bluuebunny/crossref_metadata_2025 huggingface dataset:
Numerical evaluation of building heating potential from a co-axial closed-loop geothermal system using wellbore–reservoir coupling numerical model
Authors: Xu Tianfu , Hu Zixu , Feng Bo , Feng Guanhong , Li Fengyu , Jiang Zhenjiao
Published: November 2019

Geothermal energy is one of the most potential renewable energy resources. How to efficiently extract and utilize geothermal energy has been a worldwide hot topic. Co-axial closed-loop geothermal system is a novel method using a continuously closed wellbore without water exchange with. It is more suitable for reservoirs with medium or low temperature and permeability because many problems could be avoided such as lack of in situ groundwater or low infectivity of the reservoir. Many companies and research institutes have applied closed-loop geothermal system in building heating engineering and some fine results have been gained. However, in practical engineering construction, the area of a closed-loop geothermal system heating system is a very important parameter. It directly determines the cost accounting and initial design of the project. Accurate and reliable estimation of heating capacity becomes very important. In this study, a wellbore–reservoir coupling model is established, which is calibrated using measured data from a short-term field trial operation. We have carried out mixed convective–conductive fluid-flow modeling using a wellbore flow model for TOUGH2 called T2Well to investigate the heat extraction performance of closed-loop geothermal system. The system evolution and the effect of flow rate and injection temperature on heat production performance are discussed. The result shows that the intermittent production cycles are more beneficial for heat extraction and system maintenance, and the temperature recovery between two heating seasons is enough to maintain system heating. And we can calculate that a geothermal well can ensure heating of buildings of 10,000–20,000 m2 and the heating area of intermittent operation is 4000 m2 more than continuous operation. Besides, the sensitivity analysis of parameters is also carried out.
Tool wear condition monitoring based on wavelet transform and improved extreme learning machine
Authors: Laddada Soufiane , Si-Chaib Med. Ouali , Benkedjouh Tarak , Drai Redouane
Published: November 2019

In machining process, tool wear is an inevitable consequence which progresses rapidly leading to a catastrophic failure of the system and accidents. Moreover, machinery failure has become more costly and has undesirable consequences on the availability and the productivity. Consequently, developing a robust approach for monitoring tool wear condition is needed to get accurate product dimensions with high quality surface and reduced stopping time of machines. Prognostics and health management has become one of the most challenging aspects for monitoring the wear condition of cutting tools. This study focuses on the evaluation of the current health condition of cutting tools and the prediction of its remaining useful life. Indeed, the proposed method consists of the integration of complex continuous wavelet transform (CCWT) and improved extreme learning machine (IELM). In the proposed IELM, the hidden layer output matrix is given by inverting the Moore–Penrose generalized inverse. After the decomposition of the acoustic emission signals using CCWT, the nodes energy of coefficients have been taken as relevant features which are then used as inputs in IELM. The principal idea is that a non-linear regression in a feature space of high dimension is involved by the extreme learning machine to map the input data via a non-linear function for generating the degradation model. Then, the health indicator is obtained through the exploitation of the derived model which is in turn used to estimate the remaining useful life. The method was carried out on data of the real world collected during various cuts of a computer numerical controlled tool.
Deciding on the total number of product architectures
Authors: Askhøj Christoffer , Mortensen Niels Henrik
Published: November 2019

Many industries have to deliver mass customised products rather than mass produced products in today’s markets, and companies often aim to accommodate this by introducing modular product architectures. However, today’s methods do not explicitly support the decision on how many architectures a company’s entire product programme should be based on. Therefore, this article presents a method to help companies decide on the total number of product architectures they require. The method goes through four stages: market segmentation, mapping new generation with an existing architecture strategy, architecture changes and the new architecture strategy. Essentially, the method is a way of modelling and challenging the total number of architectures in a company. The method was tested on a case company and helped it to reduce its number of architectures from 19 to 7 while at the same time introducing new product variants. Cost reductions due to a higher level of commonality were achieved and the new product architectures were prepared for future innovations.
Bareback sex, PrEP, National AIDS Trust v NHS England and the reality of gay sex
Authors: Maine Alexander
Published: November 2019

In this article, I use empirical data regarding the prevalence of bareback sex and the HIV treatment PrEP to argue that the High Court and Court of Appeal of England and Wales in National AIDS Trust v NHS England, have reflected the reality of gay sex. I argue that this case represents a shift in legal approaches to preventative sexual health methods that recognises the reality of gay male sexuality regarding the allocation of funding responsibility for the pre-exposure prophylaxis. I argue that the treatment, which prevents transmission of HIV, is a significant feature of gay and bisexual men’s sexuality and has the potential to transform narratives surrounding personal agency and individual responsibility. This article uses doctrinal, theoretical and empirical analysis, to the conclusion that the case represents a significant step in the recognition of the reality of gay sex.
Bioinspired structures for core sandwich composites produced by fused deposition modelling
Authors: Bru J , Leite M , Ribeiro AR , Reis L , Deus AM , Fátima Vaz M
Published: November 2019

