bluuebunny/crossref_metadata_2025 huggingface dataset:
Diffuse capillary malformation with overgrowth contains somatic PIK3CA variants
Authors: Goss Jeremy A. , Konczyk Dennis J. , Smits Patrick , Sudduth Christopher L. , Bischoff Joyce , Liang Marilyn G. , Greene Arin K.
Published: January 2020

Diffuse capillary malformation with overgrowth (DCMO) is a clinical diagnosis describing patients with multiple, extensive capillary malformations (CMs) associated with overgrowth and foot anomalies. The purpose of the study was to identify somatic variants in DCMO. Skin containing CM and overgrown subcutaneous adipose tissue was collected from patients with DCMO. Exons from 447 cancer‐related genes were sequenced using OncoPanel. Variant‐specific droplet digital PCR (ddPCR) independently confirmed the variants and determined variant allele frequencies (VAF). One subject contained a somatic PIK3CA p.G106V variant. A second patient had a PIK3CA p.D350G variant. VAF was 27% to 29% in skin and 16% to 28% in subcutaneous adipose. Variants were enriched in endothelial cells (VAF 50%‐51%) compared to nonendothelial cells (1%‐8%). DCMO is associated with somatic PIK3CA variants and should be considered on the PIK3CA‐related overgrowth spectrum (PROS). Variants are present in both skin and subcutaneous adipose and are enriched in endothelial cells.
Impact of fast‐food outlet density on incidence of myocardial infarction in the Hunter region
Authors: Saluja Tarunpreet , Davies Allan , Oldmeadow Chris , Boyle Andrew J.
Published: January 2020

Background

There is an established association between fast‐food consumption and metabolic diseases. Some studies also suggest that calorie‐dense food promotes a proinflammatory response, which is itself linked with myocardial infarction (MI). Whether increased fast‐food availability is a risk factor for MI remains unknown.

Aim

To investigate the role of fast‐food outlet density (FFD) as a novel environmental risk factor for MI in the Hunter region, New South Wales (NSW).

Methods

We conducted a retrospective cohort study using a database of all MI events between 1996 and 2013, extracted from the Hunter Cardiac and Stroke Outcomes unit. FFD was calculated for each local government area (LGA) of the Hunter region, allowing for a comparative analysis. Stratification by fast‐food outlet data and LGA resulted in a total of 3070 cases. Weighted linear regression was used to investigate the role of FFD on incidence of MI in regional and rural Australia.

Results

FFD was positively correlated with rates of MI, remaining consistent in both single and multivariate predictor models adjusting for age, obesity, hyperlipidaemia, hypertension, smoking status, diabetes and socioeconomic status (P < 0.001). An increase of one fast‐food outlet corresponded with four additional cases of MI per 100 000 people per year (4.07, 95% confidence interval, 3.86–4.28).

Conclusions

FFD was positively associated with incidence of MI in both rural and metropolitan areas of NSW. This relationship remained consistent after multivariate adjustment for standard cardiovascular risk factors, highlighting the importance of an individual's food environment as a potential contributor towards their health.
Thermal properties and elastic constants of ζ‐Ta4C3−x
Authors: Schwind Evan C. , Hilmas Gregory E. , Fahrenholtz William G.
Published: January 2020

Thermal and elastic properties were measured for ceramics that contained as much as 96 wt% zeta phase tantalum carbide (ζ‐Ta4C3−x). The ceramics were produced from tantalum hydride that was milled to reduce particle size and then blended with carbon. Powders were reaction hot‐pressed at 1800°C for 2 hours under a flowing He environment, which resulted in ζ‐Ta4C3−x that was about 99% dense. The main secondary phases present in the reacted ceramic were TaC and Ta2O5. ζ‐Ta4C3−x had a thermal conductivity of 9.6 W/m·K and an electrical resistivity of 160 ± 4.2 μΩ‐cm, which are lower and higher than those of TaC, respectively. The Young's modulus was 379 ± 5 GPa and the hardness was 5.1 ± 0.7 GPa, which are also both lower than TaC. This study is the first to report the thermal properties and elastic moduli of high‐purity ζ‐Ta4C3−x.
An atrial fibrillation rotor, mapped conventionally
Authors: Varma Niraj , Rizzo Raymond , Wisnoskey Brian
Published: January 2020

This case illustrates that the condition of atrial fibrillation (AF) may harbor site(s) of regular rotational activity, reentry may be an underlying mechanism, high periodicity and wavebreak through areas of the scar may generate fibrillatory conduction, and disintegration of the “rotor” may not abolish AF.
Impact of paced left ventricular dyssynchrony on left ventricular reverse remodeling after cardiac resynchronization therapy
Authors: Gauthey Anaïs , Willemen Erik , Lumens Joost , Ploux Sylvain , Bordachar Pierre , Ritter Philippe , Prinzen Frits W. , Lejeune Sibille , Pouleur Anne‐Catherine , Garnir Quentin , Marchandise Sébastien , Scavée Christophe , Wauters Aurélien , le Polain de Waroux Jean‐Benoit
Published: January 2020

Introduction

We investigated whether pacing‐induced electrical dyssynchrony at the time of cardiac resynchronization therapy (CRT) device implantation was associated with chronic CRT response.

