bluuebunny/crossref_metadata_2025 huggingface dataset:
May Measurement Month 2018: an analysis of blood pressure screening results from Argentinean cohort
Authors: Espeche Walter G , Rojas Cristina , Stisman Diego , Fuentes Analia , Fita Mariana , Lacunza Carlos Diego , Marquez Diego , Grosse Pedro , Bueno Dennis , Zilberman Judith , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Marín Marcos , Ennis Irene L
Published: August 2020

Hypertension continues to be the leading cause of death and disability in the industrialized world, with a high level of unawareness and unacceptably poor control. Therefore, the Argentinian Society of Hypertension, in agreement with the May Measurement Month (MMM) initiative of the International Society of Hypertension, implemented for the second consecutive year an educational campaign during the month of May 2018. A volunteer cross-sectional survey was carried out in public spaces and health centres during the month of May 2018 across 33 cities in Argentina. Hypertension was defined as systolic blood pressure (BP) ≥140 mmHg or diastolic BP ≥90 mmHg based on the mean of the 2nd and 3rd of three consecutive BP measurements, or in those on treatment for high BP. Statistical analysis including multiple imputation followed the MMM protocol. A total of 70 418 individuals were screened during MMM18, after excluding those under 18 years old. Of the total, 43.8% of participants were classified as hypertensive, 77.7% were aware of their diagnosis, 69.1% were on pharmacological treatment, and 38.7% were controlled. Of those on antihypertensive medication, 56.0% were controlled. It is necessary to reinforce strategies not only to increase the awareness and control of hypertension but also to identify the population groups, in which these strategies would have the greatest impact, helping to reduce the enormous health burden attributed to hypertension.
An analysis of blood pressure screening of 21 112 participants in Armenia: May Measurement Month 2018
Authors: Zelveian Parounak , Avagyan Avag , Minasyan Arsen , Hayrumyan Samvel , Gourgenyan Svetlana , Hakobyan Zoya , Kzhdryan Hovhannes , Hakobjanyan Vahan , Ustyan Tsiala , Gharibyan Heghine , Melkonyan Arevik , Aroyan Siranush , Vatinyan Susanna , Beaney Thomas , Ster Anca Chis , Poulter Neil R
Published: August 2020

Elevated blood pressure (BP) is a growing burden worldwide and is the leading cause of mortality and disability-adjusted life years all over the world. May Measurement Month (MMM) is a global initiative aimed to raise awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. An opportunistic cross-sectional survey of volunteers aged ≥18 was carried out in May to July 2018. Blood pressure measurement, the definition of hypertension (HTN) and statistical analysis followed the standard MMM protocol. The study was conducted in public areas (17 sites in Yerevan and 22 in regions), both indoor and outdoor, as well as in 78 primary care centres. A total of 21 112 individuals were screened during MMM18, of which 20 732 had three BP measurements available. The mean age of screened individuals was 46.2 ± 17.3 years, 57.8% were female. At the time of screening, 26.1% were on antihypertensive medication. After imputation, the percentage of participants with HTN was 38.7%, and 76.7% of them were aware of their high BP. Of participants receiving treatment, 47.1% had a controlled BP. MMM18 was the largest BP screening campaign undertaken in Armenia. We found that the proportion of HTN is substantial in Armenia, which may be a vital contributor to the growing burden of non-communicable diseases. Our results also suggest that untreated HTN is common and when treated still not adequately controlled in Armenia. The current situation, with an insufficient control rate of HTN, must be changed as soon as possible.
May Measurement Month 2018: an analysis of blood pressure screening results from Australia
Authors: Carnagarin Revathy , Fonseca Ricardo , Brockman Derrin , Critchley Sue , Tan Isabella , Trengove Naomi , Tan Kearney , Lambert Gavin W , Cowley Diane , Burrell Louise M , Poulter Neil R , Beaney Thomas , Ster Anca Chis , Xia Xin , Schlaich Markus P
Published: August 2020

May Measurement Month (MMM), originally initiated as a temporary solution to address the lack of blood pressure (BP) screening programs worldwide, emerged as an effective annual campaign to increase the awareness of hypertension. MMM18, a cross-sectional survey of volunteers aged ≥18 years was carried out during May 2018 predominantly in capital cities across Australia following the standard MMM protocol. Blood pressure screening along with additional information including anthropometric data and responses to questionnaires on demographic, lifestyle, and environmental factors were collected from 3 352 individuals across Australia. After multiple imputation, 1 026 (30.6%) adult Australians had hypertension. Of the 2 936 individuals not on antihypertensive treatment, 610 (20.8%) were hypertensive, and 237 (57.1%) of the 416 individuals receiving antihypertensive treatment had uncontrolled BP. In line with MMM17 results and other previous surveys, MMM18 revealed that close to one-third of the screened population (30.6%) had hypertension, 57.1% of individuals treated with BP-lowering medication remained uncontrolled indicating suboptimal management of the condition in the majority of patients. Most importantly, only 49.0% of those with hypertension were aware of their elevated BP, highlighting lack of awareness of elevated BP in nearly half of the affected population. Elevated BP was directly associated with alcohol consumption, overweight, and obesity. Our findings demonstrate the need for (i) continued efforts to increase BP awareness in the population, (ii) optimization of BP management strategies, and (iii) tackling some of the major contributors to BP elevation, including alcohol consumption and obesity.
May Measurement Month 2018: an analysis of blood pressure screening results from Botswana
Authors: Masupe Tiny , Tlhakanelo John Thato , Tiro Mary Banyana , Motlhatlhedi Keneilwe , Mamela Abraham , Makwati Obuile , Kololo Masego , Phuswane Orapeleng , Lesetedi Onalethata , Motlhagodi Amogelang , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Xia Xin , Mosepele Mosepele
Published: August 2020

