bluuebunny/crossref_metadata_2025 huggingface dataset:
The Sufficient Immunoregulatory Effect of Autologous Bone Marrow-Derived Mesenchymal Stem Cell Transplantation on Regulatory T Cells in Patients with Refractory Rheumatoid Arthritis
Authors: Ghoryani Mohsen , Shariati-Sarabi Zhaleh , Tavakkol-Afshari Jalil , Mohammadi Mojgan
Published: April 2020

Rheumatoid arthritis (RA) is an advanced autoimmune disease described by joint involvement. The special properties of mesenchymal stem cells (MSCs) introduced them as a potential therapeutic candidate for RA. In this study, a single dose of autologous MSCs isolated from bone marrow (autologous BM-MSCs, 1×106 per kg) was injected intravenously into 13 patients suffering from refractory RA who were followed up within 12 months after the intervention to evaluate immunological elements. Our results showed that the gene expression of forkhead box P3 (FOXP3) in peripheral blood mononuclear cells (PBMCs) considerably increased at month 12. We found a substantial increasing trend in the culture supernatant levels of IL-10 and transforming growth factor-beta 1 (TGF-β1) in PBMCs from the beginning of the intervention up to the end. Our data may reflect the sufficient immunoregulatory effect of autologous BM-MSCs on regulatory T cells in patients suffering from refractory RA.
miR-24-3p/KLF8 Signaling Axis Contributes to LUAD Metastasis by Regulating EMT
Authors: Jing Pengyu , Xie Nianlin , Zhao Nan , Zhu Ximing , Li Pei , Gao Guizhou , Dang Haizhou , Gu Zhongping
Published: April 2020

Reprogramming of the tumor immune microenvironment is a salient feature during metastasis in LUAD. miR-24-3p and KLF8, which are key regulators of the tumor immune microenvironment, had been proved to show metastasis-promoting property in LUAD. However, whether miR-24-3p could regulate LUAD metastasis by targeting KLF8 remains unclear. This study explored the functions and mechanisms of miR-24-3p/KLF8 signaling in advanced LUAD. The expression level of miR-24-3p and KLF8 were tested in LUAD patients, and the corelation of miR-24-3p and KLF8 was evaluated. The interaction of miR-24-3p and KLF8 was demonstrated by luciferase reporter activity assay, in vitro migration and invasion studies, and in vivo metastatic studies. miR-24-3p level was downregulated in LUAD and negatively associated with KLF8 mRNA expression. miR-24-3p controls LUAD metastasis by directly targeting KLF8 and inducing Snail and E-cadherin expressions. Targeting the miR-24-3p/KLF8/EMT axis might be of great therapeutic value to advanced LUAD patients.
Floristic Diversity and Natural Regeneration Status of Entoto Mountain and the Surrounding Area in Addis Ababa, Ethiopia
Authors: Atinafe Ergua , Assefa Ephrem , Belay Birhanu , Endale Yemenzwork , Seta Talemos
Published: April 2020

The study was carried out at Entoto Mountain and its surrounding area, about 10 km north of the center of Addis Ababa. The purpose of this study was to assess the floristic composition and regeneration status of woody species and recommend further conservation methods. Ten transect lines were laid from south-north at 1 km interval. Along these transect lines, 62 sample plots of 400 m2 (20 m × 20 m) were laid at 1 km interval. A total of 179 plant species belonging to 107 genera and 60 families were recorded. Asteraceae (30 species) was the most dominant family. Of 179 plant species, 73 were naturally regenerated woody species representing 48 genera and 34 families. Herbs account for the largest growth form (91, 50.84%), indicating the fact that disturbance favors herb species. For the analysis of vegetation diversity, woody species composition, and density, the study area was classified into five land-use types. Of the five land-use types, degraded land-use type had low species diversity and evenness (1.48 and 0.295), and it had a low density of economically and ecologically important larger trees. However, the density of seedlings and saplings showed the normal regeneration status for the herbs and shrubs. Therefore, responsible stakeholders should give high priority for the conservation of ecologically and economically important large trees using appropriate conservation methods in the study area.
Age-Related Differences in the Association between Plasma High-Sensitivity C-Reactive Protein and Noncalcified or Mixed Coronary Atherosclerotic Plaques
Authors: Li Tiewei , Chen Ning , Liu Zhengan , Shan Zhiming , Dong Geng , Yang Junmei , Qi Minglu
Published: April 2020

Background. Previous studies have demonstrated that plasma high-sensitivity C-reactive protein (hsCRP) was the predictor for unstable coronary plaque. Patients with noncalcified plaque (NCP) or mixed plaque (MP) have a higher risk of poor outcomes. However, the association between hsCRP and the presence of NCP or MP (NCP/MP) in old adults remains unclear, and if present, whether there exist differences between young and old adults remain unknown. Thus, the aim of this study was to investigate the role of hsCRP in predicting the presence of NCP/MP and evaluate whether age has any impact on this association. Methods. A total of 951 subjects were included in this study. Complete clinical and laboratory data were collected. According to the characteristics of the most stenotic plaque, we divided them into 2 groups: calcified plaque (CP) and NCP/MP. Subjects with no plaque were classified as the control group (CR). Subjects with age≥60 years were defined as older adults, and those with age<60 years were classified as nonelderly people. Results. Patients with NCP/MP had significantly higher hsCRP level compared with subjects with CR or CP in older adults but not in nonelderly people. The proportion of NCP/MP was significantly increased from 27.0% in the hsCRP<1.25 mg/L group to 42.7% in the hsCRP>2.70 mg/L group in older adults. Multiple logistic regression analysis showed that hsCRP was an independent risk factor for the presence of NCP/MP (odds ratio OR=1.093, 95% CI 1.032–1.157, P=0.001) only in older adults. Conclusions. hsCRP is independently associated with the presence of NCP/MP in older adults but not in nonelderly people. These results suggest the potential significance of hsCRP-lowering regimens in older adults with NCP/MP.
The 2-Extra Connectivity of Wheel Networks
Authors: Feng Wei , Wang Shiying
Published: April 2020

