bluuebunny/crossref_metadata_2025 huggingface dataset:
Bidirectional Brain‐gut‐microbiota Axis in increased intestinal permeability induced by central nervous system injury
Authors: Li Xiao‐jin , You Xin‐yu , Wang Cong‐ying , Li Xue‐li , Sheng Yuan‐yuan , Zhuang Peng‐wei , Zhang Yan‐jun
Published: May 2020

Central nervous system injuries may lead to the disorders of the hypothalamic‐pituitary‐adrenal axis, autonomic nervous system, and enteric nervous system. These effects then cause the changes in the intestinal microenvironment, such as a disordered intestinal immune system as well as alterations of intestinal bacteria. Ultimately, this leads to an increase in intestinal permeability. Inflammatory factors produced by the interactions between intestinal neurons and immune cells as well as the secretions and metabolites of intestinal flora can then migrate through the intestinal barrier, which will aggravate any peripheral inflammation and the central nervous system injury. The brain‐gut‐microbiota axis is a complex system that plays a crucial role in the occurrence and development of central nervous system diseases. It may also increase the consequences of preventative treatment. In this context, here we have summarized the factors that can lead to the increased intestinal permeability and some of the possible outcomes.
Fine‐needle‐aspiration using forward‐viewing echoendoscope for the recurrence of intraductal tubulopapillary neoplasm
Authors: Ohno Akihisa , Kaku Toyoma , Kawabe Ken
Published: May 2020

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Enhancers, development, and evolution
Authors: Kuroiwa Atsushi
Published: May 2020

A single‐celled fertilized egg develops into a complex, multicellular animal through a series of selection processes of developmental pathways. During these processes, regulatory genes exhibit spatiotemporally restricted expression under the control of the species‐specific genetic program, and dictate developmental processes from germ layer formation to cellular differentiation. Elucidation of molecular mechanisms underlying developmental processes and also of mechanistic bases for morphological diversification during evolution is one of the central issues in contemporary developmental biology. Progress has been made due to recent technological innovations, such as high‐throughput nucleotide sequencing, live‐cell imaging, efficient genetic manipulation, and establishment of the organoid system, opening new avenues to the above issues.
Diastology: 2020‐A practical guide
Authors: Nagueh Sherif F.
Published: June 2020

Left ventricular (LV) diastolic function can be most conveniently assessed by echocardiography which provides reliable assessments of LV structure and function. Most patients with structural heart disease have variable degrees of myocardial dysfunction. LV structural changes as pathologic hypertrophy and systolic functional abnormalities as depressed LV long‐axis systolic function are associated with diastolic dysfunction. The recognition of structural abnormalities and abnormal LV long‐axis function as indices of diastolic dysfunction is an important difference between 2016 and 2009 guidelines. In addition, there are other Doppler findings indicative of diastolic dysfunction and abnormally elevated LV filling pressures. In the absence of clinical, 2D echocardiographic, and specific Doppler indices of diastolic dysfunction, mitral annulus early diastolic velocity (e’), left atrium (LA) maximum volume index, peak velocity of tricuspid regurgitation jet by continuous‐wave Doppler, and ratio of mitral inflow early diastolic velocity to e’ velocity can be used to draw inferences about LV diastolic function. In the presence of diastolic dysfunction, mean LA pressure and grade of diastolic dysfunction should be determined. When LA pressure at rest is normal, it is reasonable to proceed to diastolic stress testing in an attempt to identify patients with dyspnea due to heart failure. There are specific algorithms recommended in patients with atrial fibrillation, moderate or severe mitral annular calcification, and noncardiac pulmonary hypertension.
INPUT TRADE LIBERALIZATION AND MARKUP DISTRIBUTION: EVIDENCE FROM CHINA
Authors: Liu Zhengwen , Ma Hong
Published: June 2020

We utilize an unprecedented liberalization episode in China, namely its World Trade Organization accession, to estimate the impact of trade liberalization on firm markup and markup distribution. Using a panel data quantile regression, we show that the impact of tariff reduction on markup can be heterogeneous to different firms, resulting in an unevenly distributed markup change across firms. In particular, reduction in output tariff reduces markup and markup dispersion, while reduction in input tariff increases markup and markup dispersion. (JEL F12, F13)
A standard protocol for reporting species distribution models
Authors: Zurell Damaris , Franklin Janet , König Christian , Bouchet Phil J. , Dormann Carsten F. , Elith Jane , Fandos Guillermo , Feng Xiao , Guillera‐Arroita Gurutzeta , Guisan Antoine , Lahoz‐Monfort José J. , Leitão Pedro J. , Park Daniel S. , Peterson A. Townsend , Rapacciuolo Giovanni , Schmatz Dirk R. , Schröder Boris , Serra‐Diaz Josep M. , Thuiller Wilfried , Yates Katherine L. , Zimmermann Niklaus E. , Merow Cory
Published: June 2020

