bluuebunny/crossref_metadata_2025 huggingface dataset:
Hormonal influence on HIV‐1 transmission in the female genital tract: New insights from systems biology
Authors: Dupont Haley A. , Lam Jeff , Woods Matthew W. , Zahoor Mohammed A. , Kaushic Charu
Published: July 2018

Although anti‐retroviral treatments have significantly slowed down the spread of the HIV‐1 pandemic, approximately 2 million new infections occur every year. The majority of new infections are in sub‐Saharan Africa where rates of infection are much higher in women than men. Young women are disproportionately affected and have higher susceptibility to HIV‐1. The complex interactions between HIV‐1 and the female genital tract (FGT) and the mechanisms regulating susceptibility in women remain incompletely understood. In this review, we focus on the current understanding of the acute events that occur in the FGT following HIV‐1 exposure with a particular focus on the effect of endogenous and exogenous sex hormones on HIV‐1 susceptibility. We highlight the contribution of the recent transcriptomic and proteomic studies in providing new insights.
Population pharmacokinetics of serelaxin in patients with acute or chronic heart failure, hepatic or renal impairment, or portal hypertension and in healthy subjects
Authors: Soubret Antoine , Pang Yinuo , Yu Jing , Dahlke Marion
Published: July 2018

Aims

Serelaxin is a recombinant human relaxin‐2 peptide being developed for the treatment of acute heart failure (AHF). The present analyses aimed to evaluate serelaxin pharmacokinetics following intravenous administration and to identify covariates that may explain pharmacokinetic variability in healthy subjects and patients.

Methods

Serum concentration–time data for 613 subjects from nine phase I and II studies were analysed using a nonlinear mixed‐effects model to estimate population pharmacokinetics and identify significant covariates. A quantile regression analysis was also conducted to assess the relationship between clearance and covariates by including sparse data from a phase III study.

Results

A three‐compartment disposition model was established to describe serelaxin pharmacokinetics. Three out of 23 covariates, including baseline body mass index (BMI) and estimated glomerular filtration rate (eGFR) and study A1201, were identified as significant covariates for clearance but with a moderate impact on steady‐state concentration, reducing the intersubject variability from 44% in the base model to 41% in the final model with covariates. The steady‐state volume of distribution (Vss) was higher in patients with AHF (544 ml kg–1) or chronic heart failure (434 ml kg–1), compared with typical nonheart failure subjects (347 ml kg–1). Quantile regression analysis showed that a 20% increase in BMI or a 20% decrease in eGFR decreased serelaxin clearance by 9.2% or 5.2%, respectively.

Conclusions

Patients with HF showed higher Vss but similar clearance (and therefore steady‐state exposure) vs. non nonheart failure subjects. BMI and eGFR were identified as the main covariates explaining intersubject variability in clearance; however, the impact of these covariates on steady‐state concentration was moderate and therefore unlikely to be clinically relevant.
CPRforblind: A video game to introduce cardiopulmonary resuscitation protocol to blind people
Authors: Rodríguez Antonio , Boada Imma , Thió‐Henestrosa Santiago , Sbert Mateu
Published: July 2018

Cardiopulmonary resuscitation (CPR) is a first aid survival technique used to recover victims of cardiac arrest. To learn CPR different handheld device applications have been proposed. Most of them are based on sophisticated graphics and interaction techniques that make them inaccessible to visually impaired people. In this paper, we propose CPRforBlind, a video game designed to introduce the main steps of the CPR protocol to visually impaired people. The game is composed of different mini‐games inspired by the CPR steps proposed by European Resuscitation Council. The player acts as a helper who has to save the victim by using tactile interaction to solve the challenges assigned to each mini‐game. To test the game, 16 participants from which 8 are blind have been considered. After and before playing the game participants answered different questionnaires related to CPR knowledge, playability and enjoyability. The obtained results are very promising detecting a great improvement on CPR knowledge. In addition, blind players enjoyed the game and found it easy to play.
Management of adults with diabetes on the haemodialysis unit: summary of guidance from the Joint British Diabetes Societies and the Renal Association
Authors: Frankel A. H. , Kazempour‐Ardebili S. , Bedi R. , Chowdhury T. A. , De P. , El‐Sherbini Nevine , Game F. , Gray S. , Hardy D. , James J. , Kong M.‐F. , Ramlan G. , Southcott E. , Winocour P.
Published: July 2018

Diabetic nephropathy remains the principal cause of end‐stage renal failure in the UK and its prevalence is set to increase. People with diabetes and end‐stage renal failure on maintenance haemodialysis are highly vulnerable, with complex comorbidities, and are at high risk of adverse cardiovascular outcomes, the leading cause of mortality in this population. The management of people with diabetes receiving maintenance haemodialysis is shared between diabetes and renal specialist teams and the primary care team, with input from additional healthcare professionals providing foot care, dietary support and other aspects of multidisciplinary care. In this setting, one specialty may assume that key aspects of care are being provided elsewhere, which can lead to important components of care being overlooked. People with diabetes and end‐stage renal failure require improved delivery of care to overcome organizational difficulties and barriers to communication between healthcare teams. No comprehensive guidance on the management of this population has previously been produced. These national guidelines, the first in this area, bring together in one document the disparate needs of people with diabetes on maintenance haemodialysis. The guidelines are based on the best available evidence, or on expert opinion where there is no clear evidence to inform practice. We aim to provide clear advice to clinicians caring for this vulnerable population and to encourage and improve education for clinicians and people with diabetes to promote empowerment and self‐management.
Glycaemic management during the inpatient enteral feeding of people with stroke and diabetes
Authors: Roberts A. W. , Penfold S. ,   the Joint British Diabetes Societies (JBDS) for Inpatient Care
Published: July 2018

