bluuebunny/crossref_metadata_2025 huggingface dataset:
Increase in HIV incidence in women exposed to rape
Authors: Abrahams Naeemah , Mhlongo Shibe , Dunkle Kristin , Chirwa Esnat , Lombard Carl , Seedat Soraya , Kengne Andre P. , Myers Bronwyn , Peer Nasheeta , Garcia-Moreno Claudia , Jewkes Rachel
Published: December 2020

Objective:

To determine the incidence of HIV acquisition in women postrape compared with a cohort of women who had not been raped.

Design:

A prospective cohort study.

Methods:

The Rape Impact Cohort Evaluation study based in Durban, South Africa, enrolled women aged 16–40 years from postrape care services, and a control group of women from Primary Healthcare services. Women who were HIV negative at baseline (441 in the rape-exposed group and 578 in the control group) were followed for 12–36 months with assessments every 3 months in the first year and every 6 months thereafter. Multivariable Cox regression models adjusted for baseline and time varying covariates were used to investigate the effect of rape exposure on HIV incidence over follow-up.

Results:

Eighty-six women acquired HIV during 1605.5 total person-years of follow-up, with an incident rate of 6.6 per 100 person-years [95% confidence interval (CI): 4.8–9.1] among the rape exposed group and 4.7 per 100 person-years (95% CI: 3.5–6.2) among control group. After controlling for confounders (age, previous trauma, social support, perceived stress, multiple partners and transactional sex with a casual partner), women exposed to rape had a 60% increased risk of acquiring HIV [adjusted hazard ratio: 1.59 (95% CI: 1.01–2.48)] compared with those not exposed. Survival analysis showed difference in HIV incident occurred after month 9.

Conclusion:

Rape is a long-term risk factor for HIV acquisition. Rape survivors need both immediate and long-term HIV prevention and care.
The expression of repulsive guidance molecule a after traumatic brain injury: Time-course changes in gene expression in a murine model of controlled cortical impact
Authors: Uemura Eri , Tajima Goro , Murahashi Shimon , Matsumoto Naoya , Tokunaga Ayako , Miura Miyuki , Murase Takehiko , Ikematsu Kazuya , Tasaki Osamu
Published: December 2020

INTRODUCTION

Repulsive guidance molecule a (RGMa) is a key protein that negatively regulates neuronal regeneration as its inhibition enhances axonal growth and promotes functional recovery in animal models of spinal cord injury. However, the role of RGMa in traumatic brain injury (TBI) remains elusive. This study aimed to clarify TBI-responsive RGMa expression in a murine model.

METHODS

Adult male C57BL/6J mice were subjected to controlled cortical impact. Brains were extracted 6 hours and 1, 3, 7, 14 and 21 days after injury (n = 6 in each group). Changes in the messenger RNA (mRNA) expression of RGMa and its receptor, neogenin, were evaluated by quantitative polymerase chain reaction in the damaged area of the cortex and contralateral cortex, along with expression measurement of inflammation-related molecules. Neurological deficit was also assessed by the cylinder test.

RESULTS

Neurological score was consistently lower in the TBI group compared to the sham group throughout the experimental period. The mRNA expressions of representative inflammatory cytokine TNF-α and chemokine receptor CCR2 were remarkably increased in the injured cortex on day 1 and gradually decreased over time, although remaining at higher values at least until day 14. The mRNA expressions of RGMa and neogenin were significantly suppressed in the damaged cortex until day 3. Interestingly, RGMa expression was suppressed most on day 1 and recovered over time.

CONCLUSION

In the acute phase of TBI, gene expression of inflammatory cytokines significantly increased, and gene expressions of RGMa and neogenin significantly decreased in the inflammatory milieu of the damaged area. Despite the subsequent remission of inflammation, RGMa gene expression recovered to the normal level 1 week after TBI. Intrinsic regenerative response to acute brain injury might be hampered by the following recovery of RGMa expression, hinting at the possibility of functional RGMa inhibition as a new, effective maneuver against TBI.
Colour-Doppler echocardiography flow field velocity reconstruction using a streamfunction–vorticity formulation
Authors: Meyers Brett A. , Goergen Craig J. , Segers Patrick , Vlachos Pavlos P.
Published: December 2020

We introduce a new method (
Do
ppler
Ve
locity
R
econstruction or DoVeR), for reconstructing two-component velocity fields from colour Doppler scans. DoVeR employs the streamfunction–vorticity equation, which satisfies mass conservation while accurately approximating the flow rate of rotation. We validated DoVeR using artificial colour Doppler images generated from computational fluid dynamics models of left ventricle (LV) flow. We compare DoVeR against the conventional intraventricular vector flow mapping (iVFM
1D
) and reformulated iVFM (iVFM
2D
). LV model error analysis showed that DoVeR is more robust to noise and probe placement, with noise RMS errors (
nRMSE
) between 3.81% and 6.67%, while the iVFM methods delivered 4.16–24.17% for iVFM
1D
and 4.06–400.21% for iVFM
2D
. We test the DoVeR and iVFM methods using
in vivo
mouse LV ultrasound scans. DoVeR yielded more haemodynamically accurate reconstructions, suggesting that it can provide a more reliable approach for robust quantification of cardiac flow.
Maxwell's quasi-demon as a property of an ideal gas in the equilibrium state
Authors: Semikolenov Andrey V.
Published: December 2020

