bluuebunny/crossref_metadata_2025 huggingface dataset:
Dose–response characteristics of noninvasive ventilation in acute respiratory failure
Authors: Hukins Craig , Murphy Michelle , Edwards Timothy
Published: January 2020

Acute noninvasive ventilation (NIV) is a well-established therapy for acute respiratory failure but the dose–response characteristics of this therapy have not been defined. The aim of this study was to define this dose–response relationship.

This study was a retrospective review of patients receiving NIV for acute respiratory failure in a tertiary hospital respiratory high-dependency unit between July 2012 and June 2017. Mask-on time (rather than the period that NIV was in use) as the “dose” was compared with hospital survival as the “response”.

654 patients were included, 594 (91%) with hypercapnic respiratory failure (HCRF). NIV was used for a median (interquartile range (IQR)) duration of 2.74 (1.51–4.73) days and median (IQR) mask-on time was 34 (18–60) h (56.1% (41.2–69.5%) of treatment time). There was evidence of a dose–response relationship in the HCRF group up to a ceiling of 24 h mask-on time, but not in the hypoxaemic respiratory failure (HRF) group. There was a difference in survival with as little as 2 h mask-on time (92% compared with 73%; p<0.001). Patients requiring NIV for 80–100% of therapy time had lower survival.

We conclude that there is evidence of a dose–response relationship between cumulative NIV usage (mask-on time) and survival from as little as 2 h to a ceiling of ∼24 h in HCRF, but not in HRF.
Transparent PAN:TiO2 and PAN-co-PMA:TiO2 Nanofiber Composite Membranes with High Efficiency in Particulate Matter Pollutants Filtration
Authors: Ruan Dongliang , Qin Liming , Chen Rouxi , Xu Guojie , Su Zhibo , Cheng Jianhua , Xie Shilei , Cheng Faliang , Ko Frank
Published: January 2020

Particulate matter is one of the main pollutants, causing hazy days, and it has been serious concern for public health worldwide, particularly in China recently. Quality of outdoor atmosphere with a pollutant emission of PM2.5 is hard to be controlled; but the quality of indoor air could be achieved by using fibrous membrane-based air-filtering devices. Herein, we introduce nanofiber membranes for both indoor and outdoor air protection by electrospun synthesized polyacrylonitrile:TiO2 and developed polyacrylonitrile-co-polyacrylate:TiO2 composite nanofiber membranes. In this study, we design both polyacrylonitrile:TiO2 and polyacrylonitrile-co-polyacrylate:TiO2 nanofiber membranes with controlling the nanofiber diameter and membrane thickness and enable strong particulate matter adhesion to increase the absorptive performance and by synthesizing the specific microstructure of different layers of nanofiber membranes. Our study shows that the developed polyacrylonitrile-co-polyacrylate:TiO2 nanofiber membrane achieves highly effective (99.95% removal of PM2.5) under extreme hazy air-quality conditions (PM2.5 mass concentration 1 mg/m3). Moreover, the experimental simulation of the test in 1 cm3 air storehouse shows that the polyacrylonitrile-co-polyacrylate:TiO2 nanofiber membrane (1 g/m2) has the excellent PM 2.5 removal efficiency of 99.99% in 30 min.
RETRACTED ARTICLE: Prognostic value of heart failure in hemodialysis-dependent end-stage renal disease patients with myocardial fibrosis quantification by extracellular volume on cardiac magnetic resonance imaging
Authors: Xu Hua-yan , Yang Zhi-gang , Zhang Yi , Peng Wan-lin , Xia Chun-chao , Li Zhen-lin , He Yong , Xu Rong , Rao Li , Peng Ying , Li Yu-ming , Gao Hong-ling , Guo Ying-kun
Published: January 2020

Background

End-stage renal disease (ESRD) patients are at high cardiovascular risk, and myocardial fibrosis (MF) accounts for most of their cardiac events. The purpose of this study is to investigate the prognostic value and risk stratification of MF as measured by extracellular volume (ECV) on cardiac magnetic resonance (CMR) for heart failure (HF) in patients with hemodialysis-dependent ESRD.

Methods

Sixty-six hemodialysis ESRD patients and 25 matched healthy volunteers were prospectively enrolled and underwent CMR to quantify multiple parameters of MF by T1 mapping and late gadolinium enhancement (LGE). All ESRD patients were followed up for 11–30 months, and the end-point met the 2016 ESC guidelines for the definition of HF.

Results

Over a median follow-up of 18 months (range 11–30 months), there were 26 (39.39%) guideline-diagnosed HF patients in the entire cohort of ESRD subjects. The native T1 value was elongated, and ECV was enlarged in the HF cohort relative to the non-HF cohort and normal controls (native T1, 1360.10 ± 50.14 ms, 1319.39 ± 55.44 ms and 1276.35 ± 56.56 ms; ECV, 35.42 ± 4.42%, 31.85 ± 3.01% and 26.97 ± 1.87%; all p<0.05). In the cardiac strain analysis, ECV was significantly correlated with global radial strain (GRS) (r = − 0.501,p = 0.009), global circumferential strain (GCS) (r = 0.553,p = 0.005) and global longitudinal strain (GLS) (r = 0.507,p = 0.008) in ESRD patients with HF. Cox proportional hazard regression models revealed that ECV (hazard ratio [HR] = 1.160, 95% confidence interval: 1.022 to 1.318,p = 0.022) was the only independent predictor of HF in ESRD patients. It also had a higher diagnostic accuracy for detecting MF (area under the curve [AUC] = 0.936; 95% confidence interval: 0.864 to 0.976) than native T1 and post T1 (allp ≤ 0.002). Kaplan-Meier analysis revealed that the high-ECV group had a shorter median overall survival time than the low-ECV group (18 months vs. 20 months, log-rankp = 0.046) and that ESRD patients with high ECV were more likely to have HF.

