bluuebunny/crossref_metadata_2025 huggingface dataset:
Nitric Oxide‐elicited Resistance to Antitumor Photodynamic Therapy via Inhibition of Membrane Free Radical‐mediated Lipid Peroxidation
Authors: Girotti Albert W.
Published: December 2020

This review focuses on the ability of nitric oxide (NO) to antagonize antitumor photodynamic therapy (PDT). NO’s anti‐PDT effects were recognized relatively recently and require a better mechanistic understanding for developing new strategies to improve PDT efficacy. Many PDT sensitizers (PSs) are amphiphilic and tend to localize in membrane compartments of tumor cells. Unsaturated lipids in these compartments can undergo peroxidative degradation after PS photoactivation. Primary Type I (free radical) vs. Type II (singlet oxygen) photochemistry of lipid peroxidation is discussed, along with light‐independent turnover of primary lipid hydroperoxides to free radical species. Chain lipid peroxidation mediated by the latter exacerbates membrane damage and cytotoxicity after a PDT challenge. Our studies have shown that NO from chemical donors can suppress chain peroxidation by intercepting lipid‐derived free radical intermediates, thereby protecting cancer cells against photokilling. More recent evidence has revealed that inducible NO synthase (iNOS) is dramatically upregulated in several cancer cell types after a photodynamic challenge, and that iNOS‐derived NO enhances resistance as well as growth and migratory aggressiveness of surviving cells. Chain breaking by NO and other possible NO‐based resistance mechanisms are discussed, along with novel pharmacologic approaches for overcoming these negative effects.
Disavowing White Identity: How Social Disgust can Change Social Identities
Authors: Jardina Ashley , Kalmoe Nathan , Gross Kimberly
Published: December 2020

Recent work finds that the sense of solidarity some whites feel with their racial group is strongly associated with their political attitudes, particularly since the election of Barack Obama. Prior work has also noted that levels of this identity have been stable across time and data sources. We, however, document a notable decline in levels of white identity in both panel and cross‐sectional national survey data immediately after the 2016 presidential election. Using a two‐wave panel design, we examine the factors associated with this decline. We examine whether particular emotional reactions, especially disgust toward Donald Trump, pushed some whites away from their racial identity. We also consider the possibility that some whites may have felt that Trump's election reduced perceptions of racial or political threat, therefore lowering levels of white identity. We find the strongest support for the former hypothesis; the decline in white identity was driven mostly by whites expressing disgust toward Trump. Our results highlight the effect that the political environment can have on group identities and point in particular to the significant role that disgust may play in attenuating the strength of group solidarity.
Kalmyks from Republic of Kalmykia, Russia
Authors: Loginova Maria , Smirnova Daria , Kutyavina Svetlana , Makhova Olga , Kashin Konstantin , Paramonov Igor
Published: December 2020

NGS typing reveals 2 novel alleles amongst 206 class I and class II alleles.
Exploring the alpha‐gliadin locus: the 33‐mer peptide with six overlapping coeliac disease epitopes in Triticum aestivum is derived from a subgroup of Aegilops tauschii
Authors: Schaart Jan G. , Salentijn Elma M. J. , Goryunova Svetlana V. , Chidzanga Charity , Esselink Danny G. , Gosman Nick , Bentley Alison R. , Gilissen Luud J. W. J. , Smulders Marinus J. M.
Published: December 2020

Most alpha‐gliadin genes of the Gli‐D2 locus on the D genome of hexaploid bread wheat (Triticum aestivum) encode for proteins with epitopes that can trigger coeliac disease (CD), and several contain a 33‐mer peptide with six partly overlapping copies of three epitopes, which is regarded as a remarkably potent T‐cell stimulator. To increase genetic diversity in the D genome, synthetic hexaploid wheat lines are being made by hybridising accessions of Triticum turgidum (AB genome) and Aegilops tauschii (the progenitor of the D genome). The diversity of alpha‐gliadins in A. tauschii has not been studied extensively. We analysed the alpha‐gliadin transcriptome of 51 A. tauschii accessions representative of the diversity in A. tauschii. We extracted RNA from developing seeds and performed 454 amplicon sequencing of the first part of the alpha‐gliadin genes. The expression profile of allelic variants of the alpha‐gliadins was different between accessions, and also between accessions of the Western and Eastern clades of A. tauschii. Generally, both clades expressed many allelic variants not found in bread wheat. In contrast to earlier studies, we detected the 33‐mer peptide in some A. tauschii accessions, indicating that it was introduced along with the D genome into bread wheat. In these accessions, transcripts with the 33‐mer peptide were present at lower frequencies than in bread wheat varieties. In most A. tauschii accessions, however, the alpha‐gliadins do not contain the epitope, and this may be exploited, through synthetic hexaploid wheats, to breed bread wheat varieties with fewer or no coeliac disease epitopes.
Whole blood donor behavior and availability after deferral: Consequences of a new ferritin monitoring policy
Authors: Spekman Marloes L.C. , Ramondt Steven , Sweegers Maike G.
Published: December 2020

Background

To prevent (negative consequences of) temporary deferral due to low hemoglobin, the Dutch national blood service Sanquin introduced a ferritin monitoring policy in 2017. Ferritin is measured after the donation (as opposed to before donation for hemoglobin), and low ferritin levels lead to deferral of 6 (ferritin 15‐30 ng/mL) or 12 months (ferritin <15 ng/mL). We explored the consequences of this policy on donor behavior and availability.

