bluuebunny/crossref_metadata_2025 huggingface dataset:
Staphylococcal Protein Secretion and Envelope Assembly
Authors: Schneewind Olaf , Missiakas Dominique M.
Published: July 2019

The highly cross-linked peptidoglycan represents the rigid layer of the bacterial envelope and protects bacteria from osmotic lysis. In Gram-positive bacteria, peptidoglycan also functions as a scaffold for the immobilization of capsular polysaccharide, wall teichoic acid (WTA), and surface proteins. This chapter captures recent development on the assembly of the envelope ofStaphylococcus aureusincluding mechanisms accounting for immobilization of molecules to peptidoglycan as well as hydrolysis of peptidoglycan for the specific release of bound molecules, facilitation of protein secretion across the envelope and cell division. Peptidoglycan, WTA and capsular polysaccharide are directly synthesized onto undecaprenol. Surface proteins are anchored by Sortase A, a membrane-embedded transpeptidase that scans secreted polypeptides for the C-terminal LPXTG motif of sorting signals. The resulting acyl enzyme intermediate is resolved by lipid II, the undecaprenol-bound peptidoglycan precursor. While these pathways share membrane diffusible undecaprenol, assembly of these molecules occurs either at the cross-walls or the cell poles. InS. aureus, the cross-wall represents the site ofde novopeptidoglycan synthesis which is eventually split to complete the cell cycle yielding newly divided daughter cells. Peptidoglycan synthesized at the cross-wall is initially devoid of WTA. Conversely, lipoteichoic acid (LTA) synthesis which does not require bactoprenol is seemingly restricted to septal membranes. Similarly,S. aureusdistinguishes two types of surface protein precursors. Polypeptides with canonical signal peptides are deposited at the cell poles, whereas precursors with conserved YSIRK-GXXS motif signal peptides traffic to the cross-wall. A model for protein trafficking in the envelope and uneven distribution of teichoic acids is discussed.
Mobile outreach health services for mothers and children in conflict-affected and remote areas: a population-based study from Afghanistan
Authors: Edmond Karen , Yousufi Khaksar , Naziri Malalai , Higgins-Steele Ariel , Qadir Abdul Qadir , Sadat Sayed Masoud , Bellows Alexandra L , Smith Emily
Published: July 2019

Objective

To assess whether sustained, scheduled mobile health team (MHT) services increase antenatal care (ANC), postnatal care (PNC) and childhood immunisation in conflict-affected and remote regions of Afghanistan.

Design

Cross-sectional, population-based study from 2013 to 2017. Proportions were compared using multivariable linear regression adjusted for clustering and socio-demographic variables.

Setting

54 intervention and 56 control districts in eight Afghanistan provinces.

Participants

338 796 pregnant women and 1 693 872 children aged under 5 years.

Interventions

‘Intervention districts’ that received MHT services for 3 years compared with ‘control districts’ in the same province without any MHT services over the same period.

Main outcome measures

District-level and clinic-level ANC, PNC, childhood immunisation (pentavalent 3, measles 1), integrated management of childhood immunisation services.

Results

Proportion of pregnant women receiving at least one ANC visit was higher in intervention districts (83.6%, 161 750/193 482) than control districts (61.3%, 89 077/145 314) (adjusted mean difference (AMD) 14.8%;95% CI: 1.6% to 28.0%). Proportion of children under 1 year receiving their first dose of measles vaccine was higher in intervention (73.8%, 142 738/193 412) than control districts (57.3%, 83 253/145 293) (AMD 12.8;95% CI: 2.1% to 23.5%). There was no association with PNC (AMD 2.8%;95% CI: −5.1% to 10.7%). MHTs did not increase clinic-level service provision for ANC (AMD 41.32;95% CI: -52.46 to 135.11) or any other outcomes.

Conclusions

Sustained, scheduled MHT services to conflict-affected and remote regions were associated with improved coverage of important maternal and child health interventions. Outreach is an essential service and not just an ‘optional extra’ for the most deprived mothers and children.
Mobile device and app use in paediatric emergency care: a survey of departmental practice in the UK and Ireland
Authors: Jahn Haiko Kurt , Jahn Ingo H , Roland Damian , Lyttle Mark D , Behringer Wilhelm
Published: July 2019

Introduction

Mobile devices and medical apps are used by healthcare professionals in adult and paediatric emergency departments worldwide. Recently, there has been a drive toward increased digitalisation especially in the UK. This point prevalence survey aims to describe hardware and software provision and their use in paediatric emergency care in the UK and Ireland.

Methods

A web-based self-report questionnaire of member sites of an international paediatric emergency research collaborative was performed. A lead site investigator completed the survey on behalf of each site.

Results

Of the 54 sites, 46 (85%) responded. At 10 (21.7%) sites, the use of a personal mobile device at the bedside was not allowed; however, this was only enforced at 4 (8.7%) of these sites. Apple iOS devices accounted for the majority (70%) of institutional mobile devices. Most sites provided between 1 and 5 medical apps on the institutional mobile device. The British National Formulary (BNF/BNFc) app was the app which was most frequently provided and recommended. No site reported any harm from medical app use.