Conclusions

Myocardial fibrosis quantification by ECV on CMR T1 mapping was shown to be an independent risk factor of heart failure, providing incremental prognostic value and risk stratification for cardiac events in ESRD patients.

Trial registration

Chinese Clinical Trial RegistryChiCTR-DND-17012976, 13/12/2017, Retrospectively registered.
A systematic review reporting quality of radiomics research in neuro-oncology: toward clinical utility and quality improvement using high-dimensional imaging features
Authors: Park Ji Eun , Kim Ho Sung , Kim Donghyun , Park Seo Young , Kim Jung Youn , Cho Se Jin , Kim Jeong Hoon
Published: January 2020

Background

To evaluate radiomics analysis in neuro-oncologic studies according to a radiomics quality score (RQS) system to find room for improvement in clinical use.

Methods

Pubmed and Embase were searched up the terms radiomics or radiogenomics and gliomas or glioblastomas until February 2019. From 189 articles, 51 original research articles reporting the diagnostic, prognostic, or predictive utility were selected. The quality of the methodology was evaluated according to the RQS. The adherence rates for the six key domains were evaluated: image protocol and reproducibility, feature reduction and validation, biologic/clinical utility, performance index, a high level of evidence, and open science. Subgroup analyses for journal type (imaging vs. clinical) and biomarker (diagnostic vs. prognostic/predictive) were performed.

Results

The median RQS was 11 out of 36 and adherence rate was 37.1%. Only 29.4% performed external validation. The adherence rate was high for reporting imaging protocol (100%), feature reduction (94.1%), and discrimination statistics (96.1%), but low for conducting test-retest analysis (2%), prospective study (3.9%), demonstrating potential clinical utility (2%), and open science (5.9%). None of the studies conducted a phantom study or cost-effectiveness analysis. Prognostic/predictive studies received higher score than diagnostic studies in comparison to gold standard (P < .001), use of calibration (P = .02), and cut-off analysis (P = .001).

Conclusions

The quality of reporting of radiomics studies in neuro-oncology is currently insufficient. Validation is necessary using external dataset, and improvements need to be made to feature reproducibility, demonstrating clinical utility, pursuits of a higher level of evidence, and open science.
Gender differences in response to war-related trauma and posttraumatic stress disorder – a study among the Congolese refugees in Uganda
Authors: Ainamani Herbert E. , Elbert Thomas , Olema David Kani , Hecker Tobias
Published: January 2020

Background

The wars in the Democratic Republic of Congo have left indelible marks on the mental health and functioning of the Congolese civilians that sought refuge in Uganda. Even though it is clear that civilians who are exposed to potentially traumatizing events in war and conflict areas develop trauma-related mental health problems, scholarly information on gender differences on exposure to different war-related traumatic events, their conditional risks to developing PTSD and whether the cumulative exposure to traumatic events affects men and women differently is still scanty.

Methods

In total, 325 (n = 143 males, n = 182 females) Congolese refugees who lived in Nakivale, a refugee settlement in the Southwestern part of Uganda were interviewed within a year after their arrival. Assessment included exposure to war-related traumatic events, and DSM-IV PTSD symptom severity.

Results

Our main findings were that refugees were highly exposed to war-related traumatic events with experiencing dangerous flight as the most common event for both men (97%) and women (97%). The overall high prevalence of PTSD differed among women (94%) and men (84%). The highest conditional prevalence of PTSD in women was associated with experiencing rape. The dose-response effect differed significantly between men and women with women showing higher PTSD symptom severity when experiencing low and moderate levels of potentially traumatizing event types.

Conclusion

In conflict areas, civilians are highly exposed to different types of war-related traumatic events that expose them to high levels of PTSD symptoms, particularly women. Interventions focused at reducing mental health problems resulting from war should take the context of gender into consideration.
Progression of the smoking epidemic in high-income regions and its effects on male-female survival differences: a cohort-by-age analysis of 17 countries
Authors: Wensink Maarten , Alvarez Jesús-Adrián , Rizzi Silvia , Janssen Fanny , Lindahl-Jacobsen Rune
Published: January 2020

Background

Of all lifestyle behaviours, smoking caused the most deaths in the last century. Because of the time lag between the act of smoking and dying from smoking, and because males generally take up smoking before females do, male and female smoking epidemiology often follows a typical double wave pattern dubbed the ‘smoking epidemic’. How are male and female deaths from this epidemic differentially progressing in high-income regions on a cohort-by-age basis? How have they affected male-female survival differences?

Methods

We used data for the period 1950–2015 from the WHO Mortality Database and the Human Mortality Database on three geographic regions that have progressed most into the smoking epidemic: high-income North America, high-income Europe and high-income Oceania. We examined changes in smoking-attributable mortality fractions as estimated by the Preston-Glei-Wilmoth method by age (ages 50–85) across birth cohorts 1870–1965. We used these to trace sex differences with and without smoking-attributable mortality in period life expectancy between ages 50 and 85.

