bluuebunny/crossref_metadata_2025 huggingface dataset:
Resisting the mainstreaming of LGBT equalities in Canadian and British Schools: Sex education and trans school friends
Authors: Nash Catherine J , Browne Kath
Published: November 2019

It is well established that schools are not neutral sites for gender and sexualities, shaping (often heteronormative) school spaces. This paper augments examinations of the implementation of inclusive school curricula by exploring heteroactivist opposition to lesbian, gay, bisexual and trans (LGBT) equalities in Canadian and British schools. It examines resistances to institution of a revised and updated Health and Physical Education curriculum in Ontario schools in Canada, and in the UK, the use of the Rowe family’s opposition to the presence of trans children in their own child’s classroom. This paper shows that once-invisible heternormativities are now being challenged through LGBT curricula and support for trans students. This creates classrooms as pivotal, geographical, social and political spaces that operate at the juncture of the public/private spaces of the home, public spaces of the neighbourhood and the imagined space of the nation and nation-building citizenship. Oppositional ideologies can no longer be understood through the labels of ‘anti-gay’, ‘homophobic’ or ‘transphobic’, and these oppositions go beyond ‘anti-gender’, such that the term heteroactivism names the activisms and ideologies that seeks to reassert the superiority of monogamous, binary cis-gendered, coupled marriages as best for children and for society. These ideologies are inherently geographical, drawing both on local and individual circumstances, but also transcending national boundaries. We highlight three dominant heteroactivist themes, namely, parental rights, interactions between state/schools/home and gender ideologies. This offers insights into how new sexual and gender rights are contested and resisted in new ways to consider the political, legal and social implications of heteroactivist strategies in schools.
Clearance of human native, proteinase-complexed, and proteolytically inactivated C1-inhibitor in rats
Authors: de Smet BJ , de Boer JP , Agterberg J , Rigter G , Bleeker WK , Hack CE
Published: November 2019

C1-inhibitor is the only known inhibitor of the classical pathway of complement and the major inhibitor of the contact pathway of coagulation. Like other serine proteinase inhibitors, C1-inhibitor can exist in three conformations, ie, the native, the proteinase-complexed, and the proteolytically inactivated form. Here we studied the plasma elimination kinetics of these three forms of human C1-inhibitor in rats. The clearance of the complexed form of C1-inhibitor appeared to be the most rapid and depended in part on the proteinase involved (observed plasma t1/2 was 20 minutes for C1s-C1-inhibitor, 32 minutes for kallikrein-C1-inhibitor, and 47 minutes for beta XIIa-C1- inhibitor), whereas that of native C1-inhibitor was the slowest (observed plasma t1/2 4.5 hours). Inactivated C1-inhibitor was cleared with an apparent plasma t1/2 of 1.6 hours. Thus, the short plasma t1/2 of complexed relative to native C1-inhibitor explains why in patients only low concentrations of C1-inhibitor complexes may be observed despite activation of the contact and/or complement systems.
Variation in fetal hemoglobin parameters and predicted hemoglobin S polymerization in sickle cell children in the first two years of life: Parisian Prospective Study on Sickle Cell Disease
Authors: Maier-Redelsperger M , Noguchi CT , de Montalembert M , Rodgers GP , Schechter AN , Gourbil A , Blanchard D , Jais JP , Ducrocq R , Peltier JY
Published: November 2019

Intracellular hemoglobin S (HbS) polymerization is most likely to be the primary determinant of the clinical and biologic manifestations of sickle cell disease (SCD). Fetal hemoglobin (HbF) does not enter the HbS polymer and its intracellular expression in sickle erythrocytes inhibits polymerization. HbF levels, high at birth but decreasing thereafter, protect the newborn from the clinical manifestations of this hemoglobinopathy. We have measured the sequential changes in HbF, F reticulocytes, and F cells in the first 2 years of life in 25 children with SCD and compared the results with those obtained in 30 normal children (AA). We have also calculated HbF per F cell (F/F cell), the preferential survival of F cells versus non-F cells, as measured by the ratio F cells versus F reticulocytes (FC/FR) and polymer tendency at 40% and 70% oxygen saturation. HbF levels decreased from about 80.4% +/- 4.0% at birth to 9.2% +/- 2.9% at 24 months. During this time, we observed a regular decrease of the F reticulocytes and the F cells. The kinetics of the decline of F/F cell was comparable with the decline of HbF, rapid from birth (mean, 27.0 +/- 3.6 pg) to 12 months of age (mean, 8.5 +/- 1.5 pg) and then slower from 12 to 24 months of age (mean, 6.2 +/- 1.0 pg) in the SCD children. In the AA children, the decrease in HbF, due to changes in both numbers of F cells and F/F cell, was more precipitous, reaching steady-state levels by 10 months of age. Calculated values for mean polymer tendency in the F-cell population showed that polymerization should begin to occur at 40% oxygen saturation at about 3 months and increase progressively with age, whereas polymerization at 70% oxygen saturation would not occur until about 24 months. These values correspond to HbF levels of 50.8% +/- 10.8% and 9.2% +/- 2.9%, respectively, and F/F cell levels of 15.6 +/- 4.5 pg and 6.2 +/- 1.0 pg, respectively. In the non--F-cell population, polymerization was expected at birth at both oxygen saturation values. Three individuals had significantly greater predicted polymerization tendency than the remainder of the group because of early decreases in HbF. These individuals in particular, the remainder of the cohort, as well as other recruited newborns, will be studied prospectively to ascertain the relationship among hematologic parameters, which determine polymerization tendency and the various clinical manifestations of SCD.
CX3CR1–fractalkine axis drives kinetic changes of monocytes in fibrotic interstitial lung diseases
Authors: Greiffo Flavia R. , Viteri-Alvarez Valeria , Frankenberger Marion , Dietel Daniela , Ortega-Gomez Almudena , Lee Joyce S. , Hilgendorff Anne , Behr Jürgen , Soehnlein Oliver , Eickelberg Oliver , Fernandez Isis E.
Published: November 2019