During the May Measurement Month 2018 (MMM18) campaign, we aimed to raise hypertension awareness and measure blood pressure (BP) across different communities in Botswana. Study sites included four large villages and Gaborone (capital city). Screening sites were shopping malls, train stations, churches, and workplaces. Individuals aged ≥18 years were recruited through fliers, word of mouth, and as volunteer walk-ins at the sites. Demographic and risk factor data were collected through a questionnaire prior to measuring three BP readings per participant. Weight was measured while height was usually estimated. Hypertension was defined as: systolic BP ≥140 mmHg or diastolic BP ≥90 mmHg or taking antihypertensive medication. The mean of readings 2 and 3 was used and was estimated using multiple imputation where missing. Amongst 4599 participants whose BPs were measured, 54.5% were female, while mean age was 35.9 years. A total of 1510 (32.8%) participants were hypertensive and of those, 712 (47.1%) were aware of the hypertension. Only 35.2% of hypertensives were on antihypertensive treatment with 54.4% had controlled BP. Amongst all hypertensives, only 19.1% had controlled BP. Risk factors associated with higher BP included obesity, more than 1 unit of alcohol/week and BP measured on Sunday. Less than half (47.1%) of those identified as having hypertension during MMM18 were aware of their condition, despite the escalating prevalence of hypertension in the country. Regular BP awareness and opportunistic BP measurement campaigns like MMM are recommended to improve detection and control of hypertension and other cardiovascular risk factors.
May Measurement Month 2018: an analysis of blood pressure screening results from Brazil
Authors: Barbosa Eduardo , Eibel Bruna , Feitosa Audes D M , Brandão Andréa A , Bortolotto Luiz A , Neves Mario F T , Martin José F V , Spinelli Antonio C S , Cestário Elizabeth E S , Campana Erika M G , Toledo Juan C Y , Póvoa Rui M S , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Mota-Gomes Marco A , Barroso Weimar Kunz Sebba
Published: August 2020

Hypertension is a pathology of high prevalence in the world. In Brazil, it is the main risk factor for the major cause of death in the country, coronary heart disease. The May Measurement Month Campaign in 2018 (MMM18) included a population with representation from all Brazilian states and reflects some of the characteristics of hypertension in Brazil. Questionnaire data were collected and three measures of blood pressure (BP) were performed. The sample consisted of 12 413 individuals, 59.1% were white, 51.3% were women. The average age was 54. ± 16.0 years. Diabetes was present in 11.6%, previous myocardial infarction in 5.9%, and previous stroke in 2.7%. Current smokers were 9.3% and 12.4% were regular drinkers. The average body mass index was 27.3 ± 4.5 kg/m2. After multiple imputations, 67.9% were hypertensive (>140/90 mmHg). Of the individuals who were not taking antihypertensive medication, 27.9% were hypertensive and of those taking antihypertensive medication, 40.3% were uncontrolled. Systolic BP increased with age. The MMM18 campaign demonstrated a large number of unknown hypertensives and a high rate of uncontrolled hypertension in Brazil, unfortunately in keeping with 2017 findings.
May Measurement Month 2018: an analysis of blood pressure screening results from Malaysia
Authors: Chia Yook Chin , Ching Siew Mooi , Devaraj Navin Kumar , Chew Bee Nah , Ooi Pei Boon , Mohamed Mohazmi , Othman Azli Shahril , Kang Pei San , Husin Hanis Saadah , Mohamad Gani Abdul Hafiz , Hamid Dalyana , Beaney Thomas , Ster Anca Chis , Poulter Neil R , Xia Xin
Published: August 2020

Hypertension continues to be the top global killer, contributing to over 10 million deaths annually. As prevalence and unawareness of hypertension remain high in Malaysia, this study was aimed to screen more individuals to identify those with undiagnosed hypertension. Respondents aged ≥18 years were recruited through opportunistic sampling at various screening sites including health clinics, hospitals, student health centres, universities, community halls, shopping malls, as well as through other health screening campaigns. Each respondent completed a questionnaire on socio-demographic, environmental, and lifestyle data. Anthropometric measurements as well as three blood pressure (BP) measurements were obtained from all participants. Hypertension was defined as a systolic BP ≥140 mmHg and/or diastolic BP ≥90 mmHg or taking antihypertensive medication. The total number of participants was 4866. The mean age of the participants was 39.8 (17.6) years with 61.1% female participants. Of the 4866 participants, 1405 (28.9%) had hypertension. The proportion of those aware of their hypertension status was 76.3% (1073/1405). The proportion of those with hypertension on medication was 71% (998/1405). Of those receiving antihypertensive treatment, 62.4% (623/998) had controlled BP. The proportion of hypertension in this study was 28.9%. The awareness rate of 76.3% compares favourably to a previously reported national level of 43.2%. Hence, BP screening programmes may be effective at increasing awareness and should be conducted annually.
May Measurement Month 2018: an analysis of blood pressure screening results from Mexico
Authors: Alcocer Luis , Chavez Adolfo , Gomez-Alvarez Enrique , Espinosa Cutberto , Pombo Jose , Beaney Thomas , Ster Anca Chis , Poulter Neil R ,   On behalf of the MMM18-Mexico investigators
Published: August 2020

