bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of United States political sanctions on international collaborations and research in Iran
Authors: Kokabisaghi Fatemeh , Miller Andrew C , Bashar Farshid R , Salesi Mahmood , Zarchi Ali A K , Keramatfar Abdalsamad , Pourhoseingholi Mohammad A , Amini Hosein , Vahedian-Azimi Amir
Published: September 2019

International research collaborations improve individual, institutional and governmental capacities to respond to health crises and inequalities but may be greatly affected by political environments. Iran ranks highly in tertiary education, productivity growth, knowledge impact and successful patent applications. In many countries, economic hardship has correlated with increased international research collaborations. Some have hypothesised that financial constraint drives scholars to seek outside collaborations for cost and risk sharing, and to access funding, materials and patient populations otherwise unavailable. This paper explores the history and importance of US political sanctions on the health of Iran’s academic sector. Although Iran’s international research collaborations increased during periods of increased sanctions, the Pearson correlation coefficient between gross domestic product and international research collaborations was not significant (r=0.183, p=0.417). This indicates that other factors are at least in part responsible. Additionally, we found Iran’s quantitative (eg, publication number) and qualitative (eg, visibility indices) publishing metrics to be discordant (two-tailed Mann–Kendall trend; p<0.0002 for both). Reasons for this are multifactorial, including increased indexing of Iranian journals, willingness of lower visibility journals to handle manuscripts with Iranian authors, widespread linkage of career advancement to science visibility indices, and others. During periods of increased sanctions, Iranian scholars were increasingly denied opportunities to publish scientific findings, attend scientific meetings, access to essential medical and laboratory supplies and information resources. We conclude that academic boycotts violate researchers’ freedom and curtail progress. Free exchange of ideas irrespective of creed is needed to optimize global scientific progress.
Not all inequalities are equal: differences in coverage across the continuum of reproductive health services
Authors: Sully Elizabeth A , Biddlecom Ann , Darroch Jacqueline E
Published: September 2019

Reducing inequalities in health service coverage is central to achieving the larger goal of universal health coverage. Reproductive health services are part of evidence-based health interventions that comprise a minimum set of essential health interventions that all countries should be able to provide. This paper shows patterns in inequalities in three essential reproductive health services that span a continuum of care—contraceptive use, antenatal care during pregnancy and delivery at a health facility. We highlight coverage gaps and their impacts across geographical regions, key population subgroups and measures of inequality. We focus on reproductive age women (15–49 years) in 10 geographical regions in Africa, Asia and Latin America and the Caribbean. We examine inequalities by age (15–19, 20–24, 25–34 and 35–49 years), household wealth quintile, residence (rural or urban) and parity. Data on service coverage and the population in need are from 84 nationally representative surveys. Our results show that dominant inequalities in contraceptive coverage are varied, and include large disparities and impact by age group, compared with maternal health services, where inequalities are largest by economic status and urban–rural residence. Using multiple measures of inequality (relative, absolute and population impact) not only helps to show if there are consistent patterns in inequalities but also whether few or many different approaches are needed to reduce these inequalities and where resources could be prioritised to reach the largest number of people in need.
Sociodemographic and health-related determinants for making repeated calls to a medical helpline: a prospective cohort study
Authors: Blakoe Mitti , Gamst-Jensen Hejdi , von Euler-Chelpin My , Collatz Christensen Helle , Møller Tom
Published: September 2019

Objectives

To identify sociodemographic and health-related characteristics of callers’ making repeated calls within 48 hours to a medical helpline, compared with those who only call once.

Setting

In the Capital Region of Denmark people with acute, non-life-threatening illnesses or injuries are triaged through a single-tier medical helpline for acute, healthcare services.

Participants

People who called the medical helpline between 18 January and 9 February 2017 were invited to participate in the survey. During the period, 38 787 calls were handled and 12 902 agreed to participate. Calls were excluded because of the temporary civil registration number (n=78), the call was not made by the patient or a close relative (n=699), or survey responses were incomplete (n=19). Hence, the analysis included 12 106 calls, representing 11.131 callers’ making single calls and 464 callers’ making two or more calls within 48 hours. Callers’ data (age, sex and caller identification) were collected from the medical helpline’s electronic records. Data were enriched using the callers’ self-rated health, self-evaluated degree of worry, and registry data on income, ethnicity and comorbidities. The OR for making repeated calls was calculated in a crude, sex-adjusted and age-adjusted analysis and in a mutually adjusted analysis.

Results

The crude logistic regression analysis showed that age, self-rated health, self-evaluated degree of worry, income, ethnicity and comorbidities were significantly associated with making repeated calls. In the mutually adjusted analysis associations decreased, however, odds ratios remained significantly decreased for callers with a household income in the middle (OR=0.71;95% CI 0.54 to 0.92) or highest (OR=0.68;95% CI 0.48 to 0.96) quartiles, whereas immigrants had borderline significantly increased OR (OR=1.34;95% CI 0.96 to 1.86) for making repeated calls.

Conclusions

Findings suggest that income and ethnicity are potential determinants of callers’ need to make additional calls within 48 hours to a medical helpline with triage function.
Blast injuries in children: a mixed-methods narrative review
Authors: Milwood Hargrave John , Pearce Phillip , Mayhew Emily Rose , Bull Anthony , Taylor Sebastian
Published: September 2019

Background and significance

Blast injuries arising from high explosive weaponry is common in conflict areas. While blast injury characteristics are well recognised in the adults, there is a lack of consensus as to whether these characteristics translate to the paediatric population. Understanding blast injury patterns in this cohort is essential for providing appropriate provision of services and care for this vulnerable cohort.

