bluuebunny/crossref_metadata_2025 huggingface dataset:
Disaster risk reduction, community resilience, and policy effectiveness: the case of the Hazard Mitigation Grant Program in the United States
Authors: Ji Hyunjung , Lee David
Published: November 2019

Disasters triggered by natural hazards resulted in an accumulative economic loss of approximately USD 7 trillion and killed some eight million people worldwide in the twentieth century. Given the escalating threat posed by natural hazards to communities, scholars and practitioners are emphasising the importance of mitigation as a strategy to enhance community resilience. Little is known, though, about the extent to which governments’ disaster risk reduction efforts have augmented community resilience outcomes. This paper bridges the gap by examining the effects of the Hazard Mitigation Grant Program (HMGP) in the United States, which was designed to improve disaster resilience at the community level. The study analysed natural hazard loss data pertaining to those US counties that received HMGP funds following the pronouncement of presidentially‐declared disasters between 2010 and 2015. The findings suggest that the counties that obtained HMGP funds are likely to experience less property damage owing to future natural hazards.
Zinc deficiency in patients with chronic liver disease in Japan
Authors: Ozeki Itaru , Arakawa Tomohiro , Suii Hirokazu , Tatsumi Ryoji , Yamaguchi Masakatsu , Nakajima Tomoaki , Kuwata Yasuaki , Toyota Joji
Published: November 2019

Aim

This study aimed to determine the distributions of serum zinc levels and the prevalence of zinc deficiency in patients with chronic liver disease (CLD) in actual clinical practice, and to analyze the association between serum zinc levels and clinical characteristics.

Methods

This study analyzed 1973 patients with CLD, including 749 with liver cirrhosis, who were admitted to Sapporo Kosei General Hospital in 2017.

Results

Zinc deficiency, defined as a serum zinc level of <60 μg/dL, was observed in 555 patients overall (28.1%), including 182 (14.9%) patients without liver cirrhosis and 373 (49.8%) with liver cirrhosis. When marginal zinc deficiency was included, zinc deficiency (serum zinc level <80 μg/dL) was observed in 1594 (80.8%) patients overall, including 924 (75.5%) patients without liver cirrhosis and 670 (89.5%) with liver cirrhosis. Serum zinc levels were most strongly correlated with serum albumin levels. Of the 257 CLD patients with an albumin level of <3.5 g/dL, 234 (91.1%) had a serum zinc level of <60 μg/dL.

Conclusions

Zinc deficiency is common in patients with CLD. Serum zinc levels should be regularly measured, particularly in patients with liver cirrhosis.
The different faces of mycosis fungoides: results of a single‐center study
Authors: Sidiropoulou Polytimi , Nikolaou Vasiliki , Marinos Leonidas , Voudouri Dimitra , Komini Elena , Economidi Afroditi , Rigopoulos Dimitris , Stratigos Alexander
Published: November 2019

Background

Mycosis fungoides (MF) accounts for the majority of cutaneous lymphomas. Apart from the predominant Alibert‐Bazin type, several clinicopathological variants of diverse prevalence and biological behavior have been described. Data on clinical and epidemiological aspects of MF clinical subtypes are still weak.

Aim

To outline the clinical and epidemiological profile of the different MF types in a large volume of Greek patients.

Methods

Retrospective analysis of 688 MF cases treated in our lymphoma clinic. Epidemiological, clinical, pathological, and immunohistochemical data were retrieved.

Results

Six‐hundred and thirty‐six patients (416 males, 220 females) were included. The mean age at diagnosis was 60.2 years; the mean duration of disease prior to diagnosis was 63.2 months. Early‐stage MF (I‐IIA) involved 475 cases (74.7%). The prevalent type was classical MF (68.5%), followed by folliculotropic (17%), poikilodermic (5.5%), and psoriasiform (4.7%) MF. Atypical MF lesions as the sole manifestation of folliculotropic mycosis fungoides (FMF) – alopecia areata‐like lesions (n = 10), keratosis pilaris‐like lesions (n = 9) or acneiform rash (n = 4) – were also observed. Both poikilodermic and folliculotropic subtypes mainly involved younger patients. A significant diagnostic latency concerning poikilodermic and psoriasiform MF cases was recorded. Only 23 (3.3%) cases were of juvenile onset, with classical and poikilodermic MF equally affecting this age group, closely followed by FMF.

Conclusions

Our study presents the whole clinical‐epidemiological spectrum of MF in a large Greek cohort. The high prevalence of atypical MF manifestations characterized by early onset and indolent clinical course stood out among our FMF sample.
Proximal composition, bioactive compounds and biorefinery approach in potato tubers of Solanum tuberosum Group Phureja: a review
Authors: Beltrán‐Penagos María‐Alejandra , Sánchez‐Camargo Andrea del Pilar , Narváez‐Cuenca Carlos‐Eduardo
Published: November 2019

Potato tubers of Group Phureja have a great relevance in terms of production and consumer acceptance in the Andean countries. However, its proximal characteristics, nutritional value and bioactive compounds have been scarcely known. For the first time, this work aims to give an overview on tubers of Group Phureja characteristics, including research works from 1993 to 2019. When analysing the micronutrients and bioactive analytes, sodium, niacin and carotenoid contents are higher as compared to those of the Group Tuberosum. Likewise, the application of a biorefinery approach for the valorisation of Group Phureja wastes was proposed. These wastes may come from tubers that fail to meet quality parameters or by processing potato products. The possibility of obtaining useful compounds for the food, feed, materials, energy and chemical industries is described. The strategy of valorisation of wastes was focused on the production of starch and proteins, previously reported with important technological properties.
Down‐regulation of MTHFD2 inhibits NSCLC progression by suppressing cycle‐related genes
Authors: Yu Chang , Yang Lehe , Cai Mengsi , Zhou Feng , Xiao Sisi , Li Yaozhe , Wan Tingting , Cheng Dezhi , Wang Liangxing , Zhao Chengguang , Huang Xiaoying
Published: November 2019