Methods and Results

We included a total of 69 consecutive heart failure patients who received a CRT device. Left (LVp‐RVs) and right (RVp‐LVs) pacing‐induced interlead delays were measured intraoperatively and used to determine if there was paced left ventricular (LV) dyssynchrony, defined as present when LVp‐RVs is larger than RVp‐LVs. CRT response was defined as a reduction in LV end‐systolic volume ≥15%, 6 months after implantation. Paced left ventricular dyssynchrony (PLVD) was associated with ischemic cardiomyopathy (ICM) (χ2: 8; P = .005) but not with QRS morphology nor with pacing lead positions. In a univariate analysis, PLVD (odds ratio [OR], 6.53; 95% confidence interval [CI], 2.2‐18.9; P = .001), atypical left bundle branch block (LBBB) (OR, 3.3; 95% CI, 1.2‐9.4; P = .022), and ICM (OR, 5.2; 95% CI, 1.6‐17; P = .006) were associated with nonresponse. In a multivariate analysis, both PLVD (OR, 9.74; 95% CI, 2.8‐33.9; P < .0001) and atypical LBBB (OR, 5.6; 95% CI, 1.5‐20.3; P = .009) were independently associated with nonresponse. Adding PLVD to a model based on QRS morphology provided a significant and meaningful incremental value to predict LV reverse remodeling after CRT (χ2 to enter: 8; P < .005). Computer simulations corroborate these findings by showing that, while intrinsic electrical dyssynchrony is a prerequisite, the level of pacing‐induced dyssynchrony modulates acute CRT response.

Conclusion

In addition to the intrinsic electrical substrate, PLVD is strongly associated with less LV reverse remodeling, demonstrating that measuring the electrical substrate during pacing has additional value for prediction of CRT response in an already well‐selected patient population.
Exogenous 8‐hydroxydeoxyguanosine ameliorates liver fibrosis through the inhibition of Rac1‐NADPH oxidase signaling
Authors: Shin Seung Kak , Kim Kyung‐Ok , Kim Se‐Hee , Kwon Oh Sang , Choi Cheol Soo , Jeong Sung Hwan , Kim Yun Soo , Kim Ju Hyun , Chung Myung‐Hee
Published: January 2020

Background and Aim

Exogenous 8‐hydroxydeoxyguanosine (8‐OHdG) was suggested as an inhibitor of Rac1 and NADPH oxidase (NOX). The aim of this study was to evaluate the effects of the exogenous 8‐OHdG on hepatic fibrogenesis in vitro and in vivo model of liver fibrosis.

Methods

Adult Sprague–Dawley rats were allocated to sham‐operated rats (n = 7), rats that underwent bile duct ligation (BDL) (n = 6), and BDL rats treated with 8‐OHdG (60 mg/kg/day by gavage, n = 6). All rats were sacrificed on day 21. Double immunofluorescence staining between either NOX1 or NOX2 and α‐smooth muscle actin (SMA) in liver was performed. Hepatic fibrotic contents were assessed by hydroxyproline assay and quantified by Sirius red staining. In vitro, hepatic stellate cell (HSC) line LX‐2 and HHSteC cells were stimulated by angiotensin II (10 μM). The reactive oxygen species (ROS) production was measured by confocal microscopy. The expressions of NOX1, NOX2, α‐SMA, transforming growth factor (TGF)‐β1, and collagen Iα were analyzed by quantitative real‐time polymerase chain reaction or immunoblotting.

Results

The 8‐OHdG treatment in BDL rats reduced the NOX1 and NOX2 protein expression, which overlapped with α‐SMA compared with BDL rats. The 8‐OHdG treatment in BDL rats significantly decreased the mRNA expression of NOX1, NOX2, α‐SMA, TGF‐β1, and collagen Iα, and fibrotic contents. Increases of ROS production, Rac1 activation, NOX1, NOX2, and fibronectin expression induced by angiotensin II in HSCs were attenuated by 8‐OHdG.

Conclusions

Rac1 activation and NOX‐derived ROS are implicated to liver fibrosis. The 8‐OHdG ameliorates liver fibrosis through the inhibition of Rac1 activation and NOX‐derived ROS.
Hemiboea guangdongensis comb. & stat. nov., a cryptic species segregated from H. subcapitata (Gesneriaceae) based on morphological and molecular data
Authors: Li Xiaoqian , Guo Zhiyou , Li Yang , Zhou Peng , Chen Xuhui , Li Zhenyu , Xiang Xiaoguo
Published: January 2020

The taxonomic problem of cryptic species has long been recognized. Hemiboea subcapitata C. B. Clarke is a widespread and morphologically diverse species including two varieties, H. subcapitata var. subcapitata C. B. Clarke and H. subcapitata var. guangdongensis (Z. Y. Li) Z. Y. Li. However, genetic distance and molecular phylogenetic analyses based on nuclear ITS and four plastid DNA sequences (atpB‐rbcL, matK, rbcL, rpS16 intron) revealed that H. subcapitata var. guangdongensis is sister to H. subacaulis, and separated from H. subcapitata var. subcapitata, suggesting that it should be raised to the rank of an independent species as H. guangdongensis (Z. Y. Li) X. Q. Li & X. G. Xiang, comb. & stat. nov. Morphologically, the new species can be distinguished from H. subacaulis by its calyx 5‐sect from base, segments narrowly oblong‐lanceolate (versus calyx 5‐sect from base or 2‐lipped and adaxial lip 2‐lobed from below middle, segments ovate), peduncle glabrous (versus pubescent), and vermiform sclereids dispersed in leaf mesophyll (versus without sclereids).
Adaptations in pediatric anesthesia care and airway management in the resource‐poor setting
Authors: Manyumwa Petros , Chimhundu‐Sithole Tsitsi , Marange‐Chikuni Danai , Evans Faye M.
Published: January 2020

