bluuebunny/crossref_metadata_2025 huggingface dataset:
The order Tethyida (Porifera) in California: taxonomy, systematics, and the first member of the family Hemiasterellidae in the Eastern Pacific
Authors: Turner Thomas L.
Published: April 2020

Sponges (phylum Porifera) are ubiquitous inhabitants of marine ecosystems and have been shown to provide substantial ecosystem services. Despite this ecological importance, the sponge fauna in California has received little study. Here I use a collection of kelp forest sponges to describe the diversity of the order Tethyida in California. This order contains the genus Tethya, which has been included in long-term ecological monitoring projects. I show that Tethya vacua is a junior synonym of Tethya californiana, and thus all Tethya populations known in California belong to a single species. Genetic data from California’s only Timeidae, Timea authia, indicate that this species is in fact in the Tethyidae and is the third known member of the genus Tethytimea. I also describe the first member of the family Hemiasterellidae from the Eastern Pacific, Galaxia gaviotensis gen. nov. sp. nov. By combining field photographs, morphological taxonomy, and phylogenetic analysis of these samples, this work will facilitate future efforts to understand the evolution of this order and the ecological role of sponges in the California kelp forest.
Mutational profiling of micro-dissected pre-malignant lesions from archived specimens
Authors: Nachmanson Daniela , Steward Joseph , Yao Huazhen , Officer Adam , Jeong Eliza , O’Keefe Thomas J. , Hasteh Farnaz , Jepsen Kristen , Hirst Gillian L. , Esserman Laura J. , Borowsky Alexander D. , Harismendy Olivier
Published: April 2020

Background

Systematic cancer screening has led to the increased detection of pre-malignant lesions (PMLs). The absence of reliable prognostic markers has led mostly to over treatment resulting in potentially unnecessary stress, or potentially insufficient treatment and avoidable progression. Importantly, most mutational profiling studies have relied on PML synchronous to invasive cancer, or performed in patients without outcome information, hence limiting their utility for biomarker discovery. The limitations in comprehensive mutational profiling of PMLs are in large part due to the significant technical and methodological challenges: most PML specimens are small, fixed in formalin and paraffin embedded (FFPE) and lack matching normal DNA.

Methods

Using test DNA from a highly degraded FFPE specimen, multiple targeted sequencing approaches were evaluated, varying DNA input amount (3-200 ng), library preparation strategy (BE: Blunt-End, SS: Single-Strand, AT: A-Tailing) and target size (whole exome vs cancer gene panel). Variants in high-input DNA from FFPE and mirrored frozen specimens were used for PML-specific variant calling training and testing, respectively. The resulting approach was applied to profile and compare multiple regions micro-dissected (mean area 5 mm2) from 3 breast ductal carcinoma in situ (DCIS).

Results

Using low-input FFPE DNA, BE and SS libraries resulted in 4.9 and 3.7 increase over AT libraries in the fraction of whole exome covered at 20x (BE:87%, SS:63%, AT:17%). Compared to high-confidence somatic mutations from frozen specimens, PML-specific variant filtering increased recall (BE:85%, SS:80%, AT:75%) and precision (BE:93%, SS:91%, AT:84%) to levels expected from sampling variation. Copy number alterations were consistent across all tested approaches and only impacted by the design of the capture probe-set. Applied to DNA extracted from 9 micro-dissected regions (8 PML, 1 normal epithelium), the approach achieved comparable performance, illustrated the data adequacy to identify candidate driver events(GATA3 mutations, ERBB2orFGFR1 gains, TP53 loss)and measure intra-lesion genetic heterogeneity.

Conclusion

Alternate experimental and analytical strategies increased the accuracy of DNA sequencing from archived micro-dissected PML regions, supporting the deeper molecular characterization of early cancer lesions and achieving a critical milestone in the development of biology-informed prognostic markers and precision chemo-prevention strategies.
Stromal NRG1 in luminal breast cancer defines pro-fibrotic and migratory cancer-associated fibroblasts
Authors: Berdiel-Acer Mireia , Maia Ana , Hristova Zhivka , Borgoni Simone , Vetter Martina , Burmester Sara , Becki Corinna , Abnaof Khalid , Binenbaum Ilona , Bethmann Daniel , Chatziioannou Aristotelis , Hasmann Max , Thomssen Christoph , Espinet Elisa , Wiemann Stefan
Published: April 2020

HER3 is highly expressed in luminal breast cancer subtypes. Its activation by NRG1 promotes activation of AKT and ERK1/2, contributing to tumour progression and therapy resistance. HER3-targeting agents that block this activation, are currently under phase 1/2 clinical studies, and although they have shown favorable tolerability, their activity as a single agent has proven to be limited. Here we show that phosphorylation and activation of HER3 in luminal breast cancer cells occurs in a paracrine manner and is mediated by NRG1 expressed by cancer-associated fibroblasts (CAFs). Moreover, we uncover an autocrine role of NRG1 in CAFs. This occurs independently of HER3 and results in the induction of a strong migratory and pro-fibrotic phenotype, describing a subset of CAFs with elevated expression of NRG1 and an associated transcriptomic profile that determines their functional properties. Finally, we identified Hyaluronan Synthase 2(HAS2), a targetable molecule strongly correlated withNRG1, as an attractive player supporting NRG1 - autocrine signaling in CAFs.
Causal relationships between substance use and insomnia
Authors: Pasman Joëlle A. , Smit Dirk J.A. , Kingma Lilian , Vink Jacqueline M. , Treur Jorien L. , Verweij Karin J.H.
Published: April 2020

Background

Poor sleep quality and insomnia have been associated with the use of tobacco, alcohol, and cannabis, but it is unclear if there is a causal link. In this Mendelian Randomization (MR) study we examine if insomnia causes substance use and/or if substance use causes insomnia.

