bluuebunny/crossref_metadata_2025 huggingface dataset:
What are the links between evidence-based medicine and shared decision-making in training programs for junior doctors? A scoping review protocol
Authors: Simons Mary , Rapport Frances , Zurynski Yvonne , Cullis Jeremy , Davidson Andrew
Published: May 2020

Introduction

Patient-centred care is pivotal to clinical practice and medical education. The practice of evidence-based medicine (EBM) and shared decision-making (SDM) are complementary aspects of patient-centred care, but they are frequently taught and reported as independent entities. To effectively perform all steps of EBM, clinicians need to include patients in SDM conversations, however, the uptake of this has been slow and inconsistent. A solution may be the incorporation of SDM into EBM training programmes, but such programmes do not routinely include SDM skills development. This scoping review will survey the literature on the kinds of EBM and SDM educational programmes that exist for recently qualified doctors, programmes that incorporate the teaching of both EBM and SDM skills, as well as identifying research gaps in the literature.

Methods and analysis

Literature searches will be conducted in the databases Medline, Embase, Scopus and Cochrane Library. Bibliographies of key articles and their citing references will also be hand-searched and assessed for inclusion. Selected grey literature will be included. Papers must be written in English, or provide English abstracts, and date from 1996 to the present day.

Two independent reviewers will screen titles and abstracts, check full texts of selected papers for eligibility and extract the data. Any disagreement will be resolved, and consensus reached, if necessary, with the assistance of a third reviewer. Qualitative and quantitative studies that address educational interventions for either EBM, SDM or both will be included. Data extraction tables will present bibliographic information, populations, interventions, context and outcomes. Data will be summarised using tables and figures and a description of findings.

Ethics and dissemination

This review will synthesise information from publicly available publications and does not require ethics approval. The results will be disseminated via conference presentations and publications in medical journals.
Cytoreductive surgery (CRS) with hyperthermic intraoperative peritoneal chemotherapy (HIPEC) versus standard of care (SoC) in people with peritoneal metastases from colorectal, ovarian or gastric origin: protocol for a systematic review and individual participant data (IPD) meta-analyses of effectiveness and cost-effectiveness
Authors: Gurusamy Kurinchi , Vale Claire L , Pizzo Elena , Bhanot R , Davidson Brian R , Mould Tim , Mughal Muntzer , Saunders Mark , Aziz Omer , O'Dwyer Sarah
Published: May 2020

Introduction

There is uncertainty about whether cytoreductive surgery (CRS)+hyperthermic intraoperative peritoneal chemotherapy (HIPEC) improves survival and/or quality of life compared with standard of care (SoC) in people with peritoneal metastases who can withstand major surgery.

Primary objectives

To compare the relative benefits and harms of CRS+HIPEC versus SoC in people with peritoneal metastases from colorectal, ovarian or gastric cancers eligible to undergo CRS+HIPEC by a systematic review and individual participant data (IPD) meta-analysis.

Secondary objectives

To compare the cost-effectiveness of CRS+HIPEC versus SoC from a National Health Service (NHS) and personal social services perspective using a model-based cost–utility analysis.

Methods and analysis

We will perform a systematic review of literature by updating the searches from MEDLINE, Embase, Cochrane library, Science Citation Index as well as trial registers. Two members of our team will independently screen the search results and identify randomised controlled trials comparing CRS+HIPEC versus SoC for inclusion based on full texts for articles shortlisted during screening. We will assess the risk of bias in the trials and obtain data related to baseline prognostic characteristics, details of intervention and control, and outcome data related to overall survival, disease progression, health-related quality of life, treatment related complications and resource utilisation data. Using IPD, we will perform a two-step IPD, that is, calculate the adjusted effect estimate from each included study and then perform a random-effects model meta-analysis. We will perform various subgroup analyses, meta-regression and sensitivity analyses. We will also perform a model-based cost–utility analysis to assess whether CRS+HIPEC is cost-effective in the NHS setting.

Ethics and dissemination

This project was approved by the UCL Research Ethics Committee (Ethics number: 16023/001). We aim to present the findings at appropriate international meetings and publish the review, irrespective of the findings, in a peer-reviewed journal.

PROSPERO registration number

CRD42019130504.
Use of the King-Devick Variable Color Contrast Sensitivity Chart to differentiate stages of age-related macular degeneration
Authors: Ittiara Shaun , Hariprasad Anya S , Messner Leonard V , Tresley David J , Leong Danielle , Schechet Sidney A
Published: May 2020

Objective

This study aimed to determine which colour contrast sensitivity differences exist in early to advanced age-related macular degeneration (AMD) and examine the potential utility of the King-Devick Variable Color Contrast Sensitivity Chart in detecting AMD severity.

Methods and analysis

A total of 85 participants (144 total eyes) were recruited from multiple clinical practices and enrolled in the study. The control group consisted of 57 healthy eyes. The non-exudative AMD (NE-AMD) group consisted of 45 eyes. The exudative AMD (E-AMD) group consisted of 42 eyes. In a single study visit, monocular best-corrected visual acuity (BCVA) at 40 cm with 100% black contrast was determined for each eye. Using the BCVA line, the number of letters correctly identified (out of 10) was recorded for various colour presentations (red, green, blue and yellow) and at decreasing contrast levels (100%, 75%, 50% and 25%).

Results

Our results show worse visual performance under various colour contrast settings in E-AMD patients compared with healthy controls and NE-AMD. Colour contrast performance using blue and yellow differentiated more advanced stages of disease in E-AMD from earlier NE-AMD disease. Blue and black colour contrast performance more accurately identified the E-AMD group from healthy controls and the NE-AMD group.

