bluuebunny/crossref_metadata_2025 huggingface dataset:
Liraglutide Attenuates Myocardial Fibrosis via Inhibition of AT1R-Mediated ROS Production in Hypertensive Mice
Authors: Chen Peng , Yang Fen , Wang Wenya , Li Xiao , Liu Dongling , Zhang Yongxi , Yin Guotian , Lv Fenghua , Guo Zhikun , Mehta Jawahar L. , Wang Xianwei
Published: July 2020

Background/Aims:

Glucagon-like peptide-1 receptor agonist liraglutide has been reported to exert cardioprotective effects, but its effect on cardiac fibrosis remains controversial. The aim of this study was to investigate the effects of liraglutide on cardiac fibrosis and potential mechanisms.

Methods:

C57BL/6 mice (3-month old) were randomly divided into control, hypertension, and hypertension + liraglutide groups. The hypertensive state was created by infusion of Ang II (100 ng/kg·min) for 4 weeks through subcutaneously implanted osmotic pumps. The control mice were infused with saline. Mice were also given vehicle or liraglutide (400 μg/kg·day). Blood pressure (BP), blood sugar, myocardial fibrosis, AT1R expression, and reactive oxygen species (ROS) levels were measured. To further elucidate the mechanisms of fibrosis, mouse cardiac fibroblasts were isolated and treated with liraglutide (300 nM/L) or losartan (10 μM) for 3 hours, followed by Ang II (10−7 M) for additional 12 hours. Reactive oxygen species production and expressions of collagen-1 and -3 were measured.

Results:

Liraglutide reduced BP and blood sugar but did not affect the body weight of the hypertensive mice. Liraglutide also inhibited collagen accumulation, AT1R expression, and ROS generation in the hearts of the hypertensive mice. In in vitro studies, pretreatment with liraglutide and losartan (as control) markedly inhibited Ang II-induced ROS production and collagen expression in the cultured cardiac fibroblasts.

Conclusion:

Liraglutide reduces myocardial fibrosis in the hypertensive mice, which appears to be dependent on at least in part inhibition of ROS production.
Viral Coagulopathy in Patients With COVID-19: Treatment and Care
Authors: Kipshidze Nickolas , Dangas George , White Christopher J. , Kipshidze Nodar , Siddiqui Fakiha , Lattimer Christopher R. , Carter Charles A. , Fareed Jawed
Published: July 2020

COVID-19 has proven to be particularly challenging given the complex pathogenesis of SARS-CoV-2. Early data have demonstrated how the host response to this novel coronavirus leads to the proliferation of pro-inflammatory cytokines, massive endothelial damage, and generalized vascular manifestations. While SARS-CoV-2 primarily targets the upper and lower respiratory tract, other organ systems are also affected. SARS-CoV-2 relies on 2 host cell receptors for successful attachment: angiotensin-converting enzyme 2 and transmembrane protease serine 2. Clinicopathologic reports have demonstrated associations between severe COVID-19 and viral coagulopathy, resulting in pulmonary embolism; venous, arterial, and microvascular thrombosis; lung endothelial injury; and associated thrombotic complications leading to acute respiratory distress syndrome. Viral coagulopathy is not novel given similar observations with SARS classic, including the consumption of platelets, generation of thrombin, and increased fibrin degradation product exhibiting overt disseminated intravascular coagulation–like syndrome. The specific mechanism(s) behind the thrombotic complications in COVID-19 patients has yet to be fully understood. Parenteral anticoagulants, such as heparin and low-molecular-weights heparins, are widely used in the management of COVID-19 patients. Beyond the primary (anticoagulant) effects of these agents, they may exhibit antiviral, anti-inflammatory, and cytoprotective effects. Direct oral anticoagulants and antiplatelet agents are also useful in the management of these patients. Tissue plasminogen activator and other fibrinolytic modalities may also be helpful in the overall management. Catheter-directed thrombolysis can be used in patients developing pulmonary embolism. Further investigations are required to understand the molecular and cellular mechanisms involved in the pathogenesis of COVID-19-associated thrombotic complications.
Rigor With or Without Templates? The Pursuit of Methodological Rigor in Qualitative Research
Authors: Harley Bill , Cornelissen Joep
Published: July 2020

The domain of qualitative research is replete with templates, standard protocols for the analysis of qualitative data. The use of such templates has sometimes been considered as automatically enhancing the rigor of qualitative research. In this article, we challenge the view that in the context of qualitative research, rigor is tied into the application of established protocols. Instead, we argue that rigor emanates from the way in which researchers engage in a deliberate reasoning process of inferring theoretical claims from their data. Such reasoning exists outside of templates, although it may make use of templates. Framing rigor as an emergent quality of reasoning, we distill the main processes through which qualitative researchers derive inferences from data and provide criteria for reflecting on the rigor with which they do so. We then extend these criteria into a set of practical recommendations through the presentation of examples and the framing of questions to focus researchers’ thinking on the application of the criteria. In doing so, we aim to help qualitative researchers to conduct research that leads to rigorously derived theoretical insights without having to resort to templates to attempt to do so.
Effect of a six-week dance-based physical education intervention on primary school children’s creativity: A pilot study
Authors: Neville Ross D , Makopoulou Kyriaki
Published: July 2020

