bluuebunny/crossref_metadata_2025 huggingface dataset:
Fundamental limits from chaos on instability time predictions in compact planetary systems
Authors: Hussain Naireen , Tamayo Daniel
Published: December 2019

Instabilities in compact planetary systems are generically driven by chaotic dynamics. This implies that an instability time measured through direct N-body integration is not exact, but rather represents a single draw from a distribution of equally valid chaotic trajectories. In order to characterize the ‘errors’ on reported instability times from direct N-body integrations, we investigate the shape and parameters of the instability time distributions (ITDs) for ensembles of shadow trajectories that are initially perturbed from one another near machine precision. We find that in the limit where instability times are long compared to the Lyapunov (chaotic) time-scale, ITDs approach remarkably similar lognormal distributions with standard deviations ≈0.43 ± 0.16 dex, despite the instability times varying across our sample from 104 to 108 orbits. We find excellent agreement between these predictions, derived from ≈450 closely packed configurations of three planets, and a much wider validation set of $\approx 10\, 000$ integrations, as well as on $\approx 20\, 000$ previously published integrations of tightly packed five-planet systems, and a seven-planet resonant chain based on TRAPPIST-1, despite their instability time-scales extending beyond our analysed time-scale. We also test the boundary of applicability of our results on dynamically excited versions of our Solar system. These distributions define the fundamental limit imposed by chaos on the predictability of instability times in such planetary systems. It provides a quantitative estimate of the instrinsic error on an N-body instability time imprinted by chaos, approximately a factor of 3 in either direction.
The Laboratory Domestication of Zebrafish: From Diverse Populations to Inbred Substrains
Authors: Suurväli Jaanus , Whiteley Andrew R , Zheng Yichen , Gharbi Karim , Leptin Maria , Wiehe Thomas
Published: December 2019

We know from human genetic studies that practically all aspects of biology are strongly influenced by the genetic background, as reflected in the advent of “personalized medicine.” Yet, with few exceptions, this is not taken into account when using laboratory populations as animal model systems for research in these fields. Laboratory strains of zebrafish (Danio rerio) are widely used for research in vertebrate developmental biology, behavior, and physiology, for modeling diseases, and for testing pharmaceutic compounds in vivo. However, all of these strains are derived from artificial bottleneck events and therefore are likely to represent only a fraction of the genetic diversity present within the species. Here, we use restriction site-associated DNA sequencing to genetically characterize wild populations of zebrafish from India, Nepal, and Bangladesh, and to compare them to previously published data on four common laboratory strains. We measured nucleotide diversity, heterozygosity, and allele frequency spectra, and find that wild zebrafish are much more diverse than laboratory strains. Further, in wild zebrafish, there is a clear signal of GC-biased gene conversion that is missing in laboratory strains. We also find that zebrafish populations in Nepal and Bangladesh are most distinct from all other strains studied, making them an attractive subject for future studies of zebrafish population genetics and molecular ecology. Finally, isolates of the same strains kept in different laboratories show a pattern of ongoing differentiation into genetically distinct substrains. Together, our findings broaden the basis for future genetic, physiological, pharmaceutic, and evolutionary studies in Danio rerio.
An Analysis of E-Cigarette Marketing in New Zealand Tobacco Retail Outlets Prior to Legislative Change
Authors: Bateman Jerram , Robertson Lindsay A , Marsh Louise , Cameron Claire , Hoek Janet
Published: December 2019

Introduction

In 2017, the New Zealand (NZ) Government announced its intention to liberalize the sale and promotion of electronic nicotine delivery systems (ENDS), including permitting any outlet to sell ENDS. This research estimated the proportion of tobacco outlets selling ENDS prior to legislative change, documented ENDS point-of-sale (POS) marketing, and examined associations between ENDS availability and outlet type, area-level deprivation, study region, and proximity to a secondary school.

Aims and Methods

After drawing a proportional random sample of 281 tobacco outlets from two NZ regions that included convenience stores, supermarkets, and petrol stations, we conducted observational in-store assessments to record ENDS product ranges and promotions. Data were collected between October and December 2017 and analyzed using descriptive statistics and regression modeling.

Results

Of tobacco outlets sampled, 22% sold ENDS; these were typically convenience stores (85%) and located in high deprivation areas (53%). Of stores selling ENDS, products were visible at POS in 89% of stores, including 15% with self-service displays and 15% with displays adjacent to children’s products. ENDS advertising was present in 31% of the outlets and generally promoted ENDS as cheaper than smoked cigarettes.

Conclusions

Liberalizing access to ENDS could reduce harms caused by smoking; however, extensive use of POS promotions will reach children and young people as well as smokers. While reducing harm among smokers is important, policy makers also need to ensure that regulations protect children from ENDS promotions.

Implications

Careful regulation is required to ensure increases in ENDS availability are not accompanied by an increase in young people’s exposure to ENDS marketing at the POS.
Prevalence and Incidence of Human Papillomavirus (HPV) Infection Before and After Pregnancy: Pooled Analysis of the Control Arms of Efficacy Trials of HPV-16/18 AS04-Adjuvanted Vaccine
Authors: Chen Jing , Gopala Kusuma , Puthatta Akarsh , Struyf Frank , Rosillon Dominique
Published: December 2019

Objective

Data on human papillomavirus (HPV) prevalence around pregnancy were inconsistent. We assessed HPV prevalence before and after pregnancy, HPV incidence after pregnancy, and risk factors for HPV infection.