Species distribution models (SDMs) constitute the most common class of models across ecology, evolution and conservation. The advent of ready‐to‐use software packages and increasing availability of digital geoinformation have considerably assisted the application of SDMs in the past decade, greatly enabling their broader use for informing conservation and management, and for quantifying impacts from global change. However, models must be fit for purpose, with all important aspects of their development and applications properly considered. Despite the widespread use of SDMs, standardisation and documentation of modelling protocols remain limited, which makes it hard to assess whether development steps are appropriate for end use. To address these issues, we propose a standard protocol for reporting SDMs, with an emphasis on describing how a study's objective is achieved through a series of modeling decisions. We call this the ODMAP (Overview, Data, Model, Assessment and Prediction) protocol, as its components reflect the main steps involved in building SDMs and other empirically‐based biodiversity models. The ODMAP protocol serves two main purposes. First, it provides a checklist for authors, detailing key steps for model building and analyses, and thus represents a quick guide and generic workflow for modern SDMs. Second, it introduces a structured format for documenting and communicating the models, ensuring transparency and reproducibility, facilitating peer review and expert evaluation of model quality, as well as meta‐analyses. We detail all elements of ODMAP, and explain how it can be used for different model objectives and applications, and how it complements efforts to store associated metadata and define modelling standards. We illustrate its utility by revisiting nine previously published case studies, and provide an interactive web‐based application to facilitate its use. We plan to advance ODMAP by encouraging its further refinement and adoption by the scientific community.
Visual snow syndrome: a comparison between an Italian and British population
Authors: Viana M. , Puledda F. , Goadsby P. J.
Published: June 2020

Background and purpose

Visual snow manifests as a pan‐field, dynamic visual disturbance described as continuous television static‐like tiny flickering dots. Current diagnostic criteria further require at least two additional symptoms for visual snow syndrome (VSS) from: palinopsia (afterimages and trailing); entoptic phenomena (floaters, blue field entoptic phenomenon, photopsia, self‐light of the eye); photophobia and nyctalopia. Our objective was to compare the phenotype of VSS in an Italian and British population.

Methods

Patients with VSS were characterized clinically using the current criteria. An online survey was prepared in collaboration with the patient group Eye‐on‐Vision. Patients were directed to the site if they contacted us by email asking to be involved in research. After data collection, we compared the phenotypic characteristics of a subgroup of British versus Italian patients taking part in the survey. As we expected more responses from the UK, we matched 100 UK patients for gender and age with our Italian cohort.

Results

Patients were enrolled from the UK (n = 100) and Italy (n = 100). The populations had similar demography. After multiple correction testing there were no differences in VSS features between the two groups. The same was true for the prevalence of migraine and previous use of recreational drugs.

Conclusion

This is the first study comparing the phenotype of VSS between two distinct populations. Our findings suggest that the visual snow phenotype, as well as migraine comorbidity, is similar across the two groups.
Towards an automatic coding of observational studies: Coding neurofeedback therapies of children with autism
Authors: López‐López Víctor R. , Escobedo Lizbeth , Trujillo Leonardo
Published: May 2020

The coding of observational data is commonly used to analyse and evaluate human behaviours. The technique can help researchers inform the design and impact of, for example, an Ubicomp system by studying specific behaviours of interest. There are some tools that can alleviate the burden of observational coding, like those that help to collect and organise data, but can still be error‐prone and time‐consuming. Moreover, most of these tools lack automation, requiring intense human interaction. In order to mitigate these issues, computer vision (CV) and machine learning (ML) techniques could be used to automate observational coding, but little work has focused on analysing the feasibility of such an approach, with the goal of reducing the total coding time while maintaining accuracy. In this work, we address this question by proposing an automated approach for a real‐world case study and compare it to manual coding. The study is composed of 10 videos with an average duration of 17 min each, where the goal is to determine the attention of children with autism that participate in a neurofeedback therapy session. Each video was hand‐coded by three human observers to define the ground truth and to measure the manual coding time. Results show that it is feasible to automate the coding of observational behaviours and obtain a noticeable reduction in coding time, but with a slight loss in accuracy. Moreover, we illustrate that the best solution would be a hybrid approach, using a semi‐automated system that combines human expertise and ML predictions Keywords Observational studies, Coding behaviours, Automatic coding, Computer‐Vision, Machine Learning.
Neuroimmune interaction in seizures and epilepsy: focusing on monocyte infiltration
Authors: Bosco Dale B. , Tian Dai‐Shi , Wu Long‐Jun
Published: May 2020

Epilepsy is a major neurological condition that affects millions of people globally. While a number of interventions have been developed to mitigate this condition, a significant number of patients are refractory to these treatments. Consequently, other avenues of research are needed. One such avenue is modulation of the immune system response to this condition, which has mostly focused on microglia, the resident immune cells of the central nervous system (CNS). However, other immune cells can impact neurological conditions, principally blood‐borne monocytes that can infiltrate into brain parenchyma after seizures. As such, this review will first discuss how monocytes can be recruited to the CNS and how they can be distinguished from there immunological cousins, microglia. Then, we will explore what is known about the role monocytes have within seizure pathogenesis and epilepsy. Considering how little is known about monocyte function in seizure‐ and epilepsy‐related pathologies, further studies are warranted that investigate infiltrated blood‐borne monocytes as a potential therapeutic target for epilepsy treatment.
Beauty is wealth: CEO attractiveness and firm value
Authors: Halford Joseph T. , Hsu Hung‐Chia S.
Published: June 2020

This paper examines whether and how CEO attractiveness relates to firm value. We construct a Facial Attractiveness Index of 667 CEOs based on their facial geometry. More attractive CEOs are associated with better stock returns surrounding their job announcements and around earnings‐announcement news with CEOs' images. Further, more attractive CEOs are related to higher acquirer returns following acquisition announcements and higher Tobin's Q. Finally, consistent with the existing literature documenting the beauty premium in pay, more attractive CEOs receive higher compensation.
An evaluation of health workforce models addressing oral health in residential aged care facilities: A systematic review of the literature
Authors: Chen Rebecca , Irving Michelle , Clive Wright F.A. , Cunich Michelle
Published: June 2020

Background

In Australia and globally, there is an increasing problem of unmet oral health needs of older people above 65 residing in aged care facilities. Various workforce models have been trialled to implement oral health care programmes in aged care facilities, but the evidence behind these programmes and their underlying workforce models is not known.

