bluuebunny/crossref_metadata_2025 huggingface dataset:
The rise of community choice aggregation and its implications for California’s energy transition: A preliminary assessment
Authors: Kennedy Sean F , Rosen Bailey
Published: June 2020

Community choice aggregation—an emerging electricity supply model allowing residents and businesses to purchase electricity from local governments instead of utilities—is projected to account for 60% of Californian customers currently served by investor-owned utilities by 2020.Community choice aggregation advocates claim that the model is an effective means of meeting California’s renewable energy policy objectives in a way that is more democratic and socially just than the prevailing utility-based model of electricity governance. We interrogate these claims through a focus on three issues: community choice aggregation governance and access to capital, electricity procurement, and customer rates and retention. We find that community choice aggregators have been able to address concerns regarding access to capital while balancing competing objectives around renewable energy and affordability. However, local benefits—particularly in terms of local economic development driven by the expansion of distributed generation—are yet to be fully realized. In addition, ongoing policy uncertainty regarding cost allocation between utility and community choice aggregation customers may limit the ability of community choice aggregators to offer competitive rates, which may threaten the model’s long-term viability. We conclude by arguing that meeting California’s future renewable energy goals requires a reconfiguration of the regulatory framework that leverages the respective strengths of both community choice aggregators and investor-owned utilities in the context of the state’s energy transition.
Migration has Stripped Us of Our Manhood: Contradictions of Failed Masculinity Among South Asian Male Migrants in Greece
Authors: Kukreja Reena
Published: June 2020

This article explores the contradictions of the failed masculine stature of South Asian male migrants in Greece. Transnational migration provides low-class rural Indian and Pakistani men an opportunity to socially re-inscribe their adult breadwinner stature. It discusses relational hierarchies of masculinities that shape these men’s encounters with Greek employers, compatriots in Greece, and transnationally located families. Discriminatory state migration and labor regimes intersect with discourses of racism, xenophobia, and Islamophobia to reinforce these racialized men’s sense of failed masculinity. Relative powerlessness to a range of local and co-ethnic men further emasculates them. Consequently, they adopt a series of compensatory strategies that include self-valorizing their masculinity relationally vis-à-vis co-ethnic males and Greek male workers. Strategically repositioning self as indispensable to the Greek nation and accentuating personal sacrifice for families notionally transforms them into mythic heroes. Notwithstanding, precarious migrant status in Greece renders hegemonic masculine stature elusive to them.
Reform of civil procedure in Cyprus: Delivering justice in a more efficient and timely way
Authors: Mouttotos Nicholas
Published: June 2020

Dissatisfaction with the administration of justice is as old as law proclaimed the distinguished American legal scholar Roscoe Pound in 1906. The system of administration of justice has been under considerable scrutiny in Cyprus following the excessive delays in resolving disputes that are highlighted in reports such as the European Union’s Justice Scoreboard, the World Bank’s Doing Business Reports as well as European Commission papers on Cyprus, urging authorities to modernize the system in order to be able to meet the demands following the financial crisis. For this reason, various experts have been assigned with the task of identifying the problems and coming up with proposals and solutions. The discussions, though, are not new as similar problems have been presented in common law jurisdictions, in particular, but they have been tackled decades ago, with the adoption of reforms that moved the adversarial system of justice closer to civilian stereotypes.
Development and Characterization of Squalene-Loaded Topical Agar-Based Emulgel Scaffold: Wound Healing Potential in Full-Thickness Burn Model
Authors: Shanmugarajan T. S. , Selvan N. Kalai , Uppuluri Varuna Naga Venkata Arjun
Published: June 2020

Full-thickness burns pose a major challenge for clinicians to handle because of their restricted self-healing ability. Even though several approaches have been implemented for repairing these burnt skin tissue defects, all of them had unsatisfactory outcomes. Moreover, during recent years, skin tissue engineering techniques have emerged as a promising approach to improve skin tissue regeneration and overcome the shortcomings of the traditional approaches. Although previous literatures report the wound healing effects of the squalene oil, in the current study, for the first time, we developed a squalene-loaded emulgel-based scaffold as a novel approach for potential skin regeneration. This squalene-loaded agar-based emulgel scaffold was fabricated by using physical cross-linking technique using lecithin as an emulsifier. Characterization studies such as X-ray diffraction, Fourier-transform infrared spectroscopy, and field emission scanning electron microscopy revealed the amorphous nature, chemical interactions, and cross-linked capabilities of the developed emulgel scaffold. The squalene-loaded emulgel scaffold showed excellent wound contraction when compared with the agar gel and negative control. In case of the histopathology and recent immunohistochemistry findings, it was clearly evidenced that squalene-loaded emulgel promoted faster rate of the revascularization and macrophage polarization in order to enhance the burn wound healing. Moreover, the findings also revealed that the incorporation of squalene oil into the formulation enhances collagen deposition and accelerates the burnt skin tissue regeneration process. Finally, we conclude that the squalene-loaded emulgel scaffold could be an effective formulation used in the treatment of the burnt skin tissue defects.
Provable secure identity-based online/offline encryption scheme with continual leakage resilience for wireless sensor network
Authors: Zhang Xiujie , Fu Xingbing , Hong Lu , Liu Yu , Wang Liangliang
Published: June 2020