Conclusion

The findings of this study demonstrate that colour contrast, particularly with black, blue and yellow, is impaired in E-AMD suggesting the potential for colour contrast measures to serve as an adjunctive clinical tool in identifying subtle altered visual function as well as the potential for detecting disease severity.
Real-world evaluation of an intravenous iron service for the treatment of iron deficiency in patients with gastroenterological disorders
Authors: Kearns Jackie , Jacob Sudheer George
Published: May 2020

Background

In gastroenterological disorders, iron deficiency (ID) is often treated with intravenous iron. This real-world study assessed the effectiveness and safety of iron isomaltoside (IIM), a high-dose intravenous iron, for the treatment of ID in patients with gastroenterological disorders, as part of a service evaluation and improvement process.

Methods

Medical records of 117 patients with gastroenterological disorders, who received IIM, were examined retrospectively. Study outcomes included dose of IIM (estimated iron need versus actual dose received), number of appointments required to deliver the dose and changes in haemoglobin (Hb) and ferritin at ~1 month and ~6 months post-treatment. Safety was assessed through adverse drug reactions (ADRs).

Results

Overall, 76.1% of patients received their estimated iron need; 23.9% were underdosed. The mean (SD) iron dose was 1317 (409.7) mg; 62.4% of patients received their dose in one appointment. From baseline, mean (SD) Hb increased by 20.9 (15.4) g/L at 1 month post-treatment (p<0.0001) and by 22.0 (17.9) g/L at 6 months post-treatment (p<0.0001). Mean (SD) baseline ferritin was 26.6 (37.8) μg/L, which increased to 234.6 (142.9) μg/L at 1 month post-treatment (p<0.0001), and remained increased at 6 months post-treatment (122.8 (99.2) μg/L; p<0.0001). A substantial proportion of patients were non-anaemic at 1 month (57.5%) and 6 months (61.8%) post-treatment. At both post-treatment timepoints, the proportion of non-anaemic patients was higher in those receiving their total iron need versus those who were underdosed. No serious ADRs were reported.

Conclusion

IIM was efficacious and well tolerated in patients with gastroenterological disorders. This real-world study highlights the importance of administering the full iron need to maximise treatment response.
Maternal cardiovascular risk after hypertensive disorder of pregnancy
Authors: Arnott Clare , Nelson Michael , Alfaro Ramirez Maria , Hyett Jon , Gale Marianne , Henry Amanda , Celermajer David S , Taylor Lee , Woodward Mark
Published: May 2020

Background and objective

Hypertensive disorders of pregnancy (HDPs) affect 5%–10% of pregnancies and have been associated with excess maternal cardiovascular disease (CVD) risk. The primary aim of this study was to reliably estimate absolute and relative risks of CVD after HDP.

Methods

A retrospective cohort of women who had singleton pregnancies in New South Wales, Australia, between 2002 and 2016 and identified using linked population health administrative databases. The primary exposure was new-onset HDP (pre-eclampsia/eclampsia and gestational hypertension), and the endpoint was hospitalisation or death due to ischaemic or hypertensive heart disease, or stroke. Kaplan-Meier analysis estimated risks among mothers following their first birth, and multivariable time-dependent Cox regression estimated the association between HDP and CVD.

Results

Among 528 106 women, 10.3% experienced HDP in their first pregnancy. The 10-year estimated risk of CVD was 2.1 per 1000 if no HDP and 5.5 per 1000 following HDP. Adjusting for demographics, gestational diabetes, small for gestational age and preterm birth, we found that there was an interaction between smoking and HDP, and a larger effect of early-onset (<34 weeks) HDP, compared with late-onset HDP. The HR for women with early-onset HDP who did not smoke was 4.90 (95% CI 3.00 to 7.80) and the HR for those who did smoke was 23.5 (95% CI 13.5 to 40.5), each compared with women without HDP who did not smoke.

Conclusion

In this nationally representative Australian cohort, HDP, especially early onset, conferred a clear increase in the risk of CVD, with amplification by smoking. Targeted preventive health, during and after pregnancy, could prevent a substantial burden of CVD among childbearing women.
Sharing leadership: current attitudes, barriers and needs of clinical and non-clinical managers in UK’s integrated care system
Authors: Aufegger Lisa , Alabi Monica , Darzi Ara , Bicknell Colin
Published: May 2020

Background

As systems become more complex, shared leadership (SL) has been suggested to have a dominant role in improving cross-functional working tailored to organisational needs. Little, however, is known about the benefits of SL in healthcare management, especially for UK’s recently formed integrated care system (ICS). The aim of this study was to understand current attitudes, barriers and needs of clinical and non-clinical managers sharing leadership responsibilities in the ICS.

Method

Twenty clinical and non-clinical leaders in 15 organisations were interviewed to understand current cross-functional leadership collaborations, and the potential SL may have on the recently established ICS in the National Health Service (NHS). The data were transcribed and analysed thematically.

Results

Findings showed perceptions and experiences of clinical and non-clinical healthcare management in relation to: (1) motivation to execute a leadership position, including the need to step up and a sense of duty; (2) attitudes towards interdisciplinary working, which is reflected in conflicts due to different values and expertise; (3) SL skills and behaviours, including the need for mutual understanding and cooperative attitudes by means of effective communication and collaboration; and (4) barriers to achieve SL in the ICS, such as bureaucracy, and a lack of time and support.

