bluuebunny/crossref_metadata_2025 huggingface dataset:
Large cliques and independent sets all over the place
Authors: Alon Noga , Bucić Matija , Sudakov Benny
Published: September 2020

We study the following question raised by Erdős and Hajnal in the early 90’s. Over all

n
n

-vertex graphs

G
G

what is the smallest possible value of

m
m

for which any

m
m

vertices of

G
G

contain both a clique and an independent set of size

log
⁡
n

\log n

? We construct examples showing that

m
m

is at most

2

2

(
log
⁡
log
⁡
n

)

1

/

2
+
o
(
1
)

2^{2^{(\log \log n)^{1/2+o(1)}}}

obtaining a twofold sub-polynomial improvement over the upper bound of about

n

\sqrt {n}

coming from the natural guess, the random graph. Our (probabilistic) construction gives rise to new examples of Ramsey graphs, which while having no very large homogenous subsets contain both cliques and independent sets of size

log
⁡
n

\log n

in any small subset of vertices. This is very far from being true in random graphs. Our proofs are based on an interplay between taking lexicographic products and using randomness.
Weak* fixed point property and the space of affine functions
Authors: Casini Emanuele , Miglierina Enrico , Piasecki Łukasz
Published: September 2020

First we prove that if a separable Banach space

X
X

contains an isometric copy of an infinite-dimensional space

A
(
S
)

A(S)

of affine continuous functions on a Choquet simplex

S
S

, then its dual

X
∗

X^*

lacks the weak

∗

^*

fixed point property for nonexpansive mappings. Then, we show that the dual of a separable

L
1

L_1

-predual

X
X

fails the weak

∗

^*

fixed point property for nonexpansive mappings if and only if

X
X

has a quotient isometric to some infinite-dimensional space

A
(
S
)

A(S)

. Moreover, we provide an example showing that “quotient” cannot be replaced by “subspace”. Finally, it is worth mentioning that in our characterization the space

A
(
S
)

A(S)

cannot be substituted by any space

C

(
K
)

\mathcal {C}(K)

of continuous functions on a compact Hausdorff

K
K

.
Weighted Poincaré inequality and the Poisson Equation
Authors: Munteanu Ovidiu , Sung Chiung-Jue , Wang Jiaping
Published: September 2020

We develop Green’s function estimates for manifolds satisfying a weighted Poincaré inequality together with a compatible lower bound on the Ricci curvature. This estimate is then applied to establish existence and sharp estimates of solutions to the Poisson equation on such manifolds. As an application, a Liouville property for finite energy holomorphic functions is proven on a class of complete Kähler manifolds. Consequently, such Kähler manifolds must be connected at infinity.
SE

eking

A

nswe

R

s for

C

are

H

omes during the COVID-19 pandemic (COVID SEARCH)
Authors: Spilsbury Karen , Devi Reena , Griffiths Alys , Akrill Cyd , Astle Anita , Goodman Claire , Gordon Adam , Hanratty Barbara , Hodkinson Peter , Marshall Fiona , Meyer Julienne , Thompson Carl
Published: September 2020

The care and support of older people residing in long-term care facilities during the COVID-19 pandemic has created new and unanticipated uncertainties for staff. In this short report, we present our analyses of the uncertainties of care home managers and staff expressed in a self-formed closed WhatsApp™ discussion group during the first stages of the pandemic in the UK. We categorised their wide-ranging questions to understand what information would address these uncertainties and provide support. We have been able to demonstrate that almost one-third of these uncertainties could have been tackled immediately through timely, responsive and unambiguous fact-based guidance. The other uncertainties require appraisal, synthesis and summary of existing evidence, commissioning or provision of a sector- informed research agenda for medium to long term. The questions represent wider internationally relevant care home pandemic-related uncertainties.
American Society for Clinical Pathology’s 2019 Wage Survey of Medical Laboratories in the United States
Authors: Garcia Edna , Kundu Iman , Fong Karen
Published: September 2020

Objectives

To inform the pathology and laboratory field of the most recent national wage data. Historically, the results of this biennial survey have served as a basis for additional research on laboratory recruitment, retention, education, marketing, certification, and advocacy.

Methods

The 2019 Wage Survey was conducted through collaboration of the American Society for Clinical Pathology (ASCP) Institute of Science, Technology, and Policy in Washington, DC, and the ASCP Board of Certification in Chicago, Illinois.

Results

Compared with 2017, results show an overall increase in salaries for most laboratory occupations surveyed except cytogenetic technologists, laboratory information systems personnel, and performance improvement or quality assurance personnel. Geographically, laboratory professionals from urban areas earned more than their rural counterparts.

Conclusions

As retirement rates continue to increase, the field needs to intensify its efforts on recruiting the next generation of laboratory personnel. To do so, the report urged the field to highlight advocacy for better salaries for laboratory personnel at the local and national levels when developing recruitment and retention strategies.
Male-to-Female Presumed Transmission of Toxoplasmosis Between Sexual Partners
Authors: Hlaváčová Jana , Flegr Jaroslav , Řežábek Karel , Calda Pavel , Kaňková Šárka
Published: September 2020