The need for safe and quality pediatric anesthesia care in low‐ and middle‐income countries (LMICs) is huge. An estimated 1.7 billion children do not have access to surgical care, and the majority are in LMICs. In addition, most LMICs do not have the requisite surgical workforce including anesthesia providers. Surgery is usually performed at three levels of facilities: district, provincial, and national referral hospitals. Unfortunately, the manpower, equipment, and other resources available to provide surgical care for children vary greatly at the different level facilities. The majority of district level hospitals are staffed solely by non‐physician anesthesia providers with variable training and little support to manage complicated pediatric patients. Airway and respiratory complications are known to account for a large portion of pediatric perioperative complications. Management of the difficult pediatric airway pathology is a challenge for anesthesia providers regardless of setting. However, in the low‐resource setting poor infrastructure, lack of transportation systems, and crippled referral systems lead to late presentation. There is often a lack of pediatric‐sized anesthesia equipment and resources, making management of the local pathology even more challenging. Efforts are being made to offer these providers additional training in pediatric anesthesia skills that incorporate low‐fidelity simulation. Out of necessity, anesthesia providers in this setting learn to be resourceful in order to manage complex pathologies with fewer, less ideal resources while still providing a safe anesthetic.
Precision pathology analysis of the development and progression of hepatocellular carcinoma: Implication for precision diagnosis of hepatocellular carcinoma
Authors: Ueno Akihisa , Masugi Yohei , Yamazaki Ken , Kurebayashi Yutaka , Tsujikawa Hanako , Effendi Kathryn , Ojima Hidenori , Sakamoto Michiie
Published: January 2020

Outcomes for patients with hepatocellular carcinoma (HCC) remain poor because the condition is often unresponsive to the available treatments. Consequently, the early and precise diagnosis of HCC is crucial to achieve improvements in prognosis. For patients with chronic liver disease, the assessment of liver fibrosis is also important to ascertain both the staging of fibrosis and the risk of HCC occurrence. Early HCC was first described in 1991 in Japan and was defined internationally in 2009. As the concept of early HCC spread, the multistage hepatocarcinogenesis process became accepted. Consequently, improvements in imaging technology made the early diagnosis of HCC possible. At present, the most appropriate therapeutic strategy for HCC is determined using an integrated staging system that assesses the tumor burden, the degree of liver dysfunction and the patient performance status; however, pathological and molecular features are not taken into account. The recent introduction of several new therapeutic agents will change the treatment strategy for HCC. Against this background, HCC subclassification based on tumor cellular and microenvironmental characteristics will become increasingly important. In this review, we give an overview of how pathological analysis contributes to understanding the development and progression of HCC and establishing a precision diagnosis of HCC.
The relationship between hydrocarbon accumulation and Mississippi Valley‐type Pb‐Zn mineralization of the Mayuan metallogenic belt, the northern Yangtze block, SW China: Evidence from ore geology and Rb‐Sr isotopic dating
Authors: Wang Guozhi , Huang Zhu , Zhao Fufeng , Li Na , Fu Yuzhen
Published: January 2020

The coexistence of Pb‐Zn deposits and oil/gas reservoirs demonstrates that a close genetic connection exists between them. The spatiotemporal relationship between Pb‐Zn mineralization and hydrocarbon accumulation is the key to understanding this genetic connection. The Mayuan large‐scale Pb‐Zn metallogenic belt is composed of a number of Mississippi Valley‐type (MVT) Pb‐Zn deposits that were recently discovered on the northern margin of the Yangtze Block, China. It is hosted in the dolostone of the Sinian (Ediacaran) Dengying Formation (Z2dn). In addition to the abundant bitumen in the Mayuan Pb‐Zn metallogenic belt, the paleo‐oil reservoir and the MVT Pb‐Zn deposit overlap in space. In this study, two precise ages of 468.3 ± 3.8 Ma and 206.0 ± 6.5 Ma were obtained via the Rb‐Sr isotopic dating of galena and sphalerite from the Mayuan Pb‐Zn metallogenic belt, respectively. The early metallogenic age of 468.3 ± 3.8 Ma is similar to the previously published age of 486 ± 12 Ma. The age of 206.0 ± 6.5 Ma is consistent with the age of the metallogenic event that occurred at 200 Ma in the Upper Yangtze Pb–Zn metallogenic province of the Sichuan‐Yunnan‐Guizhou polymetallic zone, which is located on the southwest margin of the Sichuan Basin, suggesting that the metallogenic effects of this period were regional in scale in the peripheral areas of the Sichuan Basin. Previous studies have shown that two periods of hydrocarbon accumulation occurred in the oil/gas reservoir that coexists with the Pb‐Zn deposits in the study area. The Pb‐Zn mineralization at 468.3 ± 3.8 Ma occurred during the first period of hydrocarbon accumulation, while the second mineralization at 206.0 ± 6.5 Ma occurred during the transformation of the paleo‐oil reservoir to a paleogas reservoir. The spatial relationship between the paleo‐oil/‐gas reservoir and the MVT Pb‐Zn deposits and the temporal relationship between mineralization and hydrocarbon accumulation show that a close genetic relationship exists between the MVT Pb‐Zn mineralization and hydrocarbon accumulation. Analysis of metals in the source rocks forming the paleo‐oil/‐gas reservoirs show that source rocks which formed paleo‐oil/‐gas reservoirs may have provided metals for Pb‐Zn mineralization. Both the paleo‐oil/‐gas reservoirs and Pb‐Zn mineralizing fluids had the same origin.
Natural Resources and Missing Inputs in International Productivity Comparisons*
Authors: Freeman Daan , Inklaar Robert , Diewert W. Erwin
Published: January 2020

