bluuebunny/crossref_metadata_2025 huggingface dataset:
Sharp increase in ciprofloxacin resistance of Neisseria gonorrhoeae in Yaounde, Cameroon: analyses of a laboratory database period 2012–2018
Authors: Crucitti T , Belinga S , Fonkoua MC , Abanda M , Mbanzouen W , Sokeng E , Nzouankeu A
Published: April 2020

A previous study conducted in Yaoundé, Cameroon, showed a significant increase in ciprofloxacin-resistant Neisseria gonorrhoeae. Still, ciprofloxacin is the recommended first-line medication for gonorrhoea in Cameroon. We aimed to provide further evidence of increasing resistance of N. gonorrhoeae to ciprofloxacin. We conducted a retrospective study (2012–2018) and retrieved coded patient and specimen real-world data from the Centre Pasteur du Cameroun’s laboratory information system and laboratory worksheets. We included disc diffusion method results for tetracycline, azithromycin, and spectinomycin, and minimal inhibitory concentrations obtained by E-test for ciprofloxacin, ceftriaxone, and benzylpenicillin. A total of 449 N. gonorrhoeae were isolated; a higher proportion of them presented resistance to ciprofloxacin (64.4%), benzylpenicillin (80.1%), and tetracycline (58.4%). The resistance to ciprofloxacin increased significantly (p < 0.0001) from 15.0% in 2012 to 79.5% in 2018. Since 2016 a significant decrease (p = 0.002) in resistance to benzylpenicillin occurred and the resistance to tetracycline remained stable. The level of resistance to ceftriaxone (1.8%), azithromycin (2.1%), and spectinomycin (2.0%) was low. Our study confirms that ciprofloxacin is not recommended as a first-line treatment for gonorrhoea. It also illustrates the urgent need to establish a robust and sustainable gonococcal antimicrobial surveillance programme to guide national treatment guidelines in order to control gonorrhoea in Cameroon.
COVID-19: Facts, Cultural Considerations, and Risk of Stigmatization
Authors: Bruns Debra Pettit , Kraguljac Nina Vanessa , Bruns Thomas R.
Published: April 2020

Data on COVID-19 supports targeted social distancing could be an effective way to reduce morbidity and mortality, but could inadvertently increase stigma for affected populations. As health care providers we must be aware of the facts of COVID-19, cultural implications, and potential for stigmatization of populations affected by COVID-2019. It is important to consider the real economic impact related to lost workdays due to quarantine and social isolation efforts as well as travel restrictions that may negatively impact access to care and ability to pay for care. Efforts geared towards general education about the disease and the rationale for quarantine and public health information provided to the general public can reduce stigmatization.

Countries who are successful at aggressive screening, early identification, patient isolation, contact tracing, quarantine, and infection control methods should also address the risk of stigmatization among populations and the negative effects which could occur. The cases of COVID-19 will continue to rise and the virus will be sustainable for future infections. Timely and appropriate public health interventions addressing cultural impact and risk for stigmatization along with proper screening, treatment, and follow up for affected individuals and close contacts can reduce the number of infections, serious illness, and deaths.
Further Validation of the Comprehensive Assessment of Psychopathic Personality-Self-Report (CAPP-SR) in Lithuanian Offender and Nonoffender Samples
Authors: Sellbom Martin , Laurinaitytė Ilona , Laurinavičius Alfredas
Published: April 2020

The Comprehensive Assessment of Psychopathic Personality (CAPP) is an emerging integrative model that makes use of 33 symptoms to characterize psychopathic personality disorder, but operationalizations of this model have not endured extensive validation to date. The current study sought to validate the recently published CAPP-Self-Report (CAPP-SR). Participants derived from two Lithuanian offender ( n = 231) and nonoffender ( n = 312) samples. They were administered the CAPP-SR, Triarchic Psychopathy Measure, Buss–Perry Aggression Questionnaire, and a subsample of offenders also had Offender Assessment System risk assessment scores available. The results showed that CAPP-SR total, domain, and symptom scores were associated with TriPM and Aggression Questionnaire scores in a manner consistent with conceptual expectations. CAPP-SR symptoms specifically reflective of aggression, anger, and antagonism were most strongly associated with Offender Assessment System risk scores. The findings provide support for construct validity of CAPP-SR scores as well as have implications for the CAPP model more broadly, which are discussed.
Comparison Between the Diagnostic Performance of 1.5 T and 3.0 T field Strengths for Detecting Deep Vein Thrombosis Using Magnetic Resonance Black-Blood Thrombus Imaging
Authors: Ye Yufeng , He Xueping , Huang Chen , Shi Caiyun , Deng Wei , Luo Wenfeng , Liang Jianke , He Zhuonan , Mao Huan , Liang Qiwei , Chen Dongya , Chen Hanwei , Xie Guoxi
Published: April 2020

Background:

Magnetic resonance (MR) black-blood thrombus imaging (BTI) is an accurate diagnostic technique for detecting deep vein thrombosis (DVT) but to date there have been no studies comparing the diagnostic performance and consistency of this technique at different field strengths. In this study, we evaluated and compared the diagnostic performance of BTI for detecting DVT at 1.5 T and 3.0 T field strengths.