Toxoplasmosis is one of the most widespread human parasitoses in developed countries. Sexual transmission has been confirmed in several animal species, and indirect evidence suggests it may occur in humans. We compared the seropositivity to Toxoplasma gondii in couples who visited the Center for Assisted Reproduction in Prague from June 2016 to June 2018 and analyzed various risk factors including the serological status of sexual partner. By comparing the risk factors in men and women, we tested the hypothesis of male-to-female sexual transmission of toxoplasmosis. The prevalence of toxoplasmosis in women with infected male partners (25.6%; n = 156) was higher than in women with uninfected male partners (18.2%; n = 477; P = 0.045). Therefore, a partner’s seropositivity seems to be a risk factor for infection in women (n = 593; prevalence ratio = 1.418; P = 0.045) but not in men (n = 573; prevalence ratio = 1.058; P = 0.816). Our results support the hypothesis of the sexual transmission of T. gondii from men to women. The risk may seem relatively low, but transmission can occur during unprotected sexual intercourse, which may be at the time of conception. Because of the risk of congenital toxoplasmosis, a lower risk of infection than that observed in our study can represent a serious health problem.
The Relationship Between Carotid–Femoral Pulse Wave Velocity, Pulse Pressure, and Carotid Intima–Media Thickness in the Patients With Hypertension
Authors: Chen Bing-ying , Li Lie-you , Zhou Guo-xiang , Gong Jin , Xie Liang-di
Published: September 2020

Background

To investigate the relationships between pulse pressure, carotid intima–media thickness (CIMT), and carotid–femoral pulse wave velocity (cfPWV) in patients with hypertension.

Methods

A total of 469 patients with hypertension and 274 subjects with normal blood pressure were enrolled and subdivided based on their cfPWV (≥ or <10 m/s), CIMT (≥ or <1 mm), and age (≥ or <65 years old). Blood pressure was measured in all subjects and pulse pressure was calculated. Pearson correlation analysis and multiple linear regression analysis were used to analyze the influencing factors of cfPWV.

Results

cfPWV, pulse pressure, and CIMT in patients with hypertension were higher than those in patients with normal blood pressure (9.56 ± 1.93 vs. 8.46 ± 1.47 m/s, 58.6 ± 13.5 vs. 49.2 ± 10.3 mm Hg, 0.93 ± 0.18 vs. 0.82±0.17 mm, all P < 0.05). In patients with hypertension, pulse pressure and CIMT in the increased cfPWV group were significantly higher than those in the normal cfPWV group (all P < 0.05), and cfPWV and pulse pressure were significantly higher in the elderly than the younger age group (all P < 0.05). Multiple linear regression stepwise analysis showed that pulse pressure, age, heart rate, gender, and fasting blood glucose were the influencing factors of cfPWV in all subjects (all P < 0.05), and stratified analysis showed that pulse pressure was the influencing factor of cfPWV regardless of age and gender. CIMT was an influential factor of cfPWV in the younger age group (<65 years old), but not in elderly patients (≥65 years old).

Conclusions

Pulse pressure is an important influencing factor of cfPWV in patients with hypertension, and CIMT is associated with cfPWV in hypertensive patients less than 65 years old.
A Diverse Physician-Scientist Pipeline to Fight Structural Racism
Authors: Titanji Boghuma K , Swartz Talia H
Published: September 2020

Translational research plays a pivotal role in leveraging good science to serve humanity. Structural racism and a lack of diversity severely limit our potential as scientists to exert a maximum impact. This moment calls for a renewed commitment to ridding science of racism and bias and promoting diversity, which makes us more effective at innovating and delivering therapeutics to the patients we serve.
The Cambridge economic tradition and the distribution of the social surplus
Authors: Martins Nuno Ornelas
Published: September 2020

Various research projects in economics developed at Cambridge share common philosophical presuppositions, within what can be termed as the Cambridge economic tradition. I argue here that the Cambridge economic tradition can be distinguished from other traditions in terms of its underlying ontology, methodology and ethics, and also in terms of the way in which those philosophical presuppositions are expressed in competing theoretical approaches to the distribution of the social surplus. I also distinguish between an economic tradition and a school of economics and note that various schools have existed within the Cambridge economic tradition. The various Cambridge schools can themselves be identified in terms of the specific analytical frameworks they adopted when addressing the distribution of the social surplus.
Treatment of heavily calcified coronary artery stenosis using 3.5 mm peripheral intravascular lithotripsy balloon: case series
Authors: Mekala Karthik , Mehta Rajendra H , Joumaa Mouhammed , Yamasaki Hiroshi
Published: September 2020

Background

Prevalence of coronary artery calcification is high among patients with advanced age, chronic kidney disease, and diabetes. Percutaneous coronary intervention of heavily calcified coronary artery remains a significant challenge for interventional cardiologists. Although there are several modalities available in treating calcified coronary arteries, lesion preparation of certain heavily calcified vessels remains inadequate prior to stent deployment and/or often associated with worse periprocedural adverse outcomes.

Case summary

We report feasibility and safety of 3.5 mm peripheral intravascular lithotripsy (IVL) for the treatment of severely calcified coronary stenosis in two patients after orbital atherectomy failed to debulk calcified plaque to enable stent deployment.

Discussion

Intravascular lithotripsy has recently emerged as a therapeutic option in treating calcified peripheral artery disease. However, coronary IVL is currently available only in a few centres in the USA. Studies are ongoing in the safety and efficacy of this technology in treating coronaries.
CDR132L improves systolic and diastolic function in a large animal model of chronic heart failure
Authors: Batkai Sandor , Genschel Celina , Viereck Janika , Rump Steffen , Bär Christian , Borchert Tobias , Traxler Denise , Riesenhuber Martin , Spannbauer Andreas , Lukovic Dominika , Zlabinger Katrin , Hašimbegović Ena , Winkler Johannes , Garamvölgyi Rita , Neitzel Sonja , Gyöngyösi Mariann , Thum Thomas
Published: September 2020

Aims

Cardiac miR-132 activation leads to adverse remodelling and pathological hypertrophy. CDR132L is a synthetic lead-optimized oligonucleotide inhibitor with proven preclinical efficacy and safety in heart failure (HF) early after myocardial infarction (MI), and recently completed clinical evaluation in a Phase 1b study (NCT04045405). The aim of the current study was to assess safety and efficacy of CDR132L in a clinically relevant large animal (pig) model of chronic heart failure following MI.

