bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of malaria on productivity in a workplace: the case of a banana plantation in Zimbabwe
Authors: Lukwa Akim Tafadzwa , Mawoyo Richard , Zablon Karen Nelwin , Siya Aggrey , Alaba Olufunke
Published: December 2019

Background

Malaria is known to contribute to reduction in productivity through absenteeism as worker-hours are lost thus impacting company productivity and performance. This paper analysed the impact of malaria on productivity in a banana plantation through absenteeism.

Methods

This study was carried out at Matanuska farm in Burma Valley, Zimbabwe. Raw data on absenteeism was obtained in retrospect from the Farm Manager. Malaria infection was detected using malaria Rapid Diagnostic Test. Measures of absence from work place were determined and included; incidence of absence (number of absentees divided by the total workforce), absence frequency (number of malaria spells), frequency rate (number of spells divided by the number of absentees), estimated duration of spells (number of days lost due to malaria), severity rate (number of days lost divided by number of spells), incapacity rate (number of days lost divided by the number of absentees), number of absent days (number of spells times the severity rate), number of scheduled working days (actual working days in 5 months multiplied by total number of employees), absenteeism rate.

Results

A total of 143 employees were followed up over a 5-month period. Malaria positivity was 21%, 31.5%, 44.8%, 35.7% and 12.6% for January 2014 to May 2014, respectively. One spell of absence [194 (86.6%)] was common followed by 2 spells of absence [30 (13.4%)] for all employees. Duration of spells of absence due to malaria ranged from 1.5 to 4.1 working-days, with general workers being the most affected. Incidence of absence was 143/155 (93.3%), with total of spells of absence of over a 5-month period totalling 224. The frequency rate of absenteeism was 1.6 with severity rate of absence being 2.4. and incapacity rate was 3.7.

Conclusion

Malaria contributes significantly to worker absenteeism. Employers, therefore, ought to put measures that protect workers from malaria infections. Protecting workers can be done through malaria educative campaigns, providing mosquito nets, providing insecticide-treated work suits, providing repellents and partnering with different ministries to ensure protection of workers from mosquito bites.
En-route to the ‘elimination’ of genotypic chloroquine resistance in Western and Southern Zambia, 14 years after chloroquine withdrawal
Authors: Sitali Lungowe , Mwenda Mulenga C. , Miller John M. , Bridges Daniel J. , Hawela Moonga B. , Chizema-Kawesha Elizabeth , Chipeta James , Lindtjørn Bernt
Published: December 2019

Background

Anti-malarial resistance is, and continues to be a significant challenge in the fight against malaria and a threat to achieving malaria elimination. In Zambia, chloroquine (CQ), a safe, affordable and well-tolerated drug, was removed from use in 2003 due to high levels of resistance evidenced with treatment failure. This study sought to investigate the prevalence of chloroquine resistance markers in Southern and Western Provinces of Zambia 14 years after the withdrawal of CQ.

Methods

Data from a cross-sectional, all-age household survey, conducted during the peak malaria transmission season (April–May 2017) was analysed. During the all-age survey, socio-demographic information and coverage of malaria interventions were collected. Consenting individuals were tested for malaria with a rapid diagnostic test and a spot of blood collected on filter paper to create a dried blood spot (DBS). Photo-induced electronic transfer–polymerase chain reaction (PET–PCR) was used to analyse the DBS for the presence of all four malaria species. Plasmodium falciparum positive samples were analysed by high resolution melt (HRM) PCR to detect the presence of genotypic markers of drug resistance in the P. falciparum chloroquine resistance transporter (Pfcrt) and P. falciparum multi-drug resistance (Pfmdr) genes.

Results

A total of 181 P. falciparum positive samples were examined for pfcrt K76T and MDR N86. Of the 181 samples 155 successfully amplified for Pfcrt and 145 for Pfmdr N86. The overall prevalence of CQ drug-resistant parasites was 1.9% (3/155), with no significant difference between the two provinces. No N86Y/F mutations in the Pfmdr gene were observed in any of the sample.

Conclusion

This study reveals the return of CQ sensitive parasites in Southern and Western Provinces of Zambia 14 years after its withdrawal. Surveillance of molecular resistant markers for anti-malarials should be included in the Malaria Elimination Programme so that resistance is monitored country wide.
Biannual versus annual mass azithromycin distribution and malaria seroepidemiology among preschool children in Niger: a sub-study of a cluster randomized trial
Authors: Oldenburg Catherine E. , Amza Abdou , Cooley Gretchen , Kadri Boubacar , Nassirou Beido , Arnold Benjamin F. , Rosenthal Philip J. , O’Brien Kieran S. , West Sheila K. , Bailey Robin L. , Porco Travis C. , Keenan Jeremy D. , Lietman Thomas M. , Martin Diana L.
Published: December 2019

Background

Biannual mass azithromycin administration to preschool children reduces all-cause mortality, but the mechanism for the effect is not understood. Azithromycin has activity against malaria parasites, and malaria is a leading cause of child mortality in the Sahel. The effect of biannual versus annual azithromycin distribution for trachoma control on serological response to merozoite surface protein 1 (MSP-119), a surrogate for malaria incidence, was evaluated among children in Niger.

Methods

Markers of malaria exposure were measured in two arms of a factorial randomized controlled trial designed to evaluate targeted biannual azithromycin distribution to children under 12 years of age compared to annual azithromycin to the entire community for trachoma control (N = 12 communities per arm). Communities were treated for 36 months (6 versus 3 distributions). Dried blood spots were collected at 36 months among children ages 1–5 years, and MSP-119 antibody levels were assessed using a bead-based multiplex assay to measure malaria seroprevalence.