The paper shows that for the case of an ideal gas in the equilibrium state there exists a method for splitting it into portions with different temperatures without energy transfer to or from the environment and without work being done. Compared with the thought experiment known as ‘Maxwell's demon’, in which such splitting is based on sorting specific molecules according to their energy levels, the process described does not require the energy of a specific molecule to be determined. Here the splitting is guided by the average energy of a group of molecules. The paper establishes the fact that the average energy of molecules striking the wall over a period of time is higher than the average energy of all molecules constituting the gas; this fact is what substantiates our method. This explains how a process that may result in extracting a higher temperature portion of the gas in the equilibrium state is generally possible. The paper considers one of the implementations of this process. We also show that groups of molecules may be split off from the gas, the average energy of said groups being lower than the average energy of the gas molecules in total.
A phenotypic switch in the dispersal strategy of breast cancer cells selected for metastatic colonization
Authors: Butler George , Keeton Shirley J. , Johnson Louise J. , Dash Philip R.
Published: December 2020

An important question in cancer evolution concerns which traits make a cell likely to successfully metastasize. Cell motility phenotypes, mediated by cell shape change, are strong candidates. We experimentally evolved breast cancer cells
in vitro
for metastatic capability, using selective regimes designed to simulate stages of metastasis, then quantified their motility behaviours using computer vision. All evolved lines showed changes to motility phenotypes, and we have identified a previously unknown density-dependent motility phenotype only seen in cells selected for colonization of decellularized lung tissue. These cells increase their rate of morphological change with an increase in migration speed when local cell density is high. However, when the local cell density is low, we find the opposite relationship: the rate of morphological change decreases with an increase in migration speed. Neither the ancestral population, nor cells selected for their ability to escape or invade extracellular matrix-like environments, displays this dynamic behavioural switch. Our results suggest that cells capable of distant-site colonization may be characterized by dynamic morphological phenotypes and the capacity to respond to the local social environment.
A meta-analysis of brain DNA methylation across sex, age and Alzheimer’s disease points for accelerated epigenetic aging in neurodegeneration
Authors: Pellegrini C , Pirazzini C , Sala C , Sambati L , Yusipov I , Kalyakulina A , Ravaioli F , Kwiatkowska KM , Durso DF , Ivanchencko M , Monti D , Lodi R , Franceschi C , Cortelli P , Garagnani P , Bacalini MG
Published: December 2020

Alzheimer’s disease (AD) is characterized by specific alterations of brain DNA methylation (DNAm) patterns. Age and sex, two major risk factors for AD, are also known to largely affect the epigenetic profiles in the brain, but their contribution to AD-associated DNAm changes has been poorly investigated. In this study we considered publicly available DNAm datasets of 4 brain regions (temporal, frontal, entorhinal cortex and cerebellum) from healthy adult subjects and AD patients, and performed a meta-analysis to identify sex-, age- and AD-associated epigenetic profiles. We showed that DNAm differences between males and females tend to be shared between the 4 brain regions, while aging differently affects cortical regions compared to cerebellum. We found that the proportion of sex-dependent probes whose methylation changes also during aging is higher than expected, but that differences between males and females tend to be maintained, with only few probes showing sex-by-age interaction. We did not find significant overlaps between AD- and sex-associated probes, nor disease-by-sex interaction effects. On the contrary, we found that AD-related epigenetic modifications are significantly enriched in probes whose DNAm changes with age and that there is a high concordance between the direction of changes (hyper or hypo-methylation) in aging and AD, supporting accelerated epigenetic aging in the disease.

In conclusion, we demonstrated that age-associated, but not sex-associated DNAm concurs to the epigenetic deregulation observed in AD, providing new insight on how advanced age enables neurodegeneration.
Rapid response to a measles outbreak in Ifanadiana District, Madagascar
Authors: Finnegan Karen E. , Haruna Justin , Cordier Laura F. , Razafinjato Benedicte , Rakotonirina Luc , Randrianambinina Andriamihaja , Rakotozafy Emmanuel , Andriamihaja Benjamin , Garchitorena Andres , Bonds Matthew H. , Ouenzar Mohammed Ali
Published: December 2020

In 2019, Madagascar experienced the nation’s largest documented measles outbreak ever. From September 2018 to January 2020, nearly 225,000 individuals were infected, slightly more than 1,000 of whom died. Madagascar is one of the poorest countries in the world with one of the least funded health systems. Here, we present the experience of how Madagascar’s Ministry of Health (MoH) partnered with a non-governmental organization, PIVOT, to rapidly respond to a measles outbreak in the rural district of Ifanadiana, in the southeast of the country. The epidemic reached Ifanadiana in January of 2019. By August, there were more than 4,800 identified cases of suspected measles, including 157 hospitalizations. Over the course of two weeks in February 2019, the MoH and PIVOT mobilized nine teams of 220 total staff to vaccinate 69,949 children aged 6 months to 10 years at schools and community events. Surrounding the campaign, health workers were trained in measles identification and provided with medication for symptom management. The measles response required overcoming health system weaknesses and geographic barriers which are endemic throughout the country and create chronic challenges for the provision of routine preventive and curative care. This response demonstrates that rapid mobilization of an organized health system response is feasible even in hard-to-reach areas.