Circulating immune cell populations have been shown to contribute to interstitial lung disease (ILD). In this study, we analysed circulating and lung resident monocyte populations, and assessed their phenotype and recruitment from the blood to the lung in ILD. Flow cytometry analysis of blood samples for quantifying circulating monocytes was performed in 105 subjects: 83 with ILD (n=36, n=28 and n=19 for nonspecific interstitial pneumonia, hypersensitivity pneumonitis and connective-tissue disease-associated ILD, respectively), as well as 22 controls. Monocyte localisation and abundance were assessed using immunofluorescence and flow cytometry of lung tissue. Monocyte populations were cultured either alone or with endothelial cells to assess fractalkine-dependent transmigration pattern. We show that circulating classical monocytes (CM) were increased in ILD compared with controls, while nonclassical monocytes (NCM) were decreased. CM abundance correlated inversely with lung function, while NCM abundance correlated positively. Both CCL2 and CX3CL1 concentrations were increased in plasma and lungs of ILD patients. Fractalkine co-localised with ciliated bronchial epithelial cells, thereby creating a chemoattractant gradient towards the lung. Fractalkine enhanced endothelial transmigration of NCM in ILD samples only. Immunofluorescence, as well as flow cytometry, showed an increased presence of NCM in fibrotic niches in ILD lungs. Moreover, NCM in the ILD lungs expressed increased CX3CR1, M2-like and phagocytic markers. Taken together, our data support that in ILD, fractalkine drives the migration of CX3CR1+NCM to the lungs, thereby perpetuating the local fibrotic process.
Effectiveness of interventions to alleviate emergency department crowding by older adults: a systematic review
Authors: Hesselink Gijs , Sir Özcan , Schoon Yvonne
Published: November 2019

Background

The growing demand for elderly care often exceeds the ability of emergency department (ED) services to provide quality of care within reasonable time. The purpose of this systematic review is to assess the effectiveness of interventions on reducing ED crowding by older patients, and to identify core characteristics shared by successful interventions.

Methods

Six major biomedical databases were searched for (quasi)experimental studies published between January 1990 and March 2017 and assessing the effect of interventions for older patients on ED crowding related outcomes. Two independent reviewers screened and selected studies, assessed risk of bias and extracted data into a standardized form. Data were synthesized around the study setting, design, quality, intervention content, type of outcome and observed effects.

Results

Of the 16 included studies, eight (50%) were randomized controlled trials (RCTs), two (13%) were non-RCTs and six (34%) were controlled before-after (CBA) studies. Thirteen studies (81%) evaluated effects on ED revisits and four studies (25%) evaluated effects on ED throughput time. Thirteen studies (81%) described multicomponent interventions. The rapid assessment and streaming of care for older adults based on time-efficiency goals by dedicated staff in a specific ED unit lead to a statistically significant decrease of ED length of stay (LOS). An ED-based consultant geriatrician showed significant time reduction between patient admission and geriatric review compared to an in-reaching geriatrician.

Conclusion

Inter-study heterogeneity and poor methodological quality hinder drawing firm conclusions on the intervention’s effectiveness in reducing ED crowding by older adults. More evidence-based research is needed using uniform and valid effect measures.

Trial registration

The protocol is registered with the PROSPERO International register of systematic reviews: ID = CRD42017075575).
Comparison of model-building strategies for excess hazard regression models in the context of cancer epidemiology
Authors: Maringe Camille , Belot Aurélien , Rubio Francisco Javier , Rachet Bernard
Published: November 2019

Background

Large and complex population-based cancer data are becoming broadly available, thanks to purposeful linkage between cancer registry data and health electronic records. Aiming at understanding the explanatory power of factors on cancer survival, the modelling and selection of variables need to be understood and exploited properly for improving model-based estimates of cancer survival.

Method

We assess the performances of well-known model selection strategies developed by Royston and Sauerbrei and Wynant and Abrahamowicz that we adapt to the relative survival data setting and to test for interaction terms.

Results

We apply these to all male patients diagnosed with lung cancer in England in 2012 (N = 15,688), and followed-up until 31/12/2015. We model the effects of age at diagnosis, tumour stage, deprivation, comorbidity and emergency presentation, as well as interactions between age and all of the above. Given the size of the dataset, all model selection strategies favoured virtually the same model, except for a non-linear effect of age at diagnosis selected by the backward-based selection strategies (versus a linear effect selected otherwise).

Conclusion

The results from extensive simulations evaluating varying model complexity and sample sizes provide guidelines on a model selection strategy in the context of excess hazard modelling.
Sarcopenia prevalence and associations with mortality and hospitalisation by various sarcopenia definitions in 85–89 year old community-dwelling men: a report from the ULSAM study
Authors: Sobestiansky Sigvard , Michaelsson Karl , Cederholm Tommy
Published: November 2019

Background

Operational definitions of sarcopenia, i.e. loss of muscle function and mass, have been proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) and the Foundation for the National Institutes of Health Sarcopenia Project (FNIH). The aim of this study was to analyse the prevalence and outcome, i.e. all-cause mortality and hospitalisation, of sarcopenia and its diagnostic components in octogenarian community-dwelling men.

