bluuebunny/crossref_metadata_2025 huggingface dataset:
Death by antibody
Authors: Faccini Timothy , Dhesi Zaneeta , Shah Sachin
Published: May 2019

A 42-year-old woman with a background of psoriatic arthritis presented with a 7-day medical history of fevers of unknown source; she had recently undergone elective shoulder arthroscopy, and her medications included anti-interleukin 17A (anti-IL-17A) drug, secukinumab.

She went on to develop sepsis-induced cardiomyopathy, requiring veno-arterial extracorporeal membrane oxygenation (ECMO), from which she was successfully weaned after 12 days. However, she then went on to develop a candidaemia, with new intra-abdominal collections found incidentally on CT; despite appropriate anti-fungal therapy and attempts at drainage, she passed away.

Both anti-IL-17A treatment and ECMO have been shown to be significant independent risk factors forCandidainfection. The use of monoclonal antibody therapy in the management of autoimmune disease, and the use of ECMO in the intensive care setting are each becoming increasingly widespread. Fungal infection should be screened for early in this critically unwell group of patients, and treatment initiated as indicated.
Episcleral brachytherapy for retinoblastoma
Authors: Echegaray Jose J , Al-Zahrani Yahya A , Singh Arun
Published: May 2019

Background/Aims

To report visual outcomes, survival outcomes and complications following episcleral brachytherapy (EB) for retinoblastoma.

Methods

Retrospective review of retinoblastoma cases treated with EB in a single institution. Survival outcomes were analysed using the Kaplan-Meier method.

Results

Eleven tumours of 11 eyes were treated with either iodine-125 or ruthenium-106 EB with a mean apical dose of 44 Gy. The tumours were classified as group B in 5 (46%), C in 3 (27%) or D in 3 (27%) eyes, respectively. Mean follow-up time was 75.4 months. EB served as primary treatment in 3 eyes (27%) and secondary treatment in 8 eyes (73%). Final visual acuity was better than 20/200 in 70% of cases. Globe preservation was achieved in 9 (82%) eyes. Local recurrence occurred in 18% of cases at a mean onset of 17.4 months after EB. Two group D tumours that recurred after secondary EB underwent enucleation. Mean onset of radiation retinopathy was 17.4 months following EB. No metastatic or fatal events were recorded. Kaplan-Meier analysis showed recurrence-free survival and ocular survival of 80% and overall survival of 100% at 5 years after EB.

Conclusion

EB is an effective primary or secondary treatment modality for selected retinoblastoma eyes (groups B and C). Advanced group D tumours may represent a risk factor for local recurrence. Visually significant complications such as radiation retinopathy should be anticipated.
Database analysis of the risk factors of bisphosphonate-related osteonecrosis of the jaw in Hungarian patients
Authors: Veszelyné Kotán Edit , Bartha-Lieb Tímea , Parisek Zsolt , Meskó Attiláné , Vaszilkó Mihály , Hankó Balázs
Published: May 2019

Objective

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a rare but serious side effect of bisphosphonates (BPs). Since this disease has no independent code in either of the diseases’ or in the medical procedures’ classifications, it is hard to estimate how many BP patients are affected.

Design

A retrospective observational epidemiological registry-based study was carried out, using the data of the national service of Hungary on the incidence of BRONJ and related factors.

Setting

A data analysis was performed, which is relevant for the whole Hungarian population from 2010 to 2014. The socioeconomic and medication data of 236 207 BP patients were analysed, and a method was worked out to define BRONJ patients from the Hungarian BP population.

Primary and secondary outcome measures

The incidences of BRONJ were analysed according to genders and the types of the BP drugs administered. The marginal interdependence between the types of BP drugs, modes of administration and main indication was calculated.

Results

340 BP patients (0.1%) developed BRONJ. The incidence of BRONJ in Hungary in the malignant indication of BPs is 0.9%, and 0.1% in the non-malignant indication, and the OR to develop BRONJ was OR=9.7 (95% CI 7.8 to 12.1) between them. Although more women developed BRONJ, the proportion of men was significantly higher than that of women. Steroids increase the risk of jaw osteonecrosis, and differences were also found between the BP drugs.

Conclusions

Oncology indicated, intravenously administered and steroid comedicated BP therapies pose a high risk of developing BRONJ in the Hungarian population.
Global epidemiology ofNeisseria gonorrhoeaein infertile populations: protocol for a systematic review
Authors: Chemaitelly Hiam , Harfouche Manale , Blondeel Karel , Matsaseng Thabo Christopher , Kiarie James , Toskin Igor , Abu-Raddad Laith J
Published: May 2019

Introduction

A key target of the WHO’s ‘Global Health Sector Strategy on sexually transmitted infections, 2016–2021’ is achieving 90% reduction inNeisseria gonorrhoeae(gonorrhoea for short) incidence globally by 2030. Though untreated, gonorrhoea has been linked to infertility, the epidemiology of this infection in infertile populations remains poorly understood and somewhat a neglected area of reproductive health. Our proposed systematic review aims to fill this gap by characterising comprehensively gonorrhoea infection in infertile populations globally.

