bluuebunny/crossref_metadata_2025 huggingface dataset:
Seroconversion to antinuclear antibody negativity and its association with disease flare in patients with systemic lupus erythematosus
Authors: Kwon Oh Chan , Kim Yong-Gil , Park Jung Hwan , Park Min-Chan
Published: April 2020

Objective

To evaluate the rate of seroconversion to antinuclear-antibody negativity in patients with systemic lupus erythematosus and its association with subsequent systemic lupus erythematosus flare risk.

Methods

Medical records of patients with systemic lupus erythematosus with positive antinuclear antibodies (titer ≥1 : 40) at diagnosis and at least one repeat antinuclear antibody test were reviewed. We determined the frequency of seroconversion to antinuclear antibody negativity among these patients and investigated whether seroconversion to antinuclear antibody negativity was associated with subsequent systemic lupus erythematosus flare risk. The seroconversion to antinuclear antibody negativity was defined as a conversion of positive antinuclear antibodies to a titer below the cut-off of 1 : 40. Systemic lupus erythematosus flare was defined as one new British Isles Lupus Assessment Group A or two new British Isles Lupus Assessment Group B domain scores. To estimate hazard ratios and 95% confidence intervals for systemic lupus erythematosus flare according to seroconversion to antinuclear antibody negativity, Cox regression analysis with adjustment for known systemic lupus erythematosus flare risk factors was performed. Kaplan-Meier analysis was used to compare flare-free survival rates between negative converters and non-converters.

Results

Among the total 175 patients, seroconversion to antinuclear antibody negativity was found in 17 (9.7%) patients in a median 53.5 (range: 25.7–84.0) months. After the last antinuclear antibody tests, 53 systemic lupus erythematosus flare cases were identified during 14.3 (range: 8.2–21.7) months of follow-up. Systemic lupus erythematosus flare risk was significantly lower in patients with negatively seroconverted antinuclear antibodies (adjusted hazard ratio 0.13, 95% confidence interval 0.03–0.58, p = 0.007). Kaplan-Meier analysis showed significantly higher flare-free survival in negative converters than in non-converters ( p = 0.004).

Conclusion

Seroconversion to antinuclear antibody negativity occurred in 9.7% of patients over 53.5 months and was associated with a lower future systemic lupus erythematosus flare risk.
Inflammatory myositis in systemic lupus erythematosus
Authors: Bitencourt Nicole , Solow E Blair , Wright Tracey , Bermas Bonnie L
Published: April 2020

Background

The coexistence of inflammatory myositis in systemic lupus erythematosus (SLE) has not been extensively studied. In this study, we describe the incidence, distinct types of inflammatory myositis, and risk factors for this finding in a cohort of pediatric and adult SLE patients.

Methods

We identified SLE patients with coexisting myositis followed between 2010 and 2019 at two pediatric hospitals and one adult hospital. Demographic, clinical, laboratory, and pathological features of myositis were collected, and descriptive statistics were applied.

Results

A total of 1718 individuals were identified as having SLE (451 pediatric and 1267 adult patients). Of these, 108 were also diagnosed with inflammatory myositis (6.3%). People of black race had a significantly higher prevalence of inflammatory myositis, as did those with childhood-onset SLE compared to adult-onset disease. In the majority of patients (68%), SLE and inflammatory myositis presented concurrently. Overlapping features of systemic sclerosis occurred in 48%, while dermatomyositis-specific rashes were present in a third. Arthralgias and inflammatory arthritis were seen in >90%. Thrombotic events and significant pregnancy-related morbidity were present in more than a third of patients. Lymphopenia, hypocomplementemia, and a positive RNP were the most common laboratory features noted. Myositis-specific antibodies (MSA) and myositis-associated antibodies (MAA) were present in >40% of patients. A review of 28 muscle biopsy reports revealed a wide array of pathological features, including nonspecific changes, dermatomyositis, polymyositis, and necrotizing auto-immune myopathy.

Conclusion

In our SLE patient population, 6.3% presented with concurrent inflammatory myositis. Dermatomyositis-specific rashes, clinical features of systemic sclerosis, arthralgias and arthritis, and cytopenias were common coexisting clinical manifestations. A high frequency of RNP, MSA, and MAA were found. People of black race and with childhood-onset disease had a higher prevalence of myositis. Our findings suggest that SLE patients of black race, with childhood-onset SLE, and who possess MSA or MAA should be routinely screened for myositis.
Optimization of physical properties of new gluten-free cake based on apple pomace powder using starch and xanthan gum
Authors: Azari Masoumeh , Shojaee-Aliabadi Saeedeh , Hosseini Hedayat , Mirmoghtadaie Leila , Marzieh Hosseini Seyede
Published: April 2020

Apple pomace is a valuable waste from the apple juice industry with high level of poly phenols and also phytate-free dietary fiber. This research was done to optimize and compare the physical properties of new gluten-free cake based on whole replacement of wheat flour with apple pomace powder using starch and xanthan gum by Mixture Design. The results of chemical analysis of apple pomace flour showed 10% moisture, 1.28% ash, 1.68% fat, 1.25% protein, 56% fiber and 9.62 mg gallic acid/g phenolic compounds. There was a significant difference in the texture of optimized apple pomace cakes in comparison to rice and wheat cakes as control and black samples. The hardness of the wheat flour sample was less than the gluten-free samples. Based on the results of the sensory evaluation, the cake containing apple pomace powder had the highest score in terms of overall acceptance.
A preliminary examination of the relationship between biomechanical measures and structural changes in the brain
Authors: Post Andrew , Hashim Eyesha , Hoshizaki T Blaine , Gilchrist Michael D , Cusimano Michael D
Published: April 2020

Introduction

Currently, biomechanics has not been able to effectively predict when a mild traumatic brain injury may occur as a result of head impact. To improve prediction of brain trauma and the development of protective innovations, it is important to create an understanding of the relationship between the biomechanics of the head impact event and the structural damage incurred by the brain as a result of that event. The purpose of this research was to examine the relationship between diffusion tensor imaging measures and biomechanical characteristics of a head impact.

