bluuebunny/crossref_metadata_2025 huggingface dataset:
Histone deacetylase HDA19 interacts with histone methyltransferase SUVH5 to regulate seed dormancy in Arabidopsis
Authors: Zhou Y. , Yang P. , Zhang F. , Luo X. , Xie J.
Published: July 2020

Seed dormancy controls the timing of germination and plays a significant role in adaptation and evolution of seed plants.

In this study, a yeast two‐hybrid, pull‐down assay and co‐immunoprecipitation assay were used to ascertain the protein relationship of SUVH5 and HDA19. Both qRT‐PCR and ChIP‐qPCR were used to examine the molecular mechanism of how HDA19 and SUVH5 regulate seed dormancy.

The results demonstrated that histone methyltransferase SUVH5 interacted with histone deacetylase HDA19 in vivo and in vitro. In addition, they showed that mutants of HDA19 could deepen seed dormancy, and that SUVH5 had the same effect. The hda19 suvh5 double mutant displayed a higher level of seed dormancy than the single mutants hda19 or suvh5. Moreover, the expression of seed dormancy‐related genes increased in hda19, suvh5 and in hda19 suvh5 double mutant plants, which was associated with increased histone H3 acetylation (H3ac), but decreased histone H3 Lys 9 dimethylation (H3K9me2). ChIP assays proved that HDA19 could directly integrate into the chromatin of genes regulating seed dormancy.

Taken together, our results show that HDA19 and SUVH5 work together and have a negative role in seed dormancy.
The evaluation of lycopene and cysteamine supplementation effects on sperm and oxidative stress parameters during chilled storage of canine semen
Authors: Sheikholeslami Seyyed Aliakbar , Soleimanzadeh Ali , Rakhshanpour Alaleh , Shirani Dariush
Published: July 2020

The aim of this study was to evaluate the effects of different concentrations of lycopene and cysteamine on characteristics of sperm, liquid peroxidation and enzymatic activities in seminal plasma of canine semen preserved at 5°C for 72 hr. The semen samples were divided into eight aliquots: control, control sham (dimethyl sulfoxide 5%), lycopene groups (250, 500 and 750 µg/ml) and cysteamine groups (2.5, 5 and 10 mM). Motility, viability, membrane integrity, DNA integrity, total antioxidant capacity (TAC) and malondialdehyde (MDA) levels were evaluated. Progressive motility and total motility were higher with the 500 and 750 µg/ml lycopene concentrations, respectively, compared to the control group and the cysteamine groups following 72 hr of storage in the liquid storage. Motility characteristics, viability and hypo‐osmotic swelling test (HOST) percentages were significantly improved in 500 µg/ml lycopene compared to other groups. The 500 and 750 µg/ml lycopene concentrations, respectively, showed significantly reduced percentages of spermatozoa with DNA integrity compared to the control group. The 500 and 750 µg/ml lycopene concentrations, respectively, led to the significant decrease of MDA levels. The 500 µg/ml lycopene enhanced TAC levels after 48 and 72 hr that was not observed in other groups. In conclusion, the findings of this study showed that lycopene supplementation in canine semen extenders improved canine semen parameters and TAC levels and decreased MDA levels in the chilling process.
Sedentary behavior, physical activity, and mental health in older adults: An isotemporal substitution model
Authors: Tully Mark A. , McMullan Ilona , Blackburn Nicole E. , Wilson Jason J. , Bunting Brendan , Smith Lee , Kee Frank , Deidda Manuela , Giné‐Garriga Maria , Coll‐Planas Laura , Dallmeier Dhayana , Denkinger Michael , Rothenbacher Dietrich , Caserotti Paolo
Published: July 2020

Introduction

Regular moderate‐to‐vigorous physical activity (MVPA) is associated with improved mental health, but the evidence for the effect of reducing sedentary behavior (SB) or increasing light PA (LPA) in older adults is lacking. Using isotemporal substitution (IS) models, the aim of this paper was to investigate the effect of substituting SB with LPA or MVPA on associations with mental health in older adults.

Methods

Data from 1360 older adults (mean age 75.18 years) in four countries were utilized. PA and SB was measured using ActiGraph wGT3X‐BT + accelerometers worn for 7 days. Self‐rated mental health was measured using the Hospital and Anxiety Depression Scale (HADS). IS models estimated cross‐sectional associations when 30 minutes of one behavior was substituted with another. Models were adjusted for age, sex, marital status, and educational attainment.

Results

Substituting 30 minutes of SB with LPA (β −.37; 95% CI −0.42, −0.32) or MVPA (β −.14; 95% CI −0.21, −0.07) and substituting LPA with MVPA (β −.11; 95% CI −0.18, −0.04) were associated with improvements in anxiety. However, substituting 30 minutes of SB with LPA (β .55; 95% CI 0.49, 0.62) was associated with increased depression.

