bluuebunny/crossref_metadata_2025 huggingface dataset:
Macronutrient, immunoglobulin a and total antioxidant capacity profiles of human milk from 1 to 24 months: a cross-sectional study in Thailand
Authors: Ongprasert Krongporn , Ruangsuriya Jetsada , Malasao Rungnapa , Sapbamrer Ratana , Suppansan Pikul , Ayood Pisittawoot , Kittisakmontri Kulnipa , Siviroj Penprapa
Published: October 2020

Background

An extended duration of breastfeeding of up to two years is encouraged by many health authorities, but information regarding the composition of milk after one year postpartum is limited. The goal of this study was to determine the association between the duration of lactation and macronutrient contents, immunoglobulin A (IgA) levels and total antioxidant capacity (TAC) in human milk (HM), from 1 to 24 months postpartum.

Methods

Cross-sectional milk samples were collected between January and April 2019 from mothers with healthy full-term children who had been lactating for 1 to 24 months. The HM was biochemically analyzed for protein and carbohydrate contents by colorimetric assays. The fat content was determined by capillary centrifugation, and the energy content was calculated from the results of centrifugation assays. IgA levels and TAC were determined by ELISA and a Trolox equivalent antioxidant capacity (TEAC) assay, respectively. Pearson’s correlation coefficient and Spearman’s rank correlation coefficient were used to determine associations between months of lactation and milk composition, and multiple regression analysis was used to assess associations between months of lactation and milk composition adjusted for relevant covariates. Differences were considered significant atp < 0.05.

Results

One hundred eighty-four milk samples were analyzed. The month of lactation was positively associated with the fat concentration (B = 0.31, SE = 0.09,p = 0.001), energy content (B = 3.11, SE = 0.92, p = 0.001), and IgA (B = 4.17, SE = 1.08,p < 0.001) but negatively associated with the carbohydrate concentration (B = − 0.22, SE = 0.01,p = 0.04). No association was observed between the month of lactation and the protein concentration or TAC after adjustment for maternal age, maternal BMI, birth order, and breastfeeding frequency.

Conclusion

The duration of lactation was found to be positively associated with the fat, energy, and IgA content in HM for up to two years postpartum, and negatively associated with carbohydrate concentration. More prospective cohort studies are needed to obtain evidence-based knowledge regarding the changes in HM composition throughout the course of lactation.
Parent-adolescent communication on sexual and reproductive health issues and its associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Mekie Maru , Addisu Dagne , Melkie Abenezer , Taklual Wubet
Published: October 2020

Background

Every year, 1.3 million young people reported to die from preventable causes of death. Parent-adolescent communication on sexuality is critical in informing youth about risk and protective behaviors which in turn decrease the likelihood of involvement in risky sexual behaviors. This systematic review and meta-analysis was intended to assess the prevalence of parent-adolescent communication on sexual and reproductive health (SRH) issues and its associated factors in Ethiopia.

Methods

PubMed, EMBASE, HINARI, Google Scholar, and University repositories were used to search studies. Article search was conducted from May 20 to June 9, 2020. Critical appraisal of studies was conducted using Newcastle-Ottawa Quality Assessment Scale (NOS). Data analysis was conducted using Stata 11 software following the abstraction of data using a format prepared on Microsoft excel. The heterogeneity of studies was tested using Cochran (Q test) and I2 test statistics. Similarly, funnel plot and Egger’s regression asymmetry were used to assess publication bias. Subgroup analysis was conducted based on study Regions and sample size.

Result

Fourteen studies with sample of 8018 adolescents were included in this systematic review and meta-analysis. The pooled prevalence of parent-adolescent communication on SRH issues in Ethiopia was found to be 45.18% (95%, CI, 32.23, 58.13%). Adolescents’ knowledge of reproductive health matters (OR = 2.91, 95% CI:1.21, 7.01), believe on importance of discussion on SRH issues (OR = 4.18, 95% CI: 2.63, 6.65), had history of sexual exposure (OR = 1.95, 95% CI: 1.53, 2.50), parents openness to discuss SRH issues (OR = 3.39, 95% CI: (2.48, 4.62), and being female (OR = 1.60, 95% CI:1.07, 2.38) were the positive predictors of parent-adolescent communications on SRH issues.

Conclusion

The prevalence of parent-adolescent communication on SRH issues was found to be low. Knowledge of adolescents about reproductive health matters, believe on the importance of discussion on reproductive health issues, history of sexual exposure, parents’ openness to discuss SRH issues, and being female were found to be the positive predictors of parent-adolescent communication on SRH issues in Ethiopia. The finding our study indicated that evidence based education about reproductive health matters could significant to improve adolescent parent communication on SRH issues.
Combined HIV Adolescent Prevention Study (CHAPS): comparison of HIV pre-exposure prophylaxis regimens for adolescents in sub-Saharan Africa—study protocol for a mixed-methods study including a randomised controlled trial
Authors:   on behalf of the CHAPS team, Nash S. , Dietrich J. , Ssemata A. S. , Herrera C. , O’Hagan K. , Else L. , Chiodi F. , Kelly C. , Shattock R. , Chirenje M. , Lebina L. , Khoo S. , Bekker L-G , Weiss H. A. , Gray C. , Stranix-Chibanda L. , Kaleebu P. , Seeley J. , Martinson N. , Fox J.
Published: October 2020

Background

HIV remains a major public health issue, especially in Eastern and Southern Africa. Pre-exposure prophylaxis is highly effective when adhered to, but its effectiveness is limited by cost, user acceptability and uptake. The cost of a non-inferiority phase III trial is likely to be prohibitive, and thus, it is essential to select the best possible drug, dose and schedule in advance. The aim of this study, the Combined HIV Adolescent PrEP and Prevention Study (CHAPS), is to investigate the drug, dose and schedule of pre-exposure prophylaxis (PrEP) required for the protection against HIV and the acceptability of PrEP amongst young people in sub-Saharan Africa, and hence to inform the choice of intervention for future phase III PrEP studies and to improve strategies for PrEP implementation.

