bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical significance of premature ventricular contraction among adult patients: protocol for a scoping review
Authors: Suba Sukardi , Pelter Michele M.
Published: November 2019

Background

Premature ventricular contractions (PVCs) are one of the most common arrhythmias detected from electrocardiographic (ECG) monitoring. PVCs were thought to cause lethal arrhythmias and thus were closely monitored and treated. However, in current practice, PVCs generally do not required treatment. There is also concern that PVCs contribute to excessive alarms and lead to alarm fatigue. Practice guidelines for in-hospital monitoring state that monitoring for PVCs may be indicated on some patients but do not recommend continuous ECG monitoring. Despite these recommendations, PVC monitoring practices remain part of routine care, especially in the intensive care unit, for worry of missing potentially significant arrhythmia events. A thorough scoping review of the literature regarding the clinical significance of PVC is imperative, precisely to map out the evidence on the diagnostic and prognostic values of PVCs and to identify research gaps on this issue.

Methods

The primary question of this review is “what is the clinical significance of PVCs in adults?” Preparation of this scoping review will use the PRISMA-P statement. A scoping review framework by Arksey and O’Malley will be adopted. In identifying relevant studies, the Population-Concept-Context (PCC) framework by the Joanna Briggs Institute will be used. A search strategy will be developed, and four major electronic databases will be searched: CINAHL, Embase, PubMed, and Web of Science Core Collection. Manual searches will also be conducted. The study selection process will adopt the 2009 PRISMA flow diagram. EndNote X8 will be used to manage citations, as well as for duplicates screening in addition to Microsoft Excel 2016. Two independent reviewers will assess potential studies in detail against inclusion criteria. A standardized data extraction form will be developed. Finally, critical appraisal will be conducted using a tool adapted from the Quality Appraisal Checklist by the National Institute for Health Care Excellence (NICE).

Discussion

We believe this scoping review will provide a general foundation of evidence on the potential significance of PVCs concerning its diagnostic and prognostic value among the adult patient population. The findings will allow us to map out research gaps on this topic that could shape future research and ultimately clinical practice.

Scoping review registration

This scoping review has been registered in the Open Science Framework (OSF), DOI: https://doi.org/10.17605/OSF.IO/GAVT2.
The effects of cell therapy on seizures in animal models of epilepsy: protocol for systematic review and meta-analysis of preclinical studies
Authors: Dvir Naomi , Javaid Muhammad S. , Jones Nigel C. , Powell Kim L. , Kwan Patrick , O’Brien Terence J. , Antonic-Baker Ana
Published: November 2019

Background

Epilepsy is one of the most common and serious brain conditions, characterised by recurrent unprovoked seizures. It affects about 1% of the population worldwide. Despite a range of antiepileptic drugs being available, one third of the patients do not achieve adequate seizure control. Only a minority of these patients may be suitable to undergo surgical resection of the seizure focus, but this is an invasive and not always successful procedure. There is an urgent need to develop more effective treatment options for uncontrolled seizures. With the recent advances in regenerative and translational medicine, cell therapies could prove to be beneficial. Here we describe the protocol for a proposed systematic review and meta-analysis to assess the effects for cell transplantation in animal models of epilepsy.

Methods

We will include all preclinical animal models of epilepsy that evaluate the effects of cell transplantation compared to the untreated control. The primary outcome will be the change in frequency and duration of seizures from baseline measured by video electroencephalography (EEG). The secondary outcomes will include histological and neurobehavioural assessments. We will perform an electronic search of MEDLINE via PubMed, Web of Science, and EMBASE. Search results will be screened independently by two reviewers and confirmed by a third reviewer. Data from eligible studies will be extracted and pooled, and the summary estimate of effect size will be calculated using DerSimonian and Laird random effects meta-analysis. Heterogeneity will be explored using sub-group meta-analysis, and meta-regression risk of bias will be assessed by using the CAMARADES checklist for study quality tool.

Discussion

The purpose of this systematic review is to assess and summarise the existing literature in the field of cell transplantation as a treatment for epilepsy in animal models. Efficacy will be measured by evaluating the reduction in seizure intervals, number, and duration, within animal models of epilepsy. Analysis of the existing literature will mark the achievement made in the field and locate the existing gaps, a process that will aid in the search for the next needed step.

Systematic review registration

CRD42018103628
Health outcomes of iron supplementation and/or food fortification in iron-replete children aged 4–24 months: protocol for a systematic review and meta-analysis
Authors: Hare Dominic J. , Braat Sabine , Cardoso Bárbara R. , Morgan Christopher , Szymlek-Gay Ewa A. , Biggs Beverley-Ann
Published: November 2019

Background

Direct supplementation or food fortification with iron are two public health initiatives intended to reduce the prevalence of iron deficiency (ID) and iron deficiency anaemia (IDA) in 4–24-month-old infants. In most high-income countries where IDA prevalence is < 15%, the recommended daily intake levels of iron from supplements and/or consumption of fortified food products are at odds with World Health Organisation (WHO) guidelines that recommend shorter-term (3 months/year) supplementation only in populations with IDA prevalence > 40%. Emerging concerns about delayed neurological effects of early-life iron overexposure have raised questions as to whether recommended guidelines in high-income countries are unnecessarily excessive. This systematic review will gather evidence from supplementation/fortification trials, comparing health outcomes in studies where iron-replete children did or did not receive additional dietary iron; and determine if replete children at study outset were not receiving additional iron show changes in haematological indices of ID/IDA over the trial duration.

