bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased risk of active tuberculosis during pregnancy and postpartum: a register-based cohort study in Sweden
Authors: Jonsson Jerker , Kühlmann-Berenzon Sharon , Berggren Ingela , Bruchfeld Judith
Published: December 2019

Rationale

Studies investigating the risk of active tuberculosis (TB) in association with pregnancy have not been conclusive. We aimed to investigate this risk in a large retrospective register-based cohort study in Sweden.

Methods

Data from women of 15–49 years of age who had given birth in Sweden between 2005 and 2013 were extracted from the national childbirth register and linked to the national TB register. Cohort time was divided into three exposure periods: during pregnancy, six months (180 days) postpartum and time neither pregnant nor postpartum. We calculated incidence rates (IRs) per 100 000 person-years for each period and incidence rate ratios (IRRs) with IRs neither pregnant nor postpartum as the reference.

Results

The cohort included 649 342 women, of whom 553 were registered as cases of active TB, 389 when neither pregnant nor postpartum, 85 during pregnancy and 79 when postpartum. Overall IRs were 9, 12 and 17 cases per 100 000 person-years, respectively, giving IRR 1.4, 95% CI 1.1–1.7 (during pregnancy) and IRR 1.9, 95% CI 1.5–2.5 (when postpartum). Stratification by TB incidence in country of origin showed that the increased risk was concentrated amongst women from countries with a TB incidence of 100 or higher, where IRs per 100 000 person-years were 137 (when neither pregnant nor postpartum), 182 (during pregnancy) and 233 (when postpartum).

Conclusion

We show a significant increase in risk of active TB during both pregnancy and postpartum in women from high incidence countries and recommend TB screening in pregnant women belonging to this risk group.
M3S: a comprehensive model selection for multi-modal single-cell RNA sequencing data
Authors: Zhang Yu , Wan Changlin , Wang Pengcheng , Chang Wennan , Huo Yan , Chen Jian , Ma Qin , Cao Sha , Zhang Chi
Published: December 2019

Background

Various statistical models have been developed to model the single cell RNA-seq expression profiles, capture its multimodality, and conduct differential gene expression test. However, for expression data generated by different experimental design and platforms, there is currently lack of capability to determine the most proper statistical model.

Results

We developed an R package, namely Multi-Modal Model Selection (M3S), for gene-wise selection of the most proper multi-modality statistical model and downstream analysis, useful in a single-cell or large scale bulk tissue transcriptomic data. M3S is featured with (1) gene-wise selection of the most parsimonious model among 11 most commonly utilized ones, that can best fit the expression distribution of the gene, (2) parameter estimation of a selected model, and (3) differential gene expression test based on the selected model.

Conclusion

A comprehensive evaluation suggested that M3S can accurately capture the multimodality on simulated and real single cell data. An open source package and is available through GitHub athttps://github.com/zy26/M3S.
BayesMetab: treatment of missing values in metabolomic studies using a Bayesian modeling approach
Authors: Shah Jasmit , Brock Guy N. , Gaskins Jeremy
Published: December 2019

Background

With the rise of metabolomics, the development of methods to address analytical challenges in the analysis of metabolomics data is of great importance. Missing values (MVs) are pervasive, yet the treatment of MVs can have a substantial impact on downstream statistical analyses. The MVs problem in metabolomics is quite challenging and can arise because the metabolite is not biologically present in the sample, or is present in the sample but at a concentration below the lower limit of detection (LOD), or is present in the sample but undetected due to technical issues related to sample pre-processing steps. The former is considered missing not at random (MNAR) while the latter is an example of missing at random (MAR). Typically, such MVs are substituted by a minimum value, which may lead to severely biased results in downstream analyses.

Results

We develop a Bayesian model, called BayesMetab, that systematically accounts for missing values based on a Markov chain Monte Carlo (MCMC) algorithm that incorporates data augmentation by allowing MVs to be due to either truncation below the LOD or other technical reasons unrelated to its abundance. Based on a variety of performance metrics (power for detecting differential abundance, area under the curve, bias and MSE for parameter estimates), our simulation results indicate that BayesMetab outperformed other imputation algorithms when there is a mixture of missingness due to MAR and MNAR. Further, our approach was competitive with other methods tailored specifically to MNAR in situations where missing data were completely MNAR. Applying our approach to an analysis of metabolomics data from a mouse myocardial infarction revealed several statistically significant metabolites not previously identified that were of direct biological relevance to the study.

Conclusions

Our findings demonstrate that BayesMetab has improved performance in imputing the missing values and performing statistical inference compared to other current methods when missing values are due to a mixture of MNAR and MAR. Analysis of real metabolomics data strongly suggests this mixture is likely to occur in practice, and thus, it is important to consider an imputation model that accounts for a mixture of missing data types.
Integrate multi-omics data with biological interaction networks using Multi-view Factorization AutoEncoder (MAE)
Authors: Ma Tianle , Zhang Aidong
Published: December 2019

Background

Comprehensive molecular profiling of various cancers and other diseases has generated vast amounts of multi-omics data. Each type of -omics data corresponds to one feature space, such as gene expression, miRNA expression, DNA methylation, etc. Integrating multi-omics data can link different layers of molecular feature spaces and is crucial to elucidate molecular pathways underlying various diseases. Machine learning approaches to mining multi-omics data hold great promises in uncovering intricate relationships among molecular features. However, due to the “big p, small n” problem (i.e., small sample sizes with high-dimensional features), training a large-scale generalizable deep learning model with multi-omics data alone is very challenging.

