bluuebunny/crossref_metadata_2025 huggingface dataset:
Efinaconazole topical solution 10%: Formulation and efficacy assessment in the treatment of toenail onychomycosis
Authors: Naeimifar Atefeh , Samadi Aniseh , Ahmad Nasrollahi Saman , Fattahi Azam , Ghasemi Zeinab , Azizzadeh‐Roodpishi Shadi , Malakooti Shiva , Ehsani Amir Hooshang , Firooz Alireza , Dowlatiy Yahya
Published: February 2020

Background

Efinaconazole is non‐lacquer‐based with a low surface tension that efficiently targets delivery of active ingredient into the nail and nail bed.

Objectives

To develop an optimal, stable formulation of efinaconazole topical solution 10% (ETS10).

Methods

We evaluated the safety and efficacy of ETS10 on 10 Iranian participants in a pilot, single‐group and before‐after clinical study, for up to 8 weeks in onychomycosis.

Results

The study showed reasonable results concerning the short period of treatment. During the period of storage, the formulation showed no variation in colour, odour and pH. The average pH at initial, 1st, 6th and 12th months was 4.65, 4.64, 4.65 and 4.64, respectively. The assay of an active pharmaceutical ingredient in the formulation was desired over the whole period. This indicates that antimicrobial activity has been adequate and efficient. A significant decrease in Investigator Global Assessment (IGA) of the target toenails was also defined as the efficacy endpoint. The median score for IGA at baseline visit was 3 out of 5 which decreased to 2 out of 5 and the decrease was statistically significant.

Conclusion

The study clarifies the new efficacy of ETS10 in subjects with onychomycosis and passed the safety study successfully. These properties may develop the potentiality of ETS10 as a good treatment option for patients with onychomycosis.
Superficial mycoses in Belgium: Burden, costs and antifungal drugs consumption
Authors: Becker Pierre , Lecerf Pauline , Claereboudt Julie , Devleesschauwer Brecht , Packeu Ann , Hendrickx Marijke
Published: February 2020

Background

Monitoring of superficial mycoses requires more attention due to their important incidence, health costs and antifungal drugs consumption.

Objectives

The objectives were to estimate the burden of superficial mycoses in Belgium and to assess trends in associated antifungal consumption.

Methods

The burden of dermatophytoses (including onychomycosis), as well as skin and genital candidiasis, was estimated using disability‐adjusted life years (DALY). Moreover, trends in systemic and topical antifungal consumption in ambulatory care were examined for the period 2010‐2017, together with their associated costs.

Results

Due to their high incidence and long treatment duration, dermatophytoses represented the bulk of the burden, accounting for 92.2% of the total DALYs of superficial mycoses. Terbinafine was the most prescribed antifungal in terms of doses (35.4% of the total doses) while fluconazole was the most delivered drug in terms of packages (29.1% of the total packages). More than 70% of the prescriptions were made by general practitioners while consumption varied according to age and gender of the patients. A global 12% decrease in antifungal prescriptions was observed between 2011 and 2017. However, this reduction would result mainly from packaging changes and increased self‐medication. A significant decrease in itraconazole treatments was notably compensated by an increased prescription of fluconazole packages.

Conclusion

This study emphasises that dermatological presentations of superficial mycoses are the most important in terms of both burden and antifungal consumption in Belgium. Further reduction in antifungals use can be achieved by applying the adequate treatment after identification of the causative agent.
Successful weight loss maintenance: A systematic review of weight control registries
Authors: Paixão Catarina , Dias Carlos M. , Jorge Rui , Carraça Eliana V. , Yannakoulia Mary , de Zwaan Martina , Soini Sirpa , Hill James O. , Teixeira Pedro J. , Santos Inês
Published: February 2020

Weight loss maintenance is a major challenge for obesity treatment. Weight control registries can be useful in identifying psychological and behavioural factors that could contribute to better long‐term success. The objective of this study is to describe the existing weight control registries and their participants and identify correlates of weight loss maintenance. A comprehensive search of peer‐reviewed articles published until November 2018 was conducted in PubMed, Web of Science, and Scopus. Studies that reported results from weight control registries were considered. Fifty‐two articles, corresponding to five registries (the United States, Portugal, Germany, Finland, and Greece), were included. Registries differed in inclusion criteria and procedures. Of 51 identified weight loss and maintenance strategies, grouped in 14 domains of the Oxford Food and Activity Behaviors taxonomy, the following were the most frequently reported: having healthy foods available at home, regular breakfast intake, increasing vegetable consumption, decreasing sugary and fatty foods, limiting certain foods, and reducing fat in meals. Increased physical activity was the most consistent positive correlate of weight loss maintenance. To our knowledge, this is the first systematic review of information about successful weight loss maintenance obtained from weight control registries. Key common influential characteristics of success were identified, which can inform future prospective studies and weight management initiatives.
Zygomatic implant‐based rehabilitation for patients with maxillary and mid‐facial oncology defects: A review
Authors: Hackett Stephanie , El‐Wazani Basma , Butterworth Chris
Published: February 2020

Objectives

This literature review reports the current evidence for the use of zygomatic implants in head and neck oncology patients for the prosthetic rehabilitation of defects of the mid‐face and maxilla.

Methods

MEDLINE, Embase and Cochrane databases were searched using strict search terms. Two independent reviewers reviewed the articles and applied inclusion and exclusion criteria.

