bluuebunny/crossref_metadata_2025 huggingface dataset:
Dynamic evaluation of the comparative effectiveness of an integrated program for heart failure care
Authors: Gorostiza Ania , Arrospide Arantzazu , Larrañaga Igor , Barandiarán Aitziber , Ruiz de Austri Adolfo , Ibarrondo Oliver , Mar Javier
Published: May 2020

Rationale, aims and objectives

An integrated care program for heart failure (HF) was developed in the Basque Country in 2013. The objective of this research was to evaluate its effectiveness through the number of hospital admissions in three integrated healthcare organizations (IHOs), taking into account the longitudinal nature of the disease and the intensity of the implementation.

Methods

A retrospective observational study was carried out, based on data entered in administrative and clinical databases between 2014 and 2018 for a total population of 230 000. In addition to conventional statistical analyses, Andersen‐Gill models for recurrent events were used, incorporating dynamic variables that allowed assessment of the intervention's intensity before each hospitalization.

Results

A total of 6768 patients were analysed. Age (hazard ratio [HR] = 1.016; 95% confidence interval [CI] 1.011‐1.022), the Charlson index (HR = 1.067, 95% CI 1.047‐1.087), and the number of previous hospitalizations (HR = 1.632, 95% CI 1.557‐1.712) were risk factors for readmission. Differences between IHOs were also statistically significant. Greater intervention intensity was associated with a lower hospitalization rate (HR = 0.995, 95% CI 0.990‐1.000). As indicated by the interaction between intervention intensity and IHO, differences between IHOs disappeared when intensity rose. No inequities in hospitalization were found as a function of deprivation index or sex. Nonetheless, inequity in the implementation of the program by sex was clear, women with HF receiving less intense intervention than men with the same level of comorbidity and age.

Conclusions

The extent of program implementation measured by intervention intensity is a main driver of the effectiveness of an educational and monitoring program for HF. The evaluation of HF program effectiveness on readmissions must take into account the entire natural history of the disease. Implementation intensity explains differences between IHOs.
The optimal starting age of endoscopic screening for esophageal squamous cell cancer in high prevalence areas in China
Authors: Feng Hao , Song Guohui , Ma Shanrui , Ma Qing , Li Xinqing , Wei Wenqiang , Abnet Christian , Qiao Youlin , Wang Guoqing
Published: May 2020

Background and Aim

This study aimed to evaluate effects of endoscopic screening method in different starting age groups and further confirm the optimum starting age for esophageal squamous cell cancer (ESCC) screening.

Methods

This study received institutional review board approval, and 6825 residents aged 40 to 69 years in high prevalence communities were assigned to the screening group or the control (non‐screening) group from Hebei, China. Cumulative mortalities during the 14‐year period, relative risk for participants who underwent screening, and numbers needed to invite for screening to save one life were compared between the screening group and the control group of different starting age groups at 14‐year follow‐up.

Results

The 14‐year risks of ESCC mortality were one in 55, one in 17, and one in 9 for a person screened in the starting age group of 40, 50, and 60 years old. The cumulative mortalities of ESCC in screening groups were significantly lower than control groups in starting age groups of 40 years (1.42% vs 2.38%, P = 0.033) and 50 years (4.18% vs 7.13%, P = 0.005). Relative risks for participants who underwent screening were 0.60 and 0.59 for the starting age groups of 40 and 50 years. Numbers needed to invite for screening to save one life were 104 and 34 for participants in 40 years old group and 50 years old group, respectively.

Conclusions

In conclusion, people in high prevalence area of ESCC should have endoscopy screening once at their 50 years. Forty years will be preferably defined as the starting age for screening in areas with sufficient health resources.
Resuming Normal Life as a Family Caregiver During Drip‐Like Recovery of Older Persons With Cognitive Impairment Recovering From Hip Surgery: A Grounded Theory
Authors: Shen Mei‐Hsing , Yang Ching‐Tzu , Wu Chi‐Chuan , Huang Huei‐Ling , Lin Yueh‐E , Shyu Yea‐Ing L. , Chung Shih‐Chi
Published: May 2020

Purpose

This study was undertaken to develop a theoretical framework explaining family caregiving processes for older persons with cognitive impairment recovering from hip fracture surgery.

Design and Methods

In this grounded theory study, data were collected in audio‐recorded face‐to‐face interviews with 21 family caregivers. Among these caregivers, 14 cared for hip‐fractured persons with cognitive impairment, and seven cared for those without cognitive impairment. Caregivers were interviewed five times after patients’ discharge: at 1 week and at 1, 3, 6, and 12 months. Data were analyzed by constant comparative analysis.

Findings

The core category explaining the family caregiving process for hip‐fractured persons with cognitive impairment was “resuming normal life during drip‐like recovery.” This category captures the slowness of the recovery process, as slow as dripping water. During the early postoperative period, caregivers attempted to gain control of the postoperative situation, using various maintenance and improvement strategies to deal with the chaos in individuals and the family and to protect hip‐fractured persons with cognitive impairment from further harm. The goal of recovery was to get back to their original life.

Conclusions

Family caregivers of hip‐fractured older persons with cognitive impairment needed to deal with more complex chaotic situations, exerted more efforts to administer safety measures, and required more time to achieve a stable life pattern.