Methods and analysis

All available studies of gonorrhoea infection in infertile populations, including infertility clinic attendees, will be systematically reviewed informed by Cochrane Collaboration guidelines. Findings will be reported following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data sources will be searched using broad index terms exploded to cover all subheadings and free text terms with no language or year restriction. Any epidemiological measure in infertile populations based on primary data will be eligible for inclusion. Measures based on different assay types will be extracted as separate studies for different analyses. Only one biospecimen type per assay type will be considered based on a predefined priority order. Samples including fewer than 10 participants or assessing infection in the upper genital tract will be excluded. Quality assessments will be conducted for all measures included in the review. Meta-analyses will be implemented using DerSimonian-Laird random effect models to estimate the mean prevalence of gonorrhoea in infertile populations globally, and stratified by WHO region, assay type, sex, infertility type, infertility diagnosis, among other factors. Detailed heterogeneity assessment will be performed, and potential sources of between-study heterogeneity will be explored using meta-regression. Review will be conducted from 26 March 2018 to 28 July 2019.

Ethics and dissemination

An institutional review board clearance is not required as all data are publicly available. The findings will be disseminated through a peer-reviewed publication and international scientific meetings/workshops with key stakeholders.

PROSPERO registration number

CRD42018102934
Contribution of women’s development army to maternal and child health in Ethiopia: a systematic review of evidence
Authors: Yitbarek Kiddus , Abraham Gelila , Morankar Sudhakar
Published: May 2019

Objective

The aim of this review was to identify, appraise and synthesise studies that reported on the contribution of women’s development army (WDA) to maternal and child health development.

Setting

Studies conducted in Ethiopia 2010 onwards and published in English were considered.

Data sources

Evidence were searched in MEDLINE, CINAHL and EBSCOhost from 25 March to 10 April 2018.

Eligibility criteria

Both quantitative and qualitative studies assessing the contribution of WDA to maternal and child health were considered.

Data extraction and synthesis

Two independent reviewers have extracted data using pre-planned data extraction tool separately for each study design. Findings were synthesised using tables and narrative summary.

Outcome

Maternal and child health services; maternal and child mortality.

Results

Nine studies met the inclusion criteria and were used for synthesis. The results revealed that participation and membership in women’s development teams (WDTs) have a positive effect on minimising maternal death and improving child immunisation service use. Skilled delivery and antenatal care service use were higher in WDTs located within a radius of 2 km from health facilities. Women’s development teams were also the main sources of information for mothers to prepare themselves for birth and related complications. Moreover, well-established groups have strengthened the linkage of the health facility to the community so that delays in maternal health service use were minimised; health extension workers could effectively refer women to a health facility for birth and utilisation of skilled birth service was improved.

Conclusion

Voluntary health service intervention in Ethiopia has improved maternal and child health services’ outcome. A decrease in maternal deaths, increase in antenatal and delivery service use and improved child immunisation service uptake are attributable to this intervention. The linkage between community members and the primary healthcare system served as an effective and efficient mechanism to share information.
Importance of vitamin D in acute and critically ill children with subgroup analyses of sepsis and respiratory tract infections: a systematic review and meta-analysis
Authors: Cariolou Margarita , Cupp Meghan A , Evangelou Evangelos , Tzoulaki Ioanna , Berlanga-Taylor Antonio J
Published: May 2019

Objectives

To estimate the prevalence of 25-hydroxyvitamin D (25(OH)D) deficiency and investigate its association with mortality in children with acute or critical conditions.

Design

Systematic review and meta-analysis of observational studies.

Data sources

PubMed, OVID, Google Scholar and the Cochrane Library searched until 21 December 2018.

Eligibility criteria

Studies of children hospitalised with acute or critical conditions who had blood 25(OH)D levels measured.

Data extraction and synthesis

We obtained pooled prevalence estimates of 25(OH)D deficiency and ORs for mortality. We calculated 95% CI and prediction intervals and investigated heterogeneity and evidence of small-study effects.

Results

Fifty-two studies were included. Of 7434 children, 3473 (47.0%) were 25(OH)D deficient (<50 nmol/L). The pooled prevalence estimate of 25(OH)D deficiency was 54.6% (95% CI 48.5% to 60.6%, I2=95.3%, p<0.0001). Prevalence was similar after excluding smaller studies (51.5%). In children with sepsis (18 studies, 889 total individuals) prevalence was 64.0% (95% CI 52.0% to 74.4%, I2=89.3%, p<0.0001) and 48.7% (95% CI 38.2% to 59.3%; I2=94.3%, p<0.0001) in those with respiratory tract infections (RTI) (25 studies, 2699 total individuals). Overall, meta-analysis of mortality (18 cohort studies, 2463 total individuals) showed increased risk of death in 25(OH)D deficient children (OR 1.81, 95% CI 1.24 to 2.64, p=0.002, I2=25.7%, p=0.153). Four (22.0%) of the 18 studies statistically adjusted for confounders. There were insufficient studies to meta-analyse sepsis and RTI-related mortality.

Conclusions

Our results suggest that 25(OH)D deficiency in acute and critically ill children is high and associated with increased mortality. Small-study effects, reverse causation and other biases may have confounded results. Larger, carefully designed studies in homogeneous populations with confounder adjustment are needed to clarify the association between 25(OH)D levels with mortality and other outcomes.

