bluuebunny/crossref_metadata_2025 huggingface dataset:
Upper-body cannulation for midterm mechanical circulatory support: A novel bridging strategy to cardiac retransplantation
Authors: Mogaldea Alexandru , Rojas Sebastian V , Ius Fabio , Kaufeld Tim , Sommer Wiebke , Avsar Murat , Bara Christoph , Haverich Axel , Warnecke Gregor , Kuehn Christian
Published: April 2020

Heart retransplantation remains a controversial issue, due to the overall shortage of donor organs. Many patients put on the waiting list for retransplantation, decompensate rapidly, and do not survive. The use of veno-arterial extracorporeal life support remains an option in such emergency situations as bridge-to-recovery or bridge-to-transplantation therapy. In peripheral femoral configuration, veno-arterial extracorporeal life support improves the patient’s condition by relieving low-cardiac output but immobilizes him or her for an uncertain period of time. The upper-body cannulation is an alternative approach, which allows to maintain the patient awake and mobile. We present two cases of midterm circulatory support as a bridge to heart retransplantation, using upper-body cannulation veno-arterial extracorporeal life support. Two male patients, presenting with progressive cardiac decompensation due to severe graft rejection, were placed on upper-body veno-arterial extracorporeal life support. The stabilization of hemodynamics and improvement of end-organ perfusion could be achieved after extracorporeal life support initiation. After 48 and 40 days, respectively, on extracorporeal life support with active physical therapy and no major adverse events, both patients received a cardiac retransplantation and were eventually discharged home. The presented cases are the first reported where a successful cardiac retransplant was performed following prolonged upper-body extracorporeal life support.
Evaluation of neoadjuvant gonadotropin administration with downregulation by testosterone prior to second time microsurgical testicular sperm extraction: A prospective case–control study
Authors: Amer Medhat Kamel , Ahmed Hossam ElDin Hosni , GamalEl Din Sameh Fayek , Fawzy Megawer Ahmed , Ahmed Ahmed Ragab
Published: April 2020

Purpose:

The aim of this prospective study was to determine whether there is a beneficial role of combining gonadotropin administration with testosterone downregulation in non-obstructive azoospermia patients prior to a second time microsurgical testicular sperm extraction after a negative one.

Methods:

A total of 40 non-obstructive azoospermia men were recruited from a specialized IVF center from 2014 to 2016. Participants were divided equally into two groups: Group A was subjected to testosterone downregulation alone for 1 month and then combined with gonadotropin administration for 3 months prior to second time testicular sperm extraction; Group B (controls) underwent second time microsurgical testicular sperm extraction without prior hormonal therapy.

Results:

Mean baseline follicle-stimulating hormone levels of the controls and the cases were 26.9 ± 11.8 and 25.4 ± 8.7, respectively. One month after testosterone downregulation, follicle-stimulating hormone level of the cases was normalized and became 2.4 ± 1.2. There was no statistically significant difference between baseline follicle-stimulating hormone levels of the controls and cases (p = 0.946). Remarkably, two cases were positive after downregulation (10%) and no controls were positive at second testicular sperm extraction (0%). There was no statistically significant difference between sperm retrieval after the second microsurgical testicular sperm extraction in the controls and the cases (p = 0.072).

Conclusion:

Patients who underwent first time testicular sperm extraction with unfavorable outcome due to different techniques may benefit from testosterone downregulation combined with neoadjuvant gonadotropin administration as it had shown positive sperms retrieval in 2 out of the 20 cases, especially those with hypergonadotropic azoospermia.
Two-dimensional hybrid analytical approach for the investigation of thermal aspects in human tissue undergoing regional hyperthermia therapy
Authors: Dutta Jaideep , Kundu Balaram
Published: April 2020

The formation of the present work is based on the development of the exact analytical solution of two-dimensional temperature response by employing the hyperbolic heat conduction bioheat model in a single-layered human skin tissue subjected to the regional hyperthermia therapy (RHT) for cancer treatment. The mathematical approach has been utilized as a hybrid form of ‘separation of variables’ and ‘finite integral transform’ method. Three kinds of surface heat fluxes (constant, sinusoidal and cosine) have been employed as an external heat source on the therapeutic surface of the square-shaped skin tissue of 100 mm × 100 mm. An innovative form of initial condition (spatially dependent) has been implemented in the present mathematical formulation as skin tissues are highly non-homogeneous and non-uniform in structure. The present research outcome indicates that cosine heat flux would be a suitable alternative for the sinusoidal heat flux. The impact of the relaxation time lag has been clearly noted in the thermal response with the waveform-like behaviour and it justifies the postulate of hyperbolic heat conduction. The two-dimensional temperature of the skin tissue has been observed in the range of 48.1 ℃–40 ℃ (in decreasing order). Estimated peak temperatures are in the proposed spectrum of hyperthermia therapy for an exposure time of 100 s, and this fact is true in an agreement with the medical protocol of the cancer treatment. The accuracy of the mathematical modelling and in-house computer codes are justified with the published numerical models and the maximum deviation of the thermal response has been noticed in order of 1.5–3%. The two-dimensional surface thermal contours have provided a glimpse of heat flow in the physical domain of skin tissue under different heating conditions and this research output may be beneficial to establish the theoretical standard of the regional hyperthermia treatment for cancer eradication.
Measuring moisture absorption in structural adhesive joints with fibre Bragg grating sensors
Authors: Fevery S , Hallez H , Vandepitte D , Debruyne S
Published: April 2020