Connectivity is a significant metric for evaluating the error lenience of an interconnected net G=V,E. In the paper (Fàbrega and Fiol, 1996), the authors addressed the g-extra connectivity which is applied to better measure the consistency and error tolerance of G. As a special Cayley graph, the n-dimensional wheel network CWn has some desirable features. This paper shows that the g-extra connectivity of CWnn≥6 is 6n−12 when g=2.
Systemic Inflammation Score as a Predictor of Pneumonia after Radical Resection of Gastric Cancer: Analysis of a Multi-Institutional Dataset
Authors: Shoka Michita , Kanda Mitsuro , Ito Seiji , Mochizuki Yoshinari , Teramoto Hitoshi , Ishigure Kiyoshi , Murai Toshifumi , Asada Takahiro , Ishiyama Akiharu , Matsushita Hidenobu , Tanaka Chie , Kobayashi Daisuke , Fujiwara Michitaka , Murotani Kenta , Kodera Yasuhiro
Published: April 2020

Background: Curative treatment for gastric cancer (GC) comprising gastrectomy with systematic lymph node dissection can result in postoperative complications. Postoperative pneumonia is sometimes fatal, like surgery-related complications such as anastomotic leakage. In this retrospective study, we analyzed a multi-institutional collaborative dataset with the aim of identifying predictors of postgastrectomy pneumonia. Methods: From a retrospective database of 3,484 patients who had undergone gastrectomy for GC at nine Japanese institutions between 2010 and 2014, 1,415 patients who met all eligibility criteria were identified as eligible for analysis. Predictive values of 31 candidate variables for postoperative pneumonia were assessed. Results: Forty-two patients (3.0%) had grade II or higher postoperative pneumonia. Preoperative systemic inflammation score (SIS) had the greatest area under the curve (0.655) for predicting postoperative pneumonia (optimal cutoff value = 2). The odds ratio (OR) of high SISs associated with postoperative pneumonia was 3.10 (95% confidence interval [CI], 1.54–6.07; p < 0.001). Multivariate binomial logistic analysis identified high SIS as an independent risk factor for postoperative pneumonia (OR, 2.31; 95% CI, 1.19–4.48; p = 0.013). A forest plot revealed that ORs of high SISs were highest in female patients. Conclusions: Our findings indicate that the preoperative SIS may serve as a simple predictor of postgastrectomy pneumonia, assisting physicians’ efforts to take preventive measures against this complication.
Long-Term Clinical Outcome in Familial and Sporadic Papillary Thyroid Carcinoma
Authors: Capezzone Marco , Fralassi Noemi , Secchi Chiara , Cantara Silvia , Brilli Lucia , Pilli Tania , Maino Fabio , Forleo Raffaella , Pacini Furio , Cevenini Gabriele , Cartocci Alessandra , Castagna Maria Grazia
Published: April 2020

Background: The definition and the behaviour of familial papillary thyroid cancer (FPTC) compared to the sporadic form (SPTC) are still debated. Some authors believe that only families with 3 or more affected members represent an actual example of familial diseases. Objectives: The objective of the study was to analyse the clinicopathological features and the outcome of sporadic and familial PTC patients also according to the number of affected members. Methods: Among 731 patients, we identified 101 (13.8%) with familial diseases, 79 with 2 affected members (FPTC-2) and 22 with 3 or more affected members (FPTC-3) followed for a mean period of 10 years. Results: FPTC patients had more frequently bilateral tumour (p = 0.007). No difference was found between the 2 groups for the other evaluated variables. At the time of the first follow-up (1–2 years after initial therapy), FPTC patients had a higher rate of persistent disease. However, at the last follow-up, the clinical outcome was not different between sporadic and familial patients. When the comparison between SPTC and FPTC was performed, according to the number of affected members, a significant trend between the 3 groups was observed for tumour diameter (p = 0.002) and bilaterality (p = 0.003), while we did not observe a significant trend for both response to initial therapy (p = 0.15) and last clinical outcome (p = 0.22). Conclusions: Our results suggest that, although the clinicopathological features of FPTC may be more aggressive, the long-term outcome is similar between FPTC and SPTC. A possible explanation is that PTC has a favourable prognosis, even when clinical presentation is more aggressive.
The Hyperdense Middle Cerebral Artery Sign in Drip-and-Ship Models of Acute Stroke Management
Authors: Jodaitis Lise , Ligot Noémie , Chapusette Rudy , Bonnet Thomas , Gaspard Nicolas , Naeije Gilles
Published: April 2020