This paper is an abridged and modified version of guidelines produced by the Joint British Diabetes Societies for inpatient care on glycaemic management during the enteral feeding of people with stroke and diabetes. These were revised in 2017 and have been adapted specifically for Diabetic Medicine. The full version can be found at: www.diabetes.org.uk/joint-british-diabetes-society or https://abcd.care/joint-british-diabetes-societies-jbds-inpatient-care-group. Many people have both diabetes and an acute stroke, and a stanv dard approach to the management of people with stroke is the provision of adequate nutrition. Frequently, this involves a period of enteral feeding if there is impaired ability to swallow food safely. There is currently considerable variability in the management of people with diabetes fed enterally after a stroke, and the evidence base guiding diabetes management in this clinical situation is very weak, although poor glycaemic outcomes in people receiving enteral feeding after stroke may worsen recovery and cause harm. The aim of this document is to provide sensible clinical guidance in this area, written by a multidisciplinary team; this guideline had input from diabetes specialist nurses, diabetologists, dietitians, stroke physicians and pharmacists with expertise in this area, and from UK professional organizations. It is aimed at multidisciplinary teams managing people with stroke and diabetes who require enteral feeding. We recognize that there is limited clinical evidence in this area.
Community‐wide responses to predation risk: effects of predator hunting mode on herbivores, pollinators, and parasitoids
Authors: Kersch‐Becker Mônica F. , Grisolia Bruno B. , Campos Maria J. O. , Romero Gustavo Q.
Published: July 2018

1. Flower visitation by herbivores and pollinators often occurs simultaneously, but their potential contrasting responses to predation risk are rarely investigated in concert. Predator avoidance behaviour is common in pollinators, but remarkably little is known about the responses of other flower visitors, such as herbivores and parasitoids, to predation risk. Several traits of predators and prey are important to the overall impact of predation risk in insect communities, but how predator hunting mode influences distinct feeding guilds is not well understood.

2. This study evaluated the effects of predation risk by non‐lethal predators with distinct hunting modes, a sit‐and‐wait crab spider and an actively hunting lynx spider, on floral visitation by herbivores, pollinators and parasitoids.

3. Non‐lethal spiders drastically reduced flower visitation by herbivores and parasitoids. Pollinator responses to predation risk were taxon‐specific. Non‐lethal spiders did not affect specialist pollinators. In contrast, generalist pollinators avoided plants with sit‐and‐wait non‐lethal crab spiders.

4. These results suggest that predator avoidance behaviour depends on predator and prey traits. Therefore, a community‐wide approach to predation risk effects should be considered, particularly in systems where different guilds are present.
Bone marrow iron score as an indicator for secondary iron overload in acute myeloid leukemia patients
Authors: Hoeks Marlijn , van der Pol Marit , Middelburg Rutger , Evers Dorothea , van Kraaij Marian , Zwaginga Jaap Jan
Published: July 2018

Objectives

Secondary iron overload due to red blood cell transfusions (RBCT) is associated with increased morbidity and mortality. However, attention for secondary iron overload and its side effects in patients with hematological malignancies may need improvement. The aim of this study was to determine the number of transfused RBCT needed to reach a maximum bone marrow iron score (BMIS).

Methods

Bone marrow iron score was independently assessed by two researchers on consecutive bone marrow samples of 35 acute myeloid leukemia (AML) patients. The slides were blinded to both researchers to prevent bias. A Kaplan‐Meier survival analysis was performed for estimation of the proportion of patients reaching a maximum BMIS.

Results

In total, 141 bone marrow specimens from 35 patients were included. The median number of RBCT to reach a maximum was 20 units (range 6‐42, IQR 15‐26), after a mean of 1.64 chemotherapy courses (SD 0.99).

Conclusions

In conclusion, the cumulative RBCT number is associated with BMIS. Due to the considerable variation in number of RBCT to reach a maximum BMIS, BMIS instead of only considering the cumulative RBCT number may be a valuable indicator of secondary iron overload in AML patients. BMIS could guide iron‐lowering therapy and/or transfusion strategies in an early stage.
Productivity measurement of industrial sector in China regarding air pollution
Authors: Liu Meisheng , Wu Desheng
Published: July 2018

