bluuebunny/crossref_metadata_2025 huggingface dataset:
Key Considerations for Implementing Group Prenatal Care: Lessons from 60 Practices
Authors: Pekkala Jodi , Cross‐Barnet Caitlin , Kirkegaard Margaret , Silow‐Carroll Sharon , Courtot Brigette , Hill Ian
Published: October 2019

Introduction

Group prenatal care combines clinical care with peer support and education. Research has indicated neutral or positive results for group care when compared with traditional individual prenatal visits. A national initiative, Strong Start II, was implemented to determine if specific prenatal care interventions such as group prenatal care can reduce the rate of preterm birth, improve health outcomes, and lower costs. This study explored barriers to implementation and sustainability and strategies for overcoming barriers and sustaining the model.

Methods

Results from prenatal care provider‐level qualitative case studies for the independent evaluation of Strong Start were examined. Case studies for sites implementing group prenatal care were based on a total of 313 interviews with 441 Strong Start key informants (eg, prenatal care providers, project staff, and health administrators involved in group care) and 53 focus groups with 428 Strong Start participants from 2013 to 2016. Supplemental interviews with 25 additional stakeholders were also conducted. Case study data were queried using content analysis followed by a grounded theory‐based analysis of these findings.

Results

Barriers to implementation existed at patient, provider, administrator, system, and funding levels and included inflexible appointment times, lack of childcare, lack of appropriate meeting space, new scheduling and training needs, meeting requirements of graduate medical education programs, prenatal care provider and administrator reluctance to adopt new practices, and Medicaid payment policies. Sites newly implementing group prenatal care had varying degrees of success sustaining their programs. Both new and established sites identified provider champions and opt‐out enrollment approaches as critical for maintaining buy‐in.

Discussion

Successful implementation of group prenatal care depends on systematic strategies at the practice, payer, provider, patient, and policy levels to implement, reimburse for, and sustain the model. Strategies for overcoming barriers can assist practices in offering this transformative approach, including practices with graduate medical education programs or those serving women with clinical, demographic, or psychosocial risk factors for preterm birth.
Are genetic and idiopathic forms of Parkinson's disease the same disease?
Authors: Correia Guedes Leonor , Mestre Tiago , Outeiro Tiago F. , Ferreira Joaquim J.
Published: October 2019

Genetic forms represent a small fraction of Parkinson's disease (PD) but their discovery has revolutionized research in the field, putting α‐synuclein in the spotlight, and uncovering other key neuropathological mechanisms of the disease. The question of whether genetic and idiopathic PD (iPD) correspond to a same disease entity is not simply philosophical, has implications for the discovery of the biological background of PD and for the development of novel therapeutic strategies that may also be applicable to the larger iPD group. Here, we review the current landscape of what has been labeled genetic PD and critically discuss the rational for merging or separating genetic and idiopathic forms of PD as the same or different disease entities. We conclude by addressing the potential implications for future research.

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Bilateral abdominopelvic lymphoceles secondary to huge uterine leiomyomas: A case report
Authors: Al‐Shukri Maryam , Manjunath Attibele P. , Koliyadan Sreedharan , Al‐Qassabi Badriya
Published: October 2019

Pelvic lymphocele secondary to uterine leiomyoma has not been previously reported. We report a case of abdominopelvic lymphocele associated with huge uterine fibroids which was managed conservatively. A 39‐year‐old unmarried lady presented with pressure symptoms in pelvis was diagnosed to have a huge uterine leiomyomas occupying the entire abdomen. Magnetic resonance imaging of pelvis and abdomen demonstrated multiple uterine fibroids. In addition, bilateral cystic structures were seen in the pelvis with extension to the para‐colic gutters. During myomectomy, bilateral abdominopelvic lymphoceles were noted which required only fine‐needle aspiration. Follow up abdominal ultrasound at 6 weeks, demonstrated spontaneous resolution of these lesions. The pressure exerted by these huge uterine leiomyomas might have possibly obstructed the lymphatic drainage leading to bilateral abdominopelvic lymphoceles. These secondary lymphoceles resolve spontaneously and does not need any further diagnostic procedures or surgical interventions.
Can artificial diets be a feasible alternative for the gonadal growth and maturation of the sea urchin Paracentrotus lividus (Lamarck, 1816)?
Authors: Santos Pedro M. , Ferreira Susana M. F. , Albano Pedro , Raposo Andreia , Costa José L. , Pombo Ana
Published: October 2019

Paracentrotus lividus (Lamarck 1816) has high‐value reddish‐orange gonads that are regarded as a delicacy. In this study, three jellified diets have been tested for 90 days to assess the effect of different diets on P. lividus somatic and gonadal growth, gonad color, and reproductive state. All diets contained agar as a gelling agent and consisted of: maize and spinach (A); maize, spinach, and macroalga Laminaria digitata (B); and maize, spinach, and pumpkin Cucurbita maxima (C). Diet B was the most successful in promoting somatic growth with regard to test diameter (1.2 mm month−1) and total wet weight (79.9 mg ind−1 day−1). The individuals from Diet A presented a higher final gonadosomatic index (9.07 ± 2.39%) where all sea urchins initially presented with an index of 3.33 ± 0.02%. Diets A and C led to a marked advance (p < .05) in the gametogenic cycle (66.7% and 46.7% of the individuals with mature gametes, respectively), while Diet B resulted in less‐developed gonadal stages, which are more appropriate for commercial purposes in terms of sensorial characteristics appreciated by the consumers. The gonad color analyses confirmed a redder roe in females and also the suitability of C. maxima as a potential gonad color enhancer for P. lividus.
Repeated evolution of queen parthenogenesis and social hybridogenesis in Cataglyphis desert ants
Authors: Kuhn Alexandre , Darras Hugo , Paknia Omid , Aron Serge
Published: October 2019

