bluuebunny/crossref_metadata_2025 huggingface dataset:
Development of Photoactive Supramolecular Devices and Machines
Authors: Gromov S. P. , Chibisov A. K. , Alfimov M. V.
Published: June 2021

Among the various directions of the science of photoactive organic compounds, the design, creation, and study of photoactive supramolecular devices and machines are attracting special attention, since in this way it is possible to discover new approaches to construct complex hierarchical “smart” materials.
Cardiac fibroma with cardiac arrest: a rare clinical presentation of Gorlin syndrome in an 8-month-old infant
Authors: Baidoun Mohammad , Elgendy Mohamed , Loker James
Published: June 2021

Paediatric cardiac tumours are rare, often benign and carry associations with genetic conditions. Cardiac fibromas are mainly composed of fibroblast and connective tissue . They can lead to symptoms due to obstruction of blood flow or arrythmias. In this case, we report an 8-month-old girl child who presented to paediatric cardiology office for cardiac evaluation given a family history of Gorlin syndrome, also known as nevoid basal cell carcinoma syndrome, found to have a large 4×4×6 cm fibroma in the apical lateral free wall of the left ventricle and later presented to the emergency department with cardiac arrest.
Safety and efficacy of inpatient pulmonary rehabilitation for patients hospitalised with an acute exacerbation of chronic obstructive pulmonary disease: a systematic review protocol
Authors: Zhu Kai , Gill Jagdeep , Kirkham Ashley , Chen Joel , Ellis Amy , Crosbie Stephanie , Denson-Camp Holly , Peters Hannah , Camp Pat
Published: June 2021

Introduction

Pulmonary rehabilitation (PR) following an acute exacerbation of chronic obstructive pulmonary disease (AECOPD) reduces the risk of hospital admissions, and improves physical function and health-related quality of life. However, the safety and efficacy of in-hospital PR during the most acute phase of an AECOPD is not well established. This paper describes the protocol for a systematic review with meta-analysis to determine the safety and efficacy of inpatient acute care PR during the hospitalisation phase.

Methods and analysis

Medical literature databases and registries MEDLINE, EMBASE, Physiotherapy Evidence Database, Cumulative Index to Nursing and Allied Health Literature, Canadian Agency for Drugs and Technologies in Health, CENTRAL, Allied and Complementary Medicine Database, WHO trials portal and ClinicalTrials.gov will be searched for articles from inception to June 2021 using a prespecified search strategy. We will identify randomised controlled trials that have a comparison of in-hospital PR with usual care. PR programmes had to commence during the hospitalisation and include a minimum of two sessions. Title and abstract followed by full-text screening will be conducted independently by two reviewers. A meta-analysis will be performed if there is sufficient homogeneity across selected studies or groups of studies. The Population, Intervention, Comparator, Outcomes and Study characteristics framework will be used to standardise the data collection process. The quality of the cumulative evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluations framework.

Ethics and dissemination

AECOPD results in physical limitations which are amenable to PR. This review will assess the safety and efficacy of in-hospital PR for AECOPD. The results will be presented in a peer-reviewed publication and at research conferences. Ethical review is not required for this study.

PROSPERO registration number

CRD42021198877.
Young adults’ perceptions of living with atopic dermatitis in relation to the concept of self-management: a qualitative study
Authors: Lundin Susanne , Jonsson Marina , Wahlgren Carl-Fredrik , Johansson Emma , Bergstrom Anna , Kull Inger
Published: June 2021

Objectives

Learning to take control of one’s health is an important part of the transition from adolescence to adulthood. This study aimed to explore young adults’ perceptions of living with atopic dermatitis (AD) in relation to the concept of self-management.

Design

A qualitative study with an inductive approach was performed through semistructured interviews (n=15). The interviews were recorded, transcribed verbatim and analysed with systematic text condensation.

Participants

Young adults (mean age 23,4 years) with persistent AD in a longitudinal population-based birth cohort. To capture experience of living with persistent AD (preschool/school-age onset) of different severity (mild to severe/very severe), a purposive selection was performed. In total, 15 young adults were included. Persistent AD (preschool/school-age onset) was defined as dry skin in combination with itchy rash of typical localisation in the 12 months preceding the 16-year and the 24-year follow-ups. Severity was self-assessed using the Patient Oriented Eczema Measure.

Results

Despite having experience of AD since childhood, the respondents expressed uncertainty about treatment and how it affected their bodies. Their uncertainties and feelings affected how they used topical corticosteroids. The respondents emphasised that they perceived availability of healthcare and knowledge about treatment of AD among healthcare providers to be limited. The participants did not state any experiences of support to self-management from healthcare, which affect young adults’ possibilities to take full control of their AD care.

Conclusions

Young adults with preschool/school-age onset of AD are unsure how to treat and manage the disease. One explanation may be insufficient transition process.
Cohort profile: follow-up of a Berlin Aging Study II (BASE-II) subsample as part of the GendAge study
Authors: Demuth Ilja , Banszerus Verena , Drewelies Johanna , Düzel Sandra , Seeland Ute , Spira Dominik , Tse Esther , Braun Julian , Steinhagen-Thiessen Elisabeth , Bertram Lars , Thiel Andreas , Lindenberger Ulman , Regitz-Zagrosek Vera , Gerstorf Denis
Published: June 2021

Purpose

The study ‘Sex- and gender-sensitive prevention of cardiovascular and metabolic disease in older adults in Germany’, the GendAge study, focuses on major risk factors for cardiovascular and metabolic diseases and on the development of major outcomes from intermediate phenotypes in the context of sex and gender differences. It is based on a follow-up examination of a subsample (older group) of the Berlin Aging Study II (BASE-II).

