bluuebunny/crossref_metadata_2025 huggingface dataset:
Suppressed heat shock protein response in the kidney of exercise‐trained diabetic rats
Authors: Lappalainen J. , Oksala N. K. J. , Laaksonen D. E. , Khanna S. , Kokkola T. , Kaarniranta K. , Sen C. K. , Atalay M.
Published: February 2018

Impaired expression of heat shock proteins (HSPs) and increased oxidative stress may contribute to the pathophysiology of diabetes by disrupted tissue protection. Acute exercise induces oxidative stress, whereas exercise training up‐regulates endogenous antioxidant defenses and HSP expression. Although diabetic nephropathy is a major contributor to diabetic morbidity, information regarding the effect of HSPs on kidney protection is limited. This study evaluated the effects of eight‐week exercise training on kidney HSP expression and markers of oxidative stress at rest and after acute exercise in rats with or without streptozotocin‐induced diabetes. Induction of diabetes increased DNA‐binding activity of heat shock factor‐1, but decreased the expression of HSP72, HSP60, and HSP90. The inflammatory markers IL‐6 and TNF‐alpha were increased in the kidney tissue of diabetic animals. Both exercise training and acute exercise increased HSP72 and HSP90 protein levels only in non‐diabetic rats. On the other hand, exercise training appeared to reverse the diabetes‐induced histological changes together with decreased expression of TGF‐beta as a key inducer of glomerulosclerosis, and decreased levels of IL‐6 and TNF‐alpha. Notably, HSP72 and TGF‐beta were negatively correlated. In conclusion, impaired HSP defense seems to contribute to kidney injury vulnerability in diabetes and exercise training does not up‐regulate kidney HSP expression despite the improvements in histopathological and inflammatory markers.
Antibodies to human platelet antigens form a significant proportion of platelet antibodies detected in Indian patients with refractoriness to platelet transfusions
Authors: Abraham A. S. , Chacko M. P. , Fouzia N. A. , Srivastava A. , Daniel D.
Published: February 2018

Background

The transfusion of platelets is an important therapeutic strategy in bleeding patients with thrombocytopenia. However, some chronically transfused patients fail to achieve the appropriate platelet count increment following transfusion due to the presence of platelet alloantibodies.

Objectives

The aims of this research were to study the prevalence of platelet alloimmunisation and to characterise the platelet‐reactive (PR) antibodies in haematology patients refractory to platelet transfusions in an Indian setting.

Patients and methods

A total of 80 patients with a prior history of multiple transfusions (minimum of five cellular transfusions) were included in the study if they did not achieve an adequate corrected count increment within 24 h of the platelet transfusion. Patients with non‐immunological causes of platelet refractoriness were excluded from the study. The test was performed on a blood sample of 4 mL of Ethylenediaminetetraacetic acid (EDTA) blood sample in which plasma was separated and stored at –80 °C and underwent batch testing in PAK‐2LE.

Results

The overall prevalence of platelet alloimmunisation in our study was 60%. Of the 48 patients who were detected to have platelet antibodies, the combination of anti‐human leucocyte antigen (HLA) and platelet‐specific (PS) antibodies together constituted the majority of 54·2%. The overall prevalence of anti‐HLA antibodies was 51·25% and of PS antibodies was 41·25% in the total study population of 80.

Conclusion

The overall prevalence of PS antibodies in our study was greater than that reported by other groups in India and other countries. This needs to be considered, particularly in the management of patients refractory to platelet transfusions, where HLA‐matched platelets constitute current best practice.
CsSPL functions as an adaptor between HD‐ZIP III and CsWUS transcription factors regulating anther and ovule development in Cucumis sativus (cucumber)
Authors: Liu Xiaofeng , Ning Kang , Che Gen , Yan Shuangshuang , Han Lijie , Gu Ran , Li Zheng , Weng Yiqun , Zhang Xiaolan
Published: February 2018

Anther and ovule genesis preconditions crop fertilization and fruit production; however, coordinative regulation of anther and ovule development and underlying molecular pathways remain largely elusive. Here, we found that SPOROCYTELESS (SPL)/NOZZLE (NZZ) expression was nearly abolished in a Cucumis sativus (cucumber) mutant with severely defective anther and ovule development. CsSPL was expressed specifically in the developing anthers and ovules. Knock‐down of CsSPL reduced male and female fertility with malformed pollen and suppressed ovule development. Importantly, CsSPL directly interacted with CsWUS (WUSCHEL) in the nucellus and YABBY family genes in integuments, and positively regulated CsWUS expression, meanwhile the HD‐ZIP III gene CsPHB (PHABULOSA), expressed specifically in the nucellus, promoted CsSPL expression by binding to the CsSPL promoter. Thus, CsSPL acts as an adaptor to link CsPHB and CsWUS functioning, underpinning a previously unidentified regulatory pathway orchestrating sex organ development in planta. In addition, auxin accumulation was reduced in the reproductive organs of CsSPL knock‐down plants. Biochemical analyses further showed that CsSPL stimulated the expression of AUXIN RESPONSE FACTOR 3 (CsARF3), and was positively regulated by CsARF13 during reproductive organ development, indicating sequential interactions of CsSPL with auxin signaling components in orchestrating anther and ovule development.
Some assembly required: Contributions of Tom Stevens' lab to the V‐ATPase field
Authors: Graham Laurie A. , Finnigan Gregory C. , Kane Patricia M.
Published: February 2018

