bluuebunny/crossref_metadata_2025_split huggingface dataset:
Duration of symptoms and manometric parameters offer clues to diagnosis of pseudoachalasia
Authors: Gergely Maté , Mello Michael D. , Rengarajan Arvind , Gyawali C. Prakash 
Published: August 2020

AbstractBackgroundPseudoachalasia manifests high‐resolution manometry (HRM) findings of achalasia but results from a secondary process. We analyzed clinical and HRM characteristics of pseudoachalasia, including malignant and non‐malignant subtypes.MethodsHigh‐resolution manometry was retrospectively reviewed in patients with confirmed pseudoachalasia, and corroborated with endoscopic and radiographic studies. A control cohort of idiopathic achalasia patients was identified. Clinical characteristics, Eckardt score, and HRM metrics were extracted from institutional records. Grouped data and medians (interquartile range) were compared between pseudoachalasia and idiopathic achalasia, and between malignant and non‐malignant pseudoachalasia, using parametric and non‐parametric statistical tests.Key ResultsOf 28 pseudoachalasia patients (62.2 ± 2.5 years, 60.7% female), 18 (64.3%) had malignancy, and 10 (35.7%) had non‐malignant obstruction. Although Eckardt score did not differentiate pseudoachalasia from 58 achalasia patients (55.9 ± 2.5 years, 53.4% female), weight loss was greater (median 9.1 [5.0‐18.5] vs 3.6 [0‐9.1] kg, P < .02) with shorter duration of symptoms (median 12.9 [8.0‐38.6] vs 36.0 [25.7‐45.0] weeks, P < .001] in pseudoachalasia. Esophagogastric junction (EGJ) metrics demonstrated lower mean IRP values and lower EGJ contractile integral in pseudoachalasia (P < .04 for each comparison with idiopathic achalasia). Type 1 pattern was more frequent in pseudoachalasia (39.3% vs 13.8%, P < .008). Pseudoachalasia demonstrated incomplete HRM patterns, with lower rates of lack of peristalsis (79.6%, vs 93.1% in achalasia, P < .05). Despite higher Eckardt scores in malignant vs non‐malignant pseudoachalasia (median 8.0 [7.0‐9.0] vs 6.0 [3.5‐7.8], P < .03], no significant HRM differences were noted.Conclusions and InferencesPseudoachalasia manifests with a shorter history, greater weight loss, and incomplete HRM achalasia patterns compared to achalasia.
Phytophthora infestans RXLR effector PITG20303 targets a potato MKK1 protein to suppress plant immunity
Authors: Du Yu , Chen Xiaokang , Guo Yalu , Zhang Xiaojiang , Zhang Houxiao , Li Fangfang , Huang Guiyan , Meng Yuling , Shan Weixing 
Published: August 2020

Summary

Pathogens secret a plethora of effectors into the host cell to modulate plant immunity. Analysing the role of effectors in altering the function of their host target proteins will reveal critical components of the plant immune system.

Here we show that Phytophthora infestans RXLR effector PITG20303, a virulent variant of AVRblb2 (PITG20300) that escapes recognition by the resistance protein Rpi‐blb2, suppresses PAMP‐triggered immunity (PTI) and promotes pathogen colonization by targeting and stabilizing a potato MAPK cascade protein, StMKK1. Both PITG20300 and PITG20303 target StMKK1, as confirmed by multiple in vivo and in vitro assays, and StMKK1 was shown to be a negative regulator of plant immunity, as determined by overexpression and gene silencing.

StMKK1 is a negative regulator of plant PTI, and the kinase activities of StMKK1 are required for its suppression of PTI and effector interaction. PITG20303 depends partially on MKK1, PITG20300 does not depend on MKK1 for suppression of PTI‐induced reactive oxygen species burst, while the full virulence activities of nuclear targeted PITG20303 and PITG20300 are dependent on MKK1.

Our results show that PITG20303 and PITG20300 target and stabilize the plant MAPK cascade signalling protein StMKK1 to negatively regulate plant PTI response.
Roles for the chloroplast‐localized pentatricopeptide repeat protein 30 and the ‘mitochondrial’ transcription termination factor 9 in chloroplast quality control
Authors: Alamdari Kamran , Fisher Karen E. , Sinson Andrew B. , Chory Joanne , Woodson Jesse D. 
Published: August 2020