Participants

The GendAge study assessments took place between 22 June 2018 and 10 March 2020. A total of 1100 participants (older BASE-II subsample, aged ≥65 years) with baseline data assessed at least by one of the BASE-II partner sites were investigated in the follow-up. These participants had a mean age of 75.6 years (SD ±3.8), with a mean follow-up at 7.4 years (SD ±1.5).

Findings to date

Data from different domains such as internal medicine, geriatrics, immunology and psychology were collected, with a focus on cardiometabolic diseases and in the context of sex and gender differences. Diabetes mellitus type 2 was reported by 15.6% and 8.6% of men and women, respectively. In contrast, this disease was diagnosed in 20.7% of men and 13.3% of women, indicating that a substantial proportion of almost 30% was unaware of the disease. Echocardiography revealed that left ventricular ejection fraction was higher in women than in men, in agreement with previous reports.

Future plans

A gender questionnaire assessing sociocultural aspects implemented as part of the follow-up described here will allow to calculate a gender score and its evaluation based on the newly collected data. At the same time, the other BASE-II research foci established over the past 10 years will be continued and strengthened by the BASE-II transition into a longitudinal study with follow-up data on the older subsample.

Trial registration number

DRKS00016157.
Impact of a 12-week open-label placebo treatment on headache days in episodic and chronic migraine: a study protocol for a parallel-group, multicentre, randomised controlled trial
Authors: Schmidt Katharina , Kleine-Borgmann Julian , Holle-Lee Dagny , Gaul Charly , Bingel Ulrike
Published: June 2021

Introduction

Migraine is the most common neurological disorder and one of the major causes of years lived with disability. Its treatment (especially of chronic forms) is often challenging and accompanied with adverse effects. Although new therapeutic approaches have recently emerged (eg, calcitonin gene-related peptide antibodies), these are linked to strict prescribing guidelines and therefore limited to only a minority of patients. Recently, randomised controlled trials have demonstrated that open-label placebo treatments can lead to significant and clinically relevant improvements of chronic pain conditions.

Methods and analysis

This multicentre, randomised controlled clinical trial following a parallel group between-subject design aims to systematically investigate the impact of a 12-week open-label placebo treatment on moderate to severe headache days (primary outcome) in patients with episodic and chronic migraine in addition to treatment as usual. Secondary outcomes comprise the number of migraine days, pain intensity, intake of acute medication, quality of life, disability, global impression of change, tolerability and a responder rate. To systematically address potential predictors of placebo responses in patients with migraine, this study assesses potential psychometric predictors, salivary cortisol and alpha-amylase awakening responses, catechol-o-methyltransferase Val158Met polymorphisms, as well as functional and structural brain connectivity (ie, resting state functional MRI, diffusion tensor imaging). The data analysis will be performed on basis of the general linear model considering repeated measures (mixed model).

Ethics and dissemination

This protocol and all corresponding documents were approved with regard to their content and compliance with ethical regulations by the Ethics Committee of the Medical Faculty of the University Duisburg-Essen, Germany and the Ethics Committee of the Landesärztekammer Hessen. The results from this study will be actively disseminated through manuscript publications and conference presentations.

Trial registration number

German Clinical Trials Register (DRKS00021259).
Adapting to, integrating and self-managing HIV as a chronic illness: a scoping review protocol
Authors: Sematlane Neo Phyllis , Knight Lucia , Masquillier Caroline , Wouters Edwin
Published: June 2021

Introduction

The process of adapting to a life with a chronic illness, is a well-researched phenomenon for a number of common chronic illnesses. The construct, adaptation, embeds the notions of integration of the chronic illness into identity and self-management. Integration precedes self-management and is key to living positively with a chronic illness. Adaptation is an important concept in understanding trajectory and outcomes of living with a chronic illness. Applicability of these concepts to HIV as a chronic illness; when suppressive adherence has been achieved, however, is unknown. Specifically, the adaptation process to living with HIV as a chronic illness, the integration of HIV into identity and the resulting self-management behaviours by adults living with HIV are relatively unexplored. We describe a protocol for a scoping review of adaptation to living with HIV, we structure the enquiry around integration of HIV into identity and self-management and interrogate theories, models and frameworks that have been proposed and studied and we evaluate them for relevance and usefulness in the care and management of HIV.

Methods and analysis

Methods proposed by the Johanna Briggs Institute will be followed. The protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for Scoping Reviews and was registered with the Open Science Framework. MEDLINE, SCOPUS, Cochrane Library, CINHAL and SocINDEX databases will be searched. A search in Social Science Research Network eLibrary and Open Access Theses and Dissertations will gather grey literature and reference lists of included sources will be screened. Study selection process will involve a title and abstract review and full text review, guided by clearly defined inclusion and exclusion criteria.