Over the last decade, genetic studies on social insects have revealed a remarkable diversity of unusual reproductive strategies, such as male clonality, female clonality, and social hybridogenesis. In this context, Cataglyphis desert ants are useful models because of their unique reproductive systems. In several species, queens conditionally use sexual reproduction and parthenogenesis to produce sterile workers and reproductive queens, respectively. In social hybridogenesis, two distinct genetic lineages coexist within a population, and workers result from mating between partners of different lineages; in contrast, queens and males are both produced asexually by parthenogenesis. Consequently, nonreproductive workers are all interlineage hybrids, whereas reproductives are all pure lineage individuals. Here, we characterized the reproductive systems of 11 species to investigate the distribution of the conditional use of sex and social hybridogenesis in Cataglyphis. We identified one new case in which sexual reproduction was conditionally used in the absence of dependent‐lineage reproduction. We also discovered five new instances of social hybridogenesis. Based on our phylogenetic analyses, we inferred that both the conditional use of sex and social hybridogenesis independently evolved multiple times in the genus Cataglyphis.
Attributes of person‐centred communication: A qualitative exploration of communication with older persons in home health care
Authors: Sundler Annelie J , Hjertberg Frida , Keri Helena , Holmström Inger K
Published: October 2019

Background

Previous research points to challenges related to the home healthcare of older persons and to the complexity of communication. Although person‐centred care has been advocated widely, there remains a need for in‐depth knowledge on how to enable person‐centred and supportive communication in the care of older persons.

Aim

The aim of this study was to explore attributes of person‐centred communication between nurses and older persons being cared for in their home.

Methods

A descriptive study with a qualitative approach was conducted. A data set from the COMHOME‐study consisting of 77 audio‐recorded home healthcare visits between registered nurses and older persons was analysed with a method for qualitative thematic analysis.

Results

The findings indicate that the attributes of person‐centred communication comprise recognising, inviting and involving older persons. To facilitate this form of communication, attentiveness and responsiveness on the part of RNs seemed significant. Person‐centred communication was facilitated when the RNs used verbal expressions to emphasise and acknowledge the older persons’ views and were attentive to their emotions and expressions.

Conclusion

The nurses’ attentiveness and responsiveness seems important for person‐centred communication with older persons. Communication skills are needed to recognise, invite and involve older persons in their care and to support their health and well‐being.

Implication for practice

The importance of communication which facilitate a person‐centred approach by nurses should be acknowledged when caring for older persons and included in education and training.
GABA‐A receptor and mitochondrial TSPO signaling act in parallel to regulate melanocyte stem cell quiescence in larval zebrafish
Authors: Allen James R. , Skeath James B. , Johnson Stephen L.
Published: October 2019

Tissue regeneration and homeostasis often require recruitment of undifferentiated precursors (adult stem cells; ASCs). While many ASCs continuously proliferate throughout the lifetime of an organism, others are recruited from a quiescent state to replenish their target tissue. A long‐standing question in stem cell biology concerns how long‐lived, non‐dividing ASCs regulate the transition between quiescence and proliferation. We study the melanocyte stem cell (MSC) to investigate the molecular pathways that regulate ASC quiescence. Our prior work indicated that GABA‐A receptor activation promotes MSC quiescence in larval zebrafish. Here, through pharmacological and genetic approaches we show that GABA‐A acts through calcium signaling to maintain MSC quiescence. Unexpectedly, we identified translocator protein (TSPO), a mitochondrial membrane‐associated protein that regulates mitochondrial function and metabolic homeostasis, as a parallel regulator of MSC quiescence. We found that both TSPO‐specific ligands and induction of gluconeogenesis likely act in the same pathway to promote MSC activation and melanocyte production in larval zebrafish. In contrast, TSPO and gluconeogenesis appear to act in parallel to GABA‐A receptor signaling to regulate MSC quiescence and vertebrate pigment patterning.
The Informational Fallacy in the Philosophy of Consciousness
Authors: Skempton Simon
Published: October 2019

This article argues that theories which regard the mind as merely a form of information processing are guilty of a fallacious conflation of the informational contents of consciousness with consciousness itself, with the consciousness of those contents. Such theories lie behind the thought that a consciousness could be transferred or uploaded onto a substrate other than the brain it initially occurred in. It is argued here that the ontology of information is that of a formal structure that can be instantiated in physical reality innumerable times, whereas the ontology of consciousness is that of an irreducibly singular subjective experience of being alive.
Can Hardcore Actualism Validate S5?
Authors: Kimpton‐Nye Samuel
Published: October 2019

Hardcore actualism (HA) grounds all modal truths in the concrete constituents of the actual world (see, e.g., Borghini and Williams (2008), Jacobs (2010), Vetter (2015)). I bolster HA, and elucidate the very nature of possibility (and necessity) according to HA, by considering if it can validate S5 modal logic. Interestingly, different considerations pull in different directions on this issue. To resolve the tension, we are forced to think hard about the nature of the hardcore actualist’s modal reality and how radically this departs from possible worlds orthodoxy. Once we achieve this departure, the prospects of a hardcore actualist validation of S5 look considerably brighter. This paper thus strengthens hardcore actualism by arguing that it can indeed validate S5–arguably the most popular logic of metaphysical modality–and, in the process, it elucidates the very nature of modality according to this revisionary, but very attractive, modal metaphysics.
Higher plants as bioindicators of metal contamination from Shangdong abandoned karst bauxite, southwestern China
Authors: Wang D. F. , Zhang Z. H.
Published: October 2019

Bauxite mining on karst generates numerous ecological and environmental problems, including metal pollution, water and soil erosion and destruction of vegetation. Among these, the most important environmental problem is soil metal pollution. Higher plants have a great ability to adsorb metals and can be used as biological indicators. However, the study of bioindicators for soil contamination in karst bauxite is not clear.

