bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of a Wireless Audio System on Communication in Robotic-Assisted Laparoscopic Surgery: A Prospective Controlled Trial
Authors: Tsafrir Ziv , Janosek-Albright Kirsten , Aoun Joelle , Diaz-Insua Mireya , Abd-El-Barr Abd-El-Rahman , Schiff Lauren , Talukdar Shobhana , Menon Mani , Munkarah Adnan , Theoharis Evan , Eisenstein David
Published: July 2019

Background

Robotic surgery presents a challenge to effective teamwork and communication in the operating theatre (OR). Our objective was to evaluate the effect of using a wireless audio headset device on communication, efficiency and patient outcome in robotic surgery.

Methods and findings

A prospective controlled trial of team members participating in gynecologic and urologic robotic procedures between January and March 2015. In the first phase, all surgeries were performed without headsets (control), followed by the intervention phase where all team members used the wireless headsets. Noise levels were measured during both phases. After each case, all team members evaluated the quality of communication, performance, teamwork and mental load using a validated 14-point questionnaire graded on a 1-10 scale. Higher overall scores indicated better communication and efficiency. Clinical and surgical data of all patients in the study were retrieved, analyzed and correlated with the survey results.

The study included 137 procedures, yielding 843 questionnaires with an overall response rate of 89% (843/943). Self-reported communication quality was better in cases where headsets were used (113.0 ± 1.6 vs. 101.4 ± 1.6; p < .001). Use of headsets reduced the percentage of time with a noise level above 70 dB at the console (8.2% ± 0.6 vs. 5.3% ± 0.6, p < .001), but had no significant effect on length of surgery nor postoperative complications.

Conclusions

The use of wireless headset devices improved quality of communication between team members and reduced the peak noise level in the robotic OR.
An updated analysis of opioids increasing the risk of fractures
Authors: Yue Qiaoning , Ma Yue , Teng Yirong , Zhu Yun , Liu Hao , Xu Shuanglan , Liu Jie , Liu Jianping , Teng Zhaowei , Zhang Xiguang
Published: July 2019

Objective

To assess the relationship between opioid therapy for chronic noncancer pain and fracture risk by a meta-analysis of cohort studies and case-control studies.

Methods

The included cohort studies and case-control studies were identified by searching the PubMed and EMBASE databases from their inception until May 24, 2019. The outcome of interest was a fracture. This information was independently screened by two authors. When the heterogeneity among studies was significant, a random effects model was used to determine the overall combined risk estimate.

Results

In total, 12 cohort studies and 6 case-control studies were included. We used the Newcastle-Ottawa Scale (NOS) to evaluate the quality of the included literature, and 14 of the studies were considered high-quality studies. The overall relative risk of opioid therapy and fractures was 1.78 (95% confidence interval (CI) 1.53 - 2.07). Subgroup analyses revealed sources of heterogeneity, sensitivity analysis was stable, and no publication bias was observed.

Conclusions

The meta-analysis showed that the use of opioids significantly increased the risk of fracture.
Augmented base pairing networks encode RNA-small molecule binding preferences
Authors: Oliver Carlos , Mallet Vincent , Sarrazin Gendron Roman , Reinharz Vladimir , Hamilton William L. , Moitessier Nicolas , Waldispühl Jérôme
Published: July 2019

Abstract

Motivation

The binding of small molecules to RNAs is an important mechanism which can stabilize 3D structures or activate key molecular functions. To date, computational and experimental efforts toward small molecule binding prediction have primarily focused on protein targets. Considering that a very large portion of the genome is transcribed into non-coding RNAs but only few regions are translated into proteins, successful annotations of RNA elements targeted by small-molecule would likely uncover a vast repertoire of biological pathways and possibly lead to new therapeutic avenues.

Results

Our work is a first attempt at bringing machine learning approaches to the problem of RNA drug discovery. RNAmigos takes advantage of the unique structural properties of RNA to predict small molecule ligands for unseen binding sites. A key feature of our model is an efficient representation of binding sites as augmented base pairing networks (ABPNs) aimed at encoding important structural patterns. We subject our ligand predictions to two virtual screen settings and show that we are able to rank the known ligand on average in the 73rd percentile, showing a significant improvement over several baselines. Furthermore, we observe that graphs which are augmented with non-Watson Crick (a.k.a non-canonical) base pairs are the only representation which is able to retrieve a significant signal, suggesting that non-canonical interactions are an necessary source of binding specificity in RNAs. We also find that an auxiliary graph representation task significantly boosts performance by providing efficient structural embeddings to the low data setting of ligand prediction. RNAmigos shows that RNA binding data contains structural patterns with potential for drug discovery, and provides methodological insights which can be applied to other structure-function learning tasks.

Availability

Code and data is freely available at http://csb.cs.mcgill.ca/RNAmigos.