Ethics and dissemination

Ethical approval is not required because this is a proposed review and collection of data on publicly available materials. The results will be published in a topic relevant journal and presented at related scientific events.
Risk factors, symptom reporting, healthcare-seeking behaviour and adherence to public health guidance: protocol for Virus Watch, a prospective community cohort study
Authors: Hayward Andrew , Fragaszy Ellen , Kovar Jana , Nguyen Vincent , Beale Sarah , Byrne Thomas , Aryee Anna , Hardelid Pia , Wijlaars Linda , Fong Wing Lam Erica , Geismar Cyril , Patel Parth , Shrotri Madhumita , Navaratnam Annalan M D , Nastouli Eleni , Spyer Moira , Killingley Ben , Cox Ingemar , Lampos Vasileios , McKendry Rachel A , Liu Yunzhe , Cheng Tao , Johnson Anne M , Michie Susan , Gibbs Jo , Gilson Richard , Rodger Alison , Aldridge Robert W
Published: June 2021

Introduction

The coronavirus (COVID-19) pandemic has caused significant global mortality and impacted lives around the world. Virus Watch aims to provide evidence on which public health approaches are most likely to be effective in reducing transmission and impact of the virus, and will investigate community incidence, symptom profiles and transmission of COVID-19 in relation to population movement and behaviours.

Methods and analysis

Virus Watch is a household community cohort study of acute respiratory infections in England and Wales and will run from June 2020 to August 2021. The study aims to recruit 50 000 people, including 12 500 from minority ethnic backgrounds, for an online survey cohort and monthly antibody testing using home fingerprick test kits. Nested within this larger study will be a subcohort of 10 000 individuals, including 3000 people from minority ethnic backgrounds. This cohort of 10 000 people will have full blood serology taken between October 2020 and January 2021 and repeat serology between May 2021 and August 2021. Participants will also post self-administered nasal swabs for PCR assays of SARS-CoV-2 and will follow one of three different PCR testing schedules based on symptoms.

Ethics and dissemination

This study has been approved by the Hampstead National Health Service (NHS) Health Research Authority Ethics Committee (ethics approval number 20/HRA/2320). We are monitoring participant queries and using these to refine methodology where necessary, and are providing summaries and policy briefings of our preliminary findings to inform public health action by working through our partnerships with our study advisory group, Public Health England, NHS and government scientific advisory panels.
Impact of Florida’s prescription drug monitoring program on drug- related fatal vehicle crashes: a difference-in-differences approach
Authors: Tatar Moosa , Jalali Mohammad S. , Tak Hyo Jung , Chen Li-Wu , Araz Ozgur M. , Wilson Fernando A.
Published: June 2021

Background

Prescription drug use has soared in the USA within the last two decades. Prescription drugs can impair motor skills essential for the safe operation of a motor vehicle, and therefore can affect traffic safety. As one of the epicentres of the opioid epidemic, Florida has been struck by high opioid misuse and overdose rates, and has concurrently suffered major threats to traffic disruptions safety caused by driving under the influence of drugs. To prevent prescription opioid misuse in Florida, Prescription Drug Monitoring Programs (PDMPs) were implemented in September 2011.

Objective

To examine the impact of Florida’s implementation of a mandatory PDMP on drug-related MVCs occurring on public roads.

Methods

We employed a difference-in-differences approach to estimate the difference in prescription drug-related fatal crashes in Florida associated with its 2011 PDMP implementation relative to those in Georgia, which did not use PDMPs during the same period (2009–2013). The analyses were conducted in 2020.

Results

In Florida, there was a significant decline in drug-related vehicle crashes during the 22 months post-PDMP. PDMP implementation was associated with approximately two (−2.21; 95% CI −4.04 to –0.37; p<0.05) fewer prescribed opioid-related fatal crashes every month, indicating 25% reduction in the number of monthly crashes. We conducted sensitivity analyses to investigate the impact of PDMP implementation on central nervous system depressants and stimulants as well as cocaine and marijuana-related fatal crashes but found no robust significant reductions.

Conclusions

The implementation of PDMPs in Florida provided important benefits for traffic safety, reducing the rates of prescription opioid-related vehicle crashes.
Metabolic features of cancer cells impact immunosurveillance
Authors: Joseph Adrien , Juncheng Pan , Mondini Michele , Labaied Nizar , Loi Mauro , Adam Julien , Lafarge Antoine , Astesana Valentina , Obrist Florine , Klein Christophe , Bloy Norma , Stoll Gautier , Signolle Nicolas , Genestie Catherine , Damotte Diane , Alifano Marco , Leary Alexandra , Pautier Patricia , Morice Philippe , Gouy Sebastien , Deutsch Eric , Chargari Cyrus , Dieu-Nosjean Marie-Caroline , Cremer Isabelle , Michels Judith , Kroemer Guido , Castedo Maria
Published: June 2021

Background

Tumors rewire their metabolism to achieve robust anabolism and resistance against therapeutic interventions like cisplatin treatment. For example, a prolonged exposure to cisplatin causes downregulation of pyridoxal kinase (PDXK), the enzyme that generates the active vitamin B6, and upregulation of poly ADP-ribose (PAR) polymerase-1 (PARP1) activity that requires a supply of nicotinamide (vitamin B3) adenine dinucleotide. We investigated the impact of the levels of PDXK and PAR on the local immunosurveillance (ie, density of the antigen presenting cells and adaptive immune response by CD8 T lymphocytes) in two different tumor types.

Methods

Tumors from patients with locally advanced cervical carcinoma (LACC) and non-small cell lung cancer (NSCLC) were stained for PAR, PDXK, dendritic cell lysosomal associated membrane glycoprotein (DC-LAMP) and CD8 T cell infiltration. Their correlations and prognostic impact were assessed. Cisplatin-resistant NSCLC cell clones isolated from Lewis-lung cancer (LLC) cells were evaluated for PAR levels by immunoblot. Parental (PARlow) and cisplatin-resistant (PARhigh) clones were subcutaneously injected into the flank of C57BL/6 mice. Tumors were harvested to evaluate their immune infiltration by flow cytometry.