Methods

In this mixed-methods review, original papers were screened for data pertaining to paediatric injuries following blasts. Information on demographics, morbidity and mortality, and service requirements were evaluated. The papers were written and published in English from a range of international specialists in the field.

Results

Children affected by blast injuries are predominantly male and their injuries arise from explosive remnants of war, particularly unexploded ordinance. Blasts show increased morbidity and mortality in younger children, while older children have injury patterns similar to adults. Head and burn injuries represent a significant cause of mortality in young children, while lower limb morbidity is reduced compared with adults. Children have a disproportionate requirement for both operative and non-operative service resources, and provisions for this burden are essential.

Conclusions

Certain characteristics of paediatric injuries arising from blasts are distinct from that of the adult cohort, while the intensive demands on services highlight the importance of understanding the diverse injury patterns in order to optimise future service provisions in caring for this child blast survivor.
Assessment of school readiness of children and factors associated with risk of inadequate school readiness in Ujjain, India: an observational study
Authors: Shrivastava Shreya , Patil Vandana , Shelke Madhavi , Anvikar Madhura , Mathur Aditya , Pathak Ashish
Published: September 2019

Objective

School readiness is a condition or state indicating that the child is ready to learn in a formal educational set-up. The objective of this study was to estimate the prevalence of and factors associated with school readiness in urban schoolchildren in Ujjain, India.

Methods

This cross-sectional study was conducted from February 2016 to March 2017. Two English-medium schools were conveniently selected. All children aged 5–7 years were eligible to participate. A subscale of Differential Ability Scales-Second Edition, namely ‘school readiness scale’, was used to assess school readiness in three major domains—early number concept, matching letter-like forms and phonological processing. Data on factors associated with school readiness were collected through parent interview. Quantile regression analysis was used to explore school readiness scores.

Results

This study included 203 school-going children (105 boys and 98 girls) having a mean (SD) age of 67.7 (±0.51) months. The phonological processing and matching letter-like forms had 31.5% and 30.5% children, respectively, in lower quantiles (≤25th). The higher quantile (≥75th) scores were achieved for phonological processing and early number concept (47.7% and 44.8% children, respectively). The results of quantile regression showed negative association of school readiness scores with age of children, lower socioeconomic status and hospitalisation status, especially in the lower quantiles (≤25th). The 10th, 50th and 75th quantile scores were positively correlated with the increasing education status of the mother. Birth weight was positively associated with the median and higher quantile scores (≥75th).

Conclusions

School readiness in a middle-class urban setting in India was negatively associated with lower age of the child, lower socioeconomic status, hospitalisation and positively correlated with increasing birth weight and maternal education. Lower quantile scores were achieved in matching letter-like forms, which measures complex visual–spatial processing, and phonological ability, which correlates with acquired verbal concepts. Focused interventions are needed to improve these skills.
Impact of chronic health conditions and injury on school performance and health outcomes in New South Wales, Australia: a retrospective record linkage study protocol
Authors: Mitchell Rebecca , Cameron Cate M , Lystad Reidar P , Nielssen Olav , McMaugh Anne , Herkes Geoffrey , Schniering Carolyn , Hng Tien-Ming
Published: September 2019

Introduction

Children who have sustained a serious injury or who have a chronic health condition, such as diabetes or epilepsy, may have their school performance adversely impacted by the condition, treatment of the condition and/or time away from school. Examining the potential adverse impact requires the identification of children most likely to be affected and the use of objective measures of education performance. This may highlight educational disparities that could be addressed with learning support. This study aims to examine education performance, school completion and health outcomes of children in New South Wales (NSW), Australia, who were hospitalised with an injury or a chronic health condition compared with children who have not been hospitalised for these conditions.

Method and analysis

This research will be a retrospective population-level case-comparison study of hospitalised injured or chronically ill children (ie, diabetes, epilepsy, asthma or mental health conditions) aged ≤18 years in NSW, Australia, using linked health and education administrative data collections. It will examine the education performance, school completion and health outcomes of children who have been hospitalised in NSW with an injury or a chronic health condition compared with children randomly drawn from the NSW population (matched on gender, age and residential postcode) who have not been hospitalised for these conditions.

Ethics and dissemination

The study received ethics approval from the NSW Population Health Services Research Ethics Committee (2018HRE0904). Findings from the research will be published in peer-reviewed journals and presented at scientific conferences.
Higher discontinuation rate with a standard-sized compared to a small-sized ‘gold standard’ copper intrauterine device: a case-control review
Authors: Akintomide Hannat , Barnes Pam , Brima Nataliya , Mansour Diana
Published: September 2019

Background

T-shaped intrauterine devices (IUDs) with a copper surface area of 380 mm2and copper bands on the transverse arms are the most effective types of copper-containing IUDs. A small-sized ‘gold standard’ IUD is available but there has been little research to compare the effects of this small-sized IUD to its standard-sized counterpart.

Aim

To determine discontinuation rates and reasons for discontinuation at 1 year of the small-sized Mini TT380 Slimline IUD compared with the standard-sized TT380 Slimline.

Methods

The clinical records of women fitted with Mini TT380 Slimline (‘mini’) IUDs were compared with those of women fitted with standard-sized TT380 Slimline (‘standard’) IUDs over a 3-year period (2013–2016).

Results

Clinical records were available for 67 women fitted with a mini IUD (mean age 23 years, 64% nulliparous) and 63 women fitted with a standard IUD (mean age 25 years, 39% nulliparous). At 1 year, twice as many standard IUD users (32%, n=20) had discontinued their IUD use compared with mini IUD users (15%, n=10). Complaints of pain and bleeding were more than double (70%, n=14) in those women who discontinued standard IUD use compared with those who discontinued using the mini IUD (30%, n=3). These differences were statistically significant and were unrelated to parity.