Background: Large vessel occlusion (LVO) leads to debilitating stroke and responds modestly to recombinant tissue plasminogen activator (rt-TPA). Early thrombectomy improves functional outcomes in selected patients with proximal occlusion but it is not available in all medical facilities. The best imaging modality for triage in an acute stroke setting in drip-and-ship models is still the subject of debate. Objectives: We aimed to assess the diagnostic value of millimeter-sliced noncontrast computed tomography (NCCT) hyperdense middle cerebral artery sign (HMCAS) in itself or associated with clinical data for early detection of LVO in drip-and-ship models of acute stroke management. Methods: NCCT of patients admitted to the Erasme Hospital, ULB, Brussels, Belgium, for suspicion of acute ischemic stroke between January 1 and July 31, 2017, were collected. Patients with brain hemorrhages were excluded, leading to 122 cases. The presence of HMCAS on NCCT was determined via visual assessment by 6 raters blinded to all other data. An independent rater assessed the presence of LVO on digital subtraction angiography imaging or contrast-enhanced CT angiography (CTA). The sensitivity, false-positive rate (FPR), and accuracy of HMCAS and the dot sign to detect LVO were calculated. The interobserver agreement of HMCAS was assessed using Gwet’s AC1 coefficient. Then, on a separate occasion, the first 2 observers rereviewed all NCCT provided with clinical clues. The sensitivity, FPR, and accuracy of HMCAS were recalculated. Results: HMCAS was found in 21% of the cases and a dot sign was found in 9%. The mean HMCAS sensitivity was 62% (95% CI 45–79%) and its accuracy was 86% (95% CI 79–92%) for detecting LVO. The interobserver reliability coefficient was 80% for HMCAS. Combined with clinical information, HMCAS sensitivity increased to 81% (95% CI 68–94; p = 0.041) and accuracy increased to 91% (95% CI 86–96%). Conclusion: When clinical data are provided, detection of HMCAS on thinly sliced NCCT could be enough to decide on transfer for thrombectomy in drip-and-ship models of acute stroke management, especially in situations where CTA is less available and referral centers for thrombectomy fewer and further apart.
Epstein-Barr Virus Infection and Thiopurine Therapy in a Pediatric Population with Inflammatory Bowel Disease
Authors: Espinheira Maria Do Céu , Pais Isabel Pinto , Afonso Ivete , Ferreira Jorge , Trindade Eunice , Amil-Dias Jorge
Published: April 2020

Epstein Barr virus (EBV) primoinfection may contribute to the development of post-mononucleosis lymphomas in EBV-seronegative adult males with inflammatory bowel disease (IBD) under thiopurine therapy, but data on children are sparse. Knowledge of the EBV status may influence the type of surveillance and therapy in a group particularly vulnerable to the occurrence of EBV primoinfection. We aimed to determine the EBV status at diagnosis, the primoinfection rate, and complications in a pediatric Portuguese population with IBD. Method: This was a retrospective analysis of clinical records of pediatric patients with IBD. Demographic data, EBV status, as well as clinical and therapeutic data on primoinfection were collected. Results: Of the 250 patients evaluated, 229 (91.6%) had documented EBV screening and 50.8% were male. Mean age ± SD was 13.0 ± 2.8 years at diagnosis and 14.7 ± 2.3 years at EBV screening. EBV IgG serology was positive in 76.0% of patients. A total of 218 patients had been on therapy with azathioprine at some point. The average length of exposure to azathioprine was 4 years, and 91 patients (39.7%) were on azathioprine at EBV assessment. EBV primoinfection was documented in 4 patients (1.6%), all females, 2 of whom were on azathioprine. Two presented clinical signs of infection and 2 were identified at diagnostic screening; the first 2 suspended azathioprine and the other 2 did not initiate it. Conclusions: A significant proportion of pediatric Portuguese IBD patients are EBV-naïve. Systematic screening of EBV status enables the identification of patients at risk of primoinfection, and the occurrence of symptoms suggestive of acute EBV infection in seronegative patients should lead to rapid confirmation of the diagnosis. Timely diagnosis may allow the adjustment of therapeutic strategy sparing patients from potentially severe iatrogeny.
The Association of Fractional Pulse Pressure with Acute Kidney Injury in Patients Undergoing Coronary Intervention due to ST-Segment Elevated Myocardial Infarction
Authors: Burak Cengiz , Süleymanoğlu Muhammed , Yesin Mahmut , Cap Murat , Yıldız İbrahim , Rencüzoğulları İbrahim , Çağdaş Metin , Karabağ Yavuz , Hamideyin Şerif , İliş Doğan , Baysal Erkan
Published: April 2020

Objective: Acute kidney injury (AKI), which is prevalent in ST-segment elevated myocardial infarction (STEMI) patients who have undergone primary percutaneous coronary intervention (PCI), is associated with poor cardiovascular outcomes. As high pulse pressure (PP) is associated with adverse cardiovascular events, the present study’s aim was to evaluate the relationship between fractional PP (PPf) and AKI in patients with STEMI who underwent primary PCI. Subjects and Methods: All laboratory findings as well as echocardiographic and angiographic data of 1,170 consecutive STEMI patients were retrospectively screened. PPf was calculated from the pressures invasively measured after sheath insertion and before performing coronary angiography. Results: From 1,170 eligible STEMI patients (mean age 56 years, 18.2% female), AKI developed in 143 (12.2%) patients. The PPf and pulsatility index were significantly higher in patients with AKI than those without (0.53 ± 0.10 vs. 0.61 ± 0.10, p < 0.001, and 0.80 ± 0.03 vs. 0.82 ± 0.03, p < 0.001, respectively). PPf was also found to be associated with AKI in univariable (OR 2.183, 95% CI 1.823–2.614, p< 0.001) and multivariable (OR 1.874, 95% CI 1.513–2.322, p < 0.001) analysis. In-hospital mortality was higher in patients with AKI than those without. Conclusion: Invasively measured PPf, which can be easily measured and has no additional cost in STEMI patients undergoing coronary intervention, is an independent predictor of AKI. In addition, PPf is superior to other blood pressure values and derivatives in AKI prediction.
Uma investigação sobre a focalização do Programa Bolsa Família e seus determinantes imediatos
Authors: Portela Souza André , Duarte Janete , Semedo Neves José de Anchieta , Portela de Oliveira Plínio , Ricardo de Brito Gadelha Sérgio
Published: April 2020

