bluuebunny/crossref_metadata_2025 huggingface dataset:
Atomic Absorption Spectrometry Methods to Access the Metal Solubility of Aerosols in Artificial Lung Fluid
Authors: Polezer Gabriela , Godoi Ricardo H. M. , Potgieter-Vermaak Sanja , de Souza Rodrigo A. F. , Andreoli Rita V. , Yamamoto Carlos I. , Oliveira Andrea
Published: February 2020

Recent studies to quantify the health risks that fine particulate matter with an aerodynamic less than 2.5 µm (PM2.5) pose use in vitro approaches. One of these approaches is to incubate PM2.5 in artificial lysosomal fluid for a given period at body temperature. These body fluids used have a high ionic strength and as such can be challenging samples to analyze with atomic spectroscopy techniques. As PM2.5 is a primary health hazard because it is tiny enough to penetrate deep into the lungs and could, in addition, dissolve in the lung fluid it is important to quantify elements of toxic and/or carcinogenic concerns, reliably and accurately. Sophisticated instrumentation and expensive pre-treatment of challenging samples are not always available, especially in developing countries. To evaluate the applicability of graphite furnace atomic absorption spectrometry (GFAAS) without Zeeman correction capability to detect trace quantities of heavy metals leached from PM2.5 on to artificial lung fluid, univariate and multivariate approaches have been used for optimization purposes. The limits of quantification, LOQ, obtained by the optimized method were: 2 µg L−1 (Cu), 3 µg L−1 (Cr), 1 µg L−1 (Mn), and 10 µg L−1 (Pb). The addition/recovery experiments had a mean accuracy of: (Cu) 99 ± 7%; 110 ± 8% (Cr); 95 ± 9% (Mn), and 96 ± 11% (Pb). The average soluble fractions of PM2.5 incubated in artificial lysosomal fluid (ALF) for 1 h were: 1.2 ± 0.01 ng m−3 Cu, 0.4 ± 0.01 ng m−3 Cr, 0.6 ± 0.01 ng m−3 Mn, and 4.8 ± 0.03 ng m−3 Pb. Using historical elemental averages of PM2.5 in Curitiba (Cu 3.3 ng m−3, Cr 2.1 ng m−3, Mn 6.1 ng m−3, Pb 21 ng m−3), the percentage bioaccessibility were determined to be Cu 38%, Cr 20%, Mn 10%, and Pb 23%. The elemental values of the atmospheric soluble fraction of Cu, Cr, and Mn were below the inhalation risk concentrations. However, for Pb, the atmospheric soluble fraction exceeded the inhalation unit risk of 0.012 ng m−3. This robust and straightforward GF AAS method is pivotal for low and middle-income countries were most air pollution adverse effects occur and established lower-cost technologies are likely unavailable.
Reduced allowable strength of composite laminate for unknown distribution due to limited tests
Authors: Zhang Yiming , Kim Nam H , Palliyaguru Upul R , Schutte Jaco F , Haftka Raphael T
Published: February 2020

In design under uncertainty, random distributions are often determined by expensive sampling tests. A key question is whether to invest in more samples or live with a reduced performance by fewer samples due to large uncertainty. The question is particularly difficult to answer when the type of distribution is unknown. This paper investigates the tradeoff between performance and conservativeness in estimating B-basis allowables, using experiments on composite plates with holes. Two approaches that do not require a distribution type are examined: (1) bootstrap confidence intervals and (2) Hanson-Koopmans non-parametric method. Based on the study, it is found that the Hanson-Koopmans method was more conservative than the bootstrap method because the latter penalized allowables for small-size samples. For a small number of samples (less than 29), conservative estimations are preferred over accuracy to account for the large uncertainty. Based on this observation, the bootstrap-assisted Hanson-Koopmans method is proposed to enhance the conservativeness. For the tested cases, the performance penalty using the bootstrap-assisted Hanson-Koopmans method for a small number of samples is found to be substantial.
An exploratory study of fit and size issues with mass customized men's jackets using 3D body scan and virtual try-on technology
Authors: Sohn Jae-Min , Lee Sojung , Kim Dong-Eun
Published: February 2020

The purpose of this study was to explore the potential for mass customization with fit and size issues using 3D technology in men's jacket development. The study tested a fit mass customization process that employed 3D body scanning and 3D virtual simulation technology and the results are summarized as follows. First, the fit evaluation for the final virtual jacket was improved from the first virtual jacket. Second, during the virtual jacket evaluation process, the participants made various requests to change the fit of their virtual jacket. The large-size group made more requests for alterations to their virtual jackets than the medium- and small-size groups. Third, the study underlines certain improvements needed before the technology can be used for apparel mass customization. The chest circumference, back width, and sleeve length of the real jacket each tended to be slightly tighter or shorter than that of the virtual jacket. Fourth, the study suggests that the jacket made from the mass customization process was satisfactory to potential male consumers, as the actual jacket from the mass customization scenario in this study was evaluated as being better than a ready-to-wear jacket. 3D technology is identified as an innovative tool for future tailors and the menswear industry, particularly aimed at young male consumers. The current study shows the potential for the use of this technology for menswear development.
Involvement, Engagement, and Community: Dimensions and Correlates of Parental Participation in a Majority–Minority Urban School District
Authors: Brown John C. , Graves Erin M. , Burke Mary A.
Published: February 2020

