bluuebunny/crossref_metadata_2025 huggingface dataset:
Iterative learning-based formation control for multiple quadrotor unmanned aerial vehicles
Authors: Zhao Zhihui , Wang Jing , Chen Yangquan , Ju Shuang
Published: March 2020

A double-layer formation control is proposed to solve the repeated tasks for multiple quadrotor unmanned aerial vehicle systems. The first layer aims at achieving a formation target in which the iterative learning control is designed based on relative distance with neighbor unmanned aerial vehicles and absolute distance with virtual leader unmanned aerial vehicle. The formation controller is responsible for keeping the formation shape and generating the desired flying trajectories for each drones. The second layer control aims at achieving a high-precision tracking to desired flying trajectories which are generated from the formation controller. A double closed-loop proportional–derivative strategy is designed to ensure the accuracy of trajectory tracking for each individual drone. Simulations for the circle formation mission of the multiple quadrotor unmanned aerial vehicle system are given to verify the efficiency of the proposed method.
Controls of Temporal Variations on Soil Respiration in a Tropical Lowland Rainforest in Hainan Island, China
Authors: Cui Yi-Bin , Feng Ji-Guang , Liao Li-Guo , Yu Rui , Zhang Xiang , Liu Yu-Hai , Yang Lian-Yan , Zhao Jun-Fu , Tan Zheng-Hong
Published: March 2020

Soil respiration represents the largest carbon (C) flux from terrestrial ecosystems to the atmosphere. We created a study site in tropical lowland rainforest and used static chamber method to measure the temporal variations of soil respiration and their relationship with environmental factors at monthly time scale. The temporal variations of soil respiration showed a seasonal pattern related to soil temperature ( p <  .01) and soil moisture ( p <  .05). We tested different regression models to explore the relationship between soil respiration and environmental factors. Soil respiration had a better fit with soil temperature than with soil moisture in single-factor models. At different temperatures, the Q10 values from different models changed in rather different ways. We found that the mixed quadratic model composite of soil temperature and moisture had the best-fitting effect ( R2 = .74) on soil respiration and could better explain the seasonal variation. In a certain soil moisture range close to 15%, soil respiration increased with soil temperature. However, soil respiration became restricted when the moisture was greatly higher or lower than this value. Furthermore, at low soil temperatures (lower than 16°C), higher soil moisture could decrease soil respiration rapidly. Thus, soil respiration in a tropical lowland rainforest is co-controlled by soil temperature and moisture. This study expands our observations of soil respiration in tropical forests and how it responds to environmental factors, which is important for reducing errors in evaluation and scaling up of soil carbon flux in climate change studies.
Women’s organizing against extractivism: towards a decolonial multi-sited analysis
Authors: Caretta Martina Angela , Zaragocin Sofia , Turley Bethani , Orellana Kamila Torres
Published: March 2020

In Anglophone geography, proposals have called for the decolonization of geographical knowledge production to be focused on tangible and material manifestations of how dialogue is initiated and mediated among different ontologies and epistemologies. We strive to respond to this call by empirically cutting across the American continent to highlight the embodied and transnational dimensions of natural resource extraction. Across the Americas, extractive industries’ water usage often brings corporations into prolonged conflicts with local communities, who mobilize to resist the initiation and/or expansion of extractive activities that they view as threatening to their health, way of life, and their families and communities’ territories. Through two case studies from West Virginia (WV), USA, and Cuenca, Ecuador, we propose an analytical framework capturing how women organize against the extractive industry as a result of embodied water pollution. We do this with the aim of decolonizing geographical knowledge production, as we propose a decolonial, multi-sited analytical approach, which serves to rethink the scale of effects of extractive industry. By showing how resource extraction affects women’s bodies and water while also effectively allowing us to compare and contrast embodied water relations in WV and Ecuador, we better understand how extractivism works across scales—the body, the environment, and transnationally. We contend that a multi-sited approach disrupts the North–South geographical discursive divide and furthers a decolonial geographical approach in making apparent the embodied production and lived experience of territory across various scales. In this piece, we promote debates on decoloniality within Anglophone geography by proposing that we must not only consider epistemologies and spatial ontologies outside the western canon, but engage with practices and theories occurring in different parts of the globe in a simultaneous fashion as well. We call on fellow geographers to do the same.
Exercise right heart catheterization before and after balloon pulmonary angioplasty in inoperable patients with chronic thromboembolic pulmonary hypertension
Authors: Wiedenroth Christoph B. , Rieth Andreas J. , Kriechbaum Steffen , Ghofrani H.‐Ardeschir , Breithecker Andreas , Haas Moritz , Roller Fritz , Richter Manuel J. , Lankeit Mareike , Mielzarek Lisa , Rolf Andreas , Hamm Christian W. , Mayer Eckhard , Guth Stefan , Liebetrau Christoph
Published: March 2020

Background

Balloon pulmonary angioplasty is an evolving, interventional treatment option for inoperable patients with chronic thromboembolic pulmonary hypertension (CTEPH). Pulmonary hypertension at rest as well as exercise capacity is considered to be relevant outcome parameters. The aim of the present study was to determine whether measurement of pulmonary hemodynamics during exercise before and six months after balloon pulmonary angioplasty have an added value.