Method

Data from 15 754 women in control arms of 5 AS04-HPV-16/18 vaccine efficacy trials were analyzed, including 3001 women with at least 1 pregnancy. Results of HPV deoxyribonucleic acid testing on cervical samples were available. We analyzed risk factors, including age, region, pregnancy and its outcomes, duration from pregnancy resolution to collection of first postresolution cervical sample, previous HPV infection, cigarette smoking, and number of sexual partners with Cox regression.

Results

Prevalence of high-risk oncogenic (hr)-HPV types was similar before and after pregnancy (20.8% vs 19.8%). Incidence of hr-HPV was 40.1 per 1000 person-years (95% confidence interval [CI], 23.4–64.2) at 0–3 months, 266.7 (95% CI, 217.4–323.7) at 3–6 months, and 95.7 (95% CI, 83.9–108.7) at >6 months after pregnancy. Risk factors associated with HPV infection after pregnancy are previous HPV infection, elective abortion, and younger age at pregnancy resolution.

Conclusions

Pregnancy could not be confirmed as a risk factor for HPV infection in this population despite an increased incidence detected 3–6 months after pregnancy resolution. Most women remained HPV negative after pregnancy.

Clinical Trial Registration

NCT001226810 (HPV-008 trial), NCT00294047 (HPV-015 trial), NCT00316693 and NCT00929526 (HPV-032/063 trials), and NCT00779766 (HPV-039 trial).
In Vitro Activity of Essential Oils Against Gram-Positive and Gram-Negative Clinical Isolates, Including Carbapenem-Resistant Enterobacteriaceae
Authors: Patterson Jan E , McElmeel Leticia , Wiederhold Nathan P
Published: December 2019

Background

There is increasing demand for compounds to treat antimicrobial-resistant pathogens, and essential oils have gained interest. Moreover, previous studies have demonstrated antimicrobial activity of these nonpharmaceutical products. We investigated the activity of essential oils against multiresistant bacteria and other clinical isolates to evaluate the potential of their use topically and/or internally for treatment of bacterial infections.

Methods

We studied the in vitro activity of 10 essential oils and 1 essential oil blend against clinical isolates including extended-spectrum beta-lactamase-producing Enterobacteriaceae, carbapenem-resistant Enterobacteriaceae, multidrug-resistant Pseudomonas aeruginosa, and methicillin-resistant Staphylococcus aureus.

Results

Essential oils of oregano, thyme, cinnamon bark, and lemongrass had the largest zones of inhibition against Gram-positive organisms, whereas cinnamon bark had the largest zone of inhibition against P aeruginosa. Oregano, thyme, and cinnamon bark had the largest zones of inhibition against Enterobacteriaceae.

Conclusions

Essential oils have promising in vitro activity that warrants further study of their activity and use in the clinical setting.
The role of biochemical markers of joint tissue remodelling to predict progression and treatment efficacy in inflammatory rheumatic diseases
Authors: Garnero Patrick , Landewé Robert , Chapurlat Roland D
Published: December 2019

Structural damage is a hallmark in RA, spondyloarthropy (SpA) and psoriatric arthritis (PsA). Its progression is difficult to predict and current radiological or inflammatory biological markers lack sensitivity. Biochemical markers of bone, cartilage and synovial tissues provide a dynamic indication of the anabolism and catabolism of joint tissues and can be easily measured by immunoassays. Novel biochemical markers including post-translational modifications of matrix proteins and enzyme-generated neoepitopes with increased tissue and/or biological pathway specificity have been developed. Their evaluation in clinical trials of novel biologic therapies and epidemiological studies indicated that their measurements could be useful to predict progression of structural damage and treatment efficacy, independently of current clinical, radiological and biological indices of disease activity. In this paper we briefly describe the latest developments in biochemical markers and critically analyse the clinical data assessing the utility of established and novel biochemical markers in RA, SpA and PsA.
Uncertain Sexualities and the Unusual Woman: Depictions of Jane Addams and Emily Dickinson
Authors: Bartram Robin , Brown-Saracino Japonica , Donovan Holly
Published: December 2019

How does contemporary society deal with uncertainty about sexualities in the past? We investigate how two museums manage uncertainty about the sexual histories of two female biographical subjects. Contributing to understandings of how cultural institutions handle such uncertainty, and, in particular, how museums depict gender and sexualities, our paper brings together current debates in literatures on queer histories, collective memory, and sexualities and gender. Our observations at the Jane Addams Hull House Museum and the Emily Dickinson Museum reveal that both museums handle uncertainty about their subject’s sexuality by conflating ambiguous sexuality with non-normative gender performance. This conflation results in the depiction of the character of the “unusual woman.” While one museum relies on the “unusual woman” to evade discussions of non-normativity, the other uses the same device to acknowledge and politicize uncertainty. Our research thus reveals institutional depictions of the “unusual woman” even in an era in which many cultural institutions work to frame sexual minorities as “normal” or the “same.” At the same time, our work intervenes in gender and sexualities scholarship by demonstrating that unusualness can be either obfuscatory or provocative; conflations of gender and sexuality are multifaceted and can either reproduce or disrupt normativity.
Assessing Biogeography of Coffee Rust Risk in Brazil as Affected by the El Niño Southern Oscillation
Authors: Hinnah F. D. , Sentelhas P. C. , Gleason M. L. , Dixon P. M. , Zhang X.
Published: December 2019