Tom Stevens' lab has explored the subunit composition and assembly of the yeast V‐ATPase for more than 30 years. Early studies helped establish yeast as the predominant model system for study of V‐ATPase proton pumps and led to the discovery of protein splicing of the V‐ATPase catalytic subunit. The Vma− phenotype, characteristic of loss‐of‐V‐ATPase activity in yeast was key in determining the enzyme's subunit composition via yeast genetics. V‐ATPase subunit composition proved to be highly conserved among eukaryotes. Genetic screens for new vma mutants led to identification of a set of dedicated V‐ATPase assembly factors and helped unravel the complex pathways for V‐ATPase assembly. In later years, exploration of the evolutionary history of several V‐ATPase subunits provided new information about the enzyme's structure and function. This review highlights V‐ATPase work in the Stevens’ lab between 1987 and 2017.
Variation in red cell transfusion decisions in the intensive care unit – a nationwide survey in the Netherlands
Authors: Kranenburg F. J. , Willems S. A. , Le Cessie S. , Marang‐van de Mheen P. J. , van der Bom J. G. , Arbous M. S.
Published: February 2018

Background and Objectives

Most guidelines recommend a restrictive transfusion trigger of 7 g/dl. It is unclear whether this resulted in more uniform transfusion practices. The primary objective was to uncover the extent of variation in transfusion decisions within four scenarios of critically ill patients among critical care physicians in the Netherlands.

Materials and methods

An online survey comprising four different hypothetical clinical scenarios was sent to all members of the Dutch Society of Intensive Care. The scenarios represented patients with acute myocardial infarction (Hb 8·5 g/dl), abdominal sepsis (Hb 7·1 g/dl), traumatic brain injury (TBI) (Hb 7·9 g/dl) and post‐surgical complications (Hb 7·3 g/dl). The questions explored the decision whether or not to transfuse and a ranking of clinical characteristics playing the most important role in the transfusion decision.

Results

A total of 224 members (22%) participated in the study of whom 188 (84%) completed all questions. The percentages of respondents that decided to transfuse ranged from 25·9% in the scenario with TBI to 81·6% in the scenario with post‐surgical complications. Most controversy was seen in the scenario with sepsis for which 43·2% decided to transfuse, whereas 56·8% decided not to. Haemoglobin level, diagnosis and haemodynamics were most important for the transfusion decision in all scenarios.

Conclusions

Physicians decided differently on red‐blood‐cell transfusion given the clinical scenarios and weighed clinical characteristics differently in their transfusion decisions. These findings suggest there still is substantial variation in critical care transfusion practice.
The B allele with a 5·8 kb deletion in intron 1 of the ABO gene is the major allele in Japanese individuals with Bm and A1Bm phenotypes
Authors: Ogasawara K. , Miyazaki T. , Ito S. , Yabe R. , Uchikawa M. , Enomoto T. , Yokoya N. , Hori Y. , Kumamoto M. , Watanabe S. , Satake M.
Published: February 2018

Bm and A1Bm phenotypes are the most frequent ABO variants in the Japanese population. The B antigen on Bm red blood cells is only detectable by adsorption and elution tests, and plasma B‐transferase activity is usually detected at half or less levels compared with that of common B. Recently, a B allele lacking an erythroid cell‐specific transcription enhancer in intron 1 of the ABO gene was identified from individuals with Bm and A1Bm phenotypes, which could explain the unique serologic properties of Bm. In the Japanese Red Cross Society, eight Blood Centers tested blood samples from donors throughout Japan and collected blood samples from 888 Bm and 415 A1Bm individuals. DNA analysis revealed that 1300 of 1303 (99·77%) individuals had the B allele with a 5·8 kb deletion (c.28 + 5110_10889del), which included the enhancer element.
Caveolin 3‐dependent loss of t‐tubular ICa during hypertrophy and heart failure in mice
Authors: Bryant Simon M. , Kong Cherrie H. T. , Watson Judy J. , Gadeberg Hanne C. , James Andrew F. , Cannell Mark B. , Orchard Clive H.
Published: February 2018

New Findings

What is the central question of this study?

Heart failure is associated with redistribution of L‐type Ca2+ current (ICa) away from the t‐tubule membrane to the surface membrane of cardiac ventricular myocytes. However, the underlying mechanism and its dependence on severity of pathology (hypertrophy versus failure) are unclear.

What is the main finding and its importance?

Increasing severity of response to transverse aortic constriction, from hypertrophy to failure, was accompanied by graded loss of t‐tubular ICa and loss of regulation of ICa by caveolin 3. Thus, the pathological loss of t‐tubular ICa, which contributes to impaired excitation–contraction coupling and thereby cardiac function in vivo, appears to be attributable to loss of caveolin 3‐dependent stimulation of t‐tubular ICa.

