bluuebunny/crossref_metadata_2025 huggingface dataset:
Gap Analysis of Swine-Based Hemostasis Research: “Houses of Brick or Mansions of Straw?”
Authors: Reynolds Penny S , Garvan Cynthia S
Published: February 2020

Introduction

Hemorrhage control is the top priority in far-forward care. Preclinical studies are essential for determining safety and efficacy before novel therapeutics can be tested in humans. Unfortunately, poor methodological quality jeopardizes translational potential.

Methods

We systematically reviewed 136 recent publications describing swine models of hemostasis and hemorrhage reduction to assess compliance with established standards for scientific reporting. Quality measures were summarized by descriptive statistics; randomization was assessed by using baseline group differences to test the uniform distribution assumption for observed P-values.

Results

Most articles did not report information essential to assess study validity and reliability of experimental results. Studies claiming random allocation showed clear evidence of systematic bias. Sample sizes were small, but nearly all studies reported statistically significant effects in the direction of “benefit.” Excessive hypothesis testing increased the risk of false positives.

Conclusions

Methodological quality was poor. Although funding agencies actively promote good scientific practice, investigators have been slow to comply. Poorly executed and reported animal research is an ethical and translational issue, wasting animals and potentially harming patients. To properly assess the therapeutic benefit of novel interventions, investigators must rely less on rote hypothesis testing, develop skills in experimental design and quantitative analysis, and comply with best-practice reporting guidelines.
A Randomized Trial of Mentored vs Nonmentored Military Medics Compared in the Application of a Wound Clamp Without Prior Training: When to Shut Up and Just Watch!
Authors: Kirkpatrick Andrew W , Mckee Jessica L , Netzer Itamar , Mckee Ian A , McBeth Paul , Wachs Juan P , Ball Chad G , Glassberg Elon
Published: February 2020

Introduction

Hemorrhage control is a basic task required of first responders and typically requires technical interventions during stressful circumstances. Remote telementoring (RTM) utilizes information technology to guide inexperienced providers, but when this is useful remains undefined.

Methods

Military medics were randomized to mentoring or not from an experienced subject matter expert during the application of a wound clamp (WC) to a simulated bleed. Inexperienced, nonmentored medics were given a 30-second safety briefing; mentored medics were not. Objective outcomes were time to task completion and success in arresting simulated bleeding.

Results

Thirty-three medics participated (16 mentored and 17 nonmentored). All (100%) successfully applies the WC to arrest the simulated hemorrhage. RTM significantly slowed hemorrhage control (P = 0.000) between the mentored (40.4 ± 12.0 seconds) and nonmentored (15.2 ± 10.3 seconds) groups. On posttask questionnaire, all medics subjectively rated the difficulty of the wound clamping as 1.7/10 (10 being extremely hard). Discussion: WC application appeared to be an easily acquired technique that was effective in controlling simulated extremity exsanguination, such that RTM while feasible did not improve outcomes. Limitations were the lack of true stress and using simulation for the task. Future research should focus on determining when RTM is useful and when it is not required.
Utilization of 19F MRI for Identification of Iraq-Afghanistan War Lung Injury
Authors: Mammarappallil Joseph G , Shofer Scott , Carraway Martha S , Tucker Jesse , Womack Samantha , Ainslie Maureen , Charles H Cecil
Published: February 2020

Introduction

There is mounting evidence of respiratory problems related to military service in the Middle East in the past two decades due to environmental exposures during deployment (eg, sand storms and burn pits). This pilot study tests the hypothesis that regional lung function in subjects with prior deployment in Iraq and/or Afghanistan with suspected War Lung Injury (WLI) would be worse than subjects with normal lung function.

Materials and Methods

Five subjects meeting the inclusion and exclusion criteria were recruited for this pilot study. All subjects underwent spirometry, high-resolution chest computed tomography imaging, and 19F MRI.

Results

While the WLI subjects had normal pulmonary function tests and normal high-resolution chest computed tomography evaluations, their regional lung function from 19F MRI was abnormal with compartments with poor function showing slower filling time constants for ventilation. The scans of suspected WLI subjects show higher fractional lung volume with slow filling compartments similar to patients with chronic obstructive pulmonary disease in contrast to normal subjects.

Conclusions

This is consistent with our premise that WLI results in abnormal lung function and reflects small airways dysfunction and suggests that we may be able to provide a more sensitive tool for evaluation of WLI suspected cases.
Dynamic Postural Stability in Active, Adolescent Males Following Repeated Bouts of Aerobic Exercise in Hot and Temperate Environments: A Pilot Study
Authors: Bond Colin W , Dorman Jason C , MacFadden Lisa N , Munce Thayne A
Published: February 2020

Introduction

Proper jump-landing neuromuscular control is crucial in mitigating lower-extremity musculoskeletal injuries. The presence of fatigue, especially in extreme environments, may degrade dynamic postural stability (DPS) and result in lower-extremity injuries. This study aimed to evaluate the influence of moderate intensity exercise in hot (HOT) and temperate (TEMP) ambient temperatures and residual effects of a previous bout on DPS during a single-legged jump-landing. It was hypothesized that the participants would display worse DPS after HOT compared to TEMP.

