bluuebunny/crossref_metadata_2025 huggingface dataset:
Performance of hazelnut cultivars and selections in southern Ontario
Authors: Taghavi Toktam , Dale Adam , Kelly John M. , Galic Dragan , Rahemi Alireza
Published: April 2020

The global demand for hazelnuts is increasing steadily, driven by increasing use by chocolate companies, pharmaceuticals, health products, and others. North America only produces 5% of the world crop, of which 99% is produced in Oregon (OR, USA). Most available cultivars are adapted to areas with mild winters and thus do not perform well in Ontario (ON, Canada). Our objective was to identify genotypes capable of supporting the newly formed hazelnut industry in southern Ontario. In the last several decades, selections have been identified in ON, New York (NY, USA), and Michigan (MI, USA) that may be better adapted in ON than cultivars from Europe and OR. To test our hypothesis that these new selections would outperform cultivars from Europe and OR in southern Ontario, two trials were performed to evaluate yield, nut quality, and winter hardiness. As hypothesized, selections from ON and NY such as ‘Gene’, ‘Alex’, and ‘Slate’ were winter hardy and highest yielding, followed by ‘Butler’ and ‘Gamma’ from OR; however, these selections did not perform well in other assessed parameters such as nut quality and catkin survivability. Possible explanations for the poor performance of the European and OR cultivars include (i) longer time needed to acclimatize and enter production phase relative to selections from ON, NY, and MI, and (ii) cold susceptibility during the initial establishment phase. The need to allocate resources towards survival probably delays the ability of the European and OR cultivars to enter the production phase. In conclusion, hazelnut cultivars brought from regions with a different climate need to be tested for cold hardiness.
BST204, a Rg3 and Rh2 Enriched Ginseng Extract, Upregulates Myotube Formation and Mitochondrial Function in TNF-α-Induced Atrophic Myotubes
Authors: Lee Sang-Jin , Im Minju , Park Sun Kyu , Kim Jeom-Yong , So Eui-Young , Liang Olin D. , Kang Jong-Sun , Bae Gyu-Un
Published: April 2020

The loss of skeletal muscle mass and function is a serious consequence of chronic diseases and aging. BST204 is a purified ginseng (the root of Panax ginseng) extract that has been processed using ginsenoside-[Formula: see text]-glucosidase and acid hydrolysis to enrich ginsenosides Rg3 and Rh2 from the crude ginseng. BST204 has a broad range of health benefits, but its effects and mechanism on muscle atrophy are currently unknown. In this study, we have examined the effects and underlying mechanisms of BST204 on myotube formation and myotube atrophy induced by tumor necrosis factor-[Formula: see text] (TNF-[Formula: see text]). BST204 promotes myogenic differentiation and multinucleated myotube formation through Akt activation. BST204 prevents myotube atrophy induced by TNF-[Formula: see text] through the activation of Akt/mTOR signaling and down-regulation of muscle-specific ubiquitin ligases, MuRF1, and Atrogin-1. Furthermore, BST204 treatment in atrophic myotubes suppresses mitochondrial reactive oxygen species (ROS) production and regulates mitochondrial transcription factors such as NRF1 and Tfam, through enhancing the activity and expression of peroxisome proliferator-activated receptor-[Formula: see text] coactivator1[Formula: see text] (PGC1[Formula: see text]). Collectively, our findings indicate that BST204 improves myotube formation and PGC1[Formula: see text]-mediated mitochondrial function, suggesting that BST204 is a potential therapeutic or neutraceutical remedy to intervene muscle weakness and atrophy.
Cinobufacini Inhibits Colon Cancer Invasion and Metastasis via Suppressing Wnt/β-Catenin Signaling Pathway and EMT
Authors: Wang Jie , Cai Han , Liu Qiaoli , Xia Yue , Xing LiKai , Zuo Qingsong , Zhang Yong , Chen Cao , Xu Ke , Yin Peihao , Chen Teng
Published: April 2020

Cinobufacini is a well-known Chinese medicine extracted from Venenum Bufonis, also called Chan Su. It has been used clinically for various cancers, including colon cancer. However, the function of Cinobufacini on colon cancer invasion and metastasis, and its underlying molecular mechanism, is still not clear. In this study, we investigated the function and mechanism of Cinobufacini on colon cancer invasion and metastasis both in vitro and in vivo studies. Human colon cancer cells were cultured. CCK assay was used to detect the effect of Cinobufacini on colon cancer cells proliferation. The invasion and migration abilities were observed by transwell assays, and the expression of invasion and migration related genes MMP2, MMP9, and epithelial-to-mesenchymal transition (EMT) relate genes were observed by Western blot assays. An orthotopic xenograft model in nude mice was established using colon cancer HCT116 cells, and the function of Cinobufacini on colon cancer invasion and metastasis were observed in vivo. We found Cinobufacini significantly inhibited colon cancer cell proliferation in a dose/time-dependent manner; the invasion and migration abilities of colon cancer were decreased after treated with Cinobufacini. The metastasis and EMT related genes MMP9, MMP2, N-cadherin and Snail were obviously down-regulated, while the expression of E-cadherin was up-regulated after treatment with Cinobufacini. The Wnt/[Formula: see text]-catenin signaling pathway related genes were observed using WB,and results show that the expression of [Formula: see text]-catenin, wnt3a, c-myc, cyclin D1, and MMP7 were all down-regulated after being treated with cinobufacini, while the expression of APC was up-regulated. In vivo studies of the volume and weight of orthotopic xenograft tumors showed significantly shrinkage in the Cinobufacini group compared to the control group. The enterocoelia and liver metastasis tumors were significantly decreased, and the expression of MMP9, MMP2, and [Formula: see text]-catenin were also down-regulated, while E-cadherin was up-regulated in vivo after the treatment with Cinobufacini. Our data proves that Cinobufacini can inhibit colon cancer invasion and metastasis both in vitro and in vivo; the mechanism is related by suppressing the Wnt/[Formula: see text]-catenin signaling pathway and then inhibiting the EMT of CRC.
SIGNAL-TO-NOISE RATIO GAIN VIA CORRELATED NOISE IN AN ENSEMBLE OF NOISY NEURONS
Authors: FENG TIANQUAN
Published: April 2020