Plants and their soil were collected from an abandoned karst bauxite area at Shangdong, Guizhou Province, southwestern China. Plants were collected and identified as Pteris vittata, Pinus massoniana, Miscanthus floridulus, Coriaria nepalensis, Artemisia argyi and Senecio scandens.

The content of metals in plant roots were in the order: P. vittata > M. floridulus > C. nepalensis, other plants roots had no consistent pattern. Concentrations of metal in plants (P. vittata and M. floridulus) and soil were: soil > root > leaf > stem. Levels of metals in soil samples easily exceeded background values, indicating that soil had been contaminated. Al and Fe were highest in soil samples of P. vittata, with a good correlation.

Results show that the metal content determined in plants is relatively high, particularly in P. vittata. Data also suggest that P. vittata colonies were able to tolerate and accumulate high levels of metal elements, which evidences their suitability for use as bioindicatord of soil metal contamination caused by mining activities.
Historical biogeography of the hyperdiverse hidden snout weevils (Coleoptera, Curculionidae, Cryptorhynchinae)
Authors: Letsch Harald , Balke Michael , Toussaint Emmanuel F.A. , Riedel Alexander
Published: October 2019

The first dated phylogeny of the weevil subfamily Cryptorhynchinae is presented within a framework of Curculionoidea. The inferred pattern and timing of weevil family relationships are generally congruent with previous studies, but our data are the first to suggest a highly supported sister‐group relationship between Attelabidae and Belidae. Our biogeographical inferences suggest that Cryptorhynchinae s.s. originated in the Late Cretaceous (c. 86 Ma) in South America. Within the ‘Acalles group’ and the ‘Cryptorhynchus group’, several independent dispersal events to the Western Palaearctic via the Nearctic occurred in the Late Cretaceous and Early Paleogene. A second southern route via Antarctica may have facilitated the colonization of Australia in the Late Cretaceous (c. 82 Ma), where a diverse Indo‐Australian clade probably emerged c. 73 Ma. In the Early Eocene (c. 50–55 Ma), several clades independently dispersed from Australia to proto‐New Guinea, i.e. the tribe Arachnopodini s.l., the ‘Rhynchodes group’ and the genus Trigonopterus. New Zealand was first colonized in the Late Palaeocene (c. 60 Ma). Divergence time estimations and biogeographical reconstructions indicate that the colonization of New Guinea is older than expected from current geological reconstructions of the region.
Beyond post‐politics: Offsetting, depoliticisation, and contestation in a community struggle against executive housing
Authors: Apostolopoulou Elia
Published: October 2019

In this paper I seek to explore the role of biodiversity offsetting in the evolution of public debates over controversial urban development projects and the way it may influence the outcome of social‐environmental conflicts. By drawing on empirical data obtained through 25 interviews with key stakeholders involved in a conflict around executive housing in North East England, 48 interviews with several stakeholders involved in offsetting across England, and an extensive document analysis, I explore the depoliticising effects of offsetting as an indicative example of actually existing neoliberal conservation. I also pay attention to the way offsetting relates to the fast policy complex to trace the links between neoliberalisation and depoliticisation particularly in the era following the 2008 financial crash. Understanding social‐environmental conflicts through the lens of the post‐political hypothesis can shed light on the way both participatory planning and neoliberal conservation, by favouring technocratic management and consensual policy‐making, attempt to remove contestation and agonistic engagement from the public terrain. On the other hand, seeing conflicts only through the post‐political hypothesis has important limits, primarily because it implies a catholic hegemony of post‐politics that can be both disorienting and paralysing. I conclude by showing through five key propositions the necessity for contextualised readings of historically and geographically specific political practices and for analysing depoliticisation by means of a theory of hegemony.
Multilocus phylogeny of a cryptic radiation of Afrotropical long‐fingered bats (Chiroptera, Miniopteridae)
Authors: Demos Terrence C. , Webala Paul W. , Lutz Holly L. , Kerbis Peterhans Julian C. , Goodman Steven M. , Cortés‐Delgado Natalia , Bartonjo Michael , Patterson Bruce D.
Published: October 2019

The Old World bat family Miniopteridae comprises only the genus Miniopterus, which includes 20 currently recognized species from the Afrotropical realm and 15 species from Eurasia and Australasia. Since 2003, the number of recognized Miniopterus species has grown from 19 to 35, with most newly described species endemic to Madagascar and the Comoros Archipelago. We investigated genetic variation, phylogenetic relationships and clade membership in Miniopterus focusing on Afrotropical taxa. We generated mitochondrial cytochrome‐b (cyt‐b) and nuclear intron data (five genes) from 352 vouchered individuals collected at 78 georeferenced localities. Including 99 additional mitochondrial sequences from GenBank, we analysed a total of 25 recognized species. Mitochondrial genetic distances among cyt‐b‐supported clades averaged 9.3%, representing as many as five undescribed species. Multilocus coalescent delimitation strongly supported the genetic isolation of eight of nine tested unnamed clades. A large number of sampled clades in sub‐Saharan Africa are distributed wholly or partly in East Africa (nine of 13 clades), suggesting that Miniopterus diversity has been grossly underestimated. Although 25 of 27 cyt‐b and 23 of 25 nuclear gene tree lineages from the Afrotropics were strongly supported as monophyletic, a majority of deep nodes were poorly resolved in phylogenetic analyses. Long terminal branches subtending short backbone internodes in the phylogenetic analyses suggest a rapid radiation model of diversification. This hypothesis needs to be tested using more phylogenetically informative data.
Solving the Reswitching Paradox in the Sraffian Theory of Capital
Authors: Milana Carlo
Published: October 2019