This study examines parental participation in children’s schooling. Using a survey of parents of children attending a majority Hispanic school district, we employ exploratory factor analysis and determine that standard forms of participation align along two dimensions: Involvement and Engagement. Analysis reveals a third dimension: Parental Community. The data suggest that income but not educational attainment influence Involvement, whereas family circumstances correlate best with Engagement. Households with the closest proximity to a Spanish-language/immigrant culture feel the strongest sense of Parental Community. The findings may inform the design of programming to help involve parents more fully in their children’s schooling.
How are exemplar representations transformed by encoding, retrieval, and explicit knowledge? A commentary on Ambridge (2020)
Authors: Brooks Patricia J. , Kempe Vera
Published: February 2020

The radical exemplar model resonates with work on perceptual classification and categorization highlighting the role of exemplars in memory representations. Further development of the model requires acknowledgment of both the fleeting and fragile nature of perceptual representations and the gist-based, good-enough quality of long-term memory representations. Retrieval operations potentially serve as a mechanism for abstraction as representations of exemplars are distorted through reconstructive processes. As a framework applicable to both first and second language acquisition, the model needs to account for how explicit knowledge arises and its role in filtering input via selective attention.
Anlotinib in treatment of an elderly patient with recurrent advanced SCLC
Authors: Zhang Ying , Jia Beili , Li Jing , Xu Xiaomei
Published: February 2020

Introduction:

An elderly patient with advanced small cell lung cancer who had a history of smoking and who had previously had tuberculosis and chronic kidney disease relapsed after classical treatment with etoposide combined with carboplatin.

Methods:

The patient was given chemotherapy again, with albumin-bound paclitaxel, etoposide capsules, apatinib, and other treatment. The last medication was apatinib.

Results:

After treatment with anlotinib, the patient has survived for 15 months with good quality of life.

Conclusion:

This is the first report on the precise efficacy of anlotinib in the treatment of advanced small cell lung cancer. Anlotinib is an important option for patients with small cell lung cancer.
Estimating total small solute clearance in patients treated with continuous ambulatory peritoneal dialysis without urine and dialysate collection
Authors: Fan Li , Steubl Dominik , Inker Lesley A , Tighiouart Hocine , Simon Andrew L , Foster Meredith C , Karger Amy B , Eckfeldt John H , Li Hongyan , Tang Jiamin , He Yongcheng , Xie Minyan , Xiong Fei , Li Hongbo , Zhang Hao , Hu Jing , Liao Yunhua , Ye Xudong , Shafi Tariq , Chen Wei , Yu Xueqing , Levey Andrew S
Published: February 2020

Background:

International Society for Peritoneal Dialysis guidelines recommend to routinely monitor the total measured clearance (mCl) of small solutes such as creatinine; however, collection of 24-h urine and peritoneal dialysis (PD) fluid is burdensome to patients and prone to errors. We hypothesized that equations could be developed to estimate mCl (estimated clearance (eCl)) using endogenous filtration markers.

Methods:

In the Guangzhou PD Study ( n = 980), we developed eCl equations using linear regression in two-third and validated them in the remaining one-third. Reference tests were mCl for urea nitrogen (UN) (mClUN, ml/min) and average mCl for UN and creatinine (mClUN-cr, ml/min/1.73 m2). Index tests were various eCl equations using UN, creatinine, low-molecular-weight proteins (LMWPs) (beta-trace protein (BTP), beta-2 microglobulin (B2M), and cystatin C), demographic variables, and body size. After reexpression of the equations in the combined data set, we analyzed accuracy (eCl within ± 2.0 units of mCl) and the predictive value of eCl to detect a weekly total standard Kt/V (weekly mClUN indexed for total body water) > 1.7 using receiver operating characteristic curve.

Results:

Mean age of the cohort was 50 ± 15 years, 53% were male; mClUN was 6.9 ± 1.8 and mClUN-cr was 7.5 ± 2.8. Creatinine but not UN contributed to eCl for both mCl. LMWP did not improve accuracy for mClUN (range 88–89%). BTP and B2M improved the accuracy for mClUN-cr (82% vs. 80%); however, differences were small. The area under the curve for predicting a weekly Kt/V > 1.7 was similar for all equations (range 0.79–0.80).

Conclusions:

Total small solute clearance can be estimated moderately well in continuous ambulatory PD patients using serum creatinine and demographic variables without urine and dialysate collection.
Concurrent validity of an appetite questionnaire in peritoneal dialysis
Authors: Melo Thalita L , Meireles Marion S , Kamimura Maria A , Cuppari Lilian
Published: February 2020

Background:

Decreased appetite is a symptom often found in chronic kidney disease. Poor appetite may negatively affect food intake, what in long-term may contribute to the development of protein–energy malnutrition.

Methods:

An Appetite and Food Satisfaction Questionnaire (AFSQ) was developed consisting of a question that assesses the level of appetite through a facial hedonic scale and five other questions adapted from the Buckner and Dwyer tool that assess some aspects related to food satisfaction. Each question received an arbitrary score of 0 to 3. The sum of the scores ranged from 0, the best, to 18, the worst condition. Nutritional status was assessed through seven-point SGA, bioelectrical impedance, anthropometry, and handgrip strength (HGS).