Conclusions

More women using a standard-sized ‘gold standard’ IUD rather than its smaller counterpart complained of pain and bleeding, leading to higher discontinuation at 1 year. More research on the association between size and discontinuation of these IUDs is needed.
Peri-procedural stroke or death in stenting of symptomatic severe intracranial stenosis
Authors: Yaghi Shadi , Khatri Pooja , de Havenon Adam , Yeatts Sharon , Chang Andrew D , Cutting Shawna , Mac Grory Brian , Burton Tina , Jayaraman Mahesh V , McTaggart Ryan A , Fiorella David , Derdeyn Colin , Zaidat Osama O , Dehkharghani Seena , Amin-Hanjani Sepideh , Furie Karen , Prahbakaran Shyam , Liebeskind David
Published: September 2019

Background and purpose

There are limited data on predictors of 30-day stroke or death in patients with symptomatic intracranial atherosclerosis (sICAS) undergoing stenting. We aim to determine the factors associated with stroke or death at 30 days in the stenting arm of the SAMMPRIS trial.

Methods

This is a post-hoc analysis of the SAMMPRIS trial including patients who underwent angioplasty/stenting. We compared patient-specific variables, lesion-specific variables, procedure-specific variables, and FDA-approved indications between patients with and without the primary outcome (stroke or death at 30 days). Logistic regression analyses were performed to evaluate associations with the primary outcome.

Results

We identified 213 patients, 30 of whom (14.1%) met the primary outcome. Smoking status and lesion length were associated with the primary outcome: the odds of stroke or death for non-smokers versus smokers (adjusted OR 4.46, 95% CI 1.79 to 11.1, p=0.001) and for increasing lesion length in millimeters (adjusted OR 1.20, 95% CI 1.02 to 1.39, p=0.029). These had a modest predictive value: absence of smoking history (sensitivity 66.7%, specificity 65.4%) and lesion length (area under curve 0.606). Furthermore, event rates were not significantly different between patients with and without the FDA-approved indication for stenting (15.9% vs 12%, p=0.437).

Conclusion

In SAMMPRIS patients who underwent angioplasty/stenting, neither clinical and neuroimaging variables nor the FDA indication for stenting reliably predicted the primary outcome. Further work in identifying reliable biomarkers of stroke/death in patients with sICAS is needed before considering new clinical trials of stenting.

Trial registration number

SAMMPRISNCT00576693; Results.
Secukinumab does not impair the immunogenic response to the influenza vaccine in patients
Authors: Richi Patricia , Martín María Dolores , de Ory Fernando , Gutiérrez-Larraya Rosa , Casas Inmaculada , Jiménez-Díaz Ana María , Cava Fernando , Muñoz-Fernandez Santiago
Published: September 2019

Objective

To evaluate whether immunological response to influenza vaccination is impaired in patients who are receiving secukinumab.

Patients and methods

Subjects suffering from psoriatic arthritis or ankylosing spondylitis who were receiving treatment with secukinumab and healthy volunteers were included.

All participants received seasonal inactivated trivalent influenza vaccine recommended by the WHO in the 2017–2018 northern hemisphere influenza season, which contained an A/Michigan/45/2015 (H1N1)pdm09-like virus, an A/Hong Kong/4801/2014 (H3N2)-like virus and a B/Brisbane/60/2008-like virus.

Haemagglutination inhibition was used to evaluate basal antibody (Ab) titres against the three inﬂuenza vaccine virus strains just before vaccination and at least 4 weeks after the vaccine administration. Response to vaccine was considered as >4-fold increases in Ab titre.

Results

Thirty subjects, 17 patients and 13 healthy controls, with a follow-up duration of 33±8 days, were analysed. There were no demographic differences between groups. Patients and controls achieved a median of 4.6-fold and 4.0-fold increases, respectively, for anti H1N1 and almost 4.0 (3.7) for patients and 5.3 for controls for anti-B Ab. Both groups presented a poor response against H3N2, with <1.5-fold increase. Seroconversion rates were similar in both groups. Secukinumab did not influence the response to the influenza vaccine (relative risk: 1.09 (95% CI 0.58 to 2.07) for H1N1, RR: 1.53 (95% CI 0.15 to 15.0) for H3N2 and RR: 0.72 (95% CI 0.32 to 1.83) for B strain).

Conclusion

In our study, secukinumab has no effect on the immunogenic response to the influenza vaccine.
Measuring waterpipe tobacco smoking in survey research
Authors: Sutfin Erin L , McKelvey Karma , Soule Eric , Glasser Allison , Kim Hyoshin , Wiseman Kimberly D , Grana Rachel
Published: September 2019

Waterpipe tobacco (WT) smoking remains a significant public health problem. However, few validated measures exist, presenting challenges for obtaining accurate prevalence estimates and making comparisons across studies. We identified items used to measure several WT smoking behaviours in eight US national surveys of youth and adults and two international studies, including the National Youth Tobacco Survey, National Adult Tobacco Survey, Population Assessment of Tobacco and Health Adult and Youth Surveys, Monitoring the Future, National Health Interview Survey, Health Styles, Tobacco Use Supplement: Current Population Survey, Global Adult Tobacco Survey and Global Youth Tobacco Survey. We also identified WT survey items across the first 14 Food and Drug Administration-funded Tobacco Centers of Regulatory Science. Constructs included product description and terminology, ever and current use, quantity and frequency, use of flavours and reasons for use. There was little consistency in WT measurement, highlighting the need for validated measures.
Clinical spirocercosis in a dog in the UK
Authors: McKenna Myles , Bristow Poppy Charlotte , Suarez‐Bonnet Alejandro , Fox Mark T , Glanemann Barbara
Published: September 2019

