bluuebunny/crossref_metadata_2025 huggingface dataset:
Identification of Frailty in Primary Care: Feasibility and Acceptability of Recommended Case Finding Tools Within a Primary Care Integrated Seniors’ Program
Authors: Abbasi Marjan , Khera Sheny , Dabravolskaj Julia , Garrison Melanie , King Sharla
Published: May 2019

Background: Case finding for frailty is recommended as part of routine clinical practice. We aimed to test feasibility and acceptability of three recommended case finding tools in primary care as part of an integrated seniors’ program. Method: Program of Research to Integrate Services for the Maintenance of Autonomy-7 (PRISMA-7), 4-m walk test, and electronic frailty index (eFI) were used as frailty case finding tools for a target population of community-dwelling seniors ≥65 years of age enrolled in a seniors’ program within an academic primary care clinic in Alberta, Canada. Feasibility was measured by percent completion rate and requirements for training/equipment/space/time, and acceptability by health care providers was measured using focus groups. Results: Eighty-five patients underwent case finding and 16 health care providers participated in the focus groups. Completion rate for PRISMA-7, 4-m walk test, and eFI was 97.6%, 93%, and 100%, respectively. No special training or equipment was required for PRISMA-7; brief training, equipment, and space were required for 4-m walk test. Both tools took less than 5 min to complete. Despite eFI requiring 10 to 20 min/patient chart, providers found it less intrusive. Conclusion: Despite feasibility of the tests, acceptance was higher for tools with minimal clinic interruption, low requirements for resources, and those with added benefit.
Intracohort Trends in Ethnic Earnings Gaps: The Role of Education
Authors: Yaish Meir , Gabay-Egozi Limor
Published: May 2019

This study demonstrates that studying ethnic/racial inequality on the basis of cross-sectional data conceals how such inequality might unfold over the life course. Moving beyond a snapshot perspective, we ask, Do Israel’s Jewish ethnic groups differ in their long-term earnings trajectories? Analyzing nearly 20 years of registered earnings data, the authors find that for the same cohort (25- to 32-year-old Jews in 1995), the ethnic earnings gap has widened over these years. This trend, we demonstrate, is explained largely by increasing wage premiums for college degree, even when these premiums are ethnicity blind. That is, ethnic inequality in educational attainment is translated to increasing ethnic earnings inequality over the life course. This pattern cannot be detected in previous research in Israel, which relied on the snapshot perspective on the basis of cross-sectional data. The consequences of these findings for changes in inequality in divided societies are discussed.
Accelerating Project-Based Learning in Management Contexts: An Examination of ImpactEd
Authors: Jackson Nicole C. , Halbert Austin
Published: May 2019

With greater demand for business educators and students to focus on 21st-century skills, project-based learning (PBL) has become increasingly important. The PBL method complements existing curriculum by enabling direct transference of course concepts into real-world application. Despite known benefits, some management educators may shy away from PBL because of the difficulty of finding and maintaining projects on an ongoing basis. This article evaluates ImpactEd, an education platform providing virtual access to management projects that are codesigned with leading organizations and educators. By providing educators with new PBL content to enrich directed management applications in their courses, this model moves beyond traditional learning management systems, which often simply replicate existing classroom practices in a digital format, and traditional case study methods that only simulate application. This article is thus targeted to management educators interested in using a PBL platform technology to provide real-world project applications in management education.
Health-related quality of life in children with autism spectrum disorders and children with developmental language disorders
Authors: Coales Catherine , Heaney Natalie , Ricketts Jessie , Dockrell Julie E , Lindsay Geoff , Palikara Olympia , Charman Tony
Published: May 2019

Background and aims

There is a paucity of literature investigating health-related quality of life in neurodevelopmental populations including children with developmental language disorders and children with autism spectrum disorder. Health-related quality of life in these two groups remains poorly understood. Furthermore, studies have typically relied on reports from caregivers and teachers rather than using self-report measures. The aim of the current study is to compare the levels and profiles of self-reported health-related quality of life of children with developmental language disorders and children with autism spectrum disorder.

Methods

Participants comprised 114 7-to-13-year-old children with developmental language disorders ( n = 63) and children with autism spectrum disorder ( n = 51) attending mainstream school. Self-reported health-related quality of life was measured using the KIDSCREEN-52. We also collected standardised measures of receptive language, autism spectrum disorder symptoms, nonverbal IQ and emotional and behavioural problems.

Results

Children with developmental language disorders reported health-related quality of life commensurate with normative ranges, except for 2 of the 10 dimensions; the Moods and Emotions domain and the Social acceptance/bullying domain, which were below norms. Children with autism spectrum disorder reported significantly lower health-related quality of life compared to norms and the developmental language disorders group. However, when the effects of non-verbal ability and language – on which the groups were not matched – were covaried most group differences fell to non-significance or disappeared. Child characteristics showed few associations with dimensions of health-related quality of life across groups.

Conclusions

Children with autism spectrum disorder may be particularly vulnerable to poorer health-related quality of life and the relevant professionals need to be aware of this. Children with developmental language disorders exhibit a profile of health-related quality of life more in-line with average ranges. However, certain domains warrant monitoring and may benefit from intervention. Many of the between-group differences in self-reported health-related quality of life disappeared when non-verbal and language ability were covaried, though neither of the covariates was systematically related to scores. Other within-child factors such as emotional understanding and competence should be explored in future studies.