Results

We developed a method called Multi-view Factorization AutoEncoder (MAE) with network constraints that can seamlessly integrate multi-omics data and domain knowledge such as molecular interaction networks. Our method learns feature and patient embeddings simultaneously with deep representation learning. Both feature representations and patient representations are subject to certain constraints specified as regularization terms in the training objective. By incorporating domain knowledge into the training objective, we implicitly introduced a good inductive bias into the machine learning model, which helps improve model generalizability. We performed extensive experiments on the TCGA datasets and demonstrated the power of integrating multi-omics data and biological interaction networks using our proposed method for predicting target clinical variables.

Conclusions

To alleviate the overfitting problem in deep learning on multi-omics data with the “big p, small n” problem, it is helpful to incorporate biological domain knowledge into the model as inductive biases. It is very promising to design machine learning models that facilitate the seamless integration of large-scale multi-omics data and biomedical domain knowledge for uncovering intricate relationships among molecular features and clinical features.
Listening to women’s voices: the experience of giving birth with paramedic care in Queensland, Australia
Authors: Flanagan Belinda , Lord Bill , Reed Rachel , Crimmins Gail
Published: December 2019

Background

Unplanned out-of-hospital birth is generally assumed to occur for women who are multiparous, have a history of a short pushing phase of labour or are experiencing a precipitate birth. However, there is little research that examines the woman’s perspective regarding factors that influenced their decision on when to access care. This research aimed to explore women’s experience of unplanned out-of-hospital birth in paramedic care. Due to the size of the data in the larger study of ‘Women’s experience of unplanned out-of-hospital birth in paramedic care’ [1], this paper will deal directly with the women’s narrative concerning her decision to access care and how previous birth experience and interactions with other healthcare professionals influenced her experience.

Method

Narrative inquiry, underpinned from a feminist perspective, was used to guide the research. Twenty-two women who had experienced an unplanned out-of-hospital birth within the last 5 years in Queensland, Australia engaged in this research.

Results

The decision of a woman in labour to attend hospital to birth her baby is influenced by information received from healthcare providers, fear of unnecessary medical intervention in birth, and previous birth experience. All themes and subthemes that emerged in the women’s narratives relate to the notion of birth knowledge. These specifically include perceptions of what constitutes authoritative knowledge, who possesses the authoritative knowledge on which actions are based, and when and how women use their own embodied knowledge to assess the validity of healthcare workers’ advice and the necessity for clinical intervention.

Conclusions

The women interviewed communicated a tension between women’s knowledge, beliefs and experience of the birth process, and the professional models of care traditionally associated with the hospital environment. It is essential that information provided to women antenatally is comprehensive and comprehensible. The decisions women make concerning their birth plan represent the women’s expectations for their birth and this should be used as a means to openly communicate issues that may impact the birth experience.
Association of cleft lip and palate on mother-to-infant bonding: a cross-sectional study in the Japan Environment and Children’s Study (JECS)
Authors:   Japan Environment & Children’s Study Group, Tsuchiya Shinobu , Tsuchiya Masahiro , Momma Haruki , Koseki Takeyoshi , Igarashi Kaoru , Nagatomi Ryoichi , Arima Takahiro , Yaegashi Nobuo
Published: December 2019

Background

Cleft lip and/or palate is among the most prevalent congenital birth defects, and negatively affects maternal psychological status and may consequently result in higher prevalence of child maltreatment. However, the association of childbirths of infants with cleft lip and/or palate with maternal emotional involvement still remains unclear. We examined the association between childbirths of infants with cleft lip and/or palate and mother-to-infant bonding, using data from the Japan Environment and Children’s Study, a nationwide birth cohort study.

Methods

A cross-sectional study using the jecs-an-20,180,131 dataset was performed. A total 104,065 fetuses in 15 regional centres in Japan were enrolled after obtaining informed written consent. The Mother-to-Infant Bonding Scale, a self-report scale consisting of 10 items, was used to evaluate maternal bonding at one year after childbirth. Finally, the participants consisted of 79,140 mother-infant pairs, of which 211 mothers of infants with cleft lip and/or palate were included in our analyses. Multivariable logistic regression analysis using multiple imputation for missing data was performed to calculate the odds ratio and 95% confidence interval in the estimation of the association between bonding disorders and childbirths with cleft lip and/or palate.

Results

No increased risk of bonding disorders was observed among all the mothers of infants with cleft lip and/or palate (odds ratio [95% confidence interval]; 0.97 [0.63–1.48], p = 0.880), however, advanced maternal age or multiple parity may adversely affect the associations between bonding disorders and cleft lip and/or palate, respectively. After stratification with a combination of maternal age and parity, a significant association of cleft lip and/or palate with bonding disorders was found only among advanced-age multiparae (odds ratio [95% confidence interval] = 2.51 [1.17–5.37], p = 0.018), but it was weakened after additional adjustment for maternal depression.

