bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol for a validation study of the translated stapesplasty outcome test 25 for measurement of disease-specific quality of life in Dutch patients with otosclerosis
Authors: Blijleven Esther E , Thomeer Hans G X M , Stokroos Robert , Wegner Inge
Published: December 2019

Introduction

Otosclerosis is a common cause of acquired conductive hearing loss and can be treated using hearing aids or surgically. Surgical success rates or surgical results are usually reported using pure-tone audiometric thresholds and/or speech discrimination scores. Audiometric results and patient-reported quality of life after stapes surgery do not seem to correlate well. It is therefore our opinion that health-related quality of life measurements should be implemented as an additional outcome measure after stapes surgery. So far, there is a lack of a valid, reliable and clinically feasible measuring tool for determining health-related quality of life in Dutch patients with otosclerosis who undergo stapes surgery.

Methods and analysis

A prospective validation study was designed to translate and validate the disease-specific Stapesplasty Outcome Test 25 (SPOT-25) in a population of Dutch patients with otosclerosis who undergo primary stapes surgery. A total of 125 patients with otosclerosis who will be undergoing primary stapes surgery and 50 healthy controls will be included. The patients with otosclerosis will fulfil several questionnaires preoperatively, 6 to 8 weeks postoperatively and 8 to 10 weeks postoperatively with a 2-week interval between the postoperative administrations. The patients’ audiometric results, which are measured routinely before and after undergoing primary stapes surgery, will also be used. The healthy controls will fulfil the translated SPOT-25 once. First, the original SPOT-25 will be translated from German to Dutch in a six-step process. Second, the translated SPOT-25 will be pilot-tested in a subset of patients. Lastly, validity, reliability and responsiveness of the translated SPOT-25 will be analysed.

Ethics and dissemination

The research protocol was approved by the Institutional Review Board of the University Medical Center Utrecht (protocol 18–768/C; V.1, November 2018). Initially, we planned to include 50 patients. At a later stage we decided to increase the sample size to 100 patients. We notified the Institutional Review Board of this change to the protocol. The trial results will be disseminated through peer-reviewed medical journals and presented at scientific conferences.

Trial registration number

NL7586.
Prevalence and correlates of depressive symptoms among gay, bisexual and other men who have sex with men in the PROUD randomised clinical trial of HIV pre-exposure prophylaxis
Authors: Miltz Ada , Lampe Fiona , McCormack Sheena , Dunn David , White Ellen , Rodger Alison , Phillips Andrew , Sherr Lorraine , Sullivan Ann K , Reeves Iain , Clarke Amanda , Gafos Mitzy
Published: December 2019

Objectives

The aim of this analysis is to: (i) assess the prevalence of clinically significant depressive symptoms at baseline and follow-up for participants in the PROUD trial of HIV pre-exposure prophylaxis (PrEP), examining changes in prevalence over time and (ii) investigate the association of socioeconomic and psychosocial factors with depression.

Methods

PROUD was an open label randomised trial evaluating the benefit of PrEP for 544 HIV-negative gay, bisexual and other men who have sex with men (GBMSM) in England. Enrolment was between 2012 and 2014, with at least 2 years follow-up. Prevalence of depression (score ≥10 on Patient Health Questionnaire-9) was assessed and compared across time-points (using McNemar’s χ2tests) and between trial arms (using χ2tests). Cross-sectional associations with socioeconomic and psychosocial factors were examined using baseline data in modified Poisson regression models and combined 12 and 24 month follow-up data in generalised estimating equations (GEEs). Prevalence ratios (PRs) were presented as unadjusted PR and adjusted PR (aPR) for age, UK birth, sexual identity, university education, London study clinic site and calendar time (and follow-up time-point in GEEs).

Results

Depression increased significantly from baseline (9.1%; 49/540) to the 12 month (14.4%; 59/410) and 24 month (14.4%; 48/333) follow-ups, possibly explained by underreporting at baseline. The prevalence of depression did not differ by study trial arm, at any time-point. In the baseline analysis, younger age, unemployment and crystal methamphetamine use, was associated with depression. In combined analysis of 12 and 24 month data, measures of intimate partner violence (IPV) (lifetime IPV victimisation aPR 2.57 (95% CI: 1.71 to 3.86)), internalised homophobia (aPR 1.91 (95% CI: 1.29 to 2.83)) and concealment of sexual identity (aPR 1.75 (95% CI: 1.16 to 2.65)), were strongly associated with depression.

Conclusions

There is a high concomitant burden of psychosocial factors with depression among GBMSM.

Trial registration number

ISRCTN (ISRCTN94465371) and ClinicalTrials.gov (NCT02065986).
Exploring the impact and experience of fractional work in medicine: a qualitative study of medical oncologists in Australia
Authors: Kirby Emma , Broom Alex , Karikios Deme , Harrup Rosemary , Lwin Zarnie
Published: December 2019

Objectives

Fractional (part-time) appointments are becoming more commonplace in many professions, including medicine. With respect to the contemporary oncological landscape, this highlights a critical moment in the optimisation of employment conditions to enable high-quality service provision given growing patient numbers and treatment volume intensification. Data are drawn from a broader study which aimed to better understand the workforce experiences of medical oncologists in Australia. This paper specifically aims to examine a group of clinicians’ views on the consequences of fractional work in oncology.

