bluuebunny/crossref_metadata_2025 huggingface dataset:
Human zoonotic tuberculosis and livestock exposure in low‐ and middle‐income countries: A systematic review identifying challenges in laboratory diagnosis
Authors: Luciano Sarah Anne , Roess Amira
Published: January 2020

Background

Zoonotic tuberculosis (zTB) accounts for 1.4% of the global tuberculosis burden, with the largest disease burden in low‐ and middle‐income countries (LMICs). These populations have increased exposure to zTB due to livestock rearing practices and raw dairy consumption. This qualitative systematic literature review evaluates the quality of the literature that examines the association between human zTB in LMICs and frequent exposure to livestock and livestock products and summarizes current gaps in laboratory detection methods.

Methods

The Navigation Guide, a systematic review framework utilized to assess environmental health exposures, was used to conduct this literature review. Peer‐reviewed research articles were selected and evaluated for risk of bias and quality of evidence. Only studies conducted in LMICs that mentioned livestock or livestock product exposure and had a confirmed diagnosis were eligible.

Results

Fifteen studies met the inclusion criteria. Reported prevalence of human zTB ranged from 0% to 28%, with cattle and raw dairy the primary exposures. All confirmed zTB cases were Mycobacterium bovis. Eight of the 15 studies included livestock sampling, predominantly cattle and reported prevalence of zTB between 0% and 23%. Laboratory methods used included nearly a dozen different culture methods and a variety of molecular methods, some of which are not appropriate for zTB.

Conclusions

This review revealed the need for appropriate and standardized laboratory diagnostic methods, and large prospective studies of at‐risk populations to determine exposures that lead to an increased risk of tuberculosis conversion/infection to better understand the true burden of disease.

Standardized, easy to implement laboratory diagnostics is an imperative focus for this scientific field to better identify the burden of zTB. Future studies pairing livestock and human subjects will allow better characterization of the high zTB transmission areas for targeted control and prevention programmes.
TRESK background K+ channel deletion selectively uncovers enhanced mechanical and cold sensitivity
Authors: Castellanos Aida , Pujol‐Coma Anna , Andres‐Bilbe Alba , Negm Ahmed , Callejo Gerard , Soto David , Noël Jacques , Comes Nuria , Gasull Xavier
Published: January 2020

Key points

TRESK background K+ channel is expressed in sensory neurons and acts as a brake to reduce neuronal activation.

Deletion of the channel enhances the excitability of nociceptors.

Skin nociceptive C‐fibres show an enhanced activation by cold and mechanical stimulation in TRESK knockout animals.

Channel deletion selectively enhances mechanical and cold sensitivity in mice, without altering sensitivity to heat.

These results indicate that the channel regulates the excitability of specific neuronal subpopulations involved in mechanosensitivity and cold‐sensing.

Background potassium‐permeable ion channels play a critical role in tuning the excitability of nociceptors, yet the precise role played by different subsets of channels is not fully understood. Decreases in TRESK (TWIK‐related spinal cord K+ channel) expression/function enhance excitability of sensory neurons, but its role in somatosensory perception and nociception is poorly understood. Here, we used a TRESK knockout (KO) mouse to address these questions. We show that TRESK regulates the sensitivity of sensory neurons in a modality‐specific manner, contributing to mechanical and cold sensitivity but without any effect on heat sensitivity. Nociceptive neurons isolated from TRESK KO mice show a decreased threshold for activation and skin nociceptive C‐fibres show an enhanced activation by cold and mechanical stimulation that was also observed in behavioural tests in vivo. TRESK is also involved in osmotic pain and in early phases of formalin‐induced inflammatory pain, but not in the development of mechanical and heat hyperalgesia during chronic pain. In contrast, mice lacking TRESK present cold allodynia that is not further enhanced by oxaliplatin. In summary, genetic removal of TRESK uncovers enhanced mechanical and cold sensitivity, indicating that the channel regulates the excitability of specific neuronal subpopulations involved in mechanosensitivity and cold‐sensing, acting as a brake to prevent activation by innocuous stimuli.
Elemental access to limit cycle existence in Biomath education.
Authors: Van der Hoff Quay , Harding Ansie
Published: January 2020

This paper originated from the desire to develop elementary calculus based tools to empower students, not necessarily with a strong mathematical background, to test predator-prey related models for boundedness of solutions and for the existence of limit cycles. There are several well-known methods available to prove, or disprove, the existence of bounded solutions to systems of differential equations. These methods rely on LiГ©nard's theorem or using Dulac or Lyaponov functions. The level of mathematics required in the study of differential equations is not addressed in the courses presented on the first year level, and students in biology, ecology, economics and other fields are often not suitably equipped to perform these advanced techniques.The conditions under which a unique limit cycle exists in predator-prey systems is considered a primary problem in mathematical ecology. A great deal of mathematical effort has gone into trying to establish simple, yet general, theorems which will allow one to decide whether a given set of nonlinear equations has a limit cycle or not. We introduce a method to first determine the boundedness of solution trajectories in such a way that the transformation to a LiГ©nard system or the use of a Dulac function can be avoided. Once boundedness of trajectories has been established, the nature of the equilibrium points reduces to simple eigenvalue analysis. The Elemental Limit Cycle method (ELC) provides elementary criteria to evaluate the nature of the pivotal functions of a system which will indicate boundedness and may be applicable to more general models.
Biodiesel Spray Characteristics and Their Effect on Engine Combustion and Particulate Emissions
Authors: Singh Akhilendra Pratap , Agarwal Avinash Kumar
Published: January 2020