A 2‐year‐old female neutered crossbreed dog was presented for evaluation of a 3‐day history of haematemesis, melaena and hyporexia. The dog had been imported from a rescue centre in Hungary 4 months prior to presentation. Abdominal CT revealed the presence of a 3 cm×3 cm×4 cm diameter heterogenous intraluminal mass lesion in the gastric cardia, surrounding the ostium of the cardia and continuous with the distal oesophagus. The mass lesion was subsequently surgically resected. Histopathology of the gastric mass lesion was consistent with a Spirocerca lupi granuloma. The patient unfortunately developed a pyothorax and suffered cardiopulmonary arrest resulting in death 2 days postoperatively. To the authors’ knowledge, this is the first reported case of clinical spirocercosis reported in a dog in the UK.
Keeping cool in the warming Arctic: thermoregulatory behaviour by Svalbard reindeer (Rangifer tarandus platyrhynchus)
Authors: Williamsen Linda , Pigeon Gabriel , Mysterud Atle , Stien Audun , Forchhammer Mads , Loe Leif Egil
Published: September 2019

In animals with long generation times, evolution of physiological and morphological traits may not be fast enough to keep up with rapid climate warming, but thermoregulatory behaviour can possibly serve as an important buffer mitigating warming effects. In this study, we investigated if the cold-adapted Svalbard reindeer (Rangifer tarandus platyrhynchus (Vrolik, 1829)) used cool bed sites as a thermoregulatory behaviour in the summer. We recorded habitat variables and ground temperature at 371 bed sites with random “control” sites 10 and 100 m distant. Using case-control logistic regression, we found that reindeer selected bed sites on cool substrates (snow and mire), as well as cold, dry ground on days with warm ambient temperatures, while they avoided such sites on cold days. Selection of both cool substrates and cool ground did not depend on age or sex. The study was conducted in an environment where neither predatory threat nor insect harassment influenced bed site selection. Our findings suggest that the thermal landscape is important for habitat selection of cold-adapted Arctic ungulates in summer. Thus, behavioural strategies may be important to mitigate effects of climate change, at least in the short term.
Consistency of an alternative CPT-odd and Lorentz-violating extension of QED
Authors: Felipe J. C. C. , Fargnoli H. G. , Baeta Scarpelli A. P. , Brito L. C. T.
Published: September 2019

We investigate an alternative CPT-odd Lorentz-breaking QED which includes the Carroll–Field–Jackiw (CFJ) term of the Standard Model Extension (SME), writing the gauge sector in the action in a Palatini-like form, in which the vectorial field and the field-strength tensor are treated as independent entities. Interestingly, this naturally induces a Lorentz-violating mass term in the classical action. We study physical consistency aspects of the model both at classical and quantum levels.
LONG-TERM MECHANICAL COMPATIBILITY OF POLYPROPYLENE SURGICAL MESHES
Authors: KIRILOVA-DONEVA MIGLENA , PASHKOULEVA DESSISLAVA
Published: September 2019

The properties of meshes: Surgimesh®, Technomesh[Formula: see text] and SurgiproTMaged for up to four years were assessed using tensile tests. We discovered that the elasticity of Technomesh[Formula: see text] increased in both directions, Surgimesh[Formula: see text] became more elastic in the longitudinal direction while the elastic properties of SurgiproTMremained unchanged. The mesh samples did not significantly change their strength and deformability with age. Samples from umbilical and inguinal area of the abdominal wall were isolated from 14 donors. The investigation included 90 specimens divided into three age subgroups — A (up to 60 years), B (61–80 years) and C (over 80 years). The long-term mechanical compatibility of human fascia and meshes was compared. The elastic properties of the meshes are closer to the elastic properties of the fascia in the direction parallel to fibers if the donors’ age is up to 60 years.
Wavefronts of traveling trajectories of geometric particles
Authors: Bi Wanying , Wang Zhigang
Published: September 2019

Confining the traveling trajectory of a tachyon to the two-dimensional Lorentzian space forms, we describe the trajectory as a spacelike front in these Lorentzian space forms. Introducing the differential geometry of singular curves in Lorentzian space forms, that is, the hyperbolic space and de Sitter space, and applying the Legendrian duality theorems, we establish the moving frame along the front, whereby the definitions of the evolutes of spacelike fronts in Lorentzian space forms are presented and the geometric properties of these evolutes are investigated in detail. It is shown that these evolutes can be interpreted as wavefronts under the viewpoint of Legendrian singularity theory.
Dissociating effects of error size, training duration, and amount of adaptation on the ability to retain motor memories
Authors: Alhussein Laith , Hosseini Eghbal A. , Nguyen Katrina P. , Smith Maurice A. , Joiner Wilsaan M.
Published: September 2019

Extensive computational and neurobiological work has focused on how the training schedule, i.e., the duration and rate at which an environmental disturbance is presented, shapes the formation of motor memories. If long-lasting benefits are to be derived from motor training, however, retention of the performance improvements gained during practice is essential. Thus a better understanding of mechanisms that promote retention could lead to the design of more effective training procedures. The few studies that have investigated how retention depends on the training schedule have suggested that the gradual exposure of a perturbation leads to improved retention of motor memory compared with an abrupt exposure. However, several of these previous studies showed small effects, and although some controlled the training duration and others the level of learning, none have controlled both. In the present study we disambiguated both of these effects from exposure rate by systematically varying the duration of training, type of trained dynamics, and exposure rate for these dynamics in human force-field adaptation. After controlling for both training duration and the amount of learning, we found essentially identical retention when comparing gradual and abrupt training for two different types of force-field dynamics. By contrast, we found that retention was markedly higher for long-duration compared with short-duration training for both types of dynamics. These results demonstrate that the duration of training has a far greater effect on the retention of motor memory than the exposure rate during training. We show that a multirate learning model provides a computational mechanism for these findings.

