bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of distant metastasis and prognostic prediction of recurrent salivary gland carcinomas using 18F‐FDG PET/CT
Authors: Lee Sang Hun , Roh Jong‐Lyel , Kim Jae Seung , Lee Jeong Hyun , Choi Seung‐Ho , Nam Soon Yuhl , Kim Sang Yoon
Published: April 2018

Objective

To compare the diagnostic accuracy of 18F‐FDG PET/CT and conventional contrast‐enhanced CT for the re‐staging of recurrent salivary gland carcinoma (SGC).

Materials and Methods

This study included 58 consecutive patients who underwent recurrent SGCs after definitive treatment. The recurrences were evaluated by 18F‐FDG PET/CT and contrast‐enhanced CT of the neck and chest. McNemar's test was used to compare the diagnostic accuracy of 18F‐FDG PET/CT with standard neck and chest CT imaging, and a Cox proportional hazards model was used to assess the prognostic value of PET/CT.

Results

Of 58 patients with recurrent SGCs, 17 (29%) had a local recurrence, 17 (29%) had a regional recurrence, and 38 (66%) had a distant metastasis, with these classifications showing overlap. The sensitivity and accuracy of 18F‐FDG PET/CT for the detection of distant metastases were significantly higher than those of CT (p < 0.05), whereas, for detection of loco‐regional recurrences, they did not differ (p > 0.1). The 18F‐FDG PET/CT‐positive findings at distant sites were predictors of poor progression‐free and overall survival outcome (all p < 0.05).

Conclusions

18F‐FDG PET/CT is a more effective method than CT for detecting distant site recurrences of SGC. This may lead to prognostic prediction for recurrent SGCs.
HLA‐B*40:55, an HLA‐B*40 variant, identified in Taiwanese individuals
Authors: Yang K. L. , Lin P. Y.
Published: April 2018

One nucleotide substitution at codon 248 of HLA‐B*40:01:01 results in a new allele, HLA‐B*40:55.
Metabolomics evaluation of early‐storage red blood cell rejuvenation at 4°C and 37°C
Authors: Gehrke Sarah , Srinivasan Amudan J. , Culp‐Hill Rachel , Reisz Julie A. , Ansari Andrea , Gray Alan , Landrigan Matthew , Welsby Ian , D'Alessandro Angelo
Published: April 2018

BACKGROUND

Refrigerated red blood cell (RBC) storage results in the progressive accumulation of biochemical and morphological alterations collectively referred to as the storage lesion. Storage‐induced metabolic alterations can be in part reversed by rejuvenation practices. However, rejuvenation requires an incubation step of RBCs for 1 hour at 37°C, limiting the practicality of providing “on‐demand,” rejuvenated RBCs. We tested the hypothesis that the addition of rejuvenation solution early in storage as an adjunct additive solution would prevent—in a time window consistent with the average age of units transfused to sickle cell recipients at Duke (15 days)—many of the adverse biochemical changes that can be reversed via standard rejuvenation, while obviating the incubation step.

STUDY DESIGN AND METHODS

Metabolomics analyses were performed on cells and supernatants from AS‐1 RBC units (n = 4), stored for 15 days. Units were split into pediatric bag aliquots and stored at 4°C. These were untreated controls, washed with or without rejuvenation, performed under either standard (37°C) or cold (4°C) conditions.

RESULTS

All three treatments removed most metabolic storage by‐products from RBC supernatants. However, only standard and cold rejuvenation provided significant metabolic benefits as judged by the reactivation of glycolysis and regeneration of adenosine triphosphate and 2,3‐diphosphoglycerate. Improvements in energy metabolism also translated into increased capacity to restore the total glutathione pool and regenerate oxidized vitamin C in its reduced (ascorbate) form.

CONCLUSION

Cold and standard rejuvenation of 15‐day‐old RBCs primes energy and redox metabolism of stored RBCs, while providing a logistic advantage for routine blood bank processing workflows.
Evaluation of the placement and maintenance of central venous jugular catheters in critically ill dogs and cats
Authors: Reminga Christin L. , Silverstein Deborah C. , Drobatz Kenneth J. , Clarke Dana L.
Published: April 2018

Objective

To describe problems noted during central venous jugular catheter (CVJC) placement, conditions associated with unsuccessful catheterization, and CVJC maintenance complications.

Design

Prospective observational study from September 2014 to September 2015.

Setting

University veterinary teaching hospital.

Animals

Twenty‐seven dogs and 20 cats hospitalized in a veterinary ICU. Patients were excluded if previously hospitalized with a CVJC or lacked sufficient data.

Interventions

None.

Measurements and Main Results

Ninety‐one percent of indwelling CVJCs were placed successfully (43/47, 95% CI: 80%, 98%). Procedural‐related difficulties that resulted in the inability to place a CVJC totaled 18/63 (28.6%, 95% CI: 18%, 41%) and included the inability to puncture the vessel (10), hematoma (6), malposition (1), and dislodgement (1). Procedural complications occurred in 24/47 patients (51%, 95% CI: 36%, 66%) and included cardiac dysrhythmias (13), hematoma (6), CVJC placement failure (4), and malposition (1). Risk factors associated with multiple catheterization attempts included increased age (7.5 years [± 4.2] vs 10.6 years [± 4.1], P = 0.04), smaller size (8.0 kg [0.6–51.9 kg] vs 4.4 kg [2.6–6.8 kg], P < 0.01) and thinner body condition score (median 5/9 [2/9–9/9] vs 4/9 [2/9–7/9], P = 0.04). The risk factor associated with dysrhythmias was smaller patient size (6.8 kg [2.6–51.9 kg] vs 4.8 kg [0.6–29.5 kg], P = 0.04). Eighteen indwelling complications occurred in 14 patients and included mechanical obstruction (7), skin irritation (6), malposition (4), and inflammation (1). Risk factors for indwelling complications included longer dwell time (5 days [2–30] vs 3 days [1–10], P < 0.01) and the administration of an irritant medication (P = 0.02).

