bluuebunny/crossref_metadata_2025 huggingface dataset:
Elementary preservice teachers' integration of engineering into STEM lesson plans
Authors: Maiorca Cathrine , Mohr‐Schroeder Margaret J.
Published: October 2020

Science, technology, engineering, and mathematics (STEM) integration is a desired outcome according to Next Generation Science Standards. However, learning to teach integrated STEM content has been challenging for teachers. Consequently, the purpose of this qualitative study was to describe how 16 preservice teachers enrolled in a mathematics methods course created integrated STEM lesson plans that incorporated an authentic engineering problem. Content analysis of the completed integrated STEM lesson plans used the Quality K‐12 Engineering Education Framework to identify any characteristics of engineering. We found that 15 of 16 preservice teachers demonstrated at least an emerging ability to create an integrated STEM lesson that contained an engineering problem, constraints, a prototype or model, model testing, and data collection and analysis related to the model. We concluded that giving preservice teachers opportunities to experience engineering design problems could better prepare them to design and implement integrated STEM education in their classrooms. The findings from this study have practical implications for mathematics methods teacher educators who teach the pedagogy behind STEM education. This study also has theoretical implications because socially situated learning theory was extended to Model‐Eliciting Activities and connected them to the K‐12 Framework for Quality Engineering Education.
A novel ABO allele with a 21‐bp duplication identified in two unrelated European individuals with weak A expression
Authors: Jakobsen Marianne A. , Hult Annika K. , Hellberg Åsa , Crottet Sofia Lejon , Sprogøe Ulrik , Olsson Martin L.
Published: October 2020

Objectives

To carry out genetic and serological analyses of a Swiss blood donor and a Danish patient carrying an aberrant ABO phenotype with weak A expression.

Background

ABO is the most clinically important blood group system but also one of the most complex. The system antigens are determined by carbohydrate structures generated by A and B glycosyltransferases encoded by the ABO gene. Genetic variants of ABO may encode a glycosyltransferase with reduced activity, leading to weak expression of A antigen.

Methods

Samples from two individuals were examined using genetic testing and extended immunohaematological evaluation, including standard serological methods, flow cytometry and analysis of plasma glycosyltransferase activity.

Results

Both individuals were serologically determined to be AweakB. Genetic testing revealed that both were heterozygous for a novel ABO*A1.01‐like allele with an in‐frame duplication of 21 nucleotides in exon 7 (c.543_563dup), leading to the insertion of seven amino acids (QDVSMRR). Flow cytometric testing of native red blood cells (RBCs) showed very weak A antigen expression. This was in accordance with the enzyme activity test.

Conclusion

In summary, we describe a novel A allele with a duplication of 21 nucleotides in exon 7 that significantly decreases the enzyme activity and leads to very weak expression of A antigen. (200 words)
The haemoglobinopathy survey: The reality of transfusion practice in sickle cell disease and thalassaemia in England
Authors: Trompeter Sara , Estcourt Lise , Mora Ana , Wong Esther , Collett David , Bolton‐Maggs Paula , Poles Debbi , Deary Alison , Watt Alison
Published: October 2020

Objectives

To establish, in an unselected population of London haemoglobinopathy patients, transfusion requirements, blood antigens/alloantibodies, transfusion modalities, burden of transfusion reactions and donor exposure.

Background

Haemoglobinopathy patients are among the most highly transfused patient populations, and the overall population and number of patients on long‐term transfusion programmes are increasing. To provide a safe and efficacious transfusion service for patients, it is important to understand current practice, morbidity associated with transfusion, efficacy of different transfusion modalities and geno‐/phenotype requirements.

Methods

Data on 4451 transfusion episodes in 760 patients from 12 London hospitals were collected retrospectively over a 6‐month period in 2011.

Results

Alloimmunisation prevalence was 17% for sickle cell disease (SCD) and 22% for thalassaemia, most commonly anti‐Rh/Kell/Kpa/Cw. Rh phenotypes differed between SCD (Ror 59.8%/R1r 15.9%/R2r 15.6%) and thalassaemia (R1R1 29.6%/R1r 28.4%/R1R2 15.4%). Recording of pheno‐/genotypes fell below recommendations. A 2‐weekly manual exchange and 3‐weekly automated exchange came closest to achieving presumptive targets. In adults with thalassaemia, the mean blood requirement was 36 units per year; for SCD, erythrocytapheresis was carried out every 7 weeks with 66 units; for manual exchange, it was 38 units every 4 weeks; and for simple transfusion, it was 30 units p.a. every 4 weeks.

Conclusion

Transfusion modality choice was influenced by the resources available—children mostly received simple transfusions, and adults received erythrocytapheresis; the relationships between frequency of exchanges/transfusion modality/target HbA% were not simple, possibly reflecting the difference in recipient erythropoiesis and consequent transfusion modality selection bias; adherence to existing and current guidelines regarding geno‐/phenotyping was limited; and alloimmunisation had a low incidence and high prevalence in both disorders.
The current state of the platelet supply in the US and proposed options to decrease the risk of critical shortages
Authors: Stubbs James R. , Homer Mary J. , Silverman Toby , Cap Andrew P.
Published: October 2020

