bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical measurement properties of malnutrition assessment tools for use with patients in hospitals: a systematic review
Authors: Xu Yue Camille , Vincent Joshua I.
Published: September 2020

Background

The use of malnutrition outcome measures (OM) by registered dietitians (RD) with inpatients in hospitals has increased promoting the achievement of nutritional care goals and supporting decision-making for the allocation of nutritional care resources in hospitals. There are 3 commonly used OMs: Subjective Global Assessment (SGA), Patient Generated-Subjective Global Assessment (PG-SGA) and Mini Nutritional Assessment (MNA). The purpose of this current study was to systematically review the evidence of the clinical measurement properties of malnutrition assessment tools for use with patients admitted in hospitals.

Methods

MEDLINE, Cinahl, EMBASE, and PubMed were searched for articles published between 2000 and 2019. Research articles were selected if they established reliability, validity, and responsiveness to change properties of the SGA, PG-SGA and MNA tools, were written in English, and used any of these OMs as an outcome measure. Abstracts were not considered. The risk of bias within studies was assessed using the Quality Appraisal for Clinical Measurement Study (QA-CMS).

Results

Five hundred five studies were identified, of which 34 articles were included in the final review: SGA (n = 8), PG-SGA (n = 13), and MNA (n = 13). Of the 34 studies, 8 had a quality score greater than 75%; 23 had a quality score of 40–75% and 3 studies had a quality score of less than 40%. PG-SGA was found to have excellentdiagnostic accuracy (ROC: 0.92–0.975; Sensitivity: 88.6–98%; Specificity: 82–100%), sufficient internal consistency (Cronbach’s alpha: 0.722–0.73), and strong test-retest reliability (r = 0.866). There was insufficient evidence to suggest adequate diagnostic accuracy and good inter-rater reliability for SGA. Only one study examined the minimum detectable change of MNA (MDC = 2.1).

Conclusions

The evidence of validity for the existing malnutrition assessment tools supports the use of these tools, but more studies with sound methodological quality are needed to assess the responsiveness of these OMs to detect the change in nutritional status.
“They have been neglected for a long time”: a qualitative study on the role and recognition of rural health motivators in the Shiselweni region, Eswatini
Authors: Walker Caroline , Burtscher Doris , Myeni John , Kerschberger Bernhard , Schausberger Bernadette , Rusch Barbara , Dlamini Nosipho , Whitehouse Katherine
Published: September 2020

Background

Community health workers (CHWs) are increasingly engaged to address human resource shortages and fill primary healthcare gaps. In Eswatini, a cadre of CHWs called Rural Health Motivators (RHM) was introduced in 1976 to respond to key public health challenges. However, the emergence of health needs, particularly HIV/TB, has been met with inadequate programme amendments, and the role of RHMs has become marginalised following the addition of other CHWs supported by non-governmental organisations. This study was implemented to understand the role of RHMs in decentralised HIV/TB activities. In this paper, we explore the findings in relation to the recognition of RHMs and the programme.

Methods

This exploratory qualitative study utilised individual in-depth interviews, group and focus group discussions, participatory methods (utilising a game format) and observations. Participants were purposively selected and comprised RHM programme implementers, community stakeholders and local and non-governmental personnel. Data collection took place between August and September 2019. Interviews were conducted in English or siSwati and transcribed. SiSwati interviews were translated directly into English. All interviews were audio-recorded, manually coded and thematically analysed. Data was validated through methodical triangulation.

Results

Suboptimal organisational structure and support, primarily insufficient training and supervision for activities were factors identified through interviews and observation activities. Significant confusion of the RHM role was observed, with community expectations beyond formally endorsed tasks. Community participants expressed dissatisfaction with receiving health information only, preferring physical assistance in the form of goods. Additionally, gender emerged as a significant influencing factor on the acceptability of health messages and the engagement of RHMs with community members. Expectations and structurally limiting factors shape the extent to which RHMs are recognised as integral to the health system, at all social and organisational levels.

Conclusions

Findings highlight the lack of recognition of RHMs and the programme at both community and national levels. This, along with historical neglect, has hindered the capacity of RHMs to successfully contribute to positive health outcomes for rural communities. Renewed attention and support mechanisms for this cadre are needed. Clarification of the RHM role in line with current health challenges and clearer role parameters is essential.
Clinicopathological findings of pediatric NTRK fusion mesenchymal tumors
Authors: Kang Jeongwan , Park Jin Woo , Won Jae-Kyung , Bae Jeong Mo , Koh Jaemoon , Yim Jeemin , Yun Hongseok , Kim Seung-Ki , Choi Jung Yoon , Kang Hyoung Jin , Kim Woo Sun , Shin Joo Heon , Park Sung-Hye
Published: September 2020

Background

WhileETV6- NTRK3fusion is common in infantile fibrosarcoma,NTRK1/3fusion in pediatric tumors is scarce and, consequently, not well known. Herein, we evaluated for the presence ofNTRK1/3fusion in pediatric mesenchymal tumors, clinicopathologically and immunophenotypically.

Methods

We reviewed nineNTRKfusion-positive pediatric sarcomas confirmed by fluorescence in situ hybridization and/or next-generation sequencing from Seoul National University Hospital between 2002 and 2020.