SUMMARYChloroplasts constantly experience photo‐oxidative stress while performing photosynthesis. This is particularly true under abiotic stresses that lead to the accumulation of reactive oxygen species (ROS) which oxidize DNA, proteins and lipids. Reactive oxygen species can also act as signals to induce acclimation through chloroplast degradation, cell death and nuclear gene expression. To better understand the mechanisms behind ROS signaling from chloroplasts, we have used the Arabidopsis thaliana mutant plastid ferrochelatase two (fc2) that conditionally accumulates the ROS singlet oxygen (1O2) leading to chloroplast degradation and eventually cell death. Here we have mapped mutations that suppress chloroplast degradation in the fc2 mutant and demonstrate that they affect two independent loci (PPR30 and mTERF9) encoding chloroplast proteins predicted to be involved in post‐transcriptional gene expression. These mutants exhibited broadly reduced chloroplast gene expression, impaired chloroplast development and reduced chloroplast stress signaling. Levels of 1O2, however, could be uncoupled from chloroplast degradation, suggesting that PPR30 and mTERF9 are involved in ROS signaling pathways. In the wild‐type background, ppr30 and mTERF9 mutants were also observed to be less susceptible to cell death induced by excess light stress. While broad inhibition of plastid transcription with rifampicin was also able to suppress cell death in fc2 mutants, specific reductions in plastid gene expression using other mutations was not always sufficient. Together these results suggest that plastid gene expression, or the expression of specific plastid genes by PPR30 and mTERF0, is a necessary prerequisite for chloroplasts to activate the 1O2 signaling pathways to induce chloroplast quality control pathways and/or cell death.
Comparative Study on a Straight and Helical Capillary Tube for CO2 and R22 Refrigerant
Authors: Jadhav Pravin , Agrawal Neeraj 
Published: August 2020

Abstract
A comparative study has been carried out on the adiabatic straight and helical capillary tube, using a CO2 and R22 refrigerant. The numerical model for CO2 and R22 is developed using the basic principles of conservation of mass, momentum, and energy. The effect of coiling in the helical capillary tube is compared with a straight capillary tube for CO2 and R22 refrigerant. Compared with the straight capillary tube, the percentage reduction in mass flowrate in the helical capillary tube is calculated with a change in coil diameter, tube diameter, and length. As the coil diameter increases from 30 mm to 150 mm, the percentage reduction in mass is from 5.8% to 2.2% in CO2, and 5% to 1.6% in R22. For helical capillary tube with 50 mm coil diameter, as the tube diameter increases from 1 to 1.5 mm, the percentage reduction in mass flowrate with CO2 refrigerant is from 2.65% to 4.96%, however, for R22 it is from 2.43% to 4.24%. Similarly, as the capillary tube length increases from 1.3 m to 1.8 m, the percentage reduction in mass with CO2, with 50 mm coil diameter is 4.44–4.55%. However, the percentage reduction in mass with R22 is 3.71–3.85%. Moreover, compared with the straight capillary tube, the percentage reduction in length in a helical capillary tube with coil diameter 50 mm is 16% for CO2 and 9% for R22 refrigerant.
Effects of High-Intensity Interval Training in Hypoxia on Taekwondo Performance
Authors: Chacón Torrealba Tomás , Aranda Araya Jaime , Benoit Nicolas , Deldicque Louise 
Published: August 2020

Purpose: To evaluate the effects of a 6-week taekwondo-specific high-intensity interval training (HIIT) in simulated normobaric hypoxia on physical fitness and performance in taekwondoists. Methods: Eighteen male and female black-belt taekwondoists trained twice a week for 6 weeks in normoxia or in hypoxia (FiO2 = 0.143 O2). The HIIT was composed of specific taekwondo movements and simulated fights. Body composition analyses and a frequency speed of kick test during 10 seconds (FSKT10s) and 5 × 10 seconds (FSKTmult), countermovement jump (CMJ) test, Wingate test, and an incremental treadmill test were performed before and after training. Blood lactate concentrations were measured after the FSKTmult and Wingate tests, and a fatigue index during the tests was calculated. Results: A training effect was found for FSKT10s (+35%, P < .001), FSKTmult (+32%, P < .001), and fatigue index (−48%, P = .002). A training effect was found for CMJ height (+5%, P = .003) during the CMJ test. After training, CMJ height increased in hypoxia only (+7%, P = .005). No effect was found for the parameters measured during Wingate test. For the incremental treadmill test, a training effect was found for peak oxygen consumption (P = .002), the latter being 10% lower after than before training in normoxia only (P = .002). Conclusions: In black-belt taekwondoists, hypoxic HIIT twice a week for 6 weeks provides tiny additional gains on key performance parameters compared with normoxic HIIT. Whether the trivial effects reported here might be of physiological relevance to improve performance remains debatable and should be tested individually.
Use of oximetry to screen for paediatric obstructive sleep apnoea: is one night enough and is 6 hours too much?
Authors: Galway Niamh Catherine , Maxwell Barbara , Shields Michael , O'Donoghue Dara 
Published: August 2020

