bluuebunny/crossref_metadata_2025 huggingface dataset:
New pathogens, new tricks: emerging, drug‐resistant fungal pathogens and future prospects for antifungal therapeutics
Authors: Geddes‐McAlister Jennifer , Shapiro Rebecca S.
Published: May 2018

Fungal pathogens are a growing threat to public health. As human immunodeficiency becomes increasingly common, fungal infections are becoming more prevalent. The use of antifungal agents for prophylaxis and treatment of fungal infections has favored the emergence of previously rare or unidentified species of drug‐resistant fungal pathogens, including several Candida and Cryptococcus species, as well as mold pathogens. As these new and increasingly drug‐resistant fungal pathogens continue to emerge, novel strategies for rapid identification and treatment are necessary to combat these life‐threatening infections.
Expression of stem cell markers Nanog and Nestin in lip squamous cell carcinoma and actinic cheilitis
Authors: Scotti Fernanda M. , Mitt Verônica C. , Vieira Daniella SC. , Biz Michelle T. , Castro Renata G. , Modolo Filipe
Published: May 2018

Cancer stem cell (CSC) proteins have been observed in several lesions and are associated with tumor beginning, evolution, and resistance to treatment.

Objectives

To investigate the presence of NANOG, NESTIN, and β‐tubulin in lip squamous cell carcinoma (LSCC), actinic cheilitis (AC), and normal epithelium (NE).

Materials and Methods

Thirty cases of LSCC, thirty cases of AC (both analyzed according to the WHO classification and AC according to the binary classification), and twenty cases of NE were submitted to an immunohistochemical study.

Results

NANOG was more expressed in the nuclei of AC compared to NE (p = 0.007), as well as in high‐risk AC cases (p = 0.017) and well‐differentiated LSCCs (no significance). There was an accumulation of nuclear NANOG from mild to moderate and severe ACs. NESTIN was significantly less present in NE compared to AC (p = 0.001) and LSCC (p = 0.003). There was a higher expression in severe dysplasia or high‐risk AC and well‐differentiated LSCC. These results indicate an upregulation of NANOG and NESTIN in the early stages of carcinogenesis. β‐tubulin was intensely present in all lesions.

Conclusion

The results suggest an upregulation of NANOG and NESTIN in the biological behavior these diseases, mainly in the transformation from AC to LSCC.
Oral anticoagulation and left atrial thrombi resolution in nonrheumatic atrial fibrillation or flutter: A systematic review and meta‐analysis
Authors: Wang Norman C. , Sather Matthew D. , Hussain Aliza , Althouse Andrew D. , Adelstein Evan C. , Jain Sandeep K. , Katz William E. , Shalaby Alaa A. , Voigt Andrew H. , Saba Samir
Published: May 2018

Background

Oral anticoagulation (OAC) is prescribed for left atrial thrombi (LAT) in nonrheumatic atrial fibrillation (AF) and/or atrial flutter (AFL). The study objective was to review the existing evidence regarding LAT resolution in nonrheumatic AF and/or AFL with OAC agents.

Methods

Data sources included PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) between January 1, 1991 and February 10, 2017. English‐language studies that assessed LAT resolution with OAC agents in subjects with nonrheumatic AF and/or AFL, by serial transesophageal echocardiography, and with follow‐up times ≥ 3 weeks and < 1 year, were selected. Study quality was assessed using recommendations adapted from the Agency for Healthcare Research and Quality. Pooled LAT resolution rates were evaluated for vitamin K antagonist (VKA) studies and low risk of bias warfarin studies.

Results

The pooled LAT resolution rate of 619 subjects from 16 VKA studies was 63.7% (95% confidence interval [CI], 53.3%–72.9%). The pooled LAT resolution rate of 94 subjects from four studies that specified warfarin use, exclusion of prior long‐term therapeutic OAC, and target international normalized ratio (INR) ≥ 2.0 and/or average achieved INR ≥ 2.0 was 79.3% (95% CI, 69.8%–86.4%). Two studies in direct‐acting oral anticoagulants (DOACs) reported LAT resolution rates of 89.5% (17 of 19) for dabigatran and 41.5% (22 of 53) for rivaroxaban.

Conclusions

Warfarin is the most studied initial OAC agent for treating LAT in nonrheumatic AF and/or AFL with a resolution rate of nearly 80%. Further studies in DOACs are warranted.
Ultrasound‐Guided Neurolysis of Six Genicular Nerves for Intractable Pain from Knee Osteoarthritis: A Case Series
Authors: Ahmed Arif , Arora Divesh
Published: May 2018

Introduction

Among the elderly population, chronic osteoarthritis of the knee joint is one of the leading causes of disability and causes considerable pain, joint stiffness, and functional limitations. Although knee replacement is a good option for advanced osteoarthritis, many patients could not undergo surgery due to comorbidities or other reasons.

Methods

Four patients with severe pain from grade 3 and 4 osteoarthritis of the knee had undergone ultrasound‐guided alcohol neurolysis of the 6 genicular nerves after a positive genicular nerve block with local anesthetics. The demographics, pain intensity (NRS), Oxford Knee Score (OKS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and quality of life (SF‐36) were analyzed.