Conclusions

Childbirths of infants with cleft lip and/or palate may increase the risk of bonding disorders among advanced-age multiparae, possibly through maternal depression. This finding provides valuable information for the provision of multidisciplinary cleft care.
Exercise prescription for weight management in obese adults at risk for osteoarthritis: synthesis from a systematic review
Authors: Barrow Dylan R. , Abbate Lauren M. , Paquette Max R. , Driban Jeffrey B. , Vincent Heather K. , Newman Connie , Messier Stephen P. , Ambrose Kirsten R. , Shultz Sarah P.
Published: December 2019

Background

The aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis.

Methods

A structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) “obes*” AND “exercise” AND “interven*” AND “musculoskeletal pain OR knee pain OR hip pain”. Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18–50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain.

Results

Seven studies were included. Similarities in exercise intensity (40–80% VO2max), frequency (three times per week), duration (30–60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups.

Conclusion

Common principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30–60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.
The effectiveness of Reslizumab in severe asthma treatment: a real-world experience
Authors: Ibrahim H. , O’Sullivan R. , Casey D. , Murphy J. , MacSharry J. , Plant B. J. , Murphy D. M.
Published: December 2019

Background

Increased numbers of blood and sputum eosinophils are associated with higher exacerbation frequency and increased asthma severity. In clinical trials, targeting Interleukin-5 has been shown to be a useful therapeutic strategy for patients with severe eosinophilic asthma.

Methods

Twenty-six patients have been commenced on Reslizumab in our institution since early 2017. Safety and clinical efficacy parameters were recorded at regular intervals.

Results

Mean ACQ-6 score at the start of treatment was 3.5. The average number of exacerbations in the year preceding treatment was 8.3 per person. 30% of patients had been admitted to hospital at least once over the 12 months preceding therapy. 54% of our patients were on long term oral steroid.

Our data showed sustained improvement of Asthma control (Mean improvement in ACQ-6 was 1.7 at 1 year, and 2.0 at 2 years, P = 0.0001). Of the patients who were on long term systemic steroids, 35.7% discontinued steroids completely, with a mean reduction of prednisolone dose of 5.2 mg at 1 year. There was a 79% reduction in the annual exacerbation frequency at 1 year, and 88% at 2 years (P = < 0.0001). Modest, albeit statistically significant increases in creatine kinase which seemed to plateau by 1 year were noted.

Conclusions

Overall, Reslizumab was well tolerated with discontinuation of treatment due to side effects recorded in only one patient. Our data confirm the utility of anti-IL5 therapy in a carefully selected phenotype of severe asthma with evidence of eosinophilic airway inflammation.
Synergistic effects of APOE and sex on the gut microbiome of young EFAD transgenic mice
Authors: Maldonado Weng Juan , Parikh Ishita , Naqib Ankur , York Jason , Green Stefan J. , Estus Steven , LaDu Mary Jo
Published: December 2019

Background

Alzheimer’s disease (AD) is a fatal neurodegenerative disease.APOE4is the greatest genetic risk factor for AD, increasing risk up to 15-fold compared to the commonAPOE3.Importantly, female (♀)APOE4carriers have a greater risk for developing AD and an increased rate of cognitive decline compared to male (♂)APOE4carriers. While recent evidence demonstrates that AD,APOEgenotype, and sex affect the gut microbiome (GM), howAPOEgenotype and sex interact to affect the GM in AD remains unknown.

Methods

This study analyzes the GM of 4-month (4 M) ♂ and ♀ E3FAD and E4FAD mice, transgenic mice that overproduce amyloid-β 42 (Aβ42) and express humanAPOE3+/+orAPOE4+/+. Fecal microbiotas were analyzed using high-throughput sequencing of 16S ribosomal RNA gene amplicons and clustered into operational taxonomic units (OTU). Microbial diversity of the EFAD GM was compared acrossAPOE,sex and stratified byAPOE + sex, resulting in 4-cohorts (♂E3FAD, ♀E3FAD, ♂E4FAD and ♀E4FAD). Permutational multivariate analysis of variance (PERMANOVA) evaluated differences in bacterial communities between cohorts and the effects ofAPOE + sex. Mann-Whitney tests and machine-learning algorithms identified differentially abundant taxa associated withAPOE + sex.

Results

Significant differences in the EFAD GM were associated withAPOEgenotype and sex. Stratification byAPOE + sex revealed thatAPOE-associated differences were exhibited in ♂EFAD and ♀EFAD mice, and sex-associated differences were exhibited in E3FAD and E4FAD mice. Specifically, the relative abundance of bacteria from the generaPrevotellaandRuminococcuswas significantly higher in ♀E4FAD compared to ♀E3FAD, while the relative abundance ofSutterellawas significantly higher in ♂E4FAD compared to ♂E3FAD. Based on 29 OTUs identified by the machine-learning algorithms, heatmap analysis revealed significant clustering of ♀E4FAD separate from other cohorts.

