bluuebunny/crossref_metadata_2025 huggingface dataset:
The exogenous application of AtPGLR, an endo‐polygalacturonase, triggers pollen tube burst and repair
Authors: Hocq Ludivine , Guinand Sophie , Habrylo Olivier , Voxeur Aline , Tabi Wafae , Safran Josip , Fournet Françoise , Domon Jean‐Marc , Mollet Jean‐Claude , Pilard Serge , Pau‐Roblot Corinne , Lehner Arnaud , Pelloux Jérôme , Lefebvre Valérie
Published: March 2020

Plant cell wall remodeling plays a key role in the control of cell elongation and differentiation. In particular, fine‐tuning of the degree of methylesterification of pectins was previously reported to control developmental processes as diverse as pollen germination, pollen tube elongation, emergence of primordia or elongation of dark‐grown hypocotyls. However, how pectin degradation can modulate plant development has remained elusive. Here we report the characterization of a polygalacturonase (PG), AtPGLR, the gene for which is highly expressed at the onset of lateral root emergence in Arabidopsis. Due to gene compensation mechanisms, mutant approaches failed to determine the involvement of AtPGLR in plant growth. To overcome this issue, AtPGLR has been expressed heterologously in the yeast Pichia pastoris and biochemically characterized. We showed that AtPGLR is an endo‐PG that preferentially releases non‐methylesterified oligogalacturonides with a short degree of polymerization (< 8) at acidic pH. The application of the purified recombinant protein on Amaryllis pollen tubes, an excellent model for studying cell wall remodeling at acidic pH, induced abnormal pollen tubes or cytoplasmic leakage in the subapical dome of the pollen tube tip, where non‐methylesterified pectin epitopes are detected. Those leaks could either be repaired by new β‐glucan deposits (mostly callose) in the cell wall or promoted dramatic burst of the pollen tube. Our work presents the full biochemical characterization of an Arabidopsis PG and highlights the importance of pectin integrity in pollen tube elongation.
The Relationship between Future Self-Continuity and Mobile Phone Dependence of College Students: Mediating Role of Self-Control
Authors: Fu Guifang , Li Siman , Guo Jia
Published: March 2020

The problem of mobile phone dependence is becoming more and more serious. Therefore, it is very important to explore the causes of mobile phone dependence and its psychological mechanism. One of the important characteristics of mobile phone dependence is the loss of control, which shows that self-control is an important factor affecting mobile phone dependence. Self-continuity is closely related to cell phone dependence. Mobile phone addicts usually use mobile phones to temporarily relieve the pressure and negative emotions, but it will lead to more pressure and negative emotions in the future. In order to examine the situation of college students’ future self-continuity, self-control and mobile phone addiction as well as their relationships, especially mediating effect of self-control, a total of 482 college students were assessed with Future Self-Continuity Scale (FSC), Self-Control Scale (SCS), and Mobile Phone Dependency Index (MPAI). The results showed that: (1) The future self-continuity, self-control and mobile phone dependence of the college students in this study were all at a medium level, and there was no significant difference in demographic variables (such as gender, grade, etc.); (2) Both future self-continuity and self-control were negatively correlated with mobile phone dependence; (3) There was a significant positive correlation between future self-continuity and self-control; (4) Self-control played a partial mediating role between future self-continuity and mobile phone dependence. Therefore, improving self-continuity and self-control can be an effective way to intervene mobile phone dependence. In addition research implication, limitations and future directions were discussed.
Theoretical Analyses of Heat Balance in a Diesel/Natural Gas Dual-Fuel Engine at Low and Medium Loads Based on Experimental Values
Authors: Wang Zhongshu , Du Guizhi , Li Ming , Xu Yun , Zhang Fangyuan
Published: March 2020

In order to propose the control strategies based on exergy to realize efficient and energy-saving operation of the engine, the energy and exergy balance under sensitive boundary conditions were analyzed with the first and second laws of thermodynamics on a six-cylinders, four strokes, turbocharged, intercooled, and high-pressure common rail diesel/natural gas (NG) dual-fuel engine in this paper. The results depicted that the thermal efficiency and exergy efficiency decrease with the increase of NG percentage energy substitution rate (PES). Compared with other conditions, at medium load, 1978 rpm and 90% PES, the exergy destruction caused by irreversibility process including mixing combustion, heat transfer and mechanical friction reaches 72.33%. With the advance of diesel injection time (Tinj), thermal efficiency and energy fraction of heat transfer increase first and then decrease. However, diesel injection pressure (Pinj) has little effect on improving energy utilization. Compared with single diesel injection, appropriate multiple diesel injection can improve combustion performance and energy utilization. When the first Tinj is 35 deg CA BTDC and second Tinj is 25 deg CA BTDC, nearly 50% of the energy lost in heat transfer can be converted into useful work. The lost exergy can be reduced by choosing appreciate Tinj and Pinj, adding exhaust gas recirculation (EGR) to reduce in-cylinder temperature to improve combustion and using thermal insulation materials to reduce heat transfer or using the lost heat in other processes such as preheating intake air and producing the hot water or steam of external consumption to reduce the exergy destruction.
Comparative study of two atomic layer etching processes for GaN
Authors: Mannequin Cédric , Vallée Christophe , Akimoto Katsuhiro , Chevolleau Thierry , Durand Christophe , Dussarrat Christian , Teramoto Takashi , Gheeraert Etienne , Mariette Henri
Published: March 2020

