bluuebunny/crossref_metadata_2025 huggingface dataset:
Protein antigens of Streptococcus mutans: purification and properties of a double antigen and its protease-resistant component
Authors: Russell M W , Bergmeier L A , Zanders E D , Lehner T
Published: June 2021

A surface protein antigen of Streptococcus mutans having two sets of antigenic determinants (antigens I and II) was purified by column chromatography from culture supernatants of S. mutans serotype c. The protease-resistant component, antigen II, was purified from pronase-digested antigen I/II. The antigens were analyzed chemically and immunologically, and their physicochemical properties were investigated. Antigen I/II consisted of more than 80% protein, and its peptide chain molecular weight was estimated to be 185,000. Antigen II consisted of approximately 60% protein, with a peptide chain molecular weight of 48,000. Antisera to antigens I/II and II were raised in rabbits and used to investigate the presence of the antigens in cells of other streptococci. This indicated that not only serotype c but also serotypes e and f possessed antigen I and II determinants, whereas serotypes a, d, and g possessed a determinant related to antigen I but not one related to antigen II.
Macrophage activation and resistance to pulmonary tuberculosis
Authors: Lefford M J
Published: June 2021

Mice were vaccinated with 300 micrograms of BCG cell walls (BCG-CW) in oil-in-water emulsion intravenously or with a high or low dose of living BCG by inhalation (BCG-HD or BCG-LD, respectively). The consequences of vaccination were evaluated in terms of the growth of BCG in the lungs and spleen, lung and spleen weight, resistance to intravenous and airborne challenge with Listeria monocytogenes, airborne challenge with virulent Mycobacterium tuberculosis H37Rv, and transfer of adoptive immunity. BCG-CW and BCG-HD mice developed increased lung weight, which was associated with transiet, low-level resistance to airborne L. monocytogenes and initial resistance to airborne H37Rv. Only BCG-CW mice developed splenomegaly, which was accompanied by high resistance to intravenous challenge with L. monocytogenes. The initial resistance of BCG-CW mice to H37Rv was not sustained, whereas that of BCG-HD mice persisted. There was no initial resistance to H37Rv in BCG-LD mice, but immunity was generated later. Overall, BCG-HD mice were most resistant to H37Rv, and BCG-CW and BCG-LD mice were less but equally resistant.
Cell-mediated immunity to intestinal infection
Authors: MacDonald T T , Carter P B
Published: June 2021

Specified pathogen-free B6D2F1 mice were orally infected with various doses of Listeria monocytogenes. Oral inocula containing more than 2.5 X 10(8) live organisms consistently initiated infection in the Peyer's patches (PP) of the small intestine. At lower doses the infection was sporadic, with many mice showing no apparent infection in the PP. The PP appeared to be the only site of tissue invasion and L. monocytogenes survival in the intestinal tissues, as no organisms were recovered from mucosa dissected free of all visible PP. Within the PP, the bacteria multiplied and the infection then disseminated to the mesenteric lymph node (MLN), liver, and spleen. However, bacteria were almost completely eliminated from all tissues, both systemic and gut-associated by 6 days postinfection. Mice given a primary L. monocytogenes infection by the oral route were highly resistant to subsequent intravenous or oral challenge. Likewise, sublethal intravenous infection rendered mice highly resistant to subsequent oral infection. In addition, lymphocytes from the PP, MLN, and spleens of mice recovering from a primary oral infection were able to adoptively transfer immunity to normal recipients. Finally, after oral infection, mice did not display peripheral delayed hypersensitivity to L. monocytogenes antigens until the organisms had penetrated to the spleen.
Virus replication and localization of varicella-zoster virus antigens in human embryonic fibroblast cells infected with cell-free virus
Authors: Yamanishi K , Matsunaga Y , Ogino T , Takahashi M , Takamizawa A
Published: June 2021

When human embryonic fibroblast cells were infected with cell-free varicella-zoster virus, virus replication began between 8 and 14 h postinfection, and 4 more h werp required for the virus to infect neighboring cells. Virus-specific antigens were traced by the anticomplement immunofluorescent antibody technique. Virus antigen was first detectable 2 h postinfection in the cytoplasma, and diffuse fluorescence was observed in the nucleus as early as 4 h after infection. The nuclear fluorescence got brighter and cytoplasmic fluorescence was observed at 14 h postinfection. The spread of virus to the neighboring cells was recognized in 18 h postinfection. In the period of 24 to 48 h, antigens were seen at the nuclear membrane region and in the cytoplasma. Very strong fluorescence was restricted mainly to the nucleus, when phosphonoacetic acid or cytosine arabinoside was added to the infected cultures and the cells were incubated for 48 h.
Production of mucoid microcolonies by Pseudomonas aeruginosa within infected lungs in cystic fibrosis
Authors: Lam J , Chan R , Lam K , Costerton J W
Published: June 2021