Methods

Diffusion tensor imaging was conducted on concussed subjects to identify regions of white matter structural differences. The injury event was reconstructed using physical and finite element methods to identify the biomechanical parameters of the impact as well as strain to the regions of the brain.

Results

A significant relationship was found between shear strain, rotational acceleration, and impact velocity on increases in radial diffusivity and mean diffusivity in the fornix. Linear acceleration was also found to have a weaker but significant relationship with a decrease in radial diffusivity in the cingulum hippocampus.

Conclusion

These results demonstrate that impacts resulting in high shear strains may affect radial diffusivity and mean diffusivity measures, and that impact mechanics likely have an important role in what regions may present differences in diffusion tensor imaging measures.
Strengths, assets and place – The emergence of Local Area Coordination initiatives in England and Wales
Authors: Lunt Neil , Bainbridge Laura , Rippon Simon
Published: April 2020

Local Area Coordination is an approach that emerged during the 1980s and 1990s to support individuals with learning disabilities in rural and metropolitan Western Australia. Offering direct family support, signposting and networking it aimed to improve access to services and promote social inclusion. It leveraged community resources and sought broader transformation through local collaborations and service redesign, as underpinned by a strengths-based philosophy. Scotland introduced a similar model of delivery from the early 2000s for learning disability support. Since 2010, a number of English and Welsh Local Authorities have introduced Local Area Coordination, and in doing so have expanded its support eligibility criteria to include those considered ‘vulnerable’ due to age, frailty, disability, mental health issues and housing precariousness.

Findings

This article provides the first review of developments in England and Wales. Drawing upon published evaluation studies it reflects on Local Area Coordination implementation; reviews the existing evidence base and challenges surrounding data collection; and discusses the competing logic of Local Area Coordination in its aim of supporting individual and community improvement of health outcomes and well-being, and of furthering local government civic engagement and participation.

Applications

This article points to the challenges and opportunities of implementing such a strength-, assets- and placed-based initiatives within Local Authority social service settings. Embedding Local Area Coordination within Local Authority settings requires skilled political and policy leadership. It balances emerging individual outcomes – health and well-being – with the civic mission (values, control and coproduction), and avoids one being subverted to the other.
Data normalization strategies in metabolomics: Current challenges, approaches, and tools
Authors: Misra Biswapriya B
Published: April 2020

Data normalization is a big challenge in quantitative metabolomics approaches, whether targeted or untargeted. Without proper normalization, the mass-spectrometry and spectroscopy data can provide erroneous, sub-optimal data, which can lead to misleading and confusing biological results and thereby result in failed application to human healthcare, clinical, and other research avenues. To address this issue, a number of statistical approaches and software tools have been proposed in the literature and implemented over the years, thereby providing a multitude of approaches to choose from – either sample-based or data-based normalization strategies. In recent years, new dedicated software tools for metabolomics data normalization have surfaced as well. In this account article, I summarize the existing approaches and the new discoveries and research findings in this area of metabolomics data normalization, and I introduce some recent tools that aid in data normalization.
Mothering during domestic abuse: Protective agency as a force for change
Authors: Buchanan Fiona , Moulding Nicole T
Published: April 2020

Background

If women’s use of agency to protect their children from domestic abuse is considered at all, it is usually in terms of women staying or leaving abusive partners. Elsewhere women’s mothering, when they are enduring domestic abuse, is viewed from a perspective that focuses on finding deficits by observation and categorising the relationship between them and their children.

Objective

The study, which informs this article, looked to the lived experiences of women who had mothered while enduring domestic abuse to better understand their thoughts, feelings and actions during that time.

Participants and methods

The qualitative study considers the lived experience of 16 women, residing in South Australia, who raised young children while enduring domestic abuse. Semi-structured interviews followed by focus groups, which utilised creative methodologies were employed to collect data.

Results

The study casts light on myriad ways that women exercise agency to protect their children. When lived experiences inform our understanding, it becomes clear that many women enduring domestic abuse exercise their agency to protect their children.