There is international consensus that creativity is a fundamental outcome of schooling. Opportunities exist to enhance the creativity of schoolchildren, particularly in movement-based subjects such as physical education (PE). In this pilot study, we investigated the effect of a six-week dance-based PE intervention on children’s creativity in a primary school context. Forty second grade students participated in a controlled trial. One class ( n = 20) was assigned to the intervention and participated in dance-based PE lessons (10 girls, 10 boys; age 7–8 years). The other class ( n = 20) was assigned to the control condition and continued regular PE with no dance (10 girls, 10 boys; age 7–8 years). Pre–post assessment of creativity was obtained through an adapted version of Guilford’s (1967) Alternative Uses task. Data were analysed using linear mixed models, with adjustment made for children’s perceived dance ability and for baseline differences in creativity between groups. The overall effect of the intervention was small ( d = 0.36, 95%CI = –0.21 to 0.92), but not statistically significant ( p = 0.21). Post-hoc analysis revealed a large difference in the effect of the intervention between children with above and below-average baseline creativity ( d = 1.26, 95%CI = 0.14 to 2.39, p = 0.03). Children with above-average creativity at baseline benefitted more ( d = 0.99, 95%CI = 0.01 to 1.96, p = 0.047). This pilot study provides further support for the place of dance and creativity within the PE curriculum. However, particular attention should be given to students’ starting points.
Scaling virtual health at the epicentre of coronavirus disease 2019: A case study from NYU Langone Health
Authors: Sherwin Jason , Lawrence Katharine , Gragnano Veronica , Testa Paul A
Published: July 2020

The coronavirus disease 2019 (COVID-19) pandemic has accelerated the drive of health-care delivery towards virtual-care platforms. While the potential of virtual care is significant, there are challenges to the implementation and scalability of virtual care as a platform, and health-care organisations are at risk of building and deploying non-strategic, costly or unsustainable virtual-health systems. In this article, we share the NYU Langone Health enterprise approach to building and scaling an integrated virtual-health platform prior to and during the COVID-19 pandemic, and offer lessons learned and recommendations for health systems that need to undertake or are currently undertaking the transition to virtual-care delivery.
Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers
Authors: Lopez Gabriel , Narayanan Santhosshi , Christie Aimee , Powers-James Catherine , Liu Wenli , Garcia M Kay , Gomez Telma , Wu Jimin , Chunduru Aditi , Williams Janet L. , Li Yisheng , Bruera Eduardo , Cohen Lorenzo
Published: July 2020

Background: There is increasing interest in complementary approaches such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the effects of TC/QG delivered in group classes at a comprehensive cancer center. Methods: Patients and caregivers who participated in TC or QG completed assessments before and after an in-person group class. Assessments included questions about expectancy/satisfaction and common cancer symptoms (Edmonton Symptom Assessment Scale [ESAS]). ESAS distress subscales analyzed included global (GDS), physical (PHS), and psychosocial (PSS). Results: Three hundred four participants (184 patients, 120 caregivers) were included in the analysis. At baseline, caregivers had a greater expectancy for change in energy level as a result of class participation compared with patients (22.9% vs 9.9%). No significant difference was observed between baseline patient and caregiver PSS. Clinically significant improvement in well-being was observed among patients in TC classes (1.0) and caregivers in QG classes (1.2). For fatigue, patients (1.4) and caregivers (1.0) participating in QG experienced clinically significant improvement. Both TC and QG classes were associated with clinically significant improvements (ESAS GDS decrease ≥3) in global distress for patients (TC = 4.52, SD= 7.6; QG = 6.05, SD = 7.9) and caregivers (TC = 3.73, SD = 6.3; QG = 4.02, SD = 7.8). Eighty-nine percent of participants responded that their expectations were met. Conclusions: Patients and caregivers participating in TC or QG group classes were satisfied overall and experienced significant improvement in global distress. Additional research is warranted to explore the integration of TC and QG in the delivery of supportive cancer care.
Similarity between referents constrains the processing of contrastive focus during reading
Authors: Chen Shuang , Tang Yuqing , Lv Xiuna , Paterson Kevin B , Chen Lijing
Published: July 2020

Contrastive focus implies a contrast between two elements. However, it is unclear whether and how any interplay between such a contrast and similarity between potentially contrasting elements might affect focus processing. Accordingly, we report an eye movement experiment investigating this issue. The experiment used a background story to introduce eight characters whose social identities were manipulated to be similar or dissimilar. Participants first read this background story, then a series of two-sentence discourses while their eye movements were recorded. Each discourse referred to two characters from the passage who had either similar or dissimilar identities, with one (the target character) either focused using the Chinese particle zhiyou (meaning only) or unfocused. The results showed a typical focus facilitation effect, such that target character names were processed more quickly when focused than unfocused. We also observed a main effect of the similarity/dissimilarly of characters and, crucially, an interaction between this variable and focus. This interaction was due to slower processing of a post-target region when the target character was focused and the two characters had similar rather than dissimilar identities, but no such effect when the target character was unfocused. The findings suggest that establishing a contrast between referents is effortful during reading when these have similar rather than dissimilar social identities and so are more difficult to differentiate. The distinctiveness of referents in a discourse context may therefore constrain the establishment of contrastive focus during reading. We discuss these findings in relation to current theories of focus interpretation.
Predictive person models elicit motor biases: The face-inhibition effect revisited
Authors: Schenke Kimberley C , Wyer Natalie A , Tipper Steven P , Bach Patric
Published: July 2020