Results

Antibody results were available for 991 children. MSP-119 seropositivity was 62.7% in the biannual distribution arm compared to 68.7% in the annual arm (prevalence ratio 0.91, 95% CI 0.83 to 1.00). Mean semi-quantitative antibody levels were lower in the biannual distribution arm compared to the annual arm (mean difference − 0.39, 95% CI − 0.05 to − 0.72).

Conclusions

Targeted biannual azithromycin distribution was associated with lower malaria seroprevalence compared to that in a population that received annual distribution.

Trial Registration Clinicaltrials.gov NCT00792922
Release of endothelial activation markers in lungs of patients with malaria-associated acute respiratory distress syndrome
Authors: Pham Thao-Thy , Punsawad Chuchard , Glaharn Supattra , De Meyer Simon F. , Viriyavejakul Parnpen , Van den Steen Philippe E.
Published: December 2019

Background

Malaria-associated acute respiratory distress syndrome (MA-ARDS) is an understudied complication of malaria and is characterized by pulmonary inflammation and disruption of the alveolar-capillary membrane. Its pathogenesis remains poorly understood. Since endothelial activation plays an important role in other malarial complications, the expression of two endothelial activation markers, von Willebrand factor (VWF) and angiopoietin-2 (ANG-2), was investigated in the lungs of patients with MA-ARDS.

Methods

Post-mortem lung sections of Plasmodium falciparum-infected patients without alveolar oedema (NA), P. falciparum-infected patients with alveolar oedema (MA-ARDS), and uninfected people who died accidentally with no pathological changes to the lungs (CON) were immunohistochemically stained for VWF and ANG-2, and were evaluated with semi-quantitative analysis.

Results

Alveolar oedematous VWF and ANG-2 and intravascular VWF staining were significantly increased in patients with MA-ARDS versus infected and uninfected control groups. The levels of VWF in the alveolar septa and endothelial lining of large blood vessels of patients with MA-ARDS was significantly decreased compared to controls. ANG-2 expression was increased in the alveolar septa of malaria patients without alveolar oedema versus control patients, while ANG-2+ leukocytes were increased in the alveoli in both infected patient groups.

Conclusions

This study documents a high level of VWF and ANG-2, two endothelial activation markers in the oedematous alveoli of post-mortem lung sections of Thai patients with MA-ARDS. Decreased detection of VWF in the endothelial lining of blood vessels, in parallel with an increased presence of intravascular VWF staining suggests marked endothelial activation and Weibel–Palade body release in the lungs of patients with MA-ARDS.
Use of skincare products and risk of cancer of the breast and endometrium: a prospective cohort study
Authors: Rylander Charlotta , Veierød Marit B. , Weiderpass Elisabete , Lund Eiliv , Sandanger Torkjel M.
Published: December 2019

Background

Concerns have been raised that extensive use of personal care products that contain endocrine disrupting compounds increase the risk of hormone sensitive cancers.

Objective

To assess the effect of skincare product use on the risk of pre- and postmenopausal breast cancer, estrogen receptor positive (ER+) and negative (ER-) breast cancer and cancer of the endometrium.

Methods

We used data from 106,978 participants in the population-based Norwegian Women and Cancer cohort. Participants were categorized into non-, light, moderate, frequent and heavy users of skincare products based on self-reported use of hand and facial cream and body lotion. Cancer incidence information from the Cancer Registry of Norway was linked to individual data through the unique identity number of Norwegian citizens. Multivariable Cox proportional hazard regression was used to assess the effect of skincare product use on the risk of cancer of the breast and endometrium. We used multiple imputation by chained equations to evaluate the effect of missing data on observed associations.

Results

We found no associations between use of skincare products and incidence of premenopausal breast cancer (frequent/heavy versus non−/light use: hazard ratio [HR] =1.10, 95% confidence interval [CI]: 0.92–1.32), postmenopausal breast cancer (heavy versus light use: HR = 0.87, 95% CI: 0.65–1.18, frequent versus light use: HR = 0.97, 95% CI: 0.88, 1.07) or endometrial cancer (frequent/heavy versus non−/light use: HR = 0.97, 95% CI: 0.79–1.20). Use of skincare products did not increase the risk of ER+ or ER- breast cancer and there was no difference in effect across ER status (0.58 ≤ pheterogeneity ≤ 0.99). The magnitude and direction of the effect estimates based on complete case analyses and multiple imputation were similar.

Conclusion

Heavy use of skincare products, i.e. creaming the body up to two times per day during mid-life, did not increase the risk of cancer of the breast or endometrium.
Potential factors contributing to the poor antimicrobial efficacy of SAAP-148 in a rat wound infection model
Authors: Dijksteel Gabrielle S. , Ulrich Magda M. W. , Vlig Marcel , Nibbering Peter H. , Cordfunke Robert A. , Drijfhout Jan W. , Middelkoop Esther , Boekema Bouke K. H. L.
Published: December 2019

Background

We investigated the efficacy of a synthetic antimicrobial peptide SAAP-148, which was shown to be effective against Methicillin-resistant Staphylococcus aureus (MRSA) on tape-stripped mice skin. Unexpectedly, SAAP-148 was not effective against MRSA in our pilot study using rats with excision wounds. Therefore, we investigated factors that might have contributed to the poor efficacy of SAAP-148. Subsequently, we optimised the protocol and assessed the efficacy of SAAP-148 in an adapted rat study.