Methylenetetrahydrofolate dehydrogenase 2 (MTHFD2) is a bifunctional enzyme located in the mitochondria. It has been reported to be overexpressed in several malignancies. However, the relationship between the expression of MTHFD2 and non‐small cell lung cancer (NSCLC) remains largely unknown. In this study, we found that MTHFD2 was significantly overexpressed in NSCLC tissues and cell lines. Knockdown of MTHFD2 resulted in reduced cell growth and tumorigenicity in vitro and in vivo. Besides, the mRNA and protein expression level of cell cycle genes, such as CCNA2, MCM7 and SKP2, was decreased in MTHFD2 knockdown H1299 cells. Our results indicate that the inhibitory effect of MTHFD2 knockdown on NSCLC may be mediated via suppressing cell cycle‐related genes. These findings delineate the role of MTHFD2 in the development of NSCLC and may have potential applications in the treatment of NSCLC.
Niche‐based relationship between sympatric bark living insect pests and tree vigor decline of Pinus yunnanensis
Authors: Liu Yu Jie , Gao Bing Tao , Ren Li Li , Zong Shi Xiang , Ze Sang Zi , Luo You Qing
Published: November 2019

Forest stands of Pinus yunnanensis Franch in southwestern China are seriously damaged by several bark living insect pests. These pests commonly exist in the same host tree and exploit limited phloem resources. In this study, we hypothesized that sympatric pests would occupy different ecological niches to reduce interspecific competition, and their coordinated attack would aggravate the tree vigor decline of P. yunnanensis. To quantify the ecological niches, we used a sampling method involving three dimensional divisions of tree resource states: (a) sample plot dimension (to evaluate the extent of pest colonization at plot scale), (b) trunk height dimension, and (c) tree vigor dimension. Those attacked pine canopies and colonized trunks were analysed in the field study. The results showed that Tomicus minor and Tomicus yunnanensis both widely and uniformly distributed in lightly, moderately and heavily damaged canopies while they aggregated on particular trunks of dying and withered trees. Lower and middle trunk sections (1–4 m) were mainly occupied by Monochamus alternatus and T. minor, yet T. yunnanensis dominated the upper parts (5–6 m). There was an overlap of the pine shoot beetles in the middle sections (2–4 m), whereas all three species were ecologically segregated in other trunk sections. During the shoot feeding phase, tree vigor declined with pine shoot beetles' increasing shoot feeding density. They coexisted in the same host tree, while M. alternatus only attacked dying and withered tree trunks, causing a greater infestation. Colonization of pine shoot beetle then followed by M. alternatus could be the major causes of tree mortality. This study highlights the resource utilization pattern of sympatric bark living insect pests corresponding with tree vitality. Those findings would help to understand the mechanisms of pest outbreak in P. yunnanensis ecosystem and provide potential guidance for developing an early monitoring pest warning system.
The effects of clinical decision support systems on insulin use: A systematic review
Authors: Jia Pengli , Jia Pengyan , Chen JingJing , Zhao Pujing , Zhang Mingming
Published: November 2019

Background

A clinical decision support system (CDSS) is a computerized system using case‐based reasoning to assist clinicians in assessing disease status, in selecting appropriate therapy or in making other clinical decisions. Previous randomized controlled trials (RCTs or trials) have shown that CDSSs have the potential to improve the insulin use, but the evidence was conflicting and uncertain. The purpose of our study was to determine whether a CDSS improves the use of insulin.

Method

PubMed, Embase, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov were searched from their inception to October 2018. The quality assessment was based on the risk of bias criteria of the Cochrane Handbook.

Results

Twenty‐four RCTs, involving 7653 participants, were included. Thirteen of those trials (54.2%) used a computerized algorithm or a computer‐assisted insulin protocol for insulin dose and therapy adjustment, of which 30.8% (four of 13) found significant changes. Of 10 trials that measured mean blood glucose levels and the 11 trials reported HbA1c, the computerized insulin dose adjustment resulted in lower mean blood glucose levels in 70.0% (seven of 10) and 36.4% (four of 11) of RCTs, respectively. Additionally, a significant reduction of hyperglycaemia events was reported in three of six RCTs. The evidence in a majority of the 24 RCTs was of moderate quality.

Conclusions

CDSSs have the potential to improve the insulin use and blood glucose control in a clinical setting. The methodologies in these studies were of mixed quality. Better designed and longer‐term studies are required to ensure a larger and more reliable evidence base on the effects of CDSS intervention on insulin use.
Outer membrane protein A (OmpA) is a potential virulence factor of Vibrio alginolyticus strains isolated from diseased fish
Authors: Bunpa Supansa , Chaichana Nattarika , Teng Jade L. L. , Lee Hwei Huih , Woo Patrick C. Y. , Sermwittayawong Decha , Sawangjaroen Nongyao , Sermwittayawong Natthawan
Published: November 2019