The collective response of an ensemble of leaky integrate-and-fire neurons induced by local correlated noise is investigated theoretically. Based on the linear response theory, we derive the analytic expression of signal-to-noise ratio (SNR). Numerical results show that the amplitude of internal noise can be increased up to an optimal value where the output SNR reaches a maximum value. Interestingly, we find that the correlated noise between the nearest neurons could lead to the obvious SNR gain. We also show that the SNR can reach unity under condition that the correlated noise between the nearest neurons is negative. This nonlinear amplification of SNR gain in an ensemble of noisy neurons can be related to the array stochastic resonance (SR) phenomenon. Furthermore, we also show that the SNR gain can also be optimized by tuning the number of neuron units, frequency and amplitude of the weak periodic signal.
Development of alkyne-BODIPYs as viscosity sensitive fluorescent probes for enumeration of bacterial cells
Authors: Prasannan Dijo , Vasu Suchithra Tharamel , Arunkumar Chellaiah , Parameswaran Pattiyil
Published: April 2020

We report a series of alkyne-functionalized meso-aryl boron dipyrrin (BODIPY) molecular rotors sensitive to viscosity. The planar and twisted conformation within the molecular structure decides the viscosity-dependent behavior. The variations in fluorescence lifetime and intensity were appreciable to the local viscosity. Hence, the dye has been successfully employed in the enumeration of microbes by considering the proportionate fluorescence intensity of the BODIPYs as an index of the number of cells per mL. With increasing cells per mL, the viscosity of the bacterial solution is increased. Consequently, the fluorescence intensity of the sample containing BODIPY tends to increase due to the restricted rotation in the viscous medium. The BODIPY probe offers high sensitivity and is easier than other conventional techniques of colony-forming unit (CFU) determination. The theoretical studies indicate that intramolecular charge transfer is responsible for the enhanced fluorescence intensity in a highly viscous solvent.
Efficacy of Moringa oleifera Seed Husk as Adsorptive Agent for Trihalomethanes from a Water Treatment Plant in Southwestern, Nigeria
Authors: Okoya Aderonke Adetutu , Olaiya Olasunkanmi Olalekan , Akinyele Abimbola Bankole , Ochor Nnenneh Oruada
Published: April 2020

Trihalomethanes (THMs) are formed when excess chlorine during chlorination of water reacts with organic material in water. They have mutagenic and carcinogenic properties. Moringa oleifera (MO) has found wide acceptance by many people in Nigeria who have used it for food for both humans and fauna, for health purposes, and as a coagulant for water treatment. However, the seed husks are currently discarded as waste and they have not been used as adsorbent to remove THMs from water. The physicochemical properties of both the treated and raw surface water were determined using standard methods, and the concentration of THMs was determined from the water treatment plant at different stages of treatment using gas chromatography with flame ionization detector (GC-FID). Recovery experiments were carried out to validate the procedure. The efficiencies of activated carbon of Moringa oleifera seed husk (MOSH) adsorbent for the removal of THMs in the water and as a coagulant for water treatment were also assessed. Batch adsorption experiments were carried out, and different parameters such as pH (5, 7, and 9), adsorbent dosage (0.2, 0.4, and 0.8 g), contact time (30, 60, and 90 minutes), and initial concentration (0.2, 0.4, and 0.6 mg/l) were optimized for the removal of trichloromethane and tribromomethane using the MOSH activated carbon. Experimental adsorption data from different initial concentrations of trichloromethane and tribromomethane were used to test conformity with Langmuir and Freundlich adsorption isotherms. The percentage recovery from our procedures ranged from 96.0 ± 1.41 to 100.0 ± 0.00 for trichloromethane while for tribromomethane the range was 60 ± 2.82 to 100.0 ± 0.00. The mean percentage adsorption efficiencies for the simulation experiment ranged from 34.365 ± 1.41 to 93.135 ± 0.57 and from 41.870 ± 0.27 to 94.655 ± 0.41 for trichloromethane and tribromomethane, respectively. The optimum conditions for both trichloromethane and tribromomethane were pH 9, 0.8 g adsorbent dosage, 60-minute contact time, and 0.6 mg/l initial concentration. The optimum values of these parameters used for the adsorption of the two THMs in the surface water serving the treatment plant gave an efficiency of 100.00 ± 0.00%. The turbidity values for the coagulation experiment reduced from 9.76 ± 0.03 NTU in the raw water before coagulation to 5.92 ± 0.13 NTU after coagulation while all other physicochemical parameters of the surface water decreased in value except conductivity and total dissolved solid which increased from 104.5 ± 3.54 to 108.0 ± 2.83 μS/cm and 63.00 ± 11.31 to 83.0 ± 8.49 mg/l, respectively. The experimental data best fit into Langmuir than Freundlich adsorption isotherm. The study concluded that MOSH activated carbon could serve as an adsorbent for the removal of THMs, calcium, and sulphur from water samples.
Lineage-Specific Epigenomic and Genomic Activation of Oncogene HNF4A Promotes Gastrointestinal Adenocarcinomas
Authors: Pan Jian , Silva Tiago C. , Gull Nicole , Yang Qian , Plummer Jasmine T. , Chen Stephanie , Daigo Kenji , Hamakubo Takao , Gery Sigal , Ding Ling-Wen , Jiang Yan-Yi , Hu Shaoyan , Xu Li-Yan , Li En-Min , Ding Yanbing , Klempner Samuel J. , Gayther Simon A. , Berman Benjamin P. , Koeffler H. Phillip , Lin De-Chen
Published: April 2020

