bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Divisome-Associated Protein Spatially Coupling the Z-Ring with the Chromosomal Replication Terminus in Caulobacter crescentus
Authors: Ozaki Shogo , Jenal Urs , Katayama Tsutomu
Published: April 2020

Growing bacteria require careful tuning of cell division processes with dynamic organization of replicating chromosomes. In enteric bacteria, ZapA associates with the cytoskeletal Z-ring and establishes a physical linkage to the chromosomal replication terminus through its interaction with ZapB-MatP-DNA complexes. However, because ZapB and MatP are found only in enteric bacteria, it remains unclear how the Z-ring and the terminus are coordinated in the vast majority of bacteria. Here, we provide evidence that a novel conserved protein, termed ZapT, mediates colocalization of the Z-ring with the terminus in
Caulobacter crescentus
, a model organism that is phylogenetically distant from enteric bacteria. Given that ZapT facilitates cell division processes in
C. crescentus
, this study highlights the universal importance of the physical linkage between the Z-ring and the terminus in maintaining cell integrity.
Structural Analysis of an
l
-Cysteine Desulfurase from an Ssp DNA Phosphorothioation System
Authors: Liu Liqiong , Jiang Susu , Xing Mai , Chen Chao , Lai Chongde , Li Na , Liu Guangfeng , Wu Dan , Gao Haiyan , Hong Liang , Tan Pan , Chen Shi , Deng Zixin , Wu Geng , Wang Lianrong
Published: April 2020

Apart from its roles in Fe-S cluster assembly, tRNA thiolation, and sulfur-containing cofactor biosynthesis, cysteine desulfurase serves as a sulfur donor in the DNA PT modification, in which a sulfur atom substitutes a nonbridging oxygen in the DNA phosphodiester backbone. The initial sulfur mobilization from
l
-cysteine is catalyzed by the SspA cysteine desulfurase in the SspABCD-mediated DNA PT modification system. By determining the crystal structure of SspA, the study presents the molecular mechanism that SspA employs to recognize its cysteine substrate and PLP cofactor. To overcome the long distance (8.9 Å) between the catalytic Cys314 and the cysteine substrate, a conformational change occurs to bring Cys314 to the vicinity of the substrate, allowing for nucleophilic attack.
APOBEC3C Tandem Domain Proteins Create Super Restriction Factors against HIV-1
Authors: McDonnell Mollie M. , Crawford Kate H. D. , Dingens Adam S. , Bloom Jesse D. , Emerman Michael
Published: April 2020

As a part of the innate immune system, humans encode proteins that inhibit viruses such as HIV-1. These broadly acting antiviral proteins do not protect humans from viral infections because viruses encode proteins that antagonize the host antiviral proteins to evade the innate immune system. One such example of a host antiviral protein is APOBEC3C (A3C), which weakly inhibits HIV-1. Here, we show that we can improve the antiviral activity of A3C by duplicating the DNA sequence to create a synthetic tandem domain and, furthermore, that the proteins thus generated are relatively resistant to the viral antagonist Vif. Together, these data give insights about how nature has evolved a defense against viral pathogens such as HIV.
Deciphering the Structural Diversity and Classification of the Mobile Tigecycline Resistance Gene
tet
(X)-Bearing Plasmidome among Bacteria
Authors: Li Ruichao , Lu Xiaoyu , Peng Kai , Liu Ziyi , Li Yan , Liu Yuan , Xiao Xia , Wang Zhiqiang
Published: April 2020

Tigecycline is an expanded-spectrum tetracycline used as a last-resort antimicrobial for treating infections caused by superbugs such as carbapenemase-producing or colistin-resistant pathogens. Emergence of the plasmid-mediated mobile tigecycline resistance gene
tet
(X4) created a great public health concern. However, the diversity of
tet
(X4)-bearing plasmids and bacteria remains largely uninvestigated. To cover this knowledge gap, we comprehensively identified and characterized the
tet
(X)-bearing plasmidome in different sources using advanced sequencing technologies for the first time. The huge diversity of
tet
(X4)-bearing mobile elements demonstrates the high level of transmissibility of the
tet
(X4) gene among bacteria. It is crucial to enhance stringent surveillance of
tet
(X) genes in animal and human pathogens globally.
Independent effects of 15 commonly prescribed drugs on all-cause mortality among US elderly patients with type 2 diabetes mellitus
Authors: Baik Seo H , McDonald Clement J
Published: April 2020

Objective

Most patients with type 2 diabetes mellitus (T2DM) also have hypertension and hyperlipidemia. Consequently, they are taking medications for all three conditions concurrently and the effect of one drug could be confounded with that of another. This study aimed to determine the independent effects of 15 commonly prescribed medications for three conditions on the risk of all-cause mortality among elderly patients with T2DM.

Research design and methods

A cohort of 360 437 elderly patients with T2DM from 2007 to 2016 US Medicare data was traced along with cumulative uses of 8 diabetes, 6 hypertension and 1 hyperlipidemia drugs. The relative risk of all-cause mortality for each study drug was estimated using an extended Cox regression analysis adjusting for the concurrent use of other study drugs.