Direct electron microscopic examination of postmortem lung material from cystic fibrosis patients infected with Pseudomonas aeruginosa has shown that these bacterial cells form distinct fiber-enclosed microcolonies in the infected alveoli. Similar examination of bronchoscopy material from infected cystic fibrosis patients showed that the fibres of the enveloping matrix are definitely associated with the bacterial cells. The fibers of the extracellular matrix stain with ruthenium red and are therefore presumed to be polyanionic. When mucoid strains of P. aeruginosa were recovered from cystic fibrosis patients and grown in a suitable liquid medium, they were found to produce large microcolonies whose component cells were embedded in a very extensive matrix of polyanionic fibers that could be stabilized by reaction with antibodies to prevent collapse during the dehydration steps of preparation for electron microscopy. When these mucoid strains of P. aeruginosa were used to produce pulmonary infections of rats by the agar bead method, the infected alveoli contained large fiber-enclosed bacterial microcolonies. We conclude that the cells of P. aeruginosa that infect cystic fibrosis patients form microcolonies that are enveloped in a fibrous anionic matrix and that these microcolonies can be duplicated in in vitro cultures and in animal model systems.
Depressed malarial immunity in pregnant mice
Authors: van Zon A A , Eling W M
Published: June 2021

A proportion of mice solidly immune to the rodent malaria parasite Plasmodium berghei exhibited a pregnancy-associated depressed immunity with a transient or even lethal recrudescence.
Species Specificity of In Vitro
Escherichia coli
Adherence to Host Intestinal Cell Membranes and Its Correlation with In Vitro Colonization and Infectivity
Authors: Cheney Christopher P. , Schad Peter A. , Formal Samuel B. , Boedeker Edgar C.
Published: June 2021

We have previously described an in vitro assay for examining the mucosal adherence of a rabbit diarrheagenic
Escherichia coli
, RDEC-1. That assay defined the in vitro characteristics of RDEC-1 adherence to brush borders isolated from rabbit ileal epithelial cells. The present study was conducted to examine the species specificity of both in vitro RDEC-1 adherence and in vivo infectivity of RDEC-1 and to compare these specificities. Species specificity in vitro adherence was examined by using brush borders prepared from intestinal epithelial cells of rats, guinea pigs, and rabbits, as well as from a surgically resected specimen of human ileum. Strain RDEC-1 adherence to rabbit brush borders in vitro was significantly greater (
P
< 0.001) than its adherence to brush borders from any of the other species. Regional specificity of in vitro adherence of RDEC-1 to ileal segments of rabbit intestinal mucosa was also demonstrated. There was significantly greater adherence of RDEC-1 to rabbit ileal brush borders as compared to rabbit jejunal brush borders (
P
< 0.05). In vivo infectivity was assessed by inoculating RDEC-1 into rats, guinea pigs, and rabbits. RDEC-1 elicited diarrhea in all inoculated rabbits with the mean onset of illness occurring 5 days after inoculation. In contrast, none of the RDEC-1-inoculated rats or guinea pigs developed diarrhea. Furthermore, colonization studies in these animals revealed that RDEC-1 heavily colonized the ileum and cecum (10
9
RDEC-1 colony-forming units/g of tissue) of rabbits; however, only minimal colonization was observed in guinea pigs and rats. In conclusion, the correlation between in vitro adherence and in vivo infectivity that we have observed suggests that the presence of receptors, specific for bacteria, on the surface of the host intestinal mucosa determines species susceptibility to enteric colonization and infectivity by certain strains of enteropathogenic
E. coli
.
Marrow-dependent cells depleted by 89Sr mediate genetic resistance to herpes simplex virus type 1 infection in mice
Authors: Lopez C , Ryshke R , Bennett M
Published: June 2021

Adult mice resistant to infection with 10(6) plaque-forming units of a virulent strain of herpes simplex virus type 1 were treated with 89Sr to abrogate marrow-dependent cell functions. Treated mice were found to be much more susceptible to the herpes simplex virus type 1 infection than untreated mice. The virus persisted in the visceral tissues of 89Sr-treated mice for 3 or more days postinfection but not in those of untreated mice. The virus also spread to the spinal cords of treated but not untreated mice. A marrow-dependent cell appeared to mediate resistance to herpes simplex virus type 1 by controlling the infection early after inoculation and not allowing the infection spread to the central nervous system.
Heat-stable enterotoxins from Escherichia coli P16
Authors: Burgess M N , Mullan N A , Newsome P M
Published: June 2021

Escherichia coli P16 infant mouse active heat-stable enterotoxin may be fractionated into two distinct active moieties by ion-exchange chromatography, Sephadex G-25 chromatography, and isoelectric focusing.
pH-dependent adhesion of piliated Corynebacterium renale to bovine bladder epithelial cells
Authors: Takai S , Yanagawa R , Kitamura Y
Published: June 2021

The adhesion of Corynebacterium renale 115 to bovine bladder epithelial cells was studied with two clones of the bacteria, piliated (P+) and nonpiliated (P-). The percentage of the cells with attached P+ bacteria was greater than that of the cells with attached P- bacteria, and the number of attached P+ bacteria was higher than that of the P- bacteria. The adhesion of P+ bacteria was found to be pH dependent, which was supported by the following facts: the number of attached bacteria was high at a pH above 7.6 and low at a pH below 6.8; the adhering P+ bacteria were eluted immediately after the pH was decreased from 7.4 to 6.4; and the P+ bacteria unattached at pH 6.4 adhered to the cells immediately after the pH was increased to pH 7.4. The adhesion of P+ bacteria was inhibited by anti-pilus antiserum. The adhesion was not inhibited by amino acids or sugars, including mannose, and was not influenced by Ca2+ and Mg2+. P- bacteria hardly attached to the epithelial cells, irrespective of the pH and other factors.
Sequential metabolic expressions of the lethal process in human serum-treated Escherichia coli: role of lysozyme
Authors: Martinez R J , Carroll S F
Published: June 2021

