bluuebunny/crossref_metadata_2025 huggingface dataset:
A simple modified surgical technique combined with tissue adhesive for steatocystoma multiplex
Authors: Jiang Long , Yan Jianna , Chen Xiaogang , Chen Yuchong , Tang Yichen
Published: May 2020

Background

Steatocystoma multiplex (SM) is a disorder of the pilosebaceous unit characterized by multiple sebum‐containing dermal cysts. Psychological distress of patients is always derived from these undesirable lesions. Although various treatments have been attempted to improve cosmetic outcomes, no optimal treatment strategy has been established to date..

Aims

To provide a facile and practical surgical technique combined with tissue adhesive for the treatment of steatocystoma multiplex.

Method

Forty patients diagnosed as SM were treated with simple modified surgical technique. After local anesthesia, the surface skin was incised about 1‐2 mm using a No. 11 blade. When the wall was punctured, the cyst should be squeezed to cause the contents to come out first. Then, we used single toothed forceps which were inserted through the narrow incision. When the cyst was exposed, the mosquito forceps grasp the portion of the cyst and pull it out gently. Then, the incisions were pressed locally, and tissue adhesive was employed to align them when there was no bleeding. We just took approximately 1‐2 minutes to excise one cyst completely.

Result

We successfully treated forty SM patients with our simple modified surgical technique. After treatment, excellent clinical outcomes and minimal adverse effects were observed in this study. And more importantly, no recurrence was found 12 months after the surgery.

Conclusion

Our simple modified surgical technique was proved to be practical and have excellent results in the long run. We highly recommend this treatment technique as the first‐line therapy for SM.
The Direct and Moderating Effects of Endogenous Corporate Social Responsibility on Firm Valuation: Theoretical and Empirical Evidence from the Global Financial Crisis
Authors: Hannah Sean T. , Sayari Naz , Harris Frederick H. deB. , Cain Carol L.
Published: May 2020

Research has produced inconclusive results concerning the effects of corporate social responsibility (CSR) on firm financial performance, with only 59 percent of studies demonstrating positive effects. Yet, still unaddressed is how CSR impacts the key driver of financial performance – firm growth. We develop new multidisciplinary theory integrating stakeholder and risk management theories with multi‐period capital asset pricing. We test the direct and moderating effects of Social, Institutional, Strategic, and Technical CSR using a simultaneous equations model of endogenous CSR and Tobin’s q ratio. Our 2004–12 sample of S&P 3000 firms show that all CSR dimensions directly bolster firm performance, while select dimensions moderate the relationship between firms’ sales or asset growth and capitalized market value in the periods surrounding the 2008 Global Financial Crisis (GFC). These results deepen understanding of how different forms of CSR influence market value, and refine estimates of CSR’s direct and moderating impacts on the growth‐value relationship.
A novel marine algal oil containing both EPA and DHA is an effective source of omega‐3 fatty acids for rainbow trout (Oncorhynchus mykiss)
Authors: Santigosa Ester , Constant Denis , Prudence Dauphinee , Wahli Thomas , Verlhac‐Trichet Viviane
Published: May 2020

Novel sources of omega‐3 fatty acids (FAs) are essential for the sustainable development of the aquaculture industry. In the present study, we assessed the response of the fish to a novel algal oil as a source of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) for rainbow trout (Oncorhynchus mykiss) diets. Our results show that the palatability of the diets was maintained with high inclusion levels (up to 10%) of algal oil. The digestibility of omega‐3 FAs was compared among diets containing 10% fish oil (control diet) and diets with no omega‐3 lipid sources (0AO) or increasing levels of algal oil (2.5, 5, and 10% for diets 2.5AO, 5AO, and 10AO, respectively). The digestibility of EPA and DHA was above 99% and was only significantly decreased in the 0AO diet. The FA profile of the muscle was found to reflect that of the diets, suggesting that, when high levels of omega‐3 are included in the diet of rainbow trout, they are deposited in the muscle rather than used for metabolic processes. The growth and the blood parameters of the animals were optimal for all the treatments in the safety trial, with algal oil inclusion levels up to 6%. All these results in combination show that Veramaris® algal oil containing EPA and DHA can be used as an efficient source of omega‐3 FAs for salmonids.
The phylogenetic range of bacterial and viral pathogens of vertebrates
Authors: Shaw Liam P. , Wang Alethea D. , Dylus David , Meier Magda , Pogacnik Grega , Dessimoz Christophe , Balloux François
Published: May 2020

Many major human pathogens are multihost pathogens, able to infect other vertebrate species. Describing the general patterns of host–pathogen associations across pathogen taxa is therefore important to understand risk factors for human disease emergence. However, there is a lack of comprehensive curated databases for this purpose, with most previous efforts focusing on viruses. Here, we report the largest manually compiled host–pathogen association database, covering 2,595 bacteria and viruses infecting 2,656 vertebrate hosts. We also build a tree for host species using nine mitochondrial genes, giving a quantitative measure of the phylogenetic similarity of hosts. We find that the majority of bacteria and viruses are specialists infecting only a single host species, with bacteria having a significantly higher proportion of specialists compared to viruses. Conversely, multihost viruses have a more restricted host range than multihost bacteria. We perform multiple analyses of factors associated with pathogen richness per host species and the pathogen traits associated with greater host range and zoonotic potential. We show that factors previously identified as important for zoonotic potential in viruses—such as phylogenetic range, research effort, and being vector‐borne—are also predictive in bacteria. We find that the fraction of pathogens shared between two hosts decreases with the phylogenetic distance between them. Our results suggest that host phylogenetic similarity is the primary factor for host‐switching in pathogens.
It's what's inside that matters: physiological adaptations of high‐latitude marine microalgae to environmental change
Authors: Young Jodi N. , Schmidt Katrin
Published: May 2020