Standard theory for cross‐country productivity comparisons assumes all countries use the same factor inputs in production. This assumption is violated when including natural resources, such as oil, gas and gold, because countries do not extract the full set of resources. In this paper we propose a solution by viewing it as a “missing goods” problem and assigning missing inputs a reservation price equal to the world resource price. We show that this has a substantial impact on relative productivity levels for countries heavily reliant on natural resources for generating their income. Under our new productivity measure, resource‐rich countries are no longer uncommonly productive.
Bayesian network models for incomplete and dynamic data
Authors: Scutari Marco
Published: January 2020

Bayesian networks are a versatile and powerful tool to model complex phenomena and the interplay of their components in a probabilistically principled way. Moving beyond the comparatively simple case of completely observed, static data, which has received the most attention in the literature, in this paper, we will review how Bayesian networks can model dynamic data and data with incomplete observations. Such data are the norm at the forefront of research and in practical applications, and Bayesian networks are uniquely positioned to model them due to their explainability and interpretability.
Granulomatous mural folliculitis in a dog treated with ciclosporin and methotrexate
Authors: Panzuti Pauline , Mosca Marion , Pin Didier
Published: January 2020

Background

Canine granulomatous mural folliculitis is a very rare cause of scarring alopecia with unknown pathogenesis.

Hypothesis/objectives

To report a case of granulomatous mural folliculitis in a dog treated with ciclosporin (Cs) and methotrexate (MTX).

Animal

A 13‐year‐old spayed female Pyrenean shepherd dog with a one month history of scarring alopecia.

Methods and results

Histopathological examination revealed a granulomatous and lymphocytic mural and necrotizing folliculitis and furunculosis. Immunochemistry, using antibodies for CD3, CD204, CD206, IBA‐1 and CD208, revealed that CD3+ lymphocytes were infiltrating the outer root sheath along with IBA‐1+ or CD204+ cells. Ciclosporin (5 mg/kg once daily) and MTX (0.25 mg/kg once weekly then 0.5 mg/kg once weekly) were initiated simultaneously, and Cs was stopped after stabilization of the lesions. The dog's skin disease was stable for six months.

Conclusions and clinical importance

To the best of the authors' knowledge, this is the first report of the long‐term management of a granulomatous mural folliculitis in a dog. Ciclosporin and MTX appeared to be an effective treatment option. Additional treated cases are needed to assess the effectiveness of MTX in canine immune‐mediated diseases.
Case Studies on the Impacts of Climate Change on Historical Buildings in Northern Cyprus
Authors: Angın Mehmet , Çubukçuoğlu Beste , Gökçekuş Hüseyin
Published: January 2020

The changing in climatic conditions is one of the most significant issues in the twenty-first century. The literature suggests various approaches for the understanding of the harmful influences of climate change. Climate change is caused by increases in atmospheric greenhouse gases, deforestation, altering watercourses and human actions with tragic effect on the environment has turned into certainty, as that the procedure may not be over in a short period or medium period. Climate observations showed that climate change occurrence had unfavorable impacts on society and mostly on built environment. The most vulnerable buildings are the historical buildings. The impact of climate change on historical buildings should be studied very carefully to determine the meteorological parameters and changes which are the most critical for the protection of the cultural heritage. Prediction of the effects of climate change on built cultural heritage for the next 100 years is necessary to take every step to protect the historical buildings that are likely to be worst affected by climate change effects. Against this background, this paper reviews the physical and chemical deteriorations of historical buildings and changing energy consumption of historic buildings. The research exposed the risk to lose cultural heritage and rising energy demand in the Northern part of Cyprus as a case study. Structural engineers and architects should consider the dominant forces of climate change to protect the historical buildings but also to construct sustainable, feasible and durable buildings for future projects.
Valuing Sustainability of Adaptable Infrastructure Using ROA-SEC: A Hybrid Approach
Authors: Taheriattar Reza
Published: January 2020

Infrastructure providing fundamental services for societies may become obsolete under changing environments such as climate or demographics changes, creating the need for adaptability. Designing infrastructure for adaptability may affect life cycle costs as well as environmental and social issues such as resources consumption, waste production or disruption to services provided. Sustainability valuation of adaptable infrastructure is thus required. The Real Options Analysis (ROA) is widely used to evaluate financial viability of investing in adaptable infrastructure. But, the environmental and social aspects have been barely noticed and incorporated. Hence, a valuation method is required to properly address all aspects of sustainability. This paper bridges the gap and advances the literature by presenting a methodology for designed-in adaptability valuation, considering all the sustainability aspects. To this end, a hybrid approach is suggested through integration of Social and Environmental Costing (SEC) with ROA, providing a single measure for sustainability of adaptable infrastructure. In this approach, the outputs of Life Cycle Assessment (LCA) tools are monetized using SEC methods; and then incorporated in the ROA that is built on the probabilistic Discounted Cash Flow (DCF) analysis, suitable for engineering applications. The application of the proposed approach is illustrated on a case example involving seawalls under changing climate effects. For the case example, including sustainability issues in the analysis improved the viability of designing in adaptability. This conclusion cannot be generalized and each situation requires an individual analysis. However, the proposed approach and methodology will be the same in all the situations.
Social Discourse In Malaysia’s Indie Masterpieces / Wacana Kemasyarakatan Dalam Karya-Karya Indie Di Malaysia
Authors: Jamin Asyraff , Subet Mary Fatimah
Published: January 2020