Vibrio alginolyticus is one of the most serious causative agents of diseases in cultured marine fish and shellfish. However, the characteristics of virulence factors in pathogenic V. alginolyticus are poorly known. To gain insight into fish diseases caused by V. alginolyticus, we carried out two‐dimensional gel electrophoresis (2‐DE) combined with MALDI‐TOF mass spectrometry to identify uniquely expressed proteins in the disease‐causing V. alginolyticus. V. alginolyticus strains were isolated from marine environments and diseased fish obtained from southern Thailand. We identified seven unique proteins in the disease‐causing V. alginolyticus strain. Among those, the outer membrane protein A (OmpA) had the strongest expression. Therefore, the function of this protein was further analysed. To investigate the role of OmpA protein, an in‐frame deletion mutant of ompA was constructed using the homologous recombination method. Although the ompA mutant V. alginolyticus strain (ΔompA) grew normally, the mutant exhibited a significant defect in the swarming ability and the biofilm formation. Furthermore, Galleria mellonella larvae injected with the mutant bacteria had a significantly greater survival percentage than those injected with the wild‐type strain, demonstrating that OmpA protein is required for the pathogenicity of V. alginolyticus. Together, this study suggests a potential target for vaccine development against pathogenic V. alginolyticus strain.
Investigation of dynamic quality changes and optimization of drying parameters of carrots (Daucus carota var. laguna)
Authors: Md Saleh Rosalizan , Kulig Boris , Hensel Oliver , Sturm Barbara
Published: November 2019

The effect of air temperature and sample thickness on the color changes and total carotenoids content of carrot slices was investigated. Temperature, exposure time, and moisture levels significantly affected the dynamic changes of total carotenoids and color. A slow and linear decrease in total carotenoids was observed at higher moisture content until reaching an inflection point at around 0.45 gw/gdm for all temperatures studied. Thereafter, the retention in total carotenoids decreased rapidly. The highest retention for a final product was 66.2% when drying at 60°C while retention was between 42.2 and 51.1% when drying at 50 and 70°C. These changes occurred alongside a noticeable change in color at moisture contents below the inflection point of 0.45 gw/gdm for all drying temperatures. Design of experiment based optimization of the drying process resulted in an ideal temperature of 59.8°C and 3.5 mm slice thickness with the predicted values for La*b*; ΔE of 62.18 ± 5.12, 22.46 ± 1.98, 40.35 ± 6.64, 6.31 ± 4.74; rehydration ratio of 0.48 ± 0.07; and total carotenoids of 163.83 ± 17.38 μg/g or 67.38%, respectively, all at a 95% prediction interval.

Practical applications

Convective drying is the most widely used drying technique for food preservation due to its easy application and readily available technology. However, the quality of the end product is currently lower than it would be achievable due to a lack of direct integration of quality characteristics into process design. Monitoring the quality changes as a function of moisture content throughout the drying process is essential to developing advanced process parameters with a view to increasing final product quality. This study describes the experimentally determined dynamic quality changes of carrots throughout the drying process in order to identify the critical points at which the process settings should be changed to increase the retention of valuable components and sensory quality attributes, and thus, to provide consumers with higher quality products.
Effects of salt loading on the organisation of microtubules in rat magnocellular vasopressin neurones
Authors: Hicks Amirah‐Iman , Barad Zsuzsanna , Sobrero Alberto , Lean Graham , Jacob‐Tomas Suleima , Yang Jieyi , Choe Katrina Y. , Prager‐Khoutorsky Masha
Published: November 2019

Magnocellular vasopressin (VP) neurones are activated by increases in blood osmolality, leading to the secretion of VP into the circulation to promote water retention in the kidney, thus constituting a key mechanism for the regulation of body fluid homeostasis. However, chronic high salt intake can lead to excessive activation of VP neurones and increased circulating levels of VP, contributing to an elevation in blood pressure. Multiple extrinsic factors, such as synaptic inputs and glial cells, modulate the activity of VP neurones. Moreover, magnocellular neurones are intrinsically osmosensitive, and are activated by hypertonicity in the absence of neighbouring cells or synaptic contacts. Hypertonicity triggers cell shrinking, leading to the activation of VP neurones. This cell‐autonomous activation is mediated by a scaffold of dense somatic microtubules, uniquely present in VP magnocellular neurones. Treating isolated magnocellular neurones with drugs modulating microtubule stability modifies the sensitivity of neuronal activation in response to acute hypertonic stimuli. However, whether the microtubule network is altered in conditions associated with enhanced neuronal activation and increased VP release, such as chronic high salt intake, remains unknown. We examined the organisation of microtubules in VP neurones of the supraoptic and paraventricular hypothalamic nuclei (SON and PVN, respectively) of rats subjected to salt‐loading (drinking 2% NaCl for 7 days). Using super‐resolution imaging, we found that the density of microtubules in magnocellular VP neurones from the SON and PVN was significantly increased, whereas the density and organisation of microtubules remain unchanged in other hypothalamic neurones, as well as in neurones from other brain areas (e.g., hippocampus, cortex). We propose that the increase in microtubule density in magnocellular VP neurones in salt‐loading promotes their enhanced activation, possibly contributing to elevated blood pressure in this condition.
Clinicopathological and immunohistochemical features of the oral lymphoepithelial cyst: A multicenter study
Authors: da Silva Karine Duarte , Coelho Luiza Vale , do Couto Aline Maria , de Aguiar Maria Cássia Ferreira , Tarquínio Sandra Beatriz Chaves , Gomes Ana Paula Neutzling , Mendonça Elismauro Francisco , Batista Aline Carvalho , Nonaka Cassiano Francisco Weege , de Sena Luana Samara Balduino , Alves Pollianna Muniz , Libório‐Kimura Tatiana Nayara , Louredo Brendo Vinícius Rodrigues , Câmara Jeconias , Caldeira Patrícia Carlos
Published: November 2019

Background

Analyze the clinical, demographic, histopathological, and immunohistochemical features of oral lymphoepithelial cyst (OLEC).