Methods

From March 2014 to July 2018, 172 consecutive patients underwent balloon pulmonary angioplasty. Of these, 64 consecutive patients with inoperable CTEPH underwent a comprehensive diagnostic workup that included right heart catheterization at rest and during exercise before balloon pulmonary angioplasty treatments and six months after the last intervention.

Results

Improvements in pulmonary hemodynamics at rest and during exercise, in quality of life, and in exercise capacity were observed six months after balloon pulmonary angioplasty: WHO functional class improved in 78% of patients. The mean pulmonary arterial pressure (mPAP) at rest was reduced from 41 ± 9 to 31 ± 9 mmHg (p < 0.0001). The mPAP/cardiac output slope decreased after balloon pulmonary angioplasty (11.2 ± 25.6 WU to 7.7 ± 4.1 WU; p < 0.0001), and correlated with N‐terminal fragment of pro‐brain natriuretic peptide (p = 0.035) and 6‐minute walking distance (p = 0.01).

Conclusions

Exercise right heart catheterization provides valuable information on the changes of pulmonary hemodynamics after balloon pulmonary angioplasty in inoperable CTEPH patients that are not obtainable by measuring resting hemodynamics.
Perception, Adoption, and Pattern of Usage of FinTech Services by Bank Customers: Evidences from Hojai District of Assam
Authors: Das Ankita , Das Debabrata
Published: March 2020

With the advent of technology, banking and financial services have widened their scope. India achieved FinTech adoption rate of 87 percent as against the global average of 64 percent mostly contributed by FinTech startups aiming for providing access to financial services even in the remotest areas. Realizing the potential of FinTech to contribute toward financial inclusion and stability, the Governments have taken requisite steps toward digital transformation and promote FinTech ventures. In order to meet the customers’ needs, collaborative moves with FinTech firms have been initiated by financial institutions as well. This article aims to investigate the relationship between different demographic profiles, the adoption of FinTech services, the perception, user pattern, and constraints faced by the bank customers in using FinTech services. The results based on survey of 215 respondents reveal significant association between usage of FinTech services and different demographic profiles. However, the awareness and use of such services is found more among millennials and generation Z as compared with generation X and baby boomers. While the FinTech companies gained the popularity in payment space, it is observed that misconception is an important factor that hinders the growth of technology-based services among respondents.
Meldonium: Pharmacological, toxicological, and analytical aspects
Authors: Berlato Dener Gomes , Bairros André Valle de
Published: March 2020

Meldonium is the active molecule from Mildronate® with similar chemical structure to an amino acid, and it is known as (3-(2,2,2-trimethylhydrazine) propionate) (CAS 76144-81-5). This pharmaceutical substance is approved in Eastern Europe for cerebral and myocardial ischemia and has been on the World Doping Association’s banned substances list since January 2016. The goal of this review is to relate the use of meldonium as a doping agent, considering its pharmacological, toxicological, and analytical aspects. This review is based on the scientific literature from digital platforms. The main mechanism of action of meldonium is based on a decrease in l-carnitine levels and increase of peroxisomes activity in the cytosol. Females were more susceptible to the substance in animal experiments for toxicological tests. There is currently no report in the scientific literature about acute or chronic intoxication cases by meldonium in humans. Based on the literature findings, meldonium showed ergogenic effect in animals and human volunteers. For anti-doping analysis, urine is the biological matrix of choice, and dilute-and-shoot is the most common sample treatment in addition to liquid chromatography–mass spectrometry analysis. Other approaches could be used to determine meldonium levels, mainly for screening tests, such as l-carnitine or gamma-butyrobetaine levels.
Nec-1 Attenuates Neurotoxicity Induced by Titanium Dioxide Nanomaterials on Sh-Sy5y Cells Through RIP1
Authors: Zhou Ting , Huang Wei-kun , Xu Qiu-yan , Zhou Xue , Wang Yue , Yue Zhao-hui , Song Bin
Published: March 2020

Titanium dioxide nanomaterials are applied in numerous fields due to their splendid physicochemical characteristics, which in turn poses a potential threat to human health. Recently, numerous in vivo studies have revealed that titanium dioxide nanoparticles (TNPs) can be transported into animal brains after exposure through various routes. Absorbed TNPs can accumulate in the brain and may disturb neuronal cells, leading to brain dysfunction. In vitro studies verified the neurotoxicity of TNPs. The mechanisms underlying the neurotoxicity of TNPs remains unclear. Whether necroptosis is involved in the neurotoxicity of TNPs is unknown. Therefore, we performed an in vitro study and found that TNPs induced inflammatory injury in SH-SY5Y cells in a dose-dependent way, which was mitigated by necrostatin-1 (Nec-1) pretreatment. Since receptor-interacting protein kinase 1 (RIP1) is reported to be the target of Nec-1, we silenced it by siRNA. We exposed mutant and wild-type cells to TNPs and assessed inflammatory injury. Silencing RIP1 expression inhibited inflammatory injury induced by TNPs exposure. Taken together, Nec-1 ameliorates the neurotoxicity of TNPs through RIP1. However, more studies should be performed to comprehensively assess the correlation between the neurotoxicity of TNPs and RIP1.
RETRACTED ARTICLE: The PI3K/mTOR dual inhibitor BEZ235 nanoparticles improve radiosensitization of hepatoma cells through apoptosis and regulation DNA repair pathway
Authors: Tang Xiaolong , Li Amin , Xie Chunmei , Zhang Yinci , Liu Xueke , Xie Yinghai , Wu Binquan , Zhou Shuping , Huang Xudong , Ma Yongfang , Cao Weiya , Xu Ruyue , Shen Jing , Huo Zhen , Cai Shuyu , Liang Yong , Ma Dong
Published: March 2020