Conclusions

SL may help improve current leadership cultures within the NHS; however, for SL to have a tangible impact, it needs to be delivered as part of leadership development for doctors in postgraduate training, and development programmes for aspiring, emerging and established leaders, with clear lines of communication.
CSF lactate
Authors: Baheerathan Aravindhan , Pitceathly Robert DS , Curtis Carmel , Davies Nicholas WS
Published: May 2020

Lactate is produced from anaerobic glycolysis, which occurs in most tissues in the human body. Blood lactate is tested in most physiologically unwell patients in the Emergency Department and helps to guide treatment and prognosis. Cerebrospinal fluid (CSF) lactate, however, is not often measured. Various central nervous system (CNS) conditions lead to a rise in CSF lactate, including acute neurological infection, stroke, seizures and mitochondrial pathologies. This article discusses the utility and limitations of CSF lactate, highlighting specific clinical situations where it can help in the diagnosis of CNS infections and unexplained encephalopathy.
Mechanical, electrical, linear, and nonlinear optical behavior of gamma-irradiated thiourea-doped lithium sulfate single crystals
Authors: Dileep M.S. , H.M. Suresh Kumar , Tilak Sindhu
Published: May 2020

A thiourea-doped lithium sulfate single crystal was grown by the solution growth slow evaporation technique. The unit cell parameters of the grown crystal determined by X-ray diffraction (XRD) studies indicated that the crystal belongs to a monoclinic crystal system with noncentrosymmetric space group P2. Ultraviolet–visible spectral study signified that the crystal possesses an energy gap of 4.54 eV with 68% transparency in the visible region. The grown crystals were irradiated by Co-60 gamma radiation with different doses of 10 kGy, 30 kGy, and 50 kGy and the effects on powder XRD, dielectric properties, mechanical hardness, linear transmittance, and second harmonic generation (SHG) of the crystal were studied. It is observed that the crystallite size, energy gap, and transparency decreased, whereas the dielectric constant, AC conductivity, microhardness, and SHG efficiency increased with an increase in radiation dose.
All two-loop scalar self-energies and tadpoles in general renormalisable field theories
Authors: Goodsell Mark D. , Paßehr Sebastian
Published: May 2020

We calculate the complete tadpoles and self-energies at the two-loop order for scalars in general renormalisable theories, a crucial component for calculating two-loop electroweak corrections to Higgs-boson masses or for any scalar beyond the Standard Model. We renormalise the amplitudes using mass-independent renormalisation schemes, based on both dimensional regularisation and dimensional reduction. The results are presented here in Feynman gauge, with expressions for all 121 self-energy and 25 tadpole diagrams given in terms of scalar and tensor integrals with the complete set of rules to reduce them to a minimal basis of scalar integrals for any physical kinematic configuration. In addition, we simplify the results to a set of only 16 tadpole and 58 self-energy topologies using relations in order to substitute the ghost and Goldstone-boson couplings that we derive. To facilitate their application, we also provide our results in electronic form as a new code . We test our results by applying them to the Standard Model and compare with analytic expressions in the literature.
Public debate in the media matters: evidence from the European refugee crisis
Authors: Koch Caleb M. , Moise Izabela , Helbing Dirk , Donnay Karsten
Published: May 2020

In this paper, we take a novel approach to study the empirical relationship between public debate in the media and asylum acceptance rates in Europe from 2002–2016. In theory, an asylum seeker should experience the same likelihood of being granted refugee status from each of the 20 European countries we study. Yet, in practice, acceptance rates vary widely for nearly every asylum country of origin. We address this inconsistency with a data-driven approach by analyzing refugee-related news articles and data on asylum decisions across 20 Europe countries for more than 100 asylum seekers’ countries of origin. We find that: (i) public debate sentiment in the media is strongly associated with European countries’ diverging asylum practices, much more so than social, cultural or economic factors, and (ii) by combining different measures of public debate we can make out-of-sample predictions within 3% of true acceptance rates (on average). We conclude by discussing the practical implications of our findings for European asylum practices.
INCORPORATION OF MULTI-WALLED CARBON NANOTUBES INTO OXIDE LAYER FORMED ON AL ALLOY BY PLASMA ELECTROLYTIC OXIDATION
Authors: HYUN KOANGYONG , LEE JUNG-HYUNG , KIM SEONG-JONG
Published: May 2020

Plasma electrolytic oxidation (PEO) is an electrochemical-based surface modification technique that produces oxide layers on valve metals. The PEO process is performed in an electrolyte solution, which offers the possibility of particles’ incorporation into the growing oxide layer. In this study, we employed a PEO technique on a commercial Al alloy in an aqueous suspension of carbon nanotubes (CNTs) to fabricate CNT-incorporated oxide layer. The voltage–time response was recorded during the process. The surface of the resulting oxide layer was characterized by means of a scanning electron microscope (SEM), an energy-dispersive X-ray spectrometer (EDS), and X-ray diffraction (XRD). It was found from the SEM observation that the CNTs were successfully incorporated into the oxide layer. The PEO with the addition of CNTs led to a delay in time to breakdown (50[Formula: see text][Formula: see text][Formula: see text]s) and a decrease in breakdown voltage (442[Formula: see text][Formula: see text][Formula: see text]V) in the voltage–time curve. The microstructural feature was clearly distinguishable between the oxide layers produced with and without CNTs: a pancake-like structure for PEO without CNTs, and a doughnut-like structure for PEO with CNTs. However, neither the results of the structure analysis nor the elemental analysis provides a clear indication of carbon, even though the presence of CNTs in the oxide layer is evident, suggesting that further optimization of CNT concentration is required.
Understanding variations in reservoir porosity in the Eagle Ford Shale using scanning electron microscopy: implications for basin modelling
Authors: Osborne Mark , Volk Herbert
Published: May 2020

