bluuebunny/crossref_metadata_2025 huggingface dataset:
A genome‐wide association study on low susceptibility to hepatitis C virus infection (GEHEP012 study)
Authors: Real Luis M. , Fernández‐Fuertes Marta , Sáez María E. , Rivero‐Juárez Antonio , Frías Mario , Téllez Francisco , Santos Jesús , Merino Dolores , Moreno‐Grau Sonia , Gómez‐Salgado Juan , González‐Serna Alejandro , Corma‐Gómez Anais , Ruiz Agustín , Macías Juan , Pineda Juan A.
Published: June 2019

Background

A low proportion of individuals repeatedly exposed to the hepatitis C virus (HCV) remain uninfected. This condition could have a genetic basis but it is not known whether or not it is mainly driven by a high‐penetrance common allele.

Objective

To explore whether low susceptibility to HCV infection is mainly driven by a high‐penetrance common allele.

Methods

In this genome‐wide association study (GWAS), a total of 804 HCV‐seropositive individuals and 27 high‐risk HCV‐seronegative (HRSN) subjects were included. Plink and Magma software were used to carry out single nucleotide polymorphism (SNP)‐based and gene‐based association analyses respectively.

Results

No SNP nor any gene was associated with low susceptibility to HCV infection after multiple testing correction. However, SNPs previously associated with this trait and allocated within the LDLR gene, rs5925 and rs688, were also associated with this condition in our study under a dominant model (24 out of 27 [88.9%] rs5925‐C carriers in the HRSN group vs 560 of 804 [69.6%] rs5925‐C carriers in the HCV‐seropositive group, P = 0.031, odds ratio [OR] = 3.48; 95% confidence interval [CI] = 1.04‐11.58; and 24 out of 27 [88.9%] rs688‐T carriers in the HRSN group vs 556 of 804 [69.1%] rs688‐T carriers in the HCV‐seropositive group, P = 0.028, OR = 3.57, 95% CI = 1.65‐11.96).

Conclusions

Low susceptibility to HCV infection does not seem to be mainly driven by a high‐penetrant common allele. By contrast, it seems a multifactorial trait where genes such as LDLR could be involved.
Administration of human umbilical cord blood mononuclear cells restores bladder dysfunction in streptozotocin‐induced diabetic rats
Authors: Kaya‐Sezginer Ecem , Yilmaz‐Oral Didem , Gur Serap
Published: June 2019

Objective

This study evaluated the effect of human umbilical cord blood mononuclear cells (HUCB‐MNCs) on bladder dysfunction in streptozotocin (STZ; 35 mg/kg, i.v.)‐induced diabetic rats.

Methods

Adult male Sprague–Dawley rats (n = 30) were equally divided into three groups: control group, STZ‐diabetic group, and HUCB‐MNC‐treated group (1 × 106cells). HUCB‐MNCs were isolated by density gradient centrifugation from eight healthy donors and injected into the corpus cavenosum in STZ‐diabetic rats 4 weeks after the induction of diabetes. Studies were performed 4 weeks after HUCB‐MNC or vehicle injection. In vitro organ bath studies were performed on bladder strips, whereas protein expression of hypoxia‐inducible factor (HIF)‐1α, vascular endothelial growth factor (VEGF), and α‐smooth muscle actin (SMA) in the bladder and the ratio of smooth muscle cells (SMCs) to collagen were determined using western blotting and Masson trichrome staining.

Results

Neurogenic contractions of detrusor smooth muscle strips were 55% smaller in the diabetic group than control group (P < 0.05); these contractions were normalized by HUCB‐MNC treatment. In addition, HUCB‐MNC treatment restored the impaired maximal carbachol‐induced contractile response in detrusor strips in the diabetic group (29%;P < 0.05). HUCB‐MNC treatment improved the KCl‐induced contractile response in the diabetic bladder (68%;P < 0.05), but had no effect on ATP‐induced contractile responses. Increased expression of HIF‐1α and VEGF protein and decreased expression of α‐SMA protein and the SMC/collagen ratio in diabetic rats were reversed by HUCB‐MNC.

Conclusion

Administration of HUCB‐MNCs facilitates bladder function recovery, which is likely related to downregulation of HIF‐1α expression and attenuation of fibrosis in STZ‐diabetic rats.
Behavioral responses of satellite tracked Blainville's beaked whales (Mesoplodon densirostris) to mid‐frequency active sonar
Authors: Joyce Trevor W. , Durban John W. , Claridge Diane E. , Dunn Charlotte A. , Hickmott Leigh S. , Fearnbach Holly , Dolan Karin , Moretti David
Published: June 2019

The vulnerability of beaked whales (Family: Ziphiidae) to intense sound exposure has led to interest in their behavioral responses to mid‐frequency active sonar (MFAS, 3–8 kHz). Here we present satellite‐transmitting tag movement and dive behavior records from Blainville's beaked whales (Mesoplodon densirostris) tagged in advance of naval sonar exercises at the Atlantic Undersea Test and Evaluation Center (AUTEC) in the Bahamas. This represents one of the largest samples of beaked whales individually tracked during sonar operations (n = 7). The majority of individuals (five of seven) were displaced 28–68 km after the onset of sonar exposure and returned to the AUTEC range 2–4 days after exercises ended. Modeled sound pressure received levels were available during the tracking of four individuals and three of those individuals showed declines from initial maxima of 145–172 dB re 1 μPa to maxima of 70–150 dB re 1 μPa following displacements. Dive behavior data from tags showed a continuation of deep diving activity consistent with foraging during MFAS exposure periods, but also suggested reductions in time spent on deep dives during initial exposure periods. These data provide new insights into behavioral responses to MFAS and have important implications for modeling the population consequences of disturbance.
Family Health Conversations create awareness of family functioning
Authors: Ahlberg Mona , Hollman Frisman Gunilla , Berterö Carina , Ågren Susanna
Published: June 2019

Background

The whole family is affected if one family member is critically ill. The Family Health Conversation Intervention may give the family tools that support healthier family functioning.