Due to circumstances such as increased demand and an aging donor pool, the likelihood of critical platelet shortages is increasing. The platelet supply could be improved through the expansion of the donor pool, the identification and sustained utilization of high‐quality donors, and changes in component processing and storage that result in a longer platelet shelf‐life. Refrigerated platelets, stored at 1° to 6°C, have the potential to improve patient safety by decreasing the risk of bacterial contamination while concurrently allowing for a longer storage period (eg, 14 days) and improved hemostatic effectiveness in actively bleeding patients. An approach utilizing remuneration of apheresis platelet donors combined with pathogen reduction of the platelet components could be used as a means to increase the donor pool and identify and sustain safe, reliable, high‐quality donors. Remuneration might provide an incentive for underutilized populations (eg, individuals <30 years old) to enter the apheresis platelet donor population resulting in a significant expansion of the platelet donor pool. Over time, approaches such as the use of refrigerated platelets, platelet donor remuneration, and the application of pathogen reduction technology, might serve to attract a large, reliable, and safe donor base that provides platelet collections with high yields, longer shelf‐lives and, excellent hemostatic function.
Beamforming and matched field processing in multipath environments using stable components of wave fields
Authors: Virovlyansky A. L.
Published: October 2020

The paper describes the beamforming procedures in an acoustic waveguide based on representing the field on the antenna as a superposition of several stable components formed by narrow beams of rays [A. L. Virovlyansky, J. Acoust. Soc. Am. 141, 1180–1189 (2017)]. A modification of the matched field processing method is proposed, based on the transition from comparing the measured and calculated fields on the antenna to comparing their stable components. The modified approach becomes less sensitive to the inevitable inaccuracies of the environmental model. In the case of a pulsed source, the stable components carry signals whose arrival times can be taken as input parameters in solving the inverse problems. The use of the stable components as the initial fields on the aperture of the emitting antenna makes it possible to excite narrow continuous wave beams propagating along given ray paths.
Origin and mitigation of wind noise on balloon-borne infrasound microbarometers
Authors: Krishnamoorthy Siddharth , Bowman Daniel C. , Komjathy Attila , Pauken Michael T. , Cutts James A.
Published: October 2020

High-altitude monitoring of low-frequency acoustic waves (infrasound) on Earth has regained prominence in recent years, primarily driven by improvements in light-weight sensor technology and advances in scientific ballooning techniques. Balloon-borne infrasound monitoring is also being proposed as a remote sensing technique for planetary exploration. Contrary to ground-based infrasound monitoring, the infrasound noise background in the stratosphere as measured by a balloon remains uncharacterized and the efficacy of wind noise mitigation filters has not been investigated. In this study, an analysis of pressure data collected using infrasound microbarometers during the flight of a long-duration zero pressure balloon is presented. A dramatic reduction of background noise in the stratosphere is demonstrated and it is shown that wind noise mitigation filters are not effective at reducing wind noise under these conditions. Results from this study demonstrate stratospheric balloons as a low-noise platform for infrasound monitoring and motivate the development of improved noise mitigation tools.
The Missing Link? Middle School Students’ Procedural Knowledge on Fitness
Authors: Zhang Tan , Deng Anqi , Chen Ang
Published: October 2020

Purpose: Guided by the declarative−procedural knowledge framework, the study attempts to identify middle school students’ declarative (knowing what) and procedural (knowing how) fitness knowledge and the relationship between the two. Methods: A sample of students (n = 291, age 11–14 years) from 24 middle schools took a grade-relevant standardized knowledge test on declarative fitness knowledge and received a semistructured interview designed to clarify their declarative and procedural knowledge. Results: Most students were lacking in procedural knowledge to conduct fitness-enhancing physical activities. A few students who had mastered declarative fitness knowledge demonstrated a high level of procedural knowledge consistent with personal fitness goals. Discussion: The findings suggest that incapability to engage in fitness-enhancing physical activities could be a result of lacking procedural fitness knowledge. Future school-based interventions may prioritize procedural knowledge learning for actual physical activity participation.
Running (for) the Military: An Ethnography of Sport Militarism at the Canada Army Run
Authors: Desjardins Bridgette M.
Published: October 2020

In September 2019, 19,000 amateur runners participated in the Canada Army Run, a road race hosted by the Canadian Forces (CF). This ethnographic study explores the event as a site of socialization, demonstrating that the Army Run: (a) focuses on promoting the CF rather than maximizing race results, (b) promotes the CF by exceptionalizing its members, and (c) is a celebratory site of promilitary socialization and recruitment that precludes critical engagement with the CF. These findings indicate that military promotional strategies have evolved since the immediate post 9/11 era; whereas previous initiatives used sport to tie local military agendas into larger neoliberal military imperatives, the 2019 Army Run demonstrates a new tactic, depoliticizing the CF and reifying an idealized, decontextualized Canadian military.
Ciprofloxacin Pharmacokinetics/Pharmacodynamics against Susceptible and Low-Level Resistant Escherichia coli Isolates in an Experimental Ascending Urinary Tract Infection Model in Mice
Authors: Jakobsen Lotte , Lundberg Carina Vingsbro , Frimodt-Møller Niels
Published: October 2020

The mouse ascending urinary tract infection model was used to study the pharmacokinetic/pharmacodynamic (PKPD) relationships of the effect of ciprofloxacin in subcutaneous treatment for 3 days with varying doses and dosing intervals against a susceptible
Escherichia coli
strain (MIC, 0.032 mg/liter). Further, a humanized dose of ciprofloxacin was administered for 3 days against three
E. coli
strains with low-level resistance, i.e., MICs of 0.06, 0.25, and 1 mg/liter, respectively.
The Role of Phosphorus Limitation in Shaping Soil Bacterial Communities and Their Metabolic Capabilities
Authors: Oliverio Angela M. , Bissett Andrew , McGuire Krista , Saltonstall Kristin , Turner Benjamin L. , Fierer Noah
Published: October 2020