Prospero registration number

CRD42016050638.
Symptom reporting, healthcare-seeking behaviour and antibiotic use for common infections: protocol for Bug Watch, a prospective community cohort study
Authors: Smith Catherine M , Conolly Anne , Fuller Christopher , Hill Suzanne , Lorencatto Fabiana , Marcheselli Franziska , Michie Susan , Mindell Jennifer S , Ridd Matthew J , Shallcross Laura J , Tsakos Georgios , Hayward Andrew , Fragaszy Ellen B
Published: May 2019

Introduction

Antimicrobial resistance is a significant worldwide problem largely driven by selective pressure exerted through antibiotic use. Preserving antibiotics requires identification of opportunities to safely reduce prescriptions, for example in the management of mild common infections in the community. However, more information is needed on how infections are usually managed and what proportion lead to consultation and antibiotic use. The aim of this study is to quantify consultation and prescribing patterns in the community for a range of common acute infection syndromes (respiratory, gastrointestinal, skin/soft tissue, mouth/dental, eye and urinary tract). This will inform development of interventions to improve antibiotic stewardship as part of a larger programme of work, Preserving Antibiotics through Safe Stewardship.

Methods and analysis

This will be an online prospective community cohort study in England. We will invite 19 510 adults who previously took part in a nationally representative survey (the Health Survey for England) and consented to be contacted about future studies. Adults will also be asked to register their children. Data collection will consist of a baseline registration survey followed by weekly surveys sent by email for 6 months. Weekly surveys will collect information on symptoms of common infections, healthcare-seeking behaviour and use of treatments including antibiotics. We will calculate the proportions of infection syndromes that lead to General Practitioner consultation and antibiotic prescription. We will investigate how healthcare-seeking and treatment behaviours vary by demographics, social deprivation, infection profiles and knowledge and attitudes towards antibiotics, and will apply behavioural theory to investigate barriers and enablers to these behaviours.

Ethics and dissemination

This study has been given ethical approval by the University College London Research Ethics Committee (ID 11813/001). Each participant will provide informed consent upon registration. We will disseminate our work through publication in peer-reviewed academic journals. Anonymised data will be made available through the UK Data Service (https://www.ukdataservice.ac.uk/).
Investigating the stratified efficacy and safety of pharmacological blood pressure-lowering: an overall protocol for individual patient-level data meta-analyses of over 300 000 randomised participants in the new phase of the Blood Pressure Lowering Treatment Trialists’ Collaboration (BPLTTC)
Authors: Rahimi Kazem , Canoy Dexter , Nazarzadeh Milad , Salimi-Khorshidi Gholamreza , Woodward Mark , Teo Koon , Davis Barry R , Chalmers John , Pepine Carl J
Published: May 2019

Introduction

Previous research from the Blood Pressure Lowering Treatment Trialists’ Collaboration (BPLTTC) and others has shown that pharmacological blood pressure (BP)- lowering substantially reduces the risk of major cardiovascular events, including ischaemic heart disease, heart failure and stroke. In this new phase, the aim is to conduct individual patient-level data (IPD) meta-analyses involving eligible BP-lowering randomised controlled trials (RCTs) to address uncertainties relating to efficacy and safety of BP-lowering treatment.

Methods and analysis

RCTs investigating the effect of pharmacological BP-lowering, with a minimum of 1000 patient-years of follow-up in each trial arm, are eligible. Our systematic review identified 100 potentially eligible trials. We requested their investigators/sponsors to contribute baseline, follow-up and outcomes data. As of June 2018, the collaboration has obtained data from 49 trials (n=315 046 participants), with additional data currently in the process of being transferred from four RCTs (n=34 642 participants). In addition, data harmonisation has commenced. Scientific activities of the collaboration are overseen by the Steering Committee with input from all collaborators. Detailed protocols for individual meta-analyses will be developed and registered on public platforms.

Ethics and dissemination

Ethics approval has been obtained for this new and extended phase of the BPLTTC, the largest collaboration of de-identified IPD from RCTs. It offers an efficient and ethical manner of re-purposing existing data to answer clinically important questions relating to BP treatment as well as methodological questions relating to IPD meta-analyses. Among the immediate impacts will include reliable quantification of effects of treatment modifiers, such as baseline BP, age and prior disease, on both vascular and non-vascular outcomes. Analyses will further assess the impact of BP-lowering on important, but less well understood, outcomes, such as new-onset diabetes and renal disease. Findings will be published in peer-reviewed medical journals on behalf of the collaboration.
Cerebrospinal fluid neurofilament light chain in multiple sclerosis and its subtypes: a meta-analysis of case–control studies
Authors: Martin Sarah-Jane , McGlasson Sarah , Hunt David , Overell James
Published: May 2019

Objective

Neurofilament is a biomarker of axonal injury proposed as a useful adjunct in the monitoring of patients with multiple sclerosis (MS). We conducted a systematic review and meta-analysis of case–control studies that have measured neurofilament light chain (NfL) levels in cerebrospinal fluid (CSF) of people with MS (pwMS), in order to determine whether, and to what degree, CSF NfL levels differentiate MS from controls, or the subtypes or stages of MS from each other.

Methods

Guidelines on Preferred Reporting Items for Systematic Reviews and Meta-Analyses were followed. Electronic databases were searched for published and ‘grey’ literature, with 151 hits. Of 51 full articles screened, 20 were included in qualitative analysis, and 14 in meta-analysis.

Results

CSF NfL was higher in 746 pwMS than 435 (healthy and disease) controls, with a moderate effect size of 0.61 (p < 0.00001). Mean CSF NfL levels were significantly higher in 176 pwMS with relapsing disease than 92 with progressive disease (2124.8 ng/L, SD 3348.9 vs 1121.4 ng/L, SD 947.7, p = 0.0108). CSF NfL in 138 pwMS in relapse (irrespective of MS subtype) was double that seen in 268 pwMS in remission (3080.6 ng/L, SD 4715.9 vs 1541.7 ng/L, SD 2406.5, p < 0.0001).

