDMM.

Methods

Forty‐eight transplant‐eligible patients with NDMM were included. VRd lite was administered every 4 weeks. Bortezomib 1.3 mg/m2 was administered subcutaneously on days 1, 8, 15 and 22, and dexamethasone 20 mg was administered orally on the day of and the day after bortezomib administration. Lenalidomide was omitted on days 1, 8 and 15, which are the days of bortezomib administration.

Results

The overall response rate (ORR) after four cycles of VRd lite was 83%, including a complete response of 25%. Thirty‐eight among the 45 patients who completed at least four cycles of VRd lite received autologous stem cell transplantation (ASCT). The ORR and very good partial response or better were upgraded to 100% and 74%, respectively, following ASCT.

Conclusion

Our strategy consisting of VRd lite followed by ASCT is, thus, a highly effective and well‐tolerated regimen resulting in durable responses in patients with NDMM.
HIV‐1 inhibits haematopoiesis via microRNA secreted by virus‐infected CD4+ T cells
Authors: Padmanabhan Usha , Dahake Ritwik , Chowdhary Abhay S. , Koka Prasad S.
Published: November 2019

Introduction

HIV‐1‐infected patients develop haematological disorders such as cytopenias. One possible explanation is the inhibition of haematopoiesis at the level of differentiation of CD34+ haematopoietic progenitor stem cells. Based on our previous studies, we hypothesised that there may be viral encoded, or host cellular factors which participate in the process of inhibition of haematopoiesis.

Materials and Methods

Virus‐depleted media from infected CD4+ T cells was prepared by filtration and added to CD34+ cell differentiation semisolid medium. We have also used the virus‐depleted media to isolate host/viral factors including miRNA. Isolated miRNAs were screened for their haematopoietic inhibitory function using the miRNA mining approach.

Results

Addition of virus‐depleted media caused a 40% inhibition of differentiation of CD34+ cells into myeloid and erythroid colony formation. Real‐time RT‐PCR showed miR‐15a and miR‐24 from both pIndie‐C1 and pNL4.3 HIV‐1‐infected cells showed a significant differential expression when compared to control media.

Conclusion

In this study, we have identified two miRNAs, miR‐15a and miR‐24 secreted from purified HIV‐1‐infected CD4+ T cells that inhibited CD34+ haematopoietic progenitor stem cell differentiation into myeloid and erythroid colonies in vitro.
Generalized 3D high cycle fatigue criteria for multiscale bridging‐based progressive damage analysis of multilayer composite parts under random loads and material deterioration
Authors: Shariyat Mohammad , Rahimi‐Ghozat Mahsa
Published: November 2019

Two frameworks are employed to develop two distinct categories of multiaxial high cycle fatigue life assessment models for composite components experiencing general and random loading conditions. In this regard, the decay in the material properties with cycles is also taken into account. It is obvious that in multilayer components, the fatigue failure is a progressive process that may be accompanied by gradual or sudden changes in the material properties and, consequently, the resulting stresses. In addition to using the traditional progressive damage analyses, a new concept is proposed for tracing of the localized fatigue failures more accurately. It is postulated that generally, the stress components have distinct frequencies, phase shifts, and mean values that all vary with time in a random manner. The proposed fatigue criteria, especially, the equivalent‐stress–based ones, are capable of predicting various fatigue failure modes, such as the fibre breakage, matrix cracking, and interfacial debonding. A special and comprehensive fatigue failure tracking and cycle counting algorithms that are capable of handling the mentioned general peculiarities are proposed. The proposed HCF criteria and the relevant fatigue life assessment algorithm are then implemented on a composite multilayer mono‐leaf spring of a realistic vehicle under a random field‐measured loading condition, as a typical component, and the results are compared and the experimental results conducted by the authors, for accuracy investigations. The considered stochastic road inputs have been chosen on the basis of the consumption times and field measurements.
Lakes as nitrous oxide sources in the boreal landscape
Authors: Kortelainen Pirkko , Larmola Tuula , Rantakari Miitta , Juutinen Sari , Alm Jukka , Martikainen Pertti J.
Published: November 2019

Estimates of regional and global freshwater N2O emissions have remained inaccurate due to scarce data and complexity of the multiple processes driving N2O fluxes the focus predominantly being on summer time measurements from emission hot spots, agricultural streams. Here, we present four‐season data of N2O concentrations in the water columns of randomly selected boreal lakes covering a large variation in latitude, lake type, area, depth, water chemistry, and land use cover. Nitrate was the key driver for N2O dynamics, explaining as much as 78% of the variation of the seasonal mean N2O concentrations across all lakes. Nitrate concentrations varied among seasons being highest in winter and lowest in summer. Of the surface water samples, 71% were oversaturated with N2O relative to the atmosphere. Largest oversaturation was measured in winter and lowest in summer stressing the importance to include full year N2O measurements in annual emission estimates. Including winter data resulted in fourfold annual N2O emission estimates compared to summer only measurements. Nutrient‐rich calcareous and large humic lakes had the highest annual N2O emissions. Our emission estimates for Finnish and boreal lakes are 0.6 and 29 Gg N2O‐N/year, respectively. The global warming potential of N2O from lakes cannot be neglected in the boreal landscape, being 35% of that of diffusive CH4 emission in Finnish lakes.
Molecular signature of hepatitis B virus regulation by interferon‐γ in primary human hepatocytes
Authors: Nosaka Takuto , Naito Tatsushi , Matsuda Hidetaka , Ohtani Masahiro , Hiramatsu Katsushi , Nemoto Tomoyuki , Nishizawa Tsutomu , Okamoto Hiroaki , Nakamoto Yasunari
Published: November 2019

