bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of digital communication on adolescent to adult mental health service transitions
Authors: Martin Rosie , Sturt Jackie , Griffiths Frances
Published: May 2020

Background

Inaccessible services and poor communication are barriers to successful transitions between adolescent and adult mental health services, for which digital communications (DC) offer a possible solution.

Aims

To investigate the role of DC, including smartphone apps, email and text, given the known barriers and facilitators of mental health service transitions reported in the literature.

Methods

Use of Neale’s (2016) iterative categorisation technique to undertake a secondary analysis of qualitative data collected for the Long-term conditions Young people Networked Communication (LYNC) study.

Results

DC were used successfully by young people and staff in ways that ameliorated known barriers to service transitions. They engendered responsibility in young people, promoted service access and contributed to client safety, particularly in times of crisis. DC risks included over-familiarity between young people and staff, and the possibility that messages could go unread.

Conclusions

DC have the potential to facilitate trust and familiarity during and after transition to adult mental health services. They can strengthen young people’s perceptions of adult services as supportive, empowering and available. DC can be used for frequent ‘check-ins’ and remote digital support for social and personal problems. They provide an additional safety net for at-risk individuals, but require careful boundary setting.
Mortality risk scoring in emergency general surgery: Are we using the best tool?
Authors: Thahir Azeem , Pinto-Lopes Rui , Madenlidou Stavroula , Daby Laura , Halahakoon Chandima
Published: May 2020

Background

It is imperative that an accurate assessment of risk of death is undertaken preoperatively on all patients undergoing an emergency laparotomy. Portsmouth-Physiological and Operative Severity Score for the enumeration of Mortality and Morbidity (P-POSSUM) is one of the most widely used scores. National Emergency Laparotomy Audit (NELA) presents a novel, validated score, but no direct comparison with P-POSSUM exists. We aimed to determine which would be the best predictor of mortality.

Methods

We analysed all the entries on the online NELA database over a four-and-a-half-year period. The Hosmer–Lemeshow goodness of fit test was performed to assess model calibration. For the outcome of death and for each scoring system, a non-parametric receiver operator characteristic analysis was done. The sensitivity, specificity, area under receiver operator characteristic curve and their standard errors were calculated.

Results

Data pertaining to 650 patients were included. There were 59 deaths, giving an overall observed mortality rate of 9.1%. Predicted mortality rate for the P-POSSUM score and NELA score were 15.2% and 7.8%, respectively. The discriminative power for mortality was highest for the NELA score (C-index = 0.818, CI: 0.769–0.867, p < 0.001), when compared to P-POSSUM (C-index = 0.769, CI: 0.712–0.827, p < 0.001).

Conclusions

The NELA score showed good discrimination in predicting mortality in the entire cohort. The P-POSSUM over-predicted observed mortality and the NELA score under-predicted observed mortality.
Developing a strategy to improve data sharing in health research: A mixed-methods study to identify barriers and facilitators
Authors: Krahe Michelle A , Wolski Malcolm , Mickan Sharon , Toohey Julie , Scuffham Paul , Reilly Sheena
Published: May 2020

Background:

Data sharing presents new opportunities across the spectrum of research and is vital for science that is open, where data are easily discoverable, accessible, intelligible, reproducible, replicable and verifiable. Despite this, it is yet to become common practice. Global efforts to develop practical guidance for data sharing and open access initiatives are underway, however evidence-based studies to inform the development and implementation of effective strategies are lacking.

Objective:

This study sought to determine the barriers and facilitators to data sharing among health researchers and to identify the target behaviours for designing a behaviour change intervention strategy.

Method:

Data were drawn from a cross-sectional survey of data management practices among health researchers from one Australian research institute. Determinants of behaviour were theoretically derived using well-established behavioural models.

Results:

Data sharing practices have been described for 77 researchers, and 6 barriers and 4 facilitators identified. The primary barriers to data sharing included perceived negative consequences and lack of competency to share data. The primary facilitators to data sharing included trust in others using the data and social influence related to public benefit. Intervention functions likely to be most effective at changing target behaviours were also identified.

Conclusion:

Results of this study provide a theoretical and evidence-based process to understand the behavioural barriers and facilitators of data sharing among health researchers.

Implications:

Designing interventions that specifically address target behaviours to promote data sharing are important for open researcher practices.
Towards Legislative Institutionalisation? Emerging Patterns of Routinisation in Myanmar’s Parliament
Authors: Egreteau Renaud
Published: May 2020

This article investigates the patterns of parliamentary change observed in Myanmar since a constitutionally sanctioned, partially elected legislature was revived in January 2011. In particular, it poses the question as to whether processes of legislative institutionalisation have taken place in the course of the 2010s. Grounded on ethnographic work carried out between 2013 and 2018 in Myanmar’s Union parliament, established in Naypyitaw, the article explores how in the two post-junta legislatures elected in 2010 and 2015 a number of institutional legacies and parliamentary procedures and functions have been both reintroduced and also reappropriated. The findings point to emerging patterns of routinisation of some legislative tasks and duties performed by neophyte lawmakers and parliamentary staff alike. It is argued that, despite persistent capacity and efficiency problems, and a continuing dominance of the executive and the armed forces in the post-junta context, a parliamentary culture has re-emerged in Myanmar. The article concludes by drawing attention to how a process of legislative institutionalisation has been developed, albeit cursorily.
Square peg versus a round hole? The Necessity of a Bill of Rights for Workers
Authors: Collins Philippa
Published: May 2020