Methods

We will perform a systematic review of the literature, including all studies of iron supplementation and/or fortification, including study arms with confirmed iron-replete infants at the commencement of the trial. This includes both dietary iron intervention or placebo/average dietary intakes. One reviewer will conduct searches in electronic databases of published and ongoing trials (Medline, Web of Science, Scopus, CENTRAL, EBSCO [e.g. CINAHL Complete, Food Science and Technology Abstracts], Embase, ClinicalTrials.gov, ClinicalTrialsRegister.eu and who.it/trialsearch), digital theses and dissertations (WorldCat, Networked Digital Library of Theses and Dissertations, DART-Europe E-theses Portal, Australasian Digital Theses Program, Theses Canada Portal and ProQuest). For eligible studies, one reviewer will use a data extraction form, and a second reviewing entered data for accuracy. Both reviewers will independently perform quality assessments before qualitative and, if appropriate, quantitative synthesis as a meta-analysis. We will resolve any discrepancies through discussion or consult a third author to resolve discrepancies. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement will be used as the basis for reporting.

Discussion

Recommended iron supplementation and food fortification practices in high-income countries have been criticised for being both excessive and based on outdated or underpowered studies. This systematic review will build a case for revisiting iron intake guidelines for infants through the design of new trials where health effects of additional iron intake in iron-replete infants are the primary outcome.

Systematic review registration

PROSPERO CRD42018093744.
Associations between self-reported diabetes mellitus, disordered eating behaviours, weight/shape overvaluation, and health-related quality of life
Authors: Dias Santana Danilo , Mitchison Deborah , Gonzalez-Chica David , Touyz Stephen , Stocks Nigel , Appolinario Jose Carlos , da Veiga Gloria Valeria , Hay Phillipa
Published: November 2019

Background

Eating disorders (ED) and disordered eating behaviours (DEB) have been found to be common in people with diabetes mellitus (DM). However, findings have been inconsistent.

Objective

This study investigated the association between self-reported diabetes (Type 1 or 2) with ED/DEB (binge eating, subjective binge eating or loss of control overeating, severe dieting and purging) weight/shape overvaluation, and health-related quality of life (HRQoL) in a household survey in South Australia.

Method

In 2017 2977 people aged ≥15 years, who were representative of the general population, were interviewed. Participants reported their gender, age, household income, highest educational attainment, area of residence, presence of DM, ED/DEB, level of overvaluation, current HRQoL and height and weight. For the analyses between ED/DEB, self-reported DM and HRQoL, a grouping variable was created: 1) people without ED/DEB or self-reported DM; 2) people without ED/DEB and with self-reported DM; 3) people with ED/DEB and without self-reported DM; and 4) people with ED/DEB and self-reported DM. Analyses were stratified by sex and age group.

Results

Subjective binge eating prevalence was higher in people with self-reported DM (6.6% vs 2.8%, p = 0.016), and overvaluation was lower in those with DM (36% vs 43.8%, p = 0.007). In analyses stratified by sex and age group, subjective binge eating was higher in women and in people over 45 years with self-reported DM and overvaluation was lower in men and in people over 45 years with self-reported DM. However, these differences were not significant on tests of gender and age interaction. People in both DM groups scored significantly lower than people without DM groups on physical HRQoL. In contrast, people in both ED/DEB groups scored lower than people without ED/BEB on mental HRQoL.

Conclusion

People with self-reported DM had a higher prevalence of subjective binge eating, a lower prevalence of overvaluation and there were no significant effects of age or gender. Furthermore, participants with self-reported DM and comorbid ED or DEB had impairments of both mental and physical HRQoL. Assessing an individual’s sense of control over eating along with other DEB is likely important for identification of these mental health problems.
Dynamic single-slice CT estimates whole-lung dual-energy CT variables in pigs with and without experimental lung injury
Authors: Cronin John N. , Borges João Batista , Crockett Douglas C. , Farmery Andrew D. , Hedenstierna Göran , Larsson Anders , Tran Minh C. , Camporota Luigi , Formenti Federico
Published: November 2019

Background

Dynamic single-slice CT (dCT) is increasingly used to examine the intra-tidal, physiological variation in aeration and lung density in experimental lung injury. The ability of dCT to predict whole-lung values is unclear, especially for dual-energy CT (DECT) variables. Additionally, the effect of inspiration-related lung movement on CT variables has not yet been quantified.

Methods

Eight domestic pigs were studied under general anaesthesia, including four following saline-lavage surfactant depletion (lung injury model). DECT, dCT and whole-lung images were collected at 12 ventilatory settings. Whole-lung single energy scans images were collected during expiratory and inspiratory apnoeas at positive end-expiratory pressures from 0 to 20 cmH2O. Means and distributions of CT variables were calculated for both dCT and whole-lung images. The cranio-caudal displacement of the anatomical slice was measured from whole-lung images.