Phosphorus (P) is an essential nutrient that is often in limited supply, with P availability constraining biomass production in many terrestrial ecosystems. Despite decades of work on plant responses to P deficiency and the importance of soil microbes to terrestrial ecosystem processes, how soil microbes respond to, and cope with, P deficiencies remains poorly understood. We studied 583 soils from two independent sample sets that each span broad natural gradients in extractable soil P and collectively represent diverse biomes, including tropical forests, temperate grasslands, and arid shrublands.
Deciphering the Microbial Taxonomy and Functionality of Two Diverse Mangrove Ecosystems and Their Potential Abilities To Produce Bioactive Compounds
Authors: Liao Shuilin , Wang Yayu , Liu Huan , Fan Guangyi , Sahu Sunil Kumar , Jin Tao , Chen Jianwei , Zhang Pengfan , Gram Lone , Strube Mikael Lenz , Shi Qiong , Lee Simon Ming Yuen , Liu Xin
Published: October 2020

This study comprehensively described the taxonomy and functionality of mangrove microbiomes, including their capacity for secondary metabolite biosynthesis and their ability to resist antibiotics. The microbial taxonomic and functional characteristics differed between geographical locations, corresponding to the environmental condition of two diverse mangrove regions. A large number of microbial biosynthetic gene clusters encoding novel bioactivities were found, and this can serve as a valuable resource to guide novel bioactive compound discovery for potential clinical uses.
Glycated albumin and hemoglobin A1c levels and cause-specific mortality by patients’ conditions among hemodialysis patients with diabetes: a 3-year nationwide cohort study
Authors: Hoshino Junichi , Abe Masanori , Hamano Takayuki , Hasegawa Takeshi , Wada Atsushi , Ubara Yoshifumi , Takaichi Kenmei , Nakai Shigeru , Masakane Ikuto , Nitta Kosaku
Published: October 2020

Introduction

Differences in mortality and cause-specific mortality rates according to glycated albumin (GA) and hemoglobin A1c (HbA1c) levels among dialysis patients with diabetes based on hypoglycemic agent use and malnutrition status remain unclear. Here, we examine these associations using a nationwide cohort.

Research design and methods

We examined 40 417 dialysis patients with diabetes who met our inclusion criteria (female, 30.8%; mean age, 67.3±11.2 years; mean dialysis duration, 5.4±4.6 years). The Global Leadership Initiative on Malnutrition criteria were used to assess malnutrition. Adjusted HRs and 95% confidence limits were calculated for 3-year mortality after adjustment for 18 potential confounders. HRs and subdistribution HRs were used to explore cause-specific mortality.

Results

We found a linear association between 3-year mortality and GA levels only in patients with GA ≥18% and not in patients with low GA levels, with a U-shaped association between HbA1c levels and the lowest morality at an HbA1c 6.0%–6.3%. This association differed based on patient conditions and hypoglycemic agent use. If patients using hypoglycemic agents were malnourished, mortality was increased with GA ≥24% and HbA1c ≥8%. In addition, patients with GA ≥22% and HbA1c ≥7.6% had significantly higher infectious or cardiovascular mortality rates. On the other hand, an inverse association was found between GA or HbA1c levels and cancer mortality. Patients with GA ≤15.8% had a higher risk of cancer mortality, especially those not using hypoglycemic agents (HR 1.63 (1.00–2.66)).

Conclusions

Target GA and HbA1c levels in dialysis patients may differ according to hypoglycemic agent use, nutritional status, and the presence of cancer. The levels may be higher in malnourished patients than in other patients, and a very low GA level in dialysis patients not taking hypoglycemic agents may be associated with a risk of cancer.

Trial registration number

UMIN000018641.
Study protocol: a multicentre, prospective, phase II trial of isotoxic hypofractionated concurrent chemoradiotherapy for non-small cell lung cancer
Authors: Liu Yue-E , Xue Xiao-Ying , Zhang Rui , Chen Xue-Ji , Ding Yu-Xia , Liu Chao-Xing , Qin Yue-Liang , Li Wei-Qian , Ren Xiao-Cang , Lin Qiang
Published: October 2020

Introduction

Concurrent chemoradiotherapy with conventional fractionation has been acknowledged as one of the standard treatments for locally advanced non-small cell lung cancer (NSCLC). The radiotherapy dose of 60 Gy is far from enough for local tumour control. Due to this fact, hypofractionated radiotherapy can shorten the total treatment duration, partially counteract the accelerated repopulation of tumour cells and deliver a higher biological effective dose, it has been increasingly used for NSCLC. In theory, concurrent hypofractionated chemoradiotherapy can result in an enhanced curative effect. To date, the vast majority of radiotherapy prescriptions assign a uniform radiotherapy dose to all patients. However this kind of uniform radiotherapy prescription may lead to two consequences: excess damage to normal tissues for large tumours and insufficient dose for small tumours. Our study aims to evaluate whether delivering individualised radiotherapy dose is feasible using intensity-modulated radiotherapy.