Contact

jerome@cs.mcgill.ca
Performance assessment of total RNA sequencing of human biofluids and extracellular vesicles
Authors: Everaert Celine , Helsmoortel Hetty , Decock Anneleen , Hulstaert Eva , Van Paemel Ruben , Verniers Kimberly , Nuytens Justine , Anckaert Jasper , Nijs Nele , Tulkens Joeri , Dhondt Bert , Hendrix An , Mestdagh Pieter , Vandesompele Jo
Published: July 2019

RNA profiling has emerged as a powerful tool to investigate the biomarker potential of human biofluids. However, despite enormous interest in extracellular nucleic acids, RNA sequencing methods to quantify the total RNA content outside cells are rare. Here, we evaluate the performance of the SMARTer Stranded Total RNA-Seq method in human platelet-rich plasma, platelet-free plasma, urine, conditioned medium, and extracellular vesicles (EVs) from these biofluids. We found the method to be accurate, precise, compatible with low-input volumes and able to quantify a few thousand genes. We picked up distinct classes of RNA molecules, including mRNA, lncRNA, circRNA, miscRNA and pseudogenes. Notably, the read distribution and gene content drastically differ among biofluids. In conclusion, we are the first to show that the SMARTer method can be used for unbiased unraveling of the complete transcriptome of a wide range of biofluids and their extracellular vesicles.
Detection and quantification of single mRNA dynamics with the Riboglow fluorescent RNA tag
Authors: Braselmann Esther , Stasevich Timothy J. , Lyon Kenneth , Batey Robert T. , Palmer Amy E.
Published: July 2019

Labeling and tracking biomolecules with fluorescent probes on the single molecule level enables quantitative insights into their dynamics in living cells. We previously developed Riboglow, a platform to label RNAs in live mammalian cells, consisting of a short RNA tag and a small organic probe that increases fluorescence upon binding RNA. Here, we demonstrate that Riboglow is capable of detecting and tracking single RNA molecules. We benchmark RNA tracking by comparing results with the established MS2 RNA tagging system. To demonstrate versatility of Riboglow, we assay translation on the single molecule level, where the translated mRNA is tagged with Riboglow and the nascent polypeptide is labeled with a fluorescent antibody. The growing effort to investigate RNA biology on the single molecule level requires sophisticated and diverse fluorescent probes for multiplexed, multi-color labeling of biomolecules of interest, and we present Riboglow as a new member in this toolbox.
Multiple Measures Reveal The Value of Both Race And Geographic Ancestry For Self-Identification
Authors: Damotte Vincent , Zhao Chao , Lin Chris , Williams Eric , Louzoun Yoram , Madbouly Abeer , Kotlarz Rochelle , McDaniel Marisa , Norman Paul J. , Lizee Antoine , Myres Natalie M. , Ball Catherine A. , Chahine Kenneth G. , Byrnes Jake , Wang Yong , Maiers Martin , Hollenbach Jill A.
Published: July 2019

There is long-standing tension regarding whether and how to use race or geographic ancestry in biomedical research. We examined multiple self-reported measures of race and ancestry from a cohort of over 100,000 U.S. residents alongside genetic data. We found that these measures are often non-overlapping, and that no single self-reported measure alone provides a better fit to genetic ancestry than a combination including both race and geographic ancestry. We also found that patterns of reporting for race and ancestry appear to be influenced by participation in direct-to-consumer genetic ancestry testing. Our results demonstrate that there is a place for the language of both race and geographic ancestry as we seek to empower individuals to fully describe their family history in research and medicine.

One Sentence Summary

Self-identification in the United States according to both racial and geographic terms best reflects genetic ancestry in individuals.
Two distinct actin filament populations have effects on mitochondria, with differences in stimuli and assembly factors
Authors: Fung Tak Shun , Ji Wei-Ke , Higgs Henry N. , Chakrabarti Rajarshi
Published: July 2019

Recent studies show that mitochondria and actin filaments work together in two contexts: 1) increased cytoplasmic calcium induces cytoplasmic actin polymerization that stimulates mitochondrial fission, and 2) mitochondrial depolarization causes actin assembly around mitochondria, with roles in mitophagy. It is unclear whether these two processes utilize similar actin assembly mechanisms. Here, we show that these are distinct actin assembly mechanisms in the acute phase after treatment (<10 min). Calcium-induced actin assembly is INF2-dependent and Arp2/3 complex-independent, whereas depolarization-induced actin assembly is Arp2/3 complex-dependent and INF2-independent. The two types of actin polymerization are morphologically distinct, with calcium-induced filaments throughout the cytosol and depolarization-induced filaments as “clouds” around depolarized mitochondria. We have previously shown that calcium-induced actin stimulates increases in both mitochondrial calcium and recruitment of the dynamin GTPase Drp1. In contrast, depolarization-induced actin is temporally-associated with extensive mitochondrial dynamics that do not result in mitochondrial fission, but in circularization of the inner mitochondrial membrane (IMM). These dynamics are dependent upon the protease Oma1 and independent of Drp1. Actin cloud inhibition causes increased IMM circularization, suggesting that actin clouds limit these dynamics.

Summary statement

Mitochondrial depolarization induces Arp2/3 complex-dependent actin clouds that restrain mitochondrial shape changes induced by Oma1 on the inner mitochondrial membrane. A distinct actin network stimulates mitochondrial fission in response to calcium.
Collapse and rescue of evolutionary food webs under global warming
Authors: Yacine Youssef , Allhoff Korinna T. , Weinbach Avril , Loeuille Nicolas
Published: July 2019

Global warming is severely impacting ecosystems and threatening ecosystem services as well as human well-being. While some species face extinction risk, several studies suggest the possibility that fast evolution may allow species to adapt and survive in spite of environmental changes.