Study Design and Methods

We included all Dutch whole blood donors who made a donation (attempt) between 13 November and 31 December 2017. At that point, the ferritin monitoring policy was randomly implemented in 8 of 29 regional clusters of collection centers. We extracted information from Sanquin's donor database about donors' deferrals, subsequent donation attempts, and donation cessation (up to 31 December 2019). Donors deferred for low ferritin were compared to those deferred for low hemoglobin or other reasons, as well as to donors who were not deferred.

Results

A total of 55 644 donors were included (11% deferred). For donor behavior, we found that donors deferred for low ferritin less often unsubscribed and switched to other donation types, yet also made fewer donations in the follow‐up period. For availability, we found they were less often deferred, yet they were unavailable to donate for a longer period.

Conclusion

Results suggest that the implementation of a ferritin monitoring policy may lead to a decrease in donor availability and reduced donations. However, the policy is successful in retaining more donors and reducing low hemoglobin deferrals.
Evaluation of the cutaneous inflammatory cells in dogs with leishmaniosis and in dogs without the disease that were naturally infected by Leishmania infantum (syn. L. chagasi)
Authors: Hernandez‐Bures Andrea , Gillen James , Apostolidis Kosmas , Saridomichelakis Manolis , Di Loria Antonio , Santoro Domenico
Published: December 2020

Background

Canine leishmaniosis (CanL) is associated with an aberrant cutaneous immune response. Few studies have compared cutaneous immune cells among dogs with leishmaniosis or infected without leishmaniosis, and noninfected dogs.

Hypothesis/Objective

Evaluate the number of neutrophils, histiocytes, T lymphocytes, T‐bet‐positive, GATA3‐positive, FoxP3‐positive and interleukin (IL)‐17‐positive cells, in lesional (Group A) and normal‐looking (Group B) skin of nine dogs with stage II/III leishmaniosis; in normal‐looking PCR‐positive (Group C; n = 6) or PCR‐negative (Group D; n = 6) skin of infected dogs; and in the normal‐looking skin of 12 noninfected dogs (Group E).

Methods and materials

Diagnosis of CanL considered clinical signs, clinicopathological abnormalities, detection of Leishmania amastigotes in lymph nodes, and/or bone marrow and positive serological results. Paraffin‐embedded skin biopsies were processed for routine immunofluorescence and positive cells were identified using commercially available anti‐canine antibodies.

Results

In Group A, there was a significantly higher number of neutrophils (P < 0.001), histiocytes (P = 0.012), T lymphocytes (P = 0.011), GATA3‐positive (P = 0.02) and IL‐17A‐positive (P = 0.002) cells compared to Group E. In Group B, there was a significantly higher number of histiocytes (P = 0.02), T lymphocytes (P = 0.004), GATA3‐positive (P = 0.006) and FoxP3‐positive (P = 0.028) cells compared to Group E. There was no difference in between groups A and B and between groups C or D and E.

Conclusions and clinical importance

In the lesional and/or normal‐looking skin of dogs with moderate/severe CanL there is an infiltration of neutrophils, histiocytes, T lymphocytes, GATA3‐, FoxP3‐ and IL17A‐positive cells. By contrast, the number of these cells is not increased in the normal‐looking skin of infected dogs without CanL compared to the skin of noninfected dogs.
Allelopathy and allelopathic substances of mango (Mangifera indicaL.)
Authors: Kato‐Noguchi Hisashi , Kurniadie Denny
Published: December 2020

Homegarden, traditional agroforestry system in tropical and subtropical regions, sustains the availability of daily necessities. Mango (Mangifera indicaL.) is an essential tree in the homegardens and is used for multiple purposes such as food, folk medicine, fuel, timber, and apiculture. The interaction between mango and weeds or crops has been evaluated in terms of allelopathy and the evidence of the allelopathy accumulated in the literature over two decades. The leaf extracts and leachate of mango inhibited the germination and growth of several other plants species. Soil collected from mango orchard shows growth inhibitory activity. Residues of mango leaves also suppressed the growth of other plant species. Phytotoxic substances such as coumaric, vanillic, caffeic, cinnamic, gallic and protocatechuic acids, and methyl gallate and quercetin‐3‐O‐α‐glucopyranosyl‐(1 → 2)‐β‐D‐glucopyranoside were identified in mango leaves. Those compounds may be released into the soil through the leaf leachate and the decomposition of plant residues and they can inhibit the germination and the growth of neighboring plants as allelopathic substances. Therefore, the allelopathy of mango is potentially useful for the weed management options in homegardens and other agriculture settings to reduce commercial herbicide dependency.
Governance and Social Network: Analysis in Cooperatives of Small Citrus Producers in the São Paulo State, Brazil
Authors: Aguiar Leandro Guedes de , Pigatto Giuliana Ap. Santini , Oliveira Sandra Cristina de , Paulillo Luiz Fernando
Published: December 2020