Aim

A complete cure for chronic hepatitis B virus (HBV) infection requires elimination of covalently closed circular DNA; however, this remains to be clinically achieved. Interferon (IFN)‐γ, a type II IFN, is produced by intrahepatic cytotoxic T lymphocytes and has non‐cytolytic antiviral potential. However, the mechanism by which IFN‐γ regulates HBV infection has not been fully elucidated. Thus, we developed an in vitro HBV infection assay system and analyzed the molecular signature of HBV regulation by IFN‐γ.

Methods

The in vitro HBV infection assay system was established in primary human hepatocytes infected with HBV derived from the plasmid containing 1.3‐mer HBV genome, and treated with IFN‐γ. The antiviral effects and signaling pathways of IFN‐γ were examined using microarray, and assessed by siRNA knockdown experiments of the related genes.

Results

IFN‐γ treatment suppressed both HBV propagation and transcription as efficiently as IFN‐α. Microarray analysis showed that IFN‐γ stimulation induced the activation of both IFN‐γ and IFN‐α signaling, regulating HBV covalently closed circular DNA. HBV production was decreased by IFN‐γ through Janus kinase/signal transducer and activator of transcription signaling and interferon‐stimulated genes, such as 2′‐5′‐oligoadenylate synthase 2 and apolipoprotein B mRNA editing enzyme catalytic subunit 3G.

Conclusions

IFN‐γ can suppress HBV propagation and transcription in hepatocytes by activating specific intracellular signaling pathways in hepatocytes, and suggests the future application of these particular signaling pathways or genes for the complete elimination of HBV.
Replacing K‐feldspar with a siliceous solid by‐product of zeolite industry for medium‐temperature calcium matte glazes
Authors: Lu Xilong , Cheng Kemu , Cao Chun‐e , Chen Yunxia , Shi Wei , Wang Peng
Published: November 2019

To recycle a multicomponent siliceous solid waste (MSW), a by‐product of the zeolite industry, as a K‐feldspar substitute for the preparation of medium temperature calcium matte glazes, the chemical composition, phase evolution, and thermal behavior of the waste versus temperature were characterized using multiple techniques. Based on the TG‐DTA results, the waste was thermal treated at an optimum temperature of 1200°C prior to glaze preparation. Then, the calcined MSW was substituted for various amounts of K‐feldspar and calcium matte glazes were prepared that produced high‐quality smooth surfaces with a velvety appearance after firing at 1200°C. The results indicate that the matting effects originate from the scattering of the incident light by densely populated columnar wollastonite crystals embedded in the glazes with the b‐axis parallel to the glaze layer, which facilitates the well‐resolved Raman peaks of the calcium matte glazes.
“Gene” modeling approach to new glass design
Authors: Zhang Liyan , Xu Yongchun , Li Hong
Published: November 2019

Composition‐structure‐property (C‐S‐P) approach, named as “glass structural gene modeling (GSgM), for glass database development and new glass design are detailed in this article. C‐S‐P modeling principle and modeling procedure are selectively demonstrated using two sets of phosphate glass systems with various modifications by SiO2, B2O3, and La2O3. Finally, new glass design and a selective validation of the glass design are provided. The use of S‐P modeling approach, especially for single‐component studies of glass property responses in a highly nonlinear fashion, transforms one dimensional C‐P problem solving to modeling of multidimensional response space of the glass network structural groups or genes. The spectroscopically derived structural groups aided by statistical screening for significance result in better problem solving capability in the S‐P models as compared with C‐P models.
Stability of the Y2O3–SiO2 system in high‐temperature, high‐velocity water vapor
Authors: Parker Cory G. , Opila Elizabeth J.
Published: November 2019

High‐temperature, high‐velocity water vapor (steam‐jet) exposures were conducted on Y2O3, Y2SiO5, Y2Si2O7, and SiO2 for 60 hours at 1400°C. Volatility of Y2O3 was not observed. Phase‐pure Y2SiO5 exhibited SiO2 loss forming Y2O3 and porosity. A mixed porous and dense Y2SiO5 layer formed on the surface of Y2Si2O7 due to SiO2 depletion. The mechanisms and kinetics of the reaction between SiO2 and H2O(g) to form Si(OH)4(g) from Y2SiO5, Y2Si2O7, and SiO2 are discussed.
Descriptive study of naevus involution in a series of 74 patients with atypical naevus syndrome under SIAscopy digital follow‐up
Authors: Moreno S. , Maiques O. , Gatius S. , Veà A. , Barrera J. , Barcelo C. , Santacana M. , Soria X. , Matias‐Guiu X. , Martí R.M.
Published: November 2019

Background

Characterization of nevi involution could help to understand the biological behaviour of melanocytic neoplasms.