The exercise of human rights is put at risk by the creation, conduct, and termination of employment relationships. For this reason, we often find that fundamental rights arguments are invoked in disputes between employers and workers and the mechanisms of labour and employment law are pressed to vindicate those rights through a process of ‘constitutionalisation’. Notably, the European Convention on Human Rights, through the doctrine of positive obligations, places important demands upon national legal systems, their legislators and their judges, to protect the rights of individuals against other private parties. Taking the law of dismissal in England & Wales as an illustrative example, this article argues that the current approach to safeguarding workers’ rights and complying with the Convention’s positive obligations is inadequate. Making adjustments to the existing structure of employment rights will always be insufficiently radical as those structures are ill-suited to performing this function, their limitations are systemic and furthermore the judiciary is unwilling to disrupt the established analytical approach. Instead, I propose and detail an alternative solution: introducing a Bill of Rights that would render the rights of the European Convention enforceable between worker and employer.
School Counselors’ Experiences With the Section 504 Process: “I want to be a strong team member…[not] a case manager”
Authors: Goodman-Scott Emily , Boulden Rawn
Published: May 2020

In response to a gap in the literature and to inform school counseling practice, we conducted a phenomenological study of school counselors in five states and 10 school districts, examining their experiences with Section 504 of the Rehabilitation Act of 1973 in pre-K–12 schools. Overall, school counselors communicated challenges in their involvement with the 504 process including four themes: (a) time-consuming coordination/management; (b) relational strain with teachers, students, and families; (c) lack of expertise in Section 504; and (d) ambiguity of the Section 504 process. We discuss implications for practicing school counselors, school leaders, and school counselor educators centered on increased education, support, and advocacy.
The Impact of Televised Stereotypes on the State Self-Esteem of Latino/a Emerging Adults: The Moderating Role of Ethnic–Racial Identity
Authors: Shafer Jessie , Rivadeneyra Rocío
Published: May 2020

We investigated how stereotypical portrayals of Latino/a characters on television influence Latino/a emerging adults’ ( N = 136; ages 18–25) state self-esteem (i.e., social, appearance, and performance) while examining the moderating role of ethnic–racial identity (i.e., centrality). Latino/as from across the United States were randomly sorted into one of two conditions (exposure to stereotypes or not) and completed measures of ethnic–racial identity and state self-esteem. When not exposed to stereotypes, participants with higher ethnic–racial identity had higher social self-esteem. However, when exposed to stereotypes, Latino/a participants with higher ethnic–racial identity had significantly lower social self-esteem. This finding matches previous research on the role of social identity in stereotype threat, which found that those who more strongly identified with a stereotyped group were more negatively impacted by stereotypes of that group. However, in situations without stereotypes present, stronger ethnic–racial identity is connected to well-being.
Unsettling Entrepreneurship Education
Authors: Berglund Karin , Hytti Ulla , Verduijn Karen
Published: May 2020

This special issue confronts taken-for-granted views on entrepreneurship education (EE), raises critical questions both about EE and how it is taught, and allows investigations of the potential dark sides of entrepreneurship and EE. The contributions in this issue challenge our teaching positions and evoke a pedagogical approach to invention where curiosity, cocreation, though-provoking questions can follow.
Activation of PERK-ATF4-CHOP pathway as a novel therapeutic approach for efficient elimination of HTLV-1–infected cells
Authors: Ikebe Emi , Matsuoka Sahoko , Tezuka Kenta , Kuramitsu Madoka , Okuma Kazu , Nakashima Makoto , Kobayashi Seiichiro , Makiyama Junya , Yamagishi Makoto , Oyadomari Seiichi , Uchimaru Kaoru , Hamaguchi Isao
Published: May 2020

Patients with adult T-cell leukemia (ATL) exhibit a poor prognosis and overall survival rate when treated with standard chemotherapy, highlighting the continued requirement for the development of novel safe and effective therapies for human T-cell leukemia virus type 1 (HTLV-1)-related diseases. In this study, we demonstrated that MK-2048, a second-generation HIV-1 integrase (IN) inhibitor, potently and selectively kills HTLV-1–infected cells. Differential transcriptome profiling revealed significantly elevated levels of gene expression of the unfolded protein response (UPR) PKR-like ER kinase (PERK) signaling pathway in ATL cell lines following MK-2048 treatment. We also identified a significant downregulation in glucose regulated protein 78 (GRP78), a master regulator of the UPR in the CD4+CADM1+ HTLV-1–infected cell population of primary HTLV-1 carrier peripheral blood mononuclear cells (PBMCs) (n = 9), suggesting that HTLV-1–infected cells are hypersensitive to endoplasmic reticulum (ER) stress-mediated apoptosis. MK-2048 efficiently reduced proviral loads in primary HTLV-1 carrier PBMCs (n = 4), but had no effect on the total numbers of these cells, indicating that MK-2048 does not affect the proliferation of HTLV-1–uninfected PBMCs. MK-2048 specifically activated the ER stress–related proapoptotic gene, DNA damage-inducible transcript 3 protein (DDIT3), also known as C/EBP homologous protein (CHOP), in HTLV-1–infected but not uninfected cells of HTLV-1–carrier PBMCs. Our findings demonstrated that MK-2048 selectively induces HTLV-1–infected cell apoptosis via the activation of the UPR. This novel regulatory mechanism of the HIV IN inhibitor MK-2048 in HTLV-1–infected cells provides a promising prophylactic and therapeutic target for HTLV-1–related diseases including ATL.
Persistent exercise intolerance after pulmonary endarterectomy for chronic thromboembolic pulmonary hypertension
Authors: Ruigrok Dieuwertje , Meijboom Lilian J. , Nossent Esther J. , Boonstra Anco , Braams Natalia J. , van Wezenbeek Jessie , de Man Frances S. , Marcus J. Tim , Vonk Noordegraaf Anton , Symersky Petr , Bogaard Harm-Jan
Published: May 2020