Previous work has shown redistribution of L‐type Ca2+ current (ICa) from the t‐tubules to the surface membrane of rat ventricular myocytes after myocardial infarction. However, whether this occurs in all species and in response to other insults, the relationship of this redistribution to the severity of the pathology, and the underlying mechanism, are unknown. We have therefore investigated the response of mouse hearts and myocytes to pressure overload induced by transverse aortic constriction (TAC). Male C57BL/6 mice underwent TAC or equivalent sham operation 8 weeks before use. ICa and Ca2+ transients were measured in isolated myocytes, and expression of caveolin 3 (Cav3), junctophilin 2 (Jph2) and bridging integrator 1 (Bin1) was determined. C3SD peptide was used to disrupt Cav3 binding to its protein partners. Some animals showed cardiac hypertrophy in response to TAC with little evidence of heart failure, whereas others showed greater hypertrophy and pulmonary congestion. These graded changes were accompanied by graded cellular hypertrophy, t‐tubule disruption, decreased expression of Jph2 and Cav3, and decreased t‐tubular ICa density, with no change at the cell surface, and graded impairment of Ca2+ release at t‐tubules. C3SD decreased ICa density in control but not in TAC myocytes. These data suggest that the graded changes in cardiac function and size that occur in response to TAC are paralleled by graded changes in cell structure and function, which will contribute to the impaired function observed in vivo. They also suggest that loss of t‐tubular ICa is attributable to loss of Cav3‐dependent stimulation of ICa.
Visualizing ion transport mechanisms through oxide scales grown on mixed nickel- and cobalt-base model alloys at 900 °C using FIB-SIMS techniques
Authors: Chater Richard J. , Weiser Martin , Virtanen Sannakaisa
Published: February 2018

A set of five model superalloys with a γ′-precipitate strengthened structure and a nominal composition of Ni-xCo-9Al-8 W-8Cr were oxidized at 900 °C by the two-step oxidation method in normal oxygen and tracer oxygen-18 enriched gas atmospheres. Analysis at a nanoscale resolution by gallium focused ion beam sputtering and quadrupole-based secondary ion mass spectrometry of the surface oxide cross-sections provided evidence of both anion and cation motion during the second oxygen-18 oxidation where parabolic oxidation rate conditions can be assumed. These experiments provide new insights into the mass transport vectors for modeling the important oxidation mechanisms at extreme service conditions in mixed cobalt- and nickel-base alloys.
Effects of flow gradients on directional radiation of human voice
Authors: Pulkki Ville , Lähivaara Timo , Huhtakallio Ilkka
Published: February 2018

In voice communication in windy outdoor conditions, complex velocity gradients appear in the flow field around the source, the receiver, and also in the atmosphere. It is commonly known that voice emanates stronger towards the downstream direction when compared with the upstream direction. In literature, the atmospheric effects are used to explain the stronger emanation in the downstream direction. This work shows that the wind also has an effect to the directivity of voice also favouring the downstream direction. The effect is addressed by measurements and simulations. Laboratory measurements are conducted by using a large pendulum with a loudspeaker mimicking the human head, whereas practical measurements utilizing the human voice are realized by placing a subject through the roof window of a moving car. The measurements and a simulation indicate congruent results in the speech frequency range: When the source faces the downstream direction, stronger radiation coinciding with the wind direction is observed, and when it faces the upstream direction, radiation is not affected notably. The simulated flow gradients show a wake region in the downstream direction, and the simulated acoustic field in the flow show that the region causes a wave-guide effect focusing the sound in the direction.
U.S. Pacific coastal wetland resilience and vulnerability to sea-level rise
Authors: Thorne Karen , MacDonald Glen , Guntenspergen Glenn , Ambrose Richard , Buffington Kevin , Dugger Bruce , Freeman Chase , Janousek Christopher , Brown Lauren , Rosencranz Jordan , Holmquist James , Smol John , Hargan Kathryn , Takekawa John
Published: February 2018

A comprehensive field and modeling study indicates vulnerability of tidal wetlands to sea-level rise on the U.S. Pacific coast.
Characterization of KPC-Encoding Plasmids from Enterobacteriaceae Isolated in a Czech Hospital
Authors: Kukla Rudolf , Chudejova Katerina , Papagiannitsis Costas C. , Medvecky Matej , Habalova Katerina , Hobzova Lenka , Bolehovska Radka , Pliskova Lenka , Hrabak Jaroslav , Zemlickova Helena
Published: February 2018

Ten
Enterobacteriaceae
isolates collected in a Czech hospital carried
bla
KPC
-positive plasmids of different sizes (∼30, ∼45, and ∼80 kb). Sequencing revealed three types of plasmids (A to C) with the Tn
4401a
transposon. Type A plasmids comprised an IncR backbone and a KPC-2-encoding multidrug resistance (MDR) region. Type B plasmids were derivatives of type A plasmids carrying an IncN3-like segment, while type C plasmids were IncP6 plasmids sharing the same KPC-2-encoding MDR region with type A and B plasmids.
Unique Phenotypic Characteristics of Recently Transmitted HIV-1 Subtype C Envelope Glycoprotein gp120: Use of CXCR6 Coreceptor by Transmitted Founder Viruses
Authors: Ashokkumar Manickam , Aralaguppe Shambhu G. , Tripathy Srikanth P. , Hanna Luke Elizabeth , Neogi Ujjwal
Published: February 2018