Results

Literature search revealed 437 articles, and following application of the inclusion criteria, 32 articles were included for analysis. Overall survival rates of 77%–100% were reported with few complications, although only four centres presented data on 20 or more patients. Primary implant placement at time of resective surgery has been shown to be an effective means of accelerating rehabilitation along with early loading protocols. The role of radiotherapy in implant failure has not been fully elucidated, and it is clear that zygomatic implants can be successfully used in the irradiated patient. Providing support for maxillary obturators was the most common use reported with both splinted and unsplinted implants.

Conclusions

Zygomatic implants provide remote anchorage for a variety of oral and facial prostheses that contribute to the improved function and quality of life for patients being treated for maxillary and mid‐facial tumours.
Reconstruction of a Distal Foot Skin Defect Using an Intermediate Dorsal Neurocutaneous Flap
Authors: Liu Siyi , Tan Jinhai , Tao Shengxiang , Duan Yong , Hu Xiang , Li Zonghuan
Published: February 2020

Objective

To present the use of an intermediate dorsal neurocutaneous flap for the reconstruction of defects on the distal foot.

Methods

From September 2016 to October 2018, five patients (mean age at operation 33.8 years; range, 7–70 years; female/male = 2/3) with skin defects on one of their feet caused by road‐traffic accidents, electrical injury, and syndactyly correction were retrospectively reviewed. The size of the defects ranged from 2.0 cm × 1.0 cm to 5.0 cm × 3.5 cm. All patients had undergone a reconstruction surgery using intermediate dorsal neurocutaneous flap. One patient underwent a syndactyly correction, and four patients first experienced aggressive debridement. The sizes of the flaps were between 5.0 cm × 2.0 cm and 6.0 cm × 4.0 cm. The function, appearance, and pain of the injured foot were assessed using the Chinese Manchester Foot Pain and Disability Index and visual analogue scale.

Results

These five patients were systematically followed up for a mean of 15.8 months (range, 12–20 months). The donor sites were closed primarily in two cases, and skin grafts were performed in three cases. All the flaps survived with a success rate of 100%; the wounds healed well, and the color matches were excellent. Partial superficial flap necrosis occurred in one of five flaps, which was treated by dressing change using a hypertonic saline gauze. No significant problems were found at the donor site in any patient immediately afterwards or at follow‐up. There were no problems in any patients associated with wearing shoes. Based on the Chinese Manchester Foot Pain and Disability Index, four patients were strongly satisfied and one was satisfied with the recovery of physical function; all the patients were strongly satisfied with the appearance of the injured foot; all five patients had an excellent score of pain intensity subscale. Except for one patient who reported mild pain, all the other patients reported no pain based on the visual analogue scale. Two typical cases are presented in this paper.

Conclusions

The intermediate dorsal neurocutaneous flap is an alternative and effective technique that can reliably cover minor‐ to medium‐sized defects on the distal foot, toes, and web spaces. This surgical method leads to satisfactory functional recovery with minimal donor site morbidity, and no major vessels need to be sacrificed. This procedure offers an advisable option for orthopaedic surgeons to treat defects on the distal foot.
Loneliness and social monitoring: A conceptual replication of Knowles et al.
Authors: Floyd Kory , Woo Nathan T.
Published: February 2020

Contrary to the claim that loneliness routinely impairs the decoding of social cues such as emotion displays, Knowles, Lucas, Baumeister, and Gardner (2015) proposed that lonely adults “choke under pressure,” experiencing impairments only when social monitoring is framed as diagnostic of general social skill. In four experiments, Knowles et al. showed that lonely individuals performed worse than nonlonely individuals at decoding social cues when the decoding task was framed as a test of social aptitude, but not when it was framed as a test of academic aptitude. The studies were small (N's ranging from 78 to 203), and all employed a convenience sample of mostly female undergraduate students, impairing both statistical power and external validity. In addition, the lack of a true control group precluded the studies from establishing whether loneliness inhibits social monitoring ability if no frame is offered. This study conceptually replicates the central hypothesis of Knowles et al. using a sample of adults that is substantially larger and more diverse demographically and geographically, and using a true control group in addition to the comparison group. Results revealed a significant main effect of loneliness on social monitoring ability but did not replicate the choking under pressure phenomenon.
Stability and Contingency in Federalism Preferences
Authors: Dinan John , Heckelman Jac C.
Published: February 2020

This article analyzes Americans’ preferences for making policy at the national versus the subnational level. Relying on a Pew Research Center survey question posed in multiple recent years, we investigate the extent to which partisanship and ideology are related to support for decentralization. As expected, Republicans and conservatives are more supportive of decentralization, whereas Democrats and liberals are less supportive. However, Republicans and Democrats respond asymmetrically to changes in party control of the federal government. Republicans’ support for decentralization is relatively unaffected by changes in party control, whereas Democrats’ support for decentralization increases when Republicans control the federal government. These results indicate that federalism‐based appeals in American politics tap into stable views about allocation of policy authority on the part of a subset of the electorate and in ways that can influence public officials’ support for decentralization.

Evidence for Practice

Republicans and conservatives in the electorate are generally more supportive of decentralization compared with independents and moderates, whereas Democrats and liberals are relatively less supportive.

Republicans’ views on decentralization are relatively unaffected by changes in party control of the presidency and Congress, but Democrats become more supportive of decentralization when Republicans control the federal government.

