bluuebunny/crossref_metadata_2025 huggingface dataset:
Ghrelin regulation of glucose metabolism
Authors: Gray Sarah M. , Page Laura C. , Tong Jenny
Published: March 2019

Ghrelin and its receptor, the growth hormone secretagogue receptor 1a (GHSR1a), are implicated in the regulation of glucose metabolism via direct actions in the pancreatic islet, as well as peripheral insulin‐sensitive tissues and the brain. Although many studies have explored the role of ghrelin in glucose tolerance and insulin secretion, a complete mechanistic understanding remains to be clarified. This review highlights the local expression and function of ghrelin and GHSR1a in pancreatic islets and how this axis may modulate insulin secretion from pancreatic β‐cells. Additionally, we discuss the effect of ghrelin on in vivo glucose metabolism in rodents and humans, as well as the metabolic circumstances under which the action of ghrelin may predominate.
Lack of association between denture trauma and loss of heterozygosity confronts the proposed pathologic role of chronic mucosal trauma in oral carcinogenesis
Authors: Bernardes Vanessa Fátima , Diniz Marina Gonçalves , Silva Jéssica Carolina , Moraes Débora Chaves , De Marco Luiz , Gomes Carolina Cavaliéri , Gomez Ricardo Santiago
Published: March 2019

Chronic mucosal trauma is suggested as an additional etiologic risk factor for oral squamous cell carcinoma (OSCC), but there is a lack of experimental‐molecular data. If chronic trauma of the oral mucosa is carcinogenic, it should be associated with early genetic alterations seen during typical progression of OSCC, like loss of heterozygosity (LOH). We investigated LOH in the key chromosomal arms 3p, 9p and 17p in inflammatory fibrous hyperplasia associated with removable dental prosthesis and also in normal oral mucosa, by using the polymorphic microsatellite markers D3S1300 at 3p14.2, D9S1748 at 9p21, D17S1289 at 17p12 and D17S974 at 17p13 and capillary electrophoresis. LOH was detected in 2/15 (13%) fibrous hyperplasia samples similarly to other reactive and inflammatory lesions. None of the normal mucosa samples presented LOH. Our experimental‐molecular results do not support the hypothesis that trauma associated with dental prosthesis has an important role in oral carcinogenesis.
Mouth self‐examination as a screening tool for oral potentially malignant disorders among a high‐risk Indigenous population
Authors: Ghani Wan Maria Nabillah , Razak Ishak Abdul , Doss Jennifer Geraldine , Ramanathan Anand , Tahir Zaiton , Ridzuan Nurul Anis , Edgar Suzanna , Zain Rosnah Binti
Published: March 2019

Objectives

To evaluate the efficacy of mouth self‐examination (MSE) as a self‐screening tool for detection of oral mucosal lesions among an Indigenous population in Malaysia at high risk for oral premalignant and malignant disorders.

Methods

Two villages were selected as the sampling frame based on prevalence of tobacco and betel quid chewing habit. Respondents were asked to check their mouth for presence of lesion or abnormalities. Education on oral cancer, including MSE, was provided. Subsequently, respondents were asked to perform MSE. Finally, a clinical oral examination (COE) was done by a specialist and the presence of oral mucosal lesions was recorded.

Results

Almost 64.5 percent of respondents exhibited high levels of difficulty and low mucosal visualization and retracting ability, whereas 3.0 percent demonstrated high attention level when performing MSE. Prevalence of oral mucosal lesions was 59.0 percent, whereas the prevalence of oral potentially malignant disorders (OPMDs) was 9.0 percent. Detection of oral lesions by respondents using MSE was lower than detection by the gold standard. Sensitivity and specificity of MSE for detection of all types of lesions were 8.6 and 95.0 percent respectively. When analyzing each lesion type separately, MSE was found to be most sensitive in detection of swellings (10.0 percent), and most specific in identifying white lesions (97.8 percent). For detection of OPMDs, although specificity was high (98.9 percent), sensitivity (0 percent), and +LR (0) was poor.

Conclusion

MSE is not an effective self‐screening tool for early detection of potentially malignant lesions for this population.
Investigation of sweet potato starch as a structural enhancer for three‐dimensional printing of Scomberomorus niphonius surimi
Authors: Dong Xiuping , Huang Ying , Pan Yuxi , Wang Kexin , Prakash Sangeeta , Zhu Beiwei
Published: March 2019

Three‐dimensional printing (3DP) of surimi requires a structural modifier to achieve a stable construct. This work investigated the effect of addition of sweet potato starch (0–10% wt/wt) on the physical properties (rheological properties, gel strength, water‐holding capacity [WHC], and microstructural characteristics) of surimi gels and the 3D printed behavior of these gels. The results showed that as the starch content increased, the viscosity of the starch–surimi mixture decreased facilitating the flow of the surimi out of the printer nozzle. The surimi gel with 8% sweet potato starch concentration showed good gel strength (2,021.70 g mm), WHC (82.39%), microstructural characteristics, and less cooking loss (1.95%). A comparison of the traditional surimi preparation method with 3DP showed that the surimi gel prepared by a 3D printed construct was softer in gel strength (1,398.65 g mm) and lower in hardness (945.17 g) although showing slightly higher cooking loss (6.76%) and lower WHC (72.66 g) than the conventional product. The results suggest that sweet potato starch can be effectively used as a structural enhancer for 3DP complex‐shaped surimi.
Evaluation of an Internet‐based intervention for ICD patients with elevated symptoms of posttraumatic stress disorder
Authors: Ford Jessica , Littleton Heather , Lutes Lesley , Wuensch Karl , Benton Christie , Cahill John , Hudson Christopher , Nekkanti Rajasekhar , Gehi Anil , Sears Samuel
Published: March 2019

Background

To date, treatment to reduce posttraumatic stress disorder (PTSD) symptoms in implantable cardioverter defibrillator (ICD) patients has been limited by lack of symptom recognition, lack of provider referrals, barriers to treatment access, and inadequate evidence base of treatment effectiveness in this population.