The El Niño Southern Oscillation (ENSO) is an oceanic-atmospheric phenomenon influencing worldwide weather and climate. Its occurrence is determined by the sea surface temperature (SST) anomaly of the 3.4 Niño region in the Pacific Ocean (5°N–5°S, 120°–170°W). El Niño (EN), Neutral (NT), and La Niña (LN) are the three possible phases of ENSO, respectively, for warm, normal, and cold SST anomaly. As in other regions around the world, weather in Brazil is influenced by ENSO phases. The country is the major coffee producer in the world, and production is strongly influenced by weather conditions, which affect plant yield, harvest quality, and interactions with pests and diseases. Coffee leaf rust (CLR), caused by the fungus Hemileia vastatrix, is a major cause of coffee yield and quality losses in Brazil, and requires fungicide spray applications every season. Because CLR is highly influenced by weather conditions, it is possible to use weather variables to simulate its progress during the cropping cycle. Therefore, the aims of this study were to estimate CLR infection rate based on a validated empirical model, which has daily minimum air temperature and relative humidity as inputs, and to assess the extent of ENSO influence on the annual risk of this disease at 45 sites in Brazil. Cumulative infection rates (CIR) were estimated daily from October to June of each growing season and location, based on the prevailing ENSO phase. Differences between the extreme phases (EN-LN) were assessed by the Two-One-Sided-Tests (TOST) method. Analysis of data from eight sites, located mainly in Paraná State, provided evidence of CIR differences between EN and LN phases (G1). Evidence of no difference of CIR between EN and LN was found in 18 sites (G2), whereas 19 sites showed no evidence of differences (G3) due to relatively large variation of CIR within the same ENSO phase. The G1 sites are located mostly in Southern Brazil, where ENSO exerts a well-defined influence on rainfall regime. In contrast, the G2 sites are mainly in Minas Gerais State, which is characterized as a transition region for ENSO influence on rainfall. The G3 sites are located between the northern region of Minas Gerais State and southern region of Bahia State, which is characterized by a subhumid climate that is usually very dry during winter, and where rainfall can vary up to 300% from one year to another, influencing relative humidity and resulting in a high CIR variability. Therefore, ENSO had a well-defined influence on CIR only in Paraná State, a region with minor importance for coffee production in Brazil. No ENSO influence was found in more northerly zones where the majority of Brazilian coffee is produced. This is the first evidence of ENSO-linked regional impact on the risk of coffee rust.
Complete Genome Characterization and Coat Protein Genealogy of Isolates ofMaize dwarf mosaic virusfrom Johnsongrass and Maize in Oklahoma and Missouri
Authors: Wijayasekara Dulanjani , Ali Akhtar
Published: December 2019

Maize dwarf mosaic virus (MDMV) significantly affects maize production worldwide, including the United States. This study describes the distribution and biological and molecular characterization of MDMV isolates from Johnsongrass and maize. A total of 262 samples (symptomatic = 214, asymptomatic = 48) were collected in Oklahoma and Missouri during 2016, 2017, and 2019 growing seasons. Based on a dot-immunobinding assay (DIBA), the average incidence of maize dwarf mosaic disease varied from ∼71% (79/111) in 2016, ∼76% (81/106) in 2017, and 62% (28/45) in 2019. Sixty-five DIBA-positive samples for MDMV were further confirmed by RT-PCR, and the complete coat protein (CP) gene was cloned and sequenced. Phylogenetic analysis of 132 isolates (This study = 65; GenBank = 67) revealed two main groups (G1 and G2) of MDMV isolates. All 65 MDMV isolates contained a 39-nucleotide insertion in the N-terminal region of CP genes and clustered in G1 which were different from the isolates in G2, without 39-nucleotide insertion. The first complete genome (9,563 nucleotides) of a MDMV isolate (Bixby1) from Johnsongrass was sequenced, which was distantly related to eight previously reported MDMV isolates from maize. The dN/dS ratio showed mostly purifying selection on each of cistrons except 6K1 being subjected to the diversifying selection. Further analyses revealed three putative recombination events between MDMV-Bixby1 and MDMV isolates from other countries. The successful mechanical and aphid transmission of MDMV-Bixby1 onto maize cultivars was achieved. Altogether, this information showed that Johnsongrass harbors genetically diverse MDMV isolates, which could pose a threat to cultivated crops such as maize and sorghum.
Species Diversity of Dickeya and Pectobacterium Causing Potato Blackleg Disease in Pakistan
Authors: Sarfraz Sohaib , Sahi Shahbaz Talib , Oulghazi Saïd , Riaz Kashif , Rajput Nasir Ahmed , Atiq Muhammad , Tufail Muhammad Rizwan , Hameed Akhtar , Faure Denis
Published: December 2019

Potato blackleg is caused by a diverse species of pectinolytic bacteria. In Pakistan, approximately 90% of the pathogens involved belong to Pectobacterium atrosepticum. Survey (2014 to 2017), sampling, and isolation from different potato growing areas of Punjab, Pakistan depicted an overall disease incidence of approximately 15%. Thirty-six pectinolytic strains confirmed through biochemical and pathogenicity testing were characterized via gapA gene to identify them at the species level. To further validate the identification, one strain from each species SS26 (P. atrosepticum), SS28 (Pectobacterium polaris), SS70 (Dickeya dianthicola), SS90 (Pectobacterium parmentieri), SS95 (Pectobacterium punjabense), and SS96 (Pectobacterium versatile) were selected for draft genome sequencing and multilocus sequence analysis of 13 housekeeping genes (fusA, rpoD, acnA, purA, gyrB, recA, mdh, mtlD, groEL, secY, glyA, gapA, and rplB). Phylogenetic analysis revealed considerable genetic diversity in the genus Pectobacterium. In silico DNA–DNA hybridization and average nucleotide identity values of the strains selected for genome sequencing were determined with other reference Pectobacterium and Dickeya strains. Moreover, all six representative strains were also phenotypically characterized on the basis of metabolism of different carbon sources. Overall, on the basis of genotypic and phenotypic characteristics, these 36 isolates were grouped into six species: P. atrosepticum, P. versatile, P. parmentieri, P. polaris, P. punjabense, and D. dianthicola.
Paralogous CYP51 Genes of Colletotrichum spp. Mediate Differential Sensitivity to Sterol Demethylation Inhibitors
Authors: Chen Shuning , Hu Mengjun , Schnabel Guido , Yang Daibin , Yan Xiaojing , Yuan Huizhu
Published: December 2019