Aim

Haemodynamic normalisation is the ultimate goal of pulmonary endarterectomy (PEA) for chronic thromboembolic pulmonary hypertension (CTEPH). However, whether normalisation of haemodynamics translates into normalisation of exercise capacity is unknown. The incidence, determinants and clinical implications of exercise intolerance after PEA are unknown. We performed a prospective analysis to determine the incidence of exercise intolerance after PEA, assess the relationship between exercise capacity and (resting) haemodynamics and search for preoperative predictors of exercise intolerance after PEA.

Methods

According to clinical protocol all patients underwent cardiopulmonary exercise testing (CPET), right heart catheterisation and cardiac magnetic resonance (CMR) imaging before and 6 months after PEA. Exercise intolerance was defined as a peak oxygen consumption (V′O2) <80% predicted. CPET parameters were judged to determine the cause of exercise limitation. Relationships were analysed between exercise intolerance and resting haemodynamics and CMR-derived right ventricular function. Potential preoperative predictors of exercise intolerance were analysed using logistic regression analysis.

Results

68 patients were included in the final analysis. 45 (66%) patients had exercise intolerance 6 months after PEA; in 20 patients this was primarily caused by a cardiovascular limitation. The incidence of residual pulmonary hypertension was significantly higher in patients with persistent exercise intolerance (p=0.001). However, 27 out of 45 patients with persistent exercise intolerance had no residual pulmonary hypertension. In the multivariate analysis, preoperative transfer factor of the lung for carbon monoxide (TLCO) was the only predictor of exercise intolerance after PEA.

Conclusions

The majority of CTEPH patients have exercise intolerance after PEA, often despite normalisation of resting haemodynamics. Not all exercise intolerance after PEA is explained by the presence of residual pulmonary hypertension, and lower preoperativeTLCOwas a strong predictor of exercise intolerance 6 months after PEA.
Withdrawal of inhaled corticosteroids in COPD: a European Respiratory Society guideline
Authors: Chalmers James D. , Laska Irena F. , Franssen Frits M.E. , Janssens Wim , Pavord Ian , Rigau David , McDonnell Melissa J. , Roche Nicolas , Sin Don D. , Stolz Daiana , Suissa Samy , Wedzicha Jadwiga , Miravitlles Marc
Published: May 2020

Inhaled corticosteroids (ICS) combined with bronchodilators can reduce the frequency of exacerbations in some patients with chronic obstructive pulmonary disease (COPD). There is evidence, however, that ICS are frequently used in patients where their benefit has not been established. Therefore, there is a need for a personalised approach to the use of ICS in COPD and to consider withdrawal of ICS in patients without a clear indication. This document reports European Respiratory Society recommendations regarding ICS withdrawal in patients with COPD.

Comprehensive evidence synthesis was performed to summarise all available evidence relevant to the question: should ICS be withdrawn in patients with COPD? The evidence was appraised using the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach and the results were summarised in evidence profiles. The evidence synthesis was discussed and recommendations formulated by a committee with expertise in COPD and guideline methodology.

After considering the balance of desirable and undesirable consequences, quality of evidence, and feasibility and acceptability of interventions, the guideline panel made: 1) conditional recommendation for the withdrawal of ICS in patients with COPD without a history of frequent exacerbations, 2) strong recommendation not to withdraw ICS in patients with blood eosinophil counts ≥300 eosinophils·µL−1and 3) strong recommendation to treat with one or two long-acting bronchodilators if ICS are withdrawn.

A conditional recommendation indicates that there was uncertainty about the balance of desirable and undesirable consequences of the intervention, and that well-informed patients may make different choices regarding whether to have or not have the specific intervention.
Effect of flaxseed oil supplementation on the erythrocyte membrane fatty acid composition and endocannabinoid system modulation in patients with coronary artery disease: a double-blind randomized controlled trial
Authors: Saleh-Ghadimi Sevda , Alizadeh Mohammad , Jafari-Vayghan Hamed , Darabi Masoud , Golmohammadi Ali , Kheirouri Sorayya
Published: May 2020

Background

The endocannabinoid system (ECS) overactivation, associated with increased inflammatory process, may act as a risk factor for coronary artery disease (CAD). Dietary fat may influence the ECS tone. The aim of the present study was to investigate the effect of flaxseed oil on the erythrocyte membrane fatty acid profile and ECS activity by the measurement of serum N-arachydonoil ethanolamine (AEA) and cannabinoid receptor type-1 (CB1), cannabinoid receptor type-2 (CB2), and fatty acid amide hydrolase (FAAH) mRNA expression.