Results

There was significant improvement in pain intensity at rest, on movement, and on weight bearing after the neurolysis and it has continued for 6 months (P < 0.05). The OKS and WOMAC score had improved from 7.75 ± 1.25 and 77.75 ± 4.34 at baseline, to 20.75 ± 1.70 and 56.25 ± 3.09 at 1 month, and to 18.25 ± 0.95 and 52.00 ± 2.16 at 6 months after the procedure, respectively (P < 0.05). There was also significant improvement in the quality of life after the procedure (P < 0.05).

Conclusion

Ultrasound‐guided alcohol neurolysis is a good alternative for patients having severe pain from knee osteoarthritis and provides significant pain relief for more than 6 months.
“Mirror, Mirror on the Wall”… Pediatric liver transplantation in the case of situs inversus totalis with a disrupted inferior vena cava
Authors: Edgerton Colston A. , Gross Megan , Kasi Nagraj , Hewitt Winston , Edmondson Sara , Rohan Vinayak S. , Nadig Satish N.
Published: May 2018

We present the unique case of a 15‐month‐old male born with biliary atresia and situs inversus totalis and disrupted inferior vena cava who underwent a successful liver transplantation. The patient had previously undergone a failed Kasai procedure and presented with persistent hyperbilirubinemia. The patient was transplanted with a left lateral segment donor having standard arterial anatomy. Technical considerations included identifying completely replaced arterial anatomy in the recipient from the superior mesenteric artery and creating a branch patch between the gastroduodenal artery and HA, anastomosing the donor left hepatic vein to confluences of the donor left, middle, and right hepatic veins, using a “lazy‐S” configuration of portal vein anastomosis, and suspending the allograft to the abdominal wall. Post‐operatively, his liver function tests and total bilirubin normalized and he progressed to tolerating an oral diet with tube‐feed supplementation.
Pretransplant trends in α‐fetoprotein levels as a predictor of recurrence after living donor liver transplantation for unresectable hepatoblastoma: A single‐institution experience
Authors: Isono Kaori , Ohya Yuki , Lee Kwang‐Jong , Hashimoto Shintaro , Kadohisa Masashi , Sakisaka Masataka , Uto Keiichi , Hayashida Shintaro , Yamamoto Hidekazu , Yamamoto Hirotoshi , Sugawara Yasuhiko , Inomata Yukihiro
Published: May 2018

LT is a practical therapeutic alternative for unresectable hepatoblastoma; however, deciding when to perform LT is difficult. The aim of this study was to optimize the timing of LT for hepatoblastoma using pretransplant trends in AFP levels. Trends in pretransplant AFP levels and their influence on post‐transplant outcomes were retrospectively evaluated. All patients who underwent living donor LT for hepatoblastoma in our institution since 2002 were included. Variables analyzed included history of prior tumor resection, pretransplant AFP responses to chemotherapy, metastatic disease at diagnosis, and post‐transplant chemotherapy. Eight patients (seven boys and one girl; median age, 35 months; range, 15 months‐12 years) were transplanted. The overall post‐transplant recurrence‐free survival rate was 62.5% (5/8) with a mean follow‐up of 77 months. Patients with post‐transplant recurrence showed a 0.573 log increase in AFP levels after the last chemotherapy session before LT. This was significantly higher than the 0.279 log decrease observed in patients without post‐transplant recurrence (P = .024). Because the AFP response cannot be accurately predicted before each cycle of chemotherapy, it may be appropriate to perform LT when AFP levels do not decrease after the last cycle and before they are found to be elevated again.
Geometric model and assessment of a dual‐fisheye imaging system
Authors: Campos Mariana Batista , Tommaselli Antonio Maria Garcia , Marcato Junior José , Honkavaara Eija
Published: May 2018

This paper presents a technique for the calibration of a 360° dual imaging system (Ricoh Theta S) composed of two cameras with fisheye lenses specially mounted in a common structure. The experiments are based on calibration with a bundle adjustment using the equidistant fisheye lens model and relative orientation stability constraints, such as distance, base elements and rotation matrix between individual cameras’ coordinate systems. As a result, an equidistant mathematical model using the Conrady–Brown lens distortion model was shown to be suitable for estimating the interior and relative orientation parameters of the Ricoh Theta S. The main contribution presented in this work is a simultaneous bundle adjustment approach with stability constraints on base elements and rotation matrix angles, which achieved accuracies comparable with conventional photogrammetric calibration with perspective cameras.
Did Europe Move in the Right Direction on E‐waste Legislation?
Authors: Mazahir Shumail , Verter Vedat , Boyaci Tamer , Van Wassenhove Luk N.
Published: May 2018

This study presents an analytical framework of the product take back legislation in the context of product reuse. We characterize existing and proposed forms of E‐waste legislation and compare their environmental and economic performance. Using stylized models, we analyze an OEM's decision about new and remanufactured product quantity in response to the legislative mechanism. We focus on the 2012 waste electrical and electronic equipment directive in Europe, where the policy makers intended to create additional incentives for the product reuse. Through a comparison to the Original 2002 version of the directive, we find that these incentives translate into improved environmental outcomes only for a limited set of products. We also study a proposed policy that advocates a separate target for the product reuse. Our analysis reveals that from an environmental standpoint, the Recast version is always dominated either by the Original policy or by the one that advocates a separate target for product reuse. We show that the benefits of a separate reuse target scheme can be fully replicated with the aid of fiscal levers. Our main message is that there cannot be a single best environmental policy that is suitable for all products. Therefore, the consideration of product attributes is essential in identification of the most appropriate policy tool. This can be done either by the implementation of different policies on each product category or by implementation of product‐based target levels.
miR‐26a suppresses autophagy in swine Sertoli cells by targeting ULK2
Authors: Ran M , Li Z , Cao R , Weng B , Peng F , He C , Chen B
Published: May 2018