Colletotrichum spp. isolates contain two paralogous CYP51 genes that encode sterol 14-demethylase enzymes; however, their role in sensitivity to demethylation inhibitor (DMI) fungicides is yet to be determined. In this study, each of the two genes from Colletotrichum fioriniae and C. nymphaeae was able to rescue the function of CYP51 in the yeast Saccharomyces cerevisiae, demonstrating their independent function. Deletion of CYP51A led to increased sensitivity to propiconazole, diniconazole, prothioconazole, cyproconazole, epoxiconazole, flutriafol, prochloraz, and difenoconazole in C. fioriniae, and to the same fungicides and tebuconazole in C. nymphaeae, with the exception of prochloraz. Deletion of CYP51B in C. fioriniae and CYP51B in C. nymphaeae made mutants increasingly sensitive to five of nine DMI fungicides tested. The results suggest species-specific, differential binding of DMI fungicides onto the two CYP51 enzymes. Pairing DMIs with different effects on CYP51A and -B deletion mutants resulted in synergistic effects, as determined in mycelial growth inhibition experiments. Deletion mutants showed no fitness penalty in terms of mycelial growth, sporulation, and virulence. Our study elucidates the effect of CYP51A and CYP51B of Colletotrichum spp. on DMI sensitivity, suggesting that using a mixture of DMIs may improve the efficacy for anthracnose management.
Transcriptional memory inherited from donor cells is a developmental defect of bovine cloned embryos
Authors: Zhou Chuan , Zhang Jingcheng , Zhang Min , Wang Debao , Ma Yi , Wang Yong , Wang Yizhi , Huang Yuemeng , Zhang Yong
Published: December 2019

Studies on the effects of transcriptional memory on clone reprogramming in mammals are limited. In the present study, we observed higher levels of active histone H3 lysine 4 trimethylation (H3K4me3 and 5‐hydroxymethylcytosine) and repressive (5‐methylcytosine) epigenetic modifications in bovine early cloned embryos than in in vitro fertilized embryos. We hypothesized that aberrant epigenetic modification may result in transcriptional disorders in bovine somatic cell nuclear transfer (SCNT) embryos. RNA sequencing results confirmed that both abnormal transcriptional silencing and transcriptional activation are involved in bovine SCNT reprogramming. The cloned embryos exhibited excessive transcription in RNA processing‐ and translation‐related genes as well as transcriptional defects in reproduction‐related genes whose transcriptional profiles were similar to those in donor cells. These results demonstrated the existence of active and silent memory genes inherited from donor cells in early bovine SCNT embryos. Further, H3K4me3‐specific demethylase 5B (KDM5B) mRNA was injected into the reconstructed embryos to reduce the increased H3K4me3 modification. KDM5B overexpression not only reduced the transcriptional level of active memory genes, but also promoted the expression of silent memory genes; in particular, it rescued the expression of multiple development‐related genes. These results showed that transcriptional memory acts as a reprogramming barrier and KDM5B improves SCNT reprogramming via bidirectional regulation effects on transcriptional memory genes in bovines.
Vasodilatory effects of cannabidiol in human pulmonary and rat small mesenteric arteries: modification by hypertension and the potential pharmacological opportunities
Authors: Baranowska-Kuczko Marta , Kozłowska Hanna , Kloza Monika , Sadowska Olga , Kozłowski Mirosław , Kusaczuk Magdalena , Kasacka Irena , Malinowska Barbara
Published: December 2019

Objective:

Cannabidiol (CBD) has been suggested as a potential antihypertensive drug. The aim of our study was to investigate its vasodilatory effect in isolated human pulmonary arteries (hPAs) and rat small mesenteric arteries (sMAs).

Methods:

Vascular effects of CBD were examined in hPAs obtained from patients during resection of lung carcinoma and sMAs isolated from spontaneously hypertensive (SHR); 11-deoxycorticosterone acetate (DOCA-salt) hypertensive rats or their appropriate normotensive controls using organ bath and wire myography, respectively.

Results:

CBD induced almost full concentration-dependent vasorelaxation in hPAs and rat sMAs. In hPAs, it was insensitive to antagonists of CB1 (AM251) and CB2 (AM630) receptors but it was reduced by endothelium denudation, cyclooxygenase inhibitors (indomethacin and nimesulide), antagonists of prostanoid EP4 (L161982), IP (Cay10441), vanilloid TRPV1 (capsazepine) receptors and was less potent under KCl-induced tone and calcium-activated potassium channel (KCa) inhibitors (iberiotoxin, UCL1684 and TRAM-34) and in hypertensive, overweight and hypercholesteremic patients. The time-dependent effect of CBD was sensitive to the PPARγ receptor antagonist GW9662. In rats, the CBD potency was enhanced in DOCA-salt and attenuated in SHR. The CBD-induced relaxation was inhibited in SHR and DOCA-salt by AM251 and only in DOCA-salt by AM630 and endothelium denudation.