Conclusion

The breadth of app use was relatively low. There was variability in trust guidance on app use and challenges in accessibility of Wi-Fi and devices.
A rare case of hyperammonaemic encephalopathy
Authors: Pang Yeu Jye , Day Stephanie , Sumner Daniel , Adegoke Kenneth
Published: July 2019

A 75-year-old female patient presented to the accident and emergency department following a collapse. She was treated for a saddle pulmonary embolism and underlying urinary tract infection. However, 48 hours later she was found to have reduced consciousness with no apparent cause (Glasgow Coma Scale of 8 out of 15). Subsequent blood results revealed a highammonia level. After reflection into her medical history, it was found that she had bladder exstrophy, which was managed with urinary diversion surgery as an infant, and her presentation was a rare complication of this operation.
Posterior semicircular canal dehiscence: a diagnostic and surgical conundrum
Authors: Philip Ajay , Mammen Manju Deena , Lepcha Anjali , Alex Anu
Published: July 2019

Third window defects have increasingly been identified as a cause of vertigo. These defects are bony dehiscences that occur in the bony labyrinth, resulting in abnormal pressure gradient in the inner ear fluids leading to sound (Tullio’s phenomenon) or pressure (Hennebert’s sign) induced vertigo. The superior semicircular canal dehiscence syndrome is a well-described entity in this regard, however defects of the posterior semicircular canal are rare and may have overlapping symptomatology. We describe the history, clinical profile and management of a patient who had importunate symptoms despite being on conservative management for a year and had resolution of vestibular symptoms following surgical management.
Patterns of initial opioid prescription and its association with short-term and long-term use among opioid-naïve patients in Malaysia: a retrospective cohort study
Authors: Zin Che Suraya , Nazar Nor Ilyani , Rahman Norny Syafinaz Abdul , Ahmad Wan Rohaidah , Rani Nurul Sahida , Ng Kim Swan
Published: July 2019

Objective

This study examined opioid prescription initiation patterns and their association with short-term and long-term opioid use among opioid-naïve patients.

Design

This study was designed as a retrospective cohort study.

Setting and participants

In this study, we analysed the prescription databases of tertiary hospitals in Malaysia. This study included patients aged ≥18 years with at least one opioid prescription (buprenorphine, morphine, oxycodone, fentanyl, dihydrocodeine or tramadol) between 1 January 2011 and 31 December 2016. These patients had no opioid prescriptions in the 365 days prior, and were followed up for 365 days after the initial opioid prescription.

Main outcome measures

The main outcome measures were the number of short-term (<90 days) and long-term opioid users (≥90 days), initial opioid prescription period and daily dose.

Results

There were 33 752 opioid-naïve patients who received opioid prescriptions (n=43 432 prescriptions) during the study period. Of these, 29 824 (88.36%) were short-term opioid users and 3928 (11.64%) were long-term opioid users. The majority of these short-term (99.09%) and long-term users (96.18%) received an initial daily opioid dose of <50 mg/day with a short-acting opioid formulation. Short-term opioid users were predominantly prescribed opioids for 3–7 days (59.06%) by the emergency department (ED, 60.56%), while long-term opioid users were primarily prescribed opioids for ≥7 days (91.85%) by non-ED hospital departments (91.8%). The adjusted model showed that the following were associated with long-term opioid use: increasing opioid daily doses, prescription period ≥7 days and long-acting opioids initiated by non-EDs.

Conclusions

The majority of opioid-naïve patients in tertiary hospital settings in Malaysia were prescribed opioids for short-term use. The progression to long-term use among opioid-naïve patients was attributed to the prescription of higher opioid doses for a longer duration as well as long-acting opioids initiated by non-ED hospital departments.
Continuing education for the prevention of mild cognitive impairment and Alzheimer’s-type dementia: a systematic review and overview of systematic reviews
Authors: Matyas Nina , Keser Aschenberger Filiz , Wagner Gernot , Teufer Birgit , Auer Stefanie , Gisinger Christoph , Kil Monika , Klerings Irma , Gartlehner Gerald
Published: July 2019

Objective

To summarise evidence on the preventive effects of continuing education on mild cognitive impairment and Alzheimer’s-type dementia in adults 45 years or older.

Design

Systematic review and overview of systematic reviews.

Data sources

We systematically searched MEDLINE, PsycINFO, EMBASE, Cochrane Central Register of Controlled Trials, Cumulative Index to Nursing and Allied Health Literature, and Scopus for published studies and grey literature databases for unpublished studies from January 1990 to April 2018.

Methods

To assess evidence directly addressing our objectives, we conducted a systematic review. Because we were aware of a dearth of direct evidence, we also performed an overview of systematic reviews on leisure activities that mimic formal continuing education. We a priori established the inclusion and exclusion criteria. Two authors independently assessed inclusion and exclusion at the abstract and full-text level, rated the risk of bias, and determined the certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation. We resolved all discrepancies by consensus. We synthesised the available evidence narratively.

Results

Our searches identified 4933 citations. For the systematic review, only two publications on the same prospective cohort study (Tasmanian Healthy Brain Project) met the inclusion criteria; for the overview of reviews, we included five systematic reviews. Based on 459 participants, preliminary data of the ongoing cohort study indicated that cognitive reserve statistically significantly increased in persons attending university classes compared with the control group (92.5% vs 55.7%, p<0.01). Likewise, language processing capacities statistically significantly improved (p<0.01). Episodic memory, working memory and executive function did not differ significantly between groups. Systematic reviews consistently reported a positive association between participation in cognitively stimulating leisure activities and reduced incidence of dementia and improved cognitive test performance.