Este estudo tem por objetivo realizar uma investigação sobre a focalização do Programa Bolsa Família (PBF) e seus determinantes imediatos, assim como uma análise quantitativa sobre as famílias beneficiadas. Os resultados econométricos indicam uma relação inversa entre a cobertura do PBF e os níveis de desenvolvimento social e econômico municipais. Há evidências de que municípios com maior qualidade na gestão dos recursos do PBF apresentam percentuais superiores de cobertura. Simulações de políticas sugerem a necessidade de que um direcionamento de políticas para universalização deve envolver esforços tanto para fins de efetivo alcance das famílias elegíveis, mas não beneficiárias, como para reduçãodo vazamento do programa.
Are laws restricting soft drinks sales in Brazilian schools able to lower their availability?
Authors: Azeredo Catarina Machado , Leite Maria Alvim , Rauber Fernanda , Ricardo Camila Zancheta , Levy Renata Bertazzi
Published: April 2020

OBJECTIVE: To describe students protected by laws and exposed to soft drinks sales and assess whether forbidding laws are associated with lower availability of these beverages. METHODS: We identified laws forbidding non-government administered cafeterias or sales of soft drinks in schools in the 27 Brazilian state capitals. Data on soft drinks sales were obtained from Pesquisa Nacional de Saúde do Escolar 2015 (PeNSE – National Survey of School Health 2015), for a representative sample of 9th graders from public and private schools. Students were attributed with the status of their school regarding the law and sale of soft drinks. Co-variables were school status (public or private), school size, geographic regions, mother’s educational level, score of goods and services. We performed multivariate analyses using Poisson regression. RESULTS: The total of 23 laws forbidding sales of soft drinks covered 63.0% of capitals, comprising 56.9% of students. Law coverage was higher among students from more developed regions (67.6%) and in public schools (60.6%), compared with those from less developed regions (38.0%) and private schools (45.8%). Soft drinks were available for 33.9% of students. Students attending public schools in less developed regions had the lowest availability of soft drinks, regardless of law coverage (14.8%; 12.0%); while students attending private schools in these regions had a high availability, regardless of law coverage (82.1%; 73.4%). Restrictive laws were associated with lower sales of soft drinks in more developed regions, and restrictions had a greater association with the availability of soft drinks in public schools (PR = 0.25; 95%CI = 0.15-0.41), compared with private schools (PR = 0.48; 95%CI = 0.35-0.66). CONCLUSION: Laws restricting soft drinks in schools were associated with fewer sales in more developed regions. Private schools were less compliant with the law than public schools. A broadly enforced national law could reduce the availability of soft drinks in schools.
Regular dental care in preschoolers in rural Southern Brazil
Authors: Camerini Adriana Vieira , Silva Alexandre Emidio Ribeiro , Prietsch Silvio Omar Macedo , Meucci Rodrigo Dalke , Soares Mariane Pergher , Belarmino Vanusa , Fernandes Fabiana Da Silva
Published: April 2020

OBJECTIVE: To evaluate if factors related to the mother’s previous guidance on her children’s dental health and the school attendance of children influence the regular dental care of preschoolers living in the rural area of a municipality in Southern Brazil. METHODS: A population-based study was conducted with 264 children under five years of age and their mothers. Socioeconomic and behavioral data were collected using a questionnaire, and the children were subjected to dental health tests. The outcome was the regular use of dental services. The main exposure variables were children’s care in daycare centers or schools and maternal guidance on the child’s dental health. Poisson regression analysis with robust variance adjustment was used to estimate prevalence ratios, considering a 95% confidence interval. RESULTS: The prevalence of regular use was 11.4% (95%CI 7.5–15.2). In the adjusted analysis, the regular use of services was associated with the child attending day care center/school (PR = 2.44; 95%CI 1.38–4.34), and the mother received dental health guidance (PR = 4.13; 95%CI 1.77–9.61), even with control for socioeconomic, maternal and child variables. CONCLUSION: When mothers receive previous information on child dental health care and children attend schools or daycare centers, the likelihood of regular dental appointments in preschoolers living in rural locations increases.
Robust older adults in primary care: factors associated with successful aging
Authors: Maia Luciana Colares , Colares Figueiredo Braga , Moraes Edgar Nunes de , Costa Simone De Melo , Caldeira Antônio Prates
Published: April 2020

OBJECTIVE: To estimate the prevalence of robustness among older adults assisted in primary health care and identify factors in successful aging. METHODS: This is a cross-sectional study conducted with older adults in Northern Minas Gerais, Brazil. Two questionnaires were used for data collection: the Brazilian Older Americans Resources and Services Multidimensional Function Assessment Questionnaire (BOMFAQ) and the Clinical-Functional Vulnerability Index IVCF-20). The adjusted prevalence ratios were obtained by robust Poisson regression. Statistical analysis was performed for older adults in general (60 to 107 years) and stratified by age: from 60 to 79 years and 80 years or more. RESULTS: A total of 1,750 older adults aged 60 to 107 years participated; between them, 48.7% were robust. Older adults aged 60 to 79 years (n = 1,421) and 80 years or more (n = 329) had a prevalence of robustness of 55.4% and 19.3%, respectively. Some factors associated with successful aging were: positive self-perception of health, dancing habits, walking habits, absence of cognitive impairment, absence of depressive symptoms and polypathology, as well as daily life independence. After adjustment by age, the absence of polypathology and independence for activities of daily living stand out for robustness between 60 and 79 years; in those aged 80 years and over, independence for activities of daily living and dance practice presented greater strength of association. CONCLUSION: The prevalence of robust older adults in primary care is considered satisfactory for the older population in general but decreases with age and is associated with the absence of diseases and disabilities. These results denote the need to redesign the health care system, focusing on promoting and preventing clinical-functional vulnerability.
Characteristics of primary care and rates of pediatric hospitalizations in Brazil
Authors: Lisboa Lívia Anniele Sousa , Queiroz Rejane Christine de Sousa , Thomaz Erika Bárbara Abreu Fonseca , Silva Núbia Cristina da , Rocha Thiago Augusto Hernandes , Vissoci João Ricardo Nickenig , Staton Catherine Ann , Lein Adriana , Simões Vanda Maria Ferreira , Thumé Elaine , Facchini Luiz Augusto
Published: April 2020