Conclusions

The results demonstrate that the 4 M EFAD GM is modulated byAPOE + sex. Importantly, the effect ofAPOE4on the EFAD GM is modulated by sex, a pattern similar to the greater AD pathology associated with ♀E4FAD. While this study demonstrates the importance of interactive effects ofAPOE + sex on the GM in young AD transgenic mice, changes associated with the development of pathology remain to be defined.
Computing and graphing probability values of pearson distributions: a SAS/IML macro
Authors: Yang Qing , An Xinming , Pan Wei
Published: December 2019

Background

Any empirical data can be approximated to one of Pearson distributions using the first four moments of the data (Elderton WP, Johnson NL. Systems of Frequency Curves. 1969; Pearson K. Philos Trans R Soc Lond Ser A. 186:343–414 1895; Solomon H, Stephens MA. J Am Stat Assoc. 73(361):153–60 1978). Thus, Pearson distributions made statistical analysis possible for data with unknown distributions. There are both extant, old-fashioned in-print tables (Pearson ES, Hartley HO. Biometrika Tables for Statisticians, vol. II. 1972) and contemporary computer programs (Amos DE, Daniel SL. Tables of percentage points of standardized pearson distributions. 1971; Bouver H, Bargmann RE. Tables of the standardized percentage points of the pearson system of curves in terms of β1 and β2. 1974; Bowman KO, Shenton LR. Biometrika. 66(1):147–51 1979; Davis CS, Stephens MA. Appl Stat. 32(3):322–7 1983; Pan W. J Stat Softw. 31(Code Snippet 2):1–6 2009) available for obtaining percentage points of Pearson distributions corresponding to certain pre-specified percentages (or probability values; e.g., 1.0%, 2.5%, 5.0%, etc.), but they are little useful in statistical analysis because we have to rely on unwieldy second difference interpolation to calculate a probability value of a Pearson distribution corresponding to a given percentage point, such as an observed test statistic in hypothesis testing.

Results

The present study develops a macro program to identify the appropriate type of Pearson distribution based on either input of dataset or the values of four moments and then compute and graph probability values of Pearson distributions for any given percentage points.

Conclusions

The SAS macro program returns accurate approximations to Pearson distributions and can efficiently facilitate researchers to conduct statistical analysis on data with unknown distributions.
Recommendations for the collection and use of multiplexed functional data for clinical variant interpretation
Authors:   On behalf of the Brotman Baty Institute Mutational Scanning Working Group, Gelman Hannah , Dines Jennifer N. , Berg Jonathan , Berger Alice H. , Brnich Sarah , Hisama Fuki M. , James Richard G. , Rubin Alan F. , Shendure Jay , Shirts Brian , Fowler Douglas M. , Starita Lea M.
Published: December 2019

Variants of uncertain significance represent a massive challenge to medical genetics. Multiplexed functional assays, in which the functional effects of thousands of genomic variants are assessed simultaneously, are increasingly generating data that can be used as additional evidence for or against variant pathogenicity. Such assays have the potential to resolve variants of uncertain significance, thereby increasing the clinical utility of genomic testing. Existing standards from the American College of Medical Genetics and Genomics (ACMG)/Association for Molecular Pathology (AMP) and new guidelines from the Clinical Genome Resource (ClinGen) establish the role of functional data in variant interpretation, but do not address the specific challenges or advantages of using functional data derived from multiplexed assays. Here, we build on these existing guidelines to provide recommendations to experimentalists for the production and reporting of multiplexed functional data and to clinicians for the evaluation and use of such data. By following these recommendations, experimentalists can produce transparent, complete, and well-validated datasets that are primed for clinical uptake. Our recommendations to clinicians and diagnostic labs on how to evaluate the quality of multiplexed functional datasets, and how different datasets could be incorporated into the ACMG/AMP variant-interpretation framework, will hopefully clarify whether and how such data should be used. The recommendations that we provide are designed to enhance the quality and utility of multiplexed functional data, and to promote their judicious use.
Inertial focusing in a parallelogram profiled microchannel over a range of aspect ratios
Authors: Kwon Joo Young , Lee Dong-Ki , Kim Jungwoo , Cho Young Hak
Published: December 2019

In this study, particle focusing phenomena are studied in parallelogram and rectangular cross-sectioned microchannels of varying aspect ratio. In contrast to prior work the microchannels were fabricated using anisotropic wet etching of a Si wafer, plasma bonding, and self-alignment between the Si channel and the PDMS mold. It is shown that the inertial focusing points of the fabricated microchannels of parallelogram and rectangular cross-section were modified as the aspect ratio of the microchannels changed. The particle focusing points of the parallelogram profiled microchannel are compared with those of the rectangular microchannel through experimental measurements and CFD simulation. It is shown that particles can be efficiently focused and separated at a relatively low Reynolds number using a parallelogram profiled microchannel with a low aspect ratio.
Intervention planning and modification of the BUMP intervention: a digital intervention for the early detection of raised blood pressure in pregnancy
Authors: Band Rebecca , Hinton Lisa , Tucker Katherine L. , Chappell Lucy C. , Crawford Carole , Franssen Marloes , Greenfield Sheila , Hodgkinson James , McCourt Christine , McManus Richard J. , Sandall Jane , Santos Mauro Dala , Velardo Carmelo , Yardley Lucy
Published: December 2019

Background

Hypertensive disorders in pregnancy, particularly pre-eclampsia, pose a substantial health risk for both maternal and foetal outcomes. The BUMP (Blood Pressure Self-Monitoring in Pregnancy) interventions are being tested in a trial. They aim to facilitate the early detection of raised blood pressure through self-monitoring. This article outlines how the self-monitoring interventions in the BUMP trial were developed and modified using the person-based approach to promote engagement and adherence.