Objective

To describe the frequency and morphology of naevus involution in a series of patients with atypical naevus syndrome under digital follow‐up with a SIAscopy program and, in a small sample of fading nevi, to analyse histopathological features and immunohistochemical biomarkers.

Methods

Seventy‐four patients registered from April 2007 to July 2014 in the SIAscopy system of the Department of Dermatology of Hospital Arnau de Vilanova of Lleida, Spain, were reviewed. Fourteen naevus cases with fading features were prospectively excised during follow‐up. Eleven already excised naevus controls were randomly selected from our archive.

Results

We observed that 81% of patients showed, at least, one involutive naevus and 25% of recorded nevi presented this phenomenon; the mean time of involution was 46.7 months. The predominant structural pattern was reticular (>70%), and the most frequently observed regression structures were vascular (33.8%). Histopathological significant higher intensity of inflammatory infiltrate in controls and higher presence of laminar and compact fibrosis and increase of vessels in cases were demonstrated. Regarding immunohistochemical biomarkers, only higher expression of cytoplasmic activated caspase 3 in controls was significant.

Conclusions

Naevus involution is a common phenomenon in patients with dysplastic naevus syndrome. It is usually a slow process, more frequent in naevus with reticular pattern. SIAscopy regression structures are uncommon, with the exception of vascular ones. Histologically, fading involutive pattern is characterized by scarce inflammatory infiltrate and melanophages, delicate fibrosis and increase of vessels.
Evaluation of digital staining for ex vivo confocal laser scanning microscopy
Authors: Schüürmann M. , Stecher M.M. , Paasch U. , Simon J.C. , Grunewald S.
Published: November 2019

Background

Ex vivo confocal laser scanning microscopy (CLSM) is a novel diagnostic tool for the fast examination of native tissue. However, CLSM produces black/white/green images, depending on the refraction indices of the tissue structures, complemented by nuclear fluorescence staining, which the vast majority of Mohs surgeons and dermatopathologists are not trained to interpret. Digital staining is applicable to ex vivo CLSM investigations to simulate the images of conventional slides stained with haematoxylin and eosin (H&E).

Objectives

The aim of our study was to evaluate in detail the appearance of human skin structures using digitally stained ex vivo CLSM images and compare the results to that of conventional H&E slides of the same specimen.

Methods

After providing informed consent, 26 patients donated their Burow's triangles (healthy skin) that resulted from plastic reconstruction after the R0 excision of skin tumours. After being investigated by ex vivo CLSM, including automated digital staining (VivaScope 2500M‐4G, MAVIG GmbH), the specimens were fixed in formalin, embedded in paraffin and stained with H&E.

Results

Almost all skin structures in the digitally stained ex vivo CLSM images morphologically resembled the structures in the histopathological images acquired from H&E slides. Due to the high refraction index of melanin, the hair shafts appeared bright pink, and the melanocytes and melanophages were poorly imaged, resulting in a strong pink appearance that vastly differed from the appearance of conventional H&E‐stained histopathology.

Conclusions

Digital staining of ex vivo CLSM images is an easy and highly useful tool to facilitate the interpretation of black‐field images generated by confocal laser scanning microscopy for dermatopathologists and Mohs surgeons who are familiar with H&E staining. Unlike the pigmented structures, the cutaneous and subcutaneous structures had excellent visualization with only minimal differences from their appearance on H&E slides.
Recurrent eczema herpeticum – a retrospective European multicenter study evaluating the clinical characteristics of eczema herpeticum cases in atopic dermatitis patients
Authors: Seegräber M. , Worm M. , Werfel T. , Svensson A. , Novak N. , Simon D. , Darsow U. , Augustin M. , Wollenberg A.
Published: November 2019

Background

Eczema herpeticum (EH) is a disseminated viral infection of eczematous skin disease with the herpes simplex virus. Knowledge on clinical characteristics, risk factors and recurrent disease is limited. Our aim was to better define clinical characteristics and risk factors for EH and especially for recurrent EH.

Methods

A retrospective analysis of EH cases assessed the history, clinical signs, prior treatment and laboratory results using a predefined questionnaire.

Results

A total of 224 EH cases from eight European centres were included. Extrinsic AD was identified as risk factor for EH, and only one patient suffered from intrinsic AD. Early onset of AD was identified as risk factor for recurrent EH. Pretreatment with topical steroids, systemic steroids, topical calcineurin inhibitors or plain emollients reflected standard therapy. Many patients showed AD lesions without EH, but skin without AD lesions was never affected by herpetic lesions.

Conclusion

Patients with clinically active, extrinsic AD are at risk of EH. Recurrent EH is associated with confounders of severe atopic distortion and requires active AD lesions for clinical manifestation. Recurrent eczema herpeticum mainly affects patients with early onset of AD.
Enhanced Youden's index with net benefit: A feasible approach for optimal‐threshold determination in shared decision making
Authors: Lin Senlin , Ma Yingyan , Zou Haidong
Published: November 2019

Objectives

To establish an enhanced Youden's index with net benefit, as a scientific method for optimal‐threshold determination in shared decision making.