OBJECTIVE: To evaluate the association among characteristics of primary health care center (PHCC) with hospitalizations for primary care sensitive conditions (PCSC) in Brazil. METHOD: In this study, a cross-sectional ecological study was performed. This study analyzed the 27 capitals of Brazil’s federative units. Data were aggregated from the following open access databases: National Program for Access and Quality Improvement in Primary Care, the Hospital Information System of Brazilian Unified Health System and Annual Population Census conducted by the Brazilian Institute of Geography and Statistics. Associations were estimated among characteristics of primary care with the number of three PCSC as the leading causes of hospitalization in children under-5 population in Brazil: asthma, diarrhea, and pneumonia. RESULTS: In general, PHCC showed limited structural adequacy (37.3%) for pediatric care in Brazil. The capitals in South and Southeast regions had the best structure whereas the North and Northeast had the worst. Fewer PCSC hospitalizations were significantly associated with PHCC which presented appropriate equipment (RR: 0.98; 95%CI: 0.97–0.99), structural conditions (RR: 0.98; 95%CI: 0.97–0.99), and signage/identification of professionals and facilities (RR: 0.98; 95%CI: 0.97–0.99). Higher PCSC hospitalizations were significantly associated with PHCC with more physicians (RR: 1.23, 95%CI: 1.02–1.48), it forms (RR: 1.01, 95%CI: 1.01–1.02), and more medications (RR: 1.02, 95%CI: 1.01–1.03). CONCLUSION: Infrastructural adequacy of PHCC was associated with less PCSC hospitalizations, while availability medical professional and medications were associated with higher PCSC hospitalizations.
Pattern evolution of antidepressants and benzodiazepines use in a cohort
Authors: Alcantara Geisy De Carvalho , Coutinho Evandro Silva Freire , Faerstein Eduardo
Published: April 2020

OBJECTIVE: In recent decades there has been an increase in the use of antidepressants (AD) and a decrease in the use of benzodiazepines (BDZ). Prevalence, cumulative incidence, and factors associated with the incidence of AD and BDZ use in a Brazilian population were estimated in this article. METHODS: Data were collected with a self-administered questionnaire in a cohort of employees from a university in Rio de Janeiro. The prevalence of the use of AD and BDZ was calculated for 1999 (4,030), 2001 (3,574), 2006-07 (3,058), and 2012 (2,933). The cumulative incidences of the use of AD and BDZ between 1999 and 2007 were estimated by the Poisson models with robust variance estimates. RESULTS: In 1999, the prevalence of the use of AD and BDZ were 1.4% (95%CI: 1.1–1.8) and 4.7% (95%CI: 4.1–5.4), respectively; in 2012, they were 5.4% (95%CI: 5.5–6.2) and 6.8% (95%CI: 6.0–7.8). The incidence of use, between 1999 and 2007, was 4.9% (95%CI: 4.2–5.7) for AD and 8.3% (95%CI: 7.3–9.3) for BDZ. The incidences of AD and BDZ use were higher among women and participants with a positive General Health Questionnaire. CONCLUSION: In this population, the increase in the use of AD was not accompanied by a decrease in the use of BDZ, showing the prescriptions for psychotropic medication do not follow the currently recommended guidelines for treatment of common mental health disorders.
Outbreak investigation in cargo ship in times of COVID-19 crisis, Port of Santos, Brazil
Authors: Fernandes Eder Gatti , Santos Janice Da Silva , Sato Helena Keico
Published: April 2020

In February 2020, a Chinese cargo ship docked at the Port of Santos with reports of crew members with a feverish and respiratory condition. A team was gathered to verify the existence of suspected cases of COVID-19 inside the vessel and define its clearance. All 25 crew members were interviewed, and no suspected cases were found. The vessel was then cleared for port activities. The investigation resulted from the implementation of the contingency plan to face a public health emergency of international importance and several surveillance entities cooperated.
Remote Management of Pacemaker Patients With Biennial In-Clinic Evaluation
Authors: Watanabe Eiichi , Yamazaki Fumio , Goto Toshihiko , Asai Toru , Yamamoto Toshihiko , Hirooka Keiji , Sato Toshiaki , Kasai Atsunobu , Ueda Marehiko , Yamakawa Takeshi , Ueda Yasunori , Yamamoto Katsuhito , Tokunaga Takeshi , Sugai Yoshinao , Tanaka Kazuhiko , Hiramatsu Shigeki , Arakawa Tomoharu , Schrader Jürgen , Varma Niraj , Ando Kenji
Published: April 2020

Background:

Current expert consensus recommends remote monitoring for cardiac implantable electronic devices, with at least annual in-office follow-up. We studied safety and resource consumption of exclusive remote follow-up (RFU) in pacemaker patients for 2 years.

Methods:

In Japan, consecutive pacemaker patients committed to remote monitoring were randomized to either RFU or conventional in-office follow-up (conventional follow-up) at twice yearly intervals. RFU patients were only seen if indicated by remote monitoring. All returned to hospital after 2 years. The primary end point was a composite of death, stroke, or cardiovascular events requiring surgery, and the primary hypothesis was noninferiority with 5% margin.