Spray analysis is used to characterize the fuel spray evolution and spray shape, which affects in-cylinder combustion and particulate emission characteristics of compression ignition (CI) engines. In this study, spray evolution of biodiesel blends and mineral diesel was captured using a high-speed charge coupled device (CCD) camera at different fuel injection pressures (FIPs) and ambient pressures (APs) in a constant volume spray chamber (CVSC). Results showed that spray parameters were significantly affected by FIP and AP. Higher FIPs resulted in longer fuel spray penetration length (Ls) and reduced spray cone angle (As). However, AP variation showed an exactly opposite trend of Ls and As. Increasing AP resulted in shorter Ls and increased As. Fuel properties also affected the spray characteristics, which slightly improved for lower biodiesel blends (B20: 20% v/v blend of biodiesel with mineral diesel) and then degraded for higher biodiesel blends (B40: 40% v/v blend of biodiesel with mineral diesel) with respect to baseline mineral diesel. The effects of these findings of fuel spray analysis were validated using engine experiments, which were performed in a single-cylinder research engine using identical test fuels and fuel injection parameters. Relatively superior combustion of B20-fueled engine and lower particulate emissions at higher FIPs showed good agreement with spray results.
Vehicle Shimmy Modeling With Pacejka's Magic Formula and the Delayed Tire Model
Authors: Mi Tian , Stepan Gabor , Takacs Denes , Chen Nan
Published: January 2020

This paper investigates a three-degrees-of-freedom (DoF) shimmy model of vehicle front wheels with steering system and dependent suspension. The contact models of rigid ground and elastic tire are analyzed from the viewpoint of predicting shimmy. Pacejka's magic formula and the delayed tire model are compared by means of stability charts in various parameter domains. Conclusions are obtained regarding the advantages and disadvantages of the use of the delayed tire model.
Butyrophilin 2A1 is essential for phosphoantigen reactivity by γδ T cells
Authors: Rigau Marc , Ostrouska Simone , Fulford Thomas S. , Johnson Darryl N. , Woods Katherine , Ruan Zheng , McWilliam Hamish E.G. , Hudson Christopher , Tutuka Candani , Wheatley Adam K. , Kent Stephen J. , Villadangos Jose A. , Pal Bhupinder , Kurts Christian , Simmonds Jason , Pelzing Matthias , Nash Andrew D. , Hammet Andrew , Verhagen Anne M. , Vairo Gino , Maraskovsky Eugene , Panousis Con , Gherardin Nicholas A. , Cebon Jonathan , Godfrey Dale I. , Behren Andreas , Uldrich Adam P.
Published: January 2020

A weird way to recognize phosphoantigens

In contrast to the well-studied αβ T cells, which recognize peptide antigens presented by major histocompatibility complex (MHC) and MHC-like molecules, how γδ T cells recognize antigens remains largely a mystery. One major class of γδ T cells, designated Vγ9Vδ2
+
, is activated by small, phosphorylated nonpeptide antigens, or phosphoantigens, produced by microbes and cancer cells. Rigau
et al.
found that these cells needed the combination of two immunoglobulin superfamily members, butyrophilin 2A1 (BTN2A1) and BTN3A1, on their cell surface to recognize these phosphoantigens. BTN2A1 directly binds the Vγ9
+
domain of the T cell receptor (TCR), whereas a second ligand, potentially BTN3A1, binds the Vδ2 and γ-chain regions on the opposite side of the TCR. A better understanding of this unexpected form of T cell antigen recognition should inform and enhance future γδ T cell–mediated immunotherapies.

Science
, this issue p.
eaay5516
Ultrahigh thermal conductivity in isotope-enriched cubic boron nitride
Authors: Chen Ke , Song Bai , Ravichandran Navaneetha K. , Zheng Qiye , Chen Xi , Lee Hwijong , Sun Haoran , Li Sheng , Udalamatta Gamage Geethal Amila Gamage , Tian Fei , Ding Zhiwei , Song Qichen , Rai Akash , Wu Hanlin , Koirala Pawan , Schmidt Aaron J. , Watanabe Kenji , Lv Bing , Ren Zhifeng , Shi Li , Cahill David G. , Taniguchi Takashi , Broido David , Chen Gang
Published: January 2020

A cool way to use isotopes

Thermal management of electronics requires materials that can efficiently remove heat. Several promising materials have been found recently, but diamond remains the bulk material with the highest thermal conductivity. Chen
et al.
found that isotopically pure cubic boron nitride has an ultrahigh thermal conductivity, 75% that of diamond. Using only boron-11 or boron-10 allows the crystal vibrations that carry heat to move more efficiently through the material. This property could be exploited for better regulating the temperature of high-power devices.

Science
, this issue p.
555
Geographic Patterns of Bacterioplankton among Lakes of the Middle and Lower Reaches of the Yangtze River Basin, China
Authors: Bai Chengrong , Cai Jian , Zhou Lei , Jiang Xingyu , Hu Yang , Dai Jiangyu , Shao Keqiang , Tang Xiangming , Yang Xiangdong , Gao Guang
Published: January 2020