Methods and results

In a chronic model of post-MI HF, slow-growing pigs underwent 90 min left anterior descending artery occlusion followed by reperfusion. Animals were randomized and treatment started 1-month post-MI. Monthly intravenous (IV) treatments of CDR132L over 3 or 5 months (3× or 5×) were applied in a blinded randomized placebo-controlled fashion. Efficacy was evaluated based on serial magnetic resonance imaging, haemodynamic, and biomarker analyses. The treatment regime provided sufficient tissue exposure and CDR132L was well tolerated. Overall, CDR132L treatment significantly improved cardiac function and reversed cardiac remodelling. In addition to the systolic recovery, diastolic function was also ameliorated in this chronic model of HF.

Conclusion

Monthly repeated dosing of CDR132L is safe and adequate to provide clinically relevant exposure and therapeutic efficacy in a model of chronic post-MI HF. CDR132L thus should be explored as treatment for the broad area of chronic heart failure.
Factors associated with participation over time in the Avon Longitudinal Study of Parents and Children: a study using linked education and primary care data
Authors: Cornish Rosie P , Macleod John , Boyd Andy , Tilling Kate
Published: September 2020

Background

In observational research, choosing an optimal analysis strategy when variables are incomplete requires an understanding of the factors associated with ongoing participation and non-response, but this cannot be fully examined with incomplete data. Linkage to external datasets provides additional information on those with incomplete data, allowing examination of factors related to missingness.

Methods

We examined the association between baseline sociodemographic factors and ongoing participation in the Avon Longitudinal Study of Parents and Children. We investigated whether child and adolescent outcomes measured in linked education and primary care data were associated with participation, after accounting for baseline factors. To demonstrate the potential for bias, we examined whether the association between maternal smoking and these outcomes differed in the subsample who completed the 19-year questionnaire.

Results

Lower levels of school attainment, lower general practitioner (GP) consultation and prescription rates, higher body mass index (BMI), special educational needs (SEN) status, not having an asthma diagnosis, depression and being a smoker were associated with lower participation after adjustment for baseline factors. For example, the adjusted odds ratio (OR) for participation comparing ever smokers (by 18 years) with non-smokers was: 0.65, 95% CI (0.56, 0.75). The associations with maternal smoking differed between the subsample of participants at 19 years and the entire sample, although differences were small and confidence intervals overlapped. For example: for SEN status, OR = 1.19 (1.06, 1.33) (all participants); OR = 1.03 (0.79, 1.45) (subsample).

Conclusions

A range of health-related and educational factors are associated with ongoing participation in ALSPAC; this is likely to be the case in other cohort studies. Researchers need to be aware of this when planning their analysis. Cohort studies can use linkage to routine data to explore predictors of ongoing participation and conduct sensitivity analyses to assess potential bias.
The functional relation between mean motion resonances and Yarkovsky force on small eccentricities
Authors: Milić Žitnik I
Published: September 2020

This work examines asteroid’s motion with orbital eccentricity in the range (0.1, 0.2) across the two-body mean motion resonance (MMR) with Jupiter due to the Yarkovsky effect. We calculated time delays dtr caused by the resonance on the mobility of an asteroid with the Yarkovsky drift speed. Our final results considered only asteroids that successfully cross over the resonance without close encounters with planets. We found a functional relation that accurately describes dependence between the average time lead/lag 〈dtr〉, the strength of the resonance SR, and the semimajor axis drift speed da/dt with asteroids’ orbital eccentricities in the range (0.1, 0.2). We analysed average values of 〈dtr〉 using this functional relation comparing with obtained values of 〈dtr〉 from the numerical integrations, which were performed in an ORBIT9 integrator with a very large number of test asteroids. We checked the validity of our previous functional relation, derived for asteroids’ orbital eccentricities in the range (0, 0.1), on the present results for eccentricities in the range (0.1, 0.2). Also, we tried to find a unique functional relation for the whole interested interval of asteroids’ orbital eccentricities (0, 0.2) and discussed it.
The effects of dwarf galaxies on the orbital evolution of galactic globular clusters
Authors: Garrow Turner , Webb Jeremy J , Bovy Jo
Published: September 2020

We investigate the effect that dwarf galaxies have on the orbits, tidal histories, and assumed formation environment of Milky Way globular clusters. We determine the orbits of the Milky Way’s 150 globular clusters in a gravitational potential both with and without dwarf galaxies. We find that the presence of a small number of satellite galaxies can affect the orbits of many of the globular clusters. Over 12 Gyr, we find that the semimajor axis and orbital eccentricity of individual clusters fluctuate with dispersions of the order of $\sim 10{{\ \rm per\ cent}}$ and $\sim 4{{\ \rm per\ cent}}$, respectively. Outer clusters are more strongly affected by dwarf galaxies than inner clusters, with their semimajor axis and orbital eccentricities fluctuating by more than $\sim 15{{\ \rm per\ cent}}$ and $\sim 5{{\ \rm per\ cent}}$, respectively. Using detailed N-body simulations of select clusters, we find that altering their orbital histories can lead to different mass-loss rates and structural evolution. Furthermore, we caution against using kinematics alone to identify whether a Galactic cluster formed in situ or was accreted during a past merger event as these values are no longer conserved. The presence of dwarf galaxies causes the orbital energies and actions of individual clusters to evolve over time, spanning a wider range than that coming from random uncertainties in a cluster’s proper motions and radial velocity.
Constraints on cosmological parameters from gamma-ray burst peak photon energy and bolometric fluence measurements and other data
Authors: Khadka Narayan , Ratra Bharat
Published: September 2020

