bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating putative repellent ‘push’ and attractive ‘pull’ components for manipulating the odour orientation of host-seeking malaria vectors in the peri-domestic space
Authors: Njoroge Margaret Mendi , Fillinger Ulrike , Saddler Adam , Moore Sarah , Takken Willem , van Loon Joop J. A. , Hiscox Alexandra
Published: January 2021

Background

Novel malaria vector control approaches aim to combine tools for maximum protection. This study aimed to evaluate novel and re-evaluate existing putative repellent ‘push’ and attractive ‘pull’ components for manipulating the odour orientation of malaria vectors in the peri-domestic space.

Methods

Anopheles arabiensisoutdoor human landing catches and trap comparisons were implemented in large semi-field systems to (i) test the efficacy of Citriodiol®or transfluthrin-treated fabric strips positioned in house eave gaps as push components for preventing bites; (ii) understand the efficacy of MB5-baited Suna-traps in attracting vectors in the presence of a human being; (iii) assess 2-butanone as a CO2replacement for trapping; (iv) determine the protection provided by a full push-pull set up. The air concentrations of the chemical constituents of the push–pull set-up were quantified.

Results

Microencapsulated Citriodiol®eave strips did not provide outdoor protection against host-seekingAn. arabiensis. Transfluthrin-treated strips reduced the odds of a mosquito landing on the human volunteer (OR 0.17; 95% CI 0.12–0.23). This impact was lower (OR 0.59; 95% CI 0.52–0.66) during the push-pull experiment, which was associated with low nighttime temperatures likely affecting the transfluthrin vaporisation. The MB5-baited Suna trap supplemented with CO2attracted only a third of the released mosquitoes in the absence of a human being; however, with a human volunteer in the same system, the trap caught < 1% of all released mosquitoes. The volunteer consistently attracted over two-thirds of all mosquitoes released. This was the case in the absence (‘pull’ only) and in the presence of a spatial repellent (‘push-pull’), indicating that in its current configuration the tested ‘pull’ does not provide a valuable addition to a spatial repellent. The chemical 2-butanone was ineffective in replacing CO2. Transfluthrin was detectable in the air space but with a strong linear reduction in concentrations over 5 m from release. The MB5 constituent chemicals were only irregularly detected, potentially suggesting insufficient release and concentration in the air for attraction.

Conclusion

This step-by-step evaluation of the selected ‘push’ and ‘pull’ components led to a better understanding of their ability to affect host-seeking behaviours of the malaria vectorAn. arabiensisin the peri-domestic space and helps to gauge the impact such tools would have when used in the field for monitoring or control.

Graphical Abstract
Heart rate tracking in photoplethysmography signals affected by motion artifacts: a review
Authors: Ismail Shahid , Akram Usman , Siddiqi Imran
Published: January 2021

Non-invasive photoplethysmography (PPG) technology was developed to track heart rate during motion. Automated analysis of PPG has made it useful in both clinical and non-clinical applications. However, PPG-based heart rate tracking is a challenging problem due to motion artifacts (MAs) which are main contributors towards signal degradation as they mask the location of heart rate peak in the spectra. A practical analysis system must have good performance in MA removal as well as in tracking. In this article, we have presented state-of-art techniques in both areas of the automated analysis, i.e., MA removal and heart rate tracking, and have concluded that adaptive filtering and multi-resolution decomposition techniques are better for MA removal and machine learning-based approaches are future perspective of heart rate tracking. Hence, future systems will be composed of machine learning-based trackers fed with either empirically decomposed signal or from output of adaptive filter.
Prevalence, risk factors, and interventions for chronic obstructive pulmonary disease in South Asia: a scoping review protocol
Authors: Islam Rafiqul , Hossain Md. Tarek , Chakma Nantu , Khanom Afroza , Mazumder Tapas , Islam Md. Tauhidul
Published: January 2021

Background

Chronic obstructive pulmonary disease (COPD) is increasingly contributing to the disease burden in South Asia. This review will summarize the prevalence and risk factors of COPD in South Asia and the interventions regarding COPD that have been introduced in South Asian countries.

Method

This scoping review will primarily follow Arksey and O’Malley’s six steps of scoping review methodology. Additionally, it will follow the recent upgradation of the scoping review methodology by Levac et al., and the Joanna Briggs Institute. Research questions were already identified at the beginning of the proposed scoping review. Electronic databases will be searched (PubMed, Web of Science, and ProQuest) using search terms. Studies will be screened independently by two reviewers through a two-stage screening process using pre-developed inclusion criteria for this scoping review. Eligible studies will be abstracted and charted in a standardised form. Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) will be used to report the result. Additionally, feedback from South Asia’s experienced COPD researchers on the final literature list will be collected for gap identification in literature search. Two independent reviewers will assess the quality of each included study’s design using the Joanna Briggs Institute’s tool.