Results

One case ofTPR-NTRK1fusion-positive intracranial, extra-axial, high-grade undifferentiated sarcoma (12-year-old boy), one case ofLMNA-NTRK1fusion-positive low-grade infantile fibrosarcoma of the forehead (3-year-old boy), one case ofETV6-NTRK3fusion-positive inflammatory myofibroblastic tumor (IMT) (3-months-old girl), and six cases ofETV6-NTRK3fusion-positive infantile fibrosarcoma (median age: 2.6 months, range: 1.6–5.6 months, M: F = 5:1) were reviewed. The Trk immunopositivity patterns were distinct, depending on what fusion genes were present. We observed nuclear positivity inTPR-NTRK1fusion-positive sarcoma, nuclear membrane positivityin LMNA-NTRK1fusion-positive sarcoma, and both cytoplasmic and nuclear positivityin ETV6-NTRK3fusion-positive IMT and infantile fibrosarcomas. Also, theTPR-NTRK1fusion-positive sarcoma showed robust positivity for CD34/nestin, and also showed high mitotic rate. TheLMNA-NTRK1fusion-positive sarcoma revealed CD34/S100 protein/nestin/CD10 coexpression, and a low mitotic rate. The IMT withETV6-NTRK3fusion expressed SMA. Six infantile fibrosarcomas withETV6-NTRK3fusion showed variable coexpression of nestin (6/6)/CD10 (4/5)/ S100 protein (3/6).

Conclusions

All cases ofNTRK1andNTRK3fusion-positive pediatric tumors robustly expressed the Trk protein. A Trk immunopositive pattern and CD34/S100/nestin/CD10/SMA immunohistochemical expression may suggest the presence ofNTRKfusion partner genes.LMNA-NTRK1fusion sarcoma might be a low-grade subtype of infantile fibrosarcoma. Interestingly, more than half of the infantile fibrosarcoma cases were positive for S100 protein and CD10. The follow-up period ofTPR-NTRK1andLMNA-NTRK1fusion-positive tumors are not enough to predict prognosis. However,ETV6-NTRK3fusion-positive infantile fibrosarcomas showed an excellent prognosis with no evidence of disease for an average of 11.7 years, after gross total resection of the tumor.
Efficacy of orbital radiotherapy in moderate-to-severe active graves’ orbitopathy including long-lasting disease: a retrospective analysis
Authors: Choi Jin Hwa , Lee Jeong Kyu
Published: September 2020

Background

We aimed to explore the efficacy of orbital radiotherapy (RT) in patients with moderate-to-severe active Graves’ orbitopathy (GO), including long-lasting disease, and to determine the predictive factors associated with treatment response.

Methods

This was a retrospective study of 62 moderate-to-severe active GO patients treated with RT. Demographic data and ophthalmic findings prior to RT and at 3 and 6 months afterward were analyzed. Computed tomography was performed before and after RT to compare orbital volume change. We used logistic regression to determine the predictive factors for treatment response. Subjects were divided into early- and late-active phase groups based on GO duration of 24 months and treatment outcomes were compared with each other to observe the effects of RT timing on treatment response.

Results

Forty (64.5%) and forty-six (74.1%) patients experienced improvements in GO at 3 and 6 months after radiotherapy, respectively. Ocular parameters such as clinical activity score (CAS), proptosis, extraocular muscle (EOM) limitation, and compressive optic neuropathy (CON) were improved by RT. Volumes of EOM significantly decreased after RT. The enlargement of EOMs and EOM limitation were predictive factors for a good response to RT. At 6 months after RT, 22 (68.8%) patients of late-active phase group exhibited improvement in GO, which is comparable to the number of 24 (80.0%) patients of early-active phase group. In the late-active phase group, CAS, diplopia, and visual acuity were improved significantly, but there was no change in EOM limitation.

Conclusions

In moderate-to-severe active GO patients, orbital RT may help improve high CAS, proptosis, EOM limitation, and CON. The orbital RT in long-lasting active GO patients may be considered as treatments for the relief of symptoms including high CAS and poor visual acuity.
Outcomes of platelet-rich plasma for plantar fasciopathy: a best-evidence synthesis
Authors: Yu Tao , Xia Jiang , Li Bing , Zhou Haichao , Yang Yunfeng , Yu Guangrong
Published: September 2020

Background

Plantar fasciopathy (PF) is a very common disease, affecting about 1/10 people in their lifetime. Platelet-rich plasma (PRP) had been demonstrated to be useful in achieving helpful effects for plantar fasciopathy. The purpose of this study was to compare the pain and functional outcomes between PRP and corticosteroid (CS) or placebo for plantar fasciopathy through meta-analysis and provide the best evidence.

Methods

Literature was searched systematically to explore related studies that were published in Cochrane Library, PubMed, Embase, Medline, SpringerLink, OVID, and ClinicalTrials.gov. Articles regarding comparative research about the outcomes of PRP therapy and CS or placebo injection were selected. Data of pain and functional outcomes was extracted and imported into Reviewer Manager 5.3 to analyze.

Results

Thirteen RCTs were included and analyzed. Analysis results showed significant superiority of PRP in outcome scores when compared with CS (VAS: MD = − 0.85, P < 0.0001, I2 = 85%; AOFAS: MD = 10.05, P < 0.0001, I2 = 85%), whereas there is no statistical difference in well-designed double-blind trials (VAS: MD = 0.15, P = 0.72, I2 = 1%; AOFAS: MD = 2.71, P = 0.17, I2 = 0%). In the comparison of the PRP and the placebo, the pooled mean difference was − 3.76 (P < 0.0001, 95% CI = − 4.34 to − 3.18).