Clinical Relevance

Since postoperative recovery was perceived as extremely slow, family caregivers of hip‐fractured older persons with cognitive impairment should be patient regarding recovery and be informed before hospital discharge of different strategies to resume normal life during postoperative recovery.
N‐acetylglucosamine microemulsions: Assessment of skin penetration, cytotoxicity, and anti‐melanogenesis
Authors: Wuttikul Krisada , Boonme Prapaporn , Thammarat Chayanee , Khongkow Pasarat
Published: May 2020

Background

N‐acetylglucosamine (NAG) is an amino sugar which can reduce melanin production. NAG has previously been formulated for topical use in many nanocarrier systems, excluding microemulsions (MEs). In this study, NAG was prepared in the form of MEs and assessed in terms of skin permeability, cytotoxicity, and effectiveness for cosmetic applications.

Aims

To investigate the skin penetration, cytotoxicity, and anti‐melanogenesis of N‐acetylglucosamine loaded microemulsions (NAG‐MEs).

Methods

Two NAG‐MEs (NME1 and NME2) were prepared. The in vitro penetration study of NAG‐MEs was evaluated by modified Franz diffusion cells using full‐thickness porcine ear skin as the membrane. The optimized formula was then selected for further assessment of cytotoxicity and efficiency. In vitro cytotoxicity was examined using human keratinocytes (HaCaT cells) and B16 melanoma cells. Anti‐melanogenic activity was investigated by determination of melanin production of B16 melanoma cells.

Results

The cumulative amounts of NAG from NME1 and NME2 in the receptor fluid at 24 hours were 1010.46 ± 31.63 and 1260.99 ± 100.19 µg/cm2 and those accumulated in the skin membrane were 155.59 ± 19.19 and 181.11 ± 20.38 µg/cm2, respectively. NME2 and its blank counterpart (Blank‐ME2) showed no adverse effects on the viability of both HaCaT and B16 melanoma cells. The anti‐melanogenic activity data showed that the NME2 treated B16 cells exhibited a significant melanin reduction.

Conclusions

NAG‐MEs could allow NAG penetrate through and accumulate in full‐thickness porcine ear skin. NME2 was safe for both normal human keratinocytes and melanoma cells. It also showed effectiveness on anti‐melanogenic activity in B16 melanoma cells.
Systematic retrospective analysis of 13 cases of uterine arteriovenous fistula: Pathogeny, diagnosis, treatment and follow‐up
Authors: Hong Wei , Wang Bei‐Ying , Wu Zhi‐Ping , Gao Feng , Li Shuang‐Di , Li Xiao‐Cui
Published: May 2020

Aim

To analyze the causes, clinical manifestations, diagnosis and treatment of uterine arteriovenous fistula (UAVF).

Methods

We retrospectively analyzed 13 patients with UAVF admitted to our hospital from October 2016 to April 2019.

Results

All patients had a history of intrauterine surgery (curettage for abortion, artificial removal of placenta, hysteroscopy, diagnostic curettage and intrauterine device removal). The main clinical manifestation of UAVF is paroxysmal massive vaginal bleeding; this involved a massive gush of vaginal blood that stopped suddenly. Sonographic images with typical features of UAVF were observed for 12 patients. Pelvic contrast‐enhanced magnetic resonance imaging was performed as a noninvasive adjuvant examination method for diagnosis. Twelve patients underwent uterine arteriography and a diagnosis of UAVF was confirmed. Then, bilateral uterine artery embolization (UAE) was performed. One patient underwent laparoscopic hysterectomy directly instead of uterine arteriography because of unstable vital signs and one patient underwent laparoscopic hysterectomy 25 weeks after the second UAE. The median time until menstrual recovery was 33 days (range, 20–70 days) after UAE. The median time until normal ultrasound examination results was 10 weeks (range, 2–35 weeks).

Conclusion

Acquired UAVF was associated with a history of previous intrauterine surgery. The ultrasound examination and pelvic contrast‐enhanced MRI were noninvasive adjuvant examination method to effectively assist in diagnosis. Uterine arteriography is considered the gold standard for the diagnosis of UAVF, and UAE is considered an effective intervention for treating UAVF and maintaining reproductive function with less damage. Hysterectomy is an appropriate option when conservative measures have failed to prevent a life‐threatening hemorrhage.
Copper deficiency, heart disease and homocysteine thiolactone
Authors: Klevay Leslie M.
Published: May 2020

Click here to view the Original article by Borowczyk et al.
Are self‐esteem and academic achievement reciprocally related? Findings from a longitudinal study of Mexican‐origin youth
Authors: Zheng Lucy R. , Atherton Olivia E. , Trzesniewski Kali , Robins Richard W.
Published: May 2020

Objective

Previous research has shown that self‐esteem is associated with academic achievement. However, few studies have used longitudinal data to examine how self‐esteem and achievement co‐develop over a long time span, and even fewer have focused on ethnic minority youth.

Method

We used data from a longitudinal study of Mexican‐origin youth (N = 674) to examine the bidirectional associations between self‐esteem and academic achievement from 5th to 11th grade. Global and domain‐specific self‐esteem (academic, honesty, peer relationships, appearance) were assessed at ages 10, 12, 14, and 16 using Marsh et al.'s (2005) Self‐Description Questionnaire. Academic achievement was assessed at the same ages using self‐reported grades and standardized test scores from school records.

Results

Youth with high global and academic self‐esteem showed relative improvements in their grades (but not test scores), and youth who received higher grades and test scores showed relative increases in global and academic self‐esteem. Youth with high honesty self‐esteem showed relative increases in grades and test scores, and youth with higher grades showed relative increases in peer relationship self‐esteem.