Results

The infiltration of tumors by CD8 T and DC-LAMP+ cells was associated with a favorable overall survival in patients with LACC (p=0.006 and p=0.008, respectively) and NSCLC (p<0.001 for both CD8 T and DC-LAMP cells). We observed a positive correlation between PDXK expression and the infiltration by DC-LAMP (R=0.44, p=0.02 in LACC, R=0.14, p=0.057 in NSCLC), and a negative correlation between PAR levels and CD8 T lymphocytes (R=−0.39, p=0.034 in LACC, R=−0.18, p=0.017 in NSCLC). PARP1 is constitutively hyperactivated in cisplatin-resistant LLC cells manifesting elevated intracellular levels of poly(ADP-ribosyl)ated proteins (PARhigh). Tumors formed by such cancer cells injected into immunocompetent mice were scarcely infiltrated by CD8 T (p=0.028) and antigen presenting cells (p=0.086).

Conclusions

Oncometabolic features can impact local immunosurveillance, providing new functional links between cisplatin resistance and therapeutic failure.
Fluroxypyr-resistant kochia [Bassia scoparia (L.) A.J. Scott] confirmed in Alberta
Authors: Geddes Charles M. , Ostendorf Teandra E. , Owen Mallory L. , Leeson Julia Y. , Sharpe Shaun M. , Shirriff Scott W. , Beckie Hugh J.
Published: June 2021

Recent confirmation of dicamba-resistant kochia [Bassia scoparia (L.) A.J. Scott] in Alberta warrants investigation of resistance to other commonly used synthetic auxin herbicides like fluroxypyr. A randomized-stratified survey of 305 sites in Alberta was conducted in 2017 to determine the status of fluroxypyr-resistant kochia. Overall, 13% of the kochia populations were fluroxypyr-resistant. Only 4% of the populations were both fluroxypyr- and dicamba-resistant, indicating that different mechanisms may confer resistance to these herbicides. When combined with estimates of dicamba resistance, about 28% of the kochia populations sampled in Alberta in 2017 were resistant to at least one synthetic auxin herbicide.
Disaster Management during Pandemic: A Big Data-Centric Approach
Authors: Elsotouhy Mohamed , Jain Geetika , Shrivastava Archana
Published: June 2021

The concept of big data (BD) has been coupled with disaster management to improve the crisis response during pandemic and epidemic. BD has transformed every aspect and approach of handling the unorganized set of data files and converting the same into a piece of more structured information. The constant inflow of unstructured data shows the research lacuna, especially during a pandemic. This study is an effort to develop a pandemic disaster management approach based on BD. BD text analytics potential is immense in effective pandemic disaster management via visualization, explanation, and data analysis. To seize the understanding of using BD toward disaster management, we have taken a comprehensive approach in place of fragmented view by using BD text analytics approach to comprehend the various relationships about disaster management theory. The study’s findings indicate that it is essential to understand all the pandemic disaster management performed in the past and improve the future crisis response using BD. Though worldwide, all the communities face big chaos and have little help reaching a potential solution.
Singular gauge transformations in geometrodynamics
Authors: Garat Alcides
Published: June 2021

The new tetrads introduced previously for non-null electromagnetic fields in Einstein–Maxwell spacetimes enable a direct link to the local electromagnetic gauge group of transformations. Due to the peculiar elements in the construction of these new tetrads, a direct connection can be established between the local group of electromagnetic gauge transformations and local groups of tetrad transformations on two different local and orthogonal planes of eigenvectors of the Einstein–Maxwell stress–energy tensor. These tetrad vectors are gauge dependent. It is an interesting and relevant problem to study if there are local gauge transformations that can map on the timelike-spacelike plane, the timelike and the spacelike vectors into the intersection of the local light cone and the plane itself. How many of these local gauge transformations exist and how the mathematics and the geometry of these particular transformations play out. These local gauge transformations would be singular and it is important to identify them.
Increased intracellular Cl− concentration in pulmonary arterial myocytes is associated with chronic hypoxic pulmonary hypertension
Authors: Sun Hui , Paudel Omkar , Sham James S. K.
Published: June 2021

Chloride channels play an important role in regulating smooth muscle contraction and proliferation, and contribute to the enhanced constriction of pulmonary arteries (PAs) in pulmonary hypertension (PH). The intracellular Cl− concentration ([Cl−]i), tightly regulated by various Cl− transporters, determines the driving force for Cl− conductance, thereby the functional outcome of Cl− channel activation. This study characterizes for the first time the expression profile of Cl− transporters/exchangers in PA smooth muscle and provides the first evidence that the intracellular Cl− homeostasis is altered in PA smooth muscle cells (PASMCs) associated with chronic hypoxic PH (CHPH). Quantitative RT-PCR revealed that the endothelium-denuded intralobar PA of rats expressed Slc12a gene family-encoded Na-K-2Cl cotransporter 1 (NKCC1), K-Cl cotransporters (KCC) 1, 3, and 4, and Slc4a gene family-encoded Na+-independent and Na+-dependent Cl−/HCO3− exchangers. Exposure of rats to chronic hypoxia (10% O2, 3 wk) caused CHPH and selectively increased the expression of Cl−-accumulating NKCC1 and reduced the Cl−-extruding KCC4. The intracellular Cl− concentration ([Cl−]i) averaged at 45 mM and 47 mM in normoxic PASMCs as determined by fluorescent indicator MEQ and by gramicidin-perforated patch-clamp technique, respectively. The ([Cl−]i was increased by ∼10 mM in PASMCs of rats with CHPH. Future studies are warranted to further establish the hypothesis that the altered intracellular Cl− homeostasis contributes to the pathogenesis of CHPH.
Toll-like receptors, environmental caging, and lung dysbiosis
Authors: Lipinski Jay H. , Falkowski Nicole R. , Huffnagle Gary B. , Erb-Downward John R. , Dickson Robert P. , Moore Beth B. , O’Dwyer David N.
Published: June 2021