Methods:

A total of 40 patients with DVT were enrolled in this study from November 2015 up to October 2018. All patients underwent BTI, a contrast-free T1-weighted MR imaging technique for detecting DVT, and contrast-enhanced MR venography (CE-MRV) at 1.5 T or 3.0 T field strengths. The MR data analyses used 1160 segments from the venous lumen of the 40 patients. The signal-to-noise ratio and contrast-to-noise ratio between thrombus and muscle/lumen were calculated to compare BTI at 1.5 T or 3.0 T to determine the image performance for thrombus detection at 1.5 T or 3.0 T. Two physicians blinded to the study evaluated all BTI images and calculated the overall sensitivity (SE), specificity (SP), positive predictive value (PPV) and negative predictive value (NPV), accuracy, and diagnostic consistency at 1.5 T and 3.0 T. These images and values were compared to control CE-MRV images that had been obtained by 2 senior physicians and used as reference standards. In addition, the reliability and consistency of diagnoses between observers were also evaluated.

Results:

Two study-blind physicians reviewed all BTI images to diagnose thrombus and to determine SE, SP, PPV, NPV, and accuracy. There were no statistical differences in SE, SP, PPV, NPV, or accuracy between the 1.5 T and 3.0 T groups.

Conclusions:

Black-blood thrombus imaging has high SE, SP, and accuracy for DVT diagnosis both at 1.5 T and 3.0 T field strengths. This noninvasive diagnostic technique, which does not require the use of contrast agents, can be widely used in the clinical screening of DVT and follow-up after treatment.
Oral sodium bicarbonate protocol for high-dose methotrexate urine alkalinization: A pediatric experience
Authors: Diachinsky Mark , Tran Tracey , Jupp Jennifer , McKinnon Krista
Published: April 2020

Introduction

Methotrexate (MTX) is a cytotoxic antimetabolite. Intravenous (IV) hydration and urine alkalinization with sodium bicarbonate (NaHCO3) can mitigate nephrotoxicity associated with high-dose MTX (HDMTX, doses ≥500 mg/m2). A shortage of IV NaHCO3 in 2017 prompted Alberta Children’s Hospital (ACH) and Stollery Children’s Hospital (SCH) to adopt an alternative protocol including oral NaHCO3 and IV hydration with Lactated Ringer’s (LR).

Methods

A retrospective chart review was conducted for ACH and SCH inpatients who received HDMTX between January and December 2017. The primary outcome was the proportion of cycles with delayed HDMTX clearance within the IV and oral cohorts. Secondary outcomes include NaHCO3 administered until clearance, NaHCO3 required to reach pH ≥7, time to reach pH ≥7, incidence of pH <7, time to clearance, and time to discharge. Adverse effects associated with delayed clearance or NaHCO3 administration were also reported.

Results

112 MTX cycles were included, 50 and 62 from the IV and oral cohorts, respectively. Clearance delays beyond protocol expectations occurred in 10 cycles (8.9%), 5 from each cohort ( p = 0.72). Differences between cohorts were not statistically significant, except the amounts of NaHCO3 required until clearance (383 vs. 277 mmol/m2, p = 0.005) and to reach pH ≥7 (52 vs. 40 mmol/m2, p = 0.004) were lower in the oral cohort. Incidences of adverse effects were not different.

Conclusions

Oral NaHCO3 with LR is a feasible alternative for urine alkalinization. The total dose of NaHCO3 utilized was lower in the oral cohort, with no additional delays in clearance.
Covalent immobilization of papain onto poly(hydroxyethyl methacrylate)-chitosan cryogels for apple juice clarification
Authors: Yavaşer Rukiye , Karagözler A Alev
Published: April 2020

Enzyme immobilization appears as a remarkable technique to safely attach enzymes for several applications and cryogels stand as promising support materials to be used in such investigations. In this work, papain enzyme was immobilized onto an interpenetrating network obtained by cryogelation of N,N′-methylenebisacrylamide cross-linked 2-hydroxyethyl methacrylate and glutaraldehyde cross-linked chitosan. Cryogels were modified with –NH2 functionality and glutaraldehyde in order to attach papain covalently. Immobilization was carried out at 25 ℃ in 0.1 M pH 7.0 phosphate buffer at 1.0 mg/ml enzyme concentration for 5 h. The amount of papain immobilized onto cryogel was calculated to be 15.2 ± 2.54 mg/g cryogel. Macroporous structure and surface area were determined by scanning electron microscopy and Brunauer–Emmett–Teller techniques, respectively. Energy dispersive X-ray analysis showed that papain was bound to the cryogel and cryogel structure was composed of 2-hydroxyethyl methacrylate, chitosan, and glutaraldehyde. Proteolytic activities of free and immobilized papain were measured using casein as substrate. Optimum pH values and temperatures were 8.0 and 65 ℃ for free and immobilized enzymes and kinetic parameters were calculated at these conditions. Reusability and storage stability results indicated that immobilization enhanced the stability of papain compared to free form. Efficiency of immobilized papain was demonstrated by apple juice clarification study as an industrial use of the enzyme. Phenolic compound, protein, total soluble solid contents, and viscosity of apple juice before and after clarification were determined.
The Short- and Long-Run Hotel Demand in Switzerland: A Weighted Macroeconomic Approach
Authors: Bianchi Giuliano , Chen Yong
Published: April 2020

