bluuebunny/crossref_metadata_2025 huggingface dataset:
Family conferences and shared prioritisation to improve patient safety in the frail elderly (COFRAIL): study protocol of a cluster randomised intervention trial in primary care
Authors:   on behalf of the COFRAIL study group, Mortsiefer Achim , Wilm Stefan , Santos Sara , Löscher Susanne , Wollny Anja , Drewelow Eva , Ritzke Manuela , Thürmann Petra , Mann Nina-Kristin , Meyer Gabriele , Abraham Jens , Icks Andrea , Montalbo Joseph , Wiese Birgitt , Altiner Attila
Published: March 2020

Background

Frailty in elderly patients is associated with an increased risk of poor health outcomes, including falls, delirium, malnutrition, hospitalisation, and mortality. Because polypharmacy is recognised as a possible major contributor to the pathogenesis of geriatric frailty, reducing inappropriate medication exposure is supposed to be a promising approach to improve health-related quality of life and prevent adverse outcomes. A major challenge for the process of deprescribing of inappropriate polypharmacy is to improve the communication between general practitioner (GPs), patient and family carer. This study investigates the effects of a complex intervention in frail elderly patients with polypharmacy living at home.

Methods

This is a cluster randomised controlled trial including 136 GPs and 676 patients. Patients with a positive clinical screening for frailty are eligible if they are aged 70 years or older, receiving family or professional nursing care at home, and taking in five or more drugs per day. Exclusion criteria are higher grade of dementia and life expectancy of 6 months or less. The GPs of the intervention group receive an educational training promoting a deprescribing guideline and providing information on how to conduct a family conference focussing on prioritisation of treatment goals concerning drug therapy. During the 1-year intervention, GPs are expected to perform a total of three family conferences, each including a structured medication review with patients and their family carers. GPs of the control group will receive no training and will deliver care as usual. Geriatric assessment of all patients will be performed by study nurses during home visits at baseline and after 6 and 12 months. The primary outcome is the hospitalisation rate during the observation period of 12 months. Secondary outcomes are number and appropriateness of medications, mobility, weakness, cognition, depressive disorder, health-related quality of life, activities of daily living, weight, and costs of health care use.

Discussion

This study will provide evidence for a pragmatic co-operative and patient-centred educational intervention using family conferences to improve patient safety in frail elderly patients with polypharmacy.

Trial registration

German Clinical Trials Register, DRKS00015055 (WHO International Clinical Trials Registry Platform [ICTRP]). Registered on 6 February 2019.
Tongmai Yangxin intervening in myocardial remodeling after PCI for coronary heart disease: study protocol for a double-blind, randomized controlled trial
Authors: Wang Yongxia , Wang Xinlu , Wang Jianru , Li Bin , Yu Rui , Hu Yucai , Li Xingyuan , Peng Guangcao , Zhang Mengmeng , Zhu Mingjun
Published: March 2020

Background

Coronary heart disease (CHD) has become a common cardiovascular disease that seriously threatens the health of people. As reperfusion in the early phase and drug therapy, especially percutaneous coronary intervention (PCI), have become widely used in the clinic, the mortality of acute myocardial infarction in the short term has been reduced significantly. In addition, in 40%–56% of patients who experience myocardial infarction, cardiac dysfunction occurs and about 25%–33% develop heart failure.

Methods

This study was designed as a multicenter, double-blind, randomized, placebo-controlled, parallel-group, superiority trial. Participants were randomly assigned in a 1:1 ratio through a centrally controlled, computer-generated, simple randomization schedule. The primary outcome was left ventricular end-diastolic volume index = left ventricular end-diastolic volume/body surface area. The combined secondary outcomes include traditional Chinese medicine syndrome score, echocardiogram results, 6-minute walk test results, Seattle Angina Questionnaire score, cardiac magnetic resonance imaging results, biological indicators, dynamic electrocardiogram results, and experiment event rate. Assessments will be performed at baseline and at 4, 8, and 12 weeks after randomization.

Discussion

This trial will demonstrate that the addition of a Tongmai Yangxin pill (TMYX) to conventional treatment will intervene in the development of cardiac remodeling and cardiac dysfunction.

Trial registration

This study was registered in the Chinese Clinical Trial Registry on 7 May 2019. The registration number is ChiCRT1900023023 (http://www.chictr.org.cn/showproj.aspx?proj=12370).
Adjunct low-dose ketamine infusion vs standard of care in mechanically ventilated critically ill patients at a Tertiary Saudi Hospital (ATTAINMENT Trial): study protocol for a randomized, prospective, pilot, feasibility trial
Authors: Bawazeer Mohammed , Amer Marwa , Maghrabi Khalid , Alshaikh Kamel , Amin Rashid , Rizwan Muhammad , Shaban Mohammad , De Vol Edward , Hijazi Mohammed
Published: March 2020

Background

A noticeable interest in ketamine infusion for sedation management has developed among critical care physicians for critically ill patients. The 2018 Pain, Agitation/sedation, Delirium, Immobility, and Sleep disruption guideline suggested low-dose ketamine infusion as an adjunct to opioid therapy to reduce opioid requirements in post-surgical patients in the intensive care unit (ICU). This was, however, rated as conditional due to the very low quality of evidence. Ketamine has favorable characteristics, making it an especially viable alternative for patients with respiratory and hemodynamic instability. The Analgo-sedative adjuncT keTAmine Infusion iN Mechanically vENTilated ICU patients (ATTAINMENT) trial aims to assess the effect and safety of adjunct low-dose continuous infusion of ketamine as an analgo-sedative compared to standard of care in critically ill patients on mechanical ventilation (MV) for ≥ 24 h.