Methods and analysis

Our study of individualised radiotherapy is a multicenter phase II trial. From April 2019, a total of 30 patients from three Chinese centres, with a proven histological or cytological diagnosis of inoperable NSCLC, will be recruited. The dose of radiation will be increased until one or more of the organs at risk tolerance or the maximum dose of 69 Gy is reached. The primary end point is feasibility, with response rates, progression-free survival and overall survival as secondary end points. The concurrent chemotherapy regimen will be docetaxel plus lobaplatin.

Ethics and dissemination

The study has been approved by medical ethics committees from three research centres. The trial is conducted in accordance with the Declaration of Helsinki.

The trial results will be disseminated through academic conference presentations and peer-reviewed publications.

Trial registration number

NCT03606239
Evaluating the association between unmet healthcare needs and subsequent clinical outcomes: protocol for the Addressing Post-Intensive Care Syndrome-01 (APICS-01) multicentre cohort study
Authors: Akhlaghi Narjes , Needham Dale M , Bose Somnath , Banner-Goodspeed Valerie M , Beesley Sarah J , Dinglas Victor D , Groat Danielle , Greene Tom , Hopkins Ramona O , Jackson James , Mir-Kasimov Mustafa , Sevin Carla M , Wilson Emily , Brown Samuel M
Published: October 2020

Introduction

As short-term mortality declines for critically ill patients, a growing number of survivors face long-term physical, cognitive and/or mental health impairments. After hospital discharge, many critical illness survivors require an in-depth plan to address their healthcare needs. Early after hospital discharge, numerous survivors experience inadequate care or a mismatch between their healthcare needs and what is provided. Many patients are readmitted to the hospital, have substantial healthcare resource use and experience long-lasting morbidity. The objective of this study is to investigate the gap in healthcare needs occurring immediately after hospital discharge and its association with hospital readmissions or death for survivors of acute respiratory failure (ARF).

Methods and analysis

In this multicentre prospective cohort study, we will enrol 200 survivors of ARF in the intensive care unit (ICU) who are discharged directly home from their acute care hospital stay. Unmet healthcare needs, the primary exposure of interest, will be evaluated as soon as possible within 1 to 4 weeks after hospital discharge, via a standardised telephone assessment. The primary outcome, death or hospital readmission, will be measured at 3 months after discharge. Secondary outcomes (eg, quality of life, cognitive impairment, depression, anxiety and post-traumatic stress disorder) will be measured as part of 3-month and 6-month telephone-based follow-up assessments. Descriptive statistics will be reported for the exposure and outcome variables along with a propensity score analysis, using inverse probability weighting for the primary exposure, to evaluate the relationship between the primary exposure and outcome.

Ethics and dissemination

The study received ethics approval from Vanderbilt University Medical Center Institutional Review Board (IRB) and the University of Utah IRB (for the Veterans Affairs site). These results will inform both clinical practice and future interventional trials in the field. We plan to disseminate the results in peer-reviewed journals, and via national and international conferences.

Trial registration details

ClinicalTrials.gov (NCT03738774). Registered before enrollment of the first patient.
Effects of infrapatellar fat pad preservation versus resection on clinical outcomes after total knee arthroplasty in patients with knee osteoarthritis (IPAKA): study protocol for a multicentre, randomised, controlled clinical trial
Authors: Zhu Zhaohua , Han Weiyu , Lu Ming , Lin Jianhao , Yin Zongsheng , Shang Xifu , Weng Xisheng , Zha Zhengang , Tian Jin , Lei Guanghua , Hunter David J , Ding Changhai
Published: October 2020

Introduction

The infrapatellar fat pad (IPFP) is commonly resected during total knee arthroplasty (TKA) for better exposure. However, our previous studies have suggested that IPFP size was protective against, while IPFP signal intensity alteration was detrimental on knee symptoms and structural abnormalities. We hypothesise that an IPFP with normal qualities, rather than abnormal qualities, should be preserved during TKA. The aim of this study is to compare, over a 1-year period, the postoperative clinical outcomes of IPFP preservation versus resection after TKA in patients with normal or abnormal IPFP signal intensity alteration on MRI.

Methods and analysis

Three hundred and sixty people with end-stage knee osteoarthritis and on the waiting list for TKA will be recruited and identified as normal IPFP quality (signal intensity alteration score ≤1) or abnormal IPFP quality (signal intensity alteration score ≥2). Patients in each hospital will then be randomly allocated to IPFP resection group or preservation group. The primary outcomes are the summed score of self-reported Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS subscales assessing function in daily activities and function in sport and recreation. Secondary endpoints will be included: KOOS subscales (pain, symptoms and quality of life), Knee Society Score, 100 mm Visual Analogue Scale (VAS) Pain, timed up-and-go test, patellar tendon shortening, 100 mm VAS self-reported efficacy of reduced pain and increased quality of life, and Insall-Salvati index assessed on plain X-ray. Adverse events will be recorded. Intention-to-treat analyses will be used.

Ethics and dissemination

The study is approved by the local Medical Ethics Committee (Zhujiang Hospital Ethics Committee, reference number 2017-GJGBK-001) and will be conducted according to the principle of the Declaration of Helsinki (64th, 2013) and the Good Clinical Practice standard, and in compliance with the Medical Research Involving Human Subjects Act . Data will be published in peer-reviewed journals and presented at conferences, both nationally and internationally.