Methods

Participants were 46 patients with ICDs (17 paired) with elevated PTSD symptoms who were recruited in electrophysiology clinics at community and university hospitals as well as ICD support forums. Participants were provided the Web‐based, brief psychosocial intervention, which was tailored to ICD patients and contained elements of evidence‐based cognitive‐behavioral protocols for PTSD. Pretest and posttest measurement assessed participants’ trauma experiences, mental health, and device‐specific distress (device acceptance and shock anxiety).

Results

Postintervention scores on the PTSD Checklist (PCL; M = 35.5, SD = 10.09) were significantly lower than preintervention scores (M = 46.31, SD = 9.88), t (16) = 3.51, P = 0.003, d = 1.08.

Conclusions

Preliminary results indicate that future research with a more robust design is warranted. Given limitations in accessibility of mental health providers to manage cardiac‐related psychological sequelae, brief, Web‐based intervention may be an effective, supplemental, clinical modality to offer treatment to this population.
Polymorphisms in cyanogenic glucoside and cyano‐amino acid content in natural accessions of common vetch (Vicia sativa L.) and selection for improved agronomic performance
Authors: Aouida Marwa , Rook Fred , Bianca Maimann Alexandra , Sánchez‐Pérez Raquel , Abid Ghassen , Fauconnier Marie Laure , Jebara Moez
Published: March 2019

Common vetch (Vicia sativa L.) is an important annual forage legume. It is used as a cover crop, green manure, pasture legume and for silage and hay production. Its seeds can be used as a source of highly digestible protein and minerals in animal diets. However, their utilization as a feedstuff for monogastric animals is hindered by the fact that the seeds contain cyanogenic antinutritional factors that reduce their palatability. An effective utilization of V. sativa seeds as a successful monogastric feed stuff requires selection for higher protein availability and minimization of the cyanogenic antinutritional factors content. In this study, we selected one natural accession named Mjez Ibeb, from a collection of 25 accessions and cultivars, based on its superior agronomic performance and its naturally occurring genetic variation for cyanogenic traits. We investigated the genetic variation that exists for the cyanogenesis trait in more detail and analysed the seeds of 133 lines derived from accession Mjez lbeb. Of these, 40 naturally polymorphic lines that showed deficiencies in cyanogenesis and cyano‐amino acid content, were subsequently selected for detailed chemical analysis. Cyanogenic glucosides and cyano‐amino acid concentrations varied widely in the 40 lines. Multivariate analysis was performed and three lines (L16, L21, L18) with low content of cyanogenic compounds were identified.
The 308‐nm excimer laser treatment does not increase the risk of skin cancer in patients with vitiligo: A population‐based retrospective cohort study
Authors: Bae Jung Min , Eun Sung Hye , Oh Sang Ho , Shin Jeong Hyun , Kang Hee Young , Kim Ki‐Ho , Lee Seung‐Chul , Choi Chong Won
Published: March 2019

A 308‐nm excimer laser (EL) has been widely used to treat patients with localized vitiligo. However, data are rare on the influence of EL treatment on the risks of skin cancer. To evaluate the skin cancer risks after long‐term EL treatment, we performed a nationwide population‐based retrospective cohort study using the Korean National Health Insurance Claims Database. A total of 5,052 patients with vitiligo were classified into three groups according to the EL treatment sessions between 2009 and 2016: no, 50–99, and 100 or more EL treatments after 2‐year washout period (2007 and 2008). Using multivariable Cox proportional hazard models, we found that the risks of actinic keratosis, non‐melanoma skin cancers, and melanoma did not significantly differ among the groups, respectively. In conclusion, EL treatment would not increase the risks of premalignant skin lesions and skin cancers in patients with vitiligo. Based on our results, EL is likely to be a safe treatment option for patients with localized vitiligo.
Negative Intergroup Contact and Radical Right‐Wing Voting: The Moderating Roles of Personal and Collective Self‐Efficacy
Authors: Nijs Tom , Stark Tobias H. , Verkuyten Maykel
Published: March 2019