Conclusions

No superiority of PRP had been found in well-designed double-blind studies, whereas it is implied that the outcomes of PRP are better than placebo based on available evidence.
Expectant management of pneumothorax in intubated COVID-19 positive patients: a case series
Authors: Elder Colby , Bawa Sheina , Anderson Douglas , Atkinson Stephen , Etzel Joshua , Moritz Troy
Published: September 2020

Background

There is an increasing amount of literature describing the pathogenesis of coronavirus disease 2019 (COVID-19) pneumonia and its associated complications. Historically, a small pneumothorax has been shown to be successfully treated without chest tube insertion, but this management has yet to be proven in COVID-19 pneumonia patients. In addition, pneumothorax in an intubated patient with high positive end-expiratory pressure (PEEP) provides additional uncertainty with pursuing non-operative management.

Case presentation

In this series we report four cases of patients with respiratory distress who tested positive for COVID-19 via nasopharyngeal swab and developed ventilator-induced pneumothoraces which were successfully managed with observation alone.

Conclusions

Management of patients with COVID-19 pneumonia on positive pressure ventilation who develop small stable pneumothoraces can be safely observed without chest tube insertion.
Consensus clinical management guidelines for Alström syndrome
Authors: Tahani Natascia , Maffei Pietro , Dollfus Hélène , Paisey Richard , Valverde Diana , Milan Gabriella , Han Joan C. , Favaretto Francesca , Madathil Shyam C. , Dawson Charlotte , Armstrong Matthew J. , Warfield Adrian T. , Düzenli Selma , Francomano Clair A. , Gunay-Aygun Meral , Dassie Francesca , Marion Vincent , Valenti Marina , Leeson-Beevers Kerry , Chivers Ann , Steeds Richard , Barrett Timothy , Geberhiwot Tarekegn
Published: September 2020

Alström Syndrome (ALMS) is an ultra-rare multisystem genetic disorder caused by autosomal recessive variants in the ALMS1 gene, which is located on chromosome 2p13. ALMS is a multisystem, progressive disease characterised by visual disturbance, hearing impairment, cardiomyopathy, childhood obesity, extreme insulin resistance, accelerated non-alcoholic fatty liver disease (NAFLD), renal dysfunction, respiratory disease, endocrine and urologic disorders. Clinical symptoms first appear in infancy with great variability in age of onset and severity. ALMS has an estimated incidence of 1 case per 1,000,000 live births and ethnically or geographically isolated populations have a higher-than-average frequency. The rarity and complexity of the syndrome and the lack of expertise can lead to delayed diagnosis, misdiagnosis and inadequate care. Multidisciplinary and multiprofessional teams of experts are essential for the management of patients with ALMS, as early diagnosis and intervention can slow the progression of multi-organ dysfunctions and improve patient quality of life.

These guidelines are intended to define standard of care for patients suspected or diagnosed with ALMS of any age. All information contained in this document has originated from a systematic review of the literature and the experiences of the authors in their care of patients with ALMS. The Appraisal of Guidelines for Research & Evaluation (AGREE II) system was adopted for the development of the guidelines and for defining the related levels of evidence and strengths of recommendations.

These guidelines are addressed to: a) specialist centres, other hospital-based medical teams and staffs involved with the care of ALMS patients, b) family physicians and other primary caregivers and c) patients and their families.
A WEE1 family business: regulation of mitosis, cancer progression, and therapeutic target
Authors: Ghelli Luserna di Rorà Andrea , Cerchione Claudio , Martinelli Giovanni , Simonetti Giorgia
Published: September 2020

The inhibition of the DNA damage response (DDR) pathway in the treatment of cancer has recently gained interest, and different DDR inhibitors have been developed. Among them, the most promising ones target the WEE1 kinase family, which has a crucial role in cell cycle regulation and DNA damage identification and repair in both nonmalignant and cancer cells. This review recapitulates and discusses the most recent findings on the biological function of WEE1/PKMYT1 during the cell cycle and in the DNA damage repair, with a focus on their dual role as tumor suppressors in nonmalignant cells and pseudo-oncogenes in cancer cells. We here report the available data on the molecular and functional alterations of WEE1/PKMYT1 kinases in both hematological and solid tumors. Moreover, we summarize the preclinical information on 36 chemo/radiotherapy agents, and in particular their effect on cell cycle checkpoints and on the cellular WEE1/PKMYT1-dependent response. Finally, this review outlines the most important pre-clinical and clinical data available on the efficacy of WEE1/PKMYT1 inhibitors in monotherapy and in combination with chemo/radiotherapy agents or with other selective inhibitors currently used or under evaluation for the treatment of cancer patients.
Exosomal miR-141 promotes tumor angiogenesis via KLF12 in small cell lung cancer
Authors: Mao Shuangshuang , Lu Zhiliang , Zheng Sufei , Zhang Hao , Zhang Guochao , Wang Feng , Huang Jianbing , Lei Yuanyuan , Wang Xinfeng , Liu Chengming , Sun Nan , He Jie
Published: September 2020

Background

Angiogenesis, a basic requirement for tumor cell survival, is considered to be a malignant characteristic of small cell lung cancer (SCLC) and is closely related to the poor outcomes of SCLC patients. miR-141 has been found to play pro- and antiangiogenic roles in different cancers, but its role in SCLC angiogenesis has never been explored.