As an important sector of national economy, the industrial sector accounts for 33.4% of gross domestic product while consuming 70% of energy and causing serious air pollution in China. It is meaningful to measure the productivity of industrial sector in China with air pollution consideration. The range‐adjusted measure of the nonradial data envelopment analysis, as with natural disposability and managerial disposability, is adopted in order to measure the productivity of provincial industrial sector in China during 2011–2014. The results explain that the unified efficiency under managerial disposability is lower than the unified efficiency under natural disposability and the unified efficiency under natural and managerial disposability, which means that management improvement and technology innovation should be obtained more attention from the government. As modernization of economic restructuring, there is not a trend of unified efficiency under natural disposability. Eastern China has highest unified efficiency under managerial disposability, whereas unified efficiency under natural and managerial disposability are improving in eastern China and western China in period of 2013–2014. The results also describe that more than 20 provinces and nearly half of provinces are suitable for the industrial pollution control investment and research and development investment, respectively. On the basis of the results of the truncated regression model, we can identify the influencing factors of unified efficiency. According to above results, suggestions are proposed in order to improve the productivity.
Improving the prediction of learning outcomes in educational platforms including higher level interaction indicators
Authors: Ruipérez‐Valiente José A. , Muñoz‐Merino Pedro J. , Delgado Kloos Carlos
Published: July 2018

One of the most investigated questions in education is to know which factors or variables affect learning. The prediction of learning outcomes can be used to act on students in order to improve their learning process. Several studies have addressed the prediction of learning outcomes in intelligent tutoring systems environments with intensive use of exercises, but few of them addressed this prediction in other web‐based environments with intensive use not only of exercises but also, for example, of videos. In addition, most works on prediction of learning outcomes are based on low level indicators such as number of accesses or time spent in resources. In this paper, we approach the prediction of learning gains in an educational experience using a local instance of Khan Academy platform with an intensive use of exercises and taking into account not only low level indicators but also higher level indicators such as students' behaviours. Our proposed regression model is able to predict 68% of the learning gains variability with the use of six variables related to the learning process. We discuss these results providing explanation of the influence of each variable in the model and comparing these results with other prediction models from other works.
Women's entrepreneurship, neoliberalism and economic justice in the postfeminist era: A discourse analysis of policy change in Sweden
Authors: Berglund Karin , Ahl Helene , Pettersson Katarina , Tillmar Malin
Published: July 2018

Since the early 1990s, there has been investment in women's entrepreneurship policy (WEP) in Sweden, which continued until 2015. During the same period, Sweden assumed neoliberal policies that profoundly changed the position of women within the world of work and business. The goals for WEP changed as a result, from entrepreneurship as a way to create a more equal society, to the goal of unleashing women's entrepreneurial potential so they can contribute to economic growth. To better understand this shift we approach WEP as a neoliberal governmentality which offers women ‘entrepreneurial’ or ‘postfeminist’ subject positions. The analysis is inspired by political theorist Nancy Fraser who theorized the change as the displacement of socioeconomic redistribution in favour of cultural recognition, or identity politics. We use Fraser's concepts in a discourse analysis of Swedish WEP over two decades, identifying two distinct discourses and three discursive displacements. Whilst WEP initially gave precedence to a radical feminist discourse that called for women's collective action, this was replaced by a postfeminist neoliberal discourse that encouraged individual women to assume an entrepreneurial persona, start their own business, compete in the marketplace and contribute to economic growth. The result was the continued subordination of women business owners, but it also obscured or rendered structural problems/solutions, and collective feminist action, irrelevant.
Characteristic morphological changes in anti‐VEGF therapy‐induced glomerular microangiopathy
Authors: Pfister Frederick , Amann Kerstin , Daniel Christoph , Klewer Monika , Büttner Anke , Büttner‐Herold Maike
Published: July 2018

Aims

Agents targeting vascular endothelial growth factor (VEGF) have increasingly been used for the treatment of advanced malignancies, and have been found to induce renal thrombotic microangiopathy (TMA) and proteinuria. However, histomorphological changes in human biopsies in this setting and the underlying mechanism are not yet fully understood. Therefore, we collected renal biopsy cases with a history of aVEGF therapy to review and compare morphological kidney changes in this context.

Methods and results

Renal biopsies of 15 patients who had received anti‐VEGF (aVEGF) therapy evaluated between 2013 and 2017 at a single centre were morphologically characterised with light microscopy, electron microscopy, and immunohistochemistry (IgA, IgG, IgM, C1q, and C3), and compared with cases with acute TMA caused by atypical haemolytic–uraemic syndrome or hypertension. Morphological overlap with immune complex and cryoglobulinaemic membranoproliferative glomerulonephritis, diabetic glomerulopathy and pre‐eclampsia‐induced glomerulopathy are discussed. Segmental glomerular capillary microaneurysms and segmental hyalinosis were typical morphological features of aVEGF therapy‐induced glomerular microangiopathy, whereas fibrin or platelet thrombi or fragmented erythrocytes were rarely found or were absent. aVEGF therapy‐associated microangiopathy was diffusely distributed in the glomeruli, spared preglomerular vessels, and showed morphological characteristics of chronic TMA. In individual cases, aVEGF therapy‐induced glomerular microangiopathy was accompanied by immune‐complex glomerulonephritis.

Conclusion

aVEGF therapy‐induced glomerular microangiopathy has a characteristic morphology and clinical presentation that helps to differentiate it from other causes of TMA. Awareness of these light microscopic findings allows identification of aVEGF therapy as a trigger of renal disease in critically ill cancer patients, and might therefore help in deciding on further therapy.
School Dental Service in Sri Lanka: geo‐spatial analysis of access to oral health care
Authors: Ranasinghe Nirosha , Kruger Estie , Tennant Marc
Published: July 2018

Background

The School Dental Service contributes to the reduction of social inequalities in oral health among school children.

