bluuebunny/crossref_metadata_2025 huggingface dataset:
Structural optimization design of typical adhesive bonded sandwich T-joints based on progressive damage analysis and multi-island genetic algorithm
Authors: Niu Yiran , Xu Xiwu , Guo Shuxiang
Published: October 2020

This paper deals with the optimization of multi-laminate structures by Multi-Island Genetic Algorithm (MIGA) coupled with CAE solver. The optimization problem is a compound problem which relates to size optimization for object structure and stacking sequence optimization for variable-thickness composite laminates. Taking a typical adhesive bonded sandwich T-joint under a reference pull-off load as an instance object and establishing strength conditions on the basis of progressive damage analysis, optimum design is carried out with the total weight of joint as the target function. Progressive damage model (PDM) methodology and cohesive zone model (CZM) methodology are employed to develop an exact finite element model of the object structure. Classified failure criteria are chosen to investigate the capability of the joint in bearing the applied load. The optimization procedure on the typical adhesive bonded sandwich T-joint showed 34.24% weight reduction compared to the initial laminated structure. On the basis of history data, the study further brings out the influence of design variables on some main constraint variables.
Reliability analysis of a multi-state system with identical units having two dependent components
Authors: Iscioglu Funda , Erem Aysegul
Published: October 2020

The performance evaluation of a system having n identical units, each of which consists of two components has been successfully discussed in binary-state reliability analysis. In this paper, we study the performance evaluation of a multi-state system based on bivariate order statistics. The multi-state system consists of n independent and identical units, each having two components. The components of each unit are assumed to be s-dependent. However, the units work s-independently with each other. The system and each component of each unit having three performance levels “0 (failure), 1 (partially working) and 2 (completely working)” are considered. The degradation of the components follows Markov Process and also Farlie-Gumbel-Morgenstern distribution is used to model the s-dependence of the components. The reliability analysis of a multi-state k-out-of- n system are evaluated under the assumptions. Some dynamic performance measures for the system such as the mean residual and mean past lifetime functions based on bivariate order statistics are also evaluated. The performance of the system is especially examined for different values of s-dependence parameter, the degradation rates and different number of units for the system. The results are supported with some numerical examples and graphical representations.
Effects of limb dominance on the symmetrical distribution of plantar loading during walking and running
Authors: Gao Zixiang , Mei Qichang , Xiang Liangliang , Baker Julien S , Fernandez Justin , Gu Yaodong
Published: October 2020

The purpose of this study was to investigate the symmetry or asymmetry in the plantar pressure, foot axis angle and muscle mass of dominant and non-dominant legs. Sixty-eight able-bodied participants (age: 20 ± 1 years, height: 162 ± 8 cm, mass: 53 ± 7 kg, BMI: 20.63 ± 2 kg/m2) were recruited for the walking and running tests. All participants with right dominant feet, defined as the preferred leg when kicking a ball, were asked to perform four successful trials at their self-selected walking and running speeds after warm-up. FootScan force-measuring plate was utilized to collect plantar pressure and foot axis angle. The Tanita Segmental Body Composition Analyzer was used to measure the muscle mass of the lower limbs. The time-series parameters were checked using an open-source statistical parametric mapping 1d package. The result exhibited that the medial foot pressure of the dominant limb was higher than the non-dominant limb ( p < 0.05). Foot balance index range showed asymmetry in both walking and running tasks (absolute symmetry index <10%). There was no significant difference in muscle mass between the dominant and non-dominant lower limbs ( p = 0.79). The quantification of potential differences and asymmetries could provide implications for gait injury prevention and shoe design.
Ustekinumab dose escalation improves clinical responses in refractory Crohn’s disease
Authors: Haider Syedreza A. , Yadav Abhijeet , Perry Courtney , Su Leon , Akanbi Olalekan , Kudaravalli Praneeth , Tripathi Nishant , Hashim Mahmoud A. , Abdelsalam Mohammed , Hussein Mohamed , Elkheshen Ahmed , Patel Vihang , Ali Saad Emhmed , Lamb Latoya , Ingram Karen , Mayne Casie , Stuffelbeam Amy B. , Flomenhoft Deborah , Stromberg Arnold , Barrett Terrence A.
Published: October 2020

Background:

Clinicians often utilize off-label dose escalation of ustekinumab (UST) in Crohn’s disease (CD) patients with disease refractory to standard dosing. Previous studies report mixed results with dose escalation of UST.

Methods:

A retrospective observational study of 143 adult patients with CD receiving UST over a 33-month time period was conducted. Patients receiving UST at standard dosage for a minimum of 16 weeks were included in the analysis. Primary outcomes collected were clinical response [Physician Global Assessment Score (PGA) by >1] and remission (PGA = 0). Changes in clinical parameters were calculated for dose-escalated patients beginning with the time of dose switch (~42 weeks) and compared with a group of patients who were classified as “failing” standard dosing at 42 weeks who were not dose escalated.

Results:

Dose escalation improved PGA by 0.47 ± 0.19 compared with patients remaining on every 8 weeks dosing (Q8 week), who worsened by 0.23 ± 0.23 ( p < 0.05). Dose escalation decreased CRP 0.33 ± 0.19 mg/L and increased serum albumin 0.23 ± 0.06 g/dL ( p < 0.05). Surprisingly, disease duration and prior CD surgeries inversely correlated with the need for dose escalation.