Methods

MR uses summary effect estimates from a genome-wide association study (GWAS) to create a genetic instrumental variable for a proposed ‘exposure’ variable and then identifies that same genetic instrument in an ‘outcome’ GWAS. With data of GWAS of insomnia, smoking (initiation, heaviness, cessation), alcohol use (drinks per week, dependence), and cannabis initiation, bi-directional causal effects were tested. Multiple sensitivity analyses were applied to assess the robustness of the findings.

Results

There was strong evidence for positive causal effects of insomnia on all substance use phenotypes (smoking traits, alcohol dependence, cannabis initiation), except alcohol per week. The effects on alcohol dependence and cannabis initiation were attenuated after filtering out pleiotropic SNPs. In the other direction, there was strong evidence that smoking initiation increased chances of insomnia (smoking heaviness and cessation could not be tested as exposures). We found no evidence that alcohol use per week, alcohol dependence, or cannabis initiation causally affect insomnia.

Conclusions

There were unidirectional effects of insomnia on alcohol dependence and cannabis initiation, and bidirectional effects between insomnia and smoking measures. Bidirectional effects between smoking and insomnia might give rise to a vicious circle. Future research should investigate if interventions aimed at insomnia are beneficial for substance use treatment.
Fast multi-directional DSLM for confocal detection without striping artifacts
Authors: Ricci Pietro , Sancataldo Giuseppe , Gavryusev Vladislav , Franceschini Alessandra , Müllenbroich Marie Caroline , Silvestri Ludovico , Pavone Francesco Saverio
Published: April 2020

In recent years light-sheet fluorescence microscopy (LSFM) has become a cornerstone technology for neuroscience, improving quality and capabilities of 3D imaging. By selectively illuminating a single plane, it provides intrinsic optical sectioning and fast image recording, while minimizing out of focus fluorescence background, sample photo-damage and photo-bleaching. However, images acquired with LSFM are often affected by light absorption or scattering effects, leading to un-even illumination and striping artifacts. In this work we present an optical solution to this problem, via fast multi-directional illumination of the sample, based on an acousto-optical deflector (AOD). We demonstrate that this pivoting system is compatible with confocal detection in digital scanned laser light-sheet fluorescence microscopy (DSLM) by using a pivoted elliptical-Gaussian beam. We tested its performance by acquiring signals emitted by specific fluorophores in several mouse brain areas, comparing the pivoting beam illumination and a traditional static one, measuring the point spread function response and quantifying the striping reduction. We observed real-time shadow suppression, while preserving the advantages of confocal detection for image contrast.
A two-stage homogenization for modelling of elastic-plastic functionally graded composites
Authors: Ogierman Witold
Published: April 2020

Purpose

The purpose of this study is to develop a homogenization approach that ensures both high accuracy and time-efficient solution for elastic-plastic functionally graded composites.

Design/methodology/approach

The paper presents a novel two-stage hybrid homogenization approach that combines advantages of the mean field homogenization and homogenization based on the finite element method (FEM). The groundbreaking nature of the developed approach is associated with division of the hybrid homogenization procedure into two stages, which allows to very efficiently determine the solution for arbitrary volume fraction of the reinforcement. This paper concerns also on modelling of composites with randomly distributed prolate and oblate particles. For this purpose, the hybrid homogenization was implemented in the framework of the discrete orientation averaging procedure involving pseudo-grain discretization method.

Findings

Agreement between the results obtained using the proposed approach and the standard FEM-based homogenization is very good (up to the volume fraction of 0.3).

Originality/value

The proposed two-stage homogenization approach allows to obtain the solution for materials with arbitrary volume fraction of the reinforcement very efficiently; therefore, it is highly beneficial for the two-scale modeling of nonlinear functionally graded materials and structures.
The substitute effect of internal R&D and external knowledge acquisition in emerging markets
Authors: Wang Tao , Yu Xue , Cui Nan
Published: April 2020

Purpose

This paper aims to provide a new perspective in investigating how internal research and development (R&D) and external knowledge acquisition interact regarding their influence on innovation performance in an emerging market context. Building on an attention-based view (ABV), it argues that internal R&D and external knowledge acquisition can be substitutes for each other in emerging markets. Its contingency factors are also discussed according to the principles of the ABV.

Design/methodology/approach

The proposed hypotheses were empirically tested using a Tobit model approach. The data used was from the enterprise survey and the follow-up innovation survey conducted by the World Bank in 10 emerging market countries.