Design

Qualitative, one-on-one semistructured interviews. Interview transcripts were digitally audio recorded and transcribed verbatim. Data were subject to thematic analysis supported by the framework approach and informed by sociological methods and theory.

Setting

New South Wales, Australia.

Participants

Medical oncologists (n=22), including 9 female and 13 male participants, at a range of career stages.

Results

Four key themes were derived from the analysis: (1) increasing fractional employment relative to opportunities for full-time positions and uncertainty about future opportunities; (2) tightening in role diversity, including reducing time available for research, mentoring, professional development and administration; (3) emerging flexibility of medical oncology as a specialty and (4) impact of fractional-as-norm on workforce sustainability and quality of care.

Conclusion

Fractional appointments are viewed as increasing in oncology and the broader consequences of this major shift in medical labour remain unexamined. Such appointments offer potential for flexible work to better suit the needs of contemporary oncologists; however, fractional work also presents challenges for personal and professional identity and vocational engagement. Fractional appointments are viewed as having a range of consequences related to job satisfaction, burnout and service delivery. Further research is needed to provide a critical examination of the multiple impacts of workforce trends within and beyond oncology.
Healthy Dads, Healthy Kids UK, a weight management programme for fathers: feasibility RCT
Authors: Griffin Tania , Sun Yongzhong , Sidhu Manbinder , Adab Peymane , Burgess Adrienne , Collins Clare , Daley Amanda , Entwistle Andrew , Frew Emma , Hardy Pollyanna , Hurley Kiya , Jones Laura , McGee Eleanor , Pallan Miranda , Young Myles , Morgan Philip , Jolly Kate
Published: December 2019

Objective

To assess (1) the feasibility of delivering a culturally adapted weight management programme, Healthy Dads, Healthy Kids United Kingdom (HDHK-UK), for fathers with overweight or obesity and their primary school-aged children, and (2) the feasibility of conducting a definitive randomised controlled trial (RCT).

Design

A two-arm, randomised feasibility trial with a mixed-methods process evaluation.

Setting

Socioeconomically disadvantaged, ethnically diverse localities in West Midlands, UK.

Participants

Fathers with overweight or obesity and their children aged 4–11 years.

Intervention

Participants were randomised in a 1:2 ratio to control (family voucher for a leisure centre) or intervention comprising 9 weekly healthy lifestyle group sessions.

Outcomes

Feasibility of the intervention and RCT was assessed according to prespecified progression criteria: study recruitment, consent and follow-up, ability to deliver intervention, intervention fidelity, adherence and acceptability, weight loss, using questionnaires and measurements at baseline, 3 and 6 months, and through qualitative interviews.

Results

The study recruited 43 men, 48% of the target sample size; the mean body mass index was 30.2 kg/m2 (SD 5.1); 61% were from a minority ethnic group; and 54% were from communities in the most disadvantaged quintile for socioeconomic deprivation. Recruitment was challenging. Retention at follow-up of 3 and 6 months was 63%. Identifying delivery sites and appropriately skilled and trained programme facilitators proved difficult. Four programmes were delivered in leisure centres and community venues. Of the 29 intervention participants, 20 (69%) attended the intervention at least once, of whom 75% attended ≥5 sessions. Sessions were delivered with high fidelity. Participants rated sessions as ‘good/very good’ and reported lifestyle behavioural change. Weight loss at 6 months in the intervention group (n=17) was 2.9 kg (95% CI −5.1 to −0.6).

Conclusions

The intervention was well received, but there were significant challenges in recruitment, programme delivery and follow-up. The HDHK-UK study was not considered feasible for progression to a full RCT based on prespecified stop–go criteria.

Trial registration number

ISRCTN16724454.
Doppler ultrasound values after liver transplantation in children and their association with graft outcomes: a protocol for a systematic review and meta-analysis
Authors: Ruiz Martha M , Alobaidi Rashid , Noga Michelle Lisa , Featherstone Robin , Shapiro James , Bhargava Ravi
Published: December 2019

Introduction

Liver graft and patient survival in children have improved substantially over the years; nevertheless, graft-related complications persist as the most important risk factor for mortality and graft loss. Doppler ultrasound evaluation is routinely used after liver transplantation; however, there is no consensus defining normal values, timing or frequency of Doppler ultrasound postoperative evaluation. Identification of patients who require an intervention or change in postoperative management is therefore challenging.

Methods and analysis

We will conduct a systematic review and meta-analysis to appraise and synthesise evidence describing Doppler ultrasound measurements and their association with graft complications in children who have received a liver transplant. We will search multiple databases: Ovid Medline, Embase, Wiley Cochrane Library, Web of Science—Science Citation Index Expanded, trial registry records and meeting abstracts using a combination of subject headings and keywords for liver transplantation, Doppler ultrasound and paediatric patients. All identified titles and abstracts of studies will be assessed for potential relevance. Selected studies will be retrieved and subjected to a second phase of screening, both selection phases will be done in duplicate by two independent reviewers, and discrepancies will be documented and resolved by a third reviewer. Data extraction will be done independently by two reviewers using a standardised data extraction form. Quality of evidence and risk of bias will be assessed, synthesised and pooled for meta-analysis if possible. We will perform a subgroup analysis if enough data are available.