Sandwich panels are widely used in many engineering applications where saving weight while maintaining high strength and stiffness is required. The most common core structure in sandwich panels is the two-dimensional regular hexagonal cell shape, denoted as Honeycomb. In recent times, bioinspired materials and structures have become increasingly attractive to researchers, as they provide adequate functional properties. The goal of the present work is to study two new bioinspired structures aimed at improving the performance of sandwich panel cores. Among all the large amount of structures that nature provides, two novel cores inspired in the structures of enamel and of bamboo were chosen. The compressive and flexural properties of these two innovative cellular structures were assessed and compared with the classic honeycomb. All the arrangements were numerically simulated for different relative densities. The fused deposition modelling technique enables to print selected samples in polylactic acid that were experimentally tested in compression and in bending. Results show that the mechanical properties depend strongly on the core geometry, on the relative density and on the cell thickness distribution. A satisfactory agreement was found between finite element results and experimental data. For the same relative density, the bioinspired natural structures proposed in the present study are potential competitors with the traditional core structures in what concerns strength, stiffness and energy absorption.
When interlocutors die: Time and space of mobility through the biography of a homeless man
Authors: Grassi Paolo
Published: November 2019

This article examines the ‘mobility’ of Mario, a former homeless person who settled in a neighbourhood of public housing in Milan. His mobility can be considered along two space–time dimensions. The first is ‘circular’ and concerns Mario’s daily movements. This space–time dimension can be analysed through a bibliography developed in the field of mobility studies: entangled among limitations and opportunities of movement, it refers to the constraints to which the Milanese indigent people are subject. However, a second dimension can be added. This refers to a ‘longitudinal’ space–time dimension, linked to Mario’s biography, ending with his death. This second dimension, not generally considered by mobility studies focused on homelessness, gives a wider perspective on the former dimension. Mario’s biography also challenges a dominant interpretation of the Italian ethnographic literature on homelessness, i.e. the subcultural approach. Moreover, it allows for a broader reassessment of the (im)mobility of the Milanese urban ‘pariahs’.
Mind the Absent Gap: Gender-Specific Competitive Behavior in Nonprofessional Sports
Authors: Pikos Anna Katharina , Straub Alexander
Published: November 2019

There is wide evidence for gender differences in competitive behavior and performance under pressure from experimental economics and single-sex professional sports. We analyze these differences in a sport with direct gender competition. Our unique data consist of over 500,000 observations from around 11,000 German ninepin bowling games of which around 15% are from mixed-gender leagues. Men perform better against women on average, but this is fully explained by differences in ability. Our results are robust to instrumenting for opposite gender using the sex composition of the opponent team. Gender differences in tight situations do not seem to play a role.
A cuckoo search algorithm: Effects of coevolution and application in the development of distributed layouts
Authors: Shih Yung C
Published: November 2019

This article presents a cuckoo search algorithm, via Lévy flight, considering the effects of coevolution on the displacement dynamics of animal communities, and applies this algorithm to the development of maximally distributed physical arrangements. Some variables are introduced such as egg weight and the acquired learning of host birds. The results show that the proposed algorithm prevails, in the majority of the interviewed instances, in the degree of distribution in comparison with the classic TARGET and ALVO methods, and with the Genetic Algorithm. The proposed algorithm was shown to be able to obtain a low degree of distribution in a satisfactory computational time, especially in large problems.
The Customer Isn’t Always Right: The Implications of Illegitimate Complaints
Authors: Kim Kawon , Baker Melissa A.
Published: November 2019

Due to the common business practice of the “customer is always right,” many companies have a risk of dealing with illegitimate complaints. Although illegitimate complaints are a major issue in the hospitality industry, no study has yet examined the impact of illegitimate customer complaining behavior on customers who can witness the complaining and recovery process of others. To fill this gap, this research examines the effects of service recovery aimed at illegitimate customers on customers who witness the complaints’ behavioral reactions (revisit intention, tipping behavior, intention to complain) and the role of emotional expression. A 2 (Service recovery aimed at other customer; good vs. poor) × 2 (Legitimacy of complaining behavior of other customers: legitimate vs. illegitimate) × 2 (Emotional expression: aggressive vs. calm) scenario-based between-subjects factorial experiment is utilized. This research provides evidence that witnessing illegitimate complaints of other customers and the subsequent service recovery aimed at those complainers impacts the behavioral reactions of customers who witness that situation. This study broadens the service recovery literature by incorporating third-party justice theory with illegitimate customer behavior by specifically examining the unique case where the firm is not responsible for the service recovery. In addition, the findings address the benefit to service firms by understanding the impact of witnessing other customers’ service recovery treatment on observers’ subsequent behavioral intentions.
Adherence and Efficacy of Olfactory Training as a Treatment for Persistent Olfactory Loss
Authors: Fornazieri Marco Aurélio , Garcia Ellen Cristine Duarte , Lopes Natália Medeiros Dias , Miyazawa Isabela Naomi Iha , Silva Gislene dos Santos , Monteiro Rebeca dos Santos , Pinna Fábio de Rezende , Voegels Richard Louis , Doty Richard L.
Published: November 2019

Background

Among emerging therapies, olfactory training (OT) has been proposed as a potential treatment for persistent olfactory loss. This treatment has been suggested to improve olfactory function via sensorineural modulation from repeated odor exposure. However, due to the long treatment period that is required, many patients discontinue the treatment or do not follow the treatment regimen appropriately, potentially biasing estimates of treatment success. Moreover, spontaneous improvement is known to occur without any interventions.