Conclusion

Students who feel better about themselves tend to show improvements in their grades, and getting better grades and test scores promotes more positive self‐views.
The role of caesarean section and nonbreastfeeding in preventing mother‐to‐child transmission of hepatitis B virus in HBsAg‐and HBeAg‐positive mothers: results from a prospective cohort study and a meta‐analysis
Authors: Pan Yu‐Chen , Jia Zhi‐Fang , Wang Yue‐Qi , Yang Na , Liu Jian‐Xun , Zhai Xiang‐Jun , Song Ying , Wang Chong , Li Jie , Jiang Jing
Published: May 2020

The study aimed to assess whether caesarean section and nonbreastfeeding can prevent mother‐to‐child transmission (MTCT) in HBsAg‐ and HBeAg‐positive mothers via a cohort study and a meta‐analysis. (1) Pregnant women who were positive for HBsAg and HBeAg and did not receive antiviral treatment during pregnancy were recruited from the First Hospital of Jilin University, Maternal and Child Health Care Center of Jiangsu and Henan from August 2009 to June 2015. Infants received active and passive immunity. (2) In addition, a systematic literature search was performed in the PubMed, Embase, Cochrane, China National Knowledge Infrastructure and Wanfang Chinese databases. The retrieval strategy was [(“HBV” or “hepatitis b” or “hepatitis b virus”) and (“mother‐to‐infant transmission” or “vertical transmission”)]. Studies were screened, and data were extracted. The fixed‐effect model was used to analyse the studies. A total of 852 mothers and 857 newborns were enrolled. At the age of 7 months, 41 infants (4.78%) were positive for HBsAg. Multivariate analysis showed that mothers with higher HBV DNA levels (>108 IU/mL; RR = 3.03, 95% CI: 1.41‐6.52) were associated with an increased risk of infection. Although there was no statistical significance, caesarean section (RR = 0.61) and nonbreastfeeding (RR = 0.88) showed a tendency to reduce the risk of infection. (2) A total of 5726 studies were identified. Together with our study, 13 were included in the analysis of delivery mode, and 12 were included in the analysis of feeding mode. The risk of infection in the caesarean section group was lower than that in the vaginal delivery group (RR = 0.58, 95% CI: 0.46‐0.74). In the analysis of feeding mode, the risk in the nonbreastfeeding group was significantly lower (RR = 0.74, 95% CI: 0.56‐0.98). In conclusion, caesarean section and nonbreastfeeding reduced the risk of MTCT in infants of HBsAg‐ and HBeAg‐positive mothers who did not receive antiviral therapy during pregnancy.
Amino acids and fatty acids composition in mass‐cultured Teleaulax amphioxeia strains with notable potential for rotifer (Brachionus plicatilis) enrichment
Authors: Kim Hyung Seop , Kim Jong Hyeok , Jo Soo‐Gun , Rho Jung‐Rae , Yih Wonho
Published: May 2020

To evaluate the nutritional quality of the Teleaulax/Plagioselmis/Geminigera (TPG) clade species over the conventional prey species of the Rhodomonas/Rhinomonas/Storeatula (RHO) clade for the enrichment of a rotifer, Brachionus plicatilis, two strains of Teleaulax amphioxeia (TA), CR‐MAL07 and CR‐MAL08‐02, and a Chroomonas sp. strain CR‐MAL10 from Korean coastal waters were mass cultured in 500 L photobioreactors. When harvested from the stationary growth phase, the composition of all three macronutrients and three n‐3 highly unsaturated fatty acids (UFAs) exhibited large deviations among strains and culture media. The composition of essential amino acids and UFAs was higher in CR‐08‐02 by up to 1.1 and 22.2 times, respectively, than that in a commercially available Chlorella sp. strain. For the enrichment of B. plicatilis cultures previously grown with the Chlorella concentrates, high‐density cultures of CR‐08‐02 were offered. After a 3‐hr enrichment, the compositions of eicosapentaenoic acid, n‐3 FA (fatty acids), and n‐6 FA in B. plicatilis increased by 331, 19.5, and 10.48%, respectively, which might reflect the relevant quality compositions in the TA cells. Thus, TA in the TPG clade can be another novel type of prey to enrich rotifer cultures for the marine larviculture.
Viscosity characterization of confined bitumen considering microaggregate‐bitumen interactions
Authors: Dong Zejiao , Liu Zhiyang , Yang Chen , Gong Xiangbing
Published: May 2020

Microaggregate‐bitumen interactions in asphalt mixtures cause nonuniform rheological properties of bitumen adhering to aggregates. It is necessary to quantify microaggregate‐bitumen interactions so that the properties of the confined bitumen can be precisely characterized. This study developed a viscosity model of confined bitumen film considering microsubstrate–bitumen interactions. An exponential function was introduced to characterize the spatial distribution of viscosity under the effects of these microinteractions. The apparent viscosity of the bitumen film was formulated as an expression of thickness comprising bulk and interfacial viscosities and a decay index. The bulk viscosity showed a temperature dependence that corresponded with the Williams–Landel–Ferry model. The interfacial viscosity was higher than the bulk viscosity at high temperatures but lower at low temperatures, which indicates that the effect of substrate–bitumen interactions is bidirectional and depends on temperature. This phenomenon could be attributed to the microstructural transition of interfacial bitumen from an oriented layer to a disentangled one. Molecular dynamics simulations demonstrated the microstructural changes of interfacial bitumen under the effect of microaggregate‐bitumen interactions.
A case of pure bilateral horizontal gaze palsy due to multiple sclerosis
Authors: Hatake Seira , Sakamaki Masanori , Mishina Masahiro , Kitazato Minako , Goto Shizuka , Nishiyama Yasuhiro , Nagayama Hiroshi , Kimura Kazumi
Published: May 2020