The middle and lower Yangtze Plain is a typical floodplain in which many lakes connect with each other, especially in the wet season. More importantly, with the frequent change of regional water level in the wet season, there is a mutual hydrodynamic exchange among these lakes. The microbial biogeography among these interconnected lakes is still poorly understood. This study aims to unravel the mechanisms underlying the assembly process of abundant and rare bacteria among the interconnected lakes in the middle and lower Yangtze Plain. Our findings will provide a deeper understanding of the biogeographic patterns of rare and abundant bacterial taxa and their determined processes among interconnected aquatic habitats.
Pigmentiphaga
sp. Strain D-2 Uses a Novel Amidase To Initiate the Catabolism of the Neonicotinoid Insecticide Acetamiprid
Authors: Yang Hongxing , Hu Shunli , Wang Xiang , Chuang Shaochuang , Jia Weibin , Jiang Jiandong
Published: January 2020

Acetamiprid, among the top neonicotinoid insecticides used worldwide, is one of the most important commercial insecticides. Due to its extensive use, the environmental fate of acetamiprid, especially its microbial degradation, has caused considerable concern. Although the catabolic pathways of acetamiprid in microorganisms have been extensively studied, the molecular mechanisms underlying acetamiprid biodegradation (except for a nitrile hydratase) remain largely unknown, and the enzyme responsible for the biotransformation of acetamiprid into its main intermediate, IM 1-4, have not yet been elucidated. The amidase AceAB and its encoding genes,
aceA
and
aceB
, characterized in this study, were found to be necessary and specific for the initial hydrolysis of the C-N bond of acetamiprid to generate IM 1-4 in
Pigmentiphaga
sp. strain D-2. The finding of the novel amidase AceAB will greatly enhance our understanding of the microbial catabolism of the widely used insecticide acetamiprid at the molecular level.
Microbial Community Distribution and Core Microbiome in Successive Wound Grades of Individuals with Diabetic Foot Ulcers
Authors: Jnana Apoorva , Muthuraman Vigneshwaran , Varghese Vinay Koshy , Chakrabarty Sanjiban , Murali Thokur Sreepathy , Ramachandra Lingadakai , Shenoy Kallya Rajgopal , Rodrigues Gabriel Sunil , Prasad Seetharam Shiva , Dendukuri Dhananjaya , Morschhauser Andreas , Nestler Joerg , Peter Harald , Bier Frank F. , Satyamoorthy Kapaettu
Published: January 2020

Chronic nonhealing diabetic foot ulcers (DFUs) are a serious complication of diabetes and are further exacerbated by bacterial colonization. The microbial burden in the wound of each individual displays diverse morphological and physiological characteristics with unique patterns of host-pathogen interactions, antibiotic resistance, and virulence. Treatment involves empirical decisions until definitive results on the causative wound pathogens and their antibiotic susceptibility profiles are available. Hence, there is a need for rapid and accurate detection of these polymicrobial communities for effective wound management. Deciphering microbial communities will aid clinicians to tailor their treatment specifically to the microbes prevalent in the DFU at the time of assessment. This may reduce DFUs associated morbidity and mortality while impeding the rise of multidrug-resistant microbes.
Reconstruction of the “Archaeal” Mevalonate Pathway from the Methanogenic Archaeon Methanosarcina mazei in Escherichia coli Cells
Authors: Yoshida Ryo , Yoshimura Tohru , Hemmi Hisashi
Published: January 2020

Two enzymes that have recently been identified from the hyperthermophilic archaeon
A. pernix
as components of the archaeal mevalonate pathway do not require ATP for their reactions. This pathway, therefore, might consume less energy than other mevalonate pathways to produce precursors for isoprenoids. Thus, the pathway might be applicable to metabolic engineering and production of valuable isoprenoids that have application as pharmaceuticals. The archaeal mevalonate pathway was successfully reconstructed in
E. coli
cells by introducing several genes from the methanogenic or hyperthermophilic archaeon, which demonstrated that the pathway requires the same components even in distantly related archaeal species and can function in bacterial cells.
Inhibition of Vif-Mediated Degradation of APOBEC3G through Competitive Binding of Core-Binding Factor Beta
Authors: Miyagi Eri , Welbourn Sarah , Sukegawa Sayaka , Fabryova Helena , Kao Sandra , Strebel Klaus
Published: January 2020

Of all the accessory proteins encoded by HIV-1 and other primate lentiviruses, Vif has arguably the strongest potential as a target for antiviral therapy. This conclusion is based on the observation that replication of HIV-1
in vivo
is critically dependent on Vif. Thus, inhibiting the function of Vif via small-molecule inhibitors or other approaches has significant therapeutic potential. We previously identified dominant-negative (D/N) Vif variants whose expression interferes with the function of virus-encoded wild-type Vif. We now show that D/N interference involves competitive binding of D/N Vif variants to the transcriptional cofactor core binding factor beta (CBFβ), which is expressed in cells in limiting quantities. Overexpression of CBFβ neutralized the D/N phenotype of Vif. In contrast, overexpression of Runx1, a cellular binding partner of CBFβ, phenocopied the D/N Vif phenotype by sequestering endogenous CBFβ. Thus, our results provide proof of principle that D/N Vif variants could have therapeutic potential.
Desquamative interstitial pneumonia in a non-smoker with neurofibromatosis type 1 (Von Recklinghausen syndrome)
Authors: Ferrer Gustavo , Saleh Alwiya Omar , Tazelaar Henry D , Arrossi Andrea V
Published: January 2020

Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with multiple systemic manifestations. Pulmonary involvement has been reported in the form of interstitial fibrosis, emphysema, pulmonary hypertension and thoracic neoplasm. We report a case of desquamative interstitial pneumonia in a non-smoker with NF1.
Primary clear cell sarcoma in the lung apex with spinal metastasis: a fatal outcome
Authors: Sass RemyGrace , Tandra Pavan Kumar , Shonka Nicole , Manzer Melissa
Published: January 2020