Aim

To investigate the distribution of School Dental Clinics staffed by School Dental Therapists in Sri Lanka in relation to the distribution of the child population and socioeconomic status.

Design

School Dental Clinics were mapped using geographic information system (GIS) software and overlayed with population data of 3–13‐year‐old children (including poverty status).

Results

Overall, there was an uneven geographic distribution of the total 422 School Dental Clinics. Sri Lankan children have restricted access to school dental care in a few poverty stricken districts in the Northern, Eastern, North Central, and Uva provinces. When the geographic distribution of children by poverty status was analysed, it was found that in Sri Lanka, only 53% of the most socially disadvantaged children lived within 5 km from a School Dental Clinic, compared to 75% of the least disadvantaged.

Conclusion

A coordinated national School Dental Service strategy is needed in response to identified areas of poor or inadequate accessibility to dental services for large parts of the child population, especially those from low socioeconomic backgrounds.
Genotyping of groups of cows to improve genomic breeding values of new traits
Authors: Plieschke Laura , Edel Christian , Pimentel Eduardo C. G. , Emmerling Reiner , Bennewitz Jörn , Götz Kay‐Uwe
Published: July 2018

Genotyping females and including them into the reference set for genomic predictions in dairy cattle is considered to provide gains in reliabilities of estimated breeding values for selection candidates. This should especially be true for low heritability traits. By the use of simulation, we extended a genomic reference set for an existing trait by including a fixed number of genotyped first‐crop daughters for one or two generations of reference sires. Moreover, we calculated results for the effects of a similar strategy in a situation where for a new trait the recording of phenotypes has recently started. For this case, we compared the effect of two different genotyping strategies: first, to phenotype cows but to genotype their sires only, and second, to collect phenotypes and genotypes on the same cows. We studied the effects on validation reliabilities and unbiasedness of predicted values for selection candidates. We found that by extending the reference set with genotyped daughters it is possible to increase the validation reliability of genomic breeding values. In the case of a new trait, it is always better to collect and use genotypes and phenotypes on the same animals instead of using only sire genotypes. We found that the benefits that can be achieved are sensitive to the sampling strategy used when selecting females for genotyping.
Implantable cardioverter‐defibrillator therapy in device recipients who survived a cardiac arrest associated with a reversible cause
Authors: Gupta Aman , Pasupula Deepak Kumar , Bhonsale Aditya , Kancharla Krishna , Wang Norman C. , Adelstein Evan , Jain Sandeep , Saba Samir
Published: July 2018

Background

Guideline recommendations for implantable cardioverter‐defibrillators (ICD) for secondary prevention of sudden cardiac arrest (SCA) have excluded patients with reversible causes. We previously demonstrated mortality benefit with the ICD in survivors of SCA associated with reversible causes other than myocardial infarction (MI) or ischemia treated with coronary revascularization. In the current study, we examined the incidence of ICD therapy in patients with SCA related to reversible causes.

Methods

Data were collected for all patients over the age of 18 years who had survived to hospital discharge after SCA between 2002 and 2012. ICD recipients with reversible causes were divided into 2 groups based on their reversible etiology of SCA: MI + ICD (n = 132) and non‐MI + ICD (n = 75). Delivered ICD therapy was examined.

Results

Over a follow‐up period of 3.8 ± 3.1 years, more patients without MI/ischemia who received an ICD experienced appropriate (adjusted HR, 3.96; 95% CI, 1.32‐11.84) but not inappropriate (adjusted HR, 0.65; 95% CI, 0.14‐2.97) ICD therapy compared with patients without MI/ischemia. The proportion of patients receiving appropriate (P = 0.012) but not inappropriate (P = 0.80) ICD therapy was also higher in the non‐MI + ICD compared with the MI + ICD group.

Conclusion

We show higher rates of appropriate ICD therapy in survivors of SCA associated with reversible causes other than MI/ischemia. This finding, in conjunction with the previously demonstrated lower all‐cause mortality noted in the presence of an ICD in SCA survivors with reversible etiology other than MI/ischemia, further supports consideration of ICD implantation in this population.
Valsartan reduced the vulnerability to atrial fibrillation by preventing action potential prolongation and conduction slowing in castrated male mice
Authors: Sun Yi‐Lin , Li Peng‐Hui , Shi Ling , Su Wan‐Zhen , Li De‐Sheng , Xue Gen‐Long , Zhao Yue , Li Chang‐Zhu , Li Ying , Zhou Yang , Li Shang‐Xuan , Zhang Yang , Lu Yan‐Jie , Pan Zhen‐Wei
Published: July 2018

Introduction: Deficiency of testosterone was associated with the susceptibility of atrial fibrillation (AF). Angiotensin‐II (AngII) receptor antagonists were shown to reduce AF by improving atrial electrical remodeling. This study investigated the effects and mechanism of valsartan, an AngII receptor antagonist, on the susceptibility to AF with testosterone deficiency.