Conclusion

We posit that, if agency is not a focus of enquiry it is overlooked by social workers focusing on deficits when considering mothering in domestic abuse. Too often, women are perceived solely as passive victims, unable or unwilling to protect vulnerable children. Yet important strategies to enable empowerment of both women and children are uncovered if social workers acknowledge and work with women and children to focus on the ways women exercise agency to protect.
Stem cell-based treatment of kidney diseases
Authors: Pan Binbin , Fan Guoping
Published: April 2020

Kidney dysfunction, including chronic kidney disease and acute kidney injury, is a globally prevalent health problem. However, treatment regimens are still lacking, especially for conditions involving kidney fibrosis. Stem cells hold great promise in the treatment of chronic kidney disease and acute kidney injury, but success has been hampered by insufficient incorporation of the stem cells in the injured kidney. Thus, new approaches for the restoration of kidney function after acute or chronic injury have been explored. Recently, kidney organoids have emerged as a useful tool in the treatment of kidney diseases. In this review, we discuss the mechanisms and approaches of cell therapy in acute kidney injury and chronic kidney disease, including diabetic kidney disease and lupus nephritis. We also summarize the potential applications of kidney organoids in the treatment of kidney diseases.

Impact statement

Stem cells hold great promise in regenerative medicine. Pluripotent stem cells have been differentiated into kidney organoids to understand human kidney development and to dissect renal disease mechanisms. Meanwhile, recent studies have explored the treatment of kidney diseases using a variety of cells, including mesenchymal stem cells and renal derivatives. This mini-review discusses the diverse mechanisms underlying current renal disease treatment via stem cell therapy. We postulate that clinical applications of stem cell therapy for kidney diseases can be readily achieved in the near future.
Potential biomarkers in septic shock besides lactate
Authors: Yang Hang , Du Linlin , Zhang Zhaocai
Published: April 2020

Septic shock can be defined as sepsis with persisting hypotension and is required for vasopressors after initial unsuccessful fluid resuscitation. Elevated lactate is a biomarker of tissue perfusion and oxygenation and a useful prognostic tool for resuscitation in septic shock, as it is a byproduct of anaerobic glycolysis due to inadequate oxygen delivery and tissue hypoxia. Early and serial systematic lactate measurement will prompt physician more rapid intervention and lactate normalization, which is associated with better outcome. However, lactate formation during septic shock is neither entirely related to tissue hypoxia, nor reversible by increasing oxygen delivery. Meanwhile, lactate can be oxidized via tricarboxylic acid cycle after being transferred into mitochondria via lactate shuttle, which indicates elevated lactate can be used rather than only accumulation. Glycolysis and elevated lactate can be initiated by hypoxia, but persistent hyperlactatemia may not only represent persistent hypoxia. Some other potential biomarkers have been reviewed in the article including intermediates of tricarboxylic acid cycle, malate-aspartate shuttle, the nicotinamide adenine dinucleotide/reduced nicotinamide adenine dinucleotide (NAD+/NADH) ratio, NAD+, NADH, malate, and malate dehydrogenase from the point of view of energy metabolism. Among them, malate dehydrogenase participates in both malate-aspartate shuttle and tricarboxylic acid cycle, and it can also indirectly reflex the NAD+/NADH ratio. It is reasonable to hypothesize that the combination of lactate and malate dehydrogenase will be more comprehensive to reflex hypoxia in septic shock.

Impact statement

Elevated lactate has been commonly considered as a biomarker and a useful prognostic tool for resuscitation in septic shock, facilitating physician more rapid intervention and treatment. However, it can be initiated by hypoxia, but persistent hyperlactatemia may not represent persistent hypoxia only. In the article, it is the first time to review potential biomarkers in septic shock from the point of view of energy metabolism including intermediates of TCA cycle, MAS, the NAD+/NADH ratio, NAD+, NADH, malate, and MDH. And the combination of lactate and MDH is also proposed in septic shock for the first time, as MDH in cytoplasm and mitochondria participates in both MAS and TCA cycle for ATP generation. Its feasibility in clinic has been analyzed at the end, although related research is still limited. It is reasonable the combination of lactate and MDH will be more comprehensive to reflex hypoxia in septic shock.
Cystic adventitial disease of the common femoral vein: A case report
Authors: Guo Facai , Guo Yi
Published: April 2020

Objectives

Cystic adventitial disease is an extremely rare vascular disorder and is often misdiagnosed. In order to improve the knowledge and treatment of this disease, a case of venous cystic adventitial disease was reported.

Methods

The whole processes about the diagnosis and treatment of one patient with venous cystic adventitial disease was retrospectively studied.

Results

This case of venous cystic adventitial disease was diagnosed accurately by contrast-enhanced computed tomography and treated successfully by surgical resection. No complications were detected after one-year post-operative follow-up.

Conclusions

Surgical resection is a safe and effective method for the treatment of venous CAD.
The negotiation of sharing leadership in the context of professional hierarchy: Interactions on interprofessional teams
Authors: Fox Stephanie , Comeau-Vallée Mariline
Published: April 2020

While there is growing recognition of leadership as a collective phenomenon, the question of how leadership is shared in the context of hierarchical asymmetry has been neglected in the collective leadership literature. Our article addresses this gap by examining how sharing leadership is negotiated in team interactions that are steeped in asymmetry deriving from the professional hierarchy. Adopting a leadership-in-interaction approach, we draw on fine-grained analysis of observed interactions on interprofessional teams from two health care organizations to compare the discursive strategies used by professionals in a superior hierarchical position to the ones used by those in inferior positions to share leadership. These strategies are organized into a matrix of interactional moves that resist or enact the professional hierarchy. Empirical vignettes are provided to demonstrate how sharing leadership and hierarchical leadership can be co-present and even intertwined in an interaction. We show that leadership is shared (or not) as a result of how the professional hierarchy gets negotiated in interactions. More specifically, we conclude that the sharing of leadership in this context tends to occur prior to decision making, especially around problem formulation, if the interactional climate allows. Furthermore, it requires concrete effort: Those in superior positions of influence mindfully relax the hierarchy whereas those in inferior positions create moments of sharing leadership through resistance and struggle.
Distal radius fracture volar locking plate osteosynthesis using wide-awake local anaesthesia
Authors: Dukan Ruben , Krief Elie , Nizard Remy
Published: April 2020