Aims and objectives

The aim of this study was to identify which components of family function are affected when families participate in Family Health Conversations.

Design

A secondary analysis was performed of existing qualitative interviews. The Family Health Conversation is an intervention where nurses ask the family reflective questions, and reflection is made possible in three conversation sessions.

Methods

This study included transcribed data from 13 follow‐up interviews from seven families attending Family Health Conversations after three and 12 months. Data were analysed with narrative analysis, focusing on family function.

Results

Three themes were identified. The families' family functioning had been supported with: improved understanding of each other—there was an understanding of being in the same situation but still having totally different experiences; more concern for each other—they talked about their different experiences and felt they had become closer to each other; and a process of working through—they had experienced working through various experiences, standing by and supporting, and then being able to move on.

Conclusions

The Family Health Conversation Intervention is provided to families, accompanied by nurses. The families in this study gained an awareness of their family function that brought the family closer because of improved understanding of each other and the situation. The families experienced openness, and the family members spoke more freely with each other, which facilitated the progress of working through the experience of critical illness and helped to maintain healthy family functioning.

Relevance to clinical practice

It is important to have an overall perspective and to recognize the patient and the family as equally important within the family for awareness of family function.
Brightness and contrast adjustments influence the radiographic detection of soft tissue calcification
Authors: Moreira‐Souza Larissa , Michels Mariane , Lagos de Melo Larissa Pereira , Oliveira Matheus Lima , Asprino Luciana , Freitas Deborah Queiroz
Published: June 2019

Objective

To assess the influence of subjective enhancement of brightness and contrast of digital panoramic radiographs on the detection of soft tissue calcifications.

Materials and Methods

In this observational study, 500 digital panoramic radiographs were evaluated by two examiners in consensus, who scored the images for the presence of calcifications for each right and left side of the image. After 30 days, all images were revaluated under subjective manipulation of digital brightness and contrast. Calcifications were classified based on the diagnostic hypothesis: sialolith, tonsillolith, calcified atheroma, phlebolith, rhinolith, maxillary sinus antrolith, synovial chondromatosis, lymph node calcification, stylohyoid ligament, triticeous cartilage, or/and upper horn of thyroid cartilage calcification. For intra‐examiner agreement, 20% of the sample was reevaluated. The Kappa test and McNemar test were used (α = 0.05).

Results

In original images, calcifications were observed in 44.2% of the patients, and in enhanced images, this number was 70.8%. Many calcifications were detected only in enhanced images, mainly in the diagnostic hypotheses of calcified atheroma and stylohyoid ligament. Intra‐examiner agreement was excellent for the detection of soft tissue calcifications (0.82) and for the classification (0.81).

Conclusion

Subjective enhancement of brightness and contrast alters the detection of soft tissue calcifications in digital panoramic radiograph.
Comparison of two different doses of sucrose in pain relief
Authors: Tanyeri‐Bayraktar Bilge , Bayraktar Süleyman , Hepokur Mervenur , Güzel Kıran Gülsüm
Published: June 2019

Background

Procedural pain is one of the most significant problems in neonates, especially in premature babies. Harmless and effective pain relief modalities in newborns should thus be applied. Although sucrose is the most commonly used agent, the most effective dose and concentration of sucrose is not clear. In this study, we compared the efficacy of two different doses of sucrose during venepuncture in neonates.

Methods

This was a prospective, randomized, double‐blind study. The study was conducted during venous sampling. Oral 24% sucrose (Tool sweet™ Natus Medical, San Carlos, CA, USA) was given by sterile syringe onto the anterior part of the tongue. Group 1 (n = 65) received 0.2 mL/kg 24% sucrose and group 2 (n = 64) received 0.5 mL/kg 24% sucrose. The Bernese Pain Scale for Neonates (BPSN) was used to assess the pain scores before, during and after the procedure.

Results

One hundred and twenty‐nine premature infants were enrolled in the study, consisting of 67 girls (51.9%) and 62 boys (48.1%) aged 1–24 days (mean age, 8.34 ± 6.25 days). There was no significant difference in BPSN score between the groups (P > 0.05). There was also no statistically significant difference in BPSN subscale scores between the groups (P > 0.05).