Objective

To systematically review the literature on the effectiveness, and economic feasibility of the current workforce models addressing oral care in aged care facilities.

Methods

CINAHL, Cochrane CENTRAL, MEDLINE, EMBASE, EMB Reviews, NHS Economic Evaluation Database and grey literature were searched. Studies were included if they described an oral health workforce model with a clinical intervention and defined oral health outcome measures. Analysis was conducted using the NHMRC guidelines for scientific and economic evaluations.

Results

Twenty‐eight studies were included. Four distinct workforce models of care were identified. 60% of the studies demonstrated short‐term effectiveness in clinical measures. Workforce models were similar in their effectiveness, with varying levels of quality within each model. Although three studies considered individual components of economic feasibility, only one provided a comprehensive economic analysis of both the costs and health outcomes.

Conclusions Implications of findings

All workforce models of care had some positive impact on oral health for residents of aged care. Oral health should be included as a health focus in age care facilities. Future studies should include longer‐term health outcomes with rigorous economic analysis to ensure sustainably delivered workforce models of care for oral health management within aged care.
Feminism and gendered impact of COVID‐19: Perspective of a counselling psychologist
Authors: Mukhtar Sonia
Published: June 2020

When women, girls and gender‐diverse people — who have been disproportionately impacted by the COVID‐19 pandemic outbreak since the public health crisis has also become a crisis for feminism — will identify and acknowledge their organismic phenomenological self, wholeness and growth will be fully functioning. Psychological aspects for the public health emergency operated through counselling psychologists to manage mental health, emotional, psychological, cognitive, behavioural, relational and social impacts are fundamental. And the role of counselling psychologists in maintaining personal mental health and their clients is a crucial indicator of collective wellbeing. This perspective is embedded in the gendered approach and feminist framework which attempts to explore and offer the embodied intersectional and divergent impact on living during the COVID‐19 pandemic lockdown.
A qualitative study of health‐care experiences and challenges faced by ageing homebound adults
Authors: Cheng Joyce M. , Batten George P. , Cornwell Thomas , Yao Nengliang
Published: June 2020

Background

The ageing of the global population is associated with an increasing prevalence of chronic diseases and functional impairments, resulting in a greater proportion of homebound individuals.

Objective

To examine the health‐care experiences of older homebound adults who have not previously received home‐based primary care (HBPC). To explore their impressions of this method of care.

Design

Cross‐sectional qualitative study using semi‐structured interviews.

Setting and Participants

18 older homebound individuals in Central Virginia.

Results

Our findings revealed that homebound individuals faced significant health challenges, including pain resulting from various comorbidities. They felt that their mobility was restricted by their physical conditions and transportation challenges. These were major barriers to social outings and health‐care access. Participants left their homes infrequently and typically with assistance. Regarding office‐based care, participants were concerned about long wait times and making timely appointments. Some thought that HBPC would be convenient and could result in better quality care; however, others believed that the structure of the health‐care system and its focus on efficiency would not permit routine HBPC.

Discussion and Conclusions

Older homebound adults in this study faced high burdens of disease, a lack of mobility and difficulty accessing quality health care. Our observations may help researchers and clinicians better understand the health‐care experiences and personal opinions of older homebound individuals, informing the development of effective and empathetic home‐based care. Participant responses illuminated a need for education about HBPC. We must improve health‐care delivery and develop comprehensive, patient‐centered HBPC to meet the needs of homebound individuals.
Validity and reliability of the Spanish caregiver reaction assessment scale for caregivers of people with dementia
Authors: Alvira Carmen , Cabrera Esther , Kostov Belchin , Risco Ester , Farré Marta , Miguel Susana , Zabalegui Adelaida
Published: June 2020

Aim

Of the few instruments available to measure the important, positive aspects of caring, the Caregiver Reaction Assessment is regarded as the most suitable, but there is no validated Spanish version. The aim of this study was to translate the Caregiver Reaction Assessment into Spanish and assess its psychometric properties.

Methods

The Caregiver Reaction Assessment was translated into Spanish and then back translated. Validation included construct validity, criterion validity and reliability: 287 interviews were conducted with informal caregivers of patients with dementia between November 2010 and April 2012.

Results

Principal component analysis confirmed the original instrument's five subscales. Criterion validity showed a moderate negative correlation between the impact on health and the EQ‐5D (r = −.43), that is, a greater impact on health correlated with lower health‐related quality of life. The Caregiver Reaction Assessment showed good internal consistency, with a Cronbach alpha of .804, and good temporal stability for the distinct subscales, with intraclass correlation coefficients varying from .683 to .729 (p < .001).