Atomic layer etching (ALE) of Ga-polar GaN (0001) using a standard inductively coupled plasma-reactive ion etching system is achieved in this work. The sequential process is using Cl2 to modify the surface in the adsorption step. For the activation step, the authors compare two rare gas plasmas, namely, Ar and Kr, and show a much larger and well-defined ALE window for the latter. The ALE of GaN is demonstrated by etching mesa structures masked with a photoresist. A constant etching rate per cycle of two monolayers is obtained. The experimental conditions of this self-limited process are found by changing both the adsorption and activation times, together with the source power. This provides an atomic-scale process for nanofabrication, with significant improvements to the GaN surface.
MEMS biosensor for monitoring water toxicity based on quartz crystal microbalance
Authors: Lee Kun-Lin , Ng Simon , Li Fang , Nordin Anis Nurashikin , Voiculescu Ioana
Published: March 2020

This paper presents the use of a commercial quartz crystal microbalance (QCM) to investigate live-cell activity in water-based toxic solutions. The QCM used in this research has a resonant frequency of 10 MHz and consists of an AT-cut quartz crystal with gold electrodes on both sides. This QCM was transformed into a functional biosensor by integrating with polydimethylsiloxane culturing chambers. Rainbow trout gill epithelial cells were cultured on the resonators as a sensorial layer. The fluctuation of the resonant frequency, due to the change of cell morphology and adhesion, is an indicator of water toxicity. The shift in the resonant frequency provides information about the viability of the cells after exposure to toxicants. The toxicity result shows distinct responses after exposing cells to 0.526 μM of pentachlorophenol (PCP) solution, which is the Military Exposure Guidelines concentration. This research demonstrated that the QCM is sensitive to a low concentration of PCP and no further modification of the QCM surface was required.
With COVID-19, modeling takes on life and death importance
Authors: Enserink Martin , Kupferschmidt Kai
Published: March 2020

Epidemic simulations shape national responses.
Can ‘sentinel trees’ warn of devastating pests?
Authors: Popkin Gabriel
Published: March 2020

By planting groves of exotic species, nations hope to identify potential insect invaders.
Flux-induced topological superconductivity in full-shell nanowires
Authors: Vaitiekėnas S. , Winkler G. W. , van Heck B. , Karzig T. , Deng M.-T. , Flensberg K. , Glazman L. I. , Nayak C. , Krogstrup P. , Lutchyn R. M. , Marcus C. M.
Published: March 2020

A possible Majorana sighting

Majorana zero modes, exotic quasiparticles predicted to occur in topological superconductors, hold promise as a building block of topological quantum computing. Two of the frontrunners for the physical implementation of Majoranas include hybrid semiconductor-superconductor nanowires and topological insulators in contact with a superconductor. Vaitiekėnas
et al.
introduce a platform that combines elements of both: a semiconductor nanowire that is fully wrapped by a superconductor. Combining theoretical calculations with experiments, the researchers present evidence that is consistent with the emergence of Majorana zero modes in this system.

Science
, this issue p.
eaav3392
The dark matter interpretation of the 3.5-keV line is inconsistent with blank-sky observations
Authors: Dessert Christopher , Rodd Nicholas L. , Safdi Benjamin R.
Published: March 2020

X-ray data constrain dark matter decay

Dark matter may consist of previously unknown forms of subatomic particles. An unidentified astronomical x-ray emission line has been interpreted as being caused by the decay of a dark matter particle. If this is correct, then dark matter in the halo of the Milky Way Galaxy should produce a faint emission line across the whole sky. Dessert
et al.
tested this hypothesis using observations by the XMM-Newton (X-ray Multi-Mirror Mission) space telescope. Analyzing blank-sky regions with a total exposure time of about a year, they found no evidence for the predicted line and set upper limits on the decay rate that rule out the previously proposed dark matter interpretation.

Science
, this issue p.
1465
Peptide signaling for drought-induced tomato flower drop
Authors: Reichardt S. , Piepho H.-P. , Stintzi A. , Schaller A.
Published: March 2020

Fruit abscission in response to drought

Plants faced with drought, or simply not quite enough water, may be more likely to drop their fruit prematurely. Reichardt
et al.
found that a small signaling peptide hormone, phytosulfokine, which was previously known for its ability to regulate plant cell growth, also drives fruit abscission. Processed, and thus activated, by a subtilisin-like protease, phytosulfokine in turn drives expression of the hydrolases that degrade the cell walls in the abscission zone, leading to dropped fruit.

Science
, this issue p.
1482
Last Interglacial Iberian Neandertals as fisher-hunter-gatherers
Authors: Zilhão J. , Angelucci D. E. , Igreja M. Araújo , Arnold L. J. , Badal E. , Callapez P. , Cardoso J. L. , d’Errico F. , Daura J. , Demuro M. , Deschamps M. , Dupont C. , Gabriel S. , Hoffmann D. L. , Legoinha P. , Matias H. , Monge Soares A. M. , Nabais M. , Portela P. , Queffelec A. , Rodrigues F. , Souto P.
Published: March 2020

Fruits of the sea

The origins of marine resource consumption by humans have been much debated. Zilhão
et al.
present evidence that, in Atlantic Iberia's coastal settings, Middle Paleolithic Neanderthals exploited marine resources at a scale on par with the modern human–associated Middle Stone Age of southern Africa (see the Perspective by Will). Excavations at the Figueira Brava site on Portugal's Atlantic coast reveal shell middens rich in the remains of mollusks, crabs, and fish, as well as terrestrial food items. Familiarity with the sea and its resources may thus have been widespread for residents there in the Middle Paleolithic. The Figueira Brava Neanderthals also exploited stone pine nuts in a way akin to that previously identified in the Holocene of Iberia. These findings add broader dimensions to our understanding of the role of aquatic resources in the subsistence of Paleolithic humans.