Results

Mean CT density and volume fractions of soft tissue, gas, iodinated blood, atelectasis, poor aeration, normal aeration and overdistension correlated between dCT and the whole lung (r2 0.75–0.94) with agreement between CT density distributions (r 0.89–0.97). Inspiration increased the matching between dCT and whole-lung values and was associated with a movement of 32% (SD 15%) of the imaged slice out of the scanner field-of-view. This effect introduced an artefactual increase in dCT mean CT density during inspiration, opposite to that caused by the underlying physiology.

Conclusions

Overall, dCT closely approximates whole-lung aeration and density. This approximation is improved by inspiration where a decrease in CT density and atelectasis can be interpreted as physiological rather than artefactual.
Preparation and purification of novel phosphatidyl prodrug and performance modulation of phosphatidyl nanoprodrug
Authors: Niu Rui , Zhang PeiLei , Wang Feng-Qing , Liu Min , Liu QingHai , Jia Ning , Yang ShengLi , Tao XinYi , Wei DongZhi
Published: November 2019

Background

A novel phosphatidyl nanoprodrug system can be selectively released parent drugs in cancer cells, triggered by the local overexpression of phospholipase D (PLD). This system significantly reduces the intrinsic disadvantages of conventional chemotherapeutic drugs. However, the separation and purification processes of phosphatidyl prodrug, the precursor of phosphatidyl nanoprodrug, have not been established, and the preparation of nanocrystals with good stability and tumor-targeting capability is still challenging.

Results

In this study, we established a successive elution procedure for the phosphatidyl prodrug—phosphatidyl mitoxantrone (PMA), using an initial ten-bed volume of chloroform/methanol/glacial acetic acid/water (26/10/0.8/0.7) (v/v/v/v) followed by a five-bed volume (26/10/0.8/3), with which purity rates of 96.93% and overall yields of 50.35% of PMA were obtained. Moreover, to reduce the intrinsic disadvantages of conventional chemotherapeutic drugs, phosphatidyl nanoprodrug—PMA nanoprodrug (NP@PMA)—was prepared. To enhance their stability, nanoparticles were modified with polyethylene glycol (PEG). We found that nanoprodrugs modified by PEG (NP@PEG–PMA) were stably present in RPMI-1640 medium containing 10% FBS, compared with unmodified nanoprodrug (NP@PMA). To enhance active tumor-targeting efficiency, we modified nanoparticles with an arginine-glycine-aspartic acid (RGD) peptide (NP@RGD–PEG–PMA). In vitro cytotoxicity assays showed that, compared with the cytotoxicity of NP@PEG–PMA against tumor cells, that of NP@RGD–PEG–PMA was enhanced. Thus, RGD modification may serve to enhance the active tumor-targeting efficiency of a nanoprodrug, thereby increasing its cytotoxicity.

Conclusions

A process for the preparation and purification of novel phosphatidyl prodrugs was successfully established, and the nanoprodrug was modified using PEG for enhanced nanoparticle stability, and using RGD peptide for enhanced active tumor-targeting efficiency. These procedures offer considerable potential in the development of functional antitumor prodrugs.
Homophily in networked agent-based models: a method to generate homophilic attribute distributions to improve upon random distribution approaches
Authors: Kapeller Marie Lisa , Jäger Georg , Füllsack Manfred
Published: November 2019

In the standard situation of networked populations, link neighbours represent one of the main influences leading to social diffusion of behaviour. When distinct attributes coexist, not only the network structure, but also the distribution of these traits shape the typical neighbourhood of each individual. While assortativity refers to the formation of links between similar individuals inducing the network structure, here, we separate the formation of links from the actual distribution of an attribute on the topology. This is achieved by first generating different network types (e.g., lattice, scale free, and small world), followed by the procedure of distributing attributes. With this separation, we try to isolate the effect that attribute distribution has on network diffusion from the effect of the network structure itself. We compare random distributions, where behaviour types are highly mixed, and homophilic distributions, where similar individuals are very likely to be linked, and examine the effects on social contagion in a population of mainly reciprocal behaviour types. In addition, we gradually mix homophilic distribution, by random rewiring, adding links and relocating individuals. Our main results is that attribute distribution strongly influences collective behaviour and the actual effect depends on the network type. Under homophilic distribution the equilibrium collective behaviour of a population tends to be more divers, implying that random distributions are limited for illustration of collective behaviour. We find that our results are robust when we use different gradual mixing methods on homophilic distribution.
A chemical-reaction-optimization-based neuro-fuzzy hybrid network for stock closing price prediction
Authors: Nayak Sarat Chandra , Misra Bijan Bihari
Published: November 2019

Accurate prediction of stock market behavior is a challenging issue for financial forecasting. Artificial neural networks, such as multilayer perceptron have been established as better approximation and classification models for this domain. This study proposes a chemical reaction optimization (CRO) based neuro-fuzzy network model for prediction of stock indices. The input vectors to the model are fuzzified by applying a Gaussian membership function, and each input is associated with a degree of membership to different classes. A multilayer perceptron with one hidden layer is used as the base model and CRO is used to the optimal weights and biases of this model. CRO was chosen because it requires fewer control parameters and has a faster convergence rate. Five statistical parameters are used to evaluate the performance of the model, and the model is validated by forecasting the daily closing indices for five major stock markets. The performance of the proposed model is compared with four state-of-art models that are trained similarly and was found to be superior. We conducted the Deibold-Mariano test to check the statistical significance of the proposed model, and it was found to be significant. This model can be used as a promising tool for financial forecasting.
Diagnostic performance of machine learning applied to texture analysis-derived features for breast lesion characterisation at automated breast ultrasound: a pilot study
Authors: Marcon Magda , Ciritsis Alexander , Rossi Cristina , Becker Anton S. , Berger Nicole , Wurnig Moritz C. , Wagner Matthias W. , Frauenfelder Thomas , Boss Andreas
Published: November 2019

Background

Our aims were to determine if features derived from texture analysis (TA) can distinguish normal, benign, and malignant tissue on automated breast ultrasound (ABUS); to evaluate whether machine learning (ML) applied to TA can categorise ABUS findings; and to compare ML to the analysis of single texture features for lesion classification.