KEY POINTS

Madagascar experienced the island’s worst measles outbreak in history as a result of low vaccination coverage.

In Ifanadiana District, the Ministry of Health and a non-governmental health organization collaborated to respond to the measles outbreak with a mass vaccination campaign, sensitization, and provision of supplies to health facilities for the management of disease complications.

The measles outbreak in Madagascar highlights the need for an increased focus on routine preventive care, especially in hard-to-reach communities; calls attention to the consequences of ruptures in the care continuum; and highlights the need for timely, continuous, de-centralized epidemiologic data.

The response to the outbreak in one rural district is evidence that health care can be delivered in remote areas.
Long-range PCR-based NGS applications to diagnose Mendelian retinal diseases
Authors: Maggi Jordi , Koller Samuel , Bähr Luzy , Feil Silke , Pfiffner Fatma Kivrak , Hanson James V. M. , Maspoli Alessandro , Gerth-Kahlert Christina , Berger Wolfgang
Published: December 2020

Background

The purpose of this study was to develop a flexible, cost-efficient next-generation sequencing (NGS) protocol for genetic testing.

Methods

Long-range polymerase chain reaction (LR PCR) amplicons of up to 20 kb in size were designed to amplify entire genomic regions for a panel (n=35) of loci associated with retinal diseases (RDs). Amplicons were pooled and sequenced by NGS. The analysis was applied to 227 probands diagnosed with RD: (A) 108 previously molecularly diagnosed, (B) 94 without previous genetic testing, (C) 25 undiagnosed after exome sequencing (ES).

Results

The method was validated with 100% sensitivity on cohort A. LR PCR-based sequencing revealed likely causative variant(s) in 51% and 24% of proband from cohorts B and C, respectively. Breakpoints of 3 CNVs could be characterized. LR PCR libraries spike-in extended coverage data of ES. Read phasing confirmed compound heterozygosity in 5 probands.

Conclusion

The proposed sequencing protocol provided deep coverage of the entire gene including intronic and promoter regions. Our method can be used (i) as a first-tier assay to reduce genetic testing costs, ii) to elucidate missing heritability cases, iii) to characterize breakpoints of CNVs at the nucleotide level, iv) to extend WES data to non-coding regions by spiking-in LR libraries, and v) to help with phasing of candidate variants.
Real-life evaluation of a rapid antigen test (Panbio™ COVID-19 Ag Rapid Test Device) for SARS-CoV-2 detection in asymptomatic close contacts of COVID-19 patients
Authors: Torres Ignacio , Poujois Sandrine , Albert Eliseo , Colomina Javier , Navarro David
Published: December 2020

Objectives

There is limited information on the performance of rapid antigen detection (RAD) tests to identify SARS-CoV-2-infected asymptomatic individuals. In this field study, we evaluated the Panbio™ COVID-19 Ag Rapid Test Device (Abbott Diagnostics, Jena, Germany) for the purpose.

Methods

A total of 634 individuals (355 female; median age, 37 years; range, 9-87) were enrolled. Household (n=338) contacts were tested at a median of 2 days (range, 1-7) after diagnosis of the index case and non-household contacts (n=296) at a median of 6 days (range, 1-7) after exposure. RAD testing was carried out at the point of care. The RT-PCR test used was the TaqPath COVID-19 Combo Kit (Thermo Fisher Scientific, Massachusetts, USA).

Results

In total, 79 individuals (12.4%) tested positive by RT-PCR, of whom 38 (48.1%) yielded positive RAD results. The overall sensitivity and specificity of the RAD test was 48.1% (95% CI: 37.4-58.9) and 100% (95% CI: 99.3-100), respectively. Sensitivity was higher in household (50.8%; 95% CI: 38.9-62.5) than in non-household (35.7%; 95% CI:16.3-61.2%) contacts. Individuals testing positive by RAD test were more likely (P<0.001) to become symptomatic than their negative counterparts.

Conclusion

The Panbio test displays low sensitivity in asymptomatic close contacts of COVID-19 patients, particularly in non-household contacts. Nonetheless, establishing the optimal timing for upper respiratory tract collection in this group seems imperative to pinpoint test sensitivity.
Towards high-quality nitrogen-doped diamond single crystals for X-ray optics
Authors: Shevyrtalov Sergey , Barannikov Alexander , Palyanov Yurii , Khokhryakov Alexander , Borzdov Yurii , Sergueev Ilya , Rashchenko Sergey , Snigirev Anatoly
Published: December 2020

In this manuscript, characterization of single-crystalline (111) plates prepared from type-Ib diamonds with a nitrogen content of 100–150 ppm by means of high-resolution rocking-curve imaging (RCI) is reported. Contrary to common opinion regarding the intrinsically poor diffraction quality of type-I diamonds, RCI showed the presence of nearly defect-free areas of several millimetres squared in the central part of the diamond plates. The observed broadening of the rocking curves is a result of the cutting and polishing processes, causing strains around the edges of the plates and rare defects. An improvement of the preparation technique will thus allow single-crystalline diamond plates to be made for Laue and Bragg monochromators and beam splitters from type-Ib material with areas large enough to be used as optical elements at fourth-generation synchrotron facilities.
Self-directed experiential learning to meet ever-changing entrepreneurship demands
Authors: Morris Thomas Howard , König Pascal D.
Published: December 2020

Purpose

Policy makers have called for more entrepreneurship throughout societies as a response to the digital transformation. This paper argues that the rapidly changing conditions of the digital age indeed mark a change in the bases of entrepreneurship. Specifically, as adaptivity becomes key, a learning capacity and general ability to adapt becomes a critical factor in entrepreneurial activity. The paper identifies self-directed learning (SDL) as a fundamental competence in this regard and examines its role for entrepreneurship and entrepreneurial competence.