A 30‐year‐old woman presented with paresthesia in her left lower limb and blurred vision. She had bilateral horizontal gaze palsy with the absence of cranial nerve symptoms such as horizontal saccades, pursuit, and facial nerve palsy. Considering her convalescence, we speculated that her pure bilateral horizontal gaze palsy was mainly caused by disturbance in paramedian pontine reticular formation (PPRF). Pure horizontal gaze palsy may also be a characteristic feature of multiple sclerosis.
The Effects of UI Benefits on Unemployment and Subsequent Outcomes: Evidence from a Kinked Benefit Rule
Authors: Kyyrä Tomi , Pesola Hanna
Published: May 2020

This paper analyses the effects of unemployment insurance benefits on unemployment exits and subsequent labour market outcomes. We exploit a piecewise linear relationship between the previous wage and benefits in Finland to identify the causal effects of the benefit level by using a regression kink design. Although we only find weak evidence of an effect on the time to the next job, higher benefits decrease the time spent in part‐time unemployment and thus result in more full‐time unemployment. The re‐employment probability and post‐unemployment wage are also negatively affected. The results for the duration of the first post‐unemployment job are not conclusive, but in total both employment and earnings in the two years following the beginning of the unemployment spell decrease with higher benefits.
Saliva is a non‐negligible factor in the spread of COVID‐19
Authors: Li Yuqing , Ren Biao , Peng Xian , Hu Tao , Li Jiyao , Gong Tao , Tang Boyu , Xu Xin , Zhou Xuedong
Published: May 2020

SARS‐CoV‐2, a novel emerging coronavirus, has caused severe disease (COVID‐19), and rapidly spread worldwide since the beginning of 2020. SARS‐CoV‐2 mainly spreads by coughing, sneezing, droplet inhalation, and contact. SARS‐CoV‐2 has been detected in saliva samples, making saliva a potential transmission route for COVID‐19. The participants in dental practice confront a particular risk of SARS‐CoV‐2 infection due to close contact with the patients and potential exposure to saliva‐contaminated droplets and aerosols generated during dental procedures. In addition, saliva‐contaminated surfaces could lead to potential cross‐infection. Hence, the control of saliva‐related transmission in the dental clinic is critical, particularly in the epidemic period of COVID‐19. Based on our experience of the COVID‐19 epidemic, some protective measures that can help reduce the risk of saliva‐related transmission are suggested, in order to avoid the potential spread of SARS‐CoV‐2 among patients, visitors, and dental practitioners.
Prevalence of Hip or Groin Pain in Adolescents: A Systematic Review and Meta‐Analysis
Authors: French Helen P. , Deasy Margaret , Gallagher Rebecca , O'Grady Aisling , Doyle Frank
Published: May 2020

Musculoskeletal pain is a common cause of pain in adolescence and can be an important predictor of future pain. The prevalence of hip or groin pain that could potentially affect different adolescent populations has not yet been systematically reviewed. This systematic review aimed to determine the prevalence of hip or groin pain in this population. Five electronic databases were searched until January 2019 for eligible studies that included males and females 13 to 19 years of age. Study selection, data extraction, and risk of bias assessments were completed by 2 independent researchers. Based on inclusion criteria, 8 population‐based, 8 clinical, and 4 sports populations were included. Studies were conducted in Europe, North America, and Australia. The prevalence was dichotomized into “0 to 3 months” and “3 months and above.” Meta‐analyses were performed to estimate the prevalence from 0 to 3 months, and individual estimates were reported for studies of 3 months and above. The overall prevalence of hip or groin pain in all adolescents from 0 to 3 months was 12% (95% confidence interval [CI] 6%, 23%) based on 10 studies, and was 7% (95% CI 6%, 10%) based on 7 population studies. Caution should be applied to these estimates due to substantial study heterogeneity. The pain prevalence in cerebral palsy from 0 to 3 months based on 4 studies was 13% (95% CI 10%, 15%). Individual prevalence estimates were 6% and 31% in obese and 4% in hypermobility populations, respectively, and ranged from 6% to 100% in 4 sports studies. The validity of these estimates is compromised by poor methodological quality.
Dynamics in vegetation and seed bank composition highlight the importance of post‐restoration management in sown grasslands
Authors: Valkó Orsolya , Deák Balázs , Török Péter , Tóth Katalin , Kiss Réka , Kelemen András , Miglécz Tamás , Sonkoly Judit , Tóthmérész Béla
Published: May 2020