Implications

Further research into child and contextual factors may elucidate risk or protective factors for health-related quality of life in children with neurodevelopmental disorders.
Inclusive Regional Trade: Promoting the Economic Empowerment of Women in the BBIN Region
Authors: Livani Talajeh , Rizwan Nadeem , Kathuria Sanjay
Published: May 2019

In recent years, regional integration has gained considerable importance among policymakers in Bangladesh, Bhutan, India and Nepal (often referred to as the BBIN region). There is an understanding that enhanced intra-regional trade can be a powerful tool in accelerating economic growth and reducing poverty in the BBIN region. Tapping into this potential requires careful attention to issues of exclusion and in ensuring that women and men have equal opportunity to participate and benefit from enhanced regional trade. This article discusses challenges and opportunities for women’s participation in regional trade, presents a case study of women’s participation and proposes policy recommendations for inclusive intra-BBIN trade expansion. The recommendations include strengthening female-dominated sectors with potential for intra-regional trade, supporting women’s transition to higher levels of trade value chains, facilitating female entrepreneurs’ access to productive resources and cross-border markets, mainstreaming gender in trade policy design and implementation and adopting gender-sensitive trade facilitation measures.
People need to know! Notification and the regulation of pesticide use near public schools in California
Authors: Benko Keli
Published: May 2019

This article takes up a recent proposal by the California Department of Pesticide Regulation to regulate pesticide use near public schools with the goal of examining notifications and the public debate over their use. Entailing an exchange of information between growers and schools, notifications provide schools with information about pesticide applications taking place nearby. While the procedural aspects are coherent, the regulatory purpose behind notification and its subsequent effects are considerably less so. I draw on literature related to pesticide drift and the politics of scale in order to discuss the strategic differences between notifications and their better known regulatory counterpart, buffer zones, and to highlight the significance of these differences for public debate over the problem of pesticide drift, and how best to regulate it. I argue that Department of Pesticide Regulation’s proposal presents conflicting imperatives that obfuscate the scale of pesticide drift risk and correspond to disparate sets of actors and prescribed actions. This central contradiction has put stakeholders in the position of being unsure about what notifications can do, and has led them to invoke disparate justifications for and against the proposed requirements. I argue, however, that the on-the-ground effects of notifications are the same, regardless of discursive framing. Intended to function as a protective measure, notifications instead shift the burden of protection on to individual school staff and parents through a neoliberal process of responsibilization. Literature on governmentality and health risk management animates the ways that information dissemination can work as responsibilizing policy. This effect is especially problematic considering the limitations faced by Latinx farmworker communities. As this case shows, the lack of choice in a governmental structure that ostensibly provides more freedom to take action when pesticide drift is imminent is a constraint on poor, minority communities, even while it is considered an increased freedom by others.
Reproducibility and Replicability in a Fast-Paced Methodological World
Authors: Epskamp Sacha
Published: May 2019

Methodological developments and software implementations are progressing at an increasingly fast pace. The introduction and widespread acceptance of preprint archived reports and open-source software have made state-of-the-art statistical methods readily accessible to researchers. At the same time, researchers are increasingly concerned that their results should be reproducible (i.e., the same analysis should yield the same numeric results at a later time), which is a basic requirement for assessing the results’ replicability (i.e., whether results at a later time support the same conclusions). Although this age of fast-paced methodology greatly facilitates reproducibility and replicability, it also undermines them in ways not often realized by researchers. This article draws researchers’ attention to these threats and proposes guidelines to help minimize their impact. Reproducibility may be influenced by software development and change over time, a problem that is greatly compounded by the rising dependency between software packages. Replicability is affected by rapidly changing standards, researcher degrees of freedom, and possible bugs or errors in code, whether introduced by software developers or empirical researchers implementing an analysis. This article concludes with a list of recommendations to improve the reproducibility and replicability of results.
A Longitudinal Study to Assess Abdominal Adiposity by Sonography, DXA, and BMI
Authors: Stigall A. Nicole , Hunter Randee L. , Evans Kevin D. , Spees Colleen K.
Published: May 2019

Obesity has been linked to several chronic health conditions, including increased risk for cardiovascular disease, type 2 diabetes, some cancers, and metabolic syndrome. Understanding the trends in metabolic syndrome and examining those who are at an increased risk for metabolic conditions is paramount. Currently body mass index (BMI), waist circumference (WC), and dual-energy X-ray absorptiometry (DXA) are believed to be appropriate screening measures for assessing body composition and metabolic syndrome risk. This approach uses diagnostic medical sonography (DMS) as a tool for assessing abdominal adiposity in hopes of this methodology being adopted to help determine an individual’s risk for metabolic conditions. A convenience sample of overweight and obese cancer survivors provided several anthropometric measures as well as imaging data to determine if sonographic measures of abdominal fat could be assessed longitudinally. These measures were then compared to corresponding measures of BMI, WC, and DXA (android percent body fat, subscores). These measures demonstrated moderately positive association and were statistically significant. DMS is an indirect imaging tool that could be used in correlation with other measures to help determine an individual’s risk for metabolic syndrome.
Oxygen in patients with fibrotic interstitial lung disease: an international Delphi survey
Authors: Lim Rachel K. , Humphreys Christopher , Morisset Julie , Holland Anne E. , Johannson Kerri A.
Published: May 2019

Rationale

Patients with fibrotic interstitial lung disease (ILD) frequently develop resting or exertional hypoxaemia. There is heterogeneity in clinical practice and a paucity of evidence guiding supplemental oxygen use in this patient population. The objectives of this study were to build international expert-based consensus on the indications and goals of supplemental oxygen from the perspective of healthcare providers, and identify potential barriers to its access.