Methods

We incubated 100 µL of SAAP-148 with 1 cm2 of a wound dressing for 1 h and determined the unabsorbed volume of peptide solution. Furthermore, 105 colony forming units (CFU)/mL MRSA were exposed to increasing dosages of SAAP-148 in 50% (v/v) human plasma, eschar- or skin extract or PBS. After 30 min incubation, the number of viable bacteria was determined. Next, ex vivo skin models were inoculated with MRSA for 1 h and exposed to SAAP-148. Finally, excision wounds on the back of rats were inoculated with 107 CFU MRSA overnight and treated with SAAP-148 for 4 h or 24 h. Subsequently, the number of viable bacteria was determined.

Results

Contrary to Cuticell, Parafilm and Tegaderm film, < 20% of peptide solution was recovered after incubation with gauze, Mepilex border and Opsite Post-op. Furthermore, in plasma, eschar- or skin extract > 20-fold higher dosages of SAAP-148 were required to achieve a 2-log reduction (LR) of MRSA versus SAAP-148 in PBS. Exposure of ex vivo models to SAAP-148 for 24 h resulted in a 4-fold lower LR than a 1 h or 4 h exposure period. Additionally, SAAP-148 caused a 1.3-fold lower mean LR at a load of 107 CFU compared to 105 CFU MRSA. Moreover, exposure of ex vivo excision wound models to SAAP-148 resulted in a 1.5-fold lower LR than for tape-stripped skin. Finally, SAAP-148 failed to reduce the bacterial counts in an adapted rat study.

Conclusions

Several factors, such as absorption of SAAP-148 by wound dressings, components within wound exudates, re-colonisation during the exposure of SAAP-148, and a high bacterial load may contribute to the poor antimicrobial effect of SAAP-148 against MRSA in the rat model.
IL-33 deficiency causes persistent inflammation and severe neurodegeneration in retinal detachment
Authors: Augustine Josy , Pavlou Sofia , Ali Imran , Harkin Kevin , Ozaki Ema , Campbell Matthew , Stitt Alan W. , Xu Heping , Chen Mei
Published: December 2019

Background

Interleukin-33 (IL-33) belongs to the IL-1 cytokine family and resides in the nuclei of various cell types. In the neural retina, IL-33 is predominately expressed in Müller cells although its role in health and disease is ill-defined. Müller cell gliosis is a critical response during the acute phase of retinal detachment (RD), and in this study, we investigated if IL-33 was modulatory in the inflammatory and neurodegenerative pathology which is characteristic of this important clinical condition.

Methods

RD was induced by subretinal injection of sodium hyaluronate into C57BL/6 J (WT) and IL-33−/− mice and confirmed by fundus imaging and optical coherence tomography (OCT). The expression of inflammatory cytokines, complement components and growth factors was examined by RT-PCR. Retinal neurodegeneration, Müller cell activation and immune cell infiltration were assessed using immunohistochemistry. The expression of inflammatory cytokines in primary Müller cells and bone marrow-derived macrophages (BM-DMs) was assessed by RT-PCR and Cytometric Bead Array.

Results

RD persisted for at least 28 days after the injection of sodium hyaluronate, accompanied by significant cone photoreceptor degeneration. The mRNA levels of CCL2, C1ra, C1s, IL-18, IL-1β, TNFα, IL-33 and glial fibrillary acidic protein (GFAP) were significantly increased at day 1 post-RD, reduced gradually and, with the exception of GFAP and C1ra, returned to the basal levels by day 28 in WT mice. In IL-33−/− mice, RD induced an exacerbated inflammatory response with significantly higher levels of CCL2, IL-1β and GFAP when compared to WT. Sustained GFAP activation and immune cell infiltration was detected at day 28 post-RD in IL-33−/− mice. Electroretinography revealed a lower A-wave amplitude at day 28 post-RD in IL-33−/− mice compared to that in WT RD mice. IL-33−/− mice subjected to RD also had significantly more severe cone photoreceptor degeneration compared to WT counterparts. Surprisingly, Müller cells from IL-33−/− mice expressed significantly lower levels of CCL2 and IL-6 compared with those from WT mice, particularly under hypoxic conditions, whereas IL-33−/− bone marrow-derived macrophages expressed higher levels of inducible nitric oxide synthase, TNFα, IL-1β and CCL2 after LPS + IFNγ stimulation compared to WT macrophages.

Conclusion

IL-33 deficiency enhanced retinal degeneration and gliosis following RD which was related to sustained subretinal inflammation from infiltrating macrophages. IL-33 may provide a previously unrecognised protective response by negatively regulating macrophage activation following retinal detachment.
Intrastriatal injection of preformed alpha-synuclein fibrils alters central and peripheral immune cell profiles in non-transgenic mice
Authors: Earls Rachael H. , Menees Kelly B. , Chung Jaegwon , Barber James , Gutekunst Claire-Anne , Hazim Manuel G. , Lee Jae-Kyung
Published: December 2019