Conclusion:

The CBD-induced relaxation in hPAs that was reduced in hypertensive, obese and hypercholesteremic patients was endothelium-dependent and mediated via KCa and IP, EP4, TRPV1 receptors. The CBD effect in rats was CB1-sensitive and dependent on the hypertension model. Thus, modification of CBD-mediated responses in disease should be considered when CBD is used for therapeutic purposes.
VITREOUS PROSTAGLANDIN E2 CHANGES AFTER TOPICAL ADMINISTRATION OF DICLOFENAC 0.1%, INDOMETHACIN 0.5%, NEPAFENAC 0.3%, AND BROMFENAC 0.09%
Authors: Pastore Marco R. , De Giacinto Chiara , Cirigliano Gabriella , D'Aloisio Rossella , Addobbati Riccardo , Agostinis Chiara , Radillo Oriano , Di Martino Giuseppe , Di Nicola Marta , Cecchini Paolo , Tognetto Daniele
Published: December 2019

Purpose:

To evaluate the vitreous concentration of different nonsteroidal anti-inflammatory drugs (NSAIDs) after topical administration and the related prostaglandin E2 (PGE2) levels in patients undergoing pars plana vitrectomy.

Methods:

A prospective, randomized, investigator-masked study was performed. One hundred four patients scheduled for a pars plana vitrectomy for an epiretinal membrane or a macular hole were randomized to receive topical diclofenac 0.1%, indomethacin 0.5%, nepafenac 0.3%, bromfenac 0.09%, or placebo 3 days before surgery. At the beginning of surgery, a sample of undiluted vitreous was collected in each patient to assess NSAIDs concentration and PGE2 levels.

Results:

The median vitreous concentrations were 203.35 (interquartile range 146.54–264.18) pg/mL for diclofenac, 243.45 (interquartile range 156.96–365.37) pg/mL for nepafenac, 438.21 pg/mL (interquartile range, 282.52–645.87) for its active metabolite amfenac, 350.14 (interquartile range, 290.88–481.95) pg/mL for indomethacin, and 274.59 (245.43–358.25) pg/mL for bromfenac. Vitreous PGE2 levels were significantly lower for all the NSAIDs groups compared with the control group (P < 0.001). A statistically significant higher vitreous PGE2 level was found in the diclofenac group compared with the other NSAIDs groups (P < 0.05).

Conclusion:

Topical NSAIDs achieve sufficient vitreous concentration to decrease vitreous PGE2 levels compared with the control group. The different efficacy in reducing PGE2 concentration may affect the management of posterior segment inflammation.
AUTOLOGOUS RETINAL TRANSPLANTATION AS A PRIMARY TREATMENT FOR LARGE CHRONIC MACULAR HOLES
Authors: Tanaka Shin , Inoue Maiko , Inoue Tatsuya , Yamakawa Tadashi , Uchio Eiichi , Grewal Dilraj S. , Mahmoud Tamer H. , Kadonosono Kazuaki
Published: December 2019

Purpose:

To report the outcomes of autologous neurosensory retinal transplant as a primary treatment for patients with large chronic macular holes and evaluate the safety and feasibility of the procedure.

Design:

Retrospective study, consecutive case series.

Methods:

We reviewed seven patients with a primary chronic large macular hole, who underwent autologous neurosensory retinal transplant. Mean preoperative minimum and maximum hole diameters were 643 µm and 1214 µm, respectively. Changes in visual acuity were measured postsurgery, and optical coherence tomography, fluorescein angiography, and microperimetry-3 were analyzed after the procedure.

Results:

Closure of the macular hole was achieved in all seven eyes in the study. At 1 year post-surgery, there was significant improvement in mean visual acuity (LogMAR 1.10 vs. 0.68, P = 0.001). Optical coherence tomography showed that all grafts had formed attachments to the retinal epithelial cells of the recipient retina. Mean preoperative ellipsoid zone defect was 1,089 ± 403.8 µm (range, 918–1,329 µm) which further decreased to 921 ± 129.1 µm (range, 670–1,201 µm) at final follow up (P = 0.09). Microperimetry-3 testing indicated retinal sensitivity in the graft in five eyes.

Conclusion:

Autologous retinal transplantation may help rebuild the macular structure resulting in functional improvement for eyes with primary chronic large macular hole.
THE ASSOCIATION BETWEEN CENTRAL SEROUS CHORIORETINOPATHY AND SLEEP APNEA
Authors: Liu Pei-Kang , Chang Yo-Chen , Tai Ming-Hong , Tsai Rong-Kung , Chong Inn-Wen , Wu Kwou-Yeung , Wu Wen-Chuan , Hsu Chung-Yao , Tsai Ming-Ju
Published: December 2019

Purpose:

To identify the association between sleep apnea (SA) and central serous chorioretinopathy (CSC).

Methods:

In this nationwide population-based study using the Taiwan National Health Insurance Database, we enrolled adult patients with a diagnosis of SA and matched each patient to 30 age- and gender-matched control subjects without any SA diagnosis. Using Poisson regression analyses, the incidence rate of CSC was compared between SA patients and control subjects.

Results:

A total of 10,753 SA patients and 322,590 control subjects were identified. After adjusting for age, gender, residency, income level, and comorbidities, the incidence rate of CSC was significantly higher in SA patients than in the control subjects (adjusted incident rate ratio for probable SA: 1.2 [95% CI: 1.1–1.4], P < 0.0001). Analyses of the propensity score-matched subpopulations also confirmed our findings. Risk factors for CSC in SA patients included male gender, age ≤50 years, higher income, presence of heart disease, absence of chronic pulmonary disease, and presence of liver disease. In SA patients, those who had received continuous positive airway pressure titration had a significantly lower incidence rate of CSC than the others.