Conclusion

Replacing 30 minutes of SB with LPA or MVPA was associated with improved anxiety symptoms in older adults. Greater benefits were observed when shifting SB and LPA to MVPA.
Satisfaction of basic psychological needs in an interdependence model of fathers’ own aspirations and those of their adolescent children
Authors: Nishimura Takuma , Bradshaw Emma L. , Deci Edward L. , Ryan Richard M.
Published: July 2020

Anchored in self‐determination theory (SDT), we used a sample of 310 Japanese father‐child dyads (fathers Mage = 47.95; children Mage = 14.98, 50% female), to investigate: (a) the structure of aspirations in a Japanese sample, (b) the association between fathers’ own intrinsic and extrinsic aspirations and the aspirations reported by their adolescent children, (c) the links between child‐reported father autonomy support and children’s self‐ reported aspirations, and (d) the associations between fathers’ own and children’s own aspirations and the basic psychological needs satisfaction of both fathers and children. Confirmatory factor analysis demonstrated acceptable fit for the theorized model of intrinsic and extrinsic aspirations specified by SDT. Correlation analysis revealed positive associations between the aspirations of fathers’ and those endorsed by their children, which were not moderated by father’s autonomy support. Actor‐partner interdependence modeling indicated that when fathers were relatively intrinsic in their orientations, basic psychological need satisfaction was higher for both themselves and their children. These findings highlight the relevance of intrinsic and extrinsic aspirations to the well‐being of youth and the interplay between fathers’ and children’s aspirations, suggesting that both fathers’ intrinsic aspirations and parenting styles are associated with children’s basic psychological needs satisfaction.
t‐SNAREs bind the Rhg1 α‐SNAP and mediate soybean cyst nematode resistance
Authors: Dong Jia , Zielinski Raymond E. , Hudson Matthew E.
Published: July 2020

Soybean cyst nematode (SCN; Heterodera glycines) is the largest pathogenic cause of soybean yield loss. The Rhg1 locus is the most used and best characterized SCN resistance locus, and contains three genes including one encoding an α‐SNAP protein. Although the Rhg1 α‐SNAP is known to play an important role in vesicle trafficking and SCN resistance, the protein’s binding partners and the molecular mechanisms underpinning SCN resistance remain unclear. In this report, we show that the Rhg1 α‐SNAP strongly interacts with two syntaxins of the t‐SNARE family (Glyma.12G194800 and Glyma.16G154200) in yeast and plants; importantly, the genes encoding these syntaxins co‐localize with SCN resistance quantitative trait loci. Fluorescent visualization revealed that the α‐SNAP and the two interacting syntaxins localize to the plasma membrane and perinuclear space in both tobacco epidermal and soybean root cells. The two syntaxins and their two homeologs were mutated, individually and in combination, using the CRISPR‐Cas9 system in the SCN‐resistant Peking and SCN‐susceptible Essex soybean lines. Peking roots with deletions introduced into syntaxin genes exhibited significantly reduced resistance to SCN, confirming that t‐SNAREs are critical to resisting SCN infection. The results presented here uncover a key step in the molecular mechanism of SCN resistance, and will be invaluable to soybean breeders aiming to develop highly SCN‐resistant soybean varieties.
Factors that influence flow through intravascular catheters: the clinical relevance of Poiseuille's law
Authors: Berman David J. , Schiavi Adam , Frank Steven M. , Duarte Shirley , Schwengel Deborah A. , Miller Christina R.
Published: July 2020

BACKGROUND

The physics of ideal fluid flow is well characterized. However, the effect of catheter size, tubing types, injection port adjuncts, and viscosity on flow is not well described. We used a simulated environment to determine how various permutations of common elements affect fluid flow.

STUDY DESIGN AND METHODS

We tested 16 peripheral and central venous catheters to assess flow through several standard infusion sets and a rapid infuser set; tested flow through standard and blood infusion sets with the addition of intravenous extension tubing, stopcocks, and a needleless connector; and compared the relative viscosity of commonly used blood products and colloids to that of normal saline.

RESULTS

The maximal flow rate was 200 mL/min for the standard infusion set but 800 mL/min for the rapid infusion set. Choice of infusion tubing was the rate‐limiting component for many larger catheters. A 14‐gauge, single‐lumen central venous catheter (CVC) and 18‐gauge peripheral intravenous catheter (PIV) had equivalent flow rates with all infusion sets. A 16‐gauge single‐lumen CVC allowed a flow rate that was slower than that of a 20‐gauge PIV, and faster than that of a 22‐gauge PIV. The addition of adjuncts slowed flow rate. Needleless connectors had the greatest impact, reducing flow by 75% for the blood infusion set. Packed red blood cells had a viscosity 4.5 times that of normal saline and thereby reduced flow.

CONCLUSION

Catheter and tubing choice, adjuncts, and fluid viscosity influence flow rates. Our results will help inform adequate vascular access planning in the perioperative environment.
Prognostic value of pretreatment plasma D‐dimer level in dogs with intermediate to high‐gradenon‐Hodgkinlymphoma
Authors: Boyé Pierre , Serres François , Floch Franck , Fournel‐Fleury Corinne , Tierny Dominique
Published: July 2020