We use measurements of the peak photon energy and bolometric fluence of 119 gamma-ray bursts (GRBs) extending over the redshift range of 0.3399 ≤ z ≤ 8.2 to simultaneously determine cosmological and Amati relation parameters in six different cosmological models. The resulting Amati relation parameters are almost identical in all six cosmological models, thus validating the use of the Amati relation in standardizing these GRBs. The GRB data cosmological parameter constraints are consistent with, but significantly less restrictive than, those obtained from a joint analysis of baryon acoustic oscillation and Hubble parameter measurements.
A Suzaku sample of unabsorbed narrow-line and broad-line Seyfert 1 galaxies – I. X-ray spectral properties
Authors: Waddell S G H , Gallo L C
Published: September 2020

A sample of narrow-line Seyfert 1 (NLS1) and broad-line Seyfert 1 (BLS1) galaxies observed with Suzaku is presented. The final sample consists of 22 NLS1s and 47 BLS1s, for a total of 69 active galactic nuclei (AGNs) that are all at low redshift (z < 0.5) and exhibit low host-galaxy column densities (<1022${\rm cm}^{-2}\,$). The average spectrum for each object is fit with a toy model to characterize important parameters, including the photon index, soft excess, Compton hump (or hard excess), narrow iron line strength, luminosity, and X-ray Eddington ratio (Lx/LEdd). We confirm previous findings that NLS1s have steeper power laws and higher X-ray Eddington ratios, but also find that NLS1 galaxies have stronger soft and hard excesses than their BLS1 counterparts. Studying the correlations between parameters shows that the soft and hard excesses are correlated for NLS1 galaxies, while no such correlation is observed for BLS1s. Performing a principal component analysis (PCA) on the measured X-ray parameters shows that while the X-ray Eddington ratio is the main source of variations within our sample (PC1), variations in the soft and hard excesses form the second principal component (PC2) and it is dominated by the NLS1s. The correlation between the soft and hard excesses in NLS1 galaxies may suggest a common origin for the two components, such as a blurred reflection model. The presented Suzaku sample of Seyfert 1 galaxies is a useful tool for the analysis of the X-ray properties of AGNs, and for the study of the soft and hard excesses observed in AGNs.
Influenza A virus co-opts ERI1 exonuclease bound to histone mRNA to promote viral transcription
Authors: Declercq Marion , Biquand Elise , Karim Marwah , Pietrosemoli Natalia , Jacob Yves , Demeret Caroline , Barbezange Cyril , van der Werf Sylvie
Published: September 2020

Cellular exonucleases involved in the processes that regulate RNA stability and quality control have been shown to restrict or to promote the multiplication cycle of numerous RNA viruses. Influenza A viruses are major human pathogens that are responsible for seasonal epidemics, but the interplay between viral proteins and cellular exonucleases has never been specifically studied. Here, using a stringent interactomics screening strategy and an siRNA-silencing approach, we identified eight cellular factors among a set of 75 cellular proteins carrying exo(ribo)nuclease activities or involved in RNA decay processes that support influenza A virus multiplication. We show that the exoribonuclease ERI1 interacts with the PB2, PB1 and NP components of the viral ribonucleoproteins and is required for viral mRNA transcription. More specifically, we demonstrate that the protein-protein interaction is RNA dependent and that both the RNA binding and exonuclease activities of ERI1 are required to promote influenza A virus transcription. Finally, we provide evidence that during infection, the SLBP protein and histone mRNAs co-purify with vRNPs alongside ERI1, indicating that ERI1 is most probably recruited when it is present in the histone pre-mRNA processing complex in the nucleus.
Predictive effect of salt intake on patient and kidney survival in non-dialysis CKD: competing risk analysis in older versus younger patients under nephrology care
Authors: Garofalo Carlo , Provenzano Michele , Andreucci Michele , Pisani Antonio , De Nicola Luca , Conte Giuseppe , Borrelli Silvio
Published: September 2020

Background

The optimal level of salt intake remains ill-defined in non-dialysis chronic kidney disease (CKD) patients under regular nephrology care. This unanswered question becomes critical in older patients who are exposed to higher risk of worsening of cardiorenal disease due to volemic changes.

Methods

In this pooled analysis of four prospective studies in CKD, we compared the risk of all-cause mortality and end-stage kidney disease (ESKD) between patients ≤65 and >65 years of age stratified by salt intake level (<6, 6–8 and >8 g/day) estimated from two measurements of 24-h urinary sodium.