Findings

The results indicate that internal R&D and external knowledge acquisition entails a substitute effect among emerging market firms (EMFs). A higher level of manager’s open-mindedness to external knowledge and firm performance and a lower level of firm administrative control help mitigate the substitute effect of internal R&D and external knowledge acquisition. While adequate financial resources may not necessarily mitigate the substitute effect, it is an essential condition for the external knowledge acquisition to play a role in enhancing innovation performance.

Research limitations/implications

The research uses a set of cross-sectional data. A dynamic study will provide a deeper understanding of the long-term effects of innovation investments.

Practical implications

To better use innovation investments, EMFs need to assess their specific conditions and the possible substitute effect of internal R&D and external knowledge acquisition activities.

Originality/value

Previous research discussing the interactive effect of internal R&D and external knowledge acquisition has mostly focused on an absorptive capacity perspective, which represents a firm’s technical ability. This study argues that these investments not only involve in absorbing knowledge technically but also form a challenge for the limited firm resources and can cause cognitive problems in management, especially for EMFs.
An MCDM framework for assessment of social sustainability indicators of the freight transport industry under uncertainty. A multi-company perspective
Authors: Kumar Aalok , A Ramesh
Published: April 2020

Purpose

The balancing of sustainability dimensions is the prime agenda of supply chain organisations. The supply chain sustainability greatly influenced by its freight transport activities. Most of the previous work discussed the economic and environmental sustainability of freight transport industry; although the social sustainability (SS) dimension paid less attention to researchers and practitioners of emerging economies. The purpose of this study is to investigate the importance of SS indicators in the freight transport industry. The SS assessment framework is validated with the Indian freight transport industry.

Design/methodology/approach

The proposed framework considers four SS dimension and 25 indicators. The SS indicators’ importance varies with the individual company's prospect. Therefore the proposed framework is used in multi-company perspective as well as in industry perspective to present more realistic results. The importance weight of SS dimension and indicators are computed with a novel multi-criteria decision-making (MCDM) method, i.e. fuzzy best–worst method (FBWM).

Findings

The prioritisation of SS indicators in each company perspective is compared with an industry perspective. The contribution to community health and education program is most valuable indicator followed by the prevention of child and forced labour. The model robustness is tested through sensitivity analysis and reported that less variation in indicators’ ranking.

Originality/value

To authors best of knowledge, this is the first study to highlight the importance of SS indicators in the freight transport industry. This study contributes to the sustainability assessment literature by providing a nuanced perception of the SS indicators and put forward managerial implications for improving the SS of the freight transport industry. The proposed framework could be treated as a benchmark for other developing nation's freight transport industry.
The Six Sigma framework improves the awareness and management of supply-chain risk
Authors: Andersson Roy , Pardillo-Baez Yinef
Published: April 2020

Purpose

Modern supply chains are at risk as a result of increasing disturbance. The use of Lean and Six Sigma’'s values, methods and tools can be one option to analyze, prevent and mitigate risks. The purpose of this study is to investigate whether a combined Lean Six Sigma philosophy can support the awareness and management of supply-chain risk.

Design/methodology/approach

The methodology followed in the study is based on a literature review and multiple case study, performed by means of qualitative methods of data collection, such as observations on-site, face-to-face interviews and document analysis. Case selection includes the results of research conducted in seven large Swedish companies.

Findings

It has been indicated that Lean and Six Sigma values, methods and tools can be very effective in companies’ efforts to control the supply-chain risks and that they improve the companies’ ability to handle variability and risk management. Lean Six Sigma supports a risk-management culture in the focal companies, but they must involve customers and companies in the supply chain if they wish to create a risk-management culture in the entire supply chain. In order to do this, they can use the Six Sigma training structure, but they need to include more risk tools and methods developed for the supply chain management. It has also been indicated in the literature that if more people involve in 6S projects, the financial results will be better, and the innovation of processes will increase.

Research limitations/implications

These include suggestions for how the companies can use the Six sigma training structure to collaborate in the supply chain.

Practical implications

This study gives practical suggestions for how the companies in supply chain can collaborate and use the Six Sigma training structure for creating a more holistic view of supply chain, which also decrease risks in supply chain.

Originality/value

This study indicates that Lean Six Sigma supports risk awareness and management in the focal companies of the supply chains, which improves companies’ ability to handle variability and risk management. It has also been demonstrated that the companies should use the Six Sigma framework, especially training, as a foundation, and they should create common projects for better collaboration in the supply chain, which will decrease the risks in the entire supply chain.
A dynamic microbial sulfur cycle in a serpentinizing continental ophiolite
Authors: Sabuda Mary C. , Brazelton William J. , Putman Lindsay I. , McCollom Tom M. , Hoehler Tori M. , Kubo Michael D. Y. , Cardace Dawn , Schrenk Matthew O.
Published: April 2020