Methods

Total RNA was isolated from plasm exosomes and serum of SCLC patients to examine the expression of miR-141 by qRT-PCR. Cell proliferation, invasion, migration, tube formation assay, aortic ring assay and mouse tumor model were used to investigate the effect of exosomal miR-141 in angiogenesis in vitro and in vivo. Dual-luciferase assay was conducted to explore the target gene of miR-141.

Results

Circulating miR-141 was upregulated in samples from 122 SCLC patients compared with those from normal volunteers and that the increase in miR-141 was significantly associated with advanced TNM stages, implying the potential oncogenic role of miR-141 in SCLC malignancy. In vitro, miR-141 that was packaged into SCLC cell-secreted exosomes and delivered to human umbilical vein vascular endothelial cells (HUVECs) via exosomes facilitated HUVEC proliferation, invasion, migration and tube formation and promoted microvessel sprouting from mouse aortic rings. Matrigel plug assays demonstrated that SCLC cell-derived exosomal miR-141 induced neoangiogenesis in vivo. Furthermore, mouse subcutaneous tumor nodules that were developed from miR-141-overexpressing SCLC cells had a higher microvessel density (MVD) and grew faster than those developed from negative control cells. KLF12 was found to be the direct target gene of miR-141 and that the proangiogenic effect of miR-141 on HUVECs was abrogated by KLF12 overexpression.

Conclusions

Our results demonstrate the specific function of the exosomal miR-141/KLF12 pathway in SCLC angiogenesis for the first time and provide potential novel targets for antiangiogenic therapies for SCLC patients.
Two seriously ill neonates born to mothers with COVID-19 pneumonia- a case report
Authors: Sagheb Setareh , Lamsehchi Ameneh , Jafary Mohamadreza , Atef-Yekta Reza , Sadeghi Kourosh
Published: September 2020

Background

Coronavirus disease 2019 (COVID-19), a highly contagious viral disease has spread from Wuhan, Hubei Province, China to all over the world from its first recognition on December 2019. To date, only a few neonatal early-onset sepsis by SARS-COV-2 has been reported worldwide.

Case presentation

In this report, we present two seriously ill neonates who were born from mothers with stablished COVID-19 pneumonia. Laboratory tests showed lymphopenia with high LDH and hypocalcemia right after the birth. They had fever for days without responding to antibiotics and despite ruling out other potential causes. Both patients had positive RTPCR for SARS-COV-2 in the second round of testing but the first assay tested was negative. Hydroxychloroquine was used to treat both patients; the first patient was treated with it over a period of 14 days before showing signs of improvement. The second patient responded to the treatment over a period of 5 days.

Conclusion

Although based on the available evidences, vertical transmission of COVID-19 is less likely, many aspects of pathogenesis and transmission of this novel virus are still unclear. Therefore we cannot rule out the vertical transmission totally. Further investigations are warranted to determine the exact mechanisms and routes of transmission.
Patients with unexplained mismatch repair deficiency are interested in updated genetic testing
Authors: Omark Jessica , Vilar Eduardo , You Y Nancy , Dunnington Leslie , Noblin Sarah , Stevens Blair , Mork Maureen
Published: September 2020

Background

Individuals who have colorectal or endometrial cancers displaying loss of immunohistochemical staining of one or more mismatch repair proteins without an identifiable causative germline pathogenic variant have unexplained mismatch repair deficiency (UMMRD). Comprehensive germline genetic testing for Lynch syndrome (LS) includes sequencing and deletion/duplication analysis of MLH1, MSH2, MSH6, and PMS2, deletion analysis of EPCAM, and MSH2 inversion analysis. Updated genetic testing to include elements of comprehensive LS testing not previously completed could further clarify LS status in individuals with UMMRD, allowing for tailored screening guidelines for affected individuals and their family members. However, patient understanding of the potential impact of updated genetic testing for LS is unclear. This study aimed to evaluate the interest in and perceived impact of updated genetic testing among individuals with UMMRD at a tertiary academic center.

Methods

A survey evaluating interest in and perceived impact of updated genetic testing was mailed to 98 potential participants. Electronic health record review was completed for all individuals meeting eligibility criteria. Thirty-one individuals responded to the survey.

Results

Results indicate this population is highly interested in updated genetic testing with the perceived impact being primarily for family members to have appropriate genetic testing and screening. Electronic health record review indicates that clinicians have an evolving understanding of causes of UMMRD, representing a potential change in assessment of cancer risk.

Conclusions

Updated risk assessment and genetic counseling with a discussion of the benefits and limitations of germline and somatic genetic testing, is essential as the understanding of UMMRD and genetic testing recommendations for this population evolve.
ICU admission body composition: skeletal muscle, bone, and fat effects on mortality and disability at hospital discharge—a prospective, cohort study
Authors: Jaitovich Ariel , Dumas Camille L. , Itty Ria , Chieng Hau C. , Khan Malik M. H. S. , Naqvi Ali , Fantauzzi John , Hall Jesse B. , Feustel Paul J. , Judson Marc A.
Published: September 2020

Background

Reduced body weight at the time of intensive care unit (ICU) admission is associated with worse survival, and a paradoxical benefit of obesity has been suggested in critical illness. However, no research has addressed the survival effects of disaggregated body constituents of dry weight such as skeletal muscle, fat, and bone density.