Methods

Samples were retrospectively retrieved from five oral pathology services. Clinical and demographic data were collected from patient charts. Histopathological and immunohistochemical (CD3 and CD20) features were evaluated. Data analysis involved descriptive statistics and bivariate analyses (P ≤ .05).

Results

Seventy‐seven cases were found among a total of 146 150 specimens (0.05%). OLEC was predominantly diagnosed in females (70.1%). Mean patient age was 46.51 years. The lesions arose mainly on the lateral border of the tongue (40.3%), measured up to 1 cm (61.0%), and were asymptomatic (64.9%). Twenty‐four lesions (31.2%) were white. Forty‐one cases (53.2%) presented lymphocytic inflammatory infiltrate with no specific arrangement. The cystic lining was composed of a non‐keratinized stratified epithelium (59.7%) presenting hyperplasia (39.0%). Connection with the surface, epithelium was found in 23 cases (29.9%) and 31 (40.3%) cases had two or more cystic cavities. The lumen content was predominantly desquamated cells (48.1%). Subgemmal neurogenous plaque was found in 11/42 (26.2%) cases involving the tongue. CD20+ cells predominated in 36/63 cases (57.2%), and lymphocytic inflammatory infiltrate was not always continuous around the cystic cavity (52.4%).

Conclusion

Lymphoepithelial cyst is an uncommon lesion of the oral cavity. The present study offers the largest sample of OLEC for which clinical, demographic, histopathological, and immunohistochemical features were evaluated. The clinical and demographic findings were similar to those described in previous reports, but the microscopic analyses revealed interesting aspects of the cystic epithelium and the lymphocytic inflammatory infiltrate in OLEC.
Evaluation of Fusarium wilt disease in passion fruit species inoculated with Fusarium oxysporum f.sp. passiflorae
Authors: Melo Naama Jessica de Assis , Negreiros Andréia Mitsa Paiva , Medeiros Hohana Lissa de Sousa , Sales Júnior Rui
Published: November 2019

One of the main diseases that reduces production of passion fruit crops is Fusarium wilt, caused by the fungus Fusarium oxysporum f.sp. passiflorae (FOP). The use of resistant rootstocks, such as the species Passiflora cincinnata, is one of the management strategies used to control this disease. The objective of this work was to evaluate the pathogenicity of different isolates of FOP on P. edulis and P. cincinnata in order to identify its potential for use in areas with a history of the disease. Thirteen isolates of the fungus were used, and the inoculums were produced at a concentration of 106 CFU/ml. Seedlings were produced in coconut fibre, and the root system was then immersed for five minutes in the conidial suspension before being replanted in the 770‐ml pots. Inoculated seedlings of P. edulis and P. cincinnata at the three‐leaf stage were daily evaluated from the second day after inoculation (DAI) until day 90. All isolates were pathogenic in both Passiflora species; however, the incidence, severity and mortality were higher in P. edulis. There was a statistically significant difference for the incubation period of the FOP 23 and FOP 57 isolates, being higher in P. edulis. We concluded that P. cincinnata was susceptible to FOP.
Relative bioavailability of selenium yeast for broilers fed a conventional corn–soybean meal diet
Authors: Liu Guoqing , Zhao Yuzhen , Cao Sumei , Luo Xugang , Wang Runlian , Zhang Liyang , Lu Lin , Liao Xiudong
Published: November 2019

The present study was conducted to assess the relative bioavailability of selenium (Se) as Se yeast (SY) relative to sodium selenite (SS) for broilers fed a conventional corn–soybean meal diet. A total of 360 one‐d‐old Arbor Acres commercial broilers were randomly assigned to 5 treatments with 6 replicates per treatment in a completely randomized design involving a 2 (Se sources: SY and SS) × 2 (added Se levels: 0.20 and 0.40 mg Se/kg) factorial design of treatments plus 1 (a Se‐unsupplemented control diet) for 42 days. The results showed that Se concentrations in plasma, liver, heart, breast muscle, pancreas and kidney of broilers on d 21 and 42, glutathione peroxidase (GSH‐Px) activity in the pancreas on d 21 as well as in the breast muscle and pancreas on d 42, and GSH‐Px mRNA levels in the liver, heart, breast muscle and pancreas on d 21 increased linearly (p < .03) as levels of added Se increased. Furthermore, a difference (p ≤ .05) between SY and SS was detected for Se concentrations in plasma, liver, heart, breast muscle, pancreas and kidney, GSH‐Px activity in pancreas on both d 21 and 42, as well as pancreatic GSH‐Px mRNA level on d 21. Based on slope ratios from the multiple linear regressions of the above indices, the Se bioavailabilities of SY relative to SS (100%) were 111%–394% (p ≤ .05) when calculated from the Se concentrations in plasma, liver, heart, breast muscle, pancreas, kidney and GSH‐Px activities in pancreas on d 21 and 42, as well as GSH‐Px mRNA level in pancreas on d 21. The results from this study indicated that the Se from SY was more available for enhancing the Se concentrations in plasma or tissues and the expression and activity of GSH‐Px in pancreas of broilers than the Se from SS.
Effects of L‐PRF and A‐PRF+ on periodontal fibroblasts in in vitro wound healing experiments
Authors: Pitzurra Luciano , Jansen Ineke D. C. , de Vries Teun J. , Hoogenkamp Michel A. , Loos Bruno G.
Published: November 2019

Objective

To determine whether leukocyte‐platelet‐rich fibrin (L‐PRF) and advanced platelet‐rich fibrin (A‐PRF+) differ in their in vitro capacity to induce proliferation and migration of periodontal fibroblasts.