Methods and Results: Five‐week‐old male ICR mice were castrated and valsartan was administered orally (50 mg/kg/d). High‐frequency electrical stimulation method was used to induce atrial arrhythmia. Patch‐clamp technique was used for recording action potential duration (APD), transient outward potassium current (
I
to), sustained outward potassium current (
I
ksus), and late sodium current (
I
Na‐L). Optical mapping technique was used to examine atrial conduction velocity (CV). The expression of connexin40 (Cx40) and Cx43 were detected by Western blot analysis. The occurrence rate of AF was significantly increased in castrated mice and APDs measured at 50% and 90% repolarization were markedly prolonged in castrated mice than controls, which were alleviated by the administration of valsartan. Valsartan suppressed the increase of INa‐L and rescued the reduction of Ito and Iksus in castrated mice. The left atrial CV in castrated mice was decreased and the expression of Cx43 reduced than controls, which were restored after valsartan treatment.

Conclusions: Valsartan reduced the susceptibility of AF in castrated mice, which may be related to the inhibition of action potential prolongation and improvement of atrial conduction impairment. This study indicates that valsartan may represent a useful agent for the prevention of AF pathogenesis in elderly male patients.
Successful treatment of pulmonary mucormycosis in two pediatric hematopoietic stem cell transplant patients
Authors: Elgarten Caitlin W. , Levy Ellen M. , Mattei Peter , Fisher Brian T. , Olson Timothy S. , Freedman Jason L.
Published: July 2018

Pulmonary mucormycosis diagnosed immediately after hematopoietic stem cell transplantation frequently portends a poor prognosis. However, here we describe two cases in children that were treated successfully to highlight the efficacy of a multidisciplinary approach. Despite diagnosis in the immediate post‐transplant period and requirement for ongoing immunosuppression to prevent or treat GVHD, both are long‐term survivors due to early surgical debridement with transfusion support and prompt initiation of targeted antifungal therapy. In the absence of evidence‐based treatment guidelines, survival of pulmonary mucormycosis is achievable even in high‐risk patients with a multidisciplinary team to guide management.
Chromophobe renal cell carcinoma with sarcomatoid differentiation containing various heterologous components
Authors: Hyodo Toshiki , Kanzawa Maki , Hara Shigeo , Takahashi Kosuke , Ogawa Satoshi , Furukawa Junya , Fujisawa Masato , Kobayashi Anna , Kuroda Naoto , Itoh Tomoo
Published: July 2018

Renal cell carcinoma (RCC) occasionally has sarcomatoid differentiation and rarely contains heterologous components. We report a case of chromophobe RCC with sarcomatoid differentiation that had various heterologous components including a unique lipomatous area. The patient was an 83‐year‐old woman with a palpable mass in the left lower abdomen. Grossly, the tumor was 14 cm in diameter and had yellowish‐to‐whitish color with focal necrosis and hemorrhage. Histologically, the tumor was composed of an eosinophilic subtype of chromophobe RCC with sarcomatoid differentiation including mainly chondrosarcoma, some osteosarcoma and a lipomatous area. The heterologous components of sarcomatoid RCC are usually osteosarcoma or chondrosarcoma, and sarcomatoid RCC with multiple heterologous components is extremely rare.
Using a “child's‐eye view” of social success to understand the importance of school readiness at the transition to formal schooling
Authors: Fink Elian , Browne Wendy V. , Hughes Claire , Gibson Jenny
Published: July 2018

Recent research into school readiness has highlighted the importance of not only children's cognitive and socio‐emotional skills, but also the degree to which they have family support in the home. The current study examines the association between social success upon school entry and teacher‐ratings of school readiness as assessed by the Brief Early Skills and Support Index (BESSI), controlling for language ability. Importantly, social success was assessed using a “child's‐eye view” with peer‐reported assessments of both social preference and reciprocated friendships. A total of 244 children (131 boys, Mage = 61 months, SD = 4.78 months) in their first year of formal schooling participated. Child school readiness was found to be important for social preference, with the association being more marked for boys versus girls. Family support was the only independent predictor of children's reciprocated friendships. The use of the BESSI, with its broad scope compared to other measures of school readiness, highlights the importance of focusing both on a child's cognitive and socio‐emotional skills at school entry and their family support when exploring the association of school readiness to children's social success at the transition to formal schooling.
The Model of Good Health
Authors: Thilmany Jean
Published: July 2018

This article explores the innovative ways of using advanced modeling, simulation, and analysis software in medical field. In order to meet design requirements, engineers who work for medical device makers have been putting advanced modeling, simulation, and analysis software to use in innovative ways, such as creating models of the human anatomy that can be used to virtually test potential medical technologies. They have also put new tools such as 3D printers to work building model prototypes for real-world testing. The Food and Drug Administration’s Center for Devices and Radiological Health is now creating a simulated human capable of serving as an in-silico guinea pig. The center is building a library of computer regulatory testing models and a family of ‘virtual patients’ for product design and testing. The article also describes that medical device developers can use cinematic rendering, such as an image of the blood vessels in the skull created in Syngio via Frontier, an application enabling the realistic depiction of volume datasets, to help create better treatments.
Cell Mechanics
Authors: Thilmany Jean
Published: July 2018

