bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of polyvinyl alcohol as a chemically defined compound in egg yolk‐free extender for dog sperm cryopreservation
Authors: Nabeel Abdelbagi Hamad Talha , Jeon Yubyeol , Yu Il‐Jeoung
Published: August 2019

The objectives of this study were to investigate the effects of polyvinyl alcohol (PVA) as a chemically defined compound in egg yolk (EY)‐free extender by determining the appropriate concentration of PVA and the effect of pH adjustment in EY‐free PVA extenders on dog spermatozoa. Spermatozoa (1 × 108 cells/ml) were frozen with EY‐free extenders supplemented with 0 (control), 0.025, 0.05, 0.1, 0.2 or 0.3 g/100 ml PVA. Sperm progressive motility (PM) was assessed immediately after thawing (IAT) and post‐thaw incubation (PTI), while viability, acrosome integrity and reactive oxygen species (ROS) levels were evaluated after PTI. Additionally, spermatozoa were frozen using EY‐free PVA extenders before pH adjustment (6.45) and after adjustment of pH (6.85). Viability, PM, ROS and gene expression (BCL2 and SMCP) were assessed. Supplementation with 0.05 g/100 ml or more PVA significantly increased PM compared to the control group in the IAT and PTI. Post‐thaw incubation significantly increased sperm motility in all groups. The acrosome integrity in all PVA groups was higher (p < .05) than the control without an effect on ROS and viability. Adjustment of the pH to 6.85 improved (p < .05) sperm PM compared to the non‐adjusted groups without affecting viability, ROS or expression of BCL2 and SMCP. We suggest that PVA supplementation in EY‐free Tris extenders can effectively protect dog spermatozoa during freezing and can maintain higher motility and acrosome integrity. Adjustment of pH in EY‐free PVA extenders can improve post‐thaw sperm motility. Therefore, PVA can be used as a compound in EY‐free extender for the cryopreservation of dog spermatozoa.
Parametric Modelling ofM-Quantile Regression Coefficient Functions with Application to Small Area Estimation
Authors: Frumento Paolo , Salvati Nicola
Published: August 2019

Small area estimation methods can be used to obtain reliable estimates of a parameter of interest within an unplanned domain or subgroup of the population for which only a limited sample size is available. A standard approach to small area estimation is to use a linear mixed model in which the heterogeneity between areas is accounted for by area level effects. An alternative solution, which has gained popularity in recent years, is to use M-quantile regression models. This approach requires much weaker assumptions than the standard linear mixed model and enables computing outlier robust estimators of the area means. We introduce a new framework for M-quantile regression, in which the model coefficients, β(τ), are described by (flexible) parametric functions of τ. We illustrate the advantages of this approach and its application to small area estimation. Using the European Union Survey on Income and Living Conditions data, we estimate the average equivalized household income in three Italian regions. The paper is accompanied by an R package Mqrcm that implements the necessary procedures for estimation, inference and prediction.
Characterization of the novel HLA‐DRB3*02:96 allele by sequencing‐based typing
Authors: Blouin Laura , Andreani Marco , Battarra Mariarosa , Guidicelli Gwendaline , Visentin Jonathan
Published: August 2019

HLA‐DRB3*02:96 differs from HLA‐DRB3*02:02:01:01 by one nucleotide substitution in codon 189 in exon 4.
Identification of the novel HLA‐DQB1 allele, HLA‐DQB1*05:03:01:04, in a Japanese individual
Authors: Khor Seik‐Soon , Hitomi Yuki , Omae Yosuke , Ishibashi Yoshimi , Tokunaga Katsushi
Published: August 2019

HLA‐DQB1*05:03:01:04 differs from HLA‐DQB1*05:03:01:01 by one nucleotide difference at position 5075(A > G) with no amino acid change.
Identification of the new HLA‐A*30:159 allele in a Brazilian candidate donor for bone marrow donation
Authors: Vianna Romulo , Secco Danielle , Santos Angela , Stelet Vinicius , Porto Luis Cristovao
Published: August 2019

Identification of the novel HLA‐A*30:159 allele that differs from HLA‐A*30:01:01:01 in exon 3.
Pilot study to evaluate the efficacy of lymphotropic nanoparticle enhanced MRI for diagnosis of metastatic disease in canine head and neck tumours
Authors: Griffin Lynn , Frank Chad B. , Seguin Bernard
Published: August 2019

This pilot study is designed to determine if lymphotropic nanoparticle enhanced MRI (LNMRI) is a viable technique for staging of naturally occurring canine malignant head and neck tumours. Previous imaging studies in veterinary medicine have shown variable sensitivity and specificity for determining metastasis for local lymph nodes in head and neck tumours. LNMRI utilizes ultra‐small superparamagnetic iron oxide nanoparticles (USPIOs) to help in the detection of metastatic disease in lymph nodes. USPIOs are phagocytized and localized to normal lymph nodes where they assist in evaluation for regions of effacement by cancerous cells. Six dogs underwent LNMRI for the diagnosis of metastatic lymph nodes. A truncated MRI consisting of transverse images of T2, T1 pre‐ and post‐contrast and T2* sequences were evaluated for presence of metastasis. Sentinel lymph nodes and lymph nodes with possible metastatic lesions were surgically excised for histological evaluation. In the initial phase of this study, 24 lymph nodes were included in analysis. Subjective observation by the primary investigator had a calculated sensitivity and specificity of 100% and 88% based on histological results. There were no negative side effects to the USPIOs noted in the limited number of patients in this study. Percentage signal intensity loss was calculated and found to be significantly different between metastatic and non‐metastatic lymph nodes (P‐value = .038). In conclusion, this pilot study shows that LNMRI has the potential to be a sensitive and specific method of diagnosing lymph node metastasis. Further research is warranted to determine if this method is clinically applicable and accurate.
Comodulation detection difference and binaural unmasking
Authors: Verhey Jesko L. , Nitschmann Marc
Published: August 2019