The purpose of this paper is to investigate if the network governance structure adopted by small producers’ citrus cooperatives has allowed the reduction of risks in transactions, ex-ante (adverse selection) and ex-post (moral hazard), and the problems of opportunism downstream and upstream of the production chain. The planned methodological procedure included the structuring and research of two case studies in cooperatives of small orange producers in the interior of the state of São Paulo, Brazil, comprising a sample of 35 cooperative members surveyed between the two cooperatives analyzed. The analyzes were supported by the Transaction Cost Economics and Social Network approaches. Results indicate the importance of the cooperatives and their network format, as economic agents, in maintaining small producers in the citrus industry activity, allowing the reduction of risks in transactions and the problems of opportunism, downstream and upstream of the chain. It was verified the academic contribution and theoretical reinforcement brought by this study - through the empirical surveys and results produced - to the theory of hybrid governance formats, which lacks empirical support and greater analytical strengthening on the part of the academy, according to its own authors. It is suggested, for future analysis, the use of the network governance approach aimed at strengthening the class of small producers of other agribusiness cultures, also using the theoretical basis belonging to NIE, TCE and Networks. The continuity of analyzes based on relational governance, with institutional and transactional economics as a basis, represents not only academic documentation and support for small rural producers of different cultures, but also the guarantee of theoretical robustness to a structure that is still incipient in historical terms, which finds in Brazilian agribusiness a fertile ground for its development and materialization.
Physiological regulation of bone length and skeletal proportion in mammals
Authors: Zhou Elaine , Lui Julian
Published: December 2020

New Findings

What is the topic of this review?

Mechanisms regulating bone length and skeletal proportions

What advances does it highlight?

The study of differential bone length between leg and finger bones, metatarsals of the Egyptian jerboa and genomic analysis of giraffes.

Among mammalian species, skeletal structures vary greatly in size and shape, leading to a dramatic variety of body sizes and proportions. How different bones grow to different lengths, whether among different species, different individuals of the same species, or even in different anatomical parts of our the body, has always been a fascinating subject of research in biology and physiology. In the current review, we focus on some of the recent advances in the field and discuss how these provided important new insights into the mechanisms regulating bone length and skeletal proportions.
Myths and methodologies: Degrees of freedom – limitations of infrared thermographic screening for Covid‐19 and other infections
Authors: Mekjavic Igor B. , Tipton Michael J.
Published: December 2020

Around the planet, in many different scenarios, skin temperature is being used as a surrogate measure of deep body (core) temperature in the assessment of whether an individual is infected with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2), which causes the coronavirus disease (Covid‐19), as indicated by the presence of fever. The key question is whether this is a valid methodology. If it is not, we run the risk of falsely excluding individuals from places they may want, or need, to go. We also run the risk of falsely allowing people into places where they can spread the undetected infection they have. In this review, we explore these and associated questions. We establish the limited utility of the current methodology for the mass screening of individuals for Covid‐19 related fever using infrared thermography. We propose the development of an alternative method that may prove to be more sensitive.
The effects of maternal position, in late gestation pregnancy, on placental blood flow and oxygenation: an MRI study
Authors: Couper Sophie , Clark Alys , Thompson John M. D. , Flouri Dimitra , Aughwane Rosalind , David Anna L. , Melbourne Andrew , Mirjalili Ali , Stone Peter R.
Published: December 2020

Key points

Maternal supine sleep position in late pregnancy is associated with an increased risk of stillbirth.

Maternal supine position in late pregnancy reduces maternal cardiac output and uterine blood flow.

Using MRI, this study shows that compared to the left lateral position, maternal supine position in late pregnancy is associated with reduced utero‐placental blood flow and oxygen transfer across the placenta with an average 6.2% reduction in oxygen delivery to the fetus and an average 11% reduction in fetal umbilical venous blood flow.

Maternal sleep position in late gestation is associated with an increased risk of stillbirth, though the pathophysiological reasons for this are unclear. Studies using magnetic resonance imaging (MRI) have shown that compared with lateral positions, lying supine causes a reduction in cardiac output, reduced abdominal aortic blood flow and reduced vena caval flow which is only partially compensated for by increased flow in the azygos venous system. Using functional MRI techniques, including an acquisition termed diffusion–relaxation combined imaging of the placenta (DECIDE), which combines diffusion weighted imaging and T2 relaxometry, blood flow and oxygen transfer were estimated in the maternal, fetal and placental compartments when subjects were scanned both supine and in left lateral positions. In late gestation pregnancy, lying supine caused a 23.7% (P < 0.0001) reduction in total internal iliac arterial blood flow to the uterus. In addition, lying in the supine position caused a 6.2% (P = 0.038) reduction in oxygen movement across the placenta. The reductions in oxygen transfer to the fetus, termed delivery flux, of 11.2% (P = 0.0597) and in fetal oxygen saturation of 4.4% (P = 0.0793) did not reach statistical significance. It is concluded that even in healthy late gestation pregnancy, maternal position significantly affects oxygen transfer across the placenta and may in part provide an explanation for late stillbirth in vulnerable fetuses.
A Novel Streamline-Based Objective Function for Well Placement Optimization in Waterfloods
Authors: Naderi Foroozan , Siavashi Majid , Nakhaee Ali
Published: December 2020