Gastrointestinal adenocarcinomas (GIAC) of the tubular gastrointestinal (GI) tract including esophagus, stomach, colon, and rectum comprise most GI cancers and share a spectrum of genomic features. However, the unified epigenomic changes specific to GIAC are poorly characterized. Using 907 GIAC samples from The Cancer Genome Atlas, we applied mathematical algorithms to large-scale DNA methylome and transcriptome profiles to reconstruct transcription factor (TF) networks and identify a list of functionally hyperactive master regulator (MR) TF shared across different GIAC. The top candidate HNF4A exhibited prominent genomic and epigenomic activation in a GIAC-specific manner. A complex interplay between the HNF4A promoter and three distal enhancer elements was coordinated by GIAC-specific MRTF including ELF3, GATA4, GATA6, and KLF5. HNF4A also self-regulated its own promoter and enhancers. Functionally, HNF4A promoted cancer proliferation and survival by transcriptional activation of many downstream targets, including HNF1A and factors of interleukin signaling, in a lineage-specific manner. Overall, our study provides new insights into the GIAC-specific gene regulatory networks and identifies potential therapeutic strategies against these common cancers.

Significance:

These findings show that GIAC-specific master regulatory transcription factors control HNF4A via three distal enhancers to promote GIAC cell proliferation and survival.
Antibody Responses to Helicobacter pylori and Risk of Developing Colorectal Cancer in a European Cohort
Authors: Butt Julia , Jenab Mazda , Pawlita Michael , Tjønneland Anne , Kyrø Cecilie , Boutron-Ruault Marie-Christine , Carbonnel Franck , Dong Catherine , Kaaks Rudolf , Kühn Tilman , Boeing Heiner , Schulze Matthias B. , Trichopoulou Antonia , Karakatsani Anna , La Vecchia Carlo , Palli Domenico , Agnoli Claudia , Tumino Rosario , Sacerdote Carlotta , Panico Salvatore , Bueno-de-Mesquita Bas , Vermeulen Roel , Gram Inger T. , Weiderpass Elisabete , Borch Kristin Benjaminsen , Quirós Jose Ramón , Agudo Antonio , Rodríguez-Barranco Miguel , Santiuste Carmen , Ardanaz Eva , Van Guelpen Bethany , Harlid Sophia , Imaz Liher , Perez-Cornago Aurora , Gunter Marc J. , Zouiouich Semi , Park Jin Young , Riboli Elio , Cross Amanda J. , Heath Alicia K. , Waterboer Tim , Hughes David J.
Published: April 2020

Background:

While Helicobacter pylori (H. pylori) is the major cause of gastric cancer, it has also been suggested to be involved in colorectal cancer development. However, prospective studies addressing H. pylori and colorectal cancer are sparse and inconclusive. We assessed the association of antibody responses to H. pylori proteins with colorectal cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort.

Methods:

We applied H. pylori multiplex serology to measure antibody responses to 13 H. pylori proteins in prediagnostic serum samples from 485 colorectal cancer cases and 485 matched controls nested within the EPIC study. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using multivariable conditional logistic regression to estimate the association of H. pylori overall and protein-specific seropositivity with odds of developing colorectal cancer.

Results:

Fifty-one percent of colorectal cancer cases were H. pylori seropositive compared with 44% of controls, resulting in an OR of 1.36 (95% CI, 1.00–1.85). Among the 13 individual H. pylori proteins, the association was driven mostly by seropositivity to Helicobacter cysteine-rich protein C (HcpC; OR: 1.66; 95% CI, 1.19–2.30) and Vacuolating cytotoxin A (VacA) (OR: 1.34; 95% CI, 0.99–1.82), the latter being nonstatistically significant only in the fully adjusted model.

Conclusions:

In this prospective multicenter European study, antibody responses to H. pylori proteins, specifically HcpC and VacA, were associated with an increased risk of developing colorectal cancer.

Impact:

Biological mechanisms for a potential causal role of H. pylori in colorectal carcinogenesis need to be elucidated, and subsequently whether H. pylori eradication may decrease colorectal cancer incidence.
MicroRNA-93 Targets p21 and Promotes Proliferation in Mycosis Fungoides T Cells
Authors: Gluud Maria , Fredholm Simon , Blümel Edda , Willerslev-Olsen Andreas , Buus Terkild Brink , Nastasi Claudia , Krejsgaard Thorbjørn , Bonefeld Charlotte Menné , Woetmann Anders , Iversen Lars , Litman Thomas , Geisler Carsten , Ødum Niels , Lindahl Lise M.
Published: April 2020