Conclusions

CSF NfL correlates with MS activity throughout the course of MS, reflecting the axonal damage in pwMS. Relapse is more strongly associated with elevated CSF NfL levels than the development of progression, and NfL may be most useful as a marker of disease ‘activity’ rather than as a marker of disability or disease stage.
CSF chitinase proteins in amyotrophic lateral sclerosis
Authors: Thompson Alexander G , Gray Elizabeth , Bampton Alexander , Raciborska Dominika , Talbot Kevin , Turner Martin R
Published: May 2019

Objective

To evaluate the classifier performance, clinical and biochemical correlations of cerebrospinal fluid (CSF) levels of the chitinase proteins Chitotriosidase-1 (CHIT1), Chitinase-3-like protein 1 (CHI3L1) and Chitinase-3-like protein 2 (CHI3L2) in amyotrophic lateral sclerosis (ALS).

Methods

CSF levels of CHIT1, CHI3L1, CHI3L2, phosphorylated neurofilament heavy chain (pNFH) and C-reactive protein were measured by ELISA in a longitudinal cohort of patients with ALS (n=82), primary lateral sclerosis (PLS, n=10), ALS-mimic conditions (n=12), healthy controls (n=25) and asymptomatic carriers of ALS-causing genetic mutations (AGC; n=5).

Results

CSF CHIT1, CHI3L1 and CHI3L2 were elevated in patients with ALS compared with healthy controls (p<0.001) and ALS-mimics (CHIT1, p<0.001; CHI3L1, p=0.017; CHI3L2, p<0.001). CHIT1 and CHI3L2 were elevated in ALS compared with PLS (CHIT1, p=0.021; CHI3L1, p=0.417; CHI3L2, p<0.001). Chitinase levels were similar in AGCs and healthy controls. Chitinase proteins distinguished ALS from healthy controls (area under the curve (AUC): CHIT1 0.92; CHI3L1 0.80; CHI3L2 0.90), mimics (AUC: CHIT1 0.84; CHI3L1 0.73; CHI3L2 0.88) and, to a lesser extent, PLS (AUC: CHIT 0.73; CHI3L1 0.51; CHI3L2 0.82) but did not outperform pNFH. CHIT1 and CHI3L2 correlated with disease progression rate (Pearson’s
r
=0.49, p<0.001;
r
=0.42, p<0.001, respectively). CHI3L1 correlated with degree of cognitive dysfunction (
r
=−0.25, p=0.038). All chitinases correlated with pNFH. CHIT1 levels were associated with survival in multivariate models. Chitinase levels were longitudinally stable.

Conclusions

CSF chitinase proteins may have limited value as independent diagnostic and stratification biomarkers in ALS, but offer a window into non-autonomous mechanisms of motor neuronal loss in ALS, specifically in assessing response to therapies targeting neuroinflammatory pathways.
Ethical issues in living-related corneal tissue transplantation
Authors: Behaegel Joséphine , Ní Dhubhghaill Sorcha , Draper Heather
Published: May 2019

The cornea was the first human solid tissue to be transplanted successfully, and is now a common procedure in ophthalmic surgery. The grafts come from deceased donors. Corneal therapies are now being developed that rely on tissue from living-related donors. This presents new ethical challenges for ophthalmic surgeons, who have hitherto been somewhat insulated from debates in transplantation and donation ethics. This paper provides the first overview of the ethical considerations generated by ocular tissue donation from living donors and suggests how these might be addressed in practice. These are discussed in the context of a novel treatment for corneal limbal stem cell deficiency. This involves limbal cell grafts which are transplanted, either directly or after ex vivo expansion, onto recipient stem cell-deficient eyes. Where only one eye is diseased, the unaffected eye can be used as a source of graft tissue. Bilateral disease requires an allogenic donation, preferably from a genetically related living donor. While numerous papers have dealt with the theory, surgical approaches and clinical outcomes of limbal stem cell therapies, none has addressed the ethical dimensions of this form of tissue donation.
Liquid actuated gravity experiments
Authors: Bassan Massimo , De Laurentis Martina , De Rosa Rosario , Di Fiore Luciano , Errico Luciano , Garufi Fabio , Grado Aniello , Minenkov Yury , Pucacco Giuseppe , Visco Massimo
Published: May 2019

We describe a new actuation technique for gravity experiments based on a liquid field mass. The characterizing idea is to modulate the gravity force acting on a test mass by controlling the level of a liquid in a suitable container. This allows to obtain a periodical gravity force without moving parts (except the liquid level) close to the TM. We describe in detail the most relevant aspects of the liquid actuator and discuss how it can be used in gravity experiments. In particular, we analyze an application to test the inverse square law in the mm to cm distance region.
A dynamic technique to enhance quality of service in software-defined network-based wireless sensor network (DTEQT) using machine learning
Authors: Ananth S. , Kalpana A. M. , Vijayarajeswari R.
Published: May 2019

Wireless Sensor Network (WSN) is the interconnection between things or objects embedded with hardware and software. In WSN, small end devices (like sensors) and high end devices (like servers) are connected to the Internet. For WSN enabled in Software-Defined Network (SDN), the routers are controlled using a controller server node. It is a dynamic network due to the presence of mobile nodes and energy constrained nodes. The routing is the process of detecting route from source to target. In dynamic networks like WSN, routing is a challengeable task. This paper is to provide a routing solution for backboneless SDN-enabled WSN. The proposed work enhances routing Quality of Service (QoS) in WSN. The paths are dynamically reallocated to reduce the packet loss.
Bohmian mechanics for instrumentalists
Authors: Nikolić Hrvoje
Published: May 2019