Methods

In total 287 men, aged 85–89 y, participating in the Uppsala Longitudinal Study of Adult Men (ULSAM) underwent Dual X-ray Absorptiometry (DXA), measurement of hand grip strength (HGS), gait speed (GS), and a five-times chair stand test (CS). Sarcopenia and probable sarcopenia were defined according to EWGSOP (2010), EWGSOP2 (2018), and FNIH (2014). All-cause mortality and hospitalisations over 3 years were registered.

Results

Sarcopenia according to EWGSOP, EWGSOP2 and FNIH was observed in 21%, 20%, and 8% of the men, respectively, while probable sarcopenia (EWGSOP2; eq. reduced muscle strength only) was seen in 73%. “Sarcopenia (EWGSOP)” and “probable sarcopenia (EWGSOP2)” were associated with increased mortality (HR 1.95, 95% CI 1.12–3.40 and HR 3.26, 95% CI 1.38–7.70, respectively). “Probable sarcopenia (EWGSOP2)” was associated with days of hospitalisation (RR 2.12, 95% CI 1.36–3.30), whereas sarcopenia according to FNIH showed an association with the number of hospitalisations (RR 1.75, 95% CI 1.10–2.81).

Conclusions

In very old men, reduced muscle strength, i.e. probable sarcopenia, was common and associated with mortality and length of stay during hospitalisation. When combined with low muscle mass (according to DXA), i.e. sarcopenia, the various definitions were associated more weakly with the adverse outcomes. The findings support the emphasis on reduced muscle strength as the major determinant of sarcopenia.
Healthcare professionals’ experiences of providing individualized nutritional care for Older People in hospital and home care: a qualitative study
Authors: Hestevik Christine Hillestad , Molin Marianne , Debesay Jonas , Bergland Astrid , Bye Asta
Published: November 2019

Background

Recent studies indicate inadequate nutritional care practices in healthcare institutions and identify several barriers to perform individualized nutritional care to older persons. Organisation of care can become rigid and standardised, thus failing to be respectful of and responsive to each person’s needs and preferences. There is limited research exploring health professionals’ views on how structure of care allows them to individualize nutritional care to older persons. In this study we aim to explore how healthcare professionals’ experience providing individualised nutritional care within the organisational frames of acute geriatric hospital care and home care.

Methods

Semi-structured interviews with 23 healthcare professionals from hospital acute geriatric care and home care. Interviews were analyzed using thematic analysis.

Results

Two main themes and six sub-themes emerged from the material. Theme 1: ‘Meeting patients with complex nutritional problems’ with the sub-themes: ‘It is much more complex than just not eating’ and ‘seeing nutrition as a part of the whole’. Theme 2: ‘The structure of the nutritional care’, with the sub-themes: ‘Nutritional routines: Much ado, but for what?’, ‘lack of time to individualize nutritional care’, ‘lack of interdisciplinary collaboration in nutritional care’ and ‘meeting challenging situations with limited resources in home care’.

Conclusions

The healthcare professionals described having a high focus on and priority of nutritional care when caring for older persons. They did however find it challenging to practice individualized nutritional care due to the complexity of the patients’ nutritional problems and constraints in the way nutritional care was organised. By describing the challenges the healthcare professionals face when trying to individualize the nutritional care, this study may provide important knowledge to health professionals and policy makers on how to decrease the gap between older patients’ preferences for care and nutritional care practice.
Prediction model for pneumonia in primary care patients with an acute respiratory tract infection: role of symptoms, signs, and biomarkers
Authors: Groeneveld G. H. , van ’t Wout J. W. , Aarts N. J. , van Rooden C. J. , Verheij T. J. M. , Cobbaert C. M. , Kuijper E. J. , de Vries J. J. C. , van Dissel J. T.
Published: November 2019

Background

Diagnosing pneumonia can be challenging in general practice but is essential to distinguish from other respiratory tract infections because of treatment choice and outcome prediction. We determined predictive signs, symptoms and biomarkers for the presence of pneumonia in patients with acute respiratory tract infection in primary care.

Methods

From March 2012 until May 2016 we did a prospective observational cohort study in three radiology departments in the Leiden-The Hague area, The Netherlands. From adult patients we collected clinical characteristics and biomarkers, chest X ray results and outcome. To assess the predictive value of C-reactive protein (CRP), procalcitonin and midregional pro-adrenomedullin for pneumonia, univariate and multivariate binary logistic regression were used to determine risk factors and to develop a prediction model.

Results

Two hundred forty-nine patients were included of whom 30 (12%) displayed a consolidation on chest X ray. Absence of runny nose and whether or not a patient felt ill were independent predictors for pneumonia. CRP predicts pneumonia better than the other biomarkers but adding CRP to the clinical model did not improve classification (− 4%); however, CRP helped guidance of the decision which patients should be given antibiotics.