Results

Compared with the no use of each study medication, mortality risk declined with use of 3 diabetes drugs, sodium-glucose cotransporter-2 inhibitors (HR=0.73; 95% CI 0.64 to 0.84), glucagon-like peptide-1 receptor agonists (HR=0.75; 95% CI 0.70 to 0.80) and dipeptidyl peptidase-4 inhibitors (HR=0.94; 95% CI 0.91 to 0.98), the use of 3 blood pressure medications, diuretics (HR=0.89; 95% CI 0.87 to 0.92), angiotensin receptor blockers (HR=0.86; 95% CI 0.84 to 0.89), ACE inhibitors (HR=0.98; 95% CI 0.95 to 1.01) as well as statins (HR=0.83; 95% CI 0.80 to 0.85). It increased moderately with insulin (HR=1.55; 95% CI 1.51 to 1.59), sulfonylureas (HR=1.16; 95% CI 1.13 to 1.20), a smallinconsistentamount with metformin (HR=1.05), beta-blockers (HR=1.07), dihydropyridine calcium-channel blockers (HR=0.99) and non-dihydropyridine calcium-channel blockers (HR=1.05). The use of thiazolidinedione had no effect.

Conclusion

Among older patients with diabetes, mortality riskdecreasedimportantly with three new diabetes drugs, 3 blood pressure drugs and statins. Itincreasedmoderately with sulfonylurea and insulin. Studies of aggressive use of new T2DM drugs instead of sulfonylureas and insulin are needed. Our statin results empirically validate two national guidelines for using statins in older patients with diabetes. However, 23% of study patients never took a statin, suggesting missed opportunities for prevention.
Delivering non-communicable disease interventions to women and children in conflict settings: a systematic review
Authors: Shah Shailja , Munyuzangabo Mariella , Gaffey Michelle F , Kamali Mahdis , Jain Reena P , Als Daina , Meteke Sarah , Radhakrishnan Amruta , Siddiqui Fahad J , Ataullahjan Anushka , Bhutta Zulfiqar A
Published: April 2020

Background

Non-communicable diseases (NCDs) are the leading cause of death worldwide. In the context of conflict settings, population displacement, disrupted treatment, infrastructure damage and other factors impose serious NCD intervention delivery challenges, but relatively little attention has been paid to addressing these challenges. Here we synthesise the available indexed and grey literature reporting on the delivery of NCD interventions to conflict-affected women and children in low- and middle-income countries (LMICs).

Methods

A systematic search in MEDLINE, Embase, CINAHL and PsycINFO databases for indexed articles published between 1 January 1990 and 31 March 2018 was conducted, and publications reporting on NCD intervention delivery to conflict-affected women or children in LMICs were included. A grey literature search of 10 major humanitarian organisation websites for publications dated between 1 January 2013 and 30 November 2018 was also conducted. We extracted and synthesised information on intervention delivery characteristics and delivery barriers and facilitators.

Results

Of 27 included publications, most reported on observational research studies, half reported on studies in the Middle East and North Africa region and 80% reported on interventions targeted to refugees. Screening and medication for cardiovascular disease and diabetes were the most commonly reported interventions, with most publications reporting facility-based delivery and very few reporting outreach or community approaches. Doctors were the most frequently reported delivery personnel. No publications reported on intervention coverage or on the effectiveness of interventions among women or children. Limited population access and logistical constraints were key delivery barriers reported, while innovative technology use, training of workforce and multidisciplinary care were reported to have facilitated NCD intervention delivery.

Conclusion

Large and persistent gaps in information and evidence make it difficult to recommend effective strategies for improving the reach of quality NCD care among conflict-affected women and children. More rigorous research and reporting on effective strategies for delivering NCD care in conflict contexts is urgently needed.

PROSPERO registration number

CRD42019125221
End-of-life communication in advanced cancer: international trends (2009–2014)
Authors: Verkissen Mariëtte N , Penders Yolanda W H , Onwuteaka-Philipsen Bregje D , Moreels Sarah , Donker Gé A , Vega Alonso Tomás , Van den Block Lieve , Deliens Luc
Published: April 2020

Objective

To examine trends in end-of-life communication with people with cancer in general practice.

Methods

Mortality follow-back survey among general practitioners (GPs) in representative epidemiological surveillance networks in Belgium (BE), the Netherlands (NL) and Spain (ES) in 2009–2010 (ES: 2010–2011) and 2013–2014. Using a standardised form, GPs registered all deceased adult patients in their practice and reported for five end-of-life care topics whether they had been discussed with the patient. Non-sudden cancer deaths were included (n=2306; BE: 1233; NL: 729; ES: 344).

Results

A statistically significant increase was found between 2009/2010 and 2014 in the prevalence of communication about diagnosis (from 84% to 94%) and options for end-of-life care (from 73% to 90%) in BE, and in GPs’ awareness of patients’ preferences for medical treatment and a proxy decision-maker in BE (from 41% and 20% up to 53% and 28%) and the NL (from 62% and 32% up to 70% and 52%). Communication about options for end-of-life care and psychosocial problems decreased in the NL (from 88% and 91% down to 73%) and ES (from 76% and 77% down to 26% and 39%).

Conclusion

Considerable change in GP–patient communication seems possible in a relatively short time span, but communication cannot be assumed to increase over time. Increasing specialisation of care and task differentiation may lead to new roles in communication for healthcare providers in primary and secondary care. Improved information sharing between GPs and other healthcare providers may be necessary to ensure that patients have the chance to discuss important end-of-life topics.
Obesity management for the gastroenterologist
Authors: Ansari Saleem , Haboubi Hasan , Haboubi Nadim
Published: April 2020

Obesity has reached epidemic levels in the United Kingdom. Obesity is associated with important gastrointestinal and hepatic complications which are common and can present sooner than cardiometabolic disease but often the underlying obesity remains untreated. Given that gastroenterologists and hepatologists will be at the forefront of obesity management we present an overview encompassing obesity pathophysiology, medical and surgical treatment options as well as the role of endobariatrics and the gut microbiome.
Impact of atrial fibrillation in patients with heart failure and reduced, mid-range or preserved ejection fraction
Authors: Son Mi Kyoung , Park Jin Joo , Lim Nam-Kyoo , Kim Won-Ho , Choi Dong-Ju
Published: April 2020

Objective

To determine the prognostic value of atrial fibrillation (AF) in patients with heart failure (HF) and preserved, mid-range or reduced ejection fraction (EF).