Methods

This clinical trial was performed on 44 patients with CAD. The intervention group received 1.5% fat milk supplemented with flaxseed oil (containing 2.5 g α-linolenic acid or ALA), while the placebo group received 1.5% fat milk for 10 weeks. The fatty acid profile of erythrocyte membrane phospholipids was measured by gas chromatography. The AEA level was determined using an ELISA kit, and real-time PCR was performed to measure CB1, CB2, and FAAH mRNA expression pre- and post-intervention.

Results

Flaxseed oil supplementation resulted in a significant increase in the ALA content and a significant reduction in linoleic acid (LA) content of membrane phospholipids, compared to the placebo group (MD = − 0.35 and 2.89, respectively; P < 0.05). The within group analysis showed that flaxseed oil supplementation caused a significant reduction in both LA and arachidonic acid (MD = − 4.84 and − 4.03, respectively; P < 0.05) and an elevation in the ALA (MD = 0.37, P < 0.001) content of membrane phospholipids compared with the baseline. In the intervention group, a marked reduction was observed in the serum AEA level after 10 weeks of intervention, compared with the placebo group (MD = 0.64, P = 0.016). Changes in CB2 mRNA expression in the flaxseed oil group were significant (fold change = 1.30, P = 0.003), compared with the placebo group.

Conclusion

Flaxseed oil supplementation could attenuate the ECS tone by decreasing the AEA level and increasing CB2 mRNA expression. Therefore, flaxseed oil may be considered a promising agent with cardioprotective properties.
Antibiotic prophylaxis for transrectal ultrasound-guided prostatic biopsies: a comparison of two regimens
Authors: Faty Mostafa , Saleh Saleh M. , El-Nahas Ahmed R. , Al-Shaiji Tariq F. , Al-Terki Abdullatif
Published: May 2020

Background

There were controversies about the appropriate antibiotic prophylaxis regimen in order to decrease the incidence of post-transrectal ultrasound-guided prostatic biopsies (TRUS-PB) infectious complications. This study was conducted to compare the efficacy of two antibiotics prophylaxis regimens for TRUS-PB. In group 1, patients received single IV dose of 1 g amikacin 30 min before the procedure followed by oral ciprofloxacin 500 mg immediately after TRUS-PB. Group 2 patients received the same antibiotics, but ciprofloxacin started 1 day prior to TRUS-PB. Then ciprofloxacin was given twice daily for a total of 5 days in both groups.

Results

The study included 146 patients (54 in group 1 and 92 in group 2). The baseline characters (age, comorbidities, ASA score, PSA, prostate size and presence of urethral catheter) were comparable for both groups. Post-biopsy sepsis was observed in three patients (5.6%) in group 1 and one patient in group 2 (1.1%, P = 0.143). Sepsis was successfully managed in three, while one patient (1.9%) from group 1 required ICU admission for management of septic shock.

Conclusions

The incidence of sepsis after TRUS-PB is low when dual antibiotic prophylaxis (ciprofloxacin and amikacin) was used. Starting ciprofloxacin 1 day before TRUS-PB decreased the incidence of sepsis as well as its severity.
Differential time-course tear film quantitative changes following limbal relaxing incisions
Authors: Ahmed Mohamed Attia Ali , Abdelhalim Ahmed Shawkat
Published: May 2020

Background

The study aims at evaluating the time-course changes of pre-corneal tear film after simultaneous phacoemulsification and limbal relaxing incisions (LRIs) performed in 2 groups of patients; group-A had vertical and group-B had horizontal LRIs.

Methods

Fourty-two eyes of 28 patients with co-existing cataract and corneal astigmatism were studied before and after simultaneous cataract surgery and LRIs (at weeks 1, 4 and 12), patients were classified into 2 groups according to the orientation of LRIs; vertical (A) and horizontal (B) groups. Pre-corneal tear film stability was assessed by measuring the tear break-up time (TBUT) and the tear volume was determined using Schirmer’s I test (Basic Schirmer’s test; BST), both preoperatively and postoperatively.

Results

TBUT was significantly reduced in both the study groups (P = 0.001) without significant reduction regarding basic Schirmer’s test values except for the first postoperative week in the horizontal LRI group-B (P = 0.04).

Conclusions

Precorneal tear film stability is altered in the early postoperative period after simultaneous cataract and LRI incisions shown by TBUT measurement values. These changes do not appear to differ significantly depending on the orientation of LRI incisions.
Prevalence of metabolic syndrome in primary health settings in Qatar: a cross sectional study
Authors: Syed Mohamed Ahmed , Al Nuaimi Ahmed Sameer , Latif Zainel Abdul Jaleel A. , A/Qotba Hamda Abdulla
Published: May 2020

Background

In Qatar, prevalence of metabolic components is significantly higher compared to other countries. It is therefore urgent to understand the prevalence of metabolic syndrome (MetS) with the goal of identifying etiologic factors in Qatar. This study was undertaken to estimate the prevalence of MetS, by age, gender and nationality within primary care settings in Qatar. In addition, it determined the independent effects of risk factors on the prevalence of MetS.

Methods

A cross-sectional study design was used. Data for individuals aged ≥18 and who visited a publicly funded primary health centre in Qatar during 2017 were extracted from electronic medical records and analysed.