As a potential technology, the identity-based online/offline encryption scheme is split into two phases (the offline phase and the online phase) which is especially suitable for sensor nodes with limited computation resources in that most of the works can be executed offline. However, a challenging issue is the well-known identity-based online/offline encryption schemes unable to resist continual key leakage attacks of the secret keys. To address the above security challenge, we put forth the first continual leakage-resilient identity-based online/offline encryption scheme which is suitable for ensuring secure communications in wireless sensor networks. More specifically, our formal security proofs analysis indicates that the proposed scheme can guarantee security even if partial information of the secret key is continually leaked due to side-channel attacks or fault injection attacks. Above all, compared to the existing identity-based online/offline encryption schemes, an identity-based online/offline encryption scheme with continual leakage resilient meets wireless sensor networks with strong security.
Inspiring Medical Students to Choose Primary Care Through Lifestyle Medicine Education
Authors: Bermejo David I. , Stiegmann Regan A.
Published: June 2020

Despite a growing interest in lifestyle medicine, students at most medical schools in the United States are not receiving enough nutrition education and training in the principles of lifestyle modification to be effective at applying this knowledge to real-world clinical practice. Moreover, the rising prevalence of chronic lifestyle-related diseases and the increasing deficit of primary care providers is overwhelming the US health care system. The need for primary care physicians is being circumvented by medical students’ diminishing interest in primary care partly due to concerns about salary, prestige, and being too broad in focus. Students may also recognize that the pharmaceutically based management of chronic conditions and supplemental lifestyle recommendations are often fraught with nonadherence, resulting in the progression of disease states. However, some medical schools have incorporated the concepts and practice of lifestyle medicine into their curriculums. This integration has the potential to inspire medical students to choose a primary care specialty, because students become more adept at addressing and treating the root causes of chronic disease. Lifestyle medicine education can empower students interested in primary care to fulfill their initial desires to treat and heal that may have inspired them to want to become doctors in the first place.
c-Abl-p38α signaling pathway mediates dopamine neuron loss in trigeminal neuralgia
Authors: Fu Jia , Mu Guo , Qiu Ling , Zhao Jiaomei , Ou Cehua
Published: June 2020

Trigeminal neuralgia is a common neuropathic pain in the head and face. The pathogenesis of trigeminal neuralgia is complex, and so far, the pathogenesis of trigeminal neuralgia involving peripheral and central nervous inflammation theory has not been explained clearly. The loss of dopamine neurons in striatum may play an important role in the development of trigeminal nerve, but the reason is not clear. C-Abl is a nonreceptor tyrosine kinase, which can be activated abnormally in the environment of neuroinflammation and cause neuron death. We found that in the rat model of infraorbital nerve ligation trigeminal neuralgia, the pain threshold decreased, the expression of c-Abl increased significantly, the downstream activation product p38 was also activated abnormally and the loss of dopamine neurons in striatum increased. When treated with imatinib mesylate (STI571), a specific c-Abl family kinase inhibitor, the p38 expression was decreased and the loss of dopaminergic neurons was reduced. The mechanical pain threshold of rats was also improved. In conclusion, c-abl-p38 signaling pathway may play an important role in the pathogenesis of trigeminal neuralgia, and it is one of the potential targets for the treatment of trigeminal neuralgia.
Biocognitive Classification of Antisocial Individuals Without Explanatory Reductionism
Authors: Jurjako Marko , Malatesti Luca , Brazil Inti A.
Published: June 2020

Effective and specifically targeted social and therapeutic responses for antisocial personality disorders and psychopathy are scarce. Some authors maintain that this scarcity should be overcome by revising current syndrome-based classifications of these conditions and devising better biocognitive classifications of antisocial individuals. The inspiration for the latter classifications has been embedded in the Research Domain Criteria (RDoC) approach. RDoC-type approaches to psychiatric research aim at transforming diagnosis, provide valid measures of disorders, aid clinical practice, and improve health outcomes by integrating the data on the genetic, neural, cognitive, and affective systems underlying psychiatric conditions. In the first part of the article, we discuss the benefits of such approaches compared with the dominant syndrome-based approaches and review recent attempts at building biocognitive classifications of antisocial individuals. Other researchers, however, have objected that biocognitive approaches in psychiatry are committed to an untenable form of explanatory reductionism. Explanatory reductionism is the view that psychological disorders can be exclusively categorized and explained in terms of their biological causes. In the second part of the article, we argue that RDoC-like approaches need not be associated with explanatory reductionism. Moreover, we argue how this is the case for a specific biocognitive approach to classifying antisocial individuals.
A rare case of pulmonary valve infective endocarditis in a patient with ventricular septal defect
Authors: Raja Shariff Raja Ezman Faridz , Kasim Sazzli Shahlan , Zainal Abidin Hafisyatul Aiza
Published: June 2020