This study develops a vector error correction model of hotel demand to incorporate both the short-run demand fluctuations and the long-run tourism growth. We distinguish between endogenous and exogenous variables in model development to advance previous tourism demand modeling. In addition, we develop a weighting scheme to account for the importance of explanatory economic variables that are pertinent to source markets of a destination to increase model accuracy. With an analysis of the Swiss hotel data from the first quarter of 1975 to the fourth of 2016, we found no evidence that the long-run market equilibrium exists among all three endogenous variables in the model, namely hotel nights, Swiss real gross domestic product, and real exchange rate of the Swiss franc. However, the short-run hotel demand fluctuations could be attributed to behavior persistence of tourists.
Why I Teach Advertising: Critical Voices
Authors: Champlin Sara
Published: April 2020

In this invited essay, I reflect on my enthusiasm for teaching as an early career professor. I would like to thank the Association for Education in Journalism and Mass Communication’s (AEJMC) Advertising Division for selecting me as the 2019 Early Career Teaching Excellence in Advertising award recipient.
Animal-Assisted Activity in Critically Ill Older Adults: A Randomized Pilot and Feasibility Trial
Authors: Branson Sandy , Boss Lisa , Hamlin Shannan , Padhye Nikhil S.
Published: April 2020

Background:

Limited evidence suggests the efficacy of animal-assisted activities (AAA) in improving biobehavioral stress responses in older patients in intensive care units (ICUs).

Objectives:

To assess the feasibility of an AAA (dog) intervention for improving biobehavioral stress response, measured by self-reported stress and anxiety and salivary cortisol, C-reactive protein, and interleukin-1β in older ICU patients, we examined enrollment, attrition, completion, data collection, and biobehavioral stress responses.

Methods:

ICU patients ≥60 years old were randomly assigned to a 10-min AAA intervention or control/usual ICU care. Attitudes toward pets were assessed before the intervention. Self-reported stress and anxiety and salivary stress biomarkers were collected before and after the intervention and the usual care condition.

Results:

The majority of patients were ineligible due to lack of decisional capacity, younger age, inability to provide saliva specimens, or critical illness. Though 15 participants were randomly allocated (AAA = 9; control = 6), only 10 completed the study. All participants completed the questionnaires; however, saliva specimens were significantly limited by volume. AAA was associated with decreases in stress and anxiety. Biomarker results were variable and revealed no specific trends associated with stress responses. Conclusions: Barriers to recruitment included an insufficient number of patients eligible for AAA based on hospital policy, difficulty finding patients who met study eligibility criteria, and illness-related factors. Recommendations for future studies include larger samples, a stronger control intervention such as a visitor without a dog, greater control over the AAA intervention, and use of blood from indwelling catheters for biomarkers.
Clinical and Laboratory Differences Between Early-Onset and Late-Onset Adult Atopic Dermatitis
Authors: Ha Dae-Lyong , Park Geun-Hwi , Kim Hoon-Soo , Ko Hyun-Chang , Kim Moon-Bum , Lim Kyoung-Min , Kim Byung-Soo
Published: April 2020

Background

Atopic dermatitis (AD) in adults is not uncommon, and its prevalence has been increasing in the recent decades. However, there is a paucity of data about the differences between early-onset and late-onset adult AD.

Objective

The objective of this study is to investigate the clinical and laboratory characteristics of adult AD, focusing on the differences between early-onset and late-onset adult AD.

Methods

We retrospectively reviewed the medical records and clinical photos of 214 adult AD patients (≥18 years of age) over a 3-year period. We classified the patients into 2 groups: early-onset (first onset of AD before 12 years of age) and late-onset (first onset of AD at 12 years of age or later).

Results

Among 214 patients, 151 patients (70.6%) belonged to the early-onset group (mean age 24.5 years), while 63 patients belonged to the late-onset group (mean age 29.5 years). An association with allergic asthma or rhinitis, a family history of atopic disease, elevated total serum IgE, and sensitivity to food allergens were more commonly seen in the early-onset group. The late-onset group had a significant likelihood of nonflexural involvement (38.1% vs 13.2%). There was no significant difference in the mean eczema area severity index score, eosinophil count, and sensitivity to aeroallergens between 2 groups.

Conclusion

Adult AD shows different clinical and laboratory characteristics depending on the age of onset. This study could help to create awareness about the heterogeneity of AD in adulthood and encourage further studies on clinical outcomes and different therapeutic methods depending on the age of onset.
Identifying service needs and service gaps for sexually exploited/trafficked persons in Missouri
Authors: Koegler Erica , Preble Kathleen M , Tlapek Sarah M
Published: April 2020

The U.S. Trafficking Victims’ Protection Act of 2000 established specialized victims’ services and law enforcement directives to protect victims/survivors of sex trafficking through investigation and aftercare services. Yet, gaps remain in our understanding of services needed and the best approaches to improve outcomes. Using cross-sectional electronic survey data from 107 service providers to human trafficking victims across Missouri, this study examines (1) victims’ service needs, (2) agencies’ ability to provide services, (3) victim sub-populations that agencies are able to serve, and (4) the rural/urban availability of anti-trafficking services.