Using an established paradigm, we tested whether people derive motoric predictions about an actor’s forthcoming actions from prior knowledge about them and the context in which they are seen. In two experiments, participants identified famous tennis and soccer players using either hand or foot responses. Athletes were shown either carrying out or not carrying out their associated actions (swinging, kicking), either in the context where these actions are typically seen (tennis court, soccer Pitch) or outside these contexts (beach, awards ceremony). Replicating prior work, identifying non-acting athletes revealed the negative compatibility effects: viewing tennis players led to faster responses with a foot than a hand, and vice versa for viewing soccer players. Consistent with the idea that negative compatibility effects result from the absence of a predicted action, these effects were eliminated (or reversed) when the athletes were seen carrying out actions typically associated with them. Strikingly, however, these motoric biases were not limited to In-Context trials but were, if anything, more robust in the Out-of-Context trials. This pattern held even when attention was drawn specifically to the context (Experiment 2). These results confirm that people hold motoric knowledge about the actions that others typically carry out and that these actions are part of perceptual representations that are accessed when those others are re-encountered, possibly in order to resolve uncertainty in person perception.
Putting action into testing: Enacted retrieval benefits long-term retention more than covert retrieval
Authors: Kubik Veit , Jönsson Fredrik U , de Jonge Mario , Arshamian Artin
Published: July 2020

Retrieval practice improves long-term retention. However, it is currently debated if this testing effect can be further enhanced by overtly producing recalled responses. We addressed this issue using a standard cued-recall testing-effect paradigm with verb–noun action phrases (e.g., water the plant) to prompt motor actions as a specifically powerful response format of recall. We then tested whether motorically performing the recalled verb targets (e.g., ?–the plant) during an initial recall test ( enacted retrieval) led to better long-term retention than silently retrieving them ( covert retrieval) or restudying the complete verb–noun phrases ( restudy). The results demonstrated a direct testing effect, in that long-term retention was enhanced for covert retrieval practice compared to restudy practice. Critically, enactment during retrieval further improved long-term retention beyond the effect of covert memory retrieval, both in a congruent noun-cued recall test after 1 week (Experiment 1) and in an incongruent verb-cued recall test of nouns after 2 weeks (Experiment 2). This finding suggests that successful memory retrieval and ensuing enactment contribute to future memory performance in parts via different mechanisms.
Effectiveness of a simple intervention for prevention of catheter-associated urinary tract infections on a medical hospital unit
Authors: Au Anita G , Shurraw Sabin , Hoang Holly , Wang Sukun , Wang Xiaoming
Published: July 2020

Background:

Urinary tract infections (UTI) are one of the most common hospital-acquired infections with 80% as a result of urinary catheterisation.

Aim/Objective:

This study examined the impact of a simple intervention consisting of a daily chart reminder in patients with indwelling urinary catheters (IUC) on the duration of catheter use and the incidence of catheter-associated UTIs (CAUTIs).

Methods:

The trial used a prospective pretest–post-test design with a control group over a six-month period conducted on two medical units of a community teaching hospital. We included all patients admitted to two medical units between 1 June and 30 November 2016 who had an IUC inserted at the study site. During the intervention phase, a sticker was placed in the charts of patients with urinary catheters reminding physicians to assess for catheter removal if not clinically necessary.

Results:

A total of 195 patients participated in this study (112 control unit, 83 intervention unit). There was a decrease in the duration of IUC use on the intervention unit from 11.7 days to 7.5 days ( P = 0.0028). There was a decrease in repeated catheterisation from 11.1% to 2.1% ( P = 0.0882), and CAUTIs from 17.5% to 4.6% ( P = 0.0552) but this did not reach statistical significance.

Discussion:

The implementation of a daily IUC reminder sticker in patient charts was associated with a significant reduction in the mean duration of indwelling catheter use with a trend towards a reduction in the frequency of repeated urinary catheterisation and rate of CAUTIs.
Instagram and Pilon Fractures: An Analysis of Social Media and Its Relationship to Patient Injury Perception
Authors: Rizkalla James Mina , Lines Tanner , Daoud Yahya , Zide Jacob
Published: July 2020

Background: The purpose of this study was to investigate social media posts regarding pilon fractures and its relationship to patient injury perception. We evaluated Instagram media posts in patients who have suffered pilon fractures for the following variables: gender, tone, discussion of rehabilitation, activities of daily living (ADL) reference, incision/scar reference, pain, post of radiograph/imaging, external fixation reference, discussion of bracing/splinting, pre- or postoperative swelling, and need for reoperation. Results were determined by comparing each variable to gender and tone of the post to study patient injury perception. Methods: Public Instagram posts from within a 1-year time period were isolated and evaluated using the hashtag “#pilonfracture.” Individual posts were analyzed by authors. In total, 241 patient posts were included for investigation and analysis of patient injury perception via social media. Results: Of all included posts, 88% of posts had a positive tone. A majority of the posts (66.8%) mentioned rehabilitation and postoperative progress. There were significant associations between positive tone and rehabilitation ( P = .0001), as well as positive tone and ADLs ( P = .0361). Conclusion: Reported outcomes after surgical management of pilon fractures are generally poor. Nonetheless, this analysis of patients sharing their experience on social media after open reduction internal fixation of pilon fractures demonstrates a mostly positive attitude toward the injury and recovery. A positive tone of the post was significantly associated with mentions of rehabilitation and ADLs.