Serpentinization is the hydration and oxidation of ultramafic rock, which occurs as oceanic lithosphere is emplaced onto continental margins (ophiolites), and along the seafloor as faulting exposes this mantle‐derived material to circulating hydrothermal fluids. This process leads to distinctive fluid chemistries as molecular hydrogen (H2) and hydroxyl ions (OH−) are produced and reduced carbon compounds are mobilized. Serpentinizing ophiolites also serve as a vector to transport sulfur compounds from the seafloor onto the continents. We investigated hyperalkaline, sulfur‐rich, brackish groundwater in a serpentinizing continental ophiolite to elucidate the role of sulfur compounds in fuelling in situ microbial activities. Here we illustrate that key sulfur‐cycling taxa, including Dethiobacter, Desulfitispora and ‘Desulforudis’, persist throughout this extreme environment. Biologically catalysed redox reactions involving sulfate, sulfide and intermediate sulfur compounds are thermodynamically favourable in the groundwater, which indicates they may be vital to sustaining life in these characteristically oxidant‐ and energy‐limited systems. Furthermore, metagenomic and metatranscriptomic analyses reveal a complex network involving sulfate reduction, sulfide oxidation and thiosulfate reactions. Our findings highlight the importance of the complete inorganic sulfur cycle in serpentinizing fluids and suggest sulfur biogeochemistry provides a key link between terrestrial serpentinizing ecosystems and their submarine heritage.
Sonographic and other nonglycemic factors can predict large‐for‐gestational‐age infants in diet‐managed gestational diabetes mellitus: A retrospective cohort study
Authors: Chee Chermaine , Hibbert Emily Jane , Lam Penny , Nanan Ralph , Liu Anthony
Published: April 2020

Background

Gestational diabetes mellitus (GDM) is one of the most common complications of pregnancy. Left untreated or poorly controlled, GDM results in adverse infant outcomes such as large for gestational age (LGA). This study aims to identify nonglycemic maternal and fetal factors predictive of LGA outcomes in pregnancies complicated by diet‐managed GDM.

Methods

This was a retrospective cohort study of singleton pregnancies complicated by diet‐managed GDM from 2004 to 2015. Multiple logistic regression analysis was performed on maternal and perinatal factors to identify risk factors for LGA. In addition, a subset univariate analysis was conducted for pregnancies in which fetal ultrasound abdominal circumference measurements were available at gestational weeks 18 to 22, 24 to 28, and 29 to 33.

Results

A total of 1064 women were included, delivering 123 LGA infants. Women with higher parity (odds ratio [OR] 1.44; CI, 1.23‐1.68; P < .001) and higher prepregnancy body mass index (BMI) (OR 1.09; CI, 1.06‐1.12; P < .001) were more likely to have LGA infants. Maternal smoking (OR 0.30; CI, 0.14‐0.62; P = .001) and higher gestational age at birth (OR 0.91; CI, 0.84‐0.99; P = .018) were associated with reduced risk. Subset univariate analysis showed that fetal abdominal circumference measurements at weeks 24 to 28 and 29 to 33 beyond the 75th percentile (OR 5.92 and 13.74, respectively) and 90th percentile (OR 4.57 and 15.89, respectively) were highly predictive of LGA.

Conclusions

Parity, smoking status, maternal BMI, gestational age, and ultrasound fetal abdominal circumference measurements were identified as useful predictors of LGA. Presence of these predictors may prompt closer monitoring of pregnancy and early therapeutic intervention to improve management and reduce the risk of adverse fetal and maternal outcomes.
The use of pancreatic enzyme replacement therapy in patients with a diagnosis of chronic pancreatitis and pancreatic cancer in the US is infrequent and inconsistent
Authors: Forsmark Chris E. , Tang Gong , Xu Hongzhi , Tuft Marie , Hughes Steven J. , Yadav Dhiraj
Published: April 2020

Background

Patients with chronic pancreatitis or pancreatic cancer commonly develop exocrine pancreatic insufficiency, and may not be adequately treated with pancreatic enzyme replacement therapy (PERT).

Aims

To estimate the frequency of diagnostic testing for exocrine insufficiency, and appropriate use of PERT, in a commercially insured population in the US.

Methods

We utilised a nationally representative administrative database representing 48.67 million individuals in over 80 US healthcare plans to assess testing for and treatment of exocrine insufficiency in patients who received a diagnosis of chronic pancreatitis (n = 37 061) or pancreatic cancer (n = 32 461) from 2001 to 2013. We identified the details of any testing for exocrine insufficiency and PERT use. We defined appropriate PERT use as a dosage of ≥120 000 USP units of lipase daily. Multiple logistic regression was used to identify predictors of appropriate use of PERT.

Results

In patients with chronic pancreatitis, 6.5% had any testing for exocrine insufficiency, 30.4% filled a prescription for PERT, and 8.5% were prescribed an adequate dose. In those with pancreatic cancer, 1.9% had testing for exocrine insufficiency, 21.9% filled a prescription for PERT, and 5.5% were prescribed an adequate dose. Number of comorbidities, testing for exocrine insufficiency, pancreatic surgery and duration of enrolment were independent predictors for use and appropriate dosing.