Discussion

The proposed scoping review will map the evidence on COPD in South Asia through literature review, and it will focus on prevalence, risk factors, and interventions. This review will contribute to the advancement of research on COPD and will be beneficial for policy-makers, public health specialists, and clinicians.
Infinitely many homoclinic solutions for sublinear and nonperiodic Schrödinger lattice systems
Authors: Chen Guanwei , Sun Jijiang
Published: January 2021

By using variational methods we obtain infinitely many nontrivial solutions for a class of nonperiodic Schrödinger lattice systems, where the nonlinearities are sublinear at both zero and infinity.
Existence and Ulam–Hyers stability of a kind of fractional-order multiple point BVP involving noninstantaneous impulses and abstract bounded operator
Authors: Zhao Kaihong , Deng Shoukai
Published: January 2021

In this paper, we mainly study a kind of fractional-order multiple point boundary value problem involving noninstantaneous impulse and abstract bounded operator. The existence and uniqueness is obtained by the Banach contraction principle. And by applying direct analysis methods, we establish some conditions of the Ulam–Hyers stability for this problem. Finally, an interesting application example is given to illustrate the validity of the results.
Innovation strategy on the example of companies using bamboo
Authors: Borowski Piotr F.
Published: January 2021

Innovations and new technologies allow companies to function, work, and develop in an ever-changing environment. The article discusses the importance of innovative strategies and presents the results of research carried out on the role of each employee group (CEO, R+D department, other workers) in implementing innovations, depending on the size of the enterprise: micro company, mini company, medium company, and large company. A look not only through the prism of the size of the organization, but also by the groups of people (knowledge group) responsible for innovation is a novelty of the research and fills the gap in research on innovation of enterprises. Moreover, as an exemplification of theory which is used in practice, the article also presents innovations related to bamboo use in many enterprises from different sectors of the economy (energy, automobile, and textile). Bamboo, thanks to its mechanical and chemical properties, can become an innovative material widely used by various companies. Innovations based on the use of bamboo become eco-innovations that support eco-efficiency and the circular economy. The cognitive and utilitarian value of completed research lies in the possibility of a broad look at the innovation strategy (including bamboo as an innovative material) and in the possibility of its implementation and application in various enterprises operating on the market.
The role of lactose in weanling pig nutrition: a literature and meta-analysis review
Authors: Zhao Jinbiao , Zhang Zeyu , Zhang Shuai , Page Greg , Jaworski Neil W.
Published: January 2021

Lactose plays a crucial role in the growth performance of pigs at weaning because it is a palatable and easily digestible energy source that eases the transition from milk to solid feed. However, the digestibility of lactose declines after weaning due to a reduction in endogenous lactase activity in piglets. As a result, some lactose may be fermented in the gastrointestinal tract of pigs. Fermentation of lactose by intestinal microbiota yields lactic acid and volatile fatty acids, which may positively regulate the intestinal environment and microbiome, resulting in improved gastrointestinal health of weanling pigs. We hypothesize that the prebiotic effect of lactose may play a larger role in weanling pig nutrition as the global feed industry strives to reduce antibiotic usage and pharmacological levels of zinc oxide and supra-nutritional levels of copper. Evidence presented in this review indicates that high dietary lactose improves growth performance of piglets, as well as the growth of beneficial bacteria, particularlyLactobacillus, with the positive effects being more pronounced in the first 2 weeks after weaning. However, the risk of post-weaning diarrhea may increase as pigs get older due to reduced lactase activity, high dietary lactose concentrations, and larger feed intakes, all of which may lead to excessive lactose fermentation in the intestine of the pig. Therefore, dietary lactose levels exert different effects on growth performance and gastrointestinal physiological functions in different feeding phases of weanling pigs. However, no formal recommendation of lactose for weanling pigs has been reported. A meta-analysis approach was used to determine that diets fed to swine should include 20%, 15%, and 0 lactose from d 0–7, d 7–14, and d 14–35 post-weaning, respectively. However, sustainable swine production demands that economics must also be taken into account as lactose and lactose containing ingredients are expensive. Therefore, alternatives to lactose, so called “lactose equivalents” have also been studied in an effort to decrease feed cost while maintaining piglet performance with lower dietary lactose inclusions. In summary, the present review investigated dose-response effects of dietary lactose supplementation to exert positive responses and begin to elucidate its mechanisms of action in post-weaning pig diets. The results may help to replace some or all lactose in the diet of weanling pigs, while improving production economics given the high cost of lactose and availability in some swine production markets.
Comprehensive assessments of germline deletion structural variants reveal the association between prognostic MUC4 and CEP72 deletions and immune response gene expression in colorectal cancer patients
Authors: Lin Peng-Chan , Chen Hui-O , Lee Chih-Jung , Yeh Yu-Min , Shen Meng-Ru , Chiang Jung-Hsien
Published: January 2021

Background

Functional disruptions by large germline genomic structural variants in susceptible genes are known risks for cancer. We used deletion structural variants (DSVs) generated from germline whole-genome sequencing (WGS) and DSV immune-related association tumor microenvironment (TME) to predict cancer risk and prognosis.

Methods

We investigated the contribution of germline DSVs to cancer susceptibility and prognosis by silicon and causal inference models. DSVs in germline WGS data were generated from the blood samples of 192 cancer and 499 non-cancer subjects. Clinical information, including family cancer history (FCH), was obtained from the National Cheng Kung University Hospital and Taiwan Biobank. Ninety-nine colorectal cancer (CRC) patients had immune response gene expression data. We used joint calling tools and an attention-weighted model to build the cancer risk predictive model and identify DSVs in familial cancer. The survival support vector machine (survival-SVM) was used to select prognostic DSVs.