Background: Mycosis fungoides (MF), the most common form of cutaneous T-cell lymphoma (CTCL), is a lymphoproliferative disorder characterized by proliferation of malignant T cells in a chronic inflammatory environment in the skin. The nature of MF is still not fully understood, but aberrant microRNA (miR) expression and function seem to play an important role in the pathogenesis and disease progression and have been proposed as a putative disease marker. Recent studies have reported aberrant expression of miR-93 in situin MF lesions and linked dysregulated miR-93 expression to advanced stages of MF. However, the pathophysiological role of miR-93 in MF is unknown. Objective: Here, we provide the first evidence that miR-93 targets the cell cycle regulator cyclin-dependent kinase inhibitor p21 and promotes growth of malignant T cells in MF. Methods/Results: Thus, inhibition of miR-93 in MF patient-derived malignant T-cell lines increases expression of p21 and inhibition of malignant proliferation. Notably, treatment with the histone deacetylase inhibitor Vorinostat (SAHA) reduces miR-93 expression and enhances p21 expression in the malignant T cells. Importantly, transfection with an miR-93 mimic partly blocks SAHA-induced p21 expression. Conclusions: we provide evidence that enhanced expression of the putative oncogenic miR, miR-93, represses the cell cycle inhibitor p21 and promotes proliferation of malignant T cells. Moreover, we demonstrate that SAHA triggers p21 expression – at least partly – through an inhibition of miR-93.
Interannual Variations in Summer Precipitation in Southwest China: Anomalies in Moisture Transport and the Role of the Tropical Atlantic
Authors: Yuan Chaoxia , Yang Mengzhou
Published: April 2020

Using a Lagrangian trajectory model, contributions of moisture from the Indian Ocean (IO), the South China Sea (SCS), the adjacent land region (LD), and the Pacific Ocean (PO) to interannual summer precipitation variations in southwestern China (SWC) are investigated. Results show that, on average, the IO, SCS, LD, and PO contribute 48.8%, 21.1%, 23.6%, and 3.7% of the total moisture release in SWC, respectively. In summers with the above-normal precipitation, moisture release from the IO and SCS increases significantly by 41.4% and 15.1%, respectively. In summers with below-normal precipitation, moisture release from the IO and SCS decreases significantly by 44.2% and 24.6%, respectively. In addition, the moisture anomalies from the four source regions together explain 86.5% of the total interannual variances of SWC summer precipitation, and the IO and SCS only can explain 75.7%. Variations in moisture transport from the IO, SCS, and LD to SWC are not independent of one another and are commonly influenced by the anomalous anticyclone in the western North Pacific Ocean, which enhances the moisture transport from the IO and SCS by the anomalous southwesterlies over its northwestern quadrant but reduces that from the LD east of SWC by the anomalous westerlies along its northern edge. Anomalous warming in the tropical Atlantic Ocean can modify the Walker circulation, induce anomalous descending motion over the central tropical Pacific, and excite the anomalous anticyclone in the western North Pacific as the classic Matsuno–Gill response. The observed impacts of the tropical Atlantic warming on the anomalous anticyclone and summer precipitation in SWC can be well reproduced in an atmospheric general circulation model.
Evaluation of a New Precipitation-Based Index for Global Seasonal Forecasting of Unusually Wet and Dry Periods
Authors: Lavaysse Christophe , Stockdale Tim , McCormick Niall , Vogt Jürgen
Published: April 2020

This paper describes the assessment of the performance of a method for providing early warnings of unusually wet and dry precipitation conditions globally. The indicator that is used for forecasting these conditions is computed from forecasted standardized precipitation index (SPI) values for accumulation periods of 1, 3, and 6 months. The SPI forecasts are derived from forecasted precipitation produced by the latest probabilistic seasonal forecast of ECMWF. Early warnings of unusual precipitation periods are shown only when and where the forecast is considered robust (i.e., with at least 40% of ensemble members associated with intense forecasts), and corresponding with significant SPI values (i.e., below −1 for dry, or above +1 for wet conditions). The intensity of the forecasted events is derived based on the extreme forecast index and associated shift of tails products developed by ECMWF. Different warning levels are then assessed, depending on the return period of the forecast intensity, and the coherence of the ensemble forecast members. The assessment of the indicators performance is based on the 25-member ensemble forecast system that is carried out every month during the 36 years of the hindcast period (1981–2016). The results show that significant information is provided even for the longest lead time, albeit with a large variability across the globe with the highest scores over central Russia, Southeast Asia, and the northern part of South America or Australia. Because of the loss of predictability, each SPI is based on the first lead time. A sensitivity test highlights the influence on the robustness of the forecasts of the warning levels used, as well as the effects of prior conditions and of seasonality.
Assessing the Efficiency of Health-care Facilities in Sub-Saharan Africa: A Systematic Review
Authors: Babalola Tesleem K. , Moodley Indres
Published: April 2020

Background:

The provision of health-care services is dependent on the effective and efficient functioning of various components of a health-care system. It is therefore important to evaluate the functioning of these various components. Hence, the aim of this study was to review studies on health-care facilities efficiency in sub-Saharan Africa (SSA) with respect to the methodologies used as well as outcomes and factors influencing efficiency.

Methods:

The review was conducted through a comprehensive search of electronic databases which included PubMed, Web of science, academic search complete via EBSCOhost, Science Direct, and Google scholar. A search was also conducted by looking into citations in the reference list of selected articles and through gray literature. Studies were screened by examining their titles, abstracts, and full-text based on stated inclusion and exclusion criteria. The concurrent screening and data extraction were conducted by the two authors.

Results:

A total of 40 studies were shortlisted for the review. The majority (90.0%) of the studies employed the data envelopment analysis technique for their efficiency measurements. The input and output variables utilized by most of the studies were predominantly human resources and health-related services respectively. The outcome from majority of the studies showed that less than 40% of the studied facilities were efficient. The leading influencing factors reported by the studies were catchment population, facility ownership, and location.

Conclusions:

The review showed that there was a marked degree of inefficiency across the health-care facilities. Consequently, due to severe resource constraints facing SSA, there is a need to determine how to use the available resources optimally to improve health systems performance.
Assessing the appropriateness of paediatric antibiotic overuse in Australian children: a population-based sample survey
Authors:   on behalf of the CareTrack Kids investigative team, Arnolda Gaston , Hibbert Peter , Ting Hsuen P. , Molloy Charli , Wiles Louise , Warwick Meagan , Snelling Tom , Homaira Nusrat , Jaffe Adam , Braithwaite Jeffrey
Published: April 2020

Background

Infections caused by antibiotic resistant pathogens are increasing, with antibiotic overuse a key contributing factor.