Conclusion:

Our results support UST Q4 week dose escalation for selected CD patients who fail to achieve remission on standard Q8 week dosing. Dose escalation improves clinical outcomes, prevents worsening disease severity, and positively impacts CRP and albumin levels. Together these data indicate that clinicians should attempt Q4 week UST dosing in refractory CD patients before switching to an alternative class of biologic therapy.
Occlusion and Temporomandibular Disorders: A Long-Standing Controversy in Dentistry
Authors: Al-Ani Ziad
Published: October 2020

The relationship between temporomandibular disorders (TMDs) and occlusion remains controversial. Some authors believe that occlusion is the primary factor in the onset of TMD symptoms, whereas others feel that occlusion has no role in this at all. The majority of reasoning behind causation is based upon anecdotal rather than scientific evidence. Existing evidence in the literature supports the absence of a disease-specific association. This article describes this controversy and provides the reader with findings from contemporary literature.
Management of Diabetes in People Undergoing Dental Treatment in Primary Care
Authors: Nayani Samina , Mustafa Omar G.
Published: October 2020

Diabetes mellitus is a condition resulting from loss of production of insulin, or insufficient production/insulin resistance leading to high blood glucose levels. Management of the condition can be provided in a variety of settings and is tailored to the person’s requirements. The condition has a lifelong, systemic impact due to microvascular and macrovascular complications. Diabetes mellitus has dental implications due to increased risk of infections, poor wound healing, rapid progression of periapical pathology, xerostomia, burning mouth syndrome, and a bidirectional link with periodontal disease. Two clinical cases of patients with diabetes are discussed and their dental management described. Many people with diabetes can be treated in primary care, however, some with suboptimal glycaemic control may require specialist input and liaison with the patient’s diabetes team.
Quality of life in methadone maintenance treated patients in Long An, a southern province of Vietnam
Authors: Quyen Bui Thi Tu , Nguyen Linh Thuy , Phuong Vo Thi Viet , Hoang Le Tu
Published: October 2020

This cross-sectional study was conducted to identify the quality of life (QoL) and its related factors in methadone maintenance treatment (MMT) patients at four health facilities in Long An province, Vietnam in 2019. We interviewed 373 MMT patients using the WHOQOL-BREF measurement questionnaire and used their health records to collect some other data. The findings showed that the patients had a mean QoL score of 66.1 points. Factors associated with a higher QoL score included having employment, receiving support from relatives, and having health insurance. Therefore, it is recommended that patients should be assisted to participate in health insurance and supported by their relatives.
Teaching Statistics in Public Health During COVID-19: Lessons Learned From Spring 2020 and Recommendations for the Future
Authors: Haardörfer Regine , Livingston Melvin
Published: October 2020

With new COVID-19 infections still of concern in the United States, teaching will continue to be affected in the foreseeable future. It is imperative to consider lessons learned from the Spring 2020 semester and adapt future teaching accordingly. The primary audience for this article includes those who are teaching, and mentoring those who teach, quantitative methods courses to MPH and doctoral students in programs focused on behavioral, social, and health education sciences. While some of what we present is specific to teaching statistics, many points transfer to other methods courses and beyond. Thus, we are sharing our experiences and propose some recommendations for teaching in the future while social distancing.
CoGAPS 3: Bayesian non-negative matrix factorization for single-cell analysis with asynchronous updates and sparse data structures
Authors: Sherman Thomas D. , Gao Tiger , Fertig Elana J.
Published: October 2020

Background

Bayesian factorization methods, including Coordinated Gene Activity in Pattern Sets (CoGAPS), are emerging as powerful analysis tools for single cell data. However, these methods have greater computational costs than their gradient-based counterparts. These costs are often prohibitive for analysis of large single-cell datasets. Many such methods can be run in parallel which enables this limitation to be overcome by running on more powerful hardware. However, the constraints imposed by the prior distributions in CoGAPS limit the applicability of parallelization methods to enhance computational efficiency for single-cell analysis.

Results

We developed a new software framework for parallel matrix factorization in Version 3 of the CoGAPS R/Bioconductor package to overcome the computational limitations of Bayesian matrix factorization for single cell data analysis. This parallelization framework provides asynchronous updates for sequential updating steps of the algorithm to enhance computational efficiency. These algorithmic advances were coupled with new software architecture and sparse data structures to reduce the memory overhead for single-cell data.

Conclusions

Altogether our new software enhance the efficiency of the CoGAPS Bayesian matrix factorization algorithm so that it can analyze 1000 times more cells, enabling factorization of large single-cell data sets.
Genome-wide association study of leaf rust resistance in Russian spring wheat varieties
Authors: Leonova Irina N. , Skolotneva Ekaterina S. , Salina Elena A.
Published: October 2020

Background

Leaf rust (Puccinia triticina Eriks.) is one of the most dangerous diseases of common wheat worldwide. Three approaches: genome-wide association study (GWAS), marker-assisted selection (MAS) and phytopathological evaluation in field, were used for assessment of the genetic diversity of Russian spring wheat varieties on leaf rust resistance loci and for identification of associated molecular markers.