Marine microalgae within seawater and sea ice fuel high‐latitude ecosystems and drive biogeochemical cycles through the fixation and export of carbon, uptake of nutrients, and production and release of oxygen and organic compounds. High‐latitude marine environments are characterized by cold temperatures, dark winters and a strong seasonal cycle. Within this environment a number of diverse and dynamic habitats exist, particularly in association with the formation and melt of sea ice, with distinct microalgal communities that transition with the season. Algal physiology is a crucial component, both responding to the dynamic environment and in turn influencing its immediate physicochemical environment. As high‐latitude oceans shift into new climate regimes the analysis of seasonal responses may provide insights into how microalgae will respond to long‐term environmental change. This review discusses recent developments in our understanding of how the physiology of high‐latitude marine microalgae is regulated over a polar seasonal cycle, with a focus on ice‐associated (sympagic) algae. In particular, physiologies that impact larger scale processes will be explored, with an aim to improve our understanding of current and future ecosystems and biogeochemical cycles.
Using next‐generation sequencing to detect oral microbiome change following periodontal interventions: A systematic review
Authors: Zhang Ya , Qi Yinliang , Lo Edward C. M. , McGrath Colman , Mei May Lei , Dai Ruoxi
Published: May 2020

Objectives

This systematic review was to evaluate the change of oral microbiome based on next‐generation sequencing (NGS)‐metagenomic analysis following periodontal interventions among systematically healthy subjects.

Materials and Methods

A structured search strategy consisting of “metagenomics” and “oral diseases” was applied to PubMed, EMBASE, and Web of Science to identify effective papers. The included studies were original studies published in English, using metagenomic approach to analyze the effectiveness of periodontal intervention on oral microbiome among systematically healthy human subjects with periodontitis.

Results

A total of 12 papers were included in this review. Due to the heterogeneity of selected study, quantitative analysis was not performed. The findings as to how alpha diversity changed after interventions were not consistent across studies. Six studies illustrated clear separation of microbial composition between dental plaque samples collected before and after intervention using principal coordinates/component analysis. The most commonly detected genera before intervention were Porphyromonas, Treponema, Tannerella, and Prevotella, while Streptococcus and Actinomyces usually increased and became the dominant genera after intervention. Correlation network analysis revealed that after intervention, the topology of network was different compared to the corresponding pre‐interventional samples.

Conclusion

Existing evidence of metagenomic studies depicts a complex change in oral microbiome after periodontal intervention.
Infection control in dental health care during and after the SARS‐CoV‐2 outbreak
Authors: Volgenant Catherine M. C. , Persoon Ilona F. , de Ruijter Rolf A. G. , de Soet J. J. (Hans)
Published: May 2020

COVID‐19 is an emerging infectious disease caused by the widespread transmission of the coronavirus SARS‐CoV‐2. Some of those infected become seriously ill. Others do not show any symptoms, but can still contribute to transmission of the virus. SARS‐CoV‐2 is excreted in the oral cavity and can be spread via aerosols. Aerosol generating procedures in dental health care can increase the risk of transmission of the virus. Due to the risk of infection of both dental healthcare workers and patients, additional infection control measures for all patients are strongly recommended when providing dental health care. Consideration should be given to which infection control measures are necessary when providing care in both the current situation and in the future.
Potential host range of four Phytophthora interspecific hybrids from Clade 8a
Authors: Jafari Fatemeh , Mostowfizadeh‐Ghalamfarsa Reza , Safaiefarahani Banafsheh , Burgess Treena I.
Published: May 2020

In recent years several interspecific hybrids have been reported in the plant pathogenic oomycete genus Phytophthora. Due to the large genotypic and phenotypic changes, these hybrids might have broader or more limited host ranges compared with their parental species. It is crucial to understand the host range of Phytophthora hybrids to minimize the economic losses caused by their infection. The potential host range of four hybrids belonging to Clade 8a of the Phytophthora phylogenetic tree was investigated in this study. Thirty species of herbaceous plants as well as eight species of woody plants were inoculated and monitored for any symptom of infection. In addition, the detached twigs of 32 tree species, fruits of six plant species, tubers of potato, and roots of carrot and sugar beet were investigated for susceptibility to these hybrids. Almost all hybrids caused severe rot on all tested fruits, tubers, and roots, although different isolates showed different pathogenicity on detached tree twigs. All hybrids tested had a different host range compared with their parental species: they were able to infect plants outside the host range of their parents, infect hosts of both parental species, although these parents did not have overlapping hosts, or, in some cases, they were not able to infect hosts infected by the parents.
Follow the Leader? Leader Succession and Staff Attitudes in Public Sector Organizations
Authors: Geys Benny , Connolly Sara , Kassim Hussein , Murdoch Zuzana
Published: May 2020