Pretreatment D‐dimer levels have been reported to predict survival in several types of malignancies in human patients. The objective of this study was to evaluate the prognostic value of pretreatment D‐dimer level in dogs with intermediate to high‐grade non‐Hodgkin lymphoma (NHL). In a prospective, randomized, double‐blind study of F14512 vs etoposide phosphate, we assessed the prognostic value of pretreatment plasma D‐dimer level in 48 client‐owned dogs diagnosed with intermediate to high‐grade NHL. The correlation between pretreatment plasma D‐dimer level and various clinical features, progression‐free survival (PFS) and overall survival (OS) was analysed. The median value of pretreatment plasma D‐dimer level was 0.4 μg/mL (range: 0.1‐14.3 μg/mL). High pretreatment plasma D‐dimer level (>0.5 μg/mL) was detected in 44% (21/48) of dogs. High D‐dimer levels were not correlated with naive vs relapsed lymphoma, clinical stage, substage, immunophenotype or treatment group. D‐dimer levels >0.5 μg/mL were significantly associated with inferior median PFS (54 vs 104 days,P= .011) and OS (93 vs 169 days,P= .003). In the multivariate analysis, high D‐dimer levels remained an independent predictor for worse PFS (HR: 3.21, 95% CI: 1.57‐6.56,P= .001) and OS (HR: 3.87, 95% CI: 1.88‐7.98;P < .001). This study suggests that pretreatment plasma D‐dimer level can serve as a predictor of prognosis in dogs with intermediate to high‐grade NHL. Further studies are warranted to confirm these findings.
Homeostatic versus hedonic control of carbohydrate selection
Authors: Minokoshi Yasuhiko , Nakajima Ken‐ichiro , Okamoto Shiki
Published: July 2020

Macronutrient intake is associated with cardiometabolic health, ageing and longevity, but the mechanisms underlying its regulation have remained unclear. Most rodents increase carbohydrate selection under certain physiological and pathological conditions such as fasting. When presented with a choice between a basally preferable high‐fat diet (HFD) and a high‐carbohydrate diet (HCD) such as a high‐sucrose diet, fasted mice first eat the HFD and then switch to the HCD during the first few hours of refeeding and continue to eat the HCD up to 24 h in the two‐diet choice approach. Such consumption of an HCD after fasting reverses the fasting‐induced increase in the plasma concentration of ketone bodies more rapidly than does refeeding with an HFD alone. 5′‐AMP‐activated protein kinase (AMPK)‐regulated neurons in the paraventricular nucleus of the hypothalamus (PVH) that express corticotropin‐releasing hormone (CRH) are necessary and sufficient for the fasting‐induced selection of carbohydrate over an HFD in mice. These neurons appear to contribute to a fasting‐induced increase in the positive valence of carbohydrate without affecting the preference for more palatable and energy‐dense diets such as an HFD. Identification of the neural circuits in which AMPK‐regulated CRH neurons in the PVH of mice are embedded should shed new light on the physiological and molecular mechanisms responsible for macronutrient selection.

image
Biological functions of lymphatic vessels
Authors: Petrova Tatiana V. , Koh Gou Young
Published: July 2020

Roles of organ-specific lymphatic vessels

Lymphatic vessels are spread throughout the human body and have critical functions in mammalian physiology. Petrova
et al.
review emerging roles of the lymphatic vasculature in organ function and pathology and provide perspectives beyond the traditional view of lymphatic vessels in the maintenance of fluid homeostasis. The authors highlight new insights into lymphatic vessel function and lymphatic endothelial cell biology as it relates to intestinal lacteals, lymph nodes, central nervous system meninges, and cancer. Recent steps toward therapeutic opportunities that could alter lymphatic function or growth are also discussed.

Science
, this issue p.
eaax4063
Microbial management
Authors: Byndloss Mariana X.
Published: July 2020

Colonocyte metabolism plays an essential role in balancing the gut microbiota
Fuel cells that operate at 300° to 500°C
Authors: Ni Meng , Shao Zongping
Published: July 2020

High-conductivity electrolytes are needed for electrochemical systems
Targeting the Respiratory Syncytial Virus N
0
-P Complex with Constrained α-Helical Peptides in Cells and Mice
Authors: Galloux Marie , Gsponer Nadège , Gaillard Vanessa , Fenner Brice , Larcher Thibaut , Vilotte Marthe , Rivière Julie , Richard Charles-Adrien , Eléouët Jean-François , Le Goffic Ronan , Mettier Joelle , Nyanguile Origène
Published: July 2020

Respiratory syncytial virus (RSV) is the main cause of severe respiratory infection in young children worldwide, and no therapies have been approved for the treatment of RSV infection. Data from recent clinical trials of fusion or L polymerase inhibitors for the treatment of RSV-infected patients revealed the emergence of escape mutants, highlighting the need for the discovery of inhibitors with novel mechanisms of action. Here we describe stapled peptides derived from the N terminus of the phosphoprotein (P) that act as replication inhibitors.
Inhibition of Human Adenovirus Replication by the Importin α/β1 Nuclear Import Inhibitor Ivermectin
Authors: King Cason R. , Tessier Tanner M. , Dodge Mackenzie J. , Weinberg Jason B. , Mymryk Joe S.
Published: July 2020

Human adenoviruses (HAdVs) represent a ubiquitous and clinically important pathogen without an effective antiviral treatment. HAdV infections typically cause mild symptoms; however, individuals such as children, those with underlying conditions, and those with compromised immune systems can develop severe disseminated disease. Our results demonstrate that ivermectin, an FDA-approved antiparasitic agent, is effective at inhibiting replication of several HAdV types
in vitro
. This is in agreement with the growing body of literature suggesting ivermectin has broad antiviral activity. This study expands our mechanistic knowledge of ivermectin by showing that ivermectin targets the ability of importin-α (Imp-α) to recognize nuclear localization sequences, without effecting the Imp-α/β1 interaction. These data also exemplify the applicability of targeting host factors upon which viruses rely as a viable antiviral strategy.
Cystic lymphangioma of the stomach with marked reactive changes: a rare cause of gastric outlet obstruction in adult
Authors: Nayak Mamita , Purkait Suvendu , Sasmal Prakash Kumar , Singh Pradip Kumar
Published: July 2020