Conclusions

Adding CRP measurements to a clinical model in selected patients with an acute respiratory infection does not improve prediction of pneumonia, but does help in giving guidance on which patients to treat with antibiotics. Our findings put the use of biomarkers and chest X ray in diagnosing pneumonia and for treatment decisions into some perspective for general practitioners.
Rationale and design of a multicenter Chronic Kidney Disease (CKD) and at-risk for CKD electronic health records-based registry: CURE-CKD
Authors:   on behalf of the CURE-CKD investigators, Norris Keith C. , Duru O. Kenrik , Alicic Radica Z. , Daratha Kenn B. , Nicholas Susanne B. , McPherson Sterling M. , Bell Douglas S. , Shen Jenny I. , Jones Cami R. , Moin Tannaz , Waterman Amy D. , Neumiller Joshua J. , Vargas Roberto B. , Bui Alex A. T. , Mangione Carol M. , Tuttle Katherine R.
Published: November 2019

Background

Chronic kidney disease (CKD) is a global public health problem, exhibiting sharp increases in incidence, prevalence, and attributable morbidity and mortality. There is a critical need to better understand the demographics, clinical characteristics, and key risk factors for CKD; and to develop platforms for testing novel interventions to improve modifiable risk factors, particularly for the CKD patients with a rapid decline in kidney function.

Methods

We describe a novel collaboration between two large healthcare systems (Providence St. Joseph Health and University of California, Los Angeles Health) supported by leadership from both institutions, which was created to develop harmonized cohorts of patients with CKD or those at increased risk for CKD (hypertension/HTN, diabetes/DM, pre-diabetes) from electronic health record data.

Results

The combined repository of candidate records included more than 3.3 million patients with at least a single qualifying measure for CKD and/or at-risk for CKD. The CURE-CKD registry includes over 2.6 million patients with and/or at-risk for CKD identified by stricter guide-line based criteria using a combination of administrative encounter codes, physical examinations, laboratory values and medication use. Notably, data based on race/ethnicity and geography in part, will enable robust analyses to study traditionally disadvantaged or marginalized patients not typically included in clinical trials.

Discussion

CURE-CKD project is a unique multidisciplinary collaboration between nephrologists, endocrinologists, primary care physicians with health services research skills, health economists, and those with expertise in statistics, bio-informatics and machine learning. The CURE-CKD registry uses curated observations from real-world settings across two large healthcare systems and has great potential to provide important contributions for healthcare and for improving clinical outcomes in patients with and at-risk for CKD.
Bone mesenchymal stem cell therapy for ovariectomized osteoporotic rats: a systematic review and meta-analysis
Authors: Jin Zhenxiong , Chen Jinman , Shu Bing , Xiao Yanhua , Tang Dezhi
Published: November 2019

Background

Previous studies have found that bone mesenchymal stem cells (BMSCs) were capable of self-replication, multi-differentiation, and regeneration. The aim of this study was to carry out a systematic review and meta-analysis of the efficacy of BMSC therapy for ovariectomized rats.

Methods

The PubMed, Embase, Web of Science, China National Knowledge Infrastructure, VIP, and Chinese Sinomed databases were searched systematically from their initiation date to October 5, 2018. Two researchers independently screened the literatures, which used the bone mineral density (BMD), total bone volume by total tissue volume (BV/TV) (%), and trabecular thickness/spacing (Tb/Sp) as the outcome measures.

Results

Five eligible studies were selected. In the BMSC treatment groups, the BMD values and normalized BV/TV values remarkably increased. In addition, in the BMSCs plus other treatment groups, the BMD and Tb/Sp values significantly increased.

Conclusion

This study showed that BMSCs could accelerate callus maturity, ossification and restore mechanical properties of bones in osteoporotic fractures.
Mediating effects of depression on anxiety and leisure constraints in patients with breast cancer
Authors: Huang Hsiu-Mei , Lai Jun-Hung , Huang Tsai-Wei
Published: November 2019

Background

Patients with breast cancer often exhibit high levels of anxiety and depression and a considerable decrease in their ability to participate in leisure activities, which result in the long-term disruption of their daily lives. This study intended to explore the relationships among anxiety, leisure constraints, and depression and evaluate whether depression mediates the effects of anxiety on leisure constraints in patients with breast cancer.

Method

This prospective study included 106 patients with breast cancer. All the patients completed the Taiwanese version of the Hospital Anxiety and Depression Scale and Leisure constraints questionnaire. Path analysis was used to test the mediating role of depression.

Results

Leisure constraints, anxiety, and depression were positively interrelated and co-occurred in the patients. The accelerated bootstrapping confidence intervals of the indirect effect did not include zero (0.276–1.663). Moreover, depression completely mediated the effects of anxiety on leisure constraints in patients with earlier cancer stages but not in patients with advanced cancer stages.

Conclusions

Depression is a crucial mechanism underlying the relationship between anxiety and leisure constraints in patients with breast cancer. Although many patients experience minimal disruption of activities and roles during survivorship, they are unable to perform functional activities and satisfactorily play their roles. This is the first study to explore leisure constraints in patients with breast cancer and investigate the mediating role of depression that underlies the relationship between anxiety and leisure constraints. The current findings are clinically crucial because they suggest the need to consider the simultaneous management of anxiety and depression for alleviating leisure constraints.
The impact of gender and academic achievement on the violation of academic integrity for medical faculty students, a descriptive cross-sectional survey study
Authors: Özcan Müesser , Yeniçeri Neşe , Çekiç Edip Güvenç
Published: November 2019

Purpose

The aim of this study is to determine the characteristics of medical faculty students about violations of academic integrity.

Method

From the whole population of the 572 students of the Muğla Sıtkı Koçman University Faculty of Medicine, 271 students participated voluntarily in a descriptive cross-sectional survey. Descriptive data were recorded in the survey and a five-point Likert-type instrument, namely the Tendency towards Academic Dishonesty Scale, was used as the data collection tool in the study. The scale included 22 items’ means that are considered to evaluate “Tendency towards academic dishonesty” (TTAD) score. In addition, four subscales, namely “Tendency towards cheating”, “Dishonesty in works such as assignments and projects”, “Tendency towards dishonesty in research and reporting processes” and “Tendency towards citation dishonesty” scores were evaluated separately.