Public sector organizations face regular turnover in top leadership positions. Yet little is known about how such changes affect staff attitudes. The authors argue that top leader succession may influence staff attitudes, particularly when new leaders are “outsiders” and/or subordinates interact regularly with their leaders. Using a unique two‐wave survey conducted within the European Commission in 2008 and 2014, this analysis tests these propositions by studying the same individuals before and after shifts in top political (commissioner) and administrative (director‐general) positions. The study shows that leadership succession can trigger meaningful shifts in subordinates' stated attitudes regarding the European Commission's supranational identity. These findings are important because staff attitudes about organizational values and aims represent a key driver of individual and organizational performance.
Multiple ER‐to‐nucleus stress signaling pathways are activated during Plantago asiatica mosaic virus and Turnip mosaic virus infection in Arabidopsis thaliana
Authors: Gayral Mathieu , Arias Gaguancela Omar , Vasquez Evelyn , Herath Venura , Flores Francisco J. , Dickman Martin B. , Verchot Jeanmarie
Published: May 2020

Pathogens and other adverse environmental conditions can trigger endoplasmic reticulum (ER) stress. ER stress signaling increases the expression of cytoprotective ER‐chaperones. The inositol‐requiring enzyme (IRE1) is one ER stress sensor that is activated to splice the bZIP60 mRNA that produces a truncated transcription factor that activates gene expression in the nucleus. The IRE1/bZIP60 pathway is associated with restricting potyvirus and potexvirus infection. This study shows that the Plantago asiatica mosaic virus (PlAMV) triple gene block 3 (TGB3) and the Turnip mosaic virus (TuMV) 6K2 proteins activate alternative transcription pathways involving the bZIP17, bZIP28, BAG7, NAC089 and NAC103 factors in Arabidopsis thaliana. Using the corresponding knockout mutant lines, we show that bZIP17, bZIP60, BAG7 and NAC089 are factors in reducing PlAMV infection, whereas bZIP28 and bZIP60 are factors in reducing TuMV infection. We propose a model in which bZIP60 and bZIP17 synergistically induce genes restricting PlAMV infection, while bZIP60 and bZIP28 independently induce genes supporting PlAMV infection. Regarding TuMV‐green fluorescent protein (GFP) infection, bZIP60 and bZIP28 serve to repress local and systemic infection. Finally, tauroursodeoxycholic acid treatments were used to demonstrate that the protein folding capacity significantly influences PlAMV accumulation.
CpARF2 and CpEIL1 interact to mediate auxin–ethylene interaction and regulate fruit ripening in papaya
Authors: Zhang Tao , Li Weijin , Xie Ruxiu , Xu Ling , Zhou Yan , Li Haili , Yuan Changchun , Zheng Xiaolin , Xiao Langtao , Liu Kaidong
Published: May 2020

Papaya (Carica papaya L.) is a commercially important fruit crop. Various phytohormones, particularly ethylene and auxin, control papaya fruit ripening. However, little is known about the interaction between auxin and ethylene signaling during the fruit ripening process. In the present study, we determined that the interaction between the CpARF2 and CpEIL1 mediates the interaction between auxin and ethylene signaling to regulate fruit ripening in papaya. We identified the ethylene‐induced auxin response factor CpARF2 and demonstrated that it is essential for fruit ripening in papaya. CpARF2 interacts with an important ethylene signal transcription factor CpEIL1, thus increasing the CpEIL1‐mediated transcription of the fruit ripening‐associated genes CpACS1, CpACO1, CpXTH12 and CpPE51. Moreover, CpEIL1 is ubiquitinated by CpEBF1 and is degraded through the 26S proteasome pathway. However, CpARF2 weakens the CpEBF1–CpEIL1 interaction and interferes with CpEBF1‐mediated degradation of CpEIL1, promoting fruit ripening. Therefore, CpARF2 functions as an integrator in the auxin–ethylene interaction and regulates fruit ripening by stabilizing CpEIL1 protein and promoting the transcriptional activity of CpEIL1. To our knowledge, we have revealed a novel module of CpARF2/CpEIL1/CpEBF1 that fine‐tune fruit ripening in papaya. Manipulating this mechanism could help growers tightly control papaya fruit ripening and prolong shelf life.
Detailed Design Optimization of Three-Fluid Parallel-Flow Plate-Fin Heat Exchanger Using Second Law Analysis
Authors: Aasi Harpreet Kaur , Mishra Manish
Published: May 2020

Compact parallel-flow three-fluid heat exchanger (TFHX) of plate-fin type is optimized for attaining the minimum entropy generation unit. Four different types of plate-fins (plain rectangular, offset strip, corrugated louvered, and wavy fin (WF)) which are embodied within heat exchanger have been selected for the study under both cocurrent and countercurrent flow arrangements. The range of the decision variables are 0.3≤ma, mb, mc≤3, 0.1≤Ø≤0.95, 0.1≤Lx, Ly≤2, 0.015≤H≤0.033, 100≤n≤700, 0.0001≤tf≤0.0002, 0.001≤l≤0.009, 0.01≤Lwav≤0.09, and 0.001≤A≤0.005. Genetic algorithm is selected as an optimization tool that is apt in handling various continuous and discrete variables and the problems with the complexities in the objective function as well as in constraints. Validation of the optimization model is carried out by comparing the optimum results with that obtained from the experiments, particle swarm optimization (PSO) (under without heat duty constraint), and graphical method (under with heat duty constraint). It is observed that for a specified heat duty (180 kW) and given operating conditions, corrugated louvered fin (CLF) with countercurrent flow arrangement offers the minimum entropy generation among all. It is riveting to learn that the optimum results occur for most of the considered cases when the flowrate of the central hot fluid is lower than that of the adjacent fluids. At fixed Re = 3000 for all the fin types, off-set strip fin is the most favorable one, and plain rectangular fin (PRF) offers the worst solution comparatively.
Nonhyperbolicity of Conservation Equations of RELAP5 Two-Fluid Model in Nuclear Reactor Safety Results (Investigation and Eigenvalue Analysis)
Authors: Saraswat S. P. , Munshi P. , Allison C.
Published: May 2020