Results

The findings showed that the prevalence of individual MetS components ranged between 48.5–60.3%. Overall prevalence of MetS was 48.8% (N = 62,492) in the study population. Prevalence of MetS increased with age. 50.3% of the population within the 40–49 year age group had MetS. In this age band, individuals were 5.1 times more likely of having MetS compared to the 18–29 year age group. MetS was slightly more prevalent in men (56 .7%) compared to women (42.5%). However, men were 1.33 times more likely of having MetS compared to women. The prevalence of MetS ranged between 20.6 - 60% across nationalities. It was most prevalent in Southern Asians (60%), followed by Northern Africans (50.7%) and Western Asians (excluding Qatar) (46.8%). Prevalence of MetS in Qataris was 43%. Southern Asians, Northern African and Western Asians were 1.73, 1.38 and 1.17 more likely to have MetS compared to Qataris.

Conclusions

The study provides essential epidemiological information required by decision makers. Although not nationally representative, this study is suggestive of a higher prevalence of MetS among a younger population, men and in Southern Asian, Northern African and Western Asian nationalities. Prevention, treatment and control of MetS is a public health problem in Qatar. More studies are needed to establish which public health interventions are likely to be effective in Qatar.
Prevalence of positive TST among healthcare workers in high-burden TB setting in Peru
Authors: Sedamano Juana , Schwalb Alvaro , Cachay Rodrigo , Zamudio Carlos , Ugarte-Gil César , Soto-Cabezas Gabriela , Munayco César V. , Seas Carlos
Published: May 2020

Background

Tuberculosis (TB) transmission has long been recognized as an important occupational hazard for healthcare workers (HCWs). HCWs have a 5.8% annual risk of exposure and three times greater risk of developing active TB than the general population.

Methods

We conducted an observational cross-sectional study between September 2014 and March 2015 among HCWs in a high-burden TB setting in Lima to estimate the prevalence of positive Tuberculin Skin Test (TST) and to investigate factors associated with a positive TST.

Results

Two hundred forty participants were included in the analysis; TST was administered to 190 (79.2%) while the rest were exempt due to a previous positive TST result, history of TB, or test refusal. A positive TST result was found among 56.2% of participants to whom the TST was applied (95% CI: 49.22–63.55%). When considering those who had a previous positive TST result and those with a history of TB, the prevalence of a positive TST result was 64.3% (95% CI: 57.8–70.3%). No significant differences were observed between clinical/paramedical and administrative staff in the health center. The use of N95 masks during work hours was reported by 142 (69.9%) participants. Prevalence ratios (PR) show that workers with more than 120 months as a HCW were 1.44 times more likely to be TST positive. The multivariate analysis found that HCWs with over 10 years of service were 1.52 times more likely to be TST positive.

Conclusion

This study supports previous reports that TB infection is an occupational hazard for HCWs. Prevention of TB transmission through control measures, as well as timely diagnosis of LTBI in this particular high-risk group, is critical for individual and public health.
Autologous pericardium used for reconstruction of left innominate vein in patient with mediastinal venous aneurysm:a case report
Authors: Fang Cheng , Pan Hui , Li Zhoubin , Ma Liang , Han Weili
Published: May 2020

Background

Mediastinal venous aneurysm is a very rare disease and can be easily misdiagnosed. Patients are often asymptomatic while venous aneurysm of large size with adjacent structures oppressed can lead to discomfort. The surgical treatment for aneurysm of large vessels is often complex and challenging.

Case presentation

We reported a 52-year-old man with mediastinal mass who received operation on July 2019 in our hospital. Left innominate vein aneurysm was diagnosed during operation with superior vena cava involved. The aneurysm was resected and pericardium was taken to repair part wall of superior vena cava and reconstruct left innominate vein. The patient’s postoperative course was uneventful.

Conclusions

Venous aneurysm should be considered when mediastinal mass has no clear boundary with large veins or even seems to connect with them. Magnetic resonance imaging, computed tomographic angiography and invasive venography can be performed to further evaluate the mass once diagnosis of venous aneurysm was suspected. Using pericardium to repair large veins is a good choice which is safe and costless.
The role of Piper chaba Hunt. and its pure compound, piperine, on TRPV1 activation and adjuvant effect
Authors: Panthong Sumalee , Imai Yasuyuki , Matsuoka Takeshi , Suzuki Wakana , Watanabe Tatsuo , Terada Yuko , Kurohane Kohta , Sekiguchi Kota , Ogawa Erina , Endo Yukina , Itharat Arunporn
Published: May 2020

Background

Piper chabaHunt. is used as an ingredient in Thai traditional preparation for arthritis. Its isolated compound is piperine which shows anti-inflammatory activity. Piperine produces a burning sensation because it activates TRPV1 receptor. The TRPV1 activation involved with the analgesic and adjuvant effect.P. chabaHunt. has not been reported about TRPV1 activation and adjuvant effect. The aim of this study was to investigate the effect ofP. chabaextract and piperine on TRPV1 receptor, which is considered as a target for analgesic and their adjuvant effects to support the development of an analgesic drug from herbal medicine.

Methods

The effect ofP. chabaextract and piperine on HEK cells expressing TRPV1 channel was examined by calcium imaging assay. Adjuvant effects ofP. chabaextract and piperine were investigated by a fluorescein isothiocyanate (FITC)-induced contact hypersensitivity (CHS) model in mice.