Objective

The CareTrack Kids (CTK) team assessed the care of children in Australia aged 0–15 years in 2012 and 2013 to determine the proportion of care in line with clinical practice guidelines (CPGs) for 17 common conditions. This study analyses indicators relating to paediatric antibiotic overuse to identify those which should be prioritised by antimicrobial stewardship and clinical improvement programs.

Method

A systematic search was undertaken for national and international CPGs relevant to 17 target conditions for Australian paediatric care in 2012–2013. Recommendations were screened and ratified by reviewers. The sampling frame comprised three states containing 60% of the Australian paediatric population (South Australia, New South Wales and Queensland). Multi-stage cluster sampling was used to select general practices, specialist paediatric practices, emergency departments and hospital inpatient services, and medical records within these. Medical records were reviewed by experienced paediatric nurses, trained to assess eligibility for indicator assessment and compliance with indicators. Adherence rates were estimated.

Results

Ten antibiotic overuse indicators were identified; three for tonsillitis and one each for seven other conditions. A total of 2621 children were assessed. Estimated adherence for indicators ranged from 13.8 to 99.5% while the overall estimate of compliance was 61.9% (95% CI: 47.8–74.7). Conditions with high levels of appropriate avoidance of antibiotics were gastroenteritis and atopic eczema without signs of infection, bronchiolitis and croup. Indicators with less than 50% adherence were asthma exacerbation in children aged > 2 years (47.1%; 95% CI: 33.4–61.1), sore throat with no other signs of tonsillitis (40.9%; 95% CI: 16.9, 68.6), acute otitis media in children aged > 12 months who were mildly unwell (13.8%; 95% CI: 5.1, 28.0), and sore throat and associated cough in children aged < 4 years (14.3%; 95% CI: 9.9, 19.7).

Conclusion

The results of this study identify four candidate indicators (two for tonsillitis, one for otitis media and one for asthma) for monitoring by antibiotic stewardship and clinical improvement programs in ambulatory and hospital paediatric care, and intervention if needed.
Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department
Authors: Lee Jeong-Yong , Byun Young-Hoon , Park Jun-Sung , Lee Jong Seung , Ryu Jeong-Min , Choi Seung Jun
Published: April 2020

Background

Intussusception decreases blood flow to the bowel, and tissue hypoperfusion results in increased lactic acid levels. We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes.

Methods

The electronic medical records of our emergency department pediatric patients diagnosed with intussusception, between January 2015 and October 2018, were reviewed. An outcome was considered poor when intussusception recurred within 48 h of reduction or when surgical reduction was required due to air enema failure.

Results

A total of 249 patients were included in the study, including 39 who experienced intussusception recurrence and 11 who required surgical reductions; hence, 50 patients were included in the poor outcome group. The poor and good outcome groups showed significant differences in their respective blood gas analyses for pH (7.39 vs. 7.41, P = .001), lactic acid (1.70 vs. 1.30 mmol/L, P < .001), and bicarbonate (20.70 vs. 21.80 mmol/L, P = .036). Multivariable logistic regression analyses showed that pH and lactic acid levels were the two factors significantly associated with poor outcomes. When the lactic acid level cutoff values were ≥ 1.5, ≥2.0, ≥2.5, and ≥ 3.0 mmol/L, the positive predictive values for poor outcomes were 30.0, 34.6, 50.0, and 88.9%, respectively.

Conclusion

Lactic acid levels affect outcomes in pediatric patients with intussusception; higher lactic acid levels are associated with higher positive predictive values for poor outcomes.
How to measure blood pressure using an arterial catheter: a systematic 5-step approach
Authors: Saugel Bernd , Kouz Karim , Meidert Agnes S. , Schulte-Uentrop Leonie , Romagnoli Stefano
Published: April 2020

Arterial blood pressure (BP) is a fundamental cardiovascular variable, is routinely measured in perioperative and intensive care medicine, and has a significant impact on patient management. The clinical reference method for BP monitoring in high-risk surgical patients and critically ill patients is continuous invasive BP measurement using an arterial catheter. A key prerequisite for correct invasive BP monitoring using an arterial catheter is an in-depth understanding of the measurement principle, of BP waveform quality criteria, and of common pitfalls that can falsify BP readings. Here, we describe how to place an arterial catheter, correctly measure BP, and identify and solve common pitfalls. We focus on 5 important steps, namely (1) how to choose the catheter insertion site, (2) how to choose the type of arterial catheter, (3) how to place the arterial catheter, (4) how to level and zero the transducer, and (5) how to check the quality of the BP waveform.
Nationwide system to centralize decisions around ECMO use for severe COVID-19 pneumonia in Japan (Special Correspondence)
Authors:   Japan ECMOnet for COVID-19
Published: April 2020

The novel coronavirus disease 2019 (COVID-19) is spreading in Japan. We have collected a total of 26 patients with COVID-19 who required extracorporeal membranous oxygenation (ECMO). The available data from the first 14 cases demonstrated that the median age of patients was 71 and the median PaO2/FIO2 ratio, positive end-expiratory pressure, mean airway pressure, and lung compliance were 70, 15 cmH2O, 21 cmH2O, and 28 mL/cmH2O, respectively. Median serum KL-6 level was 333 U/mL. Consequently, 16 (62%) out of the 26 have been weaned off and 6 (26%) have been extubated and on rehabilitation, while the other 10 (38%) remain on ECMO. There seemed to be two phenotypes of COVID-19: one with impaired lung compliance and one with preserved lung compliance. The latter phenotype was likely to be favored from the use of ECMO. Further investigation is necessary to clasrify the optimal use of ECMO in patients with COVID-19.
A review of the bioelectronic implications of stimulation of the peripheral nervous system for chronic pain conditions
Authors: Deer Timothy R. , Naidu Ramana , Strand Natalie , Sparks Dawn , Abd-Elsayed Alaa , Kalia Hemant , Hah Jennifer M. , Mehta Pankaj , Sayed Dawood , Gulati Amitabh
Published: April 2020

Background

Peripheral Nerve Stimulation has been used to treat human disease including pain for several decades. Innovation has made it a more viable option for treatment of common chronic pain processes, and interest in the therapy is increasing.