The RELAP5 code simulates the thermal-hydraulic characteristics of nuclear reactors by the use of a two-fluid one-dimensional, nonequilibrium, nonhomogeneous two-phase flow model. This model consists of six governing equations to describe the mass, energy, and momentum of the two fluids. The scope of this work comprises the study of the mathematical nature of the code model and to predict the accuracy of the model in the nuclear reactor safety analysis. The method of characteristics (MOC) is applied to check the nonhyperbolic nature of conservation equations for all normal and accident conditions of light water reactors (LWRs). The analysis also gives information about the soundness of the model and to identify the regions where the solutions obtained from it will be numerically convergent. The characteristics of equations of nonhyperbolic nature are complex. It implies that results thus obtained (by finite difference method) have to be interpreted very carefully in view of the sensitive nature of reactor safety analysis. The present analysis shows that governing equations of the code exhibit complex characteristics for some operating conditions thus implying nonhyperbolicity under those conditions. Results are less accurate under such conditions, so sensitivity analysis plays an important role. The sensitivity of closure relationship on the conservation equation's stability is also checked. The analysis is performed in matlab environment for three different systems, (a) pressurized water reactor (PWR), boiling water reactor (BWR), and (c) natural circulation reactor or advance heavy water reactor (AHWR). These results can also be extended to other thermal-hydraulic systems. The different values of the coefficient of closure relationship are taken for different flow regimes. It is observed that the coefficient of virtual mass (for momentum equation) has a significant effect on the hyperbolicity of the system. It is recommended that further development of the RELAP5 model be performed to identify changes that would reduce the region of complex characteristics. The importance of MOC (in nuclear reactor thermal-hydraulic safety analysis) is evident here. In addition, a detailed analysis for operating pressures range of 0.1–22.5 MPa is also performed to find out the nonhyperbolic regions of code model and realistic data of the different type of reactors is used as input of the code. It is also observed here that RELAP5 results are less accurate when system pressure exceeds 19.5 MPa.
Ultrasound-guided caudal epidural injection in three simple steps
Authors: Yildizgoren Mustafa Turgut
Published: May 2020

N/A
Exploring sound perception through vocal imitations
Authors: Bordonné Thomas , Kronland-Martinet Richard , Ystad Sølvi , Derrien Olivier , Aramaki Mitsuko
Published: May 2020

Understanding how sounds are perceived and interpreted is an important challenge for researchers dealing with auditory perception. The ecological approach to perception suggests that the salient perceptual information that enables an auditor to recognize events through sounds is contained in specific structures called invariants. Identifying such invariants is of interest from a fundamental point of view to better understand auditory perception and it is also useful to include perceptual considerations to model and control sounds. Among the different approaches used to identify perceptually relevant sound structures, vocal imitations are believed to bring a fresh perspective to the field. The main goal of this paper is to better understand how invariants are transmitted through vocal imitations. A sound corpus containing different types of known invariants obtained from an existing synthesizer was established. Participants took part in a test where they were asked to imitate the sound corpus. A continuous and sparse model adapted to the specificities of the vocal imitations was then developed and used to analyze the imitations. Results show that participants were able to highlight salient elements of the sounds that partially correspond to the invariants used in the sound corpus. This study also confirms that vocal imitations reveal how these invariants are transmitted through perception and offers promising perspectives on auditory investigations.
A strategic approach to COVID-19 vaccine R&D
Authors: Corey Lawrence , Mascola John R. , Fauci Anthony S. , Collins Francis S.
Published: May 2020

A public-private partnership and platform for harmonized clinical trials aims to accelerate licensure and distribution
Polymyxin Triple Combinations against Polymyxin-Resistant, Multidrug-Resistant, KPC-Producing Klebsiella pneumoniae
Authors: Aye Su Mon , Galani Irene , Yu Heidi , Wang Jiping , Chen Ke , Wickremasinghe Hasini , Karaiskos Ilias , Bergen Phillip J. , Zhao Jinxin , Velkov Tony , Giamarellou Helen , Lin Yu-Wei , Tsuji Brian T. , Li Jian
Published: May 2020

Resistance to polymyxin antibiotics is increasing. Without new antibiotic classes, combination therapy is often required. We systematically investigated bacterial killing with polymyxin-based combinations against multidrug-resistant (including polymyxin-resistant), carbapenemase-producing
Klebsiella pneumoniae
. Monotherapies and double- and triple-combination therapies were compared to identify the most efficacious treatment using static time-kill studies (24 h, six isolates), an
in vitro
pharmacokinetic/pharmacodynamic model (IVM; 48 h, two isolates), and the mouse thigh infection model (24 h, six isolates).
Preserving Vascular Integrity Protects Mice against Multidrug-Resistant Gram-Negative Bacterial Infection
Authors: Gebremariam Teclegiorgis , Zhang Lina , Alkhazraji Sondus , Gu Yiyou , Youssef Eman G. , Tong Zongzhong , Kish-Trier Erik , Bajji Ashok , de Araujo Claudia V. , Rich Bianca , French Samuel W. , Li Dean Y. , Mueller Alan L. , Odelberg Shannon J. , Zhu Weiquan , Ibrahim Ashraf S.
Published: May 2020