The greater stability of Republicans’ views on decentralization, in contrast with Democrats’ shifting views, indicates that Republican voters may be more likely than Democratic voters to hold their parties’ elected representatives accountable for deviating from conventional party positions on national versus subnational policy authority.
The interface of identity distress and psychological problems in students’ adjustment to University
Authors: Gfellner Barbara M. , Córdoba Ana I.
Published: February 2020

Identity distress, psychological symptoms, and adjustment to university (academic, social, and person‐emotional) were examined among students in Spain (N = 241; Mage = 19.0 (1.6), Md = 19; 84% female) and Canada (N = 531; Mage = 19.8 (2.2), Md = 19; 82% female). The expected positive relationships were found between these variables. Similarly, increased identity distress of Spanish students and greater maladjustment at university for those in Canada were associated with contextual differences in the respective environments. Psychological problems mediated the linkages between identity distress with academic, social, and person‐emotional functioning at university, respectively. Also, psychological problems and context/country were independent predictors of students’ identity distress. Findings underscore the importance of examining contextual factors that influence student adjustment to university in relation to identity development and mental health and they offer suggestions for further research and counseling services.
Suicidal Ideation in Patients Experiencing a First‐episode Psychosis: Findings From the 2‐Year Follow‐up of the “Parma Early Psychosis” Program
Authors: Pelizza Lorenzo , Pellegrini Clara , Quattrone Emanuela , Azzali Silvia , Landi Giulia , Pellegrini Pietro , Leuci Emanuela
Published: February 2020

Objective

Although suicide behavior is relevant in first‐episode psychosis (FEP), little is known about suicidal ideation and its longitudinal stability. The aim of this study was (1) to assess incidence rates of suicide attempts, completed suicide, and suicidal thinking in FEP individuals at baseline and over a 24‐month follow‐up period; (2) to explore any significant association of suicidal ideation with psychopathology at baseline; and (3) to monitor longitudinally suicidal thinking along the 2‐year follow‐up.

Methods

Participants (134 FEP patients, aged 13–54 years) were assessed with the Brief Psychiatric Rating Scale (BPRS) and the Positive and Negative Syndrome Scale (PANSS). A Kaplan–Meier survival analysis to calculate cumulative incidence rates of attempted and completed suicide was also performed.

Results

FEP patients showed a 31.3% percentage of suicidal ideation (i.e., BPRS item 4 cutoff score of ≥ 3) and a 2‐year cumulative incidence rate of attempted suicide of 11%. No completed suicide was found. In the FEP total sample, suicidal thinking was positively correlated with general psychopathology (especially depression) and negative symptoms.

Conclusions

Suicidal ideation is relevant in FEP patients, supporting a routine monitoring of suicide risk during the baseline assessment of adolescents and adults with early psychosis.
Investigating the impact of an urban community school effort on middle school STEM‐related student outcomes over time through propensity score matched methods
Authors: Sondergeld Toni A. , Provinzano Kathleen , Johnson Carla C.
Published: February 2020

This study investigates the impact of an urban community school reform initiative that focuses on an immigrant and refugee population in middle school. A 6th–8th grade cohort of students in the community school are followed over time and compared to a propensity score matched group on overall GPA, mathematics, and science academic outcomes and traditional college preparedness indicators. Further, a deeper dive into the intersection of gender and race/ethnicity was examined on all outcomes. Findings revealed that students in the urban community school demonstrated significantly more preparedness to enroll in college and move into a STEM field if they desired compared to the matched students. All gender/racial groups in the community school performed significantly higher than those in the matched group. Further, all gender/racial groups of students in the urban community school defied standard academic achievement drops common over time in middle school, and instead increase overall, math, and science grades from 6th to 8th grade.
A novel HLA‐DQA1 allele, DQA1*01:05:03, identified in a patient with suspected celiac disease
Authors: Mahmood Faiza , Saether Per C.
Published: February 2020

A novel HLA‐DQA1 allele, officially named DQA1*01:05:03 by the WHO Nomenclature Committee, was identified in a Norwegian patient with suspected celiac disease. The allele was sequenced by next‐generation sequencing and is identical to DQA1*01:05:01:01 with the exception of one synonymous nucleotide substitution in exon two.
Valoración económica de los servicios ecosistémicos más importantes que ofrece el humedal Tibanica (Bogotá, Colombia)
Authors: Cadena-Gaona Jenny Alejandra , Duque Yoscua Sergio Duván , Tovar Cortes Robinson Alfredo , Ballesteros Larrotta Tania Marcela
Published: February 2020

Los humedales son considerados ecosistemas estratégicos debido a los servicios ecosistémicos (SE) que ofrecen. El humedal Tibanica, que se encuentra ubicado en Bogotá (Colombia), ha experimentado constantes presiones antrópicas. Esta situación hace necesario que se mejore la toma de decisiones a través de instrumentos de gestión. Para contribuir a ello, en el presente estudio se evaluaron económicamente los SE más importantes del humedal. La identificación de los SE se realizó mediante una lista de chequeo, y la valoración económica por medio del método de transferencia de funciones. Se encontró que los SE más importantes son control de erosión, aprovisionamiento de agua y servir de hábitat para diferentes especies. El valor económico estimado de los SE es 111.557,14 USD/año.
Autonomia da gestante na escolha do tipo de parto
Authors: Silva Mônica Maria de Jesus , Silva Semara Caroline Brandão , Melo Gabriel Arruda
Published: February 2020