Results

In all three high-income regions, smoking explained up to 50% of sex differences in period life expectancy between ages 50 and 85 over the study period. These sex differences have declined since at least 1980, driven by smoking-attributable mortality, which tended to decline in males and increase in females overall. Thus, there was a convergence between sexes across recent cohorts. While smoking-attributable mortality was still increasing for older female cohorts, it was declining for females in the more recent cohorts in the US and Europe, as well as for males in all three regions.

Conclusions

The smoking epidemic contributed substantially to the male-female survival gap and to the recent narrowing of that gap in high-income North America, high-income Europe and high-income Oceania. The precipitous decline in smoking-attributable mortality in recent cohorts bodes somewhat hopeful. Yet, smoking-attributable mortality remains high, and therefore cause for concern.
CHD7 gene polymorphisms in female patients with idiopathic scoliosis
Authors: Borysiak Karolina , Janusz Piotr , Andrusiewicz Mirosław , Chmielewska Małgorzata , Kozinoga Mateusz , Kotwicki Tomasz , Kotwicka Małgorzata
Published: January 2020

Background

The CHD7 (chromosome domain helicase DNA binding protein 7) gene has been associated with familial idiopathic scoliosis (IS) in families of European descent. The CHD7 single-nucleotide polymorphisms have never been studied in Polish Caucasian IS patients.

Methods

The aim of this study was to investigate the relationship of CHD7 gene polymorphisms with susceptibility to or progression of IS in Polish Caucasian females. The study group comprised 211 females who underwent clinical, radiological and genetic examination. The study group was analyzed in three subgroups according to: (1) Cobb angle (Cobb angle ≤30° vs. Cobb angle ≥35°), (2) age of diagnosis (adolescent IS vs. early-onset IS) and (3) rate of progression (non-progressive vs. slowly progressive vs. rapidly progressive IS). The control group comprised 83 females with no scoliosis and with a negative family history who underwent clinical and genetic examination. In total six CHD7 gene polymorphisms were examined. Three polymorphisms (rs1017861, rs13248429, and rs4738813) were examined by RFLP (restriction fragment length polymorphism) analysis, and three were quantified by Sanger sequencing (rs78874766, rs4738824, and rs74797613).

Results

In rs13248429, rs78874766, and rs74797613 polymorphisms only the wild allele was present. The rs1017861 polymorphism demonstrated an association with IS susceptibility (p < 0.01). Two polymorphisms, rs1017861 and rs4738813, were associated with curve severity and progression rate (p < 0.05). None of the evaluated polymorphisms in CHD7 gene showed any association with the age of IS onset.

Conclusions

The polymorphism rs1017861 in CHD7 gene showed an association with IS susceptibility. Two polymorphisms (rs1017861 and rs4738813) were associated with curve severity and progression rate. None of the evaluated polymorphisms in CHD7 gene showed any association with the age of IS onset. Further evaluation of CHD7 gene should be considered as IS modifying factor.
Researcher and study participants’ perspectives of consent in clinical studies in four referral hospitals in Vietnam
Authors: Van Nuil Jennifer Ilo , Nguyen Thi Thanh Thuy , Le Nguyen Thanh Nhan , Nguyen Van Vinh Chau , Chambers Mary , Ta Thi Dieu Ngan , Merson Laura , Nguyen Thi Phuong Dung , Hoang Minh Tu Van , Parker Michael , Bull Susan , Kestelyn Evelyne
Published: January 2020

Background

Within the research community, it is generally accepted that consent processes for research should be culturally appropriate and tailored to the context, yet researchers continue to grapple with what valid consent means within specific stakeholder groups. In this study, we explored the consent practices and attitudes regarding essential information required for the consent process within hospital-based trial communities from four referral hospitals in Vietnam.

Methods

We collected surveys from and conducted semi-structured interviews with study physicians, study nurses, ethics committee members, and study participants and family members regarding their experiences of participating in research, their perspectives toward research, and their views about various elements of the consent process.

Results

In our findings, we describe three interrelated themes related to the consent process: (1) words and regulation; (2) reimbursement, suspicions, and joining; and (3) responsibilities. In general, stakeholders had highly varied perspectives of nghiên cứu (Eng.: research) and researchers used varying levels of detail regarding all aspects of the study in the consent process to build trust with and/or promote potential research participants’ choices about taking part in research. Findings additionally highlight how researchers felt that offering financial reimbursements in a hospital setting, where payment for services was routine, would be unfamiliar to participants and could raise suspicions about the research. Participants, however, focused their discussions on reimbursement or alternative reasons for joining the study, such as health related benefits or altruism. Finally, participants often relied on their physician to help them decide about joining a study or not.

Conclusion

Further research is needed to understand how researchers and participants make sense of and practice consent, and how that impacts participants’ decision-making about research participation. To promote valid consent within this context, it is important to engage with hospital-based trial communities as a whole. The data from this study will inform future research on consent, guide the revisions of consent related policies within our research sites and point to several larger issues surrounding researcher-participant expectations, communication, and trust.
Tocilizumab modifies clinical and laboratory features of macrophage activation syndrome complicating systemic juvenile idiopathic arthritis
Authors: Shimizu Masaki , Mizuta Mao , Okamoto Nami , Yasumi Takahiro , Iwata Naomi , Umebayashi Hiroaki , Okura Yuka , Kinjo Noriko , Kubota Tomohiro , Nakagishi Yasuo , Nishimura Kenichi , Mohri Mariko , Yashiro Masato , Yasumura Junko , Wakiguchi Hiroyuki , Mori Masaaki
Published: January 2020

Background

This study aimed to determine the influence of tocilizumab (TCZ) in modifying the clinical and laboratory features of macrophage activation syndrome (MAS) complicating systemic juvenile idiopathic arthritis (s-JIA). Furthermore, we assessed the performance of the 2016 MAS classification criteria for patients with s-JIA-associated MAS while treated with TCZ.