The rise in multidrug-resistant (MDR) organisms portends a serious global threat to the health care system with nearly untreatable infectious diseases, including pneumonia and its often fatal sequelae, acute respiratory distress syndrome (ARDS) and sepsis. Gram-negative bacteria (GNB), including
Acinetobacter baumannii
,
Pseudomonas aeruginosa
, and carbapenemase-producing
Klebsiella pneumoniae
(CPKP), are among the World Health Organization’s and National Institutes of Health’s high-priority MDR pathogens for targeted development of new therapies.
The Serratia marcescens Siderophore Serratiochelin Is Necessary for Full Virulence during Bloodstream Infection
Authors: Weakland Danelle R. , Smith Sara N. , Bell Bailey , Tripathi Ashootosh , Mobley Harry L. T.
Published: May 2020

Serratia marcescens
is a bacterium frequently found in the environment, but over the last several decades it has evolved into a concerning clinical pathogen, causing fatal bacteremia. To establish such infections, pathogens require specific nutrients; one very limited but essential nutrient is iron. We sought to characterize the iron acquisition systems in
S. marcescens
isolate UMH9, which was recovered from a clinical bloodstream infection. Using RNA sequencing (RNA-seq), we identified two predicted siderophore gene clusters (
cbs
and
sch
) that were regulated by iron.
Comparison of a new versus standard removable offloading device in patients with neuropathic diabetic foot ulcers: a French national, multicentre, open-label randomized, controlled trial
Authors: Potier Louis , François Maud , Dardari Dured , Feron Marilyne , Belhatem Narimene , Nobecourt-Dupuy Estelle , Dolz Manuel , Bordier Lyse , Ducloux Roxane , Chibani Abdelkader , Eveno Dominique-François , Crea Avila Teresa , Sultan Ariane , Baillet-Blanco Laurence , Rigalleau Vincent , Gand Elise , Saulnier Pierre-Jean , Velho Gilberto , Roussel Ronan , Pellenc Quentin , Dupré Jean-Claude , Malgrange Dominique , Marre Michel , Mohammedi Kamel
Published: May 2020

Introduction

The offloading is crucial to heal neuropathic diabetic foot ulcer (DFU). Removable offloading are the most used devices.Orthèse diabèteis a new customized removable knee-high offloading device immobilizing foot and ankle joints, with some specific and innovative features that may improve offloading. We aimed to evaluate the efficiency ofthis devicein DFU healing.

Research, design and methods

The evaluation of Offloading using a new removable ORTHOsis in DIABetic foot study is a French multicenter (13 centers) randomized controlled trial with blinded end points evaluation. Adults with neuropathic DFU were randomly assigned to eitherOrthèse Diabète (experimental device), or any type of conventional (usually used in France) removable offloading devices (control group). The primary outcome was the 3-month proportion of patients with fully healed DFU.

Results

Among 112 randomized patients (men 78%, age 62±10 years), the primary outcome occurred in 19 (33%) participants using conventional device vs 19 (35%)Orthèse Diabèteusers (p=0.79). Study groups were also comparable in terms of prespecified secondary end points including occurrence of new DFU (25% vs 27% in conventional and experimental groups), ipsilateral lower-limb amputation (4% vs 10%) or infectious complications (14% vs 13%) (p>0.05 for all). Adverse events were comparable between groups, including 4 deaths unrelated to study allocation (1 sudden death, 2 ventricular arrhythmias and 1 pancreatic cancer). Adverse events believed to be related to the device were higher in theOrthèse Diabètegroup than in the control group (15% vs 4%).Orthèse Diabètewas less frequently worn than conventional devices (46% vs 66%, p=0.04).

Conclusions

Orthèse Diabète, a new removable offloading orthosis immobilizing foot and ankle joints did not show superiority compared with conventional removable devices in neuropathic DFU healing and cannot be recommended to heal DFU.

Trial registration number

NCT01956162.
Validation of a simplified score for predicting latent rheumatic heart disease progression using a prospective cohort of Brazilian schoolchildren
Authors: Bechtlufft Bárbara Martins , Nascimento Bruno Ramos , Sable Craig , Fraga Clara Leal , Barbosa Márcia Melo , Reis Susana Drumond , Diamantino Adriana Costa , Meira Zilda Maria Alves , Castilho Sandra Regina Tolentino , Arantes Nayana Flamini , Oliveira Kaciane Krauss , Silva José Luiz Padilha , Rezende Breno De Filippo , Costa Waydder Antônio Aurélio , Mata Mariana Duarte , Pereira Augusto Ferreira , Ribeiro Antonio Luiz Pinho , Beaton Andrea Zawacki , Pereira Nunes Maria Carmo
Published: May 2020

Objectives

Echocardiographic (echo) screening is an important tool to estimate rheumatic heart disease (RHD) prevalence, but the natural history of screen-detected RHD remains unclear. The PROVAR+ (Programa de RastreamentO da VAlvopatia Reumática) study, which uses non-experts, telemedicine and portable echo, pioneered RHD screening in Brazil. We aimed to assess the mid-term evolution of Brazilian schoolchildren (5–18 years) with echocardiography-detected subclinical RHD and to assess the performance of a simplified score consisting of five components of the World Heart Federation criteria, as a predictor of unfavourable echo outcomes.