We formulate Bohmian mechanics (BM) such that the main objects of concern are macroscopic phenomena, while microscopic particle trajectories only play an auxiliary role. Such a formulation makes it easy to understand why BM always makes the same measurable predictions as standard quantum mechanics (QM), irrespective of the details of microscopic trajectories. Relativistic quantum field theory (QFT) is interpreted as an effective long-distance theory that at smaller distances must be replaced by some more fundamental theory. Analogy with condensed-matter physics suggests that this more fundamental theory could have a form of nonrelativistic QM, offering a simple generic resolution of an apparent conflict between BM and relativistic QFT.
Hydrothermal synthesis of Zeolite NaA from Kaolin
Authors: Wang Peng , Sun Qi , Zhang Yujiao , Cao Jun , Li Xingmao
Published: May 2019

Zeolite NaA was successfully synthesized from low-grade kaolin via hydrothermal synthesis method. The properties of the zeolite NaA were characterized by means of X-ray diffraction (XRD), Fourier transform infrared (FTIR), X-ray fluorescence (XRF), scanning electron microscopy (SEM)-energy-dispersive spectrometry (EDS), transmission electron microscopy (TEM), Brunauer-Emmett-Teller (BET), and thermogravimetry (TG)-differential thermal analysis (DTA). TEM analysis indicated the formation of body-centered cubic crystal zeolite NaA and the polycrystallinity of the zeolite NaA structure. The textural properties of the zeolite NaA were further studied by N2 adsorption-desorption technique. In addition, the TG-DTA study confirmed that the heat treatment temperature of the zeolite NaA should be controlled below 600∘C.
Appraisal and Consideration of Natural Orifice Specimen Extraction Surgery in Colorectal Cancer
Authors: Fu Zheng-Wei , Wang Li-Xia , Ge Hai-Yan
Published: May 2019

Although laparoscopic colectomy shows superior short-term outcomes and similar oncologic outcomes in comparison to conventional open colectomy, incision-related complications have weakened its advantages. The natural orifice transluminal endoscopic surgery (NOTES) has been considered as the most perfect surgical approach. However, monumental technical hurdles have precluded widely adoption of this technique. As a transient mode, the natural orifice specimen extraction surgery (NOSES) emerges as the times require. Although it is accepted by surgeons for the treatment of colorectal cancer, there are still many disputes that need to be solved.
Large electro-strain signal of the BNT–BT–KNN lead-free piezoelectric ceramics with CuO doping
Authors: Zhao Zhi-Hao , Ge Rui-Fang , Dai Yejing
Published: May 2019

This paper investigates a system of 0.93[Formula: see text][Formula: see text]TiO3–0.06BaTiO3–0.01[Formula: see text][Formula: see text]NbO3–[Formula: see text]CuO (BNT–BT–KNN–[Formula: see text]CuO, [Formula: see text][Formula: see text]mol.%) ceramics, which were fabricated by the conventional solid-state process through the granulation of vacuum freeze drier. The results show that the CuO doping made a significant enhancement on the piezoelectric properties of the BNT–BT–KNN ceramics. With the doping of CuO, the transition temperature between ferroelectric phase and ergodic relaxor state is reduced to near room temperature, resulting in pinched [Formula: see text]–[Formula: see text] loops and “sprout” shape [Formula: see text]–[Formula: see text] curves. For the composition with [Formula: see text], a high unipolar strain of 0.39% under 5[Formula: see text]kV/mm contributes a large [Formula: see text][Formula: see text]pm/V at room temperature, which is competitive with the other BNT-based ceramics.
Unpacking the Plan for the Guangdong–Hong Kong–Macao Greater Bay Area: A Mechanism for Reform
Authors: Li Linda Chelan , Kwok Man-tak
Published: May 2019

The newly released “Outline Development Plan for the Guangdong–Hong Kong–Macao Greater Bay Area (GBA)” shows that the roles of the Guangdong–Hong Kong–Macao GBA have gone beyond its original emphasis on regional economic development and now serves higher purposes in fostering the ongoing process of deepening reforms in China, and in meeting the challenges in the Chinese-led “Belt and Road Initiative”. Whereas earlier policy on cross-border collaborations and the previous literature often emphasize “harmonization” and “integration” of the diverse institutions and practices of the constituent cities into one economy, this paper suggests an alternative perspective highlighting the utility of institutional contradictions and diversity contained in the “one country, two system” framework within the GBA. Leveraging the advantages of its more internationalized special administrative regions of Hong Kong and Macao, the GBA plan would not only benefit this coastal megalopolis, but also stimulate a dynamic mechanism of reform in the whole country.
Multi-Round Transfer Learning for Low-Resource NMT Using Multiple High-Resource Languages
Authors: Maimaiti Mieradilijiang , Liu Yang , Luan Huanbo , Sun Maosong
Published: May 2019