Results

The collection, consisting of 100 Russian varieties of spring wheat, was evaluated over three seasons for resistance to the native population of leaf rust specific to the West Siberian region of Russia. The results indicated that most cultivars showed high susceptibility to P. triticina, with severity ratings (SR) of 60S–90S, however some cultivars showed a high level of leaf rust resistance (SR < 20MR-R). Based on the results of genome-wide association studies (GWAS) performed using the wheat 15 K genotyping array, 20 SNPs located on chromosomes 6D, 6A, 6B, 5A, 1B, 2A, 2B and 7A were revealed to be associated with leaf rust resistance. Genotyping with markers developed for known leaf rust resistance genes showed that most of the varieties contain genes Lr1, Lr3a, Lr9, Lr10, Lr17a, Lr20, Lr26 and Lr34, which are not currently effective against the pathogen. In the genome of three wheat varieties, gene Lr6Ai = 2 inherited from Th. intermedium was detected, which provides complete protection against the rust pathogen. It has been suggested that the QTL mapped to the chromosome 5AS of wheat cultivar Tulaikovskaya-zolotistaya, Tulaikovskaya-10, Samsar, and Volgouralskaya may be a new, previously undescribed locus conferring resistance to leaf rust. Obtained results also indicate that chromosome 1BL of the varieties Sonata, Otrada-Sibiri, Tertsiya, Omskaya-23, Tulaikovskaya-1, Obskaya-14, and Sirena may contain an unknown locus that provides a resistance response to local population.

Conclusions

This study provides new insights into the genetic basis of resistance to leaf rust in Russian spring wheat varieties. The SNPs significantly associated with leaf rust resistance can be used for the development and application of diagnostic markers in marker-assisted selection schemes.
The mechanism of potato resistance to Globodera rostochiensis: comparison of root transcriptomes of resistant and susceptible Solanum phureja genotypes
Authors: Kochetov Alex V. , Egorova Anastasiya A. , Glagoleva Anastasiya Y. , Strygina Kseniya V. , Khlestkina Elena K. , Gerasimova Sophia V. , Shatskaya Natalja V. , Vasilyev Gennady V. , Afonnikov Dmitry A. , Shmakov Nikolay A. , Antonova Olga Y. , Alpatyeva Natalia V. , Khiutti Alexander , Afanasenko Olga S. , Gavrilenko Tatjana A.
Published: October 2020

Background

Globodera rostochiensis belongs to major potato pathogens with a sophisticated mechanism of interaction with roots of the host plants. Resistance of commercial varieties is commonly based on specific R genes introgressed from natural populations of related wild species and from native potato varieties grown in the Andean highlands. Investigation of molecular resistance mechanisms and screening the natural populations for novel R genes are important for both fundamental knowledge on plant pathogen interactions and breeding for durable resistance. Here we exploited the Solanum phureja accessions collected in South America with contrasting resistance to G. rostochiensis.

Results

The infestation of S. phureja with G. rostochiensis juveniles resulted in wounding stress followed by activation of cell division and tissue regeneration processes. Unlike the susceptible S. phureja genotype, the resistant accession reacted by rapid induction of variety of stress response related genes. This chain of molecular events accompanies the hypersensitive response at the juveniles’ invasion sites and provides high-level resistance. Transcriptomic analysis also revealed considerable differences between the analyzed S. phureja genotypes and the reference genome.

Conclusion

The molecular processes in plant roots associated with changes in gene expression patterns in response to G. rostochiensis infestation and establishment of either resistant or susceptible phenotypes are discussed. De novo transcriptome assembling is considered as an important tool for discovery of novel resistance traits in S. phureja accessions.
Dynamical climatic model for time to flowering in Vigna radiata
Authors: Kozlov Konstantin , Sokolkova Alena , Lee Cheng-Ruei , Ting Chau-Ti , Schafleitner Roland , Bishop-von Wettberg Eric , Nuzhdin Sergey , Samsonova Maria
Published: October 2020

Background

Phenology data collected recently for about 300 accessions of Vigna radiata (mungbean) is an invaluable resource for investigation of impacts of climatic factors on plant development.

Results

We developed a new mathematical model that describes the dynamic control of time to flowering by daily values of maximal and minimal temperature, precipitation, day length and solar radiation. We obtained model parameters by adaptation to the available experimental data. The models were validated by cross-validation and used to demonstrate that the phenology of adaptive traits, like flowering time, is strongly predicted not only by local environmental factors but also by plant geographic origin and genotype.

Conclusions

Of local environmental factors maximal temperature appeared to be the most critical factor determining how faithfully the model describes the data. The models were applied to forecast time to flowering of accessions grown in Taiwan in future years 2020-2030.
Genetic variability of spelt factor gene in Triticum and Aegilops species
Authors: Vavilova Valeriya , Konopatskaia Irina , Blinov Alexandr , Kondratenko Elena Ya. , Kruchinina Yuliya V. , Goncharov Nikolay P.
Published: October 2020

Background

Threshability, rachis fragility and spike shape are critical traits for the domestication and evolution of wheat, determining the crop yield and efficiency of the harvest. Spelt factor gene Q controls a wide range of domestication-related traits in polyploid wheats, including those mentioned above. The main goal of the present study was to characterise the Q gene for uninvestigated accessions of wheats, including four endemics, and Aegilops accessions, and to analyze the species evolution based on differences in Q gene sequences.