Adequate information on the precise molecular and biological composition of the viral strains that establish HIV infection in the human host will provide effective means of immunization against HIV infection. In an attempt to identify the transmitted founder (TF) virus and differentiate the biological properties and infectious potential of the TF virus from those of the population of the early transmitted viruses, 250 patient-derived gp120 envelope glycoproteins were cloned in pMN-K7-Luc-IRESs-NefΔgp120 to obtain chimeric viruses. Samples were obtained from eight infants who had recently become infected with HIV through mother-to-child transmission (MTCT) and two adults who acquired infection through the heterosexual route and were in the chronic stage of infection. Among the 250 clones tested, 65 chimeric viruses were infectious, and all belonged to HIV-1 subtype C. The 65 clones were analyzed for molecular features of the envelope, per-infectious-particle infectivity, coreceptor tropism, drug sensitivity, and sensitivity to broadly neutralizing antibodies. Based on genotypic and phenotypic analysis of the viral clones, we identified 10 TF viruses from the eight infants. The TF viruses were characterized by shorter V1V2 regions, a reduced number of potential N-linked glycosylation sites, and a higher infectivity titer compared to the virus variants from the adults in the chronic stage of infection. CXCR6 coreceptor usage, in addition to that of the CCR5 coreceptor, which was used by all 65 chimeric viruses, was identified in 13 viruses. The sensitivity of the TF variants to maraviroc and a standard panel of neutralizing monoclonal antibodies (VRC01, PG09, PG16, and PGT121) was found to be much lower than that of the virus variants from the adults in the chronic stage of infection.

IMPORTANCE
Tremendous progress has been made during the last three and half decades of HIV research, but some significant gaps continue to exist. One of the frontier areas of HIV research which has not seen a breakthrough yet is vaccine research, which is because of the enormous genetic diversity of HIV-1 and the unique infectious fitness of the virus. Among the repertoire of viral variants, the virus that establishes successful infection (transmitted founder [TF] virus) has not been well characterized yet. An insight into the salient features of the TF virus would go a long way toward helping with the design of an effective vaccine against HIV. Here we studied the biological properties of recently transmitted viruses isolated from infants who acquired infection from the mother and have come up with unique characterizations for the TF virus that establishes infection in the human host.
Acupuncture versus Medication for Pain Management: A Cross-Sectional Study of Breast Cancer Survivors
Authors: Bao Ting , Li Susan Q , Dearing Josh L , Piulson Lauren A , Seluzicki Christina M , Sidlow Robert , Mao Jun J
Published: February 2018

Aim of the Study

Breast cancer survivors who take aromatase inhibitors (AI) often suffer from chronic pain. Emerging evidence supports the use of acupuncture as an effective pain management strategy for this condition, but its acceptability among cancer survivors is unknown. We evaluated breast cancer survivors’ preferences for acupuncture as compared with medication use and identified factors predictive of this preference.

Methods

We conducted a cross-sectional study among breast cancer survivors who were currently, or had been, taking an AI. The primary outcome was degree of preference for acupuncture as compared with medication for pain management. We conducted multivariate logistic regression analyses to evaluate the effects of socioeconomic status (SES) factors and health beliefs on treatment preference.

Results

Among 592 participants, 160 (27.0%) preferred acupuncture, 153 (25.8%) preferred medication and 279 (47.1%) had no clear preference. In a multivariate analysis that only included SES, higher education and white race were significantly associated with greater preference for acupuncture. When health beliefs were added, SES effects were attenuated, while greater expectation of acupuncture's effect, lower perceived barriers to its use, higher social norm (endorsement from family members and healthcare professionals) related to acupuncture and higher holistic health beliefs were associated with greater preference for acupuncture.

Conclusion

We found similar rates of preference for acupuncture versus medication among breast cancer survivors for pain management. Specific attitudes and beliefs predicted such preferences, highlighting the importance of a patient-centred approach to align patient beliefs and preferences with therapeutic options for more effective pain management.

Trial Registration Number

NCT01013337; Results.
Association of type 1 diabetes and concentrations of drinking water components in Newfoundland and Labrador, Canada
Authors: Chafe Roger , Aslanov Rana , Sarkar Atanu , Gregory Peter , Comeau Alex , Newhook Leigh Anne
Published: February 2018

Objective

To determine the association between drinking water quality and rates of type 1 diabetes in the Newfoundland and Labrador (NL) population, which has one of the highest incidences of type 1 diabetes reported globally.

Research design and methods

The study used a community-based, case-control design. We first calculated incidence rates of type 1 diabetes at the provincial, regional and community levels. The connection between incidence rates and components in public water supplies were then analyzed in three ways: to evaluate differences in water quality between communities with and without incident cases of type 1 diabetes, and to analyze the relationship between water quality and incidence rates of type 1 diabetes at both the community and regional levels.

Results

The provincial incidence of type 1 diabetes was 51.7/100 000 (0-14 year age group) for the period studied. In the community-based analysis, there were significant associations found between higher concentrations of arsenic (β=0.268, P=0.013) and fluoride (β=0.202, P=0.005) in drinking water and higher incidence of type 1 diabetes. In the regional analysis, barium (β=−0.478, P=0.009) and nickel (β=−0.354, P=0.050) concentrations were negatively associated with incidence of type 1 diabetes.

Conclusions

We confirmed the high incidence of type 1 diabetes in NL. We also found that concentrations of some components in drinking water were associated with higher incidence of type 1 diabetes, but no component was found to have a significant association across the three different levels of analysis performed.
Racial/ethnic heterogeneity in associations of blood pressure and incident cardiovascular disease by functional status in a prospective cohort: the Multi-Ethnic Study of Atherosclerosis
Authors: Kaiser Paulina , Peralta Carmen A. , Kronmal Richard , Shlipak Michael G. , Psaty Bruce M , Odden Michelle C
Published: February 2018

Objectives

Research has demonstrated that the association between high blood pressure and outcomes is attenuated among older adults with functional limitations, compared with healthier elders. However, it is not known whether these patterns vary by racial/ethnic group. We evaluated race/ethnicity-specific patterns of effect modification in the association between blood pressure and incident cardiovascular disease (CVD) by functional status.