Methods/design

This trial is a prospective, randomized, active controlled, open-label, pilot, feasibility study of adult ICU patients (> 14 years old) on MV. The study will take place in the adult ICUs in the King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh, Saudi Arabia, and will enroll 80 patients. Patients will be randomized post-intubation into two groups: the intervention group will receive an adjunct low-dose continuous infusion of ketamine plus standard of care. Ketamine will be administered over a period of 48 h at a fixed infusion rate of 2 μg/kg/min (0.12 mg/kg/h) in the first 24 h followed by 1 μg/kg/min (0.06 mg/kg/h) in the second 24 h. The control group will receive standard of care in the ICU (propofol and/or fentanyl and/or midazolam) according to the KFSH&RC sedation and analgesia protocol as clinically appropriate. The primary outcome is MV duration until ICU discharge, death, extubation, or 28 days post-randomization, whichever comes first.

Discussion

The first patient was enrolled on 1 September 2019. As of 10 October 2019, a total of 16 patients had been enrolled. We expect to complete the recruitment by 31 December 2020. The findings of this pilot trial will likely justify further investigation for the role of adjunct low-dose ketamine infusion as an analgo-sedative agent in a larger, multicenter, randomized controlled trial.

Trial registration

ClinicalTrials.gov: NCT04075006. Registered on 30 August 2019. Current controlled trials: ISRCTN14730035. Registered on 3 February 2020.
PCN-222 metal–organic framework: a selective and highly efficient sorbent for the extraction of aspartame from gum, juice, and diet soft drink before its spectrophotometric determination
Authors: Safaei Moghaddam Zahra , Kaykhaii Massoud , Khajeh Mostafa , Oveisi Ali Reza
Published: March 2020

In this paper, we describe synthesis and application of an iron porphyrinc metal–organic framework PCN-222(Fe) for solid phase extraction of aspartame, an artificial non-saccharine sweetener, from gum, juice and diet soft drink samples prior to its determination by spectrophotometry. The mesoporous MOF was synthesized solvo-thermally and characterized by Fourier transform-infrared spectroscopy, powder X-ray diffraction, scanning electron microscopy, and Brunauer–Emmett–Teller techniques. To obtain the best extraction efficiency of aspartame, significant affecting parameters such as pH of sample solution, amount of the sorbent, type and volume of eluting solvent, and adsorption and desorption times were investigated and optimized. Under optimum conditions, the calibration graph for aspartame was linear in the range of 0.1 to 100.0 mg.L−1 and relative standard deviation of aspartame was 1.7% (n = 7). Limit of detection of method calculated as 0.019 mg.L−1 and the enrichment factor of 350 folds was obtained. Adsorption capacity of synthesized sorbent was found to be 356 mg.g−1. Hierarchical porosity, the eight terminal–OH groups of the Zr6 node, and hydrogen bonding possibly play vital role for selective adsorption of aspartame. The optimized method was successfully applied to the determination of aspartame in real samples with reasonable recoveries (> 98%).
Lipase immobilized on functionalized superparamagnetic few-layer graphene oxide as an efficient nanobiocatalyst for biodiesel production from Chlorella vulgaris bio-oil
Authors: Nematian Tahereh , Shakeri Alireza , Salehi Zeinab , Saboury Ali Akbar
Published: March 2020

Background

Microalgae, due to its well-recognized advantages have gained renewed interest as potentially good feedstock for biodiesel. Production of fatty acid methyl esters (FAMEs) as a type of biodiesel was carried out from Chlorella vulgaris bio-oil. Biodiesel was produced in the presence of nano-biocatalysts composed of immobilized lipase on functionalized superparamagnetic few-layer graphene oxide via a transesterification reaction. A hybrid of few-layer graphene oxide and Fe3O4 (MGO) was prepared and characterized. The MGO was functionalized with 3-aminopropyl triethoxysilane (MGO–AP) as well as with a couple of AP and glutaraldehyde (MGO–AP–GA). The Rhizopus oryzae lipase (ROL) was immobilized on MGO and MGO–AP using electrostatic interactions as well as on MGO–AP–GA using covalent bonding. The supports, MGO, MGO–AP, and MGO–AP–GA, as well as nano-biocatalyst, ROL/MGO, ROL/MGO–AP, and ROL/MGO–AP–GA, were characterized using FESEM, VSM, FTIR, and XRD. The few-layer graphene oxide was characterized using AFM and the surface charge of supports was evaluated with the zeta potential technique. The nano-biocatalysts assay was performed with an evaluation of kinetic parameters, loading capacity, relative activity, time-course thermal stability, and storage stability. Biodiesel production was carried out in the presence of nano-biocatalysts and their reusability was evaluated in 5 cycles of transesterification reaction.

Results

The AFM analysis confirmed the few-layer structure of graphene oxide and VSM also confirmed that all supports were superparamagnetic. The maximum loading of ROL (70.2%) was related to MGO–AP–GA. The highest biodiesel conversion of 71.19% achieved in the presence of ROL/MGO–AP–GA. Furthermore, this nano-biocatalyst could maintain 58.77% of its catalytic performance after 5 cycles of the transesterification reaction and was the best catalyst in the case of reusability.