Conclusion

Available results demonstrate that cognitive reserve increases through continuing education and show a positive association of cognitive leisure activities with both improved cognitive function and lower dementia incidence.

PROSPERO registration number

CRD42017063944.
Prevalence of medically unexplained symptoms in adults who are high users of health care services: a systematic review and meta-analysis protocol
Authors: Jadhakhan Ferozkhan , Lindner Oana C , Blakemore Amy , Guthrie Elspeth
Published: July 2019

Introduction

Medically unexplained symptoms (MUS) are common in primary-care and secondary-care settings. Persistent symptoms of MUS are associated with a variety of poor outcomes including increased disability, poor quality of life and high healthcare costs. The aim of this systematic review is to review the relevant literature to determine the prevalence of MUS in patients who are high users of healthcare and/or who accrue high healthcare costs.

Methods and analysis

This review will include studies with cases that are either high users of general healthcare or are patients who accrue high healthcare costs, aged ≥18 years and where a recognised measure of MUS, either a standardised clinical interview or questionnaire, was employed. The following citation databases MEDLINE, PsycINFO, EMBASE, CINAHL, PROSPERO and the Cochrane library will be systematically searched from inception to 30 June 2018. The Cochrane library was included because of the significant proportion of non-observational studies currently published in the database. The prevalence of MUS and associated disorders along with the costs or use of healthcare associated with the presence of MUS will be estimated with 95% CI. If possible, study results will be pooled into a meta-analysis. However, if heterogeneity is high, data analysis will be presented descriptively.

Ethics and dissemination

Ethical approval is not required for this systematic review since only data from existing studies will be used. Results of this review will be disseminated in peer-reviewed publications and at national and international conferences.

PROSPERO registration number

CRD42018100388
Individual mortality information in the German Pharmacoepidemiological Research Database (GePaRD): a validation study using a record linkage with a large cancer registry
Authors: Langner Ingo , Ohlmeier Christoph , Zeeb Hajo , Haug Ulrike , Riedel Oliver
Published: July 2019

Objective

Claims data need to be validated to assess their use for epidemiological research. This study aimed to examine the validity of mortality information in the German Pharmacoepidemiological Research Database (GePaRD).

Design

Validation study, secondary data, medical claims.

Setting

Claims data of two German nationwide acting statutory health insurance providers (SHIs) contributing data for GePaRD; record linkage with epidemiological cancer registry providing individual official mortality information.

Participants

All women insured with the two SHIs whose insurance coverage ended in the period 2006–2013 and who were residents of North Rhine Westphalia.

Measures

Descriptive statistics were used to analyse the performance of the linkage procedure. Further, we calculated measures of agreement between the official and the GePaRD-based vital status and assessed differences between the official and the GePaRD-based date of death.

Results

Of the 256 111 women of the linkage sample, 25 528 were classified as ‘deceased’ in GePaRD and the others as ‘alive’. Compared with the official data, the GePaRD-based vital status showed a sensitivity of 95.9% and a specificity of 99.4%. The negative predictive value was 99.6% and the positive predictive value 94.3%. The date of death agreed in 96.3% between both data sources.

Conclusions

The vital status recorded in GePaRD was of high accuracy and discrepancies between dates of death in GePaRD and official dates were rare. This underlines the potential of the database for conducting large cohort studies with mortality as the endpoint.
Leverage points to improve smoking cessation treatment in a large tertiary care hospital: a systems-based mixed methods study
Authors: Ramsey Alex T , Prentice Donna , Ballard Ellis , Chen Li-Shiun , Bierut Laura J
Published: July 2019

Objectives

To generate system insights on patient and provider levers and strategies that must be activated to improve hospital-based smoking cessation treatment.

Design

Mixed methods study including a series of in-depth group model building sessions, which informed the design of an online survey completed by healthcare providers and a structured interview protocol administered at the bedside to patients who smoke.

Setting

Large, tertiary care hospital in the Midwestern United States.

Participants

Group model building: 28 healthcare providers and 22 previously-hospitalised patients;Online survey: 308 healthcare providers;Bedside interviews: 205 hospitalised patients.

Primary and secondary outcome measures

Hypothesis-generating, participatory qualitative methods informed the examination of the following quantitative outcomes: patient interest versus provider perception of patient interest in smoking cessation and treatment; patient-reported receipt versus provider-reported offering of inpatient smoking cessation interventions; and priority ratings of importance and feasibility of strategies to improve treatment.

Results

System insightsincluded patients frequently leaving the floor to smoke, which created major workflow disruption.Leverage pointsincluded interventions to reduce withdrawal symptoms, andaction ideasincluded nurse-driven protocols for timely administration of nicotine replacement therapy. Quantitative data corroborated system insights; for instance, 80% of providers reported that patients frequently leave the floor to smoke, leading to safety risks, missed assessments and inefficient use of staff time. Patients reported significantly lower rates of receiving any smoking cessation interventions, compared with provider reports (mean difference=17.4%–33.7%, p<0.001). Although 92% of providers cited patient interest as a key barrier, only 4% of patients indicated no interest in quitting or reducing smoking.