Methods

We propose a mixed-methods study amongst young people aged 13–24 years. The first component consists of qualitative research to identify the barriers and motivators towards the uptake of PrEP amongst young people in South Africa, Uganda and Zimbabwe. The second component is a randomised clinical trial (ClinicalTrials.gov NCT03986970, June 2019) using a novel ex vivo HIV challenge method to investigate the optimal PrEP treatment (FTC-TDF vs FTC-TAF), dose and schedule. We will recruit 144 amongst HIV-negative uncircumcised men aged 13–24 years from voluntary male medical circumcision clinics in two sites (South Africa and Uganda) and randomise them into one of nine arms. One group will receive no PrEP prior to surgery; the other arms will receive either FTC-TDF or FTC-TAF, over 1 or 2 days, and with the final dose given either 6 or 20 h prior to surgery. We will conduct an ex vivo HIV challenge on their resected foreskin tissue.

Discussion

This study will provide both qualitative and quantitative results to help decide the optimum drug, dose and schedule for a future phase III trial of PrEP. The study will also provide crucial information on successful strategies for providing PrEP to young people in sub-Saharan Africa.

Trial registration

ClinicalTrials.govNCT03986970. Registered on 14 June 2019
Review on the molecular study of the Diplozoidae: analyses of currently available genetic data, what it tells us, and where to go from here
Authors: Dos Santos Quinton Marco , Avenant-Oldewage Annemariè
Published: October 2020

The use of molecular tools in the study of parasite taxonomy and systematics have become a substantial and crucial component of parasitology. Having genetic characterisation at the disposal of researchers has produced mostly useful, and arguably more objective conclusions. However, there are several groups for which limited genetic information is available and, coupled with the lack of standardised protocols, renders molecular study of these groups challenging. The Diplozoidae are fascinating and unique monogeneans parasitizing mainly freshwater cyprinid fishes in Europe, Asia and Africa. This group was studied from a molecular aspect since the turn of the century and as such, limitations and variability concerning the use of these techniques have not been clearly defined. In this review, all literature and molecular information, primarily from online databases such as GenBank, were compiled and scrupulously analysed for the Diplozoidae. This was done to review the information, detect possible pitfalls, and provide a “checkpoint” for future molecular studies of the family. Hindrances detected are the availability of sequence data for only a limited number of species, frequently limited to a single sequence per species, and the heavy reliance on one non-coding ribosomal marker (ITS2 rDNA) which is difficult to align objectively and displays massive divergences between taxa. Challenging species identification and limited understanding of diplozoid species diversity and plasticity are also likely restricting factors, all of which hamper the accurate taxonomic and phylogenetic study of this group. Thus, a more integrated taxonomic approach through the inclusion of additional markers, application of more rigorous morphological assessment, more structured barcoding techniques, alongside thorough capturing of species descriptions including genetypes, genophore vouchers and reference collections in open sources are encouraged. The pitfalls highlighted are not singular to the Diplozoidae, and the study of other groups may benefit from the points raised here as well.
Is sex a proxy for mechanical variables during an upper limb repetitive movement task? An investigation of the effects of sex and of anthropometric load on muscle fatigue
Authors: Slopecki Matthew , Messing Karen , Côté Julie N.
Published: October 2020

Background

Women report more work-related pain and neck/shoulder musculoskeletal disorders than men. For the same absolute workload, due to lower strength, females generally work at a higher relative intensity, which could induce more fatigue. However, the arm’s anthropometric load (AL) of men is higher. Therefore, simply lifting their arm could be more fatiguing. Sex as a variable is formed of many constructs, and analyses can become muddied by their differing responses to fatigue. No studies have considered AL, when comparing how fatigue affects men and women. The purpose was to determine if including the arm’s AL in the statistical analysis would impact findings of sex-specific effects of shoulder fatigue on muscle EMG.

Methods

Fifty-five (29m/26f) participants completed a repetitive pointing task (RPT) at shoulder height until they reported fatigue of 8+ on the BORG CR-10 scale. Muscle activities were measured using surface electrodes placed over the anterior deltoid (AD) and upper trapezius (UT) muscles. Muscle activity amplitude was quantified using root mean square (RMS). First- and last-minute data were used to assess change from no-fatigue (NF) to fatigue-terminal (FT) conditions. AL was calculated using sex-specific body parameter equations. General estimating equations (GEE) were used to determine the effects of sex and fatigue on RMS values, while including AL in the GEE.

Results

There was no sex difference in time to reach fatigue. A significant main effect of sex on RMS was observed (χ2(1) = 4.17, p = 0.04) when including AL as a covariate. Females displayed a significantly higher percentage change in AD RMS from NF to FT, compared to males (p = 0.03), when AL was included in the GEE. No sex differences in UT were observed.