In reservoir development plans, well placement optimization is usually performed to better sweep oil and reduce the amount of trapped oil inside reservoirs. Long-term optimization of well placement requires multiple times simulation of reservoirs which makes these problems cumbersome, especially when a large number of decision variables exist. Cumulative oil production (COP) or net present value (NPV) functions are commonly used as the objective function of optimal enhance oil recovery projects. Use of these functions requires a full-time reservoir simulation and their convergence could be difficult with the chance to be trapped in local optimum solutions. In this study, the novel proportionally distributed streamlines (PDSLs) target function is proposed that can be minimized to reach the optimal well placement. PDSL can be estimated even without full-time reservoir simulation. PDSL tries to direct the appropriate number of streamlines toward the regions with larger amount of oil in the shortest time and hence can improve oil recovery. Particle swarm optimization (PSO) method linked to an in-house streamline-based reservoir simulator is implemented to optimize well placement of water-flooding problems in a two-dimensional heterogeneous reservoir model.
Dynamic Simulation and Comparison of a Combined Heat and Power System With/Without Thermal Energy Storage
Authors: Rostami Zadeh Khodadoost , Mirjalily Seyed Ali Agha , Oloomi Seyed Amir Abbas , Salehi Gholamreza , Khoshgoftar Manesh M. H.
Published: December 2020

The present paper simulates and dynamically analyzes a combined heat and power (CHP) system driven by a gas-fueled internal combustion engine. The CHP system uses a heat exchanger to convert the heat loss of the engine to meet heat demand and uses a generator for power generation. Then, the impact of the use or non-use thermal energy storage (TES) is examined on power and heat generation. Given the different demands of different seasons, two smart control strategies are developed concerning time to attain higher efficiency in different seasons. A TES is included in the control strategy for cold and hot seasons, and analyses are performed for a typical week. The gas engine of the CHP system uses time and temperature variables simultaneously to operate smartly by two strategies for a year instead of one single strategy. The results show that when a control strategy with variable partial loads based on temperature and time is employed, the efficiency of the CHP system’s gas engine is improved. Using the results of the new and smart control strategy, the CHP system exhibits an efficiency of 84.2% in the hot season and an efficiency of 87.0% in the cold seasons for a typical week.
Evaluation of a Novel Quadruple Combined Cycle With the Magnetohydrodynamic Generator Based on 6E Analysis
Authors: Esmaeilzadehazimi M. A. , Khoshgoftar Manesh M. H. , Majidi M. , Nourpour M.
Published: December 2020

The generation of the electric power through magnetohydrodynamic (MHD) is one of the most advanced high-temperature energy conversions as it directly turns the heat into electricity. In this study, a quadruple cycle with a MHD generator was considered as the upstream cycle, a Brayton cycle was taken as the middle cycle through heating, and an organic Rankine cycle and steam cycle were regarded as the downstream cycles using the heat loss of the MHD generator and gas turbine, respectively. Energy, exergy, exergoeconomic, exergoenvironmental, emergoeconomic, and emergoenvironmental (6E) analyses were done in the proposed system simultaneously for the first time. In addition, advanced exergy, exergoeconomic, and exergoenvironmental analyses were performed for the proposed system to show the effect of irreversibility accurately and deeply. Despite the slight difference between the results of the emergoeconomic and emergoenvironmental sector with the exergoeconomic and exergoenvironmental sector, the obtained qualitative results were very similar showing that the emergoeconomic and emergoenvironmental analyses can be proper alternatives to the conventional exergoeconomic and exergoenvironmental analyses. The temperature of the heat source is one of the most important criteria for fluid selection in the organic Rankine cycles. Five organic fluids were selected and evaluated according to the desired hot source temperature for the Rankine organic cycle (262 °C). The results showed that the R141b with energy and efficiency of 15.25 and 58.05%, respectively, had the best thermodynamic and exergy performance with the least amount of total costs using this fluid.
Analysis of LiCoO2 electrodes through principal component analysis of current–voltage datacubes measured using atomic force microscopy
Authors: Maeda Yasushi , Taguchi Noboru , Sakaebe Hikari
Published: December 2020

This study aimed to reveal the electrical characteristics of the composite electrodes of Li-ion batteries. LiCoO2 electrodes were analyzed using atomic force microscopy, and three-dimensional datasets of current–voltage (I–V) curves (IV-datacubes) were obtained. The IV-datacubes were then analyzed using principal component analysis to determine the typical I–V curve corresponding to each LiCoO2 particle on a statistical basis. Detailed analysis based on the thermionic emission model with series resistance showed that some of the particles exhibited poor electrical contact in the electrode. Overall, the obtained results suggested that our IV-datacube analysis can reveal the characteristics of buried electrical contacts within electrodes, which is otherwise difficult to accomplish using alternative methods. We, therefore, believe that the method presented herein is a promising analytical method for composite electrodes.
Unilateral persistent disc oedema due to cerebral sinus venous thrombosis (CSVT): diagnostic and management challenge
Authors: Nalawade Rohan , Kannam Mohan , Garuda Butchi Raju , Sachdeva Virender
Published: December 2020