Results

We identified 671 DSVs that could predict cancer risk. The area under the curve (AUC) of the receiver operating characteristic curve (ROC) of the attention-weighted model was 0.71. The 3 most frequent DSV genes observed in cancer patients were identified as ADCY9, AURKAPS1, and RAB3GAP2 (p < 0.05). The DSVs in SGSM2 and LHFPL3 were relevant to colorectal cancer. We found a higher incidence of FCH in cancer patients than in non-cancer subjects (p < 0.05). SMYD3 and NKD2DSV genes were associated with cancer patients with FCH (p < 0.05). We identified 65 immune-associated DSV markers for assessing cancer prognosis (p < 0.05). The functional protein of MUC4 DSV gene interacted with MAGE1 expression, according to the STRING database. The causal inference model showed that deleting the CEP72 DSV gene affect the recurrence-free survival (RFS) of IFIT1 expression.

Conclusions

We established an explainable attention-weighted model for cancer risk prediction and used the survival-SVM for prognostic stratification by using germline DSVs and immune gene expression datasets. Comprehensive assessments of germline DSVs can predict the cancer risk and clinical outcome of colon cancer patients.
Predictors of malaria rapid diagnostic test positivity in a high burden area of Paletwa Township, Chin State in Western Myanmar
Authors: Aung Pyae Linn , Soe Myat Thu , Oo Thit Lwin , Khin Aung , Thi Aung , Zhao Yan , Cao Yaming , Cui Liwang , Kyaw Myat Phone , Parker Daniel M.
Published: January 2021

Background

Despite major reductions in malaria burden across Myanmar, clusters of the disease continue to persist in specific subregions. This study aimed to assess the predictors of test positivity among people living in Paletwa Township of Chin State, an area of persistently high malaria burden.

Methods

Four villages with the highest malaria incidence from Paletwa Township were purposively selected. The characteristics of 1045 subjects seeking malaria diagnosis from the four assigned village health volunteers from January to December, 2018 were retrospectively analyzed. Their household conditions and surroundings were also recorded using a checklist. Descriptive statistics and logistic regression models were applied to investigate potential associations between individual and household characteristics and malaria diagnosis.

Results

In 2017, the Paletwa township presented 20.9% positivity and an annual parasite index of 46.9 cases per 1000 people. Plasmodium falciparum was the predominant species and accounted for more than 80.0% of all infections. Among 1045 people presenting at a clinic with malaria symptoms, 31.1% were diagnosed with malaria. Predictors for test positivity included living in a hut [adjusted odds ratios (a OR): 2.3, 95% confidence intervals (CI): 1.2–4.6], owning farm animals (aOR: 1.7, 95% CI: 1.1–3.6), using non-septic type of toilets (aOR: 1.9, 95% CI: 1.1–8.4), presenting with fever (aOR: 1.9, 95% CI: 1.1–3.0), having a malaria episode within the last year (aOR: 2.9, 95% CI: 1.4–5.8), traveling outside the village in the previous 14 days (aOR: 4.5, 95% CI: 1.5–13.4), and not using bed nets (a OR: 3.4, 95% CI: 2.3–5.1). There were no statistically significant differences by age or gender in this present analysis.

Conclusions

The results from this study, including a high proportion of P. falciparum infections, little difference in age, sex, or occupation, suggest that malaria is a major burden for these study villages. Targeted health education campaigns should be introduced to strengthen synchronous diagnosis-seeking behaviors, tighten treatment adherence, receiving a diagnosis after traveling to endemic regions, and using bed nets properly. We suggest increased surveillance, early diagnosis, and treatment efforts to control the disease and then to consider the local elimination.
A pilot radiogenomic study of DIPG reveals distinct subgroups with unique clinical trajectories and therapeutic targets
Authors: Zhu Xiaoting , Lazow Margot A. , Schafer Austin , Bartlett Allison , Senthil Kumar Shiva , Mishra Deepak Kumar , Dexheimer Phillip , DeWire Mariko , Fuller Christine , Leach James L. , Fouladi Maryam , Drissi Rachid
Published: January 2021

An adequate understanding of the relationships between radiographic and genomic features in diffuse intrinsic pontine glioma (DIPG) is essential, especially in the absence of universal biopsy, to further characterize the molecular heterogeneity of this disease and determine which patients are most likely to respond to biologically-driven therapies. Here, a radiogenomics analytic approach was applied to a cohort of 28 patients with DIPG. Tumor size and imaging characteristics from all available serial MRIs were evaluated by a neuro-radiologist, and patients were divided into three radiographic response groups (partial response [PR], stable disease [SD], progressive disease [PD]) based on MRI within 2 months of radiotherapy (RT) completion. Whole genome and RNA sequencing were performed on autopsy tumor specimens. We report several key, therapeutically-relevant findings: (1) Certain radiologic features on first and subsequent post-RT MRIs are associated with worse overall survival, including PD following irradiation as well as present, new, and/or increasing peripheral ring enhancement, necrosis, and diffusion restriction. (2) Upregulation of EMT-related genes and distant tumor spread at autopsy are observed in a subset of DIPG patients who exhibit poorer radiographic response to irradiation and/or higher likelihood of harboring H3F3A mutations, suggesting possible benefit of upfront craniospinal irradiation. (3) Additional genetic aberrations were identified, including DYNC1LI1 mutations in a subgroup of patients with PR on post-RT MRI; further investigation into potential roles in DIPG tumorigenesis and/or treatment sensitivity is necessary. (4) Whereas most DIPG tumors have an immunologically “cold” microenvironment, there appears to be a subset which harbor a more inflammatory genomic profile and/or higher mutational burden, with a trend toward improved overall survival and more favorable radiographic response to irradiation, in whom immunotherapy should be considered. This study has begun elucidating relationships between post-RT radiographic response with DIPG molecular profiles, revealing radiogenomically distinct subgroups with unique clinical trajectories and therapeutic targets.
Rewealthization in twenty-first century Western countries: the defining trend of the socioeconomic squeeze of the middle class
Authors: Chauvel Louis , Bar Haim Eyal , Hartung Anne , Murphy Emily
Published: January 2021