Right-sided infective endocarditis (IE) is rare and often affects the tricuspid valve. We report a unique case of pulmonary valve IE in a patient with a predisposing congenital heart defect – a ventricular septal defect (VSD). A 23-year old man with a VSD was admitted following 3 months’ history of fever and malaise. An initial transthoracic echocardiogram (TTE) failed to reveal any visible vegetations or mass. However, blood cultures revealed persistent methicillin-sensitive S taphylococcus aureus (MSSA). A transoesophageal echocardiogram (TOE) showed multiple hyperechoic structures in the entirety of the anterior cusp of the pulmonary valve, suggestive of vegetations. In view of his young age and subacute presentation, a trial of prolonged antibiotics was opted for. The patient was commenced on intravenous cloxacillin for 6 weeks, which was successful. Common risk factors for right-sided IE include intravenous drug abuse, central venous catheterization and alcoholism. Less common risk factors include left-to-right shunts, including VSD. Proposed mechanisms include turbulent jet flow causing damage to the valve and vegetation formation. Although response to antibiotics and prognosis in right-sided IE tend to be better than in left-sided IE, surgical intervention may still be indicated, and unfortunately, evidence remains scarce on the appropriate patient selection for surgical intervention. Isolated pulmonary valve IE due to predisposing VSD remains a rare entity. It is important to consider this diagnosis in prolonged pyrexia of unknown origin in individuals with known congenital heart defects.
Vitamin D supplementation after the menopause
Authors: Pérez-López Faustino R. , Chedraui Peter , Pilz Stefan
Published: June 2020

The purpose of this review was to assess recent evidence regarding the effects of low vitamin D levels on some highly prevalent clinical conditions of postmenopausal women. We reviewed and selected recent literature regarding menopause-related conditions associated with vitamin D deficiency and interventions to manage them. Low circulating 25-hydroxyvitamin D (25(OH)D) levels related to menopause are linked to diet, lifestyle, changes in body composition, insulin sensitivity, and reduced physical activity. Vitamin D supplementation increases serum 25(OH)D levels while normalizing parathyroid hormone and bone markers, and in women with serum 25(OH)D levels below 10 ng/ml supplementation may improve bone mineral density. Low vitamin D status has been associated with the metabolic syndrome, high triglyceride levels, and low high-density lipoprotein cholesterol levels. When compared with placebo, vitamin D supplementation may lower the risk of the metabolic syndrome, hypertriglyceridemia, and hyperglycemia. There is an inverse relationship between fat mass and serum 25(OH)D levels and, therefore, the dosage of supplementation should be adjusted according to the body mass index. Although vitamin D supplementation may improve glucose metabolism in prediabetic subjects, data regarding muscle strength are conflictive. There is evidence that vitamin D over-treatment, to reach extremely high circulating 25(OH)D levels, does not result in better clinical outcomes. The identification and treatment of vitamin D deficiency in postmenopausal women may improve their general health and health outcomes. Vitamin D supplementation should preferably be based on the use of either cholecalciferol or calcifediol.
Genetics of migraine aura: an update
Authors: de Boer Irene , Terwindt Gisela M. , van den Maagdenberg Arn M. J. M.
Published: June 2020

Migraine is a common brain disorder with a large genetic component. Of the two main migraine types, migraine with aura and migraine without aura, the genetic underpinning in the former is least understood. Given the evidence from epidemiological studies in cohorts and families that the genetic contribution is highest in migraine with aura, this seems paradoxical. Various genetic approaches have been applied to identify genetic factors that confer risk for migraine. Initially, so-called candidate gene associations studies (CGAS) have been performed that test DNA variants in genes prioritized based on presumed a priori knowledge of migraine pathophysiology. More recently, genome-wide association studies (GWAS) tested variants in any gene in an hypothesis-free manner. Whereas GWAS in migraine without aura, or the more general diagnosis migraine have already identified dozens of gene variants, the specific hunt for gene variants in migraine with aura has been disappointing. The only GWAS specifically investigating migraine with aura yielded only one single associated single nucleotide polymorphism (SNP), near MTDH and PGCP, with genome-wide significance. However, interrogation of all genotyped SNPs, so beyond this one significant hit, was more successful and led to the notion that migraine with aura and migraine without aura are genetically more alike than different. Until now, most relevant genetic discoveries related to migraine with aura came from investigating monogenetic syndromes with migraine aura as a prominent phenotype (i.e. FHM, CADASIL and FASPS). This review will highlight the genetic findings relevant to migraine with aura.
Improving the Energy Conversion Efficiency of a Laser-Driven Flyer by an In Situ-Fabricated Nano-absorption Layer
Authors: Wang Liang , Yan Yichao , Ji Xiangbo , Zhang Wanli , Jiang Hongchuan , Qin Wenzhi , Wang Yao , Tang Duo
Published: June 2020

Three kinds of Al flyer plates with different nanostructured absorption layers were in situ prepared by a direct laser writing technology to improve the energy conversion efficiency in a laser-driven flyer assembly. Microstructures, light absorption, and flyer velocity in the acceleration chamber were investigated. The reflectance for the flyers at 1064-nm wavelength can be reduced from 81.3 to 9.8% by the nanostructured absorption layer. The terminal velocity of a 50-μm-thick Al flyer irradiated by a 60-mJ laser pulse is 831 m/s, while the velocity of the flyer with an in situ-fabricated nano-absorption layer reaches up to 1113 m/s at the same condition. Resultantly, the energy conversion efficiency of the flyer with a nanostructure absorption layer can reach as high as 1.99 times that of the Al flyer. Therefore, the nanostructured absorption layer in situ prepared on the surface of a flyer provides a new method to significantly improve the energy conversion efficiency of a laser-driven flyer.
A single mutation in the ACTR8 gene associated with lineage-specific expression in primates
Authors: Choe Se-Hee , Park Sang-Je , Cho Hyeon-Mu , Park Hye-Ri , Lee Ja-Rang , Kim Young-Hyun , Huh Jae-Won
Published: June 2020

Background

Alternative splicing (AS) generates various transcripts from a single gene and thus plays a significant role in transcriptomic diversity and proteomic complexity. Alu elements are primate-specific transposable elements (TEs) and can provide a donor or acceptor site for AS. In a study on TE-mediated AS, we recently identified a novel AluSz6-exonized ACTR8 transcript of the crab-eating monkey (Macaca fascicularis). In the present study, we sought to determine the molecular mechanism of AluSz6 exonization of the ACTR8 gene and investigate its evolutionary and functional consequences in the crab-eating monkey.