Contents

A large number of microRNAs (miRNAs) have been detected from porcine testicular tissues thanks to the development of high‐throughput sequencing technology. However, the regulatory roles of most identified miRNAs in swine testicular development or spermatogenesis are poorly understood. In our previous study, ULK2 (uncoordinated‐51‐like kinase 2) was predicted as a target gene of miR‐26a. In this study, we aimed to investigate the role of miR‐26a in swine Sertoli cell autophagy. The relative expression of miR‐26a and ULK2 levels has a significant negative correlation (R2 = .5964, p ≤ .01) in nine developmental stages of swine testicular tissue. Dual‐luciferase reporter assay results show that miR‐26a directly targets the 3′UTR of the ULK2 gene (position 618–624). In addition, both the mRNA and protein expression of ULK2 were downregulated by miR‐26a in swine Sertoli cells. These results indicate that miR‐26a targets the ULK2 gene and downregulates its expression in swine Sertoli cells. Based on the expression of marker genes (LC3, p62 and Beclin‐1), overexpression of miR‐26a or knock‐down of ULK2 inhibits swine Sertoli cell autophagy. Taken together, these findings demonstrate that miR‐26a suppresses autophagy in swine Sertoli cells by targeting ULK2.
Inflation in South Africa: An Assessment of Alternative Inflation Models
Authors: Fedderke Johannes , Liu Yang
Published: May 2018

We consider the relative empirical performance of a range of inflation models for South Africa. Model coverage is of Phillips curve, New Keynesian Phillips curve, monetarist and structural models of inflation. Our core findings are that the single most robust covariate of inflation is unit labour cost. We further decompose unit labour cost into changes in the nominal wage and real labour productivity. The principal association is a strong positive relationship between inflation and nominal wages, while improvements in real labour productivity report only a relatively weak negative association with inflation. Supply‐side shocks also consistently report an association with inflation. As to demand‐side shocks, the output gap does not return a robust statistical association with inflation. Instead, it is growth in the money supply and government expenditure which return robust and theoretically consistent associations with inflationary pressure.
Role of BASIC PENTACYSTEINE transcription factors in a subset of cytokinin signaling responses
Authors: Shanks Carly M. , Hecker Andreas , Cheng Chia‐Yi , Brand Luise , Collani Silvio , Schmid Markus , Schaller G. Eric , Wanke Dierk , Harter Klaus , Kieber Joseph J.
Published: May 2018

Cytokinin plays diverse roles in plant growth and development, generally acting by modulating gene transcription in target tissues. The type‐B Arabidopsis response regulators (ARR) transcription factors have emerged as primary targets of cytokinin signaling and are required for essentially all cytokinin‐mediated changes in gene expression. The diversity of cytokinin function is likely imparted by the activity of various transcription factors working with the type‐B ARRs to alter specific sets of target genes. One potential set of co‐regulators modulating the cytokinin response are the BARLEY B‐RECOMBINANT/BASIC PENTACYSTEINE (BBR/BPC) family of plant‐specific transcription factors. Here, we show that disruption of multiple BPCs results in reduced sensitivity to cytokinin. Further, the BPCs are necessary for the induction of a subset of genes in response to cytokinin. We identified direct in vivo targets of BPC6 using ChIP‐Seq and found an enrichment of promoters of genes differentially expressed in response to cytokinin. Further, a significant number of BPC6 regulated genes are also direct targets of the type‐B ARRs. Potential cis‐binding elements for a number of other transcription factors linked to cytokinin action are enriched in the BPC binding fragments, including those for the cytokinin response factors (CRFs). In addition, several BPCs interact with a subset of type‐A ARRs. Consistent with these results, a significant number of genes whose expression is altered in bpc mutant roots are also mis‐expressed in crf1,3,5,6 and type‐A arr3,4,5,6,7,8,9,15 mutant roots. These results suggest that the BPCs are part of a complex network of transcription factors that are involved in the response to cytokinin.
Effects of Swaddled and Sponge Bathing Methods on Signs of Stress and Pain in Premature Newborns: Implications for Evidence‐Based Practice
Authors: Ceylan Sibel Serap , Bolւşւk Bahire
Published: May 2018

Aims

To determine the effects of sponge baths and swaddled bathing on premature infants’ vital signs, oxygen saturation levels, crying times, pain, and stress levels.

Methods

This study was a clinical trial with a crossover design. Data were conducted in the neonatal intensive care unit of a public hospital in Denizli, Turkey. A total of 35 premature infants, who were born at 33–37 weeks gestation with a birth weight <1,500 g, were enrolled in the study. Two bathing methods were applied at 3‐day intervals. Vital signs and oxygen saturation levels were measured before and at minutes 1, 5, 15, 30 after bathing. Infants’ bathing was video recorded to assess pain and stress behaviors. The pain and stress behaviors of infants were evaluated by independent observers. A significance level of .05 was used for all statistical analyses.