Methods

Key behavioural challenges associated with blood pressure self-monitoring in pregnancy were identified through synthesising qualitative pilot data and existing evidence, which informed guiding principles for the development process. Social cognitive theory was identified as an appropriate theoretical framework. A testable logic model was developed to illustrate the hypothesised processes of change associated with the intervention. Iterative qualitative feedback from women and staff informed modifications to the participant materials.

Results

The evidence synthesis suggested women face challenges integrating self-monitoring into their lives and that adherence is challenging at certain time points in pregnancy (for example, starting maternity leave). Intervention modification included strategies to address adherence but also focussed on modifying outcome expectancies, by providing messages explaining pre-eclampsia and outlining the potential benefits of self-monitoring.

Conclusions

With an in-depth understanding of the target population, several methods and approaches to plan and develop interventions specifically relevant to pregnant women were successfully integrated, to address barriers to behaviour change while ensuring they are easy to engage with, persuasive and acceptable.
The feasibility and acceptability of a primary school-based programme targeting diet and physical activity: the PhunkyFoods Programme
Authors: Sahota Pinki , Christian Meaghan , Day Rhiannon , Cocks Kim
Published: December 2019

Background

This study aims to evaluate the feasibility and acceptability of the PhunkyFoods Programme, a primary school-based intervention to promote healthy nutrition and physical activity knowledge and behaviours to assess outcomes to inform a phase 3 trial.

Methods

The cluster randomised feasibility trial recruited eight primary schools from the North of England. Elibility criteria included all primary schools in one town, excluding independent and special schools and schools that comprised of only key stage 2 pupils (years 3–6). Eight schools agreed to participate. Randomisation to intervention or control arms was in a 1:1 ratio. Intervention schools received PhunkyFoods over 17 months. Control schools continued with usual curriculum. Assessors were blinded to group assignment. Measures comprised of a Healthy Lifestyle Knowledge Questionnaire and Synchronised Nutrition and Activity Program to assess diet and physical activity, height, weight, and psychological wellbeing. Feasibility outcomes were recruitment, attrition rates, interviews with teaching staff, focus groups with pupils to explore the acceptability of outcome measures, implementation, intervention content, and programme fidelity.

Results

Three hundred fifty-eight pupils, aged 6–9 years from eight schools were recruited at baseline (control n = 170, intervention n = 188); 337 (94.1%) at 6 months (control n = 163, intervention n = 181); and 331 (92.5%) at 18 months (control n = 152, intervention n = 179), and 6 pupils opted out. Trends in increased knowledge of healthy lifestyle behaviours, healthier eating, and liking of fruit and vegetables were reported in the intervention compared to the control group. Year 4 intervention pupils had significantly higher healthy balanced diet knowledge scores compared to control pupils, mean difference 5.1 (95% CI 0.1 to 10.1, p=0.05). At 18 months, the mean percentage of vegetables liked was higher (intervention 53.9% vs. 43.0% control). Similarly, percentage of fruits liked was also higher (intervention 76.9% vs. 67.2% control). Qualitative data showed that delivery of the intervention was feasible and acceptable to teachers and pupils. Lessons were learned to inform the phase 3 trial around the dietary assessment measure and timing of recruitment.

Conclusions

Whilst the study was not powered to detect a definitive effect, results suggest a potential to increase knowledge of healthy lifestyle behaviours and dietary behaviours, suggesting that with minor changes, a phase 3 trial is likely to be deliverable.

Trial registration

ISRCTN, ISRCTN15641330. Registered 8 May 2015—retrospectively registered, 10.1186/ISRCTN15641330
Anti-proliferative and immunomodulatory activities of fractions from methanol root extract of Abrus precatorius L
Authors: Okoro Emeka E. , Osoniyi Omolaja R. , Jabeen Almas , Shams Sidrah , Choudhary M. I. , Onajobi Funmilayo D.
Published: December 2019

Background

Abrus precatorius possesses various therapeutic properties including anticancer potentials. This study evaluated the anti-proliferative activities of fractions of methanol root extract of A. precatorius on breast and cervical cancer cells and their immunomodulatory effect. Phytochemical screening was done by FTIR and GCMS. In vitro anti-proliferative effect was evaluated on human breast cancer (AU565) and cervical cancer (HeLa) cells and on murine fibroblast (NIH 3 T3) cells. Antioxidant activity was performed via DPPH radical scavenging assay. The immunomodulatory potential of fractions was evaluated by inhibition of phagocytes oxidative burst (ROS), Nitric oxide (NO) and proinflammatory cytokine TNF-α.