Objectives

We evaluated both the adherence rates and the efficacy of OT in patients with persistent postinfectious, posttraumatic, or idiopathic olfactory loss.

Methods

Prospective observational study. Twenty-five patients with persistent olfactory loss underwent OT. Protocol adherence and olfactory function (scores on the University of Pennsylvania Smell Identification Test or UPSIT) were assessed 3 and 6 months after the initiation of treatment. A minimum improvement of 5 UPSIT points was considered clinically significant and adherence throughout the study.

Results

The adherence rate of the patients after 3 months was 88% and after 6 months was 56%. The corresponding percentages of clinical improvement were 23.5% and 25%. There was no relation of age, sex, time of olfactory loss, race, the degree of olfactory loss, etiology, education, and type of training to the adherence rate or treatment efficacy.

Conclusions

In this patient population, adherence to training remained high in the first 3 months of OT but declined moderately thereafter. The observed prevalence and degree of improvement were similar to that reported a number of studies, including some studies whose patients did not receive OT.
Lower extremity artery disease in patients with type 2 diabetes
Authors: Buso Giacomo , Aboyans Victor , Mazzolai Lucia
Published: November 2019

Among all peripheral arterial diseases, lower extremity arterial disease is a serious condition in subjects with type 2 diabetes mellitus, associated with important disability, cardiovascular risk, and socio-economic burden. Patients with both conditions generally display poorer prognosis of affected limbs compared with non-diabetic subjects, leading to increased rates of adverse limb events including amputations. Nonetheless, awareness on lower extremity arterial disease remains somehow suboptimal in the diabetic population, partly related to an atypical clinical presentation in several cases. A regular and appropriate screening for lower extremity arterial disease in patients suffering from type 2 diabetes mellitus is therefore recommended. Affected subjects should receive optimal medical treatment including careful management of the different cardiovascular risk factors through a healthy lifestyle, a regular and structured physical activity, the administration of lipid-lowering, antidiabetic drugs, and (when indicated) antihypertensive and antithrombotic drugs. This review aims to outline current evidence about lower extremity arterial disease in patients with type 2 diabetes mellitus, in order to elucidate its epidemiology, pathophysiology, screening and diagnosis, and management options.
Heart failure and its complications in patients with diabetes: Mounting evidence for a growing burden
Authors: Ferrini Marc , Johansson Isabelle , Aboyans Victor
Published: November 2019

Heart failure (HF) is one of the major challenges in the management of diabetes patients. Among subjects with diabetes, up to 20% could have HF. Conversely, diabetes prevalence in HF patients varies greatly from more than 10% up to 50%. When it is present, the risk of mortality and rehospitalization increases substantially. In addition, current evidence points to an increased risk of atrial fibrillation and sudden cardiac death in patients with diabetes. The inter-relation between diabetes cardiomyopathy, left ventricular hypertrophy, coronary artery disease and renal dysfunction indicates complex and intricate pathways. Despite the great value of clinical assessment and echocardiography, there is insufficient data to suggest systematic screening for HF in asymptomatic patients with diabetes. There is little evidence to indicate that improved glycaemic control improves HF outcome in this population. In the case of established HF, the general guidelines apply in diabetes patients. However, recent advances concerning glucose-lowering treatment in patients with cardiovascular disease suggest that the choice of glucose-lowering agent is of crucial interest and should be based on the patient’s phenotype. New drug classes, such as SGLT2 inhibitors, seem to be of particular benefit in these patients. In the future, new personalized strategies should aim at not only good control of the glycaemic level but also the reduction and possibly the prevention of HF onset.
Does pre-angiography Total ST-segment resolution reliably predict spontaneous reperfusion of the infarct-related artery in patients with acute myocardial infarction?
Authors: Guo Zongsheng , Yang Xinchun
Published: November 2019

Background

ST resolution (STR) after AMI is a non-invasive indicator of IRA reperfusion. We investigated whether pre-angiography STR predicted spontaneous IRA reperfusion in STEMI patients.

Method

Patients with STEMI undergoing primary PCI were recruited. Standard 12-lead ECG tracings were recorded at first medical contact, immediately prior to arterial puncture and 60 min after PCI. STR was classified as total (≥70%; group I), partial (≥30 and < 70%; group II) or none (< 30%; group III). Patients were followed up for 1-year.

Results

The final analysis included 349 patients (n = 77, 160 and 112 for groups I, II and III, respectively). Compared with groups I/II, pre-procedural TIMI flow in group III was less frequently grades 2 or 3 (P < 0.001). Pre-PCI STR ≥70% was an independent predictor of pre-PCI TIMI-3 flow (OR: 2.8; P < 0.001). Pre-PCI STR < 30% was independently associated with pre-PCI TIMI flow 0–2 (OR: 3.1; P < 0.001). STR = 35.55% seems to be an optimal cut off for pre-procedural TIMI-3 flow prediction with sensitivity 0.943, specificity 0.456, Youden index 0.399, P = 0.027. STR prior to PCI was inversely correlated with 1-year combined CV events rate. STR > 70% may predict a better clinical outcome.