NEW & NOTEWORTHY Previous studies have suggested that a gradual, incremental introduction of a novel environment is helpful for improving retention. However, we used experimental and computational approaches to demonstrate that previously reported improvements in retention associated with gradual introductions fail to persist when other factors, including the duration of training and the degree of initial learning, are accounted for.
Eradication of Hepatocellular Carcinoma by NKG2D-Based CAR-T Cells
Authors: Sun Bin , Yang Dong , Dai Hongjiu , Liu Xiuyun , Jia Ru , Cui Xiaoyue , Li Wenxuan , Cai Changchun , Xu Jianming , Zhao Xudong
Published: September 2019

Despite the great success of chimeric antigen receptor T (CAR-T)–cell therapy in the treatment of hematologic malignancies, CAR-T–cell therapy is limited in solid tumors, including hepatocellular carcinoma (HCC). NK group 2 member D (NKG2D) ligands (NKG2DL) are generally absent on the surface of normal cells but are overexpressed on malignant cells, offering good targets for CAR-T therapy. Indeed, analysis of The Cancer Genome Atlas and HCC tumor samples showed that the expression of most NKG2DLs was elevated in tumors compared with normal tissues. Thus, we designed a novel NKG2D-based CAR comprising the extracellular domain of human NKG2D, 4-1BB, and CD3ζ signaling domains (BBz). NKG2D-BBz CAR-T cells efficiently killed the HCC cell lines SMMC-7721 and MHCC97H in vitro, which express high levels of NKG2DLs, whereas they less efficiently killed NKG2DL-silenced SMMC-7721 cells or NKG2DL-negative Hep3B cells. Overexpression of MICA or ULBP2 in Hep3B improved the killing capacity of NKG2D-BBz CAR-T cells. T cells expressing the NKG2D-BBz CAR effectively eradicated SMMC-7721 HCC xenografts. Collectively, these results suggested that NKG2D-BBz CAR-T cells could potently eliminate NKG2DL-high HCC cells both in vitro and in vivo, thereby providing a promising therapeutic intervention for patients with NKG2DL-positive HCC.
Molecular Basis of ABO Variants Including Identification of 16 Novel ABO Subgroup Alleles in Chinese Han Population
Authors: Ying Yan-ling , Hong Xiao-zhen , Xu Xian-guo , Chen Shu , He Ji , Zhu Fa-ming , Xie Xin-you
Published: September 2019

Introduction: The characteristic of ABO blood subgroup is crucial for elucidating the mechanisms of such variant phenotypes and offering useful information in blood transfusion. Methods: In total, 211 ABO variants including part of available family members were investigated in this study. The phenotypes of these individuals were typed with serologic methods. The full coding regions of ABO gene and the erythroid cell-specific regulatory elements in intron 1 of them were amplified with polymerase chain reaction and then directly sequenced. The novel alleles were confirmed by cloning and sequencing. Phylogenetic tree was made using CLUSTAL W software. 3D structural analyses of the glycosyltransferases (GTs) with some typical mutations were performed by PyMOL software. Results: Forty-eight distinctly rare ABO alleles were identified in 211 Chinese variant individuals, including 16 novel ABO alleles. All of the alleles were categorized as 5 groups: 16 ABO*A alleles, 23 ABO*B alleles, 4 ABO*BA alleles, 4 ABO*cisAB alleles, and 1 ABO*O alleles. ABO*A2.08 and ABO*BA.02 were the relatively predominant A and B subgroup alleles, respectively. According to the phylogenetic tree, 28 alleles (5 common alleles and 23 alleles identified in our laboratory) were classified into 3 major allelic lineages. The structural analysis of 3D homology modeling predicted reduced protein stability of the mutant GTs and may explain the reduced ABO antigen expression. Conclusions: The molecular basis of ABO variants was analyzed, and 16 novel ABO alleles were identified. The results extended the information of ABO variants and provided a basis for better transfusion strategies and helped to improve blood transfusion safety.
Epigenetic Risk Assessment of Female Cancers: Women’s Information Needs and Attitudes
Authors: Rebitschek Felix G. , Reisel Daniel , Lein Ines , Wegwarth Odette
Published: September 2019

Background: Cancer risk assessment should stratify screening and enable preventive health interventions based on individuals’ risk of developing cancer. Studies are underway to develop epigenetic tests, including trials investigating women’s risk of female-specific cancers. Objective: Given potential consequences for quality of life and care, women considering such assessment need to be able to make a fully informed choice. It is currently unknown what information they require. Method: We conducted 4 focus groups with 25 women (aged 30–65 years) to explore what they want to know about epigenetic cancer risk assessment, how they evaluate its usefulness, and how they would like to be informed about their risk. Independent coders categorised paraphrases based on transcribed recordings of the group discussions to enable a summarising text analysis. Results: The women in the study wanted to understand how the epigenetic approach is different from established genomic tests, how epigenetic changes relate to cancer, and whether the test enables monitoring of one’s cancer risk (n = 11). Furthermore, they desired information about their basic cancer risks (n = 11), about the quality of the assessment (n = 9), and about measures to deal with a risk result (n = 11). Conclusions: Informed consent in epigenetic cancer risk assessments depends on whether basic cancer risks, uncertainties of testing, and effects of tests on care management are transparently communicated prior to testing. These requirements are not limited to epigenetic testing. Accordingly, physicians and health authorities will have to provide multi-layered information when counselling women on cancer risk assessment.
The Effect of Cynara scolymus on Blood Pressure and BMI in Hypertensive Patients: A Randomized, Double-Blind, Placebo-Controlled, Clinical Trial
Authors: Ardalani Hamidreza , Jandaghi Parisa , Meraji Aramsadat , Hassanpour Moghadam Maryam
Published: September 2019