Results

P. chabaextract induced calcium influx with EC50value of 0.67 μg/ml. Piperine induced calcium influx with EC50value of 0.31 μg/ml or 1.08 μM. For mouse CHS model, we found that 1% piperine, 5% piperine, 1%P. chabaextract and 5%P. chabaextract significantly enhanced sensitization to FITC as revealed by ear swelling responses.

Conclusion

P. chabaextract and piperine activated TRPV1 channel and enhanced contact sensitization to FITC.
Sinensetin suppresses influenza a virus-triggered inflammation through inhibition of NF-κB and MAPKs signalings
Authors: Li Jiashun , Jie Xiang , Liang Xiaoli , Chen Ziyu , Xie Peifang , Pan Xiping , Zhou Beixian , Li Jing
Published: May 2020

Background

Human respiratory system infected with influenza A virus (IAV) elicited a robust pro-inflammatory response that resulted in severe illness and even death. Currently, limited immunomodulator is available to counteract IAV-associated pneumonia in the clinic. Sinensetin, a polymethoxylated flavone with five methoxy groups, has been found to possess anti-agiogenesis, anti-inflammatory and anti-diabetic activities. However, the effects of sinensetin on IAV-triggered pro-inflammatory response remain unclear. In the present study, the anti-inflammatory effects and corresponding possible mechanism of sinensetin in IAV-infected A549 cells were subjected to investigations.

Methods

The cytotoxic effects of sinensetin towards A549 cells was detected by MTT and LDH assays. The antiviral activity of sinensetin against influenza A virus was assayed in A549 cells with an engineered replication-competent influenza A virus carrying Gaussia luciferase reporter gene infection. The effect of sinensetin on influenza A virus-triggered inflammatory reaction was determined by qRT-PCR, Luminex assays, ELISA and Western blot.

Results

Our results showed that sinensetin did not exhibit antiviral activity against A/PR/8/34 (H1N1). Meanwhile, sinensetin treatment significantly decreased IAV-induced expression of pro-inflammatory mediators at mRNA and protein levels, including IL-6, TNF-α, IP-10, IL-8 and MCP-1. Additionally, levels of cyclooxygenase (COX)-2 and the downstream product prostaglandin E2 (PGE2) up-regulated by IAV infection were dramatically suppressed by sinensetin. The mechanistic investigation revealed that sinensetin treatment suppressed the NF-κB transcriptional activity using the NF-κB reporter stable HEK293 cell line stimulated with TNF-α (20 ng/mL) or influenza H1N1 virus. Furthermore, sinensetin abrogated influenza H1N1 virus-induced activation of NF-κB, ERK1/2 MAPK and p38 MAPK signalings.

Conclusion

Collectively, our results indicated that sinensetin has potential capacity to attenuate IAV-triggered pro-inflammatory response via inactivation of NF-κB, ERK1/2 MAPK and p38 MAPK signalings, which implied that sinensetin may be a promising candidate drug for influenza H1N1 virus infection therapeutics.
The assessment of stress level, anxiety, depressive symptoms, and defense mechanisms among Polish and English medical students
Authors: Pawlaczyk M. , Siembida J. , Balaj K. , Rajewska-Rager A.
Published: May 2020

Introduction

Medical education is proven to be associated with a high degree of psychological stress. Different coping strategies used by students have been investigated on their efficacy. So far, studies on medical students have been limited to a single population.

Aim of the study

Our study aimed to identify differences in the prevalence of depressive symptoms, anxiety, stress levels, and defense mechanisms among two groups of medical students, the Polish and English-speaking divisions.

Materials and methods

The study included two groups of first-year medical students, the Polish and English-speaking divisions, comprising 305 participants (n = 204 Polish, n = 101 English, men = 127, women = 176). It was divided into two periods: the students received author questionnaires during an exam-free academic period and then completed the same questionnaires during an exam session. The survey contained questions pertaining to demographics and studying habits among participants and included the Defense Style Questionnaire and Depression Anxiety Stress Scales. Data were analyzed using STATISTICA version 12.0, and p ≤ 0.05 was considered significant.

Results

Polish medical students presented with significantly increased overall stress levels (p = 0.007858) and depressive symptoms (p = 0.030420) compared to the English division students. Polish students also presented with more symptoms of stress, depression, and anxiety during the exam period compared to the exam-free period (p = 0.000625), which did not apply to the English-speaking students. The English division students reached higher scores in the mature defense mechanisms section than the Polish students (p = 0.000001). The use of mature defense mechanisms correlated negatively with the intensity of stress, anxiety, and depressive symptoms in both groups, while immature defense mechanisms promoted higher values of those variables (p = 0.000001).

Conclusions

Our study showed significant and multidirectional differences between medical students of the Polish and English divisions attending the same university. Such results could suggest that strategies aimed at reducing depressive symptoms among medical students ought to be adapted towards the needs of a specific population.
Minimally invasive dual incision with mini plate internal fixation improves outcomes over 30 months in 20 patients with Sanders type III calcaneal fractures
Authors: Chen Jianming , Yang Zhongmeng , Kong Changwang , Wei Shijun
Published: May 2020

Background

Calcaneal Sanders type III or higher fractures traditionally have been treated with open reduction and internal fixation (ORIF); however, ORIF has associated complications. We investigated a combination of minimally invasive dual incision and internal fixation using mini plates for treating Sanders type III calcaneal fractures.