Results

There were statistically significant differences between bathing methods on vital signs, oxygen saturation levels, and crying times. Levels of stress and pain according to bathing type were significantly higher in the sponge bath condition (p < .05).

Linking Evidence to Action

Swaddled bathing has a positive effect on the infant's vital signs, oxygen saturation levels, crying time, and level of stress and pain compared to the sponge bath condition. Swaddled bathing is a harmless and safe nursing practice.
The Role of Profitability in Mediating the Effect of Dividend Policy and Company Size on Company Value
Authors: Monoarfa Rio
Published: May 2018

The purpose of this research is to analyze the effect of dividend policy and company size on profitability and company value of consumer goods company in Indonesia Stock Exchange (IDX). The population of this research is consumer goods companies in Indonesia Stock Exchange in the year of 2014-2016 amounted to 45 companies. Sampling is done by saturation sampling method in which all members of population are used as sample. The data analysis of this research uses method of structural equation added by PLS (Partial Least Square) approach. The result of the research shows that dividend policy has negative effect on profitability, while company size does not give any effect on profitability. Dividend policy, company size and profitability variable have an effect on company value. Profitability can not mediate the effect of dividend policy on company value but it can mediate the effect of company size on company value.
Effectiveness of stellate ganglion blockade on refractory ventricular arrhythmias: a systematic review protocol
Authors: Mayo Elizabeth C. , Lloren Narbelito V.
Published: May 2018

Review question:

The question of this review is: what is the effectiveness of stellate ganglion blockade on refractory ventricular arrhythmias in patients 18 years or over?
Nasoenteric feeding discharge planning for cancer patients in a Brazilian teaching hospital: a best practice implementation project
Authors: Poveda Vanessa de Brito , Marques da Silva Adriana , Toyama Aline Cordeiro , Andrade da Silva Jomana , Shimoda Gilcéria Tochika , Püschel Vilanice Alves de Araújo
Published: May 2018

Objectives:

The objective of this project was to improve local practice in nasoenteric feeding discharge planning for cancer patients in a cancer teaching hospital in São Paulo, Brazil.

Introduction:

Nasoenteric tubes are commonly used for enteral nutrition in patients with cancer for over seven days during their recovery and this may be continued at home, with clear benefits.

Results:

Baseline audit results indicated poor compliance (between 0% and 22%) with the current evidence, although good compliance (100%) was observed for three audit criteria. Implementation of the strategies, including changes to achieve higher participation of caregivers, resulted in an improvement of the audited criteria (100% compliance was maintained for three criteria, compliance increased from 22% to 67% for a further three criteria, with 0% compliance for one criterion).

Conclusions:

Despite the short time frame of this study, an increase in compliance with best practices proposed by the Joanna Briggs Institute was observed. Implementing a multidisciplinary meeting before patient discharge remains a challenge.
Influence of aperture angles and design focal depths on the performance of point-focusing shear vertical wave electromagnetic acoustic transducers
Authors: Jia Xiao-juan , Ouyang Qi
Published: May 2018

Electromagnetic acoustic transducers (EMATs) with concentric meander-line (CML) coils possess the capability of producing point-focusing shear vertical (PFSV) waves. For the CML coil, an intercepted circular arc of the concentric circle with a continuously changing spacing, the aperture angle is a key factor effecting the point-focusing performance. Thus, the influence of aperture angles of CML coils on the point-focusing behavior of PFSV-EMATs is analyzed using the established finite element modeling in detail, which also considers the effect of lift-off distance on the signal amplitude. The beam directional pattern is characterized quantitatively by the half-power beam width, indicating the relationship between the aperture angle and beam width. In addition, since the focus offset is sensitive in depth direction, the effect of design focal depths on focal offset is also carefully studied. Three CML coils with an aperture angle of 30°, 90°, and 150° are fabricated by printed circuit board technique and experimentally analyzed; the experimental results are well consistent with the simulation results. These findings can be used to design optimized PFSV-EMATs with good point-focusing performance.
Nonvolatile infrared memory in MoS
2
/PbS van der Waals heterostructures
Authors: Wang Qisheng , Wen Yao , Cai Kaiming , Cheng Ruiqing , Yin Lei , Zhang Yu , Li Jie , Wang Zhenxing , Wang Feng , Wang Fengmei , Shifa Tofik Ahmed , Jiang Chao , Yang Hyunsoo , He Jun
Published: May 2018

Researchers demonstrate a nonvolatile infrared memory cell operating in the optical communication wavebands.
IRE1α prevents hepatic steatosis by processing and promoting the degradation of select microRNAs
Authors: Wang Jie-Mei , Qiu Yining , Yang Zhao , Kim Hyunbae , Qian Qingwen , Sun Qinghua , Zhang Chunbin , Yin Lei , Fang Deyu , Back Sung Hong , Kaufman Randal J. , Yang Ling , Zhang Kezhong
Published: May 2018

A high-fat diet causes liver disease by suppressing IRE1α-regulated microRNA biogenesis.
Tools for Rapid Genetic Engineering of Vibrio fischeri
Authors: Visick Karen L. , Hodge-Hanson Kelsey M. , Tischler Alice H. , Bennett Allison K. , Mastrodomenico Vincent
Published: May 2018