Surgical fixation of distal radius fractures under local anaesthesia with the patient wide awake allows an intraoperative testing of the fixation stability under active mobilization. We evaluated the feasibility and clinical results of this technique in 45 patients prospectively in two matched comparable groups: wide-awake local anaesthesia no tourniquet and loco-regional anaesthesia. We found that the pain scores during the anaesthetic administration and the surgical procedure were similar in two groups. Ranges of wrist motion and QuickDASH scores were improved significantly in the wide-awake local anaesthesia no tourniquet group at 6 weeks and 3 months and similar at 6 months compared with those receiving loco-regional anaesthesia. Patients in wide-awake local anaesthesia no tourniquet returned to work significantly earlier than the loco-regional anaesthesia group. We conclude that osteosynthesis of distal radius fractures can be safely performed under wide-awake local anaesthesia no tourniquet, leading to no increase in pain level and similar functional outcomes compared with those under loco-regional anaesthesia.

Level of evidence: III
Long-term cumulative blood pressure in young adults and incident heart failure, coronary heart disease, stroke, and cardiovascular disease: The CARDIA study
Authors: Nwabuo Chike C , Appiah Duke , Moreira Henrique T , Vasconcellos Henrique D , Yano Yuichiro , Reis Jared P , Shah Ravi V , Murthy Venkatesh L , Allen Norrina B , Sidney Stephen , Muntner Paul , Lewis Cora E , Lloyd-Jones Donald M , Schreiner Pamela J , Gidding Samuel S , Lima João A C
Published: April 2020

Aims

Cumulative blood pressure (BP) is a measure that incorporates the severity and duration of BP exposure. The prognostic significance of cumulative BP in young adults for cardiovascular diseases (CVDs) in comparison to BP severity alone is, however, unclear.

Methods and results

We investigated 3667 Coronary Artery Risk Development in Young Adults participants who attended six visits over 15 years (year-0 (1985–1986), year-2, year-5, year-7, year-l0, and year-15 exams). Cumulative BP was calculated as the area under the curve (mmHg × years) from year 0 through year 15. Cox models assessed the association between cumulative BP (year 0 through year 15), current BP (year 15), and BP change (year 0 and year 15) and CVD outcomes. Mean (standard deviation) age at year 15 was 40.2 (3.6) years, 44.1% were men, and 44.1% were African-American. Over a median follow-up of 16 years, there were 47 heart failure (HF), 103 coronary heart disease (CHD), 71 stroke, and 191 CVD events. Cumulative systolic BP (SBP) was associated with HF (hazard ratio (HR) = 2.14 (1.58–2.90)), CHD (HR = 1.49 (1.19–1.87)), stroke (HR = 1.81 (1.38–2.37)), and CVD (HR = 1.73 (1.47–2.05)). For CVD, the C-statistic for SBP (year 15) was 0.69 (0.65–0.73) and change in C-statistic with the inclusion of SBP change and cumulative SBP was 0.60 (0.56–0.65) and 0.72 (0.69–0.76), respectively. For CVD, using year-15 SBP as a reference, the net reclassification index (NRI) for cumulative SBP was 0.40 (p < 0.0001) and the NRI for SBP change was 0.22 (p = 0.001).

Conclusions

Cumulative BP in young adults was associated with the subsequent risk of HF, CHD, stroke, and CVD. Cumulative BP provided incremental prognostic value and improved risk reclassification for CVD, when compared to single BP assessments or changes in BP.
The daily impact of COVID‐19 in gastroenterology
Authors: Magro Fernando , Abreu Candida , Rahier Jean‐François
Published: April 2020

A new strain of coronavirus, called SARS‐CoV‐2, emerged in Wuhan, China, in December 2019, probably originating from a wild‐animal contamination. Since then, the situation rapidly evolved from a cluster of patients with pneumonia, to a regional epidemic and now to a pandemic called COrona VIrus Disease 2019 (COVID‐19). This evolution is related to the peculiar modes of transmission of the disease and to the globalization and lifestyle of the 21st century that created the perfect scenario for virus spread.

Even though research has not evidenced particular susceptibility of inflammatory bowel disease (IBD) patients to SARS‐CoV‐2 infection, immunosuppressive and immunomodulatory treatments were considered potential risk factors. In this context, initiating treatments with these agents should be cautiously weighted and regular ongoing treatments shall be continued, while the dose of corticosteroids should be reduced whenever possible. Due to the increased risk of contamination, elective endoscopic procedures and surgeries should be postponed and IBD online appointments shall be considered. IBD patients shall also follow the recommendations provided to the general population, such as minimization of contact with infected or suspected patients and to wash hands frequently.