Science
, this issue p.
eaaz7943
; see also p.
1422
The historical roots of economic development
Authors: Nunn Nathan
Published: March 2020

Deep origins of modern inequality

Methodological innovations are enabling scientists to study how events in the distant past affect contemporary life. Nunn reviews recent research at the intersection of history, development, and culture that aims to understand the cultural evolution of economic development. The persistence of global inequality is used as a case study to demonstrate the interplay of these dynamics. Future areas of research and implications for policy are discussed.

Science
, this issue p.
eaaz9986
Unconstrained genome targeting with near-PAMless engineered CRISPR-Cas9 variants
Authors: Walton Russell T. , Christie Kathleen A. , Whittaker Madelynn N. , Kleinstiver Benjamin P.
Published: March 2020

A PAMless base editor

CRISPR-Cas DNA base editing typically requires a specific motif for targeting known as a protospacer-adjacent motif (PAM). This requirement limits the sequences within a genome that can be targeted. Walton
et al.
engineered specific variants of the
Streptococcus pyogenes
Cas9 enzyme named SpG and SpRY that could recognize and edit a wider array of PAMs. Using SpRY, the authors were able to correct previously uneditable mutations associated with human disease. Although off-target effects were observed for these engineered Cas enzymes at levels similar to those of the wild-type enzyme, depending on the context, these engineered enzymes widen the potential applications of precision genome editing.

Science
, this issue p.
290
OPC-167832, a Novel Carbostyril Derivative with Potent Antituberculosis Activity as a DprE1 Inhibitor
Authors: Hariguchi Norimitsu , Chen Xiuhao , Hayashi Yohei , Kawano Yoshikazu , Fujiwara Mamoru , Matsuba Miki , Shimizu Hiroshi , Ohba Yoshio , Nakamura Izuru , Kitamoto Ryuki , Shinohara Toshio , Uematsu Yukitaka , Ishikawa Shunpei , Itotani Motohiro , Haraguchi Yoshikazu , Takemura Isao , Matsumoto Makoto
Published: March 2020

There is an urgent need for new, potent antituberculosis (anti-TB) drugs with novel mechanisms of action that can be included in new regimens to shorten the treatment period for TB. After screening a library of carbostyrils, we optimized 3,4-dihydrocarbostyril derivatives and identified OPC-167832 as having potent antituberculosis activity. The MICs of the compound for
Mycobacterium tuberculosis
ranged from 0.00024 to 0.002 μg/ml. It had bactericidal activity against both growing and intracellular bacilli, and the frequency of spontaneous resistance for
M. tuberculosis
H37Rv was less than 1.
Densely Populated Water Droplets in Heavy-Oil Seeps
Authors: Pannekens M. , Voskuhl L. , Meier A. , Müller H. , Haque S. , Frösler J. , Brauer V. S. , Meckenstock R. U.
Published: March 2020

Our results confirmed that small water droplets in oil are densely populated microhabitats containing active microbial communities. Since these microhabitats occurred in three tested oil seeps which are located thousands of kilometers away from each other, such populated water droplets might be a generic trait of biodegraded oil reservoirs and might be involved in the overall oil degradation process. Microbial degradation might thus also take place in water pockets in the oil-bearing oil legs of the reservoir rock rather than only at the oil-water transition zone.
Protein Biosynthesis in Mitochondria: Past Simple, Present Perfect, Future Indefinite
Authors: Levitskii S. A. , Baleva M. V. , Chicherin I. V. , Krasheninnikov I. A. , Kamenski P. A.
Published: March 2020

Mitochondria are obligate organelles of most eukaryotic cells that perform many different functions important for cellular homeostasis. The main role of mitochondria is supplying cells with energy in a form of ATP, which is synthesized in a chain of oxidative phosphorylation reactions on the organelle inner membrane. It is commonly believed now that mitochondria have the endosymbiotic origin. In the course of evolution, they have lost most of their genetic material as a result of genome reduction and gene transfer to the nucleus. The majority of mitochondrial proteins are synthesized in the cytosol and then imported to the mitochondria. However, almost all known mitochondria still contain genomes that are maintained and expressed. The processes of protein biosynthesis in the mitochondria — mitochondrial translation — substantially differs from the analogous processes in bacteria and the cytosol of eukaryotic cells. Mitochondrial translation is characterized by a high degree of specialization and specific regulatory mechanisms. In this review, we analyze available information on the common principles of mitochondrial translation with emphasis on the molecular mechanisms of translation initiation in the mitochondria of yeast and mammalian cells.
Pulmonary hyalinising granuloma: a rare and elusive cause of multiple lung nodules
Authors: Tang Ivan , Moore Alastair J , Fryer Eve , Sykes Annemarie
Published: March 2020

A 72-year-old woman was referred with incidentally detected multiple lung nodules, one of which was identified as18F-fluorodeoxyglucose (FDG)-avid on positron emission tomography. Extensive workup followed, including numerous radiographs, surveillance scans and a CT-guided biopsy which demonstrated chronic inflammation only. Following a wedge-resection, a diagnosis of pulmonary hyalinising granuloma (PHG) was made. PHG is a cause of FDG-avid single or multiple pulmonary nodules and can mimic lung cancer or metastatic disease radiologically. The diagnosis is often difficult to make with minimally invasive techniques such as needle-guided biopsies which do not tend to yield the diagnosis and requires surgical resection for definitive diagnosis and exclusion of malignancy.
Multicentre study: reliability and repeatability of Scheimpflug system measurement in keratoconus
Authors: de Luis Eguileor Beatriz , Arriola-Villalobos Pedro , Pijoan Zubizarreta Jose Ignacio , Feijoo Lera Raquel , Santamaria Carro Alaitz , Diaz-Valle David , Etxebarria Jaime
Published: March 2020

Purpose

To assess the repeatability and reliability of the most important tomographic parameters for characterising keratoconus measured with a Pentacam HR (high resolution).