Findings

Service providers, including social workers, counselors, law enforcement, and medical professionals reported that the most needed services for victims included case management, counseling, crisis services, shelter, and medical assistance. However, out of 15 possible victim services, only two were provided in-house by the majority of agencies. Additionally, respondents identified populations they were frequently unable to serve including incarcerated victims, tribal victims of violence, and refugees and immigrants. Urban counties were served by a significantly higher mean number of respondents compared to rural counties.

Applications

Findings raise concerns that some of the most critical services needed for best practice response may not be easily accessible for victims, particularly in rural regions. In addition, many providers are tasked with addressing multiple service needs with limited resources. Efforts to increase cross-discipline training, interdisciplinary collaboration, and funding for basic services are needed to ensure adequate and accessible services for survivors. Recommendations for future research and coordination of an effective response are noted.
Volunteer work with vulnerable persons in the community: A qualitative study of social inclusion
Authors: Kruithof Kasper , Suurmond Jeanine , Kal Doortje , Harting Janneke
Published: April 2020

Performing work is regarded as a key factor in the social inclusion of vulnerable persons. However, such social inclusion appears to be problematic in both mainstream and segregated settings. We aimed to examine whether volunteer work in integrated settings could be a suitable alternative. In a case study, we interviewed 13 vulnerable persons who were enabled—through a “Quarter Making” intervention—to perform volunteer work in a community setting. Data were analyzed using concepts from social epidemiology and social sciences.

Findings

Participation in the community gave respondents structure, and made them feel useful, meaningful, and proud, as well as a useful interconnected part of society. Interpersonal relationships provided them with superficial but meaningful contacts in the community, and helped them to transcend their social group, and—sometimes—build friendships. These experiences of improved social inclusion resulted in respondents reporting better mental health and wellbeing, and speaking in terms of feeling more normal and—sometimes—in terms of recovery.

Applications

To improve the social inclusion of vulnerable persons, performing volunteer work in integrated settings could be a suitable alternative for mainstream work or work in segregated settings. Interventions aimed at matching vulnerable persons to integrated settings, like Quarter Making, should preferably find a balance between creating bridging capital, to allow vulnerable persons to connect to “the normal world,” and offering bonding capital, to give them a safe place where they can “learn and relearn” to deal with the demands of modern society.
Learning from and with community-based and participatory action research: Constraints and adaptations in a youth-peacebuilding initiative in Haiti
Authors: Neufeldt Reina C , Janzen Rich
Published: April 2020

Participatory action research fits well with conflict resolution and peacebuilding; it is used by scholar-practitioners as part of field-based practice efforts that contribute to transforming conflict and add to scholarly knowledge. However, as Cynthia Chataway’s analysis of a participatory action research project undertaken with the Mohawk community of Kahnawake indicated, there are considerable constraints on mutual inquiry when it occurs in settings marked by historical oppression, distrust of outsiders and internal division; these constraints require the model to respond to the community context. Drawing on this insight, this paper explores a recent collaborative, community-based research that was part of a larger youth-centered peacebuilding and security initiative in Haiti. The initiative involved partners from Canada supporting a non-governmental organization and youth in four communities to engage in action research, under the umbrella of community-based research, as part of the 26-month project. The article draws out insights on ways in which the community-based research approach adapted to the conflict context, and reflects on the ways in which this form of engaged scholarship adds to knowledge in conflict resolution and peacebuilding.
Outcome Evaluation of an Empirical Study: Food Waste Social Marketing Pilot
Authors: Kim Jeawon , Rundle-Thiele Sharyn , Knox Kathy , Hodgkins Samuel
Published: April 2020

Background:

Evidence indicates behavior change is more likely when more social marketing benchmark principles are applied. Yet, transparent and clear reporting of the application of benchmarks to change behavior is rare.

Focus of the Article:

The aims of this study were (1) to verify the efficacy of social marketing in reducing food waste and (2) to enumerate and critique the practicality of applying social marketing benchmark criteria.

Research Question:

To address the research aims, two research questions were proposed: (1) Can a social marketing program designed with consumers reduce household food waste behavior? and (2) How are social marketing benchmarks applied to reduce food waste?

Program Design/Approach:

A consumer-insight driven social marketing program Waste Not Want Not (WNWN) was designed following the social marketing process and delivered to local Redland City Council residents located within the pilot area. This article reports a process and outcome evaluation for the pilot study and a critical evaluation of benchmark criteria application.

Importance to the Social Marketing Field:

This article demonstrates social marketing’s efficacy to reduce food waste behavior in households, and it critically evaluates application of benchmark criteria to assist future research and practice.

Methods:

In total, 314 local council area residents were randomly allocated into either a program ( n = 110) or control group ( n = 204). The program group received intervention materials and invitations to attend the 2-week program activities held in a local shopping center. Control group participants received nothing. The extent of social marketing benchmark application was examined for the WNWN program.