The wealth-to-income ratio (WIR) in many Western countries, particularly in Europe and North America, increased by a factor of two in the last three decades. This represents a defining empirical trend: a rewealthization (from the Frenchrepatrimonialisation)—or the comeback of (inherited) wealth primacy since the mid-1990s. For the sociology of social stratification, “occupational classes” based on jobs worked must now be understood within a context of wealth-based domination. This paper first illustrates important empirical features of an era of rising WIR. We then outline the theory of rewealthization as a major factor of class transformations in relation to regimes stabilized in the post-WWII industrial area. Compared to the period where wealth became secondary to education and earnings for middle-class lifestyles, rewealthization steepens society's vertical structure; the "olive-shaped" Western society is replaced by a new one where wealth "abundance" at the top masks social reproduction and frustrations below.
Clinicopathological characteristics of De Garengeot hernia: six case reports and literature review
Authors: Tsuruta Shigeaki , Miyake Hideo , Nagai Hidemasa , Yoshioka Yuichiro , Yuasa Norihiro , Fujino Masahiko
Published: January 2021

Background

De Garengeot hernia, wherein the appendix is present within a femoral hernia, is a rare disease; therefore, the clinicopathological features remain to be clarified. This study aimed to reveal the clinicopathological characteristics of De Garengeot hernia.

Case presentation

Six patients who underwent appendectomy and herniorrhaphy between 1999 and 2018 were included. The incidence of De Garengeot hernia was 3.2% among the 182 femoral hernias that required surgery during the study period. The median age of the patients was 78 years, and five patients were women. The median body mass index was 20.1. Patients frequently had fever or elevated CRP level. Preoperative diagnoses based on computed tomography were femoral (n = 3), inguinal (n = 2), and De Garengeot (n = 1) hernias. Emergency and elective surgeries were performed in four and two patients, respectively. Histopathological examination of the resected appendix showed gangrenous appendicitis (n = 3), perforated appendicitis (n = 2), and appendiceal ischemia (n = 1) in the patients. Postoperatively, one patient developed sepsis.

Conclusions

Preoperative diagnosis of De Garengeot hernia is often difficult, and patients frequently have severe appendicitis. Precise diagnosis is required, and emergency surgery should be considered depending on the severity of appendicitis.
Evaluation of classical swine fever E2 (CSF-E2) subunit vaccine efficacy in the prevention of virus transmission and impact of maternal derived antibody interference in field farm applications
Authors: Chen Jing-Yuan , Wu Chi-Ming , Chen Zeng-Weng , Liao Chih-Ming , Deng Ming-Chung , Chia Min-Yuan , Huang Chienjin , Chien Maw-Sheng
Published: January 2021

Background

Classical swine fever (CSF) is one of the most devastating pig diseases that affect the swine industry worldwide. Besides stamping out policy for eradication, immunization with vaccines of live attenuated CSF or the CSF-E2 subunit is an efficacious measure of disease control. However, after decades of efforts, it is still hard to eliminate CSF from endemically affected regions and reemerging areas. Most of previous studies demonstrated the efficacy of different CSF vaccines in laboratories under high containment conditions, which may not represent the practical performance in field farms. The inadequate vaccine efficacy induced by unrestrained factors may lead to chronic or persistent CSF infection in animals that develop a major source for virus shedding among pig populations. In this study, a vaccination-challenge-cohabitation trial on specific-pathogen-free (SPF) pigs and long-term monitoring of conventional sows and their offspring were used to evaluate the efficacy and the impact of maternally derived antibody (MDA) interference on CSF vaccines in farm applications.

Results

The trials demonstrated higher neutralizing antibody (NA) titers with no clinical symptoms and significant pathological changes in the CSF-E2 subunit vaccine immunized group after CSFV challenge. Additionally, none of the sentinel pigs were infected during cohabitation indicating that the CSF-E2 subunit vaccine could provoke adequately acquired immunity to prevent horizontal transmission. In field farm applications, sows immunized with CSF-E2 subunit vaccine revealed an average of higher and consistent antibody level with significant reduction of CSF viral RNA detection via saliva monitoring in contrast to those of live attenuated CSF vaccine immunized sows possessing diverse antibody titer distributions and higher viral loads. Furthermore, early application of the CSF-E2 subunit vaccine in 3-week-old piglets illustrated no MDA interference on primary immunization and could elicit consistent and long-lasting adequate antibody response suggesting the flexibility of CSF-E2 subunit vaccine on vaccination program determination.