Setting

Public schools of underserved areas and private schools in Minas Gerais, southeast Brazil.

Participants

A total of 197 patients (170 borderline and 27 definite RHD) with follow-up of 29±9 months were included. Median age was 14 (12–16) years, and 130 (66%) were woman. Only four patients in the definite group were regularly receiving penicillin.

Primary and secondary outcome measures

Unfavourable outcome was based on the 2-year follow-up echo, defined as worsening diagnostic category, remaining with mild definite RHD or development/worsening of valve regurgitation/stenosis.

Results

Among patients with borderline RHD, 29 (17.1%) progressed to definite, 49 (28.8%) remained stable, 86 (50.6%) regressed to normal and 6 (3.5%) were reclassified as other heart diseases. Among those with definite RHD, 13 (48.1%) remained in the category, while 5 (18.5%) regressed to borderline, 5 (18.5%) regressed to normal and 4 (14.8%) were reclassified as other heart diseases. The simplified echo score was a significant predictor of RHD unfavourable outcome (HR 1.197, 95% CI 1.098 to 1.305, p<0.001).

Conclusion

The simple risk score provided an accurate prediction of RHD status at 2-year follow-up, showing a good performance in Brazilian schoolchildren, with a potential value for risk stratification and monitoring of echocardiography-detected RHD.
Psychological concerns of Indian women with breast cancer in different national contexts: a systematic review and mixed-methods synthesis
Authors: Daniel Sunitha , Clark Joseph , Gnanapragasam Sam , Venkateswaran Chitra , Johnson Miriam J
Published: May 2020

Background

Breast cancer is becoming the most common cancer among women of Indian origin. However, little is known about the psychological impact of the disease and its treatment among this population.

Aim

To improve understanding of psychological symptoms among Indian women with breast cancer.

Design

This is a systematic literature review and critical interpretive synthesis. Medical Subject Headings(MeSH) terms and keywords for breast cancer, psychological symptoms and treatment were used to search databases from inception to 7 May 2019. The reference lists of the included articles were examined. Search results were screened against the inclusion criteria, data were extracted, and quality was appraised by two independent researchers with recourse to a third. Narrative (quantitative) and thematic qualitative syntheses were applied, followed by critical interpretive synthesis.

Data sources

ProQuest, MEDLINE, Ovid EMBASE, EBSCO, Cumulative Index to Nursing and Allied Health Literature, and PsycINFO.

Results

18 of 763 studies from India or Canada were included (13 quantitative, 5 qualitative). Critical interpretive synthesis found psychological concerns similar to ‘Western’ women, but were framed by the common culture of Indian women in either country. Family structure, religion and community appear to protect against and cause distress in relation to the expected core role of being a wife and a mother and the male dominance in decision making. Stigma was amplified by poor knowledge about the nature of cancer. Migrant Indian women had additional problems due to language barriers.

Conclusions

Indian women with breast cancer living in India and Canada experience psychological morbidities which profoundly affect their role in their family and the wider community. Culturally congruent care, including accessible communication and information, may help prevent and alleviate distressing symptoms whether in India or in a migrant community.
Overcoming resistance to anti-PD1 and anti-PD-L1 treatment in gastrointestinal malignancies
Authors: Puccini Alberto , Battaglin Francesca , Iaia Maria Laura , Lenz Heinz-Josef , Salem Mohamed E
Published: May 2020

In the last few years, the unprecedented results of immune checkpoint inhibitors have led to a paradigm shift in clinical practice for the treatment of several cancer types. However, the vast majority of patients with gastrointestinal cancer do not benefit from immunotherapy. To date, microsatellite instability high and DNA mismatch repair deficiency are the only robust predictive biomarkers of response to immune checkpoint inhibitors. Unfortunately, these patients comprise only 5%–10% of all gastrointestinal cancers. Several mechanisms of both innate and adaptive resistance to immunotherapy have been recognized that may be at least in part responsible for the failure of immune checkpoint inhibitors in this population of patients. In the first part of this review article, we provide an overview of the main clinical trials with immune checkpoint inhibitors in patients with gastrointestinal cancer and the role of predictive biomarkers. In the second part, we discuss the actual body of knowledge in terms of mechanisms of resistance to immunotherapy and the most promising approach that are currently under investigation in order to expand the population of patients with gastrointestinal cancer who could benefit from immune checkpoint inhibitors.
The impact of an integrated heart failure service in a medium-sized district general hospital
Authors: Hawley Alasdair , He Jingzhou , Crabtree Alice , Iacovides Stelios , Keeling Phil
Published: May 2020

Objectives

Assessing the impact of a new integrated heart failure service (IHFS) in a medium-sized district general hospital (DGH) on heart failure (HF) mortality, readmission rates, and provision of HF care.

Methods

A retrospective, observational study encompassing all patients admitted with a diagnosis of HF over two 12-month periods before (2012/2013), and after (2015/2016) IHFS establishment.