Methods

Patients hospitalised for acute HF were enrolled in the Korean Acute Heart Failure registry, a prospective, observational, multicentre cohort study, between March 2011 and February 2014. HF types were defined as reduced EF (HFrEF, LVEF <40%), mid-range EF (HFmrEF, LVEF 40%–49%) or preserved EF (HFpEF, LVEF ≥50%).

Results

Of 5414 patients enrolled, HFrEF, HFmrEF and HFpEF were seen in 3182 (58.8%), 875 (16.2%) and 1357 (25.1%) patients, respectively. The prevalence of AF significantly increased with increasing EF (HFrEF 28.9%, HFmrEF 39.8%, HFpEF 45.2%; p for trend <0.001). During follow-up (median, 4.03 years; IQR, 1.39–5.58 years), 2806 (51.8%) patients died. The adjusted HR of AF for all-cause death was 1.06 (0.93–1.21) in the HFrEF, 1.10 (0.87–1.39) in the HFmrEF and 1.22 (1.02–1.46) in the HFpEF groups. The HR for the composite of all-cause death or readmission was 0.97 (0.87–1.07), 1.14 (0.93–1.38) and 1.03 (0.88–1.19) in the HFrEF, HFmrEF and HFpEF groups, respectively, and the HR for stroke was 1.53 (1.03–2.29), 1.04 (0.57–1.91) and 1.90 (1.13–3.20), respectively. Similar results were observed after propensity score matching analysis.

Conclusions

AF was more common with increasing EF. AF was seen to be associated with increased mortality only in patients with HFpEF and was associated with an increased risk of stroke in patients with HFrEF or HFpEF.

Trial registration number

NCT01389843
Effect of meteorological factors and air pollutants on out-of-hospital cardiac arrests: a time series analysis
Authors: Kim Jin-Ho , Hong Jinwook , Jung Jaehun , Im Jeong-Soo
Published: April 2020

Objectives

We aimed to investigate the effects of meteorological factors and air pollutants on out-of-hospital cardiac arrest (OHCA) according to seasonal variations because the roles of these factors remain controversial to date.

Methods

A total of 38 928 OHCAs of cardiac origin that occurred within eight metropolitan areas between 2012 and 2016 were identified from the Korean nationwide emergency medical service database. A time series multilevel approach based on Poisson analysis following a Granger causality test was used to analyse the influence of air pollution and 13 meteorological variables on OHCA occurrence.

Results

Particulate matter (PM) ≤2.5 µm (PM2.5), average temperature, daily temperature range and humidity were significantly associated with a higher daily OHCA risk (PM2.5: 1.59%; 95% CI: 1.51% to 1.66% per 10µg/m3, average temperature 0.73%, 95% CI: 0.63% to 0.84% per 1°C, daily temperature range: 1.05%, 95% CI: 0.63% to 1.48% per 1°C, humidity −0.48, 95% CI: −0.40 to −0.56 per 1%) on lag day 1. In terms of the impact of these four risk factors in different seasons, average temperature and daily temperature range were highly associated with OHCA in the summer and winter, respectively. However, only PM2.5elevation (to varying extents) was an independent and consistent OHCA risk factor irrespective of the season.

Conclusions

PM2.5, average temperature, daily temperature range and humidity were independently associated with OHCA occurrence in a season-dependent manner. Importantly, PM2.5was the only independent risk factor for OHCA occurrence irrespective of seasonal changes.
Ethics of resuscitation for extremely premature infants: a systematic review of argument-based literature
Authors: Cavolo Alice , Dierckx de Casterlé Bernadette , Naulaers Gunnar , Gastmans Chris
Published: April 2020

Objective

To present (1) the ethical concepts related to the debate on resuscitation of extremely premature infants (EPIs) as they are described in the ethical literature; and (2) the ethical arguments based on these concepts.

Design

We conducted a systematic review of the ethical literature. We selected articles based on the following predefined inclusion/exclusion criteria: (1) English language articles (2) presenting fully elaborated ethical arguments (3) on resuscitation (4) of EPIs, that is, infants born before 28 weeks of gestation.

Analysis

After repeated reading of articles, we developed individual summaries, conceptual schemes and an overall conceptual scheme. Ethical arguments and concepts were identified and analysed.

Results

Forty articles were included out of 4709 screened. Personhood, best interest, autonomy and justice were concepts grounding the various arguments. Regarding these concepts, included authors agreed that the best interest principle should guide resuscitation decisions, whereas justice seemed the least important concept. The arguments addressed two questions: Should we resuscitate EPIs? Who should decide? Included authors agreed that not all EPIs should be resuscitated but disagreed on what criteria should ground this decision. Overall, included authors agreed that both parents and physicians should contribute to the decision.