Conclusions

Twenty‐four percent sucrose 0.2 mL/kg may be the minimum effective dose to relieve pain during venepuncture procedures in premature babies.
The dynamics of pigment reactions of human skin to ultraviolet A radiation
Authors: Kohli Indermeet , Sakamaki Takeshi , Dong Tian Wei , Moyal Dominique , Hamzavi Iltefat H. , Kollias Nikiforos
Published: June 2019

The pigment responses of human skin to broadband UVA radiation (320‐400 nm) occur in three distinct phases. The first phase includes immediate pigment darkening (IPD), the pigment that appears immediately after irradiation. The second phase involves an intermediate step, termed persistent pigment darkening (PPD), which leads to the third phase of neomelanogenesis or delayed tanning (DT). Since DT results from synthesis of new melanin, it persists beyond 5‐7 days. We conducted studies on human subjects to investigate the dynamic responses of the IPD and PPD reactions to broadband UVA radiation at threshold and superthreshold doses. The threshold doses for IPD, PPD, and DT were found to be approximately 1, 11, and 18 J/cm2, respectively. The colorimetry ΔL* value corresponding to minimal clinically perceptible pigmentation was found to be 0.8 ± 0.1. IPD appeared immediately and had an associated decay constant of approximately 1.4 minutes. At doses greater than PPD threshold, IPD reaction decayed while PPD developed indicating toward IPD being used as a substrate in the formation of PPD.
Explaining State Budget Punctuations: Policy Transparency, Political Institutions, and Electoral Incentives
Authors: Li Tianfeng , Feiock Richard C.
Published: June 2019

What factors cause policies experiencing long periods of stability to be interrupted occationally by a short period of large changes? This study argues that electoral incentives might influence the search, supply, and processing of information on constituency issues, as well as the associated cognitive or institutional frictions, and thus determine the presence and variation of punctuated policies. This article develops and evaluates this claim within a systemic framework consisting of policy transparency, political institutions, and electoral incentives. For the purpose of identifying policy punctuations, this research uses the Generalized Pareto Distribution in the Extreme Value Theory. This study analyzes budget spending data collected from FY 1988 to FY 2008 for all 50 American states. This study finds that greater policy transparency is associated with larger spending stability. By contrast, greater gubernatorial competition is more likely to produce extreme spending changes. Electoral incentives shaped by public preference and political term limits have a profound impact on nonincremental policy changes. The impact of policy transparency is conditional on public preference, while that of electoral competition and legislative professionalism is moderated by political term limits. Particularly, a transparent policy consistent with public preference and legislative professionalism with term limits are more likely to give rise to punctuated policies, while gubernatorial (legislative) competition leads to less punctuated changes when governors (legislators) are subject to term limits.
Finding ‘Hobby’ Farmers: A ‘Parish Study’ Methodology for Qualitative Research
Authors: Sutherland Lee‐Ann
Published: June 2019

This paper presents a methodology for undertaking research with a ‘difficult to reach population’ – hobby farmers. In an investigation designed to assess agrarian transition processes in a peri‐urban locale, data was sought on every agricultural holding in a Scottish parish (municipality). This ‘parish study’ methodology combined participant mapping and qualitative interviewing with photo elicitation. Participant mapping was found to be useful for identifying farmers who are not normally included in rural social research, leading to a high response rate and a respondent pool for photo elicitation. The method also enabled the analysis of agrarian identity and land use. However, the parish study method is not suited to studies of dispersed groups and is more resource intensive than standard qualitative interview‐based studies. A number of ethical and EU General Data Protection Regulation (GDPR) issues also arise around identifying participants, mapping, photos and incentivising participation in the research. The utility of the parish study method is demonstrated through two key findings of the research: the problematic definition of ‘hobby farmers’ in the study site and the trajectories towards de facto land abandonment in a peri‐urban locale.
Characterization of a novel HLA‐C allele, HLA‐C*01:166, in a Colombian Umbilical Cord Blood Bank Donor
Authors: González‐Acero Lorena X. , Camacho‐Rodríguez Bernardo , Perdomo‐Arciniegas Ana M.
Published: June 2019

HLA‐C*01:166 has a nonsynonymous nucleotide substitution in the position 256 position (C/T) when compared to C*01:02:01:01.
Description of a novel HLA‐A allele, HLA‐A*03:365, identified in a bone marrow donor from Russia
Authors: Loginova Maria , Cheranev Valery , Paramonov Igor
Published: June 2019

The novel allele HLA‐A*03:365 showed a single nucleotide difference from A*03:01:01:01 where 135 Alanine is changed to Proline.
Fatal disseminated infection by Gymnascella hyalinospora in a heart transplant recipient
Authors: Agnelli Caroline , Valerio Maricela , Olmedo María , Guinea Jesús , Zatarain‐Nicolás Eduardo , del Carmen Martínez‐Jiménez María , Alcalá Luis , Escribano Pilar , Cebollero Presmanes María , Bouza Emilio , Muñoz Patricia , Martín‐Rabadán Pablo
Published: June 2019

We report the first case of disseminated infection by Gymnascella hyalinospora in a solid organ transplant recipient. This case highlights the role of low‐virulence environmental molds as an emerging cause of breakthrough invasive fungal infection in immunocompromised hosts. Nosocomial strategies of infection control including antimicrobial stewardship and advances on fast diagnostic methods are strongly encouraged to improve patient prognosis.
In vitro study to assess the efficacy of CDK4/6 inhibitor Palbociclib (PD‐0332991) for treating canine mammary tumours
Authors: Schoos Alexandra , Knab Vanessa M. , Gabriel Cordula , Tripolt Sabrina , Wagner Daniela A. , Bauder Barbara , Url Angelika , Fux Daniela A.
Published: June 2019