Trial registration number

This trial was registered at Clinicaltrial.gov website on 19 October 2018 with identify numberNCT03763448.
Could Virtual Reality play a role in the rehabilitation after COVID-19 infection?
Authors: Smits Merlijn , Staal J Bart , van Goor Harry
Published: October 2020

Post-COVID-19 patients, particularly those who needed high care, are expected to have high needs for physical, psychological and cognitive rehabilitation. Yet, the resources needed to provide rehabilitation treatment are expected to be inadequate because healthcare systems faced a shortage of high-quality treatment of these symptoms already before the COVID-19 crisis emerged in patients with comparable needs. In this viewpoint, we discuss the potential of Virtual Reality (VR) administering fast, tailor-made rehabilitation at a distance, and offering a solution for the impending surge of demand for rehabilitation after COVID-19. VR consists of a head-mounted display (HMD) that can bring the user by computer-generated visuals into an immersive, realistic multi-sensory environment. Several studies on VR show its potential for rehabilitation and suggest VR to be beneficial in post-COVID-19. The immersion of VR may increase therapy adherence and may distract the patient from experienced fatigue and anxiety. Barriers still have to be overcome to easily implement VR in healthcare. We argue that embedding VR in virtual care platforms would assist in overcoming these barriers and would stimulate the spread of VR therapy, both for post-COVID-19 patients in the present and possibly for other patients with similar rehabilitation needs in the future.
Faecal microbiota transplantation halts progression of human new-onset type 1 diabetes in a randomised controlled trial
Authors: de Groot Pieter , Nikolic Tanja , Pellegrini Silvia , Sordi Valeria , Imangaliyev Sultan , Rampanelli Elena , Hanssen Nordin , Attaye Ilias , Bakker Guido , Duinkerken Gaby , Joosten Antoinette , Prodan Andrei , Levin Evgeni , Levels Han , Potter van Loon Bartjan , van Bon Arianne , Brouwer Catherina , van Dam Sytze , Simsek Suat , van Raalte Daniel , Stam Frank , Gerdes Victor , Hoogma Roel , Diekman Martin , Gerding Martin , Rustemeijer Cees , de Bakker Bernadette , Hoekstra Joost , Zwinderman Aeilko , Bergman Jacques , Holleman Frits , Piemonti Lorenzo , De Vos Willem , Roep Bart , Nieuwdorp Max
Published: October 2020

Objective

Type 1 diabetes (T1D) is characterised by islet autoimmunity and beta cell destruction. A gut microbiota–immunological interplay is involved in the pathophysiology of T1D. We studied microbiota-mediated effects on disease progression in patients with type 1 diabetes using faecal microbiota transplantation (FMT).

Design

Patients with recent-onset (<6 weeks) T1D (18–30 years of age) were randomised into two groups to receive three autologous or allogenic (healthy donor) FMTs over a period of 4 months. Our primary endpoint was preservation of stimulated C peptide release assessed by mixed-meal tests during 12 months. Secondary outcome parameters were changes in glycaemic control, fasting plasma metabolites, T cell autoimmunity, small intestinal gene expression profile and intestinal microbiota composition.

Results

Stimulated C peptide levels were significantly preserved in the autologous FMT group (n=10 subjects) compared with healthy donor FMT group (n=10 subjects) at 12 months. Small intestinalPrevotellawas inversely related to residual beta cell function (r=−0.55, p=0.02), whereas plasma metabolites 1-arachidonoyl-GPC and 1-myristoyl-2-arachidonoyl-GPC levels linearly correlated with residual beta cell preservation (rho=0.56, p=0.01 and rho=0.46, p=0.042, respectively). Finally, baseline CD4 +CXCR3+T cell counts, levels of small intestinalDesulfovibrio pigerand CCL22 and CCL5 gene expression in duodenal biopsies predicted preserved beta cell function following FMT irrespective of donor characteristics.

Conclusion

FMT halts decline in endogenous insulin production in recently diagnosed patients with T1D in 12 months after disease onset. Several microbiota-derived plasma metabolites and bacterial strains were linked to preserved residual beta cell function. This study provides insight into the role of the intestinal gut microbiome in T1D.

Trial registration number

NTR3697.
Phenotypes in adult patients with Rett syndrome: results of a 13-year experience and insights into healthcare transition
Authors: Peron Angela , Canevini Maria Paola , Ghelma Filippo , Arancio Rosangela , Savini Miriam Nella , Vignoli Aglaia
Published: October 2020

Background

Rett syndrome is a complex genetic disorder with age-specific manifestations and over half of the patients surviving into middle age. However, little information about the phenotype of adult individuals with Rett syndrome is available, and mainly relies on questionnaires completed by caregivers. Here, we assess the clinical manifestations and management of adult patients with Rett syndrome and present our experience in transitioning from the paediatric to the adult clinic.

Methods

We analysed the medical records and molecular data of women aged ≥18 years with a diagnosis of classic Rett syndrome and/or pathogenic variants in MECP2, CDKL5 and FOXG1, who were in charge of our clinic.

Results

Of the 50 women with classic Rett syndrome, 94% had epilepsy (26% drug-resistant), 20% showed extrapyramidal signs, 40% sleep problems and 36% behavioural disorders. Eighty-six % patients exhibited gastrointestinal problems; 70% had scoliosis and 90% low bone density. Breathing irregularities were diagnosed in 60%. None of the patients had cardiac issues. CDKL5 patients experienced fewer breathing abnormalities than women with classic Rett syndrome.