Methods

Overall, 230 eyes in 158 patients with keratoconus were analysed. We performed five consecutive corneal tomography examinations for each eye with a Pentacam HR in patients with keratoconus. Study eyes were classified into three groups depending on the maximum posterior elevation (max_BFS_post): grade 1 for cases of keratoconus with a max_BFS_post of 40 µm; grade 2 for those with a max_BFS_post of between 41 and 75 µm and grade 3 for those with a max_BFS_post of over 75 µm. We calculated the intraclass correlation coefficients (ICCs) and repeatability limits of parameters from tomography and aberrometry.

Results

All the parameters were found to have excellent ICCs (0.9). The repeatability limits for the key parameters were higher than 0.5D for the power parameters, 20° for the axis of corneal astigmatism and 10 µm for the thinnest corneal thickness. Further, we obtained repeatability limits of above 0.1 µm for the aberrometry values and overall greater than 15° for the coma axis. All the values increase with the severity of keratoconus, except for that of the coma axis which falls with keratoconus grade.

Conclusions

The reliability indicated by ICCs supports the view that the Pentacam HR is useful for the diagnosis of keratoconus. The repeatability limits suggest that new criteria should be established for monitoring progression taking into account the real measurements that can be made using this system.
Prediction of OCT images of short-term response to anti-VEGF treatment for neovascular age-related macular degeneration using generative adversarial network
Authors: Liu Yutong , Yang Jingyuan , Zhou Yang , Wang Weisen , Zhao Jianchun , Yu Weihong , Zhang Dingding , Ding Dayong , Li Xirong , Chen Youxin
Published: March 2020

Background/aims

The aim of this study was to generate and evaluate individualised post-therapeutic optical coherence tomography (OCT) images that could predict the short-term response of antivascular endothelial growth factor therapy for typical neovascular age-related macular degeneration (nAMD) based on pretherapeutic images using generative adversarial network (GAN).

Methods

A total of 476 pairs of pretherapeutic and post-therapeutic OCT images of patients with nAMD were included in training set, while 50 pretherapeutic OCT images were included in the tests set retrospectively, and their corresponding post-therapeutic OCT images were used to evaluate the synthetic images. The pix2pixHD method was adopted for image synthesis. Three experiments were performed to evaluate the quality, authenticity and predictive power of the synthetic images by retinal specialists.

Results

We found that 92% of the synthetic OCT images had sufficient quality for further clinical interpretation. Only about 26%–30% synthetic post-therapeutic images could be accurately identified as synthetic images. The accuracy to predict macular status of wet or dry was 0.85 (95% CI 0.74 to 0.95).

Conclusion

Our results revealed a great potential of GAN to generate post-therapeutic OCT images with both good quality and high accuracy.
Prevalence and risk factors for visual impairment among elderly residents in ‘homes for the aged’ in India: the Hyderabad Ocular Morbidity in Elderly Study (HOMES)
Authors: Marmamula Srinivas , Barrenakala Navya Rekha , Challa Rajesh , Kumbham Thirupathi Reddy , Modepalli Satya Brahmanandam , Yellapragada Ratnakar , Bhakki Madhuri , Khanna Rohit C , Friedman David S
Published: March 2020

Background/Aim

To investigate the prevalence, causes and risk factors of visual impairment (VI) among the elderly in ‘home for the aged’ in Hyderabad, India.

Methods

Individuals aged ≥60 years were recruited from 41 ‘homes for the aged’. All participants had complete eye examinations including presenting visual acuity, refraction, slit-lamp examination, intraocular pressure measurement and fundus imaging by trained clinicians. VI was defined as presenting visual acuity worse than 6/18 in the better eye. Multivariate logistic regression was used to determine the risk factors associated with VI.

Results

1512 elderly residents from 41 homes for the aged were enumerated, of whom 1182 (78.1%) were examined. The mean age of examined participants was 75.0 years (SD 8.8 years; range: 60–108 years); 35.4% of those examined were men. The prevalence of VI was 30.1% (95% CI 27.5 to 32.8). The leading cause of VI was cataract (46.3%, n=165), followed by uncorrected refractive error (27.0%, n=96), posterior capsular opacification (14.9%, n=53) and posterior segment disease (6.5%, n=23). Overall, 88.2% of the VI was either treatable or correctable. In multiple logistic regression, those aged 80 years and older (OR: 1.7, p<0.01), living in ‘free’ homes (OR: 1.5, p<0.01) and who were immobile/bedridden (OR: 3.02, p<0.01) had significantly higher odds of VI. Gender was not associated with VI.