Cystic lymphangiomas are benign lymphatic tumours which usually affect the paediatric population and are predominantly located in the head and neck region. Its occurrence during adulthood and an intra-abdominal location are both extremely uncommon. Clinically and radiologically, these lesions often mimic malignancy. Infrequently, these tumours can undergo degenerative and reactive changes obscuring the diagnostic features. We describe hereby an anecdote of cystic lymphangioma with marked reactive changes presenting with the features of gastric outlet obstruction in an adult patient.
Effect of autologous adipose-derived mesenchymal stem cell therapy in the treatment of an osteochondral lesion of the ankle
Authors: Freitag Julien , Wickham James , Shah Kiran , Tenen Abi
Published: July 2020

Osteochondral lesions (OCLs) of the talus are rare but can be associated with significant morbidity and may lead to the development of osteoarthritis. An improved understanding of the action of mesenchymal stem cells (MSCs) has seen renewed interest in their role in cartilage repair, with early preclinical and clinical research showing benefits in symptomatic and structural improvement. A 42-year-old man presented with an unstable OCL of the talus and onset of early osteoarthritis with a history of multiple previous ankle arthroscopies for ankle impingement. The patient underwent arthroscopic removal of the OCL in combination with adipose-derived MSC therapy. The patient reported progressive improvement as measured by the validated Foot and Ankle Disability Index. Repeat MRI with additional T2 mapping techniques showed successful regeneration of hyaline-like cartilage. This case is the first to show the successful use of MSC therapy in the management of an ankle OCL. Trial registration: Australian New Zealand Clinical Trials Registry - ACTRN12617000638336.
Case of anisakiasis presenting as an Amyand hernia
Authors: Hope William , Smith-Chakmakova Faye , Snyder Justin
Published: July 2020

This is a case of a 31-year-old male patient who presented with signs and symptoms of an incarcerated inguinal hernia. The patient’s preoperative imaging showed a tubular structure in the inguinal canal and given the patient’s history at presentation, there was a concern for herniation of the appendix, known as an Amyand hernia. On laparoscopy, there was no evidence of appendiceal involvement and a standard open inguinal hernia was completed. On the final pathology of the hernia sac, roundworms were identified with Y-shaped lateral cords suggesting infection byAnisakisspp. On a further interview with the patient, he revealed that he had recently travelled to Alaska and had consumed raw salmon on a fishing trip. This case demonstrates the importance of a thorough social and travel history. One should also have a low threshold to broaden the differential diagnosis when medical work-up deviates from the standard course.
Strictures, stones and cysts: an unusual cause of pancreatitis in a 20-month-old female child
Authors: Zufall Alina , Middleton Jeremy P , Rasmussen Sara , Daugherty Reza J
Published: July 2020

Choledochal cysts are dilations of the biliary tree that cause a variety of clinical symptoms and can lead to several types of complications. Choledochal cysts are most commonly diagnosed in childhood and frequently present with abdominal pain, jaundice and, in infants, an abdominal mass. Although the most concerning complication is malignant transformation of the cyst epithelium, other complications such as stone formation, acute pancreatitis and stricture can also occur and lead to patient morbidity. Treatment is aimed at not only relieving patient symptoms, but also decreasing a long-term cancer risk. We present a case of a child presenting with abdominal pain and vomiting secondary to a type IVa choledochal cyst complicated by acute pancreatitis, a common bile duct stricture and cystolithiasis.
Oral manifestations of lamellar ichthyosis in association with rickets
Authors: Tewari Nitesh , Mathur Vijay Prakash , Tamchos Rigzin , Rahul Morankar
Published: July 2020

Lamellar ichthyosis (LI) is a rare genetic condition that affects the skin, with an incidence of less than 1:300 000 in different parts of the world. This report describes a case of a 5-year-old girl with LI and rickets presenting with premature loss of 51, 52, 61, 62 and 71, grade II mobility in 72, 73, 81, 82 and 83 along with loss of supporting bone with 53, 63, 72, 73, 82 and 83. This is the first report describing oral manifestations of this combination of LI and rickets.
Pazopanib-associated interstitial lung disease in a patient with renal cell carcinoma
Authors: Harada Yukinori , Kakimoto Shintaro , Shimizu Taro
Published: July 2020

Pazopanib is a multi-targeted tyrosine kinase inhibitor, which is indicated for use in patients with advanced renal cell carcinoma or advanced soft-tissue sarcomas. Although rare, interstitial lung disease has been reported as among the adverse sequelae of pazopanib therapy. We report the case of a 75-year-old man who developed interstitial lung disease during treatment with pazopanib for renal cell carcinoma with multiple lung metastases. The patient presented with dry cough and new-onset fatigue 3 months after initiation of pazopanib. He had mild hypoxia with bilateral ground-glass opacities on chest CT. He was treated with antibiotics for presumptive pneumonia, but his respiratory status rapidly deteriorated, and he required non-invasive positive pressure ventilation. He recovered on discontinuation of pazopanib and systemic steroids. Clinicians should recognise that interstitial lung disease can occur in patients who are undergoing treatment with pazopanib.
Omeprazole-induced hypomagnesaemia, causing renal tubular acidosis with hypokalaemia, hypocalcaemia, hyperlactacidaemia and hyperammonaemia
Authors: Isse Naohi , Hashimoto Masashi
Published: July 2020