Recent studies have implicated lung microbiota in shaping local alveolar immune responses. Toll-like receptors are major sensors of microbiota and determinants of local epithelial homeostasis. The impact of toll-like receptor deficiency on lung microbiota is unknown. To determine whether the absence of toll-like receptors results in altered lung microbiota or dysbiosis, we compared lung microbiota in wild-type and toll-like receptor-deficient experimental mice using 16S ribosomal RNA gene quantification and sequencing. We used a randomized environmental caging strategy to determine the impact of toll-like receptors on lung microbiota. Lung microbiota are detectable in toll-like receptor-deficient experimental mice and exhibit considerable variability. The lung microbiota of toll-like receptor-deficient mice are altered in community composition (PERMANOVA P < 0.001), display reduced diversity ( t test P = 0.0075), and bacterial burden ( t test P = 0.016) compared with wild-type mice with intact toll-like receptors and associated signaling pathways. The lung microbiota of wild-type mice when randomized to cages with toll-like receptor-deficient mice converged with no significant difference in community composition (PERMANOVA P > 0.05) after 3 wk of cohousing. The lung microbiome of toll-like receptor-deficient mice is distinct from wild-type mice and may be less susceptible to the effects of caging as an environmental variable. Our observations support a role for toll-like receptor signaling in the shaping of lung microbiota.
Long-term survivors of murine sepsis are predisposed to enhanced LPS-induced lung injury and proinflammatory immune reprogramming
Authors: Denstaedt Scott J. , Bustamante Angela C. , Newstead Michael W. , Moore Bethany B. , Standiford Theodore J. , Zemans Rachel L. , Singer Benjamin H.
Published: June 2021

Millions of people who survive sepsis each year are rehospitalized and die due to late pulmonary complications. To prevent and treat these complications, biomarkers and molecular mediators must be identified. Persistent immune reprogramming in the form of immunoparalysis and impaired host defense is proposed to mediate late pulmonary complications after sepsis, particularly new pulmonary infections. However, immune reprogramming may also involve enhanced/primed responses to secondary stimuli, although their contribution to long-term sepsis complications remains understudied. We hypothesize that enhanced/primed immune responses in the lungs of sepsis survivors are associated with late pulmonary complications. To this end, we developed a murine sepsis model using cecal ligation and puncture (CLP) followed 3 wk later by administration of intranasal lipopolysaccharide to induce inflammatory lung injury. Mice surviving sepsis exhibit enhanced lung injury with increased alveolar permeability, neutrophil recruitment, and enhanced Ly6Chi monocyte Tnf expression. To determine the mediators of enhanced lung injury, we performed flow cytometry and RNA sequencing of lungs 3 wk after CLP, prior to lipopolysaccharide. Sepsis survivor mice showed expanded Ly6Chi monocytes populations and increased expression of many inflammatory genes. Of these, S100A8/A9 was also elevated in the circulation of human sepsis survivors for months after sepsis, validating our model and identifying S100A8/A9 as a potential biomarker and therapeutic target for long-term pulmonary complications after sepsis. These data provide new insight into the importance of enhanced/primed immune responses in survivors of sepsis and establish a foundation for additional investigation into the mechanisms mediating this response.
Occupational heat exposure and the risk of chronic kidney disease of nontraditional origin in the United States
Authors: Chapman Christopher L. , Hess Hayden W. , Lucas Rebekah A.I. , Glaser Jason , Saran Rajiv , Bragg-Gresham Jennifer , Wegman David H. , Hansson Erik , Minson Christopher T. , Schlader Zachary J.
Published: June 2021

Occupational heat exposure is linked to the development of kidney injury and disease in individuals who frequently perform physically demanding work in the heat. For instance, in Central America, an epidemic of chronic kidney disease of nontraditional origin (CKDnt) is occurring among manual laborers, whereas potentially related epidemics have emerged in India and Sri Lanka. There is growing concern that workers in the United States suffer with CKDnt, but reports are limited. One of the leading hypotheses is that repetitive kidney injury caused by physical work in the heat can progress to CKDnt. Whether heat stress is the primary causal agent or accelerates existing underlying pathology remains contested. However, the current evidence supports that heat stress induces tubular kidney injury, which is worsened by higher core temperatures, dehydration, longer work durations, muscle damaging exercise, and consumption of beverages containing high levels of fructose. The purpose of this narrative review is to identify occupations that may place US workers at greater risk of kidney injury and CKDnt. Specifically, we reviewed the scientific literature to characterize the demographics, environmental conditions, physiological strain (i.e., core temperature increase, dehydration, heart rate), and work durations in sectors typically experiencing occupational heat exposure, including farming, wildland firefighting, landscaping, and utilities. Overall, the surprisingly limited available evidence characterizing occupational heat exposure in US workers supports the need for future investigations to understand this risk of CKDnt.
State-of-the-Art Review: Demyelinating Diseases in Indonesia
Authors: Larassati Hana , Estiasari Riwanti , Yunus Reyhan E. , Parizel Paul M.
Published: June 2021