In the absence of effective treatments and vaccines, this pandemic can only be controlled through prevention of SARS‐CoV‐2 transmission with the main objectives of providing patients the best healthcare possible and reduce mortality.
Psychometric properties of the intensive care delirium screening checklist when used by bedside nurses in clinical practice: a prospective descriptive study
Authors: Detroyer Elke , Timmermans Annick , Segers Dana , Meyfroidt Geert , Dubois Jasperina , Van Assche Aimé , Joosten Etienne , Milisen Koen
Published: April 2020

Background

The Intensive Care Delirium Screening Checklist (ICDSC) demonstrates good psychometric characteristics in research settings. However, evidence about these characteristics in pragmatic ICU settings is inconsistent. This study evaluated psychometric properties and user-friendliness of the ICDSC when administered by ICU nurses in daily practice.

Methods

This prospective study included 77 patients from a surgical intensive care unit. To examine the psychometric characteristics, the scores on the ICDSC (performed by bedside nurses) were compared with the scores on the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) (performed by researchers as gold standard). The user-friendliness was evaluated by 34 ICU nurses with a 20-item questionnaire.

Results

The ICDSC had an area under the curve of 0.843. It showed a good diagnostic accuracy with a sensitivity of 81.0%, a specificity of 87.7%, and a 53.1% positive and 96.4% negative predictive value. The overall Cronbach’s alpha coefficient for all ICDSC scores was high (0.839). Overall, ICU nurses experienced the ICDSC as easy-to-use. The scale was usable in most surgical ICU patients. Yet, some nurses (11.8%) had problems to score the items ‘inappropriate speech’ and ‘symptom fluctuation’ in intubated patients.

Conclusions

The ICDSC is a valid and user-friendly tool for delirium screening in daily ICU nursing practice. Yet, some problems were reported in intubated patients. Therefore, validation studies with specific focus on intubated patients are needed.
Dietary fat quantity and quality in relation to general and abdominal obesity in women: a cross-sectional study from Ghana
Authors: Suara Sufyan Bakuri , Siassi Fereydoun , Saaka Mahama , Foroshani Abbas Rahimi , Asadi Sara , Sotoudeh Gity
Published: April 2020

Background

Although relationships between obesity and total fat and fat types have been widely examined, the associations between the relative proportions of fatty acids calculated in the form of indices and obesity/overweight are lacking. The objective of this study was to assess associations between dietary fat quality indices and odds of obesity/overweight in women from Ghana.

Methods

In this cross-sectional study, dietary information was obtained using 24-h dietary recall. The odds of obesity were evaluated across quintiles of specific DFQ indices [atherogenicity index (AI), thrombogenic index (TI), hypo- and hypercholesterolemic fatty acids ratio (h/H), omega-3 to omega-6 polyunsaturated fatty acids ratio (∑ω-3/∑ω-6), polyunsaturated fatty acids/saturated fatty acids ratio (PSR), dietary lipophilic index (LI) and percentage of energy from total fat (TF)].

Results

After adjustment for covariates, general obesity and overweight were inversely associated with ∑ω-3/∑ω-6 ratio (OR: 0.63; 95% CI: 0.24–1.63; P for trend (P) = 0.005) and positively with TI (4.14; 95% CI: 1.78–9.66; P = 0.01) and LI (2.49; 95% CI: 1.14–5.43; P = 0.01). The odds of abdominal obesity based on waist circumference (WC) were significantly higher among participants in the fifth quintile (Q) compared with those in the first Q of AI (1.24; 95% CI: 0.56–2.74; P = 0.01), TI (4.14; 95% CI: 1.78–9.66; P = 0.009), LI (2.11; 95% CI: 0.98–4.55; P = 0.02) and TF (1.59; 95% CI: (0.73–3.46; P = 0.003). Similarly, waist to height ratio (WHtR) was positively associated with AI (2.89; 95% CI: 1.32–6.31; P = 0.04), TI (2.65; 95% CI: 1.22–5.76; P = 0.03), LI (3.32; 95% CI: 1.52–7.28; P = 0.007) and TF (1.83; 95% CI: 0.85–3.93; P = 0.009).

Conclusion

There was an inverse association between ∑ω-3/∑ω-6 ratio and general obesity and WC. We also found positive associations between abdominal obesity and AI and TF. Furthermore, TI and LI showed positive relationships with both general and abdominal obesity. Therefore, intake of dietary fatty acids in favor of higher ratios of ∑ω-3/∑ω-6 may be important in obesity prevention.
Vector competence of Virginia mosquitoes for Zika and Cache Valley viruses
Authors: Chan Kevin K. , Auguste Albert J. , Brewster Carlyle C. , Paulson Sally L.
Published: April 2020

Background

Vector-borne diseases are a major public health concern and cause significant morbidity and mortality. Zika virus (ZIKV) is the etiologic agent of a massive outbreak in the Americas that originated in Brazil in 2015 and shows a strong association with congenital ZIKV syndrome in newborns. Cache Valley virus (CVV) is a bunyavirus that causes mild to severe illness in humans and ruminants. In this study, we investigated the vector competence of Virginia mosquitoes for ZIKV and CVV to explore their abilities to contribute to potential outbreaks.

Methods

To determine vector competence, mosquitoes were fed a blood meal comprised of defibrinated sheep blood and virus. The presence of midgut or salivary gland barriers to ZIKV infection were determined by intrathoracic inoculation vs oral infection. After 14-days post-exposure, individual mosquitoes were separated into bodies, legs and wings, and saliva expectorant. Virus presence was detected by plaque assay to determine midgut infection, dissemination, and transmission rates.