This article discusses various research works by engineering teams working on computer models that help explain the evolutionary dynamics of bone cancer. In order to investigate biological systems with a mechanical engineering approach, medical research teams are creating computerized mathematical models that have the potential to explain the mechanics of cancer. Researchers have found that mechanical signals can influence cancer cell migration, growth, and differentiation. Engineering models, such as the one simulating cancer immunotherapy, not only are visually striking, but also can help researchers better understand how cells respond to potential treatments. Researchers at the Center of Applied Molecular Medicine at the University of Southern California have developed two open source 3D simulation packages: BioFVM, which simulates diffusion of dozens of substrates in 3D tissues, and PhysiCell, which simulates multicellular systems in 3-D tissues. According to experts, differences between experimental information and model-returned information can also be resolved to better understand how metastasis works and, perhaps, fine-tune models.
Optimization of Heat Exchange in Manifold-Microchannel Grooves
Authors: Ladeinde Foluso , Kehinde Alabi , Li Wenhai
Published: July 2018

Manifold-microchannel (MM) combinations used on heat transfer surfaces have shown the potential for superior heat transfer performance to pressure drop ratio when compared with chevron-type corrugations for plate (frame) heat exchangers (PHEs). This paper presents an advanced genetic algorithm (GA)-based procedure for analyzing and optimizing the MM-based PHE. One distinctive feature of the implementation is the blended variable formulation for the chromosomes to allow the use of continuous variables rather than the bitwise variables in standard GA methods. The resulting GA procedure is particularly well suited for PHEs for several reasons, including the fact that it does not require continuous variables or functional dependence on the design variables. In addition, the computational effort required for the GA technique in the current implementation scales linearly with the number of design variables, making it appropriate for MM-based PHEs, which have several variables. The computed results compare well with experimental data and show better performance compared to conventional PHEs of the same volume utilizing chevron corrugations. Although a full-scale computational fluid dynamics (CFD) analysis may give more accurate results than the semi-empirical approach used in this paper, the former cannot efficiently support rapid concept de-selection during the preliminary stage of design. Optimization based on CFD also can usually not support discontinuous functions. To improve the fidelity of the current analysis, a discrete, finite-volume-type, one-dimensional (1D) reduced-order modeling is carried out, in addition to a purely bulk approach. Our discrete approach obviates the need for the є-NTU-type models.
Operationalizing Physical Literacy: Special Issue Editorial
Authors: Durden-Myers Elizabeth J. , Whitehead Margaret E.
Published: July 2018

Physical literacy has been described as a “longed for concept” and has in turn gained much interest worldwide. This interest has also given rise for calls for physical literacy to be operationalized, providing clarity and guidance on developing physical literacy informed practice. Operationalizing physical literacy is crucial in moving the concept forward by providing “substance to the claims made by (physical literacy) advocates.” This special issue aims to respond to calls for research to “unpack” physical literacy across a number of areas in pursuit of operationalizing physical literacy in practice. Nine articles are included within this special issue.
Physical Literacy From Philosophy to Practice
Authors: Pot Niek , Whitehead Margaret E. , Durden-Myers Elizabeth J.
Published: July 2018

This article aims to give an overview of the philosophical foundations of physical literacy (monism, existentialism, and phenomenology) and to discuss how philosophy can be operationalized in physical education practice. When translated into physical education practice, the physical literacy philosophies give credence to the view that, in schools, physical education should not be considered as a subsidiary subject that is needed merely to refresh the mind for the cognitive subjects. The authors also highlight that the context in which activities take place should be challenging, realistic, and adaptable to the individual preferences and levels of attainment of the different learners. Often, these contexts go beyond the traditional competitive sports context. Drawing on these philosophies, physical education must be learner centered and provide situations in which learners can discover and develop their individual potential to stay motivated, confident, and competent for engagement in physical activities for life.
The RNA-Binding Protein of a Double-Stranded RNA Virus Acts like a Scaffold Protein
Authors: Mata Carlos P. , Mertens Johann , Fontana Juan , Luque Daniel , Allende-Ballestero Carolina , Reguera David , Trus Benes L. , Steven Alasdair C. , Carrascosa José L. , Castón José R.
Published: July 2018

Structural analyses highlight the constraint of virus evolution to a limited number of capsid protein folds and assembly strategies that result in a functional virion. We report the cryo-EM and cryo-electron tomography structures and the results of atomic force microscopy studies of the infectious bursal disease virus (IBDV), a double-stranded RNA virus with an icosahedral capsid. We found evidence of a new inner shell that might act as an internal scaffold during IBDV assembly. The use of an internal scaffold is reminiscent of tailed dsDNA viruses, which constitute the most successful self-replicating system on Earth. The IBDV scaffold protein is multifunctional and, after capsid maturation, is genome bound to form ribonucleoprotein complexes. IBDV encompasses numerous functional and structural characteristics of RNA and DNA viruses; we suggest that IBDV is a modern descendant of ancestral viruses and comprises different features of current viral lineages.
Quality of life of children and adolescents with chronic kidney disease: a cross-sectional study
Authors: Francis Anna , Didsbury Madeleine S , van Zwieten Anita , Chen Kerry , James Laura J , Kim Siah , Howard Kirsten , Williams Gabrielle , Bahat Treidel Omri , McTaggart Steven , Walker Amanda , Mackie Fiona , Kara Tonya , Nassar Natasha , Teixeira-Pinto Armando , Tong Allison , Johnson David , Craig Jonathan C , Wong Germaine
Published: July 2018

Objective

The aim was to compare quality of life (QoL) among children and adolescents with different stages of chronic kidney disease (CKD) and determine factors associated with changes in QoL.