Conclusions

The CSF-E2 subunit vaccine demonstrated significant efficacy and no MDA interference for immunization in both pregnant sows and piglets. These advantages provide a novel approach to avoid possible virus shedding in sow population and MDA interference in piglets for control of CSF in field farm applications.
Diffuse intrinsic pontine glioma: current insights and future directions
Authors: Srikanthan Dilakshan , Taccone Michael S. , Van Ommeren Randy , Ishida Joji , Krumholtz Stacey L. , Rutka James T.
Published: January 2021

Diffuse intrinsic pontine glioma (DIPG) is a lethal pediatric brain tumor and the leading cause of brain tumor–related death in children. As several clinical trials over the past few decades have led to no significant improvements in outcome, the current standard of care remains fractionated focal radiation. Due to the recent increase in stereotactic biopsies, tumor tissue availabilities have enabled our advancement of the genomic and molecular characterization of this lethal cancer. Several groups have identified key histone gene mutations, genetic drivers, and methylation changes in DIPG, providing us with new insights into DIPG tumorigenesis. Subsequently, there has been increased development of in vitro and in vivo models of DIPG which have the capacity to unveil novel therapies and strategies for drug delivery. This review outlines the clinical characteristics, genetic landscape, models, and current treatments and hopes to shed light on novel therapeutic avenues and challenges that remain.
Continual updating and monitoring of clinical prediction models: time for dynamic prediction systems?
Authors: Jenkins David A. , Martin Glen P. , Sperrin Matthew , Riley Richard D. , Debray Thomas P. A. , Collins Gary S. , Peek Niels
Published: January 2021

Clinical prediction models (CPMs) have become fundamental for risk stratification across healthcare. The CPM pipeline (development, validation, deployment, and impact assessment) is commonly viewed as a one-time activity, with model updating rarely considered and done in a somewhat ad hoc manner. This fails to address the fact that the performance of a CPM worsens over time as natural changes in populations and care pathways occur. CPMs need constant surveillance to maintain adequate predictive performance. Rather than reactively updating a developed CPM once evidence of deteriorated performance accumulates, it is possible to proactively adapt CPMs whenever new data becomes available. Approaches for validation then need to be changed accordingly, making validation a continuous rather than a discrete effort. As such, “living” (dynamic) CPMs represent a paradigm shift, where the analytical methods dynamically generate updated versions of a model through time; one then needs to validate the system rather than each subsequent model revision.
A comprehensive review of DC fault protection methods in HVDC transmission systems
Authors: Muniappan Mohan
Published: January 2021

High voltage direct current (HVDC) transmission is an economical option for transmitting a large amount of power over long distances. Initially, HVDC was developed using thyristor-based current source converters (CSC). With the development of semiconductor devices, a voltage source converter (VSC)-based HVDC system was introduced, and has been widely applied to integrate large-scale renewables and network interconnection. However, the VSC-based HVDC system is vulnerable to DC faults and its protection becomes ever more important with the fast growth in number of installations. In this paper, detailed characteristics of DC faults in the VSC-HVDC system are presented. The DC fault current has a large peak and steady values within a few milliseconds and thus high-speed fault detection and isolation methods are required in an HVDC grid. Therefore, development of the protection scheme for a multi-terminal VSC-based HVDC system is challenging. Various methods have been developed and this paper presents a comprehensive review of the different techniques for DC fault detection, location and isolation in both CSC and VSC-based HVDC transmission systems in two-terminal and multi-terminal network configurations.
Development of a symptom menu to facilitate Goal Attainment Scaling in adults with Down syndrome-associated Alzheimer’s disease: a qualitative study to identify meaningful symptoms
Authors: Knox Kari , Stanley Justin , Hendrix James A. , Hillerstrom Hampus , Dunn Taylor , Achenbach Jillian , Chicoine Brian A. , Lai Florence , Lott Ira , Stanojevic Sanja , Howlett Susan E. , Rockwood Kenneth
Published: January 2021

Background

As life expectancy of people with Down syndrome (DS) increases, so does the risk of Alzheimer’s disease (AD). Identifying symptoms and tracking disease progression is especially challenging whenever levels of function vary before the onset of dementia. Goal Attainment Scaling (GAS), an individualized patient-reported outcome, can aid in monitoring disease progression and treatment effectiveness in adults with DS. Here, with clinical input, a validated dementia symptom menu was revised to facilitate GAS in adults living with Down Syndrome-associated Alzheimer’s disease (DS-AD).

Methods

Four clinicians with expertise in DS-AD and ten caregivers of adults living with DS-AD participated in semi-structured interviews to review the menu. Each participant reviewed 9–15 goal areas to assess their clarity and comprehensiveness. Responses were systematically and independently coded by two researchers as ‘clear’, ‘modify’, ‘remove’ or ‘new’. Caregivers were encouraged to suggest additional items and recommend changes to clarify items.