Polymer materials encapsulating drugs have broad prospects for drug delivery. We evaluated the effectiveness of polyethylene glycol-poly (lactic-co-glycolic acid) (PLGA-PEG) encapsulation and release characteristics of PI3K/mTOR inhibitor NVP-BEZ235 (BEZ235). We proposed a strategy for targeting radiosensitization of liver cancer cells. The biocompatibility, cell interaction, and internalization of Glypican-3 (GPC3) antibody-modified, BEZ235-loaded PLGA-PEG nanoparticles (NP-BEZ235-Ab) in hepatoma cells in vitro were studied. Also, the cell killing effect of NP-BEZ235-Ab combined with γ-ray cell was evaluated. We used confocal microscopy to monitor nanoparticle-cell interactions and cellular uptake, conducted focus-formation experiments to analyze the synergistic biological effects of NP-BEZ235-Ab and priming, and studied synergy in liver cancer cells using molecular biological methods such as western blotting. We found that PLGA-PEG has good loading efficiency for BEZ235 and high selectivity to GPC3-positive HepG2 liver cancer cells, thus documenting that NP-BEZ235-Ab acts as a small-molecule drug delivery nanocarrier. At the nominal concentration, the NP-BEZ235-Ab nanoformulation synergistically kills liver cancer cells with significantly higher efficiency than does the free drug. Thus, NP-BEZ235-Ab is a potential radiosensitizer.

Graphical Abstract
Construction of ZnTiO3/Bi4NbO8Cl heterojunction with enhanced photocatalytic performance
Authors: Gao Zhaoqun , Qu Xiaofei
Published: March 2020

Constructing heterojunction is an effective strategy to enhance photocatalytic performance of photocatalysts. Herein, we fabricated ZnTiO3/Bi4NbO8Cl heterojunction with improved performance via a typical mechanical mixing method. The rhodamine (RhB) degradation rate over heterojunction is higher than that of individual ZnTiO3 or Bi4NbO8Cl under Xenon-arc lamp irradiation. Combining ZnTiO3 with Bi4NbO8Cl can inhibit the recombination of photo-excited carriers. The improved quantum efficiency was demonstrated by transient-photocurrent responses (PC), electrochemical impedance spectroscopy (EIS), photoluminescence (PL) spectra, and time-resolved PL (TRPL) spectra. This research may be valuable for photocatalysts in the industrial application.
Tanshinone IIA alleviates hypoxia/reoxygenation induced cardiomyocyte injury via lncRNA AK003290/miR-124-5p signaling
Authors: Chen Liye , Wei Lili , Yu Qiongyang , Shi Haozhe , Liu George
Published: March 2020

Background

Acute myocardial infarction (AMI) is the leading cause of death globally and has thus placed a heavy burden on healthcare. Tanshinone IIA (TSA) is a major active compound, extracted from Salvia miltiorrhiza Bunge, that possesses various pharmacological activities. The aim of the present study was to investigate the role of TSA in AMI and its underlying mechanism of action. Results: We have shown that TSA decreased the apoptosis rate, the amount of LDH, MDA as well as ROS of cardiomyocytes. Meantime, it elevated mitochondrial membrane potential (MMP) which was decreased by H/R treatment. It was also determined that miR-124-5p targets AK003290 directly. TSA up-regulated the expression of AK003290 and its function can be reversed by knock down of AK003290 as well as miR-124-5p overexpression.

Conclusion

TSA exerts the protective role against H/R induced apoptosis, oxidative and MMP loss of cardiomyocytes via regulating AK003290 and miR-124-5p signaling.
Novel approach in whole genome mining and transcriptome analysis reveal conserved RiPPs in Trichoderma spp
Authors: Vignolle Gabriel A. , Mach Robert L. , Mach-Aigner Astrid R. , Derntl Christian
Published: March 2020

Background

Ribosomally synthesized and post-translationally modified peptides (RiPPs) are a highly diverse group of secondary metabolites (SM) of bacterial and fungal origin. While RiPPs have been intensively studied in bacteria, little is known about fungal RiPPs. In Fungi only six classes of RiPPs are described. Current strategies for genome mining are based on these six known classes. However, the genes involved in the biosynthesis of theses RiPPs are normally organized in biosynthetic gene clusters (BGC) in fungi.

Results

Here we describe a comprehensive strategy to mine fungal genomes for RiPPs by combining and adapting existing tools (e.g. antiSMASH and RiPPMiner) followed by extensive manual curation based on conserved domain identification, (comparative) phylogenetic analysis, and RNASeq data. Deploying this strategy, we could successfully rediscover already known fungal RiPPs. Further, we analysed four fungal genomes from the Trichoderma genus. We were able to find novel potential RiPP BGCs in Trichoderma using our unconventional mining approach.