Design/methodology/approach

The paper develops a theoretical framework for the role of SDL in entrepreneurship through a process of systematic review of previous studies that have linked SDL to entrepreneurship.

Findings

The formulated theoretical framework shows how SDL competence combines with experiential learning in supporting the kind of adaptivity needed for entrepreneurial competence, especially under more rapidly changing conditions. SDL competence also gains wider importance through enabling individuals to meet the demands of organizational changes in our highly volatile world.

Practical implications

SDL competence prepares individuals for entrepreneurship and resilience in face of rapid changes as well as for being more entrepreneurial in the conduct of their lives more generally. Fostering SDL competence can thus be regarded as an important objective of entrepreneurship education.

Originality/value

The described self-directed experiential learning cycle offers a novel perspective that clarifies how both self-directed and experiential learning competences are integral for understanding the basis of adaptiveness in entrepreneurial activity.
Research on underwear pressure prediction based on improved GA-BP algorithm
Authors: Cheng Pengpeng , Chen Daoling , Wang Jianping
Published: December 2020

Purpose

For comfort evaluation of underwear pressure, this paper proposes an improved GA algorithm to optimize the weight and threshold of BP neural network, namely PSO-GA-BP neural network prediction model.

Design/methodology/approach

The objective parameters of underwear, body shape data, skin deformation and other data are selected for simulation experiments to predict the objective pressure and subjective evaluation in dynamic and static state. Compared with the prediction results of BP neural network prediction model, GA-BP neural network prediction model and PSO-BP neural network prediction model, the performance of each prediction model is verified.

Findings

The results show that the BP neural network model optimized by PSO-GA algorithm can accelerate the convergence speed of the neural network and improve the prediction accuracy of underwear pressure.

Originality/value

PSO-GA-BP model provides data support for underwear design, production and processing and has guiding significance for consumers to choose underwear.
Ambient assisted living and European funds: a bibliometric approach
Authors: Puliga Gloria , Nasullaev Akhatjon , Bono Flavio , Gutiérrez Eugenio , Strozzi Fernanda
Published: December 2020

Purpose

The authors analyse the impact of European funding research programmes on the topic of Ambient Assisted Living by considering its status, future context, and the implications for prospective knowledge management.

Design/methodology/approach

The authors apply our variation of classical Systematic Literature Review – Systematic Literature Network Analysis, which also includes bibliographic networks – to identify the readership cliques of the associated technological publication outputs.

Findings

The authors’ main conclusion suggests that there was an increase in scientific production on AAL fields just after the start of the two EU funding programmes (2008 and 2014). Three main research directions were identified: activity and vital sign recognition, human-computer interaction and technology acceptance.

Originality/value

To date, previous reviews on Ambient Assisted Livig focus on specific aspects, such as the study of technology. The present review provides a complete overview of Ambient Assisted living technology and it grasps how the European funds have impacted on the development of this technology.
Investigating the link between intellectual capital and open innovation processes: a longitudinal case study
Authors: Matricano Diego , Candelo Elena , Sorrentino Mario , Cappiello Giuseppe
Published: December 2020

Purpose

This paper investigates the link between Intellectual Capital (IC) and Open Innovation (OI). Scholars worldwide consider the topics as standing alone and so they give scarce attention to the possible link between them. Managerial experiences (and few theoretical contributions), instead, hypothesize a significant role that IC can play over OI processes in order make them successful.

Design/methodology/approach

The methodology of a single case study is used to investigate the link between IC and OI. In particular, an OI process managed by a global company, LEGO, and named Mindstorms is rebuilt and analysed herein.

Findings

Intermediate results achieved by LEGO through its OI process were unsuccessful since the company had not developed its own IC (made up of relational, human and structural capital). The subsequent development of IC, instead, has driven to successful results. This suggests that if companies do not develop their IC before launching OI processes, then these processes might be not successful.

Research limitations/implications

One limitation is the use of a single case study. Despite this, the present article is a warning for all the companies: before launching OI processes they need to develop their IC.

Originality/value

To the best knowledge of the authors, this is one of the first works that deepens the investigation of the link between IC and OI. Very often, scholars investigating IC shyly refer to OI, without mentioning it, while the scholars investigating OI allude to IC, without citing it. In this study, IC and OI are investigated together.
Leadership for a healthy work environment – a question about who, what and how
Authors: Vidman Åsa , Strömberg Annika
Published: December 2020

Purpose

Recruiting and retaining staff to work with elderly people in social care is a global issue. The quality of leadership is considered important because it influences employees’ job satisfaction, job turnover and health. This paper aims to identify leadership that employees in residential elderly care facilities in Sweden consider as contributing towards a healthy work environment.

Design/methodology/approach

The authors interviewed 14 persons employed in facilities organized in different ways. The data from these interviews was analysed using qualitative content analysis..

Findings

The results showed that the employees felt that their health partly depended on the attributes that leaders possessed, what leaders do and how leaders do it. This study confirms that leadership influences the perception of a healthy workplace. It also shows that questions about leadership are complex.