Results:

Outcome evaluation indicated that the pilot study reduced self-reported household food waste and increased perceived level of self-efficacy in cooking for the program group, but not the control group. WNWN successfully applied five of the eight social marketing benchmark criteria, namely, consumer orientation, insight, competition, marketing mix, and behavior change.

Recommendations for Research or Practice:

Given that use of more benchmarks increases the likelihood of behavior change, future research must advocate for complete application of the eight major social marketing benchmark criteria in program design. Clear operational definitions are required to improve practice and behavioral change outcomes.

Limitations:

Study 1 focused on individual feedback and self-reported data minimizing the possibility of generalization. Future research could employ observational methods and involve a wider array of stakeholders to increase generalizability.
Light detection and ranging/inertial measurement unit-integrated navigation positioning for indoor mobile robots
Authors: Yan Xiaoyi , Guo Hang , Yu Min , Xu Yuan , Cheng Liang , Jiang Ping
Published: April 2020

To overcome the problem of the low accuracy and large accumulated errors of indoor mobile navigation and positioning, a method to integrate the light detection and ranging- and inertial measurement unit-based measurement is proposed. Firstly, the voxel-scale-invariant feature transform feature extraction algorithm for light detection and ranging is studied. Then, the errors of light detection and ranging measurement due to the change of the scan plane compensated based on aiding information from inertial measurement unit. The relative position parameters and the differences of measurements of light detection and ranging at adjacent times are used to estimate the error of inertial measurement unit sensors by a Kalman filter. Several experiments are carried out in the indoor corridor and the results demonstrate that precision of the light detection and ranging/inertial measurement unit-integrated indoor mobile robot localization is higher than that of single light detection and ranging sensor.
Deep submergence rescue vehicle docking based on parameter adaptive control with acoustic and visual guidance
Authors: Sun Yushan , Ran Xiangrui , Cao Jian , Li Yueming
Published: April 2020

In view of the difficulties in the attitude determination of wrecked submarine and the automatic attitude matching of deep submergence rescue vehicles during the docking and guidance of a submarine rescue vehicle, this study proposes a docking method based on parameter adaptive control with acoustic and visual guidance. This study omits the process of obtaining the information of the wrecked submarine in advance, thus saving considerable detection time and improving rescue efficiency. A parameter adaptive controller based on reinforcement learning is designed. The S-plane and proportional integral derivative controllers are trained through reinforcement learning to obtain the control parameters in the improvement of the environmental adaptability and anti-current ability of deep submarine rescue vehicles. The effectiveness of the proposed method is proved by simulation and pool tests. The comparison experiment shows that the parameter adaptive controller based on reinforcement learning has better control effect, accuracy, and stability than the untrained control method.
Trauma-informed care in the context of intellectual and developmental disability services: Perceptions of service providers
Authors: Rich Amanda J , DiGregorio Nikki , Strassle Carla
Published: April 2020

Traumatic life events have pervasive impacts on health and well-being. A growing body of literature shows that people with intellectual and developmental disabilities are disproportionately impacted by trauma. Trauma-informed care (TIC) is a philosophy of service provision that is committed to preventing traumatization and re-traumatization and promoting healing. This study explores the perceptions of 130 leaders in the field of intellectual and developmental disabilities services on the adoption and practice of TIC through the analysis of quantitative data. Results indicated a disconnect between the level of TIC integration and perceptions detailing how well organizations are currently performing in aspects of TIC. Barriers to TIC included high staff turnover, lack of accessible mental health providers, lack of affordable training, stigma, and restrictive funding structures. Implications and recommendations for service organizations and educators are provided.
The utility of narrative voices in the federal procurement contract
Authors: Ingram L Maria , Jensen Laura S
Published: April 2020

Federal procurement contracts incorporate multiple narrative voices representing a range of individual and organizational interests. We examine these contract voices as they act in, and speak from, a range of roles relevant to federal procurement, such as marketplace participants, taxpayer-citizens, chief adjudicator, and sovereign. Like tapestries, federal procurement contracts are made from textual threads that are woven, cut, tailored, and embellished to depict a particular cast of characters acting in accord with an underlying script. Recognizing this yields insight into the governmental values depicted within each contract’s formally structured, deliberately crafted pages.
An integrated hospital-to-home transitional care intervention for older adults with stroke and multimorbidity: A feasibility study
Authors: Markle-Reid Maureen , Valaitis Ruta , Bartholomew Amy , Fisher Kathryn , Fleck Rebecca , Ploeg Jenny , Salerno Jennifer
Published: April 2020

Background:

Stroke is the leading cause of death and adult disability in Canada. Eighty percent of older adults (≥65 years) who have suffered a stroke will return to their homes, and 60% will require ongoing rehabilitation. The transition between hospital and home is often fragmented, leading to adverse health outcomes, hospital readmissions, and increased health-care costs. This study examined the feasibility of a 6-month integrated transitional care stroke intervention (TCSI), and explored its effects on health outcomes, patient and provider experience, and cost in 30 community-living older adults (≥55 years) with stroke and multimorbidity (≥2 chronic conditions) using outpatient stroke rehabilitation services.