Conclusions

VI was common and largely avoidable in residents of ‘homes for the aged’ in Hyderabad, India. Screening for vision loss in ‘homes for aged’ and the provision of appropriate services should become routine practice to achieve the goal of healthy ageing in India.
Shaped corneal transplantation surgery
Authors: Sahay Pranita , Stevenson Louis Julian , Agarwal Tushar , Sharma Bhavana , Sharma Namrata , Vajpayee Rasik B
Published: March 2020

Since its inception in 1905, keratoplasty techniques have continuously evolved. Shaped keratoplasty procedures have allowed corneal surgeons to use complex graft–host junctions and non-circular graft designs to optimise wound strength and healing, facilitate early suture removal and expedite visual rehabilitation. While this was initially limited to penetrating procedures, shaped lamellar keratoplasty techniques have since emerged. Furthermore, the arrival of femtosecond laser has dramatically increased the range of graft designs available to surgeons, due to the technology’s ability to precisely cut complex wound edges. This review describes the broad range of shaped keratoplasty grafts currently available and elaborates on their respective advantages and disadvantages in relation to conventional keratoplasty.
Choriocapillaris flow impairment could predict the enlargement of geographic atrophy lesion
Authors: Sacconi Riccardo , Corbelli Eleonora , Borrelli Enrico , Capone Luigi , Carnevali Adriano , Gelormini Francesco , Querques Lea , Bandello Francesco , Querques Giuseppe
Published: March 2020

Aim

To analyse the choriocapillaris (CC) flow status in the area that subsequently showed geographic atrophy (GA) expansion secondary to age-related macular degeneration (AMD) during 1-year follow-up, matching optical coherence tomography angiography (OCT-A) and fundus autofluorescence (FAF).

Methods

In this prospective longitudinal observational study, 30 eyes of 20 consecutive patients with GA secondary to AMD (mean age 75.5±7.4 years) were included. All patients underwent OCT-A and FAF at baseline and 1-year follow-up. Main outcome measures included analysis of perfusion density (PD) in the ‘area surrounding GA margin’ (between the GA border and 500 µm distance) in comparison with the ‘control area’ (area outside the 500 µm line), and of the ‘expansion area’ (area that subsequently developed GA expansion during 1-year follow-up).

Results

During the 1-year follow-up, visual acuity significantly decreased from 0.34±0.38 Logarithm of the Minimum Angle of Resolution (LogMAR) to 0.39±0.40 LogMAR (p<0.001), and mean GA area increased from 6.82±5.47 mm2 to 8.76±6.28 mm2 (p<0.001). CC PD of the area surrounding the GA margin revealed a significant flow impairment compared with control area (PD 0.679±0.076 and 0.734±0.057, respectively (p<0.001)). Furthermore, the PD of the expansion area showed a greater CC flow impairment in comparison to the remaining area surrounding GA margin (p<0.001).

Conclusions

We reported a greater CC impairment in the area that subsequently developed GA expansion, suggesting that the CC flow impairment could predict the enlargement of GA lesion. The CC impairment could be considered as a new a risk factor for GA progression and a biomarker to be measured to determine efficacy of new interventions aiming to slow progression of GA.
Does foot mobility affect the outcome in the management of patellofemoral pain with foot orthoses versus hip exercises? A randomised clinical trial
Authors: Matthews Mark , Rathleff Michael Skovdal , Claus Andrew , McPoil Tom , Nee Robert , Crossley Kay M , Kasza Jessica , Vicenzino Bill T
Published: March 2020

Objectives

To test (i) if greater foot pronation (measured as midfoot width mobility) is associated with better outcomes with foot orthoses treatment, compared with hip exercises and (ii) if hip exercises are superior to foot orthoses, irrespective of midfoot width mobility.

Methods

A two-arm parallel, randomised superiority clinical trial was conducted in Australia and Denmark. Participants (18–40 years) were included who reported an insidious onset of knee pain (≥6 weeks duration); ≥3/10 numerical pain rating, that was aggravated by activities (eg, stairs, squatting, running). Participants were stratified by midfoot width mobility (high≥11 mm change in midfoot width) and site, randomised to foot orthoses or hip exercises and blinded to objectives and stratification. Success was defined a priori asmuch betterorbetteron a patient-perceived 7-point scale at 12 weeks.

Results

Of 218 stratified and randomised participants, 192 completed 12-week follow-up. This study found no difference in success rates between foot orthoses versus hip exercises in those withhigh(6/21 vs 9/20; 29% vs 45%, respectively) orlow(42/79 vs 37/72; 53% vs 51%) midfoot width mobility. There was no association between midfoot width mobility and treatment outcome (Interaction effect p=0.19). This study found no difference in success rate between foot orthoses versus hip exercises (48/100 vs 46/92; 48% vs 50%).

Conclusion

Midfoot width mobility should not be used to help clinicians decide which patient with patellofemoral pain might benefit most from foot orthoses. Clinicians and patients may consider either foot orthoses or hip exercises in managing patellofemoral pain.