Methods

Six recreationally active young males (16.8 ± 0.7 year, 1.88 ± 0.12 m, 83.8 ± 19.8 kg) completed two, 60-minute bouts of exercise with 60 minutes of rest between bouts in both HOT (35°C) and TEMP (22.2°C). Heart rate and core body temperature (Tc) were monitored continuously, and DPS was assessed before and after each bout.

Results

The DPS time and condition effects were not identified (p > 0.05), but HOT elicited some notable (d > 0.20) increases in heart rate, Tc, and DPS compared to TEMP.

Conclusions

The DPS decrements varied between subjects suggesting individual-specific etiology. Repeated bouts of exercise in HOT may place an individual at a greater risk for injury than TEMP if proper prevention strategies are not used.
Tactical Combat Casualty Care Training, Knowledge, and Utilization in the US Army
Authors: Gurney Jennifer M , Stern Caryn A , Kotwal Russ S , Cunningham Cord W , Burelison Dallas R , Gross Kirby R , Montgomery Harold R , Whitt Edward H , Murray Clinton K , Stockinger Zsolt T , Butler Frank K , Shackelford Stacy A
Published: February 2020

Introduction

Tactical Combat Casualty Care (TCCC) is the execution of prehospital trauma skills in the combat environment. TCCC was recognized by the 2018 Department of Defense Instruction on Medical Readiness Training as a critical wartime task. This study examines the training, understanding, and utilization of TCCC principles and guidelines among US Army medical providers and examines provider confidence of medics in performing TCCC skills.

Materials and Methods

A cross-sectional survey, developed by members of the Committee on TCCC, was distributed to all US Army Physicians and Physician Assistants via anonymous electronic communication.

Results

A total of 613 completed surveys were included in the analyses. Logistic regression analyses were conducted on: TCCC test score of 80% or higher, confidence with medic utilization of TCCC, and medic utilization of ketamine in accordance with TCCC.

Conclusions

<60% of respondents expressed confidence in the ability of the medics to perform all TCCC skills. Supervising providers who that believed 80 to 100% of their medics had completed TCCC training had more confidence in their medic’s TCCC abilities. With TCCC, a recognized lifesaver on the battlefield, continued training and utilization of TCCC concepts are paramount for deploying personnel.
Applied machine learning and artificial intelligence in rheumatology
Authors: Hügle Maria , Omoumi Patrick , van Laar Jacob M , Boedecker Joschka , Hügle Thomas
Published: February 2020

Machine learning as a field of artificial intelligence is increasingly applied in medicine to assist patients and physicians. Growing datasets provide a sound basis with which to apply machine learning methods that learn from previous experiences. This review explains the basics of machine learning and its subfields of supervised learning, unsupervised learning, reinforcement learning and deep learning. We provide an overview of current machine learning applications in rheumatology, mainly supervised learning methods for e-diagnosis, disease detection and medical image analysis. In the future, machine learning will be likely to assist rheumatologists in predicting the course of the disease and identifying important disease factors. Even more interestingly, machine learning will probably be able to make treatment propositions and estimate their expected benefit (e.g. by reinforcement learning). Thus, in future, shared decision-making will not only include the patient’s opinion and the rheumatologist’s empirical and evidence-based experience, but it will also be influenced by machine-learned evidence.
Distinction through Religious Activism: How Capital Shapes the Organizational Repertoires of Transnational Protestant Outreach
Authors: Bok Jared
Published: February 2020

How religious organizations distinguish themselves from one another influences the extent to which they compete (or cooperate) with other similar organizations, thus serving to shape both their survivability and efficacy in achieving their goals. Although theological differences provide one source of distinction, organizations also strategically distinguish themselves not only by what they do but also what they avoid doing. Adopting a Bourdieu(s)ian field theory approach to the study of transnational American Protestant mission agencies, this article explores how agencies’ ministry activities are organized into symbolically distinctive repertoires of activism that vary by agencies’ differing levels of religious and economic capital. Based on how these repertoires are diversified (versus concentrated) and focused on inner- (as opposed to other-worldly) goals, the article discusses the implications of these organizational patterns for the survivability and efficacy of agencies in the transnational missions field, as well as their prospects for interorganizational cooperation and coordination.
The Influence of Social Exclusion on Posttraumatic Stress Reactions in Older Adult Veterans
Authors: Olson Mark D
Published: February 2020

The relationship between social exclusion and posttraumatic stress reactions in aging veterans is a particularly timely issue, warranting greater attention in the social work literature. Research with military veterans indicates that the social marginalization resulting from racial and ethnic discrimination can exacerbate posttraumatic stress symptoms. This marginalization suggests an increased potential for emergent or recurrent trauma reactions in aging military veterans, as previous research has documented older adults’ unique risk for social exclusion. The issue takes on greater relevance as increased numbers of Vietnam veterans enter older adulthood. Professionals working with military veterans should be aware of the social and cultural factors that play a critical role in posttrauma response and recovery.
Conception and viable twin pregnancy in a patient with metastatic melanoma while treated with CTLA-4 and PD-1 checkpoint inhibition
Authors: Bucheit Amanda D. , Hardy John T. , Szender J. Brian , Glitza Oliva Isabella C.
Published: February 2020