Results:

Eighty-four patients on peritoneal dialysis (PD; 58.3% women, mean age 54.7 ± 14.2 years, and body mass index (BMI) of 26.0 ± 4.8 kg/m2) were evaluated. Median AFSQ score was 4.0 (1.0–6.8; median and IQ). Patients were divided into tertiles according to the AFSQ score. Comparing the third tertile (score ≥ 6) with the first tertile (score < 2), the prevalence of malnutrition was greater (32.1% vs. 6.7%, respectively, p = 0.005), HGS adequacy was lower (74.6% vs. 87.3%, p = 0.001), and body cell mass index (5.7% vs. 7.4%, p = 0.001) and lean BMI were lower (11% vs. 13.4%, p = 0.001) in the third tertile.

Conclusion:

Poor appetite and food satisfaction determined by the questionnaire was related to worse nutritional markers, indicating AFSQ as a valid easy-to-use tool to be applied as an initial screening to identify PD patients with potential risk of malnutrition.
Person-centered peritoneal dialysis prescription and the role of shared decision-making
Authors: Blake Peter G , Brown Edwina A
Published: February 2020

Person-centered care has become a dominant paradigm in modern health care. It needs to be applied to people with end-stage kidney disease considering the initiation of dialysis and to peritoneal dialysis (PD) prescription and care delivery. It is relevant to their decisions about goals of care, transplantation, palliative care, and discontinuation of dialysis. It is also relevant to decisions about how PD is delivered, including options such as incremental PD. Shared decision-making is the essence of this process and needs to become a standard principle of care. It requires engagement, education, and empowerment of patients. Patient-reported outcomes and patient-reported experience are also central to person-centered care in PD.
Intraperitoneal cefazolin and ceftazidime during short-dwell exchange in peritoneal dialysis patients with peritonitis
Authors: Triyawatanyu Pinpongsarn , Chariyavilaskul Pajaree , Phaisal Weeraya , Peerapornratana Sadudee , Kanjanabuch Talerngsak , Praditpornsilpa Kearkiat , Katavetin Pisut
Published: February 2020

Background:

Intraperitoneal (IP) cefazolin and ceftazidime during the short-dwell (≤ 2 h) automated exchange has been shown to provide adequate dialysate and plasma concentrations for up to 24 h in peritoneal dialysis (PD) patients without peritonitis. This study aimed to evaluate plasma and dialysate concentration of this novel IP cefazolin and ceftazidime regimen during the first 24 h in PD patients with peritonitis.

Methods:

Cefazolin and ceftazidime (2500 mg each) were added to in to a 5-L bag containing 2.5% of dextrose PD fluid which was placed on the warmer of PD cycling machine. Patients underwent five exchanges of 2-L PD fluid over 10 h by the PD cycling machine without last fill or additional dwell. Plasma samples and dialysate samples were collected over 24 h. Cefazolin and ceftazidime concentrations in plasma and dialysate were determined by high-performance liquid chromatography.

Results:

Seven PD patients with peritonitis participated in this study. Plasma cefazolin and ceftazidime levels increased substantially within the first few hours, peaked around 6–10 h, and sustained well above the target plasma concentrations (10 mg L−1 for cefazolin and 16 mg L−1 for ceftazidime) until 24 h. Dialysate cefazolin and ceftazidime levels were sustained above the target peritoneal concentrations (2 mg L−1 for cefazolin and 8 mg L−1 for ceftazidime) throughout the PD session except in some samples which the antibiotics levels were unusually low, probably from beta-lactamase activity.

Conclusions:

IP cefazolin and ceftazidime during the short-dwell automated exchange could provide adequate dialysate and plasma concentrations in peritonitis patients. This novel regimen is a promising regimen for peritonitis in PD patients.
Bringing People Closer: The Prosocial Effects of Immersive Media on Users’ Attitudes and Behavior
Authors: Breves Priska
Published: February 2020

This experimental study examined how varying the degree of immersiveness of a short documentary about a remote health issue influenced users’ reported spatial presence, empathic parasocial interaction, and individual issue involvement. Higher-order responses, namely, the desire for information and willingness to donate to the cause, were also analyzed. The documentary was shown to 85 participants using three different technologies with varying degrees of immersiveness (high, moderate, and low). The results show that the level of the technology’s immersiveness gradually increases the spatial presence, empathic parasocial interaction, and issue involvement of the user. While participants of the highly immersive condition reported a higher desire for additional information, the results on donation behavior were less conclusive.
A static equilibrium condition for the steady-state analysis of variable-stroke swash plate mechanism
Authors: Shin Jae Kyun , Hwang Seon , Kim Dae Wok
Published: February 2020

Variable-stoke swash plate mechanisms are widely used for compressors in automotive air-conditioning systems, but the dynamics of the system has not been investigated sufficiently. In the present study, we derived a dynamic equation based on the Lagrangian mechanics for the mechanism and solved it numerically. The solutions were compared with the ones obtained from the commercial multibody dynamics software, DAFUL. We proposed a static function that can be conveniently used to predict the steady-state behavior of the system without conducting a full dynamic analysis of the variable-stoke swash mechanism. Using the static function, for example, we showed why the stroke of the variable-stoke swash tends to increase with the driving speed and showed a simple way to reverse the tendency. Especially, we observed that the system can have multiple steady-state solutions depending on initial conditions. Based on this observation, we theoretically showed that a hysteresis phenomenon can occur in the variable-stoke swash mechanism so that the behavior of the system can depend on the operation history of the system.
Performance improvement and flow field investigation in hydraulic torque converter based on a new design of segmented blades
Authors: Liu Chunbao , Yang Konghua , Li Jing , Xu Zhixuan , Wang Tongjian
Published: February 2020