Therapy of canine mammary tumours (CMTs) with classical antitumour drugs is problematic, so better therapeutic options are needed. Palbociclib (PD‐0332991) is an innovative and effective anticancer drug for the treatment of breast cancer in women. Palbociclib is an inhibitor of cyclin‐dependent kinase 4 (CDK4) and CDK6, which are key regulators of the cell cycle machinery and thus cell proliferation. In the present in vitro study, we investigated whether Palbociclib also represents a candidate drug to combat CMT. For this purpose, the effect of Palbociclib was analysed in P114 and CF41 cells, two CMT cell lines with an endogenous CDK4/6 co‐expression. Incubation of P114 and CF41 cells with Palbociclib resulted in a dose‐ and time‐dependent loss of phosphorylated retinoblastoma protein (pRb), a classical CDK4/6 substrate within the cell cycle machinery. Moreover, treatment of CMT cells with Palbociclib‐induced cell cycle arrest affected cell viability, prevented colony formation and impaired cell migration activity. Palbociclib also inhibited the growth of P114 and CF41 cell spheroids. Immunohistochemical analysis of canine patient samples revealed a consistent expression of CDK6 in different canine mammary carcinoma types, but an individual and tumour‐specific expression pattern of phosphorylated pRb independent of the tumour grade. Together, our findings let us suggest that Palbociclib has antitumour effects on CMT cells and that canine patients may represent potential candidates for treatment with this CDK4/6 inhibitor.
An assessment of species limits of the South American mouse genus Oligoryzomys (Rodentia, Cricetidae) using unilocus delimitation methods
Authors: Hurtado Natalí , D’Elía Guillermo
Published: June 2019

Oligoryzomys, as currently understood is formed by 25 living species, is the most diverse genus of the tribe Oryzomyini of the New World subfamily Sigmodontinae of cricetid rodents. Nonetheless, the species richness of Oligoryzomys seems to be an underestimate, given some species complex has been proposed in previous studies, at the time that large geographic areas remain to be sampled, and several taxonomic forms have not been assessed with contemporary approaches. In this study, we present a new assessment of the species diversity of Oligoryzomys based on multiple unilocus species delimitation methods (ABGD, BPP, PTP, GMYC and b GMYC), using 665 cytb gene sequences as evidence (532 gathered from Genbank and 133 obtained in this study). We sampled representatives of almost all currently known species of Oligoryzomys, at the time that extending the geographic coverage to the Central Andes, a large area that was largely unrepresented in previous studies. Phylogenetic relationships, based on a non‐redundant alignment, were inferred via maximum likelihood and Bayesian inference; an ultrametric tree, used in species delimitation analyses, was obtained using multiple secondary calibration points. Results of species delimitation methods are discussed at the light of previous knowledge (e.g., taxonomic history and geographic provenance of samples in relation to type localities) and the morphological assessments of some specimens. Results of the distinct delimitation methods are mostly congruent, being BPP and PTP the most sensible to estimate species delimitation, allowing us to suggest that Oligoryzomys is composed of 30 lineages of species level. Of these, 22 correspond to forms currently considered species; some of these include in their synonymy some forms currently considered valid species (e.g., yatesi would be a synonym of longicaudatus). The remaining eight lineages are candidate species that need to be further evaluated. This study, by advancing taxonomic hypothesis that should be further tested in future studies, constitutes a stepping‐stone for upcoming taxonomic and biogeographic studies centred on Oligoryzomys.
Relationship Between Isokinetic Leg Strength and Dynamic Balance Performance of Elite Male Volleyball Players
Authors: Aktaş Yakup
Published: June 2019

Objective: This study aims at analysing the relationship between isokinetic leg strength and dynamic balance performances of MSK Urfa male volleyball players that play in Turkey Volleyball League of Swashbucklers.Materials and Methods: 13 voluntary volleyball players that played in MSK Urfa being a team in League of Swashbucklers in 2016-2017 season participated in the study. Bioelectric Impedance Measurement Device (Tanita MC 180) was used to measure body composition of volleyball players. Isokinetic dynamometer (IsoMed 2000 GmbH, Germany) was used to measure their isokinetic leg strength. Tecnobody Prokin device was used to measure their dynamic balance performance. The relationship between isokinetic leg strength and dynamic balance performance was determined by Spearman correlation analysis and the significance level was accepted as p <0.05.Findings: According to the data obtained from the study, there was no statistically significant relationship between the dynamic balance performance of volleyball players and the bilateral differences of quadriceps and hamstring muscles at the angular velocity of 60°/s (p>0,05); but there was statistically significant relationship between the bilateral differences of quadriceps and hamstring muscles at the angular velocity of 120°/s (p<0,05).There was no statistically significant relationship between dynamic balance performance and Hamstring/Quadriceps (H/Q) force ratio of dominant and non-dominant leg at angular velocity of 60°/s and 120°/s (p> 0.05).As a result; it was observed that the bilateral differences of hamstring and quadriceps muscles of volleyball players at 120°/s velocity affected their dynamic balance performance; but H/Q ratio at 60°/s and 120°/s velocity did not affect their dynamic balance performance.
Investigation of Oxidative Stress Levels of Male Football Players
Authors: Aktaş Yakup , Çelik Hakim
Published: June 2019

