bluuebunny/crossref_metadata_2025 huggingface dataset:
Effective spin distribution of black hole mergers in triples
Authors: Fragione Giacomo , Kocsis Bence
Published: February 2020

Many astrophysical scenarios have been proposed to explain the several black hole (BH) and neutron star binary mergers observed via gravitational waves (GWs) by the LIGO–Virgo collaboration. Contributions from various channels can be statistically disentangled by mass, spin, eccentricity, and redshift distributions of merging binaries. In this paper, we investigate the signatures of BH–BH binary mergers induced by a third companion through the Lidov–Kozai mechanism in triple systems. We adopt different prescriptions for the supernovae natal kicks and consider different progenitor metallicities and initial orbital parameters. We show that the typical eccentricity in the LIGO band is 0.01–0.1 and that the merger rate is in the range 0.008−9 Gpc−3 yr−1, depending on the natal kick prescriptions and progenitor metallicity. Furthermore, we find that the typical distribution of effective projected spin is peaked at χeff ∼ 0 with significant tails. We show that the triple scenario could reproduce the distribution of χeff. We find that the triple channel may be strongly constrained by the misalignment angle between the binary component spins in future detections with spin precession.
VVV WIN 1733−3349: a low extinction window to probe the far side of the Milky Way bulge
Authors: Saito R K , Minniti D , Benjamin R A , Navarro M G , Alonso-García J , Gonzalez O A , Kammers R , Surot F
Published: February 2020

Windows of low extinction in the Milky Way (MW) have been used along the past decades for the study of the Galactic structure and the stellar population across the inner bulge and disc. Here, we report the analysis of another low extinction near-IR window discovered by the VISTA Variables in the Vía Láctea Survey (VVV). VVV WIN 1733−3349 is about half a degree in size and is conveniently located right in the MW plane, at Galactic coordinates (l, b) = (−5.2, −0.3). The mean extinction of VVV WIN 1733−3349 is $A_{K_{\mathrm{ s}}}$ = 0.61 ± 0.08 mag, which is much smaller than the extinction in the surrounding area. The excess in the star counts is consistent with the reduced extinction and complemented by studying the distribution of red clump (RC) stars. Thanks to the strategic low-latitude location of VVV WIN 1733−3349, we are able to interpret their RC density fluctuations with the expected overdensities due to the presence of the spiral arms beyond the bulge. In addition, we find a clear excess in the number of microlensing events within the window, which corroborates our interpretation that VVV WIN 1733−3349 is revealing the far side of the MW bulge.
Asteroid belt survival through stellar evolution: dependence on the stellar mass
Authors: Martin Rebecca G , Livio Mario , Smallwood Jeremy L , Chen Cheng
Published: February 2020

Polluted white dwarfs are generally accreting terrestrial-like material that may originate from a debris belt like the asteroid belt in the Solar system. The fraction of white dwarfs that are polluted drops off significantly for white dwarfs with masses $M_{\rm WD}\gtrsim 0.8\, \rm M_\odot$. This implies that asteroid belts and planetary systems around main-sequence (MS) stars with mass $M_{\rm MS}\gtrsim 3\, \rm M_\odot$ may not form because of the intense radiation from the star. This is in agreement with current debris disc and exoplanet observations. The fraction of white dwarfs that show pollution also drops off significantly for low-mass white dwarfs $(M_{\rm WD}\lesssim 0.55\, \rm M_\odot)$. However, the low-mass white dwarfs that do show pollution are not currently accreting but have accreted in the past. We suggest that asteroid belts around MS stars with masses $M_{\rm MS}\lesssim 2\, \rm M_\odot$ are not likely to survive the stellar evolution process. The destruction likely occurs during the AGB phase and could be the result of interactions of the asteroids with the stellar wind, the high radiation, or, for the lowest mass stars that have an unusually close-in asteroid belt, scattering during the tidal orbital decay of the inner planetary system.
Glycine by MR spectroscopy is an imaging biomarker of glioma aggressiveness
Authors: Tiwari Vivek , Daoud Elena V , Hatanpaa Kimmo J , Gao Ang , Zhang Song , An Zhongxu , Ganji Sandeep K , Raisanen Jack M , Lewis Cheryl M , Askari Pegah , Baxter Jeannie , Levy Michael , Dimitrov Ivan , Thomas Binu P , Pinho Marco C , Madden Christopher J , Pan Edward , Patel Toral R , DeBerardinis Ralph J , Sherry A Dean , Mickey Bruce E , Malloy Craig R , Maher Elizabeth A , Choi Changho
Published: February 2020

Background

High-grade gliomas likely remodel the metabolic machinery to meet the increased demands for amino acids and nucleotides during rapid cell proliferation. Glycine, a non-essential amino acid and intermediate of nucleotide biosynthesis, may increase with proliferation. Non-invasive measurement of glycine by magnetic resonance spectroscopy (MRS) was evaluated as an imaging biomarker for assessment of tumor aggressiveness.

Methods

We measured glycine, 2-hydroxyglutarate (2HG), and other tumor-related metabolites in 35 glioma patients using an MRS sequence tailored for co-detection of glycine and 2HG in gadolinium-enhancing and non-enhancing tumor regions on 3T MRI. Glycine and 2HG concentrations as measured by MRS were correlated with tumor cell proliferation (MIB-1 labeling index), expression of mitochondrial serine hydroxymethyltransferase (SHMT2), and glycine decarboxylase (GLDC) enzymes, and patient overall survival.