Sowing grasses supports the rapid development of a closed perennial vegetation, which makes the method universally suitable for fast and effective landscape‐scale restoration of grasslands. However, to increase their diversity and to create a natural‐like species‐rich grassland is a challenging task. Understanding the role of seed bank compositional changes and vegetation dynamics can help to design management regimes that support the establishment of target species and suppress unwanted weeds. Our aim was to reveal the effect of post‐restoration management on the vegetation and seed bank dynamics in grasslands restored in one of the largest European landscape‐scale restoration projects. Eight years after restoration, we sampled the vegetation and the seed bank in 96 quadrats located in 12 restored grasslands in the Great Hungarian Plain. In each grassland stand, we studied and compared a mown (mown from Year 1 to Year 8) and an abandoned plot (mown from Year 1 to Year 3 then abandoned from Year 4 to Year 8). Mown and abandoned plots showed divergent vegetation and seed bank development. Abandonment led to the decline of sown grasses and higher cover of weeds, especially in the alkaline grasslands. Our study underlined that the developing seed bank had a limited contribution to the maintenance of biodiversity in both grassland types. We found that 5 years of abandonment had a larger effect on the seed bank than on the vegetation. We stress that long‐term management is crucial for controlling the emergence of the weeds from their dense seed bank in restored grasslands.
Supplemental oxygen improves exercise capacity in IPF patients with exertional desaturation
Authors: Arizono Shinichi , Furukawa Taiki , Taniguchi Hiroyuki , Sakamoto Koji , Kimura Tomoki , Kataoka Kensuke , Ogawa Tomoya , Watanabe Fumiko , Kondoh Yasuhiro
Published: May 2020

Background and objective

The efficacy of supplemental oxygen during exercise remains unclear for patients with IPF, as there have been conflicting results from recent prospective studies with small sample sizes.

Methods

This prospective, single‐blind, randomized, crossover trial evaluated the efficacy of supplemental oxygen compared with placebo air during exercise in consecutive patients with IPF without resting hypoxaemia at initial evaluation. Patients with <90% SpO2 in a 6MWT using room air were randomly assigned to a CWRET at 80% of peak work rate with oxygen or placebo air gas via nasal cannula at 4 L/min. The primary endpoint was the effect of supplemental oxygen on endurance time.

Results

We recruited 72 consecutive patients (median age: 66.5 years, % FVC: 84.6%, % DLCO: 61.4%). Supplemental oxygen significantly increased the endurance time (340–424 s; P < 0.001) and minimum SpO2 (88.0–94.0%; P < 0.001) compared with placebo air. Furthermore, supplemental oxygen significantly improved dyspnoea and leg fatigue. In a multivariate linear regression analysis, the endurance time on air was an independent explanatory variable of the improvement rate of endurance time (P = 0.02).

Conclusion

In mild–moderate IPF with exercise‐induced hypoxaemia even without resting hypoxaemia, supplemental oxygen during exercise improved the endurance time, desaturation and subjective symptoms. Patients with shorter endurance times with placebo air showed better improvement with supplemental oxygen.
“Some Things Never Change, We’re Always Second in Line”: Gendered Experiences of Progress and the Agricultural Crisis in Almeria, Spain*
Authors: Reigada Alicia , Soler Montiel Marta , Pérez Neira David , Delgado Cabeza Manuel
Published: May 2020

This article addresses sex‐gender relations within the context of changing class relations shaped by the historical formation of an intensive system of agricultural production in Almeria (Spain). The analysis of work, both on the farm and within the domestic unit, guides the research, which relates socio‐historical conditions and the subjective experiences and identities of men and women farmers. We begin from the theoretical premise that the change from being employed as wage laborers to becoming farm owners was a family project in which women and sex‐gender relations played an essential, though hidden, role. We use a qualitative methodology and an historical perspective focused on the different phases of the Almerian agricultural model: the origin and consolidation of the sector (1960–1970), a boom period (the decade of the 1980s) and the strangulation of the model (from the decade of the 2000s until today). The article discusses and concludes that despite the centrality of the participation of women farmers and the change in class position, the subordinate place they occupy—in both the domestic sphere and on the farm– has continued throughout the different phases of the model. Thus, we find that “Some things never change, we're always second in line.”
Concurrent activation of OsAMT1;2 and OsGOGAT1 in rice leads to enhanced nitrogen use efficiency under nitrogen limitation
Authors: Lee Sichul , Marmagne Anne , Park Joonheum , Fabien Chardon , Yim Yehyun , Kim Sun‐ji , Kim Tae‐Heon , Lim Pyung Ok , Masclaux‐Daubresse Celine , Nam Hong Gil
Published: May 2020

Nitrogen (N) is a major factor for plant development and productivity. However, the application of nitrogenous fertilizers generates environmental and economic problems. To cope with the increasing global food demand, the development of rice varieties with high nitrogen use efficiency (NUE) is indispensable for reducing environmental issues and achieving sustainable agriculture. Here, we report that the concomitant activation of the rice (Oryza sativa) Ammonium transporter 1;2 (OsAMT1;2) and Glutamate synthetase 1 (OsGOGAT1) genes leads to increased tolerance to nitrogen limitation and to better ammonium uptake and N remobilization at the whole plant level. We show that the double activation of OsAMT1;2 and OsGOGAT1 increases plant performance in agriculture, providing better N grain filling without yield penalty under paddy field conditions, as well as better grain yield and N content when plants are grown under N llimitations in field conditions. Combining OsAMT1;2 and OsGOGAT1 activation provides a good breeding strategy for improving plant growth, nitrogen use efficiency and grain productivity, especially under nitrogen limitation, through the enhancement of both nitrogen uptake and assimilation.
SARS‐CoV‐2 asymptomatic and symptomatic patients and risk for transfusion transmission
Authors: Corman Victor M. , Rabenau Holger F. , Adams Ortwin , Oberle Doris , Funk Markus B. , Keller‐Stanislawski Brigitte , Timm Jörg , Drosten Christian , Ciesek Sandra
Published: May 2020

KEY IDEAS

Oral swabs, sputum, and blood samples from 18 asymptomatic and symptomatic patients with SARS‐CoV‐2 infection were examined using RT‐PCR testing in order to assess the risk of transfusion‐related transmission.