Trial registration number

ACTRN12614000260628.
Sport and exercise genomics: the FIMS 2019 consensus statement update
Authors: Tanisawa Kumpei , Wang Guan , Seto Jane , Verdouka Ioanna , Twycross-Lewis Richard , Karanikolou Antonia , Tanaka Masashi , Borjesson Mats , Di Luigi Luigi , Dohi Michiko , Wolfarth Bernd , Swart Jeroen , Bilzon James Lee John , Badtieva Victoriya , Papadopoulou Theodora , Casasco Maurizio , Geistlinger Michael , Bachl Norbert , Pigozzi Fabio , Pitsiladis Yannis
Published: March 2020

Rapid advances in technologies in the field of genomics such as high throughput DNA sequencing, big data processing by machine learning algorithms and gene-editing techniques are expected to make precision medicine and gene-therapy a greater reality. However, this development will raise many important new issues, including ethical, moral, social and privacy issues. The field of exercise genomics has also advanced by incorporating these innovative technologies. There is therefore an urgent need for guiding references for sport and exercise genomics to allow the necessary advancements in this field of sport and exercise medicine, while protecting athletes from any invasion of privacy and misuse of their genomic information. Here, we update a previous consensus and develop a guiding reference for sport and exercise genomics based on a SWOT (Strengths, Weaknesses, Opportunities and Threats) analysis. This SWOT analysis and the developed guiding reference highlight the need for scientists/clinicians to be well-versed in ethics and data protection policy to advance sport and exercise genomics without compromising the privacy of athletes and the efforts of international sports federations. Conducting research based on the present guiding reference will mitigate to a great extent the risks brought about by inappropriate use of genomic information and allow further development of sport and exercise genomics in accordance with best ethical standards and international data protection principles and policies. This guiding reference should regularly be updated on the basis of new information emerging from the area of sport and exercise medicine as well as from the developments and challenges in genomics of health and disease in general in order to best protect the athletes, patients and all other relevant stakeholders.
Effectiveness of recombinant human granulocyte macrophage colony-stimulating factor for treating deep second-degree burns: a systematic review and meta-analysis
Authors: Li Jiamei , Liu W , Zhang G , Wang D , Lou H , Duang J
Published: March 2020

Introduction

It is uncertain whether treatment by recombinant human granulocyte macrophage colony-stimulating factor (rhGM-CSF) can promote healing of deep second-degree burns. This meta-analysis aimed to systematically review and assess randomised controlled trials (RCTs) that investigated the efficacy and safety of rhGM-CSF for treating deep second-degree burns.

Methods

This meta-analysis conformed to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. The PubMed, Cochrane Library, Medline and Embase databases and relevant references were systematically searched for RCTs (published up to November 2019). Main outcome measures included the wound healing rate, wound healing time and average optical densities of the vascular endothelial growth factor (VEGF) and fibroblast growth factor (FGF). We performed a meta-analysis using fixed or random effects models.

Results

Seven RCTs comprising 982 patients with 1184 burns (652 patients received rhGM-CSF vs 532 controls) were included. Compared with standard wound care alone, the use of rhGM-CSF significantly reduced wound healing time by 4.77 days (weighted mean difference=−4.77; 95% CI −6.45 to −3.09; p<0.001) and significantly increased the wound healing rate on days 7, 10, 14 and 20 by 6.46%, 19.78%, 17.07% and 11.38%, respectively. There was no significant difference between the groups in the wound healing rate on day 28 and average optical densities of VEGF and FGF. No systematic adverse event occurred. Redder, more swollen and painful wounds were reported after using rhGM-CSF compared with the control.

Conclusions

rhGM-CSF could be effective and safe for treating deep second-degree burns.
Rationale and protocol for the 7- and 8-year longitudinal assessments of eye health in a cohort of young adults in the Raine Study
Authors: Lee Samantha Sze-Yee , Lingham Gareth , Yazar Seyhan , Sanfilippo Paul G , Charng Jason , Chen Fred K , Hewitt Alex W , Ng Fletcher , Hammond Christopher , Straker Leon M , Eastwood Peter R , MacGregor Stuart , Rose Kathryn A , Lucas Robyn M , Guggenheim Jeremy A , Saw Seang-Mei , Coroneo Minas T , He Mingguang , Mackey David A
Published: March 2020

Introduction

Eye diseases and visual impairment more commonly affect elderly adults, thus, the majority of ophthalmic cohort studies have focused on older adults. Cohort studies on the ocular health of younger adults, on the other hand, have been few. The Raine Study is a longitudinal study that has been following a cohort since their birth in 1989–1991. As part of the 20-year follow-up of the Raine Study, participants underwent a comprehensive eye examination. As part of the 27- and 28-year follow-ups, eye assessments are being conducted and the data collected will be compared with those of the 20-year follow-up. This will provide an estimate of population incidence and updated prevalence of ocular conditions such as myopia and keratoconus, as well as longitudinal change in ocular parameters in young Australian adults. Additionally, the data will allow exploration of the environmental, health and genetic factors underlying inter-subject differential long-term ocular changes.

Methods and analysis

Participants are being contacted via telephone, email and/or social media and invited to participate in the eye examination. At the 27-year follow-up, participants completed a follow-up eye screening, which assessed visual acuity, autorefraction, ocular biometry and ocular sun exposure. Currently, at the 28-year follow-up, a comprehensive eye examination is being conducted which, in addition to all the eye tests performed at the 27-year follow-up visit, includes tonometry, optical coherence tomography, funduscopy and anterior segment topography, among others. Outcome measures include the incidence of refractive error and pterygium, an updated prevalence of these conditions, and the 8-year change in ocular parameters.

Ethics and dissemination

The Raine Study is registered in the Australian New Zealand Clinical Trials Registry. The Gen2 20-year, 27-year and 28-year follow-ups are approved by the Human Research Ethics Committee of the University of Western Australia. Findings resulting from the study will be published in health or medical journals and presented at conferences.