Conclusions

This sex difference emerged when AL was included as a covariate, suggesting that sex-associated anthropometric differences may contribute to sex differences in the fatigue response. Differences in the impact of AL on AD compared to UT could be explained by differences in their respective mechanical roles or muscle fiber content. Anthropometrics may be useful to include as covariates in future research to separate individual anthropometric differences from sex differences.
Day-to-day variability of [68Ga]Ga-PSMA-11 accumulation in primary prostate cancer: effects on tracer uptake and visual interpretation
Authors: olde Heuvel Judith , de Wit-van der Veen Berlinda J. , Donswijk Maarten L. , Slump Cornelis H. , Stokkel Marcel P. M.
Published: October 2020

Purpose

Prostate-specific membrane antigen (PSMA) agents, such as [68Ga]Ga-PSMA-11, have an unprecedented accuracy in staging prostate cancer (PCa) and detecting disease recurrence. PSMA PET/CT may also be used for response monitoring by displaying molecular changes, instead of morphological changes alone. However, there are still limited data available on the variability in biodistribution and intra-prostatic uptake of PSMA targeting radiotracers. Therefore, the aim of this study was to assess the repeatability of [68Ga]Ga-PSMA-11 uptake in primary PCa patients in a 4-week interval.

Methods

Twenty-four primary PCa patients were prospectively included, who already were scheduled for [68Ga]Ga-PSMA-11 PET/CT scan on clinical indication (≥ cT3, Gleason score ≥ 7 or PSA ≥ 20 ng/mL). These patients received two [68Ga]Ga-PSMA-11 PET/CT scans with a 4-week interval. No treatment was started in between the scans. Semiquantitative measurements (SULmax, SULmean, and SULpeak) were determined in the prostate tumor, normal tissues, and blood pool. The repeatability coefficient of every region was determined. All scans were visually analyzed by two nuclear medicine physicians.

Results

Within-subject coefficient of variation of [68Ga]Ga-PSMA-11 uptake between the two scans was on average 10% in the prostate tumor, normal tissues (liver, kidney, parotid), and blood pool. The repeatability coefficient of the prostate tumor was 18% for SULpeak and 22% for SULmax. Lesion uptake was visually different in 5 patients, though not clinically relevant.

Conclusion

Results of test-retest [68Ga]Ga-PSMA-11 PET/CT scans in a 4-week interval show that [68Ga]Ga-PSMA-11 uptake is repeatable, with a clinical irrelevant variation in tumor and physiological distribution. Based on the presented repeatable uptake, [68Ga]Ga-PSMA-11 PET/CT scans can potentially be used for disease surveillance and therapy response monitoring. Changes in uptake larger than the RC are therefore likely to reflect actual biological changes in PSMA expression.

Trial registration NL8263 at Trialregister.nl retrospectively registered on 03-01-2020. https://www.trialregister.nl/trial/8263
Quantitative proteomics revealed modulation of macrophages by MetQ gene of Streptococcus suis serotype 2
Authors: Pei Xiaomeng , Liu Junchi , Liu Mingxing , Zhou Hong , Wang Xiaomin , Fan Hongjie
Published: October 2020

Streptococcus suis serotype 2 (SS2) is a serious zoonotic pathogen; it can lead to symptoms of streptococcal toxic shock syndrome (STSS) in humans and sepsis in pigs, and poses a great threat to public health. The SS2 MetQ gene deletion strain has attenuated antiphagocytosis, although the mechanism of antiphagocytosis and pathogenesis of MetQ in SS2 has remained unclear. In this study, stable isotope labeling by amino acids in cell culture (SILAC) based liquid chromatography–mass spectrometry (LC–MS) and subsequent bioinformatics analysis was used to determine differentially expressed proteins of RAW264.7 cells infected with △MetQ and ZY05719. Proteomic results were verified by quantitative real-time polymerase chain reaction (qRT-PCR) and Western blotting for selected proteins. Further research was focused mainly on immune system processes related to downregulated proteins, such as Src and Ccl9, and actin cytoskeleton and endocytosis related upregulated proteins, like Pstpip1 and Ppp1r9b. The proteomic results in this study shed light on the mechanism of antiphagocytosis and innate immunity of macrophages infected with △MetQ and ZY05719, which might provide novel targets to prevent or control the infection of SS2.
An intelligent loader-digger heat balance system based on simulation and wireless sensor networks
Authors: Li Lei , Chen Xi , Liu Di , Zhou Hong-gen , Wu Haiyan
Published: October 2020

High temperature of the radiator group is harmful to the power system and hydraulic system. In order to improve the heat dissipation performance of the loader, the flow field characteristics of the cooling chamber are analyzed by simulation and heat balance test. Firstly, the mathematical model of heat flow is established. Secondly, the flow field in the cooling chamber under different speeds is simulated based on CFX. And then the influence of fan position and internal flow field distribution on radiator performance is studied. Through the simulation of four different distances, it is concluded that the optimal distance between cooling fan and radiator is 76 mm. Finally, the heat balance test system based on wireless sensor network is established, and the simulation results are verified. The test results show that the heat dissipation performance of the whole machine meets the requirements after optimization. In this paper, the proposed scheme can dynamically adjust the heat dissipation performance and make the loader excavator in an efficient and energy-saving operation state.
PRISMA extension for moxibustion 2020: recommendations, explanation, and elaboration
Authors: Zhang Xuan , Tan Ran , Lam Wai Ching , Cheng Chung Wah , Yao Liang , Wang Xiao-Qin , Li Si-Yao , Aixinjueluo Qi-Ying , Yang Ke-Hu , Shang Hong-Cai , Wu Tai-Xiang , Lyu Ai-Ping , Bian Zhao-Xiang
Published: October 2020