The increased joint efficiency, distribution of loads and decrease in stress concentrations have led to the increased use of adhesives for structural bonding. However, there are a limited number of techniques for verifying and monitoring the integrity and durability of adhesive bonds. This article studies the potential of estimating the curing and ageing of adhesive bulk samples with embedded fibre Bragg grating sensors through measuring the strain associated with hygroscopic expansion. This is achieved by relating the output of a fibre Bragg grating sensor to the deformation of the structure in which it is embedded. This work considers the possibility of mapping the changing structural resistance to mechanical loading (stiffness) of adhesive bonds as a function of time, under the influence of temperature and moisture as environmental factors. The goal is to map the influence of these environmental factors separately on the one hand, and their combined effect on adhesive bonds, on the other hand. This study subjects several bulk specimens to various environmental ageing loads. The swelling, associated to moisture absorption and that results in mechanical strain, is measured with fibre Bragg grating sensors. The moisture absorption behaviour at different temperatures and environmental relative humidity conditions determined in this way is verified using classical test methods (e.g. differential scanning calorimetry, gravimetric) on multiple fibreless specimens.
The impact of recent land-use change in the Araucaria araucana forest in northern Patagonia
Authors: Moreno-Gonzalez Ricardo , Giesecke Thomas , Fontana Sonia L
Published: April 2020

Land-use change in the form of extensive Pinus plantations is currently altering the natural vegetation cover at the forest–steppe ecotone in northern Patagonia. Providing recommendations for conservation efforts, with respect to this recent and earlier land-use changes, requires a longer time perspective. Using pollen analysis, we investigated to what degree the colonization of the area by Euro-American settlers changed the forest composition and the vegetation cover, and to explore the spread of the European weed Rumex acetosella. This study is based on short sediment cores from six lakes in the Araucaria araucana forest region, across the vegetation gradient from the forest to the steppe. Results document that although Araucaria araucana has been extensively logged elsewhere, near the investigated sites, populations were rather stable and other elements of the vegetation changed little with the initiation of Euro-American settlements. A reduction of Nothofagus dombeyi-type pollen occurred at some sites presumably due to logging Nothofagus dombeyi trees, while toward the steppe, Nothofagus antarctica shrubs may have been removed for pasture. The appearance of Rumex acetosella pollen is consistent with the initiation of land use by Euro-American settlers in all cores, probably indicating the onset of animal farming. The rise of the Rumex acetosella pollen curve during the 1950s marks more recent land-use change. These observations indicate that the spread and local expansion of the weed requires disturbance. Overall, the study shows that the initial colonization of the area by Euro-American settlers had little effect on the natural vegetation structure, while developments since the 1950s are strongly altering the natural vegetation cover.
Physiopathology of pain in systemic erythematosus lupus
Authors: Nichilatti Louise P , Fernandes José MC , Marques Consuelo PC
Published: April 2020

Systemic lupus erythematosus is an autoimmune disease that promotes chronic inflammation, with periods of activation and remission. Pain is commonly one of the first symptoms reported by patients with lupus. It interferes with patients’ quality of life, leading to a decrease in strength and difficulty in performing daily activities. Given the chronic nature of the disease, the high prevalence of pain and its negative impact on the quality of life of patients with lupus, the present literature review study aims to explain the pathophysiology of pain in systemic lupus erythematosus and the implications of the chronic process and contributing factors. During periods of systemic lupus erythematosus activity, pain is a significant symptom. Despite this, several studies show that severe pain can occur in patients with in mild to moderate disease activity. Also, in the early stages of the disease, the pain may be accentuated by the greater activity of the disease. However, even when advanced disease is under control, there can be comorbidities and accumulated damage that can also cause high levels of pain. This sensitivity is due to the overlap of primary, secondary, and tertiary pain pathologies, which feedback and make this symptom one of the main concerns of patients with lupus. Understanding the pathophysiology of pain in systemic lupus erythematosus, as well as its chronification and contribution factors, is essential to identify effective therapeutic alternatives in these patients at each stage of pain pathology (primary, secondary, and tertiary).
Pediatric Palliative Care During End of Life: A Privilege of a Few in a Tertiary Referral Hospital From Colombia
Authors: Cuervo-Suarez Maria Isabel , Claros-Hulbert Angélica , Manzano-Nunez Ramiro , Muñoz Mauricio , García Ximena
Published: April 2020

Background:

We aim to describe the access to palliative care (PC) in hospitalized children during end-of-life care and compare the circumstances surrounding the deaths of hospitalized children as a basis for implementing a pediatric PC program at our institution.

Methods:

We performed a retrospective chart review of deceased pediatric patients at a tertiary referral hospital in Colombia. The study group was selected by randomly drawing a sample of 100 observations from the 737 deceased children from 2013 to 2016. A 1:1 propensity score (PS) matching was performed to compare the characteristics and outcomes between PC and non-PC treated patients.