Results

The cohort included 1785 patients. The estimated glomerular filtration rate was 37 ± 21 mL/min/1.73 m2 overall, 41 ± 25 in younger patients and 34 ± 16 in older patients (P < 0.001). The median 24-h urinary sodium excretion was 143 mEq [interquartile range (IQR) 109–182] in all, 147 (112–185) in younger patients and 140 (106–179) in older patients (P = 0.012). Salt intake was ≤6, 6–8 and >8 g sodium chloride/day in 21.9, 26.2 and 52.0% of older patients and 18.6, 25.2 and 56.2% in younger patients, respectively (P = 0.145). During a median follow-up of 4.07 years we registered 383 ESKD and 260 all-cause deaths. In the whole cohort, the risks of ESKD and all-cause death did not differ by salt intake level. In older patients, ESKD risk [multi-adjusted hazard ratio (HR) and 95% confidence interval (CI)] was significantly lower at salt intakes of 6–8 g/day [HR 0.577 (95% CI 0.361–0.924)] and >8 g/day [HR 0.564 (95% CI 0.382–0.833)] versus the reference group (<6 g/day). Mortality risk was higher in older versus younger patients, with no difference across salt intake categories. No effect of salt intake on ESKD and mortality was observed in younger patients.

Conclusions

CKD patients under nephrology care show a moderate salt intake (8.4 g/day) that is lower in older versus younger patients. In this context, older patients are not exposed to higher mortality across different levels of salt intake, while salt intake <6 g/day poses a greater risk of ESKD.
User-Perceived Negative Respiratory Symptoms Associated with Electronic Cigarette Use
Authors: Soule Eric K , Bode Kendall M , Desrosiers Abigail C , Guy Mignonne , Breland Alison , Fagan Pebbles
Published: September 2020

Introduction

Electronic cigarettes (ECIGs) expose users to an aerosol containing chemicals, which could affect the respiratory system negatively. This study examined negative respiratory symptoms associated with ECIG use.

Methods

In 2019, adult current ECIG users from 24 US states who reported experiencing negative respiratory symptoms from ECIG use (n = 49; 44.9% women; mean age = 35.2, SD = 11.5) completed an online survey and brainstormed statements that completed the prompt: “A specific negative effect or symptom related to my breathing, nose, mouth, throat, or lungs that I have experienced from vaping/using my e-cigarette is...” Participants sorted the final list of 56 statements into groups of similar content and rated statements on how true they were for them. Multidimensional scaling analysis identified thematic clusters.

Results

Eight ECIG use respiratory symptom clusters identified in analysis included Mucus and Congestion, Fatigue, Throat Symptoms, Breathing Problems, Mouth Symptoms, Chest Symptoms, Illness Symptoms, and Nose and Sinus Symptoms. Highly rated (ie, most common) symptoms included dry throat or mouth, fatigue during physical activity, coughing, shortness of breath, excessive phlegm, and bad taste in mouth. Mean cluster ratings did not differ based on lifetime cigarette smoking status (100 lifetime cigarettes smoked), but current cigarette smokers (ie, dual users) rated the Fatigue, Breathing Problems, Mucus and Congestion, and Nose and Sinus Symptoms clusters higher than noncurrent cigarette smokers.

Conclusions

Participant-identified respiratory symptoms perceived to be ECIG related, many similar to cigarette smoking symptoms. Future research should assess if these symptoms are associated with other negative health outcomes.

Implications

ECIG use exposes users to chemicals that may have negative health impacts on the respiratory system. Limited research has examined the broad range of negative respiratory symptoms associated with e-cigarette use. This study identified that ECIG–cigarette users perceive their ECIG use to be associated with negative respiratory symptoms. Many e-cigarette user-reported negative respiratory symptoms are similar to those associated with cigarette smoking, though some appear unique to e-cigarette use. Future research should continue to monitor respiratory symptoms reported by ECIG users and whether these are associated with health outcomes over time.
Maximal Dynamic Inspiratory Pressure Evaluation in Heart Failure: A Comprehensive Reliability and Agreement Study
Authors: da Silva Fabiola M F , Cipriano Gerson , Lima Alexandra C G B , Andrade Joanlise M L , Nakano Eduardo Y , Chiappa Gaspar R , Cahalin Lawrence P , Cipriano Graziella F B
Published: September 2020

Objective

The purpose of this study was to analyze the reliability (interrater and intrarater) and agreement (repeatability and reproducibility) properties of tapered flow resistive loading (TFRL) measures in patients with heart failure (HF).

Methods

For this cross-sectional study, participants were recruited from the cardiopulmonary rehabilitation program at the University of Brasilia from July 2015 to July 2016. All patients participated in the study, and 10 were randomly chosen for intrarater and interrater reliability testing. The 124 participants with HF (75% men) were 57.6 (SD = 1.81) years old and had a mean left ventricular ejection fraction of 38.9% (SD = 15%) and a peak oxygen consumption of 13.05 (SD = 5.3) mL·kg·min−1. The main outcome measures were the maximal inspiratory pressure (MIP) measured with a standard manovacuometer (SM) and the MIP and maximal dynamic inspiratory pressure (S-Index) obtained with TFRL. The S-Index reliability (interrater and intrarater) was examined by 2 evaluators, the S-Index repeatability was examined with 10 repetitions, and the reproducibility of the MIP and S-Index was measured with SM and TFRL, respectively.

Results

The reliability analysis revealed high S-Index interrater and intrarater reliability values (intraclass correlation coefficients [ICCs] of 0.89 [95% CI = 0.58–0.98] and 0.97 [95% CI = 0.89–0.99], respectively). Repeatability analyses revealed that 8 maneuvers were required to reach the maximum S-Index in 75.81% (95% CI = 68.27–83.34) of the population. The reproducibility of TFRL measures (S-Index = 68.8 [SD = 32.8] cm H2O; MIP = 66 [SD = 32.3] cm H2O) was slightly lower than that of the SM measurement (MIP = 70.1 [SD = 35.9] cm H2O).