Background

Moxibustion is a common intervention of Chinese medicine (CM). Systematic reviews (SRs) on moxibustion are increasing. Although the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement provides guidelines for SRs, the quality of moxibustion-related SRs is still not satisfactory. In particular, descriptions of the interventions and the rationale for using moxibustion are insufficient. To address these inadequacies, the working group developed this PRISMA extension for reporting SRs of moxibustion (PRISMA-M 2020).

Methods

A group of CM clinical professionals, methodologists of SRs, reporting guideline developers, and journal editors developed this PRISMA-M 2020 through a comprehensive process that includes registration, literature review, consensus meetings, Delphi exercises for soliciting comments, and revision, resulting in this final draft.

Results

Seven of the 27 PRISMA checklist items, namely title (1), rationale (3), eligibility criteria (6), data item (11), additional analyses (16), study characteristics (18), and additional analysis (23), were extended, with specific reference to the application of moxibustion. Illustrative examples and explanations for each item are provided.

Conclusion

The PRISMA-M 2020 will help improve the reporting quality of SRs with moxibustion.

Systematic review registration

We have registered it on the EQUATOR (Enhancing the QUAlity and Transparency Of health Research) network, particularly under the item of PRISMA-TCM: http://www.equator-network.org/library/reporting-guidelines-under-development/reporting-guidelines-under-development-for-systematic-reviews/#65.
Ionospheric irregularities and scintillations: a direct comparison of in situ density observations with ground-based L-band receivers
Authors: Aol Sharon , Buchert Stephan , Jurua Edward
Published: October 2020

Ionospheric irregularities can affect satellite communication and navigation by causing scintillations of radio signals. The scintillations are routinely measured using ground-based networks of receivers. This study presents observations of ionospheric irregularities by Langmuir probes on the Swarm satellites. They are compared with amplitude scintillation events recorded by the Global Positioning System-Scintillation Network and Decision Aid (GPS-SCINDA) receiver installed in Mbarara (Lat:$$0.6^{\circ }\hbox {S}$$0.6∘S, Lon:$$30.8^{\circ }\hbox {E}$$30.8∘E, Mag. lat:$$10.2^{\circ }\hbox {S}$$10.2∘S). The study covers the years from 2014 to 2018 when both data sets were available. It was found that the ground-based amplitude scintillations were enhanced when Swarm registered ionospheric irregularities for a large number of passes. The number of matching observations was greater for Swarm A and C which orbited at lower altitudes compared to Swarm B. However, some counterexamples, i.e., cases when in situ electron density fluctuations were not associated with any observed L-band amplitude scintillation and vice versa, were also found. Therefore, mismatches between observed irregularity structures and scintillations can occur just over a few minutes and within distances of a few tens of kilometers. The amplitude scintillation strength, characterized by theS4 index was estimated from the electron density data using the well-known phase screen model for weak scattering. The derived amplitude scintillation was on average lower for Swarm B than for A and C and less in accordance with the observed range. Irregularities at an altitude of about 450 km contribute strongly to scintillations in the L-band, while irregularities at about 510-km altitude contribute significantly less. We infer that in situ density fluctuations observed on passes over or near Mbarara may be used to indicate the risk that ionospheric radio wave scintillations occur at that site.
iCREATE: imaging features of primary and metastatic alveolar soft part sarcoma from the EORTC CREATE study
Authors: Mcaddy Naami Charlotte , Saffar Hind , Litière Saskia , Jespers Pieter , Schöffski Patrick , Messiou Christina
Published: October 2020

Background

Alveolar Soft Part Sarcoma (ASPS) is a rare, slow-growing, but highly vascular soft tissue sarcoma, characterised by a high rate of metastases at presentation. Although imaging features of the primary are well described, less detail is available on the imaging pattern of metastatic ASPS. The EORTC 90101 (CREATE) study assessed the efficacy of Crizotinib in patients with metastatic ASPS and presents a unique opportunity to describe the imaging phenotype of primary and metastatic ASPS, based on prospectively collected imaging.

Methods

A retrospective review of the staging CT scans of 32 patients with ASPS from the CREATE study was undertaken and the imaging features of primary and metastatic disease were assessed.

Results

Imaging of the primary tumour was available in 7/32 cases (28%). All primary tumours demonstrated marked vascularity with prominent feeding vessels (7/7, 100%). The most frequent sites of metastases included lung (30/32, 94%), nodal (7/32, 22%), bone (5/32, 16%) and muscle/subcutaneous (5/32, 16%). Features of hypervascularity were identified at all sites, more appreciable in the lungs, with feeding vessels frequently demonstrated in pulmonary metastases (21/32, 66%).