Parkinson’s disease (PD) is characterized by the accumulation of alpha-synuclein (α-syn) inclusions, the major component of Lewy bodies. Extracellular α-syn aggregates act as a damage-associated molecular pattern (DAMP) and the presence of autoantibodies against α-syn species in the cerebrospinal fluid and the serum of PD patients implicate the involvement of innate and adaptive immune responses. In non-transgenic (Tg) mice, intrastriatal injection of preformed fibril (PFF) α-syn results in widespread pathologic α-syn inclusions in the CNS. While the PFF model has been broadly utilized to study the mechanistic relationship between α-syn transmission and other neuropathological phenotypes, the immune phenotypes in this model are not clearly demonstrated. This study aimed to characterize the immune phenotypes during pathologic α-syn propagation by utilizing PFF α-syn–injected non-tg mice. Here, we showed that pathologic α-syn inclusions are prevalent in various brain regions and the gut at 5 months post injection (p.i.), preceding the degeneration of dopaminergic neurons in substantia nigra (SN). We discovered a distinct inflammatory response involving both activation of microglia and astrocytes and infiltration of B, CD4+ T, CD8+ T, and natural killer cells in the brain at 5 months p.i. Moreover, PFF α-syn–injected mice display significant alterations in the frequency and number of leukocyte subsets in the spleen and lymph nodes with minimum alterations in the blood. Our data provide primary evidence that intracerebral-initiated synucleinopathies in non-tg mice alter immune cell profiles both in the CNS and peripheral lymphoid organs. Furthermore, our data provides support for utilizing this mouse model to assess the mechanistic connection between immune responses and synuclein pathology.
Opportunities and challenges for the introduction of a new female condom among young adults in urban Zambia
Authors: Gambir Katherine , Pinchoff Jessie , Obadeyi Olasubomi , Ngo Thoai D.
Published: December 2019

Background

Expanding contraceptive method choices for sexually active youth is critical to prevent STIs/HIV and unintended pregnancies. However, preferences and decision making around contraception among young adults are not well understood. A new female condom (FC), the Woman’s Condom (WC), features an improved design and is marketed as a premium product at a higher price point. We conducted a qualitative study to examine the underlying knowledge, attitudes, and perceptions around the FC generally, the WC specifically, and to explore the opportunities and challenges of introducing the WC to young adults in urban Zambia.

Methods

Thirty focus group discussions comprised of 245 men and women aged 18–24 years were facilitated by local moderators in Lusaka, Zambia between August and December 2016. Data were analyzed using thematic content analysis using ATLAS.ti (Version 7.5.17).

Results

While interest in the newly launched WC was high, few participants recognized it, so discussion was framed around FCs more generally. The decision to use a FC is challenged by misconceptions regarding safety and correct use, cost, and women’s limited power over decision making in relationships. Participants also reported low availability of the product. Several opportunities for FC uptake were discussed, including the perception that FCs provide better sensation during intercourse compared with male condoms, and women reported enthusiasm for the opportunity to be the partner responsible for contraception. Some women expressed interest in the WC in order to ensure it was not tampered with by their partner, a practice commonly reported by both genders that reflects high levels of mistrust.

Conclusions

Findings suggest the FC, including the new WC, has potential to increase gender equity by giving women a product they are comfortable buying and being able to control to ensure correct use; however, future programming should address high perceived cost of the WC and women’s limited decision making power in relationships. Findings also highlight the need for interventions that include product demonstration and promote the WC as a method that provides better sensation during sex than male condoms. To increase voluntary uptake, the challenges identified here should be incorporated into future social marketing campaigns.
EGFR inhibition for metastasized cutaneous squamous cell carcinoma in dystrophic epidermolysis bullosa
Authors: Diociaiuti Andrea , Steinke Holger , Nyström Alexander , Schwieger-Briel Agnes , Meiss Frank , Pfannenberg Christina , Bruckner-Tuderman Leena , Ruf Juri , De Vito Rita , El Hachem May , Kiritsi Dimitra
Published: December 2019

Dystrophic epidermolysis bullosa (DEB) is a hereditary skin fragility disorder, characterized by trauma-induced blistering followed by soft tissue fibrosis. One of the most feared complications is the early development of aggressive cutaneous squamous cell carcinomas (SCC). For patients with locally advanced or metastasized SCCs treatment with cetuximab, a monoclonal antibody against epidermal growth factor receptor (EGFR), has been proposed and so far, treatment of five DEB patients with cetuximab has been published. With this report, we extend the spectrum of EB patients treated with cetuximab by adding two additional patients. Taking together all DEB cases treated with cetuximab, we propose that cetuximab should be administered as early as possible, since it seems to be more efficient and is accompanied by rather mild adverse effects. We also show that EGFR is frequently expressed in DEB-associated SCCs, although there were noticeable differences in the level of expression, which may influence responsiveness to EGFR-targeting therapies. Although only limited experiences with targeted cancer treatments in EB exist, such reports highlight the treatments’ effects in this specific cohort and assist our therapeutic decisions.
Refinement multidimensional dynamic inequalities with general kernels and measures
Authors: Saker Samir H. , Rezk Haytham M. , Abohela Islam , Baleanu Dumitru
Published: December 2019

Using the properties of superquadratic and subquadratic functions, we establish some new refinement multidimensional dynamic inequalities of Hardy’s type on time scales. Our results contain some of the recent results related to classical multidimensional Hardy’s and Pólya–Knopp’s inequalities on time scales. To show motivation of the paper, we apply our results to obtain some particular multidimensional cases and provide refinements of some Hardy-type inequalities known in the literature.
Big data-oriented energy prosumption service in smart community districts: a multi-case study perspective
Authors: Anthony Bokolo , Petersen Sobah Abbas , Ahlers Dirk , Krogstie John , Livik Klaus
Published: December 2019