Conclusions

Engaging hospital providers and patients in participatory approaches to develop an implementation strategy revealed discrepant perceptions of patient interest and frequency of hospital-based treatment for smoking. These findings spurred adoption of standardised point-of-care treatment for cigarette smoking, which remains highly prevalent yet undertreated among hospitalised patients.
Content analysis of tobacco in episodic programming popular among youth and young adults
Authors: Rath Jessica Miller , Bennett Morgane , Vallone Donna , Hair Elizabeth C
Published: July 2019

Background

While evidence exists supporting a causal relationship between exposure to tobacco content in movies and youth smoking, research is limited on the prevalence and impact of tobacco content in episodic programming aired on television (TV) and online streaming platforms. The purpose of this study was to analyse episodic programming popular among young people to estimate the prevalence of tobacco imagery.

Methods

An online survey of participants aged 15–24 years (n=750) recruited from an existing panel was used to gauge viewership of episodic programming aired on Netflix, broadcast TV and cable TV. Two trained coders independently watched the entire 2015/2016 and 2016/2017 seasons of 14 programmes aired on a streaming platform, Netflix, and across broadcast and cable TV. The coding scheme was based on existing methods which involve documenting both the type of tobacco product featured and, if applicable, user information.

Results

Eighty-six per cent of Netflix programmes and 86% of broadcast and cable TV programmes had at least one occurrence of tobacco. Netflix programmes had more total occurrences (n=1185) compared with the broadcast or cable programmes (n=482). Most of the tobacco occurrences included cigarettes being actively used by a character.

Conclusions

Given the high prevalence of tobacco use found in these entertainment channels, the level of exposure to tobacco use among youth and young adults is very concerning and is serving to circumvent the restrictions of tobacco advertising on broadcast TV. Further research is needed to understand the influence of this exposure on smoking behaviour.
ACE with Compact Ciphertext Size and Decentralized Sanitizers
Authors: Yao Zhongyuan , Mu Yi
Published: July 2019

We present an access control encryption (ACE) scheme which enjoys advantages over previous works in several aspects. Our scheme ensures not only compact ciphertext size but also small size of keys installed in each user in the ACE system. Besides, to the best of our knowledge, our scheme is the first implementation of ACE with decentralized sanitizers. Comparing to ACE constructions with only one sanitizer, our scheme is more secure and reliable since it does not suffer from the single point failure. Considering the security of our scheme, we present two models catering to the no-read rule and no-write rule security requirements respectively. Additionally, our extended no-write rule model allows the corruption of some sanitizers in the ACE system and thus is stronger than the one for schemes with only one sanitizer. We prove the security of our scheme under the two models.
Characterization and mechanism of the esophago-esophageal contractile reflex of the striated muscle esophagus
Authors: Lang Ivan M. , Medda Bidyut K. , Shaker Reza
Published: July 2019

An esophago-esophageal contractile reflex (EECR) of the cervical esophagus has been identified in humans. The aim of this study was to characterize and determine the mechanisms of the EECR. Cats ( n = 35) were decerebrated, electrodes were placed on pharynx and cervical esophagus, and esophageal motility was recorded using manometry. All areas of esophagus were distended to locate and quantify the EECR. The effects of esophageal perfusion of NaCl or HCl, vagus nerve or pharyngoesophageal nerve (PEN) transection, or hexamethonium administration (5 mg/kg iv) were determined. We found that distension of the esophagus at all locations activated EECR rostral to stimulus only. EECR response was greatest when the esophagus 2.5–11.5 cm from cricopharyngeus (CP) was distended. HCl perfusion activated repetitively an EECR-like response of the proximal esophagus only within 2 min, and after ~20 min EECR was inhibited. Transection of PEN blocked or inhibited EECR 1–7 cm from CP, and vagotomy blocked EECR at all locations. Hexamethonium blocked EECR at 13 and 16 cm from CP but sensitized its activation at 1–7 cm from CP. EECR of the entire esophagus exists, which is directed in the orad direction only. EECR of striated muscle esophagus is mediated by vagus nerve and PEN and inhibited by mechanoreceptors of smooth muscle esophagus. EECR of smooth muscle esophagus is mediated by enteric nervous system and vagus nerve. Activation of EECR of the striated muscle esophagus is initially sensitized by HCl exposure, which may have a role in prevention of supraesophageal reflux.

NEW & NOTEWORTHY An esophago-esophageal contractile reflex (EECR) exists, which is directed in the orad direction only. EECR of the proximal esophagus can appear similar to and be mistaken for secondary peristalsis. The EECR of the striated muscle is mediated by the vagus nerve and pharyngoesophageal nerve and inhibited by mechanoreceptor input from the smooth muscle esophagus. HCl perfusion initially sensitizes activation of the EECR of the striated muscle esophagus, which may participate in prevention of supraesophageal reflux.
Profiling histone modifications in the normal mouse kidney and after unilateral ureteric obstruction
Authors: Hewitson Timothy D. , Holt Stephen G. , Samuel Chrishan S. , Wigg Belinda , Smith Edward R.
Published: July 2019