Results:

We included 87 patients. After PS matching, we found that patients under the care of non-PC physicians were more likely to die in the pediatric intensive care unit (non-PC: 6/10 vs PC: 1/10; P = .02), to be on vasopressor agents and mechanical ventilation (non-PC: 7/10 vs PC: 1/10; P = .02), and to receive cardiopulmonary resuscitation at the end of life (non-PC: 5/10 vs PC: 0/10; P = .03). In contrast, a significantly higher proportion of patients under the care of the pediatric PC team died with comfort measures (non-PC: 2/10 vs 8/10; P = .02) and nonescalation of care in physician orders (non-PC: 5/10 vs PC: 10/10; 0.03).

Conclusion:

In this study, only 10 of 87 patients were treated by the pediatric PC team at the end of life. The latter finding is concerning and is a call to action to improve access to pediatric PC at our institution.
A University and School District Principalship Preparation Partnership Program
Authors: Padilla George , Guerra Federico , Menchaca Velma D. , Garcia Alejandro
Published: April 2020

A School District Principal Preparation Partnership Program is designed to establish collaboration between a University and school districts that employ the school leaders graduated by the university. This collaboration improves school principal preparation by integrating relevant school district policies, practices, knowledge, and skills into a rigorous curriculum graduate culturally, responsive, transformative school leaders. The purpose of this mixed research study was to collect data to assess the perceptions of student participants about central aspects of the program. The findings indicate the program is completing many of its goals. However, program areas to improve were also identified and included.
Impact of Automated Targeted Medication Review Electronic Alerts to Reduce Potentially Inappropriate Medication Prescribing Among Medicare Enrolled Patients With Dementia
Authors: Silva-Almodóvar Armando , Malfara Andrea , Nahata Milap C.
Published: April 2020

Background:

Background:Finding ways to reduce prescribing of potentially inappropriate medications (PIMs) among patients with dementia is necessary.

Objectives:

To evaluate an automated targeted medication review (TMR) service to reduce PIM prescribing among patients with dementia.

Methods:

This was a retrospective observational analysis of patients in a Medication Therapy Management (MTM) program for year 2017. Patients included if Medicare enrolled, MTM eligible, had dementia, and with PIM prescribing. Descriptive statistics described reduced PIM prescribing. Odds ratios (ORs) assessed prescriber relationship with PIM prescribing. Regression evaluated relationship between patient characteristics and discontinued PIMs.

Results:

A total of 33 696 TMRs were triggered for 17 933 patients. Four months later, 11 608 TMRs led to a discontinued PIM among 8002 patients. Medications with the largest discontinuations were antihistamines (56%), muscle relaxants (53%), antiemetics (53%), and typical antipsychotics (40%). Physician primary care providers (PCPs) were more likely than nonphysician PCPs (OR = 4.54; 95% CI = 4.15-4.97; P < 0.001), psychiatrists (OR = 1.64; 95%CI = 1.44-1.86; P < 0.001), and neurologists (OR = 4.48; 95% CI = 4.07-4.93; P < 0.001) to prescribe medications to treat dementia and PIMs. Regression showed that younger age, female gender, higher poverty level, and a greater number of pharmacies, medications, and prescribers were associated with discontinued PIMs. Conclusions and Relevance: TMRs were effective in reducing PIM prescribing. Younger patients, individuals living in higher poverty levels, and patients with multiple prescribers or pharmacies may benefit most from this service. TMRs in primary care offices may reduce PIM prescribing.
Travelling to a Sport Event: Profiling Sport Fans Against the Transtheoretical Model of change
Authors: Musgrave James , Jopson Ann , Jamson Samantha
Published: April 2020

This article profiles the travel behavior of sport fans against the transtheoretical model of change (TTM) and its application to sport events. Using the four constructs of the TTM, we distributed a self-reporting survey to sport fans prior to home fixtures. There is some synergy with the theorized stages of change and processes of change in this context. Notwithstanding, the results showed a high level of commitment to others in the early stages of change—a movement away from the prescribed theory. Results from decisional balance and self-efficacy items reaffirmed the congruence with theory and the application of the TTM to sport fans and their travel behavior. This study assessed the application of a stage-based model of change within a sport event context; it provides an exploration of the antecedents of behavior change indicators relevant to sport fans, thus enabling policy makers to make informed decisions about future travel behavior change.
A novel mutation of BEST1 gene in Best disease
Authors: Campa Claudio , Parmeggiani Francesco , Spena Rossella , Ognibene Davide , Passerini Ilaria , Gualandi Francesca
Published: April 2020

Purpose

To describe a new genetic variation of BEST1 gene in Best vitelliform macular dystrophy.

Methods

A patient with bilateral multiple retinal yellowish lesions at the posterior pole underwent fluorescein angiography, fundus autofluorescence, optical coherence tomography, electrooculogram and blood sample for genetic testing.

Results

A diagnosis of a Best vitelliform macular dystrophy was made. Heterozygous mutation c.76G > A (p.Gly26Ser) in exon 2 of the BEST1 gene was found.