Conclusions

Assessment of STR could potentially be used to stratify risk in patients with STEMI before PCI.
Single-incision laparoscopic ileocecal resection in a 10-year-old child with appendiceal neuroendocrine tumor
Authors: Goto Ayana , Matsuhashi Nobuhisa , Takahashi Takao , Sato Yuta , Hirata Shinya , Tanahashi Toshiyuki , Matsui Satoshi , Imai Hisasi , Tanaka Yoshihiro , Yamaguchi Kazuya , Yoshida Kazuhiro
Published: November 2019

Background

In Japan, the majority of gastrointestinal tract neuroendocrine tumors (NETs) have been reported to originate from the rectum, and appendiceal NETs are relatively rare. Preoperative diagnosis is very difficult and it is diagnosed after appendectomy. Pediatric appendiceal NET is a disease with a good prognosis. However, in rare cases, lymph node metastasis could occur and additional resection is required.

Case presentation

A 10-year-old boy complained of right lower quadrant abdominal pain and underwent an appendectomy under a diagnosis of acute appendicitis in previous hospital. The final diagnosis was appendiceal NET, so he was referred to our department for additional resection. The tumor was found in the base of the appendix and invasively reached the subserosal layer with obvious vascular invasion. His Ki-67 index was 1 to 2%, so we classified it as appendiceal NET G1 according to the WHO 2015 classification. We considered the possibility of a tumor remnant or lymph node metastasis, so we performed single-incision laparoscopy with D3 lymph node dissection. The pathological diagnosis revealed no tumor remnant but metastasis to one lymph node. He was discharged on the 9th postoperative day. There has been no recurrence at 3 years and 7 months after surgery.

Conclusion

When the tumor size is 10–20 mm, the frequency of lymph node metastasis in some reports is variable, and there is no consensus yet on the indications for additional resection. However, there are definitely a certain number of cases with lymph node metastasis that require additional resection. In the present patient, long-term survival can be obtained by additional resection. At present, factors such as the presence of vascular or lymph node invasion and the malignancy grade and tumor’s location must be considered on a case-by-case basis. Although the incidence rate of appendiceal NET is rare, the diagnosis can be made only during postoperative pathological examination; thus, reliable histopathological examination is required.
Development and validation of circulating CA125 prediction models in postmenopausal women
Authors: Sasamoto Naoko , Babic Ana , Rosner Bernard A. , Fortner Renée T. , Vitonis Allison F. , Yamamoto Hidemi , Fichorova Raina N. , Titus Linda J. , Tjønneland Anne , Hansen Louise , Kvaskoff Marina , Fournier Agnès , Mancini Francesca Romana , Boeing Heiner , Trichopoulou Antonia , Peppa Eleni , Karakatsani Anna , Palli Domenico , Grioni Sara , Mattiello Amalia , Tumino Rosario , Fiano Valentina , Onland-Moret N. Charlotte , Weiderpass Elisabete , Gram Inger T. , Quirós J. Ramón , Lujan-Barroso Leila , Sánchez Maria-Jose , Colorado-Yohar Sandra , Barricarte Aurelio , Amiano Pilar , Idahl Annika , Lundin Eva , Sartor Hanna , Khaw Kay-Tee , Key Timothy J. , Muller David , Riboli Elio , Gunter Marc , Dossus Laure , Trabert Britton , Wentzensen Nicolas , Kaaks Rudolf , Cramer Daniel W. , Tworoger Shelley S. , Terry Kathryn L.
Published: November 2019

Background

Cancer Antigen 125 (CA125) is currently the best available ovarian cancer screening biomarker. However, CA125 has been limited by low sensitivity and specificity in part due to normal variation between individuals. Personal characteristics that influence CA125 could be used to improve its performance as screening biomarker.

Methods

We developed and validated linear and dichotomous (≥35 U/mL) circulating CA125 prediction models in postmenopausal women without ovarian cancer who participated in one of five large population-based studies: Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO, n = 26,981), European Prospective Investigation into Cancer and Nutrition (EPIC, n = 861), the Nurses’ Health Studies (NHS/NHSII, n = 81), and the New England Case Control Study (NEC, n = 923). The prediction models were developed using stepwise regression in PLCO and validated in EPIC, NHS/NHSII and NEC.

Result

The linear CA125 prediction model, which included age, race, body mass index (BMI), smoking status and duration, parity, hysterectomy, age at menopause, and duration of hormone therapy (HT), explained 5% of the total variance of CA125. The correlation between measured and predicted CA125 was comparable in PLCO testing dataset (r = 0.18) and external validation datasets (r = 0.14). The dichotomous CA125 prediction model included age, race, BMI, smoking status and duration, hysterectomy, time since menopause, and duration of HT with AUC of 0.64 in PLCO and 0.80 in validation dataset.