Results

Of the participants, 138 (53.3%) were male. TTAD scores were 2.15 ± 0.61, showing a slight tendency towards academic dishonesty, according to the scale. TTAD scores and standard deviations (SD) were 2.26 ± 0.65 and 2.04 ± 0.55 for men and women, respectively (P = 0.005). There was no difference in the TTAD scores for students whether they had read the ethics code. Significant differences were observed in the TTAD scores for students with gender, different academic achievements and in different academic years. However, when multivariate analysis was performed, the significance shown in the results disappeared.

Conclusion

In our study, a slight tendency to academic dishonesty was found for medical faculty students and there were no differences between all of the recorded individual factors of students.
EGFR-TKI resistance promotes immune escape in lung cancer via increased PD-L1 expression
Authors: Peng Shunli , Wang Rong , Zhang Xiaojuan , Ma Yueyun , Zhong Longhui , Li Ke , Nishiyama Akihiro , Arai Sachiko , Yano Seiji , Wang Wei
Published: November 2019

Background

The ATLANTIC trial reported that higher PD-L1 expression in tumors was involved in a higher objective response in patients with EGFR+/ALK+ non-small cell lung cancer (NSCLC), indicating the possibility of anti-PD-1/PD-L1 therapy as a third-line (or later) treatment for advanced NSCLC. Therefore, the determination of status and regulatory mechanisms of PD-L1 in EGFR mutant NSCLC before and after acquired EGFR-TKIs resistance are meaningful.

Methods

The correlation among PD-L1, c-MET, and HGF was analyzed based on TCGA datasheets and paired NSCLC specimens before and after acquired EGFR-TKI resistance. EGFR-TKI resistant NSCLC cells with three well-known mechanisms, c-MET amplification, hepatocyte growth factor (HGF), and EGFR-T790M, were investigated to determinate PD-L1 expression status and immune escape ability. PD-L1-deleted EGFR-TKIs sensitive and resistant cells were used to evaluate the immune escape ability of tumors in mice xenograft models.

Results

Positive correlations were found among PD-L1, c-MET, and HGF, based on TCGA datasheets and paired NSCLC specimens. Moreover, the above three resistant mechanisms increased PD-L1 expression and attenuated activation and cytotoxicity of lymphocytes in vitro and in vivo, and downregulation of PD-L1 partially restored the cytotoxicity of lymphocytes. Both MAPK and PI3K pathways were involved in the three types of resistance mechanism-induced PD-L1 overexpression, whereas the NF-kappa B pathway was only involved in T790M-induced PD-L1 expression.

Conclusions

HGF, MET-amplification, and EGFR-T790M upregulate PD-L1 expression in NSCLC and promote the immune escape of tumor cells through different mechanisms.
Autism-like behaviors in male mice with a Pcdh19 deletion
Authors: Lim Jisoo , Ryu Jiin , Kang Shinwon , Noh Hyun Jong , Kim Chul Hoon
Published: November 2019

Mutations in protocadherin 19 (PCDH19), which is on the X-chromosome, cause the brain disease Epilepsy in Females with Mental Retardation (EFMR). EFMR is also often associated with autism-like symptoms. In mice and humans, epilepsy occurs only in heterozygous females who have a mixture of PCDH19 wild-type (WT) and mutant cells caused by random X-inactivation; it does not occur in hemizygous PCDH19 mutant males. This unique inheritance pattern strongly suggests the underlying disease mechanism operates via interference between WT and mutant cells rather than being a result of complete loss of PCDH19 functions. Although it remains unclear whether the other symptoms of EFMR also conform to this unique genotype-phenotype relationship, PCDH19 mutant males were recently reported to demonstrate autism-like symptoms. We, therefore, used a Pcdh19 knockout (KO) mouse model to ask whether a complete lack of PCDH19 causes autism-like behaviors. Consistent with the autism observed in EFMR females, we found Pcdh19 heterozygous KO female mice (with mosaic expression of PCDH19) show defects in sociability in the 3-chamber test. Surprisingly, hemizygous Pcdh19 KO male mice (without any PCDH19 expression) exhibit impaired sociability in the 3-chamber test and reduced social interactions in the reciprocal social interaction test. We also observed that, compared to WT mice, mutant mice display more repetitive behaviors, including self-grooming and rearing. These findings indicate that hemizygous Pcdh19 KO male mice show autism-like phenotypes.
Myocarditis as a lupus challenge: two case reports
Authors: Al-Nokhatha Shamma Ahmad , Khogali Hiba Ibrahim , Al Shehhi Maryam Abdulla , Jassim Imad Tarik
Published: November 2019

Background

Myocarditis is an uncommon manifestation of systemic lupus erythematosus in which the clinical presentation can range from subclinical to life-threatening. We report cases of two patients who presented to our hospital with myocarditis as an initial manifestation of systemic lupus erythematosus despite negative results of extensive workup that excluded other diagnoses. The mainstays of treatment are corticosteroids, immunosuppressive agents, and anti-heart failure medications, with use of the latter being case-specific. Mycophenolate mofetil was the cornerstone of the proposed treatment for induction of remission, although it is well known to be used as a maintenance therapy in lupus myocarditis.

Case presentation

Both Emirati patients described satisfied the diagnostic criteria for mixed connective tissue disease (systemic lupus predominant) and systemic lupus erythematous. Other differential diagnoses of myocarditis were excluded. The patients were started on pulsed steroid followed by oral steroid, with hydroxychloroquine, mycophenolate mofetil, and anti-heart failure medications used as needed. Dramatic responses were noted in the first few weeks in terms of symptoms.