Results

We have studied the spike morphology for 15 accessions of wheat species, including four endemics, namely Triticum macha, T. tibetanum, T. aestivum ssp. petropavlovskyi and T. spelta ssp. yunnanense, and 24 Aegilops accessions, which are donors of B and D genomes for polyploid wheat. The Q-5A, q-5D and q-5S genes were investigated, and a novel allele of the Q-5A gene was found in accessions of T. tibetanum (KU510 and KU515). This allele was similar to the Q allele of T. aestivum cv. Chinese Spring but had an insertion 161 bp in length within exon 5. This insertion led to a frameshift and premature stop codon formation. Thus, the T. tibetanum have spelt spikes, which is probably determined by the gene Tg, rather than Q. We determined the variability within the q-5D genes among hexaploid wheat and their D genome donor Aegilops tauschii. Moreover, we studied the accessions C21–5129, KU-2074, and K-1100 of Ae. tauschii ssp. strangulata, which could be involved in the origin of hexaploid wheats.

Conclusions

The variability and phylogenetic relationships of the Q gene sequences studied allowed us to clarify the relationships between species of the genus Triticum and to predict the donor of the D genome among the Ae. tauschii accessions. Ae. tauschii ssp. strangulata accessions C21–5129, KU-2074 and K-1100 are the most interesting among the analysed accessions, since their partial sequence of q-5D is identical to the q-5D of T. aestivum cv. Chinese Spring. This result indicates that the donor is Ae. tauschii ssp. strangulata but not Ae. tauschii ssp. tauschii. Our analysis allowed us to clarify the phylogenetic relationships in the genus Triticum.
Genome-wide characterization and expression analysis of the heat shock transcription factor family in pumpkin (Cucurbita moschata)
Authors: Shen Changwei , Yuan Jingping
Published: October 2020

Background

Crop quality and yield are affected by abiotic and biotic stresses, and heat shock transcription factors (Hsfs) are considered to play important roles in regulating plant tolerance under various stresses. To investigate the response of Cucurbita moschata to abiotic stress, we analyzed the genome of C. moschata.

Results

In this research, a total of 36 C. moschata Hsf (CmHsf) members were identified and classified into three subfamilies (I, II, and III) according to their amino acid sequence identity. The Hsfs of the same subfamily usually exhibit a similar gene structure (intron-exon distribution) and conserved domains (DNA-binding and other functional domains). Chromosome localization analysis showed that the 36 CmHsfs were unevenly distributed on 18 of the 21 chromosomes (except for Cm_Chr00, Cm_Chr08 and Cm_Chr20), among which 18 genes formed 9 duplicated gene pairs that have undergone segmental duplication events. The Ka/Ks ratio showed that the duplicated CmHsfs have mainly experienced strong purifying selection. High-level synteny was observed between C. moschata and other Cucurbitaceae species.

Conclusions

The expression profile of CmHsfs in the roots, stems, cotyledons and true leaves revealed that the CmHsfs exhibit tissue specificity. The analysis of cis-acting elements and quantitative real-time polymerase chain reaction (qRT-PCR) revealed that some key CmHsfs were activated by cold stress, heat stress, hormones and salicylic acid. This study lays the foundation for revealing the role of CmHsfs in resistance to various stresses, which is of great significance for the selection of stress-tolerant C. moschata.
Analysis of the role of the human papillomavirus 16/18 E7 protein assay in screening for cervical intraepithelial neoplasia: a case control study
Authors: Kong Linghua , Xiao Xiaoping , Lou Huiping , Liu Pengfei , Song Shuhui , Liu Moudu , Xu Tao , Zhang Ying , Li Caijuan , Guan Ruoli , Li Yan , Yu Xin , Liu Haiyuan , Fan Qingbo , Shi Honghui , Zhu Lan
Published: October 2020

Background

Cervical cancer is the second-most common gynecological cancer, early screening plays a key role in the diagnosis and treatment of cervical intraepithelial neoplasia (CIN). Sustained E7 protein expression is the pathological basis for CIN and cervical cancer.

Methods

We collected the cervical cell samples of women who visited the gynecological clinic of Peking Union Medical College Hospital between September 2018 and September 2019 and submitted them to the high-risk human papillomavirus (Hr-HPV) test. We performed a magnetic particle–based chemiluminescence enzyme immunoassay to analyze the HPV16/18 E7 protein level in CIN of different severities and compared the results with those of cervical pathology (gold standard) and the HPV test.

Results

The positive rate of HPV16/18 E7 protein increased with the severity of CIN: 26.6% in normal tissue, 58.3% in CIN1, and 70.6% in CIN2 or higher (CIN2+). For CIN2+, the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the E7 protein were 70.6, 67.9, 52.2, and 82.3%, respectively. These values of the HPV test were 86.8, 44.5, 43.7, and 87.1%, respectively. With the combination of the E7 protein assay and HPV test, the specificity for diagnosing CIN2+ was 78.1%, which was significantly higher than that of the HPV test alone.

Conclusions

HPV16/18 E7 protein level is correlated with the severity of CIN and has a high concordance rate with the pathological result. For cervical cancer screening, the combination of HPV16/18 E7 protein assay and HPV test improves the CIN diagnostic specificity, detection rate, and detection accuracy.
Current uses and knowledge of medicinal plants in the Autonomous Community of Madrid (Spain): a descriptive cross-sectional study
Authors: Sánchez Marta , González-Burgos Elena , Iglesias Irene , Lozano Rafael , Gómez-Serranillos María Pilar
Published: October 2020

Background

The usage of medicinal plants as a key component of complementary and alternative medicine, has acquired renewed interest in developed countries. The current situation of medicinal plants in Spain is very limited. This paper provides new insights and greater knowledge about current trends and consumption patterns of medicinal plants in the Autonomous Community of Madrid (Spain) for health benefits.