Conclusion:

Our study revealed a significantly higher incidence rate of CSC in SA patients compared with the control subjects.
MULTIPLE RETINAL PIGMENT EPITHELIUM APERTURES ASSOCIATED WITH PSEUDO-VITELLIFORM LYMPHOMATOUS MACULOPATHY
Authors: Cicinelli Maria Vittoria , Marchese Alessandro , Miserocchi Elisabetta , Querques Giuseppe , Bandello Francesco , Modorati Giulio M.
Published: December 2019

Purpose:

To describe the case of a 66-year-old man with bilateral cytologically proven vitreoretinal lymphoma who presented with a pseudo-vitelliform macular lesion and multiple retinal pigment epithelium apertures.

Methods:

The patient underwent comprehensive ophthalmologic evaluation, including best-corrected visual acuity, intraocular pressure, anterior segment and fundus examination, and optical coherence tomography, at baseline and during follow-up.

Results:

A new-onset foveal yellow, ill-defined lesion was noticed in the right eye during the follow-up; best-corrected visual acuity was 20/20, and the patient was asymptomatic. The lesion was isoautofluorescent with the surrounding retina. The optical coherence tomography revealed hyperreflective subretinal material, an irregularly thickened retinal pigment epithelium, and a shallow, hyperreflective retinal pigment epithelium detachment with multiple retinal pigment epithelium apertures. After 15 days, the lesion was completely reabsorbed and replaced by outer retinal atrophy and cystoid macular edema; best-corrected visual acuity dropped to 20/100.

Conclusion:

The macular lesion may be a sign of macular infiltration, a case of paraneoplastic cloudy vitelliform submaculopathy, or coexistence of both. Retinal pigment epithelium apertures are not disease-specific and are described in vitreoretinal lymphoma for the first time.
A 4-Year Investigation of Ambulatory Health Care Expenditure Concentration and High-Cost Patients
Authors: Ebrahimoghli Reza , Sadeghi-Bazargani Homayoun , Janati Ali , Hamishehkar Hadi , Khalili-Azimi Atefeh
Published: December 2019

The aim of this study is to investigate the concentration of ambulatory health care expenditure in a large Iranian outpatient population. This study used 2013-2016 individual-level claims data of Iranian Health Insurance Organization in East Azerbaijan province. All ambulatory care utilizers were included in the study. We determined characteristics and utilization pattern of high-cost patients as well as their predictors. A total of 1 128 149 patients were included. The top 10% of patients accounted for 62.56% of the total expenditure. This skewed expenditure pattern remained relatively stable over the study period. Female sex, older age, cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes increase the odds of being high cost.
Does the Addition of Naloxone in Buprenorphine/Naloxone Affect Retention in Treatment in Opioid Replacement Therapy?
Authors: Dalton Kathryn , Butt Natalie
Published: December 2019

Background

Opioid maintenance therapy is an evidence-based first-line treatment approach to reduce the problems associated with opioid use disorders. Buprenorphine and methadone are the two most commonly recommended pharmacotherapies. Individuals who remain in treatment longer tend to have a reduced drug use, a higher social functioning, and a higher quality of life. The addition of naloxone to buprenorphine (bup/nx) was developed, in part, to help increase retention in treatment. However, this has not been shown in research. The objective of this review was to examine whether bup/nx is more effective than buprenorphine and methadone, to ultimately determine whether the addition of naloxone shows a clinical difference.

Methods

The literature search was conducted using the electronic databases PubMed, Embase, and Cochrane. Search strategies were thoroughly developed and modified for each database by combining relevant MeSH and Emtree terms as well as keywords such as “bup/nx,” “buprenorphine,” and “naloxone.” The outcome measure was treatment retention, as determined by the number of days a participant remains in a treatment program.

Results

There were four studies included in the review. The data were analyzed with Review Manager software. There was no statistically significant result for bup/nx compared with methadone or buprenorphine.

Conclusion

Bup/nx may be an alternative to standard treatments such as buprenorphine and methadone as the addition of naloxone does not affect retention in treatment.
Preliminary clinical assessment of dynamic 18F-fluorodeoxyglucose positron-emission tomography/computed tomography for evaluating the clinicopathological grade in patients with non-Hodgkin’s lymphoma: a prospective study
Authors: Shinya Takayoshi , Otomi Yoichi , Dimitrakopoulou-Strauss Antonia , Kubo Michiko , Kondo Mihoko , Otomo Maki , Terazawa Kaori , Bando Yoshimi , Harada Masafumi
Published: December 2019

Objective

We prospectively assessed the diagnostic capacity of dynamic and dual-time-point 18F-fluorodeoxyglucose PET/computed tomography and explored the most appropriate scan timing for clinicopathological discrimination of non-Hodgkin’s lymphoma.

Methods

Thirteen patients underwent dynamic scans dynamic scans (5–15, 15–25, and 25–35 minute postinjection) and consecutive dual-time-point scans (1- and 2-hour postinjection). For five indolent and 16 aggressive lymphomas, we statistically compared the maximum standardized uptake value (SUVmax) and the retention index of the SUVmax (RI-SUVmax) for each scan and explored the diagnostic capacities using receiver operating characteristic (ROC) curve analyses.

Results

SUVmax increased progressively over time in all lymphomas and was significantly higher for aggressive lymphoma than for indolent lymphoma in each timephase. RI-SUVmax of dynamic scans (RI-SUV-dynamic) was significantly higher in aggressive than in indolent lymphoma. The cutoff values obtained a sensitivity of 94%, positive-predictive value of 94%, and accuracy of 91% for SUVmax analyses of the dynamic second and third phases, 1-hour early phase, and 2-hour delayed phase, and a sensitivity of 88%, positive-predictive value of 93%, and accuracy of 86% for RI-SUV-dynamic. In contrast, for the dynamic first phase, the cutoff value of SUVmax yielded moderate sensitivity of 69%, a positive-predictive value of 92%, and an accuracy of 71%. The area under the ROC curve (AUC) of the RI-SUV-dynamic had the highest value (0.938), whereas the AUCs of the other ROC analyses were not significantly different.