Posttranslational modification of nucleosomal histones is a major determinant of chromatin structure and gene activity. In the present study, we hypothesized that unilateral ureteric obstruction (UUO), a widely used model of tubulointerstitial injury, would be associated with a distinct pattern of histone modifications (marks) in the kidney. Mass spectrometry was used to profile 63 different histone marks in normal mouse kidneys and those after 10 days of UUO. A subsequent histochemical analysis further examined examples of specific marks that changed significantly after UUO for which antisera are available. Histone marks were much more widely distributed and abundant in the normal kidney than is usually appreciated. Although aggregate analysis of the mass spectrometry results revealed net differences between control and UUO groups, residue-specific variations were subtle. Of the 16/63 significant changes ( P < 0.05), only 8 changes were quantitatively different by >5%. Nevertheless, we identified several that are not usually examined in the kidney, including marks in the globular domain of core histones (H3:K79), linker histones (H1.4), and histone variants (H3.1:K27 and H3.3:K27). In several cases, there were complementary changes in different marks on the same amino acid. Using H3:K79ME2 as an example, mark enrichment was heterogeneous but largely colocalized with active transcription in a subset of tubular pathology. In conclusion, our study highlights the importance of unbiased screening in examining histone marks. Simultaneous changes in multiple marks on the same amino acid indicate a coordinated histone mark signature. The heterogeneous enrichment of marks, even within the same tubule, highlights the importance of regulatory context.
Enhanced Glutamatergic Currents at Birth in Shank3 KO Mice
Authors: Chiesa Morgane , Nardou Romain , Lozovaya Natalia , Eftekhari Sanaz , Tyzio Roman , Guimond Damien , Ferrari Diana C. , Ben-Ari Yehezkel
Published: July 2019

Autism spectrum disorders (ASD) are neurodevelopmental disorders induced by genetic and environmental factors. In our recent studies, we showed that the GABA developmental shifts during delivery and the second postnatal week are abolished in two rodent models of ASD. Maternal treatment around birth with bumetanide restored the GABA developmental sequence and attenuated the autism pathogenesis in offspring. Clinical trials conducted in parallel confirmed the usefulness of bumetanide treatment to attenuate the symptoms in children with ASD. Collectively, these observations suggest that an alteration of the GABA developmental sequence is a hallmark of ASD. Here, we investigated whether similar alterations occur in the Shank3 mouse model of ASD. We report that in CA3 pyramidal neurons, the driving force and inhibitory action of GABA are not different in naïve and Shank3-mutant age-matched animals at birth and during the second postnatal week. In contrast, the frequency of spontaneous excitatory postsynaptic currents is already enhanced at birth and persists through postnatal day 15. Therefore, in CA3 pyramidal neurons of Shank3-mutant mice, glutamatergic but not GABAergic activity is affected at early developmental stages, hence reflecting the heterogeneity of mechanisms underlying the pathogenesis of ASD.
Network Pharmacology-Based Prediction of the Active Compounds, Potential Targets, and Signaling Pathways Involved in Danshiliuhao Granule for Treatment of Liver Fibrosis
Authors: Tao Yueying , Tian Kunming , Chen Ji , Tan Danfeng , Liu Yan , Xiong Yongai , Chen Zehui , Tian Yingbiao
Published: July 2019

This study aims to predict the active ingredients, potential targets, signaling pathways and investigate the “ingredient-target-pathway” mechanisms involved in the pharmacological action of Danshiliuhao Granule (DSLHG) on liver fibrosis. Pharmacodynamics studies on rats with liver fibrosis showed that DSLHG generated an obvious anti-liver fibrosis action. On this basis, we explored the possible mechanisms underlying its antifibrosis effect using network pharmacology approach. Information about compounds of herbs in DSLHG was collected from TCMSP public database and literature. Furthermore, the oral bioavailability (OB) and drug-likeness (DL) were screened according to ADME features. Compounds with OB≥30% and DL≥0.18 were selected as active ingredients. Then, the potential targets of the active compounds were predicted by pharmacophore mapping approach and mapped with the target genes of the specific disease. The compound-target network and Protein-Protein Interaction (PPI) network were built by Cytoscape software. The core targets were selected by degree values. Furthermore, GO biological process analysis and KEGG pathway enrichment analysis were carried out to investigate the possible mechanisms involved in the anti-hepatic fibrosis effect of DSLHG. The predicted results showed that there were 108 main active components in the DSLHG formula. Moreover, there were 192 potential targets regulated by DSLHG, of which 86 were related to liver fibrosis, including AKT1, EGFR, and IGF1R. Mechanistically, the anti-liver fibrosis effect of DSLHG was exerted by interfering with 47 signaling pathways, such as PI3K-Akt, FoxO signaling pathway, and Ras signaling pathway. Network analysis showed that DSLHG could generate the antifibrosis action by affecting multiple targets and multiple pathways, which reflects the multicomponent, multitarget, and multichannel characteristics of traditional Chinese medicine and provides novel basis to clarify the mechanisms of anti-liver fibrosis of DSLHG.
Chemical Vapour Deposition of MWCNT on Silica Coated Fe3O4 and Use of Response Surface Methodology for Optimizing the Extraction of Organophosphorus Pesticides from Water
Authors: Wanjeri Veronica W. O. , Gbashi Sefater , Ngila Jane C. , Njobeh Patrick , Mamo Messai A. , Ndungu Patrick G.
Published: July 2019