Introduction and Aim: While severe acute exercise increases the production of free radicals in skeletal muscles, regular and continuous exercise strengthens the antioxidant defence mechanism. Consequently, it was aimed to compare the oxidative stress levels of the male football players who regularly train in our study with the healthy control group who do not exercise regularly and to evaluate the effect of doing regular football training on the oxidant-antioxidant system.Material and Method: A total of 59 people consisting of 29 football players of 11 Nisan Football Club in Turkey Football Federation Regional Amateur League (BAL) who train regularly and 30 healthy and volunteer control group who are students at Harran University, Faculty of Medicine and whose ages and body mass index are similar to the each other participated in the study. Total Oxidant Level (TOS), Total Antioxidant Level (TAS), Advanced Protein Oxidation Products (AOPP) and Oxidative Stress Indexes (OSI) of the participants were studied. Mann-Whitney U test and Student-t Test were used for data analysis and p <0.05 was considered significant.Findings: At the end of the study, no statistically significant difference was observed in the TOS, TAS, AOPP and OSI levels between the football players who train regularly and the sedentary group (p> 0,01). However, TOS, OSI and AOPP values were found to be lower in favour of football players while TAS values are high in favour of football players.Consequently; although the acute exercise in the literature increases oxidative stress, it is obvious that a healthy life and physical activity is necessary to avoid from chronic diseases. As a result of our study, it is observed that when exercises are performed in long-term, regularly and at appropriate intensities they strengthen the antioxidant defence system that suppresses oxidative stress.
Anti‐inflammatory effects of oestrogen mediate the sexual dimorphic response to lipid‐induced insulin resistance
Authors: Camporez João Paulo , Lyu Kun , Goldberg Emily L. , Zhang Dongyan , Cline Gary W. , Jurczak Michael J. , Dixit Vishwa Deep , Petersen Kitt Falk , Shulman Gerald I.
Published: June 2019

Key points

Oestrogen has been shown to play an important role in the regulation of metabolic homeostasis and insulin sensitivity in both human and rodent studies.

Insulin sensitivity is greater in premenopausal women compared with age‐matched men, and metabolism‐related cardiovascular diseases and type 2 diabetes are less frequent in these same women.

Both female and male mice treated with oestradiol are protected against obesity‐induced insulin resistance.

The protection against obesity‐induced insulin resistance is associated with reduced ectopic lipid content in liver and skeletal muscle.

These results were associated with increased insulin‐stimulated suppression of white adipose tissue lipolysis and reduced inflammation.

Oestrogen has been shown to play an important role in the regulation of metabolic homeostasis and insulin sensitivity in both human and rodent studies. Overall, females are protected against obesity‐induced insulin resistance; yet, the mechanisms responsible for this protection are not well understood. Therefore, the aim of the present work was to evaluate the underlying mechanism(s) by which female mice are protected against obesity‐induced insulin resistance compared with male mice. We studied male and female mice in age‐matched or body weight‐matched conditions. They were fed a high‐fat diet (HFD) or regular chow for 4 weeks. We also studied HFD male mice treated with oestradiol or vehicle. Both HFD female and HFD male mice treated with oestradiol displayed increased whole‐body insulin sensitivity, associated with reduction in ectopic hepatic and muscle lipid content compared to HFD male mice. Reductions in ectopic lipid content in these mice were associated with increased insulin‐stimulated suppression of white adipose tissue (WAT) lipolysis. Both HFD female and HFD male mice treated with oestradiol also displayed striking reductions in WAT inflammation, represented by reductions in plasma and adipose tissue tumour necrosis factor α and interleukin 6 concentrations. Taken together these data support the hypothesis that HFD female mice are protected from obesity‐induced insulin resistance due to oestradiol‐mediated reductions in WAT inflammation, leading to improved insulin‐mediated suppression of WAT lipolysis and reduced ectopic lipid content in liver and skeletal muscle.
Dynamics of sleep oscillations is coupled to brain temperature on multiple scales
Authors: Csernai Márton , Borbély Sándor , Kocsis Kinga , Burka Dávid , Fekete Zoltán , Balogh Veronika , Káli Szabolcs , Emri Zsuzsa , Barthó Péter
Published: June 2019

Key points

Sleep spindle frequency positively, duration negatively correlates with brain temperature.

Local heating of the thalamus produces similar effects in the heated area.

Thalamic network model corroborates temperature dependence of sleep spindle frequency.

Brain temperature shows spontaneous microfluctuations during both anesthesia and natural sleep.

Larger fluctuations are associated with epochs of REM sleep.

Smaller fluctuations correspond to the alteration of spindling and delta epochs of infra-slow oscillation.