Conclusion

We demonstrate that the unusual mining approach using tools developed for bacteria can be used in fungi, when carefully curated. Our study is the first report of the potential of Trichoderma to produce RiPPs, the detected clusters encode novel uncharacterized RiPPs. The method described in our study will lead to further mining efforts in all subdivisions of the fungal kingdom.
Cognitive, functional, physical, and nutritional status of the oldest old encountered in primary care: a systematic review
Authors: Escourrou Emile , Durrieu Florence , Chicoulaa Bruno , Dupouy Julie , Oustric Stéphane , Andrieu Sandrine , Gardette Virginie
Published: March 2020

Background

The oldest old (individuals over 90 years) are a fast-growing population. Characterizing their specificity would be helpful to adapt health care. This study aimed to characterize the cognitive, functional, nutritional, and physical status of individuals over 90.

Methods

We conducted a systematic review of cross-sectional or cohort studies of individuals aged 90 years old or more, living at home or in a nursing home, in April 2018. Two reviewers selected eligible articles, extracted data, and evaluated the risk of bias (assessed by the Newcastle-Ottawa Scale).

Results

The search strategy identified 3086 references; 35 articles were included referring to 8 cross-sectional and 27 longitudinal studies. Dementia was diagnosed in 30–42.9% of study participants, cognitive impairment in 12–50%, and 31–65% had no cognitive impairment. In terms of activities of daily living, 14–72.6% of individuals had no difficulty, 35.6–38% had difficulty, and 14.4–55.5% were dependent. For instrumental activities of daily living, 20–67.9% needed help. Regarding nutritional status, the Mini Nutritional Assessment Short Form mean score ranged from 10.3 (SD: 1.8) to 11.1 (SD: 2.4). Eight to 32% of individuals could not stand up from a chair, 19–47% could stand without the use of their arms; and 12.9–15% were not able to walk 4 m.

Conclusions

These results suggest a heterogeneous population with a certain proportion of oldest old with a low level of disability. These findings suggest that a specific approach in the care of the oldest old could help prevent disability.
Ten years risk assessment of atherosclerotic cardiovascular disease using Astro-CHARM and pooled cohort equation in a south Asian sub-population
Authors: Ashraf Tariq , Mengal Muhammad Naeem , Muhammad Atif Sher , Tareen Asal Khan , Khan Muhammad Nauman , Kazmi Khawar Abbas , Nadeem Asif , Sarwar Shakil , Bashir Zara , Qamar Nadeem , Karim Musa
Published: March 2020

Background

Atherosclerotic cardiovascular diseases (ASCVD) are on the rise in low and middle-income countries attributed to modern sedentary lifestyle and dietary habits. This has led to the need of assessment of the burden of at-risk population so that prevention measures can be developed. The objective of this study was to assess ten years risk assessment of ASCVD using Astro-CHARM and Pooled Cohort Equation (PCE) in a South Asian sub-population.

Methods

A total of 386 residents of all six districts of Karachi with no ASCVD were enrolled in the study through an exponential non-discriminative referral snowball sampling technique. The inclusion criteria consisted of age 40 years or above and either gender. Study participants were enrolled after obtaining informed written consent and those study participants who were found to have either congenital heart disease or valvular heart diseases or ischemic heart disease were excluded from the study based on initial screening. For the calculation of 10 years risk of ACVD based on Astro-CHARM and PCE, the variables were obtained including medical history and coronary artery calcium and C-reactive protein measurements.

Results

Mean estimated 10-year risk of fatal or non-fatal myocardial infarction or stroke as per the Astro-CHARM was 13.98 ± 8.01%, while mean estimated 10-year risk of fatal or non-fatal myocardial infarction or stroke as per the PCE was 22.26 ± 14.01%. Based on Astro-CHARM, 11.14% of the study participants were labeled as having high risk, while PCE estimated 20.73% of study participants as having high risk of ASCVD.

Conclusion

Despite the fact that our findings showed substantial differences in ten-year risk of ASCVD between Astro-CHARM and PCE, both calculators can be used to develop a new population and specific risk estimators for this South Asian sub-population. Our study provides the first step towards developing a risk assessment guided decision-making protocol for primary prevention of ASCVD in this population.
Effectiveness of a health intervention based on WHO food safety manual in Iran
Authors: Ghaffari Mohtasham , Mehrabi Yadollah , Rakhshanderou Sakineh , Safari-Moradabadi Ali , Jafarian Seyyede Zenab
Published: March 2020

Background

Food safety manual was developed by the World Health Organization (WHO) to train professionals to reduce the burden of foodborne diseases as a global strategy. The present pioneering research aimed to explore the effectiveness of an intervention based on the manual of five keys to safer food by WHO in enhancing the knowledge, attitude and behavior of Iranian Female Community Health Volunteers (FCHVs).

Methods

In the present quasi-experimental research, FCHVs (n = 125) were selected and assigned to two groups, an intervention and a control. A modified version of the questionnaire based on WHO manual was used to measure knowledge, attitude and behavior of the sample. The questionnaire was first completed at the outset of the study (pre-test) and then once again in 2 months of the intervention (post-test). Face and content validity of the questionnaire was tested and confirmed. Cronbach’s alpha was used to test the reliability of the questionnaire along with the test-retest method of testing reliability. The data entered SPSS16 for statistical analysis. To this aim, Chi-squared test, dependent and independent samples T-test, ANOVA and ANCOVA were run. Partial population attributable risks were calculated and corresponding 95% confidence intervals (95% CIs) were estimated using a bootstrap method.