Multiwalled carbon nanotube (MWCNT) was fixed onto the surface of a magnetic silica (Fe3O4@SiO2) substrate via chemical vapour deposition (CVD). Acetylene gas was used as the carbon source and cobalt oxide as the catalyst. The chemical and physical characteristics of the materials were investigated by transmission electron microscopy (TEM), Raman spectroscopy (RS), scanning electron microscopy (SEM), energy-dispersive spectroscopy (EDS), X-ray diffraction (XRD), and nitrogen adsorption/desorption isotherm. The synthesized Fe3O4@SiO2-MWCNT nanocomposite was used as a magnetic solid phase extraction (MSPE) adsorbent for the preconcentration of organophosphorus pesticides (OPPs), specifically, azinphos methyl, chlorpyrifos, parathion, and malathion. The factors influencing the extraction efficiency such as pH, contact time, and adsorbent dosage were investigated and optimized by response surface methodology (RSM) and desirability function. Linear response was obtained in the concentration range of 10–200 μg/L for the analytes with determination coefficients ranging between 0.9955 and 0.9977. The limits of detection (LODs) and quantification (LOQs) were in the range of 0.004-0.150 μg/L and 0.013-0.499 μg/L, respectively. Fe3O4@SiO2-MWCNT was applied in the extraction and subsequent determination of OPPs in water samples from Vaal River and Vaal Dam with recoveries ranging from 84.0 to 101.4% (RSDs = 3.8–9.6%, n = 3) in Vaal River and 86.2 to 93.8% (RSDs = 2.9–10.4%, n = 3) in Vaal Dam. The obtained results showed that the newly synthesized Fe3O4@SiO2-MWCNT nanocomposite can be an efficient adsorbent with good potential for the preconcentration and extraction of selected OPPs from aqueous media.
Multiobjective Calibration Framework for Pedestrian Simulation Models: A study on the Effect of Movement Base Cases, Metrics, and Density Levels
Authors: Sparnaaij Martijn , Duives Dorine C. , Knoop Victor L. , Hoogendoorn Serge P.
Published: July 2019

Ideally, a multitude of steps has to be taken before a commercial implementation of a pedestrian model is used in practice. Calibration, the main goal of which is to increase the accuracy of the predictions by determining the set of values for the model parameters that allows for the best replication of reality, has an important role in this process. Yet, up to recently, calibration has received relatively little attention within the field of pedestrian modelling. Most studies focus only on one specific movement base case and/or use a single metric. It is questionable how generally applicable a pedestrian simulation model is that has been calibrated using a limited set of movement base cases and one metric. The objective of this research is twofold, namely, to (1) determine the effect of the choice of movement base cases, metrics, and density levels on the calibration results and (2) to develop a multiple-objective calibration approach to determine the aforementioned effects. In this paper a multiple-objective calibration scheme is presented for pedestrian simulation models, in which multiple normalized metrics (i.e., flow, spatial distribution, effort, and travel time) are combined by means of weighted sum method that accounts for the stochastic nature of the model. Based on the analysis of the calibration results, it can be concluded that (1) it is necessary to use multiple movement base cases when calibrating a model to capture all relevant behaviours, (2) the level of density influences the calibration results, and (3) the choice of metric or combinations of metrics influence the results severely.
Attenuation Characteristics of Stress Wave Peak in Sandstone Subjected to Different Axial Stresses
Authors: Cheng Yun , Song Zhanping , Jin Jiefang , Yang Tengtian
Published: July 2019

To investigate the effect of axial stress on the attenuation characteristics of stress wave peaks, stress wave propagation experiments with small disturbance of a sandstone bar were carried out by a modified split Hopkinson pressure bar test system. Then, effects of axial stress on the waveform, attenuation rate, temporal-spatial attenuation characteristics, and attenuation sensitivity factor of the peak were studied. The results showed that the presence or absence of axial stress has a significant effect on the waveform. With axial stress loading, both temporal and spatial attenuation rates undergo similar development stages, “nonlinear stage + linear stage,” in which the demarcation stress (σ/σc) is 30%. Under the same axial stress, the peak decreases exponentially with the propagation time and distance with different attenuation intensities. With increasing axial stress, the temporal and spatial response intensities also experience “nonlinear stage + linear stage.” However, the temporal and spatial attenuation coefficients undergo three stages, first a dramatic decrease, then gentle development, and finally a sharp increase, in which demarcation stresses (σ/σc) are 30% and 55%. The defined attenuation sensitivity factor can well describe the attenuation sensitivity of peaks to different axial stresses. The conclusions can provide a theoretical reference for rock mass stability analysis in blasting excavation.
Finding the Dieulafoy’s Lesion: A Case of Recurrent Rectal Bleeding in an Immunosuppressed Patient
Authors: Hudspath Caleb , Russell Dylan , Eum Ki , Guess Joel , Bunin Jessica , Goldwire Franklin
Published: July 2019

A Dieulafoy’s lesion (DL) is rare cause of acute gastrointestinal bleeding defined as a vascular abnormality of the submucosa. With a high prevalence for the stomach and upper gastrointestinal tract, it is rarely observed in the lower gastrointestinal tract. Its prevalence is rare accounting for less than 2% of all cases of acute gastrointestinal bleeding. The etiology of DL is unknown. Common comorbidities include cardiovascular disease, kidney disease, diabetes, alcohol abuse, liver disease, and chronic NSAID use. Few cases involving chronic steroid use and immunosuppressive treatment have been reported. The most common diagnostic and treatment modality is endoscopy with refractory cases treated with arterial embolization by angiography. We present a case involving a patient with significant comorbidities on chronic immunosuppression with a life-threatening, massive lower gastrointestinal bleed from a DL in the rectum.
Common Genetic Variants in the Complement System and their Potential Link with Disease Susceptibility and Outcome of Invasive Bacterial Infection
Authors: van den Broek Bryan , van der Flier Michiel , de Groot Ronald , de Jonge Marien I. , Langereis Jeroen D.
Published: July 2019