Results

Elevated glycine was strongly associated with presence of gadolinium enhancement, indicating more rapidly proliferative disease. Glycine concentration was positively correlated with MIB-1, and levels higher than 2.5 mM showed significant association with shorter patient survival, irrespective of isocitrate dehydrogenase status. Concentration of 2HG did not correlate with MIB-1 index. A high glycine/2HG concentration ratio, >2.5, was strongly associated with shorter survival (P < 0.0001). GLDC and SHMT2 expression were detectable in all tumors with glycine concentration, demonstrating an inverse correlation with GLDC.

Conclusions

The data suggest that aggressive gliomas reprogram glycine-mediated one-carbon metabolism to meet the biosynthetic demands for rapid cell proliferation. MRS evaluation of glycine provides a non-invasive metabolic imaging biomarker that is predictive of tumor progression and clinical outcome.

Key Points

1. Glycine and 2-hydroxyglutarate in glioma patients are precisely co-detected using MRS at 3T.

2. Tumors with elevated glycine proliferate and progress rapidly.

3. A high glycine/2HG ratio is predictive of shortened patient survival.
Implications of new understandings of gliomas in children and adults with NF1: report of a consensus conference
Authors: Packer Roger J , Iavarone Antonio , Jones David T W , Blakeley Jaishri O , Bouffet Eric , Fisher Michael J , Hwang Eugene , Hawkins Cynthia , Kilburn Lindsay , MacDonald Tobey , Pfister Stefan M , Rood Brian , Rodriguez Fausto J , Tabori Uri , Ramaswamy Vijay , Zhu Yuan , Fangusaro Jason , Johnston Stephen A , Gutmann David H
Published: February 2020

Gliomas are the most common primary central nervous system tumors occurring in children and adults with neurofibromatosis type 1 (NF1). Over the past decade, discoveries of the molecular basis of low-grade gliomas (LGGs) have led to new approaches for diagnosis and treatments. However, these new understandings have not been fully applied to the management of NF1-associated gliomas. A consensus panel consisting of experts in NF1 and gliomas was convened to review the current molecular knowledge of NF1-associated low-grade “transformed” and high-grade gliomas; insights gained from mouse models of NF1-LGGs; challenges in diagnosing and treating older patients with NF1-associated gliomas; and advances in molecularly targeted treatment and potential immunologic treatment of these tumors. Next steps are recommended to advance the management and outcomes for NF1-associated gliomas.
One Health Education for Future Physicians: A Case Report of Cat-Transmitted Sporotrichosis
Authors: Kaadan M Ihsan , Dennis Michael , Desai Nancy , Yadavalli Gopal , Lederer Philip
Published: February 2020

A healthy 35-year-old Brazilian woman presented with persistent redness, swelling, and multiple wounds on the hand 2 weeks after a cat bite in her home country. She was treated twice with amoxicillin-clavulanate but failed to demonstrate improvement. She then presented to our institution with a newly developed abscess on the right hand. Incision and drainage were performed and she was admitted to the hospital. She was subsequently treated with broad-spectrum antibiotics. Her symptoms improved but did not resolve. Four days after hospital discharge, a wound culture resulted as positive for Sporothrix schenchii. The patient was treated with itraconazole. Sporotrichosis is endemic in many countries including Brazil and is known to be transmitted by cat bites. Sporotrichosis should be considered in the differential diagnosis for patients who have symptoms of cellulitis after cat bites in an endemic area.
Sub-millimeter detection of a Galactic center cool star IRS 7 by ALMA
Authors: Tsuboi Masato , Kitamura Yoshimi , Tsutsumi Takahiro , Miyawaki Ryosuke , Miyoshi Makoto , Miyazaki Atsushi
Published: February 2020

IRS 7 is an M red supergiant star which is located at ${5{^{\prime \prime}_{.}}5}$ north of Sagittarius A$^\ast$. We detected firstly the continuum emission at $340\:$GHz of IRS 7 using the Atacama Large Millimeter/submillimeter Array (ALMA). The total flux density of IRS 7 is $S_{\, \nu} =448\pm 45\, \mu$Jy. The flux density indicates that IRS 7 has a photosphere radius of $R=1170\pm 60\, R_{\odot }$, which is roughly consistent with the previous Very Large Telescope Interferometer measurement. We also detected a shell-like feature with a northern extension in the H30α recombination line using ALMA. The electron temperature and electron density of the shell-like structure are estimated to be $\bar{T}^\ast _\mathrm{e}=4650\pm 500\:$K and $\bar{n}_\mathrm{e}=(6.1\pm 0.6)\times 10^4\:$cm$^{-3}$, respectively. The mass loss rate is estimated to be $\dot{m}\,\, \sim 1\times 10^{-4}\, M_{\odot }\:$yr$^{-1}$, which is consistent with a typical mass loss rate of a pulsating red supergiant star with $M = 20$–$25\, M_{\odot }$. The kinematics of the ionized gas would support the hypothesis that the shell-like structure made by the mass loss of IRS 7 is supersonically traveling in the ambient matter towards the south. The brightened southern half of the structure and the northern extension would be a bow shock and a cometary-like tail structure, respectively.
Clinical Profiles of Concurrent Cannabis Use in Chronic Pain: A CHOIR Study
Authors: Sturgeon John A , Khan James , Hah Jennifer M , Hilmoe Heather , Hong Juliette , Ware Mark A , Mackey Sean C
Published: February 2020

Objective

Despite evidence of the analgesic benefits of cannabis, there remains a relative scarcity of research on the short- and long-term effects of cannabis use in individuals with chronic pain.