Conclusions

Complications were documented in the placement and maintenance of CVJCs in critically ill patients with a low incidence of life‐threatening sequelae. Risk factors associated with both unsuccessful CVJC placement and indwelling CVJC complications were identified.
Jewish, Christian and Muslim theological perspectives about xenotransplantation
Authors: Paris Wayne , Seidler Rabbi Jerry H. , FitzGerald Kevin , Padela Aasim I. , Cozzi Emanuele , Cooper David K. C.
Published: April 2018

Background

This paper is based on a theological symposium presented at the International Xenotransplantation Association's 14th Congress held in Baltimore, MD, September, 2017.

Methods

The information explores the Jewish, Christian and Muslim theological perceptions and perspectives about cross‐species (ie pig‐to‐human) organ transplantation, the genetic alterations required in the organ‐source pig, and their potential to influence individual acceptance of the procedure.

Results/Conclusions

This work should not be considered as the ultimate word about individual theological views, but rather as part of an ongoing conversation that will hopefully lead to wider consideration and exploration of these issues as xenotransplantation science advances towards clinical trials.
Dissemination of Clostridium difficile spores between environment and households: Dog paws and shoes
Authors: Janezic Sandra , Mlakar Sabina , Rupnik Maja
Published: April 2018

Clostridium difficile is an anaerobic, spore‐forming bacterium that causes intestinal infections. Although C. difficile is still predominantly considered as a nosocomial pathogen, there has been an increase in the number of community‐associated infections. Since C. difficile is ubiquitous and can be isolated from nearly any environment, one of the possibilities for community acquisition could be exposure to spores in the domestic environment. The aim of this study was to evaluate the presence of C. difficile spores on shoes, slippers and on dog paws and to explore the importance of these surfaces as vectors for the dissemination of C. difficile in a domestic environment. Overall, C. difficile was present in 14 (70%) of 20 households and in 31 of 90 (34%) collected samples. Shoes and slippers had the highest positivity rates, 19 of 44 (43%) and 6 of 21 (28%), respectively, followed by dog paws 6 of 25 (24%). Thirteen C. difficilePCR ribotypes were identified with half of the isolates belonging to ribotype 014/020, which is the predominant type circulating in human population and is also commonly found in the environment (e.g. soil and water) in Slovenia. In three households, identical PCR ribotypes were found on dog paws, shoes and slippers. To understand the fine‐scale genetic relatedness of these isolates, we sequenced the genomes. Low level of single nucleotide variant (SNV) differences between isolates from the same households, consistent with a recent transmission from a common source, were seen for isolates of PCR ribotype 014/020 but not for PCR ribotype 010. Our results suggest that shoe soles and dog paws could serve for the dissemination of C. difficile spores between households and environment and could contribute to community‐relevant sources for C. difficile infection in humans.
Power Output and Pacing During International Cross-Country Mountain Bike Cycling
Authors: Granier Cyril , Abbiss Chris R. , Aubry Anaël , Vauchez Yvon , Dorel Sylvain , Hausswirth Christophe , Le Meur Yann
Published: April 2018

Purpose: To characterize the physiological profiles of elite cross-country mountain-bike (XCO-MTB) cyclists and to examine their pacing and power-output (PO) distribution during international races. Methods: Over 2 competitive seasons, 8 male XCO-MTB cyclists (VO2max 79.9 [5.2] mL·min−1·kg−1, maximal aerobic power [MAP] 411 [18] W and 6.3 [0.4] W·kg−1) regularly undertook incremental tests to assess their PO and heart rate (HR) at first and second ventilatory thresholds (VT1 and VT2) and at VO2max. During the same period, their PO, HR, speed, and cadence were recorded over 13 international races (total of 30 recorded files). Results: Mean PO, speed, cadence, and HR during the races were 283 (22) W (4.31 [0.32] W·kg−1, 68% [5%] MAP), 19.7 (2.1) km·h−1, 68 (8) rpm, and 172 (11) beats·min−1 (91% [2%] HRmax), respectively. The average times spent below 10% of MAP, between 10% of MAP and VT1, between VT1 and VT2, between VT2 and MAP, and above MAP were 25% (5%), 21% (4%), 13% (3%), 16% (3%), and 26% (5%), respectively. Both speed and PO decreased from the start loop to lap 1 before stabilizing until the end of the race.Conclusions: Elite off-road cyclists demonstrated typical values of world-class endurance cyclists with an excellent power-to-mass ratio. This study demonstrated that XCO-MTB races are performed at higher intensities than reported in previous research and are characterized by a fast start followed by an even pace.
Impact of Accommodating Resistance in Potentiating Horizontal-Jump Performance in Professional Rugby League Players
Authors: Strokosch Alasdair , Louit Loic , Seitz Laurent , Clarke Richard , Hughes Jonathan D.
Published: April 2018