Conclusions

The linear prediction model explained a small portion of the total variability of CA125, suggesting the need to identify novel predictors of CA125. The dichotomous prediction model showed moderate discriminatory performance which validated well in independent dataset. Our dichotomous model could be valuable in identifying healthy women who may have elevated CA125 levels, which may contribute to reducing false positive tests using CA125 as screening biomarker.
Pharmacogenomic analysis of patient-derived tumor cells in gynecologic cancers
Authors: Sa Jason K. , Hwang Jae Ryoung , Cho Young-Jae , Ryu Ji-Yoon , Choi Jung-Joo , Jeong Soo Young , Kim Jihye , Kim Myeong Seon , Paik E. Sun , Lee Yoo-Young , Choi Chel Hun , Kim Tae-Joong , Kim Byoung-Gie , Bae Duk-Soo , Lee Yeri , Her Nam-Gu , Shin Yong Jae , Cho Hee Jin , Kim Ja Yeon , Seo Yun Jee , Koo Harim , Oh Jeong-Woo , Lee Taebum , Kim Hyun-Soo , Song Sang Yong , Bae Joon Seol , Park Woong-Yang , Han Hee Dong , Ahn Hyung Jun , Sood Anil K. , Rabadan Raul , Lee Jin-Ku , Nam Do-Hyun , Lee Jeong-Won
Published: November 2019

Background

Gynecologic malignancy is one of the leading causes of mortality in female adults worldwide. Comprehensive genomic analysis has revealed a list of molecular aberrations that are essential to tumorigenesis, progression, and metastasis of gynecologic tumors. However, targeting such alterations has frequently led to treatment failures due to underlying genomic complexity and simultaneous activation of various tumor cell survival pathway molecules. A compilation of molecular characterization of tumors with pharmacological drug response is the next step toward clinical application of patient-tailored treatment regimens.

Results

Toward this goal, we establish a library of 139 gynecologic tumors including epithelial ovarian cancers (EOCs), cervical, endometrial tumors, and uterine sarcomas that are genomically and/or pharmacologically annotated and explore dynamic pharmacogenomic associations against 37 molecularly targeted drugs. We discover lineage-specific drug sensitivities based on subcategorization of gynecologic tumors and identify TP53 mutation as a molecular determinant that elicits therapeutic response to poly (ADP-Ribose) polymerase (PARP) inhibitor. We further identify transcriptome expression of inhibitor of DNA biding 2 (ID2) as a potential predictive biomarker for treatment response to olaparib.

Conclusions

Together, our results demonstrate the potential utility of rapid drug screening combined with genomic profiling for precision treatment of gynecologic cancers.
Alu insertion polymorphisms shared by Papio baboons and Theropithecus gelada reveal an intertwined common ancestry
Authors:   The Baboon Genome Analysis Consortium, Walker Jerilyn A. , Jordan Vallmer E. , Storer Jessica M. , Steely Cody J. , Gonzalez-Quiroga Paulina , Beckstrom Thomas O. , Rewerts Lydia C. , St. Romain Corey P. , Rockwell Catherine E. , Rogers Jeffrey , Jolly Clifford J. , Konkel Miriam K. , Batzer Mark A.
Published: November 2019

Background

Baboons (genusPapio) and geladas (Theropithecus gelada) are now generally recognized as close phylogenetic relatives, though morphologically quite distinct and generally classified in separate genera. Primate specificAluretrotransposons are well-established genomic markers for the study of phylogenetic and population genetic relationships. We previously reported a computational reconstruction ofPapiophylogeny using large-scale whole genome sequence (WGS) analysis ofAluinsertion polymorphisms. Recently, high coverage WGS was generated forTheropithecus gelada.The objective of this study was to apply the high-throughput “poly-Detect” method to computationally determine the number ofAluinsertion polymorphisms shared byT. geladaandPapio, and vice versa, by each individualPapiospecies andT. gelada. Secondly, we performed locus-specific polymerase chain reaction (PCR) assays on a diverse DNA panel to complement the computational data.

Results

We identified 27,700Aluinsertions fromT. geladaWGS that were also present among sixPapiospecies, with nearly half (12,956) remaining unfixed among 12Papioindividuals. Similarly, each of the sixPapiospecies had species-indicativeAluinsertions that were also present inT. gelada. In general,P. kindaeshared more insertion polymorphisms withT. geladathan did any of the other fivePapiospecies. PCR-based genotype data provided additional support for the computational findings.

Conclusions

Our discovery that several thousandAluinsertion polymorphisms are shared byT. geladaandPapiobaboons suggests a much more permeable reproductive barrier between the two genera then previously suspected. Their intertwined evolution likely involves a long history of admixture, gene flow and incomplete lineage sorting.
A comparison of BMP2 delivery by coacervate and gene therapy for promoting human muscle-derived stem cell-mediated articular cartilage repair
Authors: Gao Xueqin , Cheng Haizi , Awada Hassan , Tang Ying , Amra Sarah , Lu Aiping , Sun Xuying , Lv Guijin , Huard Charles , Wang Bing , Bi Xiaohong , Wang Yadong , Huard Johnny
Published: November 2019

Background

Osteoarthritis and cartilage injury treatment is an unmet clinical need. Therefore, development of new approaches to treat these diseases is critically needed. Previous work in our laboratory has shown that murine muscle-derived stem cells (MDSCs) can efficiently repair articular cartilage in an osteochondral and osteoarthritis model. However, the cartilage repair capacity of human muscle-derived stem cells has not been studied which prompt this study.