Results

The two groups showed no statistically significant difference in the pretest (p > .05). In the post-test, the mean scores for all variables was higher in the intervention group than the control, and this difference between the two research groups was statistically significant (p < .001). When the volunteers were adjusted for age and experience in healthcare centers, the mean scores were significantly higher in the intervention group than the control (p < .001).

Conclusion

It was revealed in the present study that the educational intervention based on five keys to food safety manual by WHO managed to improve participants’ knowledge, attitude and behavior. Translation of the target guideline in future can be a great help to researchers in prospective research.

Trial Registration

Retrospectively registered: Iranian Registry of Clinical Trials IRCT20160822029485N4, at 2020-03-16.
Pharmacotherapy for hypertension in Sub-Saharan Africa: a systematic review and network meta-analysis
Authors: Seeley Anna , Prynn Josephine , Perera Rachel , Street Rebecca , Davis Daniel , Etyang Anthony O.
Published: March 2020

Background

The highest burden of hypertension is found in Sub-Saharan Africa (SSA) with a threefold greater mortality from stroke and other associated diseases. Ethnicity is known to influence the response to antihypertensives, especially in black populations living in North America and Europe. We sought to outline the impact of all commonly used pharmacological agents on both blood pressure reduction and cardiovascular morbidity and mortality in SSA.

Methods

We used similar criteria to previous large meta-analyses of blood pressure agents but restricted results to populations in SSA. Quality of evidence was assessed using a risk of bias tool. Network meta-analysis with random effects was used to compare the effects across interventions and meta-regression to explore participant heterogeneity.

Results

Thirty-two studies of 2860 participants were identified. Most were small studies from single, urban centres. Compared with placebo, any pharmacotherapy lowered SBP/DBP by 8.51/8.04 mmHg, and calcium channel blockers (CCBs) were the most efficacious first-line agent with 18.46/11.6 mmHg reduction. Fewer studies assessing combination therapy were available, but there was a trend towards superiority for CCBs plus ACE inhibitors or diuretics compared to other combinations. No studies examined the effect of antihypertensive therapy on morbidity or mortality outcomes.

Conclusion

Evidence broadly supports current guidelines and provides a clear rationale for promoting CCBs as first-line agents and early initiation of combination therapy. However, there is a clear requirement for more evidence to provide a nuanced understanding of stroke and other cardiovascular disease prevention amongst diverse populations on the continent.

Trial registration

PROSPERO, CRD42019122490. This review was registered in January 2019.
Cancer screening among racial/ethnic groups in health centers
Authors: Lee De-Chih , Liang Hailun , Chen Nanqian , Shi Leiyu , Liu Ying
Published: March 2020

Background

Underserved and low-income population are placed at a disadvantage for receiving necessary cancer screenings. This study aims to measure the rates of receiving three types of cancer screening services, Pap test, mammogram and colorectal cancer screening, among patients seen at U.S. health centers (HCs) to investigate if cancer screening among patients varies by race/ethnicity.

Methods

We analyzed data from the 2014 U.S. Health Center Patient Survey, and included samples age 21 and above. We examined three cancer screening indicators as our dependent variables including cervical, breast, and colorectal cancer screening. Logistic regressions were used to assess the racial/ethnic disparities on cancer screening, while controlling for potentially confounding factors.

Results

The rates of receiving three types of cancer screening were comparable and even higher among HC patients than those for the U.S. general population. Both bivariate and multivariate results showed there were racial/ethnic differences in the likelihood of receiving cancer screening services. However, the differences did not favor non-Hispanic Whites. African Americans had higher odds than Whites (OR: 1.92, 95% CI: 1.44–2.55, p < 0.001) of receiving Pap tests. Similar results were also found in measures of the receipt of mammogram (OR = 1.96, 95% CI: 1.46–2.64, P < 0.001) and colorectal cancer screening (OR = 1.28, 95% CI: 1.02–1.60, p < 0.05).

Conclusion

The current study presents U.S. nationally representative estimates and imply that HCs are helping fulfill an important role as a health care safety-net in reducing racial/ethnic disparities in the delivery of cancer screening services.
Correction to: Circular RNA circNHSL1 promotes gastric cancer progression through the miR-1306-3p/SIX1/Vimentin axis
Authors: Zhu Zhonglin , Rong Zeyin , Luo Zai , Yu Zhilong , Zhang Jing , Qiu Zhengjun , Huang Chen
Published: March 2020

After publication of the article [1], the authors reported errors of inter-duplication in Figure 3.
Taking the long view: the development of the Well-being of Future Generations (Wales) Act
Authors: Messham Eleanor , Sheard Sally
Published: March 2020

Background

The Well-being of Future Generations (Wales) Act, 2015 (WFG Act), aims to change the ways of working in Wales to be sustainable for the future. Goals within the WFG Act include ‘a healthier Wales’, ‘a more equal Wales’ and ‘a more prosperous Wales’. Reviewing key factors that led to Wales enacting this ground-breaking legislation is worthwhile for other legislatures around the world that may wish to create policy for future generations. We suggest that the drive of individual politicians, events at the time and recent history were the most critical issues in developing a more nuanced piece of legislation – the WFG Act.