Results

Transmission rates for Ae. albopictus orally infected (24%) and intrathoracically inoculated (63%) with ZIKV was similar to Ae. aegypti (48% and 71%, respectively). Transmission rates of ZIKV in Ae. japonicus were low, and showed evidence of a midgut infection barrier demonstrated by low midgut infection and dissemination rates from oral infection (3%), but increased transmission rates after intrathoracic inoculation (19%). Aedes triseriatus was unable to transmit ZIKV following oral infection or intrathoracic inoculation. CVV transmission was dose-dependent where mosquitoes fed high titer (ht) virus blood meals developed higher rates of midgut infection, dissemination, and transmission compared to low titer (lt) virus blood meals. CVV was detected in the saliva of Ae. albopictus (ht: 68%, lt: 24%), Ae. triseriatus (ht: 52%, lt: 7%), Ae. japonicus (ht: 22%, lt: 0%) and Ae. aegypti (ht: 10%; lt: 7%). Culex pipiens and Cx. restuans were not competent for ZIKV or CVV.

Conclusions

This laboratory transmission study provided further understanding of potential ZIKV and CVV transmission cycles with Aedes mosquitoes from Virginia. The ability for these mosquitoes to transmit ZIKV and CVV make them a public health concern and suggest targeted control programs by mosquito and vector abatement districts.
Information cascades prediction with attention neural network
Authors: Liu Yun , Bao Zemin , Zhang Zhenjiang , Tang Di , Xiong Fei
Published: April 2020

Cascade prediction helps us uncover the basic mechanisms that govern collective human behavior in networks, and it also is very important in extensive other applications, such as viral marketing, online advertising, and recommender systems. However, it is not trivial to make predictions due to the myriad factors that influence a user’s decision to reshare content. This paper presents a novel method for predicting the increment size of the information cascade based on an end-to-end neural network. Learning the representation of a cascade in an end-to-end manner circumvents the difficulties inherent to blue the design of hand-crafted features. An attention mechanism, which consists of the intra-attention and inter-gate module, was designed to obtain and fuse the temporal and structural information learned from the observed period of the cascade. The experiments were performed on two real-world scenarios, i.e., predicting the size of retweet cascades on Twitter and predicting the citation of papers in AMiner. Extensive results demonstrated that our method outperformed the state-of-the-art cascade prediction methods, including both feature-based and generative approaches.
An improved object detection algorithm based on multi-scaled and deformable convolutional neural networks
Authors: Cao Danyang , Chen Zhixin , Gao Lei
Published: April 2020

Object detection methods aim to identify all target objects in the target image and determine the categories and position information in order to achieve machine vision understanding. Numerous approaches have been proposed to solve this problem, mainly inspired by methods of computer vision and deep learning. However, existing approaches always perform poorly for the detection of small, dense objects, and even fail to detect objects with random geometric transformations. In this study, we compare and analyse mainstream object detection algorithms and propose a multi-scaled deformable convolutional object detection network to deal with the challenges faced by current methods. Our analysis demonstrates a strong performance on par, or even better, than state of the art methods. We use deep convolutional networks to obtain multi-scaled features, and add deformable convolutional structures to overcome geometric transformations. We then fuse the multi-scaled features by up sampling, in order to implement the final object recognition and region regress. Experiments prove that our suggested framework improves the accuracy of detecting small target objects with geometric deformation, showing significant improvements in the trade-off between accuracy and speed.
Self-care behaviors related to air pollution protection questionnaire: a psychometric analysis
Authors: Mirzaei-Alavijeh Mehdi , Jalilian Farzad , Dragoi Elena-Niculina , Pirouzeh Razieh , Solaimanizadeh Laleh , Khashij Shima
Published: April 2020

Background

Air pollution is an environmental health issue that has received much attention due to its harmful effects on public health. The aim of this study was to determine the psychometric properties of the self-care behaviors related to air pollution protection. To this mean, questionnaire responses provided by Iranian college students were analyzed and a Health Belief Model (HBM) determined.

Methods

The self-care behavior related to air pollution protection was determined from responses from 301 university students using test item characteristics, face validity, reliability (internal consistency) and construct validity. Moreover, we carried out an exploratory factor analysis (EFA) to determine the factorial structure and explained variance.

Results

Based on Eigenvalues of ≥1.00 and factor loadings of ≥0.40, seven factors were extracted. The calculated Kaiser–Meyer–Olkin value was 0.804. Overall, the seven factors explain 66.39% of the variance in the hypothesized model. Cronbach’s alpha for the measured factors: the perceived susceptibility, severity, barriers, benefits, self-efficacy, cues to action and behavior were 0.85, 0.79, 0.86, 0.66, 0.74, 0.83, and 0.75, respectively.