Results

A. precatorius fractions showed different chemical groups and were somewhat selective in antiproliferative activity against studied cancer cells. Ethyl acetate fraction showed the most significant antiproliferative activity with IC50 values of 18.10 μg/mL and 11.89 μg/mL against AU565 and HeLa cells respectively. Hexane fraction significantly (p < 0.05) inhibited HeLa cells (IC50 18.24 ± 0.16 μg/mL), whereas aqueous fraction showed mild inhibition (IC50 46.46 ± 0.14 μg/mL) on AU565 cell proliferation. All fractions showed no cytotoxicity against NIH-3 T3 murine fibroblast normal cells. All fractions showed potent and significant (p < 0.001) DPPH radical scavenging activity as well as suppressed phagocytic oxidative burst. Hexane (< 1 μg/mL), ethyl acetate (< 1 μg/mL), and butanol (5.74 μg/mL) fractions potently inhibited the cytokine TNF- α, hexane (< 1 μg/mL) and ethyl acetate (< 1 μg/mL) fractions also potently inhibited NO.

Conclusions

The antiproliferative activities and suppressive effect on the phagocytic oxidative burst, NO and proinflammatory cytokine might be due to the synergistic actions of bioactive compounds especially flavonoids present in the assayed fractions and therefore, suggest chemotherapeutic use of A. precatorius in cancer treatment.
Simulated patient contributions to enhancing exercise physiology student clinical assessment skills
Authors: Reeves Nathan E. , Waite Monique C. , Tuttle Neil , Bialocerkowski Andrea
Published: December 2019

Background

The aim of this study was to evaluate exercise physiology students’ perceptions of two simulation-based learning modules focused on communication and interpersonal skills during history taking.

Methods

A prospective, repeated-measures cohort study was conducted with 15 participants. The study evaluated two simulation-based learning modules in a 1-year Graduate Diploma of Exercise Science program. Surveys were administered at four time points: prior to each module and following each module. Students rated their confidence in communication and history taking, and perception of preparedness for practice, motivation for learning, and benefits of undertaking simulation-based learning. Quantitative data were analyzed descriptively and by using repeated measures tests. Qualitative data underwent thematic analyses.

Results

Students reported a significant improvement in their confidence in communication (P = 0.043) and in two parameters related to history taking (P = 0.034 and 0.035) following the completion of the two modules. There was 96% agreement that the simulation-based learning better prepared students for practice as an exercise physiologist. Significant changes occurred in all aspects of motivation for learning (P ranging from < 0.001 to 0.036) except for usefulness, where there was a ceiling effect (medians of 7 on a 7-point scale). Qualitative analysis demonstrated benefit to participants around themes of experiential learning, realism, opportunity to develop clinical skills, and debriefing. Students also made suggestions with respect to the activity structure of the simulation-based learning modules.

Conclusions

The results of this study indicated that simulation-based learning employing SPs increased the confidence and preparedness of exercise physiology students for conducting history taking, a requisite exercise physiology skill. Future studies should include behavioral measures of skill attainment and include follow-up evaluation to appraise the application of these skills into clinical practice.
A simulation-based learning experience in augmentative and alternative communication using telepractice: speech pathology students’ confidence and perceptions
Authors: Howells Simone , Cardell Elizabeth A. , Waite Monique C. , Bialocerkowski Andrea , Tuttle Neil
Published: December 2019

Background

Simulation, as an activity in speech-language pathology training, can increase opportunities for students to gain required skills and competencies. One area that has received little attention in the simulation literature, yet is a growing area of clinical practice, is alternative and augmentative communication (AAC). Also growing, is the use of telepractice to deliver services. This exploratory study investigated graduate entry speech-language pathology student perceptions of a simulation learning experience working with an adult with complex communication needs via telepractice.

Methods

First year Master of Speech Pathology students completed a 1-day simulation using a videoconferencing delivery platform with an actor portraying an adult client with motor neurone disease requiring AAC. Quantitative and qualitative survey measures were completed pre- and post-simulation to explore students’ confidence, perceived impact on clinical performance, and perceived extent of learning, specifically, their interest, competence, and tension. Further, students’ perceptions about the telepractice system useability were explored. Fifty-two responses were received and analysed using descriptive statistics and content analysis.

Results

Post-simulation, students reported increased confidence and perceived positive impacts on their confidence and clinical skills across communication, assessment, and management domains. They felt better prepared to manage a client with a progressive neurological condition and to make AAC recommendations. For telepractice delivery, technology limitations were identified as impacting its use, including infrastructure (e.g., weak internet connection). In addition, some students reported feeling disconnected from the client.