Design

The current study is a secondary analysis of clinical data from the Collaborative Health Outcomes Information Registry (CHOIR).

Setting

Data were drawn from a cohort of patients of a multidisciplinary tertiary care pain clinic.

Subjects

The study sample consisted of data from 7,026 new patient visits from CHOIR; of these, 1,668 patients with a follow-up time point within 180 days were included in a longitudinal analysis.

Methods

Clinical data were analyzed to characterize cross-sectional differences in pain and indicators of psychological and physical function according to self-reported, concurrent cannabis use. Additionally, a propensity score–weighted longitudinal analysis was conducted, examining cannabis use as a predictor of changes in clinical variables across time.

Results

Cross-sectional analyses suggested significantly poorer sleep and significantly higher intensities of pain, emotional distress, and physical and social dysfunction in patients reporting ongoing cannabis use; however, these differences were relatively small in magnitude. However, no differences between cannabis users and nonusers in terms of longitudinal changes in clinical variables were noted.

Discussion

Our results are among the first to examine concurrent cannabis use as a prognostic variable regarding trajectories of pain-related variables in tertiary care. Future studies may benefit from examining the effect of cannabis initiation, concurrent medication use, and specific aspects of cannabis use (dose, duration of use, or cannabis type) on clinical outcomes.
Trigeminal Nerve Blockade in the Pterygopalatine Fossa for the Management of Postoperative Pain in Three Adults Undergoing Tonsillectomy: A Proof-of-Concept Report
Authors: Smith Cameron R , Helander Erik , Chheda Neil N
Published: February 2020

Setting

Post-tonsillectomy pain in adults can be severe and is often poorly controlled. Pain can lead to decreased oral intake, bleeding, longer hospital stays, emergency department visits, dehydration, and weight loss. Due to persistent pain despite scheduled medications, other methods for pain control are needed. Local/regional anesthetic options have been previously studied in this population. Unfortunately, neither the injection of local anesthetics into the tonsillar fossa nor the postoperative topical application of local anesthetics to the tonsillar bed has demonstrated efficacy in large systematic reviews.

Patients

Here we report on the post-tonsillectomy pain experience of three patients who were treated with perioperative nerve blocks placed in the pterygopalatine fossa. This represents an as-yet unexplored option for post-tonsillectomy pain control.

Intervention

After induction of general anesthesia, before surgical incision, a 25-gauge spinal needle was advanced into the pterygopalatine fossa using a suprazygomatic, ultrasound-guided approach. Ropivacaine and dexamethasone were deposited into the pterygopalatine fossa.

Results

All three patients experienced excellent pain control for the duration of their recovery and required ≤10 mg of oxycodone over the two weeks after surgery.

Conclusions

Our case series of three patients provides proof of concept that use of nerve blocks in the pterygopalatine fossa can be useful for the control of post-tonsillectomy pain. Further study is needed to confirm these initial results.
Monitoring the Monitor: Distracted Institutional Investors and Board Governance
Authors: Liu Claire , Low Angie , Masulis Ronald W , Zhang Le
Published: February 2020

Boards are crucial to shareholder wealth. Yet little is known about how shareholder oversight affects director incentives. Using exogenous shocks to institutional investor portfolios, we find that institutional investor distraction weakens board oversight. Distracted institutions are less likely to discipline ineffective directors with negative votes. Consequently, independent directors face weaker monitoring incentives and exhibit poor board performance; ineffective independent directors are also more frequently appointed. Moreover, we find that the adverse effects of investor distraction on various corporate governance outcomes are stronger among firms with problematic directors. Our findings suggest that institutional investor monitoring creates important director incentives to monitor.
Gastrointestinal involvement in adult IgA vasculitis (Henoch-Schönlein purpura): updated picture from a French multicentre and retrospective series of 260 cases
Authors: Audemard-Verger Alexandra , Pillebout Evangéline , Amoura Zahir , Cacoub Patrice , Jourde-Chiche Noémie , Lioger Bertrand , Martis Nihal , Moulis Guillaume , Rivière Etienne , Baldolli Aurélie , Girard Charlotte , Goutte Julie , Gouellec Noémie Le , Raffray Loïc , Urbanski Geoffrey , Sanges Sébastien , Maurier Francois , Thervet Eric , Aouba Achille , Guillevin Loïc , Maillot Francois , Terrier Benjamin ,   French Vasculitis Study Group (FVSG)
Published: February 2020

Objectives

To describe the clinical presentation, treatments and prognosis of gastrointestinal (GI) involvement in adult IgA vasculitis (IgAV).

Methods

Data from 260 adults with IgAV included in a French multicentre retrospective survey were analysed. Presentation and outcomes of patients with (GI+) and without (GI-) GI involvement were compared.

Results

One hundred and thirty-seven (53%) patients had GI involvement. Initial manifestations were abdominal pain in 99%, intestinal bleeding in 31%, diarrhoea in 26% and acute surgical abdomen in only 4%. Abdominal imaging revealed thickening of intestinal wall in 61%, and endoscopies revealed abnormalities in 87%, mostly mucosal ulcerations. GI+ vs GI- patients were younger (46 ± 18 vs 54 ± 18 years; P = 0.0004), had more constitutional symptoms (43% vs 23%; P = 0.0005) and joint involvement (72 vs 50%; P = 0.0002), and higher CRP levels (3.7 vs 1.9 mg/dl; P = 0.001). Clinical response and relapse rates were comparable between groups, and all causes mortality (2 vs 4%) and IgAV-related mortality (1% vs 2%) as well. GI-related deaths were due to intestinal perforation and mesenteric ischaemia.