This study investigated the efficacy of deadlifts and box squats, with a combination of traditional and accommodating resistance, as a postactivation potentiating stimulus of standing broad jumps (SBJ) in a multiple-set contrast protocol. Twelve professional rugby league players (21.4 [2.5] y; 181.3 [8.3] cm, 91.9 [8.8] kg; 1-repetition-maximum [1RM] back squat/body mass 1.59 [0.21]; 1RM deadlift/body mass 2.11 [0.25]; ≥3-y resistance-training experience) performed baseline SBJ before a contrast postactivation potentiating protocol involving 2 repetitions of 85% 1RM box squat or deadlifts, loaded with a combination of traditional barbell weight (70% 1RM) and elastic-band resistance (∼15% 1RM), followed by 2 SBJs. Exercises were separated by 90 s, and 4 contrast pairs were performed in total. Using a repeated-measures design, all subjects performed the squat followed by the deadlift and finally the control (SBJ only) condition in the same order across consecutive weeks. Changes from baseline in SBJ distance were moderate for the box squat (effect size [ES] = 0.64–1.03) and deadlift (ES = 0.80–0.96) and trivial in the control condition (ES = 0.02–0.11). The magnitude of differences in postactivation potentiating effect were considered moderate (d = 0.61) for set 1, trivial for set 2 (d = 0.10) and set 3 (d = 0.05) in favor of box squats, and moderate for set 4 (d = 0.58) in favor of deadlifts. Accommodating resistance in either box squats or deadlifts is an effective means of potentiating SBJ performance across multiple sets of a contrast protocol with only 90-s rest.
Researching Eating Disorders and Body Image in Sport: Challenges and Recommendations
Authors: Voelker Dana K. , Reel Justine J.
Published: April 2018

The number of studies examining eating disorders and body image in sport has increased, although several major challenges associated with conducting this research must be addressed to continue growth. In this paper, we describe these challenges based on our professional experiences and the academic literature. Mistrust of researchers and the area of study, communication gaps, and factors that affect data quality are among the strong barriers discussed. However, we suggest that these challenges may be addressed by building stronger partnerships between researchers and practitioners and offer critical steps for developing meaningful professional relationships that will help move the field forward.
Body Dissatisfaction in Collegiate Athletes: Differences Between Sex, Sport Type, and Division Level
Authors: Perelman Hayley , Buscemi Joanna , Dougherty Elizabeth , Haedt-Matt Alissa
Published: April 2018

Body dissatisfaction is associated with marked distress and often precipitates disordered eating symptomology. Literature on body dissatisfaction in athletes appears to be mixed, perhaps because athletes vary along several key characteristics related to how they experience their bodies. This study sought to investigate group differences in body dissatisfaction between sex (men vs. women), sport type (lean-promoting vs. non-lean-promoting), and division level (Division I vs. Division III). Collegiate athletes (N = 191) completed a self-report measure of body dissatisfaction, demographics, and sport characteristics. A factorial ANOVA revealed that women reported greater body dissatisfaction compared to men regardless of division level and sport type. There was an interaction between sex and sport type such that men in lean-promoting sports reported greater body dissatisfaction than men in non-lean-promoting sports. Findings suggest that some athletes participating in lean-promoting sports may be at risk of developing significant body dissatisfaction. Research on body dissatisfaction in collegiate athletes can be used to develop clinical interventions that aim to reduce body dissatisfaction and the potential of developing disordered eating and related psychopathology.
New connections: Ewing’s sarcoma’s driver is its Achilles’ heel
Authors: Ferrarelli Leslie K.
Published: April 2018

Several studies identify drug combinations that target or exploit the EWS-FLI1 fusion protein to kill Ewing’s sarcoma cells.
Identification of Novel Mutations in LprG (
rv1411c
),
rv0521
,
rv3630
,
rv0010c
,
ppsC
, and
cyp128
Associated with Pyrazinoic Acid/Pyrazinamide Resistance in Mycobacterium tuberculosis
Authors: Shi Wanliang , Chen Jiazhen , Zhang Shuo , Zhang Wenhong , Zhang Ying
Published: April 2018

Despite progress, the mechanisms of action and resistance of pyrazinamide (PZA) are not well understood. We characterized 109 mutants resistant to pyrazinoic acid (POA), the active form of PZA, and found that while most (
n
= 101 [93%]) mutants had
panD
mutations and 4 (4%) had
clpC1
mutations (S91G), new mutations in
lprG
(
rv1411c
) and
rv0521
(
n
= 4 [4%]),
rv3630
,
rv0010c
,
ppsC
, and
cyp128
(cytochrome P450 128) were identified, shedding new light on the mechanisms of action and resistance of PZA in
M. tuberculosis
.
TCRβ Combinatorial Immunoreceptor Expression by Neutrophils Correlates with Parasite Burden and Enhanced Phagocytosis during a Plasmodium berghei ANKA Malaria Infection
Authors: Chorazeczewski Joanna K. , Aleshnick Maya , Majam Victoria , Okoth Winter A. , Kurapova Regina , Akue Adovi , Kukuruga Mark , Kumar Sanjai , Oakley Miranda S.
Published: April 2018

Recent studies have demonstrated that a subpopulation of neutrophils express the TCRαβ combinatorial immunoreceptor in humans and mice. Here, we report that aPlasmodium bergheiANKA murine malaria infection induces expansion of TCRβ expressing CD11b+Ly6G+neutrophils in the spleen during the early phase of infection. Measurement of TCRβ transcript and protein levels of neutrophils in wild-type versus nude andRag1knockout mice establishes that the observed expression is not a consequence of nonspecific antibody staining or passive receptor expression due to phagocytosis or trogocytosis of peripheral T cells. Remarkably, on day 3 postinfection, we observed a highly significant correlation between the proportion of neutrophils that express TCRβ and peripheral blood parasite burden. In addition, TCRβ+neutrophils phagocytose parasitized erythrocytes with 4-fold greater efficiency than TCRβ−neutrophils. Together these results signify that TCR expression by the neutrophil plays an important role in the regulation of parasite burden by enhancing the phagocytic capacity of the neutrophil.
Whole-Genome Sequencing of Aggregatibacter Species Isolated from Human Clinical Specimens and Description of Aggregatibacter kilianii sp. nov
Authors: Murra May , Lützen Lisbeth , Barut Aynur , Zbinden Reinhard , Lund Marianne , Villesen Palle , Nørskov-Lauritsen Niels
Published: April 2018