Methods

This ethically approved retrospective pilot study included 54 women with benign (n = 38) and malignant (n = 32) solid breast lesions who underwent ABUS. After manual region of interest placement along the lesions’ margin as well as the surrounding fat and glandular breast tissue, 47 texture features (TFs) were calculated for each category. Statistical analysis (ANOVA) and a support vector machine (SVM) algorithm were applied to the texture feature to evaluate the accuracy in distinguishing (i) lesions versus normal tissue and (ii) benign versus malignant lesions.

Results

Skewness and kurtosis were the only TF significantly different among all the four categories (p < 0.000001). In subsets (i) and (ii), a maximum area under the curve of 0.86 (95% confidence interval [CI] 0.82–0.88) for energy and 0.86 (95% CI 0.82–0.89) for entropy were obtained. Using the SVM algorithm, a maximum area under the curve of 0.98 for both subsets was obtained with a maximum accuracy of 94.4% in subset (i) and 90.7% in subset (ii).

Conclusions

TA in combination with ML might represent a useful diagnostic tool in the evaluation of breast imaging findings in ABUS. Applying ML techniques to TFs might be superior compared to the analysis of single TF.
A methodology for unstructured damped stress inversion of microseismic focal mechanisms: Application to the Vaca Muerta Formation, Argentina
Authors: Li Bing Q. , Du Jing
Published: November 2019

Current methodologies for stress inversion from microseismic focal mechanisms require the assignment of events to a regular grid and then solving for the stress state at each grid node. This approach can lead to irregularities in the solution because some nodes may contain few or even no events. To address this issue, we modified the algorithm to solve for stresses on an irregular (unstructured) grid. We first use the [Formula: see text]-means algorithm to split the data into suitably sized groups. The centroids of these groups are then considered as the nodes of an unstructured grid, and we simultaneously solve for the stress state in each group using damped inversion. To account for the irregularity of the unstructured grid, we use the reciprocal square distance between nodes as weights, as opposed to the existing method in which a weight of unity is assigned between adjacent nodes on a regular grid. Focal planes are selected from the auxiliary plane using the fault instability criterion. The method is first applied to synthetic data sets in which we simulate and subsequently invert for the stress field around a mode-I fracture at depth, in a strike-slip and in a normal faulting stress regime. Results indicate a stress orientation error of 10° and a stress ratio error between 1% and 10%. We then consider focal mechanism data from an unconventional shale play in the Vaca Muerta Formation in Argentina, and our results suggest the presence of a preexisting strike-slip faulting stress regime. We also find that the unambiguous focal plane picks suggest that the apparent dip-slip focal mechanisms are indeed dip-slip movement along subvertical natural fractures, which correlate well with image log data. We suggest that these dip-slip events are caused by stress changes induced by the opening of the hydraulic fractures.
President's Page
Authors: Miller Rick
Published: November 2019

The 90th anniversary of the founding of our Society is coming up on 11 March 2020. In 1930, SEG was established at a time when the integration of geophysics — specifically, seismic and gravity — into oil exploration dramatically improved discovery successes. The amazing accomplishments and forethought of those groundbreaking pioneers in the early 20th century positioned our profession extremely well to be not only significant but vital to meeting the energy needs of the world over the last 100 years. Today, it is extremely rare that a production well is considered, much less drilled, without geophysics.
The value of VSP data through early phases of field appraisal and development: A modeling and acquisition case study in the Gulf of Mexico
Authors: Lanzarone Peter , L'Heureux Elizabeth , Li Qingsong
Published: November 2019

The Gulf of Mexico is a rich hydrocarbon province that contains a diversity of petroleum systems play types. Often, identifying drilling targets can be challenging when solely using surface seismic data, particularly in areas with complex salt structures in the overburden. In this paper, we present a vertical seismic profile (VSP) modeling and acquisition case study for an oil field located in a subsalt, deepwater, ultrahigh-pressure high-temperature environment. Our objective was to model the subsurface to guide the acquisition of VSP data during the early phases of exploration and appraisal drilling. In the first exploration well, a salt-proximity VSP designed in a walkaway configuration was carried out to help better define the geometry of a salt overhang and verify anisotropy parameters, helping to reduce a critical uncertainty for imaging the subsalt structure across a large segment within our field area. In the first appraisal well, a zero-offset VSP was collected to establish a direct well tie and further calibrate our velocity model. In the second appraisal well, we utilized walkaway VSP data to form a high-frequency stratigraphic image between the two appraisal wellbores. These data were used to generate an enhanced image of the reservoir section that revealed subtle stratigraphic boundaries, another key subsurface uncertainty. Finally, we modeled both ambitious and conservative 3D VSP acquisition designs to understand the imaging area achieved through a 3D acquisition and undertook an assessment to understand the impact of PP and PS imaging for reservoir characterization. We conclude that VSP data are valuable tools in the early phases of field appraisal and development, and we demonstrate the business value of VSPs to optimize development drilling locations in our study area.
Geophysics in the high school STEM setting
Authors: Doenges William , Potts Sydney , Rathman Christopher , Winters Cody , Neff Warren
Published: November 2019

