bluuebunny/crossref_metadata_2025_split huggingface dataset:
Octreotide versus oral dietary modification for the treatment of chylous fistula following neck dissection: A systematic review and meta‐analysis
Authors: Molena Emma , King Emma , Davies‐Husband Cameron 
Published: December 2020

AbstractAimsChylous fistula following neck surgery is a rare, but significant complication. Currently, there is no standardised treatment, which may comprise pressure dressings, oral dietary modification (ODM), surgery or a combination of such measures. Octreotide is a somatostatin analogue that has gained popularity in the management of cervical chyle leaks. The effectiveness of octreotide compared with ODM is unclear. We provide a comprehensive, systematic review of the literature pertaining to the management of chylous fistulae, comparing both treatment strategies.MethodsThe bibliographic databases MEDLINE, Cochrane, PubMed, EMBASE and Google Scholar were searched from inception to October 2019. Search terms included (chyle [title/abstract]) OR (chylous [title/abstract]) AND (fistula [title/abstract]) OR (fistulae [title/abstract]) OR (leak [title/abstract]) AND (neck [title/abstract]) OR (dissection [title/abstract]). The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta‐Analysis (PRISMA) guidelines. Risk of bias was assessed using guidelines from the Joanna Briggs Institute. Outcome measures included the proportion of chylous fistulae that spontaneously resolved without the need for surgery and time taken until resolution, for both DM and octreotide, respectively.ResultsThe primary search identified 20 articles for review, comprising 313 patients. Two studies were suitable for pooled analysis. There was no statistically significant difference in the time taken for chylous fistula to resolve between groups (octreotide 10.0 days; ODM 12.0 days; P = .38). The overall rate of resolution was 89.6% and 81.5%, respectively (P = .25). Surgery was highly effective in cases failing to resolve following intervention with either method (96% [53/55] patients).ConclusionThe use of octreotide for chylous fistula following neck dissection surgery is associated with a high rate of spontaneous resolution. However, significant heterogeneity, bias and concurrent use of ODM/TPN for patients in studies investigating octreotide precludes universal recommendation at this time. Further research in the form of randomised controlled trials is required to establish an independent treatment effect.
Altered anal slow‐wave pressure activity in low anterior resection syndrome: short case series in two independent specialist centres provide new mechanistic insights
Authors: Vollebregt Paul F. , Wiklendt Lukasz , Ang Daphne , Venn Mary L. , Mekhael Mira , Christensen Peter , Dinning Phil G. , Knowles Charles H. , Scott S. Mark 
Published: December 2020

AbstractAimConventional parameters (anal resting and squeeze pressures) measured with anorectal manometry (ARM) fail to identify anal sphincter dysfunction in many patients with low anterior resection syndrome (LARS). We aimed to assess whether there are differences in anal canal slow‐wave pressure activity in LARS patients and healthy individuals.MethodHigh‐resolution ARM (HR‐ARM) traces of 21 consecutive male LARS patients referred to the Royal London Hospital, UK (n = 12) and Aarhus University Hospital, Denmark (n = 9) were compared with HR‐ARM data from 37 healthy men.ResultsQualitatively (by visual inspection of HR‐ARM recordings), the frequency of slow‐wave pressure activity was strikingly different in 11/21 (52.4%) LARS patients from that observed in all the healthy individuals. Quantitative analysis showed that peaks of the mean spectrum in these 11 LARS patients occurred at approximately 6–7 cycles per minute (cpm), without activity at higher frequencies. An equivalent pattern was found in only 2/37 (5.4%) healthy individuals (P < 0.0001). Peaks of the mean spectrum in healthy individuals were concentrated at 16 cpm and 3–4 cpm.ConclusionOver half of the male LARS patients studied had altered anal slow‐wave pressure activity based on analysis of HR‐ARM recordings. Further studies could investigate the relative contributions of sex, human baseline variance and neoadjuvant/surgical therapies on anal slow waves, and correlate the presence of abnormal activity with symptom severity.
Left atrial stiffness predicts cardiac events in patients with heart failure and reduced ejection fraction: The impact of diabetes
Authors: Bytyçi Ibadete , D’Agostino Andreina , Bajraktari Gani , Lindqvist Per , Dini Frank L. , Henein Michael Y. 
Published: December 2020