Neural machine translation (NMT) has made remarkable progress in recent years, but the performance of NMT suffers from a data sparsity problem since large-scale parallel corpora are only readily available for high-resource languages (HRLs). In recent days, transfer learning (TL) has been used widely in low-resource languages (LRLs) machine translation, while TL is becoming one of the vital directions for addressing the data sparsity problem in low-resource NMT. As a solution, a transfer learning method in NMT is generally obtained via initializing the low-resource model (child) with the high-resource model (parent). However, leveraging the original TL to low-resource models is neither able to make full use of highly related multiple HRLs nor to receive different parameters from the same parents. In order to exploit multiple HRLs effectively, we present a language-independent and straightforward multi-round transfer learning (MRTL) approach to low-resource NMT. Besides, with the intention of reducing the differences between high-resource and low-resource languages at the character level, we introduce a unified transliteration method for various language families, which are both semantically and syntactically highly analogous with each other. Experiments on low-resource datasets show that our approaches are effective, significantly outperform the state-of-the-art methods, and yield improvements of up to 5.63 BLEU points.
Small amounts of involuntary muscle activity reduce passive joint range of motion
Authors: Diong Joanna , Gandevia Simon C. , Nguyen David , Foo Yanni , Kastre Cecilia , Andersson Katarina , Butler Jane E. , Héroux Martin E.
Published: May 2019

When assessing passive joint range of motion in neurological conditions, concomitant involuntary muscle activity is generally regarded small enough to ignore. This assumption is untested. If false, many clinical and laboratory studies that rely on these assessments may be in error. We determined to what extent small amounts of involuntary muscle activity limit passive range of motion in 30 able-bodied adults. Subjects were seated with the knee flexed 90° and the ankle in neutral, and predicted maximal plantarflexion torque was determined using twitch interpolation. Next, with the knee flexed 90° or fully extended, the soleus muscle was continuously electrically stimulated to generate 1, 2.5, 5, 7.5, and 10% of predicted maximal torque, in random order, while the ankle was passively dorsiflexed to a torque of 9 N·m by a blinded investigator. A trial without stimulation was also performed. Ankle dorsiflexion torque-angle curves were obtained at each percent of predicted maximal torque. On average (mean, 95% confidence interval), each 1% increase in plantarflexion torque decreases ankle range of motion by 2.4° (2.0 to 2.7°; knee flexed 90°) and 2.3° (2.0 to 2.5°; knee fully extended). Thus 5% of involuntary plantarflexion torque, the amount usually considered small enough to ignore, decreases dorsiflexion range of motion by ~12°. Our results indicate that even small amounts of involuntary muscle activity will bias measures of passive range and hinder the differential diagnosis and treatment of neural and nonneural mechanisms of contracture.

NEW & NOTEWORTHY The soleus muscle in able-bodied adults was tetanically stimulated while the ankle was passively dorsiflexed. Each 1% increase in involuntary plantarflexion torque at the ankle decreases the range of passive movement into dorsiflexion by >2°. Thus the range of ankle dorsiflexion decreases by ~12° when involuntary plantarflexion torque is 5% of maximum, a torque that is usually ignored. Thus very small amounts of involuntary muscle activity substantially limit passive joint range of motion.
The influence of direct and indirect fibroblast cell contact on human myogenic cell behavior and gene expression in vitro
Authors: Bechshøft Cecilie J. L. , Schjerling Peter , Kjaer Michael , Mackey Abigail L.
Published: May 2019

Underpinning skeletal muscle plasticity is the interplay between many cell types, of which fibroblasts are emerging as potent players, both negatively in the development of fibrosis but also positively in stimulating muscle repair through enhancing myogenesis. The mechanisms behind this interaction however remain unknown. To investigate this, waste hamstring muscle tissue was obtained from eight healthy young men undergoing reconstructive anterior cruciate ligament surgery and primary myoblasts and fibroblasts were isolated. Myoblasts were cultured alone or with fibroblasts, either in direct or indirect contact (separated by an insert with a permeable membrane). The myogenesis parameters proliferation, differentiation, and fusion were determined from immunostained cells, while, in replicate samples, gene expression levels of GAPDH, Ki67, Pax7, MyoD, myogenin, myomaker, MHC-Iβ, TCF7L2, COL1A1, and p16 were determined by RT-PCR. We found only trends for an influence of skeletal muscle fibroblasts on myogenic cell proliferation and differentiation. While greater mRNA levels of GAPDH, Pax7, MyoD, myogenin, and MHC-Iβ were observed in myogenic cells in indirect contact with fibroblasts (insert) when compared with cells cultured alone, a similar effect of an empty insert was also observed. In conclusion we find very little influence of skeletal muscle fibroblasts on myoblasts derived from the same tissue, although it cannot be excluded that a different outcome would be seen under less optimal myogenic growth conditions.

NEW & NOTEWORTHY Using passage one primary myoblasts and fibroblasts isolated from human skeletal muscle, we found only a trend for an effect of skeletal muscle fibroblasts on myogenic cell proliferation and differentiation. This is contrary to previous reports and raises the possibility that fibroblasts of different tissue origins exert distinct roles.
Adaptive Energy Efficiency Maximization for Cognitive Underwater Acoustic Network under Spectrum Sensing Errors and CSI Uncertainties
Authors: Wu Yaohui , Li Youming , Yao Qingpeng
Published: May 2019