Introdução: Inúmeros fatores estão envolvidos na tomada de decisão da mulher pelo tipo de parto a ser escolhido. Quando se trata da mulher primigesta, as experiências prévias não se fazem presentes, porém, outros fatores podem então influenciá-la na escolha pelo modo de parir. Objetivo: identificar a preferência da gestante primigesta quanto à via de parto, conhecer os fatores que influenciam a sua tomada de decisão nessa escolha, e as suas expectativas em relação ao parto mediante a via escolhida. Método: estudo descritivo com abordagem quantitativa realizado com 35 primigestas em acompanhamento pré-natal nas unidades públicas de saúde em um município do Sul de Minas Gerais, Brasil. A coleta de dados ocorreu em agosto e setembro de 2015 e utilizou um formulário semiestruturado. Resultados: predominou a escolha pela via de parto vaginal, a presença de expectativas positivas em relação a via escolhida e a não influência de terceiros sobre a tomada de decisão. Conclusão: a decisão da mulher na escolha da via de parto está se transformando em uma preferência e não apenas em uma indicação profissional, o que ressalta a importância da educação em saúde na consulta pré-natal.
A Nonfield Analytical Method for Solving Energy Transport Equations
Authors: Kulish Vladimir
Published: February 2020

In 2000, Kulish and Lage proposed an elegant method, which allows one to obtain analytical (closed-form) solutions to various energy transport problems. The solutions thus obtained are in the form of the Volterra-type integral equations, which relate the local values of an intensive property (e.g., temperature, mass concentration, and velocity) and the corresponding energy flux (e.g., heat flux, mass flux, and shear stress). The method does not require one to solve for the entire domain, and hence, is a nonfield analytical method. Over the past 19 years, the method was shown to be extremely effective when applied to solving numerous energy transport problems. In spite of all these developments, no general theoretical justification of the method was proposed until now. The present work proposes a justification of the procedure behind the method and provides a generalized technique of splitting the differential operators in the energy transport equations.
Entropy Generation Minimization Analysis of Solar Salt, Sodium, and Lead–Bismuth Eutectic as High Temperature Heat Transfer Fluids
Authors: Flesch Jonathan , Marocco Luca , Fritsch Andreas , Niedermeier Klarissa , Wetzel Thomas
Published: February 2020

The amount of entropy generation in heat transfer devices impacts their operation economy and should therefore be minimized during the design phase. Entropy generation also depends on the individual thermophysical properties of the heat transfer fluid (HTF). An entropy generation minimization analysis of three different liquid coolants, namely, solar salt (SS), sodium, and lead-bismuth eutectic (LBE) is thus performed for fully turbulent flow in a circular tube under circumferentially uniform heat flux by considering a heat rate, inlet and outlet temperatures and heat flux densities typical of a concentrated solar tower plant. The Reynolds number is determined at which the proper combination of Nusselt number and friction factor minimizing the entropy generation, and consequently the exergy loss, is obtained as well as the best thermodynamically performing coolant fluid over the operating range of Reynolds numbers. Sodium can operate at 60% lower entropy generation than solar salt while providing a smaller wall-to-bulk temperature difference. Despite its high thermal conductivity, LBE performs similarly to solar salt. However, it can be advantageous compared to solar salt if operated at higher temperatures that cannot be achieved by the latter due its thermal stability limit.
Enhanced Tire Blowout Modeling Using Vertical Load Redistribution and Self-Alignment Torque
Authors: Li Ao , Chen Yan , Du Xinyu , Lin Wen-Chiao
Published: February 2020

Tire blowout impacts vehicle stability and creates challenges to vehicle control. To accurately evaluate the impact of tire blowout in different driving scenarios, a new tire blowout model is developed in this work with explicit considerations of the tire vertical load redistribution and self-alignment torque (SAT). A two-stage vertical force redistribution model is employed for the vertical load variations instead of the one-stage model in the literature. Moreover, the SAT is formulated, and the impact on the steering system is investigated. The developed tire blowout model is validated through both simulation and experiment using a scaled test vehicle. The results indicate that the proposed tire blowout model can evaluate the tire blowout impacts on vehicle dynamics more accurately, which will benefit the evaluation of tire blowout impact and the future development on model-based fault tolerant control.
Numerical Simulations of Two Back-To-Back Horizontal Axis Tidal Stream Turbines in Free-Surface Flows
Authors: Yan Jinhui , Deng Xiaowei , Xu Fei , Xu Songzhe , Zhu Qiming
Published: February 2020

We simulate two back-to-back full-scale tidal turbines using an in-house computational free-surface flow code. We briefly present the mathematical formulation of the computational framework. We first validate the proposed method on a single turbine configuration. A mesh refinement study is conducted to ensure the result is converged. We then quantify the wake effect and free-surface effect on tidal turbine performance by a case study. To investigate the free-surface effect, we perform both pure hydrodynamics and free-surface simulations. The time history of thrust and production coefficients is quantified. In both pure hydrodynamics and free-surface flow simulations, thrust and production coefficients of the downstream turbines drop significantly due to the velocity deficit in the wake. By comparing the result between free-surface flow and pure hydrodynamics simulations for the configuration considered here, we find that the free-surface does not affect the upstream turbine but significantly affects the downstream turbine.
Vapor phase passivation of (100) germanium surfaces with HBr
Authors: Molina Alex , Shallenberger Jeffrey R. , Mohney Suzanne E.
Published: February 2020