This study examines whether negative contact with immigrants promotes voting for radical right‐wing parties, to what extent this relationship can be explained by feelings of outgroup threat, and whether this relationship depends on perceived personal and collective self‐efficacy. Hypotheses were tested among 630 native Dutch respondents, mainly living in multicultural neighborhoods. The results show that negative contact with immigrants is associated with feelings of personal (egocentric) and group (sociotropic) threat, and both these feelings, in turn, are associated with radical right‐wing voting. However, negative intergroup contact is less strongly related to egocentric threat when individuals feel able to personally address negative situations with other people (personal self‐efficacy). Furthermore, the findings suggest that negative intergroup contact is less strongly related to sociotropic threat when individuals believe that people in their neighborhood are able to collectively address some negative situations (collective self‐efficacy).
Quantitative assessment of airway remodelling and response to allergen in asthma
Authors: Adams David C. , Miller Alyssa J. , Applegate Matthew B. , Cho Josalyn L. , Hamilos Daniel L. , Chee Alex , Holz Jasmin A. , Szabari Margit V. , Hariri Lida P. , Harris R. Scott , Griffith Jason W. , Luster Andrew D. , Medoff Benjamin D. , Suter Melissa J.
Published: March 2019

Background and objective

In vivo evaluation of the microstructural differences between asthmatic and non‐asthmatic airways and their functional consequences is relevant to understanding and, potentially, treating asthma. In this study, we use endobronchial optical coherence tomography to investigate how allergic airways with asthma differ from allergic non‐asthmatic airways in baseline microstructure and in response to allergen challenge.

Methods

A total of 45 subjects completed the study, including 20 allergic, mildly asthmatic individuals, 22 non‐asthmatic allergic controls and 3 healthy controls. A 3‐cm airway segment in the right middle and right upper lobe were imaged in each subject immediately before and 24 h following segmental allergen challenge to the right middle lobe. Relationships between optical airway measurements (epithelial and mucosal thicknesses, mucosal buckling and mucus) and airway obstruction (FEV1/FVC (forced expiratory volume in 1 s/forced vital capacity) and FEV1% (FEV1 as a percentage of predictive value)) were investigated.

Results

Significant increases at baseline and in response to allergen were observed for all four of our imaging metrics in the asthmatic airways compared to the non‐asthmatic airways. Epithelial thickness and mucosal buckling exhibited a significant relationship to FEV1/FVC in the asthmatic group.

Conclusion

Simultaneous assessments of airway microstructure, buckling and mucus revealed both structural and functional differences between the mildly asthmatic and control groups, with airway buckling seeming to be the most relevant factor. The results of this study demonstrate that a comprehensive, microstructural approach to assessing the airways may be important in future asthma studies as well as in the monitoring and treatment of asthma.
Moral Luck as Moral Lack of Control
Authors: Anderson Mark B.
Published: March 2019

When Thomas Nagel originally coined the expression “moral luck,” he used the term “luck” to mean lack of control. This use was a matter of stipulation, as Nagel’s target had little to do with luck itself, but the question of how control is related to moral responsibility. Since then, we have seen several analyses of the concept of luck itself, and recent contributors to the moral luck literature have often assumed that any serious contribution to the moral luck debate must begin with a robust concept of luck simpliciter. I argue here that this assumption is a mistake, on the basis of three reasons: the issue was originally conceived as an issue about responsibility and control, analyses of luck tend to distort and needlessly complicate what is at issue when shoehorned into the moral luck debate, and these analyses have very little (if anything) to contribute to the discussion.
Uncalculated First‐Party Externalities Given a Beverage Tax
Authors: Zeiss Jessica , Carlson Les , Ball Allen Dwayne
Published: March 2019

With many characterizing obesity as a national priority, the U.S. government is considering a 1‐, 2‐, or 3‐cents‐per‐ounce (cpo) federal sin tax on soda products.

Objective

Because prior research finds that consumers substitute equally, if not more, dangerous nicotine products with a tobacco sin tax and common alcohol‐like household goods with alcohol prohibition, this research sets out to determine whether the imposition of a soda sin tax produces similar first‐party externalities.

Method

Adaptive conjoint analysis is utilized among respondents across several regions of the United States, including actual soda consumers.

Results

This study finds that given a soda sin tax, soda consumers do not substitute healthier beverages, that is, beverages with relatively fewer calories and grams of sugar and sodium, such as water, pure fruit juice, or unsweetened tea. Instead, soda consumers switch to other sugary beverages not considered in most legislation, such as sweetened coffees, teas, or sports drinks, or continue consuming soda at tax rates of 2 and 3 cpo after the shock of a one‐cent tax wears off.

Conclusion

Unlike prior research examining decreased soda consumption across a general marketplace, this research offers insight into potential externalities among the key transacting actors in such an exchange: soda consumers.
New constraints on carbonation associated with brecciation in hyperextended margins (example of Iberia and Newfoundland margins)
Authors: Picazo Suzanne , Lafay Romain , Faucheux Vincent , Vennemann Torsten
Published: March 2019

The sequestration of CO2 occurs naturally in (ultra)‐mafic rocks by carbonation processes and is commonly noted in areas of the seafloor where mantle lithologies are exhumed. As well as carbonation, mantle exhumation is also responsible for rock brecciation. The relationship between carbonation and brecciation is not well constrained. A temporal evolution from syn‐ to post‐tectonic carbonation and brecciation is proposed in line with progressive mantle exhumation. Using a petrological study of brecciated material from IODP drill cores of the Iberia–Newfoundland conjugated margins, we relate crack–seal veins to tectonic brecciation, authigenic calcite with scalenohedral structure to hydraulic brecciation and reworked clasts within cement to (tectono)‐sedimentary processes. Oxygen isotope compositions reveal late‐staged < 50°C carbonate generation in the proximal part of the ocean–continent transition, which have followed an earlier phase of sub‐seafloor carbonate generation. The results are crucial to understand CO2 exchange within the reworked sub‐seafloor in passive margins and oceanic systems.
Nested
Saturation Based Guidance Law for Unmanned Aerial Vehicles1
Authors: Patrikar Jay , Makkapati Venkata
Ramana , Pattanaik Anay , Parwana Hardik , Kothari Mangal
Published: March 2019