Conclusion

These findings contribute to expand the mutation spectrum of BEST1 gene.
Strengthening ties: The influence of microtargeting on partisan attitudes and the vote
Authors: Lavigne Mathieu
Published: April 2020

Despite the resources devoted to microtargeting in recent election campaigns, we still have a limited understanding of its impacts on the electorate. This article aims to test the reinforcement effect of microtargeted messages on voters’ attitudes. Specifically, it looks at how microtargeting influences the strength and stability of partisan affiliation and the probability of voters changing their vote choice during the 2015 Canadian election campaign. Given that individuals are not targeted randomly, entropy balancing is used to model selection into treatment and create a valid counterfactual for microtargeted individuals. This approach is complemented by an extensive sensitivity analysis to improve confidence in selection on observables. We find evidence that microtargeting reinforces party ties and makes voters less likely to defect from their preferred party.
The impacts of accountable care organizations on patient experience, health outcomes and costs: a rapid review
Authors: Wilson Michael , Guta Adrian , Waddell Kerry , Lavis John , Reid Robert , Evans Cara
Published: April 2020

Objectives

Accountable care organizations were implemented as a system-level approach to address quality differences and curb increasing healthcare costs in the United States of America, and have garnered the interest of policy makers in other countries to support better management of patients. The objectives of this paper are to: (1) identify the impacts of accountable care organizations on improving the quadruple aim goals of improving patient experience of care, enhancing population health outcomes, reducing the per capita cost of health care and ensuring positive provider experiences and (2) determine how and why such impacts have been achieved through accountable care organizations.

Methods

We used a rapid review approach, searching Health Systems Evidence (for systematic reviews) and PubMed (for reviews and studies). Results were reviewed for inclusion independently by two researchers. Data were extracted by one reviewer and checked for consistency by another.

Results

We identified one recent systematic review and 59 primary studies that addressed the first objective ( n = 54), the second objective ( n = 4) or both objectives ( n = 1). The reviewed studies suggest that accountable care organizations reduce costs without reducing quality. Key findings related to objective 1 include: (1) there are positive trends across the quadruple–aim outcomes for accountable care organizations as compared to Medicare fee-for-service or group physician fee-for-service models; (2) accountable care organizations produced modest cost savings, which are largely attributable to savings in outpatient expenses among the most medically complex patients and reductions in the delivery of low-value services; (3) accountable care organization models met the majority of quality measures and perform better than their fee-for-service counterparts and (4) there is relatively little evidence about the impact of accountable care organizations on provider experience. Qualitative studies related to objective 2 highlighted mechanisms that were important for enabling accountable care organizations, including supplemental staff to enhance coordination and accountable care organization-wide electronic health records.

Conclusions

General trends and increased adoption of models similar to accountable care organizations outside of the USA suggest that these models outperform traditional fee-for-service models across the quadruple aim goals, although with mixed evidence about health outcomes.
Dodgeball: Inadvertently teaching oppression in physical and health education
Authors: Butler Joy , Burns David P , Robson Claire
Published: April 2020

Though students can learn a great deal about ethics as they play sport, the authors of this article ask what, exactly, they learn from playing dodgeball. As they look beyond the usual arguments offered for and against the teaching of the game, they view it through three ethical lenses: the ethic of care, the ethic of anti-oppressive education, and the ethics of virtue. They conclude that in terms of modelling, confirming, and practising caring behaviours, or offering opportunities to discuss and process what might be considered fair, dodgeball can be considered miseducative. They further argue that the hidden curriculum of dodgeball reinforces the five faces of oppression defined by the feminist theorist Iris Young as marginalization, powerlessness, and the helplessness of those perceived as weaker individuals through the exercise of violence and dominance by those who are considered more powerful. They conclude that the playing of dodgeball habituates the practice of aggression and fails to contribute positively to an ethical education.
Towards systemic evaluation in turbulent times – Second-order practice shift
Authors: Schmidt-Abbey Barbara , Reynolds Martin , Ison Ray
Published: April 2020

The need for, and possibilities of, a second-order shift in evaluation practice are explored. Second-order evaluation practice enables an evaluator to improve practice as a skilled practitioner, acknowledging her embeddedness within an evaluand. The article explores evaluation practice as experienced by professional evaluators, using ideas from developmental evaluation coupled with systemic evaluation in the tradition of systems thinking in practice. Systemic evaluation aims to capture systemic sensibilities – the bigger picture – of complex turbulent situations of change underpinning evaluands. Attributes of second-order practice with systemic evaluation are understood as being aligned with both systemic and systematic modes of evaluation praxis. Personal experiences are provided where this juxtaposing praxis has been found wanting. By example, a systems thinking in practice framework is explored as heuristic support for making a second-order practice shift. The article concludes with a discussion of some implications for developments in professionalising evaluation practice and research.
Electoral Reform or Not: Party Interests Defeated Principled Arguments in the Late Nineteenth Century and Have Characterised the UK’s Electoral System Since
Authors: Johnston Ron
Published: April 2020