In asymptomatic patients as well as patients with flu‐like symptoms and fever, no SARS‐CoV‐2 RNA could be detected in the blood or serum despite a clearly positive result in all throat swabs.

As patients with symptoms of infectious disease will not be admitted to blood donation, the risk for transfusion transmission of SARS‐CoV‐2 seems to be negligible.
Networks of foreign affiliates: Evidence from Japanese micro‐data
Authors: Spinelli Francesca , Rouzet Dorothée , Zhang Hongyong
Published: May 2020

The paper provides evidence of the investment patterns of Japanese multinational enterprises (MNEs) across countries and industries and analyses the main drivers of their location strategies, using detailed micro‐data on Japanese parents and their affiliates including the final destination of affiliate sales. The breakdown of affiliate sales by destination market reveals that Japanese MNEs establish services affiliates primarily to maximise proximity to local customers, while foreign affiliates in manufacturing sectors tend to engage more widely with third countries. Yet, some economies emerge as strategic gateways to other destinations in their region. The empirical analysis delves into the drivers of host country attractiveness for FDI seeking new markets, production efficiency and to act as regional or global platforms. Important factors shaping Japanese FDI decisions include trade and investment policies in goods and services, deep FTAs, as well as streamlined customs procedures. Furthermore, well‐calibrated rules for digital commerce and investments in digital infrastructure and innovation contribute to attracting MNEs. Overall, the paper stresses the factors behind better integration into global production networks and the policy priorities to attract various types of FDI inflows.
The role of carotid bodies in the generation of active inspiratory and expiratory responses to exercise in rats
Authors: Spiller Pedro F. , da Silva Carlos A. A. , Francescato Heloísa D. C. , Moraes Davi J. A.
Published: May 2020

New Findings

What is the central question of this study?

What is the carotid bodies’ contribution to active inspiratory and expiratory response to exercise?

What is the main finding and its importance?

Removal of the carotid bodies reduced the active inspiratory and expiratory responses of diaphragm and abdominal internal oblique muscles, respectively, to high‐intensity, but not to low‐intensity, exercise in rats. Removal of the carotid bodies increased and decreased arterial pH in response to high‐intensity exercise. The carotid bodies contribute to the inspiratory and expiratory adjustments to high‐intensity exercise in rats.

Exercise involves the interaction of several physiological processes, in which adjustments in pulmonary ventilation occur in response to increased O2 consumption, CO2 production and altered acid–base equilibrium. The peripheral chemoreceptors (carotid bodies; CBs) are sensitive to changes in the chemical composition of arterial blood, and their activation induces active inspiratory and expiratory responses. Herein, we tested the hypothesis that the CBs contribute to the active inspiratory and expiratory responses to exercise in rats. We performed electromyographic recordings of the diaphragm (DiaEMG) and abdominal internal oblique (AbdEMG) muscles in rats before and after bilateral removal of the CBs (CBX) during constant‐load low‐intensity and high‐intensity progressive treadmill exercise. We also collected arterial blood samples for gaseous and pH analyses. Similar increases in DiaEMG frequency in both experimental conditions (before and after CBX) during low‐intensity exercise were observed, without significant changes in the DiaEMG amplitude. During high‐intensity exercise, lower responses of both DiaEMG frequency and DiaEMG amplitude were observed in rats after CBX. The AbdEMG phasic active expiratory response was not significant either before or after CBX during low‐intensity exercise. However, CBX reduced the phasic active expiratory responses during high‐intensity exercise. The blunted responses of inspiratory and expiratory adjustments to high‐intensity exercise after CBX were associated with higher levels and lower arterial pH values. Our data show that in rats the CBs do not participate in the inspiratory and expiratory responses to low‐intensity exercise, but are involved in the respiratory compensation against the metabolic acidosis induced by high‐intensity exercise.
Rocket-Hammer Man
Authors: Brown Alan S.
Published: May 2020

James Hobson, a mechanical engineer better known as The Hacksmith, has fashioned a YouTube career from building real-world versions of video game and comic book gadgets—Make It Real videos. Like every inventor, Hobson has a garage packed with tools. These range from laser cutters to 3D printers. Sometimes, they provide cosmetic packaging for his concoctions. Other times, like his metal printed 20-kilowatt heat saber, they are highly functional. This article charts his career journey.
Genetic Association Reveals Protection against Recurrence of
Clostridium difficile
Infection with Bezlotoxumab Treatment
Authors: Shen Judong , Mehrotra Devan V. , Dorr Mary Beth , Zeng Zhen , Li Junhua , Xu Xun , Nickle David , Holzinger Emily R. , Chhibber Aparna , Wilcox Mark H. , Blanchard Rebecca L. , Shaw Peter M.
Published: May 2020

Clostridium difficile
infection is associated with significant clinical morbidity and mortality; antibacterial treatments are effective, but recurrence of
C. difficile
infection is common. In this genome-wide association study, we explored whether host genetic variability affected treatment responses to bezlotoxumab, a human monoclonal antibody that binds
C. difficile
toxin B and is indicated for the prevention of recurrent
C. difficile
infection. Using data from the MODIFY I/II phase 3 clinical trials, we identified three genetic variants associated with reduced rates of
C. difficile
infection recurrence in bezlotoxumab-treated participants. The effects were most pronounced in participants at high risk of
C. difficile
infection recurrence. All three variants are located in the extended major histocompatibility complex on chromosome 6, suggesting the involvement of a host-driven immunological mechanism in the prevention of
C. difficile
infection recurrence.
Supplemental Material: Deep-water channel morphologies, architectures, and population densities in relation to stacking trajectories and climate states
Authors: Gong Chenglin
Published: May 2020