Method

In this study, we tested the in vitro chondrogenesis ability of six populations of human muscle-derived stem cells (hMDSCs), before and after lenti-BMP2/GFP transduction using pellet culture and evaluated chondrogenic differentiation of via histology and Raman spectroscopy. We further compared the in vivo articular cartilage repair of hMDSCs stimulated with BMP2 delivered through coacervate sustain release technology and lenti-viral gene therapy-mediated gene delivery in a monoiodoacetate (MIA)-induced osteoarthritis (OA) model. We used microCT and histology to evaluate the cartilage repair.

Results

We observed that all hMDSCs were able to undergo chondrogenic differentiation in vitro. As expected, lenti-BMP2/GFP transduction further enhanced the chondrogenic differentiation capacities of hMDSCs, as confirmed by Alcian blue and Col2A1staining as well as Raman spectroscopy analysis. We observed through micro-CT scanning, Col2A1 staining, and histological analyses that delivery of BMP2 with coacervate could achieve a similar articular cartilage repair to that mediated by hMDSC-LBMP2/GFP. We also found that the addition of soluble fms-like tyrosine kinase-1 (sFLT-1) protein further improved the regenerative potential of hMDSCs/BMP2 delivered through the coacervate sustain release technology. Donor cells did not primarily contribute to the repaired articular cartilage since most of the repair cells are host derived as indicated by GFP staining.

Conclusions

We conclude that the delivery of hMDSCs and BMP2 with the coacervate technology can achieve a similar cartilage repair relative to lenti-BMP2/GFP-mediated gene therapy. The use of coacervate technology to deliver BMP2/sFLT1 with hMDSCs for cartilage repair holds promise for possible clinical translation into an effective treatment modality for osteoarthritis and traumatic cartilage injury.
Defining the concept of family caregiver burden in patients with schizophrenia: a systematic review protocol
Authors: Tamizi Zahra , Fallahi-Khoshknab Masoud , Dalvandi Asghar , Mohammadi-Shahboulaghi Farahnaz , Mohammadi Eesa , Bakhshi Enayatollah
Published: November 2019

Background

Since the deinstitutionalization policy, in psychiatric hospitals, the care of patients with schizophrenia was left to their families which has been imposing a heavy burden on them. Family caregiver burden could have consequences for caregivers, patients, and the society. There is very little consensus on the definition and dimensions of the caregiver burden, which leads to a lack of consistency in the results of research. Thus, the present study was aimed to redefine the family caregiver burden of patients with schizophrenia.

Methods

The databases PubMed, Scopus, Web of Science, MEDLINE (Via Ovid), ProQuest, SCI, Magiran, SID, and IranDoc will be searched from 1940 to 2018 using subject headings and appropriate terms in both Farsi and English languages. Also, gray literature and the reference list of included articles will be used to offer an appropriate definition of the family caregiver burden in patients with schizophrenia. Two independent reviewers will participate in study selection, data collection, and quality assessment steps. The result will be presented in tabular form, and meta-synthesis will be performed.

Discussion

The result of this systematic review will help present the comprehensive definition of the family caregiver burden in patients with schizophrenia according to its evolutionary trend.

Systematic review registration

PROSPERO CRD42018099372
Evidence on nutritional therapy practice guidelines and implementation in adult critically ill patients: a scoping review protocol
Authors: Mooi Nomaxabiso M. , Ncama Busisiwe P.
Published: November 2019

Background

Nutritional therapy practice guidelines are designed to improve nutritional practices and thus the delivery of nutritional therapy in critically ill patients. However, they are not implemented despite the strong recommendation of nutritional therapy in the management of critical illness. The aim of this study is to map evidence on nutritional therapy guidelines and their implementation in critically ill adult patients.

Methods

Two independent reviewers will conduct a search of published scholarly and gray literature on the implementation of nutritional therapy guidelines in critically ill adults using Arksey and O’Malley’s scoping review framework. The search of studies will be conducted from databases such as PubMed, Google Scholar and EBSCOhost databases, Cumulative Index for Nursing and Allied Health Literature, MEDLINE, PsychINFO, PsychARTICLES, Health Source: Consumer Edition, Health Source: Nursing/Academic Edition, PreMEDLINE, Joanna Briggs Institute, and Cochrane Databases for Systematic Reviews. We will follow a predetermined criterion to map literature and additional articles will be searched from the reference lists of included studies. The Mixed Method Appraisal Tool (MMAT) will be used for quality assessment of the included studies. Quality assessment of included studies determines the overall quality of the resultant review.

Discussion

We hope to find studies on the implementation of nutritional therapy practice guidelines in adult critically ill patients and its impact on nutritional practices, patient outcomes, and health care costs. The results of this review will be disseminated through presentations in research seminars, conferences, and congresses and will also be available electronically and in print.