Several metabolic parameters indicative of Escherichia coli function and integrity were kinetically examined in response to treatment with normal human serum in the presence and absence of functional human lysozyme. Specific inhibition of this enzyme in bacteriolytic and bactericidal reactions was accomplished by using purified rabbit anti-human lysozyme immunoglobulin G. Initiation of the complement-mediated alterations of cytoplasmic membrane integrity, as judged by the leakage of 86Rb from prelabeled cells or the hydrolysis of o-nitrophenyl-beta-D-galactopyranoside by a cryptic strain, was found to be independent of lysozyme action. Furthermore, inhibition of macromolecular synthesis by E. coli in response to serum treatment occurred at the same time regardless of the functional state of lysozyme. Although the rate and extent of bacteriolysis were reduced in the absence of lysozyme, the bactericidal kinetics was unaffected. These results demonstrate that the lethal events associated with the action of antibody and complement on gram-negative bacteria are independent of lysozyme, suggesting an accessory role for this enzyme in immune reactions. A possible temporal sequence of complement-induced effects occurring at the cell surface is presented.
Human trials with wild-type H1N1 and recombinant H3N2-H1N1 influenza A viruses of 1977-1978
Authors: Beare A S , Kendal A P , Cox N J , Scholtissek C
Published: June 2021

A series of trials was conducted in which wild-type A/USSR/90/77 (H1N1) influenza A virus and a few of its antigenic variants were inoculated into volunteers. Infections readily occurred in people of all ages who had initial low antibody titers, but clinical effects were generally mild in comparison with those of the previously tested subtypes, H0N1, H1N1, H2N2, H3N2. There was, however, an inverse relationship between severity of symptoms and age of volunteers, although the incidence of virus excretion and of increase in anti-hemagglutinin was apparently not age related. Naturally occurring recombinant viruses with H3 hemagglutinin and one or more genes of A/USSR/098/77-like strains were likewise studied in volunteers. These clones also produced mild symptoms, providing evidence of an attenuating effect on H3N2 viruses by the substitution of some of its genes with the genes of an H1N1 virus.
Mitogenicity of a lipid-deficient lipoprotein from a mutant Escherichia coli strain
Authors: Bessler W G , Simon E , Rotering H
Published: June 2021

From the mutant bacterial strain Escherichia coli JE5511 lpp lpm, muropeptide-containing and muropeptide-free lipoproteins were prepared. By gas chromatography and by infrared spectroscopy we showed that the products were deficient in the two ester-bound N-terminal fatty acids, but still carried the amide-linked fatty acid. Mutant lipoproteins were tested for mitogenicity in lipopolysaccharide nonresponder C3H/HeJ mice by incorporation of [3H]thymidine and [3H]uridine and by hemolytic plaque assays for immunoglobulin-secreting plasma cells. Our results showed that the mutant lipoproteins still exhibited marked mitogenicity toward mouse B-lymphocytes, although the activity of the products was reduced in comparison to the wild-type lipoprotein. Thus, the presence of one fatty acid in the N-terminal part of lipoprotein is sufficient to bring about mitogenicity.
Toxin A-deficient mutants of Pseudomonas aeruginosa PA103: isolation and characterization
Authors: Ohman D E , Sadoff J C , Iglewski B H
Published: June 2021

An immunological assay utilizing double-diffusion principles was developed for identification of Pseudomonas aeruginosa mutants deficient in toxin A. Mutations were chemically induced, and mutants were isolated from P. aeruginosa strain PA103. Quantitative assays, both enzymatic and immunological, indicated that five mutants produced toxin A in vitro at levels of 0.3% or less of parental strain levels. Characterization indicated that the mutants fell into four classes and suggested that multiple genes are involved in the regulation of toxin A yields. Classes 1 to 3 produced less than 1% of parental levels of extracellular toxin A. Class 1 mutants are apparently specific for toxin A. Class 2 mutants are pleotropic and produced toxin A, protease, and other extracellular proteins at reduced yields. Class 3 mutants are pleotropic and in addition have relatively high levels of cell-bound toxin A. Class 4 mutants produce toxin A at levels greater than 1% of parental yields. Of 16 toxin A-deficient mutants examined, only 1 was a class 1 mutant. This mutant (PA103-29) was shown to be identical to the parental strain in all respects tested except for its marked deficiency in toxin A. The suitability of this class 1 mutant for use in virulence studies is discussed.
Variables Affecting Local Immune Response in Ileal Loops: Role of Immunization Schedule, Bacterial Flora, and Postsurgical Inflammation
Authors: Keren D. F. , Holt P. S. , Collins H. H. , Gemski P. , Formal S. B.
Published: June 2021