Methods

A descriptive cross-sectional study was designed for a population-based survey on medicinal plants. The data were collected (May 2018 to May 2019) using semi-structured face-to-face interviews in independent pharmacies, hospital centers and primary care health centers in the Autonomous Community of Madrid. The survey had 18 multiple choice and open-ended questions. Quantitative indices were calculated: Fidelity Level (FL), Use Value (UV) and Informants Consensus Factor (ICF). Chi-square test was used for data analysis.

Results

Five hundred forty-three people were interviewed. The majority of the participants (89.6%) have used medicinal plants to treat health disorders in the past 12 months, mainly for digestive problems, sleep disorders and central nervous system diseases. A total of 78 plants were recorded, being Matricaria recutita, Valeriana officinalis, Tilia spp. and Aloe vera the most used. The highest UV was found for Mentha pulegium (UV 0.130) followed by Aloe vera (UV 0.097) and Vaccinium macrocarpon. (UV 0.080). The highest FL values were for Eucalyptus spp. (FL 90.47%) for respiratory conditions and, Matricaria recutita (85.55%) and Mentha pulegium (84.09%) for digestive problems. The highest ICF corresponded to metabolism and depression (ICF = 1), pain (ICF = 0.97), insomnia (ICF = 0.96) and anxiety (ICF = 0.95). Participants mostly acquired herbal medicines from pharmacies, herbal shops and supermarkets. Some side effects (tachycardia, dizziness and gastrointestinal symptoms) and potential interactions medicinal plants-drugs (V. officinalis and benzodiazepines) were reported.

Conclusion

Many inhabitants of the Autonomous Community of Madrid currently use herbal products to treat minor health problems. The most common consumer pattern are young women between 18 and 44 years of age with higher education. In order to confirm the pattern, further research should be focused to investigate current uses of medicinal plants in other Spanish regions.
Out-of-hours workload among Norwegian general practitioners – an observational study
Authors: Rebnord Ingrid Keilegavlen , Morken Tone , Maartmann-Moe Kjell , Hunskaar Steinar
Published: October 2020

Background

Repeated studies of working hours among Norwegian regular general practitioners (RGPs) have shown that the average total number of weekly working hours has remained unchanged since 1994 and up until 2014. For both male and female RGPs, the mean total weekly working hours amounted to almost 50 h in 2014.

In recent years, Norwegian RGPs have become increasingly dissatisfied. They experience significantly increased workload without compensation in the form of more doctors or better payment. A study from the Norwegian Directorate of Health in 2018 (the RGP study) showed that Norwegian RGPs worked 55.6 h weekly (median 52.5). 25% of the respondents worked more than 62.2 h weekly.

Based on data from the RGP study we investigated Norwegian RGP’s out-of-hours (OOH) work, how the working time was distributed, and to what extent the OOH work affected the regular working hours.

Methods

In early 2018, an electronic survey was sent to all 4640 RGPs in Norway. Each RGP reported how many minutes that were spent that particular day on various tasks during seven consecutive days. Working time also included additional tasks in the municipality, other professional medical work and OOH primary health care. Differences were analysed by independent t-tests, and regression analyses.

Results

One thousand eighty hundred seventy-six RGPs (40.4%) responded, 640 (34.1%) had registered OOH work. Male RGPs worked on average 1.5 h more doing regular work than did females (p = 0.001) and on average 2.3 h more OOH work than females (p = 0.079). RGPs with no OOH work registered a mean of 1.0 h more clinical work than RGPs working OOH (p = 0.043). There was a large variation in OOH working hours. A linear regression analysis showed that male RGPs and RGPs in rural areas had the heaviest OOH workload.

Conclusions

One in three Norwegian RGPs undertook OOH work during the registration week in the RGP study. OOH work was done in addition to a sizeable regular workload as an RGP. We found small gender differences. OOH work was not compensated with reduced regular RGP work.
Ablation of polyamine catabolic enzymes provokes Purkinje cell damage, neuroinflammation, and severe ataxia
Authors: Zahedi Kamyar , Brooks Marybeth , Barone Sharon , Rahmati Negah , Murray Stewart Tracy , Dunworth Matthew , Destefano-Shields Christina , Dasgupta Nupur , Davidson Steve , Lindquist Diana M. , Fuller Christine E. , Smith Roger D. , Cleveland John L. , Casero Robert A. , Soleimani Manoocher
Published: October 2020

Background

Polyamine catabolism plays a key role in maintaining intracellular polyamine pools, yet its physiological significance is largely unexplored. Here, we report that the disruption of polyamine catabolism leads to severe cerebellar damage and ataxia, demonstrating the fundamental role of polyamine catabolism in the maintenance of cerebellar function and integrity.

Methods

Mice with simultaneous deletion of the two principal polyamine catabolic enzymes, spermine oxidase and spermidine/spermine N1-acetyltransferase (Smox/Sat1-dKO), were generated by the crossbreeding ofSmox-KO (Smox−/−) andSat1-KO (Sat1−/−) animals. Development and progression of tissue injury was monitored using imaging, behavioral, and molecular analyses.