Conclusion

Analysis of imaging from the CREATE cohort of patients with metastatic ASPS demonstrates that metastases from ASPS are predominantly hypervascular and demonstrate feeding vessels comparable to primary ASPS, suggesting potential sensitivity of this rare sarcoma for antivascular/antiangiogenic treatment approaches.
Design as an interactive boundary object
Authors: Tharchen Thinley , Garud Raghu , Henn Rebecca L.
Published: October 2020

What is it about the term ‘design’ that facilitates the emergence of interdisciplinary interactions even though the term may hold different meanings for those involved? To address this question, we analyzed the vocabularies, practices and orders of worth  proposed by the members of an interdisciplinaryCenter for Design. Our analysis revealed similarities and differences in the meanings accorded by these individuals to the term design. The analysis also revealed an awareness on their part that their notions of design were incomplete, and that they had to rely on the inputs of others. Such reflexivity was an important factor in fostering meaningful interactions between these individuals. Based on these findings, we argue that design is aninteractive boundary object, which enables different meaning structures to co-exist and co-inform actors from multiple disciplines and domains. Within such a view, the emergence of interactions occurs not despite but because of the diversity of views about the notion of design itself.
Comanagement Strategy Between Academic Institutions and Community Practices to Reduce Induction Mortality in Acute Promyelocytic Leukemia
Authors: Jillella Anand P. , Arellano Martha L. , Gaddh Manila , Langston Amy A. , Heffner Leonard T. , Winton Elliott F. , McLemore Morgan L. , Zhang Chao , Caprara Catherine R. , Simon Kathryn S. , Bolds Sheldon L. , DeBragga Stephanie , Karkhanis Prachi , Krishnamurthy Shruthi H. , Tongol Jose , El Geneidy Mohamed M. , Pati Asim , Gerber Jonathan M. , Grunwald Michael R. , Cortes Jorge , Bashey Asad , Stuart Robert K. , Kota Vamsi K.
Published: October 2020

PURPOSE:

Acute promyelocytic leukemia (APL) is a curable leukemia with > 90% survival in clinical trials. Population-based studies from Sweden and US SEER data have shown long-term survival rates of 62% and 65.7%, with the lower rate being from a higher percentage of early deaths.

METHODS:

In this prospective, multicenter trial, we developed a simplified algorithm that focused on prevention and early treatment of the three main causes of death: bleeding, differentiation syndrome, and infection. All patients with a diagnosis of APL were included. The initial 6 months were spent educating oncologists about early deaths in APL. At the time of suspicion of an APL, an expert was contacted. The algorithm was made available followed by discussion of the treatment plan. Communication between expert and treating physician was frequent in the first 2 weeks, during which time most deaths take place.

RESULTS:

Between September 2013 and April 2016, 120 patients enrolled in the study from 32 hospitals. The median age was 52.5 years, with 39% > 60 years and 25% with an age-adjusted Charlson comorbidity index > 4. Sixty-three percent of patients were managed at community centers. Two patients did not meet the criteria for analysis, and of 118 evaluable patients, 10 died, with an early mortality rate of 8.5%. With a median follow-up of 27.3 months, the overall survival was 84.5%.

CONCLUSION:

Induction mortality can be decreased and population-wide survival improved in APL with the use of standardized treatment guidelines. Support from experts who have more experience with induction therapy is crucial and helps to improve the outcomes.
Development of Machine Learning Models for Predicting Postoperative Delayed Remission in Patients With Cushing’s Disease
Authors: Fan Yanghua , Li Yichao , Bao Xinjie , Zhu Huijuan , Lu Lin , Yao Yong , Li Yansheng , Su Mingliang , Feng Feng , Feng Shanshan , Feng Ming , Wang Renzhi
Published: October 2020

Context

Postoperative hypercortisolemia mandates further therapy in patients with Cushing’s disease (CD). Delayed remission (DR) is defined as not achieving postoperative immediate remission (IR), but having spontaneous remission during long-term follow-up.

Objective

We aimed to develop and validate machine learning (ML) models for predicting DR in non-IR patients with CD.

Methods

We enrolled 201 CD patients, and randomly divided them into training and test datasets. We then used the recursive feature elimination (RFE) algorithm to select features and applied 5 ML algorithms to construct DR prediction models. We used permutation importance and local interpretable model–agnostic explanation (LIME) algorithms to determine the importance of the selected features and interpret the ML models.

Results

Eighty-eight (43.8%) of the 201 CD patients met the criteria for DR. Overall, patients who were younger, had a low body mass index, a Knosp grade of III–IV, and a tumor not found by pathological examination tended to achieve a lower rate of DR. After RFE feature selection, the Adaboost model, which comprised 18 features, had the greatest discriminatory ability, and its predictive ability was significantly better than using Knosp grading and postoperative immediate morning serum cortisol (PoC). The results obtained from permutation importance and LIME algorithms showed that preoperative 24-hour urine free cortisol, PoC, and age were the most important features, and showed the reliability and clinical practicability of the Adaboost model in DC prediction.

Conclusions

Machine learning–based models could serve as an effective noninvasive approach to predicting DR, and could aid in determining individual treatment and follow-up strategies for CD patients.
Serum Spermidine as a Novel Potential Predictor for Fragility Fractures
Authors: Kong Sung Hye , Kim Jung Hee , Shin Chan Soo
Published: October 2020

Context

Metabolomics is an emerging tool that provides insights into the dynamics of phenotypic changes. It is a potential method for the discovery of novel serum markers of fracture.

Objective

To identify metabolite parameters that can be used as a proxy for osteoporotic fracture risk

Design

Prospective study based on the Ansung cohort in Korea.

Setting

The general community.