Conclusions

The TFRL device provided a reliable intrarater and interrater S-Index measure in patients with HF and had acceptable repeatability, requiring 8 maneuvers to produce a stable S-Index measure. The reproducibilities of the S-Index, MIP obtained with SM, and MIP obtained with TRFL were similar.

Impact

TRFL is a feasible method to assess both MIP and the S-index as measures of inspiratory muscle strength in patients with HF and can be used for inspiratory muscle training, making the combined testing and training capabilities important in both clinical research and the management of patients with HF.
Paralogs and Off-Target Sequences Improve Phylogenetic Resolution in a Densely Sampled Study of the Breadfruit Genus (Artocarpus, Moraceae)
Authors: Gardner Elliot M , Johnson Matthew G , Pereira Joan T , Puad Aida Shafreena Ahmad , Arifiani Deby , Sahromi  , Wickett Norman J , Zerega Nyree J C
Published: September 2020

We present a 517-gene phylogenetic framework for the breadfruit genus Artocarpus (ca. 70 spp., Moraceae), making use of silica-dried leaves from recent fieldwork and herbarium specimens (some up to 106 years old) to achieve 96% taxon sampling. We explore issues relating to assembly, paralogous loci, partitions, and analysis method to reconstruct a phylogeny that is robust to variation in data and available tools. Although codon partitioning did not result in any substantial topological differences, the inclusion of flanking noncoding sequence in analyses significantly increased the resolution of gene trees. We also found that increasing the size of data sets increased convergence between analysis methods but did not reduce gene-tree conflict. We optimized the HybPiper targeted-enrichment sequence assembly pipeline for short sequences derived from degraded DNA extracted from museum specimens. Although the subgenera of Artocarpus were monophyletic, revision is required at finer scales, particularly with respect to widespread species. We expect our results to provide a basis for further studies in Artocarpus and provide guidelines for future analyses of data sets based on target enrichment data, particularly those using sequences from both fresh and museum material, counseling careful attention to the potential of off-target sequences to improve resolution. [Artocarpus; Moraceae; noncoding sequences; phylogenomics; target enrichment.]
Surgical Start Time Is Not Predictive of Microdiscectomy Outcomes
Authors: Maron Samuel Z. , Dan Joshua , Gal Jonathan S. , Neifert Sean N. , Martini Michael L. , Lamb Colin D. , Genadry Lisa , Rothrock Robert J. , Steinberger Jeremy , Rasouli Jonathan J. , Caridi John M.
Published: September 2020

Study Design:

Retrospective analysis of clinical data from a single institution.

Objective:

The objective of this study was to assess the time of surgery as a possible predictor for outcomes, length of stay, and cost following microdiscectomy.

Summary of Background Data:

The volume of microdiscectomy procedures has increased year over year, heightening interest in surgical outcomes. Previous investigations have demonstrated an association between time of procedures and clinical outcomes in various surgeries, however, no study has evaluated its influence on microdiscectomy.

Methods:

Demographic and outcome variables were collected from all patients that underwent a nonemergent microdiscectomy between 2008 and 2016. Patients were divided into 2 cohorts: those receiving surgery before 2 pm were assigned to the early group and those with procedures beginning after 2 pm were assigned to the late group. Outcomes and patient-level characteristics were compared using bivariate, multivariable logistic, and linear regression models. Adjusted length of stay and cost were coprimary outcomes. Secondary outcomes included operative complications, nonhome discharge, postoperative emergency department visits, or readmission rates.

Results:

Of the 1261 consecutive patients who met the inclusion criteria, 792 were assigned to the late group and 469 were assigned to the early group. There were no significant differences in demographics or baseline characteristics between the 2 cohorts. In the unadjusted analysis, mean length of stay was 1.80 (SD=1.82) days for the early group and 2.00 (SD=1.70) days for the late group (P=0.054). Mean direct cost for the early cohort was $5088 (SD=$4212) and $4986 (SD=$2988) for the late cohort (P=0.65). There was no difference in adjusted length of stay or direct cost. No statistically significant differences were found in operative complications, nonhome discharge, postoperative emergency department visits, or readmission rates between the 2 cohorts.

Conclusion:

The study findings suggest that early compared with late surgery is not significantly predictive of surgical outcomes following microdiscectomy.
What Is the Dislocation and Revision Rate of Dual-mobility Cups Used in Complex Revision THAs?
Authors: Unter Ecker Niklas , Kocaoğlu Hakan , Zahar Akos , Haasper Carl , Gehrke Thorsten , Citak Mustafa
Published: September 2020

Background

Dual-mobility cups have been shown to reduce the dislocation risk after THA. Although dual-mobility cups can be a useful strategy to mitigate against recurrent dislocation after revision surgery, few clinical studies have focused on the results of complex revision THAs with extensive bone and soft-tissue loss or in patients who have undergone more than one previous surgical procedure.

Questions/purposes

(1) What is the survival free from revision for dislocation of dual-mobility cups used in complex revision THAs? (2) What is the survival free from any dislocation?