Reliable evaluation of shale-play potential requires robust geological models that can simulate the generation and retention of petroleum, porosity and permeability in source rocks from first principles, and that can be implemented in basin modelling software. To be predictive, such basin models need to be calibrated against observations from real shale plays. A key control on the amount of retained petroleum is the porosity in the shale and the abundance of organic matter. Scanning electron microscopy of argon-ion milled shale samples can potentially reveal systematic variations in the amount of porosity, pore types and distributions across a range of thermal maturities. These observed variations in porosity can be used to calibrate basin modelling outputs and refine predictive models. For these reasons BP has conducted scanning electron microscopy studies of shale plays including the Eagle Ford Shale, a carbonate-rich mudstone sequence of Cenomanian to Turonian age. The results clearly show that the mean pore size decreases as thermal maturity increases and that organic matter-hosted pores are absent in low thermal maturity samples (where vitrinite random reflectance
R
o
<0.7) and become increasingly more abundant as thermal maturity increases). In moderately mature samples there are organic matter hosted pores that range in pore size from 5 to 500 nm. In highly mature samples, small (<50 nm) organic matter-hosted pores predominate. Our studies reveal that porosity evolution in this organic-rich, fine-grained, carbonate mudrock shows a strong correlation with increasing thermal maturity.
Highly Efficient Low-Pt-Based Electrocatalysts with Pt Single-Atom Active Sites for Oxygen Reduction Reaction
Authors: Liu Jing , Roh JeongHan , Song DongHoon , Bak Junu , Kim Hyo-Jong , Cho Eun Ae
Published: May 2020

Platinum (Pt) has been preferred as the most viable catalytic material to accelerate the sluggish oxygen reduction reaction (ORR) in proton exchange membrane fuel cells (PEMFCs)1,2. However, the scarcity of Pt on earth makes it expensive, resulting in a concomitantly high cost for the commercial implementation of fuel cells. In this respect, significant efforts have been made worldwide to reduce Pt loading while retaining and even improving their high catalytic performance of Pt-based ORR electrocatalysts3,4. One of the effective approaches to improve the utilization efficiency of Pt atoms is to reduce the size of Pt nanoparticles to clusters or even to single atoms. Smaller Pt particles have higher fraction of low-coordinated surface Pt atoms which can be directly involved in the ORR process5-7. Herein, based on nitrogen-doped active carbon (Black Pearls 2000, denoted as NBP), a carbon-supported highly dispersed Pt nanocatalyst (Pt1@Pt/NBP) with low Pt content of 4.96 wt.% was prepared simply using a mild hydrothermal method. Results of electrochemical measurement and physical characterization reveal that, a large number of atomically dispersed Pt sites (Fig.1a) can remarkably enhance the ORR activity of Pt1@Pt/NBP electrocatalysts with a higher half-wave potential (E1/2
= 0.827 V) than that of Pt/BP (Fig.1b, E1/2
= 0.791 V) , commercial Pt/C (Fig.1c, E1/2
= 0.811 V) and the previously reported Pt1-N /BP catalysts6. This novel low-Pt electrocatalysts can be one of the promising alternatives to traditional Pt-based catalysts for the application in PEMFCs with its exceedingly improved Pt utilization and superhigh performance.

Acknowledgements

Work was funded by the national research foundation of Korea Grant, Korean government (MSIT) (NRF-2019M3D1A1079297)

References

(1)Steele, B. C. H.; Heinzel, A. Nature 2001, 414, 345.

(2)Wang, Y.-J.; Zhao, N.; Fang, B.; Li, H.; Bi, X. T.; Wang, H. Chemical Reviews 2015, 115, 3433.

(3)Stamenkovic, V. R.; Fowler, B.; Mun, B. S.; Wang, G.; Ross, P. N.; Lucas, C. A.; Markovic, N. M. Science 2007, 315, 493.

(4)Huang, X.; Zhao, Z.; Cao, L.; Chen, Y.; Zhu, E.; Lin, Z.; Li, M.; Yan, A.; Zettl, A.; Wang, Y. M.; Duan, X.; Mueller, T.; Huang, Y. Science 2015, 348, 1230.

(5)Cheng, H.; Cao, Z.; Chen, Z.; Zhao, M.; Xie, M.; Lyu, Z.; Zhu, Z.; Chi, M.; Xia, Y. Nano Letters 2019, 19, 4997.

(6)Liu, J.; Jiao, M.; Lu, L.; Barkholtz, H. M.; Li, Y.; Wang, Y.; Jiang, L.; Wu, Z.; Liu, D.-j.; Zhuang, L.; Ma, C.; Zeng, J.; Zhang, B.; Su, D.; Song, P.; Xing, W.; Xu, W.; Wang, Y.; Jiang, Z.; Sun, G. nature commonications 2017, 8, 15938.

(7)Zhang, H.; An, P.; Zhou, W.; Guan, B. Y.; Zhang, P.; Dong, J.; Lou, X. W. Science Advances 2018, 4, eaao6657.

