bluuebunny/crossref_metadata_2025 huggingface dataset:
Vascular calcification is associated with Wnt‐signaling pathway and blood pressure variability in chronic kidney disease rats
Authors: Liao Ruoxi , Wang Liya , Li Jiameng , Sun Si , Xiong Yuqin , Li Yupei , Han Mei , Jiang Heng , Anil Mahajan , Su Baihai
Published: November 2019

Aim

Vascular calcification (VC) is a common complication in chronic kidney disease (CKD) and has been shown to be associated with increased cardiovascular events and mortality. This study was to explore the role of Wnt‐signaling pathway in CKD VC, and the association between VC and blood pressure variability (BPV) which is a risk factor of cardiovascular events.

Methods

Adult male Sprague‐Dawley rats were divided into adenine‐induced CKD group (n = 5), 5/6 nephrectomy CKD group (n = 5), sham group (n = 5) and control group (n = 5). Low‐calcium‐high‐phosphate diets were introduced to induce vascular calcification. Both daytime (hour‐to‐hour during the day) and mid‐term (day‐to‐day for 9 days) blood pressure (BP) were collected and analyzed for BPV metrics. At sacrifice, kidney, heart and aorta samples were taken for histological analyses. Calcium deposition in aorta was identified with Alizarin Red stain and graded. Immunohistochemistry stain and western blot were performed for Wnt3a, Wnt5a, β‐catenin, sclerostin, osteopontin, and α‐SMA.

Results

Compared with control rats, CKD rats suffered from markedly severer VC (Grade 2.6 ± 0.2 and 1.8 ± 0.8 vs 0.0 ± 0.0 and 0.2 ± 0.4, P = .0010). VC was positively correlated with vascular Wnt3a and β‐catenin expression (P = .0032 and .0000), but not significantly associated with Wnta5a or sclerostin. Besides, CKD rats showed increased BPV (P < .001), which was also positively correlated with VC.

Conclusion

We confirmed that CKD rats had enhanced Wnt‐signaling in vascular tissue and severer aorta calcification together with increased BPV. Wnt pathway may be a potential target in future VC and BPV management in CKD.
Immunohistochemistry and gene expression of GLUT1, RUNX2 and MTOR in reparative dentinogenesis
Authors: Takeuchi Ryosuke , Ohkura Naoto , Yoshiba Kunihiko , Tohma Aiko , Yoshiba Nagako , Edanami Naoki , Shirakashi Mari , Belal Razi Saifullah Ibn , Ohshima Hayato , Noiri Yuichiro
Published: November 2019

Objectives

To determine glucose transporter 1 (GLUT1) and runt‐related transcription factor 2 (RUNX2) expression during reparative dentinogenesis after pulpotomy with mineral trioxide aggregate (MTA) capping.

Subjects and methods

Eight‐week‐old male Wistar rats were used. Pulp of the upper left first molar was exposed and capped with MTA. The upper right first molar of the same animal was used as a control. After collecting molars at various time points, GLUT1, RUNX2 and mammalian target of rapamycin (MTOR) were examined by immunohistochemistry. mRNA levels of Slc2a1 (encoding GLUT1), Runx2, Nestin and Mtor were determined by real‐time PCR.

Results

Pulp exhibited progressive formation of reparative dentine lined with GLUT1‐ and MTOR‐immunoreactive odontoblast‐like cells at 5 days after pulpotomy. RUNX2 was detected in nuclei of most pulp tissue cells at day 5 after pulpotomy. Double immunofluorescence staining revealed GLUT1 immunoreactivity on odontoblast‐like cells positive for Nestin or RUNX2, 5 days after pulpotomy. Slc2a1, Runx2, Nestin and Mtor mRNA levels were significantly upregulated on days 3–5 after pulpotomy.

Conclusions

After rat molar pulpotomy, dental pulp induced formation of reparative dentine with colocalization of GLUT1 and Nestin or RUNX2. Moreover, mRNA levels of Slc2a1, Runx2, Nestin and Mtor were significantly upregulated in pulpotomized dental pulp.
Single‐marker and haplotype‐based association analysis of anthracnose (Colletotrichum dematium)resistance in spinach (Spinacia oleracea)
Authors: Awika Henry O. , Cochran Kimberly , Joshi Vijay , Bedre Renesh , Mandadi Kranthi K. , Avila Carlos A.
Published: November 2019

Anthracnose (Colletotrichum dematium) is an important disease in spinach (Spinacia oleracea). Sources of resistance must be identified, and molecular tools must be developed to expedite cultivar development. In this study, a diverse collection of 276 spinach accessions was scored for anthracnose disease severity. We then evaluated marker identification approaches by testing how well haplotype‐based trait modelling compares to single markers in identifying strong association signals. Alleles in linkage disequilibrium were tagged in haplotype blocks, and anthracnose‐associated molecular markers were identified using single‐SNP (sSNP), pairwise haplotype (htP) and multi‐marker haplotype (htM) SNP tagging approaches. We identified 49 significantly associated markers distributed on several spinach chromosomes using all methods. The sSNP approach identified 13 markers, while htP identified 24 (~63% more) and htM 34 (~162% more). Of these markers, four were uniquely identified by the sSNP approach, nine by htP and nineteen by htM. The results indicate that resistance to anthracnose is polygenic and that haplotype‐based analysis may have more power than sSNP. Using a combination of these methods can improve the identification of molecular markers for spinach breeding.
Oral health inequalities between differently abled and healthy school children in Bengaluru—A cross‐sectional study
Authors: Rajput Soni , Kumar Amit , Puranik Manjunath P , Sowmya KR
Published: November 2019

Aim

To assess oral health inequalities between differently‐abled and healthy school children.