Results

Median caregiver age was 65 years (range 54–77). Most were female (9/10) with ≥15 years of education (10/10). Adults with DS-AD had a median age of 58 years (range 52–61) and either a formal diagnosis (6/10) or clinical suspicion (4/10) of dementia. The initial symptom menu consisted of 67 symptoms each with 2–12 descriptors (589 total). The clinicians’ adaptation yielded 58 symptoms each with 4–17 descriptors (580 total). Of these 580 descriptors, caregivers identified 37 (6%) as unclear; these were reworded, and one goal area (4 descriptors) was removed. A further 47 descriptors and one goal area were added to include caregiver-identified concepts. The final menu contained 58 goal areas, each with 7–17 descriptors (623 total).

Conclusions

A comprehensive symptom menu for adults living with DS-AD was developed to facilitate GAS. Incorporating expert clinician opinion and input from caregivers of adults with DS-AD identified meaningful items that incorporate patient/caregiver perspectives.
The PD-1:PD-L1 axis in Inflammatory Arthritis
Authors: Canavan Mary , Floudas Achilleas , Veale Douglas J. , Fearon Ursula
Published: January 2021

The activation of antigen specific T cells during an immune response is a tightly regulated process at the level of both costimulatory and coinhibitory receptors. One such coinhibitory receptor or checkpoint inhibitor which has received much attention in the field of oncology is the programmed cell death protein 1 (PD-1). Blockade of PD-1 or its ligand PD-L1 has proven successful in the treatment of a wide variety of cancers, therefore highlighting an important role for this pathway in anti-tumour immune responses. However, a caveat of PD-1 therapy and boosting anti-tumour immune responses is the development of self-reactive T cells which can lead to the induction of various autoimmune or inflammatory diseases, referred to as immune- related adverse events (irAEs). The emergence of rheumatological irAEs such as Inflammatory Arthritis (IA) in recent years has highlighted the importance of PD-1 in maintaining self-tolerance. Furthermore, the emergence of rheumatology related irAEs raises an important question as to how defects in this pathway can contribute to spontaneous rheumatological disease. In this review, we describe the biological distribution, function and regulation of the PD-1 pathway, its potential role in IA and irAE related IA.
Endovascular repair of de novo post-stenotic aortic coarctation aneurysms with complex collateral supply: two cases with long and medium term follow-up
Authors: Abdel-Hadi Omar , Thomson John , McPherson Simon J.
Published: January 2021

Purpose

To report the technical details and outcomes of the endovascular repair of two cases of de novo post-stenotic aortic coarctation aneurysms complicated by complex collateral supply.

Case presentations

Two patients with thoracic aortic aneurysms complicated by complex aneurysm sac collaterals distal to a previously untreated thoracic aortic coarctation have been treated at our institution. Open surgical intervention was deemed to carry a high risk of haemorrhage due to the degree and complexity of arterial collateralisation. In the first case, selective embolisation of collateral vasculature was performed prior to successful exclusion of the aneurysm with a thoracic endovascular stent-graft and then balloon-expandable stent dilatation of the coarctation stenosis. In the second case, the additional technique of using a jailed sheath within the aneurysm sac allowed for selective embolisation of previously inconspicuous collaterals after deployment of the stent-graft and stent combination.

Results

Technical success was achieved in both patients with successful occlusion of the aneurysm, with no recorded complications or aneurysm sac perfusion in the long and medium term follow up periods respectively.

Conclusion

De novo post stenotic aortic coarctation aneurysms are rare. Endovascular repair is a safe and durable technique that provides a less invasive alternative to open surgical repair. The use of a jailed sheath allows for complete selective embolisation of complex collaterals avoiding a type II aneurysm endoleak.
Long-term clinical effectiveness of a drug-coated balloon for in-stent restenosis in Femoropopliteal lesions
Authors: Horie Kazunori , Tanaka Akiko , Suzuki Kenji , Taguri Masataka , Inoue Naoto
Published: January 2021

Background

The short-term efficacy of paclitaxel-coated balloons (PCBs) has been established in femoropopliteal in-stent restenosis (ISR) lesions. The aim of this study was to compare 5-year clinical outcomes of patients with femoropopliteal ISR lesions undergoing percutaneous transluminal angioplasty (PTA) with and without PCB.

Methods

After 1:1 propensity score matching, we extracted 50 patients with femoropopliteal ISR lesions undergoing PTA with (n = 25) and without (n = 25) IN.PACT PCB (Medtronic, Minneapolis, MN) from 106 consecutive ISR patients treated in our hospital between 2009 and 2015. We compared the 5-year outcomes between PCB and non-PCB groups. The primary endpoint was the cumulative 5-year incidence of recurrent restenosis. All-cause mortality, target lesion revascularization (TLR) and unplanned major amputation were also assessed.

Results

The primary patency after PCB treatment at 5 years was significantly higher than the patency after non-PCB treatment (65.7% vs. 18.7%; hazard ratio [HR]: 6.11; 95% confidence intervals [CI]: 2.57–16.82; p < 0.001), as well as freedom from TLR (77.6% vs. 53.8%; HR: 3.55; 95% CI: 1.21–12.83; p = 0.020). All-cause mortality and unplanned major amputation rates did not significantly differ between the two groups. The Cox proportional hazard multivariate analysis showed that PCB was independently associated with preventing recurrent restenosis (HR: 0.17; 95% CI: 0.06–0.41; p < 0.001).