Methods:

The TCSI is a 6-month intervention delivered by an interprofessional (IP) team (occupational therapist, physiotherapist, speech language pathologist, registered nurse, social worker). It involved care coordination, home visiting, and IP case conferences, supported by a web-based application. A qualitative descriptive approach was used to explore the feasibility of implementing the intervention. A prospective one-group pretest/posttest was used to evaluate the effects of the intervention on health outcomes and use and costs of health services, from baseline to 6 months.

Results:

Participants had an average of eight comorbid conditions. The intervention was feasible and acceptable to both older adults and providers. From baseline to 6 months, there was no statistically significant difference in health outcomes. However, there was a significant reduction in the total per person use and costs of health services.

Conclusions:

This study established the feasibility of conducting a larger randomized controlled trial of this intervention.
Cypermethrin elimination using Fe-TiO2 nanoparticles supported on coconut palm spathe in a solar flat plate photoreactor
Authors: Solano Pizarro Ricardo Andrés , Herrera Barros Adriana Patricia
Published: April 2020

In this research, the photocatalytic degradation of cypermethrin using iron-titanium dioxide (Fe-TiO2) nanoparticles supported in a biomaterial was evaluated. The nanoparticles of TiO2 were synthesized by the green chemistry method assisted by ultrasound and doped by chemical impregnation using Fe+3:Ti molar ratios of 0, 0.05, 0.075 and 0.1 to make efficient use of direct sunlight ( λ > 310 nm). All nanoparticles were immobilized on the surface of coconut spathe ( Cocos nucifera). The degradation was carried out at room temperature and natural pH in a flat plate solar reactor, on which the composite material was subjected. The concentration of cypermethrin was determined after 12,000 J m−2 of accumulated radiation from gas chromatography–mass spectrometry and the resulting material was characterized by scanning electron microscopy, transmission electron microscopy, X-ray diffraction, Fourier-transform infrared spectroscopy, ultraviolet–visible diffuse reflectance spectroscopy, and Brunauer-Emmett-Teller (BET) surface area. The best results were achieved with the use of Evonik TiO2 P-25, Fe:Ti = 0 and Fe:Ti = 0.05 in suspension, with percentages of degradation of cypermethrin of 99.84%, 99.62%, and 100%, respectively. However, the materials supported on the biomaterial of coconut allowed to reach degradation percentages higher than 80%, with the advantage that it minimizes operating costs, as they are not necessarily filtering or centrifuging processes to separate the catalyst.
Long-term outcomes for patients with limited-stage follicular lymphoma: update of a population-based study
Authors: Lo Andrea C. , Campbell Belinda A. , Pickles Tom , Aquino-Parsons Christina , Sehn Laurie H. , Connors Joseph M. , Savage Kerry J.
Published: April 2020

With a median follow-up of 16.6 years, Lo and colleagues report excellent long-term outcomes with primary radiotherapy for limited-stage follicular lymphoma in this month’s CME article.
Targeting the 4-1BB costimulatory molecule through single chain antibodies promotes the human T-cell response
Authors: Bagheri Salman , Safaie Qamsari Elmira , Yousefi Mehdi , Riazi-Rad Farhad , Sharifzadeh Zahra
Published: April 2020

Background

Adoptive T-cell therapy (ACT) using autologous tumor-reactive T lymphocytes has considerable potential for cancer immunotherapy. In ACT, T cells are isolated from cancer patients and then stimulated and expanded in vitro by cytokines and costimulatory molecules. 4-1BB is an important costimulatory protein belonging to the TNF receptor superfamily. It is involved in T-cell survival, proliferation and activation. Agonistic anti-4-1BB monoclonal antibodies have been introduced as appropriate tools for ACT.

Methods

Here, various single-chain fragment variable (scFv) antibodies were used to activate T cells isolated from peripheral blood via immune magnetic isolation. The T cells were stimulated with IL-2 and anti-CD-3 mAb and then treated with agonistic anti-4-1BB scFvs. The results showed the remarkable effects of anti-41BB scFvs on the functional properties of T cells, including their activation, proliferation and cytokine production. The flow cytometry analysis revealed a considerable increase in the expression of the T-cell activation marker CD69. Moreover, T-cell proliferation was evidenced in treated cells by CFSE labeling compared to the control groups.

Result

Anti-4-1BB scFvs significantly increased IFN-γ and IL-2 mRNA and protein expression in T cells, but exhibited no stimulatory effect on IL-4 expression. These findings show that anti-4-1BB scFvs could evoke a Type I immune response.

Conclusions

Our results demonstrate that targeting the 4-1BB molecule using agonistic scFvs could be an effective strategy for T-cell stimulation as part of an ACT approach to cancer treatment.
Rule design and status quo evaluation on cross-industrial wastewater emissions trading in China’s typical industrial sectors
Authors: Chen Luyao , Zheng Hongyuan , Yang Haizhen
Published: April 2020

Background

China’s industrial wastewater pollution control policy urgently needs to change from government enforcement to market economy incentive, especially in regions with mature market economic conditions and improved legislative basis like Yangtze River Delta. The economic principles of Water Emissions Trading policy are to achieve a win–win situation in which pollution could be controlled meanwhile abatement costs are minimized. Existing regulations lack rules and restrictions for cross-industrial wastewater emission trading, nevertheless not all wastewater from various industrial sectors are suitable for emissions trading with each other. This study attempted to determine tradable levels of wastewater emissions rights within the selected 10 industries based on the similarity of wastewater composition.