Conclusion

Early recognition and treatment of lupus myocarditis is needed to avoid fatal consequences.
Correction to: Susceptibility of livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) to chlorhexidine digluconate, octenidine dihydrochloride, polyhexanide, PVP-iodine and triclosan in comparison to hospital-acquired MRSA (HA-MRSA) and community-aquired MRSA (CA-MRSA): a standardized comparison
Authors: Dittmann Kathleen , Schmidt Thomas , Müller Gerald , Cuny Christiane , Holtfreter Silva , Troitzsch Daniel , Pfaff Peter , Hübner Nils-Olaf
Published: November 2019

The original article [1] contains an error in Fig. 1 whereby sub-figures 1B, 1C & 1D contain the wrong scale on the x-axis. The correct sub-figures are located ahead in this Correction article and should be considered instead.
Associations of thigh muscle fat infiltration with isometric strength measurements based on chemical shift encoding-based water-fat magnetic resonance imaging
Authors: Inhuber Stephanie , Sollmann Nico , Schlaeger Sarah , Dieckmeyer Michael , Burian Egon , Kohlmeyer Caroline , Karampinos Dimitrios C. , Kirschke Jan S. , Baum Thomas , Kreuzpointner Florian , Schwirtz Ansgar
Published: November 2019

Background

Assessment of the thigh muscle fat composition using magnetic resonance imaging (MRI) can provide surrogate markers in subjects suffering from various musculoskeletal disorders including knee osteoarthritis or neuromuscular diseases. However, little is known about the relationship with muscle strength. Therefore, we investigated the associations of thigh muscle fat with isometric strength measurements.

Methods

Twenty healthy subjects (10 females; median age 27 years, range 22–41 years) underwent chemical shift encoding-based water-fat MRI, followed by bilateral extraction of the proton density fat fraction (PDFF) and calculation of relative cross-sectional area (relCSA) of quadriceps and ischiocrural muscles. Relative maximum voluntary isometric contraction (relMVIC) in knee extension and flexion was measured with a rotational dynamometer. Correlations between PDFF, relCSA, and relMVIC were evaluated, and multivariate regression was applied to identify significant predictors of muscle strength.

Results

Significant correlations between the PDFF and relMVIC were observed for quadriceps and ischiocrural muscles bilaterally (p = 0.001 to 0.049). PDFF, but not relCSA, was a statistically significant (p = 0.001 to 0.049) predictor of relMVIC in multivariate regression models, except for left-sided relMVIC in extension. In this case, PDFF (p = 0.005) and relCSA (p = 0.015) of quadriceps muscles significantly contributed to the statistical model with R2adj = 0.548.

Conclusion

Chemical shift encoding-based water-fat MRI could detect changes in muscle composition by quantifying muscular fat that correlates well with both extensor and flexor relMVIC of the thigh. Our results help to initiate early, individualised treatments to maintain or improve muscle function in subjects who do not or not yet show pathological fatty muscle infiltration.
The development of Nyonya cuisine in the Malay Archipelago: Penang and Malacca Nyonya cuisine
Authors: Oh Youri , Razak Nurul Fatin Afiqah Hj Abdul , Wee Donovan Hee Tat , Ching Eric Lu , Rahman Zubaidah
Published: November 2019

Nyonya cuisine is widely spread in the Malay Archipelago which is known as fusion of Chinese immigrant and local Malay cuisine. The cuisine has been established and developed with globalisation and movement of people in the region. Furthermore, it is identified as cultural product or image of the society which represents the identity of the people in the society. This study is to understand the establishment and development of Nyonya cuisine in line with the migration of the Peranakans in the Malay Archipelago via the exiting literatures. Data collected are from secondary sources, derived from relevant literatures, media and academic articles and authorised websites relevant to Nyonya cuisine and the Peranakans in the Malay Archipelago. The authors’ observation is also used to grasp the distinction in Nyonya cuisine. As results, Nyonya cuisine is a representative result of cultural hybridisation by migration of the Peranakans into the Malay Archipelago, geographical proximity and political factors. Nyonya cuisine today is further developing along with the influx of global culture into the region which fosters rejuvenation and exchange of cuisine.
High‐Flow Nasal Cannula Oxygen in Patients with Acute Respiratory Failure and Do‐Not‐Intubate or Do‐Not‐Resuscitate Orders: A Systematic Review
Authors: Wilson Michael E , Mittal Aniket , Dobler Claudia C , Curtis J Randall , Majzoub Abdul M , Soleimani Jalal , Gajic Ognjen , Erwin Patricia J , Montori Victor M , Murad M Hassan
Published: November 2019

BACKGROUND AND OBJECTIVES

High‐flow nasal cannula (HFNC) oxygen may provide tailored benefits in patients with preset treatment limitations. The objective of this study was to assess the effectiveness of HFNC oxygen in patients with do‐not‐intubate (DNI) and/or do‐not‐resuscitate (DNR) orders.

METHODS

We conducted a systematic review of interventional and observational studies. A search was performed using MEDLINE, EMBASE, CINAHL, Scopus, and Web of Science, from inception to October 15, 2018.

RESULTS

We included six studies evaluating 293 patients. All studies had a high risk of bias. The hospital mortality rates of patients with DNI and/or DNR orders receiving HFNC oxygen were variable and ranged from 40% to 87%. In two before and after studies, the initiation of HFNC oxygen was associated with improved oxygenation and reduced respiratory rates. One comparative study found no difference in dyspnea reduction or morphine doses between patients using HFNC oxygen versus conventional oxygen. No studies evaluated quality of life in survivors or quality of death in nonsurvivors. HFNC was generally well tolerated with few adverse events identified.