Results

Total admissions for HF increased by 40% (385 vs 540), with a greater number admitted to the cardiology ward (231 vs 121). After IHFS implementation, patients were more likely to see a cardiologist (35.1% vs 43.7%, p=0.009), undergo echocardiography (70.1% vs 81.5%, p<0.001), be initiated on all three disease modifying HF medications (angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARB) and mineralocorticoid receptor antagonists (MRA)) in the heart failure with reduced ejection fraction (HFrEF) group (42% vs 99%, p<0.001) and receive specialist HF input (81.6% vs 85.4%, p=0.2). Both 30-day post-discharge mortality and HF related readmissions were significantly lower in patients with heart failure with preserved ejection fraction (HFpEF) (8.9% vs 3.1%, p=0.032, 58% reduction, p=0.043 respectively) with no-significant reductions in all other HF groups. In-patient mortality was similar. Length of stay in Cardiology wards increased from 8.4 to 12.7 days (p<0.001).

Conclusion

Establishment of an IHFS within a DGH with limited resources and only a modest service re-design has resulted in significantly improved provision of specialist in-patient care, use of HFrEF medications, early heart failure nurse follow-up, and is associated with a reduction in early mortality, particularly in the HFpEF cohort, and HF related readmissions.
DMARD-free remission as novel treatment target in rheumatoid arthritis: A systematic literature review of achievability and sustainability
Authors: Verstappen M , van Mulligen E , de Jong P H P , van der Helm-Van Mil A H M
Published: May 2020

Objectives

Although current treatment guidelines for rheumatoid arthritis (RA) suggest tapering disease-modifying anti-rheumatic drugs (DMARDs), it is unclear whether DMARD-free remission (DFR) is an achievable and sustainable outcome. Therefore, we systematically reviewed the literature to determine the prevalence and sustainability of DFR and evaluated potential predictors for DFR.

Methods

A systematic literature search was performed in March 2019 in multiple databases. All clinical trials and observational studies reporting on discontinuation of DMARDs in RA patients in remission were included. Our quality assessment included a general assessment and assessment of the description of DFR. Prevalence of DFR and its sustainability and flares during tapering and after DMARD stop were summarised. Also, potential predictors for achieving DFR were reviewed.

Results

From 631 articles, 51 were included, comprising 14 clinical trials and 5 observational studies. DFR definition differed, especially for the duration of DMARD-free state. Considering only high- and moderate-quality studies, DFR was achieved in 5.0%–24.3% and sustained DFR (duration>12 months) in 11.6%–19.4% (both relative to the number of patients eligible for tapering). Flares occurred frequently during DMARD tapering (41.8%–75.0%) and in the first year after achieving DFR (10.4%–11.8%), while late flares, >1 year after DMARD-stop, were infrequent (0.3%–3.5%). Many patient characteristics lacked association with DFR. Absence of autoantibodies and shared epitope alleles increased the chance of achieving DFR.

Conclusions

DFR is achievable in RA and is sustainable in ~10%–20% of patients. DFR can become an important outcome measure for clinical trials and requires consistency in the definition. Considering the high rate of flares in the first year after DMARD stop, a DMARD-free follow-up of >12 months is advisable to evaluate sustainability.
High prevalence of coinfection of azithromycin-resistantMycoplasma genitaliumwith other STIs: a prospective observational study of London-based symptomatic and STI-contact clinic attendees
Authors: Broad Claire E , Furegato Martina , Harrison Mark A , Pond Marcus J , Tan NgeeKeong , Okala Sandra , Fuller Sebastian S , Harding-Esch Emma M , Sadiq S Tariq
Published: May 2020

Objectives

Azithromycin treatment ofChlamydia trachomatis(CT) may not be adequate to treat concomitantMycoplasma genitalium(MG) infection, and particularly if MG has macrolide resistance-associated mutations (MG-MRAMs). We estimated prevalence of coinfections of CT with MG carrying MRAM, and risk factors for MG-MRAM among a sexual health clinic population.

Study design and setting

Among symptomatic and STI-contact clinic attendees in London, prevalence of CT-MG coinfection and MG-MRAM were estimated using nucleic acid amplification testing and Sanger sequencing, respectively, and their associated risk factors analysed using logistic regression.

Results

MG prevalence was 7.5% (23/307), 17.3% (30/173), and 11.4% (8/70) in females, men who have sex with women (MSW) and men who have sex with men (MSM), respectively; MG coinfection in CT-infected participants represented 28.0% (7/25), 13.5% (5/37), 0.0% (0/0), respectively. Presence of MG-MRAM was 39.1% (9/23) in female swabs, 70.0% (21/30) in MSW urine and 83.3% (5/6) in MSM rectal swabs. In multivariate analyses, coinfection with another STI was strongly associated with MG-MRAM (OR: 7.19; 95% CI: 2.4 to 21.5).