Methods

A panel of 15 pediatric rheumatologists conducted a combination of expert consensus and analysis of real patient data. Clinical and laboratory features of s-JIA-associated MAS in 12 TCZ-treated patients and 18 untreated patients were evaluated. Possible MAS was defined as having characteristic laboratory features but lack of clinical features of MAS, or atypical MAS, or early treatment that prevented full-blown MAS.

Results

Clinically, the TCZ-treated patients with s-JIA-associated MAS were less likely febrile and had significantly lower ferritin, triglyceride, and CRP levels than the untreated patients with s-JIA-associated MAS. Other laboratory features of MAS including lower platelet counts and lower fibrinogen were more pronounced in TCZ-treated patients. The TCZ-treated patients with s-JIA-associated MAS were less likely to be classified as MAS based on the MAS classification criteria (25% vs 83.3%, p < 0.01). This is ascribed to the absence of fever or insufficient ferritin elevation, compared with the untreated patients.

Conclusion

TCZ could modify the clinical and laboratory features of s-JIA-associated MAS. When evaluating the s-JIA patients while treated with TCZ, it is not applicable to use MAS classification criteria. Care must be taken to not underdiagnose MAS based on the MAS classification criteria.
Exploring women and traditional birth attendants’ perceptions and experiences of stillbirths in district Thatta, Sindh, Pakistan: a qualitative study
Authors: Mcnojia Sanam Zulfiqar , Saleem Sarah , Feroz Anam , Khan Kausar S. , Naqvi Farnaz , Tikmani Shiyam Sunder , McClure Elizabeth M. , Siddiqi Sameen , Goldenberg Robert L.
Published: January 2020

Background

Pakistan reports the highest stillbirth rate in the world at 43 per thousand births with more than three-quarters occurring in rural areas. The Global Network for Women’s and Children’s Health maintains a Maternal and Newborn Health Registry (MNHR) in 14 study clusters of district Thatta, Sindh Pakistan. For the last 10 years, the MNHR has recorded a high stillbirths rate with a slow decline. This exploratory study was designed to understand the perspectives of women and traditional birth attendants regarding the high occurrence of stillbirth in Thatta district.

Methods

We used an exploratory qualitative study design by conducting in-depth interviews (IDIs) and focus group discussions (FGDs) using semi-structured interview guide with rural women (FGDs = 4; n = 29) and traditional birth attendants (FGDs = 4; n = 14) who were permanent residents of Thatta. In addition, in-depth interviews were conducted with women who had experienced a stillbirth (IDIs = 4). This study presents perceptions and experiences of women and TBAs regarding high rate of stillbirth in Thatta district, Karachi.

Results

Women showed reluctance to receive skilled/ standard care when in need due to apprehensions towards operative delivery, poor attitude of skilled health care providers, and poor quality of care as service delivery factors. High cost of care, far distance to facility, lack of transport and need of an escort from the family or village to visit a health facility were additional important factors for not seeking care resulting in stillbirth. The easy availability of unskilled provider in the form of traditional birth attendant is then preferred over a skilled health care provider. TBAs shared their husband or family members restrict them to visit or consult a doctor during pregnancy. According to TBAs after delivering a macerated fetus, women are given herbs to remove infection from woman‘s body and uterus. Further women are advised to conceive soon so that they get rid of infections.

Conclusion

Women of this rural community carry lots of apprehension against skilled medical care and as a result follow traditional practices. Conscious efforts are required to increase the awareness of women to develop positive health seeking behavior during pregnancy, delivery and the post-partum period. Alongside, provision of respectful maternity care needs to be emphasized especially at public health facilities.
Rare diseases in Chile: challenges and recommendations in universal health coverage context
Authors: Encina Gonzalo , Castillo-Laborde Carla , Lecaros Juan A. , Dubois-Camacho Karen , Calderón Juan F. , Aguilera Ximena , Klein Andrés D. , Repetto Gabriela M.
Published: January 2020

Rare diseases (RDs) are a large number of diverse conditions with low individual prevalence, but collectively may affect up to 3.5–5.9% of the population. They have psychosocial and economic impact on patients and societies, and are a significant problem for healthcare systems, especially for countries with limited resources. In Chile, financial protection exists for 20 known RDs through different programs that cover diagnosis and treatments. Although beneficial for a number of conditions, most RD patients are left without a proper legal structure that guarantees a financial coverage, and in a vulnerable situation. In this review, we present and analyze the main challenges of the Chilean healthcare system and legislation on RDs, and other ambits of the RD ecosystem, including patient advocacy groups and research. Finally, we propose a set of policy recommendations that includes creating a patient registry, eliciting social preferences on health and financial coverage, improving access to clinical genetic services and therapies, promoting research on RDs and establishing a Latin-American cooperation network, all aimed at promoting equitable quality healthcare access for people living with RDs.
Management and current status of spinal muscular atrophy: a retrospective multicentre claims database analysis
Authors: Darbà Josep
Published: January 2020

Introduction

The interest in patient demographics and disease management has increased in the past years due to their utility in developing measures that allow healthcare providers to reflect disease complexity.