In 2015, arterial hypertension was responsible for 18.1% of the total deaths in Mexico and its mortality rate has increased to 29.9% in the last 6 years. It is currently the main risk factor for preventable premature deaths of adults in the country. Good quality epidemiological information is the first step to improve health services. May Measurement Month 2018 (MMM18) in Mexico is an opportunistic survey, which follows the previously published methodology. MMM18 included screening 10 139 participants, 2187 (21.6%) of whom were classified as having hypertension. Of these, 42.0% were aware of the condition before measurement, and 38.0% were on medication, of which 66.5% were controlled. Hence, of all hypertensive patients, 25.3% were controlled (<140/90 mmHg). MMM18 in Mexico provides complementary data to the existing information on arterial hypertension in the country and helps to increase the visibility of hypertension: a priority health problem.
May Measurement Month 2018: an analysis of blood pressure screening results from Sudan
Authors: Beheiry Hind M , Abdalla Asma A , Fahal Naiema A , Mohamed Maha I , Ibrahim Dina A , Medani Safaa A , Khalfa Hana A , Mutalab Samih Abdel , Atia Amna , Elsheik Wigdan A , Khalfa Rania A , Mahmoud Nagla E , Beaney Thomas , Ster Anca Chis , Ali Ibtisam A , Poulter Neil R
Published: August 2020

To raise awareness of high blood pressure (BP) levels and associated risk factors among the Sudanese population. A cross-sectional study was conducted in six Sudanese states during the period May–August 2018. The study area included public indoor and outdoor areas, institutes, and service facilities. A questionnaire for collecting the data was employed including demographic data, along with three consecutive BP measurements. Data were collected by trained volunteers. Hypertension (HTN) was defined as a systolic blood pressure ≥140 mmHg or a diastolic blood pressure ≥90 mmHg based on the mean of the second and third measurements, or in those on antihypertensive medication. The current study indicated a high prevalence of HTN (28.2%) among 40 779 participants and a low level of awareness (20.7%) amongst these participants. Of all, 18.2% of hypertensive participants were on medication and of these, 54.6% were controlled. Of all hypertensives, only 9.9% were controlled. Further action needs to be taken by all stakeholders for raising awareness and increasing screening provision of HTN, which are essential for the development of national health policies for control and management of HTN in Sudan.
May Measurement Month 2018: an analysis of blood pressure screening results from the UK and the Republic of Ireland
Authors: McDonnell Barry J , Beaney Thomas , Al Shezawi Mahfoudha , Cockcroft John R , Barciela Carolina , Tay Tricia , Keitley James , Brady Adrian J B , Padmanabhan Sandosh , McCallum Linsay , Dolan Eamon , O’Brien Eoin , Tomaszewski Maciej , Schutte Aletta E , Poulter Neil R , Cappuccio Franco P
Published: August 2020

Raised blood pressure (BP) was the biggest contributor to the global burden of disease in 2017, with lack of awareness and adequate control of BP identified as the main drivers of this disease burden. In 2017, an opportunistic BP screening and awareness campaign called May Measurement Month (MMM) in the UK and Republic of Ireland (RoI) highlighted that levels of undiagnosed hypertension and uncontrolled hypertension in the community screened were approximately 23% and 40%, respectively. MMM18 was undertaken to further the campaign’s efforts to increase awareness and create an evidence base of population risk associated with high BP. MMM18 BP screenings were conducted in the community at places of worship, supermarkets, GP surgeries, workplaces, community pharmacies, gyms, and various other public places. A total of 5000 volunteers, aged 47.3 (±17.2) years, 60% female were screened. Of all 5000 individuals screened, 1716 (34.3%) were hypertensive, of which only 51.3% were aware of their condition, 42.8% on antihypertensive treatment, and only 51.5% of those on medication controlled to target BP of <140/90 mmHg. Furthermore, obese, overweight, and underweight participants all had significantly higher BP values compared to individuals with a healthy body mass index (BMI). The 2018 MMM campaign in the UK and the RoI confirmed approximately one in three adults were hypertensive, with more than half having uncontrolled BP. In addition, these findings show that people with low BMI are at risk of having high BP. Finally, with only one in two people aware of their high BP, awareness remains a significant public health concern.
May Measurement Month 2018: an analysis of blood pressure screening results from Vietnam
Authors: Van Minh Huynh , Lan Viet Nguyen , Sinh Cao Thuc , Hung Phan Nam , Ngoc Nguyen Thi Mong , Van Hung Ngo , Son Tran Kim , Đong Nguyen Ta , Thang Đoan Chi , Thuan Nguyen Duc , Dinh Thoan Nguyen , Tien Hoang Anh , Beaney Thomas , Ster Anca Chis , Poulter Neil R
Published: August 2020