Demyelinating diseases are more common in Indonesia than previously believed. However, it is still a challenge for a country such as Indonesia to implement the scientific medical advances, especially in the diagnostic process of demyelinating diseases, to achieve the best possible outcome for these groups of patients, within the constraints of what is socially, technologically, economically, and logistically achievable. In this review, we address the 4 major classes of demyelinating disease: multiple sclerosis (MS), neuromyelitis optica (NMO), anti-MOG-associated encephalomyelitis (MOG-EM), and acute disseminated encephalomyelitis (ADEM), and discuss their prevalence, demographics, clinical diagnosis workup, and imaging features in the Indonesian population, as well as the challenges we face in their diagnosis and therapeutic approach. We hope that this overview will lead to a better awareness of the spectrum of demyelinating diseases of the central nervous system in Indonesia.
Minimally Invasive Periodontology: A Treatment Philosophy and Suggested Approach
Authors: Ng Ethan , Tay John Rong Hao , Ong Marianne Meng Ann
Published: June 2021

Severe periodontitis is a highly prevalent dental disease. With the advent of implant dentistry, teeth are often extracted and replaced. Periodontal surgery, where indicated, could also result in increased trauma to the patient. This literature review discusses different treatment modalities for periodontitis and proposes a treatment approach emphasizing maximum preservation of teeth while minimizing morbidity to the patient. Scientific articles were retrieved from the MEDLINE/PubMed database up to January 2021 to identify appropriate articles that addressed the objectives of this review. This was supplemented with hand searching using reference lists from relevant articles. As tooth prognostication does not have a high predictive value, a more conservative approach in extracting teeth should be abided by. This may involve repeated rounds of nonsurgical periodontal therapy, and adjuncts such as locally delivered statin gels and subantimicrobial-dose doxycycline appear to be effective. Periodontal surgery should not be carried out at an early phase in therapy as improvements in nonsurgical therapy may be observed up to 12 months from initial treatment. Periodontal surgery, where indicated, should also be minimally invasive, with periodontal regeneration being shown to be effective over 20 years of follow-up. Biomarkers provide an opportunity for early detection of disease activity and personalised treatment. Quality of life is proposed as an alternative end point to the traditional biomedical paradigm focused on the disease state and clinical outcomes. In summary, minimally invasive therapy aims to preserve health and function of the natural dentition, thus improving the quality of life for patients with periodontitis.
A Numerical Algorithm Applied to Free Convection Flows of the Casson Fluid along with Heat and Mass Transfer Described by the Caputo Derivative
Authors: Sene Ndolane
Published: June 2021

In this paper, we present a class of numerical schemes and apply it to the diffusion equations. The objective is to obtain numerical solutions of the constructive equations of a type of Casson fluid model. We investigate the solutions of the free convection flow of the Casson fluid along with heat and mass transfer in the context of modeling with the fractional operators. The numerical scheme presented in this paper is called the fractional version of the Adams Basford numerical procedure. The advantage of this numerical technique is that it combines the Laplace transforms and the classical Adams Basford numerical procedure. Note that the usage of the Laplace transforms makes possible the applicability of the numerical approach to diffusion equations in general. The Caputo derivative will be used in the investigations. The influence of the considered Casson fluid model parameters as the Prandtl number

Pr

, the Schmidt number

Sc

, the material parameter of the Casson fluid

β

, and the order of the Caputo fractional derivative on the dynamics of the temperature, concentration, and velocity profiles has been presented analyzed. Graphical representations have supported the results of the paper.
Blind Travel Prediction Based on Obstacle Avoidance in Indoor Scene
Authors: Lv Zhiqiang , Li Jianbo , Li Haoran , Xu Zhihao , Wang Yue
Published: June 2021

Blind people have intelligent tools to rely on for travel with the development of navigation technology. The GPS navigation, blind track, etc., are tools that blind people often use when traveling outdoors. However, indoor navigation tools and technology for blind people are lacking. We propose an obstacle avoidance algorithm and a spatial‐temporal model of trajectory prediction for the indoor travel task of the blind. The focus of this work is that it enables the blind to accurately avoid obstacles and achieve high accuracy trajectory prediction aiming at the unique movement characteristics of the blind. We set up a variety of baselines to conduct an experimental evaluation on a dataset of blind trajectories in a multistorey shopping mall. The experimental results show the advantages of the data model and predictive model of this work.
Coexpression of Helios in Foxp3+ Regulatory T Cells and Its Role in Human Disease
Authors: Yu Wen-qing , Ji Ning-fei , Gu Cheng-jing , Wang Yan-li , Huang Mao , Zhang Ming-shun
Published: June 2021