Conclusion

The dynamic second and third phase could potentially provide good predictors of clinicopathological discrimination, as can the early and delayed phases.
Colocalization of pain and reduced intraepidermal nerve fiber density in individuals with HIV-associated sensory neuropathy
Authors: Patel Imraan G. , Kamerman Peter R.
Published: December 2019

Introduction:

There is poor correlation between decreases in intraepidermal nerve fiber density (IENFD) and the presence of pain in HIV-associated sensory neuropathy (HIV-SN) and other painful distal symmetrical polyneuropathies.

Objectives:

We investigated whether in individuals with HIV-SN, having pain at the ankle skin biopsy site was associated with lower IENFD compared to when there was no pain at the ankle biopsy site.

Methods:

We recruited 15 individuals with symptomatic HIV-SN. Nine had pain at the site where the ankle biopsy was taken, whereas 6 did not. Skin punch biopsies for IENFD quantification were taken from the ankle and the thigh. Contrasts between the 2 groups were made using the overlap of confidence interval (CI) method.

Results:

Intraepidermal nerve fiber density was substantially lower in the group that had pain at the site of the ankle biopsy compared with the other group (6.6 [CI: 5.3–7.2] vs 3.3 [CI: 10.0–15.0] fibers/mm). However, there was no group differences at the thigh biopsy site (15.6 [CI: 15.0–15.9] vs 16.2 [CI: 14.5–17.8] fibers/mm). When taking the ratio of ankle IENFD:thigh IENFD, the point estimate for the pain at the ankle group (0.43 [CI: 0.36–0.48]) was about half that of the other group (0.81 [CI: 0.68–0.87]).

Conclusion:

Thus, colocalization of pain to the ankle is associated with meaningful decreases in ankle IENFD.
Cross-cultural adaptation, test–retest reliability, and construct validity of the Thai version of the University of Washington Pain-Related Self-Efficacy Scale
Authors: Khampanthip Angkana , Kanlayanaphotporn Rotsalai , Jensen Mark P. , Janwantanakul Prawit
Published: December 2019

Introduction:

One psychosocial factor in the biopsychosocial model is pain-related self-efficacy, which has been shown to be a strong predictor of response to pain treatment.

Objectives:

To cross-culturally adapt the University of Washington Pain-Related Self-Efficacy Scale (UW-PRSE6) into Thai and evaluate its psychometric properties.

Methods:

The study was approved by the Chulalongkorn University Human Ethics Committee (COA No. 156/2018). The original UW-PRSE6 was cross-culturally adapted using the Functional Assessment of Chronic Illness Therapy translation methodology. Two hundred forty-one individuals with chronic low back pain completed the Thai version of UW-PRSE6 (T-UW-PRSE6), Thai Fear Avoidance Beliefs Questionnaire (T-FABQ), and Thai Medical Outcome Study Short-Form 36 (T-SF-36). A subset of 152 participants completed the T-UW-PRSE6 again after a 7-day interval. Cronbach's alpha and intraclass correlation coefficients were calculated to estimate internal consistency and test–retest reliability, respectively. The construct validity of the T-UW-PRSE6 was evaluated by computing Spearman correlation coefficients between the T-UW-PRSE6 score and the measures of the validity criterion variables.

Results:

The T-UW-PRSE6 had good internal consistency (Cronbach's alpha = 0.85) and moderate test–retest reliability (intraclass correlation coefficient [2,1] = 0.72). The T-UW-PRSE6 was negatively correlated with the T-FABQ Work and Physical Activity subscales (rs = −0.34 and −0.34, respectively) and positively correlated with the General Health, Physical Functioning, Role Physical, Role Emotional, Social Functioning, Bodily Pain, Vitality, and Mental Health scales of the T-SF-36 (rs = 0.38, 0.42, 0.54, 0.51, 0.47, 0.54, 0.41, and 0.40, respectively).

Conclusion:

The T-UW-PRSE6 demonstrated acceptable psychometric properties for assessing pain-related self-efficacy in individuals with chronic low back pain, making available a measure for facilitating future cross-cultural research on pain self-efficacy.
Prevalence of pain and associated factors in Brazilian civil servants: an introductory analysis using baseline data from the ELSA-Brasil cohort
Authors: Machado Luciana A.C. , Telles Rosa W. , Benseñor Isabela M. , Barreto Sandhi M.
Published: December 2019

Introduction:

In Brazil, the prevalence and costs of pain will increase substantially with population ageing. Understanding of pain epidemiology is needed for the development of health care policies that can minimize this projected burden.

Objective:

To investigate the prevalence of pain and associated factors at baseline of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Methods:

Data were collected in public institutions of higher education/research (2008–2010). Pain in the past 30 days and pain attributed to psychological distress (“with psychological attributions”—PPA) were evaluated by the Clinical Interview Schedule-Revised (CIS-R). The independent t-test and χ2 test investigated associations between sociodemographic/clinical factors and each pain episode. Multivariable analyses including age, sex, leisure-time physical activity, depression, and arthritis/rheumatism, and factors showing univariate associations at the P < 0.10 level, were performed.