Ethics and dissemination

Strategies to disseminate our review include presenting in liver transplant review sessions, publishing in high-impact peer-reviewed medical journals, and presenting at national and international paediatric radiology and liver transplant meetings, conference presentations, events, courses and plain-language summaries. This knowledge will allow easier identification of patients with a higher risk of developing graft-related complications and could potentially improve patient and graft outcomes. We wish to disseminate our results to discover potential areas for future research and drive improved future practices and policies. Our target audience includes researchers, institutions, healthcare professionals, health system decision-makers, policy-makers and research funders community.

Trial registration number

CRD42019119986.
Client-level predictors of treatment engagement, outcome and dropout: moving beyond demographics
Authors: Youn Soo-jeong , Mackintosh Margaret-Anne , Wiltsey Stirman Shannon , Patrick Kaylie A , Aguilar Silvan Yesenia , Bartuska Anna D , Shtasel Derri L , Marques Luana
Published: December 2019

Background

Despite the availability of evidence-based treatments for posttraumatic stress disorder (PTSD), significant heterogeneity in the effectiveness of PTSD treatment persists, especially in community settings. Client demographics used to understand this variability in treatment outcome and dropout have yielded mixed results. Despite increasing evidence for the importance of attending to treatment engagement in community settings, few studies have explored client-level predictors.

Aim

The purpose of this study is to explore client-level predictors of treatment outcome and dropout beyond client demographics, and to identify client-level predictors of treatment engagement in community settings.

Method

Secondary data analysis was conducted with data collected as part of an implementation-effectiveness hybrid study of cognitive processing therapy (CPT) for PTSD in a diverse community health centre. Providers (n=19) treated (n=52) clients as part of their routine clinical care. Non-demographic client-level predictors included barriers to treatment, quality of life, session-level language and employment history assessed at baseline. Treatment engagement included number of weeks in the study, number of sessions with repeated CPT content, number of unique CPT sessions attended, frequency of session attendance and consistency of session attendance.

Results

Results showed language as a significant predictor of treatment engagement. There were significant differences between Spanish and English-speaking clients, with the former having a tendency to repeat more session content than the latter (β=1.4 sessions, p=0.003), and also less likely to attend treatment frequently (r=0.62, p=0.009) and consistently (r=0.57, p=0.027) if high logistical and financial barriers were endorsed. Irrespective of language, clients who reported high quality of life at baseline were less likely to repeat CPT session content (β=−0.3, p=0.04), and those with increased baseline barriers to treatment had deceleration in PTSD symptom improvement over time (β=−0.62, p<0.05). In terms of treatment engagement moderators impacting treatment outcome, clients who repeated more session content were more likely to complete treatment (OR=1.84, p=0.037).

Conclusion

Identification of client-level predictors of treatment engagement, outcome and dropout is essential to optimise treatment, particularly in community settings.
Factors affecting post-fire regeneration after coppicing of cork oak (Quercus suber) trees in northeastern Algeria
Authors: Roula Salah Eddine , Bouhraoua Rachid T. , Catry Filipe X.
Published: December 2019

Wildfires may have serious and long-lasting impacts in Mediterranean Basin oak forests. Although cork oak (Quercus suber L.) is usually considered a highly fire-resistant tree species, post-fire recovery is not guaranteed. We assessed the mortality and regeneration of 729 cork oak trees that burned and were cut in six sites with the objective of identifying the main factors affecting the short- to medium-term post-fire recovery. We used linear mixed models to investigate potential relationships among tree stump status at the end of the second and fifth growing seasons and several tree- and site-level variables. Overall tree mortality in the second year was 44% and was negatively affected by bark thickness and positively affected by root exposure, trunk injuries, and diameter, in decreasing order of importance. Between the second and fifth years, mortality increased to 53%, but this increase was only observed in sites with high grazing pressure. Grazing also had a strong negative impact on the growth of basal resprouts, thereby compromising tree recovery. The results give useful information on the need for application of adequate forest management practices (particularly avoiding debarking injuries, soil erosion, and grazing pressure) to increase the resilience of these ecosystems and reduce the negative economic and ecological impacts of wildfires.
A linear-amplification VDJ-seq technique for quantification of immunoglobulin and T cell receptor diversity
Authors: Zhao Hao , Li Zhaoqiang , Zhu Yongchang , Hao Bingtao
Published: December 2019

The V(D)J recombination is essential for generating a highly diverse repertoire of antigen receptors expressed on T and B lymphocytes. Here, we developed a linear-amplification VDJ-seq technique for quantifying V(D)J recombination of antigen receptor genes. This technique takes advantage of linear amplification using in vitro transcription and reverse transcription to avoid bias generated by the PCR amplification of low copy number of target DNA. The unrearranged alleles are removed by in vitro cleavage with the CRISPR-Cas9 system. The linear-amplification VDJ-seq assay was applied in quantification of the Vκ-Jκ recombination of the mouse Igκ gene with Jκ capture primers. The Jκ genes were detected in 95.86% of clean reads with more than half containing the Vκ gene, indicating high specificity of capturing and amplification. We also applied this approach to quantify the usage of Jα within the Trav12 gene family of the Tcra gene.
Scattering of compactlike structures
Authors: Bazeia D. , Mendonça T. S. , Menezes R. , de Oliveira H. P.
Published: December 2019