Conclusion

The delineation of an adult phenotype in Rett syndrome demonstrates the importance of a transitional programme and the need of a dedicated multidisciplinary team to optimise the clinical management of these patients.
Autologous haematopoietic stem cell transplantation compared with alemtuzumab for relapsing–remitting multiple sclerosis: an observational study
Authors: Zhukovsky Christina , Sandgren Sofia , Silfverberg Thomas , Einarsdottir Sigrun , Tolf Andreas , Landtblom Anne-Marie , Novakova Lenka , Axelsson Markus , Malmestrom Clas , Cherif Honar , Carlson Kristina , Lycke Jan , Burman Joachim
Published: October 2020

Objective

To compare outcomes after treatment with autologous haematopoietic stem cell transplantation (AHSCT) and alemtuzumab (ALZ) in patients with relapsing–remitting multiple sclerosis.

Methods

Patients treated with AHSCT (n=69) received a conditioning regimen of cyclophosphamide (200 mg/kg) and rabbit anti-thymocyte globulinerG (6.0 mg/kg). Patients treated with ALZ (n=75) received a dose of 60 mg over 5 days, a repeated dose of 36 mg over 3 days after 1 year and then as needed. Follow-up visits with assessment of the expanded disability status scale score, adverse events and MR investigations were made at least yearly.

Results

The Kaplan-Meier estimates of the primary outcome measure ‘no evidence of disease activity’ was 88% for AHSCT and 37% for ALZ at 3 years, p<0.0001. The secondary endpoint of annualised relapse rate was 0.04 for AHSCT and 0.1 for ALZ, p=0.03. At last follow-up, the proportions of patients who improved, were stable or worsened were 57%/41%/1% (AHSCT) and 45%/43%/12% (ALZ), p=0.06 Adverse events grade three or higher were present in 48/69 patients treated with AHSCT and 0/75 treated with ALZ in the first 100 days after treatment initiation. The most common long-term adverse event was thyroid disease with Kaplan-Meier estimates at 3 years of 21% for AHSCT and 46% for ALZ, p=0.005.

Conclusions

In this observational cohort study, treatment with AHSCT was associated with a higher likelihood of maintaining ‘no evidence of disease activity’. Adverse events were more frequent with AHSCT in the first 100 days, but thereafter more common in patients treated with ALZ.
Early VEGF testing in inflammatory neuropathy avoids POEMS syndrome misdiagnosis and associated costs
Authors: Marsh Eleanor S , Keddie Stephen , Terris-Prestholt Fern , D'Sa Shirley , Lunn Michael P
Published: October 2020

Background

Prompt diagnosis and early treatment prevents disability in Polyneuropathy Organomegaly Endocrinopathy Monoclonal-protein and Skin Changes (POEMS) syndrome. Delay in diagnosis is common with 55% of patients initially incorrectly diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP). Patients are often treated with intravenous immunoglobulin which is both expensive and ineffective in the treatment of POEMS. Testing patients with acquired demyelinating neuropathy with serum vascular endothelial growth factor (VEGF) more accurately identifies POEMS syndrome than the current standard of care. Incorporating VEGF testing into screening could prevent misdiagnosis and reduce costs.

Methods

We used observed treatment information for patients in the University College London Hospital’s POEMS syndrome database (n=100) and from the National Immunoglobulin Database to estimate costs associated with incorrect CIDP diagnoses across our cohort. We conducted a model-based cost-effectiveness analysis to compare the current diagnostic algorithm with an alternative which includes VEGF testing for all patients with an acquired demyelinating neuropathy.

Results

Treatment associated with an incorrect CIDP diagnosis led to total wasted healthcare expenditures of between £808 550 and £1 111 756 across our cohort, with an average cost-per-POEMS-patient misdiagnosed of £14 701 to £20 214. Introducing mandatory VEGF testing for patients with acquired demyelinating neuropathy would lead to annual cost-savings of £107 398 for the National Health Service and could prevent misdiagnosis in 16 cases per annum.

Conclusions

Misdiagnosis in POEMS syndrome results in diagnostic delay, disease progression and significant healthcare costs. Introducing mandatory VEGF testing for patients with acquired demyelinating neuropathy is a cost-effective strategy allowing for early POEMS diagnosis and potentially enabling prompt disease-directed therapy.
Early rooting and flooding tolerance in cuttings from a Populus deltoides full-sib family under greenhouse conditions
Authors: Rodríguez María E. , Mozo Irina , Cortizo Silvia , Cappa Eduardo P. , Luquez Virginia M.C.
Published: October 2020

Eastern cottonwood (Populus deltoides Bartr. ex Marsh.) is an important forest tree, with elite genotypes propagated mainly as unrooted dormant cuttings. Several areas where P. deltoides is planted periodically experience flooding episodes. The aims of this work were to analyze the early rooting capability and flooding tolerance of a P. deltoides full-sib family, and to identify growth, wood, and leaf traits that correlate with flooding tolerance. We analyzed the early rooting capability of the parental genotypes and 30 clones from the F1 generation under greenhouse conditions. The rooting percentage of the cuttings ranged from 50% to 100%. There was a positive genetic correlation between shoot weight and root traits (number, biomass, and total length). In a separate experiment, 2-month-old plants growing in pots from the same genotypes were subjected to two treatments: watering (control) and flooding for 35 days. Most genotypes showed an intermediate flooding tolerance with respect to the parental clones. Height, diameter, growth rate, biomass, plant leaf area, leaf number, and leaf increase rate had a positive phenotypic correlation with flooding tolerance, while wood density did not. Height and diameter are traits recommended for selection because they correlate with flooding tolerance, are easy to measure, and have moderate to high narrow sense heritability.
Symmetry reduction of tensor networks in many-body theory
Authors: Tichai A. , Wirth R. , Ripoche J. , Duguet T.
Published: October 2020