Results

Smox/Sat1-dKO mice are normal at birth, but develop progressive cerebellar damage and ataxia. The cerebellar injury inSmox/Sat1-dKO mice is associated with Purkinje cell loss and gliosis, leading to neuroinflammation and white matter demyelination during the latter stages of the injury. The onset of tissue damage inSmox/Sat1-dKO mice is not solely dependent on changes in polyamine levels as cerebellar injury was highly selective. RNA-seq analysis and confirmatory studies revealed clear decreases in the expression of Purkinje cell-associated proteins and significant increases in the expression of transglutaminases and markers of neurodegenerative microgliosis and astrocytosis. Further, the α-Synuclein expression, aggregation, and polyamination levels were significantly increased in the cerebellum ofSmox/Sat1-dKO mice. Finally, there were clear roles of transglutaminase-2 (TGM2) in the cerebellar pathologies manifest inSmox/Sat1-dKO mice, as pharmacological inhibition of transglutaminases reduced the severity of ataxia and cerebellar injury inSmox/Sat1-dKO mice.

Conclusions

These results indicate that the disruption of polyamine catabolism, via coordinated alterations in tissue polyamine levels, elevated transglutaminase activity and increased expression, polyamination, and aggregation of α-Synuclein, leads to severe cerebellar damage and ataxia. These studies indicate that polyamine catabolism is necessary to Purkinje cell survival, and for sustaining the functional integrity of the cerebellum.
Out-of-hospital cardiac arrest patients with an initial non-shockable rhythm could be candidates for extracorporeal cardiopulmonary resuscitation: a retrospective study
Authors: Tanimoto Atsunori , Sugiyama Kazuhiro , Tanabe Maki , Kitagawa Kanta , Kawakami Ayumi , Hamabe Yuichi
Published: October 2020

Background

Extracorporeal cardiopulmonary resuscitation (ECPR) is a promising treatment for refractory out-of-hospital cardiac arrest (OHCA). Most studies evaluating the effectiveness of ECPR include patients with an initial shockable rhythm. However, the effectiveness of ECPR for patients with an initial non-shockable rhythm remains unknown. This retrospective single-center study aimed to evaluate the effectiveness of ECPR for patients with an initial non-shockable rhythm, with reference to the outcomes of OHCA patients with an initial shockable rhythm.

Methods

Adult OHCA patients treated with ECPR at our center during 2011–2018 were included in the study. Patients were classified into the initial shockable rhythm group and the non-shockable rhythm group. The primary outcome was the cerebral performance category (CPC) scale score at hospital discharge. A CPC score of 1 or 2 was defined as a good outcome.

Results

In total, 186 patients were eligible. Among them, 124 had an initial shockable rhythm and 62 had an initial non-shockable rhythm. Among all patients, 158 (85%) were male, with a median age of 59 (interquartile range [IQR], 48–65) years, and the median low flow time was 41 (IQR, 33–48) min. Collapse was witnessed in 169 (91%) patients, and 36 (19%) achieved return of spontaneous circulation (ROSC) transiently. Proportion of female patients, presence of bystander cardiopulmonary resuscitation, and collapse after the arrival of emergency medical service personnel were significantly higher in the non-shockable rhythm group. The rate of good outcomes at hospital discharge was not significantly different between the shockable and non-shockable groups (19% vs. 16%,p = 0.69). Initial shockable rhythm was not significantly associated with good outcome after controlling for potential confounders (adjusted odds ratio 1.58, 95% confidence interval: 0.66–3.81,p = 0.31). In the non-shockable group, patients with good outcomes had a higher rate of transient ROSC, and pulmonary embolism was the leading etiology.

Conclusions

The outcomes of patients with an initial non-shockable rhythm are comparable with those having an initial shockable rhythm. OHCA patients with an initial non-shockable rhythm could be candidates for ECPR, if they are presumed to have reversible etiology and potential for good neurological recovery.
Maternal vitamin D deficiency impairs Treg and Breg responses in offspring mice and deteriorates allergic airway inflammation
Authors: Huang Fei , Ju Yang-hua , Wang Hong-bo , Li Ya-nan
Published: October 2020

Background

Vitamin D (VitD) can regulate immune responses and maternal VitD-deficiency can affect immune responses in the offspring. This study aimed at investigating the effects of maternal VitD-deficiency during pregnancy on Treg and Breg responses in offspring mice with house dust mite (HDM)-induced allergic airway inflammation.

Methods

Female BALB/c mice were randomized and fed with normal chow or VitD-deficient diet until their offspring weaned. The offspring mice were fed with normal chow and injected with vehicle or HDM to induce allergic airway inflammation. The levels of serum 25(OH)D, cytokines and infiltrate numbers as well as percentages of Tregs and Bregs in the bronchoalveolar lavage fluid (BALF) were analyzed. The relative levels of VitD receptor (VDR), VitD-binding protein (VDBP), Cytochromes P450 (CYP) 27b1, and CYP24A1 mRNA transcripts in the lungs of different groups of mice were measured.