The possibility of the reswitching of techniques in Piero Sraffa’s intersectoral model, namely the recurring capital-intensive techniques with monotonic changes in the interest rate, is traditionally considered as a paradoxical violation of the assumed convexity of technology putting at stake the viability of the neoclassical theory of production. It is argued here that this phenomenon can be rationalized within the neoclassical paradigm. Sectoral interdependencies can give rise to the well-known price Wicksell effect, which is the revaluation of capital goods due to changes in relative prices triggered by monotonic variations in income distribution. The reswitching of techniques is, therefore, the result of cost-minimizing technical choices facing returning ranks of relative input prices in full consistency with the pure marginalist theory of factor rewards. The theoretical analysis proposed in this article is applied empirically to the counterexamples of various case studies presented in the literature.
Effects of temporal distortions on consonant perception with and without undistorted visual speech cues
Authors: Phatak Sandeep A. , Grant Ken W.
Published: October 2019

Effects of temporal distortions on consonant perception were measured using locally time-reversed nonsense syllables. Consonant recognition was measured in both audio and audio-visual modalities for assessing whether the addition of visual speech cues can recover consonant errors caused by time reversing. The degradation in consonant recognition depended highly on the manner of articulation, with sibilant fricatives, affricates, and nasals showing the least degradation. Because consonant errors induced by time reversing were primarily in voicing and place-of-articulation (mostly limited to stop-plosives and non-sibilant fricatives), undistorted visual speech cues could resolve only about half the errors (i.e., only place-of-articulation errors).
Time of arrival difference estimation for narrow band high frequency echolocation clicks
Authors: Gillespie Douglas , Macaulay Jamie
Published: October 2019

Algorithms are presented for the accurate time of arrival difference estimation of high frequency narrow band echolocation clicks from Harbor Porpoise. These clicks typically have a center frequency of around 130 kHz (wavelength ∼1.2 cm) and duration of <0.1 ms. When using hydrophones spaced centimeters apart, spatial aliasing can cause large errors on inter-hydrophone timing measurements due to the incorrect peak in the cross-correlation function of two signals being selected. It is shown that at sample rates of less than about 6 times the fundamental frequency, the incorrect correlation peak will be selected in 55% of measurements leading to large errors in time of arrival estimates. For clicks with a SNR > 10 dB these errors can be reduced by over two orders of magnitude through a combination of up-sampling the data and parabolic interpolation of peaks in the cross-correlation functions.
Experimental modeling and application of push-pull electrostatic speakers
Authors: Chiang Hsin-Yuan , Huang Yu-Hsi
Published: October 2019

This study modeled the circular diaphragm of push-pull electrostatic speakers using electro-mechano-acoustical equivalent circuits to determine the frequency responses related to the average displacement and sound pressure of the diaphragm with respect to acoustic impedance effects. A laser vibrometer system was used to measure the displacement in the center of the circular diaphragms (60 mm and 65 mm in diameter) in optically transparent indium tin oxide (ITO) electrostatic speakers. The sound pressure levels (SPLs) were predicted using the average displacement of the diaphragm without resorting to sound field measurements or finite element analysis. The predicted SPL results were then compared to acoustic measurements. The results demonstrate that ITO plates are a practical tool for the measurement of displacement and the prediction of SPLs. When the proposed electrostatic speaker (65-mm-diameter diaphragm) design was applied to the over-ear electrostatic headphone, the SPL curve obtained from artificial ear measurements was similar to the preferred target curve of Harman International (Stamford, CT). This resulted in outstanding sound quality comparable to that of high-end commercial dynamic headphones.
Biliopancreatic diversion is beyond just weight loss
Authors: Ozcan Lale
Published: October 2019

Biliopancreatic diversion slows glucose absorption and increases insulin sensitivity, which results in better glycemic control than other gastric bypass procedures.
Simultaneous Infection with
Enterobacteriaceae
and Pseudomonas aeruginosa Harboring Multiple Carbapenemases in a Returning Traveler Colonized with Candida auris
Authors: Khan Ayesha , Shropshire William C. , Hanson Blake , Dinh An Q. , Wanger Audrey , Ostrosky-Zeichner Luis , Arias Cesar A. , Miller William R.
Published: October 2019

We report our clinical experience treating a critically ill patient with polymicrobial infections due to multidrug-resistant
Escherichia coli
,
Klebsiella pneumoniae
, and
Pseudomonas aeruginosa
in a 56-year-old woman who received health care in India and was also colonized by
Candida auris
. A precision medicine approach using whole-genome sequencing revealed a multiplicity of mobile elements associated with NDM-1, NDM-5, and OXA-181 and, supplemented with susceptibility testing, guided the selection of rational antimicrobial therapy.
Complete Genome Sequence of Citrobacter freundii Myophage Maroon
Authors: McDermott James R. , Shao Qiuyan , O’Leary Chandler , Kongari Rohit , Liu Mei
Published: October 2019

Citrobacter freundiiis a nosocomial opportunistic pathogen that can cause urinary and bloodstream infections. Phage therapies againstC. freundiimay prove useful in treating infections caused by this ubiquitous bacterium. Here, we report the complete genome of a T4-like myophage, Maroon, that infectsC. freundii.
Tobacco 21 policies in California and Hawaii and sales of cigarette packs: a difference-in-differences analysis
Authors: Ali Fatma Romeh M , Rice Ketra , Fang Xin , Xu Xin
Published: October 2019

Objective

To measure the association of raising the minimum legal age of tobacco sales to 21 years (T21) statewide with monthly sales of cigarette packs in California and Hawaii, the first two states to implement T21 statewide.