Figure 1
High quality gallium nitride films grown on epitaxial AlN/sapphire templates
Authors: Wu Jin
Published: May 2020

High-quality GaN films were grown on AlN/c-sapphire templates by MOVPE with Hall mobility of 802 cm2/V.s and carrier concentration of 8.1x1016/cm3 at 300K have achieved. The film low dislocation density of 5x107 cm-2 and X-ray rocking curve FWHM of 101 and 250 arcsec for the (0004) and (20-24) reflections were also obtained, respectively.
Combined effects of moderate exercise and short-term fasting on markers of immune function in healthy human subjects
Authors: Mooren Frank C. , Krueger Karsten , Ringseis Robert , Eder Klaus , Liebisch Gerhard , Conrad Kerstin , Alack Katharina , Hajizadeh Maleki Behzad
Published: May 2020

This study aimed to investigate the effects of a short-term (36 h) fasting period combined with an acute bout of exercise on markers of immune function and inflammation in healthy human subjects. Fourteen moderately trained male subjects (aged 19–39 yr) participated in a 36-h fasting trial (FA-T), followed by an acute bout of moderate exercise (60% V̇o2max). After 1 wk, the same subjects, as their own control, participated in a nonfasting trial (NFA-T) in which they performed an exercise trial of the same duration and intensity. Blood samples were taken before, immediately after, and 1 h after each exercise bout and analyzed for several immunological and metabolic markers. At baseline, fasting subjects showed lower levels of T cell apoptosis, lymphocyte-proliferative responses, IL-6, monocyte chemoattractant protein-1 (MCP-1), insulin, and leptin ( P < 0.05) as well as higher levels of neutrophil oxidative burst and thiobarbituric acid reactive substances (TBARS) than those in the NFA-T ( P < 0.05). After the exercise protocol, fasted subjects revealed higher T cell apoptosis, neutrophil oxidative burst, TBARS, TNFα, and MCP-1 levels as well as lower levels of lymphocyte-proliferative response, IL-6, insulin, and leptin than those in the NFA-T ( P < 0.05). Short-term fasting aggravates perturbations in markers of immune function, and inflammation was induced by an acute moderate-intensity exercise protocol.
Extracellular pH modulation of excitatory synaptic transmission in hippocampal CA3 neurons
Authors: Jang Il-Sung , Nakamura Michiko , Kubota Hisahiko , Noda Mami , Akaike Norio
Published: May 2020

The effects of external pH changes on spontaneous, miniature, and evoked excitatory synaptic transmission in CA3 hippocampal synapses were examined using the isolated nerve bouton preparation, which allowed for the accurate regulation of extracellular pH at the synapses. Acidification generally reduced transmission, partly via effects on presynaptic Ca2+ channel currents, while alkalization generally enhanced transmission. Both pre- and postsynaptic sites contributed to these effects.
Cosine tuning determines plantarflexors' activities during human upright standing and is affected by incomplete spinal cord injury
Authors: Fok Kai Lon , Lee Jae W , Unger Janelle , Chan Katherine , Nozaki Daichi , Musselman Kristin E , Masani Kei
Published: May 2020

Plantarflexors such as the soleus (SOL) and medial gastrocnemius (MG) play key roles in controlling bipedal stance; however, how the central nervous system controls the activation levels of these plantarflexors is not well understood. Here we investigated how the central nervous system controls the plantarflexors' activation level during quiet standing in a cosine tuning manner where the maximal activation is achieved in a preferred direction (PD). Further, we investigated how spinal cord injury affects these plantarflexors' activations. Thirteen healthy adults (AB) and thirteen individuals with chronic, incomplete spinal cord injury (iSCI) performed quiet standing trials. Their body kinematics, kinetics as well as electromyography signals from the MG and SOL were recorded. In the AB-group, we found that the plantarflexors followed the cosine tuning manner during quiet standing. That is, MG was most active when the ratio of plantarflexion torque to knee extension torque was approximately 2:-3, while SOL was most active when the ratio was approximately 2:1. This suggests that the SOL muscle despite being a monoarticular muscle is sensitive to both ankle plantarflexion and knee extension during quiet standing. The difference in the PDs accounts for the phasic activity of MG and for the tonic activity of SOL. Unlike the AB-group, the MG's activity was similar to the SOL's activity in the iSCI-group, and the SOL PDs were similar to the ones in the AB-group. This result suggests that chronic iSCI affects the control strategy, i.e., cosine tuning, for MG, which may affect standing balance in individuals with iSCI.
Effect of Origanum vulgare Essential Oil Supplementation on the Advanced Parameters of Mobility and on the Integrity of Human Sperm DNA
Authors: Mbaye Modou M. , El Khalfi Bouchra , Ouzamode Saida , Saadani Brahim , Louanjli Noureddine , Soukri Abdelaziz
Published: May 2020

The reduced sperm mobility is one of the most important causes of male infertility. Several reports have indicated that the treatment of subnormal sperm samples with certain agents prior to artificial insemination significantly improves the fertilizing potential of sperm. We have among others some stimulants such as pentoxifylline, relaxin, prostaglandin E, and diltiazem. In our precedent work, we had tested the effect of supplementation with three essential oils, namely, sage (Salvia officinalis), oregano (Origanum vulgare), and eucalyptus (Eucalyptus globulus), on sperm cell mobility and vitality. Oregano oil had shown interesting biological properties by giving the best values of progressive mobility and vitality. In this study, we aim to verify the effect of oregano oil supplementation on the advanced parameters of mobility and on the integrity of the sperm DNA of 25 male infertile volunteers. Our results showed that oregano oil over an incubation period of 5 to 10 min of exposure significantly improves the advanced parameters of mobility, namely, curvilinear velocity (VCL), linear velocity (VSL), the mean velocity of the path (VAP), and the amplitude of the displacement (ALH). The effect of the increase in the VCL decreased the linearity (LIN), the mean line (STR), and the mean wobble (WOB). Oregano oil at 5 min had no significant effect on the DNA fragmentation index (DFI) and sperm decondensation index (SDI). However, at 10 min, it had a significant effect on both DFI and SDI. The analysis of our results showed that this plant oil rich in terpenoids and phenolic antioxidants could be a quite good in vitro additive with high potential for the world of medically assisted reproduction.
The Influence of Ce or Mn Doping on Cu-Based Catalysts for De-NOx with NH3-SCR
Authors: Jiang Lei , Cai Yixi , Jin Miaomiao , Zhu Zengzan , Wang Yinhuan
Published: May 2020