Regulatory T cells (Tregs) expressing the Foxp3 transcription factor are indispensable for the maintenance of immune system homeostasis. Tregs may lose Foxp3 expression or be reprogrammed into cells that produce proinflammatory cytokines, for example, Th1-like Tregs, Th2-like Tregs, Th17-like Tregs, and Tfh-like Tregs. Accordingly, selective therapeutic molecules that manipulate Treg lineage stability and/or functional activity might have the potential to improve aberrant immune responses in human disorders. In particular, the transcription factor Helios has emerged as an important marker and modulator of Tregs. Therefore, the current review focuses on recent findings on the expression, function, and mechanisms of Helios, as well as the patterns of Foxp3+ Tregs coexpressing Helios in various human disorders, in order to explore the potential of Helios for the improvement of many immune-related diseases. The studies were selected from PubMed using the library of the Nanjing Medical University in this review. The findings of the included studies indicate that Helios expression stabilizes the phenotype and function of Foxp3+ Tregs in certain inflammatory environments. Further, Tregs coexpressing Helios and Foxp3 were identified as a specific phenotype of stronger suppressor immune cells in both humans and animal models. Importantly, there is ample evidence that Helios-expressing Foxp3+ Tregs are relevant to various human disorders, including connective tissue diseases, infectious diseases, solid organ transplantation-related immunity, and cancer. Thus, Helios+Foxp3+CD4+ Tregs could be a valuable target in human diseases, and their potential should be explored further in the clinical setting.
Study on the Proportion of Conglomerate Similar Materials Based on the Orthogonal Test
Authors: Yang Mengze , Yang Yu , Zhao Bo
Published: June 2021

Similarity model test is one of the important methods to study the properties of rock engineering. In this paper, quartz sand, 42.5 ordinary Portland cement, and tap water are used as the similar test materials to simulate the properties of conglomerate. The three control factors are cement‐to‐water ratio, cement‐to‐sand ratio, and quartz sand particle size, and orthogonal tests are set at four levels. The permeability coefficient, compressive strength, elastic modulus, density, and Poisson’s ratio are tested on specimens of similar materials of conglomerate, and the corresponding physical and mechanical indexes are obtained. The range analysis method is used to analyse the influence of various factors on the mechanical properties. The results show that (1) the physical and mechanical parameters of similar materials have a certain degree of dispersion under different proportions; (2) the proportion of similar conglomerate materials is cement : sand : water : water reducer = 1 : 2 : 0.4 : 0.6%; and (3) multiple linear regression analysis is carried out on the control factors and mechanical parameters to obtain the regression equation of the proportion of similar materials, which proves that the equation could be used to make the study of conglomerate similar materials under the stress coupling of seepage.
Silane Heat Treatment Could Eliminate the Hydrofluoric Acid Etching of Lithium Disilicate Overlays: A Four-Year Follow-Up
Authors: Yanakiev Spartak Spasov , Marinova-Takorova Mirela Borislavova
Published: June 2021

A four-year follow-up of a novel silane heat treatment method for bonding lithium disilicate overlays to tooth structures without hydrofluoric acid etching of the ceramic surface is presented in this case report. Silane heat treatment modifies the silane layer and thus enhances resin ceramic bond strength without hydrofluoric acid etching. The standard ceramic preparation technique prior to bonding silicate ceramics to tooth structure is hydrofluoric acid etching and applying a silane coupling agent, followed by dental adhesive. In this case, the micromechanical roughening of the ceramic surface was performed by air abrasion with Al2O3. Silane heat treatment with constant 120°C airflow, applied for 60 sec, followed by dental adhesive application enhanced the resin-ceramic bond strength. After a four-year follow-up, the restorations’ clinical appearance could be defined as excellent/very good according to the FDI clinical criteria for the evaluation of direct and indirect restorations. This clinical result supports many in vitro studies regarding the resin-ceramic bond strength and durability obtained through postsilanization heat treatment.
Adipose-Derived Stem Cell-Derived Extracellular Vesicles Inhibit the Fibrosis of Fibrotic Buccal Mucosal Fibroblasts via the MicroRNA-375/FOXF1 Axis
Authors: Han Bin , Zhang Yanhui , Xiao Yuxia , Shi Bohong , Wu Hong , Liu Desheng
Published: June 2021

Oral submucous fibrosis (OSF) is a precancerous lesion. Adipose-derived stem cell- (ADSC-) derived extracellular vesicles (EVs) (ADSC-EVs) regulate multiple oral diseases. Hence, this study explored the mechanism of ADSC-EVs in OSF. ADSCs were transduced with microRNA- (miR-) 375 mimic. ADSC-EVs and miR-375-overexpressed ADSC-EVs (EVs-miR-375) were extracted and identified. miR-375 expression in EVs and fibrotic buccal mucosal fibroblasts (fBMFs) was detected. EV uptake by fBMFs was observed. The targeted relationship between miR-375 and forkhead box protein F1 (FOXF1) was predicted and verified. After EVs-miR-375 treatment or FOXF1 overexpression, fBMF cell proliferation, migration, invasion, and apoptosis were evaluated, and levels of apoptosis-related proteins (cleaved-caspase-3, Bax, and Bcl-2) and fibrosis markers (α-SMA, collagen I, and collagen III) were detected. Functional rescue experiments were further performed to verify the role of the miR-375/FOXF1 axis in OSF. miR-375 was notably upregulated in EVs-miR-375 and EVs-miR-375-treated fBMFs (all

P
<
0.001

). ADSC-EVs carried miR-375 into fBMFs. fBMFs can internalize ADSC-EVs. EVs-miR-375 treatment markedly inhibited fBMF cell proliferation, migration, invasion, and fibrosis and promoted apoptosis (all

P
<
0.01

). Moreover, miR-375 targeted FOXF1 in fBMFs. FOXF1 overexpression promoted fBMF cell biological behaviors and fibrosis, which were reversed after EVs-miR-375 treatment (