Methods

State monthly cigarette tax revenues from state departments of taxation were analysed for 11 states from January 2014 through December 2018 (n=660). Monthly cigarette packs sold were constructed using cigarette tax revenue and cigarette tax rate in each state. A difference-in-differences regression method was used to estimate the association of statewide T21 policies with monthly cigarette packs sold in California and Hawaii, separately, compared to the western states that did not implement such policies. Both models were controlled for year–month fixed effects, cigarette tax rates, smoke-free air laws, Medicaid coverage of smoking cessation, minimum legal sales ages for e-cigarettes and state marijuana laws, in addition to state demographic characteristics (sex, age, education, race/ethnicity and population size).

Findings

Implementation of T21 statewide was associated with a reduction of 9.41 (95% CI=–15.52 to –3.30) million monthly packs sold in California and 0.57 (95% CI=–0.83 to –0.30) million monthly packs sold in Hawaii, compared to regional states. These translate to a reduction of 13.1%–18.2%, respectively, in monthly packs sold relative to mean values before the implementation of T21.

Conclusions

Raising the minimum legal age for tobacco sales to 21 years could reduce cigarette sales as part of a comprehensive tobacco control strategy that complements and builds on proven approaches to achieve this goal.
A three-step sequence strategy for facile construction of donor–acceptor type molecules: triphenylamine-substituted acenes
Authors: Zhang Chen , Tang Ming , Sun Bing , Wang Weizhou , Yi Ying , Zhang Fang-Lin
Published: October 2019

A new synthetic strategy was successfully developed for highly efficient construction of triphenylamine-substituted polycyclic aromatic hydrocarbons (PAHs), including anthracenes, tetraphenes, pentaphenes, and trinaphthylene. These molecules exhibited special structural characteristics, including donor–acceptor–donor (D–A–D) and donor–acceptor (D–A). Diverse aryl iodides coupled well with chlorinated 2-methyl benzaldehydes via a transient ligand-directed C–H bond arylation strategy to furnish various PAH precursors. The subsequent palladium-catalyzed Suzuki cross-couplings with 4-(diphenylamino)phenylboronic acid produced corresponding triphenylamine derivatives. Further, Brønsted acid promoted cycloaromatization generated the triphenylamine-substituted PAHs readily. The photophysical properties was investigated by UV–vis absorption and fluorescence emission spectroscope together with density functional theory (DFT) calculations.
Impact of the NaV1.8 variant, A1073V, on post-sigmoidectomy pain and electrophysiological function in rat sympathetic neurons
Authors: Coates Matthew D. , Kim Joyce S. , Carkaci-Salli Nurgul , Vrana Kent E. , Koltun Walter A. , Puhl Henry L. , Adhikary Sanjib D. , Janicki Piotr K. , Ruiz-Velasco Victor
Published: October 2019

NaV1.8 channels play a crucial role in regulating the action potential in nociceptive neurons. A single nucleotide polymorphism in the human NaV1.8 gene SCN10A, A1073V (rs6795970, G>A), has been linked to the diminution of mechanical pain sensation as well as cardiac conduction abnormalities. Furthermore, studies have suggested that this polymorphism may result in a “loss-of-function” phenotype. In the present study, we performed genomic analysis of A1073V polymorphism presence in a cohort of patients undergoing sigmoid colectomy who provided information regarding perioperative pain and analgesic use. Homozygous carriers reported significantly reduced severity in postoperative abdominal pain compared with heterozygous and wild-type carriers. Homozygotes also trended toward using less analgesic/opiates during the postoperative period. We also heterologously expressed the wild-type and A1073V variant in rat superior cervical ganglion neurons. Electrophysiological testing demonstrated that the mutant NaV1.8 channels activated at more depolarized potentials compared with wild-type channels. Our study revealed that postoperative abdominal pain is diminished in homozygous carriers of A1073V and that this is likely due to reduced transmission of action potentials in nociceptive neurons. Our findings reinforce the importance of NaV1.8 and the A1073V polymorphism to pain perception. This information could be used to develop new predictive tools to optimize patient pain experience and analgesic use in the perioperative setting.