Results

We performed RT-PCR and genomic PCR to analyze AluSz6 exonization in the ACTR8 gene and the expression of the AluSz6-exonized transcript in nine primate samples, including prosimians, New world monkeys, Old world monkeys, and hominoids. AluSz6 integration was estimated to have occurred before the divergence of simians and prosimians. The Alu-exonized transcript obtained by AS was lineage-specific and expressed only in Old world monkeys and apes, and humans. This lineage-specific expression was caused by a single G duplication in AluSz6, which provides a new canonical 5′ splicing site. We further identified other alternative transcripts that were unaffected by the AluSz6 insertion. Finally, we observed that the alternative transcripts were transcribed into new isoforms with C-terminus deletion, and in silico analysis showed that these isoforms do not have a destructive function.

Conclusions

The single G duplication in the TE sequence is the source of TE exonization and AS, and this mutation may suffer a different fate of ACTR8 gene expression during primate evolution.
Paternal weight of ducks may have an influence on offspring’ small intestinal function and cecal microorganisms
Authors: Ran Mingxia , Hu Bo , Cheng Lumin , Hu Shenqiang , Liu Hehe , Li Liang , Hu Jiwei , Wang Jiwen
Published: June 2020

Background

In animals, many factors affect the small intestinal function and cecal microorganisms, including body weight and genetic background. However, whether paternal weight impacts the small intestinal function and cecal microorganisms remains unknown to date. The current study used Nonghua sheldrake to estimate the effect of paternal weight on the intestine of the offspring by evaluating differences in small intestinal morphology, digestive enzyme activity, and cecal microorganisms between the offspring of male parents with high body weight (group H) and that of male parents with low body weight (group L).

Results

The results of the analysis of small intestinal morphology showed that the villus height of the jejunum of group H ducks was higher than that of group L ducks, and the difference was significant for ducks at 10 weeks of age. Moreover, the villus height/crypt depth of the duodenum in group H significantly exceeded that of group L at a duck age of 2 weeks. The amylase activity in the jejunum content of group H exceeded that of group L at 5 and 10 weeks of age. Furthermore, the proportion of the Firmicutes to Bacteroidetes was significantly higher in group H (duck age of 2 weeks). Among the genera with a relative abundance exceeding 1%, the relative abundances of genera Desulfovibrio, Megamonas, Alistipes, Faecalibacterium, and Streptococcus observed in group H were significantly different between group H and group L.

Conclusions

For the first time, this study identifies the effect of paternal weight on offspring small intestinal function and cecal microorganisms. Consequently, this lays a foundation for further research on the relationship between male parents and offspring intestinal function.
β1 adrenoceptor antibodies induce myocardial apoptosis via inhibiting PGC-1α-related pathway
Authors: Shi Linying , Liu Jia , Zhang Yuan , Chen Mulei , Liu Jiamei
Published: June 2020

Background

Peripartum cardiomyopathy (PPCM) is life-threatening heart disease. However, the causes and pathogenesis of PPCM remain unclear. Previous studies found that β1 adrenoceptor antibodies (β1AA) had possible involvement in the development of PPCM. In the present study, we determined the potential relationship between PPCM and β1AA, including the mechanism of β1AA leading to PPCM.

Methods

We extracted the β1AA from the postpartum Wistar rats that were injected by the antigen peptide segment of the β1 adrenoceptor to produce PPCM. We tested the effects of β1AA on H9C2 cell line by CCK-8, LDH, TUNEL, SA-ELISA, qRT-PCR, and western blot methods. Furthermore, PGC-1α was overexpressed to rescue the effect of β1AA on H9C2 cells.

Results

We found that the extracted β1AA induced apoptosis of cardiac myocytes of H9C2 cell line. Moreover, the expression of peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α), which is a master regulator of mitochondrial metabolism, and its downstream transcript vascular endothelial growth factor (VEGF) got decreased in H9C2 cells after β1AA treatment. In addition, the effect of β1AA could be inhibited by atenolol, the antagonist of β1 adrenoceptors (β1AR) and imitated by isoprenaline, the agonist of β1AR. Furthermore, overexpression of PGC-1α in the H9C2 cells rescued the apoptosis of cells and inhibitory expression of VEGF induced by β1AA.

Conclusions

Our results suggest that the symptoms of PPCM due to myocardial cell apoptosis induced by β1AA inhibiting the PGC-1α-related pathway impairs mitochondrial energy metabolism. Therefore, our results uncover a previously unknown role of the β1AA pathway in the etiology of PPCM and provide a novel potential target for the treatment of PPCM.
Do sociodemographic variables and cardiometabolic risk factors moderate the mere-measurement effect on physical activity and sedentary time?
Authors: Voigt Lisa , Ullrich Antje , Baumann Sophie , Dörr Marcus , John Ulrich , Ulbricht Sabina
Published: June 2020

Background

Participation in an assessment may change health behavior. This “mere-measurement effect” may be used for prevention purposes. However, little is known about whether individuals’ characteristics moderate the effect. The objective was to explore whether changes of physical activity (PA) and sedentary time (ST) after a cardiovascular assessment depend on sociodemographic variables and cardiometabolic risk factors.