Conclusion

This study supports the use of simulation in AAC through telepractice as a means of supporting Masters-level speech pathology student learning in this area of practice.
Difference between the biologic and chronologic age as an individualized indicator for the skincare intensity selection: skin cell profile and age difference studies
Authors: Sukhovei Yurij , Kostolomova Elena , Unger Irina , Koptyug Andrey , Kaigorodov Denis
Published: December 2019

Background

The present research addresses the issue of skin aging and corresponding skin treatment individualization. Particular research question was on the development of a simplified criterion supporting patient-specific decisions about the necessity and intensity of skin treatment. Basing on published results and a wide pool of our own experimental data, a hypothesis is formulated that a difference between biologic and chronologic age can be used as a powerful indicator of skin aging.

Methods

In the present paper, we report the results of studies with 80 volunteers between 15 and 65 years of age linking skin cell profile parameters to biologic and chronologic age. Biologic age was calculated using the empirical expressions based on the forced vital lung capacity, systolic blood pressure, urea concentration, and blood cholesterol level. Epidermis and derma cellular structures were studied using skin biopsy samples taken from the gluteal region.

Results

The present study supports the conclusion that biologic and chronologic age difference is changing in the progress of life. Our studies are showing that time point when calculated biologic age becomes equal to the chronologic one reflecting the onset of specific changes in the age dependencies of experimentally measured skin cell profile parameters. Thus, it is feasible that a difference between chronologic and individually assessed biologic age indeed reflects the process of skin aging.

Conclusions

With all reservations to the relatively small number of study participants, it seems feasible that a difference between biologic and chronologic age can be used as an indicator of skin aging. Additional research linking blood immune profile and skin topography to the difference of biologic and chronologic age (reported in the following paper) provides further support for the formulated hypotheses. So, a difference between calculated biologic age and chronologic age can be used as an individualized criterion supporting decisions on skin treatment strategies. Further research involving larger numbers of participants aimed at optimizing the expressions for calculating biologic age could lead to reliable and easily available express criterion supporting the decision for the individualized skin treatment.
Second look Holter ECG in neurorehabilitation
Authors: Knecht Stefan , Petsch Sebastian , Kirchhof Paulus , Studer Bettina
Published: December 2019

Background

Many stroke survivors suffer recurrent stroke because paroxysmal atrial fibrillation (AF) was missed and no preventive anticoagulation initiated. This prospective cohort study determined the added diagnostic yield of second-look 24-h electrocardiographic recording (ECG) in a population at high risk for AF: patients who suffered a stroke of such severity that they require inpatient neurorehabilitation.

Methods

We enrolled 508 patients with ischemic stroke admitted to post-acute inpatient neurorehabilitation and determined whether AF was detected during acute care at the referring hospital. Second-look baseline and 24-h Holter ECG were then conducted during neurorehabilitation. Primary outcome was number of newly detected AF with duration of > 30 s; secondary outcomes were number of newly detected absolute arrhythmia of 10–30 s and < 10 s duration. For comparison, we further enrolled 100 patients with hemorrhagic stroke without history of AF (age = 72 + 11 years, 51% female).

Results

In 206 of the 508 ischemic stroke patients, AF had been detected during acute phase work-up (age = 78 + 10 years, 55% female). For the remaining 302 ischemic stroke patients, no AF was detected during acute phase work-up (age = 74 + 9 years; 47% female). Second-look 24-h ECG showed previously missed AF of > 30 s in 20 of these patients, i.e. 6.6% of the sample, and shorter absolute arrhythmia in 50 patients (i.e. 16.5%).

Conclusions

Second-look 24-Hour ECG performed during post-acute inpatient neurorehabilitation has a high diagnostic yield and should become a standard component of recurrent stroke prevention.
Aerodynamic analysis of a generic wing featuring an elasto-flexible lifting surface
Authors: Piquee J. , López Canalejo I. , Breitsamter C. , Wüchner R. , Bletzinger K.-U.
Published: December 2019

A three-dimensional-membrane-type wing is investigated applying fluid-structure-interaction computations and complementary experiments. An analysis for three Reynolds numbers is conducted at various angles of attack. The computations are performed by means of the TAU-Code and the FEM Carat++ solver. Wind-tunnel tests are carried out for performance analysis and to estimate the accuracy of the computations. In the results, the advantages of an elasto-flexible-lifting-surface concept are highlighted by comparing the formvariable surface to its rigid counterpart. The flexibility of the material and its adaptivity to the freestream allow the membrane to adjust its shape to the pressure distribution. For positive angles of attack, the airfoil’s camber increases resulting in an increase in the wing lifting capacity. Furthermore, the stall onset is postponed to higher angles of attack and the abrupt decrease in the lift is replaced by a gradual loss of it.
The Work of Class in American History
Authors: Sklansky Jeffrey
Published: December 2019

In recent decades, the working class as it was once conceived has lost its paradigmatic place in labor history along with the nineteenth-century struggles from which it emerged. This essay surveys what the Working Class in American History book series has taught us about class in the age of cotton, coal, and steel, reviews the major criticisms of the concept of the working class on which it was founded, and reconsiders what its nineteenth-century subjects still have to say. The essay concludes with a call to reclaim a more capacious conception of class as a political formation based on property relations, describing at once a prospect, a project, and a perspective with labor at its core.
Assessment of tumour hypoxia, proliferation and glucose metabolism in head and neck cancer before and during treatment
Authors: Kazmierska Joanna , Cholewinski Witold , Piotrowski Tomasz , Sowinska Anna , Bak Bartosz , Cegła Paulina , Malicki Julian
Published: December 2019

Objective:

The aim of the study was to assess the feasibility of multitracer positron emission tomography (PET) imaging before and during chemoradiation and to evaluate the predictive value of image-based factors for outcome in locally advanced head and neck cancers treated with chemoradiation.