Conclusions

The included publications suggest that while the best interest is the main concept guiding resuscitation decisions, justice is the least important. The included authors also agree that both parents and physicians should be actively involved in resuscitation decisions for EPIs. However, our results suggest that parents’ decision should be over-ridden when in contrast with the EPI’s best interest.
Effective interactions in Ricci-Based Gravity below the non-metricity scale
Authors: Delhom Adrià , Miralles Victor , Peñuelas Ana
Published: April 2020

We show how minimally-coupled matter fields of arbitrary spin, when coupled to Ricci-based gravity theories, develop non-trivial effective interactions that can be treated perturbatively only below a characteristic high-energy scale $$\Lambda _{Q}$$ΛQ. We then use this interactions to set bounds on the high-energy scale $$\Lambda _{Q}$$ΛQ that controls departures of Ricci-Based Gravity theories from General Relativity. Particularly, for Eddington-inspired Born-Infeld gravity we obtain the strong bound $$ |\kappa |<10^{-26} \text {m}^5 \text {kg}^{-1}\text {s}^{-2} $$|κ|<10-26m5kg-1s-2.
Lagrangian description of Heisenberg and Landau–von Neumann equations of motion
Authors: Ciaglia F. M. , Di Cosmo F. , Ibort A. , Marmo G. , Schiavone L. , Zampini A.
Published: April 2020

An explicit Lagrangian description is given for the Heisenberg equation on the algebra of operators of a quantum system, and for the Landau–von Neumann equation on the manifold of quantum states which are isospectral with respect to a fixed reference quantum state.
Decay rates and masses for some heavy baryons in the hyper-central quark model
Authors: Abu-Shady M. , Ahmed M. M. A. , Gerish N. H.
Published: April 2020

Masses and decay width for some heavy baryons are studied within Isgur–Wise formalism. The extended Cornell potential is employed. The hyper-radial Schrödinger equation with extended Cornell potential is solved to obtain eigenvalues of energy and baryonic wave function by using the extended iteration method. Masses and the rate of decay width for some heavy baryons are calculated. The present results are improved in comparison with other recent works and are in a good agreement with experimental data.
A Lexicographic Approach to Fuzzy Linear Assignment Problems with Different Types of Fuzzy Numbers
Authors: Pérez-Cañedo Boris , Concepción-Morales Eduardo R.
Published: April 2020

The fuzzy linear assignment problem (FLAP) is an extension of the classical linear assignment problem (LAP) to situations in which uncertainty in the cost coefficients is represented by fuzzy numbers. FLAP applications range from the assignment of workers to tasks to multiple-criteria decision analysis in fuzzy environments and many other engineering applications. Most FLAP formulations assume that all cost coefficients are fuzzy numbers of the same type (e.g. triangular, trapezoidal). The standard solution approach is the defuzzification of the cost coefficients, thus transforming the FLAP into a crisp LAP that can be solved by classical assignment algorithms such as the Hungarian method. It is known that defuzzification methods suffer from lack of discrimination when comparing fuzzy numbers which may lead to suboptimal assignments. The solution approach proposed in this paper is based on the theory of algebraic assignment problems and total orderings in the set of all fuzzy numbers, and it allows to solve FLAPs with different types of fuzzy numbers. More specifically, the FLAP is transformed into a lexicographic linear assignment problem (LLAP) which is solved in its place. We show, both theoretically and numerically, how this transformation overcomes the limitations present in existing approaches.
On the Structure of the Classes of Copulas and Quasi-Copulas with a Given Diagonal Section
Authors: Fernández-Sánchez Juan , Úbeda-Flores Manuel
Published: April 2020

In this paper we provide an alternative proof to that given in Ref. 1 to the fact that the class of multivariate copulas with a given diagonal section δ — denoted by 𝒞δ — is a singleton if, and only if, the unique element of the class is the copula of comonotonicity among random variables. This will be used to prove that, for any diagonal δ different from the diagonal of the comotonic copula, 𝒞δ is strictly included in the class of all multivariate quasi-copulas whose diagonal section is δ.
Immunoinformatics: Predicting Peptide–MHC Binding
Authors: Nielsen Morten , Andreatta Massimo , Peters Bjoern , Buus Søren
Published: April 2020

Immunoinformatics is a discipline that applies methods of computer science to study and model the immune system. A fundamental question addressed by immunoinformatics is how to understand the rules of antigen presentation by MHC molecules to T cells, a process that is central to adaptive immune responses to infections and cancer. In the modern era of personalized medicine, the ability to model and predict which antigens can be presented by MHC is key to manipulating the immune system and designing strategies for therapeutic intervention. Since the MHC is both polygenic and extremely polymorphic, each individual possesses a personalized set of MHC molecules with different peptide-binding specificities, and collectively they present a unique individualized peptide imprint of the ongoing protein metabolism. Mapping all MHC allotypes is an enormous undertaking that cannot be achieved without a strong bioinformatics component. Computational tools for the prediction of peptide–MHC binding have thus become essential in most pipelines for T cell epitope discovery and an inescapable component of vaccine and cancer research. Here, we describe the development of several such tools, from pioneering efforts to the current state-of-the-art methods, that have allowed for accurate predictions of peptide binding of all MHC molecules, even including those that have not yet been characterized experimentally.
Nonresonant Polarized Raman Spectra Calculations of Nitrogen-Doped Single-Walled Carbon Nanotubes: Diameter, Chirality, and Doping Concentration Effects
Authors: Allali F. , Chadli H. , Bentaleb M. , Hermet P. , Rahmani A.
Published: April 2020

Raman spectra of nitrogen-doped single-walled carbon nanotubes are calculated using the spectral moment’s method combined with the bond polarizability model. The influence of the nanotube diameter and chirality is investigated. We also address the important question of the effect of the N-doping concentration, and we propose an equation to estimate the doping concentration from the knowledge of the tube diameter and the frequency of the radial breathing mode.
Complexity Analysis of a 3-Player Game with Bounded Rationality Participating in Nitrogen Emission Reduction
Authors: Zhang Jixiang , Xi Xuan
Published: April 2020