Methods

Ten interviews were conducted with those involved in the development of the WFG Act. Relevant documents were identified through systematic literature reviews and discussion with interviewees. Initial outcomes were tested against policy analysis frameworks, and Kingdon’s Multiple Stream Analysis was selected.

Results

Key ‘policy entrepreneurs’ were found to be important, along with growing evidence of the problems of climate change and recommendations for sustainable development in Wales. The importance of context and capitalising on global and local events by policy actors was significant. A supportive environment, including the third sector, community groups, cross-party backing, committed civil servants and a change of ministers helped with momentum.

Discussion

Policy-makers did not work directly with historians on developing the WFG Act. However, recent history was included with collaboration of the Wales Audit Office, who had evaluated the Welsh Government’s implementation of the duty to promote sustainable development. Sustainable, future-generation policies of other nations were also used to help shape the WFG Act. Kingdon’s Multiple Stream Analysis is a useful theory to interpret the timing and impact of this policy change.

Conclusions

The problem of climate change, suitable policy solutions, political support, timing and, most importantly, policy entrepreneurs were all significant in the development of the WFG Act. Due to multiple factors, policy-makers in Wales have legislated for the long term, placing sustainability and the well-being of present and future generations at the heart of public services and government.
Analyzing clinical and genetic characteristics of a cohort with multiple congenital anomalies-hypotonia-seizures syndrome (MCAHS)
Authors: Jiao Xianru , Xue Jiao , Gong Pan , Bao Xinhua , Wu Ye , Zhang Yuehua , Jiang Yuwu , Yang Zhixian
Published: March 2020

Objective

To summarize and extend the phenotypic characterization of Multiple Congenital Anomalies-Hypotonia-Seizures Syndrome, and to discuss genotype-phenotype correlations.

Methods

Collecting clinical information of 17 patients with pathogenic variants in PIGN, PIGA, and PIGT. Genetic studies were performed on all patients.

Results

There were 7 patients with 15 PIGN mutations (one patient carrying 3 mutations), 8 patients with 8 PIGA mutations, and 2 patients with 5 PIGT mutations (one patient carrying 3 mutations). All patients had epilepsy and developmental delay, with 71% of them showed hypotonia. And among these patients’ various seizure types, the focal seizure was the most common one. Eighty-two percent patients showed a significant relationship between seizures and fever. Serum ALP was elevated in one patient with PIGN mutations and in two patients with PIGA mutations. Brain MRI showed enlarged subarachnoid space in 56% of patients. Some other different characteristics had also been found in our patients: First, atypical absence seizures presented in three patients with PIGN mutations; Second, diffuse slow waves mixed with focal or multifocal discharges of interictal EEG in 88% cases with PIGA-deficient; Third, phenotypes of seven out of eight patients with PIGA mutations were difficult to be classified as severe or less severe group; Last, mild neurological symptoms and developmental status rather than severe conditions occurred in one patient with PIGT mutations.

Conclusion

With epilepsy, developmental delay, and/or hypotonia as common features, the knowledge of MCAHS in terms of phenotype and genotype has been expanded. In cases with PIGN-deficient, we expanded the types of atypical absence seizures, and described one patient with elevated serum ALP. Focal seizures with diffuse slow waves mixed with focal or multifocal discharges on EEG rather than infantile spasms with hypsarrhythmia, which as previously reported were often seen in our patients with PIGA mutations. The classifications of phenotypes caused by PIGA mutations should be more continuous than discrete. The mild phenotype of one patient with PIGT mutations expanded the clinical presentation of MCAHS3.
How could metabolomics change pediatric health?
Authors: Bardanzellu Flaminia , Fanos Vassilios
Published: March 2020

In the last years, ‘omics’ technologies, and especially metabolomics, emerged as expanding scientific disciplines and promising technologies in the characterization of several pathophysiological processes.

In detail, metabolomics, able to detect in a dynamic way the whole set of molecules of low molecular weight in cells, tissues, organs, and biological fluids, can provide a detailed phenotypic portray, representing a metabolic “snapshot.”

Thanks to its numerous strength points, metabolomics could become a fundamental tool in human health, allowing the exact evaluation of individual metabolic responses to pathophysiological stimuli including drugs, environmental changes, lifestyle, a great number of diseases and other epigenetics factors.

Moreover, if current metabolomics data will be confirmed on larger samples, such technology could become useful in the early diagnosis of diseases, maybe even before the clinical onset, allowing a clinical monitoring of disease progression and helping in performing the best therapeutic approach, potentially predicting the therapy response and avoiding overtreatments. Moreover, the application of metabolomics in nutrition could provide significant information on the best nutrition regimen, optimal infantile growth and even in the characterization and improvement of commercial products’ composition.

These are only some of the fields in which metabolomics was applied, in the perspective of a precision-based, personalized care of human health.

In this review, we discuss the available literature on such topic and provide some evidence regarding clinical application of metabolomics in heart diseases, auditory disturbance, nephrouropathies, adult and pediatric cancer, obstetrics, perinatal conditions like asphyxia, neonatal nutrition, neonatal sepsis and even some neuropsychiatric disorders, including autism.