Conclusions

In this study, the synthesized nano-biocatalyst based on bare and functionalized magnetic graphene oxide was applied and optimized in the process of converting microalgae bio-oil to biodiesel for the first time and compared with bare lipase immobilized on magnetic nanoparticles. Results showed that the loading capacity, kinetic parameters, thermal stability, and storage stability improved by the functionalization of MGO. The biocatalysts, which were prepared via covalent bonding immobilization of enzyme generally, showed better characteristics.
Imaging of the aortic root on high-pitch non-gated and ECG-gated CT: awareness is the key!
Authors: Nagpal Prashant , Agrawal Mukta D. , Saboo Sachin S. , Hedgire Sandeep , Priya Sarv , Steigner Michael L.
Published: March 2020

The aortic pathologies are well recognized on imaging. However, conventionally cardiac and proximal aortic abnormalities were only seen on dedicated cardiac or aortic studies due to need for ECG gating. Advances in CT technology have allowed motionless imaging of the chest and abdomen, leading to an increased visualization of cardiac and aortic root diseases on non-ECG-gated imaging. The advances are mostly driven by high pitch due to faster gantry rotation and table speed. The high-pitch scans are being increasingly used for variety of clinical indications because the images are free of motion artifact (both breathing and pulsation) as well as decreased radiation dose. Recognition of aortic root pathologies may be challenging due to lack of familiarity of radiologists with disease spectrum and their imaging appearance. It is important to recognize some of these conditions as early diagnosis and intervention is key to improving prognosis. We present a comprehensive review of proximal aortic anatomy, pathologies commonly seen at the aortic root, and their imaging appearances to familiarize radiologists with the diseases of this location.
HYPHYCA: a prospective study in 613 patients conducting a comprehensive analysis for predictive factors of physiological 18F-FDG anal uptake
Authors: Aide Nicolas , Tainturier Laure-Eugénie , Nganoa Cathy , Houdu Benjamin , Kammerer Jennifer , Galais Marie-Pierre , Ciappuccini Renaud , Lasnon Charline
Published: March 2020

Background

Anal cancer is a relatively rare tumor of which incidence increases in developed countries. 18F-FDG PET has been increasingly used for its post radio-chemotherapy evaluation. However, several authors have reported the risk of local false-positive findings leading to low specificity and positive predictive values. These false-positive results could be due to post-radiotherapy inflammation or infection but certainly also to physiological anal canal uptake that is observed on a regular basis in clinical practice. The purpose of this prospective study (NCT03506529; HYPHYCA) was therefore to seek predictive factors of physiological anal canal hypermetabolism.

Materials and methods

Over a 2-month period, patients aged 18 years old and more, referred for 18F-FDG PET-CT at two EARL-accredited PET centers were included, after obtaining their informed and written consent. They were asked to fill in a questionnaire including seven closed questions about usual intestinal transit, ongoing medications relative to intestinal transit, history of digestive, and anal and/or pelvic diseases. Age, gender, and body mass index (BMI) were recorded. A single nuclear medicine physician visually and quantitatively analyzed anal canal uptake (SUVmax_EARL) and assessed visual rectal content (air, feces, or both) and the largest rectal diameter (mm).

Results

Six hundred and thirteen patients were included (sex ratio F/M = 0.99) and 545 (89%) questionnaires were entirely completed. Significantly more males presented anal canal hypermetabolism (sex ratio (M/F) = 1.18 versus 0.85, p = 0.048). Moreover, patients with anal canal hypermetabolism had higher BMI (27.6 (5.7) kg/m2 versus 23.9 (4.5) kg/m2, p < 0.0001), higher rate of hemorrhoid history (43% versus 27%, p = 0.016), and higher rate of rectum filled with only feces (21% versus 12%, p = 0.019) as compared to patients with no anal canal uptake. On logistic regression, all these variables were found to be independent predictors of the occurrence of an anal canal hypermetabolism. Odds ratio were 1.16 (1.12–1.20) per unit of BMI (kg/m2) (p < 0.0001), 1.48 (1.04–2.11) for males (p = 0.030), 1.64 (1.10–2.45) for hemorrhoids history (p = 0.016), and 1.94 (1.147–3.22) for the rectum filled with only feces (p = 0.010).

Conclusion

According to our study, the predictive factors of physiological anal canal hypermetabolism are high BMI, male gender, hemorrhoid history, and rectum filled with only feces. This may pave the way to a more specific interpretation of post radio-chemotherapy PET evaluations of anal canal cancer, provided that other studies are conducted in this specific population.

Trial registration

This prospective study was registered at Clinicaltrial.gov: NCT03506529; HYPHYCA on April 24, 2018
Some new Fourier inequalities for unbounded orthogonal systems in Lorentz–Zygmund spaces
Authors: Akishev G. , Lukkassen D. , Persson L. E.
Published: March 2020

In this paper we prove some essential complements of the paper (J. Inequal. Appl. 2019:171, 2019) on the same theme. We prove some new Fourier inequalities in the case of the Lorentz–Zygmund function spaces$L_{q,r}(\log L)^{\alpha }$Lq,r(logL)αinvolved and in the case with an unbounded orthonormal system. More exactly, in this paper we prove and discuss some new Fourier inequalities of this type for the limit case$L_{2,r}(\log L)^{\alpha }$L2,r(logL)α, which could not be proved with the techniques used in the paper (J. Inequal. Appl. 2019:171, 2019).
Exact and nonstandard finite difference schemes for the generalized KdV–Burgers equation
Authors: Koroglu C.
Published: March 2020