Conclusions

Testing for exocrine insufficiency, and appropriate dosing of PERT in patients with chronic pancreatitis or pancreatic cancer, is infrequent and inconsistent in an insured US population. Efforts are needed to educate medical providers on the best practices for managing exocrine pancreatic insufficiency in these patients.
The phenotype of adverse drug effects: Do emergency visits due to adverse drug reactions look different in older people? Results from the ADRED study
Authors: Just Katja S. , Dormann Harald , Schurig Marlen , Böhme Miriam , Steffens Michael , Plank‐Kiegele Bettina , Ettrich Kristin , Seufferlein Thomas , Gräff Ingo , Igel Svitlana , Schricker Severin , Jaeger Simon U. , Schwab Matthias , Stingl Julia C.
Published: April 2020

Aims

Older patients in particular suffer from adverse drug reactions (ADR) when presenting in the emergency department. We aimed to characterise the phenotype of those ADRs, to be able to recognise an ADR in older patients.

Methods

Cases of ADRs in emergency departments collected within the multicentre prospective observational study (ADRED) were analysed (n = 2215). We analysed ADR‐associated diagnoses, symptoms and their risk profiles. We present frequencies and odds ratios (OR) with 95% confidence intervals for adults (18–64 years) compared to older adults (≥65 years; young–old 65–79, old–old ≥80 years) and regression coefficients (B) for each year of age.

Results

Most prominent differences were seen for drug‐associated confusion, dehydration, and bradycardia (OR 6.70 [1.59–28.27], B .054; OR 6.02 [2.41–15.03], B .081, and 4.82 [2.21–10.54], B .040), more likely seen in older adults. Bleedings were reported in all age groups, but gastrointestinal bleedings occurred with more than doubled chance in older adults (OR 2.46 [1.77–3.41], B .030), likewise did other bleedings such as haemorrhage from respiratory passages (OR 2.89 [1.37–6.11], B.036). Falls were more likely in older adults (OR 2.84 [1.77–4.53], B .030), while dizziness was frequent in both age groups.

Conclusion

Our data point to differences in symptoms of ADRs between adults and older individuals, with dangerous drug‐associated phenomena in the older adult such as bleedings or falls. Physicians should consider drug‐associated origins of symptoms in older adults with an increased risk for serious health problems.
Cardiorenal syndrome: Multi‐organ dysfunction involving the heart, kidney and vasculature
Authors: Savira Feby , Magaye Ruth , Liew Danny , Reid Christopher , Kelly Darren J. , Kompa Andrew R. , Sangaralingham S. Jeson , Burnett John C. , Kaye David , Wang Bing H.
Published: April 2020

Cardiorenal syndrome (CRS) is a multi‐organ disease, encompassing heart, kidney and vascular system dysfunction. CRS is a worldwide problem, with high morbidity, mortality, and inflicts a significant burden on the health care system. The pathophysiology is complex, involving interactions between neurohormones, inflammatory processes, oxidative stress and metabolic derangements. Therapies remain inadequate, mainly comprising symptomatic care with minimal prospect of full recovery. Challenges include limiting the contradictory effects of multi‐organ targeted drug prescriptions and continuous monitoring of volume overload. Novel strategies such as multi‐organ transplantation and innovative dialysis modalities have been considered but lack evidence in the CRS context. The adjunct use of pharmaceuticals targeting alternative pathways showing positive results in preclinical models also warrants further validation in the clinic. In recent years, studies have identified the involvement of gut dysbiosis, uraemic toxin accumulation, sphingolipid imbalance and other unconventional contributors, which has encouraged a shift in the paradigm of CRS therapy.
Clinoforms and clinothems: Fundamental elements of basin infill
Authors: Pellegrini Claudio , Patruno Stefano , Helland‐Hansen William , Steel Ronald J. , Trincardi Fabio
Published: April 2020

This special issue dealing with the recent advances on modern and ancient clinoform‐stratified sedimentary successions arises from a European Geoscience Union (EGU) session “Clinoform drivers and stratigraphic products in siliciclastic and carbonate successions”, Vienna, April 2018. Clinoforms and clinothems represent a dominant architectural style of strata in many sedimentary environments, including deltaic and nondeltaic shorelines in both marine and lacustrine settings, and are one of the key building blocks of the sedimentary record. This Special Issue in Basin Research aspires to represent a step forward in understanding formation and preservation of these fundamental stratigraphic elements. As this Special Issue documents, a comprehensive understanding of clinoformal strata requires a multidisciplinary and multi‐scale approach. Sixteen papers present case studies from a variety of tectonic settings worldwide, investigated with an array of methods, including seismo‐stratigraphy, well logs, cores, high‐resolution biostratigraphy, outcrop studies and modern bathymetric data. While observations document sedimentary processes and products in sedimentary basins, numerical models are necessary to provide a quantitative basis for the extrapolation of these processes and strata at different temporal and spatial scales. The papers highlight at least five main research avenues that we briefly introduce and discuss below: (a) clinoforms and clinothems as sedimentary archives; (b) the nested nature of clinoformal strata and implications for the trajectory of the rollover point(s); (c) quantitative clinoform parameters and dynamic indices; (d) architecture, growth and sequence stratigraphy of marine versus lacustrine clinoformal strata; and (e) clinoforms and geological time. This introduction also contains brief descriptions of each paper of the Special Issue.
An inverse model‐based multiobjective estimation of distribution algorithm using Random‐Forest variable importance methods
Authors: Gholamnezhad Pezhman , Broumandnia Ali , Seydi Vahid
Published: April 2020