Trial registration number

ACTRN12617001599369; Active, not recruiting.
Translation and cultural adaptation of a prostate cancer screening decision aid: a qualitative study in Portugal
Authors: Baptista Sofia , Heleno Bruno , Pinto Marta , Guimarães Bruna , China Diogo , Ramos João Pedro , Teixeira Andreia , Taylor Kathryn L , Martins Carlos
Published: March 2020

Objectives

To translate and culturally adapt an English language patient decision aid addressing prostate cancer screening, so it can be used by Portuguese men.

Design

Qualitative study. We followed the European Centre for Disease Prevention and Control’s (ECDC) five-step, stakeholder-based approach to adapting health communication materials: (1) selection of materials and process coordinators, (2) early review, (3) translation and back translation, (4) comprehension testing with cognitive semi-structured interviews and (5) proofreading. Content analysis was performed using Ligre software.

Setting and participants

Cognitive interviews with 15 men to refine a decision aid after its translation. Eligible participants were Portuguese native-speaking men aged 55–69 years old recruited from the local community (urban and suburban) of Oporto district through advertisements in social media and senior universities between January and March 2019. A previous diagnosis of prostate cancer was the single exclusion criterion.

Results

Five main themes are presented: informational content, information comprehension, sociocultural appropriateness, feelings and main message and personal perspective concerning prostate cancer screening. Most men found the translated version of the decision aid to be clear, comprehensive and appropriate for its target population, although some suggested that medical terms could be a barrier. The data collected from men’s interviews afforded the researchers the opportunity to clarify concepts and expand existing content.

Conclusions

A decision aid was successfully translated and adapted to the Portuguese cultural setting. Our ECDC based approach can be replicated by other workgroups to translate and culturally adapt decision aids.
Hours lying down per day, as a proxy for sedentary behaviour and risk of diabetes in young and middle-aged adults in Norway: an 11-year follow-up of the HUNT study
Authors: Asante Ernest O , Sun Yi-Qian , Nilsen Tom Ivar Lund , Åsvold Bjørn Olav , Sørgjerd Elin Pettersen , Mai Xiao-Mei
Published: March 2020

Objective

We aimed to examine relationship between hours lying down per day, as a proxy for sedentary behaviour and risk of diabetes in young and middle-aged adults, and to assess if leisure-time physical activity and body mass index (BMI) modified this relationship.

Design

A population-based prospective cohort study.

Setting

Nord-Trøndelag, Norway.

Participants

The cohort included 17 058 diabetes-free adults, at an age of 20–55 years in 1995–1997, who were followed-up to 2006–2008.

Primary outcome measures

Incident diabetes was defined by self-report of diabetes or non-fasting glucose levels greater than 11 mmol/L at the follow-up.

Methods

Multivariable logistic regression models were used to obtain OR with 95% CI for risk of diabetes by the categories of hours lying down (≤7, 8 and ≥9 hours/day).

Results

362 individuals (2.1%) developed diabetes during an average of 11-year follow-up. Individuals who reported lying down ≥9 hours/day had an adjusted OR of 1.35 (95% CI 1.01 to 1.80) for incident diabetes compared with those lying down 8 hours/day. Lying down ≤7 hours/day was not associated with the risk of diabetes. In analysis stratified by physical activity, the ORs associated with lying down ≥9 hours/day were 1.41 (95% CI 1.05 to 1.90) and 0.90 (95% CI 0.23 to 3.55), respectively, among the less active and highly active individuals (pinteraction=0.048). There was little evidence that the association differed by BMI status (pinteraction=0.62).

Conclusions

Prolonged hours lying down per day was associated with an increased risk of diabetes in young and middle-aged adults. The positive association appeared to be modified by physical activity but not by BMI.
Reduction of early inpatient transfers and rapid response team calls after implementation of an emergency department intake huddle process
Authors: Hermanson Sarah , Osborn Scott , Gordanier Christin , Coates Evan , Williams Barbara , Blackmore Craig
Published: March 2020

Patients admitted to the hospital and requiring a subsequent transfer to a higher level of care have increased morbidity, mortality and length of stay compared with patients who do not require a transfer during their hospital stay. We identified that a high number of patients admitted to our intermediate care (IMC) unit required a rapid response team (RRT) call and an early (<24 hours) transfer to the intensive care unit (ICU). A quality improvement project was initiated with the goal to reduce subsequent early transfers to the ICU and RRT calls. We started by focusing on IMC patients, implementing acuity-based nursing assignments and standardised daily nursing rounds in the IMC aiming to reduce early patient transfers to the ICU. Then, we expanded to all patients admitted to a hospital medical unit from the emergency department (ED), targeting patients with gastrointestinal (GI) bleed and sepsis who were at a higher risk for early transfer to the ICU. We then created an ED intake huddle process that over time was refined to target patients with SIRS criteria with an elevated serum lactic acid level greater than 2.0 mmol/L or a GI bleed with a haematocrit value less than 24%. These interventions resulted in an 10.8 percentage points (31.7% (225/710) to 20.9% (369/1764)) decrease in the early transfers to the ICU for all hospital medicine patients admitted to the hospital from the ED. Mean RRT calls/day decreased by 17%, from 3.0 mean calls/day preintervention to 2.5 mean calls/day postintervention. These quality improvement initiatives have sustained successful outcomes for over 6 years due to integrating enhanced team communication as organisational cultural norm that has become the standard.
Enzyme replacement in advanced pancreatic cancer: patient perceptions
Authors: Landers Amanda , McKenzie Clare , Pitama Suzanne G , Brown Helen
Published: March 2020

Purpose

Advanced pancreatic cancer has a universally poor survival rate. Patients frequently develop malabsorption that requires pancreatic enzyme replacement therapy (PERT). This study explores the experience of patient engagement with PERT and how the medication is taken and tolerated.