Originality/value

Research about factors that increase health risks is wide-ranging; however, research that examines factors that promote health, especially how leadership influences employees’ well-being, is not as comprehensive.
Covid-19 “tourism in flight mode”: a lost opportunity to rethink tourism – towards a more sustainable and inclusive society
Authors: Pardo Carmen , Ladeiras Ana
Published: December 2020

Purpose

This paper aims to report on a post-confinement reflection (not post-COVID-19) resulting from a series of online forums that took place during the peak moments of the pandemic, with the intention of raising awareness and mobilising tourism agents for the development of tourism planning and tourism intelligence, taking advantage of the period of stagnation of the tourism industry. The project was named “Tourism in flight mode: Thinking together the post COVID-19 tourism”.

Design/methodology/approach

The project was based on the sharing of information and experiences in virtual forums where participants from all over the world had the opportunity to explain how the pandemic was influencing their work/business, the regional or national tourism activity, GDP and jobs and how they and their regions were preparing for the recovery of tourism. On a biweekly basis, virtual forums were organised, with participants from three continents and 12 countries. The results were contextualised by carrying out a review of the most recent literature and authors’ tourism know-how in the field.

Findings

The results of the discussions allowed for an identification of new potential successful tourism products and new proposals for the design of basic pillars for destinations planning.

Practical implications

This paper offers practical recommendations for public administration and others on dealing with unexpected crises in the tourism sector and how to respond through the development of new and adapted products and approaches to tourism.

Originality/value

This paper creates awareness in public administration and other agencies about the opportunities and the needs for this “new era”.
Covid-19 crisis: a new model of tourism governance for a new time
Authors: Vargas Alfonso
Published: December 2020

Purpose

The COVID-19 crisis has had a dramatic impact on the tourism industry, with new challenges that calls for a combination of short- and medium-/long-term perspectives. At the destination level, a factor that has a critical incidence in the recovery path is the type of tourism governance. With the spotlight on this factor, the purpose of this paper is to reflect on the need to accommodate the model of tourism governance to the requirements of this new time.

Design/methodology/approach

The discussion that already existed in the literature about the roles of destination marketing organizations (DMOs) has been brought into the new context of the coronavirus crisis to propose three fundamental changes in them, together with the centrality of host communities in a model based on public–private–people partnerships.

Findings

Under the principle that the M in DMOs has to stand for management, an evolution of these organizations toward the performance of three different roles is proposed, namely, as the orchestrator of the various players in the destination, the facilitator of opportunities for its members and the intelligence promoter and their strategic mind.

Practical implications

The practical implications of this proposal are numerous, as it represents a move beyond the usual public–private partnerships of the old normal and goes further than the traditional roles of marketer, intermediary in the value chain and brand promoter.

Originality/value

To the best of the author’s knowledge, this is the first work dealing with the topic of tourism governance in the context of the pandemic.
Possible roles of CXCL13/CXCR5 axis in the development of bullous pemphigoid
Authors: Ohuchi Kentaro , Fujimura Taku , Lyu Chunbing , Amagai Ryo , Muto Yusuke , Aiba Setsuya
Published: December 2020

CXCL13 recruits CXCR5+ follicular helper T (Tfh) cells in inflammatory lesions to develop secondary lymphoid organs. Tfh cells activate B cells to produce antibodies during humoral immune responses. Indeed, as previous reports suggested, CXCR5+ cell numbers were increased in the peripheral blood of bullous pemphigoid (BP) patients when compared with healthy donors, and the ratio of CXCR5+ cells was positively correlated with the anti‐BP180‐NC16A titers. From the above findings, in this report, we hypothesized that a chemokine related to CXCR5+ cells, namely CXCL13, may play a role in the development of BP. We performed immunohistochemical staining of CXCR5, CXCL13, LL37, CXCL10 and CCL20 for 10 cases of BP and 10 cases of pemphigus vulgaris (PV), and quantitatively analyzed the staining by digital microscopy. Moreover, we investigated the CXCL10 and CXCL13 production in BP and PV patients by enzyme‐linked immunosorbent assay. The immunomodulatory effects of LL37 on the production of T‐helper 17‐related chemokines were evaluated using monocyte‐derived M2 macrophages. Immunohistochemical staining and digital microscopic analysis showed that the ratios of CXCR5+, CXCL13+ and LL37+ cells in the dermis were significantly higher in BP patients than in PV patients. Notably, the ratio of CXCL13+ cells was positively correlated with the anti‐BP180‐NC16A titers. Moreover, the serum levels of CXCL13 were positively correlated with the anti‐BP180‐NC16A titers. Furthermore, CD163+ M2 macrophages stimulated by LL37 in vitro produced CXCL10 and CCL20. In the lesional skin of BP, CD163+ macrophages CXCL10 and CCL20 were produced. The serum levels of CXCL10 were negatively correlated with the anti‐BP180‐NC16A titers. The present study results indicate that the mechanism of the development of BP may involve the CXCL13/CXCR5‐mediated migration of Tfh cells.
Recombination proteins differently control the acquisition of homeologous DNA during Bacillus subtilis natural chromosomal transformation
Authors: Serrano Ester , Ramos Cristina , Alonso Juan C. , Ayora Silvia
Published: December 2020