Clear cell sarcoma (CCS) is a rare tumour that manifests in tendons and aponeuroses of the distal extremities and comprises roughly 1% of all soft tissue cancers. Only two cases of a primary CCS arising in the lung have been reported in the literature, and neither were located in the lung apex. We report a case of a primary CCS located in the lung apex that originally presented as ptosis, as well as arm pain and weakness. Distant metastasis was discovered on diagnosis, which led to irreversible paraplegia and death of the patient.
Diabetic amyotrophy, not your typical back pain
Authors: Na Jonathan Seung Doe , Dittmar Philip C
Published: January 2020

A 49-year-old man presented to the hospital for spinal cord decompression surgery with left buttock and left leg pain. The patient described an acute burning pain radiating down from his left buttock to left lateral leg. He also noted a 13.6 kg weight loss in recent months. Physical examination showed decreased muscle bulk of the left thigh, decreased strength of the left hip, left knee flexors and extensors. Recent MRI spine showed mild canal narrowing and cord flattening in the lower thoracic spine. Serologic testing showed an elevated glucose of 17.9 mmol/L and haemoglobin A1c of 9.8%. Electromyography showed denervation of scattered muscles of the left knee flexors, hip flexors and adductors. In the setting of newly diagnosed diabetes mellitus, he was diagnosed with diabetic amyotrophy, started on insulin therapy, and his surgery was cancelled.
Yolk sac tumour of ovary with fever and overt hypothyroidism: rare clinical presentation
Authors: Kansara Megha , Yadav Garima , Gothwal Meenakshi , Singh Pratibha
Published: January 2020

Yolk sac tumours of the ovary are rare and highly malignant germ cell tumours, which comprise of only 10%–15% of all malignant germ cell tumours. They have various clinical presentations most common being subacute pelvic pain and feeling of lump but sometimes high-grade fever can be one of the rare presentations. Here, we present a case report of a 26-year-old nulliparous woman with 36 weeks gravid uterus size advanced stage yolk sac tumour of one ovary with fever as main clinical presentation and overt hypothyroidism. We did staging laparotomy with total abdominal hysterectomy with bilateral salpingo-oophorectomy and omentectomy with multiple peritoneal biopsies. Postoperatively, we had started adjuvant chemotherapy. Since yolk sac tumours are highly aggressive tumours as they rapidly increase in size, their early diagnosis and appropriate surgical management is required particularly in young women where fertility sparing surgery is possible in early stage with good prognosis.
Use of 3D modelling and 3D printing for the diagnostic process, decision making and preoperative planning of periprosthetic acetabular fractures
Authors: Marongiu Giuseppe , Prost Roberto , Capone Antonio
Published: January 2020

Periprosthetic acetabular fractures represent an uncommon but challenging complication of total hip arthroplasty (THA), mostly related to low-energy trauma and pathological conditions that reduce bone quality. Therefore, particularly in elderly patients, these fractures are associated with periprosthetic osteolysis and bone loss. CT scan is considered the gold standard to define the fracture pattern; however, the presence of the prosthetic implants in situ limits the full view of the articular surface and bone loss. A three-dimensional (3D) modelling software allows precise tridimensional reconstructions of the bony surface, virtually removing the metallic implants trough DICOM image segmentation. We highlight the case of a periprosthetic acetabular fracture around THA which occurred to a 75-year-old woman, in which a 3D modelling software was used to improve the assessment of fracture morphology and bone quality. Moreover, the 3D images were printed in a real-life size model and were used for preoperative implant templating, sizing and surgical simulation.
ASCVD risk stratification modifies the effect of HbA1c on cardiovascular events among patients with type 2 diabetes mellitus with basic to moderate risk
Authors: Zhang Hongmei , Qin Li , Sheng Chang-Sheng , Niu Yixin , Gu Hongxia , Lu Shuai , Yang Zhen , Tian Jingyan , Su Qing
Published: January 2020

Objective

To investigate the association between hemoglobin A1c (HbA1c) 7.0%–8.0% and cardiovascular disease (CVD) risk among Chinese patients with type 2 diabetes mellitus (T2DM) with different baseline 10-year atherosclerotic CVD (ASCVD) risk stratification.

Research design and methods

A prospective population-based cohort of 10 060 adults aged 40–70 years in Chongming District of Shanghai was established in 2011. These participants were followed up for 3.25 years and CVD information was recorded. We investigated this association between HbA1c categories and incident CVD stratified by the 10-year ASCVD risk using multiple Cox regression analysis among 1880 patients with T2DM without CVD history. CVD events were defined as cardiovascular death, non-fatal myocardial infarction or non-fatal stroke.

Results

The corresponding incidence of CVD per 1000 person-years for the HbA1c≤6.5%, 6.6%–6.9%, 7.0%–8.0% and >8.0% groups were 12.5, 21.8, 22.9 and 28.9, respectively. The HbA1c>8.0% group was significantly associated with a higher CVD risk in patients with T2DM. The HbA1c 7.0%–8.0% group was significantly associated with a higher CVD risk in patients with T2DM with moderate baseline ASCVD risk (HR 2.48; 95% CI 1.15 to 5.32).

Conclusion

HbA1c of 7.0%–8.0% may result in a significantly higher CVD risk among patients with T2DM with moderate baseline ASCVD risk, which support the use of HbA1c combined with baseline ASCVD risk assessment to determine future glucose-lowering treatment decisions among patients with T2DM with basic to moderate risk.
Trust, culture and communication: determinants of eye health and care among Indigenous people with diabetes in Australia
Authors: Yashadhana Aryati , Fields Ted , Blitner Godfrey , Stanley Ruby , Zwi Anthony B
Published: January 2020

Introduction

Our study aimed to identify factors that influence access to eye care and eye health outcomes for remote Indigenous Australians living with diabetes.