Methods

Participants with advanced pancreatic cancer requiring PERT were interviewed after referral to a specialist palliative care team. An inductive analysis was used to code the data. Theoretical sufficiency was reached after 12 participants.

Results

Four themes emerged from the interviews-patient context, health literacy, relationship to food and experience of taking the pancreatic enzymes. Respondents brought their own life experiences into the clinical encounter when told of the diagnosis. Patients had high levels of understanding and engagement with the diagnosis and treatment, understood the benefits of PERT in digestion and tolerated the medication well.

Conclusions

Patients with metastatic pancreatic cancer understand the life-limiting nature of their illness. They want to participate in their healthcare decisions and are capable of complex medication titration when given good explanations and they experience benefits. PERT should be offered to these patients by a team of knowledgeable health professionals with good communication skills that can continue to support and review their needs.
Specialist palliative medicine physicians and nurses accuracy at predicting imminent death (within 72 hours): a short report
Authors: White Nicola , Reid Fiona , Vickerstaff Victoria , Harries Priscilla , Stone Patrick
Published: March 2020

Objectives

Research suggests that clinicians are not very accurate at prognosticating in palliative care. The ‘horizon effect’ suggests that accuracy ought to be better when the survival of patients is shorter. The aim of this study was to determine the accuracy of specialist palliative care clinicians at identifying which patients are likely to die within 72 hours.

Design

In a secondary data analysis of a prospective observational study, specialist palliative care doctors and nurses (in a hospice and a hospital palliative care team) provided survival predictions (yes/no/uncertain) about which patients would die within 72 hours.

Results

Survival predictions were obtained for 49 patients. A prediction from a nurse was obtained for 37/49 patients. A prediction from a doctor was obtained for 46/49 patients. In total, 23 (47%)/49 patients actually died within 72 hours of assessment. Nurses accurately predicted the outcome in 27 (73%)/37 cases. Doctors accurately predicted the outcome in 30 (65%)/46 cases. When comparing predictions given on the same patients (27 [55%]/49), nurses were slightly better at recognising imminent death than doctors (positive predictive value (the proportion of patients who died when the clinician predicted death)=79% vs 60%, respectively). The difference in c-statistics (nurses 0.82 vs doctors 0.63) was not significant (p=0.13).

Conclusion

Even when patients are in the terminal phase and close to death, clinicians are not very good at predicting how much longer they will survive. Further research is warranted to improve prognostication in this population.
Electrocardiographic associations with myocardial fibrosis among sudden cardiac death victims
Authors: Holmström Lauri , Haukilahti Anette , Vähätalo Juha , Kenttä Tuomas , Appel Henrik , Kiviniemi Antti , Pakanen Lasse , Huikuri Heikki V , Myerburg Robert J , Junttila Juhani
Published: March 2020

Objective

A major challenge in reducing the incidence of sudden cardiac death (SCD) is the identification of patients at risk. Myocardial fibrosis has a substantial association with SCD risk but is difficult to identify among general populations. Our aim was to find electrocardiographic (ECG) markers of myocardial fibrosis among SCD victims.

Methods

Study population was acquired from the Fingesture study, which has gathered data from 5869 consecutive autopsied SCD victims in Northern Finland between 1998 and 2017. The degree of fibrosis was determined in histological samples taken from the heart during autopsy and was categorised into four groups: (1) no fibrosis, (2) scattered mild fibrosis, (3) moderate patchy fibrosis and (4) substantial fibrosis. We were able to collect ECGs from 1100 SCD victims.

Results

The mean age of the study subjects was 66±13 years and 75% were male. QRS duration in ECG correlated with the degree of fibrosis (p<0.001, β=0.153). Prevalence of fragmented QRS complex, pathological Q waves and T wave inversions correlated with increased degree of fibrosis (p<0.001 in each). Depolarisation abnormalities were observed both in ischaemic and non-ischaemic heart disease. Repolarisation abnormalities reached statistical significance only among ischaemic SCD victims. An abnormal ECG was observed in 75.3% of the subjects in group 1, 73.7% in group 2, 88.5% in group 3 and 91.7% in group 4 patients (p<0.001).

Conclusions

Myocardial fibrosis was associated with QRS prolongation, deep Q waves, T wave inversions and QRS fragmentation. The results provide potentially useful non-invasive early recognition of patients with fibrotic cardiomyopathy and risk of SCD.
Clues to primary vismodegib resistance lie in histology and genetics
Authors: Sun Qisi , Atzmony Lihi , Zaki Theodore , Peng Albert , Sugarman Jeffrey , Choate Keith A.
Published: March 2020

Basal cell carcinoma (BCC) is the most common human malignant neoplasm. However, there are multiple BCC subtypes that share clinical features while demanding different management. We present a case of a woman with hundreds of BCCs throughout her body that were resistant to vismodegib and without other features of basal cell nevus syndrome. Histological results of biopsies taken from various sites revealed three lesions characteristic of infundibulocystic BCCs (IBCCs) and two BCCs. Paired whole-exome sequencing performed using DNA isolated from blood and one of her IBCCs uncovered a germline heterozygousSUFU(Suppressor of Fused) mutation. The downstream location ofSUFUin the hedgehog pathway explains why its mutation results in IBCCs that will not respond to any therapeutics that target upstream components ofSUFU. These results capture the significance of histological and genetic analysis in directing treatment.