Several variables inherent in chronically isolated ileal (Thiry-Vella) loops in rabbits were studied for their effect on the local immune response of the intestine to live, locally invasive bacteria (
Shigella
X16). A much more vigorous local immunoglobulin A response to
Shigella
X16 was elicited when rabbits were immunized in their Thiry-Vella loops shortly after surgical creation of the loop than if a week were allowed to pass before they were immunized. Three major differences existed in Thiry-Vella loops on the day after surgery and a week later: (i) their microbial flora, (ii) nonspecific acute inflammation due to the surgery itself, and (iii) the histological appearance of the intestine. On day 1 after surgical creation of the Thiry-Vella loop, there were few bacteria in the loop, and the histology was that of normal small bowel except for mild acute inflammation due to the surgery. By day 6 after surgery, all loops contained large numbers of
Pseudomonas aeruginosa
and other aerobes, an atrophy of intestinal epithelium occurred, and the acute inflammation due to surgical trauma had subsided. By artificially colonizing Thiry-Vella loops with 10
8
or 10
10
live
P. aeruginosa
on the day of surgery, we found that the presence of these bacteria alone did not greatly diminish local immune responses to live
Shigella
. Furthermore, when the acute inflammation due to surgical trauma was recreated in loops 6 days old, no enhancement of the immune response was seen as compared to nontraumatized 6-day-old Thiry-Vella loops. The difference between immunization soon after surgery and a week later related to changes that occur in the loop itself with increased isolation. Finally, multiple immunizations of Thiry-Vella loops resulted in a more vigorous local immunoglobulin A response than a single immunization. These studies demonstrated that Thiry-Vella loop models can be useful in studying the kinetics of local immune responses by the intestine only if careful attention is paid to key variables inherent in the Thiry-Vella loop models themselves.
Transcription of the mouse ribosomal spacer region
Authors: Wood K M , Bowman L H , Thompson E A
Published: June 2021

This paper describes experiments designed to test the hypothesis that DNA sequences upstream from the mouse rRNA promoter are transcribed in vivo or in vitro. Plasmid pB28 contains a SalI restriction fragment that extends from -169 to -1,894 base pairs, with respect to the origin of transcription of pre-rRNA. Labeled RNA synthesized in intact cells does not hybridize to this region. Neither S1 nuclease mapping nor RNA dot blot hybridization revealed the presence of sequences complementary to this region. Transcriptional studies carried out in vitro indicated that this region is not transcribed under conditions that are optimal for utilization of the authentic rRNA promoter. Moreover, this region does not appear to form stable transcription complexes with RNA polymerase I transcription components. These data indicate that the mouse rDNA repeating unit differs from those of Xenopus spp. and Drosophila melanogaster in that reduplicated RNA polymerase I promoters are not found in the mouse rDNA spacer region.
Supplemental Material: Providencia Island: A Miocene Stratovolcano on the Lower Nicaraguan Rise, Western Caribbean—A Geological Enigma Resolved Item
Authors: Smith Alan L.
Published: June 2021

Appendix A: U/Pb geochronologic analyses of zircons from Providencia. Appendix B: Sample list. Appendix C: Chemical composition of some possible basaltic sources for the Providencia subalkaline suite. Appendix D: Chemical composition of volcanic rocks from Haiti. Appendix E: Chemical composition of volcanic rocks from the Dominican Republic.
Spontaneous regression of oesophageal squamous cell carcinoma
Authors: Khan Haroon , Casey Patrick , Hayes Stephen , Tokala Ajay , Sultan Javed
Published: June 2021

Partial or complete spontaneous regression (SR) of cancer is unusual, particularly in patients with oesophageal cancer. This case report describes a patient with biopsy-proven squamous cell carcinoma of the oesophagus which spontaneously regressed without any treatment. Regression of the primary tumour was confirmed on histological examination of the resected specimen. The process of SR remains an enigma, but potential mechanisms are considered.
Cerebellitis in a human T-lymphotropic virus type 1 carrier: a case report
Authors: Mizuma Atsushi , Enokida Kumiko , Nagata Eiichiro , Takizawa Shunya
Published: June 2021

Human T-lymphotropic virus type I (HTLV-I) is a retrovirus associated with adult T-cell lymphoma (ATL) and HTLV-I-associated myelopathy/tropical spastic paraparesis (HAM/TSP). In addition to HAM/TSP and ATL, HTLV-I-associated encephalopathy and cerebellar involvement have been reported. We report a case of an 87-year-old Japanese woman presenting with progressive dysarthria and gait disturbance. Neurological examination showed word-finding difficulty, scanning speech, saccadic eye movements, ocular dysmetria, gaze-evoked nystagmus and bilateral dysmetria. There was no motor weakness or spasticity. HTLV-I antibody was detected in both her serum and cerebrospinal fluid. Cerebrospinal fluid neopterin (57 pg/mL) and IgG index (3.27) were significantly elevated. MRI showed cerebellar swelling. She was finally diagnosed with HTLV-I associated cerebellitis. Two courses of high-dose intravenous methylpredonine therapy attenuated cerebellar ataxia and cerebellar swelling. It suggests that cerebellitis can result from HTLV-I infection, regardless of the existence of ATL or HAM/TSP.
Klotho prevents epithelial–mesenchymal transition through Egr-1 downregulation in diabetic kidney disease
Authors: Li Yang , Xue Meng , Hu Fang , Jia Yijie , Zheng Zongji , Yang Yanlin , Liu Xiaolian , Yang Yuelian , Wang Yanjing
Published: June 2021

Introduction

As a key event leading to tubulointerstitial fibrosis in diabetic kidney disease (DKD), epithelial–mesenchymal transition (EMT) has drawn increasing attention from researchers. The antiaging protein Klotho attenuates renal fibrosis in part by inhibiting ERK1/2 signaling in DKD. Early growth response factor 1 (Egr-1), which is activated mainly by ERK1/2, has been shown to play an important role in EMT. However, whether Klotho prevents EMT by inhibiting ERK1/2-dependent Egr-1 expression in DKD is unclear.The aim of this study was to investigate whether Klotho prevents EMT through Egr-1 downregulation by inhibiting the ERK1/2 signaling pathway in DKD.