Method

We redefined the Youden's index by changing the target function from the maximization of accuracy to the maximization of net benefit and established the process for pursuing the patient's individual optimal‐threshold. In addition, we illustrated how the enhanced Youden's index works with an example of cataract operation decision making using the data from Shanghai, China.

Results

We modified the method of calculating net benefit in decision curve analysis and fused it with Youden's index to expand the purpose from finding a threshold with the best test accuracy to finding one with the best net benefit. As an example, we used the enhanced Youden's index to establish an optimal‐thresholds list for cataract operation decision making. Then, we calculated three imaginary patients’ respective thresholds after integrating the local recovery rate, their visual activities, and individual preferences. The results demonstrated that the thresholds of patients with the same objective examination results might vary widely due to their individual preferences. Therefore, the thresholds are more individualized according to the enhanced Youden's index.

Conclusion

The enhanced Youden's index can establish the optimal‐thresholds from the perspective of maximization of patients' net benefit and provide a quantifiable method for shared decision making.
Relative importance of clinical and sociodemographic factors in association with post‐operative in‐hospital deaths in colorectal cancer patients in New South Wales: An artificial neural network approach
Authors: Sha Sha , Du Wei , Parkinson Anne , Glasgow Nicholas
Published: November 2019

Rationale, Aims and Objectives

Co‐morbidities in colorectal cancer patients complicate hospital care, and their relative importance to post‐operative deaths is largely unknown. This study was conducted to examine a range of clinical and sociodemographic factors in relation to post‐operative in‐hospital deaths in colorectal cancer patients and identify whether these contributions would vary by severity of co‐morbidities.

Methods

In this multicentre retrospective cohort study, we used the complete census of New South Wales inpatient data to select colorectal cancer patients admitted to public hospitals for acute surgical care, who underwent procedures on the digestive system during the period of July 2001 to June 2014. The primary outcome was in‐hospital death at the end of acute care. Multilayer perceptron and back‐propagation artificial neural networks (ANNs) were used to quantify the relative importance of a wide range of clinical and sociodemographic factors in relation to post‐operative deaths, stratified by severity of co‐morbidities based on Charlson co‐morbidity index.

Results

Of 6288 colorectal cancer patients, approximately 58.3% (n = 3669) had moderate to severe co‐morbidities. A total of 464 (7.4%) died in hospitals. The performance for ANN models was superior to logistic models. Co‐morbid musculoskeletal and mental disorders, adverse events in health care, and socio‐economic factors including rural residence and private insurance status contributed to post‐operative deaths in hospitals.

Conclusion

Identification of relative importance of factors contributing to in‐hospital deaths in colorectal cancer patients using ANN may help to enhance patient‐centred strategies to meet complex needs during acute surgical care and prevent post‐operative in‐hospital deaths.
Cumulative evidence for the relationship between body mass index and the risk of esophageal cancer: An updated meta‐analysis with evidence from 25 observational studies
Authors: Tian Jie , Zuo Chunjian , Liu Guanchu , Che Pengyu , Li Gang , Li Xiang , Chen Huanwen
Published: November 2019

Background and Aim

A large number of papers reporting the relationships between body mass index (BMI) and esophageal cancer (EC) risk have been published in the past few decades; however, these results are inconsistent. Therefore, we carried out meta‐analyses to explore the relationships between BMI and the risk of EC (including esophageal squamous cell carcinoma [ESCC] and esophageal adenocarcinoma [EADC]).

Methods

We used the Web of Science, PubMed, and Embase to identify all published/online articles before December 30, 2018, which yielded 25 articles eligible for data extraction (including 16,561 cases and 11,954,161 controls), and then pooled the relative risks (RRs) and corresponding 95% confidence intervals (CIs) using random‐effects model.

Results

Our study presented that underweight had statistically significant association with the risk of EC (RR = 1.78, 95% CI = 1.48, 2.14, P < 0.001) and ESCC (RR = 1.57, 95% CI = 1.20, 2.06, P = 0.001) when compared with normal weight. Interestingly, both overweight and obesity could increase the risk of EADC (RR = 1.56, 95% CI = 1.42, 1.71, P < 0.001; RR = 2.34, 95% CI = 2.02, 2.70, P < 0.001) while decrease the risk of ESCC (RR = 0.71, 95% CI = 0.60, 0.84, P < 0.001; RR = 0.63, 95% CI = 0.60, 0.84, P = 0.002). Additionally, obesity could increase the risk of EC (RR = 1.51, 95% CI = 1.21, 1.89, P < 0.001).

Conclusion

These meta‐analyses provide a comprehensive and updated epidemiological evidence to confirm the associations between BMI and EC risk. These findings have public health implications with respect to better control bodyweight and then reduce the occurrence of EC (including ESCC and EADC).
How people with dementia perceive a therapeutic robot called PARO in relation to their pain and mood: A qualitative study
Authors: Pu Lihui , Moyle Wendy , Jones Cindy
Published: November 2019

Background

Interacting with social robots, such as the robotic seal PARO, has been shown to improve mood and acute pain for people with dementia. Little attention has been paid to the effect of PARO on people with dementia and chronic pain.