Design

Cross-sectional.

Setting

The Kids with CKD study involved five of eight paediatric nephrology units in Australia and New Zealand.

Patients

There were 375 children and adolescents (aged 6–18 years) with CKD, on dialysis or transplanted, recruited between 2013 and 2016.

Main outcome measures

Overall and domain-specific QoL were measured using the Health Utilities Index 3 score, with a scale from −0.36 (worse than dead) to 1 (perfect health). QoL scores were compared between CKD stages using the Mann-Whitney U test. Factors associated with changes in QoL were assessed using multivariable linear and ordinal logistic regression.

Results

QoL for those with CKD stages 1–2 (n=106, median 0.88, IQR 0.63–0.96) was higher than those on dialysis (n=43, median 0.67, IQR 0.39–0.91, p<0.001), and similar to those with kidney transplants (n=135, median 0.83, IQR 0.59–0.97, p=0.4) or CKD stages 3–5 (n=91, 0.85, IQR 0.60–0.98). Reductions were most frequent in the domains of cognition (50%), pain (42%) and emotion (40%). The risk factors associated with decrements in overall QoL were being on dialysis (decrement of 0.13, 95% CI 0.02 to 0.25, p=0.02), lower family income (decrement of 0.10, 95% CI 0.03 to 0.15, p=0.002) and short stature (decrement of 0.09, 95% CI 0.01 to 0.16, p=0.02).

Conclusions

The overall QoL and domains such as pain and emotion are substantially worse in children on dialysis compared with earlier stage CKD and those with kidney transplants.
Vitamin D and its pathway genes in myopia: systematic review and meta-analysis
Authors: Tang Shu Min , Lau Tiffany , Rong Shi Song , Yazar Seyhan , Chen Li Jia , Mackey David A , Lucas Robyn M , Pang Chi Pui , Yam Jason C
Published: July 2018

Objective

To conduct a systematic review and meta-analysis of the association of blood vitamin D (25-hydroxyvitamin D, 25(OH)D) concentration and vitamin D pathway genes with myopia.

Methods

We searched the MEDLINE and EMBASE databases for studies published up to 29 January 2018. Cross-sectional or cohort studies which evaluated the blood 25(OH)D concentration, blood 25(OH)D3 concentration or vitamin D pathway genes, in relation to risk of myopia or refractive errors were included. Standard mean difference (SMD) of blood 25(OH)D concentrations between the myopia and non-myopia groups was calculated. The associations of blood 25(OH)D concentrations and polymorphisms in vitamin D pathway genes with myopia using summary ORs were evaluated.

Results

We summarised seven studies involving 25 008 individuals in the meta-analysis. The myopia group had lower 25(OH)D concentration than the non-myopia group (SMD=−0.27 nmol/L, p=0.001). In the full analysis, the risk of myopia was inversely associated with blood 25(OH)D concentration after adjusting for sunlight exposure or time spent outdoors (adjusted odds ratio (AOR)=0.92 per 10 nmol/L, p<0.0001). However, the association was not statistically significant for the <18 years subgroup (AOR=0.91 per 10 nmol/L, p=0.13) and was significant only for 25(OH)D3 (likely to be mainly sunlight derived), but not total 25(OH)D (AOR=0.93 per 10 nmol/L, p=0.00007; AOR=0.91 per 10 nmol/L, p=0.15). We analysed four single nucleotide polymorphisms in the VDR gene from two studies; there was no significant association with myopia.

Conclusions

Lower 25(OH)D is associated with increased risk of myopia; the lack of a genetic association suggests that 25(OH)D level may be acting as a proxy for time outdoors.
Could listening to music during pregnancy be protective against postnatal depression and poor wellbeing post birth? Longitudinal associations from a preliminary prospective cohort study
Authors: Fancourt Daisy , Perkins Rosie
Published: July 2018

Objectives

This study explored whether listening to music during pregnancy is longitudinally associated with lower symptoms of postnatal depression and higher well-being in mothers post birth.

Design

Prospective cohort study.

Participants

We analysed data from 395 new mothers aged over 18 who provided data in the third trimester of pregnancy and 3 and 6 months later (0–3 and 4–6 months post birth).

Primary and secondary outcome measures

Postnatal depression was measured using the Edinburgh Postnatal Depression Scale, and well-being was measured using the Short Warwick-Edinburgh Mental Well-being Scale. Our exposure was listening to music and was categorised as ‘rarely; a couple of times a week; every day <1 hour; every day 1–2 hours; every day 3–5 hours; every day 5+hrs’. Multivariable linear regression analyses were carried out to explore the effects of listening to music during pregnancy on depression and well-being post birth, adjusted for baseline mental health and potential confounding variables.