A 72-year-old Japanese man treated with omeprazole for 11 years was admitted due to loss of consciousness and muscle weakness. Wolff-Parkinson-White syndrome-induced tachycardia was considered as the cause of syncope. His blood examination revealed rhabdomyolysis, hypokalaemia, hypomagnesaemia, hypocalcaemia, hyperlactacidaemia, hyperammonaemia and high-anion-gap metabolic acidosis. Hypomagnesaemia could be caused by magnesium malabsorption due to omeprazole use. Hypocalcaemia might be caused by the inhibitory effect of hypomagnesemia on the parathyroid gland hormone secretion. Hyperammonaemia might be caused by two reasons: (1) renal ammonium production induced by hypokalaemia; (2) inhibition of ammonium secretion by omeprazole. Both hypocalcaemia and hypokalaemia might cause chronic elevation of serum creatinine phosphokinase which ended up with rhabdomyolysis. Correction of serum electrolytes rapidly improved his muscle weakness. Discontinuation of omeprazole no longer caused these abnormalities. A physician should be aware of unexplained signs and symptoms of patients using proton-pump inhibitors to avoid life-threatening electrolyte and physiologic disturbances.
Interventions with Music in PECTus excavatum treatment (IMPECT trial): a study protocol for a randomised controlled trial investigating the clinical effects of perioperative music interventions
Authors: Billar Ryan J , Kühlmann A Y Rosalie , Schnater J Marco , Vlot John , Tomas Jeremy J P , Zijp Gerda W , Rad Mandana , de Beer Sjoerd A , Stevens Markus F , Poley Marten J , van Rosmalen Joost , Jeekel Johannes F , Wijnen Rene M H
Published: July 2020

Introduction

Pectus excavatum repair is associated with substantial postoperative pain, despite the use of epidural analgesia and other analgesic regimens. Perioperative recorded music interventions have been shown to alleviate pain and anxiety in adults, but evidence for children and adolescents is still lacking. This study protocol describes a randomised controlled trial that evaluates the effects of recorded music interventions on postoperative pain relief in children and adolescents after pectus excavatum repair.

Methods

A multicentre randomised controlled trial was set up comparing the effects of perioperative recorded music interventions in addition to standard care with those of standard care only in patients undergoing a Nuss procedure for pectus excavatum repair. One hundred and seventy subjects (12–18 years of age) will be included in three centres in the Netherlands. Patient inclusion has started in November 2018, and is ongoing. The primary outcome is self-reported perceived pain measured on the visual analogue scale. Secondary outcomes are anxiety level, analgesics consumption, vital parameters such as heart rate, blood pressure and respiratory rate, length of hospital stay, postoperative complications, quality of life and cost-effectiveness.

Ethics and dissemination

This study is being conducted in accordance with the Declaration of Helsinki. The Medical Ethics Review Board of Erasmus University Medical Centre Rotterdam, The Netherlands, has approved this protocol. Results will be disseminated via peer-reviewed scientific journals and conference presentations.

Trial registration number

NL6863
Exercise versus fixed-dose combination therapy for cardiovascular risk factors control and atherosclerotic disease prevention: a network meta-analysis protocol
Authors: Pozuelo-Carrascosa Diana P , Cavero-Redondo Iván , Fernández Rodríguez Ruben , Pascual Morena Carlos , Sequí-Domínguez Irene , Martinez-Vizcaino Vicente
Published: July 2020

Introduction

Despite the consistent evidence of the benefits of physical activity on preventing atherosclerotic cardiovascular diseases (ASCVD) and some cardiovascular risk factors, such as hypertension and dyslipidaemia, the prescription of drugs remains the most widely used approach to prevent ASCVD in clinical settings. The purpose of this study protocol is to provide a meta-synthesis methodology for comparing the effect of fixed-dose combination therapy and physical exercise on controlling cardiovascular risk factors and preventing ASCVD.

Methods and analysis

This protocol follows the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols and the recommendations of the Cochrane Collaboration Handbook. We plan to conduct a computerised search in Medline, Web of Science, Embase, Cochrane Database of Systematic Reviews and SPORTDiscus from inception to May 2020 for studies testing the effectiveness of physical exercise or fixed-dose combination drug therapy in preventing ASCVD, all-cause and cardiovascular mortality and controlling some cardiovascular risk factors (hypertension and dyslipidaemia). Since performing network meta-analyses (NMA) is a statistical approach that allows direct and indirect comparisons of interventions, where sufficient studies are included, we plan to perform the following NMA comparing the effect of fixed-dose combination therapy and physical exercise interventions on (1) improving lipid profile, (2) reducing blood pressure, (3) preventing cardiovascular events and all-cause and cardiovascular mortality and (4) improving compliance with the therapeutic strategy and reducing adverse events.