Methods:

In the week prior to the treatment [18F]−2-flu-2-deoxy-D-glucose (FDG), [18F]−3'-flu-3'deoxythymidine (FLT) and [18F]-flumisonidazole (FMISO) imaging was performed. FLT scans were repeated at 14 and 28 Gy and FMISO at 36 Gy. Overall survival, disease-free survival and local control were correlated with subvolume parameters, and with tumour-to-muscle ratio for FMISO. For every tracer, total metabolic tumour volume was calculated.

Results:

33 patients were included. No correlation was found between pre-treatment maximum standardised uptake value for FDG, FLT, FMISO and outcomes. Tumour volume measured on initial CT scans and initial FLT volume correlated with disease-free survivall (p = 0.007 and 0.04 respectively). FDG and FLT metabolic tumour volumes correlated significantly with local control (p = 0.005 and 0.02 respectively). In multivariate Cox analysis only individual initial TMRmax correlated with overall survival.

Conclusion:

PET/CT imaging is a promising tool. However, various aspects of image analysis need further clinical validation in larger multicentre study employing uniform imaging protocol and standardisation, especially for hypoxia tracer.

Advances in knowledge:

Monitoring of biological features of the tumour using multitracer PET modality seems to be a feasible option in daily clinical practice.

Evaluation of hypoxic subvolumes is more patient dependent; thus, exploration of individual parameters of hypoxia is needed. tumour-to-muscle ratio seems to be the most promising so far.
Is there a role for arcing techniques in proton therapy?
Authors: Carabe-Fernandez Alejandro , Bertolet-Reina Alejandro , Karagounis Ilias , Huynh Kiet , Dale Roger G
Published: December 2019

Proton arc therapy (PAT) has been proposed as a possible evolution for proton therapy. This commentary uses dosimetric and cancer risk evaluations from earlier studies to compare PAT with intensity modulated proton therapy. It is concluded that, although PAT may not produce better physical dose distributions than intensity modulated proton therapy, the radiobiological considerations associated with particular PAT techniques could offer the possibility of an increased therapeutic index.
Infecciones quirúrgicas postparto: prevención, monitoreo y uso de apósitos con cloruro de dialquilcarbamilo (DACC)
Authors: Fronzo Camila
Published: December 2019

Sinopsis:

La región de América Latina y el Caribe tiene el mayor índice de partos por cesárea del mundo. El dato no es novedoso, pero los riesgos de infección relacionados con esta operación siguen generando preocupación. Sobre todo, en tiempos donde la resistencia a los antibióticos es considerada una de las mayores amenazas para la salud mundial. En Reino Unido, una conferencia sobre prevención de infecciones postparto resaltó esta problemática, presentó las últimas técnicas para el manejo y prevención de infecciones quirúrgicas después de una cesárea, y recomendó diferentes apósitos a la hora de elegir un tratamiento que no favorezca la resistencia a los antibióticos. La necesidad de enfrentar los desafíos que presentan las infecciones postparto, sumada a la importancia de contar con profesionales de la salud entrenados en el cuidado de las heridas y la selección de apósitos, fueron los mensajes claves.
Proximate composition and aroma quality of five aromatic upland-rice accessions from Sumba Barat Daya District, East Nusa Tenggara Province, Indonesia
Authors: Arsa IG.B. Adwita , H.J.D. LALEL  , R. POLLO
Published: December 2019

Abstract. Arsa IGBA, Lalel HJD, Pollo R. 2019. Proximate composition and aroma quality of five aromatic upland-rice accessions from Sumba Barat Daya District, East Nusa Tenggara Province, Indonesia. Trop Drylands 3: 35-40. This research aimed to know the proximate composition and aroma quality of five aromatic upland-rice accessions from South West Sumba, East Nusa Tenggara Province and their correlation with the physical and chemical properties of the soil taken from the planting area of each accession. The five accessions are ACC-04, ACC-05, ACC-06, ACC-08, and ACC-09. Proximate composition analysis of each aromatic upland-rice accession was carried out by method recommended by AOAC (1970) to determine the water content, ash, fat, protein, carbohydrate, starch, amylose, and amylopectin contents of the rice. The rice aroma score was determined by a sensory test. Analysis of physical and chemical characters of soil was done on a composited soil taken from planting area of each aromatic upland-rice accession at the time of harvest. The results showed that ACC-04 had the highest ash content, AC-09 had the highest fat content and protein contents, and ACC-06 showed the highest carbohydrate content of rice. Furthermore, the best aroma quality of rice based on aroma score and 2-AP content was shown by, respectively, ACC-06 and ACC-05. There was no significant correlation between proximate composition and aroma quality with any component of environmental factors, thus, they were more likely to be determined by genetic factors.