Most existing methods of multiobjective estimation of distributed algorithms apply the estimation of distribution of the Pareto‐solution on the decision space during the search and little work has proposed on making a regression‐model for representing the final solution set. Some inverse‐model‐based approaches were reported, such as inversed‐model of multiobjective evolutionary algorithm (IM‐MOEA), where an inverse functional mapping from Pareto‐Front to Pareto‐solution is constructed on nondominated solutions based on Gaussian process and random grouping technique. But some of the effective inverse models, during this process, may be removed. This paper proposes an inversed‐model based on random forest framework. The main idea is to apply the process of random forest variable importance that determines some of the best assignment of decision variables (xn) to objective functions (fm) for constructing Gaussian process in inversed‐models that map all nondominated solutions from the objective space to the decision space. In this work, three approaches have been used: classical permutation, Naïve testing approach, and novel permutation variable importance. The proposed algorithm has been tested on the benchmark test suite for evolutionary algorithms [modified Deb K, Thiele L, Laumanns M, Zitzler E (DTLZ) and Walking Fish Group (WFG)] and indicates that the proposed method is a competitive and promising approach.
Trends in opioid initiation among people who use opioids in three US cities
Authors: Rouhani Saba , Park Ju Nyeong , Morales Kenneth B. , Green Traci C. , Sherman Susan G.
Published: April 2020

Introduction and Aims

The increased availability of prescription opioids (PO) and non‐medical prescription opioids (NMPO) has fundamentally altered drug markets and typical trajectories from initiation to high‐risk use among people who use opioids (PWUO). This multi‐site study explores trends in opioid initiation in three US cities and associations with sociodemographic factors, current drug use and overdose risk.

Design and Methods

We analysed survey data from a cross‐sectional study of PWUO in Baltimore, Maryland (n = 173), Boston, Massachusetts (n = 80) and Providence, Rhode Island (n = 75). Age of first exposure to PO, NMPO and heroin was used to calculate opioid of initiation, and multinomial regression was employed to explore correlates of initiating with each.

Results

Thirty‐three percent of PWUO initiated with heroin, 24% with PO, 18% with NMPO and 24% with multiple opioids in their first year of use. We observed a reduction in heroin initiation and gradual replacement with PO/NMPO over time. Women were more likely to initiate with NMPO [relative risk ratio (RRR) 2.4; 95% confidence interval (CI) 1.1, 5.0], PO (RRR 2.2, 95% CI 1.1, 4.4) or multiple opioids (RRR 2.1, 95% CI 1.1, 4.2), than heroin. PWUO initiating with NMPO had significantly higher current benzodiazepine use, relative to those initiating with heroin (RRR 3.2, 95% CI 1.4, 7.4), and a high prevalence of current fentanyl use (30%).

Discussion and Conclusions

Our study highlights women and PWUO initiating with NMPO as key risk groups amid the changing landscape of opioid use and overdose, and discusses implications for targeted prevention and treatment.
Importance of intensive blood pressure control in type 2 diabetes: Mechanisms, treatments and current guidelines
Authors: Marre Michel
Published: April 2020

Observational and interventional studies have shown that intensified blood pressure (BP) reduction can benefit people with diabetes. Because of their special haemodynamic properties, renin‐angiotensin‐aldosterone system (RAAS) blockers are recommended. The results of the BP arm of the ADVANCE study strongly support the recently updated European Society of Cardiology/European Association of Diabetes recommendations for the treatment of BP in people with diabetes, which recommend a target systolic/diastolic BP of 130/80 mmHg with few exceptions, and a fixed combination of an RAAS blocker with a diuretic or a calcium channel blocker as first‐line treatment.
Elevated serum pentraxin 3 levels might predict the diagnosis of branch atheromatous disease at a very early stage
Authors: Ninomiya I. , Kanazawa M. , Uemura M. , Onodera O.
Published: April 2020

Background and purpose

Branch atheromatous disease (BAD) is one of the stroke subtypes caused by occlusion at the origin of a deep penetrating artery of the brain and is associated with a microatheroma or a junctional plaque. Patients with BAD often develop progressive worsening of neurologic deficits, although these patients often present minor stroke with clinical characteristics of lacunar syndrome at the onset. Pentraxin 3 (PTX3) is known to be a key molecule involved in the pathogenesis of atherosclerosis. Although a high level of serum PTX3 is observed in patients with acute coronary syndrome, there are no reports on PTX3 levels in patients with BAD. This study aimed to investigate whether serum PTX3 levels can distinguish BAD from other stroke subtypes.

Methods

We investigated 93 patients with ischaemic stroke. Serum PTX3 levels on admission were measured using enzyme‐linked immunosorbent assay in patients with BAD and those with other stroke subtypes (each n ≥ 20).

Results

The median PTX3 levels in patients with BAD (4840 pg/mL) were higher than those with other subtypes of stroke (3397 pg/mL in lacunar stroke, 1298 pg/mL in large‐artery atherosclerosis, 1470 pg/mL in cardioaortic embolism and 1006 pg/mL in control) (all P < 0.01).