Conclusion

The analysis of the questionnaire’s reliability and validity properties resulted in good values. The questionnaire is a promising instrument to assess self-care behavior related to air pollution protection from the perspective of college students.
An experimental investigation of attraction between knots in a stretched DNA molecule
Authors: Klotz Alexander R. , Soh Beatrice W. , Doyle Patrick S.
Published: April 2020

It has been predicted through simulations that two knots in a stretched polymer will feel an attraction towards one another and will tend to be found in close proximity. Here, we examine data from experiments in which we stretched knotted DNA molecules and investigate a subset which contained two or more knots. In contrast to the expected behavior of an isolated knot in an elongational field, we observe that pairs of knots move towards each other from distant sections of the molecule. After meeting, pairs of knots fluctuate in and out of visual contact, and can remain in proximity for minutes at a time. Our experimental results suggest that knots on an extended polymer experience an attractive interaction.
Staff unavailability and safe staffing: are headroom allowances ‘realistic’?
Authors: Drake Robert
Published: April 2020

Background:

‘Hours per patient day’ (HPPD) is an internationally recognised resourcing metric used to measure direct nursing care hours. However, hospitals often underestimate indirect time (unavailability) and specify unrealistic targets for planned unavailability (‘headroom’).

Aims:

To investigate the disparities between planned unavailability (‘headroom’) and actual staff unavailability.

Methods:

Data were collected from the e-rostering systems of 87 NHS trusts. This was compared with published data from 35 roster policies.

Results:

Many hospitals use headroom as a key performance indicator (KPI) and set targets for its components in their roster policies. This research highlights large variations in unavailability (15.8% to 33.6%) and lower variations in headroom (16–26%).

Conclusion:

Hospitals operationalise headroom around an idealised ‘target’ value. This may be detrimental. Compelling a unit with unavailability of between 28% and 30% to adopt an institution-wide headroom of 22% (for example) may, at best, increase spending on bank/agency staff, or, at worse, jeopardise patient safety.
Development of recurrent pressure ulcers, risk factors in older patients: a prospective observational study
Authors: Arisandi Defa , Ogai Kazuhiro , Urai Tamae , Aoki Miku , Minematsu Takeo , Okamoto Shigefumi , Sanada Hiromi , Nakatani Toshio , Sugama Junko
Published: April 2020

Objective:

Prevention of recurrent pressure ulcers (PU) is one of the most important challenges in wound care, furthermore, the risk factors for recurrent PUs are still not fully understood. This study aimed to explore the risk factors for recurrent PU development within two weeks, including biophysical skin properties, pro-inflammatory cytokine (tumour necrosis factor [TNF]-α) levels and bacterial species, in older patients.

Method:

This prospective study was conducted in a long-term care facility with patients whose PU had healed within two months. Biophysical skin properties were evaluated by stratum corneum hydration, pH, sebum content and transepidermal water loss. TNF-α level was measured using skin blotting. Skin bacteria were collected using tape stripping and determined by species-specific gene amplification. These parameters, along with Braden scale and interface pressure, were evaluated every two weeks for a total period of eight weeks. A penalised generalised estimating equation analysis was used to determine the risk factors for recurrent PUs.

Results:

In total, 20 patients were included in this study, with 57 observations. Of these, recurrent PU was seen in eight observations. Elevation of pH (p=0.049; odds ratio [OR] per 1 unit=3.91, 95% confidence interval [CI]:1.01–15.15), presence of Acinetobacter spp. (p=0.039; OR versus culture-negative=6.28, 95%CI:1.10–35.86) and higher interface pressure (p=0.008; OR per 1 mmHg=1.06, 95%CI:1.01–1.10) on the healed PU were significantly related to the development of recurrent PU.

Conclusion:

Higher pH, existence of Acinetobacter spp. and higher interface pressure on the site of the healed PU were associated with the development of recurrent PUs in older patients undergoing conservative treatments.
Adding herbal extracts to silicone gel on post-sternotomy scar: a prospective randomised double-blind study
Authors: Surakunprapha Palakorn , Winaikosol Kengkart , Chowchuen Bowornsilp , Jenwitheesuk Kriangsak , Jenwitheesuk Kamonwan
Published: April 2020

Objective:

Silicone gel has been shown effective in improving healing post-sternotomy scars. It remains to be determined whether adding herbal extracts to the gel would augment the healing effect.

Method:

After median sternotomy, patients were randomised into two groups. Group 1: topical silicone gel plus herbal extract gel (Allium cepa, Centella Asiatica, Aloe vera and Paper Mulberry) and Group 2: silicone gel. Patients were treated for six months. The postoperative scars were assessed at three and six months by plastic surgeons using the Vancouver Scar Scale (VSS) and the patient assessment scar scale.

Results:

Each group comprised 23 patients (n=46 in total). The VSS was significantly lower in Group 1 than in Group 2 (p=0.018 and p=0.051, respectively). In Group 1, the four differences from baseline were vascularity scores at three and six months (–0.391, p=0.025; –0.435, p=0.013, respectively), and pigmentation scores at three and six months (–0.391, p=0.019; –0.609, p=0.000, respectively). In Group 2, differences from baseline were the pigmentation and vascularity score at six months (–0.6609, p=0.000; –0.348, p=0.046, respectively).