Systematic review registration

PROSPERO CRD42017058864
The impact of later eating rhythm on childhood adiposity: protocol for a systematic review
Authors: Zou Mengxuan , Northstone Kate , Perry Rachel , Johnson Laura , Leary Sam
Published: November 2019

Background

Childhood adiposity has increased dramatically in the last few decades and is an important predictor of adulthood chronic disease. Later eating rhythm, termed night eating (NE), is increasingly prevalent in adults; however, the prevalence of NE in children and relationship between NE and adiposity in children still remains uncertain. The aim of this work is to review the association between adiposity in children and adolescents and NE, in terms of calorie intake, timing and meal frequency in the evening/night.

Methods

The Cochrane library, CINAHL, Embase, MEDLINE (via OVID) and Web of Science databases will be searched from inception to November 2019 for randomised controlled trials (RCTs) and observational studies (cohort, cross-sectional and case-control studies) which investigate the association between later vs. earlier timing of food intake at night or relatively more vs. less energy intake in any eating occasions or time period after 4 pm on adiposity in children and adolescents (4–18 years). The outcomes will be body mass index (BMI)/BMI standard deviation score (BMI-SDS or BMIZ-score), waist circumference (WC), fat mass index (FMI)/percentage of body fat (%BF) or waist to hip ratio (WHR). No language restriction will be applied. Screening for eligibility from the title and abstracts and data extraction from the full texts will be carried out by two reviewers independently. References listed in the included studies will be hand-searched for any additional articles. The quality of included RCT studies will be assessed using Revised Cochrane Risk of Bias tool (RoB 2), and of observational studies using Newcastle Ottawa scale. A qualitative synthesis of the results will be presented, and meta-analysis will be conducted, where appropriate.

Discussion

The planned systematic review will investigate the association between later eating rhythm and adiposity in children and adolescents. Understanding the best meal size, timing of energy intake and meal frequency across the evening time for maintaining healthy weight in children is important in order to give parents the best advice to help prevent adulthood obesity and associated chronic diseases in their children.

Systematic review registration

PROSPEROCRD42019134187.
The feasibility of using smartphones and mobile breathalyzers to monitor alcohol consumption among people living with HIV/AIDS
Authors: Lauckner Carolyn , Taylor Erica , Patel Darshti , Whitmire Alexis
Published: November 2019

Background

For people living with HIV/AIDS (PLWHA), alcohol consumption is associated with poor treatment outcomes and medication adherence. This pilot study examined the feasibility of using smartphones and mobile Bluetooth breathalyzers for monitoring alcohol consumption among PLWHA (N = 17).

Methods

For 2 weeks, participants responded to twice-daily text message prompts by completing a breathalyzer reading and a mobile survey about their alcohol use. They also completed baseline questionnaires assessing alcohol consumption and hazardous drinking behaviors.

Results

Participants completed an average of 22 of 28 breathalyzer readings and 17 of 28 mobile surveys, and were more likely to complete daytime (vs. evening) monitoring tasks. Results suggested that self-reported frequency of binge drinking at baseline was related to an increased number of days with alcohol consumption according to breathalyzer and mobile surveys, as well as a higher average blood alcohol content. Qualitative interviews found generally positive attitudes toward the technologies, but some participants reported experiencing technical difficulties.

Conclusions

Overall, this preliminary research suggests that smartphone monitoring of alcohol consumption among PLWHA may reflect cross-sectional self-reported alcohol consumption behaviors, but could use improvements to increase adherence to monitoring tasks.
Hand hygiene compliance and associated factors among health care providers in Central Gondar zone public primary hospitals, Northwest Ethiopia
Authors: Engdaw Garedew Tadege , Gebrehiwot Mulat , Andualem Zewudu
Published: November 2019

Background

Poor hand hygiene compliance is one in all the leading contributory factors to healthcare-associated infections. This is an important source of complications across the continuum of care and poses a serious threat to people admitted to hospitals. However, the magnitude and associated factors of hand hygiene compliance in public primary hospitals were not well investigated in Ethiopia. Therefore, this study was conducted to assess hand hygiene compliance and associated factors among health care providers in Central Gondar Zone public primary hospitals, Northwest Ethiopia.

Methods

An Institutional based cross-sectional study was conducted from March to April 2019 among health care providers. The data were collected using self-administered questionnaires and observational checklists. Using Epi Info 3.1, data was entered and analyzed using SPSS version 23. The data were analyzed using descriptive statistics and logistic regression models. A p-value less than 0.05 with 95% confidence interval was used to declare statistical significance.

Results

Of 335 study participants, 50 (14.9%), had good hand hygiene compliance. Training on hand hygiene (AOR = 8.07, 95%CI: 2.91, 22.39), availability of adequate soap and water for hand hygiene (AOR = 5.10, 95%CI: 1.93, 13.52), availability of alcohol-based hand rub (AOR = 3.23, 95%CI: 1.32, 7.92), knowledge about hand hygiene (AOR = 6.74, 95%CI: 2.96, 15.34) and attitude towards hand hygiene (AOR = 2.15, 95%CI: 1.04, 4.46) were factors associated with hand hygiene compliance.