Methods

Single-center, prospective observational cohort study of medical ICU (MICU) patients from an academic institution in the USA. Five hundred and seven patients requiring CT scanning of chest or abdomen within the first 24 h of ICU admission were evaluated with erector spinae muscle (ESM) and subcutaneous adipose tissue (SAT) areas and with bone density determinations at the time of ICU admission, which were correlated with clinical outcomes accounting for potential confounders.

Results

Larger admission ESM area was associated with decreased odds of 6-month mortality (OR per cm2, 0.96; 95% CI, 0.94–0.97; p < 0.001) and disability at discharge (OR per cm2, 0.98; 95% CI, 0.96–0.99; p = 0.012). Higher bone density was similarly associated with lower odds of mortality (OR per 100 HU, 0.69; 95% CI, 0.49–0.96; p = 0.027) and disability at discharge (OR per 100 HU, 0.52; 95% CI, 0.37–0.74; p < 0.001). SAT area was not significantly associated with these outcomes’ measures. Multivariable modeling indicated that ESM area remained significantly associated with 6-month mortality and survival after adjusting for other covariates including preadmission comorbidities, albumin, functional independence before admission, severity scores, age, and exercise capacity.

Conclusion

In our cohort, ICU admission skeletal muscle mass measured with ESM area and bone density were associated with survival and disability at discharge, although muscle area was the only component that remained significantly associated with survival after multivariable adjustments. SAT had no association with the analyzed outcome measures.
Effects of biofilm transfer and electron mediators transfer on Klebsiella quasipneumoniae sp. 203 electricity generation performance in MFCs
Authors: Guo Yating , Wang Guozhen , Zhang Hao , Wen Hongyu , Li Wen
Published: September 2020

Background

Extracellular electron transfer (EET) is essential in improving the power generation performance of electrochemically active bacteria (EAB) in microbial fuel cells (MFCs). Currently, the EET mechanisms of dissimilatory metal-reducing (DMR) model bacteria Shewanella oneidensis and Geobacter sulfurreducens have been thoroughly studied. Klebsiella has also been proved to be an EAB capable of EET, but the EET mechanism has not been perfected. This study investigated the effects of biofilm transfer and electron mediators transfer on Klebsiella quasipneumoniae sp. 203 electricity generation performance in MFCs.

Results

Herein, we covered the anode of MFC with a layer of microfiltration membrane to block the effect of the biofilm mechanism, and then explore the EET of the electron mediator mechanism of K. quasipneumoniae sp. 203 and electricity generation performance. In the absence of short-range electron transfer, we found that K. quasipneumoniae sp. 203 can still produce a certain power generation performance, and coated-MFC reached 40.26 mW/m2 at a current density of 770.9 mA/m2, whereas the uncoated-MFC reached 90.69 mW/m2 at a current density of 1224.49 mA/m2. The difference in the electricity generation performance between coated-MFC and uncoated-MFC was probably due to the microfiltration membrane covered in anode, which inhibited the growth of EAB on the anode. Therefore, we speculated that K. quasipneumoniae sp. 203 can also perform EET through the biofilm mechanism. The protein content, the integrity of biofilm and the biofilm activity all proved that the difference in the electricity generation performance between coated-MFC and uncoated-MFC was due to the extremely little biomass of the anode biofilm. To further verify the effect of electron mediators on electricity generation performance of MFCs, 10 µM 2,6-DTBBQ, 2,6-DTBHQ and DHNA were added to coated-MFC and uncoated-MFC. Combining the time–voltage curve and CV curve, we found that 2,6-DTBBQ and 2,6-DTBHQ had high electrocatalytic activity toward the redox reaction of K. quasipneumoniae sp. 203-inoculated MFCs. It was also speculated that K. quasipneumoniae sp. 203 produced 2,6-DTBHQ and 2,6-DTBBQ.

Conclusions

To the best of our knowledge, the three modes of EET did not exist separately. K. quasipneumoniae sp.203 will adopt the corresponding electron transfer mode or multiple ways to realize EET according to the living environment to improve electricity generation performance.
Melatonin deficiency decreases brown adipose tissue acute thermogenic capacity of in rats measured by 18F-FDG PET
Authors: Halpern Bruno , Mancini Marcio C. , Mendes Caroline , Machado Camila Maria Longo , Prando Silvana , Sapienza Marcelo Tatit , Buchpiguel Carlos Alberto , do Amaral Fernanda Gaspar , Cipolla-Neto José
Published: September 2020

Objective

Melatonin has been shown to increase brown adipose tissue (BAT) mass, which can lead to important metabolic effects, such as bodyweight reduction and glycemic improvement. However, BAT mass can only be measured invasively and. The gold standard for non-invasive measurement of BAT activity is positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-d-glucose (18F-FDG PET). There is no study, to our knowledge, that has evaluated if melatonin influences BAT activity, measured by this imaging technique in animals.

Methods

Three experimental groups of Wistar rats (control, pinealectomy, and pinealectomy replaced with melatonin) had an 18F-FDG PET performed at room temperature and after acute cold exposure. The ratio of increased BAT activity after cold exposure/room temperature was called “acute thermogenic capacity” (ATC) We also measured UCP-1 mRNA expression to correlate with the 18F-FDG PET results.

Results

Pinealectomy led to reduced acute thermogenic capacity, compared with the other groups, as well as reduced UCP1 mRNA expression.