Conclusion

The Caregiver Reaction Assessment is a reliable, valid instrument for the measurement of the reactions of informal caregivers of patients with dementia, with good psychometric properties.
Morphological change and characteristics of myofibroblasts during the growth process of benign prostatic hyperplasia
Authors: Hata Junya , Tanji Ryo , Onagi Akifumi , Honda‐Takinami Ruriko , Matsuoka Kanako , Hoshi Seiji , Sato Yuichi , Akaihata Hidenori , Haga Nobuhiro , Kojima Yoshiyuki
Published: June 2020

Objectives

To clarify the morphological change and characteristics of myofibroblast during the growth process of benign prostatic hyperplasia.

Methods

This study examined the characteristics of myofibroblasts during the growth process of the prostate in the stromal component‐dominant benign prostatic hyperplasia rat model. Transforming growth factor‐β1 and insulin‐like growth factor‐binding protein 3 expression were evaluated by western blotting (n = 6). We used double immunohistochemical staining to evaluate the number of myofibroblasts positive for α‐smooth muscle actin and vimentin in benign prostatic hyperplasia tissues. Expression and histological analyses of the benign prostatic hyperplasia were also carried out in rats at 2, 3 and 8 weeks after urogenital sinus implantation (n = 6). To evaluate the fine morphological characteristics of myofibroblasts in human benign prostatic hyperplasia tissues, electron microscopy analysis was additionally carried out.

Results

There was a significant upregulation of the transforming growth factor‐β1 and insulin‐like growth factor‐binding protein 3 expression in benign prostatic hyperplasia (P < 0.05). There was a significant increase in the number of myofibroblasts in benign prostatic hyperplasia (P < 0.05) compared with normal prostate, with these abundantly located in the stromal area. The transforming growth factor‐β1 and insulin‐like growth factor‐binding protein 3 expression and number of myofibroblasts showed a time‐dependent increase (P < 0.05), with growth factor expressions preceding the myofibroblast increase. Electron microscopy confirmed that the myofibroblast progenitor cells, which possess abundant stress fibers, were predominantly located around fibrous areas in human benign prostatic hyperplasia.

Conclusions

Differentiation into myofibroblasts induced by transforming growth factor‐β1 and insulin‐like growth factor‐binding protein 3 actively occurs during the growth process of benign prostatic hyperplasia. Myofibroblast progenitor cells seem to be associated with prostatic fibrosis in human benign prostatic hyperplasia.
Ureteral substitution with appendix
Authors: Komyakov Boris , Ochelenko Viktor , Guliev Bakhman , Shevnin Maksim
Published: June 2020

Objective

To study the long‐term results of ureteral reconstruction with the appendix in patients with long ureteral strictures.

Methods

From 1998 to 2019, 26 patients were operated with substitution of extended defects of the ureter with the appendix. There were 22 women and four men (mean age 44.7 ± 11.3 years). One patient had stricture of the lumbar ureter because of a gunshot wound. He underwent substitution of the upper third of the right ureter with the appendix. In the other cases, we carried out substitution of the pelvis part of the ureter with appendix, in four cases from the left side. In the last 22 cases, a novel surgical technique for better appendicovesical anastomosis was carried out: a flap was dissected from the dome of the cecum to increase the diameter of anastomosis.

Results

The postoperative follow‐up period was from 1 to 21 years. A stricture of uretero‐appendical anastomosis developed in four patients (15.4%). Resection of stricture and re‐anastomosis was carried out in one case. In another two cases associated with similar complications, endoureterotomy and ureteral stenting were carried out. One patient was managed with percutaneous nephrostomy. Kidney function was restored in all patients. Good short‐term results were achieved in 22 patients (84.6%) and long‐term (from 1 to 21 years) results in 25 patients (96.2%).

Conclusions

In patients with long ureteral stricture, the use of the appendix can help to restore the function of the upper urinary tract.
Service facilities with risk‐averse customers: a simulation approach
Authors: Delgado‐Alvarez Carlos A. , van Ackere Ann , Larsen Erik R.
Published: June 2020

In this study, a one‐dimensional cellular automata model is used to represent a self‐organized queueing system with local interaction between captive and boundedly rational customers who repeatedly choose a facility for service. While previous work has focused on decision rules based on adaptive expectations, the present work expands this analysis by explicitly incorporating customers’ attitude toward risk to study the impact of risk aversion on the collective behavior and the average system sojourn time. The customers’ decision process is modeled using adaptive expectations and incorporating the uncertainty involved in these expectations. Customers update their expectations based on their own experience and that of their neighbors. Simulation analysis is used to compare the aggregated behavior for different degrees of customer risk aversion. Risk‐neutral customers base their decisions only on their expected sojourn time, while risk‐averse customers account for uncertainty by estimating an upper bound of the sojourn times. The results indicate that the more risk‐averse the customers, the longer the transient period, and the more slowly the system converges to an almost stable average sojourn time. Systems where customers have an intermediate level of risk aversion achieve the worst average sojourn times.
The determinants of high‐interest entrusted loans in China
Authors: Yu Yan , Lee Yi‐Tsung , Fok Robert C.W.
Published: May 2020