In this paper, using the theory of input saturation, a novel path following guidance law for fixed-wing unmanned aerial vehicles (UAVs) is developed. The proposed guidance law is adapted from a pursuit plus line-of-sight guidance law. Furthermore, it employs inertial speed for computing the acceleration commands which adds an adaptive capability of accommodating vehicle speed changes due to external disturbances such as wind. The guidance law is initially developed for two-dimensional (2D) environments which enables vehicles to follow straight lines, circles, and ellipses in planar spaces. Lyapunov theory is used to establish its stability properties, followed by a comparative study with existing algorithms, proposed for 2D environments, to establish its efficacy. The guidance law is then extended for the case of three-dimensional (3D) environments, and appropriate simulation studies are performed. Finally, real-world flight tests for 2D as well as 3D cases are presented, establishing the applicability of the proposed law on UAVs.
Compact Two Degrees-of-Freedom External Fixator System for Correction of Persistent Clubfoot Deformity
Authors: Wu Ying Ying , Plakseychuk Anton , Shimada Kenji
Published: March 2019

Bone deformities are often complex three-dimensional (3D) deformities, and correcting them is difficult. To correct persistent clubfoot deformity in adolescents or adults, an external fixator is sometimes used to encourage tissue growth and preserve healthy tissues. However, it is difficult to set up, resulting in long surgeries and steep learning curves for surgeons. It is also bulky and obstructs patient mobility. In this paper, we introduce a new approach of defining clubfoot deformity correction as a six degrees-of-freedom (6DOF) correction, and then reducing it to just two degrees-of-freedom (2DOF) using the axis-angle representation. Therefore, only two physical trajectory joints are needed, which in turn enables a more compact fixator design. A computer planner was developed to minimize the bulk of the external fixator, and to optimize the distraction schedule to avoid overstretching the soft tissues. This reduces the learning curve for surgeons and shortens surgery time. To validate the system, a patient-specific clubfoot simulator was developed, and four experiments were performed on the clubfoot simulator. The accuracy of midfoot correction was 11 mm and 3.5 deg without loading, and 41 mm and 11.7 deg with loading. While the external fixator has to be more rigid to overcome resistance against correction, the surgical system itself was able to achieve accurate correction in less than 2 h. This is an improvement from the current method, which takes 2.5–4.5 h.
Periodic Control of Unmanned Aerial Vehicles Based on Differential Flatness
Authors: Ogunbodede Oladapo , Nandi Souransu , Singh Tarunraj
Published: March 2019

Unmanned aerial vehicles (UAVs) are making increasingly long flights today with significantly longer mission times. This requires the UAVs to have long endurance as well as have long range capabilities. Motivated by locomotory patterns in birds and marine animals which demonstrate a powered-coasting-powered periodic locomotory behavior, an optimal control problem is formulated to study UAV trajectory planning. The concept of differential flatness is used to reformulate the optimal control problem as a nonlinear programing problem where the flat outputs are parameterized using Fourier series. The Π test is also used to verify the existence of a periodic solution which outperforms the steady-state motion. An example of an Aerosonde UAV is used to illustrate the improvement in endurance and range costs of the periodic control solutions relative to the equilibrium flight.
Fast Scheduling of Autonomous Mobile Robots Under Task Space Constraints With Priorities
Authors: Bakshi Soovadeep , Feng Tianheng , Yan Zeyu , Chen Dongmei
Published: March 2019

Automation is becoming more and more important to achieve high efficiency and productivities in manufacturing facilities, and there has been a large increase in the use of autonomous mobile robots (AMRs) for factory automation. With the number of AMRs increasing, how to optimally schedule them in a timely manner such that a large school of AMRs can finish all the assigned tasks within the shortest time presents a significant challenge for control engineers. Exhaustive search can provide an optimal solution. However, its associated computational time is too long to render it feasible for real-time control. This paper introduces a novel two-step algorithm for fast scheduling of AMRs that perform prioritized tasks involving transportation of tools/materials from a pick-up location to a drop-off point on the factory floor. The proposed two-step algorithm first clusters these tasks such that one cluster of tasks is assigned to one single AMR, followed by scheduling of the tasks within a cluster using a model-based learning technique. For the purpose of clustering and scheduling, a task space is defined. The results from the clustering and scheduling algorithms are compared with other widely used heuristic techniques. Both the clustering and the scheduling algorithms are shown to perform better on task sets of relevant sizes and generate real-time solutions for the scheduling of multiple AMRs under task space constraints with priorities.
Latent Heat Storage: Container Geometry, Enhancement Techniques, and Applications—A Review
Authors: Arunachalam S.
Published: March 2019