The treatment of cancer during pregnancy presents a unique challenge. Optimal treatments are often altered or even delayed to protect fetal growth and organogenesis. The landscape of cancer treatment has shifted dramatically over the past several years and treatment with checkpoint inhibitors, including anti-PD1 and anti-CTLA-4 agents has revolutionized treatment outcomes for patients across numerous tumor types. Until recently, little is known about the use of checkpoint inhibitor therapy during pregnancy; however, in animal studies, exposure to checkpoint inhibitors at the time of or after conception led to high incidences of spontaneous abortion, stillbirth, and premature delivery. In this report, we describe the successful pregnancy and clinical course of a patient diagnosed with metastatic melanoma who conceived twins while undergoing dual checkpoint blockade with ipilumumab and nivolumab. While there are case reports of patients receiving checkpoint inhibitors during pregnancy, our case is the first to describe a successful pregnancy that was conceived during treatment with combination anti-CTLA-4 and PD-1, with therapy continuing throughout pregnancy. This case adds to the growing evidence that favorable pregnancy outcomes may be possible while receiving checkpoint inhibition, which will hopefully allow for more optimal treatment of young pregnant patients with cancer.
Update of the position paper on arterial hypertension and erectile dysfunction
Authors: Viigimaa Margus , Vlachopoulos Charalambos , Doumas Michael , Wolf Jacek , Imprialos Konstantinos , Terentes-Printzios Dimitios , Ioakeimidis Nikolaos , Kotsar Andres , Kiitam Urmo , Stavropoulos Konstantinos , Narkiewicz Krzysztof , Manolis Athanasios , Jelakovic Bojan. , Lovic Dragan , Kreutz Reinhold , Tsioufis Konstantinos , Mancia Giuseppe
Published: February 2020

Sexual health is an integral part of overall health, and an active and healthy sexual life is an essential aspect of a good life quality. Cardiovascular disease and sexual health share common risk factors (arterial hypertension, diabetes mellitus, dyslipidemia, obesity, and smoking) and common mediating mechanisms (endothelial dysfunction, subclinical inflammation, and atherosclerosis). This generated a shift of thinking about the pathophysiology and subsequently the management of sexual dysfunction. The introduction of phosphodiesterase type 5 inhibitors revolutionized the management of sexual dysfunction in men. This article will focus on erectile dysfunction and its association with arterial hypertension. This update of the position paper was created by the Working Group on Sexual Dysfunction and Arterial Hypertension of the European Society of Hypertension. This working group has been very active during the last years in promoting the familiarization of hypertension specialists and related physicians with erectile dysfunction, through numerous lectures in national and international meetings, a position paper, newsletters, guidelines, and a book specifically addressing erectile dysfunction in hypertensive patients. It was noted that erectile dysfunction precedes the development of coronary artery disease. The artery size hypothesis has been proposed as a potential explanation for this observation. This hypothesis seeks to explain the differing manifestation of the same vascular condition, based on the size of the vessels. Clinical presentations of the atherosclerotic and/or endothelium disease in the penile arteries might precede the corresponding manifestations from larger arteries. Treated hypertensive patients are more likely to have sexual dysfunction compared with untreated ones, suggesting a detrimental role of antihypertensive treatment on erectile function. The occurrence of erectile dysfunction seems to be related to undesirable effects of antihypertensive drugs on the penile tissue. Available information points toward divergent effects of antihypertensive drugs on erectile function, with diuretics and beta-blockers possessing the worst profile and angiotensin receptor blockers and nebivolol the best profile.
VALIDATION OF THE RECENTLY DEVELOPED ATN CLASSIFICATION AND GRADING SYSTEM FOR MYOPIC MACULOPATHY
Authors: Ruiz-Medrano Jorge , Flores-Moreno Ignacio , Ohno-Matsui Kyoko , Cheung Chui Ming Gemmy , Silva Rufino , Ruiz-Moreno José M.
Published: February 2020

Purpose:

To validate the recently developed ATN grading system for myopic maculopathy to classify eyes with pathologic myopia.

Methods:

Cross-sectional study. A series of consecutive eyes diagnosed with pathologic myopia and signs of myopic maculopathy (grade ≥1 for atrophic, tractional, or neovascular components of the ATN), with a refractive error > −6.0 diopters (D), were included. All patients underwent complete ophthalmological examination including fundus photography and swept-source optical coherence tomography. Six observers graded each eye twice using the ATN system (≥15 days between assessments) based only on the aforementioned data.

Results:

Sixty eyes from 47 patients (61.7% female) were graded. Mean patient age was 63.2 ± 11.7 years. The mean spherical equivalent was −13.8 ± 6.5 D. Mean axial length was 28.6 ± 2.16 mm. Overall, the mean intraobserver agreement (%) for the same image was 92.0%, and the mean interobserver agreement for the second image was 77.5%. The weighted Fleiss k showed excellent correlation (k > 0.8) for the traction and neovascularization components and good correlation (0.75) for atrophy. Interobserver agreement for each of these three components was 95.2%, 98.4%, 95.0%, respectively.