This research aimed to identify the social discourse presented in five Malaysia’s Indie novels entitled Aku Rindu 90’s (2012), Surat-Surat Untuk Kaherah (2013), Kunang Pesisir Morten (2013), Tuhan Jaga Dia Untukku (2017) and Budak Kelas Belakang (2018). This is a qualitative research using Georg Lukacs’ theory of realism (1963). Structural analysis is used to identify the views, visions, hopes and significant values for efforts to develop and improve the life quality of society. The objectives of this research were to identify Indie writer’s thoughts towards developing and improving the life quality of community, to analyse Indie novels which are equivalent to other serious mainstream media and to determine a new definiton for Indie masterpieces which evolving as a new literary stream in Malaysia. Research findings indicate that in the society there was a complete social discourse covering social, educational, economic, political and religious aspect. The findings also showed that Indie masterpieces conveyed serious thinking that particularly impact society on socials, educational, economic, political and religious developmet in a society. Indie masterpieces were also found to be on par with other serious mainstream media. The findings also showed that positive and fair valuation should be given towards these masterpieces. All findings have shown that Indie masterpieces are equivalent to other literary genres in Malaysia.
Serving whom? Immigrant entrepreneurs in a new local context
Authors: Lilius Johanna , Hewidy Hossam
Published: January 2020

In Helsinki, the current number of immigrants is quickly rising. Ethnic retail has emerged as a new, but visible, part of the city landscape. Compared to other European countries, becoming an entrepreneur is typically not very popular in Finland. Therefore, in this paper, we seek to comprehend this phenomenon and more specifically discover: what motivates immigrants to become entrepreneurs; what is the impact of their background and culture on the phenomenon; and finally, is the help provided by the city useful for them? Based on interviews and observations, we conclude that immigrant entrepreneurship facilitates in fluid ways the maintenance of cultural practices, while simultaneously enhancing meaningful encounters between immigrants and mainstream society. In our sample, we identify three types of entrepreneurs: growth-oriented, investors and status builders, as well as freedom and stability seekers. Although the groups are neither mutually exclusive nor collectively exhaustive, they display differences in certain aspects, which include their ways of entering into entrepreneurship, how their business is run, who their main clientele is, as well as in the future prospects for their businesses. We further infer that immigrant entrepreneurs, via their practices, also participate in making immigrant needs visible to politicians and policy-makers, thus also adding a layer to the local context within which they operate. However, we surmise that more effort is needed in addressing the freedom and stability seeker entrepreneurs if the aim of the city is to anchor immigrant retail in the city.
Imagining future worlds alongside young climate activists: a new framework for research
Authors: Bowman Benjamin
Published: January 2020

Young people’s climate activism must stand as one of the most remarkable and important mass movements of our age. At levels of organization from the local to the global, young climate activists are coming together in massive mobilizations, and particularly school strikes, under the names of Fridays For Future, #FridaysForFuture, Youth for Climate, Youth Strike for (or 4) Climate and School Strike for (or 4) Climate. This article responds to the most extensive study of young people’s climate action published to date, entitled ‘Protest for a Future: Composition, Mobilization and Motives of the Participants in Fridays For Future Climate Protests on 15 March, 2019 in 13 European Cities’. In this significant and provocative article, an analysis is provided of the potential – and the need – for empirical work at local and international levels concerning youth climate activism that recognizes the often complex, liminal nature of young political agency and the diverse, intersecting motives that lead young people to demonstrate for action on climate change. Through this analysis, this article contributes to theoretical innovation to get beyond rigid, top-down understandings of young people’s political engagement, and instead build theory from young people’s visions of social, economic and political change in response to climate emergency.
Recruitment of Shoulder Prime Movers and Torso Stabilizers During Push-Up Exercises Using a Suspension Training System
Authors: Youdas James W. , Baartman Hannah E. , Gahlon Brian J. , Kohnen Tyler J. , Sparling Robert J. , Hollman John H.
Published: January 2020

Context: Suspension training devices use body weight resistance and unstable support surfaces that may facilitate muscle recruitment during push-up exercises. Objective: The authors examined muscle recruitment with surface electromyography on 4 shoulder and 4 torso muscles during (1) standard push-ups, (2) feet-suspended push-ups, (3) hands-suspended push-ups, and (4) dual-instability push-ups in which feet were suspended and hands were on unstable surfaces. Design: Cross-sectional design with repeated measures. Setting: Biomechanics laboratory. Participants: Thirty-two healthy men and women (mean age, 24.3 y; mean body mass index, 24.6 kg·m−2) participated. Intervention: Participants were tested while performing 2 repetitions each of 4 variations of push-ups. Main Outcome Measures: Muscle recruitment, normalized to maximum voluntary isometric contraction, was measured in 4 prime movers (anterior deltoid, pectoralis major, serratus anterior, and triceps brachii) and 4 torso stabilizers (external oblique, internal oblique, rectus abdominis, and upper erector spinae). Results: Muscle recruitment in the anterior deltoid, pectoralis major, and serratus anterior during suspended exercises was no greater than during standard push-ups. In contrast, torso stabilizer recruitment was significantly greater in the external oblique, internal oblique, and rectus abdominis during all 3 suspended exercises compared with standard push-ups. Suspended exercises under a dual-instability condition did not generate greater levels of muscle activation compared with conditions of single instability. Conclusions: Push-ups performed with suspension training systems may provide benefit if one’s goal is to enhance torso muscle training. One unstable surface may be sufficiently challenging for the client or athlete when performing push-up exercises with a suspension training device.
Induction of Effective Immunity against Trypanosoma cruzi
Authors: Williams Tere , Guerrero-Ros Ignacio , Ma Yanfen , Matos dos Santos Fabiane , Scherer Philipp E. , Gordillo Ruth , Horta Aline , Macian Fernando , Weiss Louis M. , Huang Huan
Published: January 2020