We assess how such evolutionary rescue extends to multitrophic communities and whether evolution systematically preserves biodiversity under global warming.

More precisely, we expose simulated trophic networks of co-evolving consumers to warming under different evolutionary scenarios, which allows us to assess the effect of evolution on diversity maintenance. We also investigate how the evolution of body mass and feeding preference affects coexistence within a simplified consumer-resource module.

Our simulations predict that the long-term diversity loss triggered by warming is considerably higher in scenarios where evolution is slowed down or switched off completely, indicating that eco-evolutionary feedback indeed helps to preserve biodiversity. However, even with fast evolution, food webs still experience vast disruptions in their structure and functioning. Reversing warming may thus not be sufficient to restore previous structures.

Our findings highlight how the interaction between evolutionary rescue and changes in trophic structures constrains ecosystem responses to warming with important implications for conservation and management policies.
Investigating the influence of spore maturation and sporulation conditions on MalS expression during Bacillus subtilis spore germination
Authors: Swarge Bhagyashree , Nafid Chahida , Vischer Norbert , Brul Stanley
Published: July 2019

Spore forming bacteria of the orders Bacillales and Clostridiales play a major role in food spoilage and food-borne diseases. The spores remain in a dormant state for extended periods due to their highly resistant features. When environmental conditions become favourable, they can germinate as the germinant receptors located on the spore’s inner membrane get activated via germinant binding. This leads to the formation of vegetative cells via germination and subsequent outgrowth. The present study focuses on the synthesis of protein MalS during B. subtilis spore germination by investigating the dynamics of the fluorescence level of a MalS-GFP fusion protein using time-lapse fluorescence microscopy. Our results show an initial increase within the first 15 minutes of germination, followed by a drop and stabilization of the fluorescence throughout the spore ripening period. Western blot analyses, however, indicate no increase in the levels of the MalS-GFP fusion protein during the first 15 minutes after the addition of the germinants. Thus the instantaneous increase in fluorescence of MalS-GFP may likely due to a change in the physical environment as the spore germination is triggered. Our findings also show that the different sporulation conditions and the maturation time of spores affect the expression of MalS-GFP and the germination behaviour of the spores.
Prior Experience Alters the Appearance of Blurry Object Borders
Authors: Perez Diana C. , Cook Sarah M. , Peterson Mary A.
Published: July 2019

Object memories activated by borders serve as priors for figure assignment: figures are more likely to be perceived on the side of a border where a well-known object is sketched. Do object memories also affect the appearance of object borders? Memories represent past experience with objects; memories of well-known objects include many with sharp borders because they are often fixated. We investigated whether object memories affect appearance by testing whether blurry borders appear sharper when they are contours of well-known objects versus matched novel objects. Participants viewed blurry versions of one familiar and one novel stimulus simultaneously for 180ms; then made comparative (Exp. 1) or equality judgments regarding perceived blur (Exps. 2-4). For equivalent levels of blur, the borders of well-known objects appeared sharper than those of novel objects. These results extend evidence for the influence of past experience to object appearance, consistent with dynamic interactive models of perception.
Normalization by Valence and Motivational Intensity in the Sensorimotor Cortices (PMd, rM1, and cS1)
Authors: Yao Zhao , Hessburg John P , Francis Joseph Thachil
Published: July 2019

Our brain’s ability to represent vast amounts of information, such as continuous ranges of reward spanning orders of magnitude, with limited dynamic range neurons, may be possible due to normalization. Recently our group and others have shown that the sensorimotor cortices are sensitive to reward value. Here we ask if psychological affect causes normalization of the sensorimotor cortices by modulating valence and motivational intensity. We had two non-human primate (NHP) subjects (one male bonnet macaque and one female rhesus macaque) make visually cued grip-force movements while simultaneously cueing the level of possible reward if successful, or timeout punishment, if unsuccessful. We recorded simultaneously from 96 electrodes in each the following: caudal somatosensory, rostral motor, and dorsal premotor cortices (cS1, rM1, PMd). We utilized several normalization models for valence and motivational intensity in all three regions. We found three types of divisive normalized relationships between neural activity and the representation of valence and motivation, linear, sigmodal, and hyperbolic. The hyperbolic relationships resemble receptive fields in psychological affect space, where a unit is susceptible to a small range of the valence/motivational space. We found that these cortical regions have both strong valence and motivational intensity representations.
The MRL/MpJ Mouse Strain Is Not Protected From Muscle Atrophy And Weakness After Rotator Cuff Tear
Authors: Talarek Jeffrey R , Piacentini Alex N , Konja Alexis C , Wada Susumu , Swanson Jacob B , Nussenzweig Samuel C , Dines Joshua S , Rodeo Scott A , Mendias Christopher L
Published: July 2019