Main body

While clinical data is forthcoming, understanding factors that influence successful outcomes in the use of PNS still needs to be delineated. This article reviews the evolution and bioelectronic principles of peripheral nerve stimulation including patient selection, nerve targets, techniques and guidance of target delivery. We collate the current evidence for outcomes and provide recommendations for salient topics in PNS.

Conclusion

Peripheral nerve stimulation has evolved from a surgically invasive procedure to a minimally invasive technique that can be used early in the treatment of peripheral nerve pain. This review identifies and addresses many of the variables which influence the success of PNS in the clinical setting.
A snapshot of Iraqi psychiatry
Authors: Sadik Aws
Published: April 2020

During a visit to Baghdad, I was able to visit several key centres in Iraqi psychiatry: the Ministry of Health, Baghdad General Hospital, Ibn Rushd Hospital and Al Rashad Hospital. This was my first experience of mental healthcare outside England, and it left me with a range of discussions and experiences to reflect on. I hope that this article offers a fair flavour of Iraqi psychiatry from the perspective of a UK-trained doctor.
Avoiding Peg-Filgrastim Prophylaxis During the Paclitaxel Portion of the Dose-Dense Doxorubicin-Cyclophosphamide and Paclitaxel Regimen: A Prospective Study
Authors: Vaz-Luis Ines , Barroso-Sousa Romualdo , Di Meglio Antonio , Hu Jiani , Rees Rebecca , Sinclair Natalie , Milisits Lindsey , Leone Jose Pablo , Constantine Michael , Faggen Meredith , Briccetti Frederick , Block Caroline , O'Neil Kelly , Partridge Ann , Burstein Harold , Waks Adrienne G. , Trippa Lorenzo , Tolaney Sara M. , Hassett Michael , Winer Eric P. , Lin Nancy U.
Published: April 2020

PURPOSE

The use of growth factors adds considerable expense and some toxicity to adjuvant breast cancer chemotherapy. We tested the feasibility and safety of omitting routine peg-filgrastim use during the paclitaxel portion of the dose-dense doxorubicin-cyclophosphamide–paclitaxel regimen.

PATIENTS AND METHODS

This was a prospective, single-arm study in which patients 18 to 65 years of age who completed 4 cycles of dose-dense doxorubicin-cyclophosphamide for stage I-III breast cancer received paclitaxel 175 mg/m2 every 2 weeks. Peg-filgrastim was administered after paclitaxel only if patients had had febrile neutropenia in a prior cycle or at investigator discretion if patients had infections or treatment delays of > 1 week. Once a patient received peg-filgrastim, it was administered in all future cycles. The primary end point was the rate of paclitaxel completion within 7 weeks from cycle 1 day 1 to cycle 4 day 1. If ≥ 100 out of 125 patients completed 4 cycles of paclitaxel without dose delay, the regimen would be considered feasible.

RESULTS

The enrollment goal of 125 patients was met. Median age was 46 years (range, 21-65 years), and 112 patients (90% [95% CI, 83% to 94%]) completed dose-dense paclitaxel within 7 weeks. Omission of peg-filgrastim was not causally related to noncompletion of paclitaxel in any patients. The most common reasons for dose reduction or delays were nonhematologic. One patient experienced febrile neutropenia but was able to complete paclitaxel on time. Eight patients (6.4%) received peg-filgrastim during the trial. Overall, peg-filgrastim was administered in only 4.3% of paclitaxel cycles.

CONCLUSION

Omission of routine peg-filgrastim during dose-dense paclitaxel according to a prespecified algorithm seems to be safe and feasible and was associated with a 95.7% reduction in the use of peg-filgrastim relative to the current standard of care.
Knights Errant of the Distressed: Horace Walpole, Thomas Chatterton, and Eighteenth-Century Charitable Culture
Authors: Rudd Andrew
Published: April 2020

In this article, I examine how notions of charity shaped eighteenth-century literature. I begin by examining Horace Walpole’s philanthropy, which I argue belied his posthumous reputation for miserliness, and proceed to trace the theme of charity in Walpole’s The Castle of Otranto (1764), looking closely at the role of St. Nicholas, patron saint of gift-giving, who intervenes at crucial moments in the plot. I then reexamine Chatterton’s approach to Walpole in 1769 seeking patronage for his pseudo-medieval “Rowley” poems. Walpole’s infamous rejection stemmed in large part, I suggest, from his view that Chatterton, as a paid apprentice, was simply not entitled to a handout. Chatterton disagreed. A major revaluation of Chatterton’s “Rowley” poem, “An Excelente Balade of Charitie” (1769), follows. The poem, traditionally seen as a cry of despair, should rather be understood as a vigorous, indignantly satirical reworking of the Good Samaritan parable at Walpole’s expense. I conclude with reflections on how Walpole and Chatterton’s disagreement affected later ideas of charity for impoverished authors, and on the ways in which individual charitable practices might be said to influence literary form.
Multiparametric mapping in post-mortem perinatal MRI: a feasibility study
Authors: McDowell Amy R , Shelmerdine Susan C , Lorio Sara , Norman Wendy , Jones Rod , Carmichael David W , Arthurs Owen J
Published: April 2020

Objectives:

To demonstrate feasibility of a 3 T multiparametric mapping (MPM) quantitative pipeline for perinatal post-mortem MR (PMMR) imaging.