Conclusion

GI involvement is frequent in adult IgAV. GI involvement is frequent in adult IgAV. Mortality is not uncommon but does not seem to be specifically related to GI. Immunosuppressants should not be preferred as first-line therapy for GI+ patients but may be required in case of acute surgical abdomen.
Complete Genome Sequence of Indian Race 4 of Xanthomonas oryzae pv. oryzae, the Causal Agent of Bacterial Blight of Rice
Authors: Mondal Kalyan K. , Verma Geeta , Kulshreshtha Aditya , Rajrana Yuvika , Mani Chandra , Soni Madhvi , Reddy Kishorekumar , Ghoshal Thungri , Lakshmi Amrutha , NS Kalaivanan
Published: February 2020

Xanthomonas oryzae pv. oryzae, the causal bacterium of bacterial blight limits rice production globally. Currently, genome sequences for only a few X. oryzae pv. oryzae isolates are available from India. Based on the next-generation sequencing and single-molecule sequencing in real-time technologies, we present here the complete genome sequence of X. oryzae pv. oryzae race 4, a highly virulent member of the Indian X. oryzae pv. oryzae population that has been extensively used in different research studies. The genome data will contribute to our understanding of X. oryzae pv. oryzae genomic features and pave the way for research on rice–X. oryzae pv. oryzae interactions.
Original Research: Arthritis-Related Functional Limitations and Inadequate Physical Activity Among Female Adult Cancer Survivors
Authors: Park So-Hyun , Strauss Shiela M.
Published: February 2020

Background:

The American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention recommend an adequate level of physical activity for cancer prevention and survivorship. Many adults have been diagnosed with arthritis, with a significantly higher rate in women. People with arthritis tend to be less physically active than those without arthritis, and are less likely to engage in moderate or vigorous activity. The proportion of adults meeting ACS physical activity guidelines is especially low among those with arthritis.

Objective:

We wanted to explore the extent to which arthritis-related functional limitations are predictive of inadequate physical activity in female adult cancer survivors after accounting for other known predictors.

Methods:

Data included in the analyses were from a sample of 729 adult women diagnosed with cancer who participated in the U.S. National Health and Nutrition Examination Survey between 2011 and 2016. Inadequate physical activity was defined as not meeting ACS physical activity guidelines. Bivariate and multivariate logistic regression analyses were conducted to identify correlates of inadequate physical activity.

Results:

Being age 65 years or older, having no more than a high school education, being overweight or obese, being clinically depressed, and having arthritis-related functional limitations were found to be significant correlates of inadequate physical activity in the study population.

Conclusions:

Our results indicate that, in addition to previously identified predictors of inadequate physical activity in cancer survivors, having arthritis-related functional limitations is a significant predictor of inadequate physical activity in female adult cancer survivors. Assessment and management of arthritis-related functional limitations by health care providers are needed to facilitate successful adherence to physical activity guidelines.
Relationship Between Emotional Intelligence and Clinical Performance in Student Registered Nurse Anesthetists
Authors: Christianson Krista L. , Fogg Louis , Kremer Michael J.
Published: February 2020

Emotional intelligence (EI) includes skills such as recognizing, understanding, and managing emotions. This pilot study investigated the utility of the Mayer-Salovey-Caruso Emotional Intelligence Test Version 2.0 as a screening instrument in student registered nurse anesthetists by determining if EI predicted clinical performance. Scores from 11 participants enrolled in a single nurse anesthesia program were correlated with formative clinical evaluations. Relationships between EI and clinical performance were examined. Participants consistently met clinical performance objectives but were unable to use emotion to solve problems or to recognize others’ emotions, suggesting that EI abilities could impact future student registered nurse anesthetist clinical performance.
Group-based Trajectory Modeling: A Novel Approach to Classifying Discriminative Functional Status Following Adult Spinal Deformity Surgery
Authors: Yang Jingyan , Lafage Renaud , Gum Jeffrey L. , Shaffrey Christopher I. , Burton Douglas , Kim Han Jo , Ames Christopher P. , Mundis Gregory , Hostin Richard , Bess Shay , Klineberg Eric O. , Smith Justin S. , Schwab Frank , Lafage Virginie
Published: February 2020

Study Design.

Retrospective review of prospectively collected database.

Objective.

To delineate and visualize trajectories of the functional status in surgically-treated adult spinal deformity (ASD) patients.

Summary of Background Data.

Classifying long-term recovery following ASD surgery is not well defined.

Methods.

One thousand one hundred seventy-one surgically-treated patients with a minimum of 3-year follow-up were included. The group-based trajectory modeling (GBTM) was used to identify distinct trajectories of functional status over time, measured by Oswestry Disability Index (ODI). Patient profiles were then compared according to the observed functional patterns.

Results.