We investigate the collision of a new class of topological defects that tends to become compact as a control parameter increases to larger and larger values. These new compactlike defects have, in general, more than one internal discrete mode depending on the value of the control parameter and, as usual, there is a critical velocity above which the defects escape after the collision. We noticed that below the critical velocity there are the windows of escape presenting fractal structure. An interesting novelty is the appearance of metastable structures with the formation of compactlike defects, maintaining a fixed distance from each other. Another new feature is the formation of boosted localized distributions of the scalar field which we called moving oscillons. These oscillons carry away almost all scalar field energy producing a complete disruption of the compactlike defects. The pattern of the moving oscillons depends on the control parameter, and becomes more complex as we increase its value. We conjecture that the new effects may be connected with the presence of more than one vibrational mode in the spectrum of the stability potential of the model under investigation.
Probabilistic Human Intent Recognition for Shared Autonomy in Assistive Robotics
Authors: Jain Siddarth , Argall Brenna
Published: December 2019

Effective human-robot collaboration in shared autonomy requires reasoning about the intentions of the human partner. To provide meaningful assistance, the autonomy has to first correctly predict, or infer, the intended goal of the human collaborator. In this work, we present a mathematical formulation for intent inference during assistive teleoperation under shared autonomy. Our recursive Bayesian filtering approach models and fuses multiple non-verbal observations to probabilistically reason about the intended goal of the user without explicit communication. In addition to contextual observations, we model and incorporate the human agent’s behavior as goal-directed actions with adjustable rationality to inform intent recognition. Furthermore, we introduce a user-customized optimization of this adjustable rationality to achieve user personalization. We validate our approach with a human subjects study that evaluates intent inference performance under a variety of goal scenarios and tasks. Importantly, the studies are performed using multiple control interfaces that are typically available to users in the assistive domain, which differ in the continuity and dimensionality of the issued control signals. The implications of the control interface limitations on intent inference are analyzed. The study results show that our approach in many scenarios outperforms existing solutions for intent inference in assistive teleoperation and otherwise performs comparably. Our findings demonstrate the benefit of probabilistic modeling and the incorporation of human agent behavior as goal-directed actions where the adjustable rationality model is user customized. Results further show that the underlying intent inference approach directly affects shared autonomy performance, as do control interface limitations.
Adapt, Explain, Engage—A Study on How Social Robots Can Scaffold Second-language Learning of Children
Authors: Schodde Thorsten , Hoffmann Laura , Stange Sonja , Kopp Stefan
Published: December 2019

Social robots are increasingly applied to support children’s learning, but how a robot can foster (or may hinder) learning is still not fully clear. One technique used by teachers is scaffolding, temporarily assisting learners to achieve new skills or levels of understanding they would not reach on their own. We ask if and how a social robot can be utilized to scaffold second-language learning of children at kindergarten age (4--7 years). Specifically, we explore an adapt-and-explain scaffolding strategy in which a robot acts as a peer-like tutor who dynamically adapts its behavior or the learning tasks to the cognitive and affective state of the child, and provides verbal explanations of these adaptations. An evaluation study with 40 children shows that children benefit from the learning adaptation and that the explanations have a positive effect especially for slower learners. Further, in 76% of all cases the robot managed to “re-engage” children who started to disengage from the learning interaction, helping them to achieve an overall higher learning gain. These findings demonstrate that a social robot equipped with suitable scaffolding mechanisms can increase engagement and learning, especially when being adaptive to the individual behavior and states of a child learner.
Low-load resistance training to task failure with and without blood flow restriction: muscular functional and structural adaptations
Authors: Pignanelli Christopher , Petrick Heather L. , Keyvani Fatemeh , Heigenhauser George J. F. , Quadrilatero Joe , Holloway Graham P. , Burr Jamie F.
Published: December 2019

The application of blood flow restriction (BFR) during resistance exercise is increasingly recognized for its ability to improve rehabilitation and for its effectiveness in increasing muscle hypertrophy and strength among healthy populations. However, direct comparison of the skeletal muscle adaptations to low-load resistance exercise (LL-RE) and low-load BFR resistance exercise (LL-BFR) performed to task failure is lacking. Using a within-subject design, we examined whole muscle group and skeletal muscle adaptations to 6 wk of LL-RE and LL-BFR training to repetition failure. Muscle strength and size outcomes were similar for both types of training, despite ~33% lower total exercise volume (load × repetition) with LL-BFR than LL-RE (28,544 ± 1,771 vs. 18,949 ± 1,541 kg, P = 0.004). After training, only LL-BFR improved the average power output throughout the midportion of a voluntary muscle endurance task. Specifically, LL-BFR training sustained an 18% greater power output from baseline and resulted in a greater change from baseline than LL-RE (19 ± 3 vs. 3 ± 4 W, P = 0.008). This improvement occurred despite histological analysis revealing similar increases in capillary content of type I muscle fibers following LL-RE and LL-BFR training, which was primarily driven by increased capillary contacts (4.53 ± 0.23 before training vs. 5.33 ± 0.27 and 5.17 ± 0.25 after LL-RE and LL-BFR, respectively, both P < 0.05). Moreover, maximally supported mitochondrial respiratory capacity increased only in the LL-RE leg by 30% from baseline ( P = 0.006). Overall, low-load resistance training increased indexes of muscle oxidative capacity and strength, which were not further augmented with the application of BFR. However, performance on a muscle endurance test was improved following BFR training.
Transcranial alternating current stimulation attenuates BOLD adaptation and increases functional connectivity
Authors: Kar Kohitij , Ito Takuya , Cole Michael W. , Krekelberg Bart
Published: December 2019