Hydraulic torque converter is of lower efficiency in the powertrain, particularly at low speed ratio, which is crucial for vehicles due to its ability of torque multiplication. Therefore, torque converters should be taken into account with both higher start-up acceleration and transmission efficiency. Inspired by the fact that the multi-airfoils of the aircraft can improve the lift, a new design of segmented turbine blade in torque converter is presented to improve the transmission efficiency and start-up acceleration. To ensure reproducibility and popularization, the camber line and shape of blades are extracted to obtain the expression in the Cartesian coordinate system. A scale-resolving simulation setting, large eddy simulation with kinetic energy transport, and refined hexahedron meshes, which were verified by our studies, are applied to simulate the three-dimensional transient flow numerically. According to the results of computational fluid dynamics analysis, the new design eliminated the ultra-high vorticity of the near-wall boundary layer to reduce the flow loss, which further improves fuel economy. The pressure difference in the segmented turbine blade is significantly higher than that of the original model, causing the improvement of powertrain performance. As a result, the torque ratio and nominal torque increase by 6.7% and 7.7%, respectively, at stalling speed ratio; meanwhile, the maximum efficiency increases by 1.1%. This research, using a new design of segmented blades, has many advantages, such as high starting torque ratio, large adjusting range, and greater fuel economy, and shows great potential to apply in the manufacturing process.
In Our Backyard: Perceptions About Fracking, Science, and Health by Community Members
Authors: McElroy Jane A. , Kassotis Christopher D. , Nagel Susan C.
Published: February 2020

Unconventional oil and gas (UOG) extraction (fracking) has increased in the United States, as well as interest in the associated risks and benefits. This study’s purpose was to qualitatively examine residents’ perceptions about UOG development in their community. Fifteen interviewees involving residents of Garfield County, Colorado, a drilling-dense region, were transcribed and analyzed. The study found six themes: (1) health concerns, both human and animal, (2) power struggles between government and industry/between industry and residents, and (3) perception and some acceptance of increased risk. Less common themes were (4) reliance on science to accurately determine risk, (5) frustration with potential threat and loss of power, and (6) traffic and safety concerns. Community perceptions of UOG development are complex, and understanding the position of community members can support the need for additional public health research and impact assessments regarding community exposures from UOG drilling operation exposures.
Colonic Neurogenic Lesion: An Admixture of Mucosal Neurofibromatous Lesion and Submucosal Ganglioneuromatous Lesion With Transition
Authors: Hashimoto Hirotsugu , Koda Hirotomo , Horiuchi Hajime , Takayama Maho , Toyoda Junya , Momiyama Masashi , Harihara Yasushi , Morikawa Teppei
Published: February 2020

Benign neural tumors or tumor-like lesions are rarely detected in the gastrointestinal tract. In this article, we present the case of a neural lesion of the sigmoid colon, which was incidentally detected in a 68-year-old man treated with laparoscopic low anterior resection for an advanced carcinoma of the rectosigmoid junction. Within the resected specimen, a submucosal tumor-like protruding lesion was found in the sigmoid colon. Histologically, the growth was composed of mucosal neurofibromatous and submucosal ganglioneuromatous lesions, between which there was transition. Immunohistochemical analysis revealed a rupture of the perineurium in the area of transition, along with a proliferation of Schwann cells and supporting cells extending into the deep mucosa. This transition indicated that the mucosal and submucosal lesions comprised a single lesion, and that a diagnosis of neurofibroma or ganglioneuroma would be inadequate in this case. Because we could not classify it as an established single entity, we diagnosed the mass as an unclassifiable colonic neurogenic lesion. In summary, we report the case of an extremely rare occurrence of an unclassifiable colonic neurogenic lesion comprising an admixture of transitioning mucosal neurofibromatous and submucosal ganglioneuromatous lesions.
Disturbance at the dinner table: Exploring mothers’ experiences of mealtimes when caring for their son or daughter with anorexia nervosa
Authors: White Hannah J , Haycraft Emma , Williamson Iain , Meyer Caroline
Published: February 2020

This study examined mothers’ ( n = 9) mealtime experiences when caring for their son or daughter with anorexia nervosa through semi-structured interviews. Interpretative Phenomenological Analysis identified three themes: (1) managing mealtime combat through accommodation and acceptance; (2) feeling isolated, inauthentic and ill-equipped and (3) a need for understanding and to be understood. The overarching concepts of ‘combat’ and ‘distortion’ also underpin the analysis, uniquely outlining how mothers come to understand this daily situation. Mealtime-related interventions need to be developed which prioritise promoting skills and confidence in managing mealtimes and helping carers to address the emotional challenges of these occasions.
The Yin Yang Role of Nitric Oxide in Prostate Cancer
Authors: Soni Yash , Softness Kenneth , Arora Himanshu , Ramasamy Ranjith
Published: February 2020

Nitric oxide (NO) is a ubiquitous signaling molecule in the human body with well-known roles in many different processes and organ systems. In cancer, the two-concentrations hypothesis of NO has dictated that low levels of NO are cancer promoting, while high levels of NO are protective against cancer. Although prostate cancer is a hormonally driven malignancy, research has been shifting away from androgen-responsive epithelial cells and evolving to focus on NO therapies, the tumor microenvironment (TME), and inflammation. NO is reported to be able to inhibit activity of the androgen receptor. This may prevent prostate growth, but low levels of NO could conversely select for castration-resistant prostate cells, creating an aggressive cancer phenotype. At high levels, nitrosative stress created from NO overproduction can be protective against prostate neoplasia. In this review, we discuss development and possibilities of NO-based therapies for prostate cancer.
How difficult is it for adolescents to maintain attention? The differential effects of video games and sports
Authors: Petilli Marco Alessandro , Rinaldi Luca , Trisolini Daniela Carmen , Girelli Luisa , Vecchio Luca Piero , Daini Roberta
Published: February 2020