Energy storage helps in waste management, environmental protection, saving of fossil fuels, cost effectiveness, and sustainable growth. Phase change material (PCM) is a substance which undergoes simultaneous melting and solidification at certain temperature and pressure and can thereby absorb and release thermal energy. Phase change materials are also called thermal batteries which have the ability to store large amount of heat at fixed temperature. Effective integration of the latent heat thermal energy storage system with solar thermal collectors depends on heat storage materials and heat exchangers. The practical limitation of the latent heat thermal energy system for successful implementation in various applications is mainly from its low thermal conductivity. Low thermal conductivity leads to low heat transfer coefficient, and thereby, the phase change process is prolonged which signifies the requirement of heat transfer enhancement techniques. Typically, for salt hydrates and organic PCMs, the thermal conductivity range varies between 0.4–0.7 W/m K and 0.15–0.3 W/m K which increases the thermal resistance within phase change materials during operation, seriously affecting efficiency and thermal response. This paper reviews the different geometry of commercial heat exchangers that can be used to address the problem of low thermal conductivity, like use of fins, additives with high thermal conductivity materials like metal strips, microencapsulated PCM, composite PCM, porous metals, porous metal foam matrix, carbon nanofibers and nanotubes, etc. Finally, different solar thermal applications and potential PCMs for low-temperature thermal energy storage were also discussed.
Nanocrystalline tin oxide coatings on etched optical fiber Bragg grating for hydrogen sulfide detection
Authors: Rente Bruno , Mello Alexandre , Allil Regina , Werneck Marcelo M. , Camargo Sergio S.
Published: March 2019

Hydrogen sulfide is a toxic and explosive gas commonly present in human industrial activities. Thus, it is imperative to efficiently measure this gas while also avoiding risks of creating sparks or heating. The aim of the present work is to develop and characterize a detection method capable of detecting hydrogen sulfide using the fiber Bragg grating interrogation technique. The method includes etching of the fiber cladding in the vicinity of the grating and pulsed laser deposition of tin oxide thin films as a sensitive layer that will be responsible for the Bragg wavelength shift when in contact with the gas. As shown by XPS analysis, the sensor response reaches a maximum when films exhibit a high concentration of oxygen vacancies. Results show resolution in the ppm range for hydrogen sulfide and fast recovery time, indicating that this can be a novel method for gas detection applications.
Influence of working memory and attention on sound-quality ratings
Authors: Huber Rainer , Rählmann Sebastian , Bisitz Thomas , Meis Markus , Steinhauser Susanne , Meister Hartmut
Published: March 2019

This study investigated the potential influence of cognitive factors on subjective sound-quality ratings. To this end, 34 older subjects (ages 61–79) with near-normal hearing thresholds rated the perceived sound quality of speech and music stimuli that had been distorted by linear filtering, non-linear processing, and multiband dynamic compression. In addition, all subjects performed the Reading Span Test (RST) to assess working memory capacity (WMC), and the test d2-R (a visual test of letter and symbol identification) was used to assess the subjects' selective and sustained attention. The quality-rating scores, which reflected the susceptibility to signal distortions, were characterized by large interindividual variances. Linear mixed modelling with age, high-frequency pure tone threshold, RST, and d2-R results as independent variables showed that individual speech-quality ratings were significantly related to age and attention. Music-quality ratings were significantly related to WMC. Taking these factors into account might lead to improved sound-quality prediction models. Future studies should, however, address the question of whether these effects are due to procedural mechanisms or actually do show that cognitive abilities mediate sensitivity to sound-quality modifications.
Dubious diagnosis
Authors: Piller Charles
Published: March 2019

A war on "prediabetes" has created millions of new patients and a tempting opportunity for pharma. But how real is the condition?
The tumor as organizer model
Authors: Li Jinyang , Stanger Ben Z.
Published: March 2019

Cancer cells are the architects of their primary and metastatic microenvironments
How to print a 3D object all at once
Authors: Hart A. John , Rao Abhinav
Published: March 2019

A tomography-based method prints polymer objects volumetrically
A Novel Fluorescent and Bioluminescent Bireporter Influenza A Virus To Evaluate Viral Infections
Authors: Nogales Aitor , Ávila-Pérez Gines , Rangel-Moreno Javier , Chiem Kevin , DeDiego Marta L. , Martínez-Sobrido Luis
Published: March 2019

Influenza A virus (IAV) causes a human respiratory disease that is associated with significant health and economic consequences. In recent years, the use of replication-competent IAV expressing an easily traceable fluorescent or luciferase reporter protein has significantly contributed to progress in influenza research. However, researchers have been forced to select a fluorescent or a luciferase reporter gene due to the restricted capacity of the influenza viral genome for including foreign sequences. To overcome this limitation, we generated, for the first time, a recombinant replication-competent bireporter IAV (BIRFLU) that stably expresses two reporter genes (one fluorescent and one luciferase) to track IAV infections
in vitro
and
in vivo
. The combination of cutting-edge techniques from molecular biology, animal research, and imaging technologies brings researchers the unique opportunity to use this new generation of reporter-expressing IAV to study viral infection dynamics in both cultured cells and animal models of viral infection.
Essential Role of Enterovirus 2A Protease in Counteracting Stress Granule Formation and the Induction of Type I Interferon
Authors: Visser Linda J. , Langereis Martijn A. , Rabouw Huib H. , Wahedi Maryam , Muntjewerff Elke M. , de Groot Raoul J. , van Kuppeveld Frank J. M.
Published: March 2019