Vietnam in the Asia Pacific region has a high hypertension (HTN) prevalence. The May Measurement Month (MMM) program was enthusiastically responded to in Vietnam by launching and deploying it across the whole country from 2017. The aims of the MMM 2018 program in Vietnam were to screen at least 15 000 people aged 18 and over across the country; to inform participants of the risks associated with HTN; and thereby define the proportion of subjects with elevated blood pressure (BP) and assess the awareness and the effectiveness of its treatment. An opportunistic cross-sectional survey of volunteers aged ≥ 18 was carried out in May 2018. Blood pressure measurement, the definition of HTN, and statistical analysis followed the standard MMM protocol. From May 2018 to June 2018, through 10 cities/provinces in Vietnam, 17 332 individuals with mean age 47.0 ± 17.9 years were screened during MMM18. After multiple imputation, 5260 (30.3%) had HTN. Of individuals not receiving antihypertensive medication, 1956 (13.9%) were hypertensive. Of patients receiving antihypertensive medication, 1540 (46.6%) had uncontrolled BP. Those who had HTN also displayed many additional risk factors similarly to MMM 2017 including smoking, alcohol, overweight-obesity, and diabetes. In conclusion, MMM 2018 campaign is a continuation program of MMM 2017 that has promoted the strength of the BP screening survey in the community in Vietnam, which hopefully will influence on awareness of disease prevention in this century. The next steps of the program will have special innovations on how to reduce the frequency of focusing on variable risk factors to change the overall picture of HTN in Vietnam.
May Measurement Month 2018: an analysis of blood pressure screening results from Bangladesh
Authors: Malik Fazila-Tun-Nesa , Al Mamun Mohammad Abdullah , Ishraquzzaman Mir , Kalimuddin Mohammad , Shahriar Huq Tawfiq , Rahman Mohammad Shamimur , Choudhury Sohel Reza , Ahmed Nazir , Badiuzzaman Mohammad , Beaney Thomas , Xia Xin , Ster Anca Chis , Malik Abdul , Poulter Neil R
Published: August 2020

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. According to Non-communicable disease (NCD) Risk Factors Survey Bangladesh 2010, one-fifth (21.9%) of adults aged 25 years or more have hypertension. Almost one-third of the adult population did not have their BP measured in their lifetime in Bangladesh. National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) 2018 as a part of a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes nationally. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the MMM protocol. Data were collected from 10 screening sites in 9 districts in Bangladesh. A total of 5208 individuals were screened during MMM18. After multiple imputation, 1750 (33.6%) had hypertension. Among the 1750 participants with hypertension, 1312 (75.0%) were aware of having hypertension. Among those that were not on antihypertensive medication, 15.2% were hypertensive and among those that were on antihypertensive medication 33.6% had uncontrolled hypertension. The present study showed that opportunistic screening can identify significant numbers of people with raised BP. A periodic public health programme at a national level needs to be initiated to increase hypertension detection and control rates and thus for prevention of cardiovascular diseases.
Quality indicators for the care and outcomes of adults with atrial fibrillation
Authors: Arbelo Elena ,   (Chair), Aktaa Suleman , Bollmann Andreas , D’Avila André , Drossart Inga , Dwight Jeremy , Hills Mellanie True , Hindricks Gerhard , Kusumoto Fred M , Lane Deirdre A , Lau Dennis H , Lettino Maddalena , Lip Gregory Y H , Lobban Trudie , Pak Hui-Nam , Potpara Tatjana , Saenz Luis C , Van Gelder Isabelle C , Varosy Paul , Gale Chris P , Dagres Nikolaos ,   (Co-chair),   Reviewers, Boveda Serge ,   (review coordinator), Deneke Thomas , Defaye Pascal , Conte Giulio , Lenarczyk Radoslaw , Providencia Rui , Guerra Jose M , Takahashi Yoshihide , Pisani Cristiano , Nava Santiago , Sarkozy Andrea , Glotzer Taya V , Martins Oliveira Mario
Published: August 2020

Aims

To develop quality indicators (QIs) that may be used to evaluate the quality of care and outcomes for adults with atrial fibrillation (AF).

Methods and results

We followed the ESC methodology for QI development. This methodology involved (i) the identification of the domains of AF care for the diagnosis and management of AF (by a group of experts including members of the ESC Clinical Practice Guidelines Task Force for AF); (ii) the construction of candidate QIs (including a systematic review of the literature); and (iii) the selection of the final set of QIs (using a modified Delphi method). Six domains of care for the diagnosis and management of AF were identified: (i) Patient assessment (baseline and follow-up), (ii) Anticoagulation therapy, (iii) Rate control strategy, (iv) Rhythm control strategy, (v) Risk factor management, and (vi) Outcomes measures, including patient-reported outcome measures (PROMs). In total, 17 main and 17 secondary QIs, which covered all six domains of care for the diagnosis and management of AF, were selected. The outcome domain included measures on the consequences and treatment of AF, as well as PROMs.