Conclusion

Our results suggest that elevated serum PTX3 levels might predict the diagnosis of BAD at a very early stage.
Global burden of psoriasis – comparison of regional and global epidemiology, 1990 to 2017
Authors: AlQassimi Sarah , AlBrashdi Safiya , Galadari Hassan , Hashim Muhammad Jawad
Published: April 2020

Background

Psoriasis is a common disease that has not only cutaneous manifestations but also causes significant systemic illness and disability. Most epidemiological studies on the burden of psoriasis that are available in literature are regional, and thus a detailed description of the worldwide burden of psoriasis is warranted.

Methods

We analyzed the prevalence, incidence, disability adjusted life years (DALY), and years lived with disability (YLD) related to psoriasis for the period 1990 to 2017, from the Global Burden of Disease dataset (developed by the Institute of Health Metrics, University of Washington). We also searched the PubMed MEDLINE for quality of life and economic burden of psoriasis for a comprehensive evaluation of the burden of psoriasis.

Results

In 2017, the global age‐standardized prevalence rate of psoriasis was 811 per 100,000 population, approximating to 0.84% of world population or about 64.6 million individuals. The incidence of new cases increased from 92 per 100,000 in 1990 to 99 in 2017. The highest rates were recorded in North America and Western Europe, while the lowest rates were found in Asia and Western Pacific regions. The age distribution shows a rising rate of incidence from the second decade, peaking at 55–60 years. Women are slightly more likely to be affected.

Conclusions

The global incidence of psoriasis has been rising over the last three decades. The burden of the economic and psychosocial suffering caused by psoriasis calls for resource allocation and a multidisciplinary approach to address this common medical condition.

Key Message

The prevalence, incidence, and the burden of suffering caused by psoriasis have been rising over the past 17 years, despite efforts at improving diagnosis and treatment.
The application of telehealth to remote and rural Australians with chronic neurological conditions
Authors: Le Sammy , Aggarwal Arun
Published: April 2020

Background

Patients with chronic disease in rural and remote regions endure limited access to specialised medicine. Telehealth has addressed this issue with demonstrable benefits such as a reduction in costs to patients.

Aims

To explore the patient satisfaction of telehealth in Australia.

Methods

Patients from all around Australia, including Queensland, Victoria, Tasmania, South Australia, Australian Capital Territory and even Western Australia were referred to a Sydney‐based neurologist. After their initial face to face consultation, review consultations were performed by telehealth. All had chronic diseases (trigeminal neuralgia, facial pain or Parkinson disease) and received a standardised questionnaire comprising of demographics, satisfaction of technical aspects and quality of the consultation. The questionnaires were administered by the Practice Manager to remove observer bias.

Results

Twenty‐nine patient questionnaires were completed by 13 patients who had follow‐up telehealth consultations. One hundred per cent of patients reported satisfaction with the overall telehealth experience and would use it again. All were satisfied with the specialist and the privacy. The majority were satisfied with the voice quality (86%), visual quality (79%), ease of connectivity (93%) and length of the consultation (97%). In total, they saved nearly $17 000 in travel costs and on average, each patient avoided 937 km and saved $550.

Conclusion

Telehealth has proven to have multiple advantages, including improved access to healthcare, decreased costs, reduced inconvenience and improved management of chronic and complex conditions. The positive results advocate the use of telehealth for follow up of rural and remote patients with chronic disease.
Erzhu Qinggan Jiedu Recipe improves the clinical outcome of hepatocellular cancer after surgical resection: a case–control retrospective study
Authors: Cheng Yang , Ni Saisai , Chen Yiyun , Ling Qihua , Chen Jianjie
Published: April 2020

Background

This study retrospectively reviewed the recurrence rate and survival time of primary hepatocellular carcinoma (HCC) patients after treatment with Erzhu Qinggan Jiedu Recipe (ESQJR), explored the impact of Chinese medicine in reducing tumour recurrence and prolonging survival time, and explored an effective prevention treatment for the recurrence of HCC.

Aim

To explore the impact of Chinese medicine in reducing tumor recurrence and prolonging survival time, and explore an effective prevention treatment for the recurrence of HCC.

Methods

A total of 137 patients who underwent HCC resection from May 2004 to January 2018 was included in this retrospective study. The patients were divided into two groups, with 68 patients in the Western medicine group and 69 patients in the Western medicine plus ESQJR group. The relapse rate, overall survival period, and disease‐free survival period before and after treatment were analysed. Indices including alpha‐fetoprotein, alanine aminotransferase, aspartate aminotransferase and Karnofsky performance score were obtained for analysis and comparison.

Results

There was no significant difference among patient clinical parameters between the two groups. Compared with the Western medicine group, the Western medicine plus ESQJR group had a reduced cumulative recurrence rate, prolonged overall survival time and disease‐free survival time and improved clinical symptoms, including quality of life and liver function.