Enteroviruses are important pathogens that can cause a variety of diseases in humans, including aseptic meningitis, myocarditis, hand-foot-and-mouth disease, conjunctivitis, and acute flaccid paralysis. Like many other viruses, enteroviruses must counteract antiviral cellular responses to establish an infection. It has been suggested that enterovirus proteases cleave cellular factors to perturb antiviral pathways, but the exact contribution of viral proteases 2A
pro
and 3C
pro
remains elusive. Here, we show that 2A
pro
, but not 3C
pro
, of all four human EV species (EV-A to EV-D) inhibits SG formation and IFN-β gene transcription. Our observations suggest that enterovirus 2A
pro
has a conserved function in counteracting antiviral host responses and thereby is the main enterovirus “security protein.” Understanding the molecular mechanisms of enterovirus immune evasion strategies may help to develop countermeasures to control infections with these viruses.
Rare histotype of sporadic Creutzfeldt-Jakob disease, clinically suspected as corticobasal degeneration
Authors: Tilley Bension Shlomo , Smith Colin , Pavese Nicola , Attems Johannes
Published: March 2019

Sporadic Creutzfeldt-Jakob disease (sCJD) is a rare neurodegenerative disease that can mimic other neurological disorders. We present a case of sCJD in a 64-year-old man that presented with corticobasal syndrome and survived for 3 years. He presented initially with dementia, hemiparkinsonism and alien limb phenomenon and was diagnosed with corticobasal degeneration, ultimately progressing to immobility and akinetic mutism. With a normal MRI 1 year before onset, his neuroimaging 1 year later revealed abnormal DaTscan, cortical and hippocampal atrophy with ventricular dilatation on MRI, and diffusion-weighted cortical ribboning and thalamic hyperintensity. Postmortem, the patient’s brain was collected by the Parkinson’s UK Tissue Bank. Prion protein immunohistochemistry revealed widespread diffuse microvacuolar staining without kuru-type plaques. Hyperphosphorylated tau was only found in the entorhinal cortex and hippocampus. This case highlights the clinical heterogeneity of sCJD presentation and the important inclusion of CJD in the differential diagnosis of atypical presentations of neurodegenerative disease.
Serotonin syndrome unmasking thyrotoxicosis
Authors: Ronan Geoffrey Peter , Ronan Nicola , McGettigan Siobhan , Browne Gemma
Published: March 2019

A 26-year-old cachectic man presented with an altered mental status. He was agitated, tremulous, hyperthermic and diaphoretic with largely dilated pupils. Collateral history revealed acute ingestion of 3,4-methylenedioxymethamphetamine on a background of chronic drug abuse. His condition deteriorated requiring sedation and intubation with transfer to the intensive care unit. A diagnosis of serotonin syndrome was made, based on his findings in keeping with the Hunter criteria, and he was treated with supportive management during a resultant and briefly sustained delirium. With gradual resolution of his agitated state, further questioning and blood work a concurrent, and potentially contributory, thyrotoxicosis was revealed. The patient was commenced on treatment for this with urgent outpatient follow-up with both a local otolaryngologist and endocrinologist for consideration of further treatment.
Jejunal varices: an unconsidered cause of recurrent gastrointestinal haemorrhage
Authors: Heiberger Caleb Joseph , Mehta Tej Ishaan , Yim Douglas
Published: March 2019

A 78-year-old woman presented with melaenic stool and severe anaemia 4 years after a pancreaticoduodenectomy for adenocarcinoma of the pancreas. Initial workup revealed haemorrhage from the choledochojejunostomy site. Despite multiple endoscopic clips to the region, bleeding reoccurred multiple times over a period of several months. Due to ongoing haemorrhage, her case was urgently presented at the hospital’s multidisciplinary hepatobiliary conference. The contrast-enhanced abdominal CT revealed severe stenosis of the extrahepatic portal vein and large afferent jejunal varices at the choledochojejunostomy, suspected as the cause of her persistent bleed. The recommendation was a percutaneous transhepatic approach for stenting of the portal vein stenosis that resulted in rapid decompression of the jejunal varices and control of her haemorrhage.
Reflections on communication of disease prognosis and life expectancy by patients with colorectal cancer undergoing palliative care: a qualitative study
Authors: Rohde Gudrun , Söderhamn Ulrika , Vistad Ingvild
Published: March 2019

Objectives

Patients with colorectal cancer undergoing palliative treatment receive extensive treatment-related information throughout their disease trajectory. We aimed to explore the experiences of patients with incurable colorectal cancer while in palliative care and their reflections on the information provided by physicians and nurses. Our main focus was the patients’ thoughts about how information about disease status and life expectancy was communicated, from the first time that they were informed about the incurable nature of their disease through to postsurgery palliative treatment.

Settings

Patients with colorectal cancer receiving palliative chemotherapy.

Research design

We used a qualitative approach, and the data were analysed by qualitative content analysis.

Participants

20 patients (34–75 years of age) were included in the study; 12 received first-line chemotherapy and 8 received second-line chemotherapy. Eleven patients were treated by oncologists, and nine were treated by junior physicians.

Results

Data-driven empirical analysis identified three themes: (1) inadequate information during the initial phase of the disease trajectory; (2) hope and information further into the disease trajectory and (3) personal, professional and organisational factors that influenced information and communication throughout the disease trajectory.