Vibrio fischeriis used as a model for a number of processes, including symbiosis, quorum sensing, bioluminescence, and biofilm formation. Many of these studies depend on generating deletion mutants and complementing them. Engineering such strains, however, is a time-consuming, multistep process that relies on cloning and subcloning. Here, we describe a set of tools that can be used to rapidly engineer deletions and insertions in theV. fischerichromosome without cloning. We developed a uniform approach for generating deletions using PCR splicing by overlap extension (SOEing) with antibiotic cassettes flanked by standardized linker sequences. PCR SOEing of the cassettes to sequences up- and downstream of the target gene generates a DNA product that can be directly introduced by natural transformation. Selection for the introduced antibiotic resistance marker yields the deletion of interest in a single step. Because these cassettes also contain FRT (FLP recognition target) sequences flanking the resistance marker, Flp recombinase can be used to generate an unmarked, in-frame deletion. We developed a similar methodology and tools for the rapid insertion of specific genes at a benign site in the chromosome for purposes such as complementation. Finally, we generated derivatives of these tools to facilitate different applications, such as inducible gene expression and assessing protein production. We demonstrated the utility of these tools by deleting and inserting genes known or predicted to be involved in motility. While developed forV. fischeristrain ES114, we anticipate that these tools can be adapted for use in otherV. fischeristrains and, potentially, other microbes.

IMPORTANCEVibrio fischeriis a model organism for studying a variety of important processes, including symbiosis, biofilm formation, and quorum sensing. To facilitate investigation of these biological mechanisms, we developed approaches for rapidly generating deletions and insertions and demonstrated their utility using two genes of interest. The ease, consistency, and speed of the engineering is facilitated by a set of antibiotic resistance cassettes with common linker sequences that can be amplified by PCR with universal primers and fused to adjacent sequences using splicing by overlap extension and then introduced directly intoV. fischeri, eliminating the need for cloning and plasmid conjugation. The antibiotic cassettes are flanked by FRT sequences, permitting their removal using Flp recombinase. We augmented these basic tools with a family of constructs for different applications. We anticipate that these tools will greatly accelerate mechanistic studies of biological processes inV. fischeriand potentially otherVibriospecies.
Updates to Clostridium difficile Spore Germination
Authors: Kochan Travis J. , Foley Matthew H. , Shoshiev Michelle S. , Somers Madeline J. , Carlson Paul E. , Hanna Philip C.
Published: May 2018

Germination of
Clostridium difficile
spores is a crucial early requirement for colonization of the gastrointestinal tract. Likewise,
C. difficile
cannot cause disease pathologies unless its spores germinate into metabolically active, toxin-producing cells.
A Concise Review of the Epidemiology and Diagnostics of Rickettsioses: Rickettsia and Orientia spp
Authors: Abdad Mohammad Yazid , Abou Abdallah Rita , Fournier Pierre-Edouard , Stenos John , Vasoo Shawn
Published: May 2018

Rickettsioses are globally distributed and caused by the family
Rickettsiaceae
, which comprise a diverse and expanding list of organisms. These include two genera,
Rickettsia
and
Orientia
.
Entry of Herpes Simplex Virus 1 into Epidermis and Dermal Fibroblasts Is Independent of the Scavenger Receptor MARCO
Authors: Thier Katharina , Möckel Maureen , Palitzsch Katja , Döhner Katinka , Sodeik Beate , Knebel-Mörsdorf Dagmar
Published: May 2018

During entry into its host cells, the human pathogen herpes simplex virus (HSV) interacts with various cellular receptors. Initially, receptor interaction can mediate cellular adsorption, followed by receptor binding that triggers viral internalization. The intriguing question is which receptors are responsible for the various steps during entry into the natural target tissues of HSV? Previously, we demonstrated the role of nectin-1 as a major receptor and that of HVEM as an alternative receptor for HSV-1 to invade murine epidermis. As MARCO has been described to promote infection in skin, we explored the predicted role of MARCO as a receptor that mediates adsorption to epithelial cells. Our infection studies of murine skin cells indicate that the absence of MARCO does not interfere with the efficiency of HSV-1 entry and that the inhibitory effect on viral adsorption by poly(I), a ligand of MARCO, is independent of MARCO.
Lactobacillus
Mucosal Vaccine Vectors: Immune Responses against Bacterial and Viral Antigens
Authors: LeCureux Jonathan S. , Dean Gregg A.
Published: May 2018

Lactic acid bacteria (LAB) have been utilized since the 1990s for therapeutic heterologous gene expression. The ability of LAB to elicit an immune response against expressed foreign antigens has led to their exploration as potential mucosal vaccine candidates.
Pneumococcal Metabolic Adaptation and Colonization Are Regulated by the Two-Component Regulatory System 08
Authors: Gómez-Mejia Alejandro , Gámez Gustavo , Hirschmann Stephanie , Kluger Viktor , Rath Hermann , Böhm Sebastian , Voss Franziska , Kakar Niamatullah , Petruschka Lothar , Völker Uwe , Brückner Reinhold , Mäder Ulrike , Hammerschmidt Sven
Published: May 2018