The smart grid achieves bidirectional information and energy flow between energy consumer and utility grid, aiding energy users not only to utilize energy, but also to produce, sell, and share energy with other consumers or with the utility grid. This type of energy user is referred to as the “prosumer”. Thus, prosumer management structures are important within energy market. However, prior studies on energy sustainability has paid little attention on prosumer involvement and management. Likewise, the continuous growth of cities has increased data processing complexity. Consequently, processing and analysis of historical, online, and real-time streaming data from energy sensors and metering devices has become a major issue in smart cities. Therefore, this research aims to present an architecture based on big data to improve energy prosumption in smart community districts by applying enterprise architecture approach grounded on The Open Group Architecture Framework (TOGAF). Accordingly, qualitative methodology is adopted to collect data by employing case study by focus group interview from two energy companies in Norway to preliminarily validate the architecture. Findings from the case studies was demonstrated in ArchiMate modeling language to evaluate the applicability of the architecture. Moreover, findings from this study provides practical scenario that energy service providers can refer to in designing their own energy data platforms. Essentially, the architecture can be utilized as a guide to help municipalities and policy makers in creating approach for energy data analytics in smart community districts towards making decisions for future energy prosumption planning.
BMPR1A and BMPR1B Missense Mutations Cause Primary Ovarian Insufficiency
Authors: Renault Lucie , Patiño Liliana C , Magnin Françoise , Delemer Brigitte , Young Jacques , Laissue Paul , Binart Nadine , Beau Isabelle
Published: December 2019

Context

Primary ovarian insufficiency (POI) is a frequently occurring disorder affecting approximately 1% of women under 40 years of age. POI, which is characterized by the premature depletion of ovarian follicles and elevated plasma levels of follicle-stimulating hormone, leads to infertility. Although various etiological factors have been described, including chromosomal abnormalities and gene mutations, most cases remain idiopathic.

Objective

To identify and to functionally validate new sequence variants in 2 genes that play a key role in mammalian ovarian function, BMPR1A and BMPR1B (encoding for bone morphogenic protein receptor), leading to POI.

Methods

The impact on bone morphogenic protein (BMP) signaling of BMPR1A and BMPR1B variants, previously identified by whole-exome sequencing on 69 women affected by isolated POI, was established by different in vitro functional experiments.

Results

We demonstrate that the BMPR1A-p.Arg442His and BMPR1B-p.Phe272Leu variants are correctly expressed and located but lead to an impairment of downstream BMP signaling.

Conclusion

In accordance with infertility observed in mice lacking Bmpr1a in the ovaries and in Bmpr1b-/- mice, our results unveil, for the first time, a link between BMPR1A and BMPR1B variants and the origin of POI. We show that BMP signaling impairment through specific BMPR1A and BMPR1B variants is a novel pathophysiological mechanism involved in human POI. We consider that BMPR1A and BMPR1B variants constitute genetic biomarkers of the origin of POI and have clinical utility.
Serum SHBG Is Associated With the Development and Regression of Nonalcoholic Fatty Liver Disease: A Prospective Study
Authors: Wang Xu , Xie Jiewen , Pang Juan , Zhang Hanyue , Chen Xu , Lin Jiesheng , Li Qing , Chen Qian , Ma Jing , Xu Xiping , Yang Yan , Ling Wenhua , Chen Yuming
Published: December 2019

Context

SHBG, a homodimeric glycoprotein produced by hepatocytes has been shown to be associated with metabolic disorders. Whether circulating SHBG levels are predictive of later risk of nonalcoholic fatty liver disease (NAFLD) remains unknown. In this study, we prospectively investigated the association between SHBG and NAFLD progression through a community-based cohort comprising 3389 Chinese adults.

Methods

NAFLD was diagnosed using abdominal ultrasonography. Serum SHBG levels were measured by chemiluminescent enzyme immunometric assay, and their relationship with NAFLD development and regression was investigated after a mean follow-up of 3.09 years using multivariable logistic regression.

Results

Basal SHBG was negatively associated with NAFLD development, with a fully adjusted odds ratio (OR) and its 95% confidence interval (CI) of 0.22 (0.12-0.40) (P < .001). In contrast, basal SHBG was positively associated with NAFLD regression, with a fully adjusted OR of 4.83 (2.38-9.81) (P < .001). Multiple-stepwise logistic regression analysis showed that SHBG concentration was an independent predictor of NAFLD development (OR, 0.28 [0.18-0.45]; P < .001) and regression (OR, 3.89 [2.43-6.22]; P < .001). In addition, the area under the receiver operating characteristic curves were 0.764 (95% CI, 0.740-0.787) and 0.762 (95% CI, 0.738-0.785) for the prediction models of NAFLD development and regression, respectively.

Conclusions

Serum SHBG concentration is associated with the development and regression of NAFLD; moreover, it can be a potential biomarker for predicting NAFLD progression, and also a novel preventive and therapeutic target for NAFLD.
Muscle Strength, Size, and Composition Following 12 Months of Gender-affirming Treatment in Transgender Individuals
Authors: Wiik Anna , Lundberg Tommy R , Rullman Eric , Andersson Daniel P , Holmberg Mats , Mandić Mirko , Brismar Torkel B , Dahlqvist Leinhard Olof , Chanpen Setareh , Flanagan John N , Arver Stefan , Gustafsson Thomas
Published: December 2019

Context

As many sports are divided in male/female categories, governing bodies have formed regulations on the eligibility for transgender individuals to compete in these categories. Yet, the magnitude of change in muscle mass and strength with gender-affirming treatment remains insufficiently explored.