Our research group has been interested in metabolomics since several years, performing a wide spectrum of experimental and clinical studies, including the first metabolomics analysis of human breast milk. In the future, it is reasonable to predict that the current knowledge could be applied in daily clinical practice, and that sensible metabolomics biomarkers could be easily detected through cheap and accurate sticks, evaluating biofluids at the patient’s bed, improving diagnosis, management and prognosis of sick patients and allowing a personalized medicine. A dream? May be I am a dreamer, but I am not the only one.
Special attention to nurses’ protection during the COVID-19 epidemic
Authors: Huang Lishan , Lin Guanwen , Tang Li , Yu Lingna , Zhou Zhilai
Published: March 2020

As of March 8, 2020, the novel coronavirus disease 2019 (COVID-19) had caused 80,815 human infections and 3073 deaths in China, including more than 3000 infections among medical staff. Guangdong Second Provincial General Hospital (Guangzhou, Guangdong Province, China), a provincial emergency hospital, has treated more than 35 confirmed cases of COVID-19 and more than 260 suspected cases. Most of nurses’ work involves direct contact with patients. As nurses have high vulnerability to COVID-19, it is necessary to establish hospital-specific protocols to reduce the risk of nurses’ infection in interactions with COVID-19 patients. Our hospital has maintained a “zero nurse infection” rate while battling SARS in 2003 and during the present COVID-19 epidemic. The following are the key measures implemented in our hospital.
In vivo staging of frontotemporal lobar degeneration TDP-43 type C pathology
Authors: Bocchetta Martina , Iglesias Espinosa Maria del Mar , Lashley Tammaryn , Warren Jason D. , Rohrer Jonathan D.
Published: March 2020

Background

TDP-43 type C is one of the pathological forms of frontotemporal lobar degeneration (FTLD) and mainly associated clinically with the semantic variant of primary progressive aphasia (svPPA). We aimed to define in vivo the sequential pattern of neuroanatomical involvement in a cohort of patients with FTLD-TDP type C pathology.

Methods

We extracted the volumes of a set of cortical and subcortical regions from MRI scans of 19 patients with post mortem confirmed TDP-43 type C pathology (all with left hemisphere-predominant atrophy at baseline). In the initial development phase, we used w-scores computed from 81 cognitively normal controls to define a set of sequential stages of neuroanatomical involvement within the FTLD-TDP type C cohort where a w-score of < − 1.65 was considered abnormal. In a subsequent validation phase, we used 31 follow-up scans from 14 of the 19 patients in the same cohort to confirm the staging model.

Results

Four sequential stages were identified in the initial development phase. Stage 1 was defined by atrophy in the left amygdala, medial temporal cortex, temporal pole, lateral temporal cortex and right medial temporal cortex; Stage 2 by atrophy in the left supratemporal cortex; Stage 3 by atrophy in the right anterior insula; and Stage 4 by atrophy in the right accumbens. In the validation phase, calculation of w-scores in the longitudinal scans confirmed the staging system, with all patients either staying in the same stage or progressing to a later stage at follow-up.

Conclusion

In vivo imaging is able to detect distinct stages of neuroanatomical involvement in FTLD-TDP type C pathology. Using an imaging-derived staging system allows a more refined stratification of patients with svPPA during life.
Protocol for a multi-centre randomised controlled stand-alone feasibility trial to assess potential effectiveness and cost-effectiveness of digital hearing aids in patients with tinnitus and hearing loss (the HUSH trial)
Authors: Haines Rachel H. , White Jennifer , Meakin Garry , Tan Wei , Hepburn Trish , Leighton Paul , Theriou Chloi , Stockdale David , Almey Christine , Nicholson Richard , Hall Deborah A. , Sereda Magdalena
Published: March 2020

Background

The most common management strategy for tinnitus provided in the UK audiology clinics is education and advice. This may also be combined with some form of sound therapy (e.g. digital hearing aids). While education and advice is generally provided by all clinics, there is a marked variability in provision of hearing aids that depends very much on clinical decisions. A recent Cochrane review concluded a lack of evidence to support or refute hearing aid use as a routine intervention for people with tinnitus and hearing loss. This lack of evidence is reflected in the inconsistency of tinnitus management in the UK. The aim of the HUSH trial is to determine the feasibility of conducting a definitive randomised controlled trial (RCT) of the effectiveness and cost-effectiveness of hearing aids for adults with tinnitus and hearing loss.

Methods

This is a multicentre randomised controlled feasibility trial. Up to 100 adults, aged 18 and over, presenting to 5 UK audiology clinics with a complaint of tinnitus and measurable hearing loss are being randomised to receive either (i) education and advice (treatment as usual) or (ii) education and advice with digital hearing aids. Feasibility outcomes are being collected around recruitment, retention, patient and healthcare professional acceptability and clinical outcome assessment. Outcomes are being collected via postal questionnaire at 12 weeks post baseline. A nested interview study will supplement clinical and other outcome data, providing a detailed understanding of participants’ and audiologists’ experience of both tinnitus management and the research processes.