Results

The result is presented in a tradable level matrix. It shows that of all industrial wastewater, the most suitable for emissions trading are, respectively, Textile and Paper Production, Manufacture of General Purpose Machinery and Manufacture of Transport, and then Chemistry Production and Pharmaceuticals.

Conclusion

Generally, this paper provides a systematic calculation method according to the similarity analysis to formulate cross-industrial wastewater emissions trading for policy reference. At the end of the article, a rationality analysis of the domestic wastewater emissions trading pilot programs was made. Even though the current wastewater emissions trading situation is not up to expectations, individual enterprises actively achieved emission reductions to play as the supply sides in the wastewater emissions trading under economic incentive from such a policy.
The impact of the anti-diabetic drug metformin on the intestinal microbiome of larval brown trout (Salmo trutta f. fario)
Authors: Rogall Eike Thorben , Jacob Stefanie , Triebskorn Rita , Schwartz Thomas
Published: April 2020

Background

The anti-diabetic pharmaceutical metformin is frequently analysed in the aquatic environment. Its impact on the fish microbiome is studied to get a deeper knowledge about the consequence of the metformin presence in river systems. Gut microbiome analyses were performed on larval brown trout with metformin including environmental concentrations. Therefore, the fish were exposed to metformin in concentrations of 0, 1, 10, 100, and 1000 µg/L. Especially, the lower metformin concentrations were measured in river waters containing percentages of conditioned wastewater from municipal wastewater treatment plants.

Results

Two complementary molecular biological methods for population analysis targeting the 16S rRNA gene regions V1–V3, i.e.: (1) 16S amplicon sequencing and (2) polymerase chain reaction (PCR) combined with denaturing gradient gel electrophoresis (DGGE). Both analyses demonstrated significant microbiome alterations even at low metformin concentrations being analysed in German rivers. The amplicon sequencing revealed the most distinct shifts in the Firmicutes phylum, or more specifically, within the Bacillales order, which were most affected by metformin exposure. Within the Bacillales order, the Planococcaceae family, which is described to provide essential amino acids for the fish, completely disappeared after metformin treatment. Conversely, the percentage of other bacteria, such as Staphylococcaceae, increased after exposure to metformin. Similarity profiles of the microbiomes could be generated using the Sørensen index calculation after PCR-DGGE analyses and confirmed shifts in the composition of the brown trout intestinal microbiome after metformin exposures. In vitro gene expression analyses of virulence factors from fish pathogens, previously identified in the fish microbiomes DNA extracts, were conducted in the presence or absence of environmentally relevant concentrations. Here, marker genes of Enterococcus faecium, Enterococcus faecalis, and Aeromonas hydrophila were detected and quantified via PCR approaches, firstly. An increased expression of the species-specific virulence genes was observed after normalisation with control data and ribosomal housekeeping genes.

Conclusion

Environmentally relevant concentrations of metformin can alter the composition in gut microbiome of brown trout in different ways. Both, the metformin-induced expression of virulence genes in fish pathogens in vitro and the impact of metformin on the microbiome composition in vivo in larval brown trout open the discussion about a possible long-term effect on the vitality, growth, and development in more mature brown trouts.
Retinoic acid receptor-related orphan receptor α reduces lipid droplets by upregulating neutral cholesterol ester hydrolase 1 in macrophages
Authors: Matsuoka Hiroshi , Tokunaga Riki , Katayama Miyu , Hosoda Yuichiro , Miya Kaoruko , Sumi Kento , Ohishi Ami , Kamishikiryo Jun , Shima Akiho , Michihara Akihiro
Published: April 2020

Background

Neutral cholesterol ester hydrolase 1 (NCEH1) catalyzes the hydrolysis of cholesterol ester (CE) in macrophages. Genetic ablation of NCEH1 promotes CE-laden macrophages and the development of atherosclerosis in mice. Dysregulation of NCEH1 levels is involved in the pathogenesis of multiple disorders including metabolic diseases and atherosclerosis; however, relatively little is known regarding the mechanisms regulating NCEH1. Retinoic acid receptor-related orphan receptor α (RORα)-deficient mice exhibit several phenotypes indicative of aberrant lipid metabolism, including dyslipidemia and increased susceptibility to atherosclerosis.

Results

In this study, inhibition of lipid droplet formation by RORα positively regulated NCEH1 expression in macrophages. In mammals, the NCEH1 promoter region was found to harbor putative RORα response elements (ROREs). Electrophoretic mobility shift, chromatin immunoprecipitation, and luciferase reporter assays showed that RORα binds and responds to ROREs in human NCEH1. Moreover, NCEH1 was upregulated through RORα via a phorbol myristate acetate-dependent mechanism during macrophage differentiation from THP1 cells. siRNA-mediated knockdown of RORα significantly downregulated NCEH1 expression and accumulated lipid droplets in human hepatoma cells. In contrast, NCEH1 expression and removal of lipid droplets were induced by RORα agonist treatments and RORα overexpression in macrophages.