Ethics and dissemination

Ethical approval will not be needed because data included in the NMA will be extracted from published trials that meet accepted ethical standards. The results will be published in academic peer-reviewed journals, and the evidence gathered by this project could be included in the preventive cardiovascular disease guidelines.

PROSPERO registration number

CRD42019122794.
Improving Primary Care After Stroke (IPCAS) randomised controlled trial: protocol for a multidimensional process evaluation
Authors: Aquino Maria Raisa Jessica (Ryc) , Mullis Ricky , Kreit Elizabeth , Johnson Vicki , Grant Julie , Lim Lisa , Sutton Stephen , Mant Jonathan
Published: July 2020

Introduction

Primary care interventions are often multicomponent, with several targets (eg, patients and healthcare professionals). Improving Primary Care After Stroke (IPCAS) is a novel primary care-based model of long-term stroke care involving a review of stroke-related needs, a self-management programme, a direct point of contact in general practice, enhanced communication between care services, and a directory of national and local community services, currently being evaluated in a cluster randomised controlled trial (RCT). Informed by Medical Research Council guidance for complex interventions and the Behaviour Change Consortium fidelity framework, this protocol outlines the process evaluation of IPCAS within this RCT. The process evaluation aimed to explore how the intervention was delivered in context and how participants engaged with the intervention.

Methods and analysis

Mixed methods will be used: (1) design: intervention content will be compared with ‘usual care’; (2) training: intervention training sessions will be audio/video-recorded where feasible; (3) delivery: healthcare professional self-reports, audio recordings of intervention delivery and observations of My Life After Stroke course (10% of reviews and sessions) will be coded separately; semistructured interviews will be conducted with a purposive sample of healthcare professionals; (4) receipt and (5) enactment: where available, structured stroke review records will be analysed quantitatively; semistructured interviews will be conducted with a purposive sample of study participants. Self-reports, observations and audio/video recordings will be coded and scored using specifically developed checklists. Semistructured interviews will be analysed thematically. Data will be analysed iteratively, independent of primary endpoint analysis.

Ethics and dissemination

Favourable ethical opinion was gained from Yorkshire & The Humber-Bradford Leeds NHS Research Ethics Committee (19 December 2017, 17/YH/0441). Study results will be published in a peer-reviewed journal and presented at relevant conferences.

Trial registration number

NCT03353519; Pre-results.
Modelling patient flows and resource use within a sexual health clinic through discrete event simulation to inform service redesign
Authors: Mohiuddin Syed , Gardiner Rebecca , Crofts Megan , Muir Peter , Steer Jonathan , Turner Jonathan , Wheeler Helen , Hollingworth William , Horner Paddy J
Published: July 2020

Objectives

Continuous improvement in the delivery of health services is increasingly being demanded in the UK at a time when budgets are being cut. Simulation is one approach used for understanding and assessing the likely impact of changes to the delivery of health services. However, little is known about the usefulness of simulation for analysing the delivery of sexual health services (SHSs). We propose a simulation method to model and evaluate patient flows and resource use within an SHS to inform service redesign.

Methods

We developed a discrete event simulation (DES) model to identify the bottlenecks within the Unity SHS (Bristol, UK) and find possible routes for service improvement. Using the example of the introduction of an online service for sexually transmitted infection (STI) and HIV self-sampling for asymptomatic patients, the impact on patient waiting times was examined as the main outcome measure. The model included data such as patient arrival time, staff availability and duration of consultation, examination and treatment. We performed several sensitivity analyses to assess uncertainty in the model parameters.

Results

We identified some bottlenecks under the current system, particularly in the consultation and treatment queues for male and female walk-in patients. Introducing the provision of STI and HIV self-sampling alongside existing services decreased the average waiting time (88 vs 128 min) for all patients and reduced the cost of staff time for managing each patient (£72.64 vs £88.74) compared with the current system without online-based self-sampling.

Conclusions

The provision of online-based STI and HIV self-sampling for asymptomatic patients could be beneficial in reducing patient waiting times and the model highlights the complexities of using this to cut costs. Attributing recognition for any improvement requires care, but DES modelling can provide valuable insights into the design of SHSs ensuing in quantifiable improvements. Extension of this method with the collection of additional data and the construction of more informed models seems worthwhile.
FitSkills: protocol for a stepped wedge cluster randomised trial of a community-based exercise programme to increase participation among young people with disability
Authors: Shields Nora , Willis Claire , Imms Christine , Prendergast Luke A , Watts Jennifer J , van Dorsselaer Ben , McKenzie Georgia , Bruder Andrea M , Taylor Nicholas F
Published: July 2020

Introduction

There is a need to develop relevant, acceptable initiatives that facilitate physical activity participation in young people with disability. FitSkills was developed to support young people with disability to exercise. The primary aims are to investigate if FitSkills can be scaled up from a small, university-led programme to run as a larger community-university partnership programme, and to determine its effectiveness in improving physical activity participation and health-related quality of life for young people with disability. The secondary aims are to evaluate cost-effectiveness, changes in attitudes towards disability and other health-related outcomes for young people with disability.