In this study, the de-NOx performance of Cu-based zeolite catalysts supported on topological structure (SSZ-13, BEA, ZSM-5) and loaded with different doses of copper (from 2 to 6 wt.%) was investigated. The preparation of copper-based catalysts adopted the incipient wetness impregnation method. To analyze the physicochemical properties of the catalysts, advanced techniques like BET, XRD, NH3-TPD, H2-TPR, and DRS UV-Vis were used. The performance tests suggested the 4Cu/SSZ-13 catalyst exhibited higher low-temperature activity and wider temperature window. Furthermore, compared with Mn-Cu/SSZ-13, the Ce-Cu/SSZ-13 catalysts exhibited better de-NOx performance.
Diagnostic Value of miR-103 in Patients with Sepsis and Noninfectious SIRS and Its Regulatory Role in LPS-Induced Inflammatory Response by Targeting TLR4
Authors: Yang Min , Zhao Li , Sun Mingyan
Published: May 2020

Background. Sepsis is a life-threatening condition and a systemic inflammatory response syndrome (SIRS) driven by infection. This study aimed at investigating the expression of microRNA-103 (miR-103) in sepsis patients, evaluating its diagnostic value, and exploring the regulatory effect of miR-103 on LPS-induced inflammation in monocytes. Methods. Expression of miR-103 was measured using quantitative real-time PCR. A receiver operating characteristics curve was plotted to evaluate the diagnostic vale of miR-103. Serum and cell supernatant levels of proinflammatory cytokines were analyzed using ELISA. The interaction between miR-103 and Toll-like receptors 4 (TLR4) was analyzed using luciferase reporter assay. The effect of miR-103 on inflammation was examined in LPS-treated monocytes. Results. Serum expression of miR-103 was decreased in noninfectious SIRS and sepsis patients compared with healthy controls, and the lowest expression value was observed in sepsis patients (all P<0.05). Serum levels of miR-103 have considerable diagnostic accuracy in distinguishing sepsis patients from SIRS patients and healthy controls. A negative correlation was found between miR-103 and inflammatory responses in sepsis patients. TLR4 was demonstrated to be a direct target of miR-103 and was negatively regulated by miR-103 in monocytes. The promoted inflammatory responses by LPS in monocytes were reversed by the overexpression of miR-103. Conclusion. All the data revealed that serum decreased miR-103 in sepsis patients serves as a promising noninvasive diagnostic biomarker and may be involved in the pathogenesis of sepsis by regulating inflammatory responses via targeting TLR4.
Analytical Consideration of Growth in Population via Homological Invariant in Algebraic Topology
Authors: Brew Lewis , Obeng-Denteh William , Asante-Mensa Fred
Published: May 2020

This paper presents an abstract approach of analysing population growth in the field of algebraic topology using the tools of homology theory. For a topological space X and any point vn∈X, where vn is the n-dimensional surface, the group η=X,vn is called population of the space X. The increasing sequence from vin∈X to vjn∈X for i<j provides the bases for the population growth. A growth in population η=X,vn occurs if vin<vjn for all vin∈X and vjn∈X. This is described by the homological invariant Hηk=1. The aim of this paper is to construct the homological invariant Hηk and use Hηk=1 to analyse the growth of the population. This approach is based on topological properties such as connectivity and continuity. The paper made extensive use of homological invariant in presenting important information about the population growth. The most significant feature of this method is its simplicity in analysing population growth using only algebraic category and transformations.
Regulation on Calcium Oxalate Crystallization and Protection on HK-2 Cells of Tea Polysaccharides with Different Molecular Weights
Authors: Liu Hong , Sun Xin-Yuan , Wang Feng-Xin , Ouyang Jian-Ming
Published: May 2020

The regulation on calcium oxalate (CaOx) crystallization and protective effect on human proximal tubular epithelial cells (HK-2) of four green tea polysaccharides (TPSs) with molecular weights of 10.88 (TPS0), 8.16 (TPS1), 4.82 (TPS2), and 2.3 kDa (TPS3) were comparatively studied. XRD, Fourier transform infrared spectroscopy, and scanning electron microscopy results revealed that TPS1, TPS2, and TPS3 can increase the percentage of the dihydrate crystalline phase in CaOx crystals and reduce the size of CaOx monohydrate crystals. TPSs increased the absolute value of the zeta potential of CaOx crystal and inhibited crystal nucleation and aggregation. The nucleation inhibition rates of TPS1, TPS2, and TPS3 to CaOx crystallization were 56.67%, 75.52%, and 52.92%, respectively, and their aggregation inhibition rates were 22.34%, 47.59%, and 21.59%, respectively. TPS preprotection can alleviate the oxidative damage of HK-2 cells caused by oxalate, increase cell viability, protect cell morphology, and reduce lactate dehydrogenase release and reactive oxygen species levels. The degraded TSPs, especially TPS2 with moderate molecular weight, may be used as a green drug to inhibit stone formation.
Transcriptional Analysis Reveals Key Genes in the Pathogenesis of Nifedipine-Induced Gingival Overgrowth
Authors: Ju Yanqin , Huang Lijuan , Wang Shuwei , Zhao Shouliang
Published: May 2020