Hydrobromic acid (HBr) vapor was used to remove native oxide from an undoped (100) germanium (Ge) wafer with n-type conductivity and to passivate its surface against reoxidation. The Ge surfaces, examined by x-ray photoelectron spectroscopy, were suspended above a 48% HBr solution for 1, 10, 20, 60 min, and 24 h. A steady decrease in oxide thickness was observed for up to 60 min of HBr exposure time. Beyond this time, little or no difference was observed, and the wafers maintained subnanometer levels of oxidation. The stability of the passivated surface was then measured with each treated sample exposed to ambient air for 19 h. The samples exposed to HBr for 60 min or less reoxidized when exposed to air, while the sample previously exposed to HBr for 24 h showed levels of oxidation similar to the freshly passivated wafer, thereby demonstrating HBr vapor-phase treatment as a simple method for passivating Ge.
Probabilistic inversion for submerged source depth and strength from infrasound observations
Authors: Averbuch Gil , Waxler Roger M. , Smets Pieter S. M. , Evers Läslo G.
Published: February 2020

In seismology, the depth of a near-surface source is hard to estimate in the absence of local stations. The depth-yield trade-off leads to significant uncertainties in the source's depth and strength estimations. Long-range infrasound propagation from an underwater or underground source is very sensitive to variations in the source's depth and strength. This characteristic is employed in an infrasound based inversion for the submerged source parameters. First, a Bayesian inversion scheme is tested under the variations of the number of stations, the signal's frequency band, and the signal-to-noise ratio (SNR). Second, an ensemble of realistic perturbed atmospheric profiles is used to investigate the effect of atmospheric uncertainties on the inversion results. Results show that long-range infrasound signals can be used to estimate the depth and strength of an underwater source. Using a broadband signal proved to be a fundamental element to obtain the real source parameters, whereas the SNR was secondary. Multiple station inversions perform better than one-station inversions; however, variations in their position can lead to source strength estimations with uncertainties up to 50%. Regardless of the number of stations, their positions, and SNRs, all of the estimated depths were within 10% from the real source depth.
Invisible oil beyond the
Deepwater Horizon
satellite footprint
Authors: Berenshtein Igal , Paris Claire B. , Perlin Natalie , Alloy Matthew M. , Joye Samantha B. , Murawski Steve
Published: February 2020

A portion of the
Deepwater Horizon
oil spill extended beyond the satellite footprint and contained toxic oil concentrations.
A mutation-independent CRISPR-Cas9–mediated gene targeting approach to treat a murine model of ornithine transcarbamylase deficiency
Authors: Wang Lili , Yang Yang , Breton Camilo , Bell Peter , Li Mingyao , Zhang Jia , Che Yan , Saveliev Alexei , He Zhenning , White John , Latshaw Caitlin , Xu Chenyu , McMenamin Deirdre , Yu Hongwei , Morizono Hiroki , Batshaw Mark L. , Wilson James M.
Published: February 2020

AAV- and CRISPR-Cas9–mediated gene targeting in neonatal mice led to clinical benefits in a mouse model of OTC deficiency.
Dynamic interactions of the 5-HT
6
receptor with protein partners control dendritic tree morphogenesis
Authors: Pujol Camille N. , Dupuy Vincent , Séveno Martial , Runtz Leonie , Bockaert Joël , Marin Philippe , Chaumont-Dubel Séverine
Published: February 2020

Sequential interactions between a serotonin receptor and its interaction partners underlie neurite extension and branching.
A Novel Inhaled Dry-Powder Formulation of Ribavirin Allows for Efficient Lung Delivery in Healthy Participants and Those with Chronic Obstructive Pulmonary Disease in a Phase 1 Study
Authors: Dumont Etienne F. , Oliver Amanda J. , Ioannou Chris , Billiard Julia , Dennison Jeremy , van den Berg Frans , Yang Shuying , Chandrasekaran Vijayalakshmi , Young Graeme C. , Lahiry Anirban , Starbuck David C. , Harrell Andrew W. , Georgiou Alex , Hopchet Nathalie , Gillies Andy , Baker Stephen J.
Published: February 2020

Chronic obstructive pulmonary disease (COPD) is an inflammatory lung condition, causing progressive decline in lung function leading to premature death. Acute exacerbations in COPD patients are predominantly associated with respiratory viruses. Ribavirin is a generic broad-spectrum antiviral agent that could be used for treatment of viral respiratory infections in COPD. Using the Particle Replication In Nonwetting Templates (PRINT) technology, which produces dry-powder particles of uniform shape and size, two new inhaled formulations of ribavirin (ribavirin-PRINT-CFI and ribavirin-PRINT-IP) were developed for efficient delivery to the lung and to minimize bystander exposure.
In Vitro
Activity of KBP-7072, a Novel Third-Generation Tetracycline, against 531 Recent Geographically Diverse and Molecularly Characterized Acinetobacter baumannii Species Complex Isolates
Authors: Huband Michael D. , Mendes Rodrigo E. , Pfaller Michael A. , Lindley Jill M. , Strand Gregory J. , Benn Vincent J. , Zhang Jay , Li Li , Zhang Min , Tan Xiaojuan , Liu Qingmei , Flamm Robert K.
Published: February 2020