Chronic rotator cuff tears are a common source of shoulder pain and disability. Patients with rotator cuff tears often have substantial weakness, fibrosis, and fat accumulation which limit successful surgical repair and postoperative rehabilitation. The Murphy Roths Large (MRL) strain of mice have demonstrated superior healing and protection against pathological changes in several disease and injury conditions. We tested the hypothesis that, compared to the commonly used C57Bl/6 (B6) strain, MRL mice would have less muscle fiber atrophy and fat accumulation, and be protected against the loss in force production that occurs after cuff tear. Adult male mice B6 and MRL mice were subjected to a rotator cuff tear, and changes in muscle fiber contractility and histology were measured. RNA sequencing, and shotgun metabolomics and lipidomics were also performed. Muscles were harvested one month after tear. B6 and MRL mice had a 40% reduction in relative muscle force production after rotator cuff tear. RNA sequencing identified an increase in fibrosis-associated genes and a reduction in mitochondrial metabolism genes. Markers of glycolytic metabolism increased in B6 mice, while MRL mice appeared to increase amino acid metabolism after tear. There was an accumulation of lipid after injury, although there was a divergent response between B6 and MRL mice in the types of lipid species that accrued. There were strain-specific differences between the transcriptome, metabolome, and lipidome of B6 and MRL mice, but these differences did not protect MRL mice from weakness and pathological changes after rotator cuff tear.
Methods matter: your measures of explicit and implicit processes in visuomotor adaptation affect your results
Authors: Maresch Jana , Werner Susen , Donchin Opher
Published: July 2019

Visuomotor rotations are frequently used to study the different processes underlying motor adaptation. Explicit aiming strategies and implicit recalibration are two of these processes. Various methods, which differ in their underlying assumptions, have been used to dissociate the two processes. Direct methods, such as verbal reports, assume explicit knowledge to be verbalizable, where indirect methods, such as the exclusion, assume that explicit knowledge is controllable. The goal of this study was thus to directly compare verbal reporting with exclusion in two different conditions: during consistent reporting and during intermittent reporting. Our results show that our two conditions lead to a dissociation between the measures. In the consistent reporting group, all measures showed similar results. However, in the intermittent reporting group, verbal reporting showed more explicit re-aiming and less implicit adaptation than exclusion. Curiously, when exclusion was measured again, after the end of learning, the differences were no longer apparent. We suspect this may reflect selective decay in implicit adaptation, as has been reported previously. All told, our results clearly indicate that methods of measurement can affect the amount of explicit re-aiming and implicit adaptation that is measured. Since it has been previously shown that both explicit re-aiming and implicit adaptation have multiple components, discrepancies between these different methods may arise because different measures reflect different components.
Taxonomically informed scoring enhances confidence in natural products annotation
Authors: Rutz Adriano , Dounoue-Kubo Miwa , Ollivier Simon , Bisson Jonathan , Bagheri Mohsen , Saesong Tongchai , Nejad Ebrahimi Samad , Ingkaninan Kornkanok , Wolfender Jean-Luc , Allard Pierre-Marie
Published: July 2019

Mass spectrometry (MS) hyphenated to liquid chromatography (LC)-MS offers unrivalled sensitivity for metabolite profiling of complex biological matrices encountered in natural products (NP) research. With advanced platforms LC, MS/MS spectra are acquired in an untargeted manner on most detected features. This generates massive and complex sets of spectral data that provide valuable structural information on most analytes. To interpret such datasets, computational methods are mandatory. To this extent, computerized annotation of metabolites links spectral data to candidate structures. When profiling complex extracts spectra are often organized in clusters by similarity via Molecular Networking (MN). A spectral matching score is usually established between the acquired data and experimental or theoretical spectral databases (DB). The process leads to various candidate structures for each MS features. At this stage, obtaining high annotation confidence level remains a challenge notably due to the high chemodiversity of specialized metabolomes.

The integration of additional information in a meta-score is a way to capture complementary experimental attributes and improve the annotation process. Here we show that integrating unambiguous taxonomic position of analyzed samples and candidate structures enhances confidence in metabolite annotation. A script is proposed to automatically input such information at various granularity levels (species, genus, and family) and weight the score obtained between experimental spectral data and output of available computational metabolite annotation tools (ISDB-DNP, MS-Finder, Sirius). In all cases, the consideration of the taxonomic distance allowed an efficient re-ranking of the candidate structures leading to a systematic enhancement of the recall and precision rates of the tools (1.5 to 7-fold increase in the F1 score). Our results clearly demonstrate the importance of considering taxonomic information in the process of specialized metabolites’ annotation. This requires to access structural data systematically documented with biological origin, both for new and previously reported NPs. In this respect, the establishment of an open structural DB of specialized metabolites and their associated metadata (particularly biological sources) is timely and critical for the NP research community.
Kv2.1 mediates spatial and functional coupling of L-type calcium channels and ryanodine receptors in neurons
Authors: Vierra Nicholas C. , Kirmiz Michael , van der List Deborah , Santana L. Fernando , Trimmer James S.
Published: July 2019