Background. Nifedipine-induced gingival overgrowth (NGO) is a multifactorial pathogenesis with increased extracellular matrix including collagen and glycans, inflammatory cytokines, and phenotype changes of fibroblasts. However, the molecular etiology of NGO is not well understood. The objective of this study is to investigate the key genes in the pathogenesis of NGO. Methods. In this study, we examined the proliferation and migration abilities of fibroblasts derived from patients with chronic periodontitis, nifedipine nonresponder gingival overgrowth, gingival overgrowth caused by nifedipine, and healthy normal gingiva. We conducted RNA-Seq on these four groups of fibroblasts and analysed the differentially expressed genes (DEGs). Results. Fibroblasts derived from NGO patients had higher proliferation and migration abilities than those of the other groups. Protein-protein interaction network analysis indicated that TGFB2, ITGA8, ITGA11, FGF5, PLA2G4D, PLA2G2F, PTGS1, CSF1, LPAR1, CCL3, and NKX3-1 are involved in the development of NGO. These factors are related to the arachidonic acid metabolism and PI3K/AKT signaling pathways. Conclusion. Transcriptional gene expression analysis identified a number of DEGs that might be functionally related to gingival overgrowth induced by nifedipine. Our study provides important information on the molecular mechanism underlying nifedipine-induced gingival overgrowth.
The Protective Effects of Imperatorin on Acetaminophen Overdose-Induced Acute Liver Injury
Authors: Gao Zhao , Zhang Jiecheng , Wei Li , Yang Xingping , Zhang Yuan , Cheng Bo , Yang Zehong , Gao Weihang , Song Chunhui , Miao Wei , Williams Kevin , Liu Changhui , Xu Qin , Chang Yongsheng , Gao Yong
Published: May 2020

Acetaminophen (APAP) toxicity leads to severe acute liver injury (ALI) by inducing excessive oxidative stress, inflammatory response, and hepatocyte apoptosis. Imperatorin (IMP) is a furanocoumarin from Angelica dahurica, which has antioxidant and anti-inflammatory effects. However, its potential to ameliorate ALI is unknown. In this study, APAP-treated genetic knockout of Farnesoid X receptor (FXR) and Sirtuin 1 (SIRT1) mice were used for research. The results revealed that IMP could improve the severity of liver injury and inhibit the increase of proinflammatory cytokines, oxidative damage, and apoptosis induced by overdose APAP in an FXR-dependent manner. We also found that IMP enhanced the activation and translocation of FXR by increasing the expression of SIRT1 and the phosphorylation of AMPK. Besides, single administration of IMP at 4 h after APAP injection can also improve necrotic areas and serum transaminase, indicating that IMP have both preventive and therapeutic effects. Taken together, it is the first time to demonstrate that IMP exerts protective effects against APAP overdose-induced hepatotoxicity by stimulating the SIRT1-FXR pathway. These findings suggest that IMP is a potential therapeutic candidate for ALI, offering promise for the treatment of hepatotoxicity associated with APAP overdose.
Some Criteria of the Knowledge Representation Method for an Intelligent Problem Solver in STEM Education
Authors: Nguyen Hien D. , Do Nhon V. , Tran Nha P. , Pham Xuan Hau , Pham Vuong T.
Published: May 2020

Nowadays, building intelligent systems for science, technology, engineering, and math (STEM) education is necessary to support the studying of learners. Intelligent problem solver (IPS) is a system that can be able to solve or tutor how to solve the problems automatically. Learners only declare hypothesis and goal of problems based on a sufficient specification language. They can request the program to solve it automatically or to give instructions that help them to solve it themselves. Knowledge representation plays a vital role in these kinds of intelligent systems. There are various methods for knowledge representation; however, they do not meet the requirements of an IPS in STEM education. In this paper, we propose the criteria of a knowledge model for an IPS in education. These criteria orient to develop a method for knowledge representation to meet actual requirements in practice, especially pedagogical requirements. For proving the effectiveness of these criteria, a knowledge model is also constructed. This model can satisfy these criteria and be applied to build IPS for courses, such as mathematics and physics.
Impacts of Thermal Inertia Factor on Adiabatic Decomposition of 40% Mass Content DCP in Ethyl Benzene
Authors: Wu Xiaojuan , Chen Liping , Rao Guoning , Chen Wanghua , Yin Ruili
Published: May 2020