Conclusion

A significant proportion of participants in our study of symptomatic patients and STI contacts were infected with macrolide-resistant MG, suggesting that testing for MG and MRAM, for MG positives, might be clinically useful. The findings also suggest services explore potential benefits of testing CT positive samples for MG in these patient groups. Where MG testing is not available, potential high rates of MG coinfection should be borne in mind when considering azithromycin in the treatment of CT among STI contacts and symptomatic patients.
Einstein clusters as models of inhomogeneous spacetimes
Authors: Szybka Sebastian J. , Rutkowski Mieszko
Published: May 2020

We study the effect of small-scale inhomogeneities for Einstein clusters. We construct a spherically symmetric static spacetime with small-scale radial inhomogeneities and propose the Gedankenexperiment. An hypothetical observer at the center constructs, using limited observational knowledge, a simplified homogeneous model of the configuration. An idealization introduces side effects. The inhomogeneous spacetime and the effective homogeneous spacetime are given by simple solutions to Einstein equations. They provide a basic toy-model for studies of the effect of small-scale inhomogeneities in general relativity. We show that within our highly inhomogeneous model the effect of small-scale inhomogeneities remains small for a central observer. The homogeneous model fits very well to all hypothetical observations as long as their precision is not high enough to reveal a tension.
Towards a heavy diquark effective theory for weak decays of doubly heavy baryons
Authors: Shi Yu-Ji , Wang Wei , Zhao Zhen-Xing , Meißner Ulf-G.
Published: May 2020

We construct a leading-order effective field theory for both scalar and axial-vector heavy diquarks, and consider its power expansion in the heavy diquark limit. By assuming the transition from QCD to diquark effective theory, we derive the most general form for the effective diquark transition currents based on the heavy diquark symmetry. The short-distance coefficients between QCD and heavy diquark effective field theory are also obtained by a tree level matching. With the effective currents in the heavy diquark limit, we perform a reduction of the form factors for semi-leptonic decays of doubly heavy baryons, and find that only one nonperturbative function is remaining. It is shown that this soft function can be related to the Isgur–Wise function in heavy meson transitions. As a phenomenological application, we take a single pole structure for the reduced form factor, and use it to calculate the semi-leptonic decay widths of doubly heavy baryons. The obtained results are consistent with others given in the literature, and can be tested in the future.
Magneto-vortical effect in strongly coupled plasma
Authors: Bu Yanyan , Lin Shu
Published: May 2020

Based on a holographic model incorporating both the chiral anomaly and the gravitational anomaly, we study the effect of magneto-vortical coupling on the transport properties of a strongly coupled plasma. The focus of present work is on the generation of a vector charge density and an axial current, as response to vorticity in a magnetized plasma. The transport coefficients parameterizing the vector charge density and axial current are calculated both analytically (in the weak magnetic field limit) and also numerically (for general values of the magnetic field). We find the generation of vector charge receives both non-anomalous and anomalous contributions, with the non-anomalous contribution dominating in the limit of a strong magnetic field and the anomalous contribution sensitive to both chiral anomaly and gravitational anomaly. On the contrary, we find the axial current is induced entirely due to the gravitational anomaly, thus we interpret the axial current generation as chiral vortical effect. The corresponding chiral vortical conductivity is found to be suppressed by the magnetic field. By the Onsager relation, these transport coefficients are responsible for the generation of a thermal current due to a transverse electric field or a transverse axial magnetic field, which we call the thermal Hall effect and the thermal axial magnetic effect, respectively.
A first proof of principle booster setup for the MADMAX dielectric haloscope
Authors: Egge Jacob , Knirck Stefan , Majorovits Béla , Moore Christopher , Reimann Olaf
Published: May 2020

Axions and axion-like particles are excellent low-mass dark matter candidates. The MADMAX experiment aims to directly detect galactic axions with masses between 40 and $$400\,\upmu \mathrm{eV}$$400μeV by using the axion-induced emission of electromagnetic waves from boundaries between materials of different dielectric constants under a strong magnetic field. Combining many such surfaces, this emission can be significantly enhanced (boosted) using constructive interference and resonances. We present a first proof of principle realization of such a booster system consisting of a copper mirror and up to five sapphire disks. The electromagnetic response of the system is investigated by reflectivity measurements. The mechanical accuracy, calibration process of unwanted reflections and the repeatability of a basic tuning algorithm to place the disks are investigated. We find that for the presented cases the electromagnetic response in terms of the group delay predicted by one-dimensional calculations is sufficiently realized in our setup. The repeatability of the tuning is at the percent level, and would have small impact on the sensitivity of such a booster.
Magnetized particle motion around magnetized Schwarzschild-MOG black hole
Authors: Haydarov Kamoliddin , Rayimbaev Javlon , Abdujabbarov Ahmadjon , Palvanov Satimbay , Begmatova Dilfuza
Published: May 2020

In this paper, we have presented the studies of the motion of magnetized particles and energetic processes around Schwarzschild black holes in modified gravity (MOG). The study of circular stable orbits shows that orbits of magnetized particles can not be stable for the values of magnetic coupling parameter $$\beta \ge 1$$β≥1. It was also shown that the range of stable circular orbits increases with the increase of both MOG and magnetic coupling parameters, while the effects of magnetic interaction stronger than the gravity. It was obtained that the increase of the MOG parameter causes the increase of center-of-mass energy collision of magnetized particles. Moreover, we have analyzed how to mimic the magnetic interaction with the spin of Kerr and Schwarzschild-MOG black holes. We have obtained that the magnetic coupling parameter can mimic the spin parameter $$a \le 0.15$$a≤0.15 ($$a \le 0.28$$a≤0.28) giving the same radius of innermost contour(co)-rotating orbits at the values of the parameter $$\beta \in (-1,1)$$β∈(-1,1) and the MOG parameter in the range $$\alpha \in (-0.17,0.28)$$α∈(-0.17,0.28) while the MOG parameter $$\alpha \in (-0.7, 0.9)$$α∈(-0.7,0.9) mimics spin parameter of the black hole with the range $$|a| \in (0,1)$$|a|∈(0,1).