In this paper, a decision-making competition game model concerning governments, agricultural enterprises, and the public, all of which participate in the reduction of nitrogen emissions in the watersheds, is established based on bounded rationality. First, the stability conditions of the equilibrium points in the system are discussed, and the stable region of the Nash equilibrium is determined. Then, the bifurcation diagram, maximal Lyapunov exponent, strange attractor, and sensitive dependence on the initial conditions are shown through numerical simulations. The research shows that the adjustment speed of three players’ decisions may alter the stability of the Nash equilibrium point and lead to chaos in the system. Among these decisions, a government’s decision has the largest effect on the system. In addition, we find that some parameters will affect the stability of the system; when the parameters become beneficial for enterprises to reduce nitrogen emissions, the increase in the parameters can help control the chaotic market. Finally, the delay feedback control method is used to successfully control the chaos in the system and stabilize it at the Nash equilibrium point. The research of this paper is of great significance to the environmental governance decisions and nitrogen reduction management.
Rare Somatic MEN1 Gene Pathogenic Variant in a Patient Affected by Atypical Parathyroid Adenoma
Authors: Cinque Luigia , Pugliese Flavia , Clemente Celeste , Castellana Stefano , Leone Maria Pia , de Martino Danilo , Balsamo Teresa , Battista Claudia , Biagini Tommaso , Graziano Paolo , Castori Marco , Scillitani Alfredo , Guarnieri Vito
Published: April 2020

Objective. Atypical parathyroid adenoma is a rare neoplasm, showing atypical histological features intermediate between classic benign adenoma and the rarest parathyroid carcinoma, whose the clinical behaviour and outcome is not yet understood or predictable. Up to date only two cases of atypical adenoma were found associated to a MEN1 syndrome, and only one was proved to carry a pathogenic variant of the MEN1 gene. Design. We report the clinical, histologic, and molecular findings of a 44-year-old woman, presenting with a histologically proved atypical parathyroid adenoma with an apparent aggressive behaviour. Methods and Results. CDC73 gene was screened at germline and somatic levels with no results. Whole exome sequencing performed on DNA extracted from blood leukocytes and tumour tissue revealed a somatic MEN1 gene heterozygous variant, c.912+1G > A, of the splicing donor site of exon 6. On immunohistochemistry, downregulation of the menin protein expression in the neoplastic cells was also observed. Conclusions. We report the second case of a rare association of a somatic MEN1 gene mutation in a patient with atypical parathyroid adenoma. We suggest that MEN1 gene could be an underestimate genetic determinant of these rare histological entities, and we highlight the utility of a complete genetic screening protocol, by the use of next-generation sequencing technology in such undetermined clinical cases with no frank clinical presentation.
Prevalence and Risk Factors of Urinary Incontinence in Frail Elderly Females
Authors: Aly Walaa W. , Sweed Hala S. , Mossad Nora A. , Tolba Mohammad F.
Published: April 2020

Background/Purpose. Urinary incontinence (UI) is an important geriatric health problem, and it is linked to frailty syndrome. We had conducted a study to detect the prevalence and risk factors of UI and its effect on quality of life (QOL) among frail elderly females living in Cairo, Egypt. Methods. We carried out a cross-sectional study on 130 frail elderly females sixty years and older, attending Ain Shams Geriatrics Hospital, Cairo, Egypt. Each patient gave oral consent and then was subjected to history taking, full clinical examination, diagnosis of frailty (clinical frailty scale), assessment of UI by the Arabic version of International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), assessment of QOL by using the Arabic version of Incontinence Impact Questionnaire Short Form (IIQ-7 SF), and complete urine analysis. Results. The prevalence of UI among the studied population was 80%. Mixed UI was the most prevalent type. UI was significantly associated with older age, functional impairment, multiparity, osteoarthritis, stroke, vaginal prolapse, and laxative use. All IIQ-7 subscales were higher (worse health-related QOL) for women with mixed UI. Conclusion. Urinary incontinence is prevalent in frail elderly females. Mixed UI, compared with other types, has a significant negative impact on all domains of quality of life.
Chemical Compounds of Malacca Leaf (Phyllanthus emblica) after Triple Extraction with N-Hexane, Ethyl Acetate, and Ethanol
Authors: Asmilia Nuzul , Fahrimal Yudha , Abrar Mahdi , Rinidar Rinidar
Published: April 2020

Malacca (Phyllanthus emblica) is one of the plants that is often by the community in the Aceh Besar district of Indonesia as a traditional medicine for the treatment of various diseases such as antimicrobial, antibacterial, antifungals, antivirals, antimutagenic, antimalaria, and antiallergic. This research was conducted to analyze the content of chemical compounds in the ethanol extract of the Malacca leaf (EEDM) using a gas chromatography-mass spectrophotometer (GC-MS). Malacca leaves were extracted by the maceration method using n-hexane, ethyl acetate, and ethanol. The GC-MS analysis showed EEDM contained 22 chemical compounds. The highest chemical content of EEDM is octadecanoic acid reaching 22.93%, 9,12-octadecanoic acid 14.99%, octadecanoic acid 7.59%, 9-hexadecenoic acid 6.17%, octadecanoic acid 5.95%, octadecanal 5.59%, 9,12-octadecanoic acid 5.06%, 3-eicosyne 4.75%, 1-hexadecenoic acid 4.08%, 11-tetradecen-1-ol 2.92%, 2-furanmethanol 2.83%, delta-guaiene 2.43%, cyclohexane 2.13%, hexadecanoic acid 1.99%, sativen 1.87%, octadecanoic acid 1.52%, 1H-cyclopropaanaphthalene 1.40%, tetradecanoic acid 1.40%, 3,7,11-tridecatrienenitrile 1.20%, caryophellene 1.11%, 2H-pyran 1.07%, and trans-caryophellene 1.03%. This study clearly shows the presence of fatty acids which play a major role in the efficacy of these traditional medicines particularly as antioxidant and antimalarial.
Geological Type Recognition by Machine Learning on In-Situ Data of EPB Tunnel Boring Machines
Authors: Zhang Qian , Yang Kaihong , Wang Lihui , Zhou Siyang
Published: April 2020