Methods

Semistructured interviews and a comprehensive literature search informed items for the Delphi survey, with items not meeting consensus included in round 2. Round 3 contained survey questions regarding regional funding coverage for oxygen therapy.A prioridefinitions of consensus were median scores of 4 (agree) to 5 (strongly agree) for “agreement”, 1 (strongly disagree) to 2 (disagree) for “disagreement” or 3 (unsure) with an interquartile range of 0–1.

Results

42 out of 45 (93%) experts completed all three survey rounds, representing 17 countries. 20 out of 36 items met consensus for agreement or disagreement, 10 items met consensus for unsure and four items did not meet consensus. Experts agreed that oxygen should be recommended for patients with severe resting hypoxaemia and in cases of exertional desaturation to <85–89%, particularly with attributable symptoms or exercise limitation. There are regional differences in funding coverage for oxygen, based on desaturation thresholds, clinical symptoms and testing requirements.

Conclusions

Experts achieved consensus on 20 items guiding supplemental oxygen use in fibrotic ILD. These findings may inform research, clinical recommendations and funding policy.
Spirometric indices in primary ciliary dyskinesia: systematic review and meta-analysis
Authors: Halbeisen Florian S. , Jose Anu , de Jong Carmen , Nyilas Sylvia , Latzin Philipp , Kuehni Claudia E. , Goutaki Myrofora
Published: May 2019

Primary ciliary dyskinesia (PCD) is a genetic, heterogeneous disease caused by dysfunction of cilia. Evidence is sparse and reports of lung function in PCD patients range from normal to severe impairment. This systematic review and meta-analysis of studies of lung function in PCD patients examines the spirometric indices of PCD patients and differences by age group and sex.

We searched PubMed, Embase and Scopus for studies that described lung function in 10 or more patients with PCD. We performed meta-analyses and meta-regression to explain heterogeneity. We included 24 studies, ranging from 13 to 158 patients per study.

The most commonly reported spirometric indices were forced expiratory volume in 1 s (FEV1) and forced vital capacity presented as mean and standard deviation of percent predicted values. We found considerable heterogeneity for both parameters (I2=94–96%). The heterogeneity remained when we stratified the analysis by age; however, FEV1in adult patients was lower. Even after taking into account explanatory factors, the largest part of the between-studies variance remained unexplained.

Heterogeneity could be explained by genetic differences between study populations, methodological factors related to the variability of study inclusion criteria or details on the performance and evaluation of lung function measurements that we could not account for. Prospective studies therefore need to use standardised protocols and international reference values. These results underline the possibility of distinct PCD phenotypes as in other chronic respiratory diseases. Detailed characterisation of these phenotypes and related genotypes is needed in order to better understand the natural history of PCD.
Preliminary results from a legacy indicator tool for measuring climate change related impacts on built heritage
Authors: Daly Cathy
Published: May 2019

Background

Gradual changes in weathering rates and mechanisms are the barely visible impacts of climate change on cultural heritage. Long-term monitoring of built and archaeological heritage is therefore necessary to ascertain the nature of loss due to slow onset effects. During research at the Dublin Institute of Technology in 2011 a Legacy Indicator Tool (LegIT) for measuring the weathering of stone surfaces into the far future was developed by the author and piloted at five National Monuments in Ireland. While it is too soon to evaluate the tool in relation to long term climate change trends, this article considers the data from 5 years of exposure and provides an early assessment of the pilot study’s design and implementation.

Results

Measurements for colour, surface roughness, weight, and dimensions from the 5 year exposure of the LegIT were analysed. Comparisons between sites allows assessment of surface change under different atmospheric conditions. The indications for regional and localized weathering trends will aid managers in understanding risks and setting priorities—both for further monitoring and for conservation interventions.

Conclusions

Results from the 5 year pilot trial of the LegIT has allowed preliminary evaluation of its potential as a long term indicator for surface weathering. Recommendations have been made for modifications to the design, manufacture and implementation of the tool. The future aim is to compare results over time at each site, building a picture of surface weathering processes in relation to regional climatic change.
Efficient wave-equation-based diffraction imaging
Authors: Zhang Dongliang , Fei Tong W. , Tsingas Constantine , Luo Yi
Published: May 2019