Background: Recent studies have suggested that artichoke (Cynara scolymus L.) may reduce certain biochemical blood factors but the efficacy of this plant on blood pressure (BP) has not yet been investigated. In this study, we determined the clinical efficacy of C. scolymuson BP and body mass index (BMI) in hypertensive patients as an adjunctive to captopril for the first time. Methods: The total phenolic content and gas chromatography-mass spectrometry metabolite profiling in leaves of C. scolymus have been evaluated. A clinical trial was subsequently carried out on 40 patients to determine the effect of C. scolymus on BP and BMI in hypertensive patients. The treatment group received capsules containing C. scolymus(500 mg twice daily) and the placebo group received starch powder for 8 weeks. Systolic blood pressure (SBP), diastolic blood pressure, and BMI were determined before and after the study. Results: A significant improvement of the BMI was seen in the C. scolymus group compared with the placebo group (p = 0.04). Conclusions: Our findings demonstrated that the consumption of C. scolymus powder as a rich source of phenolic and antioxidant compounds could potentially improve BMI and SBP in hypertensive patients. Therefore, more trials are needed to confirm or reject the antihypertensive impact of artichoke.
Einsamkeit bei Erwachsenen mit Sehbehinderung: Prävalenz, assoziierte Faktoren und Zusammenhang mit der Lebenszufriedenheit
Authors: Brunes Audun , Hansen Marianne B. , Heir Trond
Published: September 2019

Hintergrund: Bisher ist wenig darüber bekannt, ob und in welchem Maße sich Einsamkeit auf das Leben von Menschen mit Sehbehinderung (SB) auswirkt. Das Ziel dieser Studie war es daher, die Prävalenz und die assoziierten Faktoren von Einsamkeit bei Erwachsenen mit SB sowie den Zusammenhang von Einsamkeit und Lebenszufriedenheit zu untersuchen. Methoden: In diese Querschnittsstudie wurde eine Wahrscheinlichkeitsstichprobe von 736 Erwachsenen (≥18 Jahre) mit SB eingeschlossen, die Mitglieder des Norwegischen Verbandes der Sehbehinderten und Blinden waren. Die Interviews fanden zwischen Januar und Mai 2017 statt; erhoben wurden Informationen über soziodemographische Faktoren, Merkmale der SB, negative Lebenserfahrungen, Einsamkeit laut Three Item Loneliness Scale und Lebenszufriedenheit laut Cantril's Ladder of Life Satisfaction. Die Prävalenz der Einsamkeit wurde mit Daten der norwegischen Allgemeinbevölkerung (N = 14 884; Durchschnittsalter 46,4 Jahre; 50,7% Frauen) verglichen. Ergebnisse: Die Prävalenz mittelschwerer und schwerer Einsamkeit in der SB-Population betrug 28,7% (95-%-Konfidenzintervall (KI): 25,4; 32,1) bzw. 19,7% (95-%-KI: 16,9; 22,8). Die Rate war durchgängig in allen Altersgruppen und für alle Schweregrade der Einsamkeit höher als in der Allgemeinbevölkerung. Jüngeres Lebensalter, vollständige Erblindung, Vorliegen weiterer Beeinträchtigungen, Arbeitslosigkeit sowie Mobbing- und Gewalterfahrungen waren mit Einsamkeit assoziiert. Zugleich waren höhere Einsamkeits-Scores mit geringerer Lebenszufriedenheit assoziiert (vollständig angepasstes β = −0,48; 95-%-KI: −0,55; −0,41). Schlussfolgerungen: Einsamkeit ist bei Erwachsenen mit SB weit verbreitet. Strategien, die geeignet sind, die Einsamkeit zu lindern, könnten die Lebenszufriedenheit der Menschen, die mit SB oder Blindheit leben, verbessern.
Role of Extracellular Calcium and Calcium Sensitization in the Anti-Contractile Effect of Perivascular Adipose Tissue in Pregnant Rat Aorta
Authors: Al-Jarallah Aishah , Oommen Elsie , Chacko Verghese Lilly , Oriowo Mabayoje A.
Published: September 2019