Aggregatibacterspecies are commensal bacteria of human mucosal surfaces that are sometimes involved in serious invasive infections. During the investigation of strains cultured from various clinical specimens, we encountered a coherent group of 10 isolates that could not be allocated to any validly named species by phenotype, mass spectrometry, or partial 16S rRNA gene sequencing. Whole-genome sequencing revealed a phylogenetic cluster related to but separate fromAggregatibacter aphrophilus. The meanin silicoDNA hybridization value for strains of the new cluster versusA. aphrophiluswas 56% (range, 53.7 to 58.0%), whereas the average nucleotide identity was 94.4% (range, 93.9 to 94.8%). The new cluster exhibited aggregative properties typical of the genusAggregatibacter. Key phenotypic tests for discrimination of the new cluster from validly namedAggregatibacterspecies are alanine-phenylalanine-proline arylamidase,N-acetylglucosamine, and β-galactosidase. The nameAggregatibacter kilianiiis proposed, with PN_528 (CCUG 70536Tor DSM 105094T) as the type strain.
Complex and Dynamic Interactions between Parvovirus Capsids, Transferrin Receptors, and Antibodies Control Cell Infection and Host Range
Authors: Callaway Heather M. , Welsch Kathrin , Weichert Wendy , Allison Andrew B. , Hafenstein Susan L. , Huang Kai , Iketani Sho , Parrish Colin R.
Published: April 2018

Antibody and receptor binding are key virus-host interactions that control host range and determine the success of infection. Canine and feline parvovirus capsids bind the transferrin receptor type 1 (TfR) to enter host cells, and specific structural interactions appear necessary to prepare the stable capsids for infection. Here, we define the details of binding, competition, and occupancy of wild-type and mutant parvovirus capsids with purified receptors and antibodies. TfR-capsid binding interactions depended on the TfR species and varied widely, with no direct relationship between binding affinity and infection. Capsids bound feline, raccoon, and black-backed jackal TfRs at high affinity but barely bound canine TfRs, which mediated infection efficiently. TfRs from different species also occupied capsids to different levels, with an estimated 1 to 2 feline TfRs but 12 black-backed jackal TfRs binding each capsid. Multiple alanine substitutions within loop 1 on the capsid surface reduced TfR binding but substitutions within loop 3 did not, suggesting that loop 1 directly engaged the TfR and loop 3 sterically affected that interaction. Binding and competition between different TfRs and/or antibodies showed complex relationships. Both antibodies 14 and E competed capsids off TfRs, but antibody E could also compete capsids off itself and antibody 14, likely by inducing capsid structural changes. In some cases, the initial TfR or antibody binding event affected subsequent TfR binding, suggesting that capsid structure changes occur after TfR or antibody binding and may impact infection. This shows that precise, host-specific TfR-capsid interactions, beyond simple attachment, are important for successful infection.

IMPORTANCE
Host receptor binding is a key step during viral infection and may control both infection and host range. In addition to binding, some viruses require specific interactions with host receptors in order to infect, and anti-capsid antibodies can potentially disrupt these interactions, leading to neutralization. Here, we examine the interactions between parvovirus capsids, the receptors from different hosts, and anti-capsid antibodies. We show that interactions between parvovirus capsids and host-specific TfRs vary in both affinity and in the numbers of receptors bound, with complex effects on infection. In addition, antibodies binding to two sites on the capsids had different effects on TfR-capsid binding. These experiments confirm that receptor and antibody binding to parvovirus capsids are complex processes, and the infection outcome is not determined simply by the affinity of attachment.
Lack of Transmission of Chronic Wasting Disease to Cynomolgus Macaques
Authors: Race Brent , Williams Katie , Orrú Christina D. , Hughson Andrew G. , Lubke Lori , Chesebro Bruce
Published: April 2018

Chronic wasting disease (CWD) is a fatal prion disease found in deer, elk, and moose. Since it was first discovered in the late 1960s, CWD has now spread to at least 25 U.S. states, 2 Canadian provinces, South Korea, Norway, and Finland. Eradication of CWD from areas of endemicity is very unlikely, and additional spread will occur. As the range and prevalence of CWD increase, so will the potential for human exposure to CWD prions. It is currently unknown if CWD poses a risk to human health. However, determining this risk is critical to preventing a scenario similar to that which occurred when mad cow disease was found to be transmissible to humans. In the present study, we used cynomolgus macaque monkeys as a surrogate model for CWD transmission to humans. After 13 years, no evidence for CWD transmission to macaques was detected clinically or by using highly sensitive prion disease-screening assays.
Optimising mHealth helpdesk responsiveness in South Africa: towards automated message triage
Authors: Engelhard Matthew , Copley Charles , Watson Jacqui , Pillay Yogan , Barron Peter , LeFevre Amnesty Elizabeth
Published: April 2018