AbstractBackgroundThe aim of this study was to investigate the relationship between diabetes mellitus (DM) and left atrial (LA) remodelling in a group of patients with heart failure and reduced ejection fraction (HFrEF), and their combined impact on cardiac events (CE).MethodsThis study included 136 consecutive HFrEF patients (65 ± 11 years), 36 had DM, and 86 had increased LA stiffness (LASt). All patients underwent complete conventional and tissue Doppler echocardiographic measurements were made including LA volumes and function. LASt was calculated using the formula: LASt = E/e’ ratio / PALS.ResultsAt 55 ± 37 months follow‐up, free survival from CE was 69% in patients without DM and 44.4% in those with DM (p < .0001). The CE free survival was lower in patients with increased LASt compared to normal LASt, (50 versus. 80%, p < .001), irrespective of the presence of DM (27 versus. 71%, p < .001).The best cut‐off value of LASt for predicting CE in the group as a whole was ≥ 0.82% [81% sensitivity, 72% specificity and AUC 0.82 (p < .001)]. LASt ≥ 0.82% also predicted CE in no DM patients [78% sensitivity, 71% specificity and AUC 0.80 (p < .001)] and was a stronger predictor in DM patients [85% sensitivity, 71% specificity and AUC = 0.847 (p < .001)].ConclusionHigh LA stiffness is associated with poor clinical outcome in patients with HFrEF. Diabetes has an additional incremental value in determining clinical outcome in those patients.
Karnofsky performance status predicts outcomes in candidates for simultaneous liver‐kidney transplant
Authors: Shamseddeen Hani , Pike Francis , Ghabril Marwan , Patidar Kavish R. , Desai Archita P. , Nephew Lauren , Anderson Melissa , Kubal Chandrashekhar , Chalasani Naga , Orman Eric S. 
Published: December 2020

AbstractKarnofsky performance status (KPS), a measure of physical frailty, predicts pre‐transplant and post‐transplant outcomes in liver transplantation, but has not been assessed in simultaneous liver–kidney transplantation (SLKT). We examined the association between KPS and outcomes in SLKT waitlist registrants and recipients (2005‐2018) in the UNOS database. KPS was categorized into A (able to work), B (able to provide self‐care), and C (unable to provide self‐care). Cox regression and competing risk analysis were used to assess the association between KPS groups and outcomes. A total of 10,785 patients were waitlisted (KPS: 19% A, 46% B, 35% C), and 5,516 underwent SLKT (12% A, 36% B, 52% C). One‐year waitlist mortality was 17%, 22%, and 32% for KPS A, B, and C, respectively. In adjusted competing risk regression, KPS C was associated with increased waitlist mortality (SHR 1.15, 95%CI 1.04‐1.28). One‐year post‐transplant survival was 92%, 91%, and 87% for KPS A, B, and C, respectively. In adjusted Cox regression, KPS C was associated with increased post‐transplant mortality (HR 1.32, 95%CI 1.08‐1.61). It was also associated with increased liver and kidney graft losses and with hospital length of stay. Frailty, as assessed by KPS, is associated with poor outcomes in SLKT pre‐ and post‐transplant.
Anticipating future actions: Motor planning improves with age in wild bearded capuchin monkeys (Sapajus libidinosus)
Authors: Truppa Valentina , Sabbatini Gloria , Izar Patricia , Fragaszy Dorothy M. , Visalberghi Elisabetta 
Published: December 2020

AbstractSelf‐directed object manipulation tasks illuminate development of motor planning. Grasping strategies that lead to good object control to perform the following action(s) reveal second‐order motor planning. Motor planning for efficient grips develops slowly in children. Age‐related differences in other primates have been poorly investigated. Here, we investigated anticipatory motor planning of infant, juvenile and adult wild capuchin monkeys grasping a horizontally positioned stick baited to the left or right side (a version of the elevated spoon task). We recorded the grasps capuchins used to bring the baited end of the stick to the mouth. The percentage of efficient radial grips positively correlated with age and adults used efficient grips significantly more frequently than infants. Adult wild capuchins' use of radial grips was higher than that reported for adult captive capuchins in similar tasks, suggesting that experience throughout life may influence motor anticipation. Self‐directed object manipulation tasks will be useful to compare this aspect of cognition across primates. A video abstract of this article can be viewed at https://youtu.be/a1Zbr_AQkb8.
Hydrogeomorphological controls on reach‐scale distributions of cichlid nest sites in a small neotropical river
Authors: Buege Emily A. , Esselman Peter C. , Praskievicz Sarah J. 
Published: December 2020