In 2014, Bartlesville High School in Bartlesville, Oklahoma, USA, started an advanced math applications class as part of its new science, technology, engineering, and math (STEM) program. Selected exploration geophysics topics were incorporated as part of the class. Four of the class students in the 2017–2018 school year completed independent study of various topics in seismic acquisition design for science fair projects. The contents of this paper are the findings of those science fair projects. Contents include generating evenly distributed fold for compressional wave surveys (P-P), evenly distributed fold for converted-wave surveys (P-S), evenly distributed fold for ocean-bottom-cable/seismometer surveys (P-P), and offset/depth relations for validity of using the asymptotic approximation for converted-wave surveys (P-S).
URTeC returns to the Rockies — We came, we saw, we conquered
Authors: Singleton Scott
Published: November 2019

The fourth week of July 2019 saw 5200 oil and gas professionals descend on the Colorado Convention Center in Denver for the 7th annual Unconventional Resources Technology Conference (URTeC). Despite the fact that the exhibit floor was expanded this year, the high number of attendees meant the floor was clogged for much of the three-day conference, much to the delight of the companies and organizations exhibiting. As a historical note, this level of attendance is close to that of 2014, the second year of URTeC's existence and the second year it took place in Denver. I can assure our readers that a lot of people, from the organizing team to participating societies to exhibitors to companies involved in unconventionals, are happy (and relieved) to see this level of excitement and participation in this conference, given the fact that URTeC is rapidly solidifying its position as the go-to conference for unconventionals and a key barometer to gauge the health of the unconventional industry.
Effect of Abaloparatide vs Alendronate on Fracture Risk Reduction in Postmenopausal Women With Osteoporosis
Authors: Leder Benjamin Z , Mitlak Bruce , Hu Ming-yi , Hattersley Gary , Bockman Richard S
Published: November 2019

Context

The ACTIVE study demonstrated the antifracture efficacy of abaloparatide in postmenopausal women with osteoporosis. ACTIVExtend demonstrated sustained fracture risk reduction with alendronate in abaloparatide-treated participants from ACTIVE. A direct comparison of the efficacy of abaloparatide and antiresorptive therapies has not been performed.

Objective

The objective of this analysis is to compare the antifracture efficacy of abaloparatide in ACTIVE with that of alendronate in ACTIVExtend.

Design

In this post hoc analysis, the rate of new vertebral fractures for women in ACTIVExtend (N = 1139) was calculated based on baseline and endpoint radiographs for placebo or abaloparatide in ACTIVE and alendronate in ACTIVExtend. Vertebral fracture rates between abaloparatide and alendronate were compared in a Poisson regression model. Fracture rates for nonvertebral and clinical fractures were compared based on a Poisson model during 18 months of abaloparatide or placebo treatment in ACTIVE and 18 months of alendronate treatment in ACTIVExtend.

Results

The vertebral fracture rate was lower during abaloparatide treatment in ACTIVE (0.47 fractures/100 patient-years) than alendronate treatment in ACTIVExtend (1.66 fractures/100 patient-years) (relative risk reduction 71%; P = .027). Although the comparisons did not meet statistical significance, after switching from placebo (ACTIVE) to alendronate (ACTIVExtend), the rate of new vertebral fractures decreased from 2.49 to 1.66 fractures per 100 patient-years, and after switching from abaloparatide to alendronate from 0.47 to 0.19 fractures per 100 patient-years. The rates of nonvertebral fractures and clinical fractures were not significantly different.

Conclusion

Initial treatment with abaloparatide may result in greater vertebral fracture reduction compared with alendronate in postmenopausal women with osteoporosis.
Glucagon-Receptor Signaling Reverses Hepatic Steatosis Independent of Leptin Receptor Expression
Authors: Nason Shelly R , Kim Teayoun , Antipenko Jessica P , Finan Brian , DiMarchi Richard , Hunter Chad S , Habegger Kirk M
Published: November 2019