In South Africa, a national-level helpdesk was established in August 2014 as a social accountability mechanism for improving governance, allowing recipients of public sector services to send complaints, compliments and questions directly to a team of National Department of Health (NDoH) staff members via text message. As demand increases, mechanisms to streamline and improve the helpdesk must be explored. This work aims to evaluate the need for and feasibility of automated message triage to improve helpdesk responsiveness to high-priority messages. Drawing from 65 768 messages submitted between October 2016 and July 2017, the quality of helpdesk message handling was evaluated via detailed inspection of (1) a random sample of 481 messages and (2) messages reporting mistreatment of women, as identified using expert-curated keywords. Automated triage was explored by training a naïve Bayes classifier to replicate message labels assigned by NDoH staff. Classifier performance was evaluated on 12 526 messages withheld from the training set. 90 of 481 (18.7%) NDoH responses were scored as suboptimal or incorrect, with median response time of 4.0 hours. 32 reports of facility-based mistreatment and 39 of partner and family violence were identified; NDoH response time and appropriateness for these messages were not superior to the random sample (P>0.05). The naïve Bayes classifier had average accuracy of 85.4%, with ≥98% specificity for infrequently appearing (<50%) labels. These results show that helpdesk handling of mistreatment of women could be improved. Keyword matching and naïve Bayes effectively identified uncommon messages of interest and could support automated triage to improve handling of high-priority messages.
Modern contraceptive use among HIV-infected women attending HIV care centres in Togo: a cross-sectional study
Authors: Yaya Issifou , Patassi Akouda Akessiwè , Landoh Dadja Essoya , Bignandi Essodjèlouna Manani , Kolani Kanfitine , Namoro Abdel-Daim Daou , Patchali P’Niwè Massoubayo , Djalogue Lihanimpo , Ekouevi Didier Koumavi , Saka Bayaki
Published: April 2018

Introduction

Contraceptive use among HIV-infected women in Togo is poorly documented. We aim at assessing the prevalence of modern contraceptive use and associated factors among HIV-infected women in Togo.

Design

Cross-sectional study.

Setting

The study was conducted in five HIV care centres in the Centrale and Kara regions in Togo.

Participants

We included 461 HIV-positive women aged between 15 and 49 years and who were sexually active.

Main outcome measure

The outcome variable was HIV-infected women who were using modern contraceptive methods.

Results

A total of 461 HIV-infected women were interviewed, with an average age of 34.3 (±7.1). Among them, 332 (73.1%) women reported using contraceptive methods, mostly condom alone (74.7%) or in combination with hormonal contraceptive (16.9%). In multivariate analysis, education level (primary: adjusted OR (aOR)=1.99, 95% CI (1.05 to 3.76); secondary level and higher: aOR=3.95, 95% CI (2.03 to 7.67)), WHO clinical stage (stage II: aOR=0.7, 95% CI (0.37 to 1.33)), follow-up in private care facilities (aOR=2.54, 95% CI (1.22 to 5.29)) and having a child (aOR=2.51, 95% CI (1.41 to 4.5)) were associated with higher contraceptive use, while marital status (living in union: aOR=0.45, 95% CI (0.28 to 0.74)) and WHO stages III and IV (aOR=0.47, 95% CI (0.24 to 0.94)) were associated with lower contraceptive use.

Conclusion

About three-quarters of sexually active HIV-infected women in Togo were using contraceptive methods, and private health facilities favoured this contraceptive use. It is important to strengthen the implementation of interventions to increase the incentives for HIV-infected women to use contraception in Togo.
Understanding influences on the uptake of pulmonary rehabilitation in the East of England: an Inclusive Design/mixed-methods study protocol
Authors: Liu Yuanyuan , Dickerson Terry , Early Frances , Fuld Jonathan , Clarkson P John
Published: April 2018

Introduction

1.2 million people in the UK have chronic obstructive pulmonary disease (COPD) that causes breathlessness, difficulty with daily activities, infections and hospitalisation. Pulmonary rehabilitation (PR), a programme of supervised exercise and education, is recommended for patients with COPD. However, only 1 in 10 of those who need it receive PR. Also, the UK National COPD Audit Programme concluded that the COPD treatment might not be accessible to people with disabilities. This paper applies an Inclusive Design approach to community-based PR service provisions. It aims to inform improvements to the PR service by identifying barriers to the uptake of PR in the COPD care journey in relation to patients’ capabilities that can affect their access to PR.

Methods and analysis

The protocol includes four steps. Step 1 will involve interviews with healthcare professionals and patients to gather insight into their experiences and produce a hierarchical task analysis of the COPD care journeys. Step 2 will estimate the service exclusion: the demand of every task on patients’ capabilities will be rated by predefined scales, and the proportion of the population excluded from the service will be estimated by an exclusion calculator. Step 3 will identify the challenges of the PR service; a framework analysis will guide the data analysis of the interviews and care journey. Step 4 will propose recommendations to help patients manage their COPD care informed by the challenges identified in step 3 and refine recommendations through interviews and focus groups.