Streptococcus pneumoniae and Neisseria meningitidis are pathogens that frequently colonize the nasopharynx in an asymptomatic manner but are also a cause of invasive bacterial infections mainly in young children. The complement system plays a crucial role in humoral immunity, complementing the ability of antibodies to clear microbes, thereby protecting the host against bacterial infections, including S. pneumoniae and N. meningitidis. While it is widely accepted that complement deficiencies due to rare genetic variants increase the risk for invasive bacterial infection, not much is known about the common genetic variants in the complement system in relation to disease susceptibility. In this review, we provide an overview of the effects of common genetic variants on complement activation and on complement-mediated inflammation.
Protocol for the Connected Speech Transcription of Children with Speech Disorders: An Example from Childhood Apraxia of Speech
Authors: Barrett Catherine , McCabe Patricia , Masso Sarah , Preston Jonathan
Published: July 2019

Objective: While it is known that connected speech has different features to single-word speech, there are currently few recommendations regarding connected speech transcription. This research therefore aimed to develop a clinically feasible protocol for connected speech transcription. The protocol was then used to assist with description of the connected speech of children with childhood apraxia of speech (CAS), as little is known about their connected speech characteristics. Participants and Methods: Following a literature review, the Connected Speech Transcription Protocol (CoST-P) was iteratively developed and trialled. The CoST-P was then used to transcribe 50 connected utterances produced by 12 children (aged 6–13 years) with CAS. The characteristics of participants’ connected speech were analysed to capture independent and relational analyses. Results: The CoST-P was developed, trialled, and determined to have adequate reliability and fidelity. The frequency of inter-word segregation (mean = 29) was higher than intra-word segregation (mean = 4). Juncture accuracy was correlated with intelligibility metrics such as percentage of consonants correct. Conclusion: Connected speech transcription is challenging. The CoST-P may be a useful resource for speech-language pathologists and clinical researchers. Use of the CoST-P assisted in displaying CAS speech characteristics unique to connected speech (e.g., inter-word segregation and juncture).
Correlation between Papilledema and Intracranial Hypertension in Crouzon Syndrome: A Case Report and Review of the Literature
Authors: Simonin Alexandre , Maduri Rodolfo , Viaroli Edoardo , Levivier Marc , Daniel Roy Thomas , Messerer Mahmoud
Published: July 2019

Crouzon syndrome represents the most common syndromic craniosynostosis. Ocular complications are frequent, including papilledema and optic atrophy, often related to increased intracranial pressure (ICP). However, there is a poor correlation between ICP normalization and resolution of papilledema. We describe the case of a 6-month-old infant who presented with typical phenotypic features of Crouzon syndrome. Pre- and postoperative ICP monitoring was used. Papilledema persisted despite ICP improvement after decompressive craniectomy. Possible causes of papilledema in this syndromic craniosynostosis are discussed in light of the existing literature.
Bacillus Calmette-Guérin in Immunosuppressed Patient with High-Grade Nonmuscle Invasive Bladder Carcinoma
Authors: Aznar Martínez Laura , López Cubillana Pedro , López Abad Alicia , Vidal Crespo Natalia , Gómez Gómez Guillermo Antonio
Published: July 2019

Due to their immunosuppressed status, solid organ transplant recipients are a special group of patients with an incidence of bladder cancer greater than the rest of the population, especially in the first 6 years after transplantation. Also, treatment with Bacillus Calmette-Guérin, a reference therapy in nonmuscle invasive high-risk bladder cancer, may be less effective in this group of patients and could cause more adverse effects. However, the data published so far and the experience initiated in the Virgen de la Arrixaca Clinical University Hospital do not support these hypotheses.
Single Nucleotide Polymorphisms in MicroRNA-Binding Site of Epidermal Growth Factor Receptor Signaling Pathway and Susceptibility to Esophageal Squamous Cell Carcinoma
Authors: Qu Yanhong , Zhang Yougai , Wang Kaijuan , Song Chunhua , Wang Peng , Ye Hua , Zhang Jianying , Dai Liping
Published: July 2019

Background: Epidermal growth factor receptor (EGFR) signaling pathway plays a fundamental role in regulating cell proliferation, differentiation, apoptosis, migration, and so on, which are associated with tumor development, including the esophageal squamous cell carcinoma (ESCC). The single nucleotide polymorphisms (SNPs) of microRNA-binding sites with target genes in the EGFR pathway could lead to alteration in the combination of microRNA with target genes and contribute to the susceptibility of cancer. Methods: A case-control study including 494 ESCC patients and 494 controls was carried out to investigate the genetic susceptibility of 4 microRNA-binding site SNPs (rs712 in the binding site of KRAS to let-7, rs8904 in the binding site of NFBIA to mir-507, rs3738894 in the binding site of protein kinase C epsilon to mir-218, rs701848 in the binding site of phosphatase and tensin to mir-1304) as well as the interactions of gene-environment in the development of ESCC. Results: The results showed that compared with CC genotype, the individuals with TT and TT + CT genotypes of rs701848 were significantly associated with increased ESCC risk (OR adjusted 1.56, 95% CI 1.07–2.27 and 1.41, 1.01–1.97). The gene-Environment interaction between rs3738894 and smoking history was associated with the risk of esophageal cancer. Conclusions: Results of these analyses underline the support of the notion that SNPs in microRNA-binding site of EGFR signaling pathway play certain important roles in the susceptibility to ESCC.
Starting Renal Replacement Therapy: Is It About Time?
Authors: Ku Elaine , McCulloch Charles E. , Johansen Kirsten L.
Published: July 2019