The present study investigated the combined effect of binaural cues and comodulation for a narrowband target noise masked by a narrowband noise. The threshold difference between a diotic condition (same stimuli in both ears) and a dichotic condition (target interaural phase difference of π and diotic masker) decreased with spectral distance between masker and target, irrespective of across-frequency envelope correlation. The threshold difference between a condition with comodulated target and masker and a corresponding uncorrelated condition, i.e., the comodulation detection difference, did not depend on target frequency and interaural correlation, indicating that these two stimulus properties are processed independently.
Mapping sea surface observations to spectra of underwater ambient noise through self-organizing map method
Authors: Zhang Ying , Yang Kunde , Yang Qiulong , Chen Cheng
Published: August 2019

This letter presents a model for mapping sea surface observations to the spectra of underwater ambient noise through the self-organizing map method (SOM). The data used to train and test the proposed model include observations of wind speed, atmospheric pressure, and significant wave height from public databases, as well as observations of ambient noise from two deep-water experiments. SOM extracts nonlinear relations from the data and is more suitable for the study of nonlinear dynamics in the ocean than conventional methods. Results indicate the proposed model is reliable with coefficients of determination above 0.9 and root-mean-square errors below 1 dB.
The Physiological Assessment and Analysis of the Physical Demand of Riding a Snowmobile
Authors: Pereira Tania , Durocher John , Burr Jamie
Published: August 2019

Background: Insufficient physical activity (PA) is associated with numerous chronic diseases and premature mortality, and the challenge of meeting recommended PA guidelines is exacerbated in the winter. Snowmobiling can potentially contribute to PA accumulation, but the objective metabolic and physical demands are unclear. The purpose of this study was to assess the physical demands of riding a snowmobile. Methods: Habitual snowmobile riders responded to a survey describing a typical ride (n = 4015). Using this data, terrain-specific testing courses were created, and recreational snowmobile riders (n = 40) participated in a scaled representative ride (21 [8] min) while aerobic metabolism (VO2) and muscular fatigue were quantified. Results: The mean VO2 while riding, irrespective of terrain, was 18.5 (8.4) mL·kg−1·min−1, with significant differences based on geographic location (13.4 [5.2] vs 25.7 [6.6] mL·kg−1·min−1, P < .001). Muscular fatigue was apparent in maximal handgrip (−7% [8%], P < .001) across both riding terrains, but not lower body power, suggesting a greater influence of an upper body strength component. Conclusions: Snowmobiling is an activity that generally falls within the moderate-intensity activity range and involves both aerobic fitness and muscular strength. There were substantial differences in demand between terrains, suggesting that additional benefits may be conferred from mountain riding as it was more metabolically demanding.
Dynamic Stability of Older Adults Under Dual Task Paradigm During Stair Descent
Authors: Zhang Cui , Song Qipeng , Sun Wei , Liu Yu
Published: August 2019

Daily stair activities have become increasingly challenging for older adults with deterioration in physical and cognitive capabilities. However, the dynamic stability of older adults during stair descent under a concurrent dual-task condition remains undetermined. The gait and dynamic stability variables of 40 healthy older adults were measured under single- and dual-task conditions during stair descent. The step length, step width, and single support time did not significantly increase (p > .05) under the dual-task condition during stair descent. The medial–lateral center of mass velocity significantly increased (p < .003), whereas the medial–lateral margin of dynamic stability value significantly decreased (p < .006) at the landing and initial single support under the dual-task condition during stair descent. The self-regulatory ability of healthy older adults under the dual-task condition during stair descent was underestimated. Dual tasking displayed a positive impact on the anterior–posterior dynamic stability of healthy older adults.
Molecular Basis of Class A β-Lactamase Inhibition by Relebactam
Authors: Tooke Catherine L. , Hinchliffe Philip , Lang Pauline A. , Mulholland Adrian J. , Brem Jürgen , Schofield Christopher J. , Spencer James
Published: August 2019

β-Lactamase production is the major β-lactam resistance mechanism in Gram-negative bacteria. β-Lactamase inhibitors (BLIs) efficacious against serine β-lactamase (SBL) producers, especially strains carrying the widely disseminated class A enzymes, are required. Relebactam, a diazabicyclooctane (DBO) BLI, is in phase 3 clinical trials in combination with imipenem for the treatment of infections by multidrug-resistant
Enterobacteriaceae
.
Production of Norspermidine Contributes to Aminoglycoside Resistance in
pmrAB
Mutants of Pseudomonas aeruginosa
Authors: Bolard Arnaud , Schniederjans Monika , Haüssler Susanne , Triponney Pauline , Valot Benoît , Plésiat Patrick , Jeannot Katy
Published: August 2019