Every form of neural activity depends on temperature, yet its relationship to brain rhythms is poorly understood. In this work we examined how sleep spindles are influenced by changing brain temperatures and how brain temperature is influenced by sleep oscillations. We employed a novel thermoelectrode designed for measuring temperature while recording neural activity. We found that spindle frequency is positively correlated and duration negatively correlated with brain temperature. Local heating of the thalamus replicated the temperature dependence of spindle parameters in the heated area only, suggesting biophysical rather than global modulatory mechanisms, a finding also supported by a thalamic network model. Finally, we show that switches between oscillatory states also influence brain temperature on a shorter and smaller scale. Epochs of paradoxical sleep as well as the infra‐slow oscillation were associated with brain temperature fluctuations below 0.2°C. Our results highlight that brain temperature is massively intertwined with sleep oscillations on various time scales.
Insufficient Reporting of Factors Associated With Exercise Referral Scheme Uptake, Attendance, and Adherence: A Systematic Review of Reviews
Authors: Shore Colin B. , Hubbard Gill , Gorely Trish , Polson Robert , Hunter Angus , Galloway Stuart D.
Published: June 2019

Background: Exercise referral schemes (ERS) are prescribed programs to tackle physical inactivity and associated noncommunicable disease. Inconsistencies in reporting, recording, and delivering ERS make it challenging to identify what works, why, and for whom. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guided this narrative review of reviews. Electronic databases were searched for systematic reviews of ERS. Inclusion criteria and quality assessed through A Measurement Tool to Assess Systematic Reviews (AMSTAR). Data on uptake, attendance, and adherence were extracted. Results: Eleven reviews met inclusion criteria. AMSTAR quality was medium. Uptake ranged between 35% and 81%. Groups more likely to take up ERS included (1) females and (2) older adults. Attendance ranged from 12% to 49%. Men were more likely to attend ERS. Effect of medical diagnosis upon uptake and attendance was inconsistent. Exercises prescribed were unreported; therefore, adherence to exercise prescriptions was unreported. The influence of theoretically informed approaches on uptake, attendance, and adherence was generally lacking; however, self-determination, peer support, and supervision were reported as influencing attendance. Conclusions: There was insufficient reporting across studies about uptake, attendance, and adherence. Complex interventions such as ERS require consistent definitions, recording, and reporting of these key facets, but this is not evident from the existing literature.
Increased Meal Frequency With Exercise Mitigates Postprandial Triacylglycerol
Authors: Menon Jesudas E. , Stensel David J. , Tolfrey Keith , Burns Stephen F.
Published: June 2019

Purpose: This study examined how manipulating meal frequency, with and without exercise, affects postprandial triacylglycerol (TAG). Methods: Fourteen sedentary men completed four 2-day trials in a noncounterbalanced random cross-over order: (1) consumption of 1 large high-fat milkshake without exercise (1-CON), (2) consumption of 2 smaller high-fat milkshakes without exercise (2-CON), (3) consumption of 1 large high-fat milkshake with exercise (1-EX), and (4) consumption of 2 small high-fat milkshakes with exercise (2-EX)—total energy intake was standardized across trials. On day 1, participants rested (1-CON and 2-CON) or walked briskly for 60 minutes (1-EX and 2-EX). On day 2, participants consumed either a single large high-fat milkshake (75% fat; 1-CON and 1-EX) for breakfast or 2 smaller isoenergetic milkshakes (2-CON and 2-EX) for breakfast and lunch. Plasma TAG were measured fasting and for 7 hours after breakfast. Results: Peak incremental TAG was 30% lower on 2-EX than 1-CON (P = .04, d = 0.38). Postprandial TAG increased more rapidly in the first 4 hours in 1-CON than other trials; but at 6 hours, TAG was exaggerated in 2-CON compared with 1-CON. Conclusions: Increasing meal frequency after exercise, without altering overall fat intake, attenuates postprandial TAG.
Identification of Immunodominant HIV-1 Epitopes Presented by HLA-C*12:02, a Protective Allele, Using an Immunopeptidomics Approach
Authors: Chikata Takayuki , Paes Wayne , Akahoshi Tomohiro , Partridge Thomas , Murakoshi Hayato , Gatanaga Hiroyuki , Ternette Nicola , Oka Shinichi , Borrow Persephone , Takiguchi Masafumi
Published: June 2019

Mass spectrometry (MS)-based approaches are increasingly being employed for large-scale identification of HLA-bound peptides derived from pathogens, but only very limited profiling of the HIV-1 immunopeptidome has been conducted to date. Notably, a growing body of evidence has recently begun to indicate a protective role for HLA-C in HIV-1 infection, which may suggest that despite the fact that levels of HLA-C expression on both uninfected and HIV-1-infected cells are lower than those of HLA-A/B, HLA-C still presents epitopes to CD8+T cells effectively. To explore this, we analyzed HLA-C*12:02-restricted HIV-1 peptides presented on HIV-1-infected cells expressing only HLA-C*12:02 (a protective allele) using liquid chromatography-tandem MS (LC-MS/MS). We identified a number of novel HLA-C*12:02-bound HIV-1 peptides and showed that although the majority of them did not elicit T cell responses during natural infection in a Japanese cohort, they included three immunodominant epitopes, emphasizing the contribution of HLA-C to epitope presentation on HIV-infected cells.
Nuclear Factor Y (NF-Y) Modulates Encystation in
Entamoeba
via Stage-Specific Expression of the NF-YB and NF-YC Subunits
Authors: Manna Dipak , Singh Upinder
Published: June 2019

The human parasite
Entamoeba histolytica
is an important pathogen with significant global impact and is a leading cause of parasitic death in humans. Since only the cyst form can be transmitted, blocking encystation would prevent new infections, making the encystation pathway an attractive target for the development of new drugs. Identification of the genetic signals and transcriptional regulatory networks that control encystation would be an important advance in understanding the developmental cascade. We show that the
Entamoeba
NF-Y complex plays a crucial role in regulating the encystation process in
Entamoeba
.
Identification of Pneumococcal Factors Affecting Pneumococcal Shedding Shows that the
dlt
Locus Promotes Inflammation and Transmission
Authors: Zafar M. Ammar , Hammond Alexandria J. , Hamaguchi Shigeto , Wu Weisheng , Kono Masamitsu , Zhao Lili , Weiser Jeffrey N.
Published: June 2019