The GBTM identified four distinct functional patterns. The first group (10.0%) started with minimal disability (ODI: 15 ± 10) and ended up almost disability-free (low-low). The fourth group (21.5%) began with high ODI (66 ± 11) and improvement was minimal (high-high). Groups two (40.1%) and three (28.4%) had moderate disability (ODI: 39 ± 11 vs. 49 ± 11, P < 0.001) before surgery. Following surgery, marked improvement was seen in group two (median-low), but deterioration/no change was observed in group three (median-high). The low-low group primarily included adult idiopathic scoliosis, while the high-high group had the oldest and the most severe patients as compared with the rest of the groups. A subgroup analysis was performed between groups two and three with propensity score matching on age, body mass index, baseline physical component score (PCS), and severity of deformity. Notably, the baseline mental status of the median-high group was significantly worse than that of the median-low group, though the differences in demographics, surgery, and deformity no longer existed.

Conclusions.

Patients with moderate-to-low disability are more likely to obtain better functional postoperative outcomes. Earlier surgical interventions should be considered to prevent progression of deformity, and to optimize favorable outcomes. Greatest improvement appears to occur in moderately disabled patients with good mental health. GBTM permits classification into distinct groups, which can help in surgical decision making and setting expectations regarding recovery.

Level of Evidence: 3
Machine learning in nephrology: scratching the surface
Authors: Li Qi , Fan Qiu-Ling , Han Qiu-Xia , Geng Wen-Jia , Zhao Huan-Huan , Ding Xiao-Nan , Yan Jing-Yao , Zhu Han-Yu
Published: February 2020

Machine learning shows enormous potential in facilitating decision-making regarding kidney diseases. With the development of data preservation and processing, as well as the advancement of machine learning algorithms, machine learning is expected to make remarkable breakthroughs in nephrology. Machine learning models have yielded many preliminaries to moderate and several excellent achievements in the fields, including analysis of renal pathological images, diagnosis and prognosis of chronic kidney diseases and acute kidney injury, as well as management of dialysis treatments. However, it is just scratching the surface of the field; at the same time, machine learning and its applications in renal diseases are facing a number of challenges. In this review, we discuss the application status, challenges and future prospects of machine learning in nephrology to help people further understand and improve the capacity for prediction, detection, and care quality in kidney diseases.
The role of physical activity in the link between menopausal status and mental well-being
Authors: Bondarev Dmitriy , Sipilä Sarianna , Finni Taija , Kujala Urho M. , Aukee Pauliina , Laakkonen Eija K. , Kovanen Vuokko , Kokko Katja
Published: February 2020

Objective:

To examine the relationship between menopausal status and mental well-being, and whether this relationship varies as a function of physical activity (PA).

Methods:

Based on a hormonal analysis and bleeding diary, women aged 47 to 55 were categorized as pre (n = 304), early peri (n = 198), late peri (n = 209), or postmenopausal (n = 387). Mental well-being was assessed using the Centre for Epidemiologic Studies Depression Scale, the International Positive and Negative Affect Schedule Short Form, and the Satisfaction with Life Scale. PA was self-reported and categorized as low, medium, and high. Associations between variables were analyzed using multivariate linear regression adjusted for age, marital and employment status, parity, self-reported mental disorder, use of psycholeptics and psychoanaleptics, and menopausal symptoms.

Results:

Depressive symptoms were lower amongst the pre than postmenopausal women (B = 0.07, confidence interval 0.01-0.13). Menopausal symptoms attenuated these associations. Menopausal status showed no associations with life satisfaction, or with positive or negative affectivity.

Women with high PA scored higher on positive affectivity, and the pre, early peri, and postmenopausal women scored higher on life satisfaction (B = 0.79, P < 0.001; B = 0.63, P = 0.009; B = 0.42, P = 0.009, respectively) and scored lower on depressive symptoms (B = −0.13, P = 0.039; B = −0.18, P = 0.034; and B = −0.20, P < 0.001, respectively) than their low PA counterparts. The pre and postmenopausal women with medium PA scored higher on life satisfaction (B = 0.54, P = 0.001; B = 0.038, P = 0.004, respectively) than those with low PA.

Conclusions:

Postmenopausal women reported marginally higher depressive symptoms scores compared with premenopausal women, but menopause was not associated with positive mental well-being. However, this association varies with the level of PA.

Video Summary:

http://links.lww.com/MENO/A520.
Gabapentin for the treatment of hot flushes in menopause: a meta-analysis
Authors: Yoon Sang-Hee , Lee Ji Young , Lee Chulmin , Lee Hyojin , Kim Soo-Nyung
Published: February 2020

Objective:

Gabapentin is used to treat vasomotor symptoms (VMS) in postmenopausal women with contraindications to hormonal therapy or who prefer alternatives. We investigated the efficacy and tolerability of gabapentin for treating menopausal hot flushes via a meta-analysis.

Methods:

We searched the PubMed, MEDLINE, EMBASE, and CENTRAL databases for English-language articles published until June, 2018. The following search terms were used: “menopause,” “hot flushes,” “vasomotor symptoms,” “gabapentin,” and “non-hormonal therapy.” Primary outcomes were frequency, duration, and composite score of hot flushes. Secondary outcomes were adverse effects and dropout rate. We estimated the standardized mean difference (SMD) and combined odds ratio (OR) using fixed or random-effects models, depending on study heterogeneity. Subgroup and meta-regression analyses of gabapentin dosage were performed.

Results:

We included seven randomized controlled trials that compared single-agent gabapentin with placebo for treating hot flushes in the meta-analysis. Women who received gabapentin reported a significantly greater reduction in the frequency (SMD 2.99 [95% confidence interval 2.01-3.98], P < 0.001), duration (0.89 [0.49-1.30], P < 0.001), and composite score (2.31 [1.50-3.11], P < 0.001) of hot flushes. Adverse events were significantly more frequent among those taking gabapentin than among those taking the placebo (OR 1.58 [0.98-2.18], P < 0.001; and 1.19 [0.43-1.95], P = 0.002 for dizziness and unsteadiness, respectively).