Research design and methods

Male C57BL/6J mice fed an high-fat diet for 4 weeks received 120 mg/kg streptozotocin (STZ), which was injected intraperitoneally. Klotho and Egr-1 expression was detected in the renal cortices of these mice on their sacrifice at 6 and 12 weeks after STZ treatment. In In vitro studies, we incubated HK2 cells under high-glucose (HG) or transforming growth factor-β1 (TGF-β1) conditions to mimic DKD. We then transfected the cells with an Klotho-containing plasmid, Klotho small interfering RNA.

Results

Klotho expression was significantly decreased in the renal cortices of mice with diabetes mellitus (DM) compared with the renal cortices of control mice at 6 weeks after treatment and even more significantly decreased at 12 weeks. In contrast, Egr-1 expression was significantly increased in mice with DM compared with control mice only at 12 weeks. We also found that Klotho overexpression downregulated Egr-1 expression and the (p-ERK1/2):(ERK1/2) ratio in HG-treated or TGF-β1-treated HK2 cells. Conversely, Klotho silencing upregulated Egr-1 expression and the (p-ERK1/2):(ERK1/2) ratio in HG-treated or TGF-β1-treated HK2 cells. Moreover, the effects of si-Klotho were abolished by the ERK1/2 inhibitor PD98059.

Conclusions

Klotho prevents EMT during DKD progression, an effect that has been partially attributed to Egr-1 downregulation mediated by ERK1/2 signaling pathway inhibition.
Exploring support needs of people living with diabetes during the coronavirus COVID-19 pandemic: insights from a UK survey
Authors: Sauchelli Sarah , Bradley Julia , England Clare , Searle Aidan , Whitmarsh Alex
Published: June 2021

Introduction

The coronavirus COVID-19 pandemic has radically compromised healthcare for people living with chronic conditions such as diabetes. Government-imposed restrictions to contain the spread of the virus have forced people to suddenly adjust their lifestyle. This study aimed to capture the impact of the pandemic on people living with diabetes and the views of these individuals on ways in which the information, advice and support they are receiving could be improved.

Research design and methods

An online anonymous survey was distributed across the UK during the first lockdown and initial easing. The survey comprised questions about confidence in diabetes self-management, resources used to obtain information, advice and support, and opinions on how these could be improved. Open-ended questions captured subjective experiences.

Results

The survey was completed by 773 adults with diabetes (69.2% type 1, 28.5% type 2). There was notable variability in the impact of the pandemic on confidence in self-management, with confidence having deteriorated most commonly in the ability to take care of own mental well-being (37.0% respondents) and improved most commonly in maintaining a healthy weight (21.1% respondents). 41.2% of respondents living alone reported not receiving any outside support. The quality of information, advice and support received from the healthcare team was rated poorly by 37.2%. Respondents sought greater communication and tailored advice from their care team, clear and consistent information from the government and news channels, and improved understanding of diabetes and its challenges from their personal networks and employers.

Conclusion

Adjusting to the COVID-19 pandemic has strained the mental health and well-being of people living with diabetes. Diabetes care teams must receive assistance to support these individuals without risking further inequalities in access to healthcare. Equipping personal networks and employers with knowledge on diabetes and skills to support self-management may reduce the burden on the National Health Service.
Feasibility and efficacy of a multicomponent exercise medicine programme in patients with pancreatic cancer undergoing neoadjuvant therapy (the EXPAN trial): study protocol of a dual-centre, two-armed phase I randomised controlled trial
Authors: Luo Hao , Galvão Daniel A , Newton Robert U , Tang Colin , Dean Andrew , Jasas Kevin , Johansson Mikael , Yusoff Ian , Spry Nigel , Taaffe Dennis R
Published: June 2021

Introduction

Exercise is emerging as a therapy in oncology for its physical and psychosocial benefits and potential effects on chemotherapy tolerability and efficacy. However, evidence from randomised controlled trials (RCTs) supporting exercise in patients with borderline resectable or locally advanced pancreatic cancer (PanCa) undergoing neoadjuvant therapy (NAT) are lacking.

Methods and analysis

The EXPAN trial is a dual-centre, two-armed, phase I RCT. Forty patients with borderline resectable or locally advanced PanCa undergoing NAT will be randomised equally to an exercise intervention group (individualised exercise+standard NAT) or a usual care control group (standard NAT). The exercise intervention will be supervised and consist of moderate to vigorous intensity resistance and aerobic-based training undertaken two times a week for 45–60 min per session for a maximum period of 6 months. The primary outcome is feasibility. Secondary outcomes are patient-related and treatment-related endpoints, objectively measured physical function, body composition, psychological health and quality of life. Assessments will be conducted at baseline, prior to potential alteration of treatment (~4 months postbaseline), at completion of the intervention (maximum 6 months postbaseline) and 3-month and 6-month postintervention (maximum 9 and 12 months postbaseline).