Results:

Fifteen thousand ninety-five civil servants were included (52.1 ± 9.1 years, 54.4% female). The prevalence of any pain was 62.4% (95% confidence interval 61.6%–63.2%), and of PPA was 22.8% (95% confidence interval 22.2%–23.5%). Factors associated with any pain and PPA in multivariable analyses included age (odds ratio [OR] 0.97), female sex (OR 1.86–2.01), moderate and vigorous leisure-time physical activity (OR 0.60–0.84), excessive drinking (OR 0.68–0.83), depressive symptoms (OR 1.28–1.96), anxiety symptoms (OR 1.63–2.45), sleep disturbance (OR 1.62–1.79), and arthritis/rheumatism (OR 1.32–2.18). Nonroutine nonmanual occupation (manual occupation as reference), body mass index, and smoking were independently associated with either any pain or PPA.

Conclusion:

This study provided preliminary information on the epidemiology of pain at baseline of the largest Latin American cohort on chronic noncommunicable diseases.
Degenerative and Vascular Fluent Aphasia: Looking for Differences
Authors: Silveri Maria Caterina , Di Tella Sonia , Magni Eugenio , Pepe Fulvio , Leone Edoardo , Piludu Francesca , Colosimo Cesare , Ciccarelli Nicoletta
Published: December 2019

Objective:

To investigate whether the characteristics of language disorders of degenerative and vascular aphasias depend on the underlying neuropathology.

Methods:

Logopenic variant/mixed primary progressive aphasics (lvmPPA; n=18) and poststroke fluent aphasics (PSA; n=11) underwent a neuropsychological examination and an assessment of the macro- and microlinguistic aspects of language. A principal component analysis and a cluster analysis applying a two-group solution were performed on the scores obtained from the neuropsychological and language examination.

Results:

Global cognition, lexical-semantic, and morphosyntactic components, and two components loading macrolinguistic variables, were extracted by the principal component analysis. A first cluster of 18 participants (14 lvmPPA and 4 PSA) and a second cluster of 11 participants (4 lvmPPA and 7 PSA) were identified. Participants in the first cluster were significantly more impaired than those in the second cluster in global cognition, lexical-semantic, and morphosyntactic components. Macrolinguistic components did not differentiate the two clusters. lvmPPA in the first cluster showed bilateral cortical thinning (greater on the left), whereas lvmPPA in the second cluster showed atrophy only in the left. Participants with PSA in both clusters showed vascular lesions encompassing the posterior left perisylvian regions. Underestimation of the severity of the leukoencephalopathy and damage of the interhemispheric connectivity might be responsible for the inclusion of PSA individuals in the first cluster, despite a unilateral lesion.

Conclusions:

Lesion localization is the main factor that determines the characteristics of aphasic deficits. Etiology indirectly acts through a different sensitivity of the brain regions to various pathologies.
Sleep Spindle Features and Neurobehavioral Performance in Healthy School-Aged Children
Authors: Sulkamo Saramia , Hagström Kati , Huupponen Eero , Isokangas Sirkku , Lapinlampi Anna-Maria , Alakuijala Anniina , Saarenpää-Heikkilä Outi , Himanen Sari-Leena
Published: December 2019

Purpose:

In adults, central fast-frequency sleep spindles are involved in learning and memory functions. The density of local spindles is higher than global spindles, emphasizing the importance of local plastic neural processes. In children, findings on the association of spindles with cognition are more variable. Hence, we aim to study whether the local spindles are also important for neurobehavioral performance in children.

Methods:

We studied the correlations between local (occurring in only one channel: Fp1, Fp2, C3, or C4), bilateral, and diffuse (occurring in all four channels) spindles and neurobehavioral performance in 17 healthy children (median age 9.6 years).

Results:

Local spindles were not as frequent as bilateral spindles (P-values < 0.05). Central spindle types had significant correlations with sensorimotor and language functions (e.g., the density of bilateral central spindles correlated positively with the Object Assembly in NEPSY, r = 0.490). Interestingly, frontopolar spindles correlated with behavior (e.g., the more bilateral the frontopolar spindles, the less hyperactive the children, r = −0.618).

Conclusions:

In children, the local spindles, but also more widespread central spindles, seem to be involved in the cognitive processes. Based on our findings, it is important that ageadjusted frequency limits are used in studies evaluating the frequencies of spindles in children.
Design and Validation of Education Multimedia Program for Patients With Fecal Diversions
Authors: Ashghali Farahani Mansoureh , Dorri Safoura , Yousefi Fatemeh
Published: December 2019

PURPOSE:

The purpose of this quality improvement project was to design and validate a multimedia educational software program for patients with fecal diversions.

PARTICIPANTS AND SETTING:

Ten individuals who had fecal diversion surgery and 10 experts including nurses, physicians, nutritionists, and information technologists from Imam Khomeini and Rasule Akram Hospitals, Tehran, Iran, the 2 main centers in which fecal diversion surgery took place, were included in the study.

APPROACH:

The multimedia educational software for patients with ostomy was developed in 3 phases including development and creation, validity, and modification of the software. Data for phase 1 were collected using 2 questionnaires, the Multimedia Survey Questionnaire for Clients and the Multimedia Survey Questionnaire for Experts, and several open-ended questions to further determine the content and face validity of the multimedia content for the education prototype.

OUTCOMES:

The mean ± standard deviation [SD] of multimedia evaluation by the 10 patients was 60 ± 3.27, indicating high user satisfaction. The mean ± SD of multimedia evaluation by the 10 experts was 171.1 ± 19.2, suggesting the content was of high quality. Content and face validity were reported to be 0.91 and 0.96, respectively. The program was then created and called “Self-Care of Ostomy,” which consisted of 8 computer-based modules with 22 short videos and slide presentations available for viewing by patients with newly created ostomies.

IMPLICATIONS FOR PRACTICE:

This multimedia program can provide patients with simple, portable, understandable, objective, user-friendly information about ostomy care. Future studies should address the effectiveness of ostomy management among patients, families, and care providers.