Objective

This study explored the effects of gender-affirming treatment on muscle function, size, and composition during 12 months of therapy.

Design, settings, participants

In this single-center observational cohort study, untrained transgender women (TW, n = 11) and transgender men (TM, n = 12), approved to start gender-affirming medical interventions, underwent assessments at baseline, 4 weeks after gonadal suppression of endogenous hormones but before hormone replacement, and 4 and 12 months after treatment initiation.

Main outcome measures

Knee extensor and flexor strength were assessed at all examination time points, and muscle size and radiological density (using magnetic resonance imaging and computed tomography) at baseline and 12 months after treatment initiation.

Results

Thigh muscle volume increased (15%) in TM, which was paralleled by increased quadriceps cross-sectional area (CSA) (15%) and radiological density (6%). In TW, the corresponding parameters decreased by –5% (muscle volume) and –4% (CSA), while density remained unaltered. The TM increased strength over the assessment period, while the TW generally maintained their strength levels.

Conclusions

One year of gender-affirming treatment resulted in robust increases in muscle mass and strength in TM, but modest changes in TW. These findings add new knowledge on the magnitude of changes in muscle function, size, and composition with cross-hormone therapy, which could be relevant when evaluating the transgender eligibility rules for athletic competitions.
Episodic Muscle Disorders
Authors: Sansone Valeria A.
Published: December 2019

PURPOSE OF REVIEW

This article reviews the episodic muscle disorders, including benign cramp-fasciculation syndrome, the periodic paralyses, and the nondystrophic myotonias. The core diagnostic criteria for a diagnosis of primary periodic paralysis, including clues to distinguish between the hypokalemic and hyperkalemic forms, and the distinctive elements that characterize Andersen-Tawil syndrome are discussed. Management of patients with these disorders is also discussed.

RECENT FINDINGS

Childhood presentations of periodic paralysis have recently been described, including atypical findings. Carbonic anhydrase inhibitors, such as dichlorphenamide, have recently been approved by the US Food and Drug Administration (FDA) for the treatment of both hypokalemic and hyperkalemic forms of periodic paralysis. Muscle MRI may be a useful outcome measure in pharmacologic trials in periodic paralysis. Genetic research continues to identify additional gene mutations responsible for periodic paralysis.

This article will help neurologists diagnose and manage episodic muscle disorders and, in particular, the periodic paralyses and the nondystrophic myotonias.
Lambert-Eaton Myasthenic Syndrome, Botulism, and Immune Checkpoint Inhibitor–Related Myasthenia Gravis
Authors: Guidon Amanda C.
Published: December 2019

PURPOSE OF REVIEW

This article reviews the pathophysiology, epidemiology, clinical presentation, diagnosis, and treatment of Lambert-Eaton myasthenic syndrome (LEMS) and of botulism, and immune-related myasthenia gravis (MG) occurring in the context of immune checkpoint inhibitor therapy for cancer.

RECENT FINDINGS

The suspicion that LEMS is rare but also likely underdiagnosed is supported by recent epidemiologic data. A validated, LEMS-specific scale now exists to assess and monitor disease, and symptomatic and immunomodulatory treatments are available. As presynaptic disorders of neuromuscular transmission, LEMS and botulism share electrodiagnostic abnormalities but have important distinguishing features. Knowledge of the clinical features of botulism is needed, particularly with continued cases of infant botulism, the opioid epidemic increasing the incidence of wound botulism, and medical use of botulinum toxin, which may cause iatrogenic botulism. Foodborne botulism remains rare. Prompt recognition of botulism and administration of antitoxin can improve outcomes. MG may be exacerbated or may present de novo in the context of immune activation from immune checkpoint inhibitor therapies for cancer. Immune-related MG commonly overlaps with myositis and myocarditis. Corticosteroids typically result in improvement. However, immune-related MG can be more fulminant than its idiopathic counterpart and may cause permanent disability or death.

The diagnosis of LEMS, botulism, or immune-related MG can generally be made from the patient’s history, supplemented with directed questions, a physical examination designed to demonstrate abnormalities, and laboratory and electrodiagnostic testing. Early diagnosis and carefully selected treatment not only improve outcomes of the neuromuscular disease but can affect the prognosis of underlying malignancy, when present.
Whistling is metabolically cheap for communicating bottlenose dolphins (Tursiops truncatus)
Authors: Pedersen Michael B. , Fahlman Andreas , Borque-Espinosa Alicia , Madsen Peter T. , Jensen Frants H.
Published: December 2019