Objective

To explore how people with mild to moderate dementia and chronic pain perceive PARO as an alternative intervention to manage their pain and mood.

Design

A descriptive qualitative approach nested within a pilot randomised controlled trial.

Methods

Participants with dementia and chronic pain were recruited from three residential aged care facilities. They interacted with PARO for 30 min, 5 days a week over a 6‐week period. A sample of 11 participants completed individual semi‐structured interviews at the end of the intervention. Data were collected from January 2018–January 2019. Inductive thematic analysis was undertaken. Reporting of findings followed the COREQ checklist.

Results

Four themes emerged from the data: (a) perceptions of PARO; (b) therapeutic effects of PARO; (c) limitations of PARO; and (d) programme improvement. Residents with dementia expressed positive attitudes towards the use of PARO and acknowledged the therapeutic benefits of PARO on mood improvement and relaxation for pain relief but also mentioned the limitations of its weight, voice and characteristics. Residents' responses could also fluctuate during the intervention process, and individual preferences need to be considered.

Conclusions

The PARO intervention is a promising intervention to improve positive emotion, and there is some anecdotal evidence that pain may be decreased from the perspectives of people living with chronic pain and dementia.

Relevance to clinical practice

Long‐term care staff may incorporate PARO therapy into daily dementia care. Understanding of individual's preferences may enhance the implementation of PARO for pain management in this group.
Prognostic significance of venous invasion in node‐negative head and neck squamous cell carcinoma
Authors: Gopinath Arun , Mubeen Aysha , Baskovich Brett , Mohammed Ibraheem , Makary Raafat , Hoy Erica S. , Dagan Roi , Smotherman Carmen , Gautam Shiva , Fernandes Rui P. , Bunnell Anthony M. , Pirgousis Phillip , Alkhasawneh Ahmad
Published: November 2019

Background

Venous invasion (VI) is not frequently evaluated on routine histologic examination of head and neck squamous cell carcinoma (HNSCC), and the prognostic significance is largely unknown. Studies have shown that extramural venous invasion is an adverse prognostic factor in colorectal carcinoma. To our knowledge, this is the first study evaluating the prognostic significance of venous invasion in node‐negative (without clinical or pathologic evidence of lymph node involvement) HNSCC, utilizing the elastic stain.

Methods

A total of 105 consecutive lymph node‐negative (N0) HNSCC were evaluated for the presence of venous channel invasion by tumor utilizing the elastin stain. Clinical, demographic, and follow‐up data were recorded.

Results

Of 37 patients with venous invasion, 19% had loco‐regional recurrence, as opposed to 12% of those without. Univariate analysis revealed statistically significant decreased recurrence‐free survival in the presence of venous invasion (log‐rank [Mantel‐Cox] test P‐value .025).

Conclusion

Identification of VI is greatly aided by elastic stain. In patients with node‐negative HNSCC, presence of VI resulted in decreased recurrence‐free survival on univariate analysis. The impact of VI as a prognostic marker should be further evaluated.
The effect of fly maggot in pig feeding diets on growth performance and gut microbial balance in Ningxiang pigs
Authors: Li Biao , Zeng Qinghua , Song Yukun , Gao Zhendong , Jiang Liang , Ma Haiming , He Jun
Published: November 2019

Fly maggot meal has been regarded as one of the substitutes of fish meal and soybean meal in pig feed. However, its effects on pig growth performance and faecal micro‐organism remain unclear. The purpose of this study was to investigate the effect of dietary fly maggot meal on fattening performance, plasma indices related to gut hormones, immunity and faecal microbial communities composition of finishing pigs. A total of 40 Ningxiang fattening pigs were randomly allocated to two dietary treatments and pigs in each group were arranged by control group (CK) diet or 8% maggot meal group (MMG) diet for 45 days respectively. Growth performance, indices of gut hormones and immunity in plasma were evaluated. Microbiota composition in faeces was determined using 16S rDNA Amplicon Sequencing. The results showed that dietary MMG did not affect gut hormones and immune proteins in the trial compared with CK group (p > .05). However, dietary MMG significantly increased average daily gain (ADG). The population of the Firmicutes in MMG treatment was increased, while the percentage of the Bacteroidetes was decreased (p < .05). In particular, the number of Clostridiales related to hydrolyzed sugar and protein were increased (p < .05). It can inhibit the growth of harmful intestinal bacteria, promote the proliferation of beneficial bacteria and effectively improve the ability of digestion and absorption of nutrients. In conclusion, a diet containing 8% MMG changed the proportion of intestinal micro‐organisms in finishing pigs, especially the higher richness of Firmicutes, and promoted the fattening ability of pigs to a certain extent. These changes should benefit finishing pig production during fattening period.
Control of the bifunctional O2‐sensor kinase NreB of Staphylococcus carnosus by the nitrate sensor NreA: Switching from kinase to phosphatase state
Authors: Klein Robin , Kretzschmar Ann‐Katrin , Unden Gottfried
Published: November 2019