NEW & NOTEWORTHY We present evidence that in a cohort of patients undergoing sigmoid colectomy, those homozygous for the NaV1.8 polymorphism (rs6795970) reported significantly lower abdominal pain scores than individuals with the homozygous wild-type or heterozygous genotype. In vitro electrophysiological recordings also suggest that the mutant NaV1.8 channel activates at more depolarizing potentials than the wild-type Na+ channel, characteristic of hypoactivity. This is the first report linking the rs6795970 mutation with postoperative abdominal pain in humans.
Chemical Composition and Mechanism of Vibriocidal Action of Essential Oil from Resin of Protium heptaphyllum
Authors: Mendes Josiane Lima , de Araújo Thiago Ferreira , Geraldo de Carvalho Mário , Aragão Catunda Júnior Francisco Eduardo , Albuquerque Costa Renata
Published: October 2019

Protium heptaphyllum is a plant widely distributed in Brazilian ecosystems that produce a resin which has pharmacological activities. In this study, the chemical composition, antimicrobial and antibiofilm activity, and the possible mechanism of action against the bacterium V. parahaemolyticus of essential oil from P. heptaphyllum (EOPH) were investigated. Twenty-two components were detected in EOPH, and β-phellandrene (60.68%) had the majority. The inhibition halo, MIC, and MBC values were 11 mm, 2 mg/mL, and 8 mg/mL, respectively. Biofilm biomass inhibition and biomass reduction of the preformed biofilm were detected at 4 mg/mL EOPH concentration. The assays of cell constituent release and membrane permeability indicated that EOPH may disrupt the cell membrane, leading to leakage of intracellular constituent as reducing sugars and materials with an absorbance of 260 nm.
Prevention of Divorce: Results of a 25-Year Follow-Up Study
Authors: Engl Joachim , Thurmaier Franz , Hahlweg Kurt
Published: October 2019

Background:Divorce and destructive couple conflict are major risk factors for many forms of dysfunction and psychopathology in the family. Couple relationship education has been offered in an attempt to reduce those risks and enhance couple outcomes. Aim:The current effectiveness study had three aims: to assess the 25-year outcome of relationship education on (a) separation, (b) long-term marital quality, and (c) usage of the EPL speaker and listener rules. Method:Ninety-six premarital couples, in 1988, participated in a study in which the effectiveness of the EPL I (Ein Partnerschaftliches Lernprogramm für heiratswillige Paare [A Learning Program for Premarital Couples]) was investigated. n= 64 couples self-selected to participate in the EPL I, n= 32 were part of the control group (CG). The couples were assessed prior to and after the EPL I, and 1.5, 3, 5, and 25 years later. Results:After 5 and 25 years, EPL I participants had a significantly lower divorce rate (4%/5%) than participant couples in the comparison group (24%/26%). Approximately 60% of the partners indicated that they still used the EPL communication speaker and listener skills often/very often in everyday life. Over 98% would recommend the EPL training to other couples. At the 25-year follow-up, for those couples still together, the rates of happy relationships were 83% (EPL) and 72% (CG). Over 25 years, there were no significant differences between EPL and CG partners with regard to relationship quality (Locke-Wallace MAT). Conclusion:These findings are the first to show that couple relationship enhancement (CRE) interventions can have a very long-lasting effect on relationship stability. CRE interventions should play a major role in public health.
Socioeconomic Status-Related Parameters as Predictors of Competing (Non-Bladder Cancer) Mortality after Radical Cystectomy
Authors: Froehner Michael , Muallah David , Koch Rainer , Hübler Matthias , Borkowetz Angelika , Heberling Ulrike , Huber Johannes , Wirth Manfred P. , Thomas Christian
Published: October 2019

Objective: To investigate the impact of socioeconomic status-related parameters on competing (non-bladder cancer) mortality after radical cystectomy. Patients and Methods: A total of 1,268 consecutive patients who underwent radical cystectomy for urothelial or undifferentiated bladder cancer at our institution between 1993 and 2016 with a mean age of 69 years (median 70 years) were studied. The mean ­follow-up of the censored patients was 7.2 years (median 5.7 years). Proportional hazard models for competing risk were used to identify predictors of non-bladder cancer (competing) mortality. The following parameters were included into multivariate analyses: age, American Society of Anesthesiologists physical status classification, Charlson score, gender, level of education, smoking status, marital status, local tumour stage, lymph node status, adjuvant and neoadjuvant chemotherapy. Results: Besides age and both comorbidity classifications, the socioeconomic status-related parameters gender (female versus male, hazard ratio [HR] 0.58, 95% CI 0.40–0.84, p = 0.0042), level of education (university degree or master craftsman versus others, HR 0.76, 95% CI 0.56–0.1.03, p = 0.0801), smoking status (current smoking versus others, HR 1.47, 95% CI 1.10–1.96, p = 0.0085) and marital status (married versus others, HR 0.68, 95% CI 0.50–0.92, p = 0.0133) were independent predictors of competing mortality after radical cystectomy. If considered in combination (multiplication of HRs), the prognostic impact of socioeconomic parameters superseded that of the investigated comorbidity classifications. Conclusion: Socioeconomic status-related parameters may provide important information on the long-term competing mortality risk after radical cystectomy supplementary to chronological age and comorbidity.
Vitamin K1 Inhibition of Renal Crystal Formation through Matrix Gla Protein in the Kidney
Authors: Li Yang , Lu Xiuli , Yang Baoyu , Mao Jing , Jiang Shan , Yu Daojun , Pan Jichuan , Cai Tiange , Yasui Takahiro , Gao Bing
Published: October 2019