A 50-year-old woman was incidentally diagnosed to have unilateral disc oedema during comprehensive ophthalmological evaluation. She had a prior history of ulcerative colitis. She had normal visual function and was initially diagnosed to have incipient non-arteritic anterior ischaemic optic neuropahty. Risk factor evaluation revealed hyperhomocysteinaemia. She was asked to come for a follow-up in 2 months. However, she was lost to follow-up and returned to the clinic for the evaluation for headaches, 23 months later. Her ocular examination was stable and she had persistent unilateral disc oedema unchanged from the prior visit. Repeat MRI brain and MR venogram brain with contrast-established diagnosis of cerebral sinus venous thrombosis (CSVT). She denied any neurological symptoms. Later on, she was diagnosed to have hyperhomocysteinaemia with methyl tetrahydrofolate reductase gene mutation. This case highlights the importance of recognising although rare, unilateral disc oedema secondary to elevated intracranial pressure from CSVT.
Effectiveness and cost-effectiveness of a lifestyle modification programme in the prevention and treatment of subclinical, mild and moderate depression in primary care: a randomised clinical trial protocol
Authors: Aguilar-Latorre Alejandra , Navarro Capilla , Oliván-Blázquez Bárbara , Gervilla Elena , Magallón Botaya Rosa , Calafat-Villalonga Catalina , García-Toro Mauro , Boira Santiago , Serrano-Ripoll María Jesús
Published: December 2020

Introduction

Major depression is a highly prevalent pathology that is currently the second most common cause of disease-induced disability in our society. The onset and continuation of depression may be related to a wide variety of biological and psychosocial factors, many of which are linked to different lifestyle aspects. Therefore, health systems must design and implement health promotion and lifestyle modification programmes (LMPs), taking into account personal factors and facilitators. The main objective of this protocol is to analyse the clinical effectiveness, cost-effectiveness and cost utility of an LMP and an LMP with information and communication technologies (ICTs) as adjunctive treatment for depression in primary care patients. The secondary objectives are to analyse the clinical effectiveness in the subgroup that presents comorbidity and to analyse the correlation between personal factors on health behaviour and lifestyle patterns.

Methods and analysis

A randomised, multicenter pragmatic clinical trial with three parallel groups consisting of primary healthcare patients suffering from subclinical, mild or moderate depression. The following interventions will be used: (1) Usual antidepressant treatment with psychological advice and/or psychotropic drugs prescribed by the general practitioner (treatment as usual (TAU)). (2) TAU+LMP. A programme to be imparted in six weekly 90-minute group sessions, intended to improve the following aspects: behavioural activation+daily physical activity+adherence to the Mediterranean diet pattern+sleep hygiene+careful exposure to sunlight. (3) TAU+LMP+ICTs: healthy lifestyle recommendations (TAU+LMP)+monitoring using ICTs (a wearable smartwatch). The primary outcome will be the depressive symptomatology and the secondary outcomes will be the quality of life, the use of health and social resources, personal factors on health behaviour, social support, lifestyle patterns and chronic comorbid pathology. Data will be collected before and after the intervention, with 6-month and 12-month follow-ups.

Ethics and dissemination

This study has been approved by the Clinical Research Ethics Committee of Aragón (approval number: C.P.-C.I. PI18/286) and the Research Ethics Committee of the Balearic Islands (IB3950/19 PI). Data distribution will be anonymous. Results will be disseminated via conferences and papers published in peer-reviewed, open-access journals.

Trial registration number

ClinicalTrials.gov Registry (NCT03951350).
Which psychotherapy is effective in panic disorder? And which delivery formats are supported by the evidence? Study protocol for two systematic reviews and network meta-analyses
Authors: Papola Davide , Ostuzzi Giovanni , Gastaldon Chiara , Purgato Marianna , Del Giovane Cinzia , Pompoli Alessandro , Karyotaki Eirini , Sijbrandij Marit , Furukawa Toshi A , Cuijpers Pim , Barbui Corrado
Published: December 2020

Introduction

Panic disorder is among the most prevalent anxiety diseases. Although psychotherapy is recommended as first-line treatment for panic disorder, little is known about the relative efficacy of different types of psychotherapies. Moreover, there is little evidence concerning the effectiveness of different formats of major psychotherapeutic types, such as cognitive–behavioural therapy (CBT). In this protocol, we present an overarching project consisting of two systematic reviews and network meta-analyses (NMA) to shed light on which psychotherapy (NMA-1), and specifically, which CBT delivery format (NMA-2) should be considered most effective for adults suffering from panic disorder with or without agoraphobia.

Methods and analyses

Starting from a common pool of data, we will conduct two systematic reviews and NMA of randomised controlled trials examining panic disorder. A comprehensive search will be performed in electronic databases MEDLINE, Embase, PsycINFO and the Cochrane Register of Controlled Trials—CENTRAL from database inception to 1 January 2021 to identify relevant studies. A systematic approach to searching, screening, reviewing and data extraction will be applied. Titles, abstract and—whenever necessary—full texts will be examined independently by at least two reviewers. The quality of the included studies will be assessed using the revised Cochrane risk of bias tool V.2. The primary efficacy outcome will be anxiety symptoms at study endpoint. The primary acceptability outcome will be all-cause discontinuation, as measured by the proportion of patients who had discontinued treatment for any reason at endpoint. Data will be pooled using a random-effects model. Pairwise and NMA will be conducted.