Methods

Between January 1, 2009 and December 31, 2013, 327 patients underwent a complex revision THA that included an acetabular revision, defined as preexisting massive bone loss in the acetabulum (at least Paprosky Type 2B) and/or proximal femur (at least Paprosky Type 3), substantial gluteal soft-tissue involvement, at least two previous surgical procedures or a one-stage septic revision, or history of dislocation. All 327 complex revision patients received a dual-mobility cup. Of those, 34% (111) were lost to follow-up before 5 years and were not known to have reached a study endpoint (revision for dislocation, and any dislocation) before then, leaving 216 patients for analysis. For patients with bilateral hip surgeries only the first operated hip was included for analysis. The median (range) follow-up duration was 69 months (60 to 110). The primary endpoint was dislocation or re-revision for dislocation. Fifty-six percent (120 of 216) of the patients were women and 44% (96 of 216) were men. The mean age of the patients was 69 ± 9 years. The patients underwent a median of four surgical procedures (1 to 4) before the index procedure (the revision evaluated in this study). A survival analysis was performed using the Kaplan-Meier method; any dislocation or revision for dislocation was determined as the endpoint.

Results

The dislocation-free survival rates were 96% (95% confidence interval 92 to 98) at 5 years and 82% (95% CI 72 to 89) at 9 years. The overall dislocation rate was 11% (24 of 216 patients) at the final follow-up interval. Survival free of revision for dislocation was 99% (95% CI 96 to 100) at 5 years and 85% (95% CI 75 to 92) at 9 years.

Conclusions

Dual-mobility cups used in complex revision THA in this series had a higher rate of dislocation and revision than expected, based on earlier studies of dislocations of these components. Although we believe dual-mobility cups are still the first choice of implant if the patient has instability, these cups should be used cautiously if severe bone loss or soft-tissue involvement is present.

Level of Evidence

Level III, therapeutic study.
Research based on the core pathogenesis in the treatment according to traditional Chinese medicine syndrome differentiation for heart failure with normal ejection fraction
Authors: Zhao Zhiqiang , Wang Xianliang , Wang Shuai , Zhou Ruijuan , Su Quan , Liu Yu , Cheng Tao , Li Qing , Lin Shanshan , Liu Hua , Mao Jingyuan
Published: September 2020

Background:

The incidence of heart failure with normal ejection fraction (HFNEF) is increasing yearly, accounting for approximately half of all heart failure cases. Even after standardized treatment, the patient's prognosis is not good. Therefore, it is necessary to explore new treatment methods for HFNEF. Yangyin Shuxin Decoction, a traditional Chinese medicine prescription from our clinical experience in the treatment of HFNEF, has a potential cardioprotective effect. Preliminary clinical trials have shown that this prescription can improve the quality of life of HFNEF. This prompted us to use more objective indicators to further evaluate whether Yangyin Shuxin Decoction can improve the exercise capacity in HENEF patients.

Methods:

This is a single-center parallel randomized controlled trial. The 64 patients who met the inclusion criteria were from the Cardiovascular Clinic. They will be randomly assigned to the treatment group (Yangying Shuxin Decoction combined with standard treatment) or the control group (standard treatment) according to the ratio of 1:1. The course of treatment will be 2 weeks. Both groups were interviewed at the following time points: of at enrollment (V1), and week 2 (V2), week 4 (V3), week 8 (V4), and week 12 (V5) after enrollment. The primary indicator is the peak oxygen consumption (Peak VO2) of the cardiopulmonary exercise test (CPET). Secondary indicators include CPET indicators such as anaerobic threshold oxygen consumption, carbon dioxide ventilation equivalent slope, echocardiographic indicators such as the ratio of mitral peak velocity of early filling to early diastolic mitral annular velocity(E/e′), left atrial volume index (LAVI), left ventricular mass index (LVMI), the peak velocity of tricuspid regurgitation (TR), B-type natriuretic peptide (BNP), New York Heart Association (NYHA) cardiac function grading, and so on. These indicators will be used to evaluate the effect of Yangyin Shuxin Decoction on exercise capacity in patients with HFNEF.

Discussion:

At present, it is unclear whether the exercise capacity can be maintained after long-term use of Yangyin Shuxin Decoction. In this study, we will evaluate whether Yangyin Shuxin Decoction can improve the exercise capacity and quality of life of patients with HFNEF. This will provide an objective basis for the therapeutic effect of traditional Chinese medicine on HFNEF.

Trial Registration:

This study protocol has been listed in the Chinese Clinical Trial Registry (registration number: ChiCTR-IOR-17014206, http://www.chictr.org.cn/showproj.aspx?proj=24304) on December 28, 2017.
Cervical arthroplasty versus anterior cervical discectomy in the treatment of symptomatic cervical spondylosis
Authors: Tong Yi , Jia Xufeng , Zhou Yunlong , Feng Daxiong , Yuan Dechao
Published: September 2020

Background:

Anterior cervical discectomy and fusion (ACDF) and cervical disc arthroplasty (CDA) are both the effective techniques in treatment of cervical spondylosis. The purpose of this present retrospective cohort research was to assess the efficacy and safety of ACDF and CDA in treating the symptomatic cervical spondylosis over the 6-year follow-up.

Methods:

From our registry database, we identified retrospectively patients who received CDA or ACDF in our academic institutions from 2012 to 2015. The study was approved by the Institutional Review Board in Zigong No.4 People's Hospital (Z10058072). All the subjects who participated in this trial were informed consent in writing. The inclusion criteria were the degenerative disc diseases between C3-7 resulting in myelopathy or radiculopathy, which was unresponsive to the conservative treatment. The clinical results were determined via Short Form-36, and neck disability index, numerical scoring scales for complications, arm pain and neck pain. The radiographic assessment contained the cervical lordosis, and the motion range of the functional spinal unit and total cervical spine. The routine follow-up was performed to collect the data of radiographic and clinical assessment at 6, 12, 24, 48, and 72 months before and after the surgery.