Methods:

Whole body quantitative PMMR imaging was acquired in four cases, mean gestational age 34 weeks, range (29–38 weeks) on a 3 T Siemens Prisma scanner. A multicontrast protocol yielded proton density, T1 and magnetic transfer (MT) weighted multi-echo images obtained from variable flip angle (FA) 3D fast low angle single-shot (FLASH) acquisitions, radiofrequency transmit ﬁeld map and one B0 ﬁeld map alongside four MT weighted acquisitions with saturation pulses of 180, 220, 260 and 300 degrees were acquired, all at 1 mm isotropic resolution.

Results:

Whole body MPM was achievable in all four foetuses, with R1, R2*, PD and MT maps reconstructed from a single protocol. Multiparametric maps were of high quality and show good tissue contrast, especially the MT maps.

Conclusion:

MPM is a feasible technique in a perinatal post-mortem setting, which may allow quantification of post-mortem change, prior to being evaluated in a clinical setting.

Advances in knowledge:

We have shown that the MPM sequence is feasible in PMMR imaging and shown the potential of MT imaging in this setting.
Autism Cognizance: A dilemma among medical and Allied Medical practitioners
Authors: Akhter Naheed , Mumtaz Nazia , Saqulain Ghulam
Published: April 2020

Objectives: To determine the awareness about autism among Medical and Allied-Medical Practitioners.

Methods: This cross-sectional survey recruited a sample of n=300 participants including n=150 Medical and n=150 Allied-Medical practitioners using convenience sampling from Benazir Bhutto Hospital and Autism Resource Centre, Rawalpindi, Pakistan between 20th May 2018 to 20th October 2018. Sample included both genders, aged 21 to 50 years. Basic demographic sheet and Knowledge about Childhood Autism among Health Workers (KCAHW) Questionnaire was used to collect data. Statistical analysis was done using SPSS 21.

Results: Study revealed the total mean KCAHW score of 15.20±5.17 and 8.84±6.31 for Allied-Medical and Medical practitioners respectively. While the Domain-I mean KCAHW scores was 6.28±2.10 and 3.68±2.41; Domain-II score 0.86±0.35 and 0.45±0.50; Domain-III score 3.28±1.00 and 1.91±1.65; and Domain 4 score of 4.83±1.72 and 2.80±1.75 for Allied-Medical and Medical practitioners respectively.

Conclusion: The present study shows that there is significant awareness regarding autism among Allied-Medical compared to Medical practitioners.

doi: https://doi.org/10.12669/pjms.36.4.1703

How to cite this:Akhter N, Mumtaz N, Saqulain G. Autism Cognizance: A dilemma among medical and Allied Medical practitioners. Pak J Med Sci. 2020;36(4):678-682. doi: https://doi.org/10.12669/pjms.36.4.1703

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Variations in the management of adolescents with blunt splenic trauma in England and Wales: are we preserving enough?
Authors: Green PA , Wilkinson DJ , Bouamra O , Fragoso M , Farrelly PJ
Published: April 2020

Introduction

Management of blunt splenic injury has changed drastically with non-operative management increasingly used in paediatric and adult patients. Studies from America and Australia demonstrate disparities in care of patients treated at paediatric and adult centres. This study assessed management of splenic injuries in UK adolescents.

Materials and methods

Data were acquired from the Trauma Audit and Research Network on isolated blunt splenic injuries reported 2006–2015. Adolescents were divided into age groups of 11–15 years and 16–20 years, and injuries classified as minor (grades 1/2) or major (3+). Primary outcomes were needed for splenectomy and blood transfusion.

Results

A total of 445 adolescents suffered isolated blunt splenic injuries. Road traffic collisions were the most common mechanism. There were no deaths as a result of isolated blunt splenic injuries, but 49 (11%) adolescents needed transfusions and 105 (23.6%) underwent splenectomies. There was no significant difference observed in the management of adolescents with minor trauma. In major trauma, 11–15-year-olds were more likely to have splenectomies when managed at local trauma units compared with major trauma centres (31% vs 4%, odds ratio 11.5; 95% confidence interval 3.82–34.38, p < 0.0001). Within major trauma centres, older adolescents were more likely to have splenectomies than younger adolescents (35.5% vs 3.8%, odds ratio 14; 95% confidence interval 4.55–43.26, p < 0.0001). There were no significant differences in haemodynamic status, transfusion requirement or embolisation rates.

Conclusions

There appears to be a large variation in the management of isolated blunt splenic injuries in the UK. The reasons for this remain unclear however non-operative management is safe and should be first line management in the haemodynamically stable adolescent, even with major splenic injuries.
Necrotising enterocolitis in an adult with anorexia nervosa
Authors: Schapira B , Nazarian S , Thanapal M , Parmar C , Mukhtar H
Published: April 2020

Necrotising enterocolitis (NEC) is a rare cause of the acute abdomen in adults and carries one of the highest mortality rates in gastroenterology. However, its rarity confines research to small case reports. Both its pathogenesis and aetiology remain enigmatic in adult patients, proving timely diagnosis and management a challenge.

This paper reports on one case of NEC in an adult patient with underlying anorexia nervosa, following a seven-day period of starvation. She underwent emergency laparotomy for resection of necrotic bowel and subsequently made a good recovery.