P
<
0.01

or

P
<
0.001

). We highlighted that ADSC-EVs inhibited fBMF fibrosis and then suppressed OSF progression via the miR-375/FOXF1 axis.
Unfractionated Heparin Improves the Intestinal Microcirculation in a Canine Septic Shock Model
Authors: Zhang Heng , Sun Yini , An Xin , Ma Xiaochun
Published: June 2021

Background. Alterations of microcirculation are associated with organ hypoperfusion and high mortality in septic shock. This study is aimed at investigating the effects of unfractionated heparin (UFH) on intestinal microcirculatory perfusion and systemic circulation in a septic shock model. Methods. Twenty-four beagle dogs were randomly allocated into four groups: (a) sham group: healthy controls, (b) shock group: septic shock induced by Escherichia coli, (c) basic therapy group: septic shock animals treated with antibiotics and 10 ml/kg/h saline, and (d) heparin group: septic shock animals treated with basic therapy plus UFH. Hemodynamic variables were measured within 24 h after E. coli administration. The intestinal microcirculation was simultaneously investigated with a sidestream dark-field imaging technique. Additionally, the function of vital organs was evaluated at 12 h postadministration (T12). Results. E. coli induced a progressive septic shock in which the mean arterial pressure (MAP) decreased and lactate levels sharply increased, accompanied by deteriorated microvessel perfusion. While basic therapy partially improved the microvascular flow index and the perfused microvessel density in the jejunal villi, UFH significantly restored major microcirculation variables at T12. Physiological variables, including MAP, urine output, and lactate levels, were improved by UFH, whereas some hemodynamic indices were not affected by UFH. With respect to organ function, UFH increased the platelet count and decreased the creatinine level. Conclusions. UFH improves microcirculatory perfusion of the small intestine independently of the changes in systemic hemodynamic variables in a canine model of septic shock, thereby improving coagulation and renal function.
Comparison of Survival among Colon Cancer Patients in the U.S. Military Health System and Patients in the Surveillance, Epidemiology, and End Results (SEER) Program
Authors: Lin Jie , McGlynn Katherine A. , Shriver Craig D. , Zhu Kangmin
Published: June 2021

Background:

Access to health care is associated with cancer survival. The U.S. military health system (MHS) provides universal health care to beneficiaries, reducing barriers to medical care access. However, it is unknown whether the universal care has translated into improved survival among patients with colon cancer. We compared survival of patients with colon cancer in the MHS to that in the U.S. general population and assessed whether stage at diagnosis differed between the two populations and thus could contribute to survival difference.

Methods:

The data were from Department of Defense's (DoD) Automated Central Tumor Registry (ACTUR) and the NCI's Surveillance, Epidemiology, and End Results (SEER) program, respectively. The ACTUR (N = 11,907) and SEER patients (N = 23,814) were matched to demographics and diagnosis year with a matching ratio of 1:2. Multivariable Cox regression model was used to estimate all-cause mortality for ACTUR compared with SEER.

Results:

ACTUR patients exhibited better survival than their SEER counterparts (HR, 0.82; 95% confidence interval, 0.79–0.87) overall and in most subgroups by age, in both men and women, and in whites and blacks. The better survival remained when the comparison was stratified by tumor stage.

Conclusions:

Patients with colon cancer in a universal health care system had better survival than patients in the general population.

Impact:

Universal care access is important to improve survival of patients with colon cancer.
The Inverse Association of Body Mass Index with Lung Cancer: Exploring Residual Confounding, Metabolic Aberrations and Within-Person Variability in Smoking
Authors: Wood Angela M. , Jonsson Håkan , Nagel Gabriele , Häggström Christel , Manjer Jonas , Ulmer Hanno , Engeland Anders , Zitt Emanuel , Jochems Sylvia H.J. , Ghaderi Sara , Stattin Pär , Bjørge Tone , Stocks Tanja
Published: June 2021

Background:

The inverse observational association between body mass index (BMI) and lung cancer risk remains unclear. We assessed whether the association is explained by metabolic aberrations, residual confounding, and within-person variability in smoking, and compared against other smoking-related cancers.

Methods:

We investigated the association between BMI, and its combination with a metabolic score (MS) of mid-blood pressure, glucose, and triglycerides, with lung cancer and other smoking-related cancers in 778,828 individuals. We used Cox regression, adjusted and corrected for within-person variability in smoking (status/pack-years), calculated from 600,201 measurements in 221,958 participants.

Results:

Over a median follow-up of 20 years, 20,242 smoking-related cancers (6,735 lung cancers) were recorded. Despite adjustment and correction for substantial within-person variability in smoking, BMI remained inversely associated with lung cancer [HR per standard deviation increase, 0.87 (95% confidence interval 0.85–0.89)]. Individuals with BMI less than 25 kg/m2 and high MS had the highest risk [HR 1.52 (1.44–1.60) vs. BMI ≥25 with low MS]. These associations were weaker and nonsignificant among nonsmokers. Similar associations were observed for head and neck cancers and esophageal squamous cell carcinoma, whereas for other smoking-related cancers, we generally observed positive associations with BMI.

Conclusions:

The increased lung cancer risk with low BMI and high MS is unlikely due to residual confounding and within-person variability in smoking. However, similar results for other cancers strongly related to smoking suggest a remaining, unknown, effect of smoking.

Impact:

Extensive smoking-adjustments may not capture all the effects of smoking on the relationship between obesity-related factors and risk of smoking-related cancers.