We examine the determinants of high‐interest entrusted loans in China from the perspective of corporate risk‐taking. The results of a baseline model illustrate that the propensity to offer high‐interest entrusted loans increases with loose monetary policies, corporate cash holdings and firm age, and it decreases with firm size and growth opportunity. These findings support the claim that firms offer high‐interest entrusted loans mainly for short‐term profits. Other determining factors include CEO behavior traits, market imperfections and the intensity of corporate governance. Specifically, market imperfections create an opportunity for risk‐taking while CEO behavior and the intensity of corporate governance affect a firm's tendency to take risk and engage in high‐interest entrusted loans.
CD‐1db/db mice: A novel type 2 diabetic mouse model with progressive kidney fibrosis
Authors: Mizunuma Yuiko , Kanasaki Keizo , Nitta Kyoko , Nakamura Yuka , Ishigaki Yasuhito , Takagaki Yuta , Kitada Munehiro , Li Shaolan , Liu Haijie , Li Jinpeng , Usui Isao , Aso Yoshimasa , Koya Daisuke
Published: May 2020

Aims/Introduction

To establish novel therapies to combat diabetic kidney disease, a human disease‐relevant animal model is essential. However, a type 2 diabetic mouse model presenting progressive kidney fibrosis has not yet been established. Kidneys of streptozotocin‐induced diabetic CD‐1 mice showed severe fibrosis compared with other backgrounds of mice associated with the suppression of antifibrotic peptide N‐acetyl‐seryl‐aspartyl‐lysyl‐proline. The BKS background (BKSdb/db) is often utilized for diabetic kidney disease research; the kidney fibrosis in the BKSdb/db phenotype is minimal.

Materials and Methods

We generated CD‐1db/db mice by backcrossing the db gene into the CD‐1 background, and analyzed phenotypic differences compared with BKSdb/db and CD‐1db/m mice.

Results

Male CD‐1db/db mice appeared to have elevated blood glucose levels compared with those of BKSdb/db mice. Fasting insulin levels declined in CD‐1db/db mice. Plasma cystatin C levels tended to be elevated in CD‐1db/db mice from 16 to 24 weeks‐of‐age. Male CD‐1db/db mice showed significantly progressive kidney and heart fibrosis from 16 to 24 weeks‐of‐age when compared with that of age‐matched BKSdb/db mice. The gene expression profile showed fibrogenic program‐associated genes in male CD‐1db/db mice. Male CD‐1db/db mice displayed significantly lower urine antifibrotic peptide N‐acetyl‐seryl‐aspartyl‐lysyl‐proline when compared to that of BKSdb/db at 24 weeks‐of‐age. The gene expression of prolyl oligopeptidase, the enzyme essential for antifibrotic peptide N‐acetyl‐seryl‐aspartyl‐lysyl‐proline production from thymosin β4, was significantly lower in the CD‐1 mice. Thymosin β4 levels were also lower in CD‐1 mice.

Conclusions

These results suggest that CD‐1db/db mice are a novel type 2 diabetic mouse model with progressive kidney and heart fibrosis.
Improved prediction of mortality by combinations of inflammatory markers and standard clinical scores in patients with acute‐on‐chronic liver failure and acute decompensation
Authors: Grønbæk Henning , Møller Holger Jon , Saliba Faouzi , Zeuzem Stefan , Albillos Agustin , Ariza Xavier , Graupera Isabel , Solà Elsa , Amoros Alex , Pavesi Marco , Bossen Lars , Jalan Rajiv , Gines Pere , Arroyo Vicente
Published: June 2020

Background and Aim

Acute‐on‐chronic liver failure (ACLF) is a sinister prognosis, and there is a need for accurate biomarkers and scoring systems to better characterize ACLF patients and predict prognosis. Systemic inflammation and renal failure are hallmarks in ACLF disease development and progression. We hypothesized that the combination of specific inflammatory markers in combination with clinical scores are better predictors of survival than the originally developed CLIF‐C acute decompensation (AD) and CLIF‐C ACLF scores.

Methods

We reevaluated all previously measured inflammatory markers in 522 patients from the CANONIC study, 342 without and 180 with ACLF. We used the Harrell's C‐index to determine the best marker alone or in combination with the original scores and calculated new scores for prediction of mortality in the original CANONIC cohort.

Results

The best markers to predict 90‐day mortality in patients without ACLF were the plasma macrophage activation markers soluble (s)CD163 and mannose receptor (sMR). Urinary neutrophil gelatinase associated lipocalin (UNGAL) and sCD163 were predictors for 28‐day mortality in patients with ACLF. The newly developed CLIF‐C AD + sMR score in patients without ACLF improved 90‐day mortality prediction compared with the original CLIF‐C AD score (C‐index 0.82 [0.78–0.86] vs 0.74 [0.70–0.78, P = 0.004]). Further, the new CLIF‐C ACLF + sCD163 + UNGAL improved the original CLIF‐C ACLF score for 28‐day mortality (0.85 [0.79–0.91] vs 0.75 [0.70–0.80], P = 0.039).

Conclusions

The capability of these inflammatory markers to improve the original prognostic scores in cirrhosis patients without and with ACLF points to a key role of macrophage activation and inflammation in the development and progression of AD and ACLF.
Action Seniors! Cost‐Effectiveness Analysis of a Secondary Falls Prevention Strategy Among Community‐Dwelling Older Fallers
Authors: Davis Jennifer C. , Khan Karim M. , Hsu Chun Liang , Chan Patrick , Cook Wendy L. , Dian Larry , Liu‐Ambrose Teresa
Published: May 2020

BACKGROUND

The Otago Exercise Program (OEP) has demonstrated cost‐effectiveness for the primary prevention of falls in a general community setting. The cost‐effectiveness of exercise as a secondary falls prevention (ie, preventing falls among those who have already fallen) strategy remains unknown. The primary objective was to estimate the cost‐effectiveness (incremental cost‐effectiveness/utility ratio) of the OEP from a healthcare system perspective.