Glucagon (GCG) is an essential regulator of glucose and lipid metabolism that also promotes weight loss. We have shown that glucagon-receptor (GCGR) signaling increases fatty acid oxidation (FAOx) in primary hepatocytes and reduces liver triglycerides in diet-induced obese (DIO) mice; however, the mechanisms underlying this aspect of GCG biology remains unclear. Investigation of hepatic GCGR targets elucidated a potent and previously unknown induction of leptin receptor (Lepr) expression. Liver leptin signaling is known to increase FAOx and decrease liver triglycerides, similar to glucagon action. Therefore, we hypothesized that glucagon increases hepatic LEPR, which is necessary for glucagon-mediated reversal of hepatic steatosis. Eight-week-old control and liver-specific LEPR-deficient mice (LeprΔliver) were placed on a high-fat diet for 12 weeks and then treated with a selective GCGR agonist (IUB288) for 14 days. Liver triglycerides and gene expression were assessed in liver tissue homogenates. Administration of IUB288 in both lean and DIO mice increased hepatic Lepr isoforms a-e in acute (4 hours) and chronic (72 hours,16 days) (P < 0.05) settings. LeprΔliver mice displayed increased hepatic triglycerides on a chow diet alone (P < 0.05), which persisted in a DIO state (P < 0.001), with no differences in body weight or composition. Surprisingly, chronic administration of IUB288 in DIO control and LeprΔliver mice reduced liver triglycerides regardless of genotype (P < 0.05). Together, these data suggest that GCGR activation induces hepatic Lepr expression and, although hepatic glucagon and leptin signaling have similar liver lipid targets, these appear to be 2 distinct pathways.
Stem Leydig Cells in the Adult Testis: Characterization, Regulation and Potential Applications
Authors: Chen Panpan , Zirkin Barry R , Chen Haolin
Published: November 2019

Androgen deficiency (hypogonadism) affects males of all ages. Testosterone replacement therapy (TRT) is effective in restoring serum testosterone and relieving symptoms. TRT, however, is reported to have possible adverse effects in part because administered testosterone is not produced in response to the hypothalamic–pituitary–gonadal (HPG) axis. Progress in stem cell biology offers potential alternatives for treating hypogonadism. Adult Leydig cells (ALCs) are generated by stem Leydig cells (SLCs) during puberty. SLCs persist in the adult testis. Considerable progress has been made in the identification, isolation, expansion and differentiation of SLCs in vitro. In addition to forming ALCs, SLCs are multipotent, with the ability to give rise to all 3 major cell lineages of typical mesenchymal stem cells, including osteoblasts, adipocytes, and chondrocytes. Several regulatory factors, including Desert hedgehog and platelet-derived growth factor, have been reported to play key roles in the proliferation and differentiation of SLCs into the Leydig lineage. In addition, stem cells from several nonsteroidogenic sources, including embryonic stem cells, induced pluripotent stem cells, mature fibroblasts, and mesenchymal stem cells from bone marrow, adipose tissue, and umbilical cord have been transdifferentiated into Leydig-like cells under a variety of induction protocols. ALCs generated from SLCs in vitro, as well as Leydig-like cells, have been successfully transplanted into ALC-depleted animals, restoring serum testosterone levels under HPG control. However, important questions remain, including: How long will the transplanted cells continue to function? Which induction protocol is safest and most effective? For translational purposes, more work is needed with primate cells, especially human.
Carbon Taxes and CO2 Emissions: Sweden as a Case Study
Authors: Andersson Julius J.
Published: November 2019

This quasi-experimental study is the first to find a significant causal effect of carbon taxes on emissions, empirically analyzing the implementation of a carbon tax and a value-added tax on transport fuel in Sweden. After implementation, carbon dioxide emissions from transport declined almost 11 percent, with the largest share due to the carbon tax alone, relative to a synthetic control unit constructed from a comparable group of OECD countries. Furthermore, the carbon tax elasticity of demand for gasoline is three times larger than the price elasticity. Policy evaluations of carbon taxes, using price elasticities to simulate emission reductions, may thus significantly underestimate their true effect. (JEL H23, L91, Q54, Q58)
Recent advances in signal integration mechanisms in the unfolded protein response
Authors: Karagöz G. Elif , Aragón Tomás , Acosta-Alvear Diego
Published: November 2019

Since its discovery more than 25 years ago, great progress has been made in our understanding of the unfolded protein response (UPR), a homeostatic mechanism that adjusts endoplasmic reticulum (ER) function to satisfy the physiological demands of the cell. However, if ER homeostasis is unattainable, the UPR switches to drive cell death to remove defective cells in an effort to protect the health of the organism. This functional dichotomy places the UPR at the crossroads of the adaptation versus apoptosis decision. Here, we focus on new developments in UPR signaling mechanisms, in the interconnectivity among the signaling pathways that make up the UPR in higher eukaryotes, and in the coordination between the UPR and other fundamental cellular processes.
Do north-eastern German pharmacies recommend a necessary medical consultation for acute diarrhoea? Magnitude and determinants using a simulated patient approach
Authors: Langer Bernhard , Kunow Christian
Published: November 2019

Background: To determine if pharmacy staff in Germany referred patients to a medical consultation for a scenario in which consulting a doctor was mandatory (‘appropriate outcome’) and what the quality of questioning and – if a medication was dispensed – the quality of information provided were in this context. Moreover, to determine which factors predicted a necessary referral to a doctor.

Methods: A cross-sectional covert simulated patient study was conducted in a random sample of community pharmacies stratified by location in the German state of Mecklenburg-Vorpommern. Each pharmacy was visited once by one of four trained investigators. They simulated a symptom-based request involving a grandmother with acute diarrhoea. A multivariate binary logistic regression analysis using potential variables from bivariate analysis was carried out to determine the predictors for a referral to a doctor.

Results: All 199 planned visits were conducted. A necessary referral to a doctor was recommended in 59.8% (n=119) of all test purchases. Multivariate analysis revealed that a non-pharmacist as opposed to a pharmacist and two or more questions as opposed to no questions were significantly associated with a referral to a doctor.