Methods

The study was conducted on a sample of 300 differently‐abled and 300 healthy school children in Bengaluru. A calibrated investigator recorded oral health status according to World Health Organization (WHO) proforma 2013. Chi‐square/Fisher exact test, Mann‐Whitney U test, and multiple logistic regression were applied. Ap‐value < 0.05 was considered to be statistically significant.

Results

Mean DMFT in the study group and the control group was 1.32 ± 1.36 and 1.25 ± 1.21 respectively. In the study group, 52.7% had gingival bleeding compared to 41.0% in the control group. Within the study group, children who belonged to the lower middle class (aOR = 2.02) were more likely to have caries experience whereas visually impaired children (aOR = 0.32), speech and hearing impaired children (OR = 0.10), children suffering from polio (aOR = 0.80), and those with caries‐free in deciduous dentition (aOR = 0.42) were less likely to have caries experience in permanent teeth (p < 0.05).

Conclusion

Oral healthinequalities exist for differently‐abled children. Hence, improvement of their oral health status and priority care are needed.
Increasing person‐centred care in paediatrics
Authors: Hayes Daniel , Edbrooke‐Childs Julian , Martin Kate , Reid Joanna , Brown Rob , McCulloch Jessie , Morton Louise
Published: November 2019

Background

Paediatric patients (PPs) often feel that they are not involved in care and treatment decisions. Although training clinicians may help, there is a lack of evaluated training programmes specifically for work with PPs. The aim of this article is to evaluate ‘Me first’, a training programme aimed at improving clinicians’ attitudes and communication skills when working with PPs.

Methods

A total of 69 clinicians attended ‘Me first’ training and completed questionnaires across three time points: (1) prior to attending the training; (2) at the end of the training; and (3) 4–6 weeks later. This included 14 medical staff, 29 nursing staff and 26 allied health staff. Attitude was measured using the Leeds Attitudes to Concordance II (LATCon II) scale, and communication skills were measured using the Effective Listening and Interactive Communication Scale (ELICS).

Results

Overall, clinicians reported that their attitude and communication skills improved after attending ‘Me first’. This was maintained 4–6 weeks later. Subgroup analysis showed that allied health staff did not maintain the improved attitude at the follow‐up conducted 4–6 weeks later.

Subgroup analysis showed that allied health staff did not maintain the improved attitude at the follow‐up conducted 4–6 weeks later

Conclusions

Findings suggest that ‘Me first’ may be helpful in improving clinician attitudes and communication skills with PPs. Further research should examine whether PPs report higher levels of communication and decision making with clinicians who have attended training.
Eating disorders, body image and media exposure among adolescent girls in rural Burkina Faso
Authors: Terhoeven Valentin , Nikendei Christoph , Bärnighausen Till , Bountogo Mamadou , Friederich Hans‐Christoph , Ouermi Lucienne , Sié Ali , Harling Guy
Published: November 2019

Objective

Body dissatisfaction and eating disorders (ED) among young females may increase in limited‐resource settings as exposure to media and higher‐resource cultures increases. We examined ED prevalence and its predictors among adolescent girls in rural north‐western Burkina Faso.

Methods

Fieldworkers interviewed 696 female adolescents aged 12‐20 years in the Nouna Health and Demographic Surveillance System (HDSS). ED were evaluated using the Structured Clinical Interview for DSM‐5 (SCID‐5), self‐perceived appearance and body ideal were measured using Thompson and Gray’s Contour Drawing Rating Scale (CDRS) and eating disorder predictors by the Eating Disorder Examination Questionnaire (EDE‐Q). We assessed media exposure to magazines, radio, television, and the internet.

Results

16% of respondents had a BMI below WHO age‐standardised 5th percentile, while 4% were above the 85th percentile; most respondents wanted to be larger. DSM‐5 criteria for anorexia nervosa (AN) were fulfilled by four of 696 respondents (0.6%), those for bulimia nervosa by none, and those for binge eating disorder by two (0.3%). In multivariable regression, more AN symptoms were associated with greater EDE‐Q body dissatisfaction, desiring a thinner body and a history of sexual harassment or assault, but not with media exposure. A thinner desired body was associated with greater media exposure, higher BMI z‐score and greater EDE‐Q disordered eating.

Conclusion

ED were very rare in rural Burkinabé female adolescents, but factors predictive of ED in higher‐resource settings were also predictive of ED precursor symptoms here. Our findings suggest that increasing media exposure in resource‐limited settings may lead to increased body dissatisfaction, and potentially to increased future ED prevalence.
Arabidopsis PIC30 encodes a major facilitator superfamily transporter responsible for the uptake of picolinate herbicides
Authors: Kathare Praveen K. , Dharmasiri Sunethra , Vincill Eric D. , Routray Pratyush , Ahmad Idrees , Roberts Daniel M. , Dharmasiri Nihal
Published: November 2019