Objective

To revise the current status of spinal muscular atrophy in the region of Catalonia, and to validate the utility of the database for this aim.

Methods

Five hundred twenty-four patients diagnosed with a spinal muscular atrophy were identified in the region of Catalonia via the novel program of data analysis for research and innovation in health (PADRIS). Patient records included in the analysis corresponded to primary care, hospital, emergency room, extended care and mental health admissions between 2007 and 2017.

Results

58.02% of patients with a SMA diagnosis were males while 40.84% were females. Average age of diagnosis was 38.31 ± 24.49 years ±SD. Significantly lower was the age of diagnosis of spinal muscular atrophy type I, 1.81 ± 3.01 years. An average of 22 patients died per year during the study period, with a mean decease age of 62.96 ± 25.41 years. Patients were generally attended in hospitals, and the use of healthcare resources was focused on resolving respiratory issues and scoliosis. The highest ratio of admissions per patient was registered in those aged 0 to 4 years. Patients presented a higher risk than the general population and a higher frequency of multimorbidites.

Conclusions

Patients exhibited similar characteristics to prior European studies. Multiple admissions in younger patients, mostly due to respiratory issues, have a central role in increasing medical costs of SMA. Equally, the higher risk of patients and increased number of multimorbidity groups translate in an elevated number of admissions in health centres and ER, deriving in higher expenses.
Immunological features of patients affected by Barraquer-Simons syndrome
Authors: Corvillo Fernando , Ceccarini Giovanni , Nozal Pilar , Magno Silvia , Pelosini Caterina , Garrido Sofía , López-Lera Alberto , Moraru Manuela , Vilches Carlos , Fornaciari Silvia , Gabbriellini Sabrina , Santini Ferruccio , Araújo-Vilar David , López-Trascasa Margarita
Published: January 2020

Background

C3 hypocomplementemia and the presence of C3 nephritic factor (C3NeF), an autoantibody causing complement system over-activation, are common features among most patients affected by Barraquer-Simons syndrome (BSS), an acquired form of partial lipodystrophy. Moreover, BSS is frequently associated with autoimmune diseases. However, the relationship between complement system dysregulation and BSS remains to be fully elucidated. The aim of this study was to provide a comprehensive immunological analysis of the complement system status, autoantibody signatures and HLA profile in BSS. Thirteen subjects with BSS were recruited for the study. The circulating levels of complement components, C3, C4, Factor B (FB) and Properdin (P), as well as an extended autoantibody profile including autoantibodies targeting complement components and regulators were assessed in serum. Additionally, HLA genotyping was carried out using DNA extracted from peripheral blood mononuclear cells.

Results

C3, C4 and FB levels were significantly reduced in patients with BSS as compared with healthy subjects. C3NeF was the most frequently found autoantibody (69.2% of cases), followed by anti-C3 (38.5%), and anti-P and anti-FB (30.8% each). Clinical data showed high prevalence of autoimmune diseases (38.5%), the majority of patients (61.5%) being positive for at least one of the autoantibodies tested. The HLA allele DRB1*11 was present in 54% of BSS patients, and the majority of them (31%) were positive for *11:03 (vs 1.3% allelic frequency in the general population).

Conclusions

Our results confirmed the association between BSS, autoimmunity and C3 hypocomplementemia. Moreover, the finding of autoantibodies targeting complement system proteins points to complement dysregulation as a central pathological event in the development of BSS.
Type-5 abomasal ulcer and omental bursitis in 14 cows
Authors: Braun Ueli , Reif Christina , Hilbe Monika , Gerspach Christian
Published: January 2020

Background

Type-5 abomasal ulcer (U5) is a perforated ulcer that causes peritonitis limited to the omental bursa. This retrospective study describes the clinical and laboratory findings in 14 cattle with omental bursitis due to U5. The medical records of 14 cows aged 2.5 to 14.6 years (5.4 ± 3.1 years) with U5 were scrutinised.

Results

The most common clinical findings were partial or complete anorexia (100%), abdominal guarding (100%), obtunded demeanour (93%), congested scleral vessels (79%), tachypnoea (71%), rumen atony (64%), diminished faecal output (64%), reduced skin surface temperature (64%) and fever (46%). Four (29%) cows had between one and four concomitant diseases. The most common abnormal laboratory findings were hypokalemia (71%), haemoconcentration (57%), metabolic acidosis (57%) and azotaemia (43%). All cows were euthanased; five immediately after the initial examination, one after exploratory laparotomy and eight after unsuccessful treatment. A diagnosis of U5 was made in all cows during postmortem examination.

Conclusions

There is a need for improvement of the antemortem diagnosis of U5 because reliable differentiation of this disease from other conditions with a similar clinical presentation is currently not feasible.
Trends in suicide-related research in Australia
Authors: Schlichthorst Marisa , Reifels Lennart , Krysinska Karolina , Ftanou Maria , Machlin Anna , Robinson Jo , Pirkis Jane
Published: January 2020

Background

Despite continuous research over the past 20 years in Australia there is still limited understanding of what works and what does not work in suicide prevention and where to invest research efforts that will help to expand this knowledge base. There is a recursive relationship between research activities, knowledge gain and the development of strategy and action plans as these in turn guide future decisions on research funding. In this context, the first step to continuous improvement in knowledge is to better understand where research has been invested in the past until now and where it has not.