Emergence of resistance to polymyxins in
Pseudomonas aeruginosa
is mainly due to mutations in two-component systems that promote the addition of 4-amino-4-deoxy-
l
-arabinose to the lipopolysaccharide (LPS) through upregulation of operon
arnBCADTEF-ugd
(
arn
) expression. Here, we demonstrate that mutations occurring in different domains of histidine kinase PmrB or in response regulator PmrA result in coresistance to aminoglycosides and colistin.
Therapeutic Efficacy of LN-1-255 in Combination with Imipenem in Severe Infection Caused by Carbapenem-Resistant Acinetobacter baumannii
Authors: Vázquez-Ucha Juan Carlos , Martínez-Guitián Marta , Maneiro María , Conde-Pérez Kelly , Álvarez-Fraga Laura , Torrens Gabriel , Oliver Antonio , Buynak John D. , Bonomo Robert A. , Bou Germán , González-Bello Concepción , Poza Margarita , Beceiro Alejandro
Published: August 2019

The carbapenem-hydrolyzing class D β-lactamases (CHDLs) are the main mechanism of carbapenem resistance inAcinetobacter baumannii. CHDLs are not effectively inactivated by clinically available β-lactam-type inhibitors. We have previously described thein vitroefficacy of the inhibitor LN-1-255 in combination with carbapenems.
Transcription of the Subtilase Cytotoxin Gene
subAB
1
in Shiga Toxin-Producing Escherichia coli Is Dependent on
hfq
and
hns
Authors: Heinisch Laura , Zoric Katharina , Krause Maike , Schmidt Herbert
Published: August 2019

Shiga toxin-producing
Escherichia coli
(STEC) strains are responsible for outbreaks of foodborne diseases, such as hemorrhagic colitis and the hemolytic uremic syndrome. The pathogenicity of those strains can be attributed to, among other factors, the production of toxins. Recently, the subtilase cytotoxin was detected in locus of enterocyte effacement (LEE)-negative STEC, and it was confirmed that it contributes to the cytotoxicity of those STEC strains. Although the mode of action of SubAB1 is under intensive investigation, the regulation of gene expression is currently not known. The global regulatory proteins H-NS and Hfq have impact on many cellular processes and have been described to regulate virulence factors as well. Here, we investigate the role of
hns
and
hfq
in expression of
subAB
1
as well as
stx
2a
and
cdt-V
in an
E. coli
laboratory strain as well as in wild-type STEC strain TS18/08.
Linezolid Attenuates Lethal Lung Damage during Postinfluenza Methicillin-Resistant Staphylococcus aureus Pneumonia
Authors: Verma Atul K. , Bauer Christopher , Yajjala Vijaya Kumar , Bansal Shruti , Sun Keer
Published: August 2019

Postinfluenza methicillin-resistant
Staphylococcus aureus
(MRSA) infection can quickly develop into severe, necrotizing pneumonia, causing over 50% mortality despite antibiotic treatments. In this study, we investigated the efficacy of antibiotic therapies and the impact of
S. aureus
alpha-toxin in a model of lethal influenza virus and MRSA coinfection.
A Redundant Mechanism of Recruitment Underlies the Remarkable Plasticity of the Requirement of Poliovirus Replication for the Cellular ArfGEF GBF1
Authors: Viktorova Ekaterina G. , Gabaglio Samuel , Meissner Justyna M. , Lee Eunjoo , Moghimi Seyedehmahsa , Sztul Elizabeth , Belov George A.
Published: August 2019

Enteroviruses are a vast group of viruses associated with diverse human diseases, but only two of them could be controlled with vaccines, and effective antiviral therapeutics are lacking. Here, we investigated in detail the contribution of a cellular protein, GBF1, in the replication of poliovirus, a representative enterovirus. GBF1 supports the functioning of cellular membrane metabolism and is recruited to viral replication complexes upon infection. Our results demonstrate that the virus requires a limited subset of the normal GBF1 functions and reveal the elements of GBF1 essential to support viral replication under different conditions. Since diverse viruses often rely on the same cellular proteins for replication, understanding the mechanisms by which these proteins support infection is essential for the development of broad-spectrum antiviral therapeutics.
Establishment of a Virulent Full-Length cDNA Clone for Type I Feline Coronavirus Strain C3663
Authors: Terada Yutaka , Kuroda Yudai , Morikawa Shigeru , Matsuura Yoshiharu , Maeda Ken , Kamitani Wataru
Published: August 2019

Feline coronavirus (FCoV) is one of the most significant coronaviruses, because this virus induces feline infectious peritonitis (FIP), which is a lethal disease in cats. Tissue culture-adapted type I FCoV often loses pathogenicity, which complicates research on type I FCoV-induced feline infectious peritonitis (FIP). Since we previously found that type I FCoV strain C3663 efficiently induces FIP in specific-pathogen-free cats, we established a reverse genetics system for the C3663 strain to obtain recombinant viruses in the present study. By using a reporter C3663 virus, we were able to examine the inhibitory effect of 68 compounds on C3663 replication in Fcwf-4 cells and infectivity in a canine-derived cell line. Interestingly, one canine cell line, A72, permitted FCoV replication but with low efficiency and aberrant viral gene expression.
A Central Small RNA Regulatory Circuit Controlling Bacterial Denitrification and N
2
O Emissions
Authors: Gaimster Hannah , Hews Claire L. , Griffiths Ryan , Soriano-Laguna Manuel J. , Alston Mark , Richardson David J. , Gates Andrew J. , Rowley Gary
Published: August 2019