At present, many large-scale engineering equipment can obtain massive in-situ data at runtime. In-depth data mining is conducive to the real-time understanding of equipment operation status or recognition of service environment. This paper proposes a geological type recognition system by the analysis of in-situ data recorded during TBM tunneling to address geological information acquisition during TBM construction. Owing to high dimensionality and nonlinear coupling between parameters of TBM in-situ data, the dimensionality reduction feature engineering and machine learning methods are introduced into TBM in-situ data analysis. The chi-square test is used to screen for sensitive features due to the disobedience to common distributions of TBM parameters. Considering complex relationships, ANN, SVM, KNN, and CART algorithms are used to construct a geology recognition classifier. A case study of a subway tunnel project constructed using an earth pressure balance tunnel boring machine (EPB-TBM) in China is used to verify the effectiveness of the proposed geological recognition method. The result shows that the recognition accuracy gradually increases to a stable level with the increase of input features, and the accuracy of all algorithms is higher than 97%. Seven features are considered as the best selection strategy among SVM, KNN, and ANN, while feature selection is an inherent part of the CART method which shows a good recognition performance. This work provides an intelligent path for obtaining geological information for underground excavation TBM projects and a possibility for solving the problem of engineering recognition of more complex geological conditions.
Left Ventricular Ejection Fraction Is Associated with the Risk of Thrombus in the Left Atrial Appendage in Patients with Atrial Fibrillation
Authors: Uziębło-Życzkowska Beata , Krzesiński Paweł , Jurek Agnieszka , Kapłon-Cieślicka Agnieszka , Gorczyca Iwona , Budnik Monika , Gielerak Grzegorz , Kiliszek Marek , Gawałko Monika , Scisło Piotr , Kochanowski Janusz , Jelonek Olga , Michalska Anna , Starzyk Katarzyna , Filipiak Krzysztof J. , Wożakowska-Kapłon Beata , Opolski Grzegorz
Published: April 2020

Introduction. Atrial fibrillation (AF) is associated with high risk of ischemic stroke. The most frequent thrombus location in AF is the left atrial appendage (LAA). Transthoracic echocardiography (TTE) is a basic diagnostic examination in patients (pts) with AF. Objectives. To analyse the relations between basic echocardiographic features, well-established stroke risk factors, type of AF, and anticoagulation therapy with the incidence of left atrial appendage thrombus (LAAT). Patients and Methods. The study group consisted of 768 pts with AF (mean age, 63 years), admitted to three high-reference cardiology departments. Five hundred and twenty-three pts were treated with non-vitamin K antagonist oral anticoagulants (NOACs) and 227 (30%) with vitamin K antagonists (VKAs). The subjects underwent TTE and transesophageal echocardiography (TEE) before cardioversion or ablation. Results. LAAT was significantly more frequent in pts with reduced left ventricular ejection fraction (LVEF): in 10.6% (7 pts) with LVEF<40% and in 9.0% (9 pts) with LVEF 40-49%, while only in 5.5% (33 pts) with LVEF>50%. Compared to pts without LAAT, those with LAAT presented with lower LVEF and higher left atrial diameter (LAD). Multivariate logistic regression revealed the following variables as independent predictors of LAAT: previous bleeding, treatment with VKA, and LVEF. Conclusion. LAAT is related to lower LVEF and higher LAD. LVEF is one of the independent predictors of LAAT. Even in the case of adequate anticoagulant therapy, it might be prudent to consider TEE before cardioversion or ablation in patients with low LVEF and LA enlargement, especially in the coexistence of other thromboembolic risk factors.
MicroRNA-16, via FGF2 Regulation of the ERK/MAPK Pathway, Is Involved in the Magnesium-Promoted Osteogenic Differentiation of Mesenchymal Stem Cells
Authors: Qi Hong , Liu Yang , Wu Lu , Ni Su , Sun Jing , Xue Junchao , Liu Qizhan , Ni Xinye , Fan Weimin
Published: April 2020

microRNAs (miRNAs) participate in the osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs). However, few reports have discussed the effect of miRNAs on the magnesium chloride (MgCl2)-induced promotion of osteogenic differentiation of BMSCs, a process involved in the healing of bone tissue. As determined in the present investigation, MgCl2 decreased miR-16 levels; increased levels of fibroblast growth factor 2 (FGF2), p-p38, and p-ERK; and promoted the osteogenic differentiation of BMSCs. Enhancement of miR-16 levels by an miR-16 mimic blocked these MgCl2-induced changes. Moreover, luciferase reporter assays confirmed that miR-16 binds to the 3′UTR region of FGF2 mRNA. Down-regulation of FGF2 blocked the MgCl2-induced increases of p-p38 and p-ERK and the promotion of the osteogenic differentiation of BMSCs. Furthermore, over-expression of miR-16 attenuated the MgCl2-induced overproduction of p-p38 and p-ERK1/2 and the high levels of osteogenic differentiation, effects that were reversed by elevated expression of FGF2. In summary, the present findings provide a mechanism by which miR-16 regulates MgCl2-induced promotion of osteogenic differentiation by targeting FGF2-mediated activation of the ERK/MAPK pathway.
Comparative Lipid-Lowering/Increasing Efficacy of 7 Statins in Patients with Dyslipidemia, Cardiovascular Diseases, or Diabetes Mellitus: Systematic Review and Network Meta-Analyses of 50 Randomized Controlled Trials
Authors: Zhang Xiaodan , Xing Lu , Jia Xiaona , Pang Xiaocong , Xiang Qian , Zhao Xia , Ma Lingyue , Liu Zhiyan , Hu Kun , Wang Zhe , Cui Yimin
Published: April 2020