Picloram is an auxinic herbicide that is widely used for controlling broad leaf weeds. However, its mechanism of transport into plants is poorly understood. In a genetic screen for picloram resistance, we identified three Arabidopsis mutant alleles of PIC30 (PICLORAM RESISTANT30) that are specifically resistant to picolinates, but not to other auxins. PIC30 is a previously uncharacterized gene that encodes a major facilitator superfamily (MFS) transporter. Similar to most members of MFS, PIC30 contains 12 putative transmembrane domains, and PIC30‐GFP fusion protein selectively localizes to the plasma membrane. In planta transport assays demonstrate that PIC30 specifically transports picloram, but not indole‐3‐acetic acid (IAA). Functional analysis of Xenopus laevis oocytes injected with PIC30 cRNA demonstrated PIC30 mediated transport of picloram and several anions, including nitrate and chloride. Consistent with these roles of PIC30, three allelic pic30 mutants are selectively insensitive to picolinate herbicides, while pic30‐3 is also defective in chlorate (analogue of nitrate) transport and also shows reduced uptake of . Overexpression of PIC30 fully complements both picloram and chlorate insensitive phenotypes of pic30‐3. Despite the continued use of picloram as an herbicide, a transporter for picloram was not known until now. This work provides insight into the mechanisms of plant resistance to picolinate herbicides and also shed light on the possible endogenous function of PIC30 protein.
A curious case of delayed hemolytic transfusion reaction with evanescent antibodies in a patient with hereditary hemorrhagic telangiectasia
Authors: Lemay Anne‐Sophie , Faughnan Marie , Krok Elizabeth , Pavenski Katerina
Published: November 2019

BACKGROUND

Delayed hemolytic reactions are potential complications of incompatible transfusions and are usually associated with the identification of a new antibody on serologic studies, following a second immunization event. However, in rare cases, the antibody investigation remains negative even if the clinical presentation would lead one to suspect otherwise.

CASE REPORT

A 44‐year‐old woman with hereditary hemorrhagic telangiectasia presented to the emergency department with hematuria and low back pain after she had received three units of RBCs 2 weeks earlier. Hematology and biochemistry results were consistent with delayed hemolytic transfusion reaction, but surprisingly, serologic antibody investigations were negative. It was only when her plasma was tested with enzyme (ficin)‐treated panel cells that anti‐e was finally detected, with a 3+ reaction with all homozygous e+ cells. No reaction was seen with heterozygous e+ cells. Four months later, an anti‐K was also detected on standard panels, while the anti‐e remained detectable only with ficin‐treated panel cells. Three years later, both antibodies had vanished and remained undetectable. The weakness of anti‐e reaction, combined with the quick evanescence of both antibodies led to the suspicion of a potential underlying immunodeficiency disorder, which was confirmed by low immunoglobulin levels on two occasions.

CONCLUSION

To our knowledge, this is the first case of immunodeficiency disorder diagnosed after the identification of evanescent antibody reactions. This case also outlines the importance of a good clinical history that should lead to further investigations when a hemolytic transfusion reaction is suspected.
In vitroantimicrobial activity of narasin and monensin in combination with adjuvants against pathogens associated with canine otitis externa
Authors: Chan Wei Yee , Hickey Elizabeth E. , Khazandi Manouchehr , Page Stephen W. , Trott Darren J. , Hill Peter B.
Published: November 2019

Background

The emergence of antimicrobial resistance represents a serious human and animal health risk. Good antimicrobial stewardship is essential to prolong the lifespan of existing antibiotics, and new strategies are required to combat infections in man and animals.

Hypothesis/Objectives

To determine thein vitrointeraction of ionophores (narasin or monensin) with antimicrobial adjuvants (N‐acetylcysteine (NAC), Tris‐EDTAor disodiumEDTA) against bacterial strains representing pathogens associated with canine otitis externa (OE).

Animal/Isolates

American Type Culture Collection (ATCC) strainsStaphylococcus aureus29213,Pseudomonas aeruginosa27853 andP. aeruginosabiofilm producerPAO1, and a clinical isolate ofProteus mirabilisfrom a case of canineOEwere tested.

Methods and materials

A 2D microdilution checkerboard method was used, allowing calculation of fractional inhibitory concentration index (FICI), dose reduction index (DRI) and plotting of isobolograms.

Results

The combination of narasin with either Tris‐EDTAor disodiumEDTAproduced additive effects (FICI = 0.75) againstP. aeruginosaATCC27853 andP. aeruginosabiofilm producerATCC PAO1. An additive effect (FICI = 0.53–0.75) was found againstS. aureusATCC29213 when narasin or monensin were combined withNAC. The highestDRI(32‐fold) was found with monensin/NACwhere theMICof monensin was reduced from 4 to 0.125 μg/mL.

Conclusions and clinical importance

The combination of narasin with Tris‐EDTAor disodiumEDTAis a promising strategy to inhibit the intrinsic resistance elements of Gram‐negative bacteria. These novel combinations potentially could be useful as a multimodal approach to treat mixed infections in canineOE.
Activity of Aerosolized Levofloxacin against Burkholderia cepacia in a Mouse Model of Chronic Lung Infection
Authors: Sabet Mojgan , Griffith David C.
Published: November 2019

Burkholderia cepacia
complex is an opportunistic pathogen capable of causing chronic pulmonary infections. These studies were conducted to demonstrate the activity of aerosolized levofloxacin in a chronic mouse lung infection model caused by
B. cepacia
isolates from patients with cystic fibrosis.
The Other Side of the Coin: Anti-inflammatory Antibody Therapy for Infectious Diseases
Authors: Goldman David L.
Published: November 2019