CONCLUSIONS

While HFNC oxygen remains a viable treatment option for hospitalized patients who have acute respiratory failure and a DNI and/or DNR order, there is a paucity of high‐quality, comparative, effectiveness data to guide the usage of HFNC oxygen compared with other treatments, such as noninvasive ventilation, conventional oxygen, and palliative opioids.
Sport and physical activity after stoma surgery: a survey of patient experiences
Authors: Maculotti Danila , Costanzo Carminantonio , Bonometti Stefano
Published: November 2019

Background:

Physical activity accelerates recovery from stoma surgery and enhances overall physical and mental wellbeing. Stoma care nurses and enterostomal therapists should guide ostomates to safely and confidently take part in sporting activities and to perform exercises that improve their core abdominal strength, to prevent prolapse or parastomal herniation.

Method:

An observational study was undertaken to assess barriers related to sport with a stoma, as well as how to overcome them. This used a mixed-methods online questionnaire, created ad-hoc, based on an analysis of existing literature. A convenience sample of Italian ostomates (with a colostomy, ileostomy and/or urostomy) was recruited through peer support groups.

Results:

A majority of ostomates still engaged in sport, although most had considered giving up. More than half (58%) did not think their stoma significantly affected their physical activity. Less than a quarter (24%) changed the type of sport they played after their operation. The most popular activities were swimming, walking/hiking, cycling and running. Over half (57%) felt they had not received information on sport with a stoma from a healthcare professional, and 88% believed more thorough patient education was needed.

Conclusions:

With holistic professional support, ostomates can take control of their lives and overcome the challenges of managing a stoma during physical activity. By guiding patients to start slowly and gradually build up their strength, they can be safely set on the path to a new life.
Through research and practice
Authors: Batas Renata
Published: November 2019

Renata Batas, Enterostomal Therapist from Ljubljana, Slovenia, introduces the ECET's new European Wound, Ostomy and Continence Supplement
Health visitor wins national award for inspiring diversity
Authors: Shaw Pamela
Published: November 2019

Pamela Shaw received the National BAME Health and Care Award in October, recognising her as an advocate of BAME excellence in healthcare practice
Effect extract of Ipomoea pes-caprae leaf as anti-inflammatory non immunological in rat Rattus norvegicus
Authors: Safrida Safrida , Hasanuddin Hasanuddin , Agusdinianti Nurul A.
Published: November 2019

Ipomoea pes-caprae is one of the plants in Indonesia that has the potential as a traditional herbal medicine to treat inflammation. Hence, the objective of this study was to evaluate the effect of I. pes-capraeleaf extract as anti-inflammatory in edema rats induced by 5% egg white solution. The experimental design used was a Completely Randomized Design (CRD) consisted of 5 treatments, each consisted of 5 rats.The treatment consisted of KN = negative control, KP = positive control, giving  of 25 mg diclofenac sodium, K 100 = giving 100 mg kg-1body weight (BW) of I. pes-capraeleaf extract , K300 = 300 mg kg-1BW of I. pes-capraeleaf extract, and K500 = 500 mg kg-1BW of I. pes-capraeleaf extract. The anti-inflammatory data obtained were tested statistically with a one-way ANOVA test at  99% confidence level and followed by Duncan's test. The ANOVA test results showed that the giving ofI. pes-capraeleaf extract had a very significant effect (p 0.01) on the percentage of inflammatory, obtained Fcount Ftable, 21.46 4.79 at the level of α = 0.01. The treatment of I. pes-capraeleaf extract of 500 mg kg-1BW had the effect of decreasing the volume of edema with the positive control variable using diclofenac sodium 25 mg. It is concluded that I. pes-capraeleaf extract can be used as an anti-inflammatory by decreasing rat feet edema volume. I. pes-capraeleaf extract has a prospect for non-immunological inflammatory natural drug candidates.
Heavy metals concentration and histopathological profile of some commercial fish species at Makoko Slum Neighbourhood Environment, Lagos, Nigeria
Authors: Ayoola Simeon O.
Published: November 2019

Potentially harmful substances such as pesticides, heavy metals, and hydro chemicals are often released into the aquatic environment. The objective of the present study was to assess the concentration of lead, copper, cadmium, chromium, and nickel in water samples from two different points (Mid-stream and downstream), also determine the levelsof Lead, Zinc, Manganese and copper in four commercially important fish species, Pseudotolithus senegalensis (croaker fish) and Ethmalosa fimbriata (bonga), Oreochromis mossambicus (Tilapia fish) and Bagrus bayad (silver catfish) from Makoko water body, Yaba, Lagos, Nigeria. Histopathological profile of the fish species selected was also examined. The results were compared to the World Health Organization (WHO) acceptable limit.The concentrations of the heavy metals were analyzed using Perkin Atomic Absorption Spectrophotometer (AAS). Pseudotholithus senegalensishad 3.01±0.02, 2.41±0.02, 3.48±0.01, 1.04±0.10 mg kg-1as the mean concentration of lead, zinc, manganese, and copper respectively, while E. fimbriatahad 1.06±0.02, 2.41±0.02, 4.14±0.01, 1.04±0.10 mg kg-1,O. mossambicushad 2.09±0.02, 3.11±0.04, 2.48±0.02, 0.62±0.01 mg kg-1and B. bayadhad 1.53±0.12, 3.61±0.05, 2.44±0.03, 0.66±0.01 mg kg-1 as the mean concentration of these metals in the tissues of these fishes. The concentrations of heavy metals were higher in the gills compared to other organs. The mean concentration of each heavy metal were varied significantly (p0.05) depending on the species of fish. In the histological analysis of the tissues, there was vacuolation of hepatocytes, inflammation, and necrosis. In the muscle, there was a mild lesion, necrosis, inflammation, and cellular degenerations. But the level of tissue and organ degeneration is more severe in the gills. The study showed that some levels of these metals were within the permissible recommended allowed limit for human consumption. It is concluded that Makoko Lagoon water body and fishes are heavily contaminated with heavy metals.
Cassia alata Seed Extract Loaded Chitosan: Synthesis and Release Study
Authors: Kartha Vidya G. , Suryavanshi Vandana , Maharana Tungabidya
Published: November 2019