The NreB–NreC two‐component system of Staphylococcus carnosus for O2 sensing cooperates with the accessory nitrate sensor NreA in the NreA–NreB–NreC system for coordinated sensing and regulation of nitrate respiration by O2 and nitrate. ApoNreA (NreA in the absence of nitrate) interacts with NreB and inhibits NreB autophosphorylation (and activation). NreB contains the phosphatase motif DxxxQ. The present study shows that NreB on its own was inactive for the dephosphorylation of the phosphorylated response regulator NreC (NreC‐P), but co‐incubation with NreB and NreA stimulated NreC‐P dephosphorylation. Either the presence of instead of apoNreA or mutation of the phosphatase motif (D160 or Q164) of NreB abrogated phosphatase activity of NreB. Phosphatase activity was observed for anoxic (active) NreB as well as oxic NreB, therefore the functional state of NreB is not relevant for phosphatase activity. Thus, NreB is a bifunctional sensor kinase with an integral cryptic phosphatase activity. Activation of phosphatase activity and dephosphorylation of NreC‐P requires NreA as a cofactor. Accordingly, NreA and nitrate have major and dual roles in NreA–NreB–NreC regulation by (i) inhibiting NreB phosphorylation and (ii) triggering a kinase/phosphatase switch of NreB when present as apoNreA.
Difficulty envisioning a positive future: Secondary analyses in patients in intensive care who are communication vulnerable
Authors: Koszalinski Rebecca S. , Heidel R. Eric , McCarthy Jillian
Published: November 2019

The purpose of this study was to report a secondary analysis of data collected through a primary study. The primary study was a, randomized, control trial that used a team‐designed (nursing, speech language hearing, engineering, communication sciences, and biostatistics), nurse‐led, electronic communication intervention (Speak for Myself Voice) and measured patient outcomes of symptoms of anxiety and depression in five intensive care units at a regional, magnet‐status, academic medical center. A secondary analysis of data using the Hospital Anxiety and Depression scale is reported here. The extant literature supports patient expressions of frustration, anger, anxiety, and depression when unable to communicate. This secondary analysis study report adds information about Hospital Anxiety and Depression subscales in the communication‐vulnerable population. Implications include emerging awareness of potential feelings of depression and anxiety in patients who are receiving mechanical ventilation or who are unable to verbally communicate for any reason (e.g. obstruction, trauma, head and neck cancer) in the intensive care unit.
Correlated evolution of morphology, gas exchange, growth rates and hydraulics as a response to precipitation and temperature regimes in oaks (Quercus)
Authors: Ramírez‐Valiente José Alberto , López Rosana , Hipp Andrew L. , Aranda Ismael
Published: November 2019

It is hypothesised that tree distributions in Europe are largely limited by their ability to cope with the summer drought imposed by the Mediterranean climate in the southern areas and by their competitive potential in central regions with more mesic conditions.

We investigated the extent to which leaf and plant morphology, gas exchange, leaf and stem hydraulics and growth rates have evolved in a coordinated way in oaks (Quercus) as a result of adaptation to contrasting environmental conditions in this region. We implemented an experiment in which seedlings of 12 European/North African oaks were grown under two watering treatments, a well‐watered treatment and a drought treatment in which plants were subjected to three cycles of drought.

Consistent with our hypothesis, species from drier summers had traits conferring more tolerance to drought such as small sclerophyllous leaves and lower percent loss of hydraulic conductivity. However, these species did not have lower growth rates as expected by a trade‐off with drought tolerance.

Overall, our results revealed that climate is an important driver of functional strategies in oaks and that traits have evolved along two coordinated functional axes to adapt to different precipitation and temperature regimes.
Metabolic engineering of rice endosperm for betanin biosynthesis
Authors: Tian Yong‐Sheng , Fu Xiao‐Yan , Yang Zun‐Qiu , Wang Bo , Gao Jian‐Jie , Wang Ming‐Qing , Xu Jing , Han Hong‐Juan , Li Zhen‐Jun , Yao Quan‐Hong , Peng Ri‐He
Published: November 2019

Betanin has been widely used as an additive for many centuries, and its use has increased because of its market application as an additive, high free radical scavenging activity, and safety, health‐promoting properties.

The main source of betanin is red beet, but many factors notably affect the yield of betanin from red beets. Betanin is not produced in cereal grains. Thus, developing biofortified crops with betanin is another alternative to health‐promoting food additives.

Here, rice endosperm was bioengineered for betanin biosynthesis by introducing three synthetic genes (meloS, BvDODA1S, and BvCYP76AD1S). The overexpression of these genes driven by rice endosperm‐specific promoter established the betanin biosynthetic pathways in the endosperm, resulting in new types of germplasm – ‘Betanin Rice’ (BR). The BR grains were enriched with betanin and had relatively high antioxidant activity.