The inflammatory response to the fungus
Pneumocystis jirovecii
plays a central role in the respiratory failure associated with
Pneumocystis
pneumonia. To help ameliorate the inflammatory response, corticosteroids are used as an adjuvant to standard antimicrobial therapy. Corticosteroids, however, can have a wide range of effects (including deleterious effects) on the host immune response.
Puumala and Andes Orthohantaviruses Cause Transient Protein Kinase R-Dependent Formation of Stress Granules
Authors: Christ Wanda , Tynell Janne , Klingström Jonas
Published: November 2019

Our work presents the first report on stress granule formation during hantavirus infection. We show that hantavirus infection actively inhibits stress granule formation, thereby escaping the detrimental effects on global translation imposed by host stress signaling. Our results highlight a previously uncharacterized aspect of hantavirus-host interactions with possible implications for how hantaviruses are able to cause persistent infection in natural hosts and for pathogenesis.
Translational Regulation Promotes Oxidative Stress Resistance in the Human Fungal Pathogen Cryptococcus neoformans
Authors: Leipheimer Jay , Bloom Amanda L. M. , Campomizzi Christopher S. , Salei Yana , Panepinto John C.
Published: November 2019

Fungal survival in a mammalian host requires the coordinated expression and downregulation of a large cohort of genes in response to cellular stresses. Initial infection with
C. neoformans
occurs in the lungs, where it interacts with host macrophages. Surviving macrophage-derived cellular stresses, such as the production of reactive oxygen and nitrogen species, is believed to promote dissemination into the central nervous system. Therefore, investigating how an oxidative stress-resistant phenotype is brought about in
C. neoformans
not only furthers our understanding of fungal pathogenesis but also unveils mechanisms of stress-induced gene reprogramming. We discovered that H
2
O
2
-derived oxidative stress resulted in severe translational suppression and that this suppression was necessary for the accelerated decay and expression of tested transcripts.
Hypotony maculopathy: a surgeon’s nightmare
Authors: Sen Saswati , Parija Sucheta , Nayak Bhagabat
Published: November 2019

A 14-year-old myopic male patient diagnosed as steroid-induced glaucoma and cataract elsewhere presented to the eye opd with painless and progressive diminution of vision in the right eye (oculus dexter (OD)) for last 6 months. Phacotrabeculectomy was already done in the left eye (oculus sinister (OS)) 1 year ago and he was on topical latanoprost e/d-H.S in OD and brimonidine e/d-BD and dorzolamide e/d-TDS in both eyes (oculus uterque (OU)) postsurgery. Uneventful phacotrabeculectomy was performed in the right eye under 300 mL intravenous injection mannitol. He developed hypotony maculopathy postsurgery which was managed conservatively.
Do protocols for new randomised trials take previous similar trials into account? Cohort study of contemporary trial protocols
Authors: Paludan-Müller Asger Sand , Ogden Michelle C , Marquardsen Mikkel , Vive Jonas , Jørgensen Karsten Juhl , Gøtzsche Peter Christian
Published: November 2019

Objective

To investigate to what extent evidence from previous similar trials or systematic reviews was considered before conducting new trials.

Design

Cohort study of contemporary protocols for trials with ethical approval.

Methods

All protocols for randomised trials approved by the five ethical committees in Denmark between January 2012 and March 2013 were screened for eligibility. Included protocols were read in full to determine whether a systematic search had been conducted and references were checked to evaluate whether trial rationale and design could be challenged for not adequately considering previous evidence. To investigate whether protocols cited relevant trials, we used simple search strategies that could easily be conducted by researchers without experience with literature searches.

Results

Sixty-seven protocols were included. Only two (3%) of the protocols explicitly stated to have conducted a literature search and only one (1%) provided information that allowed the search to be replicated. Eleven (16%) of the protocols described trials where we found the information insufficient to judge if the trial was ethically justified, either due to a comparator that was not supported by the presented evidence (six protocols), because they did not present a rationale for conducting the trial (two protocols), or for both reasons (three protocols). For eight (12%) of the protocols, our search identified trials that could have been relevant to cite as justification.

Conclusions

While most protocols seem to adequately consider existing evidence, a substantial minority of trials might lack a sufficient evidence base. Very few trials seemed to have been based on a literature search which makes it impossible to know whether all relevant previous trials had been considered. Rules for ethical approval should include requirements for systematic literature searches to ensure that research participants are not exposed to sub-optimal treatments or unnecessary harms as well as to reduce research waste.
Sedation AND Weaning In Children (SANDWICH): protocol for a cluster randomised stepped wedge trial
Authors: Blackwood Bronagh , Agus Ashley , Boyle Roisin , Clarke Mike , Hemming Karla , Jordan Joanne , Macrae Duncan , McAuley Daniel Francis , McDowell Clíona , McIlmurray Lisa , Morris Kevin P , Murray Margaret , Parslow Roger , Peters Mark J , Tume Lyvonne N , Walsh Tim
Published: November 2019

Introduction

Weaning from ventilation is a complex process involving several stages that include recognition of patient readiness to begin the weaning process, steps to reduce ventilation while optimising sedation in order not to induce distress and removing the endotracheal tube. Delay at any stage can prolong the duration of mechanical ventilation. We developed a multicomponent intervention targeted at helping clinicians to safely expedite this process and minimise the harms associated with unnecessary mechanical ventilation.

Methods and analysis

This is a 20-month cluster randomised stepped wedge clinical and cost-effectiveness trial with an internal pilot and a process evaluation. It is being conducted in 18 paediatric intensive care units in the UK to evaluate a protocol-based intervention for reducing the duration of invasive mechanical ventilation. Following an initial 8-week baseline data collection period in all sites, one site will be randomly chosen to transition to the intervention every 4 weeks and will start an 8-week training period after which it will continue the intervention for the remaining duration of the study. We aim to recruit approximately 10 000 patients. The primary analysis will compare data from before the training (control) with that from after the training (intervention) in each site. Full details of the analyses will be in the statistical analysis plan.