Toothed whales depend on sound for communication and foraging, making them potentially vulnerable to acoustic masking from increasing anthropogenic noise. Masking effects may be ameliorated by higher amplitudes or rates of calling, but such acoustic compensation mechanisms may incur energetic costs if sound production is expensive. The costs of whistling in bottlenose dolphins (Tursiops truncatus) have been reported to be much higher (20-50% of resting metabolic rate, RMR) than theoretical predictions (0.5-1% of RMR). Here we address this dichotomy by measuring the change in the resting O2 consumption rate (V̇O2), a proxy for RMR, in three post-absorptive bottlenose dolphins during whistling and silent trials, concurrent with simultaneous measurement of acoustic output using a calibrated hydrophone array. The experimental protocol consisted of a two-minute baseline period to establish RMR, followed by a two-minute voluntary resting surface apnea, with or without whistling as cued by the trainers, followed by a five-minute resting period to measure recovery costs. Daily fluctuations in V̇O2 were accounted for by subtracting the baseline RMR from the recovery costs to estimate the cost of apnea with and without whistles relative to RMR. Analysis of 52 sessions containing 1162 whistles showed that whistling did not increase metabolic cost (P>0.1, +4.2±6.9%) (mean±s.e.m.) as compared with control trials (-0.5±5.9%) (mean±s.e.m.). Thus, we reject the hypothesis that whistling is costly for bottlenose dolphins, and conclude that vocal adjustments such as the Lombard response to noise do not represent large direct energetic costs for communicating toothed whales.
Why do muscles lose torque potential when activated within their agonistic group?
Authors: de Brito Fontana Heiliane , de Campos Daiani , Sawatsky Andrew , Han Seong-won , Herzog Walter
Published: December 2019

Agonistic muscles lose approximately 20% of their individual torque generating capacity when activated with their agonistic muscles compared to when stimulated in isolation. In this study, we (i) tested if this loss in torque was accompanied by a corresponding loss in force, thereby testing the potential role of changes in moment arms between conditions; (ii) removed all inter-muscular connections between the quadriceps muscles, thus determining the potential role of inter-muscular force transmission; and (iii) systematically changed the inter-muscular pressure by performing experiments at different activation/force levels, thereby exploring the possible role of inter-muscular pressure in the loss of torque capacity with simultaneous muscle activation. Experiments were performed in a New Zealand White rabbit quadriceps model (n=5). Torque and force were measured during activation of femoral nerve branches that supply the individual quadriceps muscles while activating these branches simultaneously and in isolation. Regardless of joint angle and inter-muscular connections between muscles, the differences in torque values between the simultaneous and the isolated activation of the quadriceps muscles were also observed for the directly measured force values. Mean differences in simultaneous and isolated muscle activation remained similar between the intact and separated conditions: torque difference (21±5% of maximum isometric torque of intact condition [MICtorque], versus 19±6% MICtorque respectively) and for force (18±3% MICforce versus 19±7% MICforce respectively). The absolute torque loss was independent of the force, and thus presumably the inter-muscular pressures. Based on these results, we conclude that neither moment arm, inter-muscular pressure nor inter-muscular force transmission seems to be the primary cause for the torque deficit observed during simultaneous compared to isolated muscle activation. The mechanisms underlying loss of force capacity during agonistic muscle contraction remain unknown.
Case Report: Acute pancreatitis as a complication for the use of furosemide during transurethral resection of the prostate
Authors: Grandez-Urbina J. Antonio , Santillan-Romero Anggie , Corrales-Acosta Mariela , Tejeda-Mariaca J. Eduardo , Fernandez-Luque J. Luis
Published: December 2019

Background: Pancreatitis caused after transurethral resection of the prostate (TURP) is an uncommon complication, with few reports found in the literature. Here we present the case of a middle-aged patient without comorbidities with this pathology.

Clinical case: A 66-year-old male patient with no prior medical history underwent TURP surgery due to benign prostatic hyperplasia. The evolution was unfavourable, leading to post TURP syndrome. On the fifth day after surgery, the patient was admitted for emergency dialysis. During his emergency stay, the patient was unstable; he was diagnosed with pancreatitis, moving to an intensive care unit for management The patient progressed favourably from renal failure and pancreatitis, and on the 5th day the patient was discharged, tolerating oral feeding and stabilized renal failure.

Conclusions: Pancreatitis caused by TURP is very rare. This complication has been reported in the literature infrequently and should be suspected when there is pain in the epigastrium. If this complication is suspected, imaging tests and pancreatic enzyme levels should be immediately requested, as it can have an unfavourable evolution until death.
Population-based palliative care planning in Ireland: how many people will live and die with serious illness to 2046?
Authors: May Peter , Johnston Bridget M. , Normand Charles , Higginson Irene J. , Kenny Rose Anne , Ryan Karen
Published: December 2019

Background: All countries face growing demand for palliative care services.  Projections of need are essential to plan care in an era of demographic change.   We aim to estimate palliative care needs in Ireland from 2016 to 2046.

Methods: Static modelling of secondary data.  First, we estimate the numbers of people in Ireland who will die from a disease associated with palliative care need.  We combine government statistics on cause of death (2007-2015) and projected mortality (2016-2046).  Second, we combine these statistics with survey data to estimate numbers of people aged 50+ living and dying with diseases associated with palliative care need.  Third, we use these projections and survey data to estimate disability burden, pain prevalence and health care utilisation among people aged 50+ living and dying with serious medical illness.

Results: In 2016, the number of people dying annually from a disease indicating palliative care need was estimated as 22,806, and the number of people not in the last year of life aged 50+ with a relevant diagnosis was estimated as 290,185.  Equivalent estimates for 2046 are 40,355 and 548,105, increases of 84% and 89% respectively.  These groups account disproportionately for disability burden, pain prevalence and health care use among older people, meaning that population health burdens and health care use will increase significantly in the next three decades.