Ethics and dissemination

No ethical approval is necessary for these two studies, as there will be no collection of primary data. The results will be disseminated through peer-reviewed publications and presentations at national and international conferences and meetings.
Dose–response association between fluid overload and in-hospital mortality in critically ill patients: a multicentre, prospective, observational cohort study
Authors: Wang Meiping , Zhu Bo , Jiang Li , Wen Ying , Du Bin , Li Wen , Liu Guangxu , Li Wei , Wen Jing , He Yan , Xi Xiuming
Published: December 2020

Objectives

Fluid management is important in ensuring haemodynamic stability in critically ill patients, but can easily lead to fluid overload (FO). However, the optimal fluid balance plot or range for critically ill patients is unknown. This study aimed to explore the dose–response relationship between FO and in-hospital mortality in critically ill patients.

Design

Multicentre, prospective, observational study.

Setting

Eighteen intensive care units (ICUs) of 16 tertiary hospitals in China.

Participants

Critically ill patients in the ICU for more than 3 days.

Primary outcome measures and analyses

FO was defined as the ratio of the cumulative fluid balance (L) and initial body weight (kg) on ICU admission, expressed as a percentage. Maximum FO was defined as the peak value of FO during the first 3 days of ICU admission. Logistic regression models with restricted cubic splines were used to explore the pattern and magnitude of the association between maximum FO and risk of in-hospital mortality. Age, sex, Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score on admission, main diagnosis on admission to ICU, comorbidities, time of maximum FO, mechanical ventilation, renal replacement therapy, use of vasopressors and centres were adjusted in multivariable analysis.

Results

A total of 3850 patients were included in the study, 929 (24.1%) of whom died in the hospital. For each 1% L/kg increase in maximum FO, the risk of in-hospital mortality increased by 4% (adjusted HR (aHR) 1.04, 95% CI 1.03 to 1.05, p<0.001). A maximum FO greater than 10% was associated with a 44% increased HR of in-hospital mortality compared with an FO less than 5% (aHR 1.44, 95% CI 1.27 to 1.67). Notably, we found a non-linear dose–response association between maximum FO and in-hospital mortality.

Conclusions

Both higher and negative fluid balance levels were associated with an increased risk of in-hospital mortality in critically ill patients.

Trial registration number

ChiCTR-ECH-13003934.
Investigating associations between physical activity and presenteeism: a scoping review protocol
Authors: Hervieux Valérie , Biron Caroline , Dima Justine
Published: December 2020

Introduction

Considering that physical activity plays a key role in the health of workers, a growing number of researchers are studying its relationship with various workplace outcomes, such as presenteeism. Numerous scientists recognise the relevance of further studying this relationship in order to improve our understanding of it. However, studies about the association between physical activity and presenteeism show some discrepancy in the results obtained. Disparity in the way of measuring presenteeism makes it even more challenging to compare results. In addition, it remains difficult to determine the optimal frequency, intensity, duration and type of physical activity to increase the productivity benefits of physical activity. In light of these issues, clarification through a scoping review of the literature on the subject is warranted.

Method and analysis

A search strategy will be conducted in six scientific databases: MEDLINE, CINAHL, PsycINFO, ABI Inform Global, Web of Science and Business Source Premier. A screening process by two independent reviewers will lead to study selection. Quantitative and qualitative studies written in English about the relation between physical activity and presenteeism will be considered for inclusion. Data on the definition and measurement of presenteeism as well as the measurement of physical activity will be extracted. Additional data will be extracted to provide a descriptive overview of studies that have examined the relationship between presenteeism and physical activity.

Ethics and dissemination

As this study will be based only on published studies, ethics approval is not required. Through the manner in which the included studies will be presented (categorised by their approach to presenteeism), this scoping review has the potential to improve our understanding of some of the inconsistencies observed in the literature. This review can also identify gaps in the existing evidence base and lead to new avenues of research.
Air pollutants and development of interstitial lung disease in patients with connective tissue disease: a population-based case–control study in Taiwan
Authors: Chen Hsin-Hua , Yong You-Ming , Lin Ching-Heng , Chen Yi-Hsing , Chen Der-Yuan , Ying Jia-Ching , Chao Wen-Cheng
Published: December 2020

Objective

The aim of this study was to assess the association between air pollutant exposure and interstitial lung disease (ILD) in patients with connective tissue diseases (CTDs).

Setting

A nationwide, population-based, matched case–control study in Taiwan.

Participants

Using the 1997–2013 Taiwanese National Health Insurance Research Database, we identified patients with newly diagnosed CTD during 2001–2013, including systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), systemic sclerosis (SSc), dermatomyositis (DMtis)/polymyositis (PM) and primary Sjögren’s syndrome (pSS).

Primary and secondary outcome measures

Patients with newly diagnosed ILD during 2012–2013 were identified as ILD cases, and selected patients with CTD without ILD matching (1:4) the CTD cases for CTD diagnosis, age, gender, disease duration and year of ILD diagnosis date were identified as non-ILD controls. Data of hourly level of air pollutants 1 year before the index date were obtained from the Taiwan Environmental Protection Agency. The association between ILD and air pollutant exposure was evaluated using logistic regression analysis shown as adjusted ORs (aORs) with 95% CIs after adjusting for potential confounders.

Results

We identified 505 newly diagnosed CTD-ILD patients, including 82 with SLE, 210 with RA, 47 with SSc, 44 with DMtis/PM and 122 with pSS. Ozone (O3) exposure (per 10 ppb) was associated with a decreased ILD risk in patients with CTD (aOR, 0.51; 95% CI, 0.33 to 0.79) after adjusting for potential confounders.