DESIGN

A concurrent 12‐month prospective economic evaluation conducted alongside the Action Seniors! randomized critical trial (OEP compared with usual care).

SETTING

Vancouver Falls Prevention Clinic (Vancouver, BC, Canada; http://www.fallsclinic.ca).

PARTICIPANTS

A total of 344 community‐dwelling older adults, aged 70 years and older, who attended a geriatrician‐led Falls Prevention Clinic in Vancouver, after sustaining a fall in the previous 12 months.

MEASUREMENTS

Main outcome measures included: incidence rate ratio for falls, healthcare costs, incremental cost per fall prevented, and incremental cost per quality‐adjusted life year (QALY) gained.

RESULTS

The OEP costs $393 CAD per participant to implement. The incremental cost per fall prevented resulted in a savings of $2 CAD. The incremental cost per QALY gained (where QALYs were estimated using the Euro‐Qol 5D three‐level version [EQ‐5D‐3L]) indicated the OEP was less effective than usual care. The incremental cost per QALY gained (where QALYs were estimated using the Short Form 6D [SF‐6D]) indicated the OEP was more effective and less costly than usual care. The incremental QALYs estimated using the EQ‐5D‐3L and the SF‐6D were not clinically significant and close to zero, indicating no change in quality of life.

CONCLUSION

Compared with usual care, healthcare system costs are saved and falls are prevented when older fallers who attend a geriatrician‐led falls clinic are allocated to, and provided, the physiotherapist‐guided exercise‐based falls prevention program (the OEP).
Reply to Comment on: Delirium after Transcatheter Aortic Valve Implantation Under General Anesthesia
Authors: van der Wulp Kees , Vart Priya , van Royen Niels
Published: May 2020

This letter comments on the letter by Fu Shan Xue
Comment on: Delirium After Transcatheter Aortic Valve Implantation Under General Anesthesia
Authors: Dong Peng , Xue Fu‐Shan , Liu Shao‐Hua
Published: May 2020

See the Reply by Royen et al.
Family members' prioritisation of care in residential aged care facilities: A case for individualised care
Authors: Ludlow Kristiana , Churruca Kate , Ellis Louise A. , Mumford Virginia , Braithwaite Jeffrey
Published: May 2020

Objectives

To investigate family members' prioritisation of care in residential aged care facilities (RACFs).

Introduction and background

Family members are often involved in the care of their older relatives even after these relatives transit to a RACF. Understanding family members' priorities regarding care (i.e., what is most important to them) can provide valuable insights into how to better meet residents' needs.

Design

A multisite mixed‐methods study comprising qualitative methods and Q methodology. The qualitative component of the study was guided by the COREQ checklist.

Methods

Participants comprised 27 family members of residents living in one of five participating Australian RACFs. Participants rank‐ordered 34 cards, each representing an aspect of care, on a predefined grid from “Least important” (−4) to “Most important” (+4). Participants also engaged in a think‐aloud task, demographic questionnaire, post‐sorting interview and semi‐structured interview. Q data were analysed using inverted factor techniques to identify factors that each represent a portion of shared meaning. Factors were interpreted as viewpoints using data from the think‐aloud task and interviews. These data were further analysed using inductive content analysis to reveal influences on prioritisation decision‐making.

Results

Three distinct viewpoints were identified through Q methodology: prioritisation of residents' physical needs, maintaining residents' independence, and human connection. Inductive content analysis revealed four influences on prioritisation decision‐making: residents' capabilities and support requirements, unmet needs, family bridging the gaps, and family knowledge of residents.

Conclusions

The study indicated that to meet residents' needs and family members' priorities, individualised approaches to care are warranted. It also demonstrated the vital role family members play in residents' care when needs are not fully met.

Relevance to Clinical Practice

Strategies to improve individualised care in clinical practice include flexibility of routines, supporting family members' involvement in care, workforce training focused on family–staff communication, and safer staffing ratios.
Volumetric and Functional Activity Lateralization in Healthy Subjects and Patients with Focal Epilepsy: Initial Findings in a 7T MRI Study
Authors: Canjels Lisanne P.W. , Backes Walter H. , van Veenendaal Tamar M. , Vlooswijk Marielle C.G. , Hofman Paul A.M. , Aldenkamp Albert P. , Rouhl Rob P.W. , Jansen Jacobus F.A.
Published: May 2020

BACKGROUND AND PURPOSE

In 30% of the patients with focal epilepsy, an epileptogenic lesion cannot be visually detected with structural MRI. Ultra‐high field MRI may be able to identify subtle pathology related to the epileptic focus. We set out to assess 7T MRI‐derived volumetric and functional activity lateralization of the hippocampus, hippocampal subfields, temporal and frontal lobe in healthy subjects and MRI‐negative patients with focal epilepsy.