We have developed an efficient and practical wave-equation-based technique to image subsurface geologic features such as isolated scatterers, reflector edges, fault, fracture zones, and erosion whose information is mainly contained in diffracted waves. This technique has the ability to directly reveal and differentiate important geologic features compared with results obtained using reflected seismic waves. This new technique comprises three steps. First, the source and receiver wavefields are decomposed into left- and right-downgoing propagating waves, respectively. Second, applying the imaging condition to the right-downgoing source and receiver wavefields to generate the so-called right-right image. Similarly, a left-left image is generated. Third, the left-left and right-right images are multiplied sample-by-sample to form the final diffraction-based image. The key idea of this method is based on the fact that any dipping reflector exhibits a particular dip direction, so its subsurface image can exist either in the left-left or the right-right image, but not in both. As a result, the sample-by-sample multiplication of the two images eliminates the reflector images. Alternatively, because diffractions are generated by subsurface geologic features, which act as secondary sources and radiate in all directions, ranging from [Formula: see text] to 90°, their energy can exist in both images. After multiplication of both images, only the diffractors remain, whereas the reflectors are suppressed. Our method is applicable only for diffracting objects that radiate in all directions. An exception occurs when reflectors exhibit zero dip. In such a case, zero-dip reflectors could be present in both images and leak into the final diffractor image. We mitigate this problem in several ways, such as omitting near zero-offset input data, muting vertical-propagation components, or applying an [Formula: see text]-[Formula: see text] filter on the final diffraction image.
Ideal and Reality of Neuroleptic Relapse Prevention
Authors: Kissling Werner
Published: May 2019

The discovery of neuroleptics some 40 years ago brought about a revolution in the treatment of schizophrenia. Until then, schizophrenic patients were primarily treated with various forms of coma and shock therapy, and many were permanently confined in psychiatric hospitals. With the availability of neuroleptic medication, however, hospital stays have become considerably shorter and many patients can be returned home for out-patient care. In addition, psychosocial therapy for schizophrenic psychoses could not have been effective without the protective effect of neuroleptics.
Cytoreductive Surgery With or Without Hyperthermic Intraperitoneal Chemotherapy for Gastric Cancer With Peritoneal Metastases (CYTO-CHIP study): A Propensity Score Analysis
Authors: Bonnot Pierre-Emmanuel , Piessen Guillaume , Kepenekian Vahan , Decullier Evelyne , Pocard Marc , Meunier Bernard , Bereder Jean-Marc , Abboud Karine , Marchal Frédéric , Quenet François , Goere Diane , Msika Simon , Arvieux Catherine , Pirro Nicolas , Wernert Romuald , Rat Patrick , Gagnière Johan , Lefevre Jeremie H. , Courvoisier Thomas , Kianmanesh Reza , Vaudoyer Delphine , Rivoire Michel , Meeus Pierre , Passot Guillaume , Glehen Olivier ,   on behalf of the FREGAT and BIG-RENAPE Networks
Published: May 2019

PURPOSE

Gastric cancer (GC) with peritoneal metastases (PMs) is a poor prognostic evolution. Cytoreductive surgery (CRS) yields promising results, but the impact of hyperthermic intraperitoneal chemotherapy (HIPEC) remains controversial. Here we aimed to compare outcomes between CRS-HIPEC versus CRS alone (CRSa) among patients with PMs from GC.

PATIENTS AND METHODS

From prospective databases, we identified 277 patients with PMs from GC who were treated with complete CRS with curative intent (no residual nodules > 2.5 mm) at 19 French centers from 1989 to 2014. Of these patients, 180 underwent CRS-HIPEC and 97 CRSa. Tumor burden was assessed using the peritoneal cancer index. A Cox proportional hazards regression model with inverse probability of treatment weighting (IPTW) based on propensity score was used to assess the effect of HIPEC and account for confounding factors.

RESULTS

After IPTW adjustment, the groups were similar, except that median peritoneal cancer index remained higher in the CRS-HIPEC group (6 v 2; P = .003). CRS-HIPEC improved overall survival (OS) in both crude and IPTW models. Upon IPTW analysis, in CRS-HIPEC and CRSa groups, median OS was 18.8 versus 12.1 months, 3- and 5-year OS rates were 26.21% and 19.87% versus 10.82% and 6.43% (adjusted hazard ratio, 0.60; 95% CI, 0.42 to 0.86; P = .005), and 3- and 5-year recurrence-free survival rates were 20.40% and 17.05% versus 5.87% and 3.76% ( P = .001), respectively; the groups did not differ regarding 90-day mortality (7.4% v 10.1%, respectively; P = .820) or major complication rate (53.7% v 55.3%, respectively; P = .496).

CONCLUSION

Compared with CRSa, CRS-HIPEC improved OS and recurrence-free survival, without additional morbidity or mortality. When complete CRS is possible, CRS-HIPEC may be considered a valuable therapy for strictly selected patients with limited PMs from GC.
Estimation of Mortality Risk in Type 2 Diabetic Patients (ENFORCE): An Inexpensive and Parsimonious Prediction Model
Authors: Copetti Massimiliano , Shah Hetal , Fontana Andrea , Scarale Maria Giovanna , Menzaghi Claudia , De Cosmo Salvatore , Garofolo Monia , Sorrentino Maria Rosaria , Lamacchia Olga , Penno Giuseppe , Doria Alessandro , Trischitta Vincenzo
Published: May 2019

Context

We previously developed and validated an inexpensive and parsimonious prediction model of 2-year all-cause mortality in real-life patients with type 2 diabetes.