Methods

Twenty patients with Sanders type III intra-articular calcaneal fractures with a posterior subtalar articular displacement > 2 mm were included. Surgical outcomes were assessed by visual analogue scale (VAS) pain score, American Orthopaedic Foot and Ankle Society (AOFAS) hindfoot score, and calcaneal geometry, including Böhler and Gissane angles.

Results

The Böhler angle, Gissane angle, and height and length of the calcaneus were increased following treatment. Based on the AOFAS score, 80% of cases had excellent or good outcomes. The mean postoperative VAS pain score was 1.6. Complications such as malunion or a screw positioning deviation occurred in 6 patients, and one patient experienced delayed wound healing. There were no wound infections.

Conclusions

These results indicate that minimally invasive dual incision with mini plate internal fixation may be an effective alternative to ORIF for treating Sanders type III calcaneal fractures. Advantages include improvement of calcaneal geometry and a lower rate of wound infections.
Vertebral mobility is a valuable indicator for predicting and determining bone union in osteoporotic vertebral fractures: a conventional observation study
Authors: Sato Kozo , Yamada Yuichiro , Kogawa Masakazu , Sekiguchi Takuya
Published: May 2020

Background

Conservative treatments for osteoporotic vertebral fractures (OVFs) have not been standardized, and criteria for determining bone union have not been established. To determine bone union, we have adopted a cutoff value of 1.0 mm for vertebral mobility (V-mobility), defined as the difference in anterior vertebral height (Ha) between lateral radiographs taken in weight-bearing and non-weight-bearing positions. The present study aimed to investigate the usefulness of V-mobility for determining bone union and predicting bone union at 6 months after OVF onset.

Methods

The study included 54 acute OVFs from T11 to L3 in 53 patients (12 males, 41 females; mean age 82 years; age range 55–97 years) who were hospitalized at ≤ 3 weeks after OVF onset. Vertebral deformity (V-deformity) and V-mobility were evaluated in accordance with Ha on lateral radiographs taken in the sitting position (SIT), lateral decubitus position (DEC), and supine position (SUP). OVFs showing V-mobility of ≤ 1.0 mm between SIT and DEC radiographs and no intravertebral cleft on DEC radiograph were defined as semi-union, while those showing V-mobility of ≤ 1.0 mm between SIT and SUP radiographs and no intravertebral cleft on SUP radiograph were defined as bone union. We calculated the bone union rates including semi-unions associated with V-mobility cutoff values of 1.0 mm, 1.5 mm, and 2.0 mm and estimated cutoff values for V-mobility at 5 weeks after OVF onset to predict bone union at 6 months after OVF onset.

Results

The cumulative number of bone unions including semi-unions was more influenced by the different V-mobility cutoff values in Ha for determining bone union in the earlier period compared with the later period in the time course of OVF. Receiver-operating characteristic curve analyses revealed that V-mobility cutoff value of 2.1 mm in Ha between SIT and DEC radiographs at 5 weeks after OVF had moderate accuracy for predicting bone union including semi-union at 6 months after OVF. The mean V-deformity value on SIT radiographs did not progress significantly.

Conclusion

V-mobility in the early stage after OVF can predict bone union at 6 months after OVF and is a useful quantitative indicator for determining bone union.
The effect of luseogliflozin on bone microarchitecture in older patients with type 2 diabetes: study protocol for a randomized controlled pilot trial using second-generation, high-resolution, peripheral quantitative computed tomography (HR-pQCT)
Authors: Haraguchi Ai , Shigeno Riyoko , Horie Ichiro , Morimoto Shimpei , Ito Ayako , Chiba Ko , Kawazoe Yurika , Tashiro Shigeki , Miyamoto Junya , Sato Shuntaro , Yamamoto Hiroshi , Osaki Makoto , Kawakami Atsushi , Abiru Norio
Published: May 2020

Background

Older patients with type 2 diabetes mellitus (T2DM) have an increased risk of bone fracture independent of their bone mineral density (BMD), which is explained mainly by the deteriorated bone quality in T2DM compared to that in non-diabetic adults. Sodium-glucose co-transporter (SGLT) 2 inhibitors have been studied in several trials in T2DM, and the Canagliflozin Cardiovascular Assessment Study showed an increased fracture risk related to treatment with the SGLT2 inhibitor canagliflozin, although no evidence of increased fracture risk with treatment with other SGLT2 inhibitors has been reported. The mechanism of the difference in the fracture risk between the SGLT2 inhibitors is unknown, but the differences among the SGLT2 inhibitors in the selectivity of SGLT2 against SGLT1 may affect bone metabolism, since among the SGLT2 inhibitors the selectivity of canagliflozin is lowest. We will investigate whether the SGLT2 inhibitor luseogliflozin, which has the higher SGLT2 selectivity, affects bone metabolism by using high-resolution, peripheral quantitative computed tomography (HR-pQCT) which provides direct in vivo morphometric information about the bone microarchitecture.

Methods/design

This is a single-center, randomized, open-label, active-controlled, parallel pilot trial. Eligible participants are older (age ≥ 60 years) individuals with T2DM with HbA1c levels at 7.0–8.9%. A total of 24 participants will be allocated to either the luseogliflozin group (taking luseogliflozin) or the control group (taking metformin) in a 1:1 ratio to compare the groups’ changes in bone microarchitecture of the radius and tibia which are analyzed by HR-pQCT before and at 48 weeks after the administration of each medication. The laboratory data associated with glycemic control and bone metabolism will be collected every 12 weeks during the study. Recruitment began in June 2019.