N
2
O is an important greenhouse gas and a major cause of ozone depletion. Denitrifying bacteria play vital roles in the production and consumption of N
2
O in many environments. Complete denitrification consists of the conversion of a soluble N-oxyanion, nitrate (NO
3
-
), to an inert gaseous N-oxide, dinitrogen (N
2
). Incomplete denitrification can occur if conditions are prohibitive, for example, under conditions of low soil copper concentrations, leading to emission of N
2
O rather than N
2
. Although enzymatically well characterized, the genetic drivers that regulate denitrification in response to environmental and physiological cues are not fully understood. This study identified a new regulatory sRNA-based control mechanism for denitrification in the model denitrifying bacterium
P. denitrificans
. Overexpression of this sRNA slows the rate of denitrification. This report highlights that there are gaps in understanding the regulation of this important pathway which need to be filled if strategies for N
2
O mitigation can be rationally and carefully developed.
Efficient Inhibition of Human Papillomavirus Infection by L2 Minor Capsid-Derived Lipopeptide
Authors: Yan Huan , Foo Suan-Sin , Chen Weiqiang , Yoo Ji-Seung , Shin Woo-Jin , Wu Christine , Jung Jae U.
Published: August 2019

HPV is a human oncogenic virus that causes a major public health problem worldwide, which is responsible for approximately 5% of total human cancers and almost all cases of cervical cancers. HPV capsid consists of two structure proteins, the major capsid L1 protein and the minor capsid L2 protein. While L2 plays critical roles during the viral life cycle, the molecular mechanism in viral entry remains elusive. Here, we performed fine mapping of the L2 N-terminal region and defined a short 36-amino-acid peptide, called L2N, which is critical for HPV infection. Specifically, L2N peptide with carboxyl-terminal lipidation acted as a potent and cross-type HPV inhibitor. Taken together, data from our study highlight the essential role of the L2N sequence at the early step of HPV entry and suggests the L2N lipopeptide as a new strategy to broadly prevent HPV infection.
Elucidating Syntrophic Butyrate-Degrading Populations in Anaerobic Digesters Using Stable-Isotope-Informed Genome-Resolved Metagenomics
Authors: Ziels Ryan M. , Nobu Masaru K. , Sousa Diana Z.
Published: August 2019

Predicting the metabolic potential and ecophysiology of mixed microbial communities remains a major challenge, especially for slow-growing anaerobes that are difficult to isolate. Unraveling the
in situ
metabolic activities of uncultured species may enable a more descriptive framework to model substrate transformations by microbiomes, which has broad implications for advancing the fields of biotechnology, global biogeochemistry, and human health. Here, we investigated the
in situ
function of mixed microbiomes by combining stable-isotope probing with metagenomics to identify the genomes of active syntrophic populations converting butyrate, a C
4
fatty acid, into methane within anaerobic digesters. This approach thus moves beyond the mere presence of metabolic genes to resolve “who is doing what” by obtaining confirmatory assimilation of the labeled substrate into the DNA signature. Our findings provide a framework to further link the genomic identities of uncultured microbes with their ecological function within microbiomes driving many important biotechnological and global processes.
The Oral Mouse Microbiome Promotes Tumorigenesis in Oral Squamous Cell Carcinoma
Authors: Stashenko Philip , Yost Susan , Choi Yoonhee , Danciu Theodora , Chen Tsute , Yoganathan Subbiah , Kressirer Christine , Ruiz-Tourrella Montserrat , Das Bikul , Kokaras Alexis , Frias-Lopez Jorge
Published: August 2019

There is growing evidence that changes in the microbiome are associated with carcinogenesis. To date, no consistent oral microbiome composition associated with OSCC has been identified. Longitudinal and functional studies like the study presented here should yield a better understanding of the role that the oral microbiome plays in OSCC. Our findings, obtained using a germ-free mouse model, indicate that the presence of different oral microbiomes enhances tumorigenesis and increases the final number of tumors in mice. By studying community-wide expression profiles, we found that regardless of the phylogenetic composition of the microbiome, the same metabolic activities were consistently associated with OSCC. Therefore, due to the functional redundancy of the microbiome, the critical element in explaining the contribution of the microbiota in OSCC is the collective physiological activity of the community, thus accounting for the previous inability to identify a consensus community profile or etiologic agents for OSCC.
Tuberculosis, onychomycosis and immune deficiency in complicated Crohn’s disease
Authors: Hejazi Rayan , Hasosah Mohammed
Published: August 2019

The immune system is composed of innate humoral defence and adaptive immunity. One of the key mechanisms of the innate humoral defence is through complement activation. Mutations of certain enzyme may affect the complement activation and result in decreased defence against microorganisms. Mannan-binding lectin serine protease 2 (MASP-2) mutation was associated with recurrent infections and autoimmune diseases. Tuberculosis (TB) has been linked with mannose-binding lectin and MASP-2 gene polymorphism. We report a case of a paediatric patient with MASP-2 deficiency with classical and atypical features associated with Crohn’s, onychomycosis and severe cutaneous infections including TB. We also report the presence of a new mutation variant in MASP-2 reported in whole exome sequencing of our patient.
Metastatic uterine leiomyosarcoma at 26 weeks gestation
Authors: Eastwood-Wilshere Naomi , Turner Jessica , Oliveira Niara , Morton Adam
Published: August 2019

Uterine leiomyosarcoma (ULMS) is a highly malignant neoplasm which has been rarely described in pregnancy. A case of advanced metastatic ULMS presenting at 26 weeks gestation is reported. The principles in managing invasive cancer in pregnancy are discussed.
Tear neuromediators in eyes on chronic topical antiglaucoma therapy with and without BAK preservatives
Authors: Murugesan Vanathi , Dwivedi Roopa , Saini Manu , Gupta Viney , Dada Tanuj , Vivekanandhan S
Published: August 2019

Purpose

To evaluate tear neuropeptides (NPs) (vasoactive intestinal peptide (VIP), neuropeptide Y (NPY), calcitonin gene-related peptide (CGRP), substance P (SP), nerve growth factor (NGF)) in chronic ocular topical hypotensive therapy with and without benzalkonium chloride (BAK) preservative.

