bluuebunny/crossref_metadata_2025 huggingface dataset:
Under-the-Radar Dengue Virus Infections in Natural Populations of Aedes aegypti Mosquitoes
Authors: Boyles Sean M. , Mavian Carla N. , Finol Esteban , Ukhanova Maria , Stephenson Caroline J. , Hamerlinck Gabriela , Kang Seokyoung , Baumgartner Caleb , Geesey Mary , Stinton Israel , Williams Katie , Mathias Derrick K. , Prosperi Mattia , Mai Volker , Salemi Marco , Buckner Eva A. , Lednicky John A. , Rivers Adam R. , Dinglasan Rhoel R.
Published: April 2020

Since 1999, dengue outbreaks in the continental United States involving local transmission have occurred only episodically and only in Florida and Texas. In Florida, these episodes appear to be coincident with increased introductions of dengue virus into the region through human travel and migration from countries where the disease is endemic. To date, the U.S. public health response to dengue outbreaks has been largely reactive, and implementation of comprehensive arbovirus surveillance in advance of predictable transmission seasons, which would enable proactive preventative efforts, remains unsupported. The significance of our finding is that it is the first documented report of DENV4 transmission to and maintenance within a local mosquito vector population in the continental United States in the absence of a human case during two consecutive years. Our data suggest that molecular surveillance of mosquito populations in high-risk, high-tourism areas of the United States may enable proactive, targeted vector control before potential arbovirus outbreaks.
Modified Whitaker test: a novel diagnostic for nephroptosis
Authors: Grauer Ralph , Gray Mikel , Schenkman Noah
Published: April 2020

A 77-year-old woman presented with right flank pain radiating to the ipsilateral groin and associated nausea, consistent with renal colic. In the emergency department, a non-contrast CT scan revealed severe right-sided hydronephrosis but failed to demonstrate a calculus or ureteropelvic obstruction. The patient improved with fluids and followed up with a community urologist. Initial work-up with cystoscopy and ureteroscopy, voiding cystourethrogram and diuretic renography failed to deduce a diagnosis. At our hospital, we used a modified dynamic (supine and upright) Whitaker test in a novel fashion to diagnose nephroptosis, a rare hypermobility condition of the kidney.
Retinal light sensitivity as outcome measure in recessive Stargardt disease
Authors: Pfau Maximilian , Holz Frank G. , Müller Philipp L.
Published: April 2020

Background/aims

To evaluate the applicability of mesopic light sensitivity measurements obtained by fundus-controlled perimetry (FCP, also termed ‘microperimetry’) as clinical trial endpoint in Stargardt disease (STGD1).

Methods

In this retrospective, monocentre cohort study, 271 eyes of 136 patients (age, 37.1 years) with STGD1 and 87 eyes of 54 healthy controls (age, 41.0 years) underwent mesopic FCP, using a pattern of 50 stimuli (achromatic, 400–800 nm) centred on the fovea. The concurrent validity of mesopic FCP testing using the MAIA device (CenterVue, Italy), the retest variability and its determinants, and the progression of sensitivity loss over time were investigated using mixed-model analyses. The main outcomes were the average pointwise sensitivity loss in dependence of patients’ demographic, functional and imaging characteristics, the intrasession 95% coefficient of repeatability, and the pointwise sensitivity loss over time.

Results

Pointwise sensitivity loss was on average (estimate (95% CI)) 13.88 dB (12.55 to 15.21) along the horizontal meridian and was significantly associated with the electrophysiological subgroup, presence/absence of foveal sparing, best-corrected visual acuity and disease duration. The 95% coefficient of repeatability was 12.15 dB (10.78 to 13.38) and varied in dependence of the underlying mean sensitivity and local sensitivity slope. The global progression rate for the sensitivity loss was 0.45 dB/year (0.13 to 0.78) and was higher for the central and inner ETDRS subfields compared with more peripheral regions.

Conclusions

Mesopic light sensitivity measured by FCP is reliable and susceptible for functional changes. It constitutes a potential clinical outcome for both natural history studies as well as future interventional studies in patients with STGD1.
Ethical considerations in global surgery: a scoping review
Authors: Grant Chantalle Lauren , Robinson Tessa , Al Hinai Alreem , Mack Cheryl , Guilfoyle Regan , Saleh Abdullah
Published: April 2020

Introduction

An unmet burden of surgical disease exists worldwide and is disproportionately shouldered by low-income and middle-income countries (LMICs). As the field of global surgery grows to meet this need, ethical considerations need to be addressed. Currently, there are no formal guidelines to help inform relevant stakeholders of the ethical challenges and considerations facing global surgical collaborations. The aim of this scoping review is to synthesise the existing literature on ethics in global surgery and identify gaps in the current knowledge.

Methods

A scoping review of relevant databases to identify the literature pertaining to ethics in global surgery was performed. Eligible articles addressed at least one ethical consideration in global surgery. A grounded theory approach to content analysis was used to identify themes in the included literature and guide the identification of gaps in existing literature.

Results

Four major ethical domains were identified in the literature: clinical care and delivery; education and exchange of trainees; research, monitoring and evaluation; and engagement in collaborations and partnerships. The majority of published literature related to issues of clinical care and delivery of the individual patient. Most of the published literature was published exclusively by authors in high-income countries (HICs) (80%), and the majority of articles were in the form of editorials or commentaries (69.1%). Only 12.7% of articles published were original research studies.