We consider the generalized KdV–Burgers $\operatorname{KdVB}(p,m,q)$KdVB(p,m,q) equation. We have designed exact and consistent nonstandard finite difference schemes (NSFD) for the numerical solution of the $\operatorname{KdVB}(2,1,2)$KdVB(2,1,2) equation. In particular, we have proposed three explicit and three fully implicit exact finite difference schemes. The proposed NSFD scheme is linearly implicit. The chosen numerical experiment consists of tanh function. The NSFD scheme is compared with a standard finite difference(SFD) scheme. Numerical results show that the NSFD scheme is accurate and efficient in the numerical simulation of the kink-wave solution of the $\operatorname{KdVB}(2,1,2)$KdVB(2,1,2) equation. We see that while the SFD scheme yields numerical instability for large step sizes, the NSFD scheme provides reliable results for long time integration. Local truncation error reveals that the NSFD scheme is consistent with the $\operatorname{KdVB}(2,1,2)$KdVB(2,1,2) equation.
Severe hydroxymethylbilane synthase deficiency causes depression-like behavior and mitochondrial dysfunction in a mouse model of homozygous dominant acute intermittent porphyria
Authors: Berger Stefanie , Stattmann Miranda , Cicvaric Ana , Monje Francisco J. , Coiro Pierluca , Hotka Matej , Ricken Gerda , Hainfellner Johannes , Greber-Platzer Susanne , Yasuda Makiko , Desnick Robert J. , Pollak Daniela D.
Published: March 2020

Acute intermittent porphyria (AIP) is an autosomal dominant inborn error of heme biosynthesis due to a pathogenic mutation in the Hmbs gene, resulting in half-normal activity of hydroxymethylbilane synthase. Factors that induce hepatic heme biosynthesis induce episodic attacks in heterozygous patients. The clinical presentation of acute attacks involves the signature neurovisceral pain and may include psychiatric symptoms. Here we used a knock-in mouse line that is biallelic for the Hmbs c.500G > A (p.R167Q) mutation with ~ 5% of normal hydroxymethylbilane synthase activity to unravel the consequences of severe HMBS deficiency on affective behavior and brain physiology. Hmbs knock-in mice (KI mice) model the rare homozygous dominant form of AIP and were used as tool to elucidate the hitherto unknown pathophysiology of the behavioral manifestations of the disease and its neural underpinnings. Extensive behavioral analyses revealed a selective depression-like phenotype in Hmbs KI mice; transcriptomic and immunohistochemical analyses demonstrated aberrant myelination. The uncovered compromised mitochondrial function in the hippocampus of knock-in mice and its ensuing neurogenic and neuroplastic deficits lead us to propose a mechanistic role for disrupted mitochondrial energy production in the pathogenesis of the behavioral consequences of severe HMBS deficiency and its neuropathological sequelae in the brain.
The Association of Aquaporin-1 Gene with Marathon Running Performance Level: a Confirmatory Study Conducted in Male Hispanic Marathon Runners
Authors: Rivera Miguel A. , Fahey Thomas D. , López-Taylor Juan R. , Martínez Juan L.
Published: March 2020

Background

Replication studies are essential for identifying credible associations between alleles and phenotypes. Validation of genotype-phenotype associations in the sports and exercise field is rare. An initial genetic association study suggested that rs1049305 (C > G) in the 3′ untranslated region (3′UTR) of the aquaporin-1 (AQP1) gene was associated with marathon running (MR) performance level in Hispanic males. To validate this finding, we conducted a replication analysis in an independent case-control sample of Hispanic male marathon runners (n= 1430; casesn= 713 and controlsn= 717). A meta-analysis was utilized to test the extent of the association between the initial results and the present report. It also provided to test the heterogeneity (variation) between the two studies.

Results

The replication study showed a statistically significant (p≤ 0.05) association between rs1049305 (C > G) of the AQP1 gene and MR performance level. Association test results using a fixed effect model for the combined, original study and the present report, yielded an odds ratio = 1.28, 95% confidence interval = 1.13–1.45,p= 0.0001. The extent of the measures of heterogeneity was Tau-squared = 0,Hstatistic = 1,I2statistic = 0, and Cochran’sQtest (Q= 0.29;pvalue 0.59), indicated the variation between studies were due to chance and not to differences in heterogeneity between the two studies. Within the limitations of the present replication, contrast of two studies and its effects on meta-analysis, the findings were robust.

Conclusion

This study successfully replicated the results of Martínez et al. (Med Sportiva 13:251-5, 2009). The meta-analysis provided further epidemiological credibility for the hypothesis of association between the DNA rs1049305 (C > G) variation in the 3′UTR of the AQP1 gene and MR running performance level in Hispanics male marathon runners. It is not precluded that a linked DNA structure in the surrounding molecular neighborhood could be of influence by been part of the overly complex phenotype of MR performance level.
Childhood vitiligo impacts emotional health of parents: a prospective, cross-sectional study of quality of life for primary caregivers
Authors: Andrade Gabriela , Rangu Sneha , Provini Lauren , Putterman Elana , Gauthier Abigail , Castelo-Soccio Leslie
Published: March 2020

Background/objectives

Individuals with vitiligo have an increased risk of depression, anxiety, social isolation and detrimental effects on body image/self-esteem. However, assessments of quality of life (QoL) impact have not focused on caregivers of children with vitiligo. To address this, we determined the QoL impact in parents of children with vitiligo to assess the relationship between QoL parameters and disease duration, location, and severity.

Methods

We performed a cross-sectional study involving 123 parents of children diagnosed with vitiligo for at least 3 months, and who presented to the pediatric dermatology clinic of a major United States children’s hospital. Parents completed a demographics survey, Quality of Life in a Child’s Chronic Disease Questionnaire (QLCCDQ) and Family Dermatology Life Quality Index (FDLQI) to assess QoL measures. The lower the QLCCDQ score and higher the FLDQI score, the more quality of life is impaired.

Results

Subject age ranged from 20 to 57, and 13.9% received mental health intervention. QLCCDQ emotional domain scores were most impaired, and severity and location of disease impacted these scores. FDLQI scores decreased as children age, indicating overall parent wellbeing increased as children age.