Methods

A comparative, open label, cross-sectional study of patients using antiglaucoma medications for >6 months with BAK (group I), without BAK (group II) and controls was done. Tear NPs (ELISA), ocular surface evaluation tests (tear breakup time (TBUT), Schirmer’s test, corneal and conjunctival staining score) and confocal central corneal subbasal nerve fibre layer (SBNFL) imaging was done.

Results

Of 153 eyes evaluated, group 1 (82 eyes (41 patients; mean age 48±14.5 years)) and group 2 (71 eyes (36 patients; mean age 43.11±15 years)) were on therapy for a mean duration of 10.05±2.0 and 9.67±2.3 months, respectively. Tear analysis showed elevated SP and NGF (p<0.01); decreased CGRP (p=0.03), VIP and NPY (p<0.01) compared with controls (n=30, mean age 29.33±5.7 years). Tear NP levels (SP (p=0.1), NGF (p=0.33), CGRP (p=1), VIP (p=0.87), NPY (p=0.83)) and SBNFL (p=0.09) were comparable in both groups. There was no correlation seen between tear NP levels and clinical tests and SBNFL.

Conclusion

Our study analysis points towards altered tear NP levels in eyes on chronic topical hypotensive therapy in comparison with controls with no significant difference in tear NP levels and central corneal SBNFL density between the BAK preservative and BAK-free antiglaucoma therapy.
Essential tremor: diagnosis and management
Authors: Shanker Vicki
Published: August 2019

Essential tremor is one of the most common movement disorders in adults and can affect both children and adults. An updated consensus statement in 2018 redefined essential tremor as an isolated action tremor present in bilateral upper extremities for at least three years. Tremor may also be present in other locations, commonly the neck or the vocal cords. Patients with additional neurologic symptoms are now categorized as “essential tremor plus.” Additional clinical features associated with the condition include but are not limited to cognitive impairment, psychiatric disorders, and hearing loss. When treatment is needed, propranolol and primidone are considered first line treatments. Patients who are severely affected are often offered deep brain stimulation. Although the ventral intermediate nucleus of the thalamus is the traditional surgical target, the caudal zona incerta is also being studied as a possible superior alternative. Magnetic resonance imaging guided high intensity focused ultrasound is a newer surgical alternative that may be ideal for patients with substantial medical comorbidities. Current research explores novel oral treatments, chemodenervation, and noninvasive neuromodulation for treatment of essential tremor.
Sources of information used by patients prior to elective surgery: a scoping review
Authors: Atlas Alvin , Milanese Steve , Grimmer Karen , Barras Sarah , Stephens Jacqueline H
Published: August 2019

Objective

To describe the range and nature of available research regarding sources of information that patients access to inform their decisions about elective surgery.

Design

Scoping review.

Data sources

Peer-reviewed studies published until February 2019 from the six scientific literature databases were searched and included in the study: Medline, PubMed, CINAHL, Academic Search Premier, EMBASE and SCOPUS. Web searches for grey literature were conducted in Google, South Australia Department of Health, Commonwealth Department of Health (Australia) and My Aged Care from the Department of Social Services (Australia).

Eligibility criteria

Studies with a focus on elective surgery information sources oriented to patients were eligible for inclusion. Only studies written in English were sought and no publication date or study restrictions were applied.

Data extraction and synthesis

Included literature was described by National Health and Medical Council hierarchy of evidence, and data were extracted on country and year of publication, type of literature, who provided it and any information on end users. Information sources were categorised by type and how information was presented.

Results

A pool of 1039 articles was reduced to 26 after screening for duplicates and non-relevant studies. Face-to-face exchanges were the most likely source of information prior to elective surgery (59.3%), printed information (55.6%) followed by e-learning (51.9%) and multimedia (14.8%). The face-to-face category included information provided by the physician/general practitioners/specialists, and family and friends. Printed information included brochures and pamphlets, e-learning consisted of internet sites or videos and the use of multimedia included different mixed media format.

Conclusion

There is considerable variability regarding the types of information patients use in their decision to undergo elective surgery. The most common source of health information (face-to-face interaction with medical personnel) raises the question that the information provided could be incomplete and/or biased, and dependent on what their health provider knew or chose to tell them.
Adherence to childhood cancer treatment: a prospective cohort study from Northern Vietnam
Authors: Lan Bui Ngoc , Castor Anders , Wiebe Thomas , Toporski Jacek , Moëll Christian , Hagander Lars
Published: August 2019

Objectives

Global incidence and attention to childhood cancer is increasing and treatment abandonment is a major cause of treatment failure in low- and middle-income countries. The purpose of this study was to gain an understanding of factors contributing to non-adherence to treatment.

Design

A prospective cohort study with 2 year follow-up of incidence, family-reported motives and risk factors.

Setting

The largest tertiary paediatric oncology centre in Northern Vietnam.

Participants

All children offered curative cancer treatment, from January 2008 to December 2009.