METHODS

Twenty controls and 10 patients with MRI‐negative temporal or frontal lobe epilepsy (TLE and FLE, respectively) underwent a 7T MRI exam. T1‐weigthed imaging and resting‐state fMRI was performed. T1‐weighted images were segmented to yield volumes, while from fMRI data, the fractional amplitude of low frequency fluctuations was calculated. Subsequently, volumetric and functional lateralization was calculated from left‐right asymmetry.

RESULTS

In controls, volumetric lateralization was symmetric, with a slight asymmetry of the hippocampus and subiculum, while functional lateralization consistently showed symmetry. Contrarily, in epilepsy patients, regions were less symmetric. In TLE patients with known focus, volumetric lateralization in the hippocampus and hippocampal subfields was indicative of smaller ipsilateral volumes. These patients also showed clear functional lateralization, though not consistently ipsilateral or contralateral to the epileptic focus. TLE patients with unknown focus showed an obvious volumetric lateralization, facilitating the localization of the epileptic focus. Lateralization results in the FLE patients were less consistent with the epileptic focus.

CONCLUSION

MRI‐derived volume and fluctuation amplitude are highly symmetric in controls, whereas in TLE, volumetric and functional lateralization effects were observed. This highlights the potential of the technique.
Methodological Quality of Systematic Reviews Relating to Performance of All‐Ceramic Implant Abutments, Frameworks, and Restorations
Authors: AL‐Rabab'ah Mohammad A. , AlTarawneh Sandra , Jarad Fadi D. , Devlin Hugh
Published: May 2020

Purpose

To assess the methodological quality of published systematic reviews relating to all ceramic implant frameworks, abutments and restorations.

Materials and Methods

Published systematic reviews relating to all ceramic implant restorations for single tooth and multiple teeth replacements were retrieved to assess their methodological qualities. Sixteen systematic reviews were included for methodological quality assessment by two independent assessors using AMSTAR‐2 critical appraisal tool. Inter‐rater agreement was assessed using the weighted Cohen's Kappa statistic.

Results

Most systematic reviews included randomized clinical trials and nonrandomized studies of intervention. The majority of included systematic reviews (15 out of 16) scored critically low on quality with more than one critical flaw when assessed using the AMSTAR‐2 tool. Most systematic reviews assessed lacked analysis of the effects of the risk of bias and heterogeneity of the included studies. The inter‐rater agreement of the independent assessors was substantial (0.63).

Conclusions

Confidence in the evidence presented in these systematic reviews was undermined by their tendency to overlook the effect of risk of bias and heterogeneity in evidence synthesis.
Cultural Factors Influencing Young Adult Indian Women's Beliefs about Disclosing Domestic Violence Victimization
Authors: Stephens Dionne , Eaton Asia
Published: May 2020

According to India's National Family Health Survey (Ghosh, 2007), over one third of women in India have experienced domestic violence (DV). In this study, we examined young adult Indian women's attitudes toward domestic violence DV help seeking behaviors using a reproductive justice framework. A total of 81 young adult women age 18–24 from Mysore, India, participated via in‐depth qualitative focus groups. Findings suggested that informal familial systems and gender‐focused formal support systems were viewed as the most acceptable networks for disclosing DV victimization. Women's organizations emerged as the second most appropriate network, particularly when it was deemed that an escalated response to DV victimization was needed. If the DV was perceived as severe or escalating, seeking judicial support was deemed appropriate. However, there were several cultural barriers that informed the women's perceptions of these systems effectiveness, including cultural beliefs about privacy, gender roles, and prior experiences. These results highlight the importance of addressing the multilevel cultural processes that serve to both facilitate and limit young adult Indian women's ability to address DV victimization. In contrast to the popular perception of abused women as passive victims, these women's assertions valuing empowerment highlight culturally specific responses to effectively addressing DV.
Comparison of MAFLD and NAFLD diagnostic criteria in real world
Authors: Lin Su , Huang Jiaofeng , Wang Mingfang , Kumar Rahul , Liu Yuxiu , Liu Shiying , Wu Yinlian , Wang Xiaozhong , Zhu Yueyong
Published: June 2020

Background and aims

Metabolic associated fatty liver disease (MAFLD) is a novel concept proposed in 2020, the utility of which has not been tested and validated in real world. We aimed to compare the characteristics of MAFLD and non‐alcoholic fatty liver disease (NAFLD).

Methods

The data was retrieved from the third National Health and Nutrition Examination Surveys of the United States, which is an unbiased survey dataset and frequently used for the study of fatty liver disease.

Results

A total of 13 083 cases with completed ultrasonography and laboratory data were identified from the NHANES III database. MAFLD was diagnosed in 4087/13 083 (31.24%) participants, while NAFLD in 4347/13 083 (33.23%) amongst the overall population and 4347/12 045 (36.09%) in patients without alcohol intake and other liver diseases. Compared with NAFLD, MAFLD patients were significantly older, had higher BMI level, higher proportions of metabolic comorbidities (diabetes, hypertension) and higher HOMA‐IR, lipid and liver enzymes. MAFLD patients with alcohol consumption were younger than those without, and more likely to be male. They had less metabolic disorder but higher liver enzymes. There were more cases with advance fibrosis in MAFLD patients with alcohol consumption.