Conclusions: Regarding the necessary referral to a doctor, an enormous potential for improvement was revealed for community pharmacies in the German state of Mecklenburg-Vorpommern. The results should make both the Mecklenburg-Vorpommern pharmacy association and legislators aware of the need to significantly escalate their quality management efforts.
Fronto-temporal dementia: a case study and strategies and support for caregivers
Authors: Mulkey Malissa A. , Everhart D. Erik , Hardin Sonya R.
Published: November 2019

Fronto-temporal dementia, also known as fronto-temporal lobular degeneration, is the second most common form of early-onset dementia with a prevalence equal to Alzheimer's dementia. Behavioural variant fronto-temporal dementia primarily involves the frontal and temporal lobes of the brain. Myelination of nerve fibres in these areas allow for highly synchronized action potential timing. Diagnosis is often significantly delayed because symptoms are insidious and appear as personality and behavioural changes such as lack of inhibition, apathy, depression, and being socially inappropriate rather than exhibiting marked memory reductions. In this article, a case study illustrates care strategies and family education. Management of severe behavioural symptoms requires careful evaluation and monitoring. Support is especially important and beneficial in the early to middle stages of dementia when nursing home placement may not be required based on the individual's condition.
The role of primary care in preventing male suicide
Authors: Hardy Sheila
Published: November 2019

Men in the UK are three times more likely to take their own lives than women. Sheila Hardy describes how practice nurses can help to prevent these unnecessary deaths

Men are more likely to die by suicide than women in the UK. Studies have found that most people whose death was due to suicide had been in contact with primary care in the year prior to death. Primary care clinicians, including practice nurses, are often the first health professionals seen by people who are experiencing distress or suicidal thoughts, and mental illness is mainly managed in primary care. However, mental illness is unrecognised in two-thirds of primary care patients. This article describes the responsibilities of health professionals in primary care consulting with men who may be at risk of suicide.
Creating a global covenant for healthcare reform in nursing
Authors: Best Catherine
Published: November 2019

Social determinants of health continue to exist and perpetuate health inequalities. Catherine Best explores the contribution of nurses on an international scale, particularly in regards to solving inequality in access to healthcare

Encouraging nursing to be a global profession has gained considerable momentum in recent years. For significantly longer, social determinants of health have featured in multiple national and international reports, and their devastating impacts on societies, both nationally and globally, are still being experienced. The time for rhetoric has long gone. Instead, unprecedented action is needed to bring this to the fore of all governments across the globe. The World Health Organization, International Council of Nurses and the United Nations have done much to raise awareness of the need for change and make it clear that the nursing profession can contribute to take positive action. The provision of good healthcare should not be reliant on where you live and work, but should be available to everyone. This article will explore the difference that nurses can make to the everyday lives of those we care for, and in improving equal access to healthcare for everyone.
Research Roundup
Authors: Winter George
Published: November 2019

George Winter provides an overview of recently published articles that may be of interest to practice nurses. Should you wish to look at any of the papers in more detail, a full reference is provided.
Educação Alimentar e Nutricional sob uma ótica da promoção de práticas alimentares saudáveis com adolescentes: um relato de experiência
Authors: Santos Paula Silva , Lisboa Cinthia Soares , Almeida Leila Magda Rodriges , Aragão Núbia Samara Caribé , Conceição Sarah dos Santos , Dos Santos Monique Lima
Published: November 2019

A educação alimentar e nutricional (EAN) se consolida como uma importante estratégia de promoção da saúde, posto os problemas alimentares e nutricionais atuais. Apesar do reconhecimento da importância da EAN, há poucas pesquisas sobre relatos de experiências no âmbito da educação nutricional. Sendo assim, o objetivo deste estudo é descrever e avaliar uma experiência acerca da educação alimentar e nutricional com estudantes de uma escola municipal do Recôncavo Baiano. O relato baseia-se em uma ação de EAN realizada em dois momentos, sendo que o primeiro correspondeu a um levantamento de dados sobre as características sociais, demográficas e nutricionais dos escolares, e o segundo foi à ação de EAN com a construção de uma Pirâmide Alimentar. O tema principal da ação de EAN foi alimentação saudável, com incentivo para o consumo de frutas, hortaliças e alimentação escolar, em detrimento do consumo de doces, refrigerantes e frituras. Foram utilizadas atividades lúdicas, as quais têm demostrado efetividade na ampliação do conhecimento sobre alimentos e nutrição, de forma alegre e integrativa. Portanto, este trabalho teve como objetivo descrever uma experiência acerca da EAN no contexto da promoção das práticas alimentares saudáveis, bem como avaliar intervenções de educação alimentar em estudantes do sexto ano do ensino fundamental, de uma escola municipal do Recôncavo Baiano.
A poesia Pneumotórax de Manuel Bandeira: reflexões sobre o cuidado em saúde a partir da Clínica Ampliada
Authors: Barbosa Elane da Silva , Fonseca Ailton Siqueira de Sousa , Vieira Alcivan Nunes , Carrilho Camila de Araújo , Chaves Márcia Jaínne Campelo , Duarte Suênia de Lima
Published: November 2019