To date, there have only been eight reports linking NEC with anorexia nervosa. We review our patient in the context of plausible mechanisms hypothesised in these cases. Successful management depends on prompt diagnosis, resuscitation and surgical intervention.
Iteratively reweighted ℓ1−ℓ2 norm minimization using wavelets in inverse scattering: publisher’s note
Authors: Sanghvi Yash , Bisht Hrishitosh , Khankhoje Uday K. , Gadre V. M. , Kulkarni S. V.
Published: April 2020

This publisher’s note corrects the author list in
J. Opt. Soc. Am.
A 37, 680
(2020).JOAOD60740-323210.1364/JOSAA.381365
Silicon photonic subsystem for broadband and RoF detection while enabling carrier reuse
Authors: Lyu Mingyang , Shi Wei , Rusch Leslie A.
Published: April 2020

We experimentally validate a silicon photonic subsystem designed for passive optical networks with carrier reuse. The subsystem is intended for future wavelength division multiplexed (WDM) PONs. It enables radio-over-fiber signals to cohabit an assigned wavelength slot without perturbing the PON signal, while conserving carrier power for the uplink. A microring modulator remodulates the residual carrier for the RoF uplink. We successfully detected the dropped 8 GHz broadband signal and five 125 MHz radio-over-fiber signals. Two 125 MHz radio over fiber signals are remodulated onto the carrier. The uplink signal shows good performance, validating the residual downlink signals have been well rejected by the microring filters. The subsystem conserves a clean carrier for remodulation with good signal-to-carrier ratio.
Multimode waveguide crossing with ultralow loss and low imbalance
Authors: Wu Beibei , Yu Yu , Zhang Xinliang
Published: April 2020

The mode-division-multiplexing (MDM) technology has become an alternative solution to further increase the link capacity in optical communication systems. Ultralow loss waveguide crossings for multimode waveguides are requisite in on-chip MDM systems. We propose and demonstrate an ultralow loss silicon multimode waveguide crossing using a combination of fully etched and shallowly etched waveguides in the multimode-interference coupler region to reduce the imbalance for two transverse electric polarized (TE) modes. By engineering the geometries and the proportion of the two waveguides, the self-imaging positions for different modes can coincide exactly. Simulated results show that the insertion losses are 0.043 and 0.084 dB for the fundamental TE (TE0) mode and the first-order TE (TE1) mode at 1550 nm, while the experimental values are 0.1 and 0.12 dB, respectively. The measured crosstalk is less than -30 dB for both modes within a 75 nm wavelength span.
Improved TDM scheme and data extracting algorithm for polymerization evaluation
Authors: Zhao Yu , Li Shengfu , Zhang Diqin , Zhao Yuxia , Ye Yan , Li Zuoyou , Li Zeren
Published: April 2020

To quickly evaluate holographic photopolymers with different formulations, the most effective method is to record a volume holographic grating in the samples and detect the grating’s diffraction in real time. Since the volume grating is highly sensitive to incident angle, existing schemes need to precisely control many space-related parameters. This study proposes an improved scheme, in which two different sized spots are used to reduce the requirements for the overlap of the two spots and the installation precision of the samples. Transmittances, diffractive efficiencies and diffractive asymmetries are obtained at a high sampling rate, through a specifically designed algorithm with the data from uncalibrated high-speed photodiodes. The experimental results show that the proposed scheme performance well in evaluating holographic photopolymer.
IT-Compliance in KMU – State of the art
Authors: Deistler Nico , Rentrop Christopher
Published: April 2020

Kleine und mittelständische Unternehmen (KMU) sind bekannt für ihre Innovationskraft und bilden das Rückgrat der deutschen Wirtschaft. Wie Studien zeigen sind sie in Bezug auf Compliance-Maßnahmen im Vergleich zu kapitalmarktorientierten Unternehmen jedoch im Rückstand. Eine gesonderte Betrachtung der IT-Compliance erfolgt dabei in den Studien in der Regel nicht. Auch wenn zu den Gründen und Motiven fehlender IT-Compliance-Strukturen in KMU kaum Forschungsergebnisse vorliegen, zeigen doch die vielen Publikationen, die sich mit Teilaspekten von Compliance und KMU beschäftigen, dass Handlungsbedarf besteht. Insbesondere die aktuellen Veränderungen unter dem Stichwort Digitalisierung deuten auf eine gesteigerte Bedeutung von IT-Compliance-Maßnahmen vor allem in mittelständischen Unternehmen. In dieser Arbeit sollen daher mithilfe einer Literaturrecherche die aktuell behandelten Themen in Bezug auf IT-Compliance und KMU analysiert sowie aktuelle Themenschwerpunkte herausgearbeitet werden.
Unpacking the ‘Singapore New Wave’
Authors: Fong Siao Yuong , Ng How Wee
Published: April 2020

As the cinema of a small nation, Singapore cinema punches above its weight. The series of international film festival awards won by Singaporean filmmakers alongside the multiple books published on Singapore cinema since the 2010s seem to signal a revival of the industry. This editorial introduction unpacks the term ‘Singapore New Wave’ as a starting point for this Special Issue to raise questions about the changes that appear to be happening in Singapore’s film industry. By situating the ‘Singapore New Wave’ within global cinema, this article argues for the importance of considering the issue of survival in the cinema of a small nation, and for an expansion of ways in which film scholars can gain the critical insights traditionally obtained from conventional new wave films. More positively, this more expansive working definition adds to broader new wave literature by exploring unconventional ways in which films can constitute or contribute to a new wave beyond traditional genres, auteurs, styles or themes associated with new wave cinema.