Levels of Evidence: Level III: Retrospective comparative study
Hemodynamic trajectories and outcomes in patients with pulmonary arterial hypertension
Authors: Amsallem Myriam , Bagherzadeh Shadi P. , Boulate David , Sweatt Andrew J. , Kudelko Kristina T. , Sung Yon K. , Feinstein Jeffrey A. , Fadel Elie , Mercier Olaf , Denault Andre , Haddad Francois , Zamanian Roham
Published: July 2020

The relative pulmonary to systemic pressure ratio (mean pulmonary arterial pressure/mean arterial pressure) has been proven to be valuable in cardiac surgery. Little is known on the prognostic value of baseline and trajectory of mean pulmonary arterial pressure/mean arterial pressure in pulmonary arterial hypertension. Patients with confirmed idiopathic, familial, drug and toxins, or connective tissue disease‐related pulmonary arterial hypertension and at least one complete right heart catheterization were included and prospectively followed‐up for 5.9 ± 4.03 years. Correlates of the primary end point (i.e. death or lung transplant need) during follow‐up were determined using Cox regression modeling. Results showed that among the 308 patients included, 187 had at least one follow‐up catheterization (median time between catheterizations: 2.16 (1.16–3.19) years). In the total cohort (mean age 47.3 ± 14.9 years, 82.8% of female and 58.1% in New York Heart Association class 3 or 4), mean pulmonary arterial pressure/mean arterial pressure (1.38 (1.07–1.77)) was associated with outcome (p = 0.01). Mean pulmonary arterial pressure/mean arterial pressure was incremental to a basic model (including right atrial pressure, systolic blood pressure, New York Heart Association class 3 or 4, and connective tissue disease) for outcome prediction, while mean pulmonary arterial pressure was not. In the 187 patients with a follow‐up catheterization, both delta mean pulmonary arterial pressure and delta mean pulmonary arterial pressure/mean arterial pressure were associated with outcome (1.32 (1.11–1.58) and 1.31 (1.1–1.57) respectively, p < 0.01). Mean pulmonary arterial pressure and mean pulmonary arterial pressure/mean arterial pressure were both incremental to the basic model, while worsening in mean pulmonary arterial pressure or mean pulmonary arterial pressure/mean arterial pressure did not reach significance. In conclusion, mean pulmonary arterial pressure/mean arterial pressure at baseline prognosticates long‐term outcome with a significant, albeit modest, incremental value to basic variables.
Multiself Bargaining
Authors: Henkel Rudy
Published: July 2020

I propose a dual-self model in which two selves have conflicting preferences over the action to be taken by an agent. Departing from existing dual-self models, the two selves are treated symmetrically. They have identical instantaneous utility, and only differ in their time preference. The default action of the agent is modelled as the outcome of a Tullock contest among the selves, where the self who wins chooses their preferred action. Viewing the outcome of this contest as the point of disagreement, the selves are allowed to negotiate to a mutually preferred outcome, and this negotiation is modelled as a Nash bargaining problem. I show that multiple well documented ‘behavioural’ deviations from standard utility maximizing behaviour can be generated from this model, including time inconsistent behaviour such as diminishing impatience, as well as violations of independence of irrelevant alternatives in choice problems. Notably the preference reversals from time inconsistency are ‘smooth’, as opposed to the singular reversal in quasi-hyperbolic discounting, the standard model used in the literature. Further, the model implies correlation of these deviations due to their dependence on the same parameters. Finally, this approach provides insight on evaluating the welfare effects of various interventions.

JEL Classifications: D01, D11, D79, D91
Recipient and donor genetic variants associated with mortality after allogeneic hematopoietic cell transplantation
Authors: Martin Paul J. , Levine David M. , Storer Barry E. , Nelson Sarah C. , Dong Xinyuan , Hansen John A.
Published: July 2020