AbstractThe Cichlidae are among the most diversified families of fish in the Neotropics and represent an important component of aquatic biodiversity. Understanding cichlid nest‐site selection is important for assemblages facing uncertain futures due to species invasions and environmental change. This information could be used to predict how inter‐ and intraspecific competition for reproductive space may affect populations with changing community dynamics or to identify areas as targets for conservation. We investigated which hydrogeomorphological factors correlated to preferred nest sites of four native cichlid species in the Bladen River, Belize. We recorded the locations of nest sites and collected habitat data through the study reach, including flow velocity, depth, sediment type, fish cover type richness and distance to the bank. Nest locations and physical habitat data were used to construct spatially explicit habitat models using boosted regression trees (BRTs). The models provided statistically significant evidence that physical habitat variables influence the distribution of the nest sites. We found that all species except Archocentrus spilurus were associated with substrate, specifically sand. Thorichthys meeki was also associated with lower water velocities, whereas Cichlasoma salvini was influenced by all five variables. Vieja maculicauda and Archocentrus spilurus were both influenced by flow velocity, distance to bank and depth, although A. spilurus preferred deeper, slightly faster locations about the same distance to the bank. This study suggests that the spatial distribution of nest sites within this cichlid community is significantly different than random and is at least partially governed by physical controls.
“Kids from here don't go to uni”: Considering first in family students' belonging and entitlement within the field of higher education in Australia
Authors: O’Shea Sarah 
Published: December 2020

AbstractIncreasingly students from diverse backgrounds are attending university, many from contexts where accessing higher education is the exception rather than the norm. We know that these learners often have a lower sense of belonging when compared to their second or third generation peers but how this is experienced at an individual level remains unclear. This article explores how current and graduated students articulated their belonging within the higher education environment and how understandings of entitlement played into this conceptualisation. Drawing on Bourdieu's concepts of field and habitus, particularly the notion of cleft habitus (habitus clivé), this article seeks to explore how learners negotiate their status both as university students and graduates. Utilising interviews and surveys conducted with enrolled and graduated first in family learners, the focus is on those who are regarded as successful in the sense of meritocratic achievements and degree conferral. This richly descriptive data points to the emotional undercurrents and relational complexity that attending university can have for those with no generational biographical belonging to this environment and the ways in which learners negotiate between existing and new expectations and norms.
Deciphering key regulators involved in epilepsy‐induced cardiac damage through whole transcriptome and proteome analysis in a rat model
Authors: Sharma Supriya , Sharma Meetal , Rana Anil Kumar , Joshi Robin , Swarnkar Mohit Kumar , Acharya Vishal , Singh Damanpreet 
Published: December 2020

AbstractObjectiveSudden unexpected death in epilepsy (SUDEP) is a major outcome of cardiac dysfunction in patients with epilepsy. In continuation of our previous work, the present study was envisaged to explore the key regulators responsible for cardiac damage associated with chronic seizures using whole transcriptome and proteome analysis in a rat model of temporal lobe epilepsy.MethodsA standard lithium‐pilocarpine protocol was used to induce recurrent seizures in rats. The isolated rat heart tissue was subjected to transcriptomic and proteomic analysis. An integrated approach of RNA‐Seq, proteomics, and system biology analysis was used to identify key regulators involved in seizure‐linked cardiac changes. The analyzed differential expression patterns and network interactions were supported by gene and protein expression studies.ResultsAltogether, 1157 differentially expressed genes and 1264 proteins were identified in the cardiac tissue of epileptic animals through RNA‐Seq and liquid chromatography with tandem mass spectrometry‐based proteomic analysis, respectively. The network analysis revealed seven critical genes—STAT3, Myc, Fos, Erbb2, Erbb3, Notch1, and Mapk8—that could play a role in seizure‐mediated cardiac changes. The LC‐MS/MS analysis supported the activation of the transforming growth factor β (TGF‐β) pathway in the heart of epileptic animals. Furthermore, our gene and protein expression studies established a key role of STAT3, Erbb, and Mapk8 to develop cardiac changes linked with recurrent seizures.SignificanceThe present multi‐omics study identified STAT3, Mapk8, and Erbb as key regulators involved in seizure‐associated cardiac changes. It provided a deeper understanding of molecular, cellular, and network‐level operations of the identified regulators that lead to cardiac changes in epilepsy.
Commercial amniotic membrane extract for treatment of corneal ulcers in adult horses
Authors: Lyons Victoria N. , Townsend Wendy M. , Moore George E. , Liang Siqi 
Published: December 2020