Conclusion: The global population is ageing, although significant differences in intensity of ageing can be seen between countries. Prevalence of palliative care need in Ireland will nearly double over 30 years, reflecting Ireland’s relatively young population.  People living with a serious disease outnumber those in the last year of life by approximately 12:1, necessitating implementation of integrated palliative care across the disease trajectory. Urgent steps on funding, workforce development and service provision are required to address these challenges.
On the System CB1 and a Lattice of the Paraconsistent Calculi
Authors: Ciuciura Janusz
Published: December 2019

In this paper, we present a calculus of paraconsistent logic. We propose an axiomatisation and a semantics for the calculus, and prove several important meta-theorems. The calculus, denoted as CB1, is an extension of systems PI, C min and B1, and a proper subsystem of Sette’s calculus P1. We also investigate the generalization of CB1 to the hierarchy of related calculi.
Knowledge of immunosuppressive drugs used in kidney transplants
Authors: Mohamad Mas Linda , Yang Li , Jin Xu , Eng Priscilla Tan Lee , Shern Terence Kee Yi
Published: December 2019

Aim:

A key role of renal nurses is the correct and safe administration of immunosuppressive drug therapy (ImmRx) to kidney transplant recipients. The authors sought to examine the knowledge and competency of ImmRx in kidney transplant patients and whether an annual kidney transplant nurse education programme had any beneficial effects.

Methods:

The study population was comprised of 63.2% (n=50/79) of all nurses from renal wards (ward A (n=17/35), ward B (n=21/32)) and 12 nurses from a high-dependency urology ward (ward C (n=12)). Kidney transplant patients usually receive inpatient care in wards A, B or C only as these wards specialise in urology and renal care. Each nurse completed a 35-question test that covered ImmRx in areas of indication, identification, interaction, pharmcokinetics/pharmacodynamics, therapeutic drug monitoring, administration and adverse effects. A minimum score of 70% was required to pass the test.

Results:

Only 46% of participants passed the test. The proportion of nurses who passed was not significantly different with respect to years of nursing experience, professional rank, postgraduate nursing qualifications or ward location. Unexpectedly, a greater proportion of nurses who did not attend the education programme passed the test (63.6%; n=14/22) than those who did attend it (32.1%; n=9/28]; p=0.03). Notably, 24% (n=12/50), 4% (n=2/50) and 4% (n=2/50) were unable to correctly answer any of the identification, interaction and therapeutic drug monitoring questions.

Conclusion:

These findings suggest that the nurses' understanding and knowledge of ImmRx is insufficient and they need to update their knowledge on ImmRx continually.
Get into the groove
Authors: Harris Judith
Published: December 2019

In part two of her series on music, Judith Harries outlines ways to tap into children's innate ability to move to the beat. Encourage them to combine singing and movement, and observe how their confidence and enjoyment grows.
‘My family story’
Authors: Clarke Jenni
Published: December 2019

Jenni Clarke kicks off a series exploring ‘in the moment planning’, outlining how this approach to children's learning can be harnessed effectively. Here she provides scenarios for using picture books as a key resource to support a ‘my family’ theme.
Ar/Cl2 etching of GaAs optomechanical microdisks fabricated with positive electroresist
Authors: Benevides Rodrigo , Ménard Michaël , Wiederhecker Gustavo S. , Mayer Alegre Thiago P.
Published: December 2019

A method to fabricate GaAs microcavities using only a soft mask with an electrolithographic pattern in an inductively coupled plasma etching is presented. A careful characterization of the fabrication process pinpointing the main routes for a smooth device sidewall is discussed. Using the final recipe, optomechanical microdisk resonators are fabricated. The results show very high optical quality factors of Qopt > 2 × 105, among the largest already reported for dry-etching devices. The final devices are also shown to present high mechanical quality factors and an optomechanical vacuum coupling constant of g0 = 2π × 13.6 kHz enabling self-sustainable mechanical oscillations for an optical input power above 1 mW.
Portraits of Automated Facial Recognition
Authors: Lee-Morrison Lila
Published: December 2019

Automated facial recognition algorithms are increasingly intervening in society. This book offers a unique analysis of these algorithms from a critical visual culture studies perspective. The first part of this study examines the example of an early facial recognition algorithm called »eigenface« and traces a history of the merging of statistics and vision. The second part addresses contemporary artistic engagements with facial recognition technology in the work of Thomas Ruff, Zach Blas, and Trevor Paglen. This book argues that we must take a closer look at the technology of automated facial recognition and claims that its forms of representation are embedded with visual politics. Even more significantly, this technology is redefining what it means to see and be seen in the contemporary world.
Leaf geometric morphometrics among populations of Dalbergia ecastaphyllum (L.) Taub.
Authors: Morais Daniel Vieira de , Nunes Lorena Andrade , Mata Vandira Pereira da , Costa Maria Angélica Pereira de Carvalho , Sodré Geni da Silva , Carvalho Carlos Alfredo Lopes de
Published: December 2019

Leaves are plant structures that express important traits of the environment where they live. Leaf description has allowed identification of plant species as well as investigation of abiotic factors effects on their development, such as gases, light, temperature, and herbivory. This study described populations of Dalbergia ecastaphyllum through leaf geometric morphometrics in Brazil. We evaluated 200 leaves from four populations. The principal component analysis (PCA) showed that the first four principal components were responsible for 97.81% of variation. The non-parametric multivariate analysis of variance (NPMANOVA) indicated significant difference between samples (p = 0.0001). The Mentel test showed no correlation between geographical distances and shape. The canonical variate analysis (CVA) indicated that the first two variables were responsible for 96.77 % of total variation, while the cross-validation test showed an average of 83.33%. D. ecastaphyllum leaves are elliptical and ovate.