The voltage-gated K+channel Kv2.1 serves a major structural role in the soma and proximal dendrites of brain neurons, tethering the plasma membrane (PM) to the endoplasmic reticulum (ER). Although Kv2.1 clustering at neuronal ER-PM junctions (EPJs) is tightly regulated and conserved across species, its function at these sites is unclear. By identifying and evaluating proteins in close spatial proximity to Kv2.1-containing EPJs, we discovered that a significant role of Kv2.1 at EPJs is to promote the clustering and functional coupling of PM L-type Ca2+channels (LTCCs) to ryanodine receptor (RyR) ER Ca2+release channels. Kv2.1 clustering also unexpectedly enhanced LTCC opening at polarized membrane potentials. This enabled Kv2.1-LTCC-RyR triads to generate localized Ca2+release events (i.e., Ca2+sparks) independently of action potentials. Together, these findings uncover a novel mode of LTCC regulation and establish a unique mechanism whereby Kv2.1-associated EPJs provide a molecular platform for localized somatodendritic Ca2+signals.
Changing clinical trends in 10 000 robot‐assisted laparoscopic prostatectomy patients and impact of the 2012 US Preventive Services Task Force's statement against PSA screening
Authors: Onol Fikret F. , P. Ganapathi Hariharan , Rogers Travis , Palmer Kenneth , Coughlin Geoff , Samavedi Srinivas , Coelho Rafael , Jenson Cathy , Sandri Marco , Rocco Bernardo , Patel Vipul
Published: July 2019

Objectives

To evaluate the clinical trend changes in our robot‐assisted laparoscopic prostatectomy (RALP) practice and to investigate the effect of 2012 US Preventive Services Task Force (USPSTF) statement against PSA screening on these trends.

Patients and Methods

Data of 10 000 RALPs performed by a single surgeon between 2002 and 2017 were retrospectively analysed. Time trends in successive 1000 cases for clinical, surgical and pathological characteristics were analysed with linear and logistic regression. Time‐trend changes before and after the USPSTF's statement were compared using a logistic regression model and likelihood‐ratio test.

Results

Unfavourable cancer characteristics rate, including D'Amico high risk, pathological non‐organ‐confined disease and Gleason score ≥4+4 increased from 11.5% to 23.3%, 14% to 42.5%, and 7.7% to 20.9%, respectively, over time (all P < 0.001). Significant time‐trend changes were detected after the USPSTF's statement with an increase in the positive trend of Gleason ≥4+4 and increase in the negative trends of Gleason ≤3+4 tumours. There was a significant negative trend in the rate of full nerve‐sparing (NS) with a decrease from 59.3% to 35.7%, and a significant positive trend in partial NS with an increase from 15.8% to 62.5% over time (both P < 0.001). The time‐trend slope in ‘high‐grade’ partial NS significantly decreased and ‘low‐grade’ partial NS significantly increased after the USPSTF's statement. The overall positive surgical margin rate increased from 14.6% to 20.3% in the first vs last 1000 cases (P < 0.001), with a significant positive slope after the USPSTF's statement.

Conclusions

The proportion of high‐risk patients increased in our series over time with a significant impact of the USPSTF's statement on pathological time trends. This stage migration resulted in decreased utilisation of high‐quality NS and increased performance of poor‐quality NS.
Environmental Learning of Social Cues: Evidence From Enhanced Gaze Cueing in Deaf Children
Authors: Pavani Francesco , Venturini Marta , Baruffaldi Francesca , Caselli Maria Cristina , van Zoest Wieske
Published: July 2019

The susceptibility to gaze cueing in deaf children aged 7–14 years old (N = 16) was tested using a nonlinguistic task. Participants performed a peripheral shape‐discrimination task, whereas uninformative central gaze cues validly or invalidly cued the location of the target. To assess the role of sign language experience and bilingualism in deaf participants, three groups of age‐matched hearing children were recruited: bimodal bilinguals (vocal and sign‐language, N = 19), unimodal bilinguals (two vocal languages, N = 17), and monolinguals (N = 14). Although all groups showed a gaze‐cueing effect and were faster to respond to validly than invalidly cued targets, this effect was twice as large in deaf participants. This result shows that atypical sensory experience can tune the saliency of a fundamental social cue.
Risk of ischaemic stroke in thyrotoxic atrial fibrillation
Authors: Chen Zhih‐Cherng , Wu Nan‐Chun , Chang Chia‐Li , Ho Chung‐Han , Liao Chia‐Te , Chiang Chun‐Yen , Chang Wei‐Ting
Published: July 2019

Objective

Atrial fibrillation (AF) is the most common cardiac complication of thyrotoxicosis and is strongly implicated in thromboembolic events. However, the incidence of stroke in thyrotoxic AF remains unclear. Herein, we aimed to investigate the risks of mortality and ischaemic stroke between patients with thyrotoxic AF and nonthyrotoxic AF.

Designs and Methods

From Taiwan's National Health Insurance Research Database, 1868 patients with the concomitant diagnoses of AF and thyrotoxicosis identified between 2001 and 2010 were compared to 7472 patients with nonthyrotoxic AF using propensity score matching for age, sex and comorbidities.

Results

There was no significant difference in either CHA2DS2‐VASc score or anticoagulant usage between the groups. Alternatively, the thyrotoxic group contained more β‐blocker/digoxin users, whereas the nonthyrotoxic group contained more statin users. Patients with thyrotoxic AF exhibited lower risks of all‐cause mortality (HR: 0.66, CI: 0.59‐0.73, P < .0001) and ischaemic stroke (HR: 0.73, CI: 0.64‐0.84, P < .0001) than those with nonthyrotoxic AF, especially thyrotoxic patients with CHA2DS2‐VASc scores ≥1. Comorbidities, including diabetes, hyperlipidaemia, hypertension and coronary artery disease, contributed to all‐cause mortality in patients with nonthyrotoxic AF; however, this effect was diminished in thyrotoxic AF.