Conclusion

This document defines six domains of AF care (patient assessment, anticoagulation, rate control, rhythm control, risk factor management, and outcomes), and provides 17 main and 17 secondary QIs for the diagnosis and management of AF. It is anticipated that implementation of these QIs will improve the quality of AF care.
Chemical characterization, release, and bioactivity of Eucalyptus camaldulensis polyphenols from freeze-dried sodium alginate and sodium carboxymethyl cellulose matrix
Authors: Nwabor Ozioma Forstinus , Singh Sudarshan , Marlina Dwi , Voravuthikunchai Supayang Piyawan
Published: August 2020

Crude ethanolic extract of Eucalyptus camaldulensis was encapsulated with sodium alginate–sodium carboxymethyl cellulose (CMC) using freeze-drying techniques. The microcapsules were characterized for particle size, morphology, physicochemical parameters, and micromeritics properties. Antioxidant and antimicrobial activities of the microcapsules were also demonstrated. Results revealed an irregular-shaped microparticles with a mean diameter ranging from 6.7 to 26.6 µm. Zeta potential and polydispersity index ranged from −17.01 to 2.23 mV and 0.34 to 0.49, respectively. Percentage yield ranged between 70.4 and 81.5 per cent whereas encapsulation efficiency ranged between 74.2 ± 0.011 and 82.43 ± 0.77 per cent. Swelling index and solubility varied inversely with extract concentration, with a range of 54.4%–84.0% and 18.8%–22.2%, respectively. Antioxidant activities varied directly with the concentration of the extract. Minimum inhibitory and minimum bactericidal concentrations of the microcapsules against Gram-positive foodborne pathogens ranged from 0.19 to 3.12 and 0.19–12.25 mg/ml, respectively. The Higuchi model indicated a time-dependent, delayed, and regulated release of polyphenols at 37°C. The results suggested that alginate–CMC possessed good encapsulant properties that preserved the bioactive extract, thus might be employed for application of natural products in food systems.
Antioxidant Apigenin Relieves Age-Related Muscle Atrophy by Inhibiting Oxidative Stress and Hyperactive Mitophagy and Apoptosis in Skeletal Muscle of Mice
Authors: Wang Dongtao , Yang Yajun , Zou Xiaohu , Zhang Jing , Zheng Zena , Wang Ziwei
Published: August 2020

Skeletal muscle atrophy in the aged causes loss in muscle mass and functions. Naturally occurring antioxidant flavonoid apigenin is able to ameliorate obesity- and denervation-induced muscle atrophies, but its effects on age-related muscle atrophy remain unknown. We hypothesized that apigenin can relieve muscle atrophy in aged mice, probably through special effects on reactive oxygen species and enzymes with antioxidant functions. For the male mice of the study, apigenin showed significant dose-dependent effects in relieving aging-related muscle atrophy according to results of frailty index as indicator of frailty associated with aging, grip strength, and running distance. Apigenin also improved myofiber size and morphological features and increased mitochondria number and volume, as manifested by succinate dehydrogenase staining and transmission electron microscopy. Our tests also suggested that apigenin promoted activities of enzymes such as superoxide dismutase and glutathione peroxidase for antioxidation and those for aerobic respiration such as mitochondrial respiratory enzyme complexes I, II, and IV, increased ATP, and enhanced expression of genes such as peroxisome proliferator-activated receptor-γ coactivator 1α, mitochondrial transcription factor A, nuclear respiratory factor-1, and ATP5B involved in mitochondrial biogenesis. The data also suggested that apigenin inhibited Bcl-2/adenovirus E1B 19kD-interacting protein 3 and DNA fragmentation as indicators of mitophagy and apoptosis in aged mice with skeletal muscle atrophy. Together, the results suggest that apigenin relieves age-related skeletal muscle atrophy through reducing oxidative stress and inhibiting hyperactive autophagy and apoptosis.
Long-term Effects of Calcium β-Hydroxy-β-Methylbutyrate and Vitamin D3 Supplementation on Muscular Function in Older Adults With and Without Resistance Training: A Randomized, Double-blind, Controlled Study
Authors: Rathmacher John A , Pitchford Lisa M , Khoo Paul , Angus Hector , Lang James , Lowry Kristin , Ruby Carol , Krajek Alex C , Fuller John C , Sharp Rick L
Published: August 2020

The primary aim of this study was to determine whether supplementation with calcium β-hydroxy-β-methylbutyrate (HMB) and vitamin D3 (D) would enhance muscle function and strength in older adults. Older adults over 60 years of age with insufficient circulating 25-hydroxy-vitamin D (25OH-D) levels were enrolled in a double-blinded controlled 12-month study. Study participants were randomly assigned to treatments consisting of: (a) Control + no exercise, (b) HMB+D + no exercise, (c) Control + exercise, and (d) HMB+D + exercise. The study evaluated 117 participants via multiple measurements over the 12 months that included body composition, strength, functionality, and questionnaires. HMB+D had a significant benefit on lean body mass within the nonexercise group at 6 months (0.44 ± 0.27 kg, HMB+D vs −0.33 ± 0.28 kg, control, p < .05). In nonexercisers, improvement in knee extension peak torque (60°/s) was significantly greater in HMB+D-supplemented participants than in the nonsupplemented group (p = .04) at 3 months, 10.9 ± 5.7 Nm and −5.2 ± 5.9 Nm, respectively. A composite functional index, integrating changes in handgrip, Get Up, and Get Up and Go measurements, was developed. HMB+D + no exercise resulted in significant increases in the functional index compared with those observed in the control + no exercise group at 3 (p = .03), 6 (p = .04), and 12 months (p = .04). Supplementation with HMB+D did not further improve the functional index within the exercising group. This study demonstrated the potential of HMB and vitamin D3 supplementation to enhance muscle strength and physical functionality in older adults, even in individuals not engaged in an exercise training program.
Global Autocracies: Strategies of Transnational Repression, Legitimation, and Co-Optation in World Politics
Authors: Tsourapas Gerasimos
Published: August 2020