Ethics and dissemination

This protocol was reviewed and approved by NRES Committee East Midlands—Nottingham 1 Research Ethics Committee (reference: 17/EM/0301). All sites started patient recruitment on 5 February 2018 before randomisation in April 2018. Results will be disseminated in 2020. The results will be presented at national and international conferences and published in peer-reviewed medical journals.

Trial registration number

ISRCTN16998143.
Relationship between cricket participation, health and well-being: scoping review protocol
Authors: Bullock Garrett Scott , Panagodage-Perera Nirmala K , Murray Andrew , Arden Nigel K , Filbay Stephanie R
Published: November 2019

Introduction

Cricket is a popular sport played by 2.5 billion people of all ages and abilities. However, cricket participation is decreasing in the UK, despite an increased focus of governments on increasing sport participation to enhance public health. Understanding the health benefits and mitigating the health risks of cricket participation may help cricket organisations promote cricket participation while optimising the long-term health of cricket participants. Currently, there is no literature review on the relationship between cricket participation, health and well-being; thus, this relationship remains unclear. Therefore, the aims of this scoping review were (1) to investigate the relationship between cricket participation, health and well-being and (ii) to identify the research gaps related to cricket, health and well-being.

Methods and analysis

Due to the broad nature of our research question and the large number of health outcomes assessed within the cricket literature and to facilitate identification of research gaps, a scoping review methodology was used. The methodology of this paper was informed by previous scoping review protocols and best practice methodological frameworks. MEDLINE, CINAHL, Embase, Scopus, PsycINFO, SPORTDiscus, Cochrane Library, EBSCO, Web of Science and PEDro and grey literature sources (Google Scholar, ClinicalTrials.gov, ISRCTN Registry and ProQuest) will be systematically searched. Studies that assess a construct related to health and/or well-being in current and/or former cricketers from all ages and standards of play will be eligible. Two reviewers will independently screen full texts of identiﬁed studies for eligibility and will perform data extraction. Results will be presented in tabular and graphical forms and will be reported descriptively.

Ethics and dissemination

This research is exempt from ethics approval due to the data being available through published and public available resources. Results will be published in a peer-reviewed sports and exercise medicine journal regardless of positive or negative findings. In addition, results will be disseminated through multiple platforms, including conference presentations and social media using multimedia resources (eg, infographics, animations, videos, podcasts and blogs), to engage stakeholder groups, including cricketers, cricket coaches, sporting bodies, sports medicine professionals and policy makers. There findings will inform clinical decision making, policy changes and future research agendas.
Evaluation of the efficacy of 3D total-body photography with sequential digital dermoscopy in a high-risk melanoma cohort: protocol for a randomised controlled trial
Authors: Primiero Clare Amy , McInerney-Leo Aideen M , Betz-Stablein Brigid , Whiteman David C , Gordon Louisa , Caffery Liam , Aitken Joanne F , Eakin Elizabeth , Osborne Sonya , Gray Len , Smithers B Mark , Janda Monika , Soyer H Peter , Finnane Anna
Published: November 2019

Introduction

Melanoma is Australia’s fourth most common cancer. Early detection is fundamental in maximising health outcomes and minimising treatment costs. To date, population-based screening programmes have not been justified in health economic studies. However, a skin surveillance approach targeting high-risk individuals could improve the cost-benefit ratio.

Methods and analysis

This paper describes a 2-year longitudinal randomised controlled trial (RCT) to compare routine clinical care (control) with an intensive skin surveillance programme (intervention) consisting of novel three-dimensional (3D) total-body photography (TBP), sequential digital dermoscopy and melanoma-risk stratification, in a high-risk melanoma cohort. Primary outcomes will evaluate clinical, economic and consumer impact of the intervention. Clinical outcomes will evaluate differences in the rate of lesion excisions/biopsies per person, benign to malignant ratio for excisions and thickness of melanomas diagnosed. A health economic analysis using government data repositories will capture healthcare utilisation and costs relating to skin surveillance. Consumer questionnaires will examine intervention acceptability, the psychological impact, and attitudes towards melanoma risk and sun protective behaviour. Secondary outcomes include the development of a holistic risk algorithm incorporating clinical, phenotypic and genetic factors to facilitate the identification of those most likely to benefit from this surveillance approach. Furthermore, the feasibility of integrating the intervention with teledermatology to enhance specialist care in remote locations will be evaluated. This will be the first RCT to compare a targeted surveillance programme utilising new 3D TBP technology against current routine clinical care for individuals at high risk of melanoma.

Ethics and dissemination

This study has received Human Research Ethics Committee (HREC) approval from both Metro South Health HREC (HREC/17/QPAH/816) and The University of Queensland HREC (2018000074).

Trial registration number

ANZCTR12618000267257; Pre-results.
Omega-3 fatty acids supplementation protects the retina from age-associated degeneration in aged C57BL/6J mice
Authors: Prokopiou Ekatherine , Kolovos Panagiotis , Georgiou Christos , Kalogerou Maria , Potamiti Louiza , Sokratous Kleitos , Kyriacou Kyriacos , Georgiou Tassos
Published: November 2019

Objective

To evaluate the therapeutic effects of omega-3 (ω3) fatty acids in the retina of aged mice when the blood arachidonic acid (AA)/eicosapentaenoic acid (EPA) ratio is maintained between 1.0 and 1.5.