Conclusion

The literature on ethics in global surgery remains sparse, with most publications coming from HICs, and focusing on clinical care and short-term surgical missions. Given that LMICs are frequently the recipients of global surgical initiatives, the relative absence of literature from their perspective needs to be addressed. Furthermore, there is a need for more literature focusing on the ethics surrounding sustainable collaborations and partnerships.
Palliative care knowledge test for nurses and physicians: validation and cross-cultural adaptation
Authors: Lopez-Garcia Monica , Rubio Leticia , Gomez-Garcia Rafael , Sanchez-Sanchez Fuensanta , Miyashita Mitsunori , Medina-Abellan Maria Dolores , Perez-Carceles Maria D.
Published: April 2020

Background

Palliative care knowledge is essential in primary healthcare due to the increasing number of patients who require attention in the final stage of their life. Health professionals (physicians and nurses) need to acquire specific knowledge and abilities to provide high-quality palliative care. The development of education programmes in palliative care is necessary. The Palliative Care Knowledge Test (PCKT) is a questionnaire that evaluates the basic knowledge about palliative care, but it has not been adapted into Spanish, and its effectiveness and utility for Spanish culture have not been analysed.

Objective

The aim of this study was to report the translation into Spanish and a psychometric analysis of the PCKT.

Methods

The questionnaire survey was validated with a group of 561 physicians and nurses. The PCKT Spanish Version (PCKT-SV) was obtained from a process, including translation, back translation and revision by experts and a pilot study. The content validity and reliability of the questionnaire were analysed.

Results

The results showed internal consistency and reliability indexes similar to those obtained by the original version of PCKT.

Conclusion

The PCKT-SV is a useful instrument for measuring Spanish-speaking physician and nurse knowledge of palliative care, and it is suitable to evaluate the effectiveness of training activities in palliative care.
Pulmonary complications for women with sickle cell disease in pregnancy: systematic review and meta-analysis
Authors: Inparaj Sivarajini , Buckingham Mickey , Oakley Laura , Seed Paul T , Lucas Sebastian , Oteng-Ntim Eugene
Published: April 2020

Background

Sickle cell disease (SCD) is a multisystem disease characterised by vaso-occlusive crisis, chronic anaemia and a shorter lifespan. More patients with SCD are living till reproductive age and contemplating pregnancy. Pulmonary complications in pregnancy are significant causes of maternal morbidity and mortality but yet this has not been systematically quantified. A systematic review and meta-analysis were conducted to quantify the association between SCD and pulmonary complications in pregnancy.

Methods

MEDLINE, EMBASE, Web of Science, Cochrane and Maternity and Infant Care databases were searched for publications between January 1998 and April 2019. Observational studies involving at least 30 participants were included. Random-effects models were used for statistical meta-analysis.

Findings

Twenty-two studies were included in the systematic review and 18 in the quantitative analysis. The meta-analysis included 3964 pregnancies with SCD and 336 559 controls. Compared with women without SCD, pregnancies complicated by SCD were at increased risk of pulmonary thromboembolism (relative risk (RR) 7.74; 95% CI 4.65 to 12.89). The estimated prevalence of acute chest syndrome and pneumonia was 6.46% (95% CI 4.66% to 8.25%), with no significant difference between the HbSS and HbSC genotypes (RR 1.42; 95% CI 0.90 to 2.23).

Interpretation

This meta-analysis highlighted a strong association between SCD and maternal pulmonary complications. Understanding the risks of and the factors associated with pulmonary complications would aid preconceptual counselling and optimal management of the condition in pregnancy, thereby reducing associated maternal morbidity and mortality.

PROSPERO registration number

CRD42019124708.
Tool to assess appeal–aversion response to graphic warning labels on cigarette packs among US smokers
Authors: Stone Matthew D , Dimofte Claudiu V , Strong David R , Villasenor Adriana , Pulvers Kim , Messer Karen , Pierce John P
Published: April 2020

Introduction

Graphic warning labels on cigarette packaging are mandated in 118 countries and are under consideration in the USA. We propose an appeal–aversion assessment tool to help regulators choose among graphic packaging options.

Methods

After familiarisation with different cigarette packaging, adult daily smokers (n=338) from San Diego, California, USA completed a discrete choice appeal–aversion purchasing task and provided information on nicotine dependence and sociodemographics (2017–2019). The conjoint analysis estimated the importance and price utility for product attributes (ie, packaging, price, tobacco origin and quitline number). The price premiums that smokers would be willing to pay to avoid purchasing graphic packaging were calculated.

Results

Among purchase determinants, the price was the most important attribute (65.5%), followed by packaging design (27.1%). Compared with blank packaging without marketing, branded industry packs had appeal valuations (US$0.54; 95% CI: US$0.44 to US$0.65), whereas graphic warning packs had aversion valuations that varied with the salience of the image (blindness=−US$2.53, 95% CI: −US$2.76 to −US$2.31; teeth damage=−US$2.90, 95% CI: −US$3.17 to −US$2.63; and gangrenous foot=−US$3.70, 95% CI: −US$4.01 to −US$3.39). The aversion was such that 46.2% of participants were willing to pay a 50+% premium over their current cigarette price to have their branded packs rather than a graphic pack. These appeal–aversion valuations were moderated by sex, income and nicotine dependence (p<0.05).