Objective

This model, now named ENFORCE (EstimatioN oF mORtality risk in type 2 diabetiC patiEnts), was investigated in terms of (i) prediction performance at 6 years, a more clinically useful time-horizon; (ii) further validation in an independent sample; and (iii) performance comparison in a real-life vs a clinical trial setting.

Design

Observational prospective randomized clinical trial.

Setting

White patients with type 2 diabetes.

Patients

Gargano Mortality Study (GMS; n = 1019), Foggia Mortality Study (FMS; n = 1045), and Pisa Mortality Study (PMS; n = 972) as real-life samples and the standard glycemic arm of the ACCORD (Action to Control Cardiovascular Risk in Diabetes) clinical trial (n = 3150).

Main Outcome Measure

The endpoint was all-cause mortality. Prediction accuracy and calibration were estimated to assess the model's performances.

Results

ENFORCE yielded 6-year mortality C-statistics of 0.79, 0.78, and 0.75 in GMS, FMS, and PMS, respectively (P heterogeneity = 0.71). Pooling the three cohorts showed a 6-year mortality C-statistic of 0.80. In the ACCORD trial, ENFORCE achieved a C-statistic of 0.68, a value significantly lower than that obtained in the pooled real-life samples (P < 0.0001). This difference resembles that observed with other models comparing real-life vs clinical trial settings, thus suggesting it is a true, replicable phenomenon.

Conclusions

The time horizon of ENFORCE has been extended to 6 years and validated in three independent samples. ENFORCE is a free and user-friendly risk calculator of all-cause mortality in white patients with type 2 diabetes from a real-life setting.
Why We Should Still Treat by Neurosurgery Patients With Cushing Disease and a Normal or Inconclusive Pituitary MRI
Authors: Cristante Justine , Lefournier Virginie , Sturm Nathalie , Passagia Jean Guy , Gauchez Anne Sophie , Tahon Florence , Cantin Stéphane , Chabre Olivier , Gay Emmanuel
Published: May 2019

Context

In patients with Cushing disease (CD) and a typical image of adenoma at MRI, transsphenoidal surgery is consensual. However, when MRI is inconclusive or normal, some authors now advocate medical treatment instead. The implicit assumption is that modern MRI should miss only very small microadenomas that are too difficult to visualize at surgery.

Objective

To analyze the evolution with time of the performances of MRI and the outcomes of surgery in patients with CD with a typical image of adenoma vs an inconclusive or normal MRI.

Design and Patients

Retrospective single center study of 195 patients with CD treated by transsphenoidal surgery between 1992 and 2018, using first a translabial microscopic and then a transnasal endoscopic approach. Patients with inconclusive or normal MRI were explored by bilateral inferior petrosal sinus sampling. Four MRI groups were defined: microadenomas (n = 89), macroadenomas (n = 18), or MRI either inconclusive (n = 44) or normal (n = 44).

Results

The proportion of inconclusive/normal MRI decreased with time, from 60% (21/35) in 1992 to 1996 to 27% (14/51) in 2012 to 2018 (P = 0.037). In the four MRI groups, the per-operatory adenoma visualization rate was only slightly lower when MRI was normal (95%, 100%, 86%, 79%; P = 0.012) and postoperative remission rates were not different (85%, 94%, 73%, 75%; P = 0.11).

Conclusion

The diagnostic performances of MRI have improved but remain inferior to the eye of an expert neurosurgeon, best assisted by endoscopy. We propose that patients with CD and an inconclusive/normal MRI be addressed by an expert neurosurgeon for transsphenoidal surgery rather than being treated medically.
Long-Acting and Selective Oxytocin Peptide Analogs Show Antidiabetic and Antiobesity Effects in Male Mice
Authors: Snider Brandy , Geiser Andrea , Yu Xiao-peng , Beebe Emily Cathleen , Willency Jill Amanda , Qing Keyun , Guo Lili , Lu Jianliang , Wang Xiaojun , Yang Qian , Efanov Alexander , Adams Andrew Charles , Coskun Tamer , Emmerson Paul Joseph , Alsina-Fernandez Jorge , Ai Minrong
Published: May 2019

Oxytocin (OXT) has been shown to suppress appetite, induce weight loss, and improve glycemic control and lipid metabolism in several species, including humans, monkeys, and rodents. However, OXT’s short half-life in circulation and lack of receptor selectivity limit its application and efficacy. In this study, we report an OXT peptide analog (OXTGly) that is potent and selective for the OXT receptor (OXTR). OXT, but not OXTGly, activated vasopressin receptors in vitro and acutely increased blood pressure in vivo when administered IP. OXT suppressed food intake in mice, whereas OXTGly had a moderate effect on food intake when administered IP or intracerebroventricularly. Both OXT (IP) and OXTGly (IP) improved glycemic control in glucose tolerance tests. Additionally, both OXT (IP) and OXTGly (IP) stimulated insulin, glucagon-like peptide 1, and glucagon secretion in mice. We generated lipid-conjugated OXT (acylated-OXT) and OXTGly (acylated-OXTGly) and demonstrated that these molecules have significantly extended half-lives in vivo. Compared with OXT, 2-week treatment of diet-induced obese mice with acylated-OXT [subcutaneous(ly) (SC)] resulted in enhanced body weight reduction, an improved lipid profile, and gene expression changes consistent with increased lipolysis and decreased gluconeogenesis. Treatment with acylated-OXTGly (SC) also resulted in a statistically significant weight loss, albeit to a lesser degree compared with acylated-OXT treatment. In conclusion, we demonstrate that selective activation of the OXTR pathway results in both acute and chronic metabolic benefits, whereas potential activation of vasopressin receptors by nonselective OXT analogs causes physiological stress that contributes to additional weight loss.
Inequitable Long-Term Outcomes for an Indigenous Population After Definitive Treatment of Patients With Graves Disease
Authors: Tamatea Jade A U , Tu'akoi Kelson , Meyer-Rochow Goswin Y , Conaglen John V , Elston Marianne S
Published: May 2019