Despite a large body of evidence suggests positive effects of playing action video games and practising sports on various visual attentional skills, the impact of these activities on the ability to maintain attention over prolonged periods of time (i.e., sustained attention) has been largely neglected. Here, we first explored free-time habits on a group of 310 adolescents by means of a self-reported questionnaire. We found an inverse relationship between the time spent with sports and video games, but not with other extra-scholastic activities: the time spent practising sports and playing video games clearly competed with each other, with the more-intensive-sport practitioners being less involved in video game play. Next, we directly measured sustained attention and other attentional skills in a subgroup of 76 participants, divided as a function of their time spent in sports and action video games. In particular, sustained attention was assessed by means of two tasks: a classic exogenous task, requiring participants to attend to a flashing visual stimulus; and an internal (endogenous) sustained attention task, requiring participants to synchronise their manual responses to the rhythm of auditory pulses presented in an earlier phase. As previously documented, we found that action video game players displayed worse ability to maintain attention over time, as compared with non-action players. In striking contrast, intensive sports practice was associated with an increased ability to maintain attention over time. Overall, these findings unveil distinct cascading effects on sustained attention induced by doing sport and playing action video games.
Frailty: An overview
Authors: Mulla Ebrahim , Montgomery Ursula
Published: February 2020

Ageing well is ‘everyone’s concern’. However, everyone who ages does not necessarily live with frailty, and frailty is no respecter of age. This article is part of a series unravelling frailty. We draw upon the latest thinking, evidence and policy to explore the nature of frailty, why frailty matters and how GP services are developing to meet the challenge to better support people living with frailty.
Efficacy, safety, and tolerability of a ready-to-drink bowel preparation: subanalysis by age from a phase III, assessor-blinded study
Authors: Hookey Lawrence , Bertiger Gerald , Johnson Kenneth Lee , Boules Mena , Ando Masakazu , Dahdal David N.
Published: February 2020

Background:

The incidence and mortality of colorectal cancer (CRC) increase with age and, therefore, it is recommended that adults undergo regular CRC screening, ideally by colonoscopy, with some new guidelines recommending screening begin at 45 years. Effective bowel preparation is a critical step to a successful colonoscopy. Of concern is that older adults may have poorer quality of bowel preparation or reduced tolerability for the bowel preparation. Here, we performed a post hoc secondary analysis for the effect of age on the efficacy, tolerability, and safety of ready-to-drink sodium picosulfate, magnesium oxide, and citric acid (SPMC oral solution) bowel preparation.

Methods:

A phase III, randomized, assessor-blinded, multicenter, non-inferiority study was conducted comparing split-dose, low-volume SPMC oral solution with split-dose, low-volume sodium picosulfate, magnesium oxide, and citric acid powder for oral solution. A post hoc secondary analysis was performed to assess efficacy, safety, and tolerability of SPMC oral solution by age group (<50 years, 50–64 years, ⩾65 years). The prespecified primary efficacy endpoint (‘responders’) was the proportion of participants with ‘excellent’ or ‘good’ ratings on a modified Aronchick Scale (AS). Secondary efficacy outcomes were the quality of cleansing of the right colon as assessed by the Boston Bowel Preparation Scale (BBPS); as well as selected findings from the Mayo Clinic Bowel Prep Tolerability Questionnaire. Safety assessments included adverse events (AEs) and laboratory evaluations.

Results:

Within age groups, at least 83.9% of participants were responders by the AS, and at least 91.1% of participants were responders by the BBPS in the right colon. On both scales, responder rates were highest in the youngest age group and decreased with increasing age. Greater than 88% of participants in any age group found the preparation ‘easy’ or ‘acceptable’ to ingest, with rates of ‘easy’ being highest in the oldest age group. No new safety signals were seen in any age group. The most commonly reported drug-related, treatment-emergent AEs were, by ascending age group, nausea (7.0%, 3.2%, 0.8%), headache (4.2%, 2.8%, 1.6%) and vomiting (2.8%, 1.2%, 0.8%).

Conclusion:

Ready-to-drink SPMC oral solution showed good efficacy of overall colon cleansing and tolerability in adults across different age groups, including those ⩾65 years. ClinicalTrials.gov identifier: NCT03017235.
Proposed methodology for estimating the magnitude at which subduction megathrust ground motions and source dimensions exhibit a break in magnitude scaling: Example for 79 global subduction zones
Authors: Campbell Kenneth W.
Published: February 2020

In this article, I propose a method for estimating the magnitude [Formula: see text] at which subduction megathrust earthquakes are expected to exhibit a break in magnitude scaling of both seismic source dimensions and earthquake ground motions. The methodology is demonstrated by applying it to 79 global subduction zones defined in the literature, including Cascadia. Breakpoint magnitude is estimated from seismogenic interface widths, empirical source scaling relations, and aspect ratios of physically unbounded earthquake ruptures and their uncertainties. The concept stems from the well-established observation that source-dimension and ground motion scaling decreases for shallow continental (primarily strike-slip) earthquakes when rupture exceeds the seismogenic width of the fault. Although a scaling break for megathrust earthquakes is difficult to observe empirically, all of the instrumentally recorded historical [Formula: see text] mega-earthquakes have occurred on subduction zones with [Formula: see text] (8.1–8.9), consistent with an observed break in source scaling relations derived from these same events. The breakpoint magnitudes derived in this study can be used to constrain the magnitude at which the scaling of ground motion is expected to decrease in subduction ground motion prediction equations.
Exploring naturally occurring clinical subgroups of post-traumatic headache
Authors: Chan T. L. H. , Woldeamanuel Y. W.
Published: February 2020

Objective

To explore naturally occurring clinical subgroups of post-traumatic headache.