The ongoing progress in (nuclear) many-body theory is accompanied by an ever-rising increase in complexity of the underlying formalisms used to solve the stationary Schrödinger equation. The associated working equations at play in state-of-the-art ab initio nuclear many-body methods can be analytically reduced with respect to angular-momentum, i.e. SU(2), quantum numbers whenever they are effectively employed in a symmetry-restricted context. The corresponding procedure constitutes a tedious and error-prone but yet an integral part of the implementation of those many-body frameworks. Indeed, this symmetry reduction is a key step to advance modern simulations to higher accuracy since the use of symmetry-adapted tensors can decrease the computational complexity by orders of magnitude. While attempts have been made in the past to automate the (anti-) commutation rules linked to Fermionic and Bosonic algebras at play in the derivation of the working equations, there is no systematic account to achieve the same goal for their symmetry reduction. In this work, the first version of an automated tool performing graph-theory-based angular-momentum reduction is presented. Taking the symmetry-unrestricted expressions of a generic tensor network as an input, the code provides their angular-momentum-reduced form in an error-safe way in a matter of seconds. Several state-of-the-art many-body methods serve as examples to demonstrate the generality of the approach and to highlight the potential impact on the many-body community.
Decomposition of halogenated nucleobases by surface plasmon resonance excitation of gold nanoparticles
Authors: Marques Telma S. , Śmiałek Małgorzata A. , Schürmann Robin , Bald Ilko , Raposo Maria , Eden Sam , Mason Nigel J.
Published: October 2020

Halogenated uracil derivatives are of great interest in modern cancer therapy, either as chemotherapeutics or radiosensitisers depending on their halogen atom. This work applies UV-Vis spectroscopy to study the radiation damage of uracil, 5-bromouracil and 5-fluorouracil dissolved in water in the presence of gold nanoparticles upon irradiation with an Nd:YAG ns-pulsed laser operating at 532 nm at different fluences. Gold nanoparticles absorb light efficiently by their surface plasmon resonance and can significantly damage DNA in their vicinity by an increase of temperature and the generation of reactive secondary species, notably radical fragments and low energy electrons. A recent study using the same experimental approach characterized the efficient laser-induced decomposition of the pyrimidine ring structure of 5-bromouracil mediated by the surface plasmon resonance of gold nanoparticles. The present results show that the presence of irradiated gold nanoparticles decomposes the ring structure of uracil and its halogenated derivatives with similar efficiency. In addition to the fragmentation of the pyrimidine ring, for 5-bromouracil the cleavage of the carbon-halogen bond could be observed, whereas for 5-fluorouracil this reaction channel was inhibited. Locally-released halogen atoms can react with molecular groups within DNA, hence this result indicates a specific mechanism by which doping with 5-bromouracil can enhance DNA damage in the proximity of laser irradiated gold nanoparticles.

Graphical abstract
Measuring the Volatility of Market Risk of Vietnam Banking Industry After the Low Inflation Period 2015–2017
Authors: Thach Nguyen Ngoc , Van Bao Nguyen , Huy Dinh Tran Ngoc , Thanh Bui Dan , Nga Le Thi Viet , Ha Truong Thu , Binh Nguyen The
Published: October 2020

The Vietnam economy has gained lots of achievements after the financial crisis 2007–2011, until it reached a low inflation rate of 0.6% in 2015. This paper measures the volatility of market risk in Vietnam banking industry after this period (2015–2017). The main reason is the vital role of the bank system in Vietnam in the economic development and growth in recent years always goes with risk potential and risk control policies.

This research paper aims to figure out the increase or decrease in the market risk of Vietnam banking firms during the post-low inflation period 2015–2017.

First, by using the quantitative combined with comparative data analysis method, we find out the risk level measured by equity beta mean in the banking industry is acceptable, although it is little higher than ([Formula: see text]) 1.

Then one of its major findings is the comparison between risk level of banking industry during the financial crisis 2007–2009 compared to those in the post-low inflation time 2015–2017. In fact, the research findings show us market risk level during the post-low inflation time has increased much. We compare beta in two periods because we want to figure out the reason underlying the fact beta has increased. One of the reasons is that the accumulated banking risks during the longer time and criteria to meet Basel 2 have been partially contributing to increasing market risk.