A atuação do profissional de saúde adquire determinados contornos em cada abordagem clínica. A fim de valorizar a assistência integral em saúde sob outras perspectivas, além daquela inspirada no modelo biomédico, vem ganhando espaço a Clínica Ampliada. A poesia, enquanto linguagem sensível da vida humana, pode se constituir em estímulo para a reflexão do profissional de saúde sobre a sua prática. Este ensaio se propõe, portanto, a refletir sobre o cuidado em saúde na perspectiva da Clínica Ampliada. Como operador cognitivo que instigue reflexões acerca dessa temática, utiliza-se a poesia “Pneumotórax”, de Manuel Bandeira. Esse poema tem caráter autobiográfico, pois Bandeira fora diagnosticado com tuberculose, incurável naquela época. O profissional de saúde nessa poesia não restringe o sujeito aos sinais e sintomas, mas valoriza outros aspectos da sua existência. Essa reflexão, na área da saúde, responde por Clínica Ampliada, a qual se centra no sujeito, e não na patologia. Assim, o cuidado em saúde pressupõe relações entre os sujeitos e as maneiras como as necessidades e os problemas de saúde serão apreendidos. O poema Pneumotórax suscita esta reflexão-ação por parte do profissional de saúde: tornar-se mediador que instiga o outro a aceitar a doença como companheira no desafiador itinerário humano.
Aminas bioativas, aminoácidos livres e amônia como índices de qualidade de leites fermentados
Authors: Ciríaco Naiara Meireles , Moreira Gisela De Magalhães Machado , Reis Guilherme Coelho Lopes dos , Deus Valterney Lima , Glória Maria Beatriz Abreu
Published: November 2019

Leites fermentados são alimentos saudáveis por serem veiculadores de microrganismos probióticos. O objetivo deste estudo foi investigar o perfil e teores de aminoácidos, aminas bioativas e amônia em cinco marcas distintas de leites fermentados antes e após a validade. Dentro da validade, as amostras apresentaram pH de 4,04 a 4,06, acidez titulável de 0,82 a 0,99 g ácido lático/100 g, sólidos totais de 7,33 a12,0 g/100 g, e teores de espermina de 0,28 a 0,80 mg/kg. Três a 11 aminoácidos livres foram encontrados, dependendo da marca, em teores totais de 4,19 a 17,77 mg/kg. Arginina e asparagina estavam presentes em todas as marcas, enquanto ácido aspártico, leucina e lisina estavam presentes em apenas uma marca cada. Fenilalanina estava presente em duas marcas. Arginina, asparagina, histidina, prolina e treonina foram os aminoácidos predominantes. Após a validade, não houve alteração no pH, acidez e sólidos totais para todas as marcas. O perfil e teores de aminoácidos, aminas e amônia mudaram para três marcas. Novos aminoácidos (glicina e serina) e a amônia foram detectados. Em geral, os teores de prolina, leucina, lisina e fenilalanina aumentaram; enquanto os de asparagina, histidina e treonina diminuíram. Novas aminas foram detectadas: serotonina e agmatina. Análise multivariada (PCA e HCA) confirmou que os aminoácidos glicina e serina e as aminas serotonina e agmatina são potenciais diferenciadores da qualidade de três das cinco marcas pesquisadas de leites fermentados.
Nisin reduces the Staphylococcus aureus count without changing the characteristics of artisanal Minas cheese from Araxá
Authors: Sobral Denise , Pinto Maximiliano Soares , Teodoro Vanessa Aglaê Martins , Costa Renata Golin Bueno , De Paula Junio Cesar Jacinto , De Carvalho Antônio Fernandes , Moreira Gisela De Magalhães Machado
Published: November 2019

O queijo tradicional de Araxá é produzido com leite cru, o que representa um risco para a saúde dos consumidores. A ação da nisina (100 UI/g e 400 UI/g) contra Staphylococcus aureus durante a maturação de Queijos Minas Artesanais de Araxá foi avaliada e a nisina reduziu a contagem de S. aureus para menos de 1 log UFC/g do começo ao fim da maturação. A nisina aumentou ligeiramente o pH e o teor de umidade e diminuiu o teor de gordura do Queijo Minas Artesanal de Araxá; no entanto, com a menor concentração de bacteriocina, essas mudanças não alteraram os índices de maturação, cor ou textura do queijo, que variaram apenas em função da maturação. A nisina tem o potencial de limitar o crescimento de S. aureus em Queijo Minas Artesanal de Araxá, sem alterar as características essenciais deste produto artesanal.
OPORTUNOS DIÁLOGOS: SOBRE CIRCULAÇÃO DE EXPERIÊNCIAS E AFETOS
Authors: Rubert Rosane Aparecida , Fonseca Leandra Ribeiro
Published: November 2019

O texto se propõe a relatar o encontro de três mulheres quilombolas, que figuram como lideranças em suas respectivas comunidades, assim como a troca de experiências destas com um público maior, o qual incluía outras mulheres negras e quilombolas. Apoiando-nos em perspectivas teóricas que primam pela abordagem articulada das diversas dimensões que moldam trajetórias coletivas e individuais – como classe, raça, gênero -, ousamos perscrutar o significado do encontro entre lideranças de diferentes gerações e que residem em comunidades distantes umas das outras, não obstante compartilharem condições de vida e experiências de articulação política similares, a partir da identidade comum de quilombolas.