Conclusion:

Application of the ATN resulted in high intraobserver and interobserver correlation, underscoring the reproducibility of the system.
Herpes Simplex DNA in Tears of Atypical Dendritic Keratitis and Multiple Punctate Subepithelial Stromal Opacity: A Case Report
Authors: Hirota Akira , Inada Noriko , Shiraki Yukiko , Shoji Jun , Yamagami Satoru
Published: February 2020

Purpose:

To report an atypical presentation of herpes simplex virus (HSV) keratitis followed up using expression levels of HSV DNA in tears.

Methods:

A 22-year-old Japanese woman with hyperemia and foreign body sensation in her left eye was diagnosed with atypical dendritic keratitis. A slit-lamp examination at presentation indicated the presence of a rush of dendritic lesions with a sparse branching pattern and poor development of terminal bulbs; follicular conjunctivitis was also observed. Positivity for house-dust-mite- and cedar pollen-specific IgE antibodies in her serum indicated atopic diathesis. The HSV DNA levels in her tears were measured by a real-time polymerase chain reaction.

Results:

At the initial visit, the HSV DNA levels in tears were 6.4 × 102 copies/sample in the right eye and 1.6 × 105 copies/sample in the left eye. The keratitis improved after treatment with topical acyclovir ointment, 5 times a day for 7 days, and systemic valacyclovir 1000 mg/d for 5 days. Multiple punctate subepithelial opacities developed in her left eye on day 7, with undetectable HSV DNA in tears, bilaterally.

Conclusions:

We have successfully monitored the HSV DNA levels in tears using quantitative real-time polymerase chain reaction in HSV keratitis where the corneal findings progressed from atypical dendritic keratitis to multiple punctate corneal subepithelial opacities during the treatment period.
MicroRNAs as potential therapeutic targets for muscle wasting during cancer cachexia
Authors: Sannicandro Anthony J. , McDonagh Brian , Goljanek-Whysall Katarzyna
Published: February 2020

Purpose of review

Muscle wasting in cancer cachexia remains an unmet clinical need due to lack of effective therapies associated with the complexity of the disease. Here, we discuss microRNAs, robust regulators of the expression of multiple genes, only recently characterized in cancer cachexia in humans and their therapeutic potential for muscle wasting.

Recent findings

Changes in microRNAs in muscle of cancer patients have been demonstrated for the first time and these are associated with dysregulated signalling networks during muscle wasting. These data, together with studies in animal models, indicate that microRNAs are attractive therapeutic candidates for maintaining muscle mass, both during and following cancer treatment ultimately improving patient outcomes.

Cancer cachexia is a complex metabolic condition associated with muscle wasting. Maintenance of muscle mass in cancer patients can improve their response to therapy and prognosis. microRNAs, which can act as oncogenes or tumour suppressors, are also dysregulated in muscle of cachexia patients. Studies in animal models of muscle wasting have demonstrated that microRNAs regulate muscle mass and strength. With more microRNA-based therapeutics in clinical trials and first RNA drugs approved, microRNAs present an attractive novel therapeutic avenue for maintaining muscle homeostasis in cachexia patients to improve their prognosis.
Increased-risk donors and solid organ transplantation: current practices and opportunities for improvement
Authors: Brown Craig S. , Wakam Glenn K. , Englesbe Michael J.
Published: February 2020

Purpose of review

The development and implementation of ‘increased risk donor’ (IRD) status by the Centers for Disease Control (CDC) was intended to guide patients and providers in decision making regarding risk of infectious transmission via solid organ transplantation. Several contemporary studies have shown underutilization of these organs. This review summarizes the issues surrounding IRD status as well as recent advances in our understanding of the risks and benefits of increased risk organs and their appropriate utilization.

Recent findings

Risk of window-period infection remains exceedingly low, and implementation of nucleic acid testing for HIV and hepatitis C virus (HCV) has resulted in decreasing risk of window-period infection often by an order of magnitude or more. Surgeons remain hesitant to utilize IRD organs. In addition, surgeon assessment of risk by donor behaviour was often discordant with known risks of those behaviours. Studies investigating outcomes of utilization of IRD organs suggest long-term mortality and graft survival is at least equivalent to non-IRD organs. Contemporary results suggest that IRD organs continue to be underutilized, particularly adult kidneys and lungs, with hundreds of wasted organs per year.

CDC IRD labelling has led to an underutilization of organs for transplantation. The risks associated with acceptance of an IRD organ are inflated by surgeons and patients, and outcomes for patients who undergo transplantation with increased risk organs are similar to or better than those for patients whom accept standard risk organs. The rate of transmission of window-period infection from IRD organs is exceptionally low. The harms regarding the utility of Public Health Service increased risk classification outweigh the benefits for patients in need of transplant.
Vaginal Microbiota and Mucosal Immune Markers in Women With Vulvovaginal Discomfort
Authors: Mitchell Caroline M. , Watson LaTina , Mitchell Alissa J. , Hyrien Ollivier , Bergerat Agnes , Valint D.J. , Pascale Alisa , Hoffman Noah , Srinivasan Sujatha , Fredricks David N.
Published: February 2020

Background

Up to 30% of women with vaginal symptoms are not assigned a diagnosis after standard diagnostic assessment.