Conclusion

Melatonin deficiency impairs BAT response when exposed to acute cold exposure. These results can lead to future studies of the influence of melatonin on BAT, in animals and humans, without needing an invasive evaluation of BAT.
Dietary inflammatory index is associated with pain intensity and some components of quality of life in patients with knee osteoarthritis
Authors: Toopchizadeh Vahideh , Dolatkhah Neda , Aghamohammadi Dawood , Rasouli Mahrokh , Hashemian Maryam
Published: September 2020

Objectives

We aim to measure dietary inflammatory index (DII) and its association with functional status, pain intensity and quality of life (QOL) in patients with knee osteoarthritis (KOA). Dietary information from 220 qualified patients with KOA was collected by a 168-item food frequency questionnaire. The functional status, pain intensity and QOL were evaluated by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire, Visual Analogue Scale (VAS) and SF36 questionnaire respectively.

Results

Linear regression analysis showed that the DII was significantly associated with VAS (p = 0.040; β = 0.151), and physical function (p = 0.039; β = − 0.184), emotional wellbeing (p = 0.048; β = − 0.158) and pain (p = 0.020; β = 0.161) scales and physical health (p = 0.047; β = 0.110) subscale of QOL after adjusting for age, sex, body mass index, and physical activity. There was no significant differences concerning WOMAC across the DII tertiles with and without adjustment to probable confounders (Ptrend = 0.091 and 0.181, respectively). After adjustment, a significantly increased severe pain odds was observed in the highest tertile of DII score in comparison with the lowest tertile (OR tertile3 vs. 1 = 1.55, 95% CI 1.04–2.31; Ptrend = 0.04).
Comparison of Galdieria growth and photosynthetic activity in different culture systems
Authors: Carbone Dora Allegra , Olivieri Giuseppe , Pollio Antonino , Melkonian Michael
Published: September 2020

In the last years, the acidothermophilic red microalga Galdieria sulphuraria has been increasingly studied for industrial applications such as wastewater treatment, recovery of rare earth elements, production of phycobilins. However, even now it is not possible an industrial cultivation of this organism because biotechnological research on G. sulphuraria and allied species is relatively recent and fragmented. Having in mind a possible scale-up for commercial applications, we have compared the growth and photosynthetic performance of G. sulphuraria in four suspended systems (Inclined bubble column, Decanter Laboratory Flask, Tubular Bioreactor, Ultra-flat plate bioreactor) and one immobilized system (Twin Layer Sytem). The results showed that G. sulphuraria had the highest growth, productivity and photosynthetic performance, when grown on the immobilized system, which also offers some economics advantages.
Superconvergence of a finite element method for the time-fractional diffusion equation with a time-space dependent diffusivity
Authors: An Na
Published: September 2020

In this work, a time-fractional diffusion problem with a time-space dependent diffusivity is considered. The solution of such a problem has a weak singularity at the initial time$t=0$t=0. Based on the L1 scheme in time on a graded mesh and the conforming finite element method in space on a uniform mesh, the fully discrete L1 conforming finite element method (L1 FEM) of a time-fractional diffusion problem is investigated. The error analysis is based on a nonstandard discrete Gronwall inequality. The final superconvergence result shows that an optimal grading of the temporal mesh should be selected as$r\geq (2-\alpha )/\alpha $r≥(2−α)/α. Numerical results confirm that our analysis is sharp.
Protective effect of procyanidin B2 on hydrogen peroxide (H2O2)-induced oxidative damage in MCF-7 cells
Authors: Tan Jia-qi , Li Peng-cheng , Li Qian , Tang Jin-tian , Xue Hong-kun
Published: September 2020

The aim of this study is to assess the cytoprotection and potential molecular mechanisms of procyanidin B2 (PCB2) on hydrogen peroxide (H2O2)-induced oxidative damage in MCF-7 cells. The 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay was performed to determine the viability of MCF-7 cell exposure to H2O2 or PCB2. We measured the antioxidant properties of PCB2 by determining the activities of SOD, GSH-Px, LDH and MDA levels, and evaluated apoptosis and intracellular reactive oxygen species (ROS) levels. The related proteins expression levels were monitored by Western blot. MCF-7 cells induced with H2O2 had a remarkable decrease in cell viability that was suppressed when it was interfered with PCB2 (0.1–10.0 μM). PCB2 interference memorably and dose-dependently inhibited H2O2-induced LDH leakage, ROS and MDA overproduction, while PCB2 markedly increased H2O2-induced the activities of SOD and GSH-Px. Eventually, H2O2 prominently down-regulated the ratio of Bcl-2/Bax and the relative proteins expression levels of Nrf2, GCLC, NQO1 and HO-1, and up-regulated the relative proteins expression levels of cytochrome c, caspase-3 and Keap1. However, the relative expression levels of these proteins were reversed in PCB2-interfered MCF-7 cells. This study implied that protective effect of PCB2 on H2O2-induced oxidative damage in MCF-7 cells might be related to inhibition of mitochondria-dependent apoptosis, activation of Keap1/Nrf2/HO-1 signaling pathway and improvement of the antioxidant enzymes activities.
Co-designing the pedestrian revolution in Muscat
Authors: De Siqueira Gustavo , Al Balushi Amal
Published: September 2020