Our results proved that betanin can be biosynthesized de novo in rice endosperm by introducing three genes in the committed betanin biosynthetic pathway. The betanin‐fortified rice in this study can be used as a functional grain to promote health and as a raw material to process dietary supplements.
Energy and sugar signaling during hypoxia
Authors: Cho Hsing‐Yi , Loreti Elena , Shih Ming‐Che , Perata Pierdomenico
Published: November 2019

The major consequence of hypoxia is a dramatic reduction in energy production. At the onset of hypoxia, both oxygen and ATP availability decrease. Oxygen and energy sensing therefore converge to induce an adaptive response at both the transcriptional and translational levels. Oxygen sensing results in stabilization of the transcription factors that activate hypoxia‐response genes, including enzymes required for efficient sugar metabolism, allowing plants to produce enough energy to ensure survival. The translation of the resulting mRNAs is mediated by SnRK1, acting as an energy sensor. However, as soon as the sugar availability decreases, a homeostatic mechanism, detecting sugar starvation, dampens the hypoxia‐dependent transcription to reduce energy consumption and preserves carbon reserves for regrowth when oxygen availability is restored.
Regional Injury Classification and Treatment of Open Pelvic Fractures
Authors: Wang Zheng‐hao , Li Kai‐nan
Published: November 2019

Objectives

To propose the regional injury classification of open pelvic fracture and summarize the characteristics of its treatment.

Methods

Clinical data for 67 open pelvic fractures treated from January 2001 to December 2017 were retrospectively analyzed. There were 48 male and 19 female patients. The patients were aged from 12 to 68 years old, and their pelvic fractures were categorized according to Tile classification (type A: 23 cases; type B: 19 cases; type C: 25 cases). Main injury distribution: pubic perineum, 29 cases; ilioinguinal, 20 cases; and sacroiliac, 7 cases. There were 5 cases of ilioinguinal‐perineum and 6 cases of sacroiliac‐perineum injury. Based on the region of the injury, the mortality and combined injury of each group were observed. The relationship between regional injury groups and death was examined.

Results

Following active treatment, 28 patients died. The mortality rate was 41.8% (28/67), with 39 patients surviving. The average follow‐up time was 6 months (3 months to 1 year after discharge). Majeed pelvic fracture score: the score was excellent in 12 cases, good in 14 cases, fair in 9 cases, and poor in 4 cases; there was an excellent and good rate of 66.7%. Open pelvic fracture regional injury classification includes: the perineal type (type I); the ilioinguinal type (type II); the sacroiliac type (type III); and the composite type (type IV). All types were independent of each other, and the mortality of open pelvic fractures was positively correlated with this classification, with a correlation coefficient of 0.620 (P = 0.001 < 0.05; the difference was statistically significant). In this study, cystourethral injury, anorectal injury, and infection were the main combined injuries of type I. The type II and III injuries were mainly iliac vascular injuries. The main combined injuries of type IV were infection, injury of ilium vessels and its branches. There was a statistical difference among the combined injuries of each subtype (P = 0.001 < 0.05).

Conclusions

The criteria for regional classification were clear, the mortality of the four subtypes increased gradually, and the incidence of combined injury of each subtype varied. Each subtype had different therapeutic characteristics.
Evolving pediatric epidural practice: An institution's clinical experience over 20 years—A retrospective observational cohort study
Authors: Gupta Akhil , Jay Matthew A. , Williams Glyn
Published: November 2019

Background and Objectives

Epidural analgesia is an effective, established perioperative intervention in all age‐groups. In children, however, epidural‐related data are limited compared to the adult population. The aim of this study was to examine the use of pediatric epidural analgesia in our institution and, thereby, add to the existing data pool.

Methodology

Patients who received epidural analgesia as part of their perioperative management between 1996 and 2016 at Great Ormond Street Hospital, London, UK, were studied to determine how epidural practice has changed over time, associated incidence of serious adverse events, complications, and patient/parent satisfaction. Epidural use and monitoring were in accordance with standard hospital protocols. Data were prospectively collected and entered into a secure database by trained personnel. These data were subsequently extracted for retrospective analysis.

Results

A total of 3876 patients were included. The median age was 4.4 years (range 1 day to 20 years), and the median weight was 20.3 kg. Across all age‐groups, the lumbar region was the most common site of epidural insertion while urology (42.2%) and general surgery (37.3%) were the specialities for which it was most utilized. Over the study period, the number of epidurals performed declined while the number of surgical procedures performed simultaneously increased. The infusate most commonly used was local anesthetic with preservative‐free morphine (71.9%). In 923 (23.2%) patients, systemic opioids were additionally used for analgesic management by means of patient‐controlled analgesia or nurse‐controlled analgesia. There was one serious adverse event in the form of permanent nerve injury, giving an overall incidence of approximately 1:3800. Other complications included postoperative nausea and vomiting (35.9%), urinary retention (4.4%), and pruritus (31%). Overall global satisfaction with the service was generally high, with 95% providing a rating of “very good” or “good.”