Methods

In collaboration with Indigenous Community-Based Researchers (CBR) and Aboriginal Community Controlled Health Services (ACCHS), a qualitative, participatory action research approach was taken, drawing on Indigenist and decolonising methodologies. The study was undertaken in four remote communities, in the Katherine region, Northern Territory and north-western New South Wales, Australia. Interviews and focus groups were undertaken with Indigenous adults aged ≥40 years living with diabetes (n=110), and primary care clinicians working in ACCHSs (n=37). A series of interviews with CBRs (n=13) were undertaken before and after data collection to add cultural insights and validation to participant accounts. Data were analysed inductively using grounded theory, in-depth discussion and NVivo V.11.

Results

More than one-third of all patients had little to no knowledge of how diabetes affects eye health. Limited access to health information and interpreters, language barriers, distrust of health providers and services, and limited cultural responsivity among non-Indigenous clinicians, were identified as determining factors in eye health and care.

Discussion

We outline a need to address gaps in trust and communication, through increased access to and resourcing of Indigenous language interpreters and cultural brokers, understandable and culturally sensitive diabetic eye health information and cultural responsivity training for non-Indigenous clinicians. Centring Indigenous cultures in healthcare practice will enable a shared understanding between clinicians and Indigenous patients, and subsequently more equitable eye health outcomes.
Short-term exposure to pollen and the risk of allergic and asthmatic manifestations: a systematic review and meta-analysis
Authors: Kitinoja Milja A , Hugg Timo T , Siddika Nazeeba , Rodriguez Yanez Daniel , Jaakkola Maritta S , Jaakkola Jouni J K
Published: January 2020

Background

Several studies have assessed effects of short-term exposure to pollen on allergic and asthmatic manifestations. The evidence is inconclusive, and no meta-analysis has been published.

Objective

To synthesise the evidence on the relations between short-term pollen exposure and the risk of allergic and asthmatic manifestations.

Methods

We performed a systematic literature search of PubMed and Scopus databases up to the end of August 2018. In addition, we reviewed the reference lists of relevant articles. Two authors independently evaluated the eligible articles and extracted relevant information in a structured form. We calculated summary effect estimates (EE) based on the study-specific ORs and regression coefficients (β) by applying both fixed-effects and random-effects models.

Results

26 studies met the a priori eligibility criteria, and 12 of them provided sufficient information for the meta-analysis. The summary EE related to 10 grains per m³ increase in pollen exposure showed an 1% increase (EE 1.01, 95% CI 1.00 to 1.02) in the risk of lower respiratory symptoms and a 2% increase (EE 1.02, 95% CI 1.01 to 1.03) in the risk of any allergic or asthmatic symptom. Correspondingly, the risk of upper respiratory symptoms and ocular symptoms increased 7% (EE 1.07, 95% CI 1.04 to 1.09) and 11% (EE 1.11, 95% CI 1.05 to 1.17), respectively, in relation to such pollen exposure. Short-term exposure to pollen did not show any significant effect on daily lung function levels.

Conclusion

Our results provide new evidence that short-term pollen exposure significantly increases the risks of allergic and asthmatic symptoms.
Worldwide prevalence of obesity among firefighters: a systematic review protocol
Authors: Soares Edgard Melo Keene Von Koenig , Smith Denise , Grossi Porto Luiz Guilherme
Published: January 2020

Introduction

Obesity may interfere with job performance and increase the risk of injury during firefighting activity. Obesity also has many deleterious effects on health indices and is associated with higher all-cause mortality. Studies report a high prevalence of obesity in the fire service. Also, firefighters’ work schedule (12-hour to 24-hour shifts) and food availability during night shifts may be related to weight gain. Studies in American firefighters have shown annual weight gain between 0.5 and 1.5 kg. This study aims to report the obesity prevalence in the fire service to describe how it varies based on country and region, job status, type of firefighter and gender.

Methods and analysis

The main outcome evaluated will be obesity prevalence. We will systematically search the literature databases PubMed, Medline, Web of Science, Sportdiscus, Academic Search Premier, Cumulative Index of Nursing and Allied Health Literature (CINAHL), SciTech Premium Collection, Sports Medicine & Education Index, Research Library and Scopus. One reviewer will perform the search. Two independent reviewers will select studies, extract data from eligible studies and evaluate their methodological and reporting quality. Agreement between reviewers will be measured using Cohen’s kappa. Other data of interest will include age, body mass index, body fat percentage, job status (career, volunteer or military), years of service and type of firefighter (eg, structural and wildland firefighter). We will produce a narrative summary of our findings. Tables will be generated to summarise data.

Ethics and dissemination

This systematic review does not require ethics clearance since published studies with non-identifiable data will be used. The results of the systematic review will be disseminated via publication in a peer-reviewed journal and through conference presentations.

PROSPERO registration number

CRD42019129122.
A town level comprehensive intervention study to reduce salt intake in China: protocol for a cluster randomised controlled trial
Authors: Xu Jianwei , Tang Biwei , Liu Min , Bai Yamin , Yan Wei , Zhou Xue , Xu Zhihua , He Jun , Jin Donghui , Sun Jixin , Li Yuan , He Feng J , MacGregor Graham A , Wu Jing , Zhang Puhong
Published: January 2020

Introduction

Salt intake in China (≈12 g/day) is more than twice the upper limit recommended by the WHO (5 g/day). To reduce salt intake, Action on Salt China (ASC) was launched in 2017. As one of four randomised controlled trials (RCTs) in the ASC programme, a comprehensive intervention study was designed to test whether all the components of the interventions adopted by other RCTs are acceptable, scalable and effective when provided to a region in the real world.