Chagas disease, caused byTrypanosoma cruzi, is a major public health issue. Limitations in immune responses to naturalT. cruziinfection usually result in parasite persistence with significant complications. A safe, effective, and reliable vaccine would reduce the threat ofT. cruziinfections; however, no suitable vaccine is currently available due to a lack of understanding of the requirements for induction of fully protective immunity.
Transcriptional Regulation and Macrophage Differentiation
Authors: Hume David A. , Summers Kim M. , Rehli Michael
Published: January 2020

Monocytes and macrophages are professional phagocytes that occupy specific niches in every tissue of the body. Their survival, proliferation, and differentiation are controlled by signals from the macrophage colony-stimulating factor receptor (CSF-1R) and its two ligands, CSF-1 and interleukin-34. In this review, we address the developmental and transcriptional relationships between hematopoietic progenitor cells, blood monocytes, and tissue macrophages as well as the distinctions from dendritic cells. A huge repertoire of receptors allows monocytes, tissue-resident macrophages, or pathology-associated macrophages to adapt to specific microenvironments. These processes create a broad spectrum of macrophages with different functions and individual effector capacities. The production of large transcriptomic data sets in mouse, human, and other species provides new insights into the mechanisms that underlie macrophage functional plasticity.
Potential of Chemically Synthesized Oligosaccharides To Define the Carbohydrate Moieties of the Fungal Cell Wall Responsible for the Human Immune Response, Using Aspergillus fumigatus Galactomannan as a Model
Authors: Wong Sarah Sze Wah , Krylov Vadim B. , Argunov Dmitry A. , Karelin Alexander A. , Bouchara Jean-Phillipe , Fontaine Thierry , Latgé Jean-Paul , Nifantiev Nikolay E.
Published: January 2020

Methodologies to identify epitopes or ligands of the fungal cell wall polysaccharides influencing the immune response of human pathogens have to date been imperfect. Using the galactomannan (GM) of
Aspergillus fumigatus
as a model, we have shown that synthetic oligosaccharides of distinct structures representing key fragments of cell wall polysaccharides are the most precise tools to study the serological and immunomodulatory properties of a fungal polysaccharide.
Potentially inappropriate prescribing in dementia: a state-of-the-art review since 2007
Authors: Delgado Joao , Bowman Kirsty , Clare Linda
Published: January 2020

Objectives

Dementia frequently occurs alongside comorbidities. Coexisting conditions are often managed with multiple medications, leading to increased risk of potentially inappropriate medication and adverse drug reactions. We aimed to estimate prevalence of, and identify factors reported to be associated with, potentially inappropriate prescribing (PIP) for older individuals diagnosed with dementia.

Design

We used a state-of-the-art review approach, selecting papers written in English and published from 2007 to January 2018. Publications were retrieved from Scopus and Web of Science databases. Inclusion criteria included a formal diagnosis of dementia, a formal classification of PIP and reported prevalence of PIP as an outcome. Random effects models were used to provide a pooled estimate of prevalence of PIP. The Appraisal tool for Cross-Sectional Studies (AXIS tool) was used to assess bias in the included studies.

Results

The bibliographic search yielded 221 citations, with 12 studies meeting the inclusion criteria. The estimates of PIP prevalence for people living with dementia ranged from 14% to 64%. Prevalence was 31% (95% CI 9 to 52) in the community, and 42% (95% CI 30 to 55) in nursing/care homes. PIP included prescribing likely related to dementia (eg, hypnotics and sedative and cholinesterase inhibitors) and prescribing related to treatment of comorbidities (eg, cardiovascular drugs and non-steroidal anti-inflammatory medication). Higher levels of comorbidity were associated with increased risk of PIP; however, only one study investigated associations with specific comorbidities of dementia.

Conclusion

PIP remains a significant issue in healthcare management for people living with dementia. Higher levels of comorbidity are associated with increased prevalence of PIP, but the specific conditions driving this increase remain unknown. Further work is necessary to investigate PIP related to the presence of common comorbidities in patients living with dementia.
Patterns of benzodiazepine prescription among older adults in Switzerland: a cross-sectional analysis of claims data
Authors: Luta Xhyljeta , Bagnoud Christophe , Lambiris Mark , Decollogny Anne , Eggli Yves , Le Pogam Marie-Annick , Marques-Vidal Pedro , Marti Joachim
Published: January 2020

Objective

This study aimed to examine the prevalence and determinants of benzodiazepine prescription among older adults in Switzerland, and analyse association with hospitalisation and costs.