Rapid growth coupled with the prevailing land allocation system in Oman led to a shift from compact dwellings typologies to detached single-family houses, arranged in monofunctional zoning systems that exclusively rely on cars. Due to the sprawled transformation, authorities are unable to provide new neighborhoods with basic infrastructure and attractive open spaces. Consequently, the level of non-communicable diseases is increasing, making urban regeneration programs promoting active lifestyles in built environments a matter of public health. In our research we explore participative-planning strategies to enhance pedestrian activity within existing neighborhoods and regenerate public spaces. We conducted a quantitative survey using a standard walkability scale and physical maps to identify barriers to pedestrian activity. Subsequently, we employed the data to frame culturally sensitive co-creation workshops, gaining in-depth knowledge to guide future redesign proposals. We found that mosques are walking magnets yet engender contrasting views with regard to walkability; finding solutions to the spatial problems could develop them into walkable cores. We also observed that residents were aware of health problems caused by lack of physical activity and how that links with the built environment they inhabit. They were eager to discuss solutions, including alternative governance models, as long as the process was short and produced immediate small interventions with high-level impact on their surroundings. We employed a fine-grained combination of methods to address site-specific challenges. Its quantitative data allows the insertion in a broader discourse and the linkage to a large body of research in walkability. Co-creation workshops, especially city games, proved to be a powerful tool to initiate dialogue on complex spatial negotiation, even in societies where participatory approaches do not have a well-established tradition.
“They heard our voice!” patient engagement councils in community-based primary care practices: a participatory action research pilot study
Authors: Haesebaert Julie , Samson Isabelle , Lee-Gosselin Hélène , Guay-Bélanger Sabrina , Proteau Jean-François , Drouin Guy , Guimont Chantal , Vigneault Luc , Poirier Annie , Sanon Priscille-Nice , Roch Geneviève , Poitras Marie-Ève , LeBlanc Annie , Légaré France
Published: September 2020

Background

Patient engagement could improve the quality of primary care practices. However, we know little about effective patient engagement strategies. We aimed to assess the acceptability and feasibility of embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices.

Methods

Using a participatory action research approach, we conducted our study in two non-academic primary care practices in Quebec City (Canada). Patient-experts (patients trained in research) were involved in study design, council recruitment and meeting facilitation. Advisory councils were each to include patients and/or caregivers, clinicians and managers. Over six meetings, councils would identify quality improvement priorities and plan projects accordingly. We assessed acceptability and feasibility of the councils using non-participant observations, audio-recordings and self-administered questionnaires. We used descriptive analyses, triangulated qualitative data and performed inductive thematic analysis.

Results

Between December 2017 and June 2018, two advisory councils were formed, each with 11 patients (36% male, mean age 53.8 years), a nurse and a manager practising as a family physician (25% male, mean age 45 years). The six meetings per practice occurred within the study period with a mean of eight patients per meeting. Councils worked on two projects each: the first council on a new information leaflet about clinic organization and operation, and on communications about local public health programs; the second on methods to further engage patients in the practice, and on improving the appointment scheduling system. Median patient satisfaction was 8/10, and 66.7% perceived councils had an impact on practice operations. They considered involvement of a manager, facilitation by patient-experts, and the fostering of mutual respect as key to this impact. Clinicians and managers liked having patients as facilitators and the respect among members. Limiting factors were difficulty focusing on a single feasible project and time constraints. Managers in both practices were committed to pursuing the councils post-study.

Conclusion

Our results indicated that embedding advisory councils of clinicians, managers, patients and caregivers to conduct patient-oriented quality improvement projects in primary care practices is both acceptable and feasible. Future research should assess its transferability to other clinical contexts.
Population aging and the historical development of intergenerational transfer systems
Authors: Lee Ronald
Published: September 2020

From our evolutionary past, humans inherited a long period of child dependency, extensive intergenerational transfers to children, cooperative breeding, and social sharing of food. Older people continued to transfer a surplus to the young. After the agricultural revolution, population densities grew making land and residences valuable assets controlled by older people, leading to their reduced labor supply which made them net consumers. In some East Asian societies today, elders are supported by adult children but in most societies the elderly continue to make private net transfers to their children out of asset income or public pensions. Growing public intergenerational transfers have crowded out private transfers. In some high-income countries, the direction of intergenerational flows has reversed from downward to upwards, from young to old. Nonetheless, net private transfers remain strongly downward, from older to younger, everywhere in the world. For many but not all countries, projected population aging will bring fiscal instability unless there are major program reforms. However, in many countries population aging will reduce the net cost to adults of private transfers to children, partially offsetting the increased net costs to working age adults for public transfers to the elderly.
Long-fibre reinforced polymer composites by 3D printing: influence of nature of reinforcement and processing parameters on mechanical performance
Authors: Dantas Francis , Couling Kevin , Gibbons Gregory J.
Published: September 2020

The aim of this study was to identify the effect of material type (matrix and reinforcement) and process parameters, on the mechanical properties of 3D Printed long-fibre reinforced polymer composites manufactured using a commercial 3D Printer (Mark Two). The effect of matrix material (Onyx or polyamide), reinforcement type (Carbon, Kevlar®, and HSHT glass), volume of reinforcement, and reinforcement lay-up orientation on both Ultimate Tensile Strength (UTS) and Flexural Modulus were investigated.