To reduce the fire and explosion accident of dicumyl peroxide (DCP) in experiment and production, the thermal hazards of DCP and 40% mass content DCP in ethyl benzene (40% DCP) have been studied by the differential scanning calorimeter (DSC) and the accelerating rate calorimeter (ARC) in this paper. DSC experiment showed that ethyl benzene has no effect on the characteristic parameters of thermal decomposition of DCP, such as the temperature of the exothermic peak (Tpeak) and the decomposition energy (Ea), and the thermal decomposition reaction of 40% DCP followed the one-step reaction principle. ARC experiment showed that with the increase of inertia factor (Φ), the measured initial decomposition temperature (Ton) would be higher and the caculated Ea and pre-exponential factor (A) would be greater. It was also proved that after modification of Φ, TD24 was relatively consistent near Ton, but different at higher temperatures. Fisher's correction method was used to verify the necessity of consistency between experimental conditions and prediction conditions.
The Genomic Landscape of Intrinsic and Acquired Resistance to Cyclin-Dependent Kinase 4/6 Inhibitors in Patients with Hormone Receptor–Positive Metastatic Breast Cancer
Authors: Wander Seth A. , Cohen Ofir , Gong Xueqian , Johnson Gabriela N. , Buendia-Buendia Jorge E. , Lloyd Maxwell R. , Kim Dewey , Luo Flora , Mao Pingping , Helvie Karla , Kowalski Kailey J. , Nayar Utthara , Waks Adrienne G. , Parsons Stephen H. , Martinez Ricardo , Litchfield Lacey M. , Ye Xiang S. , Yu Chunping , Jansen Valerie M. , Stille John R. , Smith Patricia S. , Oakley Gerard J. , Chu Quincy S. , Batist Gerald , Hughes Melissa E. , Kremer Jill D. , Garraway Levi A. , Winer Eric P. , Tolaney Sara M. , Lin Nancy U. , Buchanan Sean G. , Wagle Nikhil
Published: May 2020

Mechanisms driving resistance to cyclin-dependent kinase 4/6 inhibitors (CDK4/6i) in hormone receptor–positive (HR+) breast cancer have not been clearly defined. Whole-exome sequencing of 59 tumors with CDK4/6i exposure revealed multiple candidate resistance mechanisms including RB1 loss, activating alterations in AKT1, RAS, AURKA, CCNE2, ERBB2, and FGFR2, and loss of estrogen receptor expression. In vitro experiments confirmed that these alterations conferred CDK4/6i resistance. Cancer cells cultured to resistance with CDK4/6i also acquired RB1, KRAS, AURKA, or CCNE2 alterations, which conferred sensitivity to AURKA, ERK, or CHEK1 inhibition. Three of these activating alterations—in AKT1, RAS, and AURKA—have not, to our knowledge, been previously demonstrated as mechanisms of resistance to CDK4/6i in breast cancer preclinically or in patient samples. Together, these eight mechanisms were present in 66% of resistant tumors profiled and may define therapeutic opportunities in patients.

Significance:

We identified eight distinct mechanisms of resistance to CDK4/6i present in 66% of resistant tumors profiled. Most of these have a therapeutic strategy to overcome or prevent resistance in these tumors. Taken together, these findings have critical implications related to the potential utility of precision-based approaches to overcome resistance in many patients with HR+ metastatic breast cancer.

This article is highlighted in the In This Issue feature, p. 1079
Advanced Imaging and Direct Targeting of the Motor Thalamus and Dentato-Rubro-Thalamic Tract for Tremor: A Systematic Review
Authors: Gravbrot Nicholas , Saranathan Manojkumar , Pouratian Nader , Kasoff Willard S.
Published: May 2020

Direct targeting methods for stereotactic neurosurgery in the treatment of essential tremor have been the subject of active research over the past decade but have not yet been systematically reviewed. We present a clinically oriented topic review based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses Group guidelines. Our focus is studies using advanced magnetic resonance imaging (MRI) techniques (ultrahigh-field structural MRI, diffusion-weighted imaging, diffusion-tensor tractography, and functional MRI) for patient specific, in vivo identification of the ventral intermediate nucleus and the dentato-rubro-thalamic tract.
Chronic Pain Does Not Impact Baseline Circulating Cytokine Levels in Adults with Sickle Cell Disease
Authors: Karafin Matthew S. , Simpson Pippa , Field Joshua J.
Published: May 2020

Chronic pain affects 50% of adults with sickle cell disease (SCD). Although inflammation is thought to contribute to the pathogenesis of chronic pain, no studies have examined the differences in circulating cytokines between patients with SCD with and without chronic pain. We performed an observational cohort study using blood and urine samples from adults with SCD with and without chronic pain at their usual state of health. We tested the hypothesis that, compared to those without chronic pain, those with chronic pain would have significantly higher baseline circulating proinflammatory cytokines. A total of 61 adults with SCD, 40 with chronic pain and 21 without chronic pain were tested. When SCD patients with chronic pain were compared to those without chronic pain, no significant differences in cytokine levels were noted. The variables most associated with the diagnosis of chronic pain in this population were opioid dose and subject age.
Massive Hepatomegaly Secondary to Amyloidosis with Normal Liver Chemistries
Authors: Doe-Williams Sarah , Hixson Lee J. , Pfeiffer David C.
Published: May 2020

Amyloid light chain (AL) amyloidosis is a disease of misfolded, fibrous proteins, either kappa or lambda subtype, that can be deposited into one or more organs, caused by a proliferation of plasma cells. The liver is uncommonly the main organ system affected and rarely the only organ affected by amyloid deposition. With hepatic involvement, the most common presenting findings are hepatomegaly and elevation of serum alkaline phosphatase. We report a case of a 50-year-old male who presented to our gastroenterology clinic with marked hepatomegaly secondary to hepatic amyloidosis, in concert with bone marrow involvement and nephrotic syndrome. Biopsies in conjunction with Congo red staining demonstrated 95% replacement of hepatic structure and 80% replacement of bone marrow with amyloid deposition. Despite these findings, liver chemistries, renal function, and blood count were normal. Our case presents not only the rare finding of primary hepatic amyloidosis but also an atypical presentation of this disorder. Although rare, AL amyloidosis should be in a differential diagnosis of any patient who presents with unexplained hepatomegaly, nephrotic-range proteinuria, heart failure with preserved ejection fraction, fatigue, weight loss or a history of monoclonal gammopathy of undetermined significance.