AbstractBackgroundAmniotic membrane extract enhances the rate of epithelialisation after corneal ulceration in several species but has not been studied in the equine cornea.ObjectivesTo evaluate the effect of amniotic membrane extract on re‐epithelialisation of equine corneal ulcers compared with ulcers treated with antibiotic, antifungal and mydriatic medical therapy alone, and to evaluate equine corneal healing after experimentally induced superficial ulceration.Study designMasked, randomised, controlled experimental trial.MethodsSuperficial, 8 mm corneal ulcers were created bilaterally in each horse. One eye was treated with amniotic membrane extract and the opposite was control. Both eyes were treated with medical therapy. Treatment eyes received amniotic membrane extract, and control eyes received the amniotic membrane extract vehicle. Ulcers were stained with fluorescein and photographed in 12‐hour increments until completely healed. Ulcer surface area was determined by analysing photographs with ImageJ. A mixed linear model was used to compare ulcer surface area and hours until healing between treatment groups. A regression model was also used to calculate corneal re‐epithelialisation rate over time.ResultsRegardless of therapy, healing occurred in two phases: an initial rapid phase of 0.88 mm2/hr (95% CI: 0.81‐0.94 mm2/hr) for approximately 48‐54 hours followed by a second, slow phase of 0.07 mm2/hr (95% CI: 0.04‐0.09 mm2/hr). Most eyes healed within 135.5 ± 48.5 hours. Treatment (amniotic membrane extract vs. control) was not significantly associated with size of ulcers over time (P = .984). Discomfort was minimal to absent in all horses.Main limitationsResults achieved experimental studies may differ from outcomes in the clinical setting.ConclusionsThere was no significant difference in healing rate with addition of amniotic membrane extract to medical therapy for equine superficial corneal ulcers. A biphasic corneal healing process was observed, with an initial rapid phase followed by a slow phase. Further study will be needed to determine whether amniotic membrane extract will be helpful for infected or malacic equine corneal ulcers.
Skin pigmentation and its control: From ultraviolet radiation to stem cells
Authors: Yardman‐Frank Joseph Michael , Fisher David E. 
Published: December 2020

AbstractIn the light of substantial discoveries in epithelial and hair pigmentation pathophysiology, this review summarizes the current understanding of skin pigmentation mechanisms. Melanocytes are pigment‐producing cells, and their key regulating transcription factor is the melanocyte‐specific microphthalmia‐associated transcription factor (m‐MITF). Ultraviolet (UV) radiation is a unique modulator of skin pigmentation influencing tanning pathways. The delayed tanning pathway occurs as UVB produces keratinocyte DNA damage, causing p53‐mediated expression of the pro‐opiomelanocortin (POMC) gene that is processed to release α‐melanocyte‐stimulating hormone (α‐MSH). α‐MSH stimulates the melanocortin 1 receptor (MC1R) on melanocytes, leading to m‐MITF expression and melanogenesis. POMC cleavage also releases β‐endorphin, which creates a neuroendocrine pathway that promotes UV‐seeking behaviours. Mutations along the tanning pathway can affect pigmentation and increase the risk of skin malignancies. MC1R variants have received considerable attention, yet the allele is highly polymorphic with varied phenotypes. Vitiligo presents with depigmented skin lesions due to autoimmune destruction of melanocytes. UVB phototherapy stimulates melanocyte stem cells in the hair bulge to undergo differentiation and upwards migration resulting in perifollicular repigmentation of vitiliginous lesions, which is under sophisticated signalling control. Melanocyte stem cells, normally quiescent, undergo cyclic activation/differentiation and downward migration with the hair cycle, providing pigment to hair follicles. Physiological hair greying results from progressive loss of melanocyte stem cells and can be accelerated by acute stress‐induced, sympathetic driven hyperproliferation of the melanocyte stem cells. Ultimately, by reviewing the pathways governing epithelial and follicular pigmentation, numerous areas of future research and potential points of intervention are highlighted.
Crystal structures of a novel family IV esterase in free and substrate‐bound form
Authors: Höppner Astrid , Bollinger Alexander , Kobus Stefanie , Thies Stephan , Coscolín Cristina , Ferrer Manuel , Jaeger Karl‐Erich , Smits Sander H. J. 
Published: December 2020