Background: Studies of the timing of end-stage renal disease (ESRD) have primarily defined “early” versus “late” initiation of dialysis using estimated glomerular filtration rate (eGFR)-based criteria. Our objective was to determine the theoretical time that could be spent in chronic kidney disease (CKD) stage 5 prior to reaching a conservative eGFR threshold of 5 mL/min/1.73 m2 compared to the actual time spent in CKD stage 5 by risk factors of interest. Methods: Eight-hundred and seventy Chronic Renal Insufficiency Cohort participants with CKD stage 5 who started renal replacement therapy (RRT) were included for retrospective study. We used mixed models to estimate the person-specific trajectory of renal function. We then used these individual trajectories to estimate the amount of time that would be spent in CKD stage 5 (between eGFR of 15 and 5 mL/min/1.73 m2) and compared this estimate to the actual time spent in CKD stage 5 prior to ESRD (between eGFR of 15 mL/min/1.73 m2 and ESRD). Results: We found the median observed time between eGFR of 15 mL/min/1.73 m2 to RRT was 9.6 months, but the median predicted time between eGFR of 15 mL/min/1.73 m2 to eGFR of 5 mL/min/1.73 m2 was 17.7 months. Some of the largest differences between the predicted and actual amount of time spent in CKD stage 5 were noted among those with systolic blood pressure <140 mm Hg (9.7 months longer predicted compared to actual), proteinuria <1 g/g (9.1 months), and serum albumin ≥3.5 g/dL (9.0 months). Conclusion: We found marked differences between the actual and predicted time spent in CKD stage 5 based on risk factors of interest. We believe that placing timing of dialysis initiation in the perspective of time is novel and may identify subgroups of patients who may derive particular benefit from a more concerted effort to delay RRT.
Cancer Location in Upgrading and Detection after Transperineal Template-Guided Mapping Biopsy for Patients in Active Surveillance and Negative Transrectal Ultrasonography-Guided Prostate Biopsy
Authors: Lee Chung Un , Sung Si Hyun , Jang Chun Tae , Kang Minyong , Sung Hyun Hwan , Jeong Byong Chang , Seo Seong Il , Jeon Seong Soo , Lee Hyun Moo , Jeon Hwang Gyun
Published: July 2019

Objectives: We investigated the efficacy of transperineal template-guided mapping biopsy (TTMB) for patients on active surveillance (AS) or those with previous negative transrectal ultrasound-guided biopsy (TRUS-Bx). Methods: We retrospectively analyzed 99 patients on AS and 60 patients with previous negative TRUS-Bx, which is a total of 159 patients who underwent TTMB from May 2017 to January 2019. Cancer location was analyzed with focus on the anterior and apex lesions of the prostate after TTMB. Multiparametric magnetic resonance imaging was performed before TTMB. Cancer location after TTMB in 138 patients, excluding 21 patients who were not eligible for analysis (4 patients on AS and 17 patients with previous negative TRUS-Bx) was compared with Prostate Imaging-Reporting and Data System version 2 (PI-RADSTM v2) score. Factors that may affect detecting cancer after TTMB with previous negative TRUS-Bx was analyzed using a logistic regression model. Results: In AS patients, 29 patients (29.3%) exhibited an upgrade in Gleason score (GS) after TTMB. Among them, 22 patients (75.9%) showed at the anterior or apex lesions. In patients with previous negative TRUS-Bx, 18 patients (30.0%) were diagnosed with prostate cancer. Among them, 13 patients (72.2%) exhibited cancer at the anterior or apex lesion. Among the 25 AS patients with PI-RADSTM score 1–2, 5 patients (20.0%) showed an upgrade in GS. Among the 26 patients with previous negative TRUS-Bx and PI-RADSTM score 1–2, 6 patients (23.1%) had cancer. In multivariate regression model, prostate volume (OR 0.951) was identified as the predictor for a positive biopsy result after TTMB with previous negative TRUS-Bx. Conclusions: TTMB is efficient for patients on AS in the detection of upgraded cancer located in anterior or apex or those with previous negative TRUS-Bx in the detection of anterior or apex cancer. In PI-RADSTM score 1–2, a substantial proportion of patients after experienced upgrade in GS on AS patients or cancer detection on previous negative TRUS-Bx. Moreover, we identified prostate volume is the independent predictor for a positive biopsy result after TTMB with previous negative TRUS-Bx.
Judith Butler leitora de Walter Benjamin: para uma crítica das políticas progressistas e identitárias
Authors: Brum Neto Benjamim
Published: July 2019

No presente artigo pretendemos mostrar de que forma Judith Butler se apropria de alguns conceitos bastante conhecidos pelos leitores de Walter Benjamin para tecer suas considerações a respeito de algumas políticas nacionais contemporâneas, com destaque para as políticas sexuais e as políticas seculares. Nossa hipótese é que o tema que perpassa todas as obras da filósofa é o da subversão ou crítica da identidade, seja ela usada como fundamento para o movimento feminista ou para políticas nacionais. Veremos de que forma Butler se apropria das noções de “história contínua”, “tempo vazio”, “violência mítica”, “violência divina”, “mandamento” e de messianismo, sobretudo em duas obras da filósofa, a saber, Quadros de guerra e Caminhos divergentes.