Morphometrics and architectures of 142 chosen deep-water channels and their relation to stacking trajectories and climates.
PDCD4 deficiency ameliorates left ventricular remodeling and insulin resistance in a rat model of type 2 diabetic cardiomyopathy
Authors: Zhang Jie , Zhang Meng , Yang Zhi , Huang Shanying , Wu Xiao , Cao Lei , Wang Xiaohong , Li Qian , Li Na , Gao Fei
Published: May 2020

Objective

Diabetic cardiomyopathy (DCM) is characterized by cardiac remodeling, dysfunction, and insulin resistance; however, the underlying mechanism has not been fully elucidated. Programmed cell death 4 (PDCD4) is a novel inflammation and apoptosis gene, but its role in type 2 DCM remains elusive. We aimed to determine if PDCD4 intervention improves DCM by affecting left ventricular remodeling, function, and insulin resistance.

Research design and methods

We designed a PDCD4-/-rat, established a type 2 diabetes animal model, and constructed a PDCD4 overexpressed adenovirus and PDCD4 small interfer RNA (siRNA) vectors to alter PDCD4 expression in H9c2 cardiomyocytes. Thereafter, glucose levels, lipid metabolism, echocardiography, and extent of myocardial fibrosis, inflammation, and apoptosis were compared in vivo and in vitro.

Results

PDCD4 deficiency improved insulin resistance, cardiac remodeling, and dysfunction in type 2 DCM rats and improved myocardial hypertrophy, fibrosis, inflammation, and apoptosis. Proliferation and transformation of cardiac fibroblasts was reduced via PDCD4 downregulation in vitro under high-glucose stimulation. Furthermore, PDCD4 regulated the myocardial phosphatidylinositol 3-kinase-protein kinase B (PI3K-AKT) pathway in vivo and in vitro. PDCD4 intervention affected cardiac remodeling, dysfunction, and insulin resistance by influencing fibrosis, inflammation, and apoptosis via the PI3K-AKT pathway in vivo.

Conclusions

PDCD4 knockdown protected against left ventricular remodeling, dysfunction, and insulin resistance in type 2 DCM rats. The underlying mechanisms may involve reducing cardiomyocyte apoptosis, inflammation, fibrosis, and normalized PI3K-AKT phosphorylation. To the best of our knowledge, our study is the first to report the effects and underlying mechanisms of PDCD4 in type 2 DCM. These results provide a potential new treatment avenue for improving the prognosis of patients with type 2 DCM.
Predicting the risk of future diabetic foot ulcer occurrence: a prospective cohort study of patients with diabetes in Tanzania
Authors: Naemi Roozbeh , Chockalingam Nachiappan , Lutale Janet K , Abbas Zulfiqarali G
Published: May 2020

Objectives

The aim of this study was to identify the parameters that predict the risk of future foot ulcer occurrence in patients with diabetes.

Research design and methods

1810 (male (M)/female (F): 1012/798) patients, with no foot ulcer at baseline, participated in this study. Data from a set of 28 parameters were collected at baseline. During follow-up, 123 (M/F: 68/55) patients ulcerated. Survival analyses together with logistic regression were used to identify the parameters that could predict the risk of future diabetic foot ulcer occurrence.

Results

A number of parameters (HR (95% CI)) including neuropathy (2.525 (1.680 to 3.795)); history of ulceration (2.796 (1.029 to 7.598)); smoking history (1.686 (1.097 to 2.592)); presence of callus (1.474 (0.999 to 2.174)); nail ingrowth (5.653 (2.078 to 15.379)); foot swelling (3.345 (1.799 to 6.218)); dry skin (1.926 (1.273 to 2.914)); limited ankle (1.662 (1.365 to 2.022)) and metatarsophalangeal (MTP) joint (2.745 (1.853 to 4.067)) ranges of motion; and decreased (3.141 (2.102 to 4.693)), highly decreased (5.263 (1.266 to 21.878)), and absent (9.671 (5.179 to 18.059)) sensation to touch; age (1.026 (1.010 to 1.042)); vibration perception threshold (1.079 (1.060 to 1.099)); duration of diabetes (1.000 (1.000 to 1.000)); and plantar pressure at the first metatarsal head (1.003 (1.001 to 1.005)), temperature sensation (1.019 (1.004 to 1.035)) and temperature tolerance (1.523 (1.337 to 1.734)) thresholds to hot stimuli and blood sugar level (1.027 (1.006 to 1.048)) were all significantly associated with increased risk of ulceration. However, plantar pressure underneath the fifth toe (0.990 (0.983 to 0.998)) and temperature sensation (0.755 (0.688 to 0.829)) and temperature tolerance (0.668 (0.592 to 0.0754)) thresholds to cold stimuli showed to significantly decrease the risk of future ulcer occurrence. Multivariate survival model indicated that nail ingrowth (4.42 (1.38 to 14.07)); vibration perception threshold (1.07 (1.04 to 1.09)); dry skin status (4.48 (1.80 to 11.14)); and temperature tolerance threshold to warm stimuli (1.001 (1.000 to 1.002)) were significant predictors of foot ulceration risk in the final model. The mean time to ulceration was significantly (p<0.05) shorter for patients with: dry skin (χ2=11.015), nail ingrowth (χ2=14.688), neuropathy (χ2=21.284), or foot swelling (χ2=16.428).