Background

L‐PRF and A‐PRF + are autologous materials used in periodontal regenerative surgery. They derive from blood from patients, but have different characteristics. The literature is controversial regarding the effects of the two PRF preparations on periodontal tissue fibroblasts.

Materials and methods

L‐PRF and A‐PRF + membranes were prepared from eight patients and incubated in 3 mL of culture medium for 2 days. Gingival fibroblasts (G‐F) and periodontal ligament fibroblast (PDL‐F) primary cells were retrieved from 7 donors. These cells were pre‐cultured for 1 day in wound healing experiment plates leaving a gap of 500 ± 50 µm in a concentration of 3.3 x 105 cells/mL. 70 µL of the cell suspension was placed in each half of the well. Thereafter, the pre‐cultured L‐PRF and A‐PRF + supernatants were added to the experimental plates, and the fibroblasts were incubated for another 24 h. Medium alone (NEG) and fibroblast growth factor II (FGF) were used as controls. Subsequently, cell migration was registered for 24 h with live cell imaging in a time frame microscope at 5% CO2 in air at 37°C. Images were analyzed using ImageJ. Cell proliferation and cell viability were measured.

Results

L‐PRF and A‐PRF + induced higher cell proliferation than FGF and NEG. Both A‐PRF + and L‐PRF induced significant faster artificial wound closure than controls. Both PRF conditioned media induced faster cell migration in the initial phase (P < .01), but in the stoppage phase, the induced migration was higher for the A‐PRF+, compared with L‐PRF (P < .01).

Conclusion

L‐PRF and A‐PRF + have a stimulatory effect on migration and proliferation of periodontal fibroblasts, and artificial wound closure was longer sustained by A‐PRF + than L‐PRF.
Early viral reactivation despite excellent immune reconstitution following haploidentical Bone marrow transplant with post‐transplant cytoxan for sickle cell disease
Authors: Patel Dilan A. , Dhedin Nathalie , Chen Heidi , Karnik Leena , Gatwood Katie , Culos Katie , Mohan Sanjay , Engelhardt Brian G. , Kitko Carrie , Connelly Jim , Satyanarayana Gowri , Jagasia Madan , De La Fuente Josu , Kassim Adetola
Published: November 2019

Background

Haploidentical bone marrow transplant (haplo‐BMT) offers near universal donor availability as a curative modality for individuals with severe sickle cell disease (SCD). However, the required intense immunodepletion is associated with increased infectious complications. A paucity of data exists on immune reconstitution following haplo‐BMT for SCD.

Methods

A multi‐institution learning collaborative was developed in the context of a phase II clinical trial of a non‐myeloablative, related haplo‐BMT with post‐transplant cyclophosphamide for SCD. We report results from a cohort of 23 patients for whom immune reconstitution data up to one year were available.

Results

Median age was 14.8 years. Out of 23, 18 participants received pre‐conditioning with azathioprine, hydroxyurea, and hypertransfusions. 70% (16/23) of participants had multiple indications for haplo‐BMT. We observed excellent immune reconstitution of CD4, CD8, CD19, and CD56 cellular subsets by 6 months post transplant. Engraftment rate and event‐free survival in this cohort were 100% and 96%, respectively. 70% (16/23) of patients had at least one viral reactivation or infection, including CMV 35% (8/23), HHV‐6 22% (5/23), and polyoma virus 17% (4/23), with no cases of post‐transplant lymphoproliferative disease.

Conclusion

Further prospective studies are needed to better characterize immune reconstitution and the immunologic basis for increased viral reactivation following haplo‐BMT with post‐transplant cyclophosphamide for SCD.
Freezing expired platelets does not compromise in vitro quality: An opportunity to maximize inventory potential
Authors: Johnson Lacey , Waters Lauren , Green Sarah , Wood Ben , Marks Denese C.
Published: November 2019

BACKGROUND AND OBJECTIVES

Cryopreservation provides an option for long‐term storage of platelet concentrates. While platelets are usually frozen as soon as practical after collection (within 2 days), the ability to freeze units at a later stage of the shelf life may improve inventory management. As such, the aim of this study was to determine the impact of freezing platelets approaching expiry (Day 5/6).

MATERIALS AND METHODS

Two ABO‐matched buffy coat–derived platelets (30% plasma/70% platelet additive solution) were pooled and split to produce matched pairs (n = 8 pairs). Platelets were frozen on Day 1 after collection (cryopreserved platelets [CPPs]) or Day 5 or 6 (expired‐CPPs) at −80°C with 5% to 6% dimethyl sulfoxide. In vitro platelet quality was tested before freezing and after thawing and reconstitution in plasma.

RESULTS

The majority of prefreeze parameters were equivalent for all platelet units (Day 1 vs. Day 5 or 6). Expired‐CPPs had a higher mean postthaw platelet recovery (82 ± 4%) compared to CPPs (75 ± 4%; p = 0.0021). Cryopreservation resulted in a loss of surface glycoproteins (glycoprotein (GP) Ibα, GPIIb, GPVI), an increase in activation markers (phosphatidylserine and P‐selectin) and microparticle release, compared to unfrozen platelets. However, the cryopreservation‐induced changes were equivalent in CPPs and expired‐CPPs. Functionality was measured by thromboelastography and was similar between expired‐CPPs (R‐time: 5.3 ± 0.3) and CPPs (R‐time: 5.4 ± 0.5; p = 0.7094).