Conclusion

This study evaluated two decades of epidural practice in our institution. Epidural analgesia remains a safe, effective option for postoperative analgesia, but its use has declined over time, and this trend is likely to continue. Rates of serious adverse events and complications were low and comparable to those published in other similar studies. Global satisfaction among patients/parents remains high.
The 18O‐signal transfer from water vapour to leaf water and assimilates varies among plant species and growth forms
Authors: Lehmann Marco M. , Goldsmith Gregory R. , Mirande‐Ney Cathleen , Weigt Rosemarie B. , Schönbeck Leonie , Kahmen Ansgar , Gessler Arthur , Siegwolf Rolf T.W. , Saurer Matthias
Published: November 2019

The 18O signature of atmospheric water vapour (δ18OV) is known to be transferred via leaf water to assimilates. It remains, however, unclear how the 18O‐signal transfer differs among plant species and growth forms. We performed a 9‐hr greenhouse fog experiment (relative humidity ≥ 98%) with 18O‐depleted water vapour (−106.7‰) on 140 plant species of eight different growth forms during daytime. We quantified the 18O‐signal transfer by calculating the mean residence time of O in leaf water (MRTLW) and sugars (MRTSugars) and related it to leaf traits and physiological drivers. MRTLW increased with leaf succulence and thickness, varying between 1.4 and 10.8 hr. MRTSugars was shorter in C3 and C4 plants than in crassulacean acid metabolism (CAM) plants and highly variable among species and growth forms; MRTSugars was shortest for grasses and aquatic plants, intermediate for broadleaf trees, shrubs, and herbs, and longest for conifers, epiphytes, and succulents. Sucrose was more sensitive to δ18OV variations than other assimilates. Our comprehensive study shows that plant species and growth forms vary strongly in their sensitivity to δ18OV variations, which is important for the interpretation of δ18O values in plant organic material and compounds and thus for the reconstruction of climatic conditions and plant functional responses.
Cross comparison of seminal plasma proteins from cattle and buffalo (Bubalus bubalis)
Authors: Codognoto Viviane Maria , Yamada Paulo Henrique , Schmith Rúbia Alves , Rydygier de Ruediger Felipe , de Paula Freitas‐Dell’Aqua Camila , de Souza Fabiana Ferreira , Brochine Suzane , do Carmo Lucas Monteiro , Vieira Andressa Filaz , Oba Eunice
Published: November 2019

The objective of this study was to evaluate seminal plasma proteins from cattle and buffalo (Bubalus bubalis), to identify differences between related species. Sixteen buffaloes and 16 cattle between 30 and 60 months of age were used. Semen collection was performed by electroejaculation, followed by macroscopic and microscopic subjective analyses. After analysis, the samples were centrifuged at 800 g for 10 min, and the supernatant (seminal plasma) was recentrifuged at 10,000 g for 30 min at 4°C. The total protein concentration was determined by the Bradford method, and the proteins were digested in solution for mass spectrometry (nLC‐MS/MS). Multivariate statistical analysis was used to evaluate the proteomics results by non‐hierarchical clustering the considering exponentially modified protein abundance index (emPAI). Principal component analysis (PCA) and partial least squares discriminant analysis (PLS‐DA) were used for clustering. Proteomics identified 78 proteins, and multivariate analysis showed 4 that were over‐expressed in buffaloes (cystatin C, prosaposin, peptide YY and keratin type II cytoskeletal 5) and 9 in cattle (spermadhesin‐1, seminal plasma protein PDC‐109, ribonuclease 4, metalloproteinase inhibitor 2, acrosin inhibitor 1, seminal ribonuclease, C‐type natriuretic peptide, angiogenin‐1 and osteopontin). Among the proteins identified in seminal plasma, the C‐type natriuretic peptide and metalloproteinase inhibitors were described for the first time in buffaloes. Some protease inhibitors were found over‐expressed in buffaloes, and important proteins in seminal plasma of cattle were not identified or were found at lower expression levels in buffaloes, which can contribute to reproductive performance in this species.
Improving management of type 2 diabetes, hypertension and dyslipidaemia in the Caribbean: a systematic review of intervention studies
Authors: Persaud‐Lachhman Marissa , Andall‐Brereton Glennis , Jaacks Lindsay M.
Published: November 2019

Objective

To evaluate published interventions aimed at improving the management of type 2 diabetes, hypertension and dyslipidaemia in the Caribbean.

Methods

We conducted a systematic review of four databases in accordance with PRISMA guidelines. Inclusion criteria were conducted in the Caribbean among adults ≥ 18 years who had type 2 diabetes, hypertension or dyslipidaemia; controlled trials, interventions, or comparative studies with pre‐post designs and reported on at least one of the clinical outcomes of interest.

Results

Seventeen studies met the criteria for inclusion. The majority were conducted in Cuba and Trinidad and Tobago, and 35% were conducted over 10 years ago. Samples were small and largely consisted of older adult females and patients with type 2 diabetes. Four of eight (50%) studies that reported on HbA1c, 5 of 12 (42%) that reported on blood pressure and 2 of 7 (29%) that reported on body mass index observed significant improvements. Study heterogeneity precluded our ability to conduct a meta‐analysis. The overall quality of evidence based on GRADE criteria was low for all outcomes assessed.

Conclusion

There is insufficient evidence on interventions to address type 2 diabetes, hypertension and dyslipidaemia in the Caribbean.