Conclusion

MAFLD definition is more practical for identifying patients with fatty liver disease with high risk of disease progression.
Footprint tunnels are effective for detecting dormouse species
Authors: Melcore Ilaria , Ferrari Giulia , Bertolino Sandro
Published: June 2020

Glirids are arboreal rodents that are difficult to monitor due to their nocturnal activity and their relatively low density. We compared results from footprint tunnels with those from two other monitoring methods (nest boxes and nesting tubes) for three dormouse species in an occupancy framework. Footprint tunnels performed better than the other two methods for the hazel dormouse Muscardinus avellanarius and the edible dormouse Glis glis, and were the only method which detected the garden dormouse Eliomys quercinus. Our findings provide evidence to support the effectiveness of footprint tunnels in monitoring the occurrence of dormouse species in comparison with other methods.
Covido‐pedago‐phobia
Authors: Eachempati Prashanti , Ramnarayan Komattil
Published: May 2020

Straight out of the Diagnostic and Statistical Manual COVID‐19 edition comes Covido‐pedago‐phobia. Here the authors identify its manifestations and reflect on its prevalence.
A case of triple seronegative myasthenia gravis with Graves' disease ameliorated after the removal of enlarged thymus with elevated uptake in fluorine‐18 fluorodeoxyglucose positron emission tomography
Authors: Matsumoto Namiko , Omote Yoshio , Nakano Yumiko , Takemoto Mami , Hishikawa Nozomi , Sato Kota , Ohta Yasuyuki , Yamashita Toru , Toji Tomohiro , Abe Koji
Published: May 2020

We report on a 35‐year‐old woman who complained of myasthenia in ocular, bulbar, and limb muscles, but who was negative for antibodies against acetylcholine receptor, muscle‐specific kinase, or low‐density lipoprotein receptor‐related protein 4, accompanied by the suppression of thyroid‐stimulating hormone with elevated free T3 and free T4. Administration of edrophonium significantly ameliorated blepharoptosis, and electromyography revealed 13.9% waning after 3 Hz repetitive stimulation in the left accessory nerve. Thus, she was suspected of having triple seronegative myasthenia gravis or thyrotoxic myasthenia. She was remitted after the resection of her enlarged thymus with an elevated uptake in fluorine‐18 fluorodeoxyglucose positron emission tomography, suggesting an unknown autoimmune target that escaped detection by current autoantibody screens. Consequently, thymectomy may still be effective in patients with seronegative MG plus hyperthyroidism.
Microbiota changes induced by microencapsulated sodium butyrate in patients with inflammatory bowel disease
Authors: Facchin Sonia , Vitulo Nicola , Calgaro Matteo , Buda Andrea , Romualdi Chiara , Pohl Daniel , Perini Barbara , Lorenzon Greta , Marinelli Carla , D’Incà Renata , Sturniolo Giacomo Carlo , Savarino Edoardo Vincenzo
Published: June 2020

Background

Butyrate has shown anti‐inflammatory and regenerative properties, providing symptomatic relief when orally supplemented in patients suffering from various colonic diseases. We investigated the effect of a colonic‐delivery formulation of butyrate on the fecal microbiota of patients with inflammatory bowel diseases (IBDs).

Methods

In this double‐blind, placebo‐controlled, pilot study, 49 IBD patients (n = 19 Crohn's disease, CD and n = 30 ulcerative colitis, UC) were randomized to oral administration of microencapsulated‐sodium‐butyrate (BLM) or placebo for 2 months, in addition to conventional therapy. Eighteen healthy volunteers (HVs) were recruited to provide a healthy microbiota model of the local people. Fecal microbiota from stool samples was assessed by 16S sequencing. Clinical disease activity and quality of life (QoL) were evaluated before and after treatment.

Key Results

At baseline, HVs showed a different microbiota composition compared with IBD patients. Sodium‐butyrate altered the gut microbiota of IBD patients by increasing bacteria able to produce SCFA in UC patients (Lachnospiraceae spp.) and the butyrogenic colonic bacteria in CD patients (Butyricicoccus). In UC patients, QoL was positively affected by treatment.

Conclusions and Inferences

Sodium‐butyrate supplementation increases the growth of bacteria able to produce SCFA with potentially anti‐inflammatory action. The clinical impact of this finding requires further investigation.
Species diversity of fungal endophytes across a stress gradient for plants
Authors: Oono Ryoko , Black Danielle , Slessarev Eric , Sickler Burton , Strom Amanda , Apigo Austen
Published: May 2020

Foliar fungal endophytes are one of the most diverse guilds of symbiotic fungi found in the photosynthetic tissues of every plant lineage, but it is unclear how plant environments and leaf resource availability shape their diversity.

We explored correlations between leaf nutrient availability and endophyte diversity among Pinus muricata and Vaccinium ovatum plants growing across a soil nutrient gradient spanning a series of coastal terraces in Mendocino, California.

Endophyte richness decreased in plants with higher leaf nitrogen‐to‐phosphorus ratios for both host species, but increased with sodium, which may be toxic to fungi at high concentrations. Isolation frequency, a proxy of fungal biomass, was not significantly predicted by any of the same leaf constituents in the two plant species.

We propose that stressed plants can exhibit both low foliar nutrients or high levels of toxic compounds, and that both of these stress responses predict endophyte species richness. Stressful conditions that limit growth of fungi may increase their diversity due to the suppression of otherwise dominating species. Differences between the host species in their endophyte communities may be explained by host specificity, leaf phenology, or microclimates.