For Onyx, carbon fibre reinforcement offered the largest increase in both UTS and Flexural Modulus over unreinforced material (1228 ± 19% and 1114 ± 6% respectively). Kevlar® and HSHT also provided improvements but these were less significant. Similarly, for Nylon, the UTS and Flexural Modulus were increased by 1431 ± 56% and 1924 ± 5% by the addition of carbon fibre reinforcement. Statistical analysis indicated that changing the number of layers of reinforcement had the largest impact on both UTS and Flexural Strength, and all parameters were statistically significant.
Albizia chinensis bark extract ameliorates the genotoxic effect of cyclophosphamide
Authors: Nabil Marian , Hassan Entesar E. , Ghaly Neven S. , Aly Fawzia A. , Melek Farouk R. , Hassan Zeinab M. , Fahmy Maha A. , Farghaly Ayman A.
Published: September 2020

Background

The genus Albizia (Leguminoseae) is used in folk medicine for the treatment of a wide range of ailments. Recently, saponins from plant origin have attracted much attention. Saponins are recorded to have a broad range of biological and pharmacological activities. This study was performed to evaluate the protective role of Albizia chinensis bark methanolic extract (MEAC) against the genotoxicity induced by cyclophosphamide (CP) using different mutagenic parameters.

Results

The results showed that MEAC induced an inhibitory effect against chromosomal aberrations of CP in mouse bone marrow and spermatocytes. Such effect was found to be significant (p < 0.01) with a dose of 100 mg/kg treated once for 24 h and also after repeated treatment at a dose of 25 mg/kg for 7 days. In sperm abnormalities, the protective effect of Albizia extract showed a dose-related relationship. Different doses of MEAC (25, 50, and 100 mg/kg) significantly (p < 0.01) ameliorated sperm abnormalities induced by CP dose-dependently. The percentage of sperm abnormalities was decreased to 5.14 ± 0.72 in the group of animals treated with CP plus MEAC (100 mg/kg) indicating an inhibitory effect of about 50%.

Conclusion

MEAC at the doses examined was non-genotoxic compared to control (negative) and exhibited a protective role against CP genotoxicity.
Durometry as an alternative tool to the modified Rodnan’s skin score in the assessment of diffuse systemic sclerosis patients: a cross-sectional study
Authors: de Oliveira Marília de Fátima Cirioli , Leopoldo Vanessa Cristina , Pereira Karla Ribeiro Costa , de Moraes Daniela Aparecida , Dias Juliana Bernardes Elias , Gonçalves Maynara Santana , Ramalho Leandra Naíra Zambelli , dos Santos Bruna Nogueira , de Oliveira Maria Carolina , Silveira Renata Cristina Campos Pereira
Published: September 2020

Background

The reproducibility and reliability of the modified Rodnan’s Skin Score (mRSS) are debated due to investigator-related subjectivity. Here, we evaluate if durometry correlates with mRSS in patients with diffuse systemic sclerosis (SSc).

Methods

This cross-sectional study was conducted from December 2018 to June 2019, including 58 diffuse SSc patients. Two certified researchers, blind to each other’s scores, performed the mRSS, followed by durometry at 17 predefined skin sites. For durometry and mRSS, individual scores per skin site were registered. Durometry and mRSS results measured by each researcher, as well as scores from different researchers, were compared. Skin thickness measurements from forearm skin biopsies were available in a subset of the patients, for comparisons. Statistical analyses included Cohen’s Kappa Coefficient, Intraclass Correlation Coefficient, Kendall’s Coefficient and Spearman’s test.

Results

Mean (standard deviation, SD) patient age was 44.8 (12.9) years, and 88% were female. Inter-rater agreement varied from 0.88 to 0.99 (Intraclass correlation coefficient) for durometry, and 0.54 to 0.79 (Cohen’s Kappa coefficient) for mRSS, according to the specific evaluated sites. When data were compared with skin thickness assessed in forearm biopsies, durometry correlated better with skin thickness than mRSS.

Conclusion

Durometry may be considered as an alternative method to quantify skin involvement in patients with diffuse SSc. The strong inter-rater agreement suggests that the method may be useful for the assessment of patients by multiple researchers, as in clinical trials.
A predictive model of the sunscreen use in the paddy workers based on the health action process approach model: a path analysis
Authors: Panahi Hadiseh , Salehi Leili , Mahmoodi Zohreh
Published: September 2020

Background

Skin cancer is considered as one of the most common cancers in the world. There is little information about identifying factors affecting sunscreen use among paddy workers and their protective behavior. The present study aimed to determine a predictive model of the sunscreen use in the paddy workers based on the health action process approach model (HAPA).

Methods

This cross-sectional study was conducted on 177 paddy workers who engaged in agricultural work in the north of Iran in 2018. Convenience sampling methods was used. Inclusion criteria were being a farmer for 5 years, working under the sunshine more than 2 h per day, and above the age of 30 years. A multi-sectional questionnaire (intention, risk perception (RP), outcome expectation (OE), action self-efficacy (ASE), action planning (AP), coping planning (CP), coping SE (CSE), self-monitoring (SM), and sunscreen use) was used for data collection. Data were analyzed with SPSS-21 and Lisrel-8.8 software.

Results

The mean age of participants was 47.78 ± 12.66 years. The final path model fitted well (comparative fit index (CFI) = 0.98, RMSEA = 0.000), only coping self-efficacy (CSE) from both direct and indirect paths had an impact on sunscreen use (B = 0.73). Among the variables which are influenced only in one direction, coping planning (CP) had the most direct influence (B = 0.30) on behavior, and action planning had the lowest influence (B = 0.24).

Conclusion

Coping self-efficacy was the most important factor which had influence on the use of sunscreen, and it should be considered when designing interventional programs related to sunscreen use among paddy workers.