Methods and analysis

A stepped wedge cluster randomised trial using a cohort design and embedded health economic evaluation will compare the effect of FitSkills with a control phase. FitSkills matches a young person with disability with a student mentor and the pair exercise together at their local gymnasium for 1 hour, two times per week for 12 weeks (24 sessions in total). One hundred and sixty young people with disability aged 13 to 30 years will be recruited. Eight community gymnasia will be recruited and randomised into four cluster units to have FitSkills introduced at 3-month intervals. Primary (feasibility, participation and health-related quality of life) and secondary outcomes will be collected longitudinally every 3 months from trial commencement, with eight data collection time points in total. The Practical Robust Implementation and Sustainability Model will be used to support knowledge translation and implementation of project findings into policy and practice.

Ethics and dissemination

Ethical approval was obtained from the La Trobe University Human Ethics Committee (HEC17-012), Australian Catholic University (2017–63R), Deakin University (2017–206) and the Victorian Department of Education and Training (2018_003616). Results will be disseminated through published manuscripts, conference presentations, public seminars and practical resources for stakeholder groups.

Trial registration number

ACTRN12617000766314.

Trial sponsor

La Trobe University.
Are we advancing universal health coverage through cataract services? Protocol for a scoping review
Authors: Lee Chan Ning , Ramke Jacqueline , McCormick Ian , Zhang Justine H , Aghaji Ada , Mwangi Nyawira , Burn Helen , Gordon Iris , Yusufu Mayinuer , He Mingguang , Silva Juan Carlos , Burton Matthew J
Published: July 2020

Introduction

Universal health coverage (UHC) includes the dimensions of equity in access, quality services that improve health and protection against financial hardship. Cataract continues to be the leading cause of blindness globally, despite cataract surgery being an efficacious intervention. The aim of this scoping review is to map the nature, extent and global distribution of data on cataract services for UHC in terms of equity, access, quality and financial protection.

Methods and analysis

The search will be constructed by an Information Specialist and undertaken in MEDLINE, Embase and Global Health databases. We will include all published non-interventional primary research studies and systematic reviews that report a quantitative assessment of access, equity, quality or financial protection of cataract surgical services for adults at the subnational, national, regional or global level from population-based surveys or routinely collected health service data since 1 January 2000 and published through to February 2020.

Screening and data charting will be undertaken using Covidence systematic review software. Titles and abstracts of identified studies will be screened by two authors independently. Full-text articles of potentially relevant studies will be obtained and reviewed independently by two authors against the inclusion criteria. Any discrepancies between the authors will be resolved by discussion, and with a third author as necessary. A data charting form will be developed and piloted on three studies by three authors and amendments made as necessary. Data will be extracted by two reviewers independently and summarised narratively and using maps.

Ethics and dissemination

Ethical approval was not sought as the scoping review will only use published and publicly accessible data. The review will be published in an open access peer-reviewed journal. A summary of the results will be developed for website posting, stakeholder meetings and inclusion in the ongoing Lancet Global Health Commission on Global Eye Health.
Chinese perspective on end-of-life communication: a systematic review
Authors: Pun Jack K H , Cheung Ka Man , Chow James C H , Chan Wing Lok
Published: July 2020

Background

Palliative care providers serving Chinese patients lack a culture-specific model of communication, a strong evidence base for this and clear guidance on its application. Thus, providers find it challenging to address patients’ dignity, and determine their priorities and preferences for treatments and care, at the patients’ final stage of life.

Aim

This study explores the culture-specific influences and current understanding of end-of-life (EOL) communication in the Chinese context.

Methods

A qualitative systematic review of qualitative studies was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. PsycINFO, PubMed and ERIC databases were searched for studies between January 1994 and July 2019, using keywords ‘end of life’, ‘terminal care’, ‘communication’ and ‘Chinese’. Included studies were appraised with Critical Appraisal Skills Programme criteria.

Results

The search strategy yielded 982 entries and 13 studies were included. Six themes were identified in EOL communication in the Chinese context: (1) Chinese philosophies on the meaning of ‘good death’. (2) Negative attitudes towards communication on dying. (3) EOL communication as a taboo topic. (4) Clinician-centred approaches to treatment-decision making. (5) Family expectations being prioritised over patient self-autonomy in prognosis disclosure. (6) Care-providers expressing puzzlement over cultural preferences regarding EOL communication.

Conclusions

The review detailed the complexity of EOL communication in the Chinese context, urging for a communication model distinct from Western-based practices. Future research could explore a validated communication framework that addresses the local culture, thus enabling an understanding of patients’ priorities and interpreting EOL encounters from a cross-cultural perspective.
Hydroxychloroquine and COVID-19: critiquing the impact of disease public profile on policy and clinical decision-making
Authors: Aquino Yves S J , Cabrera Nicolo
Published: July 2020

The controversy surrounding the use of hydroxychloroquine (HCQ), an antimalarial drug, for COVID-19 has raised numerous ethical and policy problems. Since the suggestion that HCQ has potential for COVID-19, there have been varying responses from clinicians and healthcare institutions, ranging from adoption of protocols using HCQ for routine care to the conduct of randomised controlled trials to an effective system-wide prohibition on its use for COVID-19. In this article, we argue that the concept of ‘disease public profile’ has become a prominent, if not the sole, determinant in decision-making across various healthcare responses to the pandemic. In the case of COVID-19, the disease’s public profile is based on clinical and non-clinical factors that include contagiousness, clinical presentation and media coverage. In particular, we briefly examine the dangers of a heightened public profile in magnifying the inequality of diseases and undermining three key ethical concepts, namely (1) evidence-based practice, (2) sustainable allocation and (3) meaningful consent.
Solidarity is for other people: identifying derelictions of solidarity in responses to COVID-19
Authors: West-Oram Peter
Published: July 2020