Background and Objectives: Vitamin K (VK) plays a major role in modifying the binding of calcium in bones and blood vessels. Understanding the effect of VK on crystal formation in the kidney would contribute to advancing the treatment and prevention of kidney stones. Methods: Rats were treated with vitamin K1 (VK1) for 8 weeks. VK1 levels were detected and crystal formation were observed. HK2 cells were exposed to calcium oxalate monohydrate crystals. Apoptosis and cell viability were detected. Crystal deposition was analyzed using atomic absorption assay. The adenovirus vectors expressing matrix Gla protein (MGP) and siMGP were constructed to elucidate the effect and mechanism of VK1 on crystal formation. MGP expression in vivo and in vitro was analyzed by Western blot. The mRNA levels of monocyte chemoattractant protein-1 (MCP-1) and collagen I was measured by semiquantitative RT-PCR. Results: The concentrations of VK1 in whole blood and kidney tissues rose under treatment with VK1. Crystal formation was inhibited from the second to the 6th week, the frequency and quality of crystal formation decreased significantly, and the location of crystal formation was limited to a greater extent in the rats treated by VK1 compared to the control group. Warfarin treatment in the crystals-exposed HK2 cells significantly increased the number of crystals adhering to cells and the number of apoptotic cells and reduced cell viability. VK1 treatment reversed warfarin’s above influence. VK1 inhibited the upregulations of MCP-1 and collagen I in kidney tissues under crystal load. VK1 treatment increased MGP expression in vivo and in vitro, and MGP is necessary for VK1 to play a role in crystal deposition in cells. Conclusions: VK1 treatment can inhibit the formation of renal crystals in vivo. VK1 increases MGP expression and functions through MGP to reduce crystal deposition in cells and provide cell protection. Our findings suggest that VK1 treatment could be a potential strategy for the treatment and prevention of nephrolithiasis.
Enhanced Platelet Reactivity under Aspirin Medication and Major Adverse Cardiac and Cerebrovascular Events in Patients with Coronary Artery Disease
Authors: Dannenberg Lisa , Metzen Daniel , Zako Saif , Pöhl Martin , Mourikis Philipp , Helten Carolin , Trojovsky Kajetan , Naguib David , Konsek Daniel , Knoop Betül , Ayhan Aysel , Hohlfeld Thomas , Petzold Tobias , Levkau Bodo , Veulemans Verena , Zeus Tobias , Kelm Malte , Polzin Amin
Published: October 2019

Aspirin is indispensable in secondary prevention of ischemic events in patients with coronary artery disease (CAD). However, insufficient platelet inhibition despite aspirin medication is frequent. This is referred to as high on-treatment platelet reactivity (HTPR). Nevertheless, if this is associated with clinical outcome instead of only laboratory phenomenon remains unclear so far. In this study, we test whether patients with ischemic events have higher platelet reactivity despite aspirin medication than patients without ischemic events. In this prospective study of 72 CAD patients, we determined pharmacodynamic response to aspirin by arachidonic acid induced aggregation via light-transmission aggregometry and expressed as maximum of aggregation (MoA). During a mean follow-up duration of 3.2 years, major adverse cardiac and cerebrovascular events (MACCE), mortality, non-ST-elevation myocardial infarction (NSTEMI), and stroke were assessed as endpoints via yearly telephone interviews with the treating physician of the patients. Patients who suffered from MACCE, death, and NSTEMI had a significantly higher MoA than those without (MACCE: 5.4 vs. 16.4%, p < 0.05; death: 5.6 vs. 16.8%, p < 0.05; NSTEMI: 1.8 vs. 21%, p < 0.001). MoA did not differ with regard to the occurrence of stroke (10.1 vs. 14.9%, p = 0.59). Patients with MACCE, death, and NSTEMI show enhanced platelet reactivity despite aspirin medication as compared to patients without ischemic events. Hence, insufficient response to aspirin medication should be regarded as risk factor for ischemic events in CAD patients. Further trials are needed to assess options to overcome HTPR to aspirin.
Multiple Congenital Anomalies in a Patient with Interstitial 6q26 Deletion
Authors: Puvabanditsin Surasak , Negroponte Emily , Jang Peter , Hedges Amanda , Kased Ramnan , Mehta Rajeev
Published: October 2019

We report a preterm male neonate presenting with a lumbosacral meningomyelocele, type II Arnold Chiari malformation, hypoplasia of the aortic arch, bicuspid aortic valve, ventricular septal defect, secundum atrial septal defect, multicystic dysplastic kidney, and hydronephrosis. Analysis with whole genome SNP microarray revealed an interstitial deletion of about 237 kb in chromosome 6q26. Long contiguous stretches of homozygosity (>3 Mb) were seen in 18 chromosomes with a total genomic size of 219 Mb. The phenotype seen in our patient has not been reported in association with the genes in the homozygous regions. However, our patient shares many phenotypic features with other reported cases that have shown a deletion in the same region of chromosome 6.
Persistence with Biologic Treatment in Patients with Inflammatory Bowel Disease: A German Claims Data Analysis
Authors: Mevius Antje , Brandes Alina , Hardtstock Fränce , Wilke Thomas , Ratsch Boris A. , Orzechowski Hans-Dieter , Fuchs Andreas , Deiters Barthold , Bokemeyer Bernd
Published: October 2019