Conclusion

The overall level of hand hygiene compliance among health care providers was poor. Training, availability of adequate soap and water, availability of alcohol-based hand rub, knowledge on hand hygiene, and attitude of health care providers were significantly associated with hand hygiene compliance.
Association of Female Sexual Dysfunction and Fertility: a cross sectional study
Authors: Oindi Felix Mwembi , Murage Alfred , Lema Valentino Manase , Mukaindo Abraham Mwaniki
Published: November 2019

Background

Sexual function plays an essential role in the bio-psychosocial wellbeing and quality of life of women and disturbances in sexual functioning often result in significant distress. Female sexual dysfunction (FSD) and subfertility are common problems affecting approximately 43 and 20% of women respectively. However, despite the high prevalence of both conditions, little has been studied on the effects of subfertility on sexual functioning especially in sub-Saharan Africa. We set out to compare the prevalence of female sexual dysfunction in patients on assessment for sub-fertility and those either seeking or already on fertility control services at a private tertiary teaching hospital in Kenya.

Methods

This was an analytical cross sectional study. Eligible women of reproductive age (18–49 years), attending the gynaecological clinics with complaints of subfertility and those seeking fertility control services were requested to fill a general demographic tool containing personal data and the Female Sexual Function Index (FSFI) questionnaire after informed consent. Prevalence of sexual dysfunction was calculated as a percentage of patients not achieving an overall FSFI score of 26.55. Univariate and multivariate analysis were done to compare clinical variables to delineate the potential association.

Results

The prevalence of female sexual dysfunction was 31.2% in the subfertile group and 22.6% in fertility control group. The difference was not statistically significant (p = 0.187). The mean domain and overall female sexual function scores were lower in the subfertile group than the fertility control group though this was not statistically significant. The most prevalent sexual domain dysfunctions in both the subfertility and fertility control groups were desire and arousal while the least in both groups was satisfaction dysfunction. Subfertility type was not associated with sexual dysfunction. Higher education attainment was protective of female sexual dysfunction in the subfertile group while use of hormonal contraception was associated with greater sexual impairment in the fertility control group. On logistic regression analysis, higher maternal age and alcohol use appeared to be protective against sexual dysfunction.

Conclusion

The present study demonstrated no association between the fertility status and the prevalence female sexual dysfunction. Subfertility type was not associated with sexual dysfunction. Education level and hormonal contraception use were associated with female sexual dysfunction in the subfertile and fertility control groups respectively while alcohol use and higher maternal age appeared to be protective against sexual dysfunction.
Synergistic effect of reirradiation and PD-1 inhibitors in recurrent high-grade gliomas.
Authors: Iwamoto Fabio Massaiti , Donovan Laura , Schaff Lauren R. , Wang Tony J. C. , Lassman Andrew B.
Published: November 2019

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Background: To date, studies of single agent PD-1 or PDL-1 inhibitors in recurrent high-grade gliomas (HGG) have shown infrequent responses ( < 10%) and limited efficacy. Reirradiation is considered one of the standard salvage regimens for selected patients with recurrent gliomas but tumor responses are also infrequent ( < 5%). Radiotherapy counteracts the immunosuppressive tumor microenvironment by increasing MHC class I expression and enhancing tumor neoantigen presentation and has a significant synergistic effect with PD-1 inhibition in preclinical models of glioma. Methods: From December 2014 to June 2016, 20 patients (14 men, 6 women) with recurrent HGG were treated with the combination of reirradiation and PD-1 inhibitors. 18 patients had a glioblastoma, 1 anaplastic astrocytoma and 1 anaplastic oligodendroglioma. The median KPS at the start of this regimen was 70 (50 to 80). The median number of prior treatments for recurrent tumor was 2 (1-4), 100% had prior radaition, 95% prior temozolomide and 55% prior bevacizumab. 8 patients received pembrolizumab (2 mg/Kg every 3 weeks) and 12 patients received nivolumab (3 mg/Kg or 240 mg flat dose every 2 weeks). Median reirradiation dose was 35 Gy (12 Gy to 35 Gy). Results: There were 7 confirmed partial responses (35% objective response rate, ORR), 5 stable disease and 8 progressive disease. The median duration of response was 5 months (2.2 to 10+ months). Median PFS was 4 months and median OS was 10 months. Most common side effects were increased ALT (3 patients) and fatigue (2 patients). There was no obvious case of cerebral edema related to treatment. 5 patients required a mild increase of dexamethasone (2-4 mg) and all other 15 patients had decreased or stable dexamethasone dosage after the reirradiation. Conclusions: PD-1 inhibitors in combination with re-irradiation can be administered safely to patients with recurrent HGG. The ORR of 35% is an early signal of the potential synergist effect of the combination of PD-1 inhibitors with re-irradiation in HGG. This retrospective analysis of a heavily pre-treated population of recurrent HGG showed significantly higher ORR than either PD-1 inhibitors or re-irradiation alone. A clinical trial under development to test this hypothesis.