Transcranial alternating current stimulation (tACS) is used as a noninvasive tool for cognitive enhancement and clinical applications. The physiological effects of tACS, however, are complex and poorly understood. Most studies of tACS focus on its ability to entrain brain oscillations, but our behavioral results in humans and extracellular recordings in nonhuman primates support the view that tACS at 10 Hz also affects brain function by reducing sensory adaptation. Our primary goal in the present study is to test this hypothesis using blood oxygen level-dependent (BOLD) imaging in human subjects. Using concurrent functional magnetic resonance imaging (fMRI) and tACS, and a motion adaptation paradigm developed to quantify BOLD adaptation, we show that tACS significantly attenuates adaptation in the human motion area (hMT+). In addition, an exploratory analysis shows that tACS increases functional connectivity of the stimulated hMT+ with the rest of the brain and the dorsal attention network in particular. Based on field estimates from individualized head models, we relate these changes to the strength of tACS-induced electric fields. Specifically, we report that functional connectivity (between hMT+ and any other region of interest) increases in proportion to the field strength in the region of interest. These findings add support for the claim that weak 10-Hz currents applied to the scalp modulate both local and global measures of brain activity.

NEW & NOTEWORTHY Concurrent transcranial alternating current stimulation (tACS) and functional MRI show that tACS affects the human brain by attenuating adaptation and increasing functional connectivity in a dose-dependent manner. This work is important for our basic understanding of what tACS does, but also for therapeutic applications, which need insight into the full range of ways in which tACS affects the brain.
Spirochetes in the Liver: An Unusual Presentation of a Common STI
Authors: Narang Natasha , Al-Jashaami Layth , Patel Nayan
Published: December 2019

It is estimated that 10% of patients with secondary syphilis have liver enzyme elevations, but clinical hepatitis is rare. However, in HIV-positive patients, syphilitic hepatitis may be much more common. We report a case of a 67-year-old male who developed progressively elevated liver enzymes, followed by development of neurological symptoms and then rash. Though the timeline of his symptom development was unusual, his constellation of symptoms prompted an RPR and FTA-ABS which returned reactive. He was additionally found to be HIV positive with a CD4 count of 946. He was treated with IV Penicillin, and his hepatitis improved thereafter.
Systematic Review with Meta-Analysis: The Effects of Probiotics in Nonalcoholic Fatty Liver Disease
Authors: Xiao Meng-Wei , Lin Shi-Xin , Shen Zhao-Hua , Luo Wei-Wei , Wang Xiao-Yan
Published: December 2019

Background and Aims. Probiotics was considered as a potential therapy for nonalcoholic fatty liver disease (NAFLD) without approval and comprehensive assessment in recent years, which call for a meta-analysis. Methods. We performed electronic and manual searches including English and Chinese databases published before April 2019, with the use of mesh term and free text of “nonalcoholic fatty liver disease” and “probiotics.” Clinical trials evaluating the efficacy of probiotic therapy in NAFLD patients were included according to the eligibility criteria. With the use of random effects models, clinical outcomes were presented as weighted mean difference (WMD) with 95% confidence interval (CI), while heterogeneity and meta-regression were also assessed. Results. 28 clinical trials enrolling 1555 criterion proven NAFLD patients with the use of probiotics from 4 to 28 weeks were included. Overall, probiotic therapy had beneficial effects on body mass index (WMD: -1.46, 95% CI: [-2.44, -0.48]), alanine aminotransferase (WMD: -13.40, 95% CI: [-17.03, -9.77]), aspartate transaminase (WMD: -13.54, 95% CI: [-17.86, -9.22]), gamma-glutamyl transpeptidase (WMD: -9.88, 95% CI: [-17.77, -1.99]), insulin (WMD: -1.32, 95% CI: [-2.43, -0.21]), homeostasis model assessment-insulin resistance (WMD: -0.42, 95% CI: [-0.73, -0.12]), and total cholesterol (WMD: -15.38, 95% CI: [-26.50, -4.25]), but not in fasting blood sugar, lipid profiles, or tumor necrosis factor-alpha. Conclusion. The systematic review and meta-analysis support that probiotics are superior to placebo in NAFLD patients and could be utilized as a common complementary therapeutic approach.
Apolipoprotein M Serum Levels Correlate with IgA Vasculitis and IgA Vasculitis Nephritis
Authors: Wu Jiali , He Lagu , Bai Le , Tan Li , Hu Min
Published: December 2019

Objective. IgA vasculitis (lgAV) is the most frequent vessel vasculitis in children, and the prognosis is related to the children’s age and degree of nephritis. This study is aimed at investigating serum apolipoprotein M (apoM) levels in patients with lgAV patients and at evaluating the association between apoM and disease severity.Methods. A total of 109 lgAV patients and 76 age- and sex-matched healthy controls were included. The age and gender of the study participants were matched. ApoM levels were measured by an enzyme-linked immunosorbent assay. Additionally, the serum levels of lipids, apolipoproteins, kidney biochemical profiles, immunoglobulins (IgA, IgG, IgM, and IgE), and the complements (C3 and C4) were assessed using an automatic biochemical analyzer.Results. ApoM was increased significantly in lgAV patients compared to healthy controls. ApoM, meanwhile, was lower in patients with nephritis than in those without nephritis. The apoM levels were higher in classes I and II IgA vasculitis nephritis (lgAVN) patients than in classes III and IV. Besides, the apoM serumlevel<24.81 mg/Lwas an independent predictive factor for lgAVN and can be independently associated with the presence of nephritis in lgAV patients. Meanwhile, the serum apoM concentration negatively correlated with the ISKDC grading score in lgAVN patients.Conclusions. Serum apoM was elevated in lgAV patients and decreased gradually with the ISKDC grading score. ApoM (OR=0.32,95%CI=0.12‐0.85,p=0.023) was identified as a protective factor for nephritis in all lgAV patients.
Preparation of Polyamide 6/CeO2 Composite Nanofibers through Electrospinning for Biomedical Applications
Authors: Zhang Xinyu , Chen Xinggang
Published: December 2019