Methods and analysis

Aged (24-month-old) wild-type C57BL/6J mice were allocated to two groups: ω3 treated and untreated. Treatment with ω3 was by daily gavage administration of EPA and docosahexaenoic acid for 60 days. Gas chromatography was used to identify and quantify fatty acids in the blood and retina. To count lipofuscin granules and measure the photoreceptor layer, eyecups were examined histologically using transmission electron microscopy and light microscopy. We also analysed eyecups using mass spectrometry-based proteomics.

Results

AA levels were lower, and EPA levels were higher, in the blood and retinas of the ω3-treated group than in the untreated group, resulting in a lower AA/EPA ratio. The ω3-treated group also showed significantly fewer lipofuscin granules and a thicker outer nuclear layer than the untreated group. Proteomic analysis revealed significantly greater expression of myelin basic protein, myelin regulatory factor-like protein, myelin proteolipid protein and glial fibrillar acidic protein in the ω3-treated group than in the untreated group. Three different pathways were significantly affected by ω3 treatment: fatty acid elongation, biosynthesis of unsaturated fatty acids and metabolic pathways.

Conclusion

Two months of ω3 supplementation (when the blood AA/EPA~1.0–1.5) in aged mice reduced lipofuscin granule formation in the retina and protected the photoreceptor layer, suggesting that ω3 supplementation slows normal age-related retinal degeneration.
Pilot study of an integrated model of sleep support for children: a before and after evaluation
Authors: Elphick Heather E , Lawson Candi , Ives Ann , Siddall Sue , Kingshott Ruth N , Reynolds Janine , Dawson Victoria , Hall Lorraine
Published: November 2019

Objective

Despite the success of behavioural sleep support interventions in the third sector, sleep support is not universally available for families in the UK. The aim of the study was to provide evidence of efficacy and to propose a delivery model for integrated sleep support for families of vulnerable children.

Design and setting

A sleep support intervention was carried out in Sheffield Local Authority evaluated using a preintervention and postintervention study design by Sheffield Children’s National Health Service (NHS) Trust.

Participants

Fifty-six children aged 6–16 years with significant sleep problems were recruited; 39 completed the intervention and evaluation.

Interventions

Basic sleep education and an individualised programme was delivered by a sleep practitioner. Follow-on telephone support was provided to empower the parent (and/or young person) to carry out the sleep programme at home. An integrated NHS and Local Authority delivery model was designed and implemented.

Results

Parents’ ratings of their child’s ability to self-settle improved from 1.1/10 to 6.4/10 (p<0.05). Mean Warwick-Edinburgh Mental Well-being Scale scores improved significantly for parents/carers (MD 5.16, 95%CIs 2.62 to 7.69, p<0.05). Children who completed the intervention gained on average an extra 2.4 hours sleep a night. There was reduction in healthcare utilisation, illnesses and medication use.

Conclusions

The behavioural approach to sleep support for these vulnerable groups of children is highly effective. Follow-on individual support to empower parents is key to achieving success. Sleep support can be implemented in NHS and Local Authority services by integration into the existing workforce using a cross-agency model.
High-intensity interval training in haemodialysis patients: a pilot randomised controlled trial
Authors: Nilsson Birgitta Blakstad , Bunæs-Næss Heidi , Edvardsen Elisabeth , Stenehjem Aud-Eldrid
Published: November 2019

Objectives

Patients with end-stage renal disease (ESRD) undergoing haemodialysis (HD) have significantly reduced cardiorespiratory fitness and health-related quality of life (HRQoL). Our hypothesis was that high-intensity interval training (HIIT) is a feasible and safe form of exercise during HD and that HIIT would elicit greater change in cardiorespiratory fitness and HRQoL compared with moderate-intensity continuous training (MICT).

Methods

Twenty patients were randomised to either HIIT (n=6), MICT (n=8) (two times a week within 22 weeks) or usual care (n=6). Feasibility was assessed by session attendance and adherence to exercise intensity. Safety was assessed by adverse event reporting. Efficacy was determined from change in peak oxygen uptake (VO2peak), 6 min walk distance and a HRQoL questionnaire (the COOP-WONCA chart).

Results

Eleven patients (55%) completed premeasurements and postmeasurements. The main reason for drop-out was due to kidney transplant during follow-up. The patients completed the same number of sessions in each group and adhered to the target heart rates after habituation. There were no adverse events. In the HIIT group, two of the three patients increased VO2peakby 46% and 53%, respectively. Three of the five patients in the MICT group increased their VO2peakby 6%, 18% and 36%, respectively.

Conclusions

This pilot study demonstrated that HIIT is a feasible and safe exercise model for intradialytic exercise in patients undergoing HD. There might be a considerable potential of intradialytic HIIT in patients undergoing HD. Further studies with larger sample sizes are needed to determine if HIIT is an optimal approach in patients with ESRD undergoing HD.

Trial registration number

NCT01728415.
Generalised joint hypermobility increases ACL injury risk and is associated with inferior outcome after ACL reconstruction: a systematic review
Authors: Sundemo David , Hamrin Senorski Eric , Karlsson Louise , Horvath Alexandra , Juul-Kristensen Birgit , Karlsson Jon , Ayeni Olufemi R , Samuelsson Kristian
Published: November 2019

Objectives

To investigate the association between generalised joint hypermobility (GJH) and ACL injury risk. Secondary aims involved evaluating associations between GJH and postoperative outcome (including graft-failure risk, knee laxity and patient-reported outcome). Furthermore, we aimed to compare the performance of different grafts in patients with GJH.