Background

Māori, the indigenous people of Aotearoa/New Zealand, have an increased incidence of Graves disease and often require more than one radioiodine (RAI) dose, raising the question as to whether surgery may be preferable in this population. However, there is a lack of outcome data after definitive therapy in an indigenous population.

Aim

To assess ethnic differences in thyroid status after definitive therapy for Graves disease.

Methods

Single-center retrospective review of patients treated by RAI or thyroidectomy from 1 December 2001 to 31 March 2013. TSH levels at 1, 2, 5, and 10 years after treatment were recorded.

Results

A total of 798 patients were included: 589 received RAI, and 209 underwent surgery. Overall, 48% of patients were euthyroid at 1 year after definitive treatment, and 63.5% were euthyroid by 10 years. Māori were less likely to be euthyroid when compared with Europeans at all time points (e.g., 29.7% vs 57.3% at 1 year and 52.2% vs 70.9% at 10 years, P < 0.0005). Māori were more likely to receive more than one dose of RAI compared with Europeans (30.2% vs 14.2%, P < 0.0005). Persistent thyrotoxicosis at 1 year after RAI was seen in 25.8% of Māori compared with 8.3% of Europeans (P < 0.0005).

Conclusions

Māori have lower rates of optimal thyroid levels than their European counterparts at all time points studied. Early disparity was associated with a higher RAI failure rate. Late differences were due to higher rates of untreated hypothyroidism. Overall, euthyroid rates were low, indicating the need for improvement in care, particularly for indigenous peoples.
Dietary iron restriction leads to a reduction in hepatic fibrosis in a rat model of non-alcoholic steatohepatitis
Authors: Abe Naomichi , Tsuchida Takuma , Yasuda Shin-Ichiro , Oka Kozo
Published: May 2019

Iron overload in the liver causes oxidative stress and inflammation, which result in organ dysfunction, making it a risk factor for non-alcoholic steatohepatitis (NASH) and hepatocellular carcinoma. We aimed to evaluate the effect of dietary iron restriction on disease progression in rats fed a choline-deficient L-amino acid-defined (CDAA) diet. Male F344 rats were fed a choline-sufficient amino acid-defined (control) diet, a CDAA diet or an iron-restricted CDAA diet for 4, 8 and 12 weeks. At each time point, hepatic iron levels, oxidative stress, inflammation and fibrosis were evaluated by immunohistochemistry. The iron-restricted CDAA diet significantly decreased serum iron levels for 12 weeks compared with the CDAA diet. Histological analysis confirmed that feeding with the CDAA diet induced hepatic iron overload and that this was associated with oxidative stress (number of 8-hydroxydeoxyguanosine-positive cells), inflammation (CD68 positive area) and fibrosis (Sirius Red positive area). Iron restriction with the CDAA diet significantly led to a reduction in the hepatic iron levels, oxidative stress, inflammation and fibrosis. Therefore, dietary iron restriction could be a useful therapeutic approach for NASH patients with hepatic iron overload.
Physiological and behavioral stress responses to predators are altered by prior predator experience in juvenile qingbo (Spinibarbus sinensis)
Authors: Xu Jia-Jia , Fu Shi-Jian , Fu Cheng
Published: May 2019

All vertebrates exhibit physiological responses to predator stress, and these responses are the basis of appropriate behavioral adaptation. We aimed to identify the physiological and behavioral responses of juvenile qingbo (Spinibarbus sinensis) to its natural predator, the southern catfish (Silurus meridionalis) and to test whether these responses can be altered by prior predator experience. We measured the routine metabolic rate (RMR), cortisol levels, and spontaneous behavior of both predator-naive and predator-experienced qingbo under predator-absent, predator-present and non-predator-present (Hemibarbus maculatus) conditions. Predator-naive qingbo showed a typical stress response in the form of increased RMR and cortisol when exposed to predators. Spontaneous activity showed no difference between prior-experience groups or among stimulus conditions when tested alone; however, when tested with a companion, predator-naive qingbo showed increased activity and decreased distance to the stimulus arena under the predator-present condition than they did under the predator-absent condition. Both predator-naive and predator-experienced qingbo showed different physiological and behavioral responses between predatory and non-predatory fish, which suggested that predator-naive qingbo can instinctually discriminate between natural predators and non-predators. Predator-naive qingbo increase their inspection behavior when exposed to a predator compared with the predator-absent condition only when tested with a companion, which is possibly due to decreased predation risk and increased boldness.
Spring-loaded inverted pendulum goes through two contraction-extension cycles during the single support phase of walking
Authors: Antoniak Gabriel , Biswas Tirthabir , Cortes Nelson , Sikdar Siddhartha , Chun Chanwoo , Bhandawat Vikas
Published: May 2019