Background

Persistent post-traumatic headache (PTH) is defined as a headache developing within 7 days of an injury that lasts for greater than 3 months. However, there is no evidence available from the International Classification of Headache Disorders (ICHD) based classification between persistent and acute PTH based on clinical phenotypes.

Methods

We conducted a retrospective study using the Stanford Research Repository Cohort Discovery Tool. We reviewed 500 electronic patient charts between January 2015 to September 2019 using inclusion criteria of adults older than 18 years with a diagnosis of PTH. The following variables were extracted from each patient’s chart: diagnosis of PTH as dependent variable, and predictor variables as age, sex, history of migraine, loss of consciousness during head injury, pre-existing psychological history, duration of PTH and new PTH-associated comorbidities (e.g. new onset vertigo, post-traumatic stress disorder). Logistic regression was employed to identify clinical phenotypes predicting persistent PTH. All predictor variables were tested in one block to determine their predictive capacity while controlling for other predictors in the model. Two-step cluster analysis was conducted to identify naturally occurring PTH subgroups.

Results

A total of 300 patients were included (150 acute, 150 persistent PTH) with a median age of 47 years (IQR 31, 59) and female: male ratio of 2.7:1. Two hundred patients were excluded due to misdiagnoses. Pre-existing psychological history (standardized beta 0.16), history of migraine (0.20), new PTH-associated comorbidities (0.23) and medication overuse (0.37) statistically significantly predicted the presence of persistent PTH (p <  0.0001). Clustering analysis revealed PTH subgrouping comparable to ICHD-based classification: 140 patients in Cluster 1 (76% persistent PTH) and 160 patients in Cluster 2 (83% acute PTH). Four distinct clusters were found within persistent PTH.

Conclusion

Pre-existing psychological history, history of migraine, new PTH-associated comorbidities and medication overuse predicted the occurrence of persistent PTH as well as two naturally occurring PTH clusters correlating to acute and persistent PTH. Management emphasis should focus on these phenotypes.
Discovery of a putative blood-based protein signature associated with response to ALK tyrosine kinase inhibition
Authors: Couëtoux du Tertre Mathilde , Marques Maud , McNamara Suzan , Gambaro Karen , Hoffert Cyrla , Tremblay Lise , Bouchard Nicole , Diaconescu Razvan , Blais Normand , Couture Christian , Pelsser Vincent , Wang Hangjun , McIntosh Laura , Hindie Valérie , Parent Stephane , Cortes Laetitia , Breton Yannick-André , Pottiez Gwenael , Croteau Pascal , Higenell Valerie , Izzi Luisa , Spatz Alan , Cohen Victor , Batist Gerald , Agulnik Jason
Published: February 2020

Background

ALK tyrosine kinase inhibition has become a mainstay in the clinical management of ALK fusion positive NSCLC patients. Although ALK mutations can reliably predict the likelihood of response to ALK tyrosine kinase inhibitors (TKIs) such as crizotinib, they cannot reliably predict response duration or intrinsic/extrinsic therapeutic resistance. To further refine the application of personalized medicine in this indication, this study aimed to identify prognostic proteomic biomarkers in ALK fusion positive NSCLC patients to crizotinib.

Methods

Twenty-four patients with advanced NSCLC harboring ALK fusion were administered crizotinib in a phase IV trial which included blood sampling prior to treatment. Targeted proteomics of 327 proteins using MRM-MS was used to measure plasma levels at baseline (including pre-treatment and early treatment blood samples) and assess potential clinical association.

Results

Patients were categorized by duration of response: long-term responders [PFS ≥ 24 months (n = 7)], normal responders [3 < PFS < 24 months (n = 10)] and poor responders [PFS ≤ 3 months (n = 5)]. Several proteins were identified as differentially expressed between long-term responders and poor responders, including DPP4, KIT and LUM. Next, using machine learning algorithms, we evaluated the classification potential of 40 proteins. Finally, by integrating the different analytic methods, we selected 22 proteins as potential candidates for a blood-based prognostic signature of response to crizotinib in NSCLC patients harboring ALK fusion.

Conclusion

In conjunction with ALK mutation, the expression of this proteomic signature may represent a liquid biopsy-based marker of long-term response to crizotinib in NSCLC. Expanding the utility of prognostic biomarkers of response duration could influence choice of therapy, therapeutic sequencing, and potentially the need for alternative or combination therapy.