Participants

A total of 1504 participants with metabolomic analyses.

Interventions

None.

Main Outcome Measure

Fragility fractures.

Results

We measured 135 baseline metabolite profiles in fasting serum of the participants. The participants had a mean age of 60.2 years and were comprised of 585 (38.9%) men. During a mean 9-year follow-up, 112 osteoporotic fracture events occurred. Of all metabolites measured, only serum spermidine concentrations were positively associated with the risk of fracture (hazard ratio [HR] per 1 μM of spermidine 1.35, 95% confidence interval [CI] = 1.03–1.65, P = 0.020) after adjusting for age, sex, body mass index, diabetes, hypertension, smoking status, previous fracture history, and baseline tibial quantitative ultrasound. Participants with spermidine concentrations >1.57 μM had a 2.2-fold higher risk of fractures (95% CI 1.08–4.51, P = 0.030) compared with those with concentrations ≤1.57 μM after adjustment. In a subgroup analysis, women with baseline spermidine concentrations >1.57 μM also had a 2.4-fold higher risk of fracture than those with concentrations ≤1.57 μM (95% CI 1.02–5.48, P = 0.047).

Conclusions

Increased baseline spermidine concentrations were associated with a risk of osteoporotic fracture during a mean 9-year follow-up. The biological significance of the metabolites in the musculoskeletal system could be a subject for future studies.
Progression of acromegalic arthropathy in long-term controlled acromegaly patients: 9 years of longitudinal follow-up
Authors: Pelsma Iris C M , Biermasz Nienke R , van Furth Wouter R , Pereira Alberto M , Kroon Herman M , Kloppenburg Margreet , Claessen Kim M J A
Published: October 2020

Context

Joint complaints in patients with acromegaly are common, although the long-term disease course is largely unknown.

Objective

This study aims to evaluate the long-term course of acromegalic arthropathy.

Design and Setting

A prospective longitudinal cohort study was conducted in controlled acromegaly patients followed at a tertial referral center, with 3 study visits: at baseline and after a median of 2.6 and 9.1 years.

Patients

We included 31 patients with biochemically controlled acromegaly for 2 or more years (49% female; median age, 60 years) at baseline.

Main Outcome Measures

Radiographic arthropathy of the knee, hip, hand, and cervical and lumbar spine were evaluated using Kellgren and Lawrence (KL) scores, developed for assessment of primary osteoarthritis (OA). Radiographic progression was defined as a KL increase above the smallest detectable change. Joint symptoms were assessed using self-reported questionnaires. Progression was defined using existing clinically important cutoff values. Risk factors for progression were investigated using a multivariable model.

Results

All patients had definite radiographic OA at 1 or more joints at baseline. Radiographic progression was observed in 29%, 48%, 84%, and 94% of patients in the knees, hips, hands, and axial joints, respectively. Deterioration in hand-related pain and function was observed in 10 (32.3%) and 11 patients (35.5%), respectively. Solely baseline KL scores of the hip were associated with hip OA progression (OR 1.88; 95% CI, 1.09-3.16).

Conclusions

Acromegalic arthropathy showed significant radiographic progression over 9.1 years of follow-up in patients in remission, whereas clinical progression was observed less frequently. Future studies should focus on adequate prevention and treatment strategies of acromegalic arthropathy.
Uterine Epithelial Progesterone Receptor Governs Uterine Receptivity Through Epithelial Cell Differentiation
Authors: Gebril Mona , Hirota Yasushi , Aikawa Shizu , Fukui Yamato , Kaku Tetsuaki , Matsuo Mitsunori , Hirata Tomoyuki , Akaeda Shun , Hiraoka Takehiro , Shimizu-Hirota Ryoko , Takeda Norihiko , Taha Tamer , Balah Osama Al , Elnoury Mohamed Amr H , Fujii Tomoyuki , Osuga Yutaka
Published: October 2020

Progesterone receptor (PGR) is indispensable for pregnancy in mammals. Uterine PGR responds to the heightened levels of ovarian progesterone (P4) after ovulation and regulates uterine gene transcription for successful embryo implantation. Although epithelial and stromal P4-PGR signaling may interact with each other to form appropriate endometrial milieu for uterine receptivity and the subsequent embryo attachment, it remains unclear what the specific roles of epithelial P4-PGR signaling in the adult uterus are. Here we generated mice with epithelial deletion of Pgr in the adult uterus (Pgrfl/flLtfCre/+ mice) by crossing Pgr-floxed and Ltf-Cre mice. Pgrfl/flLtfCre/+ mice are infertile due to the impairment of embryo attachment. Pgrfl/flLtfCre/+ uteri did not exhibit epithelial growth arrest, suggesting compromised uterine receptivity. Both epithelial and stromal expressions of P4-responsive genes decreased in Pgrfl/flLtfCre/+ mice during the peri-implantation period, indicating that epithelial Pgr deletion affects not only epithelial but stromal P4 responsiveness. In addition, uterine LIF, an inducer of embryo attachment, was decreased in Pgrfl/flLtfCre/+ mice. The RNA-seq analysis using luminal epithelial specimens dissected out by laser capture microdissection revealed that the signaling pathways related to extracellular matrix, cell adhesion, and cell proliferation are altered in Pgr fl/flLtf Cre/+ mice. These findings suggest that epithelial PGR controls both epithelial and stromal P4 responsiveness and epithelial cell differentiation, which provides normal uterine receptivity and subsequent embryo attachment.
Accelerator or Brake? Cash for Clunkers, Household Liquidity, and Aggregate Demand
Authors: Green Daniel , Melzer Brian T. , Parker Jonathan A. , Rojas Arcenis
Published: October 2020