Conti’s Parliament the Mirror of the Nation is an excellent, thorough exploration and explication of nineteenth-century debates over electoral reform as members of Britain’s intellectual elite wrestled with the issue of how to create a system that would ensure that all opinions were advanced in the country’s Parliament without an expansion of the franchise, meaning that the House of Commons was overwhelmed by the working class. A superb contribution to intellectual history, however, it makes little contact with the ‘real world’ of politics, where the short-term interests of the dominant political parties led to pragmatic rather than idealistic resolution to that issue. That resolution, negotiated by leading politicians from the two main parties, led to an electoral reform in 1885 based on single-member, territorially based constituencies that, with modifications only, remains in place today, generating general election results that are both disproportional and biased as a consequence of the system’s geographical construction
Experimental assessment of adding carbon nanotubes on the impact properties of Kevlar-ultrahigh molecular weight polyethylene fibers hybrid composites
Authors: B Bigdilou Mansour , Eslami-Farsani Reza , Ebrahimnezhad-Khaljiri Hossein , Mohammadi Mohammad A
Published: April 2020

In the present study, the effect of adding various percentage (0.1, 0.3, 0.5, and 0.9 wt.%) of carbon nanotubes on the impact properties of hybrid composites reinforced with the different stacking sequence of Kevlar fibers and ultrahigh molecular weight polyethylene was investigated. The obtained results showed that the composite with the configuration of sandwiched ultrahigh molecular weight polyethylene layers by Kevlar layers had the higher impact properties as compared with other hybrid configurations. Adding 0.1 wt.% carbon nanotubes in this configuration was caused to increase the normalized absorbed energy more than 6.5 times. The fracture surface of this configuration showed that the branching and expanding the damage area were the dominant mechanisms for the energy absorption of impactor. Also, the field emission scanning electron microscope illustrated that the carbon nanotubes by bridging, pulling out, and fracturing mechanisms increased the capability of energy absorption in the hybrid composites.
Circular RNA circ-CDYL sponges miR-1180 to elevate yes-associated protein in multiple myeloma
Authors: Chen Fang , Wang Xiaohui , Fu Shuang , Wang Shaokun , Fu Yu , Zhang Jihong , Liu Zhuogang
Published: April 2020

The covalently closed circular RNA has recently been proposed as a pivotal player in tumorigenesis. In the current study, we found that circ-CDYL was notably elevated in multiple myeloma tissue and plasma samples and had good diagnostic and prognostic efficacy. Functional assays showed that circ-CDYL enhanced the viability and DNA synthesis of multiple myeloma cells and inhibited apoptosis. Mechanically, cytoplasmic circ-CDYL was co-localized with miR-1180, and circ-CDYL absorbed miR-1180 to upregulate yes-associated protein (YAP), thereby facilitating multiple myeloma progression. Importantly, we further confirmed the existence of this circ-CDYL/miR-1180/YAP regulatory axis in vivo by using the xenograft tumor model. Taken together, our data demonstrate that circ-CDYL is novel promoter of multiple myeloma, and targeting circ-CDYL and its associated network implicates the therapeutic possibility for multiple myeloma patients.

Impact statement

Multiple myeloma (MM) is an extremely complex and heterogeneous disease, and its pathogenesis is poorly understood. Here, we described an important MM-related circular RNA (circRNA), circ-CDYL. It was remarkably increased in both MM cells and plasma. Depletion of circ-CDYL evidently stunted MM growth. Circ-CDYL could absorb miR-1180 and alleviated the repression of miR-1180 on YAP, leading to increased YAP expression, ultimately triggering MM uncontrolled growth. Therefore, our findings advance the understanding of MM pathogenesis, and also raise the possibility of considering circ-CDYL as a potential therapeutic intervention for MM.
A Call to Action: The Need for a Cultural Psychological Approach to Discrimination on the Basis of Skin Color in Asia
Authors: Bettache Karim
Published: April 2020

A strong preference for fair skin appears to be the norm across the Asian continent and may pervade many aspects of social life. Yet scholarly work on this ubiquitous phenomenon is rare within psychological science. This article is a call for a psychological investigation into colorism in Asia. I argue that colorism has firm systemic roots as a result of the sociohistorical trajectories of different Asian societies that have attached cultural meanings to skin color. Consequently, similarities and differences in such trajectories may account for variability in the expression of colorism within contemporary Asian societies. Directions for a cultural psychological approach to colorism are suggested.
The Effect of β-d-Mannuronic Acid in Animal Model of Epilepsy
Authors: Kamali Ali N. , Hamedifar Haleh , Sepehri Nima , Tahmasebi Saeed , Miladi Hosein , Moniri Shakiba , Goudarzvand Mahdi , Azizi Gholamreza , Mirshafiey Abbas
Published: April 2020