Conclusions:

Gabapentin could be used to treat VMS in postmenopausal women with contraindications to hormonal therapy. Future studies should investigate the lowest effective dose of gabapentin to minimize adverse effects.

Video Summary:

http://links.lww.com/MENO/A521.
Differences between accelerometer cut point methods among midlife women with cardiovascular risk markers
Authors: Arigo Danielle , Mogle Jacqueline A. , Brown Megan M. , Roberts Savannah R. , Pasko Kristen , Butryn Meghan L. , Downs Danielle Symons
Published: February 2020

Objective:

Midlife women experience elevated risk for cardiovascular disease and often receive advice to increase physical activity to mitigate this risk. Use of accelerometers to measure ambulatory physical activity requires selection of appropriate thresholds for estimating moderate-to-vigorous physical activity (MVPA), and choice of cut points may lead to meaningfully different conclusions about midlife women's physical activity (PA) engagement. This is particularly important given the recent elimination of 10-minute bout requirements for MVPA. This two-phase study examined differences between four cut point methods among midlife women with cardiovascular disease (CVD) risk. We used findings from Study 1 (exploratory) to generate hypotheses for Study 2 (confirmatory).

Methods:

Across studies, participants (N = 65) were midlife women with an additional CVD risk factor (eg, hypertension). Participants wore waistband accelerometers for seven days. Daily totals were calculated for minutes in light and MVPA using four common quantification methods (Freedson, Matthews, Swartz, and Troiano).

Results:

Multilevel models showed meaningful differences between methods (P < 0.0001). For total (non-bouted) minutes of MVPA, Freedson and Troiano methods showed that participants barely met MVPA recommendations (30 min per day), whereas Matthews and Swartz methods showed that participants greatly exceeded this goal. As differences between methods were smaller using MVPA bouts of 10 minutes or more (though remained significant), the observed variation was due in part to small bursts of MVPA dispersed throughout the day.

Conclusions:

Findings demonstrate the need for careful consideration of PA quantification among midlife women with CVD risk, and for further investigation to determine the most appropriate quantification method.

Video Summary:http://links.lww.com/MENO/A545.
The association between hormone therapy and sarcopenia in postmenopausal women: the Korea National Health and Nutrition Examination Survey, 2008-2011
Authors: Kim Sung-Woo , Kim Rebecca
Published: February 2020

Objective:

Menopausal transition contributes to sarcopenia, but the effects of hormone therapy (HT) on sarcopenia in postmenopausal women have not been determined. This study assessed the effect of HT on sarcopenia in postmenopausal women.

Methods:

The present study included 4,254 postmenopausal women who participated in the Korea National Health and Nutritional Examination Surveys from 2008 to 2011. Appendicular skeletal muscle mass divided by weight (ASM/Wt) and the prevalence of sarcopenia were analyzed in groups of women stratified by duration of HT use.

Results:

ASM/Wt was higher and the prevalence of sarcopenia was lower in participants with a history of prolonged (≥13 mo) HT use than in participants with a shorter duration of HT use or no HT use. After adjusting for multiple confounding factors, prolonged use of HT remained significantly associated with estimated mean ASM/Wt and the prevalence of sarcopenia (odds ratio: 0.60; 95% confidence interval: 0.41-0.88; P = 0.01). In addition, the prevalence of sarcopenia was linearly associated with history of hypertension, duration of hypertension, physical activity, and duration of HT use. Subgroup analysis showed that the association between duration of HT use and the prevalence of sarcopenia was maintained in younger (<65 y old) and leaner (body mass index <25 kg/m2) postmenopausal women.

Conclusions:

The present study showed that the prolonged use of HT was associated with high muscle mass and a low prevalence of sarcopenia in postmenopausal women.
The Effect of Aromatherapy Application on Cognitive Functions and Daytime Sleepiness in Older Adults Living in a Nursing Home
Authors: Aydın Yıldırım Tuğba , Kitiş Yeter
Published: February 2020

Changes in the aging process affect the duration and quality of sleep. Not having a quality night's sleep leads to a reduction in daytime wakefulness in older adults. We examined the effect of aromatherapy on the cognitive functions and daytime sleepiness of older adults living in a nursing home. The research was a pretest and posttest design, which was conducted without a control group. The sample included 39 elders. A rosemary-lemon oil mixture was smelled by elders in the mornings for a week. After a 1-week washout period, lavender oils were smelled in the evenings for a week. After application of the rosemary-lemon oil mixture, the mean score of participants' daytime sleepiness was lower, but that decline was not statistically meaningful (P > .050). After the same application, the mean score of the participants' cognitive functions was significantly lower (P < .001). After application of lavender oil, the scores were significantly lower (P < .001). Lower scores on the scales used indicate lower sleepiness. The results showed that the 2 applications can be used to improve cognitive functions in older adults; in addition, lavender oil has an advantage in reducing daytime sleepiness.
Factors Influencing Corneal Biomechanics in Diabetes Mellitus
Authors: Ramm Lisa , Herber Robert , Spoerl Eberhard , Pillunat Lutz E. , Terai Naim
Published: February 2020

Purpose:

Diabetes mellitus (DM) induces changes in corneal biomechanical properties. The influence of disease-specific factors was evaluated, and a novel DM index was created.