Despite the overall complexity of legged locomotion, the motion of the center of mass (COM) itself is relatively simple, and can be qualitatively described by simple mechanical models. In particular, walking can be qualitatively modeled by a simple model in which each leg is described by a spring-loaded inverted pendulum (SLIP). However, this model has many limitations and is unlikely to serve as a quantitative model. As a first step to obtaining a quantitative model for walking, we explored the ability of SLIP to model the single-support phase of walking, and found that SLIP has two limitations. First, it predicts larger horizontal ground reaction forces (GRFs) than empirically observed. A new model – angular and radial spring-loaded inverted pendulum (ARSLIP) – can overcome this deficit. Second, although the leg spring (surprisingly) goes through two contraction-extension-contraction-extension (CECE) during the single stance phase of walking and can produce the characteristic M-shaped vertical GRFs, modeling the single stance phase requires active elements. Despite these limitations, SLIP as a model provides important insights. It shows that the CECE cycling lengthens the stance duration allowing the COM to travel passively for longer, and decreases the velocity redirection between the beginning and end of a step.
Idiopathic pulmonary fibrosis: the radiologist’s role in making the diagnosis
Authors: Mohning Michael P. , Richards John Caleb , Huie Tristan J.
Published: May 2019

Radiologists have a critical role in the evaluation and diagnosis of suspected idiopathic pulmonary fibrosis (IPF). Accurate pattern identification on imaging is key in the multidisciplinary diagnostic process and frequently obviates the need for a surgical lung biopsy. In this review, we describe the clinical and imaging features of IPF in the context of recently revised international guidelines; contrast findings in other diseases that may inform differential diagnosis of fibrotic lung disease; and highlight common complications associated with pulmonary fibrosis.
Human PRPF40B regulates hundreds of alternative splicing targets and represses a hypoxia expression signature
Authors: Lorenzini Paolo Alberto , Chew Resilind Su Ern , Tan Cheryl Weiqi , Yong Jing Yen , Zhang Fan , Zheng Jie , Roca Xavier
Published: May 2019

Altered splicing contributes to the pathogenesis of human blood disorders including myelodysplastic syndromes (MDS) and leukemias. Here we characterize the transcriptomic regulation of PRPF40B, which is a splicing factor mutated in a small fraction of MDS patients. We generated a full PRPF40B knockout (KO) in the K562 cell line by CRISPR/Cas9 technology and rescued its levels by transient overexpression of wild-type (WT), P383L or P540S MDS alleles. Using RNA sequencing, we identified hundreds of differentially expressed genes and alternative splicing (AS) events in the KO that are rescued by WT PRPF40B, with a majority also rescued by MDS alleles, pointing to mild effects of these mutations. Among the PRPF40B-regulated AS events, we found a net increase in exon inclusion in the KO, suggesting that this splicing factor primarily acts as a repressor. PRPF40B-regulated splicing events are likely cotranscriptional, affecting exons with A-rich downstream intronic motifs and weak splice sites especially for 5′ splice sites, consistent with its PRP40 yeast ortholog being part of the U1 small nuclear ribonucleoprotein. Loss of PRPF40B in K562 induces a KLF1 transcriptional signature, with genes involved in iron metabolism and mainly hypoxia, including related pathways like cholesterol biosynthesis and Akt/MAPK signaling. A cancer database analysis revealed that PRPF40B is lowly expressed in acute myeloid leukemia, whereas its paralog PRPF40A expression is high as opposed to solid tumors. Furthermore, these factors negatively or positively correlated with hypoxia regulator HIF1A, respectively. Our data suggest a PRPF40B role in repressing hypoxia in myeloid cells, and that its low expression might contribute to leukemogenesis.
Effect of continuous furosemide infusion on outcome of acute kidney injury
Authors: Ni Jie , Jiang Hui , Wang Fang , Zhang Long , Sha Dujuan , Wang Jun
Published: May 2019

Objective: To evaluate the clinical effects of continuous intravenous infusion with high-dose furosemide on early acute kidney injury (AKI) complicated with acute lung edema.

Methods: Ninety patients who had been treated by furosemide at routine dose for 12 hour but with unsatisfactory outcomes were selected and subjected to continuous intravenous infusion with high-dose furosemide. The dose was adjusted according to hourly urine output. Serum levels of urea nitrogen, creatinine and potassium, pH, oxygenation index and mechanical ventilation time before and 6, 12, 24, 48 and 72 hour after treatment were compared.

Results: The urine outputs before and 6, 12, 24, 48 and 72 hour after treatment were (10.71±1.81), (164.52±21.42), (189.71±29.61), (181.33±23.52), (176.82±24.80) and (164.52±18.91) ml/h respectively. Compared with data before treatment, the serum levels of urea nitrogen, creatinine and potassium significantly decreased while pH and oxygenation index significantly increased after six hour of treatment (P<0.05). After treatment, the kidney functions of 80 patients (88.9%) were completely recovered, without obvious adverse reactions.