Trial registrationClinicalTrials.gov, NCT02041468. Registered 22 January 2014,https://clinicaltrials.gov/ct2/show/NCT02041468?term=NCT02041468&rank=1
A field study in support of the monitoring of priority substances in German freshwater fish: derivation of fillet-to-whole fish conversion factors
Authors: Rüdel Heinz , Radermacher Georg , Fliedner Annette , Lohmann Nina , Duffek Anja
Published: February 2020

Background

Bioaccumulating contaminants in surface waters are preferably monitored in fish for assessing the related risks to and via the aquatic environment. Consequently, the European Water Framework Directive (WFD) requires a monitoring of certain priority substances such as mercury, polybrominated diphenyl ethers (PBDE), perfluorooctane sulfonic acid and its derivatives (PFOS), hexachlorobenzene (HCB), hexabromocyclododecanes (HBCDD) and polychlorinated dioxins/dioxin-like compounds (dioxins) in freshwater and coastal fish. Tissue levels have to comply with biota environmental quality standards (EQSs) given in Directive 2013/39/EU. EQSs are justified either by risks for human health (assessed on the basis of fillet) or secondary poisoning of wildlife (based on whole fish). To support the practical implementation of the WFD biota monitoring in Germany, comparative investigations of target fish species caught at six sites were performed.

Results

At each site, at least three fish species listed in a national guidance document were sampled (e.g., chub, roach, bream, perch). Beside biometric data, concentrations of seven priority substances were determined in pooled fillet and carcass samples and whole fish data were calculated. The EQSs for PBDE and mercury were exceeded in nearly all fillet and whole fish samples. PFOS was above the EQS at several sites especially in perch, while HCB exceeded the EQS only at one site (Elbe River). All fillet and whole fish samples complied with the EQSs for dioxins and HBCDD. Based on wet weight concentrations of a homogeneous set of 20 composite sample pairs of 3–5 year-old fish, the following fillet-to-whole fish conversion factors were derived: mercury 0.81, PBDE 5.4, HCB 3.6, PFOS 2.7, dioxins 5.3, and HBCDD 1.8.

Conclusions

Recommendations on selection of target fish species, age or tissue given by EU and national guidance documents are practical and feasible. However, further adjustments of the samplings such as the determination of site-specific length–age relationships are required from both ecological and risk assessment perspectives. The derived conversion factors allow the translation of fillet-to-whole fish concentrations (and vice versa), and thus the EQS compliance assessment for the appropriate tissue (fillet for human health, whole fish for wildlife risks) if only one tissue is investigated.
Distribution of virulence genes and phylogenetics of uropathogenic Escherichia coli among urinary tract infection patients in Addis Ababa, Ethiopia
Authors: Dadi Belayneh Regasa , Abebe Tamrat , Zhang Lixin , Mihret Adane , Abebe Workeabeba , Amogne Wondwossen
Published: February 2020

Background

Urinary tract infection (UTI) is a common cause of morbidity worldwide. Uropathogenic Escherichia coli (UPEC) bacteria are the major cause of urinary tract infections. UPEC strains derive from different phylogenetic groups and possess an arsenal of virulence factors that contribute to their ability to overcome different defense mechanisms and cause disease. The objective of this study was to identify phylogroup and virulence genes of UPEC among urinary tract infection patients.

Methods

A cross sectional study was conducted from January 1, 2017 to October 9, 2017. E. coli bacteria were isolated from UTI patients using culture and conventional biochemical tests. Identification of phylogroup and genes that encodes for virulence factors was done using multiplex polymerase chain reaction (PCR). Data was processed and analyzed with SPSS version16.0 and Epi-info version 3.4.1 software.

Results

The most common urologic clinical manifestation combinations in this study were dysuria, urine urgency and urgency incontinence. The frequent UPEC virulence gene identified was fimH 164 (82%), followed by aer 109 (54.5%), hly 103 (51.5%), pap 59 (29.5%), cnf 58 (29%), sfa 50 (25%) and afa 24 (12%).There was significant association between pap gene and urine urgency (p-0.016); sfa and dysuria and urine urgency (p-0.019 and p-0.043 respectively); hly and suprapubic pain (p-0.002); aer and suprapubic pain, flank pain and fever (p-0.017, p-0.040, p-0.029 respectively). Majority of E. coli isolates were phylogroup B2 60(30%) followed by D 55(27.5%), B1 48(24%) and A 37(18.5%). There was significant association between E. coli phylogroup B2 and three virulence genes namely afa, pap, and sfa (p-0.014, p-0.002, p-0.004 respectively).

Conclusion

In this study the most frequent E. coli virulence gene was fimH, followed by aer, hly, pap, cnf, sfa and afa respectively. There was significant association between E. coli virulence genes and clinical symptoms of UTI. The phylogenetic analysis indicates majority of uropathogenic E. coli isolates were phylogroup B2 followed by phylogroup D. Phylogroup B2 carries more virulence genes. Hence, targeting major UPEC phylogroup and virulence genes for potential vaccine candidates is essential for better management of UTI and further research has to be conducted in this area.
Tick-borne pathogens in Ixodidae ticks collected from privately-owned dogs in Italy: a country-wide molecular survey
Authors: Zanet Stefania , Battisti Elena , Pepe Paola , Ciuca Lavinia , Colombo Liliana , Trisciuoglio Anna , Ferroglio Ezio , Cringoli Giuseppe , Rinaldi Laura , Maurelli Maria Paola
Published: February 2020

Background

Ticks and tick-borne diseases are increasingly recognized as a cause of disease in dogs worldwide. The epidemiology of ticks and tick-transmitted protozoa and bacteria has changed due to the spread of ticks to urban and peri-urban areas and the movement of infected animals, posing new risks for animals and humans. This countrywide study reports information on distribution and prevalence of pathogens in ticks collected from privately-owned dogs in Italy.