Methods:

Eighty-one patients with DM and 75 healthy subjects were matched according to age, intraocular pressure, and central corneal thickness. Information on the disease was collected, and measurements with the Ocular Response Analyzer and the Corvis ST were taken. Results were compared between the groups, and the influence of disease-specific factors was evaluated. From dynamic corneal response parameters, a DM index was calculated.

Results:

In DM, corneal hysteresis was higher than in healthy subjects (10.5 ± 1.9 vs. 9.7 ± 1.9 mm Hg, P = 0.008). In addition, dynamic corneal response parameters showed significant differences. Among others, highest concavity (HC) (17.212 ± 0.444 vs. 16.632 ± 0.794 ms, P < 0.001) and A2 time (21.85 ± 0.459 vs. 21.674 ± 0.447 ms, P = 0.017) as well as A1 (0.108 ± 0.008 vs. 0.104 ± 0.011 mm, P = 0.019) and A2 deflection amplitudes (0.127 ± 0.014 vs. 0.119 ± 0.014 mm, P < 0.001) were increased in DM. In DM type 1, HC deformation amplitude (1.14 ± 0.19 vs. 1.095 ± 0.114 mm, P = 0.035) was higher than in type 2. The time of deflection amplitude max correlated with the severity of retinopathy (R = 0.254, P= 0.023). In case of diabetic maculopathy, A1 velocity (0.155 ± 0.018 vs. 0.144 ± 0.019 ms, P = 0.043) and A2 time (22.052 ± 0.395 vs. 21.79 ± 0.46 ms, P = 0.04) were increased. Deformation amplitude max (R = 0.297, P = 0.024), HC time (R = 0.26, P = 0.049), HC deformation amplitude (R = 0.297, P = 0.024), and A2 deformation amplitude (R = 0.276, P = 0.036) were associated to disease duration. The DM index revealed a sensitivity of 0.773 and a specificity of 0.808 (area under the curve of receiver operating characteristic = 0.833).

Conclusions:

In DM, changes in corneal biomechanics were correlated with disease-specific factors. The DM index achieved reliable sensitivity and specificity values.
Corneal Endothelial Cell Toxicity Determines Long-Term Outcome After Ocular Exposure to Sulfur Mustard Vapor
Authors: McNutt Patrick M. , Nguyen Dominique L. , Nelson Marian R. , Lyman Megan E. , Eisen Margaret M. , Ondeck Celinia A. , Wolfe Sarah E. , Pagarigan Kathleen T. , Mangkhalakhili Mark C. , Kniffin Denise M. , Hamilton Tracey A.
Published: February 2020

Purpose:

Ocular exposure to sulfur mustard (SM) vapor causes acute loss of corneal endothelial cells (CECs). Persistent corneal endothelial pathologies are observed in eyes that do not recover from SM exposure, suggesting that endothelial toxicity contributes to mustard gas keratopathy (MGK). Here, we evaluated the contributions of endothelial loss to acute and chronic corneal injuries in SM-exposed eyes.

Methods:

Rabbit eyes were exposed in vivo to equivalent doses of SM using 9-, 11-, or 14-mm vapor caps. The effects of exposure area on corneal injury progression were longitudinally evaluated over 12 weeks using clinical evaluations. The effects of exposure area on CEC morphology, endothelial and epithelial ultrastructure, and endothelial barrier function were determined from 1 day to 12 weeks.

Results:

SM exposure caused loss of CECs and failure of endothelial barrier integrity at 1 day, independent of exposure cap size. By 3 weeks, eyes exposed with the 14-mm vapor cap exhibited increased corneal permeability, repopulation of the endothelium by cells with fibroblastic morphology, and abnormal deposition of extracellular matrix. Eyes exposed with 9- or 11-mm vapor caps exhibited transient symptoms of injury that fully resolved, with the rate of recovery correlated with cap size.

Conclusions:

The nonlinear correlation between endothelial lesion size and probability of developing MGK suggests that the CEC loss is a determinative factor for emergence of MGK. These studies illustrate the importance of endothelial repair in preventing MGK. Furthermore, they exclude chemical modification of basement membrane as a mechanistic cause of recurrent epithelial erosions in MGK eyes.
Lupus Miliaris Disseminatus Faciei of the Posterior Eyelids: A Case Report
Authors: Ramakrishnan Meera S. , Lee Vivian , Seykora John T. , Briceño César A.
Published: February 2020

A 70-year-old woman with a history of Demodex blepharitis presented with a 1-year history of red-yellow nodules in the tarsus of her eyelids. Excisional biopsy revealed robust caseating granulomatous inflammation, consistent with the diagnosis of lupus miliaris disseminatus faciei. Lupus miliaris disseminatus faciei is a rare granulomatous dermatosis of unknown etiology. Estimated 200 cases have been reported to date, but none have been reported affecting the posterior lamellae of the eyelids. Lupus miliaris disseminatus faciei classically presents as symmetric yellow or brown papules on the central face and eyelid skin. Infectious etiologies and systemic granulomatous disease need to be ruled out with histologic staining and serologies.
Extended depth-of-focus technology in intraocular lenses
Authors: Kohnen Thomas , Suryakumar Rajaraman
Published: February 2020