Natural chromosomal transformation (CT) plays a major role in prokaryote evolution, yet factors that govern the integration of DNA from related species remain poorly understood. We show that in naturally competent Bacillus subtilis cells the acquisition of homeologous sequences is governed by sequence divergence (SD). Integration initiates in a minimal efficient processing segment via homology‐directed CT, and its frequency decreases log‐linearly with increased SD up to 15%. Beyond this and up to 23% SD the interspecies boundaries prevail, the CT frequency marginally decreases, and short (<10‐nucleotides) segments are integrated via homology‐facilitated micro‐homologous integration. Both mechanisms are RecA dependent. We identify the other recombination proteins required for the acquisition of homeologous DNA. The absence of AddAB, RecF, RecO, RuvAB or RecU, crucial for repair‐by‐recombination, did not affect CT. However, dprA, radA, recJ, recX or recD2 inactivation strongly decreased intraspecies and interspecies CT. Interspecies CT was not detected beyond ~8% SD in ΔdprA, ~10% in ΔrecJ, ΔradA, ΔrecX and ~14% in ΔrecD2 cells. We propose that DprA, RecX, RadA/Sms, RecJ and RecD2 accessory proteins are important for the generation of genetic diversity. Together with RecA, they facilitate gene acquisition from bacteria of related species.
Is it necessary to always resect elastofibroma dorsi?
Authors: Sahin Mutlu , Gul Vahit O.
Published: December 2020

Background

Elastofibroma dorsi (ED) is a benign soft tissue tumour of the subscapular region of the chest wall. It is a frequent lesion, especially seen in females and in the elderly. It remains unclear whether the size or symptomatology of the tumour is important to make a resection decision. Our aim in this study is to reveal the results between asymptomatic or symptomatic ED cases, and to reveal which factors are important for making a resection decision.

Methods

Patients operated between January 2010 and December 2019 were included in the study, and divided into two groups as patients who were asymptomatic or with various symptoms. Patients were evaluated in terms of demographic and operational factors.

Results

The study included 57 patients with the average age of 56.1 ± 11.5 years. Whilst 31 (54.4%) of these patients were asymptomatic, 26 (45.6%) were symptomatic. There was a statistical significance between groups in terms of occupation (P < 0.001), comorbidity (P = 0.042) and the duration of complaints (P = 0.001). A statistically significant difference was analysed between comorbidity versus early and late complications (P = 0.011 and P = 0.002, respectively).

Conclusion

ED probably occurs as a result of repeated trauma in the subcapular region in people who use their arms extensively. Regardless of the size of the lesion, surgery should be avoided as much as possible, especially in asymptomatic patients. However, in patients who are symptomatic, a precise surgical procedure can give satisfactory results. In these patients, who are generally elderly, early and late complications can be seen more, if they have comorbidity.
Is there a safe and effective way to wean patients off long‐term glucocorticoids?
Authors: Baker Emma
Published: December 2020

Glucocorticoids are highly effective medicines in the treatment of inflammatory disorders. However, they cause severe adverse reactions, particularly where taken at high doses systemically for prolonged periods. Systemic glucocorticoids are therefore given at dosage sufficient to control the disease, then withdrawn as fast as is possible to minimise dose‐ and time‐related adverse drug reactions without losing disease control. Adverse withdrawal reactions present a major challenge in the withdrawal of long‐term glucocorticoids. Suppression of the hypothalamic–pituitary–adrenal (HPA) axis causes adrenal insufficiency, which is potentially life threatening and can become symptomatic as treatment is withdrawn. Adrenal insufficiency can be extremely difficult to differentiate from glucocorticoid withdrawal syndrome, where patients experience symptoms despite adequate adrenal function, and from psychological dependence. Long‐term systemic glucocorticoids should therefore be withdrawn slowly. The rate at which the dose is tapered should initially be determined by treatment requirements of the underlying disease. Once physiological doses are reached, the rate of reduction is determined by rate of HPA recovery and need for exogenous glucocorticoid cover while endogenous secretion recovers. If symptoms prevent treatment withdrawal, HPA testing should be used to look for adrenal insufficiency. Patients with adrenal insufficiency require physiological doses of glucocorticoids for adrenal replacement, which may be lifelong if the HPA axis fails to recover.
Process lessons from evaluating a combined continuity of carer and home birth scheme
Authors: Symon Andrew , Shinwell Shona , Craig Justine
Published: December 2020

Introduction

Continuity of midwifery carer improves outcomes, but there is significant variation in how such schemes are implemented and evaluated cross‐culturally. The Angus home birth scheme in Scotland incorporates continuity of carer throughout pregnancy, labor, birth, and the postnatal period.

Methods

Manual maternity case note review to evaluate the 80% continuity of carer and 3% planned home birth rate targets.

Results

Of 1466 women booking for maternity care, 69 joined the scheme. Forty‐four had a planned home birth (3% overall), of whom seven were originally deemed ineligible. Of the 44, eight (18%) also achieved 80% continuity of carer with the primary midwife; by including a home birth team colleague, the continuity rate rose to 73%. Women whose care achieved home birth and continuity targets had lower deprivation scores. Eligibility issues, women's changing circumstances, and data recording lapses were complicating issues.