Results:

Of 1274 randomized patients (50.4% female, age 77±10 years), 558 (RFU) and 550 (Conventional follow-up) patients reached either the primary end point or 24 months follow-up. The primary end point occurred in 10.9% and 11.8%, respectively (
P
=0.0012 for noninferiority). The median (interquartile range) number of in-office follow-ups was 0.50 (0.50–0.63) in RFU and 2.01 (1.93–2.05) in conventional follow-up per patient-year (
P
<0.001). Insurance claims for follow-ups and directly related diagnostic procedures were 18 800 Yen (16 500–20 700 Yen) in RFU and 21 400 Yen (16 700–25 900 Yen) in conventional follow-up (
P
<0.001). Only 1.4% of remote follow-ups triggered an unscheduled in-office follow-up, and only 1.5% of scheduled in-office follow-ups were considered actionable.

Conclusions:

Replacing periodic in-office follow-ups with remote follow-ups for 2 years in pacemaker patients committed to remote monitoring does not increase the occurrence of major cardiovascular events and reduces resource consumption.

Registration:

URL:
https://clinicaltrials.gov
; Unique identifier: NCT01523704.
Job Strain as a Risk Factor for Peripheral Artery Disease: A Multi‐Cohort Study
Authors: Heikkilä Katriina , Pentti Jaana , Madsen Ida E. H. , Lallukka Tea , Virtanen Marianna , Alfredsson Lars , Bjorner Jakob , Borritz Marianne , Brunner Eric , Burr Hermann , Ferrie Jane E. , Knutsson Anders , Koskinen Aki , Leineweber Constanze , Magnusson Hanson Linda L. , Nielsen Martin L. , Nyberg Solja T. , Oksanen Tuula , Pejtersen Jan H. , Pietiläinen Olli , Rahkonen Ossi , Rugulies Reiner , Singh‐Manoux Archana , Steptoe Andrew , Suominen Sakari , Theorell Töres , Vahtera Jussi , Väänänen Ari , Westerlund Hugo , Kivimäki Mika
Published: April 2020

Background

Job strain is implicated in many atherosclerotic diseases, but its role in peripheral artery disease (
PAD
) is unclear. We investigated the association of job strain with hospital records of
PAD
, using individual‐level data from 11 prospective cohort studies from Finland, Sweden, Denmark, and the United Kingdom.

Methods and Results

Job strain (high demands and low control at work) was self‐reported at baseline (1985–2008).
PAD
records were ascertained from national hospitalization data. We used Cox regression to examine the associations of job strain with
PAD
in each study, and combined the study‐specific estimates in random effects meta‐analyses. We used τ
2
, I
2
, and subgroup analyses to examine heterogeneity. Of the 139 132 participants with no previous hospitalization with
PAD
, 32 489 (23.4%) reported job strain at baseline. During 1 718 132 person‐years at risk (mean follow‐up 12.8 years), 667 individuals had a hospital record of
PAD
(3.88 per 10 000 person‐years). Job strain was associated with a 1.41‐fold (95% CI, 1.11–1.80) increased average risk of hospitalization with
PAD
. The study‐specific estimates were moderately heterogeneous (τ
2
=0.0427, I
2
: 26.9%). Despite variation in their magnitude, the estimates were consistent in both sexes, across the socioeconomic hierarchy and by baseline smoking status. Additional adjustment for baseline diabetes mellitus did not change the direction or magnitude of the observed associations.

Conclusions

Job strain was associated with small but consistent increase in the risk of hospitalization with
PAD
, with the relative risks on par with those for coronary heart disease and ischemic stroke.
Greater Daily Psychosocial Stress Exposure is Associated With Increased Norepinephrine‐Induced Vasoconstriction in Young Adults
Authors: Greaney Jody L. , Surachman Agus , Saunders Erika F. H. , Alexander Lacy M. , Almeida David M.
Published: April 2020

Background

Epidemiological data suggest a link between psychological stress and increased cardiovascular disease risk; however, the underlying mechanisms remain incompletely understood. The purpose of this investigation was to directly examine the influence of daily psychosocial stress on microvascular adrenergic vasoconstrictor responsiveness in healthy adults. We hypothesized increased daily psychosocial stress would be positively related to increased norepinephrine‐induced vasoconstriction.

Methods and Results

Eighteen healthy adults (19–36 years; 10 women) completed a daily psychosocial experiences telephone interview for 8 consecutive evenings in order to document their exposure and emotional responsiveness to common stressors (eg, arguments, work stress) over the preceding 24 hrs. On the last interview day, red cell flux (laser Doppler flowmetry) was measured during graded intradermal microdialysis perfusion of norepinephrine (10
−12
to 10
−2
 mol/L) and expressed as a percentage of baseline vascular conductance. Exogenous norepinephrine elicited progressive and robust vasoconstriction in all individuals (maximal vasoconstriction: 71±4%
base
; cumulative vasoconstriction [area under the curve]: 118±102 arbitrary units). Participants experienced a stressor on 51±5% of days and a total of 5.2±0.9 stressors over the 8‐day time frame. Increased daily frequency of stressor exposure was positively related to both maximal (
R
2
=0.26;
P
=0.03) and cumulative (
R
2
=0.31;
P
=0.02) vasoconstrictor responsiveness. Likewise, the total number of stressors was associated with increased maximal (
R
2
=0.40;
P
<0.01) and cumulative (
R
2
=0.27;
P
=0.03) norepinephrine‐induced vasoconstriction. Neither stressor severity nor stress‐related emotions were related to vasoconstrictor responsiveness.