CONCLUSION

The phenotype and functional profile of platelets frozen at expiry were similar to platelets frozen 1 day following collection. These data suggest that expired platelets may represent a suitable starting material for cryopreservation.
The adrenergic receptor antagonists propranolol and carvedilol decrease bone sarcoma cell viability and sustained carvedilol reduces clonogenic survival and increases radiosensitivity in canine osteosarcoma cells
Authors: Duckett Megan M. , Phung Shee Kwan , Nguyen Linh , Khammanivong Ali , Dickerson Erin , Dusenbery Kathryn , Lawrence Jessica
Published: November 2019

Adrenergic receptor (AR) expression has been demonstrated at several sites of primary and metastatic tumour growth and may influence proliferation, survival, metastasis and angiogenesis. AR antagonists like propranolol and carvedilol inhibit proliferation, induce apoptosis and synergize with chemotherapy agents in some cancers. Radiation resistance is mediated in many cells by upregulation of pro‐survival pathways, which may be influenced by ARs. Studies evaluating AR antagonists combined with radiation are limited. The purpose of this study was to determine the effect of propranolol and carvedilol on viability and radiosensitivity in sarcoma cell lines. The hypothesis was that propranolol and carvedilol would increase radiosensitivity in four primary bone sarcoma cell lines. Single agent propranolol or carvedilol inhibited cell viability in all cell lines in a concentration‐dependent manner. The mean inhibitory concentrations (IC50) for carvedilol were approximately 4‐fold lower than propranolol and may be clinically relevant in vivo. Immunoblot analysis confirmed AR expression in both human and canine sarcoma cell lines; however, there was no correlation between baseline AR protein expression and radiosensitivity. Short duration treatment with carvedilol and propranolol did not significantly affect clonogenic survival. Prolonged exposure to propranolol and carvedilol significantly decreased the surviving fraction of canine osteosarcoma cells after 3Gy radiation. Based on our results and possible in vivo activity in dogs, further studies investigating the effects of carvedilol on sarcoma are warranted.
Femorotibial kinematics in dogs treated with tibial plateau leveling osteotomy for cranial cruciate ligament insufficiency: An in vivo fluoroscopic analysis during walking
Authors: Tinga Selena , Kim Stanley E. , Banks Scott A. , Jones Stephen C. , Park Brian H. , Burtch Matthew , Pozzi Antonio , Lewis Daniel D.
Published: November 2019

Objective

To determine the ability of tibial plateau leveling osteotomy (TPLO) to address abnormal femorotibial kinematics caused by cranial cruciate ligament (CCL) rupture during walking in dogs.

Study design

Prospective, clinical.

Animals

Sixteen dogs (20‐40 kg) with unilateral complete CCL rupture.

Methods

Lateral view fluoroscopy was performed during treadmill walking preoperatively and 6 months after TPLO. Digital three‐dimensional (3D) models of the femora and tibiae were created from computed tomographic (CT) images. Gait cycles were analyzed by using a 3D‐to‐2D image registration process. Craniocaudal translation, internal/external rotation, and flexion/extension of the femorotibial joint were compared between preoperative and 6‐month postoperative time points for the affected stifle and 6‐month postoperative unaffected contralateral (control) stifles.

Results

In the overall population, CCL rupture resulted in 10 ± 2.2 mm (mean ± SD) cranial tibial translation at midstance phase, which was converted to 2.1 ± 4.3 mm caudal tibial translation after TPLO. However, five of 16 TPLO‐treated stifles had 4.1 ± 0.3 mm of cranial tibial subluxation during mid‐to‐late stance phase, whereas 10 of 16 TPLO‐treated stifles had 4.3 ± 0.4 mm of caudal tibial subluxation throughout the gait cycle. Overall, postoperative axial rotational and flexion/extension patterns were not different from control, but stifles with caudal tibial subluxation had more external tibial rotation during mid‐to‐late stance phase compared with stifles with cranial tibial subluxation.

Conclusion

TPLO mitigated abnormal femorotibial kinematics but did not restore kinematics to control values in 15 of 16 dogs during walking.

Clinical significance

Tibial plateau leveling osteotomy reduces cranial tibial subluxation during walking, but persistent instability is common.
Changes in pharyngeal collapsibility and genioglossus reflex responses to negative pressure during the respiratory cycle in obstructive sleep apnoea
Authors: Osman Amal M. , Carberry Jayne C. , Gandevia Simon C. , Butler Jane E. , Eckert Danny J.
Published: November 2019

Key points

Impaired pharyngeal anatomy and increased airway collapsibility is a major cause of obstructive sleep apnoea (OSA) and a mediator of its severity.

Upper airway reflexes to changes in airway pressure provide important protection against airway closure.

This study shows increased pharyngeal collapsibility and attenuated genioglossus reflex responses during expiration in people with OSA.