Ethics and dissemination

The Cambridge Central Research Ethics Committee gave the study protocol a positive ethical opinion (17/EE/0136). Study results will be disseminated through peer-reviewed journals, conferences and the British Lung Foundation networks. They will also be fed into a Research for Patient Benefit project on increasing the referral and uptake of PR.
Long-term neuroprotective effect of erythropoietin on executive functions in very preterm children (EpoKids): protocol of a prospective follow-up study
Authors: Wehrle Flavia Maria , Held Ulrike , O’Gorman Ruth Tuura , Disselhoff Vera , Schnider Barbara , Fauchère Jean-Claude , Hüppi Petra , Latal Beatrice , Hagmann Cornelia Franziska
Published: April 2018

Introduction

Premature infants are particularly vulnerable to brain injuries with associated cognitive and behavioural deficits. The worldwide first randomised interventional multicentre trial investigating the neuroprotective effects of erythropoietin (entitled ‘Does erythropoietin improve outcome in very preterm infants?’ (NCT00413946)) included 450 very preterm infants in Switzerland. MRI at term equivalent age showed less white matter (WM) injury in the erythropoietin group compared with the placebo group. Despite these promising imaging findings, neurodevelopmental outcome at 2 years showed no beneficial effect of early erythropoietin. One explanation could be that the assessment of more complex cognitive functions such as executive functions (EFs) is only possible at a later age. We hypothesise that due to improved WM development and fewer WM injuries, children born preterm treated with early erythropoietin will have better EF abilities at 7–12 years than those treated with placebo.

Methods and analysis

365 children who were included into the primary analysis of the original trial (NCT00413946) will be eligible in this prospective follow-up study at the age of 7–12 years. 185 children born at term will be control children. Primary outcome measures are EF abilities and processing speed, while secondary outcomes are academic performance, IQ, fine motor abilities and global brain connectivity. A comprehensive test battery will be applied to assess EFs. MRI will be performed to assess global brain connectivity. Cognitive scores and MRI measures will be compared between both groups using the Wilcoxon test. Propensity score matching will be used to balance gender, age, socioeconomic status and other potentially unbalanced variables between the children born preterm and the healthy control children.

Ethics and dissemination

The cantonal ethical committee granted ethical approval for this study (KEK 2017-00521). Written consent will be obtained from the parents. Findings from this study will be disseminated via international and national conference presentations and publications in peer-reviewed journals.
Longitudinal change in blood pressure is associated with cardiovascular disease mortality in a Chinese cohort
Authors: Fan Jin-Hu , Wang Jian-Bing , Wang Shao-Ming , Abnet Christian C , Qiao You-Lin , Taylor Philip R
Published: April 2018

Background

A number of studies have demonstrated a J-shaped curve between blood pressure (BP) and all-cause mortality, but few studies have used longitudinal change in BP to study mortality in the Chinese population.

Methods

We performed a 30-year follow-up study to examine the association between BP (at baseline and longitudinal change) and risk of mortality in the Linxian General Population Trial Cohort. At baseline, a total of 29 584 healthy adults were enrolled in the Linxian General Population Trial in 1985 and followed through to the end of 2014. The final analysis was restricted to 29 439 participants (55% women) after exclusion of outliers. We also examined the potential effects of BP trajectory patterns during the period of 1985–1999 on sequent risk of mortality. Adjusted Cox proportional hazards models were used to estimate HRs and 95% CIs.

Results

Compared with participants with normal BP, patients with prehypertension, stage 1, stage 2 or stage 3 hypertension had an increased risk of all-cause mortality, with HRs of 1.09 (95% CI 1.05 to 1.14), 1.34 (95% CI 1.28 to 1.40), 1.69 (95% CI 1.60 to 1.79) and 2.14 (95% CI 2.01 to 2.28), respectively. Relative to stable BP of normotension, having a rise in BP from normotension to hypertension or from prehypertension to hypertension both conferred an increased risk of total and cardiovascular disease and stroke mortality (total: HRs 1.22 (95% CI 1.12 to 1.34) and 1.36 (95% CI 1.23 to 1.51); cardiovascular disease: HRs 1.42 (95% CI 1.17 to 1.73) and 1.55 (95% CI 1.24 to 1.93); stroke: HRs 2.29 (95% CI 1.88 to 2.80) and 2.61 (95% CI 2.11 to 3.24), respectively).

Conclusions

These findings emphasise that development of incident hypertension in middle age could increase the risk of total, cardiovascular disease and stroke mortality, and suggest that current BP targets could be revised.

Trial registration number

NCT00342654;Post-results.
Optimal location of emergency stations in underground mine networks using a multiobjective mathematical model
Authors: Lotfian Reza , Najafi Mehdi
Published: April 2018

BackgroundEvery year, many mining accidents occur in underground mines all over the world resulting in the death and maiming of many miners and heavy financial losses to mining companies. Underground mining accounts for an increasing share of these events due to their special circumstances and the risks of working therein. Thus, the optimal location of emergency stations within the network of an underground mine in order to provide medical first aid and transport injured people at the right time, plays an essential role in reducing deaths and disabilities caused by accidents

ObjectiveThe main objective of this study is to determine the location of emergency stations (ES) within the network of an underground coal mine in order to minimize the outreach time for the injured.

MethodsA three-objective mathematical model is presented for placement of ES facility location selection and allocation of facilities to the injured in various stopes.

ResultsTaking into account the radius of influence for each ES, the proposed model is capable to reduce the maximum time for provision of emergency services in the event of accident for each stope. In addition, the coverage or lack of coverage of each stope by any of the emergency facility is determined by means of Floyd-Warshall algorithm and graph. To solve the problem, a global criterion method using GAMS software is used to evaluate the accuracy and efficiency of the model.

Conclusions7 locations were selected from among 46 candidates for the establishment of emergency facilities in Tabas underground coal mine.
Cognitive function trajectories and their determinants in older people: 8 years of follow-up in the English Longitudinal Study of Ageing
Authors: Zaninotto Paola , Batty G David , Allerhand Michael , Deary Ian J
Published: April 2018

Background

Maintaining cognitive function is an important aspect of healthy ageing. In this study, we examined age trajectories of cognitive decline in a large nationally representative sample of older people in England. We explored the factors that influence such decline and whether these differed by gender.