We analyzed 2681 Ixodidae ticks, collected from 1454 pet dogs from Italy. Specific PCR protocols were used to detect i) Piroplasms of the genera Babesia and Theileria, ii) Gram-negative cocci of the family Anaplasmataceae and iii) Borrelia burgdorferi sensu lato. Sequencing of positive amplicons allowed for species identification.

Results

Babesia/Theileria spp. DNA was detected in 435 homogeneous tick-pools (Minimum Infection Rate (MIR) = 27.6%; 95% confidence interval (CI) = 25.4–29.8%) with higher prevalence in Ixodes ricinus and Rhipicephalus sanguneus group. The zoonotic B. venatorum was the most prevalent species (MIR = 7.5%; 95% CI = 6.3–9.0%). Anaplasma and Ehrlichia species were detected in 165 tick-pools (MIR = 10.5%; 95% CI = 9.3–11.8%) and specifically, A. phagocytophilum was identified with MIR = 5.1% (95% CI = 4.1–6.3%). Borrelia burgdorferi s.l. and B. afzelii were detected with MIR = 0.4% (95% CI = 0.2–0.8%) and MIR = 0.3% (95% CI 0.1–0.7%) respectively.

Conclusions

Zoonotic pathogens B. venatorum and A. phagocytophilum were the most frequently detected in ticks collected from privately-owned dogs which might be used as markers of pathogens presence and distribution.
Effects of Lactobacillus plantarum on intestinal integrity and immune responses of egg-laying chickens infected with Clostridium perfringens under the free-range or the specific pathogen free environment
Authors: Xu Tianyue , Chen Yan , Yu Longfei , Wang Jun , Huang Mingxing , Zhu Nianhua
Published: February 2020

Background

Necrotic enteritis, which is caused by Clostridium perfringens, has resulted in more than $2 billion losses in the poultry industry every year. Due to the ban of antibiotics in feed industry, alternatives like environment improvement and probiotics have been found to be effective as well. In our study, we aim to explore the protective effect of Lactobacillus plantarum supplementation on CP infected chickens in two environments.

Results

The results showed that the Clostridium perfringens administration led to visible and histomorphological gut lesions. In the specific pathogen free or free-range system environment, dietary supplementation with LP obvious increased the ratio of intestinal villus height to crypt depth and the expression of MUC2 mRNA in ileum mucosa, then reduced the mRNA expression level of TNF-α gene in the ileum mucosa. LP treatment significantly reduced the contents of total protein, total superoxide dismutase and glutamic oxaloacetic transaminase in serum of the chickens.

Conclusions

The specific pathogen free environment contributed to the recovery of pre-inflammation of the chickens, and free-range system environment contributed to the repair of damage in the later stages of chicken inflammation. Supplementation of LP in FRS environment was more conducive to the recovery of CP infected in chickens.
Comparing the EQ-5D-3 L and EQ-5D-5 L: studying measurement and scores in Indonesian type 2 diabetes mellitus patients
Authors: Arifin Bustanul , Purba Fredrick Dermawan , Herman Hendra , Adam John M. F. , Atthobari Jarir , Schuiling-Veninga Catharina C. M. , Krabbe Paul F. M. , Postma Maarten J.
Published: February 2020

Background

The EuroQoL five-dimensional instrument (EQ-5D) is the favoured preference-based instrument to measure health-related quality of life (HRQoL) in several countries. Two versions of the EQ-5D are available: the 3-level version (EQ-5D-3 L) and the 5-level version (EQ-5D-5 L). This study aims to compare specific measurement properties and scoring of the EQ-5D-3 L (3 L) and EQ-5D-5 L (5 L) in Indonesian type 2 diabetes mellitus (T2DM) outpatients.

Methods

A survey was conducted in a hospital and two primary healthcare centres on Sulawesi Island. Participants were asked to complete the two versions of the EQ-5D instruments. The 3 L and 5 L were compared in terms of distribution and ceiling, discriminative power and test-retest reliability. To determine the consistency of the participants’ answers, we checked the redistribution pattern, i.e., the consistency of a participant’s scores in both versions.

Results

A total of 198 T2DM outpatients (mean age 59.90 ± 11.06) completed the 3 L and 5 L surveys. A total of 46 health states for 3 L and 90 health states for 5 L were reported. The ‘11121’ health state was reported most often: 17% in the 3 L and 13% in the 5 L. The results suggested a lower ceiling effect for 5 L (11%) than for 3 L (15%). Regarding redistribution, only 6.1% of responses were found to be inconsistent in this study. The 5 L had higher discriminative power than the 3 L version. Reliability as reflected by the index score was 0.64 for 3 L and 0.74 for 5 L. Pain/discomfort was the dimension mostly affected, whereas the self-care dimension was the least affected.

Conclusions

This study suggests that the 5 L-version of the EQ-5D instrument performs better than the 3 L-version in T2DM outpatients in Indonesia, regarding measurement and scoring properties. As such, our study supports the use of the 5 L as the preferred health-related quality of life measurement tool.

We did not do a trial but this study was approved by the Medical Ethics Committee of Universitas Gadjah Mada Yogyakarta, Indonesia (document number KE/FK/1188/EC, 12 November 2014, amended 16 March 2015).