Primary and secondary outcome measures

Family decision to start treatment was analysed with multivariable logistic regression, and family decision to continue treatment was analysed with a multivariable Cox model. This assessment of non-adherence is thereby methodologically consistent with the accepted definitions and recommended practices for evaluation of treatment abandonment.

Results

Among 731 consecutively admitted patients, 677 were eligible for treatment and were followed for a maximum 2 years. Almost half the parents chose to decline curative care (45.5%), either before (35.2%) or during (10.3%) the course of treatment. Most parents reported perceived poor prognosis as the main reason for non-adherence, followed by financial constraints and traditional medicine preference. The odds of starting treatment increased throughout the study-period (OR 1.04 per month (1.01 to 1.07), p=0.002), and were independently associated with prognosis (OR 0.51 (0.41 to 0.64), p=<0.0001) and travel distance to hospital (OR 0.998 per km (0.996 to 0.999), p=0.004). The results also suggest that adherence to initiated treatment was significantly higher among boys than girls (HR 1.69 (1.05 to 2.73), p=0.03).

Conclusions

Non-adherence influenced the prognosis of childhood cancer, and was associated with cultural and local perceptions of cancer and the economic power of the affected families. Prevention of abandonment is a prerequisite for successful cancer care, and a crucial early step in quality improvements to care for all children with cancer.
Association between LKB1 expression and prognosis of patients with solid tumours: an updated systematic review and meta-analysis
Authors: Ren Yun Hong , Zhao Feng Juan , Mo Han Yue , Jia Rong Rong , Tang Juan , Zhao Xin Hua , Wei Jue Ling , Huo Rong Rui , Li Qiu Qin , You Xue Mei
Published: August 2019

Objectives

Liver kinase B1 (LKB1) is considered a tumour suppressor that can control cell growth and metabolism. Whether LKB1 expression levels are related to clinicopathology and prognosis is controversial. This review aimed to quantitatively examine the latest evidence on this question.

Design

An updated systematic review and meta-analysis on the association between LKB1 expression and prognosis of patients with solid tumours were performed.

Data sources

Eligible studies were identified through literature searches from database establishment until 15 June 2018 in the following databases: Embase, PubMed, Web of Science, Cochrane Library, China National Knowledge Infrastructure and Wan Fang databases.

Eligibility criteria

The association between LKB1 expression and clinicopathological characteristics, overall survival (OS), disease-free survival (DFS) and relapse-free survival (RFS) of patients with solid tumours were reported. Sufficient data were available to calculate the OR or HR and 95% CI.

Data extraction and synthesis

Relevant data were meta-analysed for OS, DFS, RFS and various clinical parameters.

Results

The systematic review included 25 studies containing 6012 patients with solid tumours. Compared with patients with high LKB1 expression, patients with low expression showed significantly shorter OS in univariate analysis (HR=1.63, 95% CI 1.35 to 1.97, p<0.01) and multivariate analysis (HR=1.61, 95% CI 1.26 to 2.06, p<0.01). In contrast, the two groups showed similar DFS in univariate analysis (HR=1.49, 95% CI 0.73 to 3.01, p=0.27) as well as similar RFS in univariate analysis (HR=1.44, 95% CI 0.65 to 3.17, p=0.37) and multivariate analysis (HR=1.02, 95% CI 0.42 to 2.47, p=0.97). Patients with low LKB1 expression showed significantly worse tumour differentiation (OR=1.71, 95% CI 1.14 to 2.55, p<0.01), larger tumours (OR=1.68, 95% CI 1.24 to 2.27, p<0.01), earlier lymph node metastasis (OR=1.43, 95% CI 1.26 to 1.62, p<0.01) and more advanced tumour, node, metastases (TNM) stage (OR=1.80, 95% CI 1.56 to 2.07, p<0.01).

Conclusion

Low LKB1 expression predicts shorter OS, worse tumour differentiation, larger tumours, earlier lymph node metastasis and more advanced TNM stage. Low LKB1 expression may be a useful biomarker of poor clinicopathology and prognosis.
Complementary therapies for clinical depression: an overview of systematic reviews
Authors: Haller Heidemarie , Anheyer Dennis , Cramer Holger , Dobos Gustav
Published: August 2019

Objectives

As clinical practice guidelines vary widely in their search strategies and recommendations of complementary and alternative medicine (CAM) for depression, this overview aimed at systematically summarising the level 1 evidence on CAM for patients with a clinical diagnosis of depression.

Methods

PubMed, PsycInfo and Central were searched for meta-analyses of randomised controlled clinical trials (RCTs) until 30 June 2018. Outcomes included depression severity, response, remission, relapse and adverse events. The quality of evidence was assessed according to Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) considering the methodological quality of the RCTs and meta-analyses, inconsistency, indirectness, imprecision of the evidence and the potential risk of publication bias.

Results

The literature search revealed 26 meta-analyses conducted between 2002 and 2018 on 1–49 RCTs in major, minor and seasonal depression. In patients with mild to moderate major depression, moderate quality evidence suggested the efficacy of St. John’s wort towards placebo and its comparative effectiveness towards standard antidepressants for the treatment for depression severity and response rates, while St. John’s wort caused significant less adverse events. In patients with recurrent major depression, moderate quality evidence showed that mindfulness-based cognitive therapy was superior to standard antidepressant drug treatment for the prevention of depression relapse. Other CAM evidence was considered as having low or very low quality.