Conclusions

A previously unrecognised inverse correlation was found between O3 exposure and ILD in patients with RA and SSc. Further studies are warranted to explore the underlying mechanisms.
What is spiritual care? Professional perspectives on the concept of spiritual care identified through group concept mapping
Authors: Hvidt Niels Christian , Nielsen Kristina Tomra , Kørup Alex K , Prinds Christina , Hansen Dorte Gilså , Viftrup Dorte Toudal , Assing Hvidt Elisabeth , Hammer Elisabeth Rokkjær , Falkø Erik , Locher Flemming , Boelsbjerg Hanne Bess , Wallin Johan Albert , Thomsen Karsten Flemming , Schrøder Katja , Moestrup Lene , Nissen Ricko Damberg , Stewart-Ferrer Sif , Stripp Tobias Kvist , Steenfeldt Vibeke Østergaard , Søndergaard Jens , Wæhrens Eva Ejlersen
Published: December 2020

Objectives

The overall study aim was to synthesise understandings and experiences regarding the concept of spiritual care (SC). More specifically, to identify, organise and prioritise experiences with the way SC is conceived and practised by professionals in research and the clinic.

Design

Group concept mapping (GCM).

Setting

The study was conducted within a university setting in Denmark.

Participants

Researchers, students and clinicians working with SC on a daily basis in the clinic and/or through research participated in brainstorming (n=15), sorting (n=15), rating and validation (n=13).

Results

Applying GCM, ideas were identified, organised and prioritised online. A total of 192 unique ideas of SC were identified and organised into six clusters. The results were discussed and interpreted at a validation meeting. Based on input from the validation meeting a conceptual model was developed. The model highlights three overall themes: (1) ‘SC as an integral but overlooked aspect of healthcare’ containing the two clusters SC as a part of healthcare and perceived significance; (2) ‘delivering SC’ containing the three clusters quality in attitude and action, relationship and help and support, and finally (3) ‘the role of spirituality’ containing a single cluster.

Conclusion

Because spirituality is predominantly seen as a fundamental aspect of each individual human being, particularly important during suffering, SC should be an integral aspect of healthcare, although it is challenging to handle. SC involves paying attention to patients’ values and beliefs, requires adequate skills and is realised in a relationship between healthcare professional and patient founded on trust and confidence.
Inequalities in avoidable hospitalisation in large urban areas: retrospective observational study in the metropolitan area of Milan
Authors: Pongiglione Benedetta , Torbica Aleksandra , Gusmano Michael K
Published: December 2020

Objective

Significant inequalities in access to healthcare system exist between residents of world megacities, even if they have different healthcare systems. The aim of this study was to estimate avoidable hospitalisations in the metropolitan area of Milan (Italy) and explore inequalities in access to healthcare between patients and across their areas of residence.

Design

Retrospective observational study.

Setting

Public and accredited private hospitals in the metropolitan area of Milan. Data obtained from the hospital discharge database of the Italian Health Ministry.

Participants

472 579 patients hospitalised for ambulatory care sensitive conditions and resident in the metropolitan area of Milan from 2005 to 2016.

Outcome measure

Age-adjusted rates of avoidable hospitalisations; OR for hospital admissions with ambulatory care sensitive conditions.

Methods

Age-adjusted rates of avoidable hospitalisations in the metropolitan area of Milan were estimated from 2005 to 2016 using direct standardisation. For the hospitalised population, multilevel logistic regression model with patient random effects was used to identify patients, hospitals and municipalities’ characteristics associated with risk of avoidable hospitalisation in the period 2012–2016.

Results

The rate of avoidable hospitalisation in Milan fell steadily between 2005 and 2016 from 16.6 to 10.5 per 1000. Among the hospitalised population, the odds of being hospitalised with an ambulatory care sensitive condition was higher for male (OR 1.42, 95% CI 1.36 to 1.48), older (OR 1.012, 95% CI 1.01 to 1.014), low-educated (elementary school vs degree OR 4.23, 95% CI 3.72 to 4.81) and single (vs married OR 2.08, 95% CI 2.01 to 2.16) patients with comorbidities (OR 1.47, 95% CI 1.38 to 1.56); avoidable admissions were more frequent in public non-teaching hospitals while municipality’s characteristics did not appear to be correlated with hospitalisation for ambulatory care sensitive conditions.