Many studies have suggested that genetic variants in donors and recipients are associated with survival-related outcomes after allogeneic hematopoietic cell transplantation (HCT), but these results have not been confirmed. Therefore, the utility of testing genetic variants in donors and recipients for risk stratification or understanding mechanisms leading to mortality after HCT has not been established. We tested 122 recipient and donor candidate variants for association with nonrelapse mortality (NRM) and relapse mortality (RM) in a cohort of 2560 HCT recipients of European ancestry with related or unrelated donors. Associations discovered in this cohort were tested for replication in a separate cohort of 1710 HCT recipients. We found that the donor rs1051792 A allele in MICA was associated with a lower risk of NRM. Donor and recipient rs1051792 genotypes were highly correlated, making it statistically impossible to determine whether the donor or recipient genotype accounted for the association. Risks of grade 3 to 4 graft-versus-host disease (GVHD) and NRM in patients with grades 3 to 4 GVHD were lower with donor MICA-129Met but not with MICA-129Val, implicating MICA-129Met in the donor as an explanation for the decreased risk of NRM after HCT. Our analysis of candidate variants did not show any other association with NRM or RM. A genome-wide association study did not identify any other variants associated with NRM or RM.
ERS International Congress, Madrid, 2019: highlights from the Paediatric Assembly
Authors: Nenna Raffaella , Slaats Monique , Ersu Refika , Lo David , Seglani Sejal , Nissenbaum Claire , Horsley Alex R. , Proesmans Marijke , Petrarca Laura , Williams Emma , Dassios Theodore , Ardura-Garcia Cristina , Duijts Liesbeth , Marczak Honorata , Snijders Deborah , Rottier Robbert , Chao Cho-Ming , Pijnenburg Marielle W. , Grigg Jonathan
Published: July 2020

In this article, the Group Chairs and the Early Career Members of the Paediatric Assembly of the European Respiratory Society (ERS) highlight some of the most interesting findings in the field of paediatrics presented at the 2019 ERS International Congress, which was held in Madrid, Spain. The main findings from each group are summarised at the end of each chapter.
ERS International Congress, Madrid, 2019: highlights from the Clinical Techniques, Imaging and Endoscopy Assembly
Authors: d'Hooghe Julia , Alvarez Martinez Haizea , Pietersen Pia Iben , Laursen Christian B. , Hersch Nicole , Tárnoki Ádám Domonkos , Walsh Simon , Annema Jouke , Gompelmann Daniela
Published: July 2020

This manuscript summarises the highlights from Assembly 14, “Clinical techniques, imaging and endoscopy”, which were presented at the 2019 European Respiratory Society (ERS) International Congress in Madrid, Spain. Novel diagnostic approaches and innovative therapeutic strategies in patients with lung cancer, interstitial lung disease, obstructive airway disorders and infectious diseases are discussed. The authors from the different Assembly 14 subgroups focus on the key take-home messages given new study results, and place them in the context of current knowledge in these areas.

At the 2019 ERS International Congress, encouraging results of numerous trials in the field of interventional pulmonology, imaging and ultrasound were presented. Key topics included novel diagnostic and therapeutic approaches in patients with lung cancer, interstitial lung disease, obstructive airway disorders and infectious diseases.
Ability of the LACE index to predict 30-day hospital readmissions in patients with community-acquired pneumonia
Authors: Dobler Claudia C. , Hakim Maryam , Singh Sidhartha , Jennings Matthew , Waterer Grant , Garden Frances L.
Published: July 2020

Background and objective

Hospital readmissions within 30 days are used as an indicator of quality of hospital care. We aimed to evaluate the ability of the LACE (Length of stay, Acuity of admission, Comorbidities based on Charlson comorbidity score and number of Emergency visits in the last 6 months) index to predict the risk of 30-day readmissions in patients hospitalised for community-acquired pneumonia (CAP).

Methods

In this retrospective cohort study a LACE index score was calculated for patients with a principal diagnosis of CAP admitted to a tertiary hospital in Sydney, Australia. The predictive ability of the LACE score for 30-day readmissions was assessed using receiver operator characteristic curves with C-statistic.

Results

Of 3996 patients admitted to hospital for CAP at least once, 8.0% (n=327) died in hospital and 14.6% (n=584) were readmitted within 30 days. 17.8% (113 of 636) of all 30-day readmissions were again due to CAP, followed by readmissions for chronic obstructive pulmonary disease, heart failure and chest pain. The LACE index had moderate discriminative ability to predict 30-day readmission (C-statistic=0.6395) but performed poorly for the prediction of 30-day readmissions due to CAP (C-statistic=0.5760).

Conclusions

The ability of the LACE index to predict all-cause 30-day hospital readmissions is comparable to more complex pneumonia-specific indices with moderate discrimination. For the prediction of 30-day readmissions due to CAP, the performance of the LACE index and modified risk prediction models using readily available variables (sex, age, specific comorbidities, after-hours, weekend, winter or summer admission) is insufficient.
Small airway function in obese individuals with self-reported asthma
Authors: Oppenheimer Beno W. , Goldring Roberta M. , Soghier Israa , Smith David , Parikh Manish , Berger Kenneth I.
Published: July 2020

Diagnosis of asthma in obese individuals frequently relies on clinical history, as airflow by spirometry may remain normal. This study hypothesised that obese subjects with self-reported asthma and normal spirometry will demonstrate distinct clinical characteristics, metabolic comorbidities and enhanced small airway dysfunction as compared with healthy obese subjects.

Spirometry, plethysmography and oscillometry data pre/post-bronchodilator were obtained in 357 obese subjects in three groups as follows: no asthma group (n=180), self-reported asthma normal spirometry group (n=126), and asthma obstructed spirometry group (n=51). To assess the effects of obesity related to reduced lung volume, oscillometry measurements were repeated during a voluntary inflation to predicted functional residual capacity (FRC).