Methods

A sample of n = 175 adults aged 40 to 65 received baseline assessment including self-administered PA and ST questionnaires and standardized measurement of blood pressure, waist circumference, and blood parameters. After 5 weeks, participants again reported PA and ST without any prior treatment or intervention. Linear regression models were used to analyze the dependence of five-week changes in PA and ST on baseline sociodemographic and cardiometabolic variables.

Results

Men increased transport-related PA more than women (b = 9.3 MET-hours/week, P = .031). Men with higher triglycerides increased transport-related PA less than men with lower triglycerides (b = − 5.6 MET-hours/week, P = .043). Men with higher systolic blood pressure reduced ST more than those with lower systolic blood pressure (b = − 35.7 min/week, P = .028). However, this linear association ceased to exist at a level of approximately 145 mmHg (b of squared association = 1.0, P = .080). A similar relationship was found for glycated hemoglobin and ST.

Conclusions

The findings suggest that sex and cardiometabolic risk factors moderate mere-measurement effects on PA and ST. Researchers and practitioners using mere measurement for prevention purposes may address PA and ST according to these individual characteristics.

Trial registration

ClinicalTrials.govNCT02990039. Registered 7 December 2016. Retrospectively registered.
Inflammatory polyps occur more frequently in inflammatory bowel disease than other colitis patients
Authors: Ashktorab Hassan , Brim Hassan , Hassan Sally , Nouraie Mehdi , Gebreselassie Agazi , Laiyemo Adeyinka O. , Kibreab Angesom , Aduli Farshad , Latella Giovanni , Brant Steven R. , Sherif Zaki , Habtezion Aida
Published: June 2020

Background

Colitis is generally considered a risk factor for colon neoplasia. However, not all types of colitis seem to have equal neoplastic transformation potential.

Aim

To determine the prevalence of colorectal polyps in a predominantly African American population with inflammatory bowel disease (IBD) and Non-IBD/Non-Infectious Colitis (NIC).

Methods

We retrospectively evaluated medical records of 1060 patients previously identified with colitis at Howard University Hospital, based on ICD-10 code. Among these, 485 patients were included in the study: 70 IBD and 415 NIC based on a thorough review of colonoscopy, pathology and clinical reports. Logistic regression analysis was applied to estimate the risk of polyps in patients with IBD compared to those with NIC after adjusting for age and sex. A subgroup analysis within the IBD group was performed.

Results

Of the 485 patients, 415 were NIC and 70 were IBD. Seventy-three percent of the NIC patients and 81% of the IBD patients were African Americans. Forty six percent of IBD and 41% of NIC cases were male. IBD patients were younger than NIC patients (median age of 38 years vs. 50, P < 0.001). The prevalence of all types of polyps was 15.7 and 8.2% in the IBD and NIC groups, respectively (P = 0.045). Among patients with polyps, the prevalence of inflammatory polyps was higher in the IBD group (55%) compared to the NIC group (12%). After adjusting for age, sex and race, odds ratio of inflammatory polyps in IBD patients was 6.0 (P = 0.016). Adenoma prevalence was 4.3% (3/70) in IBD patients and 3.9% (16/415) in the NIC patients (p = 0.75). The anatomic distribution of lesions and colitis shows that polyps occur predominantly in the colitis field regardless of colitis type. More polyps were present in the ulcerative colitis patients when compared to Crohn’s disease patients (27% vs. 5%, P < 0.001) within the IBD group.

Conclusion

Our study shows that inflammatory polyps are more common in IBD patients when compared to NIC patients. Most polyps were in the same location as the colitis.
Feasibility and safety of high-intensity interval training for the rehabilitation of geriatric inpatients (HIITERGY) a pilot randomized study
Authors: Pires Peixoto Rita , Trombert Véronique , Poncet Antoine , Kizlik Jérôme , Gold Gabriel , Ehret Georg , Trombetti Andrea , Reny Jean-Luc
Published: June 2020

Background

High-intensity interval training (HIIT) has been shown to be more effective than moderate-intensity continuous training (MICT) for the physical rehabilitation. However, data on its suitability for older hospitalized patients is scarce.

Methods

Randomized controlled trial in a hospital setting. Inclusion of 100 patients, ≥65 years old, hospitalized for rehabilitation after an acute medical condition, in a two-week rehabilitation program of either four HIIT or three MICT sessions per week. Completion was defined as participation in all but two planned sessions accomplishing ≥50% of each session. We assessed: upper-limb muscle strength (handgrip isometric strength test), lower-limb muscle strength (quadriceps and ankle flexion and extension tests); gait speed and spatio-temporal parameters (instrumented walkway), and exercise capacity (6-min walk test). All adverse events were recorded as safety endpoints.