Conclusions

Patients with thyrotoxicosis and AF have a lower risk of stroke than patients with nonthyrotoxic AF. Treatment for thyrotoxicosis is also crucial as the prescription of anticoagulants based on CHA2DS2‐VASc scores.
Effect of OSAS on cerebral vasoreactivity and cIMT before and after CPAP treatment
Authors: Piraino Alessio , Sette Giuliano , D'Ascanio Michela , La Starza Sara , Aquilini Mauro , Ricci Alberto
Published: July 2019

Introduction

Obstructive sleep apnea syndrome (OSAS) has been shown to be an important risk factor for ischaemic cerebral disease. Specific Doppler parameters may be used to measure cerebral vascular dynamics opening the door to new markers/predictors of risk. The objective of our study was to shed light on how the treatment of OSA with continuous positive airway pressure (CPAP) may have an impact on these parameters and, consequently, lower the risk of cerebral ischemic events in these patients.

Methods

A total of 40 untreated patients diagnosed with moderate to severe obstructive sleep apnoea were submitted to a comprehensive ultrasonographic transcranial Doppler evaluation. The parameters measured were: Breath holding index (BHI), mean blood flow velocity (MBFV) and pulsatility index in middle cerebral artery. Colour Doppler ultrasound was also used to measure carotid intima‐media thickness (cIMT). These parameters were compared before and after CPAP treatment.

Results

After CPAP treatment, MBFV and BHI were shown to be increased (without statistical significance), while cIMT and polysomnographic parameters were significantly decreased.

Conclusion

The improvement of cerebral vasoreactivity parameters and cIMT after long‐term CPAP treatment suggest that treatment of OSA may influence the cerebral vascular regulation and consequently reduce the risk of stroke.
Rural to urban migration contributes to the high burden of asthma in the urban area
Authors: Ponte Eduardo Vieira , Lima Aline , Almeida Paula Cristina Andrade , de Jesus Juliana Pires Viana , Souza‐Machado Adelmir , Barreto Maurício Lima , Cruz Álvaro A.
Published: July 2019

Introduction

It is unknown whether rural‐urban migration contributes to worse the burden of asthma in the cities.

Objectives

The aim of this study was to evaluate whether subjects with asthma that migrated from rural areas to a large urban center in Brazil have more severe disease than asthmatic subjects that was born and always lived in the urban area.

Methods

This is a case‐control study. We enrolled two groups of subjects with asthma currently living in a large urban center in Brazil: 486 subjects with moderate‐severe asthma and 432 subjects with mild asthma.

Results

Rural‐urban migrants had higher odds of moderate‐severe asthma [adjusted OR 1.57, 95% CI (1.18‐2.01)] and uncontrolled symptoms of asthma [adjusted OR 1.80, 95% CI (1.16‐2.76)] than urban‐born subjects.

Conclusions

Rural‐urban migrants in Brazil have more severe asthma than urban‐born subjects. Our results suggest that rural‐urban migration is associated with the high burden of asthma in the urban area.
Diagnosing Kikuchi's disease on fine needle aspiration biopsy
Authors: Wang Miao , Yu Xiaomeng , Yang Yan
Published: July 2019

Objective

To investigate the diagnostic utility of fine needle aspiration (FNA) smear, cell block (CB), flow cytometry (FC) and tuberculosis polymerase chain reaction (Tb‐PCR) analysis for Kikuchi's disease (KD).

Methods

A total of 173 FNA biopsy samples were collected using a Youyi aspirator. KD was diagnosed by FNA smear, with or without, CB, FC and Tb‐PCR.

Results

Out of 173 patients, 131 (75.7%) were female and 126 (72.8%) aged 21‐40 years. Of these, 171 patients (98.8%) presented with painful enlarged cervical lymph nodes. All cytological samples identified intracellular apoptotic debris embedded in the cytoplasm of crescentic and phagocytic macrophages. In 24 cell‐blocks (CBs), clusters of CD123 positive plasmacytoid monocytes were observed in KD. FC and CBs showed non‐specific lymphoid hyperplasia in nine cases with suspicious lymphoma. Tb‐PCR was negative in five cases with suspicion of tuberculosis.

Conclusions

In summary, FNA biopsy is a fast, reliable, and relatively inexpensive diagnosis tool for KD. CB preparation is an important adjunct method for the diagnosis of KD.
How older people enact care involvement during transition from hospital to home: A systematic review and model
Authors: Murray Jenni , Hardicre Natasha , Birks Yvonne , O’Hara Jane , Lawton Rebecca
Published: July 2019

Background

Current models of patient‐enacted involvement do not capture the nuanced dynamic and interactional nature of involvement in care. This is important for the development of flexible interventions that can support patients to ‘reach‐in’ to complex health‐care systems.

Objective

To develop a dynamic and interactional model of patient‐enacted involvement in care.

Search strategy

Electronic search strategy run in five databases and adapted to run in an Internet search engine supplemented with searching of reference lists and forward citations.

Inclusion criteria

Qualitative empirical published reports of older people's experiences of care transitions from hospital to home.

Data extraction and synthesis

Reported findings meeting our definition of involvement in care initially coded into an existing framework. Progression from deductive to inductive coding leads to the development of a new framework and thereafter a model representing changing states of involvement.