Ethics and dissemination

The EXPAN trial has been approved by Edith Cowan University (reference no.: 2020-02011-LUO), Sir Charles Gairdner Hospital (reference no.: RGS 03956) and St John of God Subiaco Hospital (reference no.: 1726). The study results will be presented at national/international conferences and submitted for publications in peer-reviewed journals.

Trial registration number

ACTRN12620001081909.
Assessment, outcomes and implications of multiple anthropometric deficits in children
Authors: Kundan Idzes , Nair Rajalakshmi , Kulkarni Shashwat , Deshpande Aparna , Jotkar Raju , Phadke Mrudula
Published: June 2021

Background

Malnutrition in children is widely prevalent around the world. It has been observed that malnourished children with multiple anthropometric deficits have higher mortality. However, adequate studies are not available on the outcome and recovery of these children.

Nandurbar, a tribal district from Maharashtra, India, shows high prevalence of all three forms of malnutrition, often occurring simultaneously. A project previously undertaken in Nandurbar from July 2014 to June 2016 studied the effect of various therapeutic feeds in treatment of children with uncomplicated severe acute malnutrition (SAM). In this study, we analyse secondary data from it to correlate effects of stunting, wasting and underweight on treatment recovery.

Methods

Analysis was done on 5979 children with SAM using linear and logistic regression on R software for recovery rates and weight gain in children with SAM with single versus multiple anthropometric deficits, their relation to age, sex, and recovery from severe stunting by gain in height.

Results

The mean age of children was 35 months and 53.1% of the children were males. 2346 (39.2%) children recovered at the end of the 8-week treatment. 454 (7.6%) had single anthropometric deficit (SAM only), 3164 (52.9%) had two anthropometric deficits (SAM and severe underweight (SUW)) and 2355 (39.4%) children had three anthropometric deficits (SAM, SUW and severe stunting). Out of the 5979 children with SAM, only 52 (0.9%) of children were not underweight (severe or moderate).

44.94% of children with SAM who were severely stunted recovered, compared with 35.52% of children who were not (p<0.001). After controlling for confounders, severe stunting was found to increase the odds of recovery by 1.49. Severely stunted children with SAM also showed faster recovery and weight gain by 1.93 days (p<0.012) and 0.29 g/kg/day (p<0.001), respectively. Recovery was higher in females and younger age group. Recovery was also found to depend on the therapeutic feed, with children receiving medical nutrition therapy showing better recovery for severely stunted children.

Conclusion

Our findings corroborate previous literature that stunting is a way for the body to deal with chronic stress of nutritional deprivation and provides a survival advantage to a child.
Understanding decisions about antibiotic prescribing in ICU: an application of the Necessity Concerns Framework
Authors: Pandolfo Alyssa M , Horne Robert , Jani Yogini , Reader Tom W , Bidad Natalie , Brealey David , Enne Virve I , Livermore David M , Gant Vanya , Brett Stephen J
Published: June 2021

Background

Antibiotics are extensively prescribed in intensive care units (ICUs), yet little is known about how antibiotic-related decisions are made in this setting. We explored how beliefs, perceptions and contextual factors influenced ICU clinicians’ antibiotic prescribing.

Methods

We conducted 4 focus groups and 34 semistructured interviews with clinicians involved in antibiotic prescribing in four English ICUs. Focus groups explored factors influencing prescribing, whereas interviews examined decision-making processes using two clinical vignettes. Data were analysed using thematic analysis, applying the Necessity Concerns Framework.

Results

Clinicians’ antibiotic decisions were influenced by their judgement of the necessity for prescribing/not prescribing, relative to their concerns about potential adverse consequences. Antibiotic necessity perceptions were strongly influenced by beliefs that antibiotics would protect patients from deterioration and themselves from the ethical and legal consequences of undertreatment. Clinicians also reported concerns about prescribing antibiotics. These generally centred on antimicrobial resistance; however, protecting the individual patient was prioritised over these societal concerns. Few participants identified antibiotic toxicity concerns as a key influencer. Clinical uncertainty often complicated balancing antibiotic necessity against concerns. Decisions to start or continue antibiotics often represented ‘erring on the side of caution’ as a protective response in uncertainty. This approach was reinforced by previous experiences of negative consequences (‘being burnt’) which motivated prescribing ‘just in case’ of an infection. Prescribing decisions were also context-dependent, exemplified by a lower perceived threshold to prescribe antibiotics out-of-hours, input from external team members and local prescribing norms.