Streptococcus pneumoniae
(the pneumococcus) is a common cause of respiratory tract and invasive infection. The overall effectiveness of immunization with the organism’s capsular polysaccharide depends on its ability to block colonization of the upper respiratory tract and thereby prevent host-to-host transmission. Because of the limited coverage of current pneumococcal vaccines, we carried out an unbiased
in vivo
transposon mutagenesis screen to identify pneumococcal factors other than its capsular polysaccharide that affect transmission. One such candidate was expressed by the
dlt
locus, previously shown to add
d
-alanine onto the pneumococcal lipoteichoic acid present on the bacterial cell surface. This modification protects against host antimicrobials and augments host inflammatory responses. The latter increases secretions and bacterial shedding from the upper respiratory tract to allow for transmission. Thus, this study provides insight into a mechanism employed by the pneumococcus to successfully transit from one host to another.
Web and mobile-based technologies for monitoring high-risk pregnancies
Authors: Ayatollahi Haleh , Ghalandar Abadi Malihe , Hemmat Morteza
Published: June 2019

Introduction

High-risk pregnancy is an illness in which there are severe complications and problems that may cause fetal loss and requires continuous care. It seems that using telemedicine technology is helpful to provide wider access to prenatal care. The aim of this study was to compare the feasibility of using web-based and mobile-based technologies in caring for high-risk pregnancy.

Materials and methods

This was a cross-sectional study and the participants included midwives and gynaecologists who worked at teaching hospitals. The data were collected by using two five-point Likert scale questionnaires which were designed based on the literature review. The questionnaires included two main sections: demographic questions and questions related to five aspects of a feasibility study. Face and content validity of the questionnaires were confirmed by the experts and the reliability was checked by using the test-retest method. The data were analysed using descriptive and inferential statistics.

Results

In this study, 79 questionnaires were completed by 50 midwives (63.29%) and 29 gynaecologists (36.71%). Overall, midwives (p=0.001) and gynaecologists (p=0.003) believed that using mobile-based technologies was more feasible than using web-based technologies in caring for high-risk pregnancies.

Conclusion

It seems that planning for the future technological direction and providing mobile-based applications should be taken into account and prioritised to improve the quality of prenatal care and to increase access to healthcare services for high-risk pregnancies.
Dual antiplatelet therapy following percutaneous coronary intervention: protocol for a systematic review
Authors: Elliott Jesse , Kelly Shannon E , Bai Zemin , Skidmore Becky , Boucher Michel , So Derek Y F , Wells George A
Published: June 2019

Introduction

Dual antiplatelet therapy (DAPT) is routinely given to patients after percutaneous coronary intervention (PCI) with stenting; however, there is ongoing debate about the optimal duration, especially in specific patient groups. In the proposed systematic review, we intend to assess the optimal duration of DAPT following PCI with stenting, with a focus on clinically relevant patient subgroups.

Methods and analysis

We will perform a comprehensive search of the published literature for randomised controlled trials (RCTs) assessing the benefits and harms of extended DAPT (>12 months) compared with short-term DAPT (6–12 months) following PCI with stenting (bare metal or drug eluting). ClinicalTrials.gov and ICTRP will also be searched to identify ongoing and completed clinical trials. Two independent reviewers will select studies for inclusion, and the risk of bias will be assessed by use of Cochrane’s Risk of Bias tool. The primary outcome of interest is death (all-cause, cardiovascular, non-cardiovascular). Secondary outcomes are bleeding (major, minor, gastrointestinal), urgent target vessel revascularisation, major adverse cardiovascular events, myocardial infarction, stroke and stent thrombosis. Subgroup data will be sought for patients with prior myocardial infarction, acute coronary syndrome at presentation and diabetes, and based on smoking status and age group. Data will be analysed by random-effects meta-analysis, and separate analyses will be performed for patient subgroups. Bayesian network meta-analysis will be performed to investigate the effect of individual P2Y12 inhibitors at different DAPT durations longer than 6 months.

Ethics and dissemination

This review will provide a comprehensive overview of the available evidence of the benefits and harms associated with extending DAPT beyond 12 months following PCI with stenting and the effects on clinically important subgroups. The results of this review will inform clinical and policy decisions regarding the optimal treatment duration of DAPT following PCI with stenting.

Systematic review registration

PROSPERO no. CRD42018082587
Association between the recurrence period of acute kidney injury and mortality: a single-centre retrospective observational study in Japan
Authors: Sako Keisuke , Furuichi Kengo , Yamamura Yuta , Oshima Megumi , Toyama Tadashi , Kaneko Shuichi , Wada Takashi
Published: June 2019

Objectives

Recurrent acute kidney injury (AKI) is a recognised risk factor for mortality. However, it is unclear whether the period until AKI recurrence may have a major factor on patient outcome or not. To explore this issue, we (1) framed the hypothesis that early recurrence increases the risk of mortality and (2) evaluated the prognosis of recurrent AKI cases by setting 21 days as the cut-off period.