IntroductionNocturnal pulse oximetry can be used to screen for obstructive sleep apnoea (OSA) using the McGill Oximetry Score (MOS). The MOS has a time threshold for a technically adequate study of 6 hours. It has been suggested that one night of oximetry is sufficient to screen for OSA using the MOS.Aims(1) To evaluate night-to-night variation of the MOS. (2) To determine the impact of recording three nights of oximetry on the screening yield for OSA. (3) To explore whether useful MOS data are discarded when a threshold of 6 hours of oximetry recording is used.MethodsA retrospective study of nocturnal pulse oximetry done at home over three consecutive nights in paediatric patients with suspected OSA. Studies were scored (MOS) using thresholds of ≥6 and ≥4 hours of recording.ResultsA total of 329 patients were studied. MOS scores over three nights showed only fair to moderate agreement. On the first night 126 patients (38%) screened positive for OSA. When three nights of oximetry were done 195 patients (59%) screened positive on at least one of the nights. There were 48 patients with studies of between 4 and 6 hours duration on one or more nights. If these studies are scored 20 patients (42%) would screen positive for OSA on at least one night based on scoring these studies alone.ConclusionOne night of oximetry screening may not be sufficient to screen for OSA. Lowering the time threshold to ≥4 hours may increase the screening capability of nocturnal oximetry.
Proposal and validation of a new grading system for pterygium (SLIT2)
Authors: Ting Darren Shu Jeng , Liu Yu-Chi , Patil Moushmi , Ji Angel Jung Se , Fang Xiao Ling , Tham Yih Chung , Lee Yi-Fang , Htoon Hla M , Mehta Jodhbir S. 
Published: August 2020

Background/aimsTo propose and validate a new pterygium grading system based on slit-lamp evaluation.MethodsThis prospective cross-sectional study included 217 patients with pterygium. All patients underwent slit-lamp examination, and slit-lamp photographs were independently graded by two graders twice. A total of eight parameters were evaluated and all parameters were assigned with a score of 1–4 (normal–severe). Intra-rater and inter-rater reliability as determined by weighted Cohen’s kappa analysis.ResultsA total of 868 independent assessment, based on 217 slit-lamp images, were performed by two graders. For conjunctival assessment, the intra-rater reliability was excellent for body thickness (κ=0.81–0.89) and size at limbus (κ=0.87–0.92), substantial-to-excellent for body vascularity (κ=0.72–0.86), and moderate-to-excellent for body length (κ=0.57–0.81), whereas the inter-rater reliability was excellent for size at limbus (κ=0.86), substantial for body thickness (κ=0.72–0.73) and body vascularity (κ=0.66–0.75), and moderate for body length (κ=0.54–0.57). For corneal assessment, the intra-rater reliability was excellent for all four parameters (κ=0.84–0.90) whereas the inter-rater reliability was excellent for head length (κ=0.86–0.87), substantial-to-excellent for head vascularity (κ=0.78–0.82), substantial for Stocker’s line (κ=0.79–0.80) and head thickness (κ=0.67–0.69). The grading system was named SLIT2, which included Stocker’s line, Size at limbus, Length of head/body, Injection/vascularity of body/head, and Thickness of body/head.ConclusionThe proposed SLIT2 grading system, consisting of eight components, may serve as a reliable tool to standardise the reporting of pterygium severity and disease recurrence for clinical and research applications.
Trends in excess mortality associated with atrial fibrillation over 45 years (Framingham Heart Study): community based cohort study
Authors: Vinter Nicklas , Huang Qiuxi , Fenger-Grøn Morten , Frost Lars , Benjamin Emelia J , Trinquart Ludovic 
Published: August 2020