Conclusions

Childhood vitiligo has great emotional impact on the quality of life of caregivers. Recognizing this will enable dermatologist who primarily care for these patients to incorporate care giver specific interventions during clinical visits. Emotional domain scores for parents of children with vitiligo were the most impaired as much or more than of those seen in parents of children with chronic stable medical disease such as type 1 diabetes and asthma.
Virulence and proteolytic activity of entomopathogenic fungi against the two-spotted spider mite, Tetranychus urticae Koch (Acari: Tetranychidae)
Authors: Elhakim Enas , Mohamed Omar , Elazouni Iman
Published: March 2020

The virulence and proteolytic activity of some entomopathogenic fungi isolates, viz., Metarhizium anisopliae, Beauveria bassiana, Verticillium lecanii, and Trichoderma harzianum, against the two-spotted spider mite, Tetranychus urticae Koch (Acari: Tetranychidae), were evaluated. Common maize plants (Zea mays L.) infested with females of T. urticae were treated in vivo by spraying with suspensions of 1 × 108 conidia ml−1 concentration of selected isolates. Lethal effects of fungal isolates were assessed as percentages of daily mortalities of mites, compared to the mortality in control. Virulence of the fungi isolates was estimated based on the LC50 values calculated by probit analysis for the individuals treated by 1 × 105 conidia ml−1 concentration. Proteolytic activity of isolates was assayed on casein substrate to reflect their virulence towards T. urticae. The mite mortality rates increased with increasing conidial concentrations as well as days after treatment. The mortality rate caused by M. anisopliae isolate varied from 18.75 to 85%, with LC50 value of 4.6 × 105 conidia/ml and LC90 value of 2.4 × 108 conidia/ml during 7 days, respectively. The isolate of B. bassiana caused 15 to 70% mortality, and its LC50 and LC90 values estimated 3.3 × 106 and 7.8 × 109 conidia/ml, respectively. However, V. lecanii isolate caused 11.25 to 72.50% mortality with LC50 of 5.2 × 106 conidia/ml, while T. harzianum was potentially less virulent than other isolates causing 8.75 to 63.75% mortality rate to T. urticae with LC50 of 9.4 × 106 conidia/ml. M. anisopliae showed the highest proteolytic activity at all concentrations, followed by B. bassiana in 3rd, 5th, and 7th day post treatment. These findings recommend the selection of virulent fungal isolates for use as natural and environmentally safe agents in biological control programs to combat mite pests.
Statistical optimization of chemical modification of chitosan-magnetic nano-particles beads to promote Bacillus subtilis MK1 α-amylase immobilization and its application
Authors: Abdella Mohamed A. A. , El-Sherbiny Gamal M. , El-Shamy Aliaa R. , Atalla Sherien M. M. , Ahmed Samia A.
Published: March 2020

Background

α-Amylase randomly hydrolyzes starch molecule to produce oligosaccharides of different chain length. It is among the most significant hydrolytic enzymes used in industrial applications. Enzyme immobilization is the simplest way to solve the stability problem of protein under industrial harsh conditions. Magnetic nano-particles considered suitable for immobilization due to their unique characteristics. The polymer nanocarriers still the feature of modifiable surfaces of carriers for further conjugation with biomolecule. This study aims to promote the immobilization of Bacillus subtilis MK1 α-amylase using the statistical optimization of the chemical modification of the chitosan-magnetic nano-magnetic particle beads and their ability to apply.

Results

B. subtilis MK1 α-amylase was successfully immobilized on chitosan-magnetic nano-particles using a method combining the advantages of both physical adsorption and covalent binding. The beads were chemically modified using polyethyleneimine (PEI) followed by glutaraldehyde (GA). Aminated beads by (PEI), activated beads by (GA), and immobilized enzyme on activated beads were characterized using FTIR. Morphological examinations of the beads surface before and after conjugation with the α-amylase enzyme were carried out using scanning electron microscope (SEM). Chemical modification parameters of the beads were optimized using response surface methodology based on central composite design. Statistical approach enhanced the immobilization yield (IY%) by 1.5-fold. The application of immobilized enzyme in the baking process enhanced dough-raising about 2.3-fold and can be reused for 5 cycles with 100% activity.

Conclusions

Statistical methods are an important way to improve immobilization yield and efficiency. The ANOVA data confirmed the fitness of the model which possessed R2 value (0.975) and the adjusted R2 value (0.940). The results confirm the ability to reuse the immobilized enzyme in industrial processes.
Effectiveness of treatment for 6813 patients with mental health conditions in Cambridgeshire: a cross-sectional study
Authors: Dean Nathan J. , Arnaoutoglou Nikitas , Underwood Benjamin R.
Published: March 2020

Background

The Health of the Nation Outcomes Scales (HoNOS) has been widely used as an outcome measure in UK mental health settings for the past decade. The data-set gathered provides a unique opportunity to evaluate the effectiveness of the totality of mental healthcare in ‘real-world’ conditions; much of our clinical evidence currently comes from highly parameterised clinical trials investigating single interventions in highly selected patients.

Aims

To examine all outcomes measured by HoNOS for a range of diagnostic groups, evaluate the influence of patient demographics on those outcomes, and observe changes in patient groups over time.

Method

Here we show the data from 6813 adult patients treated in Cambridgeshire between 2012 and 2017. Patients were split into three diagnostic groups: psychosis, non-psychosis and organic. Changes in HoNOS scores from initial assessment to discharge were tested and regressions were used to evaluate the influence of age, gender and ethnicity on the changes, as well as to model changes in the severity of initial presenting symptoms with time.

Results

HoNOS scores significantly improve after treatment for psychotic, non-psychotic and organic conditions in adults and older adults. Age, but not gender or ethnicity, influenced change in HoNOS scores. Patients entering secondary mental health services had increased initial HoNOS scores over time.