Conclusions

At 5 years, patients with femoropopliteal ISR lesions undergoing PCB treatment showed significantly lower recurrent restenosis than those that underwent non-PCB treatment.

Evidence-based medicine

Level of Evidence: Level 2b, Non-randomized controlled cohort/follow-up study.
Evaluation of the control effect of SAR inducers against citrus Huanglongbing applied by foliar spray, soil drench or trunk injection
Authors: Li Jinyun , Kolbasov Vladimir G. , Pang Zhiqian , Duan Shuo , Lee Donghwan , Huang Yixiao , Xu Jin , Teper Doron , Lamichhane Tirtha , Wang Nian
Published: January 2021

Huanglongbing (HLB) or greening disease, associated with the bacterial pathogen Candidatus Liberibacter asiaticus (Las), is currently the most devastating citrus disease worldwide and no cure is available. Inducers of systemic acquired resistance (SAR) are effective and sustainable to combat various plant diseases. In this study, the SAR inducers acibenzolar-S-methyl (ASM), imidacloprid (IMI), 2,6-dichloroisonicotinic acid (INA), and salicylic acid (SA), applied individually by foliar spray, soil drench or trunk injection at various rates and frequencies, were evaluated for control of HLB in a 3-year field trial with mature Hamlin sweet orange trees in central Florida, USA in the 2016, 2017, and 2018 crop seasons. Six foliar sprays, six soil applications, and three trunk injections of ASM, IMI, INA, or SA per year were conducted with the untreated as a negative control. HLB disease severity, Las titers, pre-harvest fruit drop, yield and fruit quality were investigated for the treatments. By the end of the 2018 season, all trunk injection treatments at 0.25 g/tree and foliar sprays of INA or SA (but not ASM or IMI) at 0.5 g/tree significantly reduced disease severity, Las population, and fruit drop, and increased fruit yield; whereas all foliar spray treatments at 0.25 g/tree, trunk injection treatments at 0.125 g/tree, and soil drench treatments at 0.25 or 0.5 g/tree did not provide effective control of HLB. Additionally, all trunk injection treatments at 0.25 g/tree had shown a significant decrease in fruit drop and increase of fruit yield starting from 2016 after 1 year of applications, whereas foliar sprays of INA or SA at 0.5 g/tree exhibited similar effects at 2018 after 3 years of applications. None of the SAR inducer treatments had significant effect on fruit quality. Economic analysis suggested that the trunk injection treatments at 0.25 g/tree might produce financial benefits. Overall, this study presents useful information for management of citrus HLB with SAR inducers.
A combined geophysical and lithological study on eruptive history and Quaternary lacustrine stratigraphy of a maar in Leizhou Peninsula, China
Authors: Chen Cong , Zheng Zhuo , Zeng Li-Feng , Xiao Fan , Tian Li-Ping , Huang Kang-You
Published: January 2021

As the second common type of volcanic vent on Earth, maar-diatreme volcanoes and their post-eruptive lacustrine sediments are a main focus of volcanology, palaeolimnology, palaeoclimatology and palaeontology. A number of maar-type volcanoes have been found in Leizhou Peninsula, South China, but little is known about their eruption processes and detailed stratigraphy of the post-eruptive sediments. We present a combined geophysical and geological analysis to study the eruptive history and post-eruptive sediment stratigraphy of a large maar, the elliptical (1.8 × 3.0 km2) Jiudouyang (JDY) maar. The lacustrine stratigraphy revealed by drilling cores shows that the JDY maar lake has three major stages of evolution: (i) deep-lake sedimentary environment characterized by high autochthonous diatom productivity; (ii) shallow lake to swamp with very low water levels, characterized by a high total organic carbon (TOC) and abundant wood fragments; and, (iii) intermittent shallow lake and alluvial deposits composed of clay minerals and sand. The electrical resistivity tomography (ERT) values and lithological features are highly consistent, which clearly reveal the presence of ca. 50 m thick lacustrine sediments, directly underlain by a ca. 70 m thick basaltic lava rather than diatreme breccia in the crater. This infill sequence implies an alternation of eruption style from phreatomagmatic to Strombolian and/or lava flow, due to high magma flux and ascent rate of the Hainan Plume during the middle Pleistocene. The ERT data also reveal the initial phreatomagmatic crater floor at ca. 120 m depth. The initial crater had a large diameter/depth ratio (ca. 17), with an elongated shape (major axis to minor axis = 0.6), implying possible lateral vent migration during the eruption. A significant erosion under tropical weathering condition during the last few hundred thousand years, accounted for the large size of the maar crater. The study provides insights into the eruptive history and post-eruptive evolution of a large maar, as well as the spatial distribution of the lacustrine sediments.
A comprehensive review on bioactive peptides derived from milk and milk products of minor dairy species
Authors: Guha Snigdha , Sharma Heena , Deshwal Gaurav Kr , Rao Priyanka Singh
Published: January 2021

Milk from different species has been exploited for the isolation of various functional ingredients for decades. Irrespective of the source, milk is considered as a complete food, as it provides essential nutrients required by the human body. Proteins and their fractions are valuable sources of bioactive peptides that might exert a health beneficial role in the human body such as immune-modulation, antioxidant activity, ACE-inhibitory activity, anti-neoplastic, anti-microbial, etc. In milk, bioactive peptides may either be present in their natural form or released from their parental proteins due to enzymatic action. The increasing interest in bioactive peptides among researchers has lately augmented the exploration of minor dairy species such as sheep, goat, camel, mithun, mare, and donkey. Alternative to cow, milk from minor dairy species have also been proven to be healthier from infancy to older age owing to their higher digestibility and other nutritive components. Therefore, realizing the significance of milk from such species and incentivized interest towards the derivatization of bioactive peptides, the present review highlights the significant research achievements on bioactive peptides from milk and milk products of minor dairy species.