Design

Retrospective analysis of claims data.

Setting

The study was conducted in nine cantons in Switzerland.

Participants

Older adults aged 65 years and older enrolled with a large Swiss health insurance company participated in the study.

Primary and secondary outcome measures

The primary outcome was prevalence of benzodiazepine prescription. The secondary outcomes were (1) determinants of any benzodiazepine prescription; (2) the association between any prescription and the probability of hospitalisation for trauma and (3) the association between any prescription and total healthcare expenditures.

Results

Overall, 69 005 individuals were included in the study. Approximately 20% of participants had at least one benzodiazepine prescription in 2017. Prescription prevalence increased with age (65–69: 15.9%; 70–74: 18.4%; 75–80: 22.5%; >80: 25.8%) and was higher in women (25.1%) compared with men (14.6%). Enrollees with the highest deductible of Swiss Francs (CHF) 2500 were 70% less likely to receive a prescription than enrollees with the lowest deductible of CHF 300 (adjusted OR=0.29, 95% CI 0.24 to 0.35).

Individuals with at least one prescription had a higher probability of hospitalisation for trauma (OR=1.31, 95% CI 1. 20 to 1.1.44), and 70% higher health care expenditures (β=0.72, 95% CI 0. 67 to 0.77). Enrollees in canton Valais were three times more likely to receive a prescription compared to enrollees from canton Aargau (OR=2.84, 95% 2.51 to 3.21).

Conclusions

The proportion of older adults with at least one benzodiazepine prescription is high, as found in the data of one large Swiss health insurance company. These enrollees are more likely to be hospitalised for trauma and have higher healthcare expenditures. Important differences in prescription prevalence across cantons were observed, suggesting potential overuse. Further research is needed to understand the drivers of variation, prescription patterns across providers, and trends over time.
Epidemiological features of human brucellosis in Tongliao City, Inner Mongolia province, China: a cross-sectional study over an 11-year period (2007–2017)
Authors: Li Di , Li Lifei , Zhai Jingbo , Wang Lingzhan , Zhang Bin
Published: January 2020

Objectives

To describe the epidemiology of human brucellosis in the past decade and provide evidence of disease control in Tongliao city, which is one of the highest-risk areas of human brucellosis in Inner Mongolia province, China.

Design

Cross-sectional study.

Participants

Clinically and bacteriologically confirmed human brucellosis cases.

Primary and secondary outcome measures

An analysis of the reported cases of human brucellosis during 2007–2017 was carried out to describe the age, sex and occupational distributions of the cases. The time series analysis model and the geographical information system were explored to describe the seasonality and spatiotemporal distribution, respectively, at the county level.

Results

A total of 13 938 cases of human brucellosis was collected in Tongliao from 2007 to 2017; the majority was aged 25 years to 59 years (85.4%) and the male-to-female ratio was 2.64:1; most of them were agriculturalists (81.9%) and pastoralists (12.4%). The incidence rates increased dramatically from 9.22/100 000 in 2007 to 69.16/100 000 in 2011 with an annual increase of 14.99%. They decreased during 2012–2016 (annual decrease of 8.37%) and rose again in 2017 (44.32/100 000). The disease peaked during March–July, with a clear periodicity and trend of monthly anterior displacement since 2012. Jarud Banner, the region located in the north-west of Tongliao, had the highest accumulated incidence rate (130.1/100 000) compared with other counties. The high-risk regions were spread from the north-west to the south and east of Tongliao during the past decade.

Conclusions

The prevalence of human brucellosis in Tongliao was aggravated during the past decade and peaked during March–July. High-risk areas were mainly concentrated in the counties with extensive prairies and livestock.
Azithromycin as an add-on treatment for persistent uncontrolled asthma in adults: protocol of a systematic review and meta-analysis
Authors: Liu Wei , Mu Wei , Zhang Huiting , Zhai Jingbo , Li Xiaodan , Guan Peng , Lian Fu , Feng Jihong , Yu Shuangjiang , Wang Xuepin , Si Jinhua , Sun Zengtao , Huang Yuhong
Published: January 2020

Introduction

Clinical management of asthma remains a public challenge. Despite standard treatment with inhaled corticosteroids (ICS) and long-acting beta-agonists (LABAs), asthma remains uncontrolled in a substantial number of chronic asthma patients who risk reduced lung function and severe exacerbations. Azithromycin could have add-on effects for these patients. This study is proposed to systematically evaluate the efficacy of azithromycin as an add-on treatment for adults with persistent uncontrolled symptomatic asthma.

Methods and analysis

Two reviewers will perform a comprehensive search of PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL) and four Chinese electronic databases including China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), WanFang Data and VIP Database from inception to May 2019. Only randomised controlled trials will be included. There is no restriction on language or publication status. Combined oral azithromycin and an ICS or/and a LABA will be compared with standard treatment alone or with a placebo. The primary outcomes are the number or frequency of asthma exacerbations, changes in asthma symptoms and lung function. Secondary outcomes include the number or frequency of inhalations of beta-agonists with or without corticosteroids for rescue use, eosinophil counts in blood or sputum, adverse events and others. A meta-analysis will be attempted to provide an estimate of the pooled treatment effect. Otherwise, qualitative descriptions of individual studies will be given.

Ethics and dissemination

Ethical approval is not required because no primary data will be collected. Study findings will be presented at scientific conferences or published in a peer-reviewed journal.