Methods

Latent growth curve modelling was used to explore age-specific changes, and influences on them, in an 8-year period in memory, executive function, processing speed and global cognitive function among 10 626 participants in the English Longitudinal Study of Ageing. We run gender-specific models with the following exposures: age, education, wealth, childhood socioeconomic status, cardiovascular disease, diabetes, physical function, body mass index, physical activity, alcohol, smoking, depression and dementia.

Results

After adjustment, women had significantly less decline than men in memory (0.011, SE 0.006), executive function (0.012, SE 0.006) and global cognitive function (0.016, SE 0.004). Increasing age and dementia predicted faster rates of decline in all cognitive function domains. Depression and alcohol consumption predicted decline in some cognitive function domains in men only. Poor physical function, physical inactivity and smoking were associated with faster rates of decline in specific cognitive domains in both men and women. For example, relative to study members who were physically active, the sedentary experienced greater declines in memory (women −0.018, SE 0.009) and global cognitive function (men −0.015, SE 0.007 and women −0.016, SE 0.007).

Conclusions

The potential determinants of cognitive decline identified in this study, in particular modifiable risk factors, should be tested in the context of randomised controlled trials.
Association between admission haematocrit and mortality among men with acute ischaemic stroke
Authors: Sico Jason J , Myers Laura J , Fenton Brenda J , Concato John , Williams Linda S , Bravata Dawn M
Published: April 2018

Objective

Anaemia is associated with higher mortality among patients with non-stroke cardiovascular conditions; less is known regarding the relationship between anaemia and mortality among patients with acute ischaemic stroke.

Methods

Medical records were abstracted for n=3965 veterans from 131 Veterans Health Administration facilities who were admitted with ischaemic stroke in fiscal year 2007. Haematocrit values within 24 hours of admission were classified as ≤27%, 28%–32%, 33%–37%, 38%–42%, 43%–47% or ≥48%. Multivariate logistic regression was used to examine the relationship between anaemia and in-hospital, 30-day, 6-month and 1-year mortality, adjusting for age, medical comorbidities, modified Acute Physiology and Chronic Health Evaluation-III and stroke severity. Impact factors were calculated to standardise comparisons between haematocrit tier and other covariates.

Results

Among n=3750 patients included in the analysis, the haematocrit values were ≤27% in 2.1% (n=78), 28%–32% in 6.2% (n=234), 33%–37% in 17.9% (n=670), 38%–42% in 36.4% (n=1366), 43%–47% in 28.2% (n=1059) and ≥48% in 9.1% (n=343). Patients with haematocrit ≤27%, compared with patients in the 38%–42% range, were more likely to have died across all follow-up intervals, with statistically significant adjusted ORs (aORs) ranging from 2.5 to 3.5. Patients with polycythaemia (ie, haematocrit ≥48%) were at increased risk of in-hospital mortality (aOR=2.9; 95% CI 1.4 to 6.0), compared with patients with mid-range admission haematocrits. Pronounced differences between patients receiving and not receiving blood transfusion limited our ability to perform a propensity analysis. Impact factors in the 1-year mortality model were 0.46 (severe anaemia), 0.06 (cancer) and 0.018 (heart disease).

Conclusions

Anaemia is independently associated with an increased risk of death throughout the first year post stroke; high haematocrit is associated with early poststroke mortality. Severe anaemia is associated with 1-year mortality to a greater degree than cancer or heart disease. These data cannot address the question of whether interventions targeting anaemia might improve patient outcomes.
Cardiogenic effects of characterized Geum urbanum extracts on adipose-derived human mesenchymal stem cells
Authors: Neshati Vajiheh , Mollazadeh Samaneh , Fazly Bazzaz Bibi Sedigheh , Iranshahi Mehrdad , Mojarrad Majid , Naderi-Meshkin Hojjat , Kerachian Mohammad Amin
Published: April 2018

Stem cell therapy is considered as a promising treatment for cardiovascular diseases. Adipose-derived mesenchymal stem cells (ADMSCs) have the ability to undergo cardiomyogenesis. Medicinal plants are effective and safe candidates for cell differentiation. Therefore, the aim of our study was to investigate cardiogenic effects of characterized (HPLC–UV) extracts of Geum urbanum on ADMSCs of adipose tissue. The methanolic extracts of the root and aerial parts of G. urbanum were obtained and MTT assay was used for studying their cytotoxic effects. Then, cells were treated with 50 or 100 μg/mL of the extracts from root and aerial parts of G. urbanum. MTT assay showed that the extracts of G. urbanum did not have any toxic effects on ADMSCs. Immunostaining results showed increase in the expression of α-actinin and cardiac troponin I (cTnI), and quantitative real-time reverse-transcription PCR data confirmed the upregulation of ACTN, ACTC1, and TNNI3 genes in ADMSCs after treatment. According to HPLC fingerprinting, some cardiogenic effects of G. urbanum extracts are probably due to ellagic and gallic acid derivatives. Our findings indicated that G. urbanum extracts effectively upregulated some essential cardiogenic markers, which confirmed the therapeutic role of this plant as a traditional cardiac medicine.
Combined rupture mechanisms in shallow foundations
Authors: Gajo A. , Smith C.C.
Published: April 2018