Conclusions

Smokers indicated a willingness to pay substantial premiums to avoid purchasing graphic packaging. Results suggest that mandating graphic warnings on US cigarette packs would induce price aversion and may deter cigarette purchasing. Price valuations from this appeal–aversion tool could be useful for regulators to differentiate between graphic warning labels.
Developmental sequence of the syncarpous gynoecium of Sarracenia purpurea (Sarraceniaceae) with flattened and broadened carpels and an umbrella-shaped style
Authors: Guo Jinyan , Halson Chad T.
Published: April 2020

The umbrella-shaped style of Sarracenia has a flattened and broadened distal half forming an umbrella canopy, and a slender cylindrical proximal half forming an umbrella stalk. The developmental sequence that gives rise to this unique structure has never been studied in detail. Data from light microscopy and scanning electron microscopy showed that the five carpels are initiated as discrete primordia, which then undergo congenital fusion and conduplicate folding and become a pentagonal syncarpous gynoecium. The distal region of the carpel then bends abaxially and undergoes significant expansion via a marginal meristem, forming the umbrella shape. Carpel closure is achieved via postgenital fusion at both transverse and longitudinal slits. Each of the five pollen tube transmitting tracts is enclosed by the adaxial surface of the carpel, and the inner epidermis of the umbrella canopy represents the expanded abaxial surface of the carpels, whereas the outer epidermis represents the expanded distal region of the fused carpellary margins. Epidermal trichomes develop first, then secretory glands and stomata appear later at the same stage on the umbrella canopy. This study provides insights into the evolution of the umbrella-shaped style utilizing both common and specialized carpel developmental programs with a novel spatial and temporal pattern.
Study on the characteristic of light transmission in a single-multimode fiber
Authors: Liu Ying , Kang Ruo-Nan , Wang Bin , Guo Fei-Fei , Du Kun , Kou Dan-Dan , Chang Chun-Rui
Published: April 2020

Based upon the optical coherence superposition principle, a system to acquire light transmitted by a single-multimode fiber has been built. By collecting the optical interference images and using MATLAB software for analysis, the target light transmitted by a single-multimode optical fiber can be extracted from it. Thus, the transmission characteristics of light in a single-multimode optical fiber can be obtained, aiming to realize the direct transmission imaging through the multimode optical fiber by the compensation principle according to the change of phase in the transmission process and to provide technical support for the development of medical examination and medical devices in China.
RNA Conformation Capture by Proximity Ligation
Authors: Kudla Grzegorz , Wan Yue , Helwak Aleksandra
Published: April 2020

RNA proximity ligation is a set of molecular biology techniques used to analyze the conformations and spatial proximity of RNA molecules within cells. A typical experiment starts with cross-linking of a biological sample using UV light or psoralen, followed by partial fragmentation of RNA, RNA–RNA ligation, library preparation, and high-throughput sequencing. In the past decade, proximity ligation has been used to study structures of individual RNAs, networks of interactions between small RNAs and their targets, and whole RNA–RNA interactomes, in models ranging from bacteria to animal tissues and whole animals. Here, we provide an overview of the field, highlight the main findings, review the recent experimental and computational developments, and provide troubleshooting advice for new users. In the final section, we draw parallels between DNA and RNA proximity ligation and speculate on possible future research directions.
Genetic and Environmental Risk Factors for Keratoconus
Authors: Lucas Sionne E.M. , Burdon Kathryn P.
Published: April 2020

Keratoconus, a progressive corneal ectasia, is a complex disease with both genetic and environmental risk factors. The exact etiology is not known and is likely variable between individuals. Conditions such as hay fever and allergy are associated with increased risk, while diabetes may be protective. Behaviors such as eye rubbing are also implicated, but direct causality has not been proven. Genetics plays a major role in risk for some individuals, with many large pedigrees showing autosomal inheritance patterns. Several genes have been implicated using linkage and follow-up sequencing in these families. Genome-wide association studies for keratoconus and for quantitative traits such as central corneal thickness have identified several genetic loci that contribute to a cumulative risk for keratoconus, even in people without a family history of the disease. Identification of risk genes for keratoconus is improving our understanding of the biology of this complex disease.
Characteristics of myoelectrical activities along the small intestine and their responses to test meals of different glycemic index in rats
Authors: Liu Yi , Ye Feng , Zhang Sujuan , Li Shiying , Chen Jiande
Published: April 2020

The purpose of this study was to characterize intestinal myoelectrical activity along the small intestine and investigate its responses to test meals with different glycemic index at different locations. Sixteen rats were implanted with electrodes in the serosal surface of the duodenum, jejunum, and ileum. Intestinal myoelectrical activities were recorded from these electrodes for 30 min in the fasting state and 3 h after four kinds of meals with different glycemic index, together with the assessment of blood glucose. The results were as follows: 1) in the fasting state, the percentage of normal intestinal slow waves (%NISW) showed no difference; however, the dominant frequency (DF), power (DP), and percentage of spike activity superimposed on the intestinal slow wave (NS/M) were progressively decreased along the entire small intestine; 2) regular solid meal and Ensure solicited no changes in any parameters of intestinal myoelectrical activity; whereas glucose and glucose + glucagon significantly altered the %NISW, DF, DP, and NS/M, and the effects on the proximal intestine were opposite to those in the distal intestine; and 3) postprandial blood glucose level was significantly correlated with %NISW along the entire small intestine. We found that that, in addition to the well-known frequency gradient, there is also a gradual decrease in the DP and spikes along the small intestine in the fasting state. Glucose and hyperglycemic meals inhibit myoelectrical activities in the proximal small intestine but result in enhanced but more dysrhythmic intestinal myoelectrical activities. There is a significant negative correlation between the normality of intestinal slow waves and blood glucose.
Antibacterial, Antifungal, Antiviral, and Anthelmintic Activities of Medicinal Plants of Nepal Selected Based on Ethnobotanical Evidence
Authors: Joshi Bishnu , Panda Sujogya Kumar , Jouneghani Ramin Saleh , Liu Maoxuan , Parajuli Niranjan , Leyssen Pieter , Neyts Johan , Luyten Walter
Published: April 2020