Conclusions

The UK repository of HoNOS scores provides a significant and relatively underutilised resource that can be exploited to gain insights into mental illness and treatment effectiveness. This is likely to have many applications, including influencing the commissioning of services.
Risk Factors for Small Adult Height in Childhood Cancer Survivors
Authors: Demoor-Goldschmidt Charlotte , Allodji Rodrigue S. , Journy Neige , Rubino Carole , Zrafi Wael Salem , Debiche Ghazi , Llanas Damien , Veres Cristina , Thomas-Teinturier Cécile , Pacquement Hélène , Vu-Bezin Giao , Fresneau Brice , Berchery Delphine , Bolle Stephanie , Diallo Ibrahima , Haddy Nadia , de Vathaire Florent
Published: March 2020

PURPOSE

Between 10% and 20% of childhood cancer survivors (CCS) experience impaired growth, leading to small adult height (SAH). Our study aimed to quantify risk factors for SAH or growth hormone deficiency among CCS.

METHODS

The French CCS Study holds data on 7,670 cancer survivors treated before 2001. We analyzed self-administered questionnaire data from 2,965 CCS with clinical, chemo/radiotherapy data from medical records. SAH was defined as an adult height ≤ 2 standard deviation scores of control values obtained from a French population health study.

RESULTS

After exclusion of 189 CCS treated with growth hormone, 9.2% (254 of 2,776) had a SAH. Being young at the time of cancer treatment (relative risk [RR], 0.91 [95% CI, 0.88 to 0.95] by year of age), small height at diagnosis (≤ 2 standard deviation scores; RR, 6.74 [95% CI, 4.61 to 9.86]), pituitary irradiation (5-20 Gy: RR, 4.24 [95% CI, 1.98 to 9.06]; 20-40 Gy: RR, 10.16 [95% CI, 5.18 to 19.94]; and ≥ 40 Gy: RR, 19.48 [95% CI, 8.73 to 43.48]), having received busulfan (RR, 4.53 [95% CI, 2.10 to 9.77]), or > 300 mg/m2 of lomustine (300-600 mg/m2: RR, 4.21 [95% CI, 1.61 to 11.01] and ≥ 600 mg/m2: RR, 9.12 [95% CI, 2.75 to 30.24]) were all independent risk factors for SAH. Irradiation of ≥ 7 vertebrae (≥ 15 Gy on ≥ 90% of their volume) without pituitary irradiation increased the RR of SAH by 4.62 (95% CI, 2.77 to 7.72). If patients had also received pituitary irradiation, this increased the RR by an additional factor of 1.3 to 2.4.

CONCLUSION

CCS are at a high risk of SAH. CCS treated with radiotherapy, busulfan, or lomustine should be closely monitored for growth, puberty onset, and potential pituitary deficiency.
Neuroendocrine and Behavioral Consequences of Hyperglycemia in Cancer
Authors: Vasquez Juan H , Borniger Jeremy C
Published: March 2020

A hallmark of cancer is the disruption of cellular metabolism during the course of malignant growth. Major focus is now on how these cell-autonomous processes propagate to the tumor microenvironment and, more generally, to the entire host system. This chain of events can have major consequences for a patient’s health and wellbeing. For example, metabolic “waste” produced by cancer cells activates systemic inflammatory responses, which can interfere with hepatic insulin receptor signaling and glucose homeostasis. Research is just now beginning to understand how these processes occur, and how they contribute to systemic symptoms prevalent across cancers, including hyperglycemia, fatigue, pain, and sleep disruption. Indeed, it is only recently that we have begun to appreciate that the brain does not play a passive role in responding to cancer-induced changes in physiology. In this review, we provide a brief discussion of how oncogene-directed metabolic reprogramming disrupts host metabolism, with a specific emphasis on cancer-induced hyperglycemia. We further discuss how the brain senses circulating glucose concentrations and how this process goes awry as a response to distant neoplastic growth. Finally, as glucose-sensing neurons control diverse aspects of physiology and behavior, we link cancer-induced changes in energy balance to neuroendocrine and behavioral consequences for the host organism.
Glucagon-like Peptide-1 Receptor Agonists versus Sodium-Glucose Cotransporter Inhibitors for Treatment of T2DM
Authors: McKee Alexis , Al-Khazaali Ali , Albert Stewart G
Published: March 2020

Context

Cardiovascular outcome trials (CVOT) of glucagon-like peptide-1 receptor agonists (GLP-1 RA) and sodium-glucose cotransporter 2 inhibitors (SGLT2i) demonstrated reduction of major adverse cardiovascular events (MACE), cardiovascular deaths (CVD), and renal outcomes.

Objective

Assist in the prescribing decision regarding severity of illness and risk for adverse events.

Design

Meta-analysis of the major CVOT and previous meta-analyses.

Main Outcome Measures

Six trials of GLP-1 RA (51 762 subjects) and 4 trials of SGLT2i (33 457 subjects) showed both drug classes reduced MACE and CVD versus controls, with neither class preferred (comparison GLP1-RA vs SGLT2i: relative rate [rr] MACE 1.04, 95% confidence interval [CI] 0.94, 1.16, P = ns; rr CVD 1.04, 95% CI 0.87, 1.24, P = ns). Hospitalization for heart failure (HHF) improved with SGLT2i (rr 0.68, CI 0.61, 0.76, P < 0.001) but not with GLP-1 RA, (rr 0.93, CI 0.86,1.03, P = ns). Meta-regression suggested benefits of the SGLT2i on CVD and HHF were accentuated with the underlying rate of MACE in the cohort (i.e., >10 events/1000pt*year). GLP-1 RA and SGLT2i showed reduction in renal outcomes (GLP-1 RA rr 0.83, CI 0.75, 0.91, p ≤ 0.001, SGLT2i rr 0.67, CI 0.57, 0.79, P < 0.001) without a preferential difference (GLP-1 RA vs SGLT2i, rr 1.24, CI 0.95, 1.61, P = ns; relative difference (rd) 0.005, CI -0.011, 0.021, P = ns). Serious adverse events for SGLT2i were mycotic genital infections in women (number needed to harm [NNH] = 13 and diabetic ketoacidosis NNH = 595. Gastrointestinal intolerance was the serious adverse event in the GLP1-RA class (NNH = 35).