How, when, and why does a state take repressive action against individuals residing outside its territorial jurisdiction? Beyond state-led domestic forms of control over citizens living within their legal borders, autocracies also seek to target those abroad—from African states’ sponsoring violence against exiled dissidents to Central Asian republics’ extraditions of political émigrés, and from the adoption of spyware software to monitor digital activism across Latin America to enforced disappearances of East Asian expatriates. Despite growing global interconnectedness, the field of international studies currently lacks an adequate comparative framework for analyzing how autocracies adapt to growing cross-border mobility. I argue that the rise of global migration flows has contributed to the emergence of “transnational authoritarianism,” as autocracies aim to both maximize material gains from citizens’ “exit” and minimize political risks by controlling their “voice” abroad. I demonstrate that governments develop strategies of transnational repression, legitimation, and co-optation that transcend state borders, as well as co-operation with a range of non-state actors. Bringing work on the international politics of migration in conversation with the literature on authoritarianism, I provide illustrative examples drawn from a range of transnational authoritarian practices by the fifty countries categorized as “Not Free” by Freedom House in 2019, covering much of Africa, Asia, the Middle East, and South America. I sketch an emerging field of international studies research around the novel means that autocracies employ to exercise power over populations abroad, while shedding light on the evolving nature of global authoritarianism.
Associations of mucosal disaccharidase kinetics and expression in the jejunum of steers with divergent average daily gain
Authors: Smith Wyatt N , Brake Derek W , Lindholm-Perry Amanda K , Oliver William T , Freetly Harvey C , Foote Andrew P
Published: August 2020

The objective of this study was to quantify the differences in the activity of jejunal maltase and isomaltase between two groups of steers with average dry matter intake (DMI) and differing average daily gain (ADG). DMI and ADG were measured in crossbred steers (n = 69; initial body weight = 456 ± 5.0 kg) consuming a finishing diet containing 67.8% dry-rolled corn, 20.0% wet distillers grains with solubles, 8.0% alfalfa hay, and 4.2% vitamin/mineral supplement on a dry matter basis for 84 d. Jejunal mucosal samples were collected from eight steers with the greatest (high) or least (low) ADG and average DMI (± 0.55 standard deviation). Homogenates of jejunal mucosa were incubated with increasing amounts of maltose and isomaltose to determine the disaccharidase kinetics. Total mucosal protein concentration (mg protein/g tissue; P = 0.45) of the mucosa and small intestinal weights (P = 0.69) did not differ between the groups. Neither the Michaelis–Menten constant (Km) of isomaltase (P = 0.15) nor maltase (P = 0.21) differed between groups. The isomaltase maximum velocity (Vmax) expressed per gram of protein tended to differ (P = 0.10) between groups of steers but did not differ (P = 0.13) when expressed on a tissue basis. Similarly, neither the maltase Vmax expressed per gram of protein (P = 0.31) nor tissue (P = 0.32) differed between groups. While previous studies have indicated that disaccharidase expression is associated with differences in ADG, data presented here indicate that differences in enzyme activity at the end of the finishing period are minimal.
What Is the Predictive Value of a Single Nasopharyngeal SARS-CoV-2 PCR Swab Test in a Patient With COVID-Like Symptoms and/or Significant COVID-19 Exposure?
Authors: George Blessen , McGee James , Giangrasso Eileen , Finkelstein Sheila , Wu Susan , Glatt Aaron E
Published: August 2020

Utilizing results of polymerase chain reaction (PCR) testing and subsequent antibody titers, we report on the test characteristics of a PCR screening test for severe acute respiratory syndrome coronavirus 2 among hospital workers. The PCR test was found to be 87% sensitive and 97% specific, with a positive predictive value of 0.98 and a negative predictive value of 0.80.
Systemic inflammation as a moderator between sleep and incident dementia
Authors: Baril Andrée-Ann , Beiser Alexa S , Redline Susan , McGrath Emer R , Aparicio Hugo J , Gottlieb Daniel J , Seshadri Sudha , Pase Matthew P , Himali Jayandra J
Published: August 2020

Study Objectives

To determine whether C-reactive protein (CRP), a marker of systemic inflammation, moderates the association between sleep and incident dementia.

Methods

We studied Framingham Heart Study participants who completed at baseline a serum CRP assessment and in-home polysomnography to measure sleep duration, sleep efficiency, sleep latency, wake after sleep onset (WASO), number of awakenings, arousal index, and apnea–hypopnea index. Participants were divided into groups according to their CRP level: low (<1 mg/L), average (1–3 mg/L), and high inflammation (>3 mg/L). Surveillance for outcomes (incident all-cause and Alzheimer’s disease [AD] dementia) commenced at baseline and continued up to 22.5 years.

Results

In 291 participants (mean age 67.5 ± 4.9 years, 51.6% men) followed for 13.4 ± 5.4 years, we observed 43 cases of all-cause dementia, 33 of which were clinically consistent with AD. Whereas no direct association between CRP or sleep exposures was observed with incident dementia, CRP levels interacted with nighttime wakefulness when predicting both incident all-cause and AD dementia. In the high CRP group, longer WASO (hazard ratio [HR], 2.89; 95% CI, 1.31–6.34) and more nighttime awakenings (HR, 4.55; 95% CI, 1.19–17.38) were associated with higher risk of incident dementia. In the low CRP group, fewer nighttime awakenings were associated with a higher risk of incident dementia (HR, 0.07; 95% CI, 0.01–0.68).