Conclusions

Targets must be both feasible and meaningful and should be complemented by assessing a broad range of outcomes while viewing the scheme holistically. By expanding eligibility criteria, the home birth rate target was met; including input from a home birth team colleague in the calculation meant the continuity target was nearly met. With dedicated and competent staff, adequate resource and political support, and when considered in the round, the scheme's viability within local services was confirmed. Other generalizable learning points included the need to standardize definitions and data recording methods. Comparability across schemes helps grow the evidence base so that the links between processes and outcomes can be identified.
Developments allergy in 2019 through the eyes of clinical and experimental allergy, part I mechanisms
Authors: Roberts Graham , Almqvist C. , Boyle R. , Crane J. , Hogan S. P. , Marsland B. , Saglani S. , Woodfolk J. A.
Published: December 2020

In the first of two linked articles, we describe the development in the mechanisms underlying allergy as described by Clinical & Experimental Allergy and other journals in 2019. Experimental models of allergic disease, basic mechanisms, clinical mechanisms and allergens are all covered.
On‐ and off‐licensed premises drinking behaviour among adults in the city of Tshwane, South Africa: An analysis of data from the International Alcohol Control study
Authors: Londani Mukhethwa , Morojele Neo K. , Egbe Catherine O. , Nel Elmarie , Petersen Williams Petal , Harker Nadine , Parry Charles D. H.
Published: December 2020

Introduction and Aims

Alcohol use is among the leading risk factors for premature death and morbidity in South Africa. This study sought to identify factors associated with drinking behaviour in on‐ and off‐licensed premises (typical occasion quantity and frequency) among adults in the City of Tshwane, South Africa.

Design and Methods

A household survey was conducted in 2014, using a multi‐stage stratified cluster random sampling design. Participants comprised 982 adults (65% males) aged 18–65 years. Factors explored included socio‐demographic variables and situational variables at on‐ and off‐licensed premises. Multiple logistic regression analysis was performed to predict drinking behaviour at on‐ and off‐licensed premises.

Results

The majority of the participants consumed alcohol in off‐licensed premises (64% vs. 36%). However, participants who consumed alcohol at on‐licensed premises were more likely to drink more alcohol and more frequently (weekly). Additionally, participants who consumed alcohol in above‐average sized containers were more likely to consume six or more drinks and drink weekly. Being of high socio‐economic status was associated with drinking weekly at off‐licensed premises, while being less educated was associated with a significantly higher frequency of drinking at on‐licensed premises.

Discussion and Conclusions

Interventions to reduce alcohol use should target specific drinking behaviour at on‐ and off‐licensed premises, for example, regulating the availability of alcohol in big‐sized containers and the need for cutting down on quantity of alcohol and frequency of drinking for South African males who drink at on‐ and off‐licensed premises.
Treatment persistence in patients with type 2 diabetes treated with glucagon‐like peptide‐1 receptor agonists in clinical practice in Sweden
Authors: Svensson Ann‐Marie , Toll Anders , Lebrec Jeremie , Miftaraj Mervete , Franzén Stefan , Eliasson Björn
Published: December 2020

Aim

To compare treatment persistence in patients with type 2 diabetes initiating the glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) dulaglutide, exenatide once‐weekly (QW), liraglutide or lixisenatide in routine clinical practice in Sweden and assess clinical outcomes.

Materials and Methods

We performed a retrospective study using data from several nationwide Swedish health registries, including the National Diabetes Register and other mandatory and population‐based registries. Individual level data were collected from 17 361 patients who initiated GLP‐1 RA treatment from 23 May 2015 to 15 October 2017, up to 2.5 years postindex (treatment start date). Treatment persistence and modification, predictors of discontinuation, HbA1c and body weight were recorded. Non‐persistence was defined as a treatment gap of more than 45 days. Treatment modification included switching and augmentation. Confounding was addressed through the use of propensity scores.

Results

Treatment persistence was higher and treatment modifications were lower in patients initiating dulaglutide compared with those on exenatide QW, liraglutide and lixisenatide. Patients who remained on the same treatment for 1‐year postindex experienced greater HbA1c reductions and a steadier decrease in body weight.

Conclusions

Our study suggests that in clinical practice in Sweden there is a greater persistence of treatment among patients initiating dulaglutide compared with those on exenatide QW, liraglutide and lixisenatide. Persistence with the index GLP‐1 RA was closely correlated with positive clinical outcomes and thus should be considered a critical factor of patient‐centric treatment in Sweden.
Sex differences in survival: viability selection in nymphal tree crickets from a conopid fly parasitoid
Authors: Etzler Erik A. , Gwynne Darryl T.
Published: December 2020

1. Variation in mortality due to parasitoids is expected to be affected by host sex and size.

2. We use selection analyses to examine the effects of Stylogaster neglecta (Diptera: Conopidae), a recently discovered parasitoid of nymphal Oecanthus nigricornis (Orthoptera: Gryllidae), on sex and size viability in the host crickets.

3. O. nigricornis nymphs were sampled across Ontario and New York State and dissected to determine whether they were parasitised. Logistic regression was used to examine parasitism by host body size and sex.

4. There was strong evidence for an effect of sex and body size on parasitism, with males and smaller crickets being more likely to be parasitised and containing more parasitoids in them. There was also weaker evidence of an interaction effect between sex and body size, with body size being a significant predictor of parasitism only in males. Using a selection analysis, we found evidence of positive and disruptive selection on male body size.