Methods

We compared premenopausal women with idiopathic vaginitis (IV) or vulvodynia (VVD) to healthy controls. Microbiota were characterized using rRNA sequencing. Cytokines/chemokines (IL-10, IL-1α, IL-1β, IL-6, IL-8, IL-2, IL-18, IL-4, IL-9, and IL-13) were measured in vaginal lavage fluid using the Meso Scale Discovery platform or ELISA (IL-1ra). Immunoglobulins were measured in vaginal lavage fluid using a bead-based immunoassay (Millipore). Cases and controls were compared using Kruskal-Wallis, analysis of variance, and linear regression or (for microbiome composition) the Bray-Curtis dissimilarity statistic.

Results

We compared 20 women with IV, 30 with VVD, and 52 controls. Most (80%) had greater than 90% 16S rRNA gene sequences from Lactobacillus crispatus, L. jensenii, L. gasseri, or L. iners. In analyses adjusted for age and hormonal contraception (HC), Gardnerella vaginalis was less prevalent and abundant in women with VVD (2/30, 7%) versus controls (16/52, 31%) or IV (5/20, 25%) (P = 0.030). Bray-Curtis dissimilarity was not significantly different between IV and controls or VVD. Fungal sequences were only detected in 5 participants: 2 control, 1 IV, 2 VVD. In univariate analysis, cytokines were not associated with diagnosis. Median vaginal concentration of IgE (but not other immunoglobulins) was lower in women with VVD (P = 0.006).

Conclusions

Minimal differences in vaginal microbiota and inflammatory markers between women with IV, VVD or controls suggest no striking association between vaginal bacteria, fungi or inflammation and diagnosis in these women.
Frequency of Sexually Transmitted Infection/HIV Testing Among Commercially Insured Patients With International Classification of Disease Tenth Revision Specified Sex Partners
Authors: Kumar Sagar , Patel Chirag , Tao Guoyu
Published: February 2020

Background

High-risk sexual behaviors (HRSB) are associated with sexually transmitted infections (STIs). The Centers for Disease Control and Prevention and US Preventive Services Task Force recommend routine testing for patients with HRSB. Providers can classify patients with HRSB based on the sex of their sex partners using the International Classification of Disease Tenth Revision. We analyzed STI/human immunodeficiency virus (HIV) testing frequencies among patients with HRSB.

Methods

This study used a large US administrative outpatient medical claims data set from 2015 to 2017. Patients aged 15 to 64 years were identified with HRSB using International Classification of Disease Tenth Revision codes. An initial HRSB diagnosis in 2016 served as the index date. We assessed chlamydia, gonorrhea, syphilis, and HIV testing by HRSB at the index date, and 4 time intervals of 1 to 6 months, and 7 to 12 months before and after the index date.

Results

We identified 52,160 patients with HRSB: 90.3% were patients with opposite-sex partners, 7.7% patients with same-sex partners, and 2.1% patients with same- and opposite-sex partners. There were 77.5% and 82.1% of the patients insured 6 months before and after the index, respectively. On the index date, patients with opposite-sex partners tested most for chlamydia (65.3%) and gonorrhea (65.2%), patients with same-sex partners tested most for syphilis (51.5%) and HIV (57.8%). Among insured patients, follow-up STI/HIV testing was 89.5% during 1 to 6 months and 33.1% during 7 to 12 months after the index date. Patients tested on the index date were more likely to have an STI/HIV test within 1 to 6 months after the index date.

Conclusions

The STI/HIV testing among patients with HRSB could improve. It is important for patients identified as HRSB to get tested and continue testing patients based on recommendations.
Improving HIV outreach testing yield at cross-border venues in East Africa
Authors: Edwards Jessie K. , Arimi Peter , Ssengooba Freddie , Herce Michael E. , Mulholland Grace , Markiewicz Milissa , Babirye Susan , Ssendagire Steven , Weir Sharon S.
Published: February 2020

Objective:

The aim of this study was to evaluate HIV testing yield under several candidate strategies for outreach testing at venues (i.e. places where people socialize and meet new sex partners) in East Africa cross-border areas.

Design:

Population-based cross-sectional biobehavioural survey of people who had not been previously diagnosed with HIV found in venues.

Methods:

We identified participants who would have been tested for HIV under each of 10 hypothetical outreach testing strategies and calculated the proportion who would have newly tested positive for HIV under each strategy. On the basis of this proportion, we calculated the ‘number needed to test’ (NNT) to identify one new case of HIV under each strategy. All estimates were obtained by applying survey sampling weights to account for the complex sampling design.

Results:

If testing was performed at a random sample of venues, 35 people would need to be tested to identify one new case of HIV, but higher yield could be found by limiting testing to venues with specific characteristics. Strategies focusing on women had higher testing yield. Testing women employed by venues would result in highest yield of all strategies examined (NNT = 15), while testing men under age 24 would result in the lowest yield (NNT = 99).

Conclusion:

Quantitatively evaluating HIV testing strategies prior to implementation using survey data presents a new opportunity to refine and prioritize outreach testing strategies for the people and places most likely to result in high HIV testing yield.
Establishing Reference Intervals for Gadolinium Concentrations in Blood, Plasma, and Urine in Individuals Not Previously Exposed to Gadolinium-Based Contrast Agents
Authors: Layne Kerry A. , Wood David M. , Dixon-Zegeye Miriam , Archer John R.H. , Raja Kishor , Dargan Paul I.
Published: February 2020

Objectives

Over the recent years, there have been increasing concerns that exposure to gadolinium-based contrast agents (GBCAs) may be associated with retention of Gd within the skin, bones, and solid organs in patients with normal renal function, although the clinical implications of this deposition remain to be established. There are no published data available to guide the development of reference intervals for Gd concentrations in biological samples from healthy people. The aims of this study were to (1) determine whether healthy individuals who have not received GBCAs have detectable concentrations of Gd in their blood and urine, and (2) to develop a reference range for Gd concentrations in blood and spot urine samples for healthy individuals.