Conclusions

Our findings suggest that inflammation moderates the association between sleep, particularly nighttime wakefulness, and dementia risk. The presence of inflammation may be an important determinant in evaluating how sleep disturbances relate to neurodegeneration.
A Flexible Neural Representation of Faces in the Human Brain
Authors: Cao Runnan , Li Xin , Todorov Alexander , Wang Shuo
Published: August 2020

An important question in human face perception research is to understand whether the neural representation of faces is dynamically modulated by context. In particular, although there is a plethora of neuroimaging literature that has probed the neural representation of faces, few studies have investigated what low-level structural and textural facial features parametrically drive neural responses to faces and whether the representation of these features is modulated by the task. To answer these questions, we employed 2 task instructions when participants viewed the same faces. We first identified brain regions that parametrically encoded high-level social traits such as perceived facial trustworthiness and dominance, and we showed that these brain regions were modulated by task instructions. We then employed a data-driven computational face model with parametrically generated faces and identified brain regions that encoded low-level variation in the faces (shape and skin texture) that drove neural responses. We further analyzed the evolution of the neural feature vectors along the visual processing stream and visualized and explained these feature vectors. Together, our results showed a flexible neural representation of faces for both low-level features and high-level social traits in the human brain.
Dynamics and Spread of Bacterial Spot Epidemics in Tomato Transplants Grown for Field Production
Authors: Abrahamian Peter , Sharma Anuj , Jones Jeffrey B. , Vallad Gary E.
Published: August 2020

Tomato transplants are the primary means of establishing commercial tomato production fields in the eastern United States. Transplants are often suspected as the source of inoculum for major outbreaks in production fields of bacterial spot of tomato (BST) caused by Xanthomonas perforans (Xp). A combination of high plant densities with overhead irrigation, high humidity, and high temperatures are conducive to BST outbreaks during transplant production. In addition to chemical control, transplant growers use roguing to remove diseased transplants, as a primary way to manage BST during transplant production. The value of roguing is often questioned, because information about the rate of pathogen spread and the incubation period between infection and symptom development is limited. In this study, we evaluated the extent of X. perforans spread on tomato transplants relative to symptom development by using a rifampicin-resistant X. perforans strain and conducting experiments in an environmentally controlled greenhouse simulating grower practices and also at a commercial transplant facility in Florida. BST symptom development typically lagged behind X. perforans dispersal by at least 5 to 7 days depending on environmental conditions. Furthermore, X. perforans was capable of aerosolization, which resulted in long-distance dispersal of ≤2 m under highly favorable conditions. Growers should rogue diseased plants and surrounding nonsymptomatic plants by >1 and ≤3 m, depending on outbreak severity, to limit disease spread. As a result, proper disease management should reduce introduction of nonsymptomatic transplants into the field and subsequently reduce pesticide applications.
Effect of Renal Denervation on Cardiac Function and Inflammatory Factors in Heart Failure After Myocardial Infarction
Authors: Li Chao , Xia Wei , Wang Li , Zhang Jin , He Qiang , Liu Yin , Xia Dasheng , Lu Chengzhi
Published: August 2020

Heart failure (HF) affects around 100 million people and is a staggering burden for health care system worldwide. Rapid and sustained activation of inflammatory response is an important feature of HF after myocardial infarction. Sympathetic overactivation is also an important factor in the occurrence and progression of HF. The beneficial effect of renal denervation (RDN) has been demonstrated in HF. In the current study, we hypothesized that RDN improves cardiac function in HF canine models due to acute myocardial infarction (AMI) and reduced inflammation might be involved. Twenty-four beagles were randomized into the control (n = 8), HF (n = 8), and HF + RDN group (n = 8). The HF model after AMI was established by embolization the anterior descending distal artery with anhydrous ethanol in the HF and HF + RDN group. Bilateral renal artery ablation was performed in the HF + RDN group. Cardiac function, serum creatine kinase, creatine kinase-MB and NT-Pro BNP level, and expression of inflammation-related proteins in myocardial were examined. Because the paraventricular nucleus of the hypothalamus might be involved in inflammation-induced central neural excitation in HF and plays an important role in regulating extracellular fluid volume and sympathetic activity, expression of inflammation-related proteins in hypothalamus was also examined. AMI and post-AMI HF model was created successfully. Compared with the HF group, dogs in the HF + RDN group showed better cardiac function 4 weeks after AMI: lower left ventricular end-diastolic pressure, left ventricular end-diastolic dimension, and left ventricular end-systolic dimension and higher LEVF and left ventricular systolic pressure (P < 0.05 for all) were observed in the HF + RDN group. In addition, dogs in the HF + RDN group had slightly less ventricular fibrosis. Interestingly, RDN had lower expression of inflammation-related proteins including interleukin-6, tumor necrosis factors-α, nuclear factor κB, and monocyte chemotactic protein 1 (P < 0.05 for all) in both myocardial tissue and hypothalamus. RDN can improve cardiac function in dogs with HF after myocardial infarction. Our results suggested that RDN might affect cytokine-induced central neural excitation in HF and later affect sympathetic activity. Our results suggested a potential beneficial mechanism of RDN independent of mechanism involving renal afferent and efferent sympathetic nerves.
Associations Between Neurochemistry and Gait Performance Following Concussion in Collegiate Athletes
Authors: Charney Molly F. , Howell David R. , Lanois Corey , Starr Tyler C. , Liao Huijun , Coello Eduardo , Breedlove Katherine M. , Meehan William P. , Koerte Inga , Lin Alexander P.
Published: August 2020

Objective:

To evaluate the strength of associations between single-task and dual-task gait measures and posterior cingulate gyrus (PCG) neurochemicals in acutely concussed collegiate athletes.