5. Causes of these viability differences may include sex differences in larval cricket immune function, riskier behaviour of male nymphs as they acquire resources necessary for adult trait development, as well as the effects of S. neglecta flies targeting hosts that maximise fitness.
Spawning strategy of Japanese anchovy Engraulis japonicus in the coastal Yellow Sea: Choice and dynamics
Authors: Zhang Wenchao , Yu Haiqing , Ye Zhenjiang , Tian Yongjun , Liu Yang , Li Jianchao , Xing Qinwang , Jiang Yiqian
Published: December 2020

Understanding the relationships between hydrodynamics and the spawning activities of small pelagic fishes is crucial for understanding their recruitment dynamics and for fisheries management. Here, we clarify the effects of marine environmental factors and the associated hydrodynamic processes on the spawning activities of the Japanese anchovy Engraulis japonicus in the coastal Yellow Sea using data from in situ ichthyoplankton surveys (7 recent years), a hydrodynamic model and satellite remote sensing. We confirmed the peak spawning period (May and June) and primary spawning location (Haizhou Bay). We defined the ‘spawning temperature optima’ hypothesis to identify the optimal spawning temperature (13.0–18.0°C) for the Japanese anchovy based on egg occurrence and abundance. We detected fortnightly variation in spawning behaviour, which peaked after the spring tide. Anchovy eggs showed evident aggregation in the nearshore upwelling area during May and June, while strong upwelling in July may cause a negative spawning‐site choice in upwelling zone. These findings clarify the effects of hydrodynamics on the spawning behaviour of the Japanese anchovy in the coastal Yellow Sea.
Further evaluation of the world health organization international reference reagent for Haemoglobin A2 measurement
Authors: Wild Barbara J. , Chohan Duljeet K. , Harteveld Cornelis L. , De la Salle Barbara
Published: December 2020

Introduction

The accurate measurement of HbA2 is essential for the detection of β‐thalassaemia carriers and as no single calibrant is used by the various manufacturers of analysers, differences are seen in results obtained. The World Health Organization International Reference Reagent for HbA2 (WHO IRR 89/666) was made available to diagnostic laboratories in the 1980s and remains the only international reference material available. A previous study (2015) demonstrated that the WHO IRR remained suitable for use as an HbA2 standard as tested by 52 participants in the UK NEQAS Haematology Abnormal Haemoglobins Programme. This study was undertaken to include simultaneous analysis of three whole blood specimens over a range of HbA2 values with the WHO IRR and to include participants from laboratories outside of the UK.

Method

Three whole blood specimens with HbA2 levels ranging from 2.4% to 5.7% and the WHO IRR were distributed to 56 laboratories located in 14 different countries. Participants were requested to test the specimens at defined intervals and return results accompanied by chromatograms or electropherograms produced.

Results

Differences found in results from different analyser groups reflect the bias found in the 2015 study in that bias is seen according to the methodology used and also varies in relation to the level of analyte being measured.

Conclusion

Results of measurements from whole blood specimens and the lyophilized WHO IRR standard did not show any deterioration of the IRR, and it remains suitable for use. Linearity and calibration of analysers remain a problem.
Multicentric evaluation of the new HemosIL Acustar® chemiluminescence ADAMTS13 activity assay
Authors: Pascual Cristina , Nieto Jorge M. , Fidalgo Teresa , Seguí Inés Gómez , Díaz‐Ricart Maribel , Docampo Marta Fernández , del Rio Julio , Salinas Ramon
Published: December 2020

Introduction

Thrombotic thrombocytopenic purpura (TTP) is a rare life‐threatening thrombotic microangiopathy (TMA) characterized by the severe deficiency of ADAMTS13 activity (<10%). Rapid ADAMTS13 testing is crucial for early diagnosis and optimal management of TTP patients and other TMAs. The objective of this study was to retrospectively evaluate the performance of the recently commercialized HemosIL Acustar® ADAMTS13 activity chemiluminescent immunoassay (Instrumentation Laboratory, Bedford, Massachusetts, United States) in a multicentric study between Spain and Portugal.

Methods

A comparison method was performed to compare HemosIL Acustar® with an in‐house FRETS‐VWF73 assay and two commercial ELISA assays: the TECHNOZYM® ADAMTS13 Activity (Technoclone GmbH, Vienna, Austria) and the DG‐EIA ADAMTS‐13 Activity (Diagnostic Grifols, SA, Barcelona, Spain). A set of 241 frozen plasma samples with known ADAMST13 levels was used. Agreement between methods was assessed with focus on two cut‐off ADAMTS13 activity values: <10% (the clinical accepted cut‐off value to confirm TTP diagnosis) and <5%.

Results

HemosIL AcuStar® showed high agreement with the other methods in correctly classify patients with ADAMTS13 values below 10% (Kappa = 0.89) and even below 5% (Kappa = 0.94) with no false negatives and few false positives (5.40%; 95% CI: 2.20 to 8.60%). However, it also tended to underestimate ADAMTS13 levels, especially for the high assay range values (>40%) (absolute mean bias of 8.40% (95% CI: 6.53 to 10.42%)) when compared to other assays.

Conclusions

HemosIL AcuStar® is highly sensitive to detect ADAMTS13 values below 10% and 5%. A large prospective validation study is needed to corroborate its utility in clinical practice.