Results:

This study had limited inclusion and exclusion criteria and a well-controlled intervention. It was assumed that both techniques could obtain the similar postoperative effects.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5878).
Maternal anxiety in relation to growth failure and growth hormone treatment in children
Authors: Majewska Katarzyna Anna , Stanisławska-Kubiak Maia , Wiecheć Katarzyna , Naskręcka Monika , Kędzia Andrzej , Mojs Ewa
Published: September 2020

Health disorders in mothers and their children are subject to mutual influences arising from the nature of mother–child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in aspect of growth hormone (GH) therapy in Poland.

The study was based on a group of 101 mothers of originally short-stature children: 70 with GH deficiency treated with recombinant human GH and 31 undergoing the diagnostic process, without any treatment. Collected medical data included the child's gender, height and weight, chronological age, bone age delay, and GH therapy duration. For all children the height SDS (standard deviation score of height) and BMI SDS (standard deviation score of body mass index) were calculated. The Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels among the recruited mothers. Obtained results revealed low trait anxiety levels in all mothers, with no statistically significant differences between the groups. State anxiety levels were significantly higher in mothers of children without diagnosis and treatment than in mothers of children receiving appropriate therapy. Significantly lower levels of maternal state anxiety were observed during the first stage of the GH therapy, and they were further reduced in mothers of children treated for more than 4 years.

Growth failure in Polish children is not associated with high maternal anxiety as a personality trait, but lack of diagnosis and lack of appropriate treatment seem to generate high levels of anxiety as a transient state in mothers. The initiation of GH therapy induces a substantial reduction of maternal state anxiety, and the duration of this treatment causes its further decrease. Mothers of short children undergoing diagnostic process could benefit from psychological support, but it seems to be unnecessary when their children are treated with GH.
Tacrolimus ointment in the treatment of hormone-dependent dermatitis
Authors: Li Mao , Tan Wen , Du Jingjing , Wang Qiuyue , Wang Linyue , Lei Min , Hao Ping-Sheng
Published: September 2020

Background:

Long-term use of corticosteroid ointment for external using or skin management products and cosmetics containing corticosteroid will produce a hormone-dependent effect on facial skin and destroy the barrier function of the skin. It is easy to cause repeated attacks of facial skin inflammation after drug withdrawal because corticosteroid hormones can cause the expression of inflammatory factors in the body, which has a serious impact on patients. The general treatment method is to stop using hormone drugs for psychotherapy and inform patients of the basic knowledge of hormone-dependent dermatitis and daily facial care, but the effect is not good. At present, non-steroidal ointment tacrolimus (a calcineurin inhibitor) is widely used in the treatment of hormone-dependent dermatitis. Tacrolimus ointment is effective for corticosteroid-dependent dermatitis, but adverse events can also occur.

Methods:

We plan to searched all randomized controlled trials (RCTs) fortacrolimus ointment therapy of hormone-dependent dermatitis in: MEDLINE, PubMed, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Springer and Web of Science, China Biomedical Literature Database (CBM), China Science Journal Database (VIP database) and Wanfang Database, China National Knowledge Infrastructure (CNKI), without the limitation of publication status and language until September 1, 2020. The systematic review will also search will also search for identify publications, meeting minutes, and grey literature (including unpublished meeting articles).

Discussion:

The systematic review mainly to access the safety and efficacy of tacrolimus ointment for hormone-dependent dermatitis (facial corticosteroid addiction dermatitis and facial steroid dermatitis). The results of our research will facilitate evidence-based management of patients with facial corticosteroid-dependent dermatitis and provide clinical advice on their treatment options.

Registration:

PROSPERO CRD42020171813.
Safety and Feasibility of Electrochemotherapy of the Pancreas in a Porcine Model
Authors: Dežman Rok , Čemažar Maja , Serša Gregor , Seliškar Alenka , Erjavec Vladimira , Trotovšek Blaž , Gašljevič Gorana , Bošnjak Maša , Lampreht Tratar Urša , Kos Bor , Djokić Mihajlo , Milevoj Nina , Štukelj Marina , Boc Nina , Izlakar Jani , Popovič Peter
Published: September 2020

Objectives

The use of thermal ablative therapies in the pancreatic tumors is limited because of the risk of the vessel injury and potential pancreatitis or fistula formation. Electrochemotherapy (ECT) is an ablative therapy with an established role in the treatment of cutaneous and liver tumors. This study was designed to evaluate the safety and feasibility of ECT of the pancreas in a porcine survival model.

Methods

In the first group, 4 animals underwent computed tomography (CT)–guided percutaneous ECT with bleomycin of the pancreatic tail. In the second group (4 animals), the intraoperative ECT with bleomycin of pancreatic tail and head was performed. Animals were followed for 7 days and then killed. Clinical parameters, CT imaging, laboratory, and histologic analysis were performed.

Results

All pigs survived the ECT procedure and none of them developed clinical signs of acute pancreatitis or related complications. There were no signs of acute pancreatitis or damage to the large vessels present in the follow-up CT scans. No significant change in laboratory parameters was obtained after procedure.

Conclusions

This study shows that ECT with bleomycin is feasible and safe in the pancreatic parenchyma. Clinical studies are needed to evaluate the efficacy of ECT in pancreatic cancer.