Conclusion: For patients with early AKI complicated with acute pulmonary edema who cannot be cured by diuretic agent at routine dose, high-dose furosemide increases urine output and improves success rate.

doi: https://doi.org/10.12669/pjms.35.3.1012

How to cite this:Ni J, Jiang H, Wang F, Zhang L, Sha D, Wang J. Effect of continuous furosemide infusion on outcome of acute kidney injury. Pak J Med Sci. 2019;35(3):754-757. doi: https://doi.org/10.12669/pjms.35.3.1012

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Decreased levels of serum zonulin and copeptin in chronic Hepatitis-B patients
Authors: Calgin Mustafa Kerem , Cetinkol Yeliz
Published: May 2019

Background & Objective: Liver and intestines are anatomically and physiologically linked. Zonulin is a protein modulating intercellular tight junctions and regulating intestinal permeability. Copeptin was studied as a marker of systemic circulation disorders in research about vasopressin and was associated with liver disease prognosis. Serum zonulin and copeptin levels were measured in patients with diagnosis of chronic hepatitis B (CHB) with the aim of easing antiviral treatment management in clinical applications and to investigate the association with normal population and viral load.

Methods: Analysis included the serum of 30 CHB patients and 17 controls. HBV-DNA real-time PCR tests were completed. CHB patients were divided into three subgroups according to viral load in serum. Zonulin and copeptin levels were measured using ELISA kits.

Results: Serum zonulin and copeptin levels were significantly low in CHB patients compared to controls (p<0.001). When CHB subgroups are investigated in terms of serum zonulin and copeptin levels, there was an inverse correlation observed with significant difference (p<0.01, p<0.05).

Conclusion: The negative correlation between serum zonulin and copeptin with HBV-DNA load revealed in our study shows they may be used to monitor treatment. Zonulin and copeptin assays provide the possibility of developing new approaches to CHB diagnosis and monitoring.

doi: https://doi.org/10.12669/pjms.35.3.144

How to cite this:Calgin MK, Cetinkol Y. Decreased levels of serum zonulin and copeptin in chronic Hepatitis-B patients. Pak J Med Sci. 2019;35(3):842-846. doi: https://doi.org/10.12669/pjms.35.3.144

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The impact of physical activity to the child’s quality of life: a bibliometric study
Authors: Završnik Jernej , Kokol Peter , Blažun Vošner Helena
Published: May 2019

Background: The application of bibliometrics in healthcare research is becoming popular, however at present it is still an under-researched area.

Methods: In our study we used a bibliometric technique called bibliometric mapping to visualize the published research regarding the influence of physical activity to children’s quality of life. The research was visualized in the form of both chronological and cluster science landscapes. Science landscapes, contrary to conventional reviews, capture the relationships between multiple topics and concepts, enabling the generation of “synthetic reviews”.

Results: Evolutionarily, three distinct research phases appeared, namely research on influence of physical activity on various chronic non-communicable diseases; research on quality of life and childhood diseases related to physical activity; and outcome-related research. The research consists of six main topics: asthmatic child and exercising, blood diseases, health-related quality of life, obesity and chronic diseases, childhood obesity and behaviour, and depression and health outcomes.

Conclusions: The study identified some research that may be helpful to general paediatricians whose everyday practice or research is not focused on physical activity and child’s quality of life, but wants to learn about the taxonomy of the topics, the most interesting discoveries, guidelines and practices and the state of the art in the field. It also revealed some hidden association, otherwise not easily identified, even by informed researchers and clinicians.
Chance-Constrained Surgery Planning Under Conditions of Limited and Ambiguous Data
Authors: Deng Yan , Shen Siqian , Denton Brian
Published: May 2019

Surgery planning decisions include which operating rooms (ORs) to open, allocation of surgeries to ORs, sequence, and time to start each surgery. They are often made under uncertain surgery durations with limited data that lead to unknown distributional information. Moreover, cost parameters for criteria such as overtime and surgery delays are often difficult or impossible to estimate in practice. In this paper, we formulate distributionally robust (DR) chance constraints on surgery waiting and OR overtime, which recognize practical limitations on data availability and cost parameter accuracy. We use [Formula: see text]-divergence measures to build an ambiguity set of possible distributions of random surgery durations, and derive a branch-and-cut algorithm for optimizing a mixed-integer linear programming reformulation based on finite samples of the random surgery durations. We test instances generated from real hospital-based surgery data. The results show computational efficacy of our approaches, and provide insights for DR surgery planning.
Simulated Annealing and Artificial Bee Colony for the Redistricting Process in Mexico
Authors: Gutiérrez-Andrade Miguel Ángel , Rincón-García Eric Alfredo , de-los-Cobos-Silva Sergio Gerardo , Lara-Velázquez Pedro , Mora-Gutiérrez Roman Anselmo , Ponsich Antonin
Published: May 2019

Short abstract: To facilitate the redistricting process in Mexico, the authors designed two optimization algorithms; one is based on simulated annealing, and the other is based on artificial bee colony. In this paper, they describe their methodology and the results they obtained when they used these algorithms.