KBP-7072 is a novel third-generation tetracycline (aminomethylcycline) antibacterial that overcomes common efflux and ribosomal protection resistance mechanisms that cause resistance in older-generation tetracyclines. KBP-7072 completed phase 1 clinical development studies for safety, tolerability, and pharmacokinetics (ClinicalTrials.gov identifier NCT02454361) and multiple ascending doses in healthy subjects (ClinicalTrials.gov identifier NCT02654626) in December 2015. Both oral and intravenous formulations of KBP-7072 are being developed.
Draft Genome Sequences of Three Francisella tularensis subsp.
mediasiatica
Strains Isolated in the Altai Territory, Russian Federation
Authors: Mokrievich Alexander N. , Kislichkina Angelina A. , Kudryavtseva Tamara Y. , Mironova Raisa I. , Vakhrameeva Galina M. , Shishkova Nina A. , Timofeev Vitalii S. , Bogun Alexandr G. , Pavlov Vitaliy M. , Dyatlov Ivan A.
Published: February 2020

We report the draft genome sequences of three
Francisella tularensis
subsp.
mediasiatica
strains isolated in the Altai Territory, Russian Federation.
Complete Coding Sequence of a Swine Influenza A Variant (H3N2) Virus Isolated in the Republic of Korea in 2017
Authors: Noh Ji Yeong , Lo Van Thi , Kim Young Ji , Yoon Sun-Woo , Jeong Dae Gwin , Na Woonsung , Song Daesub , Kim Hye Kwon
Published: February 2020

Cases of human infection with a swine influenza A virus variant have been reported in the United States, and since 2011, H3N2 variant viruses have also been regularly isolated from swine in the Republic of Korea. Here, we genetically characterized an influenza A H3N2 isolate (A/swine/P17-4/2017). BLASTN analysis of the 8 gene sequences revealed a high degree of nucleotide similarity (97.0 to 99.0%) to porcine strains circulating in the Republic of Korea and the United States. Specifically, we found a high degree of similarity in the nucleotide matrix gene to those of recent isolates from North Carolina.
Draft Genome Sequence of Phenol-Degrading Variovorax boronicumulans Strain HAB-30
Authors: Aziz Fatma Azwani Abdul , Suzuki Kenshi , Moriuchi Ryota , Dohra Hideo , Tashiro Yosuke , Futamata Hiroyuki
Published: February 2020

We report the draft genome sequence of
Variovorax boronicumulans
strain HAB-30, which was isolated from a phenol-degrading chemostat culture. This strain contains genes encoding a multicomponent type of phenol hydroxylase, with degradation pathways for catechol and other aromatic compounds. The genome sequence will be useful for understanding the metabolic pathways involved in phenol degradation.
Complete Genome Sequence of Akkermansia muciniphila JCM 30893, Isolated from Feces of a Healthy Japanese Male
Authors: Ogata Yusuke , Sakamoto Mitsuo , Ohkuma Moriya , Hattori Masahira , Suda Wataru
Published: February 2020

Akkermansia muciniphila
is an anaerobic and mucin-degrading bacterium in the human gut. Here, we report the complete genome sequence of
Akkermansia muciniphila
JCM 30893 harboring the plasmid pJ30893.
Vulvar tuberculosis
Authors: Singh Vishwajeet , Singh Gyanendra , Sinha Rahul Janak , Babu Suresh
Published: February 2020

Genital tuberculosis (TB) in women is a chronic disease with low-grade symptoms. Genital tract tuberculosis is usually secondary to extragenital TB. The fallopian tubes are most commonly affected, and along with endometrial involvement, it causes infertility in such patients. Involvement of the cervix and the vulva is very rare. We present one such rare case of vulvar tuberculosis presented with a large ulcer diagnosed on histopathology and treated with antitubercular chemotherapy.
Congenital blindness and autism spectrum disorder (ASD): diagnostic challenges and intervention options
Authors: Suhumaran Sharline , Yeleswarapu Sita Padmini , Daniel Lourdes Mary , Wong Chui Mae
Published: February 2020

The case of a 6-year-old boy with congenital blindness and features suggestive of autism spectrum disorder (ASD) is reported. He presented to a developmental paediatrician with global developmental delay, worsening self-injurious behaviours and difficulties in social interaction, transitions and interactive play. He demonstrated poor response to his name, rigidity, repetitive behaviours and had a sensory profile suggestive of ASD. This paper discusses the challenges in diagnosing and managing ASD in visually impaired children.
Effect of partial posterior vitreous detachment on spectral-domain optical coherence tomography retinal nerve fibre layer thickness measurements
Authors: Liu Yao , Baniasadi Neda , Ratanawongphaibul Kitiya , Chen Teresa C
Published: February 2020

Background/aims

To assess the effect of partial posterior vitreous detachment (pPVD) on spectral-domain optical coherence tomography (OCT) peripapillary retinal nerve fibre layer thickness (RNFL) measurements.

Methods

Spectral-domain OCT RNFL thickness measurements were obtained from 684 consecutive patients who were seen in the Massachusetts Eye and Ear Glaucoma Service. Of these patients, we compared RNFL thickness measurements between 101 eyes of 101 glaucoma suspects who met inclusion criteria (55 eyes with and 46 eyes without pPVD).