Methods and analysis

Using a cluster RCT design, 2688 participants were selected from 48 towns (clusters) in 12 counties in 6 provinces and assigned to the intervention group or the control group. Randomisation was performed after the baseline survey was completed. Information on salt-related knowledge, attitude and practice (KAP), blood pressure and 24-hour urinary sodium were collected. The intervention includes government engagement, health education and other intervention components targeting restaurants, home cooks and primary school students and their families that have been used in other RCTs. The control group will not receive the intervention. The project will be followed up for 2 years, with the intervention being carried out for the first year only. The primary outcome is salt intake measured by 24-hour urinary sodium excretion after 1 year. The secondary outcomes are the long-lasting effectiveness on salt intake and blood pressure measured by the same method, as well as salt-related KAP and blood pressure at the 1-year and 2-year follow-ups. Process evaluation and health economics analysis will be conducted as well.

Ethics and dissemination

The study was reviewed and approved by the Institutional Review Board of the National Center for Chronic and Noncommunicable Disease Control and Prevention, the Chinese Center for Disease Control and Prevention, and Queen Mary Research Ethics Committee. Results will be disseminated through presentations, publications and social media.

Trial registration number

ChiCTR1800018119
Evaluation of community pharmacists’ readiness to implement the Falsified Medicines Directive (Directive 2011/62/EC): an English cross-sectional survey with geospatial analysis
Authors: Barrett Ravina
Published: January 2020

Objectives

To evaluate the readiness to implement the Falsified Medicines Directive (FMD) by community pharmacies in England. Eight secondary objectives were assessed.

Setting

Community/retail pharmacies.

Participants

We invited pharmacists from 501 pharmacies to complete a survey. Non-contractors, non-pharmacists or pharmacists practising abroad were excluded. We randomly selected addresses, ensuring that they were nationally representative.

Interventions

We mailed the survey in October 2018 with a single follow-up in January 2019. Respondents were invited to provide self-reported answers. A prepaid self-addressed envelope was provided. We received favourable ethical approval.

Results

102 responses (20.44% response rate) were received. Readiness to implement was poor: 4 (3.9%) said very much, while 40 (39.2%) said not at all and 29 (28.4%) said not really. Increased workload and reduced profitability were anticipated, accompanied with improved patient safety. Prevalence of ‘substandard and falsified (SF) medical products’ was estimated at 1%–5%, with erectile dysfunction at greatest risk of falsification. Different packaging would raise suspicions. Five (4.9%) had identified SFs (p<0.001 one-sample binomial test). Of these, three (2.9%) informed the medicines agency. None had been involved in any public health campaigns. Confidence and self-efficacy was low. Strategies to reduce SFs reaching the public are described. Pharmacist’s role in combating SFs was elucidated. SFs were identified in deprived areas 4 (9%) more often than in affluent areas 1 (2%).

Conclusions

Many pharmacies are not ready to implement FMD, potentially not capturing anticipated benefits of the directive, with greatest risk of harm in deprived area. We further validated a confidence scale. Limited public health campaigns may result in a lack of awareness among pharmacy professionals and patients. Limited awareness of technologies to identify falsified medicines exist, though further training is welcome. A worrying trend of under-reporting maybe prevalent. A larger sample study using this survey would be valuable.
Epidemiology of at-risk alcohol use and associated comorbidities of interest among community-dwelling older adults: a protocol for a systematic review
Authors: Latanioti Maria , Schuster Jean-Pierre , Rosselet Amoussou Joelle , Strippoli Marie-Pierre F. , von Gunten Armin , Ebbing Karsten , Verloo Henk
Published: January 2020

Introduction

There is little epidemiological evidence and knowledge about at-risk alcohol use among community-dwelling older adults and their chronic and acute alcohol-related comorbidities of interest. This systematic review will summarise and examine relevant studies about the epidemiology of at-risk alcohol use and associated comorbidities of interest in this population.

Methods

We will search the following databases, without language or date restrictions, from inception to 31 August 2019: Embase.com, Medline Ovid SP, Pubmed (NOT medline[sb]), CINAHL EBSCO, PsycINFO Ovid SP, Central—Cochrane Library Wiley and Web of Science (Core Collection). Search strategies will be developed in collaboration with a librarian. We will use predefined search terms for alcoholism, epidemiology, the elderly, living place and comorbidities of interest, as well as terms related to the identification of “measurements”, “tools” or “instruments” for measuring harm from alcohol use. At-risk status will be determined by the amount of alcohol consumed and any comorbidities of interest associated with at-risk alcohol use, with the latter being documented separately or using an assessment tool for at-risk drinking. We will also examine the bibliographies of all the relevant articles found and search for unpublished studies. We will consider publications in all languages.

Ethics and dissemination

No ethical approval is necessary. Results will be presented in national and international conferences on addiction and published in a peer-reviewed journal.