Setting

We used data from the Multi-Ethnic Study of Atherosclerosis (2002–2004, with an average of 8.8 years of follow-up for incident CVD). We assessed effect modification of systolic blood pressure and cardiovascular outcomes by self-reported physical limitations and by age.

Participants

The study included 6117 participants (aged 46 to 87; 40% white, 27% black, 22% Hispanic and 12% Chinese) who did not have CVD at the second study examination (when self-reported physical limitations were assessed).

Outcome measures

Incident CVD was defined as an incident myocardial infarction, coronary revascularisation, resuscitated cardiac arrest, angina, stroke (fatal or non-fatal) or death from CVD.

Results

We observed weaker associations between systolic blood pressure (SBP) and CVD among white adults with physical limitations (incident rate ratio (IRR) per 10 mm Hg higher SBP: 1.09 (95% CI 0.99 to 1.20)) than those without physical limitations (IRR 1.29 (1.19, 1.40); P value for interaction <0.01). We found a similar pattern among black adults. Poor precision among the estimates for Hispanic or Chinese participants limited the findings in these groups. The attenuated associations were consistent across both multiplicative and additive scales, though physical limitations showed clearer patterns than age on an additive scale.

Conclusion

Attenuated associations between high blood pressure and incident CVD were observed for blacks and whites with poor function, though small sample sizes remain a limitation for identifying differences among Hispanic or Chinese participants. Identifying the characteristics that distinguish those in whom higher SBP is associated with less risk of morbidity or mortality may inform our understanding of the consequences of hypertension among older adults.
Sex differences in presenting symptoms of acute coronary syndrome: the EPIHeart cohort study
Authors: Araújo Carla , Laszczyńska Olga , Viana Marta , Melão Filipa , Henriques Ana , Borges Andreia , Severo Milton , Maciel Maria Júlia , Moreira Ilídio , Azevedo Ana
Published: February 2018

Objectives

Prompt diagnosis of acute coronary syndrome (ACS) remains a challenge, with presenting symptoms affecting the diagnosis algorithm and, consequently, management and outcomes. This study aimed to identify sex differences in presenting symptoms of ACS.

Design

Data were collected within a prospective cohort study (EPIHeart).

Setting

Patients with confirmed diagnosis of type 1 (primary spontaneous) ACS who were consecutively admitted to the Cardiology Department of two tertiary hospitals in Portugal between August 2013 and December 2014.

Participants

Presenting symptoms of 873 patients (227 women) were obtained through a face-to-face interview. Outcome measures: Typical pain was defined according to the definition of cardiology societies. Clusters of symptoms other than pain were identified by latent class analysis. Logistic regression was used to quantify differences in presentation of ACS symptoms by sex.

Results

Chest pain was reported by 82% of patients, with no differences in frequency or location between sexes. Women were more likely to feel pain with an intensity higher than 8/10 and this association was stronger for patients aged under 65 years (interaction P=0.028). Referred pain was also more likely in women, particularly pain referred to typical and atypical locations simultaneously. The multiple symptoms cluster, which was characterised by a high probability of presenting with all symptoms, was almost fourfold more prevalent in women (3.92, 95% CI 2.21 to 6.98). Presentation with this cluster was associated with a higher 30-day mortality rate adjusted for the GRACE V.2.0 risk score (4.9% vs 0.9% for the two other clusters, P<0.001).

Conclusions

While there are no significant differences in the frequency or location of pain between sexes, women are more likely to feel pain of higher intensity and to present with referred pain and symptoms other than pain. Knowledge of these ACS presentation profiles is important for health policy decisions and clinical practice.
Defining a set of standardised outcome measures for newly diagnosed patients with multiple myeloma using the Delphi consensus method: the IMPORTA project
Authors: Blade Joan , Calleja Miguel Ángel , Lahuerta Juan José , Poveda José Luis , de Paz Héctor David , Lizán Luis
Published: February 2018

Objective

To define a standard set of outcomes and the most appropriate instruments to measure them for managing newly diagnosed patients with multiple myeloma (MM).

Methods

A literature review and five discussion groups facilitated the design of two-round Delphi questionnaire. Delphi panellists (haematologists, hospital pharmacists and patients) were identified by the scientific committee, the Spanish Program of Haematology Treatments Foundation, the Spanish Society of Hospital Pharmacies and the Spanish Community of Patients with MM. Panellist’s perception about outcomes’ suitability and feasibility of use was assessed on a seven-point Likert scale. Consensus was reached when at least 75% of the respondents reached agreement or disagreement. A scientific committee led the project.

Results

Fifty-one and 45 panellists participated in the first and second Delphi rounds, respectively. Consensus was reached to use overall survival, progression-free survival, minimal residual disease and treatment response to assess survival and disease control. Panellists agreed to measure health-related quality of life, pain, performance status, fatigue, psychosocial status, symptoms, self-perception on body image, sexuality and preferences/satisfaction. However, panellist did not reach consensus about the feasibility of assessing in routine practice psychosocial status, symptoms, self-perception on body image and sexuality. Consensus was reached to collect patient-reported outcomes through the European Organisation for the Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ) Core questionnaire 30 (C30), three items from EORTC-QLQ-Multiple Myeloma (MY20) and EORTC-QLQ-Breast Cancer (BR23), pain Visual Analogue Scale, Morisky-Green and ad hoc questions about patients’ preferences/satisfaction.