Objective. The drug efficacy may differ among different statins, and evidence from head-to-head comparisons is sparse and inconsistent. The study is aimed at comparing the lipid-lowering/increasing effects of 7 different statins in patients with dyslipidemia, cardiovascular diseases, or diabetes mellitus by conducting systematic review and network meta-analyses (NMA) of the lipid changes after certain statins’ use. Methods. In this study, we searched four electronic databases for randomized controlled trials (RCTs) published through February 25, 2020, comparing the lipid-lowering efficacy of no less than two of the included statins (or statin vs. placebo). Three reviewers independently extracted data in duplicate. Firstly, mixed treatment overall comparison analyses, in the form of frequentist NMAs, were conducted using STATA 15.0 software. Then, subgroup analyses were conducted according to different baseline diseases. At last, sensitivity analyses were conducted according to age and follow-up duration. The trial was registered with PROSPERO (number CRD42018108799). Results. As a result, seven statin monotherapy treatments in 50 studies (51956 participants) were used for the analyses. The statins included simvastatin (SIM), fluvastatin (FLU), atorvastatin (ATO), rosuvastatin (ROS), lovastatin (LOV), pravastatin (PRA), and pitavastatin (PIT). In terms of LDL-C lowering, rosuvastatin ranked 1st with a surface under cumulated ranking (SUCRA) value of 93.1%. The comparative treatment efficacy for LDL-C lowering was ROS>ATO>PIT>SIM>PRA>FLU>LOV>PLA. All of the other ranking and NMA results were reported in SUCRA plots and league tables. Conclusions. According to the NMAs, it can be concluded that rosuvastatin ranked 1st in LDL-C, ApoB-lowering efficacy and ApoA1-increasing efficacy. Lovastatin ranked 1st in TC- and TG-lowering efficacy, and fluvastatin ranked 1st in HDL-C-increasing efficacy. The results should be interpreted with caution due to some limitations in our review. However, they can provide references and evidence-based foundation for drug selection in both statin monotherapies and statin combination therapies.
Approximation-Based Fixed-Time Adaptive Tracking Control for a Class of Uncertain Nonlinear Pure-Feedback Systems
Authors: He Cheng , Wu Jian , Dai Jiyang , Zhang Zhe , Xu Libin , Li Pinwei
Published: April 2020

This paper examines approximation-based fixed-time adaptive tracking control for a class of uncertain nonlinear pure-feedback systems. Novel virtual and actual controllers are designed that resolve the meaninglessness of virtual and actual controllers at the origin and in the negative domain, and the sufficient condition for the system to have semiglobal fixed-time stability is also provided. Radial basis function neural networks are introduced to approximate unknown functions for solving the fixed-time control problem of unknown nonlinear pure-feedback systems, and the mean value theorem is used to solve the problem of nonaffine structure in nonlinear pure-feedback systems. The controllers designed in this paper ensure that all signals in the closed-loop system are semiglobally uniform and ultimately bounded in a fixed time. Two simulation results show that appropriate design parameters can limit the tracking error within a region of the origin in a fixed time.
Atenolol’s Inferior Ability to Reduce Central vs Peripheral Blood Pressure Can Be Explained by the Combination of Its Heart Rate-Dependent and Heart Rate-Independent Effects
Authors: Teeäär Tuuli , Serg Martin , Paapstel Kaido , Vähi Mare , Kals Jaak , Cockcroft John R. , Zilmer Mihkel , Eha Jaan , Kampus Priit
Published: April 2020

Objective. Whether the inferior ability of atenolol to reduce central (aortic) compared to peripheral (brachial) blood pressure (BP) is related to its heart rate (HR)-dependent or -independent effects, or their combination, remains unclear. To provide further mechanistic insight into this topic, we studied the acute effects of atenolol versus nebivolol and ivabradine on systolic blood pressure amplification (SBPA; peripheral systolic BP minus central systolic BP) in a model of sick sinus syndrome patients with a permanent dual-chamber cardiac pacemaker in a nonrandomized single-blind single-group clinical trial. Methods. We determined hemodynamic indices noninvasively (Sphygmocor XCEL) before and at least 3 h after administration of oral atenolol 50 or 100 mg, nebivolol 5 mg, or ivabradine 5 or 7.5 mg during atrial pacing at a low (40 bpm), middle (60 bpm), and high (90 bpm) HR level in 25 participants (mean age 65.5 years, 12 men). Results. At the low HR level, i.e., when the drugs could exert their HR-dependent and HR-independent effects on central BP, only atenolol produced a significant decrease in SBPA (mean change 0.74 ± 1.58 mmHg (95% CI, 0.09–1.40; P=0.028)), indicating inferior central vs peripheral systolic BP change. However, we observed no significant change in SBPA with atenolol at the middle and high HR levels, i.e., when HR-dependent mechanisms had been eliminated by pacing. Conclusion. The findings of our trial with a mechanistic approach to the topic imply that the inferior ability of atenolol to reduce central vs peripheral BP can be explained by the combination of its heart rate-dependent and -independent effects. This trial is registered with NCT03245996.
High Glucose Induces the Loss of Retinal Pericytes Partly via NLRP3‐Caspase‐1‐GSDMD‐Mediated Pyroptosis
Authors: Gan Jinhua , Huang Maomao , Lan Genyin , Liu Li , Xu Fangyuan
Published: April 2020