Background. Infections by microbes (viruses, bacteria, and fungi) and parasites can cause serious diseases in both humans and animals. Heavy use of antimicrobials has created selective pressure and caused resistance to currently available antibiotics, hence the need for finding new and better antibiotics. Natural products, especially from plants, are known for their medicinal properties, including antimicrobial and anthelmintic activities. Geoclimatic variation, together with diversity in ethnomedicinal traditions, has made the Himalayas of Nepal an invaluable repository of traditional medicinal plants. We studied antiviral, antibacterial, antifungal, and anthelmintic activities of medicinal plants, selected based upon ethnobotanical evidence. Methods. Ethanolic and methanolic extracts were tested (1) on a panel of microbes: two Gram‐positive bacteria (Staphylococcus aureus and Listeria innocua), four Gram‐negative bacteria (Escherichia coli, Pseudomonas aeruginosa, Salmonella enterica, and Shigella sonnei), and one fungal species: Candida albicans; (2) against three different viruses: yellow fever, chikungunya, and enterovirus; and (3) on the nematode Caenorhabditis elegans. Also, cytotoxicity was assessed on human hepatoma (Huh), rhabdosarcoma (RD), and Vero (VC) cell lines. Results. Of 18 plants studied, Ampelocissus tomentosa and Aleuritopteris anceps inhibited S. aureus (MIC 35 μg/mL and 649 μg/mL, respectively) and Pseudomonas aeruginosa (MIC 15 μg/mL and 38 μg/mL, respectively). Rhododendron arboreum and Adhatoda vasica inhibited S. enterica (MIC 285 μg/mL and 326 μg/mL, respectively). Kalanchoe pinnata, Ampelocissus tomentosa, and Paris polyphylla were active against chikungunya virus, and Clerodendrum serratum was active against yellow fever virus (EC50 15.9 μg/mL); Terminalia chebula was active against enterovirus (EC50 10.6 μg/mL). Ampelocissus tomentosa, Boenninghausenia albiflora, Dichrocephala integrifolia, and Kalanchoe pinnata significantly reduced C. elegans motility, comparable to levamisole. Conclusions. In countries like Nepal, with a high burden of infectious and parasitic diseases, and a current health system unable to combat the burden of diseases, evaluation of local plants as a treatment or potential source of drugs can help expand treatment options. Screening plants against a broad range of pathogens (bacteria, viruses, fungi, and parasites) will support bioprospecting in Nepal, which may eventually lead to new drug development.
The Postoperative Lymphocyte to Monocyte Ratio Change Predicts Poor Clinical Outcome in Patients with Esophageal Squamous Cell Carcinoma Undergoing Curative Resection
Authors: Song Qian , Wu Jun-zhou , Jiang Hui-fen , Wang Sheng , Cai Shu-nv
Published: April 2020

Background. Postoperative lymphocyte to monocyte ratio (post-LMR) change (LMRc) reflects the dynamic change of balance between inflammatory reaction and immune reaction after curative operation. An elevated preoperative LMR (pre-LMR) has been shown to be a prognostic factor in patients with esophageal squamous cell carcinoma (ESCC), but the clinical value of the LMRc remains unknown. Methods. 674 patients in ESCC undergoing curative operation were enrolled in this study. LMRc (LMRc=pre‐LMR–post‐LMR) was counted on the basis of data within one week before and after operation. The median of LMRc was chosen to be the optimal cut-off value to evaluate the prognostic value of LMRc. Results. Kaplan-Meier curves revealed that LMRc≤1.59 was significantly associated with worse overall survival (OS) (P=0.003) and disease-free survival (DFS) (P=0.008). Multivariate analysis suggested that LMRc could serve as an independent prognostic predictor for both OS (P=0.006, HR=0.687, 95% CI 0.526-0.898) and DFS (P=0.003, HR=0.640, 95% CI 0.476-0.859). Conclusions. LMRc is a promising prognostic predictor for predicting the worse clinical outcome in patients with ESCC undergoing curative operation.
Antagonistic Peptides That Specifically Bind to the First and Second Extracellular Loops of CCR5 and Anti-IL-23p19 Antibody Reduce Airway Inflammation by Suppressing the IL-23/Th17 Signaling Pathway
Authors: Zhang Yingli , Liang Rongrong , Xie Aicen , Shi Wenqian , Huang Huarong , Zhong Yingqiang
Published: April 2020

Asthma is a heterogeneous chronic inflammatory disorder of the airways with a complex etiology, which involves a variety of cells and cellular components. Therefore, the aim of the study was to investigate the effects and mechanisms of antagonistic peptides that specifically bind to the first and second extracellular loops of CCR5 (GH and HY peptides, respectively) and anti-interleukin-23 subunit p19 (anti-IL-23p19) in the airway and thereby mediate inflammation and the IL-23/T helper 17 (Th17) cell pathway in asthmatic mice. An experimental asthma model using BALB/c mice was induced by ovalbumin (OVA) and treated with peptides that are antagonistic to CCR5 or with anti-IL-23p19. The extents of the asthmatic inflammation and mucus production were assessed. In addition, bronchoalveolar lavage fluid (BALF) was collected, the cells were counted, and the IL-4 level was detected by ELISA. The IL-23/Th17 pathway-related protein and mRNA levels in the lung tissues were measured, and the positive production rates of Th17 cells in the thymus, spleen, and peripheral blood were detected. The groups treated with one of the two peptides and/or anti-IL-23p19 showed significant reductions in allergic inflammation and mucus secretion; decreased expression levels of IL-23p19, IL-23R, IL-17A and lactoferrin (LTF); and reduced proportions of Th17 cells in the thymus, spleen, and peripheral blood. Specifically, among the four treatment groups, the anti-IL-23p19 with HY peptide group exhibited the lowest positive production rate of Th17 cells. Our data also showed a significant and positive correlation between CCR5 and IL-23p19 protein expression. These findings suggest that the administration of peptides antagonistic to CCR5 and/or anti-IL-23p19 can reduce airway inflammation in asthmatic mice, most likely through inhibition of the IL-23/Th17 signaling pathway, and the HY peptide can alleviate inflammation not only through the IL-23/Th17 pathway but also through other mechanisms that result in the regulation of inflammation.
Topical Anti‐Inflammatory Activity of Essential Oils of Alpinia calcarata Rosc., Its Main Constituents, and Possible Mechanism of Action
Authors: Chandrakanthan Madhuvanthi , Handunnetti Shiroma M. , Premakumara Galbada Sirimal Arachchige , Kathirgamanathar Selvaluxmy
Published: April 2020