PROSPERO registration number

CRD42019117272.
Nutrition competence of primary care physicians in Saudi Arabia: a cross-sectional study
Authors: Al-gassimi Osamah , Shah Hassan Bin Usman , Sendi Rawan , Ezmeirlly Heba A , Ball Lauren , Bakarman Marwan A
Published: January 2020

Objectives

Primary care physicians have an opportunity to support healthy dietary behaviours of patients by providing nutrition care. However, it is unclear whether primary care physicians in the Kingdom of Saudi Arabia (KSA) are sufficiently competent in nutrition. This study aimed to assess the nutrition competence of primary care physicians in KSA and identify whether nutrition competence is associated with the provision of nutrition care to patients living with diet-related chronic disease.

Design

A cross-sectional study.

Setting

Chronic disease clinics across 48 primary care centres under the Ministry of Health in the city of Jeddah, KSA.

Participants

90 primary care physicians completed the survey (response rate: 98%). General practitioners and family medicine residents, specialists, and consultants actively working in chronic disease clinics between February and May 2019 were included.

Primary and secondary outcome measures

Primary outcome measure was nutrition competence of primary care physicians measured via the validated nutrition competence (NUTCOMP) questionnaire.

Results

Primary care physicians perceived themselves as competent in nutrition care but their reported provision of nutrition care was limited. Confidence in their nutrition knowledge and skills elicited the lowest mean scores of 25.8 (±5.4) out of 35 and 29 (±5.2) out of 40, respectively. The reported provision of nutrition care was closely correlated with physicians’ confidence in their nutrition knowledge (r=0.57) and communication (r=0.52). Three factors were identified as predicting whether physicians provide nutrition care to patients: confidence in counselling about nutrition (p<0.001), having previous nutrition education (p=0.005) and a higher professional qualification (p=0.008).

Conclusions

Primary care physicians felt confident in providing nutrition care to patients living with diet-related chronic disease. Primary care physicians would benefit from higher levels of nutrition knowledge and skills to effectively support patients to improve their dietary behaviours and health conditions, leading to a positive impact on public health.
Acupuncture for emotional disorders in patients with migraine: a systematic review protocol
Authors: Sun Ning , Sun Mingsheng , Li Zhengjie , Sun Rui-Rui , Zhao Ling , Chen Jiao , Liang Fan-rong
Published: January 2020

Introduction

Migraine is the second-leading cause of years lived with disability worldwide. The high prevalence of migraine-related emotional disorders is often overlooked. Acupuncture is often used to treat both migraine and emotional disorders. This systematic review protocol aims to analyse whether acupuncture is effective for treating emotional disorders in patients with migraine.

Methods and analysis

Nine databases will be searched from inception to may 2019: cochrane central register of controlled trials, medline, embase, allied and complementary medicine database, cinahl, china national knowledge infrastructure, chinese biomedical literature database, vip database and wanfang database. Randomised controlled trials (rcts) of acupuncture therapy for migraine with emotional functioning outcomes, which were reported in chinese or english, will be included. The primary outcome is the change in emotional functioning. Study selection, data extraction and assessment of the risk of bias will be performed independently by two or more reviewers. Revman software (v.5.3) will be used to perform the assessment of the risk of bias and data synthesis.

Ethics and dissemination

Ethics approval is not be needed because the data will not contain individual patient data, and there are no concerns about privacy. The results of this meta-analysis will be disseminated through publication in a peer-reviewed journal or relevant conference.

Trial registration number

CRD42019139433.
Getting started in research, redefined: five questions for clinically focused physicians in family medicine
Authors: Ventres William , Whiteside-Mansell Leanne
Published: January 2020

Research is crucial to the development of family medicine around the world. However, family physicians in practice often hesitate to enter into investigative endeavours. Common reasons for such hesitation include limited exposure to the process of conducting research and the belief that research is best conducted by academic scholars. Our intent here is to encourage clinically focused family physicians’ involvement in research activities by explaining how they can cultivate inquisitiveness so as to develop questions for exploration. We present an approach to research that focuses on five steps emergent from the day-to-day, habitual practice of family medicine, wherever in the world it is practised. We illustrate this approach by describing a successful practice-based research study. We conclude by inviting all family physicians to consider integrating research into their practice lives so as to expand their professional horizons and help educate the next generation of global family physicians.
Fundamentals of qualitative analysis in family medicine
Authors: Babchuk Wayne A
Published: January 2020

The primary purpose of this article is to provide family physician researchers interested in conducting a qualitative research study a concise guide to the analysis. Drawing from approaches outlined in popular research methodology textbooks and employing an exemplar from a minority health disparities research study, this article outlines specific steps useful for researchers and practitioners in the field of family medicine. This process of qualitative data analysis is situated within the larger framework of qualitative research to better position those new to qualitative designs to more effectively conduct their studies. A 10-step process useful for guiding qualitative data analysis is provided. The 10 steps include (1) assembling data for analysis, (2) refamiliarising oneself with the data, (3) open or initial coding procedures, (4) generating categories and assigning codes to them, (5) generating themes from categories, (6) strategies of validation, (7) interpreting and reporting findings from the participants, (8) interpreting and reporting findings from the literature, (9) visual representations of data and findings, and (10) strengths, limitations, delimitations and suggestions for future research. This work provides clear and accessible guidelines for conducting qualitative data analysis for emerging researchers that is applicable across a wide array of topics, disciplines and settings.