Materials and Methods

Whole blood, plasma, and spot urine samples were taken from 120 healthy volunteers with estimated glomerular filtration rate 70 mL/min per 1.73 m2 or greater. Gd concentrations were measured in these samples using inductively coupled plasma mass–spectrometry. The reference intervals for Gd concentrations in whole blood, plasma, and urine were estimated as the 2.5th percentile and the upper reference limit as the 97.5th percentile.

Results

Ten (8.33%) of the 120 subjects had detectable concentrations of Gd in their whole blood (n = 5) or spot urine (n = 5) samples; no subjects had detectable concentrations of Gd in their plasma samples. Our proposed reference intervals for Gd are as follows: whole blood, <0.008 ng/mL or <0.050 nmol/L; plasma, <0.009 ng/mL or <0.057 nmol/L; spot urine, <0.036 μg/g or <0.0250 nmol/mmol.

Conclusions

The results of this study provide reference intervals for whole blood, plasma, and urine Gd concentrations in healthy subjects who have not previously received GBCAs and will assist clinicians in assessing patients who have concerns regarding potential Gd retention postexposure and help guide further clinical studies to explore the pharmacokinetics of GBCAs in patients with normal renal function.
Simulating and Forecasting the Cumulative Confirmed Cases of SARS-CoV-2 in China by Boltzmann Function-based Regression Analyses
Authors: Fu Xinmiao , Ying Qi , Zeng Tieyong , Long Tao , Wang Yan
Published: February 2020

An ongoing outbreak of atypical pneumonia caused by the 2019 novel coronavirus (SARS-CoV-2) is hitting Wuhan City and has spread to other provinces/cities of China and overseas. It very urgent to forecast the future course of the outbreak. Here, we provide an estimate of the potential total number of confirmed cases in mainland China by applying Boltzmann-function based regression analyses. We found that the cumulative number of confirmed cases from Jan 21 to Feb 14, 2020 for mainland China, Hubei Province, Wuhan City and other provinces were all well fitted with the Boltzmann function (R2 being close to 0.999). The potential total number of confirmed cases in the above geographic regions were estimated at 95% confidence interval (CI) as 79589 (71576, 93855), 64817 (58223, 77895), 46562 (40812, 57678) and 13956 (12748, 16092), respectively. Notably, our results suggest that the number of daily new confirmed cases of SARS-CoV-2 in mainland China (including Hubei Province) will become minimal between Feb 28 and Mar 10, 2020, with 95% CI. In addition, we found that the data of cumulative confirmed cases of 2003 SARS-CoV in China and Worldwide were also well fitted to the Boltzmann function. To our knowledge this is the first study revealing that the Boltzmann function is suitable to simulate epidemics. The estimated potential total number of confirmed cases and key dates for the SARS-CoV-2 outbreak may provide certain guidance for governments, organizations and citizens to optimize preparedness and response efforts.
Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients
Authors: Liu Jing , Li Sumeng , Liu Jia , Liang Boyun , Wang Xiaobei , Wang Hua , Li Wei , Tong Qiaoxia , Yi Jianhua , Zhao Lei , Xiong Lijuan , Guo Chunxia , Tian Jin , Luo Jinzhuo , Yao Jinghong , Pang Ran , Shen Hui , Peng Cheng , Liu Ting , Zhang Qian , Wu Jun , Xu Ling , Lu Sihong , Wang Baoju , Weng Zhihong , Han Chunrong , Zhu Huabing , Zhou Ruxia , Zhou Helong , Chen Xiliu , Ye Pian , Zhu Bin , He Shengsong , He Yongwen , Jie Shenghua , Wei Ping , Zhang Jianao , Lu Yinping , Wang Weixian , Zhang Li , Li Ling , Zhou Fengqin , Wang Jun , Dittmer Ulf , Lu Mengji , Hu Yu , Yang Dongliang , Zheng Xin
Published: February 2020

Background

The dynamic changes of lymphocyte subsets and cytokines profiles of patients with novel coronavirus disease (COVID-19) and their correlation with the disease severity remain unclear.

Methods

Peripheral blood samples were longitudinally collected from 40 confirmed COVID-19 patients and examined for lymphocyte subsets by flow cytometry and cytokine profiles by specific immunoassays.

Results

Of the 40 COVID-19 patients enrolled, 13 severe cases showed significant and sustained decreases in lymphocyte counts but increases in neutrophil counts than 27 mild cases. Further analysis demonstrated significant decreases in the counts of T cells, especially CD8 + T cells, as well as increases in IL-6, IL-10, IL-2 and IFN-γ levels in the peripheral blood in the severe cases compared to those in the mild cases. T cell counts and cytokine levels in severe COVID-19 patients who survived the disease gradually recovered at later time points to levels that were comparable to those of the mild cases. Moreover, the neutrophil-to-CD8+ T cell ratio (N8R) were identified as the most powerful prognostic factor affecting the prognosis for severe COVID-19.