Results

An intention-to-treat analysis showed a 44% completion rate for the HIIT group (95% CI, 30–59) and 77% for MICT (95% CI, 55–82). A modified intention-to-treat analysis restricted to patients who participated in ≥1 session showed an 88% completion rate in the HIIT group (95%CI, 69–97) and an 80% completion rate in MICT (95%CI, 65–90). The exercises most frequently undertaken were the pedal exerciser (54%) and the NuStep (32%). There were no significant differences in the various measures. No serious adverse events occurred.

Conclusion

A HIIT rehabilitation program for this population was feasible, safe and had a high adherence rate.

Trial registration number

Clinicatrials.gov ID: NCT02318459.

Trial registration date: November 7th, 2014. Retrospectively registered.

This study adheres to the CONSORT guidelines.
Prevalence of chronic HBV infection in pregnant woman attending antenatal care in a tertiary hospital in Mwanza, Tanzania: a cross-sectional study
Authors: Geffert Karin , Maponga Tongai G. , Henerico Shimba , Preiser Wolfgang , Mongella Stella , Stich August , Kalluvya Samuel , Mueller Andreas , Kasang Christa
Published: June 2020

Background

Tanzania has a high prevalence (7.17%) of chronic hepatitis B infection. Mother to Child transmission is very common, resulting in high rate of chronic infections. Currently, there is no screening program for HBV in pregnant women. This study investigated the prevalence and risk factors for chronic HBV infection in pregnant women in a tertiary hospital in Mwanza, Tanzania.

Methods

Seven hundred and forty-three women attending antenatal care and/or delivering at the Bugando Medical Centre were enrolled. All answered a questionnaire on sociodemographic and other risk factors and were tested for HBsAg using a rapid test. In HBsAg positive mothers, maternal blood and umbilical cord blood samples collected after delivery were analyzed for serological (HBsAg, HBeAg and anti-HBe) and virologic (HBV-DNA viral load and genotype) markers. All their babies were vaccinated within 24 h of delivery. The children were followed up at 3 years of age. Data was analyzed using the Mann-Whitney U-test, independent sample T-test and logistic regression.

Results

Of the 743 participants, 22 (3%) were positive for HBsAg, and 2 (9%) had detectable HBe-antigen. Low condom use was the only statistically significant risk factor for chronic HBV infection (OR = 3.514, 95%CI = 1.4–8.0). Of 14 maternal blood samples genotyped, 10 (71%) were genotype A and 4 (29%) were genotype D. HBV-DNA was detected in 21/22 samples, with a median of 241 IU/ml (range: 27.4–25.9 × 107 IU/ml). Five (33%) of 15 available cord blood samples were positive for HBsAg and 10 (67%) were negative. At follow-up, one child showed chronic HBV infection characteristics, one had anti-HBs level of 7 mIU/ml and 5/7(71%) had protective anti-HBs levels (> 10 mIU/ml).

Conclusion

This cohort of pregnant women showed a lower-intermediate prevalence of HBV of 3%. In the 3 years follow-up only 1 out of 7 children showed evidence of chronic HBV infection. The child’s mother with high viral load (25.9 × 107 IU/ml), was positive for HBeAg with a high degree of sequence similarity suggesting vertical transmission. These results highlight a need for improved diagnosis and treatment of HBV infection in pregnant women in Tanzania, in order to prevent vertical transmission.
Delta neutrophil index as a predictive and prognostic factor for Candidemia patients: a matched case-control study
Authors: Park So Yeon , Lee Jin Seo , Oh Jihyu , Park Ji-Young
Published: June 2020

Background

Delayed antifungal therapy for candidemia leads to increased mortality. Differentiating bacterial infection from candidemia in systemic inflammatory response syndrome (SIRS) patients is complex and difficult. The Delta Neutrophil Index (DNI) has recently been considered a new factor to distinguish infections from non-infections and predict the severity of sepsis. We aimed to assess if the DNI can predict and provide a prognosis for candidemia in SIRS patients.

Methods

A matched case-control study was conducted from July 2016 to June 2017 at Kangdong Sacred Heart Hospital. Among patients with a comorbidity of SIRS, those with candidemia were classified as the case group, whereas those with negative blood culture results were classified as the control group. The matching conditions included age, blood culture date, and SIRS onset location. Multivariate logistic regression was performed to evaluate DNI as a predictive and prognostic factor for candidemia.

Results

The 140 included patients were assigned to each group in a 1:1 ratio. The DNI_D1 values measured on the blood culture date were higher in the case group than in the control group (p <  0.001). The results of multivariate analyses confirmed DNI_D1 (odds ratio [ORs] 2.138, 95% confidential interval [CI] 1.421–3.217, p <  0.001) and Candida colonization as predictive factors for candidemia. The cutoff value of DNI for predicting candidemia was 2.75%. The area under the curve for the DNI value was 0.804 (95% CI, 0.719–0.890, p < 0.001), with a sensitivity and specificity of 72.9 and 78.6%, respectively. Analysis of 14-day mortality in patients with candidemia showed significantly higher DNI_D1 and DNI_48 in the non-survivor group than in the survivor group.