Methods

We conducted a study that collected data over two periods. The first data collection was done in 2006 for the period of 1999 to 2006 and the second data collection was in 2017 for the period from 2010 to 2017. This allowed us to examine changes in published suicide-related journal articles, and grants/fellowships funded between the two periods. Published articles and grants/fellowships were classified according to a pre-determined framework.

Results

The number of suicide-related articles and grants/fellowships increased over the two periods. We noted shifts in the types of research that were funded and published, and in the emphasis that was given to different types of suicidal behavior, suicide methods, and settings. Research target groups showed a trend towards increasing diversification.

Conclusions

Our findings help to identify current research priorities and inform where future priorities for suicide-related research in Australia lie by linking findings to other external data sources (population risk data, stakeholder consultations, national strategies and action plan documents).
Highly specific PCR-RFLP assays for karyotyping the widespread 2Rb inversion in malaria vectors of the Anopheles gambiae complex
Authors: Montanez-Gonzalez Raquel , Pichler Verena , Calzetta Maria , Love Rachel R. , Vallera Alexandra , Schaecher Lydia , Caputo Beniamino , Pombi Marco , Petrarca Vincenzo , della Torre Alessandra , Besansky Nora J.
Published: January 2020

Background

Chromosomal inversion polymorphisms play a role in adaptation to heterogeneous environments. Inversion polymorphisms are implicated in the very high ecological flexibility of the three main malaria vector species of the Afrotropical Anopheles gambiae complex, facilitating the exploitation of anthropogenic environmental modifications and promoting a strong association with humans. In addition to extending the species’ spatial and temporal distribution, inversions are associated with epidemiologically relevant mosquito behavior and physiology, underscoring their medical importance. We here present novel PCR-RFLP based assays strongly predictive of genotype for the cosmopolitan 2Rb inversion in An. coluzzii and An. gambiae, a development which overcomes the numerous constraints inherent to traditional cytological karyotyping.

Methods

We designed PCR-RFLP genotyping assays based on tag SNPs previously computationally identified as strongly predictive (> 95%) of 2Rb genotype. We targeted those tags whose alternative allelic states destroyed or created the recognition site of a commercially available restriction enzyme, and designed assays with distinctive cleavage profiles for each inversion genotype. The assays were validated on 251 An. coluzzii and 451 An. gambiae cytologically karyotyped specimens from nine countries across Africa and one An. coluzzii laboratory colony.

Results

For three tag SNPs, PCR-RFLP assays (denoted DraIII, MspAI, and TatI) reliably produced robust amplicons and clearly distinguishable electrophoretic profiles for all three inversion genotypes. Results obtained with the DraIII assay are ≥ 95% concordant with cytogenetic assignments in both species, while MspAI and TatI assays produce patterns highly concordant with cytogenetic assignments only in An. coluzzii or An. gambiae, respectively. Joint application of species-appropriate pairs of assays increased the concordance levels to > 99% in An. coluzzii and 98% in An. gambiae. Potential sources of discordance (e.g. imperfect association between tag and inversion, allelic dropout, additional polymorphisms in the restriction target site, incomplete or failed restriction digestion) are discussed.

Conclusions

The availability of highly specific, cost effective and accessible molecular assays for genotyping 2Rb in An. gambiae and An. coluzzii allows karyotyping of both sexes and all developmental stages. These novel tools will accelerate deeper investigations into the role of this ecologically and epidemiologically important chromosomal inversion in vector biology.
E-test versus agar dilution for antibiotic susceptibility testing of Helicobacter pylori: a comparison study
Authors: Miftahussurur Muhammad , Fauzia Kartika Afrida , Nusi Iswan Abbas , Setiawan Poernomo Boedi , Syam Ari Fahrial , Waskito Langgeng Agung , Doohan Dalla , Ratnasari Neneng , Khomsan Ali , Adnyana I. Ketut , Akada Junko , Yamaoka Yoshio
Published: January 2020

Objective

For evaluating the antibiotic resistance ofHelicobacter pylori, the agar dilution method is the gold standard; however, using this method in daily practice is laborious. E-test has been proposed to be an uncomplicated method. This study was aimed at validating the E-test and detecting the presence of any bias between the agar dilution method and E-test.

Results

The agar dilution method and E-test were performed using five antibiotics for 72 strains ofH. pyloriobtained from clinical patients in Indonesia. The E-test’s results showed a higher prevalence of resistance to all the antibiotics tested but the difference was not significant. Results showed high essential agreement (> 90.0%) for all the antibiotics, but only 84.7% for metronidazole. The agreement for MIC value was acceptable for levofloxacin, clarithromycin, and metronidazole. For amoxicillin, it showed only fair agreement (0.25) by the Kappa analysis and significant difference by Passing-Bablok regression. Even though some discrepancies were found, the E-test has an acceptable agreement for levofloxacin, metronidazole, tetracycline, and clarithromycin but further confirmation may be necessary for amoxicillin.
Design and implementation of an educational game considering issues for visually impaired people inclusion
Authors: Neto Luiz Valério , Fontoura Junior Paulo H.F. , Bordini Rogério A. , Otsuka Joice L. , Beder Delano M.
Published: January 2020