Conclusions

The degree of lymphopenia and a proinflammatory cytokine storm is higher in severe COVID-19 patients than in mild cases, and is associated with the disease severity. N8R may serve as a useful prognostic factor for early identification of severe COVID-19 cases.

Lymphocyte subsets and cytokine profiles in the peripheral blood of COVID-19 patients were longitudinally characterized. The study revealed the kinetics features of immune parameters associated with the disease severity and identified N8R as a useful prognostic factor for predicting severe COVID-19 cases.
First pump–probe–probe hard X-ray diffraction experiments with a 2D hybrid pixel detector developed at the SOLEIL synchrotron
Authors: Bachiller-Perea Diana , Abiven Yves-Marie , Bisou Jérôme , Fertey Pierre , Grybos Pawel , Jarnac Amélie , Kanouté Brahim , Koziol Anna , Langlois Florent , Laulhé Claire , Legrand Fabien , Maj Piotr , Menneglier Claude , Noureddine Arafat , Orsini Fabienne , Thibaux Gauthier , Dawiec Arkadiusz
Published: February 2020

A new photon-counting camera based on hybrid pixel technology has been developed at the SOLEIL synchrotron, making it possible to implement pump–probe–probe hard X-ray diffraction experiments for the first time. This application relies on two specific advantages of the UFXC32k readout chip, namely its high frame rate (50 kHz) and its high linear count rate (2.6 × 106 photons s−1 pixel−1). The project involved the conception and realization of the chips and detector carrier board, the data acquisition system, the server with its specific software, as well as the mechanical and cooling systems. This article reports on in-laboratory validation tests of the new detector, as well as on tests performed at the CRISTAL beamline within the targeted experimental conditions. A benchmark experiment was successfully performed, showing the advantages of the pump–probe–probe scheme in correcting for drifts of the experimental conditions.
Tomographic reconstruction with a generative adversarial network
Authors: Yang Xiaogang , Kahnt Maik , Brückner Dennis , Schropp Andreas , Fam Yakub , Becher Johannes , Grunwaldt Jan-Dierk , Sheppard Thomas L. , Schroer Christian G.
Published: February 2020

This paper presents a deep learning algorithm for tomographic reconstruction (GANrec). The algorithm uses a generative adversarial network (GAN) to solve the inverse of the Radon transform directly. It works for independent sinograms without additional training steps. The GAN has been developed to fit the input sinogram with the model sinogram generated from the predicted reconstruction. Good quality reconstructions can be obtained during the minimization of the fitting errors. The reconstruction is a self-training procedure based on the physics model, instead of on training data. The algorithm showed significant improvements in the reconstruction accuracy, especially for missing-wedge tomography acquired at less than 180° rotational range. It was also validated by reconstructing a missing-wedge X-ray ptychographic tomography (PXCT) data set of a macroporous zeolite particle, for which only 51 projections over 70° could be collected. The GANrec recovered the 3D pore structure with reasonable quality for further analysis. This reconstruction concept can work universally for most of the ill-posed inverse problems if the forward model is well defined, such as phase retrieval of in-line phase-contrast imaging.
Adoption of internet of things (IoT) in the agriculture industry deploying the BRT framework
Authors: Pillai Rajasshrie , Sivathanu Brijesh
Published: February 2020

Purpose

The purpose of this paper is to investigate the adoption of Internet of Things (IoT) in the agriculture industry by the farmers' in India using the theoretical lens of the behavioral reasoning theory (BRT).

Design/methodology/approach

A survey on farmers was conducted to examine the adoption of IoT in agriculture industry (IoT-A) using BRT. The data analysis of the primary survey was done by applying the structural equation modelling (SEM) technique.

Findings

The ‘reasons for’ adoption of IoT-A were as follows: Relative advantage, social influence, perceived convenience, and perceived usefulness. The ‘reasons against’ adoption were as follows: Image barrier, technological anxiety, perceived price and perceived risk. The BRT theory provides the platform to discuss the psychological processing of acceptance of IoT in agriculture industry by the farmers.

Practical implications

This research has unique implications as it studies the rural consumers’ behavior of innovation adoption namely IoT in agriculture. It provides the specific reasons ‘for’ and ‘against’ IoT adoption in agriculture, which will give directions to the marketers of IoT technology to develop suitable marketing strategies to improve the adoption in rural areas.

Originality/value

This research takes the first step in the direction toward deliberation of the adoption of IoT-A by farmers in an emerging Indian economy using the BRT theory, which discusses the ‘reasons for’ and ‘reasons against’ adoption in a proposed model.
Empowerment through induction: supporting the well-being of beginning teachers
Authors: Wilcoxen Chris , Bell Julie , Steiner Amanda
Published: February 2020

Purpose

The purpose of this paper is to explore ways teachers undergoing induction via the Career Advancement and Development of Recruits and Experienced (CADRE) Teachers Project felt empowered and supported in their well-being through mentoring and coaching.