The extended depth-of-focus (EDOF) intraocular lens (IOL) is an emerging technology that is designed to improve range of vision, especially at intermediate distances. In this review, we describe the clinical performance of 4 emerging EDOF IOL technologies; that is, small aperture, bioanalogic, diffractive optics, and nondiffractive optical manipulations. The American Academy of Ophthalmology generated a consensus statement for EDOF IOLs that provided benchmarks and recommendations for classifying an implant as an EDOF IOL as well as standardized testing criteria for evaluating performance. Although many types of EDOF technologies are being developed, there are important differences in their performance that require further testing and evaluation.
Anemia in preschool children from Angola: a review of the evidence
Authors: Fançony Cláudia , Lavinha João , Brito Miguel , Barros Henrique
Published: February 2020

Angola is one of the southern African countries with the highest prevalence of anemia, and despite the high geographic heterogeneity of its distribution across the country, it was reported to be indicative of a severe public health problem in some areas, mainly in children. Despite the relevance of this condition in the country there is still an important gap regarding scientific evidences and knowledge systematization in the indexed literature, that could be used to inform and optimize national public health policies willing to address it. Furthermore, the changes in anemia epidemiology among African preschool children and the late updates in nutrition-specific and nutrition-sensitive preventive strategies in the continent are of imperative relevance, as they could contribute to design context-specific national approaches to reduce anemia's morbidity and mortality. In this study we intent to perform a systematic review regarding the sparse evidence available on the country regarding the prevalence of anemia, its associated factors, the prevention, and/or control strategies with potential to reduce anemia that were implemented, and to discuss interventions targeting infections and/or nutrition conducted in other African countries.
Nursing Interventions of Intraoperative Malignant Hyperthermia in Patients With Scoliosis: A Report of 3 Cases
Authors: An Xiaoyan , Wang Qiaogui , Qiu Yong , Zhu Zezhang , Ma Zhengliang , Hua Wei , Li Xueyun
Published: February 2020

INTRODUCTION: The report summarizes the intraoperative rescue and nursing intervention of malignant hyperthermia (MH) in the correction surgery for 3 patients with spinal deformity. Although rare, MH may occur in up to 1 of 5000 cases. INTERVENTION: The key points of nursing care include preoperative MH risk assessment, MH early warning, cessation of anesthetic, use of a validated scoring system, and initiation of cooling measures. CONCLUSION: Prompt nursing recognition and team-fcoused interventions provided successful rescue of 3 patients with MH.
Interrupting Sedentary Time in the Workplace Using Regular Short Activity Breaks
Authors: Hargreaves Elaine Anne , Hayr Kirsty Therese , Jenkins Matthew , Perry Tracy , Peddie Meredith
Published: February 2020

Objective:

To understand the practicalities of undertaking 2 to 3 minutes of light to moderate intensity physical activity after every 30 minutes of prolonged sitting by examining barriers and facilitators.

Methods:

Around 27 (n = 22 women) employees working in higher education who sat for greater than 5 hours during a work day participated in a focus group discussion.

Results:

Through inductive thematic analysis, themes characterising workplace culture and having the knowledge (or not) of benefits were found to be a facilitator and a barrier. Additional barriers were a perceived reduction in work productivity and specific work tasks that precluded taking activity breaks. Extrinsic motivators and prompts were suggested to facilitate participation.

Conclusions:

Environmental and individual strategies are required to build capability, opportunity, and motivation for undertaking regular activity breaks and should inform the development of an ecologically valid workplace intervention.
Oncological outcomes of addition of anti-PD1/PD-L1 to chemotherapy in the therapy of patients with advanced gastric or gastro-oesophageal junction cancer
Authors: Zheng Zheng , Guo Ying , Zou Chang-Peng
Published: February 2020

Background:

Patients with advanced gastric or gastro-oesophageal junction cancer (GC/GEJC) that fail to respond to prior chemotherapy have poor clinical prognosis. Lately, many trials have paid much attention on the oncological outcomes of immune checkpoint inhibitors (ICI). A new therapy based on programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) inhibitors has recognized as promising prospects for advanced GC/GEJC. We assessed efficacy and safety of PD-L1 antibody versus chemotherapy alone in previously treated non-small cell lung cancer.

Methods:

Computerized literature search was done on the published trials in: Pubmed, Embase, Cochrane library updated on June 2019. Randomized controlled trials were selected investigating chemotherapy plus PD-1/PD-L1 versus chemotherapy alone.

Results:

Three randomized controlled trails were included. The pooled analysis of overall survival (OS) was longer with anti-PD1/PD-L1 than with chemotherapy alone in the OS (OR = 0.66, 95%CI = 0.47–0.92, P = .02) and sub-group OS of GEJC (OR = 0.73, 95%CI = 0.58–0.93, P = .01). Whereas, there is no significant difference in progression-free survival (OR = 0.93, 95%CI = 0.62–1.39, P = .72). The pooling adverse events (AE) data did not achieve advantage in the PD-1/PD-L1 targeted agents (OR = 0.53, 95%CI = 0.13–2.10, P = .36), the same as the treatment-related AE of grade 3 to 5 (OR = 0.53, 95%CI = 0.16–1.74, P = .30).

Conclusions:

Treatment of patients with advanced GC/GEJC with PD-1/PD-L1 targeted did result in an improvement in some but not all survival endpoints. Moreover, it had a comparable toxicity profile as compared with chemotherapy alone. More well designed studies are needed to develop a database of all anti-PD1/PD-L1 sub-groups and their individual impact on the differing anti-PD1/PD-L1 treatments.