Methods

All studied cases were admitted and followed up at the Kanazawa University Hospital (Kanazawa, Japan) between 1 November 2006 and 31 October 2007. In total, 21 939 patients were retrospectively evaluated in their recurrences of AKI for 2 years and followed up until 31 October 2016. Risks for death were evaluated by the recurrences of AKI (Analysis 1). Patients who developed AKI recurrence before 21 days were defined as the early-recurrence group and the remaining cases as the late-recurrence group. Risks for death were evaluated by the two groups (Analysis 2).

Results

510 patients (2.3%) developed the first AKI. Of these, 151 developed recurrent AKI within 2 years. The number of early-recurrence cases was 44 and that of non-recurrence or late-recurrence was 357. A total of 196 cases (38.4%) died, and higher risk for death was observed in the recurrent AKI group (Analysis 1; p=0.015, log-rank test). We found that the rate of all-cause mortality was higher in the early-recurrence group involving 33.8 deaths per 100 person-years, whereas the non-recurrence or late-recurrence group included only 6.2 deaths per 100 person-years (Analysis 2; p<0.001, log-rank test).

Conclusions

Patients experiencing recurrent AKI before 21 days from the first AKI clearly showed a relatively poor prognosis. Evidently, careful follow-up for at least 21 days after AKI would be highly useful to detect a recurrence event, possibly leading to a better prognosis after AKI.
Understanding of and perceptions towards cardiovascular diseases and their risk factors: a qualitative study among residents of urban informal settings in Nairobi
Authors: Wekesah Frederick Murunga , Kyobutungi Catherine , Grobbee Diederick E , Klipstein-Grobusch Kerstin
Published: June 2019

Objectives

The study explored the understanding of and perception towards cardiovascular disease (CVD) and risk factors, and how they influence prevention and development of the conditions, care-seeking and adhering to treatment.

Setting

Informal settlements of Nairobi.

Participants

Nine focus group discussions consisting of between six and eight purposively sampled participants were conducted among healthy individuals aged 20 years or older. A total of 65 participants (41 female) were involved.

Results

Poverty, ignorance and illiteracy promoted behaviours like smoking, (harmful) alcohol consumption, physical inactivity and unhealthy diet, implicated in the development of obesity, diabetes and hypertension. Some respondents could not see the link between behavioural risk factors with diabetes, hypertension and stroke and heart attacks. Contaminated food items consumed by the residents and familial inheritance were factors that caused CVD, whereas emotional stress from constant worry was linked to hypertension, stroke and heart attacks. Few and inadequately equipped public health facilities were hindrances to treatment seeking and adherence to treatment for CVD conditions. Lack of medication in public health facilities was considered to be the single most important barrier to adherence to treatment next to lack of family support among older patients.

Conclusion

Interventions to prevent and manage CVD in low-resource and urban poor settings should consider perceptions and understanding of risk factors for CVD, and the interrelationships among them while accounting for cultural and contextual issues for example, stigma and disregard for conventional medicine. Programmes should be informed by locally generated evidence on awareness and opportunities for CVD care, coupled with effective risk communication through healthcare providers. Screening for and treatment of CVD must address perceptions such as prohibitive cost of healthcare. Finally, social determinants of disease and health, mainly poverty and illiteracy, which are implicated in addressing CVD in low-resource settings, should be addressed.
Assessing the knowledge, perception and practices of physicians and pharmacists towards medication reconciliation in Kuwait governmental hospitals: a cross-sectional study
Authors: Lemay Jacinthe , Bayoud Tania , Husain Hajer , Sharma Prem
Published: June 2019

Objectives

To assess the knowledge, perception and practices towards medication reconciliation (MedRec) and its related institutional policies among physicians and pharmacists in governmental hospitals in Kuwait and identifying potential obstacles that prevent the successful implementation of MedRec.

Design

A descriptive, cross-sectional study.

Setting

Six governmental hospitals across Kuwait in January–May 2017.

Participants

351 physicians and 214 pharmacists.

Brief intervention

A self-administered questionnaire distributed to the participants.

Main outcome measures

Knowledge, perception, attitudes and practices of hospital physicians and pharmacists towards MedRec, and major barriers to implementing a MedRec process in their institution/department.

Results

Of the 739 questionnaires distributed, 565 were completed (351 physicians and 214 pharmacists), giving a response rate of 76.5%. Results showed that most participants were familiar with the term MedRec (n=419; 75.2%) with significantly more pharmacists compared with physicians (n=171; 81.8% vs n=248; 71.3%; p=0.005). Most participants (n=432; 80.0%) reported perceiving MedRec as a valuable process for patient safety. However, significantly more physicians compared with pharmacists were aware of a MedRec policy in their institution (n=195; 55.9% vs n=78; 37.9%; p<0.001) and routinely asked patients about their current list of medication on arrival (n=339; 96.6% vs n=129; 61.1%; p<0.001) and provided an updated list on discharge (n=281; 80.1% vs n=107; 52.0%; p<0.001). These results are supported by the findings that participants perceived physicians as providers, mainly responsible for various steps of MedRec.

Conclusions

Overall, this study showed low awareness among physicians and pharmacists of hospital policy despite MedRec being perceived as valuable. Physicians were the providers most responsible and involved in MedRec, who may be driven by the policy putting them at core of the process. The current findings could pave the way for the expansion of the existing MedRec policies and processes in Kuwait to include pharmacists and improve patient safety.