Finally, this paper provides some ideas that could provide companies and government more evidence in establishing their policies in governance. This is the complex task but the research results show us warning that the market risk might be higher during the post-low inflation period 2015–2017. Our conclusion part will recommend some policies and plans to deal with it.
Two-tree graphs with maximum general sum-connectivity index
Authors: Khoeilar R. , Shooshtari H.
Published: October 2020

For a simple graph [Formula: see text], the general sum-connectivity index is defined as [Formula: see text], where [Formula: see text] is the degree of the vertex [Formula: see text] and [Formula: see text] is a real number. In this paper, we will obtain sharp upper bounds on the general sum-connectivity index for [Formula: see text]. Moreover, the two trees with the maximum and the second maximum the general sum-connectivity index, respectively, are determined.
Performance evaluation of natural esters and dielectric correlation assessment using artificial neural network (ANN)
Authors: Raj Raymon Antony , Samikannu Ravi , Yahya Abid , Mosalaosi Modisa
Published: October 2020

The performance of correlation between the dielectric parameters of Baobab Oil (BAO) and Mongongo Oil (MGO) is evaluated using Artificial Neural Network (ANN). The BAO and MGO naturally own high Unsaturated Fatty Acids (UFAs) and are highly biodegradable. The temperature studies and dielectric studies are carried out and found that the Natural Esters (NEs) show a reliable performance over mineral oil-based Transformer Oil (TO). Further the endurance test, Partial Discharge Inception Voltage (PDIV) repetition rate and drop after 30 days, dielectric measurements are done as per the standards of IEC (International Electrotechnical Commission) and ASTM (American Society for Testing and Materials). The NEs show stable performance under PDIV and show minimum repetition rate when compared to the TO. The C[Formula: see text]H[Formula: see text] or Kerosene (KER) and NEs mixture prove that the NE-based transformer fluids show lesser tendency to hydro peroxidation. The C[Formula: see text]H[Formula: see text] acts as a thinning agent and reduces the ageing rate of the NEs, and this leads to slower rate of water saturation. This in turn increases the thermal conductivity of the oil and nearly a 30-days thermal ageing of the oil samples at 90[Formula: see text]C shows better strength of liquid insulation. The performance of association between the dielectric properties like breakdown voltage and water content, dissipation factor and thermal conductivity prove that the NEs show consistent performance and is a better substitute for the mineral oil-based TO.
The Nonesuch Formation Lagerstätte: a rare window into freshwater life one billion years ago
Authors: Strother Paul K. , Wellman Charles H.
Published: October 2020

The Nonesuch Formation in the clastic sedimentary Oronto Group on the Keweenaw Peninsula of the Upper Peninsula, Michigan, USA most likely represents an ancient lake that formed between 1083 and 1070 Ma. Exceptional preservation, seen in palynological preparations, provides a snapshot of cell morphology, biological complexity and ecology at an early stage in the evolution of the eukaryotes. A wide range of unicellular organization is documented in both vegetative and encysted cell morphologies, but the extent to which multicellularity is developed seems very limited at this time. Overall, the Nonesuch microbiota, when viewed as a Lagerstätte, opens up a window onto the early evolution of unicellular eukaryotes, presenting an essential baseline of both eukaryotic diversity and cell structure well in advance of eukaryotic diversification documented in marine deposits from the later Neoproterozoic.

Supplementary material:
Materials and methods with a detailed specimen list are available at:
https://doi.org/10.6084/m9.figshare.c.5183652
COSMOS educational toolkit
Authors: Skrimponis Panagiotis , Makris Nikos , Rajguru Sheila Borges , Cheng Karen , Ostrometzky Jonatan , Ford Emily , Kostic Zoran , Zussman Gil , Korakis Thanasis
Published: October 2020

This paper focuses on the K-12 educational activities of COSMOS-Cloud enhanced Open Software defined MObile wireless testbed for city-Scale deployment. The COSMOS wireless reasearch testbed is being deployed in West Harlem (New York City) as part of the NSF Platforms for Advanced Wireless Research (PAWR) program. COSMOS' approach for K-12 education is twofold: (i) create an innovative and concrete set of methods/tools that allow teaching STEM subjects using live experiments related to wireless networks/IoT/cloud, and (ii) enhance the professional development (PD) of K-12 teachers and collaborate with them to create hands-on educational material for the students. The COSMOS team has already conducted successful pilot summer programs for middle and high school STEM teachers, where the team worked with the teachers and jointly developed innovative real-world experiments that were organized as automated and repeatable math, science, and computer science labs to be used in the classroom. The labs run on the COSMOS Educational Toolkit, a hardware and software system that offers a large variety of pre-orchestrated K-12 educational labs. The software executes and manages the experiments in the same operational philosophy as the COSMOS testbed. Specifically, since it is designed for use by non-technical middle and high school teachers/students, it adds easy-to-use enhancements to the experiments' execution and the results visualization. The labs are also supported by Next Generation Science Standards (NGSS)-compliant teacher/student material. This paper describes the teachers' PD program, the NGSS lessons created and the hardware and software system developed to support the initiative. Additionally, it provides an evaluation of the PD approach as well as the expected impact to K-12 STEM education. Current limitations and future work are also included as part of the discussion section.
REACT
Authors: Xiong Li , Shahabi Cyrus , Da Yanan , Ahuja Ritesh , Hertzberg Vicki , Waller Lance , Jiang Xiaoqian , Franklin Amy
Published: October 2020

Contact tracing is an essential public health tool for controlling epidemic disease outbreaks such as the COVID-19 pandemic. Digital contact tracing using real-time locations or proximity of individuals can be used to significantly speed up and scale up contact tracing. In this article, we present our project, REACT, for REAal-time Contact Tracing and risk monitoring via privacy-enhanced tracking of users' locations and symptoms. With privacy enhancement that allows users to control and refine the precision with which their information will be collected and used, REACT will enable: 1) contact tracing of individuals who are exposed to infected cases and identification of hot-spot locations, 2) individual risk monitoring based on the locations they visit and their contact with others; and 3) community risk monitoring and detection of early signals of community spread. We will briefly describe our ongoing work and the approaches we are taking as well as some challenges we encountered in deploying the app.