Dyspnoea was equally prevalent in all groups. In contrast, cough, wheeze and metabolic comorbidities were more frequent in the asthma normal spirometry and asthma obstructed spirometry groupsversusthe no asthma group (p<0.05). Despite similar body size, oscillometry measurements demonstrated elevatedR5–20(difference between resistance at 5 and 20 Hz) in the no asthma and asthma normal spirometry groups (0.19±0.12; 0.23±0.13 kPa/(L·s−1), p<0.05) but to a lesser degree than the asthma obstructed spirometry group (0.34±0.20 kPa/(L·s−1), p<0.05). Differences between groups persisted post-bronchodilator (p<0.05). Following voluntary inflation to predicted FRC,R5–20in the no asthma and asthma normal spirometry groups fell to similar values, indicating a reversible process (0.11±0.07; 0.12±0.08 kPa/(L·s−1), p=NS). Persistently elevatedR5–20was seen in the asthma obstructed spirometry group, suggesting chronic inflammation and/or remodelling (0.17±0.11 kPa/(L·s−1), p<0.05).

Thus, small airway abnormalities of greater magnitude than observations in healthy obese people may be an early marker of asthma in obese subjects with self-reported disease despite normal airflow. Increased metabolic comorbidities in these subjects may have provided a milieu that impacted airway function.
Where there’s smoke, there’s fire: what current and future providers do and do not know about electronic cigarettes
Authors: Hwang Josephine , Lee Crystal , Mastrolonardo Eric , Frasso Rosemary
Published: July 2020

Background

Health care providers play a pivotal role as educators on health-related matters ranging from vaccination to smoking cessation. With the rising popularity of electronic cigarettes (e-cigarettes), providers face a new challenge. To date, studies have identified a general lack of knowledge among providers regarding e-cigarettes and discomfort with counseling patients on e-cigarette use. This study aims to systematically explore the perspectives of different health care providers on e-cigarettes and their health implications. With a growing availability of research on the health consequences of e-cigarette use, our study also aims to assess the familiarity of our participants with this literature.

Methods

From July to October 2018, a sample of attendings (n = 15), residents (n = 15), medical students (n = 33), and nursing students (n = 28) from Thomas Jefferson University participated in a freelisting interview and survey.

Results

Our study found that perceptions of e-cigarettes vary across different participant groups, as evidenced by the range of responses when asked to think about e-cigarettes and their health implications. We identified gaps in knowledge among students regarding FDA regulation of e-cigarettes and found that attending physicians are less aware than junior trainees of the prevalence of use. Familiarity with evidence-based health consequences was variable and low across all groups. Finally, participants most commonly reported learning about e-cigarettes from news outlets and social media rather than professional platforms.

Conclusion

This study highlights the need for curricular development in nursing and medical schools, residency training, and continuing medical education regarding e-cigarette use and their impact on human health.
Quality of life in cancer patients treated with mistletoe: a systematic review and meta-analysis
Authors: Loef Martin , Walach Harald
Published: July 2020

Background

Mistletoe extracts are used as an adjunct therapy for cancer patients, but there is dissent as to whether this therapy has a positive impact on quality of life (QoL).

Methods

We conducted a systematic review searching in several databases (Medline, Embase, CENTRAL, CINAHL, PsycInfo, Science Citation Index, clinicaltrials.gov,opengrey.org) by combining terms that cover the fields of “neoplasm”, “quality of life” and “mistletoe”. We included prospective controlled trials that compared mistletoe extracts with a control in cancer patients and reported QoL or related dimensions. The quality of the studies was assessed with the Cochrane Risk of Bias tool version 2. We conducted a quantitative meta-analysis.

Results

We included 26 publications with 30 data sets. The studies were heterogeneous. The pooled standardized mean difference (random effects model) for global QoL after treatment with mistletoe extracts vs. control was d = 0.61 (95% CI 0.41–0.81,p < 0,00001). The effect was stronger for younger patients, with longer treatment, in studies with lower risk of bias, in randomized and blinded studies. Sensitivity analyses support the validity of the finding. 50% of the QoL subdomains (e.g. pain, nausea) show a significant improvement after mistletoe treatment. Most studies have a high risk of bias or at least raise some concern.

Conclusion

Mistletoe extracts produce a significant, medium-sized effect on QoL in cancer. Risk of bias in the analyzed studies is likely due to the specific type of treatment, which is difficult to blind; yet this risk is unlikely to affect the outcome.

PROSPERO registration

CRD42019137704.
Cold-inducible RNA-binding protein might determine the severity and the presences of major/minor criteria for severe community-acquired pneumonia and best predicted mortality
Authors: Guo Qi , Song Wei-dong , Li Hai-yan , Li Ming , Chen Xiao-ke , Liu Hui , Peng Hong-lin , Yu Hai-qiong , Liu Nian , Lü Zhong-dong , Liang Li-hua , Zhao Qing-zhou , Jiang Mei
Published: July 2020

Background

Severity of community-acquired pneumonia (CAP) depends on microbial pathogenicity, load and virulence, and immune responses. The Infectious Disease Society of America and the American Thoracic Society (IDSA/ATS) minor criteria responsible for clinical triage of patients with CAP are of unequal weight in predicting mortality. It is unclear whether the IDSA/ATS major/minor criteria might be strongly and positively associated with the immune responses. It is warranted to explore this intriguing hypothesis.