Conclusions

DNI was identified as a predictive factor for candidemia in patients with SIRS and a prognostic factor in predicting 14-day mortality in candidemia patients. DNI, along with clinical patient characteristics, was useful in determining the occurrence of candidemia in patients with SIRS.
Objective cognitive performance and subjective complaints in patients with chronic Q fever or Q fever fatigue syndrome
Authors: Reukers Daphne F. M. , Aaronson Justine , van Loenhout Joris A. F. , Meyering Birte , van der Velden Koos , Hautvast Jeannine L. A. , van Jaarsveld Cornelia H. M. , Kessels Roy P. C.
Published: June 2020

Background

Primary aim of this study was to compare cognitive performance of patients with chronic Q fever or Q fever fatigue syndrome (QFS) to matched controls from the general population, while taking performance validity into account. Second, we investigated whether objective cognitive performance was related to subjective cognitive complaints or psychological wellbeing.

Methods

Cognitive functioning was assessed with a neuropsychological test battery measuring the domains of processing speed, episodic memory, working memory and executive functioning. Tests for performance validity and premorbid intelligence were also included. Validated questionnaires were administered to assess self-reported fatigue, depressive symptoms and cognitive complaints.

Results

In total, 30 patients with chronic Q fever, 32 with QFS and 35 controls were included. A high percentage of chronic Q fever patients showed poor performance validity (38%) compared to controls (14%, p = 0.066). After exclusion of participants showing poor performance validity, no significant differences between patients and controls were found in the cognitive domains. QFS patients reported a high level of cognitive complaints compared to controls (41.2 vs 30.4, p = 0.023). Cognitive complaints were not significantly related to cognitive performance in any of the domains for this patient group.

Conclusions

The high level of self-reported cognitive complaints in QFS patients does not indicate cognitive impairment. A large proportion of the chronic Q fever patients showed suboptimal mental effort during neuropsychological assessment. More research into the underlying explanations is needed. Our findings stress the importance of assessing cognitive functioning by neuropsychological examination including performance validity, rather than only measuring subjective cognitive complaints.
Cryptococcal osteomyelitis of the Zygomatic bone: a case report
Authors: Matsuki Takashi , Miyamoto Shunsuke , Yamashita Taku
Published: June 2020

Background

Disseminated cryptococcosis is a well-characterized complication in immunocompromised patients with cryptococcal pneumonia or meningitis; however, isolated cryptococcal osteomyelitis is a rare entity that occurs in approximately 5% of patients with cryptococcosis. Cryptococcal osteomyelitis in the head and neck region is extremely rare. To the best of our knowledge, no cases of cryptococcal osteomyelitis affecting only the zygomatic bone have been reported to date.

Case presentation

A 78-year-old man without other comorbidities presented with progressive swelling of the right cheek along with pain and trismus. Clinical examination revealed a tender swelling in the right zygomatic region; the maximal mandibular opening was about 2 cm. Laboratory data showed mildly elevated inflammatory indices (C-reactive protein: 0.45 mg/dL; erythrocyte sedimentation rate: 35 mm/h). Computed tomography showed a 30-mm-diameter lesion at the right zygomatic arch. A part of the lesion has extended to the subcutaneous area of the cheeks with signs of bone destruction and surrounding contrast effects. Histopathological examination of fine-needle aspirate and needle biopsy showed cryptococcus. Furthermore, culture of the aspirate showed growth of Cryptococcus neoformans. No evidence of any other site involvement was observed. Therefore, the patient was diagnosed with isolated cryptococcal osteomyelitis and was initiated on fluconazole therapy. The treatment was effective, and all symptoms were resolved in 4 weeks. Fluconazole therapy was stopped after 6 months. There are no signs of recurrence as of 15-month follow-up. The patient has no cosmetic abnormalities or sequelae.

Conclusions

Fine-needle aspiration cytology, needle biopsy, and fungal culture were useful for definitive diagnosis. Immunocompetent patients with isolated osteomyelitis may be cured with oral fluconazole alone.
Effectiveness of fetal scalp stimulation test in assessing fetal wellbeing during labor, a retrospective cohort study
Authors: Shakouri Farzaneh , Iorizzo Linda , Edwards Hellen Mc Kinnon , Vinter Christina Anne , Kristensen Karl , Isberg Per-Erik , Wiberg Nana
Published: June 2020

Background

It is discussed whether fetal scalp stimulation (FSS) test is a reliable complimentary tool to cardiotocography (CTG) to assess fetal wellbeing during labor. The test is based on the assumption that a well-oxygenated fetus, in contrast to the depressed fetus, will respond to a certain stimulus. The aim of this study was to investigate the effectiveness of the FSS-test.

Methods

A retrospective observational study carried out Copenhagen University Hospital, Herlev, Denmark. Laboring women with singleton pregnancies in cephalic presentation after gestation week 33 and indication for fetal blood sampling (FBS) were eligible for inclusion. The FSS-test was classified as positive when an acceleration was absent at the time of FBS and negative when an acceleration was present. Lactate in scalp blood was measured by the point-of-care device LactatePro™ and pH in artery umbilical cord blood by the stationary blood gas analyzer ABL800. Lactate level < 4.2 mmol/L in scalp blood and arterial cord pH > 7.1 were cut-offs for normality.

Results

Three hundred eighty-five women were included. The cohort was divided by the FBS-to-delivery time: Group 1 (n = 128) ≤ 20 min, Group 2 (n = 117) 21–59 min and Group 3 (n = 140) ≥ 60 min. The proportion of FSS-positive tests differed significantly between the groups (p < 0.000). In Group 1 the sensitivity, specificity and likelihoods for scalp lactate ≥4.2 mmol/L were 81.5 (95% CI 67–90.1), 13.3 18.5 (95% CI 5.9–24.6), LHR+ 0.94 (95% CI 0.8–1.1) and LHR – 1.4 (95% CI 0.6–3.2) and for umbilical artery pH ≤ 7.10 the values were 82.6% (95% CI 61.2–95.1), 16% (95% CI 9.4–24.7), 1.0 (95% CI 0.8–1.2) and 1.1 (95% CI 0.4–3) respectively. Regardless of the FBS-to-delivery time the LHR+ for lactate ≥4.2 mmol/L increased to 1.38 (95% CI 1.2–1.6).