Upper airway collapse contributes to obstructive sleep apnoea (OSA) pathogenesis. Pharyngeal dilator muscle activity varies throughout the respiratory cycle and may contribute to dynamic changes in pharyngeal collapsibility. However, whether upper airway collapsibility and reflex responses to changes in airway pressure vary throughout the respiratory cycle in OSA is unclear. Thus, this study quantified differences in upper airway collapsibility and genioglossus electromyographic (EMG) activity and reflex responses during different phases of the respiratory cycle. Twelve middle‐aged people with OSA (2 female) were fitted with standard polysomnography equipment: a nasal mask, pneumotachograph, two fine‐wire intramuscular electrodes into the genioglossus, and a pressure catheter positioned at the epiglottis and a second at the choanae (the collapsible portion of the upper airway). At least 20 brief (∼250 ms) pressure pulses (∼−11 cmH2O at the mask) were delivered every 2–10 breaths during four conditions: (1) early inspiration, (2) mid‐inspiration, (3) early expiration, and (4) mid‐expiration. Mean baseline genioglossus EMG activity 100 ms prior to pulse delivery and genioglossus reflex responses were quantified for each condition. The upper airway collapsibility index (UACI), quantified as 100 × (nadir choanal − epiglottic pressure)/nadir choanal pressure during negative pressure pulses, varied throughout the respiratory cycle (early inspiration = 43 ± 25%, mid‐inspiration = 29 ± 19%, early expiration = 83 ± 19% and mid‐expiration = 95 ± 11% (mean ± SD) P < 0.01). Genioglossus EMG activity was lower during expiration (e.g. mid‐expiration vs. mid‐inspiration = 76 ± 23 vs. 127 ± 41% of early‐inspiration, P < 0.001). Similarly, genioglossus reflex excitation was delayed (39 ± 11 vs. 23 ± 7 ms, P < 0.001) and reflex excitation amplitude attenuated during mid‐expiration versus early inspiration (209 ± 36 vs. 286 ± 80%, P = 0.009). These findings may provide insight into the physiological mechanisms of pharyngeal collapse in OSA.
Oriented attachment induces fivefold twins by forming and decomposing high-energy grain boundaries
Authors: Song Miao , Zhou Gang , Lu Ning , Lee Jaewon , Nakouzi Elias , Wang Hao , Li Dongsheng
Published: November 2019

Finding the fivefold path

Crystals formed in nature or synthesized in a lab can have domains with different orientations that are called twins. Having five of these domains is relatively common, but how these fivefold twins form is still a mystery. Song
et al.
combined in situ transmission electron microscope observations with simulations to find two different pathways for forming fivefold twins in gold, platinum, and palladium nanoparticles. This combination provides a key insight into the twin-forming process, which might be exploited for developing nanoparticles suitable for a variety of applications.

Science
, this issue p.
40
Using the fringe field of a clinical MRI scanner enables robotic navigation of tethered instruments in deeper vascular regions
Authors: Azizi Arash , Tremblay Charles C. , Gagné Kévin , Martel Sylvain
Published: November 2019

Magnetic actuation provided by the MRI fringe field can be used to navigate micro–tethered instruments into deeper vascular regions.
Классификация методов расчeта диффузных угловых коэффициентов излучения
Authors: Винокуров Дмитрий Константинович , Vinokurov Dmitrii Konstantinovich
Published: November 2019

Приводятся результаты систематизации существующих методов определения диффузных угловых коэффициентов (УК) при расчете переноса излучения в зональной модели в системе тел с поверхностями сложной формы при решении задач определения температур конструкции, освещeнностей поверхностей, построения реалистичных изображений и др. в различных отраслях: космической, светотехнике, строительстве, энергетике, прикладной оптике, компьютерной графике и пр. Предлагается классификация методов определения УК по источникам погрешностей, возникающих при расчeтах. Выделены четыре класса методов: точные, специальные, численного интегрирования, комбинированные. Проведено распределение методов по классам. Приведены исходные формулы и формулы для численного определения УК. Полученная классификация методов позволит пользователям и разработчикам компьютерных программ расчeта УК сориентироваться в многообразии методов и выбрать из них наиболее адекватные для решения своей задачи, а также может быть положена в основу построения обобщeнного алгоритма и программного комплекса расчeта диффузных УК для широкого класса задач.
Разработка математической модели расчeта поездок пассажиров на маршруте по данным входа и выхода
Authors: Ембулаев Владимир Николаевич , Embulaev Vladimir Nikolaevich
Published: November 2019

Случайная величина поездок пассажиров между двумя любыми остановочными
пунктами на маршруте (корреспонденции пассажиров) представляет собой дискретную величину. Для каждого значения дискретной случайной величины вычисляется еe вероятность. В качестве решения задачи определения числа корреспондирующих пассажиров между двумя остановочными пунктами на маршруте принимается то значение случайной величины, вероятность которого максимальна.
Faecal microbiota transplantation for refractoryClostridiumdifficileinfection
Authors: Tamilarasan Aravind Gokul , Irving Peter , Meadows Christopher IS , Goldenberg Simon
Published: November 2019

Faecal microbiota transplantation (FMT) has become a part of the treatment algorithm forClostridium difficileinfection (CDI), particularly for recurrent infections when antibiotics have diminishing efficacy. Notably, despite a significant proportion of patients suffering from refractory disease, there is a general lack of evidence describing the use of FMT in this patient cohort. We present here a case of successful treatment of refractory CDI in a patient under critical care.
Pharmacological and behavioural interventions to promote smoking cessation in adults with schizophrenia and bipolar disorders: a systematic review and meta-analysis of randomised trials
Authors: Pearsall Robert , Smith Daniel J , Geddes John R
Published: November 2019

Objective

Smoking in people with serious mental illness is a major public health problem and contributes to significant levels of morbidity and mortality. The aim of the review was to systematically examine the efficacy of methods used to aid smoking cessation in people with serious mental illness.

Method

A systematic review and meta-analysis of randomised controlled trials to compare the effectiveness and safety of pharmacological and behavioural programmes for smoking cessation in people with serious mental illness. Electronic databases were searched for trials to July 2018. We used the Cochrane Collaboration’s tool for assessing the risk of bias.