Methods

A prospective cohort study of 404 CAP patients was performed. Cold-inducible RNA-binding protein (CIRP) levels were measured using a sandwich-based enzyme-linked immunosorbent assay. The receiver operating characteristic curves were created and the areas under the curves were calculated to illustrate and compare the accuracy of the indices.

Results

Severe CAP patients meeting the major criteria had the highest plasma concentrations of CIRP. The more the number of most predictive minor criteria strongly associated to mortality, i.e. arterial oxygen pressure/fraction inspired oxygen ≤ 250 mmHg, confusion, and uremia, present, the higher the CIRP level. Interestingly, the patients with non-severe CAP meeting the most predictive minor criteria demonstrated unexpectedly higher CIRP level compared with the patients with severe CAP not fulfilling the criteria. Procalcitonin (PCT), interleukin-6 (IL-6), C-reactive protein (CRP), sequential organ failure assessment (SOFA) and pneumonia severity index (PSI) scores, and mortality confirmed similar intriguing patterns. CIRP was strongly linked to PCT, IL-6, CRP, minor criteria, SOFA and PSI scores, and mortality (increased odds ratio 3.433). The pattern of sensitivity, specificity, positive predictive value, and Youden’s index of CIRP ≥ 3.50 ng/mL for predicting mortality was the optimal. The area under the receiver operating characteristic curve of CIRP was the highest among the indices.

Conclusions

CIRP levels were strongly correlated with the IDSA/ATS major/minor criteria. CIRP might determine the severity and the presences of major/minor criteria and best predicted mortality, and a CIRP of ≥ 3.50 ng/mL might be more valuable cut-off value for severe CAP, suggesting that CIRP might be a novel and intriguing biomarker for pneumonia to monitor host response and predict mortality, which might have implications for more accurate clinical triage decisions.
Macrophages inhibit adipogenic differentiation of adipose tissue derived mesenchymal stem/stromal cells by producing pro-inflammatory cytokines
Authors: Ma Hui , Li Ya-nan , Song Lin , Liu Rui , Li Xiaolei , Shang Qianwen , Wang Ying , Shao Changshun , Shi Yufang
Published: July 2020

Background

Mesenchymal stem/stromal cells (MSCs) and macrophages are critical components in many tissue microenvironments, including that in adipose tissue. The close interaction between MSCs and macrophages modulates various adipose-related disease development. However, the effects of macrophages on the fate of MSCs remain largely elusive. We here studied the effect of macrophages on the adipogenic differentiation of MSCs.

Methods

Macrophages were obtained from THP-1 cells treated with phorbol-12-myristate-13-acetate (PMA). The induced matured macrophages were then induced to undergo classically activated macrophage (M1) or alternatively activated macrophage (M2) polarization with Iipopolysaccharide (LPS)/interferon (IFN)-γ and interleukin (IL)-4/IL-13, respectively. The supernatants derived from macrophages under different conditions were applied to cultured human adipose tissue-derived mesenchymal stem/stromal cells (hADSCs) undergoing adipogenic differentiation. Adipogenic differentiation was evaluated by examining Oil Red O staining of lipid droplets and the expression of adipogenesis-related genes with real-time quantitative polymerase chain reaction (Q-PCR) and western blot analysis.

Results

The adipogenic differentiation of hADSCs was impaired when treated with macrophage-derived supernatants, especially that from the M1-polarized macrophage (M1-sup). The inhibitory effect was found to be mediated by the inflammatory cytokines, mainly tumor necrosis factor-α (TNF-α) and IL-1β. Blocking TNF-α and IL-1β with neutralizing antibodies partially alleviated the inhibitory effect of M1-sup.

Conclusion

Macrophage-derived supernatants inhibited the adipogenic differentiation of hADSCs in vitro, irrespective of the polarization status (M0, M1 or M2 macrophages). M1-sup was more potent because of the higher expression of pro-inflammatory cytokines. Our findings shed new light on the interaction between hADSCs and macrophages and have implications in our understanding of disrupted adipose tissue homeostasis under inflammation.
Impact of improved beehives technology adoption on honey production efficiency: empirical evidence from Southern Ethiopia
Authors: Tarekegn Kassa , Ayele Assefa
Published: July 2020

Background

Kaffa, Sheka and Bench Maji zones of Southern Ethiopia are high honey production areas with dense forest coverage. However, due to the traditional production system, the productivity per hive is low. To exploit this production potential in these zones by increasing productivity per hive, different governmental and non-governmental organizations disseminate improved beehives technologies. Yet, the impact of these disseminated and adopted technologies on honey production has not been determined. Thus, this study aimed to estimate the impact of improved beehive adoption on honey production efficiency.

Methodology

A multistage sampling technique was used to select 360 sampled households. This study applied a stochastic frontier model to assess the technical efficiency (TE) of honey producers and propensity score matching (PSM) with probit model to analyze adoption decision of improved beehive and its impact on honey production efficiency.

Results

The finding of this study shows that the number hives, type of beehive used, and proximity to the available forest had a significant and positive effect on honey production. The mean TE was 77% that shows the deviation of actual from optimal production amounts. Beekeeping experience, education, level, cooperative membership, participation in improved beehive technology demonstration and extension contact had significant effects on TE. The result of PSM indicates that the adoption of improved beehive technology has a positive and significant effect on production efficiency, as measured by TE. Farmers who adopted improved beehive technology were less technically inefficient than those who did not adopt.