Results

Maternal VitD-deficiency significantly reduced serum 25(OH)D levels in offspring mice. VitD-deficiency significantly increased the relative levels of VDR, VDBP and CYP27B1 mRNA transcripts, but decreased CYP24A1 expression in the lungs of mice. In comparison with the control mice, significantly elevated levels of pro-inflammatory cytokines, increased numbers of lymphocytes and eosinophils, but decreased levels of anti-inflammatory cytokines were detected in the BALF of VitD-deficient mice. VitD-deficiency significantly increased the frequency of Th1, Th2, Th9, Th17 cells, but decreased regulatory T (Tregs) and B cells (Bregs) in the BALF of mice with allergic airway inflammation.

Conclusion

Maternal VitD-deficiency lowed serum 25(OH)D levels and enhanced HDM-induced allergic airway inflammation in the offspring by impairing Breg and Treg responses.
Health-promoting and preventive interventions for community-dwelling older people published from inception to 2019: a scoping review to guide decision making in a Swedish municipality context
Authors: Bajraktari Saranda , Sandlund Marlene , Zingmark Magnus
Published: October 2020

Background

Despite the promising evidence of health-promoting and preventive interventions for maintaining health among older people, not all interventions can be implemented due to limited resources. Due to the variation of content in the interventions and the breadth of outcomes used to evaluate effects in such interventions, comparisons are difficult and the choice of which interventions to implement is challenging. Therefore, more information, beyond effects, is needed to guide decision-makers. The aim of this review was to investigate, to what degree factors important for decision-making have been reported in the existing health-promoting and preventive interventions literature for community-dwelling older people in the Nordic countries.

Methods

This review was guided by the PRISMA-ScR checklist (Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews), the methodological steps for scoping reviews described in the Arksey and O′Malley’s framework, and the Medical Research Council’s (MRC) guidance on complex interventions. Eligible studies for inclusion were randomised controlled trials (RCTs) concerning health promotion or primary prevention for community-dwelling older people implemented in the Nordic countries. Additionally, all included RCTs were searched for related papers that were reporting on additional factors. Eligible studies were searched in seven databases: PubMed, SCOPUS, CINAHL, Academic Search Elite, PsycINFO, SocINDEX, and SPORTDiscus.

Results

Eighty-two studies met the inclusion criteria (twenty-seven unique studies and fifty-five related studies). Twelve studies focused on fall prevention, eleven had a health-promoting approach, and four studies focused on preventing disability. All interventions, besides one, reported positive effects on at least one health outcome. Three studies reported data on cost-effectiveness, three on experiences of participants and two conducted feasibility studies. Only one intervention, reported information on all seven factors.

Conclusions

All identified studies on health-promoting and preventive interventions for older people evaluated in the Nordic countries report positive effects although the magnitude of effects and number of follow-ups differed substantially. Overall, there was a general lack of studies on feasibility, cost-effectiveness, and experiences of participants, thus, limiting the basis for decision making. Considering all reported factors, promising candidates to be recommended for implementation in a Nordic municipality context are ‘Senior meetings’, ‘preventive home visits’ and ‘exercise interventions’ on its own or combined with other components.
COVID-19 financial support to small businesses in Switzerland: evaluation and outlook
Authors: Brülhart Marius , Lalive Rafael , Lehmann Tobias , Siegenthaler Michael
Published: October 2020

We analyse small businesses’ recourse to public support measures during the COVID-19 crisis using a survey of 1011 self-employed workers and small business owners in Switzerland. We find that “objective” measures of lockdown affectedness and economic structure explain fairly well how businesses availed of support measures to cover labour costs. Recourse to government-backed corona loans, however, appears to be driven to a larger extent by behavioural idiosyncrasies across firms. Specifically, previously indebted businesses took out corona loans more readily than those who had been debt-free before the pandemic. Since uptake is not well in line with firm fundamentals, we propose making loan repayments contingent on future profits. This will more effectively target and sustain businesses that are in trouble today but would be viable in the absence COVID-19.
Motivations and expectations for using cannabis products to treat pain in humans and dogs: a mixed methods study
Authors: Wallace Jean E. , Kogan Lori R. , Carr Eloise C. J. , Hellyer Peter W.
Published: October 2020

Background

Social media and academic literature suggest that more people are using cannabis to treat their own or their dog’s chronic pain. This study identifies the reasons people use cannabis products to treat their own pain or their dog’s pain and explores whether these products have fulfilled their expectations.

Methods

An anonymous, online survey was used to collect quantitative and qualitative self-report data on respondents’ perceptions, motivations and expectations about their or their dog’s chronic pain and cannabis use. The analyses are based on U.S. adults who reported using cannabis products to treat their own (N = 313) or their dog’s (N = 204) chronic pain. Quantitative responses from the two groups were compared using Chi-Square tests and qualitative data were analyzed using a thematic analysis.

Results

Human patients and dog owners reported similar motivations for using cannabis products to treat chronic pain, with the more popular reasons being that cannabis products are natural, are preferred over conventional medication, are believed to be the best treatment or good treatment option for pain. Similar proportions of human patients and dog owners reported that the use of cannabis products fulfilled their expectations (86% vs. 82% respectively, χ2(1, 200) = .59,p = .32). The qualitative data revealed that their expectations were met by reducing pain, increasing relaxation, and improving sleep, coping, functionality and overall well being. Additionally, the qualitative data suggests that cannabis products offer a return to normalcy and a restored sense of self to human and dog patients.