Setting:

Participants were recruited from an NCAA Division 1 University.

Participants:

Nineteen collegiate athletes acutely (<4 days) following sports-related concussion.

Design:

We acquired magnetic resonance spectroscopy (MRS) in the PCG and gait performance measurements in the participants, acutely following concussion. Linear mixed-effects models were constructed to measure the effect of gait performance, in the single- and dual-task settings, and sex on the 6 neurochemicals quantified with MRS in mmol. Correlation coefficients were also calculated to determine the direction and strength of the relationship between MRS neurochemicals and gait performance, postconcussion symptom score, and number of previous concussions.

Main Measures:

Average gait speed, average cadence,N-acetyl aspartate, choline, myo-inositol, glutathione, glutamate plus glutamine, and creatine.

Results:

Single-task gait speed (P= .0056) and cadence (P= .0065) had significant effects on myo-inositol concentrations in the PCG, independent of sex, in concussed collegiate athletes. Single-task cadence (P= .047) also had a significant effect on glutathione in the PCG. No significant effects were observed between dual-task gait performance and PCG neurochemistry.

Conclusions:

These findings indicate that increased concentrations of neuroinflammatory markers in the PCG are associated with slower single-task gait performance within 4 days of sports-related concussion.
Pollutants in Breast Milk
Authors: Lapillonne Alexandre , Bocquet Alain , Briend André , Chouraqui Jean‐Pierre , Darmaun Dominique , Feillet François , Frelut Marie‐Laure , Guimber Dominique , Hankard Régis , Peretti Noel , Roze Jean‐Christophe , Simeoni Umberto , Turck Dominique , Dupont Christophe ,   Comité de Nutrition de la Société Française de Pédiatrie (CNSFP)
Published: August 2020

Pregnant and lactating women are continuously and ubiquitously exposed to numerous environmental pollutants from various sources including air, food, water, and occupational and household environments. The available evidence shows that pollutants are present in human milk and one of the emerging questions is what happens when the nursing infant is involuntarily exposed to contaminants through breastfeeding.

The available literature does not currently provide a conclusive evidence of any consistent or clinically relevant health consequences in infants exposed to environment chemicals through breast milk. The available data strongly suggest that the benefits of breastfeeding outweigh the potential harmful effects of pollutants contained in human milk. The committee of nutrition of the French Pediatric Society strongly supports breastfeeding but also calls for public health actions to reduce the overall contamination level in the environment, to continue promoting breastfeeding, and to support research in this area.
Subcutaneous Versus Intravenous Rehydration in Hospitalized Older Adults
Authors: Barreto Annes Laryssa Maryssan , Andrade Rebeca Gonelli Albanez da Cunha , Pontes Isabelle Eunice de Albuquerque , Sena Gabrielle R. , Telles Jurema , de Orange Flávia Augusta
Published: August 2020

Subcutaneous rehydration is an optional infusion route in hospitalized older adults. This meta-analysis sought to compare the effectiveness of subcutaneous versus intravenous (IV) fluid administration to reverse mild-to-moderate dehydration in hospitalized older adults. A literature search was performed. No restrictions were imposed regarding language. Three randomized clinical trials conducted with patients 60 years of age or older treated with subcutaneous or IV rehydration were included, with a total sample size of 197 patients. Controlled quasi-randomized and crossover trials were excluded. The primary end point was reversal of dehydration. Secondary end points were patient satisfaction and frequency of adverse events (eg, cellulitis, edema, phlebitis, erythema, hyponatremia, and pain). Both treatments were effective in rehydrating the patients within 48 hours, with no statistically significant difference between the groups. Subcutaneous fluid administration effectively reversed dehydration while protecting against phlebitis. Since the quality of evidence was considerably low, further multicenter randomized clinical trials of efficient methodological quality should be conducted to consolidate the body of evidence.
Nurses' Perceptions of Their Practice Following a Redesign Initiative
Authors: Thomas Lily , White Jane , Scanlon Kerri
Published: August 2020

A significant number of quantitative studies have associated a positive or healthy work environment with job satisfaction. Nurses, patients, and organizational characteristics have been studied as contributing factors. Other studies have focused on structural or physical environmental factors such as noise, space, or lighting as influencing to satisfaction. Little research has focused on how a changed work environment initiated by an organization for improved patient care affected the nurses' perceptions of how their practice had changed. The purpose of this qualitative study was to determine nurses' perceptions of a changed work environment on their practice, specifically patient care. Twelve nurses participated in the semistructured interviews. Interviews were transcribed verbatim and content analysis was used to identify categories of phrases and the resulting major themes. Most importantly, and the significant overall theme of patient- and family-centered improved care described their perceptions of this change. Other themes included camaraderie, nurse-patient relationships, being valued by the organization, and efficiency for decreasing stress. The results illuminate and extend some of the findings from prior quantitative studies on professional practice environments. A major contribution of this research is the perception of the nurses, often overlooked in quantitative studies. Significant was the nurses' view that the changed environment improved patient- and family-centered care although, as in other study findings, there was a view that peer camaraderie decreased.