PROSPERO registration number

CRD42018099965.
Improving the effectiveness and efficiency of a skin dose investigation protocol in interventional radiology
Authors: Harries Debbie , Platten David J
Published: January 2020

Cardiac catheterisation is an invasive procedure carried out under fluoroscopic guidance, which exposes the patient’s skin to X-ray radiation. In some cases, the skin receives a radiation dose, which is sufficiently high to cause a radiation injury. To ensure the timely identification of patients at risk of such an injury, a skin dose investigation protocol was implemented within the United Lincolnshire Hospitals Trust. However, two shortcomings with the new protocol were identified: first, it was possible for a patient to receive a clinically significant skin dose without the protocol being triggered; second, the investigation protocol increased staff workload. The Radiation Protection Department undertook to resolve these issues by making use of two software packages (openSkin and OpenREM) to automate key processes in the skin dose investigation protocol. The automation was introduced over three distinct Plan-Do-Study-Act cycles. The introduction of openSkin and OpenREM eliminated the possibility of a high skin dose procedure failing to trigger an investigation. The time spent by staff on skin dose investigations was reduced by an estimated 94%.
Sleep disturbance in patients with cancer: a feasibility study of multimodal therapy
Authors: Yennurajalingam Sriram , Carmack Cindy , Balachandran Dave , Eng Cathy , Lim Bora , Delgado Marvin , Guzman Gutierrez Diana , Raznahan Monica , Park Minjeong , Hess Kenneth R , Williams Janet L , Lu Zhanni , Ochoa Jewel , Bruera Eduardo
Published: January 2020

Background

Our aim was to determine feasibility and effect sizes of bright light therapy (BLT), melatonin (MLT), methylphenidate (MP) and eight combinations (BLT+MLT+MP, BLT+MLT, BLT+MP, BLT alone, MLT+MP, MLT alone, MP alone, placebo for BLT, MLT and MP) defined as multimodal therapy (MMT), to improve sleep quality (SQ) (Pittsburgh Sleep Quality Index (PSQI)) from baseline to day 15. We also examined the effects of MMT on insomnia, fatigue, depression, quality of life and actigraphy.

Methods

Patients with advanced cancer with poor SQ (PSQI ≥5) were eligible. Using a double-blind randomised factorial study design, patients were randomised into 1 of the 8 arms for 2 weeks. Feasibility and effect sizes were assessed.

Results

81% (54/67) of randomised patients completed the study. There were no differences in the demographics and SQ between groups. The adherence rates for BLT, MLT and MP were 93%, 100% and 100%, respectively. BLT+MLT+placebo of MP; BLT+placebo of MLT+placebo of MP; BLT+MLT+MP showed an effect size (Cohen’s d) for change in PSQI scores of 0.64, 0.57 and 0.63, respectively. PSQI change using linear regression showed BLT (n=29) has effect size of 0.46, p=0.017; MLT (n=26), 0.24, p=0.20; MP (n=26), 0.06, p=0.46. No significant differences were observed in scores for insomnia, fatigue, depression, quality of life and actigraphy. There were no differences in adverse events by groups(p=0.80).

Conclusions

The use of MMT to treat SQ disturbance was feasible. BLT+MLT showed the most promising effect size in improvement in SQ, and additional larger studies are needed.

Trial registration number

NCT01628029.
Process of risk assessment by research ethics committees: foundations, shortcomings and open questions
Authors: Rudra Pranab , Lenk Christian
Published: January 2020

Risks and burdens in the study participation, as well as an adequate risk-benefit balance, are key concepts for the evaluation of clinical studies by research ethics committees (RECs). An adequate assessment and continuous monitoring to ensure compliance of risks and burdens in clinical trials have long been described as a central task in research ethics. However, there is currently no uniform and solid theoretical approach to risk assessment by RECs. Regulatory standards of research ethics such as the Declaration of Helsinki provide only minimal guidance on how risk decisions are considered. Due to discrepancies in the existing literature and guidance documents, adequate risk assessment by RECs remains to be elusive. In this article, we address current definitions of risk and present our own concept of aggregate risk definition. Moreover, we highlight the concept of benefit, the standard of reasonableness with respect to ethics literature and different approaches of risk-benefit assessment. In order to present a comprehensive theoretical approach of risk assessment by RECs, further understanding of the definitions of risk may improve adequate decision-making tasks by RECs. To improve the process of risk assessment by RECs, a dynamic framework will be illustrated, showing step-by-step risk assessment functions. This approach may be a promising tool to ensure adequacy in risk assessment by RECs.
Methotrexate effect on immunogenicity and long-term maintenance of adalimumab in axial spondyloarthritis: a multicentric randomised trial
Authors: Ducourau Emilie , Rispens Theo , Samain Marine , Dernis Emmanuelle , Le Guilchard Fabienne , Andras Lucia , Perdriger Aleth , Lespessailles Eric , Martin Antoine , Cormier Grégoire , Armingeat Thomas , Devauchelle-Pensec Valérie , Gervais Elisabeth , Le Goff Benoit , de Vries Annick , Piver Eric , Paintaud Gilles , Desvignes Céline , Ternant David , Watier Hervé , Goupille Philippe , Mulleman Denis
Published: January 2020

Objectives

Anti-drug antibodies (ADA) are responsible for decreased adalimumab efficacy in axial spondyloarthritis (SpA). We aimed to evaluate the ability of methotrexate (MTX) to decrease adalimumab immunisation.

Methods

A total of 110 patients eligible to receive adalimumab 40 mg subcutaneously (s.c.) every other week were randomised (1:1 ratio) to receive, 2 weeks before adalimumab (W-2) and weekly, MTX 10 mg s.c. (MTX+) or not (MTX−). ADA detection and adalimumab serum concentration were assessed at weeks 4 (W4), 8 (W8), 12 (W12) and 26 (W26) after starting adalimumab (W0). The primary outcome was the proportion of patients with ADA at W26. Four years after the study completion, we retrospectively analysed adalimumab maintenance in relation with MTX co-treatment duration.