Graphical abstract
Effect of discontinuation of ticagrelor and switching-over to other P2Y12 agents in patients with acute coronary syndrome: a single-center real-world experience from India
Authors: Senguttuvan Nagendra Boopathy , Sankaran Ramesh , Rajeev Yashasvi , Thaiyal Devi , Mathew Angel , Dharsini K. , Marcelene Divya , Kalsingh Maria Jusler , Sahu Sujit Kumar , Sampath Aravind , Prem Kumar K. J. , Parthasarathy Harikrishnan , Louis Amal , Gnanaraj Anand , Reddy K. N. , Abraham K. A.
Published: January 2021

Background

Dual antiplatelet therapy is the current standard of care after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI). We intended to study the pattern of use of ticagrelor in patients with acute coronary syndrome undergoing PCI and the effect of switching over to other P2Y12 receptor inhibition on clinical outcomes.

Results

All patients aged > 18 years who had been admitted with acute coronary syndrome and had been provided ticagrelor as the second antiplatelet agent were included as study participants. The primary outcome of the study was the composite outcome of death, recurrent myocardial infarctions, re-intervention, and major bleeding.

We studied 321 patients (54 female patients, 16.82%). The mean age of the patients was 56.65 ± 11.01 years. Ticagrelor was stopped in 76.7% on follow-up. It was stopped in 6.3%, 13.5%, 13.1%, 21.9%, and 45.1% of patients during the first month but after discharge, between first and third months, between 3 and 6 months, between 6 and 12 months, and after 12 months, respectively. In the majority of patients, ticagrelor was replaced by clopidogrel (97.9%). It was stopped according to the physician’s discretion in 79.3% of patients, whereas it was the cost of the drug that made the patient to get swapped to another agent in 18.6%. No difference in the primary composite outcome was observed between the groups where ticagrelor was continued post 12 months and ticagrelor was continued and ticagrelor was switched-over to another agent. Similarly, no difference in death, recurrent myocardial infarctions, re-interventions, or major bleeding manifestations was observed between the two groups.

Conclusion

In patients with acute coronary syndrome who undergo PCI, we observed that early discontinuation of ticagrelor and switching over to other P2Y12 inhibitors after discharge did not affect clinical outcomes.
The added value of chemical shift imaging in evaluation of bone marrow changes in sickle cell disease
Authors: Allam Mohammad Fouad Abdel-Baki , Samra Manal Fayez Abu , Rahman Al Shaimaa Mahfouz Abdel
Published: January 2021

Background

The aim of this study was to assess the added value of chemical shift imaging when used with routine MRI study in evaluation of bone marrow changes in SCD. Forty-two patients with SCD and bone pain were included in the study; they underwent CSI and routine MRI study on the symptomatic anatomic part of the skeleton.

Results

Four patterns of diffuse bone marrow changes were recognized; they varied from persistent red marrow to diffuse hypointense patterns with abnormal signal loss percentage on CSI that suggest presence of iron overload (n = 28, 66.6%). Serum ferritin level was increasing in accordance to the degree of signal changes found on CSI with significant high negative correlation between the percentage of signal loss on CSI obtained from IP-OP/IP formula and serum ferritin level. In focal marrow lesions, all T1 hyperintense lesions demonstrated corresponding hyperintensity on IP and OP; the detection frequency on CSI was relatively higher on OP compared with IP images.

Conclusion

CSI has high diagnostic performance in detecting diffuse marrow changes and development of iron overload in SCD. In SCD-related focal marrow lesions, CSI could have a complementary role in detection of T1 hyperintensity and lesion conspicuity.
Chemical profiling of selected Ayurveda formulations recommended for COVID-19
Authors: C. T. Sulaiman , M. Deepak , P. R. Ramesh , K. Mahesh , E. M. Anandan , Balachandran Indira
Published: January 2021

Background

The novel coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is the global health concern since December 2019. It has become a big challenge for the researchers to find a solution for this newly evolved pandemic. In Ayurveda point of view, COVID-19 is a Janapadodhwamsa vikara (epidemic disease), a situation where the environment—air, water, land, and seasons—is vitiated, causing a simultaneous manifestation of a disease among large populations. The aim of this study is to identify the active compounds of selected Ayurveda medicines recommended for COVID-19.

Results

The selected preparations are traditionally recommended for the management of various kinds of fever including the infectious ones and to enhance the immunity. HPTLC analysis of the same showed presence of many active molecules like umbelliferone, scopoletin, caffeic acid, ferulic acid, gallic acid, piperine, curcumin, berberine, and palmatine.

Conclusion

The study provided valuable scientific data regarding the active ingredients of the selected medicines with proven therapeutic potentials like anti-viral, immunomodulatory, and anti-inflammatory activities.