Polyamide 6 (PA6)/CeO2 composite nanofibers were prepared by electrospinning technique. The morphological, structural, and mechanical properties of the PA6/CeO2 nanofibers were investigated by using SEM, XRD, Fourier transform-infrared (FT-IR) spectroscopy, and an electronic universal tensile testing machine. SEM images revealed that the nanofibers were well oriented and had good incorporation with CeO2, the average diameter of composite fibers first decreases and then increases with the loading of CeO2. The crystallinity of fibers decreases after the addition of CeO2. The tensile strength of the fibers first increases and then decreases with the increasing concentration of CeO2. The proliferation properties of mouse macrophages and osteoblasts on the PA6/CeO2 nanofibers were analyzed by an in vitro cell compatibility test, the results show that PA6/CeO2 composite fibers is nontoxic to macrophages and osteoblasts and has good biocompatibility.
Fermented Garlic Ameliorates Hypercholesterolemia and Inhibits Platelet Activation
Authors: Irfan Muhammad , Kim Minki , Kim Kil-Soo , Kim Tae-Hwan , Kim Sung-Dae , Hong Seung-Bok , Kim Hyun Kyoung , Rhee Man Hee
Published: December 2019

Dietary cholesterol augments the lipid profile and induces the production and activation of platelets, leading to the development of atherosclerosis with detrimental effects on cardiovascular health. Ethnomedicine and Mediterranean diets are natural and cost-effective approaches against several ailments including cardiovascular diseases. In addition, fermented foods have attracted interest due to their increased nutrient profile and enhanced bioavailability and efficacy. Garlic is known to reduce cholesterol and inhibit platelet activation. Therefore, we examined whether fermented garlic could effectively ameliorate the effects of hypercholesterolemia and platelet functions in rats. Male Sprague-Dawley rats were fed a hypercholesterolemic diet and treated with spirulina and fermented and nonfermented preparations of garlic for one month. Platelet aggregation and granule secretion were assessed to evaluate platelet activation. Analysis of the liver and kidney weights and lipid and enzymatic profiles of the serum and whole blood analysis was performed. The expression levels of SREBP-2, ACAT-2, and HMG-CoA were assessed by RT-PCR, while ACAT-1 and ACAT-2 were assessed by real-time PCR, and histological changes in the liver and adipose tissues were analyzed. Both fermented and nonfermented garlic inhibited platelet aggregation and granule secretion; however, fermented garlic exhibited a greater inhibitory effect. In comparison with nonfermented garlic, fermented garlic significantly reduced liver weight and triglyceride concentrations. Fermented garlic also markedly abrogated the detrimental effects of steatosis on liver and adipose tissues. We conclude that fermented garlic significantly improved the lipid profile and modulated platelet functions, thereby inhibiting atherosclerosis- and platelet-related cardiovascular disorders.
Thermal Properties of Woven Kenaf/Carbon Fibre-Reinforced Epoxy Hybrid Composite Panels
Authors: Aisyah H. A. , Paridah M. T. , Sapuan S. M. , Khalina A. , Berkalp O. B. , Lee S. H. , Lee C. H. , Nurazzi N. M. , Ramli N. , Wahab M. S. , Ilyas R. A.
Published: December 2019

The effects of carbon fibre hybridisation on the thermal properties of woven kenaf-reinforced epoxy composites were studied. Woven kenaf hybrid composites of different weave designs of plain and satin and fabric counts of5×5and6×6were manually prepared by a vacuum infusion technique. A composite made from 100% carbon fibre was served for a comparison purpose. Thermal properties of pure carbon fibre and hybrid composites were determined by using a thermogravimetric analyser (TGA) and differential scanning calorimeter (DSC). It was found that a hybrid composite with higher kenaf fibre content (fabric count6×6) showed better thermal stability while the highest thermal stability was found in the pure carbon fibre composite. The TG and DTG results showed that the amount of residue decreased in the plain-designed hybrid composite compared to the satin-designed hybrid composite. The DSC data revealed that the presence of woven kenaf increased the decomposition temperature.
Mitochondrial Neurogastrointestinal Encephalomyopathy: Novel Pathogenic Mutation in Thymidine Phosphorylase Gene in a Patient from Cape Verde Islands
Authors: Falcão de Campos Catarina , Oliveira Santos Miguel , Roque Rafael , Conceição Isabel , de Carvalho Mamede
Published: December 2019