Bacterial lipolytic enzymes of family IV are homologs of the mammalian hormone‐sensitive lipases (HSL) and have been successfully used for various biotechnological applications. The broad substrate specificity and ability for enantio‐, regio‐, and stereoselective hydrolysis are remarkable features of enzymes from this class. Many crystal structures are available for esterases and lipases, but structures of enzyme–substrate or enzyme–inhibitor complexes are less frequent although important to understand the molecular basis of enzyme–substrate interaction and to rationalize biochemical enzyme characteristics. Here, we report on the structures of a novel family IV esterase isolated from a metagenomic screen, which shows a broad substrate specificity. We solved the crystal structures in the apo form and with a bound substrate analogue at 1.35 and 1.81 Å resolution, respectively. This enzyme named PtEst1 hydrolyzed more than 60 out 96 structurally different ester substrates thus being substrate promiscuous. Its broad substrate specificity is in accord with a large active site cavity, which is covered by an α‐helical cap domain. The substrate analogue methyl 4‐methylumbelliferyl hexylphosphonate was rapidly hydrolyzed by the enzyme leading to a complete inactivation caused by covalent binding of phosphinic acid to the catalytic serine. Interestingly, the alcohol leaving group 4‐methylumbelliferone was found remaining in the active site cavity, and additionally, a complete inhibitor molecule was found at the cap domain next to the entrance of the substrate tunnel. This unique situation allowed gaining valuable insights into the role of the cap domain for enzyme–substrate interaction of esterases belonging to family IV.DatabaseStructural data of PtEst1 are available in the worldwide protein data bank (https://www.rcsb.org) under the accession codes: 6Z68 (apo‐PtEst1) and 6Z69 (PtEst1‐inhibitor complex).
Exploring biogeochemical and ecological redundancy in phytoplankton communities in the global ocean
Authors: Dutkiewicz Stephanie , Boyd Philip W. , Riebesell Ulf 
Published: December 2020

AbstractClimate‐change‐induced alterations of oceanic conditions will lead to the ecological niches of some marine phytoplankton species disappearing, at least regionally. How will such losses affect the ecosystem and the coupled biogeochemical cycles? Here, we couch this question in terms of ecological redundancy (will other species be able to fill the ecological roles of the extinct species) and biogeochemical redundancy (can other species replace their biogeochemical roles). Prior laboratory and field studies point to a spectrum in the degree of redundancy. We use a global three‐dimensional computer model with diverse planktonic communities to explore these questions further. The model includes 35 phytoplankton types that differ in size, biogeochemical function and trophic strategy. We run two series of experiments in which single phytoplankton types are either partially or fully eliminated. The niches of the targeted types were not completely reoccupied, often with a reduction in the transfer of matter from autotrophs to heterotrophs. Primary production was often decreased, but sometimes increased due to reduction in grazing pressure. Complex trophic interactions (such as a decrease in the stocks of a predator's grazer) led to unexpected reshuffling of the community structure. Alterations in resource utilization may cause impacts beyond the regions where the type went extinct. Our results suggest a lack of redundancy, especially in the ‘knock on’ effects on higher trophic levels. Redundancy appeared lowest for types on the edges of trait space (e.g. smallest) or with unique competitive strategies. Though highly idealized, our modelling findings suggest that the results from laboratory or field studies often do not adequately capture the ramifications of functional redundancy. The modelled, often counterintuitive, responses—via complex food web interactions and bottom‐up versus top‐down controls—indicate that changes in planktonic community will be key determinants of future ocean global change ecology and biogeochemistry.