In recent years there has been an increase in research focusing on the effectiveness of using video games as educational digital resources that can contribute to the learning process at different levels, which has also subsidised the development of educational games. However, these games are mostly visual and not accessible to people with visual impairments. As an educational resource, it is essential that the design of educational games be conducted not only with a focus on the balance between playful and educational aspects, but also with a focus on including the largest number of people. This article, therefore, aims to describe the design, implementation and evaluation processes of an accessible version of the educational game Em Busca do Santo Grau, based on EduGameAccess – a set of recommendations that integrates educational, playability and accessibility aspects for people with visual impairments.
18F-FDG PET/CT imaging findings in anaplastic large cell lymphoma, a rare subtype of lymphoma
Authors: Jiang Yanping , Wang Lijuan , Zhou Wenlan , Gu Jiamei , Tian Ying , Dong Ye , Fu Lilan , Wu Hu-bing
Published: January 2020

Objective

To investigate the 18F-FDG PET/CT imaging manifestations for anaplastic large cell lymphoma (ALCL), a rare subtype of T/NK cell lymphoma.

Methods

Fifty patients with ALCL, including 32 anaplastic lymphoma kinase (ALK)-positive patients and 18 ALK-negative patients, were enrolled. The positive detection, maximal standardized uptake value (SUVmax), and distribution of nodal and extranodal involvement were recorded and analysed. Fifty patients with diffuse large B cell lymphoma (DLBCL) were collected as a control group.

Results

ALCL lesions were demonstrated to be 18F-FDG-avid tumours with a mean SUVmax of 19.4 ± 12.6. Most (76%) ALCL patients presented with stage III-IV disease, and nodal and extranodal involvement occurred in 74.0 and 72.0% of the patients, respectively. ALCL and DLBCL showed many similarities in tumour stage, 18F-FDG uptake and tumour involvement (P > 0.05), although the preferred extranodal organs of involvement (bone and the gastrointestinal tract, respectively) were different (P < 0.05). Compared to ALK-negative lesions, a higher uptake of 18F-FDG was found in the ALK-positive lesions (SUVmax: 22.1 ± 14.3 vs. 15.1 ± 6.6, t = 2.354, P = 0.023). ALK-positive ALCL was more likely to involve the lymph nodes than ALK-negative ALCL (84.3% vs. 55.5%, χ2 = 4.973, P = 0.043), while ALK-negative ALCL was more prone to involve the extranodal organs compared to ALK-positive ALCL (88.9% vs. 62.5%, χ2 = 3.979, P = 0.046).

Conclusion

The present study demonstrated that ALCL is a systemic 18F-FDG-avid lymphoma with many imaging manifestations similar to DLBCL on PET/CT. The present study also showed that ALK expression actually influenced tumour 18F-FDG uptake and lesion distribution. These findings may be useful to improve the understanding of the biological characteristics of ALCL.
Performance evaluation of a new custom, multi-component DNA isolation method optimized for use in shotgun metagenomic sequencing-based aerosol microbiome research
Authors: Bøifot Kari Oline , Gohli Jostein , Moen Line Victoria , Dybwad Marius
Published: January 2020

Background

Aerosol microbiome research advances our understanding of bioaerosols, including how airborne microorganisms affect our health and surrounding environment. Traditional microbiological/molecular methods are commonly used to study bioaerosols, but do not allow for generic, unbiased microbiome profiling. Recent studies have adopted shotgun metagenomic sequencing (SMS) to address this issue. However, SMS requires relatively large DNA inputs, which are challenging when studying low biomass air environments, and puts high requirements on air sampling, sample processing and DNA isolation protocols. Previous SMS studies have consequently adopted various mitigation strategies, including long-duration sampling, sample pooling, and whole genome amplification, each associated with some inherent drawbacks/limitations.

Results

Here, we demonstrate a new custom, multi-component DNA isolation method optimized for SMS-based aerosol microbiome research. The method achieves improved DNA yields from filter-collected air samples by isolating DNA from the entire filter extract, and ensures a more comprehensive microbiome representation by combining chemical, enzymatic and mechanical lysis. Benchmarking against two state-of-the-art DNA isolation methods was performed with a mock microbial community and real-world air samples. All methods demonstrated similar performance regarding DNA yield and community representation with the mock community. However, with subway samples, the new method obtained drastically improved DNA yields, while SMS revealed that the new method reported higher diversity. The new method involves intermediate filter extract separation into a pellet and supernatant fraction. Using subway samples, we demonstrate that supernatant inclusion results in improved DNA yields. Furthermore, SMS of pellet and supernatant fractions revealed overall similar taxonomic composition but also identified differences that could bias the microbiome profile, emphasizing the importance of processing the entire filter extract.