Energy efficiency (EE) maximization problem for Cognitive Underwater Acoustic Network is investigated in this study. Available works on EE usually assume that spectrum sensing is accurate or that channel state information (CSI) is perfect, which is often impractical. Thus, an adaptive resource allocation scheme is proposed to maximize the EE, subject to the transmission power constraint of secondary user (SU) and the interference power constraint of primary user (PU). By taking the spectrum sensing errors into account, we add power interference from PU to SU in the objective function. Besides, interference tolerance factor is introduced to control the interference from SU to PU. Assuming CSI uncertainties of the involved channels are bounded, they are separately modeled as stochastic-case or worst-case according to their nature. Since the established optimization problem is nonconvex, it is converted into a convex one and then solved by the techniques of fractional programming and dual decomposition. Simulation results validate that the EE can be improved by classifying the CSI uncertainties and solving the expectation of the CSI correlation function. Furthermore, the interference from SU to PU can be controlled well by the adjustment of the interference tolerance factor.
GSH Synthetic Analogue O-Methyl-L-Tyrosinylglutathione Regulates Nrf2-Mediated Expression of GCLc and GCLm
Authors: Hansen Mats , Porosk Rando , Mahlapuu Riina , Kairane Ceslava , Kilk Kalle , Soomets Ursel
Published: May 2019

A glutathione (L-γ-glutamyl-L-cysteinylglycine, GSH) analogue, UPF1 (O-methyl-L-tyrosinylglutathione), has been shown to increase intracellular concentration of total glutahione (tGSH) in K562 cells. The synthesis of GSH is a two-step process that requires the actions of two distinct enzymes:γ-glutamyl-cysteine ligase (GCL) and glutathione synthetase (GS). Transcription of the GCL is controlled by multiple different factors, among others the nuclear factor (erythroid-derived 2)-like 2 transcription factor (Nrf2), which under the oxidative stress translocates into nucleus, where it binds to the dedicated binding site—antioxidant response element (ARE). In the present study, we investigated if the observed increased concentration of intracellular tGSH is a result of activation of Nrf2 protein—a key transcription factor in the cellular antioxidant response. Two distinct cell lines, adherent human hepatocarcinoma cell line HepG2 and nonadherent human myelogenous cell line K562, were chosen to establish if the increased intracellular tGSH is a universal response to the UPF1 treatment. Western blot analysis demonstrated that, after 3 h, the catalytic subunit of GCL (GCLc) level in HepG2 cells was higher than the modifying subunit of GCL (GCLm), while in K562 cells no change was observed. After 24 h, the GCLc level was higher than GCLm in K562 cells but not in the HepG2 cell line. Reverse-transcriptase PCR experiment demonstrated that no statistically significant difference was found in GCLm or GCLc mRNA levels, while the expression of the mRNA of Nrf2 and GS was elevated in the K562 cell line. Our findings suggest that UPF1 displays unique properties of mobilizing cellular defence mechanisms against reactive oxygen species while it is previously been shown to act as potent antioxidant per se.
Validity and Reliability of Brief International Cognitive Assessment for Multiple Sclerosis (BICAMS) in Indonesia and the Correlation with Quality of Life
Authors: Estiasari Riwanti , Fajrina Yuhyi , Lastri Diatri Nari , Melani Syarli , Maharani Kartika , Imran Darma , Pangeran David , Sitorus Freddy
Published: May 2019

Introduction. Multiple Sclerosis (MS) can affect cognitive function that might interfere with quality of life. Processing speed and memory are the most common area of cognitive impairment. Cognitive evaluation in daily practice is often difficult to be performed since it needs neuropsychological expert and is time-consuming. Brief International Cognitive Assessment for MS (BICAMS) is valid and practical for cognitive evaluation. This study aims to validate BICAMS in Indonesian MS patients and healthy controls (HC) and to analyse the effect of cognitive impairment on quality of life. Methods. BICAMS, which composes Symbol Digits Modalities Test (SDMT), California Verbal Learning Test-Second Edition (CVLT-II), and Brief Visuospatial Memory Test-Revised (BVMT-R), was translated and cross-culturally adapted to Indonesian from the original BICAMS and then administered to 40 Indonesian MS patients and 66 HC matched by sex, age, and education. Test-retest reliability was performed on 16-MS patients and 42 HC. Quality of life was measured using Multiple Sclerosis Quality of Life (MSQOL-54) instrument. Results. The SDMT, CVLT-II, and BVMT-R score in MS patients were significantly lower than those in HC (effect size, r: 0.61, 0.36, and 0.47, respectively). Test-retest reliability for all tests was satisfactory with correlation coefficient for SDMT, CVLT-II, and BVMT-R in MS subjects 0.86, 0.81, and 0.83, respectively. Using 5th percentile of HC score as cut-off, 15% MS subjects had impairment in one test, 27.5% in two tests, and 40% in three tests. BICAMS was moderately correlated with EDSS but was not correlated with disease duration and relapse rate. SDMT score correlated with physical function and physical and mental role limitation. Conclusion. BICAMS is valid and reliable for assessing cognitive function of Indonesia MS patients.
Splenic Blood Flow Increases after Hypothermic Stimulus (Cold Pressor Test): A Perfusion Magnetic Resonance Study
Authors: Galea Nicola , Cundari Giulia , Borrazzo Cristian , Pambianchi Giacomo , Bracci Angelica , Rosato Edoardo , Francone Marco , Carbone Iacopo , Catalano Carlo
Published: May 2019