Results

Among all 684 patients, 253 (37%) had pPVD in at least one eye. Among a subset of 101 eyes of 101 glaucoma suspects, average RNFL thickness was greater in eyes with compared to eyes without pPVD (p=0.02). Measurements were significantly greater in the inferior (p=0.004) and superior quadrants (p=0.008), but not in the nasal (p=0.10) and temporal quadrants (p=0.25). The difference in average RNFL thickness remained significant (p=0.05) even when corrected for expected age-related decline in RNFL thickness.

Conclusion

Over a third of patients were found on peripapillary spectral-domain OCT to have a pPVD, which was associated with greater RNFL thickness measurements. Judicious clinical interpretation of this finding on spectral-domain OCT RNFL thickness scans should be factored into the assessment of glaucoma suspects.
Three-year follow-up of accelerated transepithelial corneal cross-linking for progressive paediatric keratoconus
Authors: Tian Mi , Jian Weijun , Zhang Xiaoyu , Sun Ling , Zhou Xingtao
Published: February 2020

Purpose

To investigate the long-term safety and efficacy of accelerated transepithelial corneal cross-linking (ATE-CXL) in children with progressive keratoconus.

Methods

Fifty-three eyes of 41 paediatric patients (34 boys, 7 girls; mean age 14.81±1.96 years) undergoing ATE-CXL were enrolled in the study. Corrected distance visual acuity (CDVA) and manifest refraction were assessed preoperatively and 36 months postoperatively. Corneal keratometry, corneal thickness and posterior elevation were measured using Pentacam preoperatively and 1, 6, 12 and 36 months postoperatively. Pachymetry and epithelial thicknesses were measured using optical coherence tomography preoperatively and 6, 12, and 36 months postoperatively.

Results

Thirty-six months postoperatively, CDVA improved from 0.32±0.28 to 0.26±0.25 in logarithm of the minimum angle resolution (p=0.025). Maximum keratometry was 58.73±9.70 D preoperatively and 59.20±10.24, 58.28±9.33, 57.88±9.99 and 58.98±10.79 D at 1, 6, 12 and 36 months postoperatively throughout the 36-month follow-up period (p>0.05). Similarly, corneal central thickness, which was 492.42±33.83 µm postoperatively, also remained stable during the 36-month follow-up (p>0.05). Both posterior central elevation and posterior highest elevation were stable at 12 months after ATE-CXL (p>0.05), but increased at 36 months postprocedure (p<0.05). Corneal pachymetry and epithelial thicknesses remained stable throughout the follow-up period (p>0.05).

Conclusions

ATE-CXL is a safe and effective treatment in paediatric progressive keratoconus patients, leading to stable keratometry and corneal thickness throughout the 36-month follow-up.
Three-year follow-up of choroidal neovascularisation in eyes of chronic central serous chorioretinopathy
Authors: Chen Yen-Chih , Chen San-Ni
Published: February 2020

Aims

This study aimed to report the 3-year follow-up results of the clinical course and structural changes of choroidal neovascularisation (CNV) by optical coherence tomography angiography (OCT-A) in eyes with a history of chronic central serous chorioretinopathy (CSC).

Methods

This is a retrospective study of patients with chronic CSC complicated with CNV. Patients were recorded of best-corrected visual acuity (BCVA) and treatment modalities. OCT was used to evaluate the presence of subretinal fluid (SRF), type of CNV, changes in central retinal thickness (CRT) and subfoveal choroidal thickness (SFCT). Changes in the size, vessel density (VD) and morphology of CNV were evaluated by OCT-A. Comparison between baseline and final parameters was made.

Results

A total of 30 eyes in 26 patients, most of whom had previous treatment for chronic CSC, were included with a mean follow-up period of 40.37±4.11 months. No changes in BCVA were noted (p=0.562). During the 3-year follow-up period with OCT-A, five eyes had SRF noted. The other 25 eyes remained SRF free throughout the course. Regarding the morphological changes, the size of CNV enlarged significantly (p<0.01); VD of CNV decreased significantly (p=0.01); and the number of CNV with visible core vessel significantly increased (p<0.01). A significant reduced SFCT was noted (p=0.02), while the CRT remained unchanged (p=0.855).

Conclusion

For most eyes infected with chronic CSC receiving previous treatment for the activity of chronic CSC, with CNV subsequently found on OCT-A, a midterm stable clinical course up to 3 years was noted, despite significant structural changes of CNV evaluated by OCT-A.
The quality of malaria care in 25 low-income and middle-income countries
Authors: Macarayan Erlyn , Papanicolas Irene , Jha Ashish
Published: February 2020

Introduction

Even with accessible and effective diagnostic tests and treatment, malaria remains a leading cause of death among children under five. Malaria case management requires prompt diagnosis and correct treatment but the degree to which this happens in low-income and middle-income countries (LMICs) remains largely unknown.

Methods

Cross-sectional study of 132 566 children under five, of which 25% reported fever in the last 2 weeks from 2006 to 2017 using the latest Malaria Indicators Survey data across 25 malaria-endemic countries. We calculated the per cent of patient encounters of febrile children under five that received poor quality of care (no blood testing, less or more than two antimalarial drugs and delayed treatment provision) across each treatment cascade and region.

Results

Across the study countries, 48 316 (58%) of patient encounters of febrile children under five received poor quality of care for suspected malaria. When comparing by treatment cascade, 62% of cases were not blood tested despite reporting fever in the last 2 weeks, 82% did not receive any antimalarial drug, 17% received one drug and 72% received treatment more than 24 hours after onset of fever. Of the four countries where we had more detailed malaria testing data, we found that 35% of patients were incorrectly managed (26% were undertreated, while 9% were overtreated). Poor malaria care quality varies widely within and between countries.