Conclusion

GLP-1 RA and SGLT2i classes showed similar reduction in MACE, CVD, and renal outcomes. SGLT2i have advantages over GLP-1 RA in reduction in HHF.
Aging induces aberrant state transition kinetics in murine muscle stem cells
Authors: Kimmel Jacob C. , Hwang Ara B. , Scaramozza Annarita , Marshall Wallace F. , Brack Andrew S.
Published: March 2020

Murine muscle stem cells (MuSCs) experience a transition from quiescence to activation that is required for regeneration, but it remains unknown if the trajectory and dynamics of activation change with age. Here, we use timelapse imaging and single cell RNA-seq to measure activation trajectories and rates in young and aged MuSCs. We find that the activation trajectory is conserved in aged cells, and develop effective machine learning classifiers for cell age. Using cell behavior analysis and RNA velocity, we find that activation kinetics are delayed in aged MuSCs, suggesting that changes in stem cell dynamics may contribute to impaired stem cell function with age. Intriguingly, we also find that stem cell activation appears to be a random walk like process, with frequent reversals, rather than a continuous, linear progression. These results support a view of the aged stem cell phenotype as a combination of differences in the location of stable cell states and differences in transition rates between them.
ALTERED MERISTEM PROGRAM1 regulates leaf identity independently of miR156-mediated translational repression
Authors: Fouracre Jim P. , Chen Victoria J. , Poethig R. Scott
Published: March 2020

In Arabidopsis, loss of the carboxypeptidase ALTERED MERISTEM PROGRAM1 (AMP1) produces an increase in the rate of leaf initiation, an enlarged shoot apical meristem and an increase in the number of juvenile leaves. This phenotype is also observed in plants with reduced levels of miR156-targeted SQUAMOSA PROMOTER BINDING PROTEIN-LIKE (SPL) transcription factors, suggesting that AMP1 might promote SPL activity. However, we found that the amp1 mutant phenotype is only partially corrected by elevated SPL gene expression, and that amp1 has no significant effect on SPL transcript levels, or on the level or the activity of miR156. Although AMP1 has been reported to promote miRNA-mediated translational repression, amp1 did not prevent the translational repression of the miR156 target SPL9 or the miR159 target MYB33. These results suggest that AMP1 regulates vegetative phase change downstream of, or in parallel to, the miR156/SPL pathway, and that it is not universally required for miRNA-mediated translational repression.
Interleukin-2 Therapy of Autoimmunity in Diabetes (ITAD): a phase 2, multicentre, double-blind, randomized, placebo-controlled trial
Authors: Marcovecchio M. Loredana , Wicker Linda S. , Dunger David B. , Dutton Susan J. , Kopijasz Sylwia , Scudder Claire , Todd John A. , Johnson Paul R. V.
Published: March 2020

Type 1 diabetes is a common autoimmune disease due to destruction of pancreatic β cells, resulting in lifelong need for insulin. Evidence suggest that maintaining residual β-cell function can improve glucose control and reduce risk of hypoglycaemia and vascular complications.

Non-clinical, preclinical and some preliminary clinical data suggest that low-dose interleukin-2 (IL-2) therapy could block pancreatic β cells destruction by increasing the number of functional regulatory T cells (Tregs) that inhibit islet-specific autoreactive effector T cells (Teffs). However, there is lack of data on the effect of low-dose IL-2 in newly diagnosed children and adolescents with T1D as well as lack of specific data on its potential effect on β-cell function.

The ‘Interleukin-2 Therapy of Autoimmunity in Diabetes (ITAD)’ is a phase 2, multicentre, double-blind, randomised, placebo-controlled trial in children and adolescents (6-18 years; having detectable C-peptide) initiated within 6 weeks of T1D diagnosis. A total of 45 participants will be randomised in a 2:1 ratio to receive either ultra-low dose IL-2 (aldesleukin), at a dose of 0.2 x 106 IU/m2 twice-weekly, given subcutaneously, or placebo, for 6 months.

The primary objective is to assess the effects of ultra-low dose aldesleukin administration on endogenous β-cell function as measured by frequent home dried blood spot (DBS) fasting and post-prandial C-peptide in children and adolescents with newly diagnosed T1D. The secondary objectives are: 1) to assess the efficacy of regular dosing of aldesleukin in increasing Treg levels; 2) to confirm the clinical safety and tolerability of ultra-low dose aldesleukin; 3) to assess changes in the immune system indicating benefit or potential risk for future gains/loss in β-cell function and immune function; 4) to assess treatment effect on glycaemic control.