Conclusions

The results suggest that people choose cannabis products because they are natural and a possible solution to managing chronic pain when conventional medicines have not been effective. Most people report that their expectations regarding pain management are fulfilled by these products. More accurate assessments are vital, however, for understanding both the objective biomedical and subjective socioemotional benefits of cannabis products for effective pain management for human and dog patients. In addition, objective factual information regarding cannabis products for effective pain management in humans and dogs is needed. It is recommended that both physicians and veterinarians work towards feeling more comfortable proactively broaching the subject of cannabis use with additional training and education.
Effect of a 6-week and 12-week cardiac rehabilitation program on heart rate recovery
Authors: El Missiri Ahmed , Amin Sameh Atteya , Tawfik Islam Reda , Shabana Adel Mohamed
Published: October 2020

Background

Cardiac rehabilitation has been shown to reduce cardiac mortality, improve quality of life, and reduce hospitalizations. Cardiac rehabilitation programs are usually performed over a 12-week period. Studies have shown that similar benefits could be achieved with shorter programs. Abnormal heart rate recovery after exercise has been associated with an increased risk of cardiovascular events and mortality. The main aim of this study was to compare the effect of a 6-week phase 2 cardiac rehabilitation program on heart rate recovery to a 12-week one in patients who had recovered from an anterior wall ST segment elevation myocardial infarction.

Results

This prospective study included 60 patients enrolled in cardiac rehabilitation programs randomized into two equal groups: a 6-week and a 12-week program. Baseline patient demographics, lipid profile, and left ventricular ejection fraction (LVEF) were assessed. METs achieved, total exercise time, resting heart rate, peak heart rate, and heart rate recovery at 1 min were examined. These were re-assessed at the end of each program.

Results showed no difference between both groups at the end of each program regarding lipid profile and LVEF. Patients enrolled in the 12-week cardiac rehabilitation program were able to achieve more METs, had a longer exercise time, a higher peak heart rate, and had a lower resting heart rate at the end of the program. Heart rate recovery was slightly higher in patients enrolled in the 6-week program 26.5 ± 6.78 versus 23.17 ± 6.12 bpm (p = 0.051).

On comparing the magnitude of change between both programs, those in the 12-week program had more increase in HDL-C levels, METs achieved, and exercise time. Additionally, they had more reduction of resting heart rate. Heart rate recovery was more increased for those in the 6-week program.

Conclusion

Although heart rate recovery increases after completion of each of a 6-week and 12-week cardiac rehabilitation program compared to their baseline, there is no difference on comparing heart rate recovery between both programs at their end.

Patients enrolled in a standard 12-week cardiac rehabilitation program achieve more METs, have a longer exercise time, a higher peak HR, and a lower resting HR at the end of the program compared to those in the 6-week program.
Case report: Amyand hernia reincarnate and the utility of computed tomography
Authors: Fields Joshua , Quinn Kristen , Hollinger Laura , Jones Richard
Published: October 2020

Background

An Amyand hernia is a rare condition in which the vermiform appendix follows the bowel as it bulges through the inguinal canal. Originally described by Claudius Amyand in 1735 in an 11-year-old boy who had a pin in the appendix (Philos Trans R Soc Lond. 1735;39:329–36), we describe here the first case with CT depicting all components of Dr. Amyand’s original case.

Case presentation

A 10-year-old boy presented with right lower quadrant and groin pain. CT imaging revealed a retained metallic foreign body perforating the appendix, acute appendicitis, and an Amyand hernia. A laparoscopic attempt at reduction failed due to tethering by the needle and inflammation of the hernia sac, requiring an open inguinal exploration and excision of the hernia sac. The patient was discharged on postoperative day 2 with plans for delayed hernia repair.

Conclusions

CT is a crucial diagnostic test for surgical decision-making in Amyand hernias. In this case, it accurately classified the hernia and led to anticipation of unsuccessful laparoscopic hernia reduction. Management in the setting of foreign body and perforation includes appendectomy and tissue herniorrhaphy with delayed formal inguinal hernia repair after inflammation has subsided.
Recidivism of childhood cholesteatoma and surgical techniques: a meta-analysis study
Authors: Shewel Yasser , Tawfik Seddik Abdel Salam , Aaref Abdulla A. L. , Saleh Noha
Published: October 2020

Background

There is a debate in the literature about surgical management of childhood cholesteatoma. We aimed to conduct a meta-analysis study about the recidivism of acquired cholesteatoma in children after two primary surgical procedures, namely canal wall up (CWU) and canal wall down (CWD) mastoidectomy.

Main body of the abstract

A Medline search of English language literature on PubMed and Cochrane Collaboration from their dates of inception until August 2019 was conducted using the following search terms: “pediatric or child and Cholesteatoma Surgery”. Twenty-eight full-text papers fulfilled the selection criteria and were included in this meta-analysis

This analysis showed an odd risk of 1.72 for recidivism of childhood cholesteatoma in single-stage canal wall up procedure relative to canal wall down procedures. The 95% confidence interval (CI) for the overall odds ratio was 1.27–2.34. The I2 statistic was 37%, representing low heterogeneity. Comparing the rate of recidivism before and after the year 2000 showed that there was still increased risk of recidivism in the canal wall up versus canal wall down mastoidectomy (the odds ratio was 1.87 and 1.57 respectively).

Short conclusion

Single-stage canal wall up mastoidectomy was significantly associated with a higher risk of cholesteatoma recidivism compared to canal wall down technique in children with acquired cholesteatoma