This study aimed at investigating the anti‐inflammatory potential of essential oil from rhizome and leaf of Alpinia calcarata Rosc. (ACEO) with the focus of its topical anti‐inflammatory activity along with its dominant compounds 1,8‐cineole and α‐terpineol using mouse ear edema model. ACEOs were analyzed by GC‐MS. The anti‐inflammatory activity was determined by studying the inhibition of overproduction of proinflammatory mediators—nitric oxide, reactive oxygen species, prostaglandins, cyclooxygenases, and cytokines induced by lipopolysaccharides in murine macrophages. Topical anti‐inflammatory and antinociceptive activity was studied by 12‐O‐tetradecanoylphorbol‐13‐acetate (TPA) induced skin inflammation and formalin‐induced pain model in mice, respectively. Rhizome oil has 1,8‐cineole (31.08%), α‐terpineol (10.31%), and fenchyl acetate (10.73%) as major compounds whereas the ACEO from leaves has 1,8‐cineole (38.45%), a‐terpineol (11.62%), and camphor (10%). ACEOs reduced the production of inflammatory mediators in vitro in a concentration‐dependent manner. Further, ACEO and its major compounds reduced ear thickness, weight, myeloperoxidase, and cytokines significantly (p < 0.01) in mouse ear. Dose‐dependent reduction in flinching and licking in both the phases of pain sensation concludes the topical analgesic effect. Our findings suggest the potency of topical use of ACEOs for inflammatory disease conditions.
Analyzing Drivers’ Intention to Accept Parking App by Structural Equation Model
Authors: Yang Chang , Ye Xiaofei , Xie Jin , Yan Xingchen , Lu Lili , Yang Zhen , Wang Tao , Chen Jun
Published: April 2020

With the concept of sharing economic entering into our lives, many parking Apps are designed for connecting the drivers and vacated parking spaces. However, there are not many drivers who use the mobile Apps to reserve and find available parking spaces, which is largely due to the insufficient information provided by the parking App. In order to better explain, predict, and improve drivers’ acceptance of parking App, the conceptual framework based on technology acceptance model was developed to establish the relationships between the drivers’ intention to accept parking App, trust in parking App, perceived usefulness of parking App, and perceived ease of its use. Then structural equation model was established to analyze the relationship between various variables. The results show that the trust in parking App, perceived usefulness, perceived ease of use, and parking App attributes are the main factors that determine the intention to use parking App. Through the test of direct effect, indirect effect, and total effect in the model, it is found that perceived usefulness has the largest total impact on acceptance intention, with a standardized coefficient of 0.984, followed by parking App attribute (0.743), perceived ease of use (0.384), and trust in parking App (0.381).
Evaluation of Functional Outcomes and OCT-Biomarkers after Intravitreal Dexamethasone Implant for Postoperative Cystoid Macular Edema in Vitrectomized Eyes
Authors: Freissinger Sigrid , Vounotrypidis Efstathios , Wolf Armin , Kortuem Karsten U. , Shajari Mehdi , Sakkias Filippos , Herold Tina , Priglinger Siegfried G. , Mayer Wolfgang J.
Published: April 2020

Purpose. To evaluate the efficacy of dexamethasone implant (DEX) for the treatment of postoperative cystoid macular edema (PCME) in vitrectomized eyes and to investigate visual and morphological OCT predictive factors. Methods. In this retrospective study, eyes with PCME after vitrectomy were treated with at least one DEX injection and were observed over 12 months. Indications for surgery were epiretinal membrane (ERM) or rhegmatogenous retinal detachment (RRD) without macular involvement. Prior treatments, if any, were noted. Best corrected visual acuity (BCVA), central foveal thickness (CFT), and OCT morphology including the presence of intraretinal cysts/fluid or subretinal fluid (IRF/SRF) and ellipsoid zone (EZ) continuity were evaluated. Correlations between OCT measures and visual outcomes were analyzed by the generalized estimating equations procedure. Results. Forty-six eyes with ERM and 15 eyes with RRD were enrolled. The ERM group was more likely to gain BCVA than RRD (odds ratio (OR), 1.168; 95% confidence interval (CI), 1.003–1.360; p=0.046). The absence of SRF (OR, 0.860; 95% CI, 0.743–0.995; p=0.043) was predictive of worse BCVA, whereas the integrity of EZ (OR, 1.094; 95% CI, 0.951–1.257; p=0.209) or naïve status (OR, 0.946; 95% CI, 0.871–1.137, p=0.853) was not. Eyes with a worse baseline BCVA were more likely to gain >1 line after 12 months (OR, 1.485; 95% CI, 1.171–1.884; p=0.001). Conclusion. The efficacy of the treatment of PCME in vitrectomized eyes seems to be affected by baseline BCVA, the absence of SRF, and the indication for surgery. Naïve status appears not to play any significant role in the prediction of BCVA. This trial is registered with DRKS00018955.
Undernutrition and Associated Factors among Lactating Women: Community-Based Cross-Sectional Study in Moyale District, Borena Zone, Southern Ethiopia
Authors: Bekele Hailu , Jima Gebi Husein , Regesu Ashenafi Habtamu
Published: April 2020