In the present study, we aimed to evaluate the therapeutic efficacy of β-d-mannuronic acid (M2000) in a rat model of epilepsy. Pentylenetetrazole (PTZ)-induced kindling model was applied in 30 Wistar rats divided into 3 groups through a total of 14 injections, while the rats in the drug-tested group were treated with M2000. Animals were observed for various seizure stages, delay that the rats developed in stages 2 and 5, and the duration of stage 5 seizures. After the last injection, the animals were euthanized and analysis was conducted in the brain for the various gene expression profiles along with histopathology assessments. Pretreatment of animals with M2000 has significantly accelerated epilepsy outcomes promptly following the first PTZ injection (mean ± standard deviation [SD] for seizure stage in the M2000 group was 3.12 ± 1.55 vs 0.75 ± 1.03 for control, P = 0.004). Notably, the mean (±SD) on the latency phase 2 and 5 seizures was lower in the M2000 group compared with control group (79.4 ± 30.7 vs 133.0 ± 38.4, P < 0.001, and 126.1 ± 27.6 vs 233.3 ± 142.8, P = 0.001, respectively). Finally, the mean (±SD) duration of phase 5 seizures was significantly higher in the M2000 pretreated group compared with control rats (344 ± 54 vs 197 ± 94, P < 0.001). Histological findings on the hippocampus showed no significant differences among all groups. Elevated expression level of interleukin (IL)-1β, IL-6, tumor necrosis factor-α, interferon-γ, and cyclooxygenase-2 was seen in the PTZ-induced kindling group. An elevated expression level of IL-10 was observed in the brains of rats in the M2000 treat group. Our results indicated that rats pretreated with M2000 were predisposed to epilepsy promptly after the first PTZ injection.
Plumbagin Induces Cell Cycle Arrest and Apoptosis in A431 Cisplatin-Resistant Cancer Cells
Authors: Giacomini Isabella , Cocetta Veronica , Carrara Maria , Ragazzi Eugenio , Montopoli Monica
Published: April 2020

The onset of drug resistance represents the leading cause of chemotherapy failure in clinics. In the last decades, natural compounds have emerged as possible anticancer strategies used either alone or in combination with chemotherapeutic drugs, in order to overcome drug resistance. In fact, plant-derived therapies present biological activity and minimal side effects showing promising roles in the resensitization of resistant cancer cells. This work was aimed at investigating the anticancer potential of the natural naphthoquinone plumbagin in a cisplatin-resistant cancer cell line. The results indicated cytotoxic and pro-oxidant activity of plumbagin in both sensitive (A431wt) and cisplatin-resistant (A431/Pt) human cervix squamous carcinoma cell lines. Moreover, plumbagin treatment induced cell cycle arrest and apoptosis in A431/Pt cells and the inhibition of retinoblastoma complex, suggesting a stronger activity on the cisplatin-resistant cell line. Taken together, the data indicate appreciable in vitro anticancer activity of plumbagin, suggesting that this natural compound could become a tool to overcome cisplatin resistance. Although further studies are necessary, this work underlines a promising role of plumbagin in the resensitization of cisplatin-resistant cancer cells.
Right ventricular dyssynchrony: from load‐independent right ventricular function to wall stress in severe pulmonary arterial hypertension
Authors: Richter Manuel J. , Badagliacca Roberto , Wan Jun , Vanderpool Rebecca , Dalmer Antonia , Ghofrani Hossein A. , Harth Sebastian , Seeger Werner , Gall Henning , Naeije Robert , Tello Khodr
Published: April 2020

Right ventricular (RV) dyssynchrony has been related to outcome in pulmonary arterial hypertension. Prospectively, we performed echocardiography with measurement of right ventricular dyssynchrony and pressure–volume loop catheterization in 27 pulmonary arterial hypertension patients. Afterload and diastolic function emerged as determinates of wall stress, which results in dyssynchrony.
Inequities Faced by Female Doctors Serving Communities of Need
Authors: Motta-Moss Ana , Hussain Zainab
Published: April 2020

The reasons for sex inequity in medicine are complex and partly interface ethnic background, specialty choice, and practice location. Multiple factors influence career choices including cultural values, balancing family responsibilities with professional growth, and career mentoring and support. Over the last 40 years, the Sophie Davis/CUNY School of Medicine (CSOM) has pursued a mission to increase diversity in medicine at the same time in which it has fostered the importance of primary care and service in underserved areas of New York State. Data from 1524 CSOM graduates show an increase in the number of women and underrepresented groups, with about a quarter of them working in Health Professional Shortage Areas (HPSAs). When compared with their male counterparts, our female graduates report lower income for similar work hours, with this disparity increasing slightly between female and male doctors working in HPSAs. In addition, our female graduates have chosen primary care specialties at a ratio of nearly 2:1 when compared with their male peers. Despite these inequities, our female graduates report satisfaction with their career choices, primarily due to a strong commitment to serving back patients in those communities where some of them come from. More research is needed to identify specific factors that perpetuate pay inequity at the state level to minimize the implications of disparity for women doctors, particularly those working in low-income communities.
Why CBA and NIMBY Syndrome Are Important Challenges to China’s BRI?
Authors: Euston Quah , Nursultan Iuldashov
Published: April 2020

The purpose of this article is to make a preliminary assessment of the Belt and Road Initiative (BRI) in the context of environmental impacts and arising not-in-my-backyard (NIMBY) opposition in host countries. We discuss the use of cost-benefit analysis (CBA) in developing countries (most members of BRI) and application of the available conflict-resolution mechanisms to deal with siting issues. We review these instruments and suggest a way forward for BRI NIMBY projects.