Conclusion

The effectiveness of scalp stimulation test was poor for both ruling in and out fetal hypoxia during labor. Absence of a provoked acceleration seems to be a normal phenomenon in the second stage of labor.
Prognostic value of OCT4A and SPP1C transcript variant co-expression in early-stage lung adenocarcinoma
Authors: Koshimune Seijiro , Kosaka Mitsuko , Mizuno Nobuhiko , Yamamoto Hiromasa , Miyamoto Tomoyuki , Ebisui Kohta , Toyooka Shinichi , Ohtsuka Aiji
Published: June 2020

Background

Octamer-binding transcription factor 4A (OCT4A) is essential for cell pluripotency and reprogramming both in humans and mice. To date, however, the function of human OCT4 in somatic and/or tumour tissues is largely unknown.

Methods

RT-PCR was used to identify full-length splice forms of OCT4 transcripts in normal and cancer cells. A FLAG-tagged OCT4 genomic transgene was used to identify OCT4-positive cancer cells. A potential role for OCT4 in somatic cancer cells was examined by cell ablation of OCT4-positive cells using promoter-driven diphtheria toxin A. OCT4 and secreted phosphoprotein 1 (SPP1) transcripts in early-stage lung adenocarcinoma tumours were analysed and compared with pathohistological features.

Results

The results show that, unlike in murine cells, OCT4A and OCT4B variants are transcribed in both human cancer cells and in adult tissues such as lung, kidney, uterus, breast, and eye. We found that OCT4A and SPP1C are co-expressed in highly aggressive human breast, endometrial, and lung adenocarcinoma cell lines, but not in mesothelial tumour cell lines. Ablation of OCT4-positive cells in lung adenocarcinoma cells significantly decreased cell migration and SPP1C mRNA levels. The OCT4A/SPP1C axis was found in primary, early-stage, lung adenocarcinoma tumours.

Conclusions

Co-expression of OCT4 and SPP1 may correlate with cancer aggressiveness, and the OCT4A/SPP1C axis may help identify early-stage high-risk patients with lung adenocarcinoma. Contrary to the case in mice, our data strongly suggest a critical role for OCT4A and SPP1C in the development and progression of human epithelial cancers.
INFORM2 NivEnt: The first trial of the INFORM2 biomarker driven phase I/II trial series: the combination of nivolumab and entinostat in children and adolescents with refractory high-risk malignancies
Authors: van Tilburg Cornelis M. , Witt Ruth , Heiss Melanie , Pajtler Kristian W. , Plass Christoph , Poschke Isabel , Platten Michael , Harting Inga , Sedlaczek Oliver , Freitag Angelika , Meyrath David , Taylor Lenka , Balasubramanian Gnana Prakash , Jäger Natalie , Pfaff Elke , Jones Barbara C. , Milde Till , Pfister Stefan M. , Jones David T. W. , Kopp-Schneider Annette , Witt Olaf
Published: June 2020

Background

Pediatric patients with relapsed or refractory disease represent a population with a desperate medical need. The aim of the INFORM (INdividualized Therapy FOr Relapsed Malignancies in Childhood) program is to translate next generation molecular diagnostics into a biomarker driven treatment strategy. The program consists of two major foundations: the INFORM registry providing a molecular screening platform and the INFORM2 series of biomarker driven phase I/II trials. The INFORM2 NivEnt trial aims to determine the recommended phase 2 dose (RP2D) of the combination treatment of nivolumab and entinostat (phase I) and to evaluate activity and safety (phase II).

Methods

This is an exploratory non-randomized, open-label, multinational and multicenter seamless phase I/II trial in children and adolescents with relapsed / refractory or progressive high-risk solid tumors and CNS tumors. The phase I is divided in 2 age cohorts: 12–21 years and 6–11 years and follows a 3 + 3 design with two dose levels for entinostat (2 mg/m2 and 4 mg/m2 once per week) and fixed dose nivolumab (3 mg/kg every 2 weeks). Patients entering the trial on RP2D can seamlessly enter phase II which consists of a biomarker defined four group basket trial: high mutational load (group A), high PD-L1 mRNA expression (group B), focal MYC(N) amplification (group C), low mutational load and low PD-L1 mRNA expression and no MYC(N) amplification (group D). A Bayesian adaptive design will be used to early stop cohorts that fail to show evidence of activity. The maximum number of patients is 128.

Discussion

This trial intends to exploit the immune enhancing effects of entinostat on nivolumab using an innovative biomarker driven approach in order to maximize the chance of detecting signs of activity. It prevents exposure to unnecessary risks by applying the Bayesian adaptive design for early stopping for futility. The adaptive biomarker driven design provides an innovative approach accelerating drug development and reducing exposure to investigational treatments in these vulnerable children at the same time.

Trial registration

ClinicalTrials.gov, NCT03838042. Registered on 12 February 2019.