Conclusions

Collectively, these data suggest that daily psychosocial stressor exposure by itself is sufficient to adversely influence microvascular vasoconstrictor function, regardless of the perceived severity or emotional consequences of the stressor exposure.
Efficient Position Decoding Methods Based on Fluorescence Calcium Imaging in the Mouse Hippocampus
Authors: Tu Mengyu , Zhao Ruohe , Adler Avital , Gan Wen-Biao , Chen Zhe S.
Published: April 2020

Large-scale fluorescence calcium imaging methods have become widely adopted for studies of long-term hippocampal and cortical neuronal dynamics. Pyramidal neurons of the rodent hippocampus show spatial tuning in freely foraging or head-fixed navigation tasks. Development of efficient neural decoding methods for reconstructing the animal's position in real or virtual environments can provide a fast readout of spatial representations in closed-loop neuroscience experiments. Here, we develop an efficient strategy to extract features from fluorescence calcium imaging traces and further decode the animal's position. We validate our spike inference-free decoding methods in multiple in vivo calcium imaging recordings of the mouse hippocampus based on both supervised and unsupervised decoding analyses. We systematically investigate the decoding performance of our proposed methods with respect to the number of neurons, imaging frame rate, and signal-to-noise ratio. Our proposed supervised decoding analysis is ultrafast and robust, and thereby appealing for real-time position decoding applications based on calcium imaging.
Eucheumatopsis sanibelensis sp. nov. from the Gulf coast of Florida, USA

Authors: PETERSON ELIAS S. , SCHNEIDER CRAIG W. , SAUNDERS GARY W.
Published: April 2020

Based upon COI-5P, LSU rDNA and rbcL sequence data, as well as its morphological characteristics, a new red algal species, Eucheumatopsis sanibelensis E.S.Peterson, C.W.Schneider et G.W.Saunders sp. nov., was discovered on the Gulf coast of Florida, USA and shown to be distinct from the generitype E. isiformis with a type locality in the eastern Caribbean Sea. The new more attenuate taxon from Sanibel Island represents only the second species in this newly described genus, a genus recently segregated from Eucheuma based upon significant molecular and morphological differences. The two species have overlapping geographic distributions in the eastern Gulf of Mexico, but thus far E. sanibelensis is only known from a single location.
Schoenus inconspicuus (Cyperaceae, tribe Schoeneae): a new species from Southern Africa

Authors: ELLIOTT TAMMY LYNN , EUSTON-BROWN DOUG I. W. , MUASYA A. MUTHAMA
Published: April 2020

Schoenus is a predominately austral genus of sedges in which the Southern African taxa have recently received detailed taxonomic attention, starting with a transfer of 24 species into Schoenus from Tetraria and Epischoenus in 2017. The taxonomy of the Southern African Schoenus species is currently being revised, which has brought insight into the existence of several species new to science. Here, we build on this recent taxonomic work by describing one new species that has been previously overlooked (Schoenus inconspicuus), while including a distribution map, an assessment of conservation status and an updated identification key.
Cyanus uysalii (Asteraceae, Cardueae), a new combination for the flora of Turkey

Authors: NEGARESH KAZEM
Published: April 2020

Cyanus uysalii (Şirin & Çeçen) Negaresh is proposed here as a new combination. It is morphologically similar to C. bourgaei, but differs from it by the stem length, the involucres size, the florets length, the rosette leaves dissection, and the achenes size.
Notes on the genus Streblocera Westwood, 1883 (Hymenoptera: Braconidae: Euphorinae) from Vietnam, with description of four new species
Authors: LONG KHUAT DANG , NHI PHAM THI
Published: April 2020

Species of the genus Streblocera Westwood are reviewed with four new species from Vietnam described and illustrated, viz. Streblocera (Eutanycerus) intermedia Long, sp. n.; S. (E.) quangbinhensis Long, sp. n.; S. (E.) trangana Long & Pham, sp. n.; and S. (E.) tuyenquangensis Long, sp. n.. A key to Vietnamese species of the subgenus Eutanycerus is provided.
A new species of the genus Euthystiroides Zhang, Zheng & Ren, 1995 from
Heilongjiang, China (Orthoptera, Acridoidea, Acrididae)
Authors: LI GUOCHAO , WEN XIAOCHEN , ZHI YONGCHAO
Published: April 2020

A new species of the genus Euthystiroides Zhang, Zheng & Ren, 1995 i.e. Euthystiroides heilongjiangensis sp. nov is described from Heilongjiang, China. The new species is allied to E. dalianensis Zhang, Zheng & Ren, 1995, but differs from latter by head shorter than pronotum distinctly and without black stripe in the middle, tegmina of male narrower, length 4.0 times width; length of interspace 1.9 times minimum width in mesosternum and width of epiphallus almost equal to high.
Laryngeal Evaluation during the COVID‐19 Pandemic: Transcervical Laryngeal Ultrasonography
Authors: Noel Julia E. , Orloff Lisa A. , Sung Kwang
Published: April 2020

The novel coronavirus disease (COVID‐19), caused by the SARS‐CoV‐2 virus, has quickly become a global pandemic since its initial outbreak in China in late 2019. Institutions are faced with the challenge of upholding the standard of care while maintaining safety for health care personnel and patients. Due to the common performance of aerosol‐generating endoscopic procedures in the upper respiratory tract, otolaryngologists are at uniquely high risk for potential infection. When possible, alternative diagnostic and treatment strategies should be pursued. For patients suspected of having functional laryngeal abnormalities, transcervical laryngeal ultrasound provides a rapid and noninvasive evaluation of vocal fold motion to inform decisions about safety of feeding, airway, and progression of care.
The Streetlight Effect: Regulating Genomics Where the Light Is
Authors: Evans Barbara J.
Published: April 2020