This paper evaluates the Car Allowance Rebate System (CARS ) by comparing the vehicle purchases and disposals of households with eligible “clunkers” to those of households with similar but ineligible vehicles. CARS caused roughly 500,000 purchases during the program period. The provision of liquidity, through a rebate usable as a down payment, was critical in generating this large response. Participation was rare among households that owned clunkers with outstanding loans, which required loan repayment. This decline in participation is attributed to households’ preference for lower down payments and distinguished from the effects of income, other indebtedness, and the program subsidy. (JEL E23, E62, G51, H24, H31)
Reported MPC and Unobserved Heterogeneity
Authors: Jappelli Tullio , Pistaferri Luigi
Published: October 2020

Panel data on reported marginal propensity to consume in the 2010 and 2016 Italian Survey of Household Income and Wealth uncover a strong negative relationship between cash on hand and MPC. Even though the relationship is attenuated when using regression methods that control for unobserved heterogeneity, the amount of bias is moderate. MPC estimates are used to evaluate the effectiveness of revenue-neutral fiscal policies targeting different parts of the distribution of household resources. (JEL E21, E62, G51)
Hidden Baggage: Behavioral Responses to Changes in Airline Ticket Tax Disclosure
Authors: Bradley Sebastien , Feldman Naomi E.
Published: October 2020

We examine the impact of a January 2012 enforcement action by the US Department of Transportation that required US air carriers and online travel agents to modify their web interfaces to incorporate all ticket taxes in up-front, advertised fares. We show that the more prominent display of tax-inclusive prices is associated with significant reductions in consumer tax incidence, demand, and ticket revenues along more heavily taxed itineraries. In particular, the fraction of unit taxes that airlines passed onto consumers fell by roughly 75 cents for every dollar of tax. These results present evidence of consumer inattention in a novel institutional setting featuring quasi-experimental variation in tax salience, economically significant tax amounts, and endogenous price responses. (JEL D91, H22, H25, H31, L84, L93)
Violência na Estratégia de Saúde da Família: riscos para a saúde dos trabalhadores e ao atendimento
Authors: Leite Caroline Do Nascimento , De Oliveira Elias Barbosa , Lisboa Marcia Tereza Luz , Penna Lucia Helena Garcia , Oliveira Sonia Acioli de , Rafael Ricardo De Mattos Russo
Published: October 2020

Objetivo: identificar a ocorrência da violência na Estratégia de Saúde da Família e analisar as repercussões para a saúde dos trabalhadores e ao atendimento. Método: estudo qualitativo, descritivo, realizado com 27 trabalhadores de uma unidade de Estratégia de Saúde da Família localizada no município do Rio de Janeiro em 2018. Trabalhou-se com a técnica de entrevista semiestruturada mediante roteiro e para a categorização dos depoimentos a análise de conteúdo temática. Projeto de pesquisa aprovado pelo Comitê de Ética em Pesquisa. Resultados: identificou-se a violência psicológica perpetrada por usuários através de ameaças, xingamentos e intimidações e a urbana com a exposição dos profissionais a tiros, assaltos e brigas durante as visitas domiciliares ocasionando repercussões na saúde mental dos trabalhadores e prejuízos para a qualidade do atendimento. Conclusão: a violência ocupacional é um risco a integridade física e psíquica dos trabalhadores e a qualidade do atendimento.
Capturing the impacts of balancing caring and employment: a photovoice study of Filipino-Canadian transnational working carers
Authors: Ilagan Chloe , Williams Allison , Sethi Bharati , Maynard Kevin
Published: October 2020

An ageing population has resulted in an increase in informal care. Many carers balance employment with care, called ‘working carers’. Research is lacking on minority ethnic working carers. This article explores the experiences of Filipino-Canadian working carers and the health impacts of their roles through qualitative photovoice methods. Participants took photographs recording their experiences. Data were collected from eight participants in Ontario from May to November 2017. Photographs and interviews revealed themes of: (1) transplanted values dictating attitudes to care; (2) challenges to personal health; and (3) coping mechanisms and sources of help. These findings address knowledge gaps as regards the experiences of Filipino-Canadian working carers.
High-NA two-photon single cell imaging with remote focusing using a diffractive tunable lens
Authors: May Molly A. , Bawart Martin , Langeslag Michiel , Bernet Stefan , Kress Michaela , Ritsch-Marte Monika , Jesacher Alexander
Published: October 2020

Fast, volumetric structural and functional imaging of cellular and sub-cellular dynamics inside the living brain is one of the most desired capabilities in the neurosciences, but still faces serious challenges. Specifically, while few solutions for rapid 3D scanning exist, it is generally much easier to facilitate fast in-plane scanning than it is to scan axially at high speeds. Remote focusing in which the imaging plane is shifted along the optical axis by a tunable lens while maintaining the position of the sample and objective is a promising approach to increase the axial scan speed, but existing techniques often introduce severe optical aberrations in high-NA imaging systems, eliminating the possibility of diffraction-limited single-cell imaging. Here, we demonstrate near diffraction-limited, volumetric two-photon fluorescence microscopy in which we resolve the deep sub-micron structures of single microglia cells with axial scanning performed using a novel high-NA remote focusing method. Image contrast is maintained to within 7% compared to mechanical sample stepping and the focal volume remains nearly diffraction-limited over an axial range greater than 86 µm.
Multi-GHz repetition rate, femtosecond deep ultraviolet source in burst mode derived from an electro-optic comb
Authors: Ye Hanyu , Pontagnier Lilia , Dixneuf Clément , Santarelli Giorgio , Cormier Eric
Published: October 2020