Methods

Databases MEDLINE/PubMed, EMBASE and the Cochrane Library were searched, including 2760 studies. Two reviewers independently screened studies for eligibility. A modified version of the MINORS score was applied for quality appraisal. Studies assessing GJH while reporting the risk of ACL injury and/or postoperative outcome were included.

Results

Twenty studies were included, using several different methods to determine GJH. There was consistent evidence showing that GJH is a risk factor for unilateral ACL injury in males, while in females, the results were conflicting. There was limited evidence associating GJH with increased knee laxity 5 years postoperatively. There was consistent evidence of inferior postoperative patient-reported outcome in patients with GJH. Moreover, there was limited yet consistent evidence indicating that patellar-tendon autografts are superior to hamstring-tendon autografts in patients with GJH in terms of knee laxity and patient-reported outcome. There was insufficient evidence to draw conclusions regarding the outcomes of bilateral ACL injury and graft failure.

Conclusions

In men, GJH was associated with an increased risk of unilateral ACL injury. Moreover, GJH was associated with greater postoperative knee laxity and inferior patient-reported outcome. Based on the available evidence, a patellar-tendon autograft appears to be superior to a hamstring-tendon autograft in patients with GJH. However, the included studies were heterogeneous and there is a need for consensus in the assessment of GJH within sports medicine.
Mortality rates in teaching hospital complex care wards in England: a retrospective audit
Authors: Burrell Alexander , Woodcraft Heather , Devine Mark
Published: November 2019

Objective

Existing data examining mortality rates following inpatient hospital admissions in the UK are either condition specific or examining all inpatient mortality based on single time point audits. This clinical effectiveness project aimed to assess mortality rates in patients admitted to complex care (CC) wards managed by geriatricians at Southmead hospital, Bristol.

Methods

Data were collected by the trust’s audit department and analysed by the authors. All patients admitted to the four CC wards from July to December 2017 were included. Data collected included age, gender, date of admission, length of stay, date of discharge and date of death if applicable.

Results

2673 patients were admitted to CC wards from July to December 2017. 42.72% of patients were men, and mean age of patients was 82.46 years. Mean length of stay was 16.68 days. 292 (10.92%) of patients died during the index admission. Overall mortality rates were: (1) 1 month: 11.34% (303 patients); (2) 3 months: 21.59% (577 patients); (3) 6 months: 30.15% (806 patients); (4) 12 months: 38.53% (1030 patients). 12-month mortality increased with age from 75 upwards (34.04% in 75–79 years, 42.94% in 85–89 years, 50.27% in 95–99 years, 66.67% in 100–104 years) but was similar in those aged 65–69 and 70–74 years (29.41% and 28.18%, respectively).

Conclusions

An improved understanding of mortality rates in patients requiring an admission under geriatricians may aid clinicians’ ability to prognosticate. Appreciating that over a third of these patients are potentially in the last year of life provides further impetus to begin advance care planning discussions during inpatient admissions.
Injuries associated with electric-powered bikes and scooters: analysis of US consumer product data
Authors: DiMaggio Charles J , Bukur Marko , Wall Stephen P , Frangos Spiros G , Wen Andy Y
Published: November 2019

Background

Powered, two-wheeled transportation devices like electric bicycles (E-bikes) and scooters are increasingly popular, but little is known about their relative injury risk compared to pedal operated bicycles.

Methods

Descriptive and comparative analysis of injury patterns and trends associated with E-bikes, powered scooters and pedal bicycles from 2000 to 2017 using the US National Electronic Injury Surveillance System.

Results

While persons injured using E-bikes were more likely to suffer internal injuries (17.1%; 95% CI 5.6 to 28.6) and require hospital admission (OR=2.8, 95% CI 1.3 to 6.1), powered scooter injuries were nearly three times more likely to result in a diagnosis of concussion (3% of scooter injuries vs 0.5% of E-bike injuries). E-bike-related injuries were also more than three times more likely to involve a collision with a pedestrian than either pedal bicycles (OR=3.3, 95% CI 0.5 to 23.6) or powered scooters (OR=3.3, 95% CI 0.3 to 32.9), but there was no evidence that powered scooters were more likely than bicycles to be involved in a collision with a pedestrian (OR=1.0, 95% CI 0.3 to 3.1). While population-based rates of pedal bicycle-related injuries have been decreasing, particularly among children, reported E-bike injuries have been increasing dramatically particularly among older persons.

Conclusions

E-bike and powered scooter use and injury patterns differ from more traditional pedal operated bicycles. Efforts to address injury prevention and control are warranted, and further studies examining demographics and hospital resource utilisation are necessary.
Estimation of individual knot volumes by mixed-effects modelling
Authors: Manso Rubén , McLean J. Paul , Ash Adam , Achim Alexis
Published: November 2019