Trial registration: EudraCT 2017-002126-20 (06/02/2019)
The basics of commodity food products
Authors: PAVLOVA Tamara
Published: March 2020

This tutorial covers the basics of commodity food products, to detail the storage conditions of food products of various kinds, raskryvaetsja their classification, nutritive and useful properties of products.
Meets the requirements of Federal state educational standards of secondary professional education of the last generation.
Designed for students of institutions of secondary professional education.
Marketing in the aerospace field
Authors: Ryzhikova tamara
Published: March 2020

The tutorial provides an overview of the main methodological approaches to the analysis of the market of rocket and space technology and services on the basis of its specific features, methods of evaluating competition and its justification, the reinterpretation of basic marketing tools and approaches in combination with innovative ideas and methods of achieving high economic results in the space market.
The main aim is to provide future marketers with the necessary material, methods, technologies and tools with which to solve various problems related to the understanding of the structure of the space market, the company's place in the market, its competitive position and overall competitiveness.
Meets the requirements of Federal state educational standards of higher education of the last generation.
Intended for undergraduates and academics in aerospace orientation, postgraduate students, marketing analysts, marketers, corporate executives and agencies of the military-industrial complex.
Public opinion in the United States on the eve of the Civil war (1850-1861), was
Authors: Alent'eva Tat'yana
Published: March 2020

The monograph first examines American public opinion as a major factor of social and political life in the period of the maturing of the Civil war (1861-1865 gg.). Special value it is given by the study of the struggle in the South and in the North, consideration of the process of formation of two socio-cultural models.
On the wide canvas of the socio-economic and political history in the monograph analyses the state and development of public opinion in the United States, sequentially from the compromise of 1850, a small civil war in Kansas, the uprising of John brown, of the maturing of "inevitable conflict," the secession of the southern States to the formation of the southern Confederacy and the Civil war. Reveals a fierce struggle, which was accompanied by the adoption of the compromise Kansas-Nebraska and the Supreme court decision in the Dred Scott case of 1857, which annulled the action of the famous Missouri compromise. Special attention is paid to the formation of the Republican party and the presidential elections of 1856 and 1860
Shown, as were incitement to hatred between citizens of the same country, which were used propaganda and manipulative techniques. The totality of facts gleaned from primary sources, especially the materials about these manipulations give an opportunity to look behind the scenes politics that led to the outbreak of the Civil war in the United States, a deeper understanding of its causes.
For students of historical faculties and departments of sociology and political Sciences, and anyone interested in American history.
Psychology of addictions (addictologie)
Authors: Mandel' Boris
Published: March 2020

The manual is a unique course, including the work program. It is created on the basis of the developed programs in psychology in accordance with Federal state educational standards of higher education of the last generation. Contains 18 chapters, a detailed indicative work program of the discipline and based on modern information on psychology, psychiatry and addiktology. Each Chapter concludes with a list of key words for memorization and repetition, as well as questions and tasks. In addition, the manual contains a significant number of references and explanations that contain information about the referenced authors and the interpretation of terms and a list of additional literature, a sample of workshop topics, a list of questions for self-study for exams and credits.
For students and teachers of higher educational institutions that train teachers, psychologists, medical professionals, and those interested in addictologia as an integral part of the General psychology and psychiatry.
The Levels of Antinutritional Factors in Moringa Oleifera and Vernomia Amygdalina Leaves Found in Some Part of Plateau State, Nigeria
Authors: Auwal Musa M. , Yelwa Jibrin M. , Abubakar Ibrahim , Umar Jamilu B. , Anchau Hussaina G. , Tanimu Fatima B.
Published: March 2020

In this research work, various materials were used and they include; apparatus such as fume cupboard, measuring cylinder, spatula, centrifuge, pipette and reagent such as Na2CO3, CaCl2, H2SO4, HCl, AgNO3. The nutrient composition of V. Amydalina are: Phytate 11.9 ± 0.01 (mg/100g), oxalate 244.02 ± 0.57 (mg/100g), tannins 1.28 ± 0.50 (mg/100g), alkaloid 1.66 ± 0.01%, HCN 2036.00 ± 0.58 (mg/100g) and M. oleifera are: phytate 10.58 ± 0.01 (mg/100g), oxalate 334.33 ± 0.67 (mg/100g), tannin 8.19 ± 0.01 (mg/100g), alkaloid 1.72 ± 0.01% and HCN 3998.30 ± 0.49 (mg/100g). These results showed that V. Amydalina leaves could be a bioresources for Zn as a result of the low level of phytate. But they are not Cu bioavailable resources due to the high level of oxalate. Hence, people are encouraged to utilize V. amydalina and M. oleifera leaves as a good source of micronutrient particularly those prove to be bioavailable.
Air pollution and human health
Authors: Dwi Susanto Agus
Published: March 2020

[No abstract available]
Consumption of growing up milk and stunting among Indonesian toddlers: authors’ reply
Authors: Sjarif Damayanti Rusli , Yuliarti Klara , Iskandar William Jayadi
Published: March 2020

[No abstract available]
Streptococcus suis meningitis related to processing and consuming raw pork during Balinese tradition, Mebat
Authors: Aryasa IGM Ardika , Widiasari Ni Putu Ayu , Susilawathi Ni Made , Fatmawati Ni Nengah Dwi , Adnyana I Made Oka , Sudewi Anak Agung Raka , Adi Tarini Ni Made
Published: March 2020

Streptococcus suis is a zoonotic pathogen that can infect humans, especially meningitis. S. suis meningitis has been commonly diagnosed in Bali, which is associated with the consumption of raw pork. We reported case of S. suis meningitis that could have occurred due to the ingestion of undercooked pork during a traditional ceremony, which also involved two more patients with similar symptoms. A 62-year-old male was brought to the emergency unit because of decreased consciousness (Glasgow coma scale 14/15) in the last 8 hours before admission. He also had a headache, high fever, and stiff neck. Examination of cerebrospinal fluid revealed the presence of S. suis infection and was confirmed by polymerase chain reaction. The patient was administered ceftriaxone and showed a clinical improvement on the third day without any hearing problem.