Conclusions

A consensual standard set of outcomes for managing newly diagnosed patients with MM has been defined. The feasibility of its implementation in routine practice will be assessed in a future pilot study.
Optimising gestational weight gain and improving maternal and infant health outcomes through antenatal dietary, lifestyle and physical activity advice: the OPTIMISE randomised controlled trial protocol
Authors: Dodd Jodie M , Deussen Andrea R , Louise Jennie
Published: February 2018

Introduction

Obesity represents a significant health burden, and WHO recognises the importance of preventing weight gain and subsequent development of obesity among adults who are within the healthy weight range. Women of reproductive age have demonstrated high rates of weight gain during pregnancy placing them at risk of becoming overweight or obese. We will evaluate the effects of dietary and physical activity advice on maternal, fetal and infant health outcomes, among pregnant women of normal body mass index (BMI).

Methods and analysis

We will conduct a randomised controlled trial, consenting and randomising women with a live singleton pregnancy between 10+0and 20+0weeks and BMI 18.5–24.9 kg/m2at first antenatal visit, from a tertiary maternity hospital. Women randomised to theLifestyle Advice Groupwill receive three face-to-face sessions (two with a research dietitian and one with a trained research assistant) and three telephone calls over pregnancy, in which they will be provided with dietary and lifestyle advice and encouraged to make change using a SMART goals approach. Women randomised to theStandard Care Groupwill receive routine antenatal care. The primary outcome is infant birth weight >4 kg. Secondary outcomes will include adverse infant and maternal outcomes, maternal weight change, maternal diet and physical activity changes, maternal quality of life and emotional well-being, fetal growth and costs of healthcare. We will recruit 624 women to detect a reduction from 8.72% to 3.87% (alpha 0.05 (two-tailed); power 70%) in infants with birth weight >4 kg. Analyses will be intention to treat with estimates reported as relative risks and 95% CIs.

Ethics and dissemination

Ethical approval has been obtained from the Women’s and Children’s Hospital ethics committee. Findings will be disseminated widely via journal publication and conference presentation(s), and participants informed of results.

Trial registration number

ACTRN12614000583640.
Ethical decision-making climate in the ICU: theoretical framework and validation of a self-assessment tool
Authors: Van den Bulcke Bo , Piers Ruth , Jensen Hanne Irene , Malmgren Johan , Metaxa Victoria , Reyners Anna K , Darmon Michael , Rusinova Katerina , Talmor Daniel , Meert Anne-Pascale , Cancelliere Laura , Zubek Làszló , Maia Paolo , Michalsen Andrej , Decruyenaere Johan , Kompanje Erwin J O , Azoulay Elie , Meganck Reitske , Van de Sompel Ariëlla , Vansteelandt Stijn , Vlerick Peter , Vanheule Stijn , Benoit Dominique D
Published: February 2018

Background

Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU).

Objectives

To better conceptualise EDM climate in the ICU and to validate a tool to assess EDM climates.

Methods

Using a modified Delphi method, we built a theoretical framework and a self-assessment instrument consisting of 35 statements. This Ethical Decision-Making Climate Questionnaire (EDMCQ) was developed to capture three EDM domains in healthcare: interdisciplinary collaboration and communication; leadership by physicians; and ethical environment. This instrument was subsequently validated among clinicians working in 68 adult ICUs in 13 European countries and the USA. Exploratory and confirmatory factor analysis was used to determine the structure of the EDM climate as perceived by clinicians. Measurement invariance was tested to make sure that variables used in the analysis were comparable constructs across different groups.

Results

Of 3610 nurses and 1137 physicians providing ICU bedside care, 2275 (63.1%) and 717 (62.9%) participated respectively. Statistical analyses revealed that a shortened 32-item version of the EDMCQ scale provides a factorial valid measurement of seven facets of the extent to which clinicians perceive an EDM climate: self-reflective and empowering leadership by physicians; practice and culture of open interdisciplinary reflection; culture of not avoiding end-of-life decisions; culture of mutual respect within the interdisciplinary team; active involvement of nurses in end-of-life care and decision-making; active decision-making by physicians; and practice and culture of ethical awareness. Measurement invariance of the EDMCQ across occupational groups was shown, reflecting that nurses and physicians interpret the EDMCQ items in a similar manner.

Conclusions

The 32-item version of the EDMCQ might enrich the EDM climate measurement, clinicians’ behaviour and the performance of healthcare organisations. This instrument offers opportunities to develop tailored ICU team interventions.
Repetitive simulation is an effective instructional design within a pediatric resident simulation curriculum
Authors: Sagalowsky Selin Tuysuzoglu , Prentiss Kimball A , Vinci Robert J
Published: February 2018

Introduction

Repetitive paediatric simulation (scenario-debrief-scenario; RPS) is an instructional design that allows immediate application of learner-directed feedback, in contrast to standard simulation (scenario-debrief; STN). Our aim was to examine the impact of RPS embedded within a paediatric resident simulation curriculum, comparing it to STN.