We present a new method to estimate individual knot volumes based on a knot geometry model coupled with observations on branch characteristics. X-ray computer tomography and image analysis were used to measure the volume and geometry of 424 knots of Sitka spruce (Picea sitchensis (Bong.) Carrière). Knot geometry can be described mathematically by deriving functions for relative vertical position, diameter, and slope dependent on radial position in the stem. These functions were parameterized using “seemingly unrelated regression” and mixed-modelling techniques. This provided a base model for typical knots. To estimate individual knot volume, we used available data for branch diameter and insertion angle to obtain conditional predictions. We imputed the most likely knot trajectory, as relative vertical position cannot be measured on branches. The model explained up to 96% of the variability in knot volume by incorporating the branch measurements, in contrast to the 43% explained using the typical knot model. Knot volume assessment based only on conditional predictions of diameter and marginal predictions of vertical position also accounted for 96% of the variability. Therefore, measurements of branch diameter alone would be enough to obtain highly precise predictions of individual knot volume. This estimator is a first step towards a knot model to be used for the management of Sitka spruce in Great Britain.
Full two-loop QCD corrections to the Higgs mass in the MSSM with heavy superpartners
Authors: Bagnaschi Emanuele , Degrassi Giuseppe , Paßehr Sebastian , Slavich Pietro
Published: November 2019

We improve the determination of the Higgs-boson mass in the MSSM with heavy superpartners, by computing the two-loop threshold corrections to the quartic Higgs coupling that involve both the strong and the electroweak gauge couplings. Combined with earlier results, this completes the calculation of the two-loop QCD corrections to the quartic coupling at the SUSY scale. We also compare different computations of the relation between the quartic coupling and the pole mass of the Higgs boson at the EW scale. We find that the numerical impact of the new corrections on the prediction for the Higgs mass is modest, but comparable to the accuracy of the Higgs-mass measurement at the LHC.
Limits on the charged Higgs parameters in the two Higgs doublet model using CMS $$\sqrt{s}=13$$ TeV results
Authors: Sanyal Prasenjit
Published: November 2019

The latest CMS results on the upper limits on $$\sigma _{H^\pm }$$σH±BR($$H^\pm \rightarrow \tau ^\pm \nu )$$H±→τ±ν) and $$\sigma _{H^\pm }$$σH±BR($$H^+ \rightarrow t{\bar{b}}$$H+→tb¯) for $$\sqrt{s}=13$$s=13 TeV at an integrated luminosity of 35.9 $$\hbox {fb}^{-1}$$fb-1 are used to impose constraints on the charged Higgs $$H^\pm $$H± parameters within the Two Higgs Doublet Model (2HDM). The 2HDM is the simplest extension of the Standard Model (SM) under the same gauge symmetry to contain charged Higgs and is relatively little constrained compared to the Minimal Supersymmetric Standard Model (MSSM). The latest results lead to much more stringent constraints on the charged Higgs parameter space than for the earlier 8 TeV results. The CMS collaboration also studied the exotic bosonic decays $$H^\pm \rightarrow W^\pm A$$H±→W±A and $$A \rightarrow \mu ^+ \mu ^-$$A→μ+μ- for the first time and put upper limits on the BR($$t\rightarrow H^+ b$$t→H+b) for the light charged Higgs boson. These constraints lead to the exclusion of parameter space which is not excluded by the $$\tau \nu $$τν channel. For comparison the exclusion regions from flavor physics constraints are also discussed.
Nilpotent charges of a toy model of Hodge theory and an 𝒩 = 2 SUSY quantum mechanical model: (Anti-)chiral supervariable approach
Authors: Bhanja T. , Srinivas N. , Malik R. P.
Published: November 2019

We derive the nilpotent (anti-)BRST and (anti-)co-BRST symmetry transformations for the system of a toy model of Hodge theory (i.e. a rigid rotor) by exploiting the (anti-)BRST and (anti-)co-BRST invariant restrictions on the (anti-)chiral supervariables that are defined on the appropriately chosen [Formula: see text]-dimensional super-submanifolds of the general [Formula: see text]-dimensional supermanifold on which our system of a one [Formula: see text]-dimensional (1D) toy model of Hodge theory is considered within the framework of the augmented version of the (anti-)chiral supervariable approach (ACSA) to Becchi–Rouet–Stora–Tyutin (BRST) formalism. The general [Formula: see text]-dimensional supermanifold is parametrized by the superspace coordinates [Formula: see text], where [Formula: see text] is the bosonic evolution parameter and [Formula: see text] are the Grassmannian variables which obey the standard fermionic relationships: [Formula: see text], [Formula: see text]. We provide the geometrical interpretations for the symmetry invariance and nilpotency property. Furthermore, in our present endeavor, we establish the property of absolute anticommutativity of the conserved fermionic charges which is a completely novel and surprising observation in our present endeavor where we have considered only the (anti-)chiral supervariables. To corroborate the novelty of the above observation, we apply this ACSA to an [Formula: see text] SUSY quantum mechanical (QM) system of a free particle and show that the [Formula: see text] SUSY conserved and nilpotent charges do not absolutely anticommute.
Optimal learning with Gaussians and correntropy loss
Authors: Lv Fusheng , Fan Jun
Published: November 2019

Correntropy-based learning has achieved great success in practice during the last decades. It is originated from information-theoretic learning and provides an alternative to classical least squares method in the presence of non-Gaussian noise. In this paper, we investigate the theoretical properties of learning algorithms generated by Tikhonov regularization schemes associated with Gaussian kernels and correntropy loss. By choosing an appropriate scale parameter of Gaussian kernel, we show the polynomial decay of approximation error under a Sobolev smoothness condition. In addition, we employ a tight upper bound for the uniform covering number of Gaussian RKHS in order to improve the estimate of sample error. Based on these two results, we show that the proposed algorithm using varying Gaussian kernel achieves the minimax rate of convergence (up to a logarithmic factor) without knowing the smoothness level of the regression function.