JEL Codes: O53, R58
Nanopore basecalling from a perspective of instance segmentation
Authors: Zhang Yao-zhong , Akdemir Arda , Tremmel Georg , Imoto Seiya , Miyano Satoru , Shibuya Tetsuo , Yamaguchi Rui
Published: April 2020

Background

Nanopore sequencing is a rapidly developing third-generation sequencing technology, which can generate long nucleotide reads of molecules within a portable device in real-time. Through detecting the change of ion currency signals during a DNA/RNA fragment’s pass through a nanopore, genotypes are determined. Currently, the accuracy of nanopore basecalling has a higher error rate than the basecalling of short-read sequencing. Through utilizing deep neural networks, the-state-of-the art nanopore basecallers achieve basecalling accuracy in a range from 85% to 95%.

Result

In this work, we proposed a novel basecalling approach from a perspective of instance segmentation. Different from previous approaches of doing typical sequence labeling, we formulated the basecalling problem as a multi-label segmentation task. Meanwhile, we proposed a refined U-net model which we call UR-net that can model sequential dependencies for a one-dimensional segmentation task. The experiment results show that the proposed basecaller URnano achieves competitive results on the in-species data, compared to the recently proposed CTC-featured basecallers.

Conclusion

Our results show that formulating the basecalling problem as a one-dimensional segmentation task is a promising approach, which does basecalling and segmentation jointly.
Molecular marker assisted gene stacking for disease resistance and quality genes in the dwarf mutant of an elite common wheat cultivar Xiaoyan22
Authors: Zheng Weijun , Li Song , Liu ZiHui , Zhou Qi , Feng Yanru , Chai Shoucheng
Published: April 2020

Background

Development of wheat cultivars with multiple disease resistance and high quality are major objectives in modern wheat breeding programs. Gene stacking is an efficient approach to achieve this target. In this study, we pyramided yellow rust resistance gene (Yr26), powdery mildew resistance gene (ML91260) and high-molecular-weight glutenin subunits Dx5 + Dy10 into the dwarf mutant of an elite wheat cultivar, Xiaoyan22.

Results

Six pyramided wheat lines were obtained by molecular marker-assisted selection (MAS) and field evaluation of disease resistance. The desirable agronomic traits of pyramided lines, their identity with the original cultivar Xiaoyan22 except for plant height, tiller number and disease resistance, was achieved in this study. Meanwhile, the yield of pyramided lines is higher than Xiaoyan22 in the field test. In addition, analysis of flour quality indicated that the dough stability time of pyramided lines was longer than that of Xiaoyan22.

Conclusions

Six pyramided wheat lines with two disease resistance and high quality were achieved in this study. It is feasible to improve multiple agronomic traits simultaneously by rational application of MAS.
Genomic analysis of a riboflavin-overproducing Ashbya gossypii mutant isolated by disparity mutagenesis
Authors: Kato Tatsuya , Azegami Junya , Yokomori Ami , Dohra Hideo , El Enshasy Hesham A. , Park Enoch Y.
Published: April 2020

Background

Ashbya gossypii naturally overproduces riboflavin and has been utilized for industrial riboflavin production. To improve riboflavin production, various approaches have been developed. In this study, to investigate the change in metabolism of a riboflavin-overproducing mutant, namely, the W122032 strain (MT strain) that was isolated by disparity mutagenesis, genomic analysis was carried out.

Results

In the genomic analysis, 33 homozygous and 1377 heterozygous mutations in the coding sequences of the genome of MT strain were detected. Among these heterozygous mutations, the proportion of mutated reads in each gene was different, ranging from 21 to 75%. These results suggest that the MT strain may contain multiple nuclei containing different mutations. We tried to isolate haploid spores from the MT strain to prove its ploidy, but this strain did not sporulate under the conditions tested. Heterozygous mutations detected in genes which are important for sporulation likely contribute to the sporulation deficiency of the MT strain. Homozygous and heterozygous mutations were found in genes encoding enzymes involved in amino acid metabolism, the TCA cycle, purine and pyrimidine nucleotide metabolism and the DNA mismatch repair system. One homozygous mutation in AgILV2 gene encoding acetohydroxyacid synthase, which is also a flavoprotein in mitochondria, was found. Gene ontology (GO) enrichment analysis showed heterozygous mutations in all 22 DNA helicase genes and genes involved in oxidation-reduction process.

Conclusion

This study suggests that oxidative stress and the aging of cells were involved in the riboflavin over-production in A. gossypii riboflavin over-producing mutant and provides new insights into riboflavin production in A. gossypii and the usefulness of disparity mutagenesis for the creation of new types of mutants for metabolic engineering.
Comparison of pulmonary vein reconnection patterns after multielectrode phased radiofrequency- and cryoballoon ablation of atrial fibrillation
Authors: Wieczorek Marcus , Sassani Kiarash , Hoeltgen Reinhard
Published: April 2020

Background

Pulmonary vein isolation (PVI) using phased radiofrequency (RF) energy has been shown to be effective in the treatment of atrial fibrillation (AF).

Methods

We characterize and compare pulmonary vein (PV) reconnection at repeat ablation in patients with AF after initially successful PVI using phased RF technology (PVAC) or 2nd generation cryoballoon (CB). Eighty five patients undergoing redo PVI using multielectrode PVAC phased RF catheter and 66 patients after CB PVI were enrolled 9.7 ± 3.4 months after the initial ablation procedure.