Design/methodology/approach

Surveys about CADRE Project impact were e-mailed to 675 current and former participants. Out of 438 surveys returned, researchers used homogeneous sampling to identify 341 teacher respondents. Researchers used qualitative thematic analysis to determine ways teachers felt supported.

Findings

Coaching and mentoring supported CADRE Project participants’ well-being through empowerment (theme). Sub-themes included: growth, collaboration, networking, improvement and resources.

Research limitations/implications

Possibilities for future research include exploring the role of mentors/coaches, tracking teachers’ leadership roles and investigating the link between induction and teacher retention in more detail.

Practical implications

Opportunities for growth and collaboration are cornerstones of first-year teacher support. These support systems can lead to a sense of belonging, develop a mindset for continuous improvement and create long-term networking opportunities. The support teachers need to empower them and maintain their well-being changes with each first-year teacher phase.

Originality/value

Few studies exist on induction programs with the longevity of the CADRE Project. The high survey response rate with overwhelmingly positive responses suggests that CADRE is unique in its support of beginning teachers’ well-being through the first-year teacher phases, specifically due to the combination of mentoring and coaching beginning teachers receive.
Design and evaluation of an ontology-based tool for generating multiple-choice questions
Authors: Cubric Marija , Tosic Milorad
Published: February 2020

Purpose

The recent rise in online knowledge repositories and use of formalism for structuring knowledge, such as ontologies, has provided necessary conditions for the emergence of tools for generating knowledge assessment. These tools can be used in a context of interactive computer-assisted assessment (CAA) to provide a cost-effective solution for prompt feedback and increased learner’s engagement. The purpose of this paper is to describe and evaluate a tool developed by the authors, which generates test questions from an arbitrary domain ontology, based on sound pedagogical principles encapsulated in Bloom’s taxonomy.

Design/methodology/approach

This paper uses design science as a framework for presenting the research. A total of 5,230 questions were generated from 90 different ontologies and 81 randomly selected questions were evaluated by 8 CAA experts. Data were analysed using descriptive statistics and Kruskal–Wallis test for non-parametric analysis of variance.

Findings

In total, 69 per cent of generated questions were found to be useable for tests and 33 per cent to be of medium to high difficulty. Significant differences in quality of generated questions were found across different ontologies, strategies for generating distractors and Bloom’s question levels: the questions testing application of knowledge and the questions using semantic strategies were perceived to be of the highest quality.

Originality/value

The paper extends the current work in the area of automated test generation in three important directions: it introduces an open-source, web-based tool available to other researchers for experimentation purposes; it recommends practical guidelines for development of similar tools; and it proposes a set of criteria and standard format for future evaluation of similar systems.
Manufacturing and selling tactics for a green supply chain under a green cost sharing and a refund agreement
Authors: Taleizadeh Ata Allah , Noori-Daryan Mahsa , Sana Shib Sankar
Published: February 2020

Purpose

This paper aims to deal with optimal pricing and production tactics for a bi-echelon green supply chain, including a producer and a vendor in presence of three various scenarios. Demand depends on a price, refund and quality where the producer controls quality and the vendor proposes a refund policy to purchasers to encourage them to order more.

Design/methodology/approach

In the first scenario, the members seek to optimize their optimum decision variables under a centralized decision-making method while in the second scenario, a decentralized system is assumed where the members make a decision about variables and profits under a non-cooperative game. In the third scenario, a cost-sharing agreement is concluded between the members to provide a high-quality item to the purchasers.

Findings

The performance of the proposed model is investigated by illustrating a numerical example. A sensitivity analysis of some key parameters has been done to study the effect of the changes on the optimal values of the decision variables and profits. From sensitivity analysis, the real features are observed and mentioned in this section.

Originality/value

This research examines the behavior of partners in a green supply chain facing with a group of purchasers whose demand is the function of a price, greenery degree and refund rate. This proposed mathematical model is developed and analyzed which has an implication in supply chain model.
Followers’ reactions to influencers’ Instagram posts
Authors: Belanche Daniel , Flavián Marta , Ibáñez-Sánchez Sergio
Published: February 2020

Purpose

The purpose of this study is to analyze how positive behaviors toward influencers (customer interaction) and promoted products (looking for product information) can be achieved, taking into account influencer–product fit, in a fashion marketing campaign. In addition, account following and product involvement are examined as possible moderators in these relationships.

Design/methodology/approach

The data were gathered from online participants. The participants were Instagram users who already knew a popular influencer on the platform. The experimental design manipulated the types of picture posted by the influencer to observe customers’ reactions in terms of intention to interact with the influencer’s account and to look for further information about promoted products.

Findings

The authors’ findings suggested that influencer–product matches in posts on Instagram encourage users to search for information about promoted products but do not affect their intention to interact with influencers’ accounts. Nevertheless, customers’ reactions toward an influencer’s posts differ based on whether they are followers of the influencer and whether they are highly or lowly involved with the promoted product.

Practical implications

Both brands and influencers should properly manage influencer marketing actions. Brands should control influencers’ audiences and their involvement with featured products so that they are seen to promote them in a natural way. Influencers should endorse branded products that fit their own style; this will increase the interaction on their accounts.

Originality/value

This research contributes to a better understanding of how users can be encouraged to undertake positive online actions as regards influencers (interaction with their accounts) and promoted products (information search) in influencer marketing campaigns.