Conventional ultimate limit state (ULS) shallow foundation design is typically based on a simplified analysis that fails to consider the possible existence of a combined structural and geotechnical failure, which is shown here to significantly affect the limit load. Neglecting this occurrence may lead to unsafe design, whereas a full analysis can be beneficial for the dimensioning. With the emphasis on separate serviceability limit state and ULS design in modern design codes such as Eurocode 7 (EN 1997-1, 2004 edition), this paper explores unsafe loading scenarios and the benefits to be gained from a rigorous ULS design based on combined failure. For the sake of simplicity, a long foundation slab subjected to three different loading conditions is analysed using elastic, elasto-plastic, and rigid-plastic methods, and the results compared for a range of foundation strengths and stiffnesses. It is found that the limit load may be significantly influenced by plastic hinges in the structure and for each load condition it is possible to derive a curve relating ultimate load to plastic bending moment representing the ultimate limit state of the foundation.
Dynamic Redistribution of Plasticity in a Cerebellar Spiking Neural Network Reproducing an Associative Learning Task Perturbed by TMS
Authors: Antonietti Alberto , Monaco Jessica , D'Angelo Egidio , Pedrocchi Alessandra , Casellato Claudia
Published: April 2018

During natural learning, synaptic plasticity is thought to evolve dynamically and redistribute within and among subcircuits. This process should emerge in plastic neural networks evolving under behavioral feedback and should involve changes distributed across multiple synaptic sites. In eyeblink classical conditioning (EBCC), the cerebellum learns to predict the precise timing between two stimuli, hence EBCC represents an elementary yet meaningful paradigm to investigate the cerebellar network functioning. We have simulated EBCC mechanisms by reconstructing a realistic cerebellar microcircuit model and embedding multiple plasticity rules imitating those revealed experimentally. The model was tuned to fit experimental EBCC human data, estimating the underlying learning time-constants. Learning started rapidly with plastic changes in the cerebellar cortex followed by slower changes in the deep cerebellar nuclei. This process was characterized by differential development of long-term potentiation and depression at individual synapses, with a progressive accumulation of plasticity distributed over the whole network. The experimental data included two EBCC sessions interleaved by a trans-cranial magnetic stimulation (TMS). The experimental and the model response data were not significantly different in each learning phase, and the model goodness-of-fit was [Formula: see text] for all the experimental conditions. The models fitted on TMS data revealed a slowed down re-acquisition (sessions-2) compared to the control condition ([Formula: see text]). The plasticity parameters characterizing each model significantly differ among conditions, and thus mechanistically explain these response changes. Importantly, the model was able to capture the alteration in EBCC consolidation caused by TMS and showed that TMS affected plasticity at cortical synapses thereby altering the fast learning phase. This, secondarily, also affected plasticity in deep cerebellar nuclei altering learning dynamics in the entire sensory-motor loop. This observation reveals dynamic redistribution of changes over the entire network and suggests how TMS affects local circuit computation and memory processing in the cerebellum.
Second-Order M-Composed Tangent Derivative and Its Applications
Authors: Xu Yi-Hong , Peng Zhen-Hua
Published: April 2018

A new kind of second-order tangent derivative, second-order [Formula: see text]-composed tangent derivative, for a set-valued function is introduced with help of a modified Dubovitskij–Miljutin cone. By using the concept, several generalized convex set-valued functions are introduced. When both the objective function and constrained function are second-order [Formula: see text]-composed derivable, under the assumption of nearly cone-subconvexlikeness, by applying a separation theorem for convex sets, Fritz John and Kuhn–Tucker second-order necessary optimality conditions are obtained for a point pair to be a weak minimizer of set-valued optimization problem. Under the assumption of generalized pseudoconvexity, a Kuhn–Tucker second-order sufficient optimality condition is obtained for a point pair to be a weak minimizer of set-valued optimization problem. A unified second-order necessary and sufficient optimality condition is derived in terms of second-order [Formula: see text]-composed tangent derivatives.
Gate length scaling optimization of FinFETs
Authors: Chen Shoumian , Shang Enming , Hu Shaojian
Published: April 2018

This paper introduces a device performance optimization approach for the FinFET through optimization of the gate length. As a result of reducing the gate length, the leakage current (I[Formula: see text]) increases, and consequently, the stress along the channel enhances which leads to an increase in the drive current (I[Formula: see text]) of the PMOS. In order to sustain I[Formula: see text], work function is adjusted to offset the effect of the increased stress. Changing the gate length of the transistor yields different drive currents when the leakage current is fixed by adjusting the work function. For a given device, an optimal gate length is found to provide the highest drive current. As an example, for a standard performance device with I[Formula: see text] = 1 nA/um, the best performance I[Formula: see text] = 856 uA/um is at L = 34 nm for 14 nm FinFET and I[Formula: see text] = 1130 uA/um at L = 21 nm for 7 nm FinFET. A 7 nm FinFET will exhibit performance boost of 32% comparing with 14 nm FinFET. However, applying the same method to a 5 nm FinFET, the performance boosting is out of expectance comparing to the 7 nm FinFET, which is due to the severe short-channel-effect and the exhausted channel stress in the FinFET.
Spectator isobar production in the A(γ,πNN)B reaction
Authors: Glavanakov I. V. , Tabachenko A. N.
Published: April 2018

We present an analysis of the spectator mechanism of [Formula: see text]-isobar production in the pion photoproduction on nuclei with the emission of two nucleons. The reaction mechanism is studied within the framework of the [Formula: see text]-correlation model, which considers the isobar and nucleon of the [Formula: see text]-system produced in the nucleus at the virtual [Formula: see text] transition to be in a dynamic relationship. The two-particle transition operator for nuclei is obtained by the S-matrix approach. We consider the properties of the spectator mechanism of isobar production using the example of the reaction [Formula: see text]O[Formula: see text]O. Numerical estimates of the cross-section are obtained in the kinematic region, where it is possible to expect the manifestation of bound isobar-nuclear states.