Discussion

The reason that we use metformin as an active control is to avoid yielding differences in glycemic control between the luseogliflozin and control groups. Besides, metformin is considered to have a neutral effect on bone. This trial should reveal the effect of luseogliflozin on bone metabolism in older patients with T2DM.

Trial registration

The study was registered with the University Hospital Medical Information Network (UMIN000036202) on 1 April 2019 and with the Japan Registry of Clinicla Trials (jRCTs071180061) on 14 March 2019.
Is natural (6S)-5-methyltetrahydrofolic acid as effective as synthetic folic acid in increasing serum and red blood cell folate concentrations during pregnancy? A proof-of-concept pilot study
Authors: Cochrane Kelsey M. , Mayer Chantal , Devlin Angela M. , Elango Rajavel , Hutcheon Jennifer A. , Karakochuk Crystal D.
Published: May 2020

Background

North American health authorities recommend 0.4 mg/day folic acid before conception and throughout pregnancy to reduce the risk of neural tube defects. Folic acid is a synthetic form of folate that must be reduced by dihydrofolate reductase and then further metabolized. Recent evidence suggests that the maximal capacity for this process is limited and unmetabolized folic acid has been detected in the circulation. The biological effects of unmetabolized folic acid are unknown. A natural form of folate, (6S)-5-methyltetrahydrofolic acid (Metafolin®), may be a superior alternative because it does not need to be reduced in the small intestine. Metafolin® is currently used in some prenatal multivitamins; however, it has yet to be evaluated during pregnancy.

Methods/design

This double-blind, randomized trial will recruit 60 pregnant women aged 19–42 years. The women will receive either 0.6 mg/day folic acid or an equimolar dose (0.625 mg/day) of (6S)-5-methyltetrahydrofolic acid for 16 weeks. The trial will be initiated at 8–21 weeks’ gestation (after neural tube closure) to reduce the risk of harm should (6S)-5-methyltetrahydrofolic acid prove less effective. All women will also receive a prenatal multivitamin (not containing folate) to ensure adequacy of other nutrients. Baseline and endline blood samples will be collected to assess primary outcome measures, including serum folate, red blood cell folate and unmetabolized folic acid. The extent to which the change in primary outcomes from baseline to endline differs between treatment groups, controlling for baseline level, will be estimated using linear regression. Participants will have the option to continue supplementing until 1 week postpartum to provide a breastmilk and blood sample. Exploratory analyses will be completed to evaluate breastmilk and postpartum blood folate concentrations.

Discussion

This proof-of-concept trial is needed to obtain estimates of the effect of (6S)-5-methyltetrahydrofolic acid compared to folic acid on circulating biomarkers of folate status during pregnancy. These estimates will inform the design of a definitive trial which will be powered to assess whether (6S)-5-methyltetrahydrofolic acid is as effective as folic acid in raising blood folate concentrations during pregnancy. Ultimately, these findings will inform folate supplementation policies for pregnant women.

Trial registration

ClinicalTrials.gov, ID: NCT04022135. Registered on 14 July 2019.
Athlete availability and incidence of overuse injuries over an athletics season in a cohort of elite Swedish athletics athletes - a prospective study
Authors: Lundberg Zachrisson Andreas , Ivarsson Andreas , Desai Pia , Karlsson Jon , Grau Stefan
Published: May 2020

Background

Athletics is a sport with a high incidence of injury, where most injuries are caused by overuse. Research on injury incidence and the occurrence of overuse injuries during a season in athletics is scarce. An athlete availability (unrestricted ability to participate in training or competition) of less than 80% has been linked with athletes being less likely to reach their performance goals. The purpose of this study was to estimate the monthly injury incidence rates, athlete availability, and the overuse injury incidence rate per 1000 athletics-hours of training in a cohort of Swedish elite athletics athletes.

Methods

The cohort consisted of 59 male and female elite athletes competing in either middle or long-distance running, sprint, or jumping events. Injury and training data were collected during one athletics season, from October to the end of August. All injury data were collected by medical professionals. Training data were collected monthly, and consisted of event-specific training diaries covering training sessions, training days, and non-training or non-competition days. Monthly injury incidence rates were based on the number of new injuries per month in relation to the number of exposed (injury-free) athletes.

Results

The overall injury incidence rate for all athletes was highest in October (22.0%). Monthly injury incidence rate for middle and long-distance runners was highest in October (26.1%), for sprinters in April (19.0%), and for jumpers in October (21.4%). The overall athlete availability was 78.0% for the cohort. Sprinters had the lowest athlete availability (71.4%), followed by jumpers (77.3%), and middle-distance and long-distance runners (82.7%). Female athletes (76.5%) had a lower athlete availability than male athletes (79.7%). The injury incidence rate was 1.81 injuries per 1000 athletics hours of training. Middle and long-distance runners had the highest injury incidence rate (2.38), followed by jumpers (1.62), and sprinters (1.34).

Conclusion

Monthly injury incidence rates during a season appears to correspond to periods of high training volume (conditioning phases and training camps). The low overall athlete availability (> 80%) indicates that many Swedish elite athletes are less likely to reach their full potential.