Objectives: This study aimed to assess the real-world rates of treatment discontinuation and switching of biologic therapies in patients with inflammatory bowel disease (IBD). Methods: A retrospective claims data analysis on all continuously insured adult IBD patients with initiation of a biologic therapy was conducted. Observation started with the date of the first prescription of index tumor necrosis factor α-inhibitors (anti-TNFα) or vedolizumab (VDZ) therapy and lasted 12 months. Non-persistence was assumed in case of a switch to another biologic or a treatment gap of >90 days. Results: We included 1,248 IBD biologic treatment starters (502 adalimumab, 77 golimumab, 441 infliximab, 228 VDZ); 837/411 were biologic-naïve (bio-naïve)/ biologic-experienced (bio-experienced). Mean age of bio-naïve/bio-experienced anti-TNFα patients was 39.2/38.1 years (54.9%/56.7% female) and 42.6/37.8 years for VDZ patients (56.3%/54.9% female). Seven hundred and seventy-two patients (61.9%) were persistent with their index biologic therapy after 12 months (61.9%/61.8% bio-naïve/bio-experienced). Percentage of persistent patients was 69.7% for VDZ (65.6%/71.3%) and 60.1% for anti-TNFα (61.4%/55.5%). VDZ was associated with later non-persistence in a multivariable Cox regression analysis (hazard ratio 0.675; p = 0.003) compared to anti-TNFα. Conclusions: Only 60–70% of IBD ­patients are still persistent with their biologic therapy after 12 months. VDZ therapy is associated with a higher persistence than anti-TNFα therapy in this analysis.
Post-Radiation Grade 3 Neuroendocrine Carcinoma: A New Entity?
Authors: Hadoux Julien , Blanchard Pierre , Scoazec Jean-Yves , Burtin Pascal , Planchard David , Malka David , Berdelou Amandine , Boige Valérie , Duvillard Pierre , Leboulleux Sophie , Faron Matthieu , Tselikas Lambros , Deutsch Eric , Ducreux Michel , Baudin Eric
Published: October 2019

Background: Cancer survivors have a 14% increased risk of developing a malignancy compared with the general population. Second radiation-induced malignancies with different histologies have been described in different organs. Based on individual observations, we hypothesized that neuroendocrine carcinoma (NEC) could arise in irradiated organs. Methods: In a retrospective analysis of Gustave Roussy database of NEC patients (small cell lung cancer excluded) diagnosed as a second cancer, we looked for the frequency of grade 3 NEC that arose in patients who had received previous radiation therapy for a first cancer. Radiation therapy for the first cancer, dose, location of radiation therapy, pathological characteristics, overall survival, and response to treatment of secondary NEC were analyzed. Results: From January 1995 to December 2017, 847 cases of NEC were seen at Gustave Roussy. Among them, 95 (11.2%) patients had a history of previous malignancy of which 36 (4%) had been treated with radiation therapy. Out of these 36 patients, 12 (1.4% of all NEC patients) developed a NEC within the previous irradiated organ (median dose of 50 Gy, range 36–67.5). Most frequent first cancers were breast cancer (n = 4) and Hodgkin lymphoma (n = 3). NEC arose within a median time of 21.7 years (range 5.1–36.4) from radiation in the thorax (n = 5), digestive tract (n = 3), and other sites. Five large cell NEC, 3 small cell NEC, 1 mixed neuroendocrine neoplasm and 3 not otherwise specified NEC were diagnosed. Ten patients had stage IV disease at diagnosis; median overall survival was 37.8 months (95% CI [17.6 to NA]). Three patients (25%) achieved complete response with multimodal treatment. Conclusions: NEC can arise from previously irradiated organs and may have a better outcome in this setting. Other risk factors should be investigated to explain the high rate of previous cancer in this population of neuroendocrine neoplasm.
АНАЛІЗ ПОКАЗНИКІВ НАЙБІЛЬШ РОЗПОВСЮДЖЕНИХ ЗАХВОРЮВАНЬ, ЩО ПЕРЕДАЮТЬСЯ СТАТЕВИМ ШЛЯХОМ, У ВІННИЦЬКІЙ ОБЛАСТІ
Authors: Komar O. M. , Pidlisna I. V.
Published: October 2019

Мета: проаналізувати динаміку показників найбільш розповсюджених захворювань, що передаються статевим шляхом (ЗПСШ), у Вінницькій області за 2014–2018 рр.

Матеріали і методи. Проведено епідеміологічне ретроспективне дослідження підсумково-звітної статистичної документації Вінницького обласного клінічного шкірно-венерологічного диспансеру (за даними звіту лікувально-профілактичного закладу ф. № 20) з використанням методу викопіювання даних за п’ятирічний період 2014–2018  рр. Статистичній обробці, аналізу та оцінці підлягали показники найбільш розповсюджених ЗПСШ захворювань, що передаються статевим шляхом (сифіліс, гонорея, трихомоніаз, хламідіоз, урогенітальний мікоплазмоз), у Вінницькій області та по Україні. Методи дослідження – епідеміологічний, медико-статистичний.

Результати. Аналіз показників п’яти найбільш розповсюджених захворювань, що передаються статевим шляхом, у Вінницькій області за 2014–2018 рр. виявив, що чотири з них (сифіліс, гонорея, трихомоніаз, хламідіоз) щорічно знижувались, крім урогенітального мікоплазмозу, показник наочності якого у 2018 р. до базового 2014 р. склав (+) 0,9 %. Така ж тенденція (до зниження), за досліджуваний період, характерна для усіх вказаних захворювань по Україні: сифіліс – (-) 30,2 %, гонорея – (-) 32,6 %, трихомоніаз – (-) 31,9 %, хламідіоз – (-) 16,7 %, урогенітальний мікоплазмоз – (-) 19,9 %. Доведено річні темпи зростання регіональних показників виокремлених захворювань за статтю і місцем проживання, крім показника захворюваності на трихомоніаз, який постійно знижувався у всіх когортах.

Висновки. Найбільш вагомими причинами зниження показників розповсюдження захворювань, що передаються статевим шляхом, в Україні й Вінницькій області за досліджуваний період є: 1) відсутність реєстрації цих захворювань у: приватних клініках, переважне звертання хворих до яких пов’язано з причиною уникнення стигматизації, особливо жителів сільської місцевості; фахівців інших спеціальностей (урологи, акушер-гінекологи та ін.) державних закладів охорони здоров’я; 2) фінансова недоступність до дороговартісної фармакотерапії.