Regulatory policy for genomic testing may be subject to biases that favor reliance on existing regulatory frameworks even when those frameworks carry unintended legal consequences or may be poorly tailored to the challenges genomic testing presents. This article explores three examples drawn from genetic privacy regulation, oversight of clinical uses of genomic information, and regulation of genomic software. Overreliance on expedient regulatory approaches has a potential to undercut complete and durable solutions.
The Future of DTC Genomics and the Law
Authors: Greely Henry T.
Published: April 2020

Direct-to-Consumer (“DTC”) genomics has been a controversial topic for over a decade. Much work has been done on the legal issues it raises. This article asks a different question: What will DTC genomics and its legal issues look like in ten to twenty years? After discussing the five current uses of DTC genomics, it describes three current legal issues: medical uses, privacy of genomic information, and privacy in collection and analysis of human DNA. It then suggests that changes in human genomics and how it is used will make the first of those DTC genomics legal issues less important in the future, but that the third will be increasingly significant.
From “Informed” to “Engaged” Consent: Risks and Obligations in Consent for Participation in a Health Data Repository
Authors: Bromley Elizabeth , Mendoza-Graf Alexandra , Berry Sandra , Nebeker Camille , Khodyakov Dmitry
Published: April 2020

The development and use of large and dynamic health data repositories designed to support research pose challenges to traditional informed consent models. We used semi-structured interviewing (n=44) to elicit diverse research stakeholders' views of a model of consent appropriate to participation in initiatives that entail collection, long-term storage, and undetermined future research use of multiple types of health data. We demonstrate that, when considering health data repositories, research stakeholders replace a concept of consent as informed with one in which consent is engaged. In engaged consent, a participant's ongoing relationship with a repository serves as a substitute or adjunct to information exchange at enrollment. We detail research stakeholders' views of the risks of engaged consent and suggest questions for further study about engagement and consent procedures in initiatives that aim to store data for future unspecified research purposes.
Online Pediatric Research: Addressing Consent, Assent, and Parental Permission
Authors: Brothers Kyle B. , Clayton Ellen Wright , Goldenberg Aaron J.
Published: April 2020

This article provides practical guidance for researchers who wish to enroll and collect data from pediatric research participants through online and mobile platforms, with a focus on the involvement of both children and their parents in the decision to participate.
Expert Perspectives on Oversight for Unregulated mHealth Research: Empirical Data and Commentary
Authors: Beskow Laura M. , Hammack-Aviran Catherine M. , Brelsford Kathleen M. , O'Rourke P. Pearl
Published: April 2020

In qualitative interviews with a diverse group of experts, the vast majority believed unregulated researchers should seek out independent oversight. Reasons included the need for objectivity, protecting app users from research risks, and consistency in standards for the ethical conduct of research. Concerns included burdening minimal risk research and limitations in current systems of oversight. Literature and analysis supports the use of IRBs even when not required by regulations, and the need for evidence-based improvements in IRB processes.
To What Extent Does the EU General Data Protection Regulation (GDPR) Apply to Citizen Scientist-Led Health Research with Mobile Devices?
Authors: Dove Edward S. , Chen Jiahong
Published: April 2020

In this article, we consider the possible application of the European General Data Protection Regulation (GDPR) to “citizen scientist”-led health research with mobile devices. We argue that the GDPR likely does cover this activity, depending on the specific context and the territorial scope. Remaining open questions that result from our analysis lead us to call for lex specialis that would provide greater clarity and certainty regarding the processing of health data by for research purposes, including these non-traditional researchers.
Hematopoietic stem cell function in β-thalassemia is impaired and is rescued by targeting the bone marrow niche
Authors: Aprile Annamaria , Gulino Alessandro , Storto Mariangela , Villa Isabella , Beretta Stefano , Merelli Ivan , Rubinacci Alessandro , Ponzoni Maurilio , Marktel Sarah , Tripodo Claudio , Lidonnici Maria Rosa , Ferrari Giuliana
Published: April 2020

Hematopoietic stem cells (HSCs) are regulated by signals from the bone marrow (BM) niche that tune hematopoiesis at steady state and in hematologic disorders. To understand HSC-niche interactions in altered nonmalignant homeostasis, we selected β-thalassemia, a hemoglobin disorder, as a paradigm. In this severe congenital anemia, alterations secondary to the primary hemoglobin defect have a potential impact on HSC-niche cross talk. We report that HSCs in thalassemic mice (th3) have an impaired function, caused by the interaction with an altered BM niche. The HSC self-renewal defect is rescued after cell transplantation into a normal microenvironment, thus proving the active role of the BM stroma. Consistent with the common finding of osteoporosis in patients, we found reduced bone deposition with decreased levels of parathyroid hormone (PTH), which is a key regulator of bone metabolism but also of HSC activity. In vivo activation of PTH signaling through the reestablished Jagged1 and osteopontin levels correlated with the rescue of the functional pool of th3 HSCs by correcting HSC-niche cross talk. Reduced HSC quiescence was confirmed in thalassemic patients, along with altered features of the BM stromal niche. Our findings reveal a defect in HSCs in β-thalassemia induced by an altered BM microenvironment and provide novel and relevant insight for improving transplantation and gene therapy approaches.
Impact of exercise on the immune system and outcomes in hematologic malignancies
Authors: Sitlinger Andrea , Brander Danielle M. , Bartlett David B.
Published: April 2020

Exercise is increasingly recognized as important to cancer care. The biology of how exercise improves outcomes is not well understood, however. Studies show that exercise favorably influences the immune system in healthy individuals (neutrophils, monocytes, natural killer cells, T cells, and a number of cytokines). Thus, exercise in patients with hematologic cancer could significantly improve immune function and tumor microenvironment. We performed a literature search and identified 7 studies examining exercise and the immune environment in hematologic malignancies. This review focuses on the role of exercise and physical activity on the immune system in hematologic malignancies and healthy adults.