Conclusions

The effects of all but two CAM treatments found in studies on clinical depressed patients based on low to very low quality of evidence. The evidence has to be downgraded mostly due to avoidable methodological flaws of both the original RCTs and meta-analyses not following the Consolidated Standards of Reporting Trials and Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Further research is needed.
Prevalence of hospitalisation caused by adverse drug reactions at an internal medicine ward of a single centre in Japan: a cross-sectional study
Authors: Komagamine Junpei , Kobayashi Masaki
Published: August 2019

Objectives

Few studies have investigated the prevalence of adverse drug reactions (ADRs) leading to hospitalisation in Japan. The aim of this study was to determine the prevalence of ADRs leading to hospitalisation and to evaluate the preventability of these ADRs in Japan.

Design

A single-centre cross-sectional study using electronic medical records.

Setting

Acute care hospital.

Participants

All 1545 consecutive hospital admissions to an internal medicine ward due to acute medical illnesses from April 2017 to May 2018. The median patient age was 79 years (IQR 66–87), and the proportion of women was 47.9%.

Outcome measures

The primary outcome was the proportion of hospitalisations caused by ADRs among all hospitalisations. All suspected cases of ADRs were independently evaluated by two reviewers, and disagreements were resolved by discussion. The causality assessment for ADRs was performed by using the WHO-Uppsala Monitoring Committee criteria. The contribution of ADRs to hospitalisation and their preventability were evaluated based on the Hallas criteria.

Results

Of the 1545 hospitalisations, 153 hospitalisations (9.9%, 95% CI 8.4% to 11.4%) were caused by 200 ADRs. Cardiovascular agents (n=46, 23.0%), antithrombic agents (n=33, 16.5%), psychotropic agents (n=29, 14.5%) and non-steroidal anti-inflammatory drugs (n=24, 12.0%) accounted for approximately two-thirds of all ADRs leading to hospitalisation. Of 153 hospitalisations caused by ADRs, 102 (66.7%) were judged to be preventable.

Conclusions

Similar to other countries, one in every ten hospitalisations is caused by ADRs according to data from an internal medicine ward of a Japanese hospital. Most of these hospitalisations are preventable. Some efforts to minimise hospitalisations caused by ADRs are needed.
Mutaba’ah—Mother and Child Health Study: protocol for a prospective cohort study investigating the maternal and early life determinants of infant, child, adolescent and maternal health in the United Arab Emirates
Authors: Al Haddad Amal , Ali Nasloon , Elbarazi Iffat , Elabadlah Haba , Al-Maskari Fatima , Narchi Hassib , Brabon Christel , Ghazal-Aswad Saad , AlShalabi Fatima M , Zampelas Antonis , Loney Tom , Blair Iain , Ahmed Luai A
Published: August 2019

Introduction

Early life exposures, particularly environmental and parental lifestyle factors, have a major influence on children’s health and development. Due to increasing interest in the early life developmental origins of diseases, many birth cohorts have been established. These studies constitute a repository of data which researchers use over many years to investigate emerging research questions. However, no such databank or cohort study is available in the United Arab Emirates (UAE). This project aims to establish a prospective mother and child cohort study in Al Ain (Abu Dhabi, UAE) to investigate the maternal and early life determinants of infant, child, adolescent and maternal health of the Emirati population.

Methods and analysis

During the period 2017–2021, this study aims to recruit 10 000 pregnancies at approximately 12 weeks of gestation from hospitals and clinics in Al Ain city. For each mother/newborn pair, an initial dataset will be collected including anthropometric, physiological and biochemical measurements, medical interventions, circumstances of pregnancy, delivery details and neonatal and perinatal growth and health using a combination of questionnaires, interviews and medical record extractions. Baseline data will act as the starting point from which the children will be followed up and re-surveyed at intervals throughout their life course until the age of 16 years, to explore how familial, socioeconomic and lifestyle factors interact with genetic and environmental factors to influence health outcomes and achievements later in life.

Ethics and dissemination

Ethical approval has been granted by the United Arab Emirates University Human Research Ethics Committee and the ethical committees of the participating institutions. Results will be widely disseminated via peer-reviewed manuscripts, conference presentations, media outlets and reports to relevant authorities.
Randomised controlled trial of a theory-based intervention to prompt front-line staff to take up the seasonal influenza vaccine
Authors: Schmidtke Kelly Ann , Nightingale Peter G , Reeves Katharine , Gallier Suzy , Vlaev Ivo , Watson Samuel I , Lilford Richard J
Published: August 2019

Objective

To evaluate the effectiveness of reminder letters informed by social normative theory (a type of ‘nudge theory’) on uptake of seasonal influenza vaccination by front-line hospital staff.

Design

Individually randomised controlled trial.

Setting

A large acute care hospital in England.

Participants

Front-line staff employed by the hospital (n=7540) were randomly allocated to one of four reminder types in a factorial design.

Interventions

The standard letter included only general information directing the staff to take up the vaccine. A second letter highlighted a type of social norm based on peer comparisons. A third letter highlighted a type of social norm based on an appeal to authority. A fourth letter included a combination of the social norms.

Main outcome measure

The proportion of hospital staff vaccinated on-site.

Results

Vaccine coverage was 43% (812/1885) in the standard letter group, 43% (818/1885) in the descriptive norms group, 43% (814/1885) in the injunctive norms group and 43% (812/1885) in the combination group. There were no statistically significant effects of either norm or the interaction. The OR for the descriptive norms factor is 1.01 (0.89–1.15) in the absence of the injunctive norms factor and 1.00 (0.88–1.13) in its presence. The OR for the injunctive norms factor is 1.00 (0.88–1.14) in the absence of the descriptive norms factor and 0.99 (0.87–1.12) in its presence.