Conclusion

ESQJR effectively improved long‐term survival in resected HCC patients. ESQJR has the potential to be used as an adjuvant therapy with significant beneficial effects for treating HCC.
Prospective cohort study of influenza vaccine effectiveness among healthcare personnel in Lima, Peru: Estudio Vacuna de Influenza Peru, 2016‐2018
Authors: Wesley Meredith G. , Soto Giselle , Arriola Carmen Sofia , Gonzales Miriam , Newes‐Adeyi Gabriella , Romero Candice , Veguilla Vic , Levine Min Z. , Silva Maria , Ferdinands Jill M. , Dawood Fatimah S. , Reynolds Sue B. , Hirsch Avital , Katz Mark , Matos Eduardo , Ticona Eduardo , Castro Juan , Castillo Maria , Bravo Eduar , Cheung Angela , Phadnis Rachel , Martin Emily Toth , Tinoco Yeny , Neyra Quijandria Joan Manuel , Azziz‐Baumgartner Eduardo , Thompson Mark G. ,   the VIP Cohort Study Working Group
Published: April 2020

Background

The Estudio Vacuna de Influenza Peru (VIP) cohort aims to describe the frequency of influenza virus infection, identify predictors of vaccine acceptance, examine the effects of repeated influenza vaccination on immunogenicity, and evaluate influenza vaccine effectiveness among HCP.

Methods

The VIP cohort prospectively followed HCP in Lima, Peru, during the 2016‐2018 influenza seasons; a fourth year is ongoing. Participants contribute blood samples before and after the influenza season and after influenza vaccination (for vaccinees). Weekly surveillance is conducted to identify acute respiratory or febrile illnesses (ARFI). When an ARFI is identified, participants self‐collect nasal swabs that are tested for influenza viruses by real‐time reverse transcriptase‐polymerase chain reaction. Influenza vaccination status and 5‐year vaccination history are ascertained. We analyzed recruitment and enrollment results for 2016‐2018 and surveillance participation for 2016‐2017.

Results

In the first 3 years of the cohort, VIP successfully contacted 92% of potential participants, enrolled 76% of eligible HCP, and retained >90% of participants across years. About half of participants are medical assistants (54%), and most provide “hands‐on” medical care (76%). Sixty‐nine percent and 52% of participants completed surveillance for >70% of weeks in years 1 and 2, respectively. Fewer weeks of completed surveillance was associated with older age (≥50 years), being a medical assistant, self‐rated health of fair or poor, and not receiving the influenza vaccine during the current season (P‐values < .05).

Conclusions

The VIP cohort provides an opportunity to address knowledge gaps about influenza virus infection, vaccination uptake, effectiveness and immunogenicity among HCP.
New‐onset intrinsic and paced QRS morphology of right bundle branch block pattern after atrioventricular nodal ablation: Longitudinal dissociation or anatomical bifurcation?
Authors: Wu Shengjie , Su Lan , Zheng Rujie , Xu Lei , Huang Weijian
Published: April 2020

We performed left bundle pacing combined with atrioventricular nodal (AVN) ablation in a patient with persistent atrial fibrillation and refractory symptomatic heart failure. The major findings were new‐onset intrinsic and paced QRS morphology of right bundle branch block (RBBB) pattern after AVN ablation which was performed at a more atrial site compared with the pacing site and the paced RBBB pattern could not be corrected regardless of the pacing output. Longitudinal dissociation cannot explain this observation, while anatomical separation could. We also confirm this was proximal left bundle pacing rather than His bundle pacing.
Practitioner Review: Effectiveness of indicated school‐based interventions for adolescent depression and anxiety – a meta‐analytic review
Authors: Gee Brioney , Reynolds Shirley , Carroll Ben , Orchard Faith , Clarke Tim , Martin David , Wilson Jon , Pass Laura
Published: April 2020

Background

Interest in delivering psychological interventions within schools to facilitate early intervention is increasing. However, most reviews have focused on universal or preventative programmes rather than interventions designed to decrease existing symptoms of depression or anxiety. This paper aims to provide a meta‐analytic review of randomised controlled trials of indicated psychological interventions for young people aged 10–19 with elevated symptoms of depression and/or anxiety.

Methods

Eight electronic databases were systematically searched from inception to April 2019 for eligible trials. Study quality was assessed using two scales designed to evaluate psychotherapy intervention trials. Random effects meta‐analyses were conducted separately for trials that recruited participants based on symptoms of depression and based on symptoms of anxiety.

Results

Data from 45 trials were analysed. Most interventions studied used cognitive and behavioural strategies. Few studies met methodological quality criteria, but effect size was not associated with study quality. Indicated school‐based interventions had a small effect on reducing depression symptoms (SMD = .34, 95% CI −0.48, −0.21) and a medium effect on reducing anxiety symptoms (SMD = −.49, 95% CI −0.79, −0.19) immediately postintervention. Subgroup analyses indicated that interventions delivered by internal school staff did not have significant effects on symptoms. Reductions in depression were maintained at short‐term (≤6 months) but not medium (>6 months ≤ 12) or long‐term (>12‐month) follow‐up. Reductions in anxiety symptoms were not maintained at any follow‐up.

Conclusions

Indicated school‐based interventions are effective at reducing symptoms of depression and anxiety in adolescents immediately postintervention but there is little evidence that these reductions are maintained. Interventions delivered by school staff are not supported by the current evidence base. Further high‐quality randomised controlled trials incorporating assessment of longer‐term outcomes are needed to justify increased investment in school‐based interventions for adolescent depression and anxiety.