AbstractObjectiveTo assess temporal trends in the association between newly diagnosed atrial fibrillation and death.DesignCommunity based cohort study.SettingFramingham Heart Study cohort, in 1972-85, 1986-2000, and 2001-15 (periods 1-3, respectively), in Framingham, MA, USA.ParticipantsParticipants with no atrial fibrillation, aged 45-95 in each time period, and identified with newly diagnosed atrial fibrillation (or atrial flutter) during each time period.Main outcome measuresThe main outcome was all cause mortality. Hazard ratios for the association between time varying atrial fibrillation and all cause mortality were calculated with adjustment for time varying confounding factors. The difference in restricted mean survival times, adjusted for confounders, between participants with atrial fibrillation and matched referents at 10 years after a diagnosis of atrial fibrillation was estimated. Meta-regression was used to test for linear trends in hazard ratios and restricted mean survival times over the different time periods.Results5671 participants were selected in time period 1, 6177 in period 2, and 6174 in period 3. Adjusted hazard ratios for all cause mortality between participants with and without atrial fibrillation were 1.9 (95% confidence interval 1.7 to 2.2) in time period 1, 1.4 (1.3 to 1.6) in period 2, and 1.7 (1.5 to 2.0) in period 3 (Ptrend=0.70). Ten years after diagnosis of atrial fibrillation, the adjusted difference in restricted mean survival times between participants with atrial fibrillation and matched referents decreased by 31%, from −2.9 years (95% confidence interval −3.2 to −2.5) in period 1, to −2.1 years (−2.4 to −1.8) in period 2, to −2.0 years (−2.3 to −1.7) in period 3 (Ptrend=0.03).ConclusionsNo evidence of a temporal trend in hazard ratios for the association between atrial fibrillation and all cause mortality was found. The mean number of life years lost to atrial fibrillation at 10 years had improved significantly, but a two year gap compared with individuals without atrial fibrillation still remained.
Rod phototransduction and light signal transmission during type 2 diabetes
Authors: Becker Silke , Carroll Lara S , Vinberg Frans 
Published: August 2020

IntroductionDiabetic retinopathy is a major complication of diabetes recently associated with compromised photoreceptor function. Multiple stressors in diabetes, such as hyperglycemia, oxidative stress and inflammatory factors, have been identified, but systemic effects of diabetes on outer retina function are incompletely understood. We assessed photoreceptor physiology in vivo and in isolated retinas to better understand how alterations in the cellular environment compared with intrinsic cellular/molecular properties of the photoreceptors, affect light signal transduction and transmission in the retina in chronic type 2 diabetes.Research design and methodsPhotoreceptor function was assessed in BKS.Cs-Dock7m+/+Lepr db/J mice, using homozygotes for Leprdb as a model of type 2 diabetes and heterozygotes as non-diabetic controls. In vivo electroretinogram (ERG) was recorded in dark-adapted mice at both 3 and 6 months of age. For ex vivo ERG, isolated retinas were superfused with oxygenated Ames’ media supplemented with 30 mM glucose or mannitol as iso-osmotic control and electrical responses to light stimuli were recorded.ResultsWe found that both transduction and transmission of light signals by rod photoreceptors were compromised in 6-month-old (n=9–10 eyes from 5 animals, ***p<0.001) but not in 3-month-old diabetic mice in vivo (n=4–8 eyes from 2 to 4 animals). In contrast, rod signaling was similar in isolated retinas from 6-month-old control and diabetic mice under normoglycemic conditions (n=11). Acutely elevated glucose ex vivo increased light-evoked rod photoreceptor responses in control mice (n=11, ***p<0.001), but did not affect light responses in diabetic mice (n=11).ConclusionsOur data suggest that long-term diabetes does not irreversibly change the ability of rod photoreceptors to transduce and mediate light signals. However, type 2 diabetes appears to induce adaptational changes in the rods that render them less sensitive to increased availability of glucose.
The contribution of grandmother involvement to child growth and development: an observational study in rural Pakistan
Authors: Chung Esther O , Hagaman Ashley , LeMasters Katherine , Andrabi Nafeesa , Baranov Victoria , Bates Lisa M , Gallis John A , O'Donnell Karen , Rahman Atif , Sikander Siham , Turner Elizabeth L , Maselko Joanna 
Published: August 2020