Discussion

This feasibility trial will help us to (i) determine if it is feasible to conduct a multicentre RCT comparing treatment as usual and treatment as usual plus digital hearing aids; (ii) optimise the design of a future definitive, multicentre RCT; and (iii) inform which outcome(s) is/are relevant for patients. This work presents an important first step in determining the effectiveness of hearing aids as a tinnitus management strategy.

Trial registration

ISRCTN, ISRCTN14218416. Registered on 30 July 2018.
A comparison between barbed suture and conventional suture in total knee arthroplasty: a systematic review and meta-analysis
Authors: Li Erliang , Niu Wenjing , Lu Tingting , Li Xiaolin , Zhang Tong , Cai Jinchi , Wang Wenji
Published: March 2020

Objective

The aim of this systematic review and meta-analysis was to evaluate the efficacy of barbed versus conventional sutures in total knee arthroplasty.

Methods

Two investigators independently performed data extraction and assessed study quality using the keywords “barbed suture, wound suture, total knee arthroplasty” in two search trials, individual trials, and trials from Systematic Reviews or Meta-analyses in PubMed, Cochrane Library, Web of Science, and EMBASE databases.

Result

A total of 11 articles (involving 1546 total knee arthroplasties) were included in this study. Comparison was made between barbed and conventional sutures in terms of various measures. No significant differences were identified in superficial infection and deep infection (p > 0.51; odds ratio 0.84 [95% confidence interval, 0.50, 1.4] andp > 0.28; odds ratio 0.50 [95% confidence interval, 0.14, 1.75], respectively). There was no significant difference in time for capsular suture (p < 0.05; odds ratio − 4.05 [95% confidence interval, − 4.39, − 3.71]). There existed no significant differences in Hospital for Special Surgery Knee Score and Knee Society Score (p > 0.05; odds ratio − 1.20 [95% confidence interval, − 2.98, 0.58] andp > 0.05; odds ratio − 1.62 [95% confidence interval, − 4.06, 0.18], respectively). No significant differences were revealed in suture breakage and needle stick injury (p < 0.05; odds ratio 36.51 [95% confidence interval, 7.06, 188.72] andp < 0.05; odds ratio 0.16 [95% confidence interval, 0.04, 0.72], respectively). No significant difference was exhibited in dehiscence (p = 0.99; odds ratio 0.99 [95% confidence interval, 0.41, 2.38]).

Conclusion

In total knee arthroplasty, both barbed and conventional sutures yielded similar results in terms of superficial and deep infection, Hospital for Special Surgery Knee Score, Knee Society Score, and wound dehiscence. Barbed suture was associated with higher incidence of suture breakage, shorter suture time, and less needle stick injury.
Accuracy of diffusion-weighted magnetic resonance imaging in evaluation of muscle invasion and histologic grading of the urinary bladder carcinoma
Authors: Abd elsalam Sahar Mahmoud , Abdelbary Ahmed Mahmoud
Published: March 2020

Background

Carcinoma of the urinary bladder is a common malignant tumor of the urinary tract in both men and women. Proper management of the urinary bladder cancer depends on the stage of the lesions. The aim of this prospective study was to determine the accuracy of diffusion-weighted images in early detection of muscle invasion, local tumor staging of urinary bladder carcinoma, and to measure the correlation between apparent diffusion coefficient (ADC) and histologic grade. Sixty patients with urinary bladder mass lesions underwent transurethral cystoscopy and biopsy after MR imaging. Radical cystectomy was done for lesions infiltrating muscularis propria. Different MR image sets (T2WIs, DWIs images) were interpreted; ADC values of tumors were calculated.

Results

Kappa agreement was better in DWI than T2WI (Kappa was 0.756 and 0.484) and the overall agreement was (83.6% and 63.6%) among both respectively. Accuracy of DWI in diagnosis of tumor stages were 80%, 43%, 96%, and 100% while in T2WI were 55%, 43%, 74%, and 80% for T1, T2, T3, and T4 stages respectively. ANOVA test showed statistically significant difference between mean ADC values of different tumor grades.

Conclusion

DWI showed higher accuracy than T2WI in detection of the degree of muscle invasion of the urinary bladder carcinoma, so it can be added to the routine protocol of MRI examination especially in patients with renal impairment. ADC value can predict the histological grade of the tumor.
Can PET/CT detect recurrence in post-operative colorectal carcinoma patients with elevated CEA level?
Authors: Ragheb Samar R. , Sharara Sherine M.
Published: March 2020

Background

PET is considered to be the most sensitive and specific modality for the detection of recurrent colorectal cancer. This study is to assess the role of F18-FDG PET/CT in post-operative assessment in a patient with colorectal cancer with elevated CEA level to rule out local recurrence and/or metastasis and hence guiding the clinician to the proper management strategy.

Results

This study was performed on 45 patients who underwent surgical resection of the colon and/or rectal cancer; they were referred for PET/CT assessment at least 3 months after surgical resection. F18-FDG PET/CT sensitivity and specificity in detecting the recurrence and/or metastasis were 96.9 % and 83.3%, respectively. The positive predictive value was 94.2% while the negative predictive value was 90%.

Conclusion

For post-operative detection of loco-regional recurrence and metastasis in patients with colorectal cancer and elevated CEA level, 18F-FDG PET/CT can be considered as an efficient diagnostic imaging tool due to its high sensitivity and specificity which extensively affect further management.