Conclusion

These data strongly suggested that NCEH1 is a direct RORα target, defining potential new roles for RORα in the inhibition of lipid droplet formation through NCEH1.
Molecular adaptation to salinity fluctuation in tropical intertidal environments of a mangrove tree Sonneratia alba
Authors: Feng Xiao , Xu Shaohua , Li Jianfang , Yang Yuchen , Chen Qipian , Lyu Haomin , Zhong Cairong , He Ziwen , Shi Suhua
Published: April 2020

Background

Mangroves have adapted to intertidal zones - the interface between terrestrial and marine ecosystems. Various studies have shown adaptive evolution in mangroves at physiological, ecological, and genomic levels. However, these studies paid little attention to gene regulation of salt adaptation by transcriptome profiles.

Results

We sequenced the transcriptomes of Sonneratia alba under low (fresh water), medium (half the seawater salinity), and high salt (seawater salinity) conditions and investigated the underlying transcriptional regulation of salt adaptation. In leaf tissue, 64% potential salinity-related genes were not differentially expressed when salinity increased from freshwater to medium levels, but became up- or down-regulated when salt concentrations further increased to levels found in sea water, indicating that these genes are well adapted to the medium saline condition. We inferred that both maintenance and regulation of cellular environmental homeostasis are important adaptive processes in S. alba. i) The sulfur metabolism as well as flavone and flavonol biosynthesis KEGG pathways were significantly enriched among up-regulated genes in leaves. They are both involved in scavenging ROS or synthesis and accumulation of osmosis-related metabolites in plants. ii) There was a significantly increased percentage of transcription factor-encoding genes among up-regulated transcripts. High expressions of salt tolerance-related TF families were found under high salt conditions. iii) Some genes up-regulated in response to salt treatment showed signs of adaptive evolution at the amino acid level and might contribute to adaptation to fluctuating intertidal environments.

Conclusions

This study first elucidates the mechanism of high-salt adaptation in mangroves at the whole-transcriptome level by salt gradient experimental treatments. It reveals that several candidate genes (including salt-related genes, TF-encoding genes, and PSGs) and major pathways are involved in adaptation to high-salt environments. Our study also provides a valuable resource for future investigation of adaptive evolution in extreme environments.
Combined pulmonary vein stenosis stenting and left atrial appendage occlusion in a patient with hemoptysis after atrial fibrillation ablation
Authors: Li Yan-Jie , Pan Xin , Wang Cheng , He Ben
Published: April 2020

Background

Pulmonary vein stenosis (PVS) after radiofrequency ablation for non-valvular atrial fibrillation (AF) is an uncommon but serious complication. PVS stenting can rapidly restore pulmonary flow and improve symptoms with long-term low incidence of restenosis. However, high risk of thrombosis remains if AF is recurrent, especially for CHA2DS2-VASc > 2.

Case presentation

A 67-year-old man with diabetes, hypertension and a history of stroke underwent radiofrequency pulmonary vein isolation for persistent AF 1 year ago. Six months later he developed recurrent respiratory infection and massive hemoptysis. Computed tomography pulmonary angiography revealed severe left pulmonary vein stenosis. Simultaneous percutaneous PVS stenting and left atrial appendage occlusion were performed to resolve recurrent hemoptysis and prevent stroke. The clinical follow-up indicated a good short and mid-term result with significant improvement of symptoms.

Conclusions

Simultaneous PVS stenting and left atrial appendage occlusion is feasible and effective in patients with recurrence of AF and hemoptysis induced by radiofrequency ablation for AF.
Patients’ experiences of alcohol screening and advice in primary care: a qualitative study
Authors: O’Donnell Amy , Hanratty Barbara , Schulte Bernd , Kaner Eileen
Published: April 2020

Background

Despite evidence supporting the effectiveness of alcohol screening and brief advice to reduce heavy drinking, implementation in primary healthcare remains limited. The challenges that clinicians experience when delivering such interventions are well-known, but we have little understanding of the patient perspective. We used Normalization Process Theory (NPT) informed interviews to explore patients’ views on alcohol screening and brief advice in routine primary healthcare.

Methods

Semi-structured qualitative interviews with 22 primary care patients who had been screened for heavy drinking and/or received brief alcohol advice were analysed thematically, informed by Normalisation Process Theory constructs (coherence, cognitive participation, collective action, reflexive monitoring).

Results

We found mixed understanding of the adverse health consequences of heavy drinking, particularly longer-term risks. There was some awareness of current alcohol guidelines but these were viewed flexibly, depending on the individual drinker and drinking context. Most described alcohol screening as routine, with clinicians viewed as trustworthy and objective. Patients enacted a range of self-regulatory techniques to limit their drinking but perceived such strategies as learned through experience rather than based on clinical advice. However, most saw alcohol advice as a valuable component of preventative healthcare, especially those experiencing co-occurring health conditions.

Conclusions

Despite strong acceptance of the screening role played by primary care clinicians, patients have less confidence in the effectiveness of alcohol advice. Primary care-based alcohol brief advice needs to reflect how individuals actually drink, and harness strategies that patients already commonly employ, such as self-regulation, to boost its relevance.