Conclusions

By demonstrating and benchmarking a new DNA isolation method optimized for SMS-based aerosol microbiome research with both a mock microbial community and real-world air samples, this study contributes to improved selection, harmonization, and standardization of DNA isolation methods. Our findings highlight the importance of ensuring end-to-end sample integrity and using methods with well-defined performance characteristics. Taken together, the demonstrated performance characteristics suggest the new method could be used to improve the quality of SMS-based aerosol microbiome research in low biomass air environments.
Atypical citizenship regimes: comparing legal and political conceptualizations
Authors: Naujoks Daniel
Published: January 2020

Notions, features, and forms of citizenship, understood as legal membership in a state, are changing the world over. While contestations of the monolithic understanding of citizenship generally focus on the content of individuals’ rights and their belonging and participation in social and political institutions, this essay shows that official membership categories that are labeled ‘citizenship’ by state actors vary. Drawing on the experiences of the Overseas Citizenship of India, the British Overseas Citizenship, and Citizenship of the European Union the essay proposes an analytical framework that aims at advancing the comparative study of state membership policies by introducing six key dimensions that policy actors consider when designing citizenship policies. Apart from systematizing the content of citizenship, the framework sheds light on the importance of citizenship terminology, as states employ the label of citizenship and use the status as a vehicle of communication. The essay highlights differences in the construction of special subjects, moral obligations and the exercise of power, analyzes the aspirations of political actors, the political rhetoric, and explores the interplay between tangible rights and intangible narratives. The discussion of the three atypical membership regimes reveals that states operate in grey areas of membership statuses that partly mimic existing forms of state membership and partly push the boundaries of what state membership means. This has significant repercussions for comparative citizenship and democracy theory and the meaning of membership.
Adequacy of decision-making based on each kidney function estimation method for Japanese living kidney donor candidates: a retrospective observational study
Authors: Hashimoto Koji , Harada Makoto , Yamada Yosuke , Sugano Mitsutoshi , Minagawa Tomonori , Ogawa Teruyuki , Ishizuka Osamu , Kamijo Yuji
Published: January 2020

Background

Living kidney transplantation comprises the majority of kidney transplantations in Japan. Living kidney donors should be assured of their own health. Therefore, Japanese guidelines define the criterion of kidney function for living donors. Glomerular filtration rates (GFR) ≥ 70 mL/min/1.73 m2 are required for marginal donors. The guidelines require that GFRs of donors be measured by the inulin (In) clearance method (CIn) or the radioisotope method, but these methods can be substituted with the creatinine (Cr) clearance method (CCr). Methods for estimating kidney function are susceptible to error, and decision-making regarding donor eligibility could be affected by the estimation method used. We investigated the adequacy of decision-making based on kidney function estimation methods used in Japanese living kidney donor candidates by comparing CCr or estimated GFR (eGFR), calculated by several equations, and CIn as measured GFR (mGFR).

Methods

In total, 210 people, including 36 actual kidney donor candidates, who had both CIn and CCr measured at Shinshu University Hospital from April 2011 to April 2015, were included. Cr and cystatin C (Cys) levels measured at the same time were used to calculate eGFR (eGFRCr and sGFRCys, respectively). We evaluated the concordance rates of cases whose GFR levels were ≥ 70 mL/min/1.73 m2 in this study and assumed that they were living kidney donor candidates. Only kidney donor candidates underwent an additional sensitivity analysis.

Results

Median CIn and CCr were 55.5 mL/min/1.73 m2 and 68.0 mL/min/1.73 m2, respectively. CCr had the highest tendency to overestimate kidney function. Some participants were incorrectly evaluated as adequate using CCr, despite their mGFR being inadequate for living kidney donors according to the guidelines. These results were independent of sex or actual living kidney donor candidates. The average of eGFRCr and eGFRCys was well correlated with CIn.

Conclusions

Kidney function estimated by CCr is not equal to the mGFR. When using CCr as a kidney function estimation method to determine the adequacy of a living kidney donor, it should be noted that CCr overestimates kidney function. In evaluating adequacy for a marginal donor, GFR estimated by CIn should be assessed.
Optimization of cultivation conditions for Microcystis aeruginosa for biodiesel production using response surface methodology
Authors: El-Mekkawi Samar A. , El-Ibiari N. N. , El-Ardy Ola A. , Abdelmonem Nabil M. , Elahwany Ahmed H. , Abadir Magdi F. , Ismail Ibrahim M.
Published: January 2020

Background

Biodiesel is expected to play a key role in the development of a sustainable, economical, and environmentally safe source of energy. The third generation of biodiesel is derived from microalgae and cyanobacteria that have sufficient amount of oil. The optimization of biomass and oil content in biodiesel production based on algal cultivation relies upon several factors. The present experimental work aims at optimizing some of the cultivation conditions to obtain maximum oil and biomass yield and create a prediction model that describe the effect of the initial inoculum concentration, and irradiance on the biomass yield and oil concentration were designed using Design Expert 6.0.8.

Results

The results revealed that the optimum surface-to-volume ratio for the airlift bubble column photobioreactor was 0.9, and the most applicable model for describing Microcystis aeruginosa growth was the hyperbolic tangent model with a model constant value of 1.294 mg·L− 1·d− 1/μmol·m− 2·s− 1. The optimum cultivation conditions were 81 μmol·m− 2·s− 1 irradiance and 67 mg·L− 1 initial inoculum concentration, and these conditions achieved a biomass yield of 163 mg·L− 1·d− 1 and an oil concentration of 143 mg·L− 1.

Conclusions

This work focused on the cultivation of microalgae in closed systems. Cyanobacteria as M. aeruginosa has high lipid content, and high lipid productivity makes it suitable as a lipid feed stock for biodiesel production. The response surface method was the most suitable route to study the simultaneous influence of irradiance and initial inoculum concentration through statistical methods as well as to establish a model for predicting the biomass yield and oil concentration of M. aeruginosa.