Results

The percentage of patients with PV reconnection(s) was comparably high between both groups (93% PVAC and 92% CB). However, 75% of all PVs and left common trunks (CTs) isolated with PVAC were reconnected, compared with 52% reconnections after CB PVI (p < 0.001). A mean of 2.79 ± 1.2 PVs and CTs/patient were reconnected after PVAC PVI compared with 1.97 ± 0.8 in CB patients,p < 0.0001. No patients in the CB group had 4 reconnected PVs, while this pattern of reconnection was observed in 33% in the PVAC group (p < 0.0001). The percentage of patients in the PVAC group with ≥3 reconnected PVs was significantly higher compared with CB patients (56 patients (66%) vs. 17 patients (26%),p < 0.0001), while the percentage of patients with no PV reconnection was comparably low in PVAC and CB patients (7 and 8%, respectively). CTs were most frequently reconnected after PVAC PVI (94%) and left superior PVs after CB ablation (67%), respectively.

Conclusions

The number of patients with recurrent AF and PV reconnection(s) at redo PVI was comparably high between both groups. However, the extent and distribution of PV reconnections was different in many aspects, indicating more stable atrial lesions after CB PVI compared with PVAC technology.
Prevalence of loneliness and association with depressive and anxiety symptoms among retirees in Northcentral Nigeria: a cross-sectional study
Authors: Igbokwe Chima C. , Ejeh Veronica J. , Agbaje Olaoluwa S. , Umoke Prince Ifeanachor Christian , Iweama Cylia N. , Ozoemena Eyuche L.
Published: April 2020

Background

Retirees face numerous challenges, including disassociation from persons in their social networks in Nigeria. Perceived social isolation or loneliness could impair the quality of life in old age, and lead to mental disorders. However, it is uncertain whether perceived loneliness has an independent association with depressive and anxiety symptoms and comorbid conditions in Nigerian retirees. Therefore, we aimed at examining the association between perceived loneliness, depressive and anxiety symptoms, including comorbid conditions among retirees in Northcentral Nigeria.

Methods

This community-based cross-sectional study enrolled retirees aged 60 years and above in different pension zones from February 2019 to August 2019. A two-stage sampling procedure was used to select the study participants. Data on perceived loneliness, depressive, and anxiety symptoms were collected using the 8-item University of California, Los Angeles Loneliness Scale (ULS-8), and the DASS 21-depression and anxiety subscales, respectively. We collected information on the demographic characteristics using a well-validated structured questionnaire. Descriptive statistics, binary and multivariable logistic regression were used to examine the independent associations between loneliness, depression, anxiety, and anxious depression. P-values below 0.05 were considered statistically significant.

Results

The mean age of participants was 71.3 (± 6.01) years, and 54.4% were men. The prevalence of loneliness, depression, anxiety, and anxious depression was 21.8, 52.0, 27.7, and 20.5%, respectively. Retirees with depression or anxiety symptoms perceived that they were lonelier than those without depression or anxiety. The multivariable logistic regression model showed that female gender (AOR 1.49; 95% CI (1.09, 2.00), having secondary education (AOR 2.24, 95% CI (1.40, 3.57) and having higher education (AOR 3.82, 95%CI (2.37, 6.16) were significantly associated with depression. Also, lonely retirees are 1.19 times (AOR 1.19; 95% CI (0.84, 1.69) more likely to be depressed compared to retirees that are not lonely, and the anxious depressed retirees are 314.58 times (AOR 314.58; 95% CI (508.05, 1941.70) more likely to be depressed than those without anxious depression.

Conclusion

The prevalence of loneliness, depression, anxiety, and anxious depression were relatively high among the older retirees. Female gender and advanced age were significantly associated with perceived loneliness, depression and anxiety.
Impaired circadian heart rate variability in Parkinson’s disease: a time-domain analysis in ambulatory setting
Authors: Arnao V. , Cinturino A. , Mastrilli S. , Buttà C. , Maida C. , Tuttolomondo A. , Aridon P. , D’Amelio M.
Published: April 2020

Background

Heart rate variability (HRV) decreases in Parkinson’s disease (PD) and it can be considered a marker for cardiovascular dysautonomia. The purpose of this pilot study is to evaluate long-term time-domain analysis of HRV of PD patients and compare the results with those of matched healthy individuals.

Methods

Idiopathic PD patients without comorbidity impairing HRV, and age-matched healthy individuals were recruited in a pilot study. A long-term time domain analysis of HRV using 24-h ambulatory ECG was performed.

Results

Overall, 18 PD patients fulfilling inclusion criteria completed the evaluation (mean age was 55.6 ± 8.8, disease duration: 5.0 ± 4.7). Mean SCOPA-AUT score was 10.1 ± 7.3. Patients were on Hoehn & Yahr stage 1–2 and mean Levodopa Equivalent Dose (LED) was 311 ± 239.9. Mean of the 5-min standard deviation (SD) of R-R intervals distribution (SDNN) for all 5 min segments of the entire recording (ISDNN) was significantly lower in patients compared to controls. ISDNN was significantly different between Parkinson’s disease patients and healthy controls.

Conclusions

In our population characterized by mild to moderate disease severity, time-domain assessment of HRV seemed to be a potential tool to characterize cardiovascular dysautonomia. Decrease of ISDNN in PD may reflect an autonomic derangement extending all day and night long.