IntroductionEarly childhood interventions primarily focus on the mother–child relationship, but grandmothers are often critical in childcare in low-resource settings. Prior research is mixed on how grandmother involvement influences child outcomes and there is a paucity of research on grandmother caregiving in low-income and middle-income countries. We examined the role of grandmother involvement on child growth and development in the first 2 years of life cross sectionally and longitudinally in rural Pakistan.MethodsWe used data from the Bachpan Cohort, a longitudinal birth cohort in rural Pakistan. Maternally reported grandmother involvement in daily instrumental and non-instrumental caregiving was collected at 3 and 12 months. A summed score was created and categorised into non-involved, low and high. Outcomes included 12-month and 24-month child growth, 12-month Bayley Scales of Infant and Toddler Development and 24-month Ages and Stages Questionnaire—Socioemotional. We used multivariable generalised linear models to estimate mean differences (MD) at 12 months (n=727) and 24 months (n=712). Inverse probability weighting was used to account for missingness and sampling.ResultsIn our sample, 68% of children lived with a grandmother, and most grandmothers were involved in caregiving. Greater 3-month grandmother involvement was positively associated with 12-month weight z-scores; however, greater involvement was associated with lower 24-month weight z-scores. High 12-month grandmother involvement was associated with improved 12-month cognitive (MD=0.38, 95% CI −0.01 to 0.76), fine motor skills (MD=0.45, 95% CI 0.08 to 0.83) and 24-month socioemotional development (MD=−17.83, 95% CI −31.47 to –4.19). No meaningful associations were found for length z-scores or language development.ConclusionIn rural Pakistan, grandmothers provide caregiving that influences early child development. Our findings highlight the complex relationship between grandmother involvement and child weight, and suggest that grandmothers may positively promote early child cognitive, fine motor and socioemotional development. Understanding how grandmother involvement affects child outcomes in early life is necessary to inform caregiving interventions.
Severe mental illness and palliative care: patient semistructured interviews
Authors: Knippenberg Inge , Zaghouli Nasira , Engels Yvonne , Vissers Kris C P , Groot Marieke M 
Published: August 2020

ObjectivesTo explore perceptions, experiences and expectations with respect to palliative care of patients with severe mental illness (SMI) and an incurable, life-limiting chronic illness.MethodsFace-to-face semistructured interviews were conducted with 12 patients (10 of them living in a mental healthcare institution) with severe mental and physical health issues in the Netherlands. A semistructured interview guide was used to elicit perceptions of, experiences with and expectations regarding palliative care. Data were analysed using inductive content analysis.ResultsAnalysis of the data revealed eight categories: perceptions on health and health issues, coping with illness and symptoms, experiences with and wishes for current healthcare, contact with relatives and coresidents, experiences with end of life of relatives and coresidents, willingness to discuss end of life and death, wishes and expectations regarding one’s own end of life and practical aspects relating to matters after death. These categories were clustered into two separate themes: current situation and anticipation of end of life. Interviewees with SMI appeared not accustomed to communicate about end-of-life issues, death and dying due to their life-threatening illness. They tended to discuss only their current situation and, after further exploration of the researcher, the terminal phase of life. They seemed not engaged in their future palliative care planning.ConclusionsFindings of this study highlight inadequacies in advance care planning for patients with SMI. Results suggest using values, current and near wishes, and needs as a starting point for establishing a gradual discussion concerning goals and preferences for future medical and mental treatment and care.
Outcomes and biomarker analyses among patients with COVID-19 treated with interleukin 6 (IL-6) receptor antagonist sarilumab at a single institution in Italy
Authors: Montesarchio Vincenzo , Parella Roberto , Iommelli Chiara , Bianco Antonella , Manzillo Elio , Fraganza Fiorentino , Palumbo Cristiana , Rea Gaetano , Murino Patrizia , De Rosa Rosanna , Atripaldi Luigi , D’Abbraccio Maurizio , Curvietto Marcello , Mallardo Domenico , Celentano Egidio , Grimaldi Antonio Maria , Palla Marco , Trojaniello Claudia , Vitale Maria Grazia , Million-Weaver Samuel Lewis , Ascierto Paolo Antonio 
Published: August 2020

BackgroundThe inflammatory pathology observed in severe COVID-19 disease caused by the 2019 novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is characterized by elevated serum levels of C reactive protein (CRP) and cytokines, including interferon gamma, interleukin 8 (IL-8), and interleukin 6 (IL-6). Initial reports from the outbreak in Italy, China and the USA have provided anecdotal evidence of improved outcomes with the administration of anti-IL-6 agents, and large-scale trials evaluating these therapies are ongoing.Study descriptionIn this retrospective case series, clinical outcomes and correlates of response to treatment with the IL-6 receptor antagonist sarilumab are described for 15 patients with COVID-19 from a single institution in Southern Italy. Among 10 patients whose symptoms improved after sarilumab treatment, rapid decreases in CRP levels corresponded with clinical improvement. Lower levels of IL-6 at baseline as well as lower neutrophil to lymphocyte ratio as compared with patients whose COVID-19 did not improve with treatment were associated with sarilumab-responsive disease.ConclusionsThis observation may reflect a possible clinical benefit regarding early intervention with IL-6-modulatory therapies for COVID-19 and that CRP could be a potential biomarker of response to treatment.