Background. Undernutrition is one of the most widespread public health problems that affect both developed and developing countries. In Ethiopia, it is one of the factors leading to unacceptable high morbidity and mortality among women. However, little is documented on undernutrition among lactating women particularly in such a purely pastoral community. Therefore, this study was designed to assess prevalence of undernutrition and its associated factors among lactating women living in pastoral community of Moyale District, Borena Zone, Southern Ethiopia, 2018. Methods. A community-based cross-sectional study was conducted. Data were collected from a random sampled 545 lactating women using structured interviewer-administered questionnaire. Height and weight measurements of the study participants were also taken to compute body mass index. Data were entered in to Epi info version 7 and then exported to SPSS version 21 software for analysis. Descriptive statistics like frequency, mean, and percentage were computed to describe characteristics of the sample. Multivariable analysis was carried out, association between independent and dependent variables were measured using adjusted odds ratios, and its 95% confidence interval and P value below 0.05 were considered statistically significant. Results. This study showed that prevalence of undernutrition among lactating women was 17.7%. Dietary diversity (AOR = 2.49, 95% CI: 1.43–4.36), monthly income (AOR = 5.22, 95% CI: 1.40–19.40), extra meal taking (AOR = 2.76, 95% CI: 1.43–5.29, delivery place (AOR = 2.65, 95% CI: 1.24–5.65), and household food insecurity (AOR = 6.57, 95% CI: 3.50–12.34) were independent variables showing statistically significant association with undernutrition of lactating women. Conclusion and recommendations. The study revealed that magnitude of undernutrition among lactating women was high. Dietary diversity, monthly income, extra meal, delivery place, and household food insecurity were found to be predictor of undernutrition. Finally, we recommend that governmental and nongovernmental organizations should organize timely interventions targeting lactating women.
The Effects of Biopesticide and Fusarium oxysporum f.sp. vanillae on the Nutrient Content of Binucleate Rhizoctonia-Induced Vanilla Plant
Authors: Haryuni Haryuni , Harahap Andre Fahriz Perdana , Supartini  , Priyatmojo Achmadi , Gozan Misri
Published: April 2020

Binucleate Rhizoctonia (BNR) fungi are essential for the germination of vanilla seeds. Chemical control of the soil-borne pathogen might adversely affect BNR. The purpose of this study is to determine the effect of Nicotiana tabacum extract biopesticides and Fusarium oxysporum f.sp. vanillae (Fusarium) on vanilla plant nutrient content induced by BNR. Materials and Methods. The research design was completely randomized design with two factors and three replications. The first factor was biopesticide (dosage of 0, 10, 20, and 30 ml/seedling), and the second factor was the application of Fusarium. Results. The increase in the nitrogen, phosphorus, and potassium content of vanilla was affected by biopesticides and Fusarium inoculation. Fusarium inoculation has no significant effect on nitrogen and phosphorus levels but significantly affects potassium levels. The biopesticide dosage is significant for nitrogen, phosphorus, and potassium. The interaction of biopesticides with Fusarium inoculation did not significantly affect the parameters of nitrogen and phosphorus content, but significantly affected potassium content. Conclusion. The application of biopesticides and Fusarium inoculation after induction of BNR can increase nitrogen, phosphorus, and potassium content of vanilla plants.
Evaluation of Inflammatory Markers in Patients Undergoing a Short-Term Aerobic Exercise Program while Hospitalized due to Acute Exacerbation of COPD
Authors: Knaut Caroline , Bonfanti Mesquita Carolina , Dourado Victor Zuniga , de Godoy Irma , Tanni Suzana E.
Published: April 2020

Introduction. Acute exacerbation is an important factor for a worse prognosis in patients with chronic obstructive pulmonary disease (COPD). It promotes the increase of the inflammatory process and worsens quality of life, lung function, and muscle weakness. It is believed that physical exercise performed during the exacerbation breaks the vicious cycle of systemic manifestations without an increase in the inflammatory process. Objective. To evaluate the influence of short-term aerobic physical exercise during hospitalization on inflammatory markers. Patients and Methods. 26 patients were evaluated (69.2% female, FEV 137.5 ± 12.9%, and age 68.4 ± 11.6 years) 24 hours after hospitalization for smoking history, Charlson index, quality of life, systemic inflammatory markers, and body composition. After 48 hours of hospitalization, all patients underwent a 6-minute walk test (6MWT) and a new spirometry test, and BODE index was calculated. After 72 hours of hospitalization, patients in the intervention group underwent aerobic exercise on a treadmill for 15 minutes twice daily; before and after the aerobic exercise, blood samples were collected for evaluation of inflammatory markers. Finally, a month after hospital discharge, all patients were reevaluated according to systemic inflammatory markers, quality of life, body composition, spirometry, 6MWT, and BODE index. Results. Patients of both groups did not differ in severity of disease and general characteristics. The intervention group did not show worsening in the inflammatory process after aerobic activity: TNF-α from 1.19 (0 99–1.71) to 1.21 (0.77–1.53) (p=0.58), IL-6 from 2.41 (2.02–0.58) to 2.66 (1.69–0.48) (p=0.21), and CRP from 3.88 (2.26–8.04) to 4.07 (2.65–13.3) (p=0.56). There was a negative correlation between the IL-6 marker and the 6MWT; that is, with the reduction in inflammatory levels, there was an improvement in exercise capacity one month after hospital discharge. Conclusion. The present study showed that the aerobic physical activity initiated during hospitalization in patients with exacerbated COPD did not worsen the inflammatory process.
In Vitro Nephrotoxicity Induced by Herb-Herb Interaction between Radix Glycyrrhizae and Radix Euphorbiae Pekinensis
Authors: Chen Meng , Geng Di , Yang Xin , Liu Xiaoxuan , Liu Siqi , Ding Pengmin , Pang Yuesheng , Du Min , Hu Xiuhua , Wang Rufeng
Published: April 2020