Conclusion

Overall, the estimated 19.5% difference in TE among the two groups shows there is considerable room for the improvement of beekeeping by efficient utilization of inputs and also provides strong evidence for the diffusion of improved beehives in Kaffa Sheka and Bench Maji zones.
Japanese version of the 42-item psychological well-being scale (PWBS-42): a validation study
Authors: Sasaki Natsu , Watanabe Kazuhiro , Imamura Kotaro , Nishi Daisuke , Karasawa Mayumi , Kan Chiemi , Ryff Carol Diane , Kawakami Norito
Published: July 2020

Background

The aim of this study was to examine the internal consistency, structural validity, and convergent/known-group validity of the Japanese version of the 42-item Psychological Well-Being Scale (PWBS-42).

Methods

The PWBS-42 includes six 7-item subscales designed to measure the following dimensions of eudaimonic psychological well-being: 1) autonomy, 2) environmental mastery, 3) personal growth, 4) positive relations with others, 5) purpose in life, and 6) self-acceptance. A questionnaire was administered to 2102 community residents in Tokyo aged 30 or over as a part of the Midlife in Japan (MIDJA) survey, in 2008. The internal consistency reliability was tested using Cronbach’s α. Structural validity was examined using exploratory factor analysis (EFA). Convergent validity was evaluated by calculating correlations of the Japanese PWBS-42 subscales with life satisfaction, negative affect, negative adjectives, positive affect, positive adjectives, self-esteem, and perceived stress scales.

Results

Data from 1027 respondents (505 males and 522 females) were analyzed (valid response rate = 56.2%). Cronbach’s α values ranged from 0.70 to 0.78 for five of the subscales, while that for purpose in life was lower (0.57). EFA yielded a five-factor structure: The first two factors consisted of negative and positive items mostly from the environmental mastery, purpose in life, and self-acceptance subscales. The third, fourth, and fifth factors consisted mostly of items from the positive relations with others, autonomy, and personal growth subscales, respectively. As hypothesized, the scores for life satisfaction, negative and positive affect/adjectives, self-esteem and perceived stress were significantly correlated with all subscales of the Japanese PWBS-42.

Conclusion

The subscales of the Japanese version of the PWBS-42 showed accep. levels of reliability and support for convergent validity in the Japanese population. The factor structure was slightly different from the theoretical 6-factor model: items of three subscales (environmental mastery, purpose in life, and self-acceptance) loaded together on two factors. This finding may be interpreted in light of the interdependent self construal found in Japan in which these three components could be closely linked.
Meningioma cells express primary cilia but do not transduce ciliary Hedgehog signals
Authors: Findakly Sarah , Choudhury Abrar , Daggubati Vikas , Pekmezci Melike , Lang Ursula E. , Raleigh David R.
Published: July 2020

Meningiomas are the most common primary intracranial tumors, but treatment options for meningioma patients are limited due to incomplete understanding of tumor biology. A small percentage of meningiomas harbor somatic variants in the Hedgehog pathway, a conserved gene expression program that is essential for development and adult stem cell homeostasis. Hedgehog signals are transduced through primary cilia, and misactivation of the Hedgehog pathway is known to underlie cancer. Nevertheless, the mechanisms of Hedgehog signaling in meningioma are unknown. Here, we investigate mechanisms of ciliary Hedgehog signaling in meningioma using tissue microarrays containing 154 human meningioma samples, NanoString transcriptional profiling, primary meningioma cells, pharmacology, and CRISPR interference. Our results reveal that meningiomas of all grades can express primary cilia, but that cilia are less prevalent among anaplastic tumors. Moreover, we find that expression of Smoothened alleles that are oncogenic in other contexts fail to activate the Hedgehog transcriptional program or promote proliferation in primary meningioma cells. These data reveal that meningiomas can express the subcellular structure necessary for canonical Hedgehog signaling, but suggest that they do not transduce ciliary Hedgehog signals.
A dual-genotype oligoastrocytoma with histologic, molecular, radiological and time-course features
Authors: Nasrallah Mac Lean P. , Desai Arati , O’Rourke Donald M. , Surrey Lea F. , Stein Joel M.
Published: July 2020

A case of a true dual-genotype IDH-mutant oligoastrocytoma with two different cell types within a single mass in a young woman is presented. Imaging findings of the left frontal infiltrating glioma predicted the two neoplastic components that were identified upon resection. Tissue examination demonstrated areas of tumor with contrasting histologic and molecular features, including specific IDH1, ATRX, TP53, TERT and CIC mutational profiles, consistent with oligodendroglioma and astrocytoma, respectively. The clinical and radiological course over 17 months from first diagnosis included three surgical resections with slow progression of the astrocytic component, and ultimately chemotherapy and radiation treatments were commenced. Reports of the clinical courses for these rare cases of dual-genotype oligoastrocytomas will inform therapy choices, to optimize benefit while minimizing side effects. The steadily increasing number of cases suggests that the neoplasm might be reconsidered as an official entity by the WHO.