Streptococcus pneumoniae
interplays with its environment by using 13 two-component regulatory systems and one orphan response regulator. These systems are involved in the sensing of environmental signals, thereby modulating pneumococcal pathophysiology. This study aimed to understand the functional role of genes subject to control by the TCS08. The identified genes play a role in transport of compounds such as sugars or amino acids. In addition, the intermediary metabolism and colonization factors are modulated by TCS08. Thus, TCS08 regulates genes involved in maintaining pneumococcal physiology, transport capacity, and adhesive factors to enable optimal colonization, which represents a prerequisite for invasive pneumococcal disease.
Physicians’ attitudes towards the media and peer-review selection of the ‘best cancer doctor’: comparison of two different selection methods
Authors: Shin Dong Wook , Cho Juhee , Yang Hyung Kook , Kim So Young , Lee Soohyeon , Nam Eun Joo , Chung Joo Seop , Im Jeong-Soo , Park Keeho , Park Jong Hyock
Published: May 2018

Objectives

The choice of doctor is an important issue for patients with cancer, and the reputation of the doctor is the single most important factor for patients to choose a doctor. Media are providing information about the ‘best cancer doctor’, but they vary widely in their selection methodology. We investigated cancer physicians’ attitudes towards the selection of the ‘best cancer doctor’ by the media, by comparing two different selection methodologies: selection by media personnel or selection through peer-review system.

Design

Nationwide, cross-sectional survey.

Setting

National Cancer Center and 12 Regional Cancer Centers across Korea.

Participants

A total of 680 cancer care physicians participated in the survey (75.5% participation rate), and two were excluded due to incomplete response.

Main outcome measures

Physicians’ opinions on the credibility, fairness, validity, helpfulness to patients, their intention to use the information and helpfulness to improve the quality of cancer care of the two different methods.

Results

Only a few physicians believed that the selection method of the ‘best cancer doctor’ by the media personnel was credible (9.1%), fair (6.1%) or valid (10.0%). In contrast, the majority agreed that the peer-selection method of the ‘best doctor’ is credible (74.7%), fair (64.7%) and valid (67.4%). More physicians believed the latter methods would be useful for patients when selecting their doctor (38.5% vs 82.2%) and may lead to improvement of the quality of cancer care from the perspective of the healthcare system (12.6% vs 59.8%). The need for ensuring objectiveness and transparency was also raised.

Conclusion

Physicians showed different attitudes towards two different selection methods. Regulations or guidelines for selecting the ‘best cancer doctor’ and for disclosing the information should be considered in order to control the quality of the information and to protect the customers.
Development and testing of the Youth Alcohol Norms Survey (YANS) instrument to measure youth alcohol norms and psychosocial influences
Authors: Burns Sharyn K , Maycock Bruce , Hildebrand Janina , Zhao Yun , Allsop Steve , Lobo Roanna , Howat Peter
Published: May 2018

Objectives

This study aimed to develop and validate an online instrument to: (1) identify common alcohol-related social influences, norms and beliefs among adolescents; (2) clarify the process and pathways through which proalcohol norms are transmitted to adolescents; (3) describe the characteristics of social connections that contribute to the transmission of alcohol norms; and (4) identify the influence of alcohol marketing on adolescent norm development.

Setting

The online Youth Alcohol Norms Survey (YANS) was administered in secondary schools in Western Australia

Participants

Using a 2-week test–retest format, the YANS was administered to secondary school students (n=481, age=13–17 years, female 309, 64.2%).

Primary and secondary outcome measures

The development of the YANS was guided by social cognitive theory and comprised a systematic multistage process including evaluation of content and face validity. A 2-week test–retest format was employed. Exploratory factor analysis was conducted to determine the underlying factor structure of the instrument. Test–retest reliability was examined using intraclass correlation coefficient (ICC) and Cohen’s kappa.

Results

A five-factor structure with meaningful components and robust factorial loads was identified, and the five factors were labelled as ‘individual attitudes and beliefs’, ‘peer and community identity’, ‘sibling influences’, ‘school and community connectedness’ and ‘injunctive norms’, respectively. The instrument demonstrated stability across the test–retest procedure (ICC=0.68–0.88, Cohen’s kappa coefficient=0.69) for most variables.

Conclusions

The results support the reliability and factorial validity of this instrument. The YANS presents a promising tool, which enables comprehensive assessment of reciprocal individual, behavioural and environmental factors that influence alcohol-related norms among adolescents.
Efficacy and safety of GHX02 in the treatment of acute bronchitis: protocol of a phase II, double-blind, randomised placebo-controlled trial
Authors: Lyu Yee Ran , Yang Won-Kyung , Park So Jung , Kim Seung-Hyeong , Kang Wee-Chang , Jung In Chul , Park Yang Chun
Published: May 2018

Introduction

Acute bronchitis is a self-limiting infection of the large airways; cough is the primary symptom, usually lasting for about 3 weeks. Annually, approximately 5% of adults develop acute bronchitis, and its economic burden is substantial. There are also problems of antibiotic abuse in public health systems and symptomatic therapies are commonly prescribed, for which there is insufficient supporting evidence. GHX02 contains four herbs originating from gwaruhaengryeon-hwan, which has been used in the treatment of patients with acute bronchitis in Korea. The objective is to compare the GHX02 and placebo in terms of efficacy and safety, and to determine the appropriate dosage.