We present a femtosecond, 11.48 GHz intra-burst repetition rate deep UV source at 258 nm based on forth-harmonic generation (FHG) of an electro-optic (EO) comb operating in burst mode. Second-harmonic generation (SHG) of the burst-mode EO comb in LiB3O5 (LBO) leads to 3.7 W average power and 242 fs root-mean-square pulse duration. A second stage of SHG is further performed using two separate β-BaB2O4 (BBO) crystals, delivering deep UV pulses at 523 mW and 294 mW, with estimated pulse durations of half-ps and sub-300 fs, respectively. At divided pulse repetition rates of 5.7 GHz and 2.9 GHz, FHG is also demonstrated, highlighting the potential of flexible repetition rate operation at the GHz level.
Efficient scheme for creating a W-type optical entangled coherent state
Authors: Zhang Hanyu , Su Qi-Ping , Yang Chui-Ping
Published: October 2020

W-type optical entangled coherent states have important applications in quantum communication. Previous works require performing measurement in the preparation of such W states. We here propose an efficient scheme for creating a W-type optical entangled coherent state without measurement. This scheme employs a setup composed of three microwave cavities and a superconducting flux coupler qutrit. Because no measurement is required, the W state can be generated deterministically. In addition, the system complexity is greatly reduced because of using only one qutrit to couple the three cavities. Numerical analysis shows that within current experimental technology, the W state can be prepared with high fidelity. This scheme is universal and can be extended to create the W-type optical entangled coherent state, by using three microwave or optical cavities coupled via a three-level natural or artificial atom.
Tragic Elements in Dion 55.2 and Brutus 36.7
Authors: González-González Marta
Published: October 2020

According to Plutarch, the daimon which appears to Dion and announces to him his imminent death looks as a Tragic Erinys (Dion 55.2). Plutarch says also that a vision which identifies itself as “your evil daimon” appears to Brutus, just before the battle of Philippi, to announce to him his death (Brutus 36.7). We find this last motive also in Caesar. This paper focuses on the similarities between these episodes which announce the death to Dion and Brutus in a similar way, establishing intertextual links between these Lives. Secondly, I’ll pay attention to the relationship between these texts and the tragedy.
Inteligência Emocional e o Capital Psicológico nas Organizações e em suas Lideranças / Emotional Intelligence and Psychological Capital in Organizations and their Leadership
Authors: Oliveira Giovana Aparecida De , Figueiredo Taynara Barbosa de , Dutra Júlio Afonso Alves
Published: October 2020

Uma das habilidades mais buscada nos colaboradores, por trazer excelentes resultados as organizações é a inteligência emocional, tanto que tem merecido especial atenção e investimento das empresas. Esta habilidade, a inteligência emocional, tem sido muito prestigiada no ambiente corporativo, pois a capacidade de perceber as emoções e saber superá-las, gera satisfação e prepara os profissionais sejam capazes de ter um relacionamento saudável e colaborativo com os colegas, provocando que o desempenho das funções supere as expectativas. Os gestores já compreenderam que viabilizar o autoconhecimento e o amadurecimento emocional traz resultados positivos as organizações, pois as emoções descrevem todos os âmbitos da nossa vida. Em situações de estresse, o desenvolvimento da inteligência emocional tem apresentado excelente resultados, auxiliando nos momentos de crise e no enfrentamento das situações de pressão, assumindo assim um papel importante para os negócios.
Ressurgimento da Sífilis Congênita / Resurgence of Congenital Syphilis
Authors: Lobão Ana Graziela Soares Rêgo , Andrade Luciana Campelo de , Costa Lívia Betânia Da
Published: October 2020

A sífilis congênita é resultado da infecção fetal pelo Treponema pallidum. Os bebês podem ser infectados por transmissão vertical, o que pode levar a alterações patológicas durante a gravidez. Apesar da compreensão da doença e expansão dos programas de rastreamento muitas barreiras limitam os esforços de rastreamento e tratamento da sífilis materna, fazendo com que a sífilis continue sendo uma grande preocupação de saúde pública nos países em desenvolvimento e atualmente também se tornou um problema de saúde emergente em países desenvolvidos. A pesquisa teve como objetivo identificar os possíveis fatores que podem estar contribuindo para que ocorra o aumento do número de casos de sífilis congênita na sociedade. Dentre os fatores que estão associados ao crescente número de casos de sífilis congênita destacam-se a falta de acesso a informação, falhas no acesso ao pré-natal, baixa escolaridade, classe social, múltiplos parceiros e aumento da cobertura de testagens da sífilis nos sistemas de saúde. Iniciativas de Saúde Pública contribuíram para a melhoria das notificações embora não se mostrem suficientes para prevenir as infecções na gestação ou mesmo detectar precocemente e tratar as gestantes e seus parceiros, no sentido de se evitarem novos casos de sífilis congênita.