Previous studies have shown that the anti-contractile effect of the perivascular adipose tissue (PVAT) is attenuated in pregnancy. In the present investigation, we have examined the possibility that this loss of anti-contractile effect could be due to changes in calcium mobilization. PVAT exerted anti-contractile effect against 5-hydroxytryptamine (5-HT)-induced contractions of aorta segments from pregnant and non-pregnant rats and this anti-contractile effect was attenuated in segments from pregnant rats. Nifedipine (10–6 mol/L), an inhibitor of L-type dihydropyridine calcium channels, significantly reduced 5-HT-induced contraction of aorta segments from non-pregnant and pregnant rats with and without PVAT. The inhibitory effect of nifedipine against 5-HT-induced contractions was attenuated in PVAT-free aorta segments from pregnant rats. However, while PVAT reduced the effectiveness of nifedipine in aorta segments from non-pregnant rats, it partially restored the inhibitory effect of nifedipine in aorta segments from pregnant rats. Inhibitors of calcium sensitization, Y-27632 (10–6 mol/L) and GF 109203X (10–6 mol/L), significantly reduced 5-HT-induced contractions of PVAT-free aorta segments from non-pregnant and pregnant rats. Both inhibitors, however, were less effective in aorta segments from pregnant rats. The presence of PVAT reduced the effectiveness of Y-27632 and GF 109203X in aorta segments from pregnant and non-pregnant rats. Protein expression of Rho-associated protein kinase (ROCK) I and II was detected in aorta segments and PVAT from pregnant and non-pregnant rats. There was a reduction in the expression of both isoforms in aorta segments but not PVAT from pregnant rats. In addition, there was no significant difference in the expression of ROCK-I and ROCK-II in PVAT from pregnant and non-pregnant rats. We concluded that the loss of anti-contractile effect of PVAT in aorta segments from pregnant rats could be due to increased influx of extracellular calcium through nifedipine-sensitive dihydropyridine channels.
Late Recurrence of Bladder Cancer following Radical Cystectomy: Characteristics and Outcomes
Authors: Yoo Sang Hyun , Kim Hwanik , Kwak Cheol , Kim Hyeon Hoe , Jung Jae Hyun , Ku Ja Hyeon
Published: September 2019

Purpose: There are only a few studies on characteristics and outcomes of late recurrence (LR) of urothelial carcinoma of bladder (UCB) after radical cystectomy (RC). The objective of this study was to assess characteristics and oncological outcomes of such LR that developed 5 years after RC. Materials and Methods: We retrospectively reviewed 570 patients who underwent RC and bilateral regional lymphadenectomy for UCB at our institution. Comparisons of post-recurrence disease-specific survival (DSS) according to the timing of recurrence and the site of recurrence were performed using Kaplan-Meier survival curves and log-rank test. Cox regression model was fitted to assess factors for post-recurrence DSS. Results: Disease recurrence occurred in 214 (37.5%) patients, including 20 (9.3%) who had LRs. Median time from RC to recurrence was 13.0 (interquartile range 6.0–32.0) months. There were no significant differences in clinicopathological factors between early- and late-recurrence groups. Post-recurrence 5-year DSS was not significantly different (21.6 vs. 14.1%, p = 0.344) between early- and late-recurrence groups. However, it was worse in the nonurothelial recurrence group compared to that in the urothelial recurrence group (14.0 vs. 19.4%, p = 0.056). Older age (HR 1.03, 95% CI 1.01–1.05, p = 0.001), nonorgan-confined disease at RC (HR 1.73, 95% CI 1.15–2.61, p = 0.008), and lymph node invasion (HR 1.58, 95% CI 1.01–2.45, p = 0.043) were significant predictors for post-recurrence 5-year DSS. Conclusions: LR after RC with lymphadenectomy is not common. However, it cannot be overlooked. LR had similar characteristics to early recurrence. Interestingly, the time to recurrence did not affect post-recurrence survival.
Serum Heparanase Level Is Decreased in Stable Coronary Artery Disease
Authors: Gurbuz Ahmet Seyfeddin , Ozturk Semi , Efe Suleyman Cagan , Yilmaz Mehmet Fatih , Yanik Raziye Ecem , Yaman Ali , Kirma Cevat
Published: September 2019

Objective: Heparanase (HPA), mammalian endo-β-D-glu­cu­ronidase, separates heparan sulfate chains of proteoglycans and changes the structure of the extracellular matrix. We investigated whether serum levels of HPA differ in patients with stable coronary artery disease (SCAD) and subjects with normal coronary arteries. Methods: This study enrolled 92 patients with SCAD and 34 controls with normal coronary arteries. Levels of HPA were measured by a commercially available human HPA enzyme-linked immunosorbent assay kit. Results: Serum HPA levels were significantly lower in the SCAD group (137.5 [104.1–178.9] vs. 198.8 [178.2–244.9] pg/mL; p < 0.001). Serum HPA levels were significantly higher in subjects with diabetes mellitus (DM) compared to those without DM (p = 0.008). Levels of HPA were lower in the SCAD group, both in the diabetic and nondiabetic subgroups, as compared to controls (p < 0.001 for both subgroups). Levels of HPA positively correlated with fasting blood glucose (FBG) (r: 0.42; p < 0.001). In multiple logistic regression analysis, serum HPA level (odds ratio [OR]: 0.975; 95% confidence interval [CI]: 0.966, 0.985; p < 0.001) and FBG (OR: 1.028; 95% CI: 1.010, 1.047; p = 0.002) were independently associated with SCAD. The receiver operating characteristic curve showed that HPA levels less than 160.6 pg/mL predicted SCAD with 65% sensitivity and 97% specificity (AUC: 0.80; 95% CI: 0.728, 0.878; p < 0.001). Conclusion: Diabetes and FBG levels were closely associated with serum levels of HPA. Low serum levels of HPA may predict SCAD in both diabetic and nondiabetic populations.
Can Collagenase Be Used in the Treatment of Adhesive Capsulitis?
Authors: Karahan Nazım , Ozdemir Güzelali , Kolukısa Duygu , Duman Serda , Arslanoğlu Fatih , Çetin Mehmet
Published: September 2019