Methods and analysis

We planned a phase II, multicentre, dose-finding, double-blind, randomised placebo-controlled trial of two different doses of GHX02 compared with placebo. A total of 150 patients, aged 19–75 years, with a Bronchitis Severity Score (BSS) ≥5 due to acute bronchitis starting within 2 weeks of study enrolment will be recruited from three university-affiliated hospitals across Korea. Participants will be stratified into three patterns using the Korean Standard Tool of Pattern Identifications of Cough and Sputum and randomly assigned to either a high-dose GHX02 group (1920 mg/day), standard-dose GHX02 group (960 mg/day) or placebo group according to a 1:1:1 allocation ratio. Patients will take medications three times daily for 7 days, with two visiting days. The primary outcome measure is a change in BSS from day 0 to day 7. The secondary outcomes are the Questionnaire of Clinical Symptoms of Cough and Sputum, Leicester Cough Questionnaire, frequency of coughing fits, Integrative Medicine Outcome Scale, Integrative Medicine Patient Satisfaction Scale and withdrawal rate of patients with exacerbation. Safety will be assessed by adverse events, vital signs and laboratory examinations.

Ethics and dissemination

The study has been approved by our Institutional Review Board (No. DJDSKH-17-DR-14). The trial results will be disseminated via peer-reviewed journals and the Clinical Research Information Service.

Trial registration number

NCT03310385; Pre-results.
Association between an individual housing-based socioeconomic index and inconsistent self-reporting of health conditions: a prospective cohort study in the Mayo Clinic Biobank
Authors: Ryu Euijung , Olson Janet E , Juhn Young J , Hathcock Matthew A , Wi Chung-Il , Cerhan James R , Yost Kathleen J , Takahashi Paul Y
Published: May 2018

Objective

Using surveys to collect self-reported information on health and disease is commonly used in clinical practice and epidemiological research. However, the inconsistency of self-reported information collected longitudinally in repeated surveys is not well investigated. We aimed to investigate whether a socioeconomic status based on current housing characteristics, HOUsing-based SocioEconomic Status (HOUSES) index linking current address information to real estate property data, is associated with inconsistent self-reporting.

Study setting and participants

We performed a prospective cohort study using the Mayo Clinic Biobank (MCB) participants who resided in Olmsted County, Minnesota, USA, at the time of enrolment between 2009 and 2013, and were invited for a 4-year follow-up survey (n=11 717).

Primary and secondary outcome measures

Using repeated survey data collected at the baseline and 4 years later, the primary outcome was the inconsistency in survey results when reporting prevalent diseases, defined by reporting to have ‘ever’ been diagnosed with a given disease in the baseline survey but reported ‘never’ in the follow-up survey. Secondary outcome was the response rate for the 4-year follow-up survey.

Results

Among the MCB participants invited for the 4-year follow-up survey, 8508/11 717 (73%) responded to the survey. Forty-three per cent had at least one inconsistent self-reported disease. Lower HOUSES was associated with higher inconsistency rates, and the association remained significant after pertinent characteristics such as age and perceived general health (OR=1.46; 95% CI 1.17 to 1.84 for the lowest compared with the highest HOUSES decile). HOUSES was also associated with lower response rate for the follow-up survey (56% vs 77% for the lowest vs the highest HOUSES decile).

Conclusion

This study demonstrates the importance of using the HOUSES index that reflects current SES when using self-reporting through repeated surveys, as the HOUSES index at baseline survey was inversely associated with inconsistent self-report and the response rate for the follow-up survey.
Digital breast tomosynthesis plus synthesised images versus standard full-field digital mammography in population-based screening (TOSYMA): protocol of a randomised controlled trial
Authors: Weigel Stefanie , Gerss Joachim , Hense Hans-Werner , Krischke Miriam , Sommer Alexander , Czwoydzinski Jörg , Lenzen Horst , Kerschke Laura , Spieker Karin , Dickmaenken Stefanie , Baier Sonja , Urban Marc , Hecht Gerold , Heidinger Oliver , Kieschke Joachim , Heindel Walter
Published: May 2018

Introduction

Development of digital breast tomosynthesis (DBT) provides a technology that generates three-dimensional data sets, thus reducing the pitfalls of overlapping breast tissue. Observational studies suggest that the combination of two-dimensional (2D) digital mammography and DBT increases diagnostic accuracy. However, because of duplicate exposure, this comes at the cost of an augmented radiation dose. This undesired adverse impact can be avoided by using synthesised 2D images reconstructed from the DBT data (s2D).

We designed a diagnostic superiority trial on a high level of evidence with the aim of providing a comparison of screening efficacy parameters resulting from DBT+s2D versus the current screening standard 2D full-field digital mammography (FFDM) in a multicentre and multivendor setting on the basis of the quality-controlled, population-based, biennial mammography screening programme in Germany.

Methods and analysis

80 000 women in the eligible age 50–69 years attending the routine mammography screening programme and willing to participate in the TOSYMA trial will be assigned by 1:1 randomisation to either the intervention arm (DBT+s2D) or the control arm (FFDM) during a 12-month recruitment period in screening units of North Rhine-Westphalia and Lower Saxony. State cancer registries will provide the follow-up of interval cancers.

Primary endpoints are the detection rate of invasive breast cancers at screening examination and the cumulative incidence of interval cancers in the 2 years after a negative examination. Secondary endpoints are the detection rate of ductal carcinoma in situ and of tumour size T1, the recall rate for assessment, the positive predictive value of recall and the cumulative 12-month incidence of interval cancers. An adaptive statistical design with one interim analysis provides the option to modify the design.

Ethics and dissemination

This protocol has been approved by the local medical ethical committee (2016-132-f-S). Results will be submitted to international peer-reviewed journals.