The Cold Pressor Test (CPT) is a novel diagnostic strategy to noninvasively assess the myocardial microvascular endothelial-dependent function using perfusion magnetic resonance imaging (MRI). Spleen perfusion is modulated by a complex combination of several mechanisms involving the autonomic nervous system and vasoactive mediators release. In this context, the effects of cold temperature on splenic blood flow (SBF) still need to be clarified. Ten healthy subjects were studied by MRI. MRI protocol included the acquisition of GRE T1-weighted sequence (“first pass perfusion”) during gadolinium administration (0.1mmol/kg of Gd-DOTA at flow of 3.0 ml/s), at rest and after CPT. Myocardial blood flow (MBF) and SBF were measured by applying Fermi function deconvolution, using the blood pool input function sampled from the left ventricle cavity. MBF and SBF values after performing CPT were significantly higher than rest values (SBF at rest: 0.65 ± 0.15 ml/min/g Vs. SBF after CPT: 0.90 ± 0.14 ml/min/g, p: <0.001; MBF at rest: 0.90 ± 0.068 ml/min/g Vs. MBF after CPT: 1.22 ± 0.098 ml/min/g, p<0.005). Both SBF and MBF increased in all patients during the CPT. In particular, the CPT-induced increase was 43% ± 29% for SBF and 36.5% ± 17% for MBF. CPT increases SBF in normal subjects. The characterization of a standard perfusion response to cold might allow the use of the spleen as reference marker for the adequacy of cold stimulation during myocardial perfusion MRI.
Solution Strategies for a Multiport Container Ship Stowage Problem
Authors: Parreño-Torres Consuelo , Alvarez-Valdes Ramon , Parreño Francisco
Published: May 2019

The multiport container ship stowage problem consists in determining the position of the containers on board a ship along its route with the objective of minimizing the number of unproductive moves required in the loading and unloading operations at each port. This paper presents an integer programming model for the problem and proposes several sets of valid constraints that bring its LP‐relaxation closer to an integer solution. Moreover, it presents a GRASP algorithm that generates stowage plans with a minimal number of unproductive moves in a high percentage of medium and large‐size instances. An extended computational analysis has been performed in which, to the best of the authors’ knowledge, the efficiency of integer programming models for the problem is tested for the first time. With respect to GRASP, the computational results show that it performs well on different sized datasets.
Assessment of Youth-Friendly Service Quality and Associated Factors at Public Health Facilities in Southern Ethiopia: A Facility-Based Cross-Sectional Study
Authors: Mulugeta Betebebu , Girma Meseret , Kejela Gemechu , Meskel Feleke Gebre , Andarge Eshetu , Zerihun Eshetu
Published: May 2019

Background. Evidence shows that services for youths are poorly coordinated and uneven in quality. There is a lack of evidence which informs the level of youth-friendly service quality in the study area. So, this study fills the information gaps and recommends practical solutions. Objective. The main aim of the study was to assess youth-friendly service quality and associated factors at public health facilities in Arba Minch town, Southern Ethiopia. Methods. Facility-based quantitative cross-sectional study supplemented with the qualitative design was conducted from September to December 2017 at two public health centers in Arba Minch town. Sample sizes of 403 young clients were included in the study using a systematic sampling technique. Data was collected by using an interview-administered questionnaire and observation checklist. Quantitative data analysis was made using SPSS version 20.0 to identify the association between the dependent and independent variables. Qualitative findings were coded and analyzed by using content analysis in Microsoft Excel. Finally, results are presented using narrations, tables, and figures. Results. A total of 403 youth-friendly service clients participated in the study. The overall score input, process, and youth clients’ satisfaction was 54.41%, 42.0%, and 49.1%, respectively. Age (15-19) [AOR (95% CI) = 3.2 (1.4-7.8)], employment [AOR (95% CI) = 6.4 (2-17)], place of YFS [AOR (95% CI) = 0.35 (0.1-0.8)], frequency of visit [AOR (95% CI) = 0.03 (0.0-0.3)], waiting time [AOR (95% CI) = 0.02 (0.0-0.09)], and comfort with providers’ sex [AOR (95% CI) = 0.07 (0.02-0.2)] were factors which are significantly associated with client satisfaction in this study. Conclusion and Recommendation. The study revealed that the overall quality of youth-friendly health service is below-set criteria (not good quality) in its all components, i.e., structural, process, and output. So, improvement of facility setup, client-provider interaction, and service sensitivity to all young groups and waiting time of services is essential.
Prevalence and Correlates of Truancy among School-Going Adolescents in Mozambique: Evidence from the 2015 Global School-Based Health Survey
Authors: Seidu Abdul-Aziz
Published: May 2019

This study examined the prevalence of truancy and its associated factors among 1500 school-going adolescents using the 2015 Mozambique Global School-based Student Health Survey data. The association was assessed using bivariate (Chi square) and multivariate (logistic regression) analysis. The prevalence of truancy was 36.6% (38.4% of males and 35.1% of females). It was found that adolescents aged 15 years and older [OR=1.460,95% CI=1.153,1.848], experiencing hunger [OR=1.613 95% CI= 1.051,2.475], current tobacco use [OR=1.613 95%CI=1.051,2.475], being bullied [OR=1.314, 95% CI=1.027,1.681], facing an attack, smoking [OR= 1.893, 95% CI=1.293,2.771], having 1-2 close friends [OR=1.656, 95% CI=1.276,2.14], and feeling lonely [OR=1.295, 95% CI=1.019,1.646] were the factors that predisposed adolescents to truant behaviour. Conversely, parental supervision [OR=0.53, 95% CI=0.232,0.791] was a protective factor against truancy. There is the need to design school-based interventions aimed at reducing truancy in Mozambique by tackling the predisposing factors and encouraging the protective factors.