Conclusion:

Our results suggest, post-sternotomy scars trend to have better vascularity and pigmentation when treated with silicone gel plus herbal extracts.
Preparing for COVID-19: what can the past teach us?
Authors: Winter George
Published: April 2020

With COVID-19 declared a public health emergency of international concern, George Winter takes a look at previous outbreaks, considering what we can learn when tackling COVID-19
Treatment and management of fibromyalgia
Authors: Perry Margaret
Published: April 2020

This article will give and overview of this fibromyalgia, a highly complex disease, which presents in many cases with a variety of symptoms, making diagnosis extremely difficult. There are a number of treatment options available both non-pharmacological and pharmacological, and although the former are usually tried first, this article will largely focus on the later. The article aims to give non-medical prescribers more knowledge and confidence when faced with prescribing for this highly complicated disease.
The NHSX factor: Giving practices the tech they need
Authors: Barker Chris
Published: April 2020

Chris Barker discusses the adoption of digital technology in the 21st century, and outlines the four key trends for 2020 as NHS organisations look to build on their existing infrastructure to improve digital maturity
Supporting families with a diagnosis of autism
Authors: Tinsley Elizabeth
Published: April 2020

This article will look at the characteristics of autism and the support needed for children and young people in order to live as independently as possible in the long term
COVID-19: Your NHS needs you
Authors: Moffat Polly
Published: April 2020

Responding to the government's call, 4,500 retired doctors and nurses have pledged to return to the NHS to help fight the coronavirus
The Roman Suburb on the Vrina Plain Outside Butrint, Albania
Authors: Richard Hodges
Published: April 2020

Luigi Maria Ugolini identified the suburb at Phoinike but not at Butrint. This short essay in honour of Sandro De Maria summarizes the early Roman archaeological sequence of the suburb identified and excavated by the Butrint Foundation between 2000-7. The unfortified suburb grew up around a multi-arched bridge over the Vivari channel. It was initially a settlement of small dwellings and shops, before it was aggregated to become a substantial channelside villa (like those within the walled enclosure of Butrint).
Length-weight relationships and ponderal index of three reef fish (Teleostei: Labridae) off the Tanjung Tiram coast, Southeast Sulawesi, Indonesia
Authors: Asriyana Asriyana , Irawati Nur , Halili Halili
Published: April 2020

Abstract. Asriyana A, Irawati N, Halili H. 2020. Length-weight relationships and ponderal index of three reef fish (Teleostei: Labridae) off the Tanjung Tiram coast, Southeast Sulawesi, Indonesia. Biodiversitas 21: 1279-1286. Parameters of length-weight relationship and ponderal index were estimated for first time for three reef fish (Labridae), Cheilinus trilobatus, Cheilinus chlorourus, and Choerodon anchorago, off the Tanjung Tiram coast, Indonesia. A total of 292 specimens (C. trilobatus 146 specimens; C. chlorourus 100 specimens; C. anchorago 46 specimens) were collected monthly in experimental gillnets in coral reefs and seagrass beds from January to June 2018. The length-weight relationship and ponderal index were calculated for each species. C. trilobatus showed total length and weight of 9.0-17.2 cm and 12.33-78.79 g, respectively, while C. chlorourus was 8.5-17.5 cm and 10.41-100.21 g, and C. anchorago 9.0-27.0 cm and 18.51-414.00 g. C. trilobatus showed negative allometric growth, while C. chlorourus and C. anchorago had isometric growth. The length-weight relationship of C. trilobatus followed the linear equation of W=0.10TL2.35, while C. chlorourus and C. anchorago fit to W=0.03TL2.83; W=0.03TL2.91 respectively. The highest ponderal index occurred in May for C. trilobatus and in June for C. chlorourus and C. anchorago indicating a peak of the spawning season. The study results could be used as baseline information for future fisheries management of the area.
Pathogenesis of gall-rust disease on Falcataria moluccana in areas affected by Mount Merapi eruption in Indonesia
Authors: Rahayu S. , Widiyatno Widiyatno , Dwi Tyaningsih Adriyanti
Published: April 2020

Abstract. Rahayu S, Widiyatno, Adriyanti DT. 2020. Pathogenesis of gall-rust disease on Falcataria moluccana in areas affected by Mount Merapi eruption in Indonesia. Biodiversitas 21: 1310-1315. The gall rust pathogen Uromycladium falcatarium affects the fast-growing tree species Falcataria moluccana (Sengon) from seedling to mature stage producing galls on all its parts. Severe infestation causes tree mortality. There were two eruptions of the volcano at Mount Merapi, Java, Indonesia during October-November 2010 near to which Sengon is grown under community forests. This study, conducted in 2014, examined the implications of the volcanic eruptions on the incidence and severity of gall rust disease on Sengon trees growing in areas affected by the eruption. It revealed that the percentage infestation on seedlings caused by teliospores of U. falcatarium collected from areas close to Mount Merapi (3-7 km away-risky area) was significantly higher compared to those collected from trees 7.1-11 (are under alert) and 11.1-15 km (area under threat) away. The teilospores and galls collected from the ‘risky area’ also exhibited morphological variations. The gall rust incidence on different parts of the tree was significantly higher in the ‘risky’ area compared to trees growing in other areas. The incidence of the disease was close to 100% in the risky area but less than 80% in areas ‘under alert and under threat’. Overall, the data indicated that the incidence and severity of gall rust disease was significantly higher in areas close to the Mount Merapi apparently due to increased virulence of the pathogen and increased susceptibility of the trees due to damges caused by the eruption. Conducive environmental conditions such as high relative humidity and temperature in the area may also have favoured this situation. Artifical inoculations using teliospores collected from infected trees in the risky area, area under alert and under threat caused severe infection on seedlings.