Conclusion

The participants’ experience of being told for the first time that they had an incurable disease was perceived as inadequate, while postsurgery palliative chemotherapy, physicians and nurses offered hope. The participants preferred customised information about their treatment and likely future prospects and physicians and nurses who took a holistic and compassionate approach focusing on their lifeworld. To be a sensitive, holistic and compassionate physician or nurse requires knowledge and confidence. To achieve this requires training and guidance at universities and in hospitals.
Top research priorities in liver and gallbladder disorders in the UK
Authors: Gurusamy Kurinchi S , Walmsley Martine , Davidson Brian R , Frier Claire , Fuller Barry , Madden Angela , Masson Steven , Morley Richard , Safarik Ivana , Tsochatzis Emmanuel A , Ahmed Irfan , Cowlin Maxine , Dillon John F , Ellicott Graham , Elsharkawy Ahmed M , Farrington Liz , Glachan Anthony , Kumar Nagappan , Milne E J , Rushbrook Simon M , Smith Amanda , Stafford Lizzie , Yeoman Andrew
Published: March 2019

Objectives

There is a mismatch between research questions considered important by patients, carers and healthcare professionals and the research performed in many fields of medicine. The non-alcohol-related liver and gallbladder disorders priority setting partnership was established to identify the top research priorities in the prevention, diagnostic and treatment of gallbladder disorders and liver disorders not covered by the James-Lind Alliance (JLA) alcohol-related liver disease priority setting partnership.

Design

The methods broadly followed the principles of the JLA guidebook. The one major deviation from the JLA methodology was the final step of identifying priorities: instead of prioritisation by group discussions at a consensus workshop involving stakeholders, the prioritisation was achieved by a modified Delphi consensus process.

Results

A total of 428 unique valid diagnostic or treatment research questions were identified. A literature review established that none of these questions were considered ‘answered’ that is, high-quality systematic reviews suggest that further research is not required on the topic. The Delphi panel achieved consensus (at least 80% Delphi panel members agreed) that a research question was a top research priority for six questions. Four additional research questions with highest proportion of Delphi panel members ranking the question as highly important were added to constitute the top 10 research priorities.

Conclusions

A priority setting process involving patients, carers and healthcare professionals has been used to identify the top 10priority areas for research related to liver and gallbladder disorders. Basic, translational, clinical and public health research are required to address these uncertainties.
Patient, client, consumer, survivor or other alternatives? A scoping review of preferred terms for labelling individuals who access healthcare across settings
Authors: Costa Daniel S J , Mercieca-Bebber Rebecca , Tesson Stephanie , Seidler Zac , Lopez Anna-Lena
Published: March 2019

Objectives

Use of the term ‘patient’ has been recently debated, compared with alternatives including ‘consumer’ and ‘client’. This scoping study aimed to provide an integrated view of preferred labels across healthcare contexts and countries to clarify labelling preferences of individuals accessing healthcare.

Design

Scoping study.

Data sources

A preliminary literature search using GoogleScholar, Medline, Embase and PsycINFO found 43 key papers discussing terminology for labelling individuals accessing healthcare services. We then used citation chaining with PubMed and GoogleScholar to identify studies discussing term preferences among healthcare recipients.

Eligibility criteria

No date limits were applied, and all healthcare settings were considered. Primary research studies examining terminology preferences of individuals accessing healthcare, published in peer-reviewed journals were eligible.

Data extraction and synthesis

All authors extracted data regarding preferred term and study characteristics, and assessed reporting quality of the studies using criteria relevant to our design.

Results

We identified 1565 articles, of which 47 met inclusion criteria. Six articles that examined preference for personal address (eg, first name) were excluded. Of the remaining 41 studies, 33 examined generic terms (‘patient’, ‘client’, ‘consumer’) and 8 focused on cancer survivorship. Of the 33 examining generic terms, 27 reported a preference for ‘patient’ and four for ‘client’. Samples preferring ‘client’ were typically based in mental health settings and conducted in the USA. Of the eight cancer survivorship studies, five found a preference for ‘survivor’, and three ‘someone who had had cancer’.

Conclusions

Overall, healthcare recipients appear to prefer the term ‘patient’, with few preferring ‘consumer’. Within general clinical and research contexts, it therefore seems appropriate to continue using the label ‘patient’ in the absence of knowledge about an individual’s preferences. Reasons for preferences (eg, familiarity, social identity) and the implications of labelling for healthcare have not been investigated adequately, necessitating future empirical (including qualitative) research.
Alcohol consumption behaviours in the immediate aftermath of earthquakes: time series study
Authors: Kobayashi Daiki , Hayashi Hana , Kuga Hironori , Kuriyama Nagato , Terasawa Yoshihiro , Osugi Yasuhiro , Takahashi Osamu , Deshpande Gautam , Kawachi Ichiro
Published: March 2019

Objectives

Earthquakes are a distressing natural phenomenon that can disrupt normal health-related behaviours. The aim of this study was to investigate changes in alcohol consumption behaviours in the immediate aftermath of mild to moderate earthquakes.

Setting

This retrospective cohort study was conducted at a large academic hospital in Tokyo, Japan from April 2004 to March 2017.

Participants

We included all adult patients presenting with acute alcohol intoxication in the emergency room.