Methods

In this prospective educational cohort study, paediatric residents were enrolled in STN (n=18) or RPS (n=15) groups from August 2012 through June 2013. Each group performed an initial high-fidelity simulation and another after 1–2 weeks. Attitudes, confidence and knowledge were assessed using anonymous surveys with each scenario and at 4–6 months. Skills were assessed in real time with a modified Tool for Resuscitation Assessment Using Computerised Simulation (TRACS). Two blinded reviewers assessed a subset of videotaped scenarios for TRACS inter-rater reliability.

Results

Both STN and RPS designs were rated highly. The curriculum led to significant short-term and long-term improvements in confidence, knowledge and performance, with no significant differences between groups. All final respondents reported that they would prefer RPS to STN (n=6 STN, 4 RPS). TRACS intraclass correlation was 0.87 among all reviewers.

Conclusions

Paediatric residents reported preference for RPS over STN, with comparable impacts on confidence, knowledge and performance. The modified TRACS was a reliable tool to assess individual resident performance. Further research is needed to determine whether RPS is a more effective instructional design for teaching resuscitation skills to paediatric residents.
Making sense of the clinical spectrum of limb girdle muscular dystrophies
Authors: Khadilkar Satish V , Patel Bhagyadhan A , Lalkaka Jamshed A
Published: February 2018

The expansion of the spectrum of limb girdle muscular dystrophies (LGMDs) in recent years means that neurologists need to be familiar with the clinical clues that can help with their diagnosis. The LGMDs comprise a group of genetic myopathies that manifest as chronic progressive weakness of hip and shoulder girdles. Their inheritance is either autosomal dominant (LGMD1) or autosomal recessive (LGMD2). Their prevalence varies in different regions of the world; certain ethnic groups have documented founder mutations and this knowledge can facilitate the diagnosis. The clinical approach to LGMDs uses the age at onset, genetic transmission and clinical patterns of muscular weakness. Helpful clinical features that help to differentiate the various subtypes include: predominant upper girdle weakness, disproportionate respiratory muscle involvement, distal weakness, hip adductor weakness, ‘biceps lump’ and ‘diamond on quadriceps’ sign, calf hypertrophy, contractures and cardiac involvement. Almost half of patients with LGMD have such clinical clues. Investigations such as serum creatine kinase, electrophysiology, muscle biopsy and genetic studies can complement the clinical examination. In this review, we discuss diagnostic clinical pointers and comment on the differential diagnosis and relevant investigations, using illustrative case studies.
Adolescent tobacco coupon receipt, vulnerability characteristics and subsequent tobacco use: analysis of PATH Study, Waves 1 and 2
Authors: Rose Shyanika W , Glasser Allison M , Zhou Yitong , Cruz Tess Boley , Cohn Amy M , Lienemann Brianna A , Byron M Justin , Huang Li-Ling , Meissner Helen I , Baezconde-Garbanati Lourdes , Unger Jennifer B
Published: February 2018

Objectives

We examine adolescent receipt of tobacco coupons and subsequent tobacco use.

Methods

Data were from the Population Assessment of Tobacco and Health (PATH) Study (2013–2015). We identified correlates of coupon receipt at Wave 1 (youth sample age 12–17 ; n = 13 651) including demographics, additional vulnerability factors that may place youth at risk of tobacco use and correlates of coupon receipt by channel. We examined associations of Wave 1 coupon receipt with Wave 2 tobacco use using weighted multivariable models.

Results

Overall, 7.6% of US youth received tobacco coupons in the 6 months before Wave 1. Coupon recipients were more likely to be women, living outside urban areas, living with a tobacco user, current and former (vs never) tobacco users, having high internalising mental health symptoms and having a favourite tobacco advertisement. Coupons were received primarily through direct mail (56%), product packs (28%) and online (25%). Never tobacco users at Wave 1 who received coupons were more likely to be ever users at Wave 2 (adjusted OR (aOR)=1.42; 95% CI 1.06 to 1.91). Coupon recipients were more likely to use a new tobacco product between waves (aOR=1.67; 95% CI 1.18 to 2.36) and report past 30-day tobacco use at Wave 2 (aOR=1.81; 95% CI 1.31 to 2.49).

Conclusions

One in 13 US youth (7.6%) received coupons. Vulnerable youth had the greatest odds of coupon receipt. Coupon recipients had greater odds of tobacco use among never users, trying a new tobacco product and current use. Coupon bans, limits on youth coupon exposure, stronger age verification, pack inserts or restricting coupon redemption may help reduce tobacco use among adolescents, particularly for those at greatest risk.
Developing fire safety engineering as a practice in Canada
Authors: Quiquero Hailey , Smith Matthew , Gales John
Published: February 2018

The goal of fire safety engineering (FSE) is to design a strategy that meets human safety and property protection goals with an optimized solution. In comparison to international practice, Canada could be considered highly underdeveloped in a technical perspective of performance versus prescription. In Canada, FSE is a subdivision within civil and mechanical engineering, rather than treated as a profession in and of itself. With a requirement for more complex infrastructure to meet Canadian societal needs, there is stimulus that is fostering a demand to create professionals educated with FSE skill sets. This literary study therefore aims to present a state-of-the-art review of the design practice of FSE in Canada and abroad with explicit focus on performance-based fire design for the Canadian practitioner who seeks to develop their expertise in this subject.
Egg size and lipid content of lake trout (Salvelinus namaycush) in the wild and in captivity
Authors: Johnston Thomas A.
Published: February 2018