Background: The objective of this study was to evaluate the efficacy of subacromial injections of collagenase and corticosteroid in rats with experimentally induced adhesive capsulitis. Method: Thirty adult Wistar albino male rats were distributed into 3 groups of 10 rats each after stabilization of their shoulders for 3 weeks: the first group received a single dose of 0.002 mg (0.25 mL) subacromial collagenase; the second group received a single dose of 1.60 mg (0.25 mL) subacromial steroid, and the third group received a single dose of 0.25 mL subacromial saline solution. One week later, we investigated shoulder range of motions, collagen content of the shoulder, and joint cartilage structure. Results: There was no statistically significant difference in the cartilage damage between the groups (p > 0.05). Fibrosis measurements were significantly lower in the collagenase group than in the steroid and saline groups. There was no significant difference in fibrosis between the steroid and saline groups (p > 0.05). Abduction measurements were significantly higher in the collagenase group than in the steroid and saline groups (p < 0.001). No significant difference in the abduction measurements was observed between the saline and steroid groups (p > 0.05). Conclusion: We observed that subacromial injections of collagenase Clostridium histolyticum effectively treated adhesive capsulitis. The results suggest that this treatment could be considered for use in patients with an intact rotator cuff.
O Instituto Internacional da Língua Portuguesa da CPLP
Authors: Oliveira Gilvan Muller de
Published: September 2019

Este texto constitui-se em um esforço para sistematizar uma história institucional do Instituto Internacional da Língua Portuguesa (IILP), da Comunidade dos Países da Língua Portuguesa (CPLP). Periodiza a vida da instituição em quatro momentos: 1. Concepção (1989-99), 2. Instalação (2000-05), 3. Consolidação (2006-10) e 4. Expansão (2011 até o presente). Analisa o seu funcionamento, as suas realizações e as suas limitações no âmbito da promoção da língua portuguesa como língua pluricêntrica, bem como os seus projetos mais contemporâneos.
O português no contexto multilingue timorense
Authors: Soares Lúcia Vidal
Published: September 2019

Timor-Leste, jovem país do sudeste asiático que viu reconhecida a sua independência no início do séc. XXI, após 400 anos de colonialismo português e 24 anos de invasão indonésia, é um verdadeiro mosaico linguístico. Aí encontramos um “multilinguismo endógeno” (CAVALLI et al., 2009), fruto da deambulação e de miscigenações naquele espaço e um “multilinguismo exógeno”(Idem, 2009), resultado da abertura da sociedade à diversidade, mas também de interesses económicos vários e na sequência e como consequência de processos histórico-políticos. Atualmente, o português é uma das línguas cooficiais deste jovem país, depois de ter estado proibido durante o período da ocupação indonésia. Neste artigo abordamos as relações entre o português e as restantes línguas que circulam naquele território, quer do ponto de vista da política linguística, quer numa perspetiva mais pessoal, no âmbito das representações dos sujeitos. Para tal, recorreremos, em parte, ao estudo de Soares (2014), realizado a partir de dados recolhidos no terreno, em 2010, e a fontes escritas oficiais e não oficiais sobre as línguas em presença.
Abstract 003: Early and Late Post-Kidney Transplant Hypertension and Late Renal Allograft Outcome
Authors: Tantisattamo Ekamol , Vutthikraivit Possawat , Leelaviwat Natnicha , Dejhansathit Siroj
Published: September 2019

Background:
Association between pattern of blood pressure (BP) change at different period after kidney transplantation (KTx) and renal allograft function is unclear. We examine the association between changes in BP patterns and long-term allograft function.

Methods:
Kidney transplant recipients were stratified into 4 groups based on presence (+) or absence (-) of systolic hypertension (SHTN; SBP ≥130 mmHg) both at 1 and 6 mo post-KTx (Gr1 (-,-), Gr2 (-,+), Gr3 (+,-), Gr4 (+,+)). Declined allograft function defined by a decrease in eGFR from baseline eGFR at 1-mo post-KTx during 24 mo of follow-up among 4 different groups is examined by multivariable Cox regression analysis.

Results:
Of all 70 patients, mean±SD age was 52.7±12 yr and 41% was female. Mean SBP at 1- and 6-mo post-KTx were 130.9±18.3 and 136.2±18.2 mmHg, respectively. Baseline mean eGFR at 1-mo post-KTx was 50.86±18.89 ml/min/1.73 m
2
and were not different among all 4 groups. Among 70 patients, 57 patients (81%) had a decrease in eGFR between 1 and 24 mo post-KTx with a median time to outcome of 6.8 mo (IQR 2.8-19.6) and the incidence rate of 0.075 person-mo. The number of patients (% in each group) with declined eGFR in Gr1, 2, 3 and 4 were 15 (88%), 17 (89%), 7 (78%), and 18 (72%) patients, respectively (x
2
2.8830, p 0.410). Compared to Gr1, Gr2 had higher, but Gr 3 and 4 had lower the risk of declining eGFR but no statistical significance (HR(95% CI): Gr2 1.20 (0.60-2.40); Gr3 0.79 (0.32-1.95); Gr4 0.78 (0.39-1.55)). After adjusted for age, gender, race, types of induction immunosuppression, types of KTx, SBP, DBP, and BMI at the time of KTx, Gr3 became higher risk; otherwise, the direction of the association remains the same for Gr2 and Gr4.

Conclusion:
Changes in SBP from either normotension to HTN or vice versa between 1 and 6 mo post-KTx appears to be associated with poorer allograft function within 24 mo post-KTx; whereas, maintaining SBP pattern both normotension or HTN from 1 to 6 mo post-KTx may be protective for a decline in allograft function. Very early BP levels during 1 mo post-KTx may be the suitable target SBP for kidney transplant recipients and too liberal or tight BP control in normotensive or hypertensive patients after 1 mo post-KTx may associated with greater risk for worsening long-term allograft outcomes.