Diabetic retinopathy (DR) is one of the hallmark complications of diabetes and a leading cause of vision loss in adults. Retinal pericyte death seems to be a prominent feature in the onset of DR. Pyroptosis is an inflammatory form of programmed cell death, defined as being caspase‐gasdermin‐D (GSDMD)‐dependent. The NOD‐like receptor pyrin 3 (NLRP3) inflammasome plays an important role in mediating GSDMD activation. However, the role and mechanism of pyroptosis in the loss of retinal pericytes during the pathogenesis of DR are still unclear. In the present study, we cultured primary human retinal pericytes (HRPs) in high glucose medium; caspase‐3 inhibitor DEVD, caspase‐1 inhibitor YVAD, or NLRP3 inhibitor glyburide was used as intervention reagents; GSDMD was overexpressed or suppressed by transfection with an expressing vector or retroviral silencing of GSDMD, respectively. Our data showed that high glucose induced NLRP3‐caspase‐1‐GSDMD activation and pore formation in a dose‐ and time‐dependent manner (p < 0.05) and resulted in the inflammatory cytokines IL‐1β and IL‐18 and lactate dehydrogenase (LDH) release from HRPs (p < 0.05), which are all signs of HRP pyroptosis. Overexpression of GSDMD facilitated high glucose‐induced pyroptosis (all p < 0.05). However, these effects were blunted by synergistically treating DEVD, YVAD, and silencing GSDMD (p < 0.05). Taken together, our results firstly revealed that high glucose induced the loss of retinal pericytes partly via NLRP3‐caspase‐1‐GSDMD‐mediated pyroptosis.
Blood Pressure Indices and Associated Risk Factors in a Rural West African Adult Population: Insights from an AWI-Gen Substudy in Ghana
Authors: Agongo Godfred , Nonterah Engelbert A. , Amenga-Etego Lucas , Debpuur Cornelius , Kaburise Michael B. , Ali Stuart A. , Crowther Nigel J. , Ramsay Michèle , Oduro Abraham R.
Published: April 2020

Systolic (SBP) and diastolic blood pressure (DBP) are commonly used for cardiovascular disease (CVD) risk prediction, and pulse pressure (PP) and mean arterial blood pressure (MAP) can provide additional information. It is therefore important to understand the factors associated with these cardiovascular risk markers. This cross-sectional study involved 1839 men and women aged 40–60 years. Data on SBP, DBP, MAP, PP, sociodemography, lifestyle, anthropometry, and lipids were collected. Gender-stratified linear regression analyses were performed to determine the association between log-transformed blood pressure indices and the study variables. Age was associated with all measured blood pressure indices (p<0.001) among men and women. Men had higher SBP (p=0.007) and PP (p<0.001) than women. Nankana ethnicity was associated with higher PP levels (p<0.005) in the total population. Vendor meal consumption among women was associated with higher PP levels (p<0.05). Fruit intake among men was associated with lower PP levels (p<0.05). Currently unmarried women had higher SBP (p<0.005), DBP (p<0.05), MAP (p<0.005), and PP (p<0.005) than currently married women. Pesticide exposure was negatively associated with SBP (p<0.005), DBP (p<0.005), MAP (p<0.005), and PP (p<0.05) among women. Increased subcutaneous fat was associated with DBP (p<0.005) and MAP (p<0.05) among women. Among men, hip circumference was associated with higher DBP and MAP (p<0.05 for both associations), subcutaneous fat associated with higher SBP (p<0.005), DBP (p<0.001), and MAP (p<0.001) and visceral fat was associated with higher PP (p<0.05). In the total population, visceral fat was associated with higher DBP (p<0.05) and MAP (p<0.001). High-density lipoprotein cholesterol was positively associated with SBP (p<0.005), DBP (p<0.005), and MAP (p<0.001) for women and positively associated with SBP, DBP, and MAP (p<0.001 for all three) and PP (p<0.05) for men. The association of blood pressure indices with modifiable risk factors suggests that targeted health interventions may reduce CVD risk in this population.
Lifetime Prevalence of Abortion and Risk Factors in Women: Evidence from a Cohort Study
Authors: Moradinazar Mehdi , Najafi Farid , Nazar Zeinab Moradi , Hamzeh Behrooz , Pasdar Yahya , Shakiba Ebrahim
Published: April 2020

Background. 10-20% of pregnancies end due to spontaneous abortions. In recent years, nondocumentary evidence has been indicative of an increase in the prevalence of nonspontaneous abortions in Iran, especially in the Kurdish regions. The aim of this study is to assess the lifetime prevalence of spontaneous abortions and factors affecting spontaneous abortion in women 35-65 years old. Method. Data from the recruitment phase of Ravansar Non-Communicable Disease (RaNCD) cohort study was used. All of the 4831 married women 35-65 years old and with history of pregnancy were included in this study. In order to determine the abortion ratio, the number of abortions was divided by the number of live births, and multiple logistic regression analysis was applied to determine associated factors affecting abortion. Results. About 25.7% of women had a history of spontaneous abortion. The abortion ratio in women was 0.10. The abortion ratio in women with secondary education, first pregnancy and marriage age at ≥26, socioeconomic condition, and hyperthyroid and diabetes was high while the abortion ratio of women with high physical activity and BMI<18.9 or residents of rural area was low. After assessing the effective variables, it was found that women with high blood pressure have 63% less odds for nonspontaneous abortion, which is statistically significant (p value<0.05). Conclusion. Considering the effect of factors such as level of education, older age at the first marriage, and age at the first pregnancy on increased chance of spontaneous abortion, measures should be taken to take more care for these people.