Egg quality influences early life survival in fishes, but drivers of egg quality variation remain poorly understood. I examined egg quality of a long-lived, iteroparous salmonid (lake trout (Salvelinus namaycush)) with respect to maternal traits and environmental conditions in wild and captively reared populations. Variation was stronger and more consistent for egg size than for lipid content. Among females, egg size was most strongly related to maternal age, in both wild and captive populations, and faster-growing females tended to produce larger eggs. Among wild populations, maternal growth was more strongly associated with indices of ecosystem size or productivity than climate, whereas the opposite was observed for egg size. Egg size and, to a lesser extent, maternal growth in captive populations were positively correlated with egg size and growth, respectively, in their wild source populations. However, captive females grew faster and produced larger eggs at age, but smaller eggs at length, than their wild counterparts. Lake trout egg quality variation has both maternal and environmental components, and captive rearing appears to alter the ontogenetic progression of egg size.
Robustness of Regular Caterpillars
Authors: Aytaç Aysun , Berberler Zeynep Nihan Odabaş
Published: February 2018

Robustness of the network topology is a key aspect in the design of computer networks. Vertex residual closeness is a new graph-theoretic concept defined as a measure of network robustness. In this model, edges are perfectly reliable and the vertices fail independently of each other. In this paper, vertex residual closeness of paths and regular caterpillars are calculated by giving an insight of how to evaluate the vertex residual closeness of path-like graphs.
IDPM: An Improved Degenerate Pattern Matching Algorithm for Biological Sequences
Authors: Lin Jie , Jiang Yue , Harner E. James , Jiang Bing-Hua , Adjeroh Don
Published: February 2018

Let [Formula: see text] be a string, with symbols from an alphabet. [Formula: see text] is said to be degenerate if for some positions, say [Formula: see text], [Formula: see text] can contain a subset of symbols from the symbol alphabet, rather than just one symbol. Given a text string [Formula: see text] and a pattern [Formula: see text], both with symbols from an alphabet [Formula: see text], the degenerate string matching problem, is to find positions in [Formula: see text] where [Formula: see text] occured, such that [Formula: see text], [Formula: see text], or both are allowed to be degenerate. Though some algorithms have been proposed, their huge computational cost pose a significant challenge to their practical utilization. In this work, we propose IDPM, an improved degenerate pattern matching algorithm based on an extension of the Boyer–Moore algorithm. At the preprocessing phase, the algorithm defines an alphabet-independent compatibility rule, and computes the shift arrays using respective variants of the bad character and good suffix heuristics. At the search phase, IDPM improves the matching speed by using the compatibility rule. On average, the proposed IDPM algorithm has a linear time complexity with respect to the text size, and to the overall size of the pattern. IDPM demonstrates significance performance improvement over state-of-the-art approaches. It can be used in fast practical degenerate pattern matching with large data sizes, with important applications in flexible and scalable searching of huge biological sequences.
Approximation Algorithm for Resource Allocation Problems with Time Dependent Penalties
Authors: Wadhwa Vaishali M. , Garg Deepak
Published: February 2018

The Resource Allocation Problem with Time Dependent Penalties (RAPTP) is a variant of uncapacitated resource allocation problems generally referred as uncapacitated facility allocation problems or uncapacitated facility location problem (UFLP). Work done in this paper is motivated by the work of Du, Lu and Xu [7] in which authors considered facility location problems with submodular penalties and presented a 3-approximation primal dual algorithm. This paper considers that each unallocated demand point adds to penalty that increases as time passes and is thus represented by function [Formula: see text] where [Formula: see text] and [Formula: see text] are elapse time and priority of demand point [Formula: see text]. As this problem has been considered for emergency service allocation, all demand points should be allocated to some facility or resource within some stipulated time limit beyond which it may lose its purpose. Thus penalty incurred by a demand point is considered till that threshold value only. Thus it is assumed that penalty contribution by a demand point remains constant after a specified threshold value. By exploiting the properties of time dependent penalties, a 4-approximation primal-dual algorithm is proposed which is based on LP framework, and is the first constant-factor approximation algorithm for RAPTP.
Synthesis, characterization and luminescent properties of mixed phase bismuth molybdate-doped with Eu3+ ions
Authors: Wang Liyong , Guo Xiaoqing , Cai Xiaomeng , Song Qingwei , Han Yuanyuan , Jia Guang
Published: February 2018

Red phosphors of Eu[Formula: see text]-doped bismuth molybdate (BMO) are prepared by a low temperature hydrothermal method assisting with Phenol Formaldehyde resin (PFr), and characterized by X-ray diffraction (XRD) patterns, Fourier transform infrared-spectroscopy (FT-IR), thermogravimetric analyzer (TGA), differential thermal analyzer (DTA), and photoluminescence (PL) spectroscopy. PL properties influence factors including molar ratio of Bi[Formula: see text] and Mo[Formula: see text] ions, PFr dosage and dopants concentration are discussed in detail. The results show that BMO can act as a useful host for Eu[Formula: see text] ions doping, and energy transferring from Bi[Formula: see text] to Eu[Formula: see text] achieved efficiently, the BMO phosphors displayed intense red color emission under ultraviolet light excitation.