Conclusions

We find no evidence that the uptake of the seasonal influenza vaccination is affected by reminders using social norms to motivate uptake.
Assessment of rectalChlamydia trachomatisviable load in women by viability-PCR
Authors: Janssen Kevin J H , Wolffs Petra , Lucchesi Mayk , Dukers-Muijrers Nicole H T M , Hoebe Christian J P A
Published: August 2019

Objectives

In recent years, studies have demonstrated frequent rectalChlamydia trachomatis(CT) detection in women, irrespective of reported anal sex or rectal symptoms. However, the clinical relevance and public health implication of rectal CT detection in women remain under debate. Therefore, evaluating CT viability may provide more insight into the relevance of standard routine nucleic acid amplification test (NAAT)–positive results.

Methods

In this cross-sectional explorative study, a convenience sample of female patients at our STI clinic aged 18 years or older, diagnosed with vaginal and/or rectal CT, were invited to participate. On return for treatment, rectal CT-diagnosed women were instructed to self-collect rectal swab samples before being treated. Standard COBAS 4800 CT/NG routine NAAT testing was applied for CT diagnosis. Rectal viable CT load was evaluated by using viability-PCR (V-PCR).

Results

53 women with rectal CT were included in this study; 86.8% (46/53) had a quantifiable rectal total CT load. Of women with quantifiable samples, 52.2% (24/46) had viable CT detected from rectal swabs by V-PCR, with a mean rectal viable CT load of 3.31 log10CT/mL (range 1.16–6.22). No statistically significant difference (p=0.73) was observed in the mean rectal viable CT load of women with an indication for rectal testing (n=9) and without (n=15), 3.20 log10CT/mL (range 2.06–4.36) and 3.38 log10CT/mL (range 1.16–6.22), respectively. CT culture yielded positive test results from rectal swabs in 22.6% (12/53) of rectal CT NAAT-diagnosed women. Of women with viable rectal CT by V-PCR (n=24), 50% (12/24) were positive by CT culture.

Conclusions

Overall, the detection of high rectal viable CT loads in this study indicates that rectal CT in some women might represent a currently ongoing infection rather than just the presence of remnant DNA from dead bacteria or only contamination from an active vaginal CT infection.
Molecular diversity of
Treponema pallidum
subspecies
pallidum
isolates in Amsterdam, the Netherlands
Authors: Zondag Helene C A , Cornelissen Akke R , van Dam Alje P , Bruisten Sylvia M
Published: August 2019

Objectives

The prevalence of syphilis, caused by the spirochete
Treponema pallidum
subsp
. pallidum
(TPA), remains high despite the availability of effective antibiotics. In the Netherlands, most syphilis cases are found among men who have sex with men (MSM). We studied the distribution of TPA strain types by molecular characterisation and related this to available characteristics. In addition, resistance to macrolides was assessed.

Methods

TPA DNA was extracted from 136 genital ulcer swab or skin lesions samples deriving from 135 patients diagnosed with syphilis in 2016 and 2017 at the Public Health Service in Amsterdam, the Netherlands. Molecular typing was done according to the enhanced CDC method (E-CDC), in which three genetic regions of the
arp
,
tpr
and
tp0548
genes are analysed by gel electrophoresis of the
arp
and
tpr
regions and by sequence analysis for the
tp0548
region. Part of the 23S rDNA locus was sequenced to determine the presence of macrolide resistance-associated mutations.

Results

Full E-CDC strain types could be determined for 99/136 (73%) DNA samples, which tested positive in a diagnostic PCR targeting the
polA
gene. Types differed within one patient of whom two samples were available. No association was found between the demographic and clinical characteristics and the TPA types. The most prevalent type was 14d/g, found in 23 of the 99 (23%) fully typed samples. Part of the 23S rDNA locus was successfully sequenced for 93/136 (68%) samples and 83 (88%) contained the A2058G mutation. No A2059G mutation was found.

Conclusions

A broad strain distribution was found. Few subtypes were clonally expanded, and most other subtypes were rare. Detection of the most prevalent strain type, 14d/g, is in concordance with other TPA typing studies. The high prevalence of genetic macrolide resistance indicates that azithromycin is not an alternative treatment option.
Respiratory syncytial virus (RSV): a scourge from infancy to old age
Authors: Coultas James Andrew , Smyth Rosalind , Openshaw Peter J
Published: August 2019

Respiratory syncytial virus (RSV) is the most common single cause of respiratory hospitalisation of infants and is the second largest cause of lower respiratory infection mortality worldwide. In adults, RSV is an under-recognised cause of deterioration in health, particularly in frail elderly persons. Infection rates typically rise in late autumn and early winter causing bronchiolitis in infants, common colds in adults and insidious respiratory illness in the elderly. Virus detection methods optimised for use in children have low detection rate in adults, highlighting the need for better diagnostic tests. There are many vaccines under development, mostly based on the surface glycoprotein F which exists in two conformations (prefusion and postfusion). Much of the neutralising antibody appears to be to the prefusion form. Vaccines being developed include live attenuated, subunit, particle based and live vectored agents. Different vaccine strategies may be appropriate for different target populations: at-risk infants, school-age children, adult caregivers and the elderly. Antiviral drugs are in clinical trial and may find a place in disease management. RSV disease is one of the major remaining common tractable challenges in infectious diseases and the era of vaccines and antivirals for RSV is on the near horizon.