Main results

Patients and caregivers occupy and move through multiple states of involvement in response to perceived interactions with health‐care professionals as they attempt to resolve health‐ and well‐being‐related goals. ‘Non‐involvement’, ‘information‐acting’, ‘challenging and chasing’ and ‘autonomous‐acting’ were the main states of involvement. Feeling uninvolved as a consequence of perceived exclusion leads patients to act autonomously, creating the potential to cause harm.

Discussion and conclusion

The model suggests that involvement is highly challenging for older people during care transitions. Going forward, interventions which seek to support patient involvement should attempt to address the dynamic states of involvement and their mediating factors.
Quality of life in patients aged 65 years and older with overactive bladder treated with mirabegron across eight European countries: Secondary analysis of BELIEVE
Authors: Foley Stephen , Choudhury Nurul , Huang Moses , Stari Anny , Nazir Jameel , Freeman Robert
Published: July 2019

Objectives

To describe quality of life outcomes in patients with overactive bladder aged ≥65 years receiving mirabegron, a β3‐adrenoreceptor agonist (BELIEVE).

Methods

BELIEVE was a European, prospective, non‐interventional, real‐world study of 848 patients with overactive bladder prescribed mirabegron in clinical practice. Overactive bladder questionnaire subscales were prespecified primary end‐points, analyzed in the full analysis set (patients completing the questionnaire at baseline and ≥1 follow‐up visit) and per protocol set (patients still taking mirabegron at 10–12 months) using accepted standards for minimally important differences (10 points).

Results

Nearly half of the patients in the full analysis set (380/796 [47.7%]) and per protocol set (224/452 [49.6%]) were aged ≥65 years. Similar proportions of patients aged ≥65 years (224/407; 55.0%) and <65 years (228/441; 51.7%) were taking mirabegron at 10–12 months. Mean symptom bother scores improved from baseline to month 10–12 in older patients (full analysis set 52.4 to 32.9; per protocol set 51.6 to 30.4) and younger patients (full analysis set 52.2 to 27.4; per protocol set 47.8 to 23.7). Proportions of older/younger patients with improvement in symptom bother were similar (full analysis set 52.1%/52.9%; per protocol set 70.1%/72.4%, respectively). Mean total quality of life scores improved in older patients (full analysis set 60.7–75.9; per protocol set 61.1–77.5) and younger patients (full analysis set 54.9 to 77.6; per protocol set 56.8 to 80.1). No unexpected safety issues were observed.

Conclusions

Patients aged ≥65 years receiving mirabegron in clinical practice reported clinically meaningful improvements in quality of life.
Pressureless low temperature sintering of nanocrystalline zirconia ceramics via dry powder processing
Authors: Drazin John W. , Wollmershauser James A. , Ryou Heonjune , Wolak Mason A. , Gorzkowski Edward P.
Published: July 2019

Pressureless sintering approaches provide a simple avenue to manufacture dense ceramic parts with minimal processing equipment, but current pressureless sintering techniques have yet to demonstrate capabilities of producing dense ceramics while maintaining sub‐50 nm grain sizes. Nanocrystalline yttria stablized zirconia ceramics were process from 4 mol% yttria stablized zirconia (4YSZ) nanopowders with a crystallite size of 7.5 nm using dry cold isostatic pressing (CIP) where powders are dried immediately prior to green compact formation and CIP vacuum bagging. It is shown that CIP pressures >75 000 psi (517 MPa) effectively remove pores larger than 100 nm and that pressureless sintering occurs at reduced temperatures for green densities ≥50%. Though the sintering kinetics are shown to be similar to other zirconia nanopowder sintering studies, the small initial crystallize size and reduced sintering temperature allowed densities as high as 97.2%, while retaining a ceramic grain size at or below 40 nm. Produced nanocrystalline 4YSZ ceramics with a grain size of 30.3 nm and a density of 96.3% had Vicker's hardnesses as high as 14.2 GPa and Vicker's indentation fracture resistance of 3.43 MPa·, demonstrating that simple processing approaches can be refined to fabricate nanocrystalline ceramics while maintaining high hardness and indentation fracture resistance.
Fabrication, microstructure, and optical properties of Yb:Y3ScAl4O12 transparent ceramics with different doping levels
Authors: Feng Yagang , Toci Guido , Pirri Angela , Patrizi Barbara , Hu Zewang , Wei Jiabei , Pan Hongming , Zhang Xing , Li Xiaoying , Su Sha , Vannini Matteo , Li Jiang
Published: July 2019

Transparent Yb:Y3ScAl4O12 (Yb:YSAG) ceramics with different ytterbium doping concentrations such as 5, 10, 15, 20 at.% have been successfully fabricated by solid‐state reactive sintering. All the obtained ceramics are in dense and homogeneous structure after sintering at 1820°C for 30 hours and with a posttreatment by hot isostatic pressing at 1750°C for 3 hours with 200 MPa pressure. We systematically analyzed the influence of Yb3+ doping concentration on the microstructure and optical properties of the ceramics. The 10 at.% Yb:Y3ScAl4O12 ceramics with a thickness of 3.2 mm show the best transparency as high as 80.9% at 1100 nm. The laser emission of the 10 at.% Yb:YSAG ceramics was tested, resulting in a maximum slope efficiency of 67.6% and a maximum output power of 11.3 W under quasi‐continuous wave pump conditions. The tuning range spanned from 990 to 1071 nm.
The mobilizing and protective role of national identification in normative and non‐normative collective action
Authors: Stathi Sofia , Vezzali Loris , Waldzus Sven , Hantzi Alexandra
Published: July 2019