Results

Twenty-eight randomised controlled trials were identified. Varenicline increased the likelihood of smoking cessation at both 3 months (risk ratio (RR) 3.56, 95% CI 1.82 to 6.96, p=0.0002) and at 6 months (RR 3.69, 95% CI 1.08 to 12.60, p=0.04). Bupropion was effective at 3 months (RR 3.96, 95% CI 1.86 to 8.40, p=0.0003), especially at a dose of 300 mg/day, but there was no evidence of effect at 6 months (RR 2.22, 95% CI 0.52 to 9.47, p=0.28). In one small study, nicotine therapy proved effective at increasing smoking cessation up to a period of 3 months. Bupropion used in conjunction with nicotine replacement therapy showed more effect than single use. Behavioural and bespoke interventions showed little overall benefit. Side effects were found to be low.

Conclusion

The new information of this review was the effectiveness of varenicline for smoking cessation at both 3 and 6 months and the lack of evidence to support the use of both bupropion and nicotine products for sustained abstinence longer than 3 months. Overall, the review found relatively few studies in this population.
Student perspectives on barriers to performance for black and minority ethnic graduate-entry medical students: a qualitative study in a West Midlands medical school
Authors: Morrison Nariell , Machado Michelle , Blackburn Clare
Published: November 2019

Objective

To explore graduate-entry medical students experiences of undergraduate training in the context of academic underperformance of medical students from ethnic minority backgrounds.

Design

Qualitative study using semi-structured focus groups.

Setting

A West Midlands medical school.

Participants

24 graduate-entry MBChB students were recruited using volunteer and snowball sampling; all students self-identified as being from Black and Minority Ethnic (BME) backgrounds.

Results

BME students reported facing a range of difficulties, throughout their undergraduate medical training, that they felt impeded their learning and performance. Their relationships with staff and clinicians, though also identified as facilitators to learning, were also perceived to have hindered progress, as many students felt that a lack of BME representation and lack of understanding of cultural differences among staff impacted their experience. Students also reported a lack of trust in the institution’s ability to support BME students, with many not seeking support. Students’ narratives indicated that they had to mask their identity to fit in among their peers and to avoid negative stereotyping. Although rare, students faced overt racism from their peers and from patients. Many students reported feelings of isolation, reduced self-confidence and low self-esteem.

Conclusions

BME students in this study reported experiencing relationship issues with other students, academic and clinical staff, lack of trust in the institution and some racist events. Although it is not clear from this small study of one institution whether these findings would be replicated in other institutions, they nevertheless highlight important issues to be considered by the institution concerned and other institutions. These findings suggest that all stakeholders of graduate-entry undergraduate medical education should reflect on the current institutional practices intended to improve student–peer and student–staff relationships. Reviewing current proposals intended to diversify student and staff populations as well as evaluating guidance on tackling racism is likely to be beneficial.
Machine learning with sparse nutrition data to improve cardiovascular mortality risk prediction in the USA using nationally randomly sampled data
Authors: Rigdon Joseph , Basu Sanjay
Published: November 2019

Objectives

We aimed to test whether or not adding (1) nutrition predictor variables and/or (2) using machine learning models improves cardiovascular death prediction versus standard Cox models without nutrition predictor variables.

Design

Retrospective study.

Setting

Six waves of Survey (NHANES) data collected from 1999 to 2011 linked to the National Death Index (NDI).

Participants

29 390 participants were included in the training set for model derivation and 12 600 were included in the test set for model evaluation. Our study sample was approximately 20% black race and 25% Hispanic ethnicity.

Primary and secondary outcome measures

Time from NHANES interview until the minimum of time of cardiovascular death or censoring.

Results

A standard risk model excluding nutrition data overestimated risk nearly two-fold (calibration slope of predicted vs true risk: 0.53 (95% CI: 0.50 to 0.55)) with moderate discrimination (C-statistic: 0.87 (0.86 to 0.89)). Nutrition data alone failed to improve performance while machine learning alone improved calibration to 1.18 (0.92 to 1.44) and discrimination to 0.91 (0.90 to 0.92). Both together substantially improved calibration (slope: 1.01 (0.76 to 1.27)) and discrimination (C-statistic: 0.93 (0.92 to 0.94)).

Conclusion

Our results indicate that the inclusion of nutrition data with available machine learning algorithms can substantially improve cardiovascular risk prediction.
Phase I cancer trials: a qualitative study of specialist palliative care
Authors: Bellhouse Sarah , Galvin Lucy , Turner Lorraine , Taylor Sally , Davies Michelle , Krebs Matthew , Berman Richard , Yorke Janelle
Published: November 2019

Objective

In recent years, a simultaneous care model for advanced cancer patients has been recommended meaning that palliative care services are offered throughout their cancer journey. To inform the successful adoption of this model in a phase I trial context, the study aimed to explore patients’ care needs and their perceptions of specialist palliative care.

Methods

Semi-structured interviews were conducted with 10 advanced cancer patients referred to the Experimental Cancer Medicine team. Interviews were transcribed verbatim and thematically analysed with a framework approach to data organisation.

Results

Despite reporting considerable physical and psychological impacts from cancer and cancer treatment, participants did not recognise a need for specialist palliative care support. Understanding of the role of specialist palliative care was largely limited to end of life care. There was perceived conflict between considering a phase I trial and receiving specialist palliative care. Participants felt specialist palliative care should be introduced earlier and educational resources developed to increase patient acceptability of palliative care services.

Significance of results

Patients with advanced cancer referred for phase I trials are likely to benefit from specialist palliative care. However, this study suggests patients may not recognise a need for support nor accept this support due to misperceptions about the role of palliative care. Developing a specific educational resource about specialist palliative care for this population would help overcome barriers to engaging with a simultaneous care model.