Conclusions

The health system in metropolitan Milan has experienced a reduction in avoidable hospitalisations between 2005 and 2016, quite homogeneously across its 134 municipalities. The study design allowed to explore inequalities among the hospitalised population for which we found specific sociodemographic disadvantages.
Analysis of Pregnancy Development by Complexity and Information-Based Analysis of Fetal Phonocardiogram (PCG) Signals
Authors: Namazi Hamidreza , Krejcar Ondrej
Published: December 2020

One of the crucial areas of pregnancy research is to analyze the pregnancy development. For this purpose, scientists analyze the different conditions of fetuses to understand their development. In this paper, we conducted complexity and information-based analyses on Phonocardiogram (PCG) signals to investigate pregnancy development. We calculated the fractal dimension, approximate entropy, and sample entropy as the measures of complexity and the Shannon entropy as the measure of the information content of signals for 24 fetuses in four ranges of gestational weeks. Based on the obtained results, increasing the gestational age of fetuses is reflected on the increment of the complexity of their PCG signals. We also observed similar findings in the case of the information content of PCG signals. Among all calculated measures, the fractal dimension of PCG signals showed significant variations among different gestational weeks. The method of analysis can be used to evaluate the alterations of other biomedical signals of fetuses (e.g., heart rate) to investigate their development.
On Kadison-Schwarz Approximation to Positive Maps
Authors: Chruściński Dariusz , Mukhamedov Farrukh , Hajji Mohamed Ali
Published: December 2020

We analyze Kadison-Schwarz approximation to positive maps in matrix algebras. This is an analogue of the well known structural physical approximation to positive maps used in entanglement theory. We study several known maps both decomposable (like transposition) and non-decomposable (like Choi map and its generalizations).
Contribution of thermogenic mechanisms by male and female mice lacking pituitary adenylate cyclase-activating polypeptide in response to cold acclimation
Authors: Filatov Ekaterina , Short Landon I. , Forster Maeghan A. M. , Harris Simon S. , Schien Erik N. , Hughes Malcolm C. , Cline Daemon L. , Appleby Colin J. , Gray Sarah L.
Published: December 2020

This manuscript adds to the literature of endocrine regulation of adaptive thermogenesis and energy balance. It specifically describes the role of pituitary adenylate cyclase-activating polypeptide on the regulation of brown adipose tissue via the sympathetic nervous system with a focus on compensatory mechanisms of thermogenesis. We highlight sex-specific differences in energy metabolism.
TAVR: A Review of Current Practices and Considerations in Low-Risk Patients
Authors: Spears Jenna , Al-Saiegh Yousif , Goldberg David , Manthey Sina , Goldberg Sheldon
Published: December 2020

Transcatheter aortic valve replacement (TAVR) is an established treatment for severe, symptomatic, aortic stenosis (AS) in patients of all risk categories and now comprises 12.5% of all aortic valve replacements. TAVR is a less invasive alternative to traditional surgical aortic valve replacement (SAVR), with equivalent or superior outcomes. The use of TAVR has increased rapidly. The success and increase in use of TAVR are a result of advances in technology, greater operator experience, and improved outcomes. Indications have recently expanded to include patients considered to be at low risk for SAVR. While TAVR outcomes have improved, remaining challenges include the management of coexistent coronary artery disease, prevention of periprocedural stroke, and issue of durability. These issues are even more relevant for low-risk, younger patients.
Gender Differences in Rheumatoid Arthritis: Interleukin-4 Plays an Important Role
Authors: Yu Chaojie , Liu Chong , Jiang Jie , Li Hao , Chen Jiarui , Chen Tianyou , Zhan Xinli
Published: December 2020

Introduction. Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by symmetrical peripheral polyarthritis. A large number of studies have shown that RA is characterized by gender differences in clinical manifestations. The purpose of this study is to identify the key molecules of gender differences in patients with RA and to provide new molecular targets for personalized therapy. Material and Methods. The data from GSE55457 were downloaded from the comprehensive gene expression comprehensive database, and two groups (RA vs. No-RA groups, Male-RA vs. Female-RA groups) of differentially expressed genes (EDGs) were obtained by GEO2R. The GO function and KEGG pathway analyses of DEGs were carried out through the plug-in ClueGO in Cytoscape. Based on the STRING online, a protein-protein interaction (PPI) network was constructed. Hub genes were selected from CytoHubba. Through the intersection of the top 10 hub genes in two sets of EDGs, the key genes and related KEGG pathways were found. Quantitative Real-Time PCR and Western blotting analysis were performed for verification. Results. 1230 DEGs were screened between RA and No-RA groups, and 306 DEGs were screened between male and female RA groups. The common key gene of the two groups is IL-4. Between RA group and No-RA group, interleukin-4 (IL-4) participates in cytokine-cytokine receptor interaction, Th1 and Th2 cell differentiation, Th17 cell differentiation, T cell receptor signaling pathway, etc. Conclusion. This study contributes to the molecular biological mechanism of gender differences in RA. IL-4 may have played an important role.
On the Derivation of Nonclassical Symmetries of the Black–Scholes Equation via an Equivalence Transformation
Authors: Sinkala Winter
Published: December 2020

The nonclassical symmetries method is a powerful extension of the classical symmetries method for finding exact solutions of differential equations. Through this method, one is able to arrive at new exact solutions of a given differential equation, i.e., solutions that are not obtainable directly as invariant solutions from classical symmetries of the equation. The challenge with the nonclassical symmetries method, however, is that governing equations for the admitted nonclassical symmetries are typically coupled and nonlinear and therefore difficult to solve. In instances where a given equation is related to a simpler one via an equivalent transformation, we propose that nonclassical symmetries of the given equation may be obtained by transforming nonclassical symmetries of the simpler equation using the equivalence transformation. This is what we illustrate in this paper. We construct four nontrivial nonclassical symmetries of the Black–Scholes equation by transforming nonclassical symmetries of the heat equation. For completeness, we also construct invariant solutions of the Black–Scholes equation associated with the determined nonclassical symmetries.