Conclusion

Quality of malaria care remains poor and varies widely in endemic LMICs. Treatments are often prescribed regardless of malaria test results, suggesting that presumptive diagnosis is still commonly practiced among cases of suspected malaria, rather than the WHO recommendation of ‘test and treat’. To reach the 2030 global malaria goal of reducing mortality rates by at least 90%, focussing on improving the quality of malaria care is needed.
Non-urgent visits to emergency departments: a qualitative study in Iran exploring causes, consequences and solutions
Authors: Bahadori Mohammadkarim , Mousavi Seyyed Meysam , Teymourzadeh Ehsan , Ravangard Ramin
Published: February 2020

Objective

To explore the causes and consequences of non-urgent visits to emergency departments in Iran and then suggest solutions from the healthcare providers’ viewpoint.

Design

Qualitative descriptive study with in-depth, open-ended, and semistructured interviews, which were inductively analysed using qualitative content analysis.

Setting

A territorial, educational and military hospital in Iran.

Participants

Eleven healthcare providers including eight nurses, two emergency medicine specialists and one emergency medicine resident.

Results

Three overarching themes of causes and consequences of non-urgent visits to the emergency department in addition to four suggested solutions were identified. The causes have encompassed the specialised services in emergency department, demand-side factors, and supply-side factors. The consequences have been categorised into three overarching themes including the negative consequences on patients, healthcare providers and emergency departments as well as the health system in general. The possible solutions for limiting and controlling non-urgent visits also involved regulatory plans, awareness-raising plans, reforms in payment mechanisms, and organisational arrangements.

Conclusion

We highlighted the need for special attention to the appropriate use of emergency departments in Iran as a middle-income country. According to the complex nature of emergency departments and in order to control and prevent non-urgent visits, it can be suggested that policy-makers should design and implement a combination of the possible solutions.
Cost-effectiveness analysis of cetuximab combined with chemotherapy as a first-line treatment for patients with RAS wild-type metastatic colorectal cancer based on the TAILOR trial
Authors: Wang Huijuan , Huang Lingfei , Gao Peng , Zhu Zhengyi , Ye Weifeng , Ding Haiying , Fang Luo
Published: February 2020

Objectives

Cetuximab plus leucovorin, fluorouracil and oxaliplatin (FOLFOX-4) is superior to FOLFOX-4 alone as a first-line treatment for patients with metastatic colorectal cancer with RAS wild-type (RAS wt mCRC), with significantly improved survival benefit by TAILOR, an open-label, randomised, multicentre, phase III trial. Nevertheless, the cost-effectiveness of these two regimens remains uncertain. The following study aims to determine whether cetuximab combined with FOLFOX-4 is a cost-effective regimen for patients with specific RAS wt mCRC in China.

Design

A cost-effectiveness model combined decision tree and Markov model was built to simulate pateints with RAS wt mCRC based on health states of dead, progressive and stable. The health outcomes from the TAILOR trial and utilities from published data were used respectively. Costs were calculated with reference to the Chinese societal perspective. The robustness of the results was evaluated by univariate and probabilistic sensitivity analyses.

Participants

The included patients were newly diagnosed Chinese patients with fully RAS wt mCRC.

Interventions

First-line treatment with either cetuximab plus FOLFOX-4 or FOLFOX-4.

Main outcome measures

The primary outcomes are costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs).

Results

Baseline analysis disclosed that the QALYs was increased by 0.383 caused by additional cetuximab, while an increase of US$62 947 was observed in relation to FOLFOX-4 chemotherapy. The ICER was US$164 044 per QALY, which exceeded the willingness-to-pay threshold of US$28 106 per QALY.

Conclusions

Despite the survival benefit, cetuximab combined with FOLFOX-4 is not a cost-effective treatment for the first-line regime of patients with RAS wt mCRC in China.

Trial registration number

TAILOR trial (NCT01228734); Post-results.
Increasing emergency hospital activity in Denmark, 2005–2016: a nationwide descriptive study
Authors: Fløjstrup Marianne , Bogh Soren Bie , Henriksen Daniel Pilsgaard , Bech Mickael , Johnsen Søren Paaske , Brabrand Mikkel
Published: February 2020

Objectives

To describe changes in unplanned acute activity and to identify and characterise unplanned contacts in hospitals in Denmark from 2005 to 2016, including following healthcare reform.

Design

Descriptive study.

Setting

Data from Danish nationwide registers.

Population

Adults (≥18 years).

Participants

All adults with an unplanned acute hospital contacts (acute inpatient admissions and emergency care visits) in Denmark from 2005 to 2016.

Primary and secondary outcome measures

Outcomes were annual number of contacts, length of stay, number of contacts per 1000 citizen per year, age-adjusted contacts per 1000 citizens per year, sex, age groups, country of origin, Charlson Comorbidity Index score, discharge diagnosis and time of arrival.

Results

We included a total of 13 524 680 contacts. The annual number of acute hospital contacts increased from 1 067 390 in 2005 to 1 221 601 in 2016. The number also increased with adjustment for age per 1000 citizens. In addition, regional differences were observed.

Conclusions

Unplanned acute activity changed from 2005 to 2016. The national number of contacts increased, primarily because of changes in one of the five regions.