Results

We analysed data for 107 patients (MTX+; n=52; MTX-; n=55). ADA were detected at W26 in 39/107 (36.4%) patients: 13/52 (25%) in the MTX+ group and 26/55 (47.3%) in the MTX− group (p=0.03). Adalimumab concentration was significantly higher in the MTX+ than MTX− group at W4, W8, W12 and W26. The two groups did not differ in adverse events or efficacy. In the follow-up study, MTX co-treatment >W26 versus no MTX or ≤W26 was significantly associated with adalimumab long-term maintenance (p=0.04).

Conclusion

MTX reduces the immunogenicity and ameliorate the pharmacokinetics of adalimumab in axial SpA. A prolonged co-treatment of MTX>W26 seems to increase adalimumab long-term maintenance.
Antimicrobial resistance in
Mycoplasma genitalium
sampled from the British general population
Authors: Pitt Rachel , Unemo Magnus , Sonnenberg Pam , Alexander Sarah , Beddows Simon , Cole Michelle Jayne , Clifton Soazig , Mercer Catherine H , Johnson Anne M , Ison Catherine A , Field Nigel
Published: January 2020

Background

Mycoplasma genitalium
is a common sexually transmitted infection. Treatment guidelines focus on those with symptoms and sexual contacts, generally with regimens including doxycycline and/or azithromycin as first-line and moxifloxacin as second-line treatment. We investigated the prevalence of antimicrobial resistance (AMR)-conferring mutations in
M. genitalium
among the sexually-active British general population.

Methods

The third national survey of sexual attitudes and lifestyles (Natsal-3) is a probability sample survey of 15 162 men and women aged 16–74 years in Britain conducted during 2010–12. Urine test results for
M. genitalium
were available for 4507 participants aged 16–44 years reporting
>
1 lifetime sexual partner. In this study, we sequenced regions of the 23S rRNA and
parC
genes to detect known genotypic determinants for resistance to macrolides and fluoroquinolones respectively.

Results

94% (66/70) of specimens were re-confirmed as
M. genitalium
positive, with successful sequencing in 85% (56/66) for 23S rRNA and 92% (61/66) for
parC
genes. Mutations in 23S rRNA gene (position A2058/A2059) were detected in 16.1% (95%CI: 8.6% to 27.8%) and in
parC
(encoding
ParC
D87N/D87Y) in 3.3% (0.9%–11.2%). Macrolide resistance was more likely in participants reporting STI diagnoses (past 5 years) (44.4% (18.9%–73.3%) vs 10.6% (4.6%–22.6%); p=0.029) or sexual health clinic attendance (past year) (43.8% (23.1%–66.8%) vs 5.0% (1.4%–16.5%); p=0.001). All 11 participants with AMR-conferring mutations had attended sexual health clinics (past 5 years), but none reported recent symptoms.

Conclusions

This study highlights challenges in
M. genitalium
management and control. Macrolide resistance was present in one in six specimens from the general population in 2010–2012, but no participants with AMR
M. genitalium
reported symptoms. Given anticipated increases in diagnostic testing, new strategies including novel antimicrobials, AMR-guided therapy, and surveillance of AMR and treatment failure are recommended.
Relationship between expression pattern of vitamin D receptor, 1 alpha‐hydroxylase enzyme, and chemokine RANTES genes and selected serum parameters during transition period in Holstein dairy cows
Authors: Saed Hala A R , Ibrahim Hussam M M , El‐Khodery Sabry A , Youssef Mohamed A
Published: January 2020

Objectives

The objective of the present study was to evaluate the pattern of genetic expression of vitamin D receptor (VDR), 1 alpha‐hydroxylase (1α‐OHase) enzyme and chemokine regulated on activation normal T‐cell expressed and secreted (RANTES) in peripheral blood of Holstein dairy cows during transition period.

Methods

Blood samples were collected from 16 Holstein dairy cows at 3 weeks prior expected date of delivery (EDD), at the day of parturition, and 3 weeks post‐partum for assessment of expression profile of studied genes using real‐time PCR and measurement of glucose, ionized calcium (Ca), parathyroid hormone (PTH), inorganic phosphorous (P), sodium (Na), potassium (K), chloride (Cl), and magnesium (Mg) levels.

Results

Compared with 3 weeks prior EDD, VDR gene expression decreased significantly at the day of parturition then increased significantly at 3 weeks post‐partum. The genetic expression of 1α‐OHase enzyme as well as PTH, K, Na and Cl levels increased significantly at the day of parturition. The Ca level decreased significantly at the day of parturition then increased significantly at 3 weeks post‐partum. The P level increased significantly at the day of parturition then decreased significantly at 3 weeks post‐partum. Glucose level decreased significantly at the day of parturition and at 3 weeks post‐partum. RANTES gene expression showed non‐significant changes among the three different time points. The expression of VDR gene had a negative correlation with the expression of 1α‐OHase enzyme gene, and serum levels of glucose, PTH, P and K, but had a positive correlation with the serum Ca level. The expression of 1α‐OHase enzyme gene had a positive correlation with serum levels of PTH, P and K, but had a negative correlation with the serum Ca level.

Conclusions

Results of the current study indicate the importance of monitoring the genetic expression of VDR and 1α‐OHase enzyme as indicators of metabolic changes during transition period, suggesting that they are candidate genes to judge the health status of dairy cows during such period.