Mitochondrial Neurogastrointestinal Encephalomyopathy (MNGIE) is a rare autosomal recessive disorder caused by mutations in the gene encoding the Thymidine Phosphorylase (TP). It is clinically characterized by severe gastrointestinal dysmotility, cachexia, palpebral ptosis, ophthalmoparesis, sensorimotor polyneuropathy and leukoencephalopathy. The diagnosis is established by the presence of typical clinical and neuroimaging features, positive family history, and abnormal genetic test. A 19-year-old Cape Verdean patient with a history since childhood of recurrent episodes of nausea, vomiting, diarrhoea and painful abdominal distension associated with progressive motor disability with difficulty in climbing stairs and running and clumsiness with her hands. The diagnostic workup was suggestive of MNGIE. Genetic screening of the TYMP gene identified a novel mutation (c. 1283 G>A). Patients with MNGIE have significant comorbidity and mortality, and they are frequently misdiagnosed. A better acknowledgment of this disorder is essential to permit an earlier diagnosis and to improve disease management.
Prevalance of Celiac Disease in Patients with Inflammatory Bowel Disease in Turkish Population
Authors: Bengi Göksel , Cıvak Musa , Akarsu Mesut , Soytürk Müjde , Ellidokuz Ender , Topalak Ömer , Akpınar Hale
Published: December 2019

Background. Celiac disease (CD) and inflammatory bowel disease (IBD) involve inflammation of the gastrointestinal lumen, which environmental, genetic, and immunological factors have a role in their pathogenesis. The prevalence of celiac disease in IBD ranges from 0% to 14%. In this study, our aim was to determine the prevalence of CD in IBD patients followed by us who are attending the hospital or outpatient clinic over a period of time of seven years. Methods. Seven hundred and fifty nine patients (425 M, 334 F, mean age: 46.75, 396 ulcerative colitis (UC), 363 Crohn’s disease (CrD)) diagnosed and followed up for IBD between January 2009 and July 2016 were evaluated retrospectively, and clinical, demographic, laboratory, and endoscopic data were collected. Results. CD was investigated in 79 (%10.4) inflammatory bowel disease patients according to symptoms, and in 5.06% (n=4) of them, we diagnosed CD. The most common indication for investigating for CD was iron deficiency anemia unreponsive to iron supplementation. Conclusions. We did not find an increased prevalance of celiac disease in Turkish IBD patients in this study. In the presence of refractory iron deficiency anemia without any other cause in IBD patients, investigations for celiac disease should be considered.
Phytoestrogens and Thyroid Cancer Risk: A Population-Based Case–Control Study in Connecticut
Authors: Wang Qian , Huang Huang , Zhao Nan , Ni Xin , Udelsman Robert , Zhang Yawei
Published: December 2019

Background:

Very few previous studies have examined the relationship between thyroid cancer risk and intake of phytoestrogens (PE); furthermore, these studies have reached inconsistent results.

Methods:

We analyzed data from a population-based case–control study in Connecticut from 2010 to 2011, including 387 histologically confirmed thyroid cancer cases and 433 population-based controls, with compound data available concerning specific PEs. Multivariate unconditional logistic regression models were used to estimate the associations between specific PEs and the risk of thyroid cancer, adjusting for potential confounders.

Results:

An elevated risk of thyroid cancer was associated with moderate to high levels of coumestrol intake [OR = 2.48, 95% confidence interval (CI), 1.39–4.43 for 40–80 μg/day; OR = 2.41, 95% CI, 1.32–4.40 for 80–130 μg/day; and OR = 2.38, 95% CI, 1.26–4.50 for >200 μg/day compared with <40 μg/day], and the main elevation in risk appeared among microcarcinomas (≤1 cm). A decreased risk of papillary macrocarcinomas (>1 cm; OR = 0.26, 95% CI, 0.08–0.85 for 1,860–3,110 μg/day compared with <760 μg/day) was associated with moderate genistein intake among women.

Conclusions:

Our study suggests that high coumestrol intake increases the risk of thyroid cancer, especially microcarcinomas, whereas moderate amounts of genistein intake appear to be protective for females with thyroid macrocarcinomas.

Impact:

The study highlights the importance of distinguishing between microcarcinomas and macrocarcinomas in future research on the etiology of thyroid cancer.
Genetic Interactions and Tissue Specificity Modulate the Association of Mutations with Drug Response
Authors: Cramer Dina , Mazur Johanna , Espinosa Octavio , Schlesner Matthias , Hübschmann Daniel , Eils Roland , Staub Eike
Published: December 2019

In oncology, biomarkers are widely used to predict subgroups of patients that respond to a given drug. Although clinical decisions often rely on single gene biomarkers, machine learning approaches tend to generate complex multi-gene biomarkers that are hard to interpret. Models predicting drug response based on multiple altered genes often assume that the effects of single alterations are independent. We asked whether the association of cancer driver mutations with drug response is modulated by other driver mutations or the tissue of origin. We developed an analytic framework based on linear regression to study interactions in pharmacogenomic data from two large cancer cell line panels. Starting from a model with only covariates, we included additional variables only if they significantly improved simpler models. This allows to systematically assess interactions in small, easily interpretable models. Our results show that including mutation–mutation interactions in drug response prediction models tends to improve model performance and robustness. For example, we found that TP53 mutations decrease sensitivity to BRAF inhibitors in BRAF-mutated cell lines and patient tumors, suggesting a therapeutic benefit of combining inhibition of oncogenic BRAF with reactivation of the tumor suppressor TP53. Moreover, we identified tissue-specific mutation–drug associations and synthetic lethal triplets where the simultaneous mutation of two genes sensitizes cells to a drug. In summary, our interaction-based approach contributes to a holistic view on the determining factors of drug response.
Bilateral Vestibular Hypofunction in the Time of the Video Head Impulse Test
Authors: Pérez-Fernández Nicolás , Alvarez-Gomez Laura , Manrique-Huarte Raquel
Published: December 2019