In present study, a herbal extract, Cassia alata seed extract has been loaded into chitosan matrix as drug delivery systems. The major components of Cassia alata seed extract are flavonoids and anthraquinone. Cassia alata seed extract loaded chitosan has been characterized by FTIR, SEM, XRD, thermal and NMR analysis. The characterization has shown successful loading of Cassia alata seed extract into chitosan. Further, swelling properties and drug release profiles of Cassia alata seed extract loaded chitosan has been carried out at two different pH 2 and 7.4. It is observed that the swelling behaviour and drug release profile was much better at pH 2 than pH 7.4. Thus, the loaded chitosan can be used as a biomedicine.
Interactions of Cetyltrimethylammonium Bromide with 1,3-Dioxolane
in Water: A Study of Viscosity and Volumetric Properties
Authors: Sarangi Dayananda , Samantaray A.C. , Sahu Rojalin , Nanda Braja B.
Published: November 2019

Densities and viscosities of ternary mixtures containing cetyltrimethyl ammonium bromide (CTAB) in aqueous solution of 1,3-dioxolane have been measured at 5 K intervals from 298.15 to 313.15 K and at atmospheric pressure. The experimental results of viscosity and density have been analyzed by using Jones-Dole equation and Masson equation. The values of constants A and B of Jones-Dole equation have been interpreted in terms of solute-solute and solute-solvent interactions. The standard partial molar volume,Vφ
0 at infinite dilution were determined from Masson equations. The structure making/breaking capacity of solute is interpreted with the help of Helper equation. The positive value of Helper′s constant (∂2Vφ 0/∂T2)p and the negative value of dB/dT shows that CTAB in studied organic solvent predominantly acts as a structure-maker.
Effect of Pb2+ Ions on the Mechanical, Structural and Thermal Behaviour of B2O3-CaO Glasses
Authors: Subashini C. , Pavai R. Ezhil , Balu L.
Published: November 2019

B2O3-CaO-PbO glasses with different concentrations of PbO (5-20 mol % in four steps) were prepared by melt quench technique. The amorphous nature and homogeneities of the prepared glasses were confirmed by XRD and SEM analyses. Ultrasonic velocities and density were measured at 303 K using pulse-echo technique and Archimedes’ principle respectively. Various parameters, viz., molar volume, longitudinal modulus, shear modulus, bulk modulus, Young’s modulus, Poisson’s ratio, micro-hardness and Debye temperature have been evaluated from the measured data. The results of ultrasonic properties indicate that the incorporation of lead ions expand the calcium borate network structure. FTIR spectra revealed that boron exists in both trigonal and tetrahedral structural units and no boroxial ring formation takes place in the glass structure. The transition temperature, melting temperature and crystallization temperature have been identified using DTA measurements.
Ultrasonic Study of Effect of Temperature and Concentration on Molecular Interaction in Ternary Liquid Mixture (Propylene Glycol + Benzene + Ethanol)
Authors: Hema  , Bhatt Tara , Pant Tarun , Dhondiyal Charu Ch. , Tiwari Himani
Published: November 2019

Ultrasonic velocity, density and viscosity in the ternary mixture of propylene glycol, benzene and ethanol have been measured at 303, 308, 313 and 318 K and 2 MHz. The values of excess thermo-acoustic parameters uE, ηE, Ks E , Lf E , Vm E, ZE; and the Lennard-Jones potential repulsive term exponent (n) have been calculated by using the values of measured parameters. The variation in values and signs of excess parameters with increase in concentration of propylene glycol and temperature is explained by the mechanism of changing the nature of molecular interactions between unlike molecules. Further, the experimental ultrasonic velocities are compared with theoretical values calculated by using various theories like Nomoto′s relation (NR), Schaaffs′s collision factor theory (CFT) and Jacobson′s free length theory (FLT). The relative applicability of these theories is discussed in terms of average percentage errors (APE). The average percentage errors follows the order CFT < NR < FLT at each temperature.
Synthesis, Characterization and Biological Activity of Novel 1,3,4-Oxadiazole
Derivatives of 1,3-Dihydro-1-oxoisobenzofuran-5-carboxylic Acid
Authors: Rao Nunna Madhava , Viveka Tella Lakshmi , Raju Koneti Mallikarjuna , Chary Maringanti Thirumala
Published: November 2019

This work relates to the synthesis of novel 1,3,4-oxadiazole derivatives (5a-h) from
1,3-dihydro-1-oxoisobenzofuran-5-carboxylic acid. The structure of the synthesized compounds were confirmed by using IR, 1H NMR, 13C NMR and mass spectroscopy. Further these synthesized derivatives were subjected to biological activity.