Radix Glycyrrhizae (RG)-Radix Euphorbiae Pekinensis (REP) is a representative incompatible herbal pair of Eighteen Incompatible Medicaments (EIM) and has been disputed in clinical application for a long time. The present study was performed with the Madin-Darby canine kidney (MDCK) cell line using cell cytotoxicity assay, apoptosis detection, cell cycle measurement, reactive oxygen species (ROS) determination, and high content analysis (HCA) in combination with high-performance liquid chromatography (HPLC) fingerprint comparison to clarify whether RG and REP can be concomitantly used from the perspective of cytotoxicity, investigate the major correlated compounds, and elucidate the underlying mechanisms. The results showed that the toxicity of REP could be significantly enhanced through its concomitant use with RG in the ratio of 1 : 1, and this increased toxicity could be weakened with the further increased proportion of RG. 3,3′-di-O-methylellagic acid-4′-O-β-D-xylopyranoside (DEAX) and 3,3′-di-O-methylellagic acid (DEA) were shown to be mainly responsible for the toxicity induced by concomitant use of REP and RG. Both RG-REP decoctions and the above two compounds boosted cell apoptosis, cellular morphological change, ROS accumulation, and mitochondrial membrane potential (MMP) disruption. In conclusion, the incompatible use of RG and REP is conditionally established because of the bidirectional regulatory effect of RG, and the major compounds responsible for RG-REP incompatibility are DEAX and DEA, which result in toxicity through activation of mitochondria-dependent apoptosis induced by increased ROS production. This study provided a basis for understanding the incompatible use of RG and REP and the EIM theory.
Longitudinal Monitoring of ctDNA in Patients with Melanoma and Brain Metastases Treated with Immune Checkpoint Inhibitors
Authors: Lee Jenny H. , Menzies Alexander M. , Carlino Matteo S. , McEvoy Ashleigh C. , Sandhu Shahneen , Weppler Alison M. , Diefenbach Russell J. , Dawson Sarah-Jane , Kefford Richard F. , Millward Michael J. , Al-Ogaili Zeyad , Tra Thien , Gray Elin S. , Wong Stephen Q. , Scolyer Richard A. , Long Georgina V. , Rizos Helen
Published: April 2020

Purpose:

Brain involvement occurs in the majority of patients with metastatic melanoma. The potential of circulating tumor DNA (ctDNA) for surveillance and monitoring systemic therapy response in patients with melanoma brain metastases merits investigation.

Experimental Design:

This study examined circulating BRAF, NRAS, and c-KIT mutations in patients with melanoma with active brain metastases receiving PD-1 inhibitor–based therapy. Intracranial and extracranial disease volumes were measured using the sum of product of diameters, and response assessment performed using RECIST. Longitudinal plasma samples were analyzed for ctDNA over the first 12 weeks of treatment (threshold 2.5 copies/mL plasma).

Results:

Of a total of 72 patients, 13 patients had intracranial metastases only and 59 patients had concurrent intracranial and extracranial metastases. ctDNA detectability was 0% and 64%, respectively, and detectability was associated with extracranial disease volume (P < 0.01). Undetectable ctDNA on-therapy was associated with extracranial response (P < 0.01) but not intracranial response. The median overall survival in patients with undetectable (n = 34) versus detectable (n = 38) ctDNA at baseline was 39.2 versus 10.6 months [HR, 0.51; 95% confidence interval (CI), 0.28–0.94; P = 0.03] and on-therapy was 39.2 versus 9.2 months (HR, 0.32; 95% CI, 0.16–0.63; P < 0.01).

Conclusions:

ctDNA remains a strong prognostic biomarker in patients with melanoma with brain metastases, especially in patients with concurrent extracranial disease. However, ctDNA was not able to detect or monitor intracranial disease activity, and we recommend against using ctDNA as a sole test during surveillance and therapeutic monitoring in patients with melanoma.
Tumor Fusion Burden as a Hallmark of Immune Infiltration in Prostate Cancer
Authors: Wagle Marie-Claire , Castillo Joseph , Srinivasan Shrividhya , Holcomb Thomas , Yuen Kobe C. , Kadel Edward E. , Mariathasan Sanjeev , Halligan Daniel L. , Carr Adrian R. , Bylesjo Max , McAdam Paul R. , Lynagh Sarah , Marien Koen M. , Kockx Mark , Waumans Yannick , Huang Shih-Min A. , Lackner Mark R. , Mounir Zineb
Published: April 2020