Results

Listening during pregnancy is associated with higher levels of well-being (β=0.40, SE=0.15, 95% CI 0.10 to 0.70) and reduced symptoms of postnatal depression (β=−0.39, SE=0.19, 95% CI −0.76 to −0.03) in the first 3 months post birth. However, effects disappear by 4–6 months post birth. These results appear to be particularly found among women with lower levels of well-being and high levels of depression at baseline.

Conclusions

Listening to music could be recommended as a way of supporting mental health and well-being in pregnant women, in particular those who demonstrate low well-being or symptoms of postnatal depression.
GP-OSMOTIC trial protocol: an individually randomised controlled trial to determine the effect of retrospective continuous glucose monitoring (r-CGM) on HbA1c in adults with type 2 diabetes in general practice
Authors: Furler John , O’Neal David Norman , Speight Jane , Blackberry Irene , Manski-Nankervis Jo-Anne , Thuraisingam Sharmala , de La Rue Katie , Ginnivan Louise , Browne Jessica Lea , Holmes-Truscott Elizabeth , Khunti Kamlesh , Dalziel Kim , Chiang Jason , Audehm Ralph , Kennedy Mark , Clark Malcolm , Jenkins Alicia Josephine , Liew Danny , Clarke Philip , Best James
Published: July 2018

Introduction

Optimal glycaemia can reduce type 2 diabetes (T2D) complications. Observing retrospective continuous glucose monitoring (r-CGM) patterns may prompt therapeutic changes but evidence for r-CGM use in T2D is limited. We describe the protocol for a randomised controlled trial (RCT) examining intermittent r-CGM use (up to 14 days every three months) in T2D in general practice (GP).

Methods and analysis

General Practice Optimising Structured MOnitoring To achieve Improved Clinical Outcomes is a two-arm RCT asking ‘does intermittent r-CGM in adults with T2D in primary care improve HbA1c?’

Primary outcome

Absolute difference in mean HbA1c at 12 months follow-up between intervention and control arms. Secondary outcomes: (a) r-CGM per cent time in target (4–10 mmol/L) range, at baseline and 12 months; (b) diabetes-specific distress (Problem Areas in Diabetes).

Eligibility

Aged 18–80 years, T2D for ≥1 year, a (past month) HbA1c>5.5 mmol/mol (0.5%) above their individualised target while prescribed at least two non-insulin hypoglycaemic therapies and/or insulin (therapy stable for the last four months). Our general glycaemic target is 53 mmol/mol (7%) (patients with a history of severe hypoglycaemia or a recorded diagnosis of hypoglycaemia unawareness will have a target of 64 mmol/mol (8%)).

Our trial compares r-CGM use and usual care. The r-CGM report summarising daily glucose patterns will be reviewed by GP and patient and inform treatment decisions. Participants in both arms are provided with 1 hour education by a specialist diabetes nurse.

The sample (n=150/arm) has 80% power to detect a mean HbA1c difference of 5.5 mmol/mol (0.5%) with an SD of 14.2 (1.3%) and alpha of 0.05 (allowing for 10% clinic and 20% patient attrition).

Ethics and dissemination

University of Melbourne Human Ethics Sub-Committee (ID 1647151.1). Dissemination will be in peer-reviewed journals, conferences and a plain-language summary for participants.

Trial registration number

>ACTRN12616001372471; Pre-results.
Information management goals and process failures during home visits for middle-aged and older adults receiving skilled home healthcare services after hospital discharge: a multisite, qualitative study
Authors: Arbaje Alicia I , Hughes Ashley , Werner Nicole , Carl Kimberly , Hohl Dawn , Jones Kate , Bowles Kathryn H , Chan Kitty , Leff Bruce , Gurses Ayse P
Published: July 2018

Background

Middle-aged and older adults requiring skilled home healthcare (‘home health’) services following hospital discharge are at high risk of experiencing suboptimal outcomes. Information management (IM) needed to organise and communicate care plans is critical to ensure safety. Little is known about IM during this transition.

Objectives

(1) Describe the current IM process (activity goals, subactivities, information required, information sources/targets and modes of communication) from home health providers’ perspectives and (2) Identify IM-related process failures.

Methods

Multisite qualitative study. We performed semistructured interviews and direct observations with 33 home health administrative staff, 46 home health providers, 60 middle-aged and older adults, and 40 informal caregivers during the preadmission process and initial home visit. Data were analysed to generate themes and information flow diagrams.

Results

We identified four IM goals during the preadmission process: prepare referral document and inform agency; verify insurance; contact adult and review case to schedule visit. We identified four IM goals during the initial home visit: assess appropriateness and obtain consent; manage expectations; ensure safety and develop contingency plans. We identified IM-related process failures associated with each goal: home health providers and adults with too much information (information overload); home health providers without complete information (information underload); home health coordinators needing information from many places (information scatter); adults’ and informal caregivers’ mismatched expectations regarding home health services (information conflict) and home health providers encountering inaccurate information (erroneous information).

Conclusions

IM for hospital-to-home health transitions is complex, yet key for patient safety. Organisational infrastructure is needed to support IM. Future clinical workflows and health information technology should be designed to mitigate IM-related process failures to facilitate safer hospital-to-home health transitions.