Conclusion

Efforts to improve antibiotic stewardship should consider clinicians’ desire to protect with a prescription. Rapid molecular microbiology, with appropriate communication, may diminish clinicians’ fears of not prescribing or of using narrower-spectrum antibiotics.
Role of combining anticoagulant and antiplatelet agents in COVID-19 treatment: a rapid review
Authors: Matli Kamal , Farah Raymond , Maalouf Mario , Chamoun Nibal , Costanian Christy , Ghanem Georges
Published: June 2021

Although primarily affecting the respiratory system, COVID-19 causes multiple organ damage. One of its grave consequences is a prothrombotic state that manifests as thrombotic, microthrombotic and thromboembolic events. Therefore, understanding the effect of antiplatelet and anticoagulation therapy in the context of COVID-19 treatment is important. The aim of this rapid review was to highlight the role of thrombosis in COVID-19 and to provide new insights on the use of antithrombotic therapy in its management. A rapid systematic review was performed using preferred reporting items for systematic reviews. Papers published in English on antithrombotic agent use and COVID-19 complications were eligible. Results showed that the use of anticoagulants increased survival and reduced thromboembolic events in patients. However, despite the use of anticoagulants, patients still suffered thrombotic events likely due to heparin resistance. Data on antiplatelet use in combination with anticoagulants in the setting of COVID-19 are quite scarce. Current side effects of anticoagulation therapy emphasise the need to update treatment guidelines. In this rapid review, we address a possible modulatory role of antiplatelet and anticoagulant combination against COVID-19 pathogenesis. This combination may be an effective form of adjuvant therapy against COVID-19 infection. However, further studies are needed to elucidate potential risks and benefits associated with this combination.
Association of body pain and chronic disease: evidence from a 7-year population-based study in China
Authors: Luo Yaxin , Liu Zheran , Yang Lianlian , Li Juejin , Zhang Qiang , Peng Xingchen , Hu Xiaolin
Published: June 2021

Background

Evidence is limited on the risk impact of body pain on future chronic disease. The present study aimed to investigate the association between body pain and chronic diseases.

Methods

Data were analyzed using four waves of the China Health and Retirement Longitudinal Study with 17 708 individual respondents aged 45 years and older. The association between body pain and chronic disease was estimated in both a cross-sectional cohort (2011) and a longitudinal cohort (2011–2018). The key outcomes include the incidence of overall and any specific chronic diseases. The associations among different body pain sites and 10 independent chronic disease risks were also assessed.

Findings

A total of 17 128 participants in 2011 were included in the cross-sectional cohort and 5611 participants were included in the 2011–2018 longitudinal cohort. Body pain showed an association with overall chronic disease in both the cross-sectional models (OR 2.71, 95% CI 2.47 to 2.98) and longitudinal model (risk ratio (RR) 1.21, 95% CI 1.07 to 1.35). Moreover, body pain was found to be associated with an increased risk of chronic respiratory disease (RR 1.43, 95% CI 1.06 to 1.92), heart disease (RR 1.45, 95% CI 1.12 to 1.89), kidney disease (RR 1.83, 95% CI 1.28 to 2.6), and digestive disease (RR 1.48, 95% CI 1.17 to 1.88).

Conclusion

Body pain is associated with major disease and mortality. Future clinical research should be targeted to whether or not improved pain control can mitigate this population-level disease burden.
Small-Scale Phenomena in Reactive Bubbly Flows: Experiments, Numerical Modeling, and Applications
Authors: Schlüter Michael , Herres-Pawlis Sonja , Nieken Ulrich , Tuttlies Ute , Bothe Dieter
Published: June 2021

Improving the yield and selectivity of chemical reactions is one of the challenging tasks in paving the way for a more sustainable and climate-friendly economy. For the industrially highly relevant gas–liquid reactions, this can be achieved by tailoring the timescales of mixing to the requirements of the reaction. Although this has long been known for idealized reactors and time- and space-averaged processes, considerable progress has been made recently on the influence of local mixing processes. This progress has become possible through joint research between chemists, mathematicians, and engineers. We present the reaction systems with adjustable kinetics that have been developed, which are easy to handle and analyze. We show examples of how the selectivity of competitive-consecutive reactions can be controlled via local bubble wake structures. This is demonstrated for Taylor bubbles and bubbly flows under technical conditions. Highly resolvednumerical simulations confirm the importance of the bubble wake structure for the performance of a particular chemical reaction and indicate tremendous potential for future process improvements.
Boron-Silicon Film Chemical Vapor Deposition Using Boron Trichloride, Dichlorosilane and Monomethylsilane Gases
Authors: Muroi Mitsuko , Otani Mana , Habuka Hitoshi
Published: June 2021

A boron-silicon film was formed by chemical vapor deposition at 800 °C and atmospheric pressure using boron trichloride, dichlorosilane and monomethylsilane gases. With the increasing boron trichloride gas flow rate at the fixed dichlorosilane gas flow rate, the deposition rate and the boron concentration decreased and saturated, respectively, following the rate theory assuming the Langmuir-type model. The obtained film was amorphous and dense without any voids. The monomethylsilane and the silicon hydrides, produced by the thermal decomposition of the monomethylsilane gas, were considered to help decomposing the intermediate boron species at the surface. The boron concentrations of 20%–40%, significantly greater than the solubility in the crystalline silicon, were concluded to be obtained using the boron trichloride gas.
[Retracted] Digital Twin‐Based Ecogreen Building Design
Authors: Liu Yang , Sun Yuhui , Yang Ang , Gao Jing
Published: June 2021