Conclusion

Nail ingrowth and dry skin were found to be strong indicators of vulnerability of patients to diabetic foot ulceration. Results highlight that assessments of neuropathy in relation to both small and larger fiber impairment need to be considered for predicting the risk of diabetic foot ulceration.
Missing men with tuberculosis: the need to address structural influences and implement targeted and multidimensional interventions
Authors: Chikovore Jeremiah , Pai Madhukar , Horton Katherine Chisholm , Daftary Amrita , Kumwenda Moses Kelly , Hart Graham , Corbett Elizabeth Lucy
Published: May 2020

Tuberculosis (TB) is treatable but is the leading infectious cause of death worldwide, with men over-represented in some key aspects of the disease burden. Men’s TB epidemiological scenario occurs within a wider public health and historical context, including their prior sidelining in health discussions. Differences are however noticeable in how some Western countries and high TB and HIV burden low and middle-income countries (LMIC) including in Africa have approached the subject(s) of men and health. The former have a comparatively long history of scholarship, and lately are implementing actions targeting men’s health and wellness, both increasingly addressing multilevel social and structural determinants. In contrast, in the latter men have received attention primarily for their sexual practices and role in HIV and AIDS and gender-based violence; moreover, interventions, guided by the public health approach, have stressed short-term, measurable and medical goals. Debates and the limited available empirical literature on men’s engagement with TB-related healthcare are nevertheless indicating need for a shift, within TB work with men in high burden LMICs towards, structural and multicomponent interventions.
Facial protection for healthcare workers during pandemics: a scoping review
Authors: Garcia Godoy Laura R , Jones Amy E , Anderson Taylor N , Fisher Cameron L , Seeley Kylie M L , Beeson Erynn A , Zane Hannah K , Peterson Jaime W , Sullivan Peter D
Published: May 2020

Background

The coronavirus disease 2019 (COVID-19) pandemic has led to personal protective equipment (PPE) shortages, requiring mask reuse or improvisation. We provide a review of medical-grade facial protection (surgical masks, N95 respirators and face shields) for healthcare workers, the safety and efficacy of decontamination methods, and the utility of alternative strategies in emergency shortages or resource-scarce settings.

Methods

We conducted a scoping review of PubMed and grey literature related to facial protection and potential adaptation strategies in the setting of PPE shortages (January 2000 to March 2020). Limitations included few COVID-19-specific studies and exclusion of non-English language articles. We conducted a narrative synthesis of the evidence based on relevant healthcare settings to increase practical utility in decision-making.

Results

We retrieved 5462 peer-reviewed articles and 41 grey literature records. In total, we included 67 records which met inclusion criteria. Compared with surgical masks, N95 respirators perform better in laboratory testing, may provide superior protection in inpatient settings and perform equivalently in outpatient settings. Surgical mask and N95 respirator conservation strategies include extended use, reuse or decontamination, but these strategies may result in inferior protection. Limited evidence suggests that reused and improvised masks should be used when medical-grade protection is unavailable.

Conclusion

The COVID-19 pandemic has led to critical shortages of medical-grade PPE. Alternative forms of facial protection offer inferior protection. More robust evidence is required on different types of medical-grade facial protection. As research on COVID-19 advances, investigators should continue to examine the impact on alternatives of medical-grade facial protection.
Physicians’ perceptions of the uptake of biosimilars: a systematic review
Authors: Sarnola Kati , Merikoski Merja , Jyrkkä Johanna , Hämeen-Anttila Katri
Published: May 2020

Objectives

To examine physicians’ perceptions of the uptake of biosimilars.

Design

Systematic review.

Data sources

MedLine Ovid and Scopus databases at the end of 2018.

Eligibility criteria

Original scientific studies written in English that addressed physicians’ perceptions of the uptake of biosimilars.

Data extraction and synthesis

The search resulted in altogether 451 studies and 331 after removing duplicates. Two researchers examined these based on the title, abstract and entire text, resulting in 20 studies. The references in these 20 studies were screened and three further studies were included. The data of these 23 studies were extracted. All the publications were quality assessed by two researchers.

Results

Most of the selected studies were conducted in Europe and commonly used short surveys. Physicians’ familiarity with biosimilars varied: 49%–76% were familiar with biosimilars while 2%–25% did not know what biosimilars were, the percentages varying from study to study. Their measured knowledge was generally more limited compared with their self-assessed knowledge. Physicians’ perceptions of biosimilars also varied: 54%–94% were confident prescribing biosimilars, while 65%–67% had concerns regarding these medicines. Physicians seemed to prefer originator products to biosimilars and prescribed biosimilars mainly for biologic-naive patients. They considered cost savings and the lower price compared with the originator biologic medicine as the main advantages of biosimilars, while their doubts were often related to safety, efficacy and immunogenicity. 64%–95% of physicians had negative perceptions of pharmacist-led substitution of biologic medicines.

Conclusions

Physicians’ knowledge of and attitudes towards biosimilars vary. Although physicians had positive attitudes towards biosimilars, prescribing was limited, especially for patients already being treated with biologic medicines. Perceptions of pharmacist-led substitution of biologic medicines were often negative. Education and national recommendations for switching and substitution of biologic medicines are needed to support the uptake of biosimilars.