In the context of the financial crisis in Europe and drawing on social identity and perceived disadvantage literature, this research explored national identification, perceived prejudice, perceived ostracism, and anger as predictors of intentions to engage in normative collective action and support for non‐normative and destructive action. Correlational data were collected in Greece (N = 218), Portugal (N = 312), and Italy (N = 211) during the financial crisis that affected several European countries in the early 2010s. Hierarchical regressions showed that national identification, above and beyond all other variables, positively predicted normative collective action intentions, and negatively predicted support for non‐normative action. That is, people who were identified more strong with their national identity were more likely to report that they will engage in collective action to enhance the position of their (national) in‐group, and less likely to support destructive collective action. Mediation analyses revealed that in the case of Portugal and Italy, national identification associated negatively with anger, while anger positively predicted normative collective action. The findings of this research point to the importance of national identification as a factor, that, on the one hand motivates people's mobilization toward supporting the rights of the ingroup but on the other hand impedes the more negative and destructive side of collective action. The contextual and instrumental role of national identity in contexts of threat is discussed.
Revisiting the influence of aggressive interactions on the survival of the first‐laid egg in crested penguins (genusEudyptes)
Authors: Massaro Melanie , Davidson R. Scott , Freire Rafael , Davis Lloyd S.
Published: July 2019

Crested penguinsEudyptesspp. have evolved a unique form of breeding in which the first of two eggs laid is much smaller than the second and has a higher likelihood of being lost during egg laying and incubation. In this study, we quantified aggressive behaviour in nesting Snares penguins and undertook an egg survival analysis to examine which factors influence egg loss. During 120 h of observation of 50 nests, we recorded a total of 300 aggressive events in which females were repeatedly pecked, bitten and beaten. Aggressive events lasted from less than a minute to up to 55 min (mean 4.6 ± 7.4 min). Single males were the aggressor in 75% of aggressive events and in 50.7% of aggressive events the aggressor was identified as a neighbouring, breeding male. A greater percentage of the small first eggs (34%) were lost than the large second eggs (4%). We found that egg mortality was influenced by 1) whether the other egg within a nest had hatched, 2) who was present at the nest (father, mother or both) and 3) the average duration of aggressive events on the nest. When one egg within a nest had hatched, the other egg had a vastly increased mortality risk irrespective of aggression. However, long, aggressive events directed towards females after their partners had gone foraging, also increased the probability of egg loss. We suggest that the prolonged nest attendance by breeding males well beyond egg laying is in response to the high frequency of aggressive behaviour during this time. Our data show that A‐egg losses occur due to intraspecific aggression in this species. Further research is needed to clarify whether aggressive behaviour in breeding crested penguins is modulated by elevated testosterone levels in the males and whether any reproductive benefits accrue to the aggressors.
Danger management and the seasonal adjustment of migratory speed by sandpipers
Authors: Ydenberg R. C. , Hope D. D.
Published: July 2019

The behavior of migrating birds is governed by time‐, energy‐ and danger‐minimizing strategies. The adjustment of migration speed (i.e. the rate at which distance is covered during a migration) is a behavioral tactic that might contribute to these strategic goals. Shorter stopovers and greater fuel loads increase migration speed, but both require more intensive foraging at stopovers, making migrants more vulnerable to predators. A simple numerical model shows how seasonal alterations in migration speed can lower the exposure of western sandpipers to peregrine falcons, their most important predator. The ‘caution–speed–caution’ pattern of higher migration speed in the mid‐passage period, observed in earlier work, requires that the intensive foraging necessary heightens vulnerability, and that migrants are exposed to both migrant predators as well as predators resident at migratory stopovers.
Comparing treatments for basal cell carcinoma in terms of long‐term treatment‐failure: a network meta‐analysis
Authors: Fukumoto T. , Fukumoto R. , Oka M. , Horita N.
Published: July 2019

Abstracts

Although many variations of guidelines have been released, there is limited research that compares multiple treatment strategies for basal cell carcinoma (BCC). The aim of this study was to systematically review the studies reporting on multiple treatments for BCC with systematic review and network meta‐analyses. Search formulas for databases, such as PubMed, EMBASE, Web of Science Core Collection and Cochrane Central Register of Controlled Trials, were created with the support of Cochrane Japan. The patient‐level and tumour‐level meta‐analyses were performed for both the long‐term treatment‐failure and treatment‐success. Of the 1464 studies identified from the database and hand searches, 14 met our inclusion criteria. These 14 studies included 2524 patients and 1738 tumours. Our study indicated that the incidence of treatment‐failure of invasive treatments such as surgery and Mohs micrographic surgery was significantly lower than that of superficial therapies such as cryotherapy, photodynamic therapy, radiotherapy or topical therapies, in the patient‐level and the tumour‐level analyses, despite histological‐type and pretreatment. Relapse of BCC may be a low life‐threatening risk, and there are merits of non‐surgical treatment. However, the significant difference in the recurrence rate is essential. Our study can provide useful guidance to clinicians in selecting treatment options for BCC.