The high operation cost of green building, insufficient informationization and automation management capability, and the lack of effective operation cost control seriously restrict the development of the industry and the realization of green goals. In order to solve the problem of insufficient capability of green building operation cost management, based on the digital twin technology in the manufacturing field, we analyze the characteristic requirements and theoretical basis of green building operation cost management for system, propose a green building operation cost management system based on digital twin, and refine the design of each structural layer of this system. It is necessary to set up a series of lines, although it takes a certain amount of time. There are four types of applications, namely, the number of types of applications, the completion of the effective number, the comparison of functions, and the implementation capabilities. The study shows that the proposed system framework can improve the efficiency and quality of green building operation cost management through technology upgrade and process optimization. The implementation of digital twin and human‐machine collaboration is an advanced stage in the development of digital architecture because virtual things and real things, materials, and numbers are mutually promoting processes. The inspiration of this technological view for architecture is that digital twin and human‐machine collaboration not only allow the interaction between virtual and reality and emphasize the feedback of actual construction to virtual simulation but also promote a kind of mutual promotion of human and machine thinking and construction ability.
[Retracted] Moving Target Localization in Sports Image Sequence Based on Optimized Particle Filter Hybrid Tracking Algorithm
Authors: Guo Yan
Published: June 2021

This paper proposes a fusion stadium positioning algorithm, which uses self‐optimizing particle filter to integrate the improved athlete dead reckoning and WiFi position fingerprint algorithm for stadium positioning. In order to determine the initial absolute position of the stadium positioning, for athletes entering the stadium from the outside, a seamless switching algorithm outside the stadium is proposed, using the characteristics of high‐altitude satellite GPS to find a suitable switching point as the initial absolute position. If in the stadium, WiFi static positioning determines the initial absolute position. Then, aiming at the problem that the poorly diversified particles cannot be better integrated and localized, a self‐optimized particle filter algorithm is proposed. After resampling and retaining high‐weight particles, the characteristics of low‐weight particles are embedded in the copied high‐weight particles. This can improve diversity, and we finally carry out fusion positioning. The target tracking algorithm based on Mean Shift has a fixed‐scale tracking window, and the tracking effect of variable‐size targets is not ideal. In this paper, an affine transformation algorithm is introduced to improve it. First, we iterate the adjacent image frames in reverse Mean Shift to determine the center position of the target and then use the corner matching method to perform template matching on the target to adjust the size of the tracking window. Through simulation verification, it is proved that the optimized particle filter hybrid tracking algorithm can achieve the ideal result when the target size changes. For the image sequence S1, the tracking window of the 20th frame and the 40th frame has a small offset, but the optimal position can be quickly found by Mean Shift iteration. For the image sequence S2, between the 40th frame and the 60th frame, the target occlusion causes the accuracy of the target template to decrease, and the Bhattacharyya coefficient is at a relatively low value. For the image sequence S3, the tracking effect of the optimized particle filter hybrid tracking algorithm meets the requirements.
[Retracted] Evaluation and Numerical Simulation of Music Education Informationization Based on the Local Linear Regression Method
Authors: Liu Jiping
Published: June 2021

The study of this theoretical problem enables sparse or dense functional data, including educational information evaluation data. The choice of different weights is subjected to principal component analysis. The evaluation of music education informatization level mainly evaluates the status quo of music education informatization development, provides a basis for formulating and adjusting music education informatization development policies, and provides support for educational decision‐making, to promote the sustainable and balanced development of music education informatization. The evaluation of music education informatization has become the key promotion work of music education informatization at this stage. This paper studies the convergence rate of functional principal components based on the local linear method under general weighting conditions. First, we introduce the related research on the estimation of mean and covariance function under general weighting. Secondly, for principal functional components under general weighting, namely, eigenvalues and eigen functions, the text gives the corresponding estimated values and derives its strong uniform convergence rate. Finally, the convergence rate was verified by simulation research. The estimation methods and conclusions of this article enrich the research of functional linear regression models and will help analyze the complex and changeable problems encountered in the application of music education information.
Volume Changes and Mechanical Properties of Expansive Mudstone below Canals under Wet‐Dry/Wet‐Dry‐Freeze‐Thaw Cycles
Authors: Zhu Rui , Huang Ying-hao , Song Zhu , Zhou Feng
Published: June 2021

The complex environment in northern China is the main reason for degradation of expansive mudstone below the canals, which resulted in instability and damage of canal slopes. In this study, a serial of laboratory tests was conducted to explore the volume changes and mechanical behaviors of expansive mudstone below the canals in Xinjiang. The experimental program includes wet‐dry (WD) and wet‐dry‐freeze‐thaw (WDFT) tests, volume measurement, and unconfined compression tests. The test results show that during the WD cycles, the volume changes of expansive mudstones with a higher dry range would be more significant. The freeze‐thaw process in the WDFT cycles resulted in a decrease of volume change ranges when the expansive mudstones had a relatively smaller dry range and a slight increase of volume change ranges when the expansive mudstones had a relatively larger dry range. In the meantime, the stress‐strain relationships of expansive mudstones with different dry ranges all presented strain softening under the cycles of WD or WDFT. The first cycle resulted in a significant decrease of failure strength. After seven WD/WDFT cycles, the failure strength of expansive mudstones with different dry ranges decreased by 37.2%∼59.1%. In addition, the freeze‐thaw process in the WDFT cycles promoted the softening of the stress‐strain relationships and aggravated the failure strength attenuation of expansive mudstones. Through this study, we expect to provide a preliminary basis for the construction and maintenance of expansive mudstone canals in Xinjiang.