Objectives: Bilateral vestibulopathy is a clinical syndrome in which laboratory testing plays a crucial diagnostic role. We aimed to establish the frequency of detection of that finding in a tertiary level hospital considering the new methods of laboratory vestibular examination nowadays in use, with respect to the conventional caloric and rotatory chair test approaches. Design: Two similar time periods (5 years) were retrospectively evaluated, and the demographic, clinical data and test results from 4,576 patients were reviewed. In the first period, the diagnosis was based on caloric and rotatory chair tests and, in the second, on the video head impulse test. Results: Of the patients included, 3.77% in the first period and 4.58% in the second met the criteria for bilateral vestibular hypofunction; there was no significant difference between both periods. Conclusions: The functional vestibular evaluation to detect bilateral deficiency makes no significant difference to the number of patients diagnosed with a bilateral vestibulopathy. New diagnostic categories probably depend not only on the availability and accessibility of complete vestibular and visual-vestibular evaluation, but also on recent advances in defining vestibular disorders. Bilateral vestibular hypofunction manifests with very different patterns. Progress in more detailed definition (clinical and laboratory) is needed, in particular when all 6 semicircular canals and both maculae are available for testing.
Practice Patterns for the Treatment of Uveal Melanoma with Iodine-125 Plaque Brachytherapy: Ocular Oncology Study Consortium Report 5
Authors: Binder Christina , Mruthyunjaya Prithvi , Schefler Amy C. , Seider Michael I. , Crilly Richard , Hung Arthur , Meltsner Sheridan , Mowery Yvonne , Kirsch David G. , Teh Bin S. , Jennelle Richard L.S. , Studenski Matthew T. , Liu Wu , Lee Choonik , Hayman James A. , Kastner Brian , Hadsell Michael , Skalet Alison H. ,   Ocular Oncology Study Consortium
Published: December 2019

Background: Treatment planning for I-125 plaque therapy for uveal melanoma has advanced significantly since the Collaborative Ocular Melanoma Study trial, with more widely available image-guided planning and improved dosimetry. Objective: We evaluated real-world practice patterns for I-125 plaque brachytherapy in the United States by studying practice patterns at centers that comprise the Ocular Oncology Study Consortium (OOSC). Methods: The OOSC database and responses to a treatment practice survey were evaluated. The database contains treatment information from 9 institutions. Patients included in the database were treated between 2010 and 2014. The survey was conducted in 2018 and current treatment planning methods and prescriptions were queried. Results: Examination of the OOSC database revealed that average doses to critical structures were highly consistent, with the exception of one institution. Survey responses indicated that most centers followed published guidelines regarding dose and prescription point. Dose rate ranged from 51 to 118 cGy/h. As of 2018, most institutions use pre-loaded plaques and fundus photographs and/or computed tomography or magnetic resonance imaging in planning. Conclusions: While there were differences in dosimetric practices, overall agreement in plaque brachytherapy practices was high among OOSC institutions. Clinical margins and planning systems were similar among institutions, while prescription dose, dose rates, and dosimetry varied.
Ventilated Infants Have Increased Dead Space and Lower Alveolar Tidal Volumes during the Early versus Recovery Phase of Respiratory Distress
Authors: Zuiki Masashi , Yamano Akio , Kitamura Kazumasa , Goda Takeshi , Oya Satoshi , Komatsu Hiroshi
Published: December 2019

Background: Few studies have reported the measurement of anatomical dead space (Vd,an) and alveolar tidal volume (VA) in ventilated neonates with respiratory distress. Objective: The aim of this study was to determine the differences in Vd,an and VA in ventilated infants between the early and recovery phases of respiratory distress using volumetric ­capnography (Vcap) based on ventilator graphics and capnograms. Methods: This study enrolled twenty-five ventilated infants (mean birth weight, 2,220 ± 635 g; mean gestational age, 34.7 ± 3.3 weeks). We adjusted respiratory settings to maintain appropriate oxygenation and tidal volume (VT), and performed Vcap based on waveforms of ventilator graphics and capnograms. Vd,an and VAwere measured in infants with respiratory disorders, immediately after intubation (early phase) and subsequently when they were clinically stable (recovery phase). Results: The early phase, with lower dynamic lung compliance, required a higher level of ventilator support, not positive end-expiratory pressure, than the recovery phase. There were significant differences between the early and recovery phases for Vd,an (mean difference in Vd,an/kg = 0.57 mL/kg; 95% confidence interval [CI], 0.38–0.77; mean difference in Vd,an/VT = 0.10; 95% CI, 0.07–0.14) and VA (mean difference in VA/kg = –0.60 mL/kg; 95% CI, –0.94 to –0.27; mean difference in VA/VT = –0.12; 95% CI, –0.15 to –0.09), despite no difference in VT. Conclusions: We evaluated changes in Vd,an and VA during mechanical ventilation using Vcap based on waveforms. The increase in Vd,an and decrease in VA suggested dilation of the airways and collapse of the alveoli in ventilated infants with low lung compliance.