Primary and secondary outcome measures

Our outcome was the number of such patients per 24 hours period comparing days with and without earthquake activity. We mainly focused on mild to moderate earthquakes (Shindo scale of less than 3). We conducted a simple generalised autoregressive conditional heteroscedasticity (GARCH) analysis, followed by a multivariate GARCH, including year-fixed effects and secular changes in alcohol taxation. Subanalyses were conducted by gender and age group.

Results

During the study period, 706 earthquakes were observed with a median Shindo scale of 2 (IQR: 1). During this period, 6395 patients were admitted with acute ethanol intoxication; the mean age was 42.6 (SD: 16.9) years and 4592 (71.8%) patients were male. In univariate analyses, the occurrence of daytime earthquakes was marginally inversely related to the number of acutely intoxicated patients (β coefficient: −0.19, 95% CI −0.40 to 0.01). This finding remained similar in multivariate analyses after adjustment for covariates. In analyses stratified by gender, the inverse association between daytime earthquakes and alcohol intoxication was only observed among men (p<0.03 for males and p=0.99 for females). In subanalyses by age, older people were less likely to be admitted to the hospital due to acute alcohol intoxication on days with daytime earthquakes (p=0.11), but this was not the case for younger people (p=0.36).

Conclusion

On days when a mild to moderate daytime earthquake occurred, the number of patients with acute alcohol intoxication was lower compared with days without earthquakes. Even milder forms of potentially catastrophic events appear to influence social behaviour; mild to moderate earthquake activity is associated with the avoidance of excessive alcohol consumption.
A qualitative focus group study of perceived barriers and benefits to exercise by self-described exercise status among older adults living with HIV
Authors: Johs Nikolas A , Kellar-Guenther Yvonne , Jankowski Catherine M , Neff Hadlai , Erlandson Kristine M
Published: March 2019

Objectives

Although exercise interventions have been shown to improve health outcomes among older people with HIV (PLWH), this population remains highly sedentary. The purpose of this study was to examine the differences in perceived barriers and benefits of exercise among older PLWH by self-identified exercise status.

Design

Five focus groups were formed among PLWH: two groups of exercising men, two groups of non-exercising men and one group of women (mixed exercisers and non-exercisers). Themes were analysed in relation to the social-ecological model, utilising the constant comparative approach.

Setting

Patients were recruited from an academic medical centre, HIV clinic and community locations.

Participants

PLWH aged 50 or older, diagnosed with HIV for at least 2 years, with no other health conditions that would preclude exercise.

Primary and secondary outcome measures

Determine facilitators, barriers and the ideal environment for exercise or physical activity and determine whether these differ between older PLWH who self-identify as exercisers or non-exercisers.

Results

Among 25 men (11 exercisers and 14 non-exercisers) and four women (three non-exercisers and one exerciser), non-exercisers mentioned fewer benefits of exercise (n=46) than exercisers (n=75). Exercisers emphasised positive reinforcement, positive mood change and increased energy as benefits of exercise; interpersonal benefits of exercise were also discussed twice as often by exercisers than by non-exercisers. Non-exercisers emphasised barriers to exercise including lack of motivation, lack of self-efficacy and a negative perception of gym culture. Non-exercisers identified the need for age-appropriate activities as a feature of an ideal exercise environment. Both groups identified time, cost and health-related challenges as barriers to exercise.

Conclusions

Unique exercise barriers and benefits by self-identified exercise status provide important insights into the design of future interventions to initiate and maintain exercise.

Trial registration number

NCT02404792; Results.
Moving from prefabricated temporary housing to public reconstruction housing and social isolation after the Great East Japan Earthquake: a longitudinal study using propensity score matching
Authors: Sekiguchi Takuya , Hagiwara Yoshihiro , Sugawara Yumi , Tomata Yasutake , Tanji Fumiya , Yabe Yutaka , Itoi Eiji , Tsuji Ichiro
Published: March 2019

Objectives

After the Great East Japan Earthquake (GEJE) of 2011, many survivors have been forced to live in prefabricated temporary housing, which is uncomfortable and insufficiently durable for permanent living. Public reconstruction housing has been built to improve their living conditions; however, those moving have to rebuild personal relationships and adapt to a new environment. This study examined whether survivors moving to public reconstruction housing became more socially isolated than those remaining in prefabricated temporary housing.

Design, setting and participants

Self-report questionnaire data collected in 2015 (4 years after the GEJE) were used as the baseline for follow-up surveys in 2016 and 2017, as many survivors moved from prefabricated temporary housing to public reconstruction housing from 2015. We analysed longitudinal data from 393 survivors, distinguishing those who moved to public reconstruction housing during the 5th year after the disaster from those who remained in prefabricated temporary housing. Participants were assessed using the Lubben Social Network Scale-6 (LSNS-6) in all three surveys, with social isolation defined by a score of <12/30. To reduce the effect of selection bias, propensity score analysis was performed (178 of 393 participants were retained). We used a generalised estimated equation to evaluate the association between moving from prefabricated temporary housing to public reconstruction housing and changes in social isolation over 2 years.

Results

LSNS-6 scores of the reconstruction housing group were worse than those of the prefabricated housing group between 4 and 6 years after the GEJE (P=0.006). Over the same period, social isolation worsened in the reconstruction housing group but improved in the prefabricated housing group (P=0.002).

Conclusions

Social isolation should be monitored while supporting survivors who moved to public reconstruction housing, and further longitudinal research is needed to clarify the risk of social isolation.