The role and importance of solidarity for effective health provision is the subject of lengthy and heated debate which has been thrown into even sharper relief by the COVID-19 pandemic. In various ways, and by various authorities we have all been asked, even instructed, to engage in solidarity with one another in order to collectively respond to the current crisis. Under normal circumstances, individuals can engage in solidarity with their compatriots in the context of public health provision in a number of ways, including paying taxes which fund welfare state initiatives, and avoiding others when ill. While there has been significant engagement in solidarity worldwide, there have also been high profile examples of refusals and failures to engage in solidarity, both by individual agents, and governments. In this paper I examine the consequence of these failures with reference to the actions of the current British government, which has failed to deliver an effective response to the crisis. This failure has effectively devolved responsibility for responding to the crisis to people who are simultaneously more vulnerable to infection, and less able to do anything about it. I argue that such responses represent mismanagement of a public health crisis, and a rejection of important democratic and egalitarian norms and values.
Carbon storage recovery in surviving lodgepole pine (Pinus contorta var. latifolia) 11 years after mountain pine beetle attack in northern British Columbia, Canada
Authors: McEwen Jesse , Fredeen Arthur L. , Pypker Thomas G. , Foord Vanessa N. , Black T. Andrew , Jassal Rachhpal S. , Nesic Zoran
Published: July 2020

We studied the recovery of tree- and stand-level carbon (C) storage in a lodgepole pine (Pinus contorta Dougl. ex Loud. var. latifolia Engelm.) forest in northern British Columbia that experienced substantial (∼83%) mortality in 2006–2007 (total loss by 2013 = 86%) during a severe mountain pine beetle (MPB; Dendroctonus ponderosae Hopkins, 1902) infestation. Earlier work suggested that this forest recovered positive annual C storage 3 years after attack based on eddy covariance measurements. We sought to confirm these results by examining C storage in surviving pine trees using tree core analysis. Average growth release of surviving lodgepole pine trees was 392% (range of –53% to 2326%) compared with mean decadal growth prior to MPB attack. Nearly 97% of trees underwent a growth release, considerably higher than the 15%–75% reported for lodgepole pine in previous studies. Mean annual stem C storage of the surviving trees in this study was highly correlated (r = 0.88) with 10 years of annual net ecosystem productivity estimates made using the eddy covariance technique, indicating that surviving lodgepole pine remain an important part of C recovery after MPB attack. Mean annual stem C storage was also highly correlated (r = 0.92) with the cumulative percentage of downed stems per hectare at the site, suggesting that increased availability of resources is likely assisting the growth release.
Clocking effect in a centrifugal pump with a vaned diffuser
Authors: Lai Fen , Zhu Xiangyuan , Duan Yongqiang , Li Guojun
Published: July 2020

The performance and service life of centrifugal pumps can be influenced by the clocking effect. In this study, 3D numerical calculations based on the k-omega shear stress transport model are conducted to investigate the clocking effect in a centrifugal pump. Time-averaged behavior and transient behavior are analyzed. Results show that the optimum diffuser installation angle in the centrifugal pump is [Formula: see text] due to the minimum total pressure loss and radial force acting on the impeller. Total pressure loss, particularly in the volute, is considerably influenced by the clocking effect. The difference in total pressure loss in the volute at different clocking positions is 2.75 m under the design flow rate. The large total pressure loss in the volute is primarily caused by the large total pressure gradient within the vicinity of the volute tongue. The radial force acting on the impeller is also considerably affected by the clocking effect. When the diffuser installation angle is [Formula: see text], flow rate fluctuations in the volute and impeller passage are minimal, and flow rate distribution in the diffuser passage is more uniform than those in other diffuser installation angles. Moreover, static pressure fluctuations in the impeller midsection and the diffuser inlet section are at the minimum value. These phenomena explain the minimum radial force acting on the impeller. The findings of this study can provide a useful reference for the design of centrifugal pumps.
Coupled Diffusion-Mechanical Model of NiTi Alloys Accounting for Hydrogen Diffusion and Ageing
Authors: Elkhal Letaief Wissem , Hassine Tarek , Gamaoun Fehmi , Sarraj Riheme , Ben Kahla Nabil
Published: July 2020

Certain shape memory alloys (SMAs) are considered to be good absorbents of hydrogen atoms (e.g., NiTi). However, upon the absorption of hydrogen atoms, SMAs exhibit deteriorated effects of superelasticity and shape memory mechanisms. In this paper, we have developed a coupled model, based on experimental results, that demonstrates the effects of hydrogen diffusion on NiTi SMAs. The proposed model has been derived thermodynamically while appending the chemical potential of hydrogen to the energy balance law. The effects of hydrogen distribution on the mechanical behavior have been taken into consideration to simulate the ageing effects. Moreover, the model considers the saturation of transformation stress, the preservation of the transformation strain of the hydrogen-induced residual martensite and the recovery of superelasticity after hydrogen desorption. The model has been simulated by means of UMAT and UMATHT subroutines and ABAQUS finite-element software. The numerical results indicate a strong agreement with the experimental ones.