Trial registration

NCT03377036; Pre-results.
Comparison of indoor temperatures of homes with recommended temperatures and effects of disability and age: an observational, cross-sectional study
Authors: Huebner Gesche M , Hamilton Ian , Chalabi Zaid , Shipworth David , Oreszczyn Tadj
Published: May 2018

Objectives

We examine if temperatures in winter in English homes meet the recommendation of being at least 18°C at all times. We analyse how many days meet this criterion and calculate the hours per day and night being at/above 18°C. These metrics are compared between households with occupants aged above 64 years or having a long-term disability (LTD) and those younger and without disability.

Design

Cross-sectional, observational.

Setting

England.

Participants

635 households.

Outcomes measures

(1) Mean temperatures, (2) proportion of days of the measurement period meeting the criterion, (3) average hours at/above 18°C, (4) average hours at night at/above 18°C.

Results

Mean winter temperatures in the bedroom were MBR=18.15°C (SD=2.51), the living room MLR=18.90°C (SD=2.46) and the hallway MHall=18.25°C (SD=2.57).

The median number of days meeting the criterion was 19–31%. For the living room, more days meet the criterion in the group with a LTD (Mdisability=342 vs Mno_disability=301, 95% CI 8 to 74), and with someone over 64 years present (Mabove64=341, Mbelow65=301 95%, CI 8 to 74).

The median number of hours/day meeting the criterion was 13–17. In the living room, households with a disability had more hours at 18°C (Mdisability=364, Mno_disability=297, 95% CI 17 to 83) as did the older age group (Mabove64=347, Mbelow65=296, 95% CI 18 to 84). In the hallway, more hours met the criterion in households with a disability (Mdisability=338, Mno_disability=302, 95% CI 3 to 70).

247 homes had at least nine hours of at least 18°C at night; no effect of age or disability.

Conclusions

Many households are at risk of negative health outcomes because of temperatures below recommendations.
Association between secondhand smoke exposure and hypertension in never smokers: a cross-sectional survey using data from Korean National Health and Nutritional Examination Survey V, 2010–2012
Authors: Park Young Sik , Lee Chang-Hoon , Kim Yu-Il , Ahn Chul Min , Kim Ju Ock , Park Ju-Heon , Lee Sang Haak , Kim Jae Yeol , Chun Eun Mi , Jung Tae-Hoon , Yoo Kwang-Ha
Published: May 2018

Objectives

Secondhand smoke (SHS) exposure is associated with cardiovascular disease. This study aims to determine the association between SHS exposure estimated by questionnaire and hypertension in Korean never smokers.

Setting

Korean National Health and Nutrition Examination Survey (KNHANES) V was conducted from 2010 to 2012.

Participants

We selected the never smokers aged over 20 years who answered the question about the SHS exposure.

Primary and secondary measures

SHS exposure in both the home and work place was estimated using a self-reporting questionnaire. We investigated the association between SHS exposure and hypertension by using multivariate analysis. And we evaluated the mean systolic and diastolic blood pressure values according to SHS exposure after adjusting for possible confounding factors. All analyses were stratified by women and men.

Results

There were 10 532 (women 8987 and men 1545) never smokers. We divided the subjects into three groups according to the amount of SHS exposure: none—group I, <2 hour/day—group II and ≥2 hour/day—group III. Using multivariate analysis, hypertension was more commonly associated with group III than group I in women (adjusted OR 1.50, 95% CI 1.00 to 2.04, p=0.011). Adjusted mean systolic and diastolic blood pressure values in women who were not taking antihypertensive medication were significantly elevated in group III by 2.3 and 1.7 mm Hg, respectively.

Conclusion

SHS exposure is significantly associated with hypertension in women never smokers.
Experiences of women in Ireland who accessed abortion by travelling abroad or by using abortion medication at home: a qualitative study
Authors: Aiken Abigail R A , Johnson Dana M , Broussard Kathleen , Padron Elisa
Published: May 2018

Background

The Republic of Ireland has one of the world’s most restrictive abortion laws, allowing abortion only to preserve a pregnant woman’s life. We examined the impact of the law on women’s options for accessing abortion, their decision-making regarding whichpathway to follow, and their experiences with their chosen approach.

Methods

We conducted semi-structured in-depth interviews with 38 women who had either travelled abroad to access abortion in a clinic or had self-managed a medical abortion at home using online telemedicine, between 2010 and 2017. We coded interview transcripts according to an iteratively developed coding guide and performed a thematic analysis to identify key themes.

Results

We identified four key themes: (1) self-managing a medical abortion at home using online telemedicine can be a preference over travelling abroad to access abortion services; (2) regardless of the pathway chosen, women experience a lack of pre- and post-abortion support in the Irish healthcare system; (3) feelings of desperation while searching for safe abortion care can lead to considering or attempting dangerous methods; and (4) Irish abortion law and attitudes have impacts beyond physical health considerations, engendering shame and stigma.

Conclusions

Despite the country’s restrictive abortion law, women in Ireland do obtain abortions, using methods that are legal and safe elsewhere. However, the law negatively impacts women’s ability to discuss their options with their healthcare professionals and to seek follow-up care, and can have serious implications for their physical and emotional health. This study’s findings provide evidence to inform public and policy discourse on Ireland’s abortion laws.