Prostate cancer is the second leading cause of cancer-related death in men. Despite having a relatively lower tumor mutational burden than most tumor types, multiple gene fusions such as TMPRSS2:ERG have been characterized and linked to more aggressive disease. Individual tumor samples have been found to contain multiple fusions, and it remains unknown whether these fusions increase tumor immunogenicity. Here, we investigated the role of fusion burden on the prevalence and expression of key molecular and immune effectors in prostate cancer tissue specimens that represented the different stages of disease progression and androgen sensitivity, including hormone-sensitive and castration-resistant prostate cancer. We found that tumor fusion burden was inversely correlated with tumor mutational burden and not associated with disease stage. High fusion burden correlated with high immune infiltration, PD-L1 expression on immune cells, and immune signatures, representing activation of T cells and M1 macrophages. High fusion burden inversely correlated with immune-suppressive signatures. Our findings suggest that high tumor fusion burden may be a more appropriate biomarker than tumor mutational burden in prostate cancer, as it more closely associates with immunogenicity, and suggests that tumors with high fusion burden could be potential candidates for immunotherapeutic agents.
Cerebrospinal Fluid YKL-40 and Chitotriosidase Levels in Frontotemporal Dementia Vary by Clinical, Genetic and Pathological Subtype
Authors: Woollacott Ione O.C. , Nicholas Jennifer M. , Heller Carolin , Foiani Martha S. , Moore Katrina M. , Russell Lucy L. , Paterson Ross W. , Keshavan Ashvini , Schott Jonathan M. , Warren Jason D. , Heslegrave Amanda , Zetterberg Henrik , Rohrer Jonathan D.
Published: April 2020

Background: Chronic glial dysfunction may contribute to the pathogenesis of frontotemporal dementia (FTD). Cerebrospinal fluid (CSF) levels of glia-derived proteins YKL-40 and chitotriosidase are increased in Alzheimer’s disease (AD) but have not been explored in detail across the spectrum of FTD. Methods: We investigated whether CSF YKL-40 and chitotriosidase levels differed between FTD patients and controls, across different clinical and genetic subtypes of FTD, and between individuals with a clinical FTD syndrome due to AD versus non-AD (frontotemporal lobar degeneration, FTLD) pathology (based on CSF neurodegenerative biomarkers). Eighteen healthy controls and 64 people with FTD (behavioural variant FTD, n = 20; primary progressive aphasia [PPA], n = 44: nfvPPA, n = 16, svPPA, n = 11, lvPPA, n = 14, PPA-NOS, n = 3) were included. 10/64 had familial FTD, with mutations in GRN(n = 3), MAPT(n = 4), or C9orf72 (n = 3). 15/64 had neurodegenerative biomarkers consistent with AD pathology. Levels were measured by immunoassay and compared using multiple linear regressions. We also examined relationships of YKL-40 and chitotriosidase with CSF total tau (T-tau), phosphorylated tau 181 (P-tau) and β-amyloid 1–42 (Aβ42), with each other, and with age and disease du­ration. Results: CSF YKL-40 and chitotriosidase levels were higher in FTD, particularly lvPPA (both) and nfvPPA (YKL-40), compared with controls. GRN mutation carriers had higher levels of both proteins than controls and C9orf72 expansion carriers, and YKL-40 was higher in MAPT mutation carriers than controls. Individuals with underlying AD pathology had higher YKL-40 and chitotriosidase levels than both controls and those with likely FTLD pathology. CSF YKL-40 and chitotriosidase levels were variably associated with levels of T-tau, P-tau and Aβ42, and with each other, depending on clinical syndrome and underlying pathology. CSF YKL-40 but not chitotriosidase was associated with age, but not disease duration. Conclusion: CSF YKL-40 and chitotriosidase levels are increased in individuals with clinical FTD syndromes, particularly due to AD pathology. In a preliminary analysis of genetic groups, levels of both proteins are found to be highly elevated in FTD due to GRN mutations, while YKL-40 is increased in individuals with MAPT mutations. As glia-derived protein levels generally correlate with T-tau and P-tau levels, they may reflect the glial response to neurodegeneration in FTLD.
Amelioration of High Fructose Diet-Induced Insulin Resistance, Hyperuricemia, and Liver Oxidative Stress by Combined Use of Selective Agonists of PPAR-α and PPAR-γ in Rats
Authors: Farag Mahmoud M. , Ashour Ehab H. , El-Hadidy Wessam F.
Published: April 2020

Background: The use of high-fructose (Fr) corn sweeteners and sucrose in manufactured food has markedly increased recently. This excessive Fr intake has been proposed in the etiology of the metabolic syndrome, which shows an increasing prevalence throughout the world. Objective: In this study, we questioned whether fenofibrate (FF), a peroxisome proliferator-activated receptor (PPAR)-α agonist, and pioglitazone (PG), a PPAR-γ agonist, might be effective in ameliorating the metabolic syndrome in a rat model. Materials and Methods: The metabolic syndrome was induced by feeding rats a high-Fr (60%) diet for 10 weeks. The rats were divided into 5 groups: control group, fed a normal rat chow; Fr + vehicle group; Fr + FF group; Fr + PG group; and Fr + (FF + PG) group (treated with both drugs). Drug or vehicle treatment was given daily for 6 weeks (from weeks 5 to 10). Thereafter, blood and liver samples were obtained for biochemical studies. Results: Rats fed a high-Fr diet developed hyperglycemia, hyperinsulinemia, hyperuricemia, hypertriglyceri­demia, and hypercholesterolemia, and had increased serum alanine aminotransferase, hepatic tumor necrosis factor-α, and malondialdehyde levels but decreases in both glutathione content and superoxide dismutase activity. Rat treatment with FF and/or PG attenuated these alterations. The improvement was greater with the combined treatment than with either drug alone, and normalization of insulin sensitivity was observed only in rats treated with the combination therapy. Conclusion: Acting on the 2 main PPAR subfamilies, the combination of FF and PG provides a more efficacious therapy for modulating the changes in serum insulin, uric acid, and lipids, as well as the accompanying hepatic inflammation and oxidative stress that characterize the Fr-induced metabolic syndrome.