bluuebunny/crossref_metadata_2025 huggingface dataset:
Species-specific differences in Toxoplasma gondii, Neospora caninum and Besnoitia besnoiti seroprevalence in Namibian wildlife
Authors: Seltmann Anne , Schares Gereon , Aschenborn Ortwin H. K. , Heinrich Sonja K. , Thalwitzer Susanne , Wachter Bettina , Czirják Gábor Á.
Published: January 2020

Background

Knowledge about parasitic infections is crucial information for animal health, particularly of free-ranging species that might come into contact with livestock and humans.

Methods

We investigated the seroprevalence of three tissue-cyst-forming apicomplexan parasites (Toxoplasma gondii, Neospora caninum and Besnoitia besnoiti) in 506 individuals of 12 wildlife species in Namibia using in-house enzyme linked immunosorbent assays (indirect ELISAs applying purified antigens) for screening and immunoblots as confirmatory tests. We included six species of the suborder Feliformia, four species of the suborder Caniformia and two species of the suborder Ruminantia. For the two species for which we had most samples and life-history information, i.e. cheetahs (Acinonyx jubatus, n = 250) and leopards (Panthera pardus, n = 58), we investigated T. gondii seroprevalence in relation to age class, sex, sociality (solitary, mother-offspring group, independent sibling group, coalition group) and site (natural habitat vs farmland).

Results

All but one carnivore species (bat-eared fox Otocyon megalotis, n = 4) were seropositive to T. gondii, with a seroprevalence ranging from 52.4% (131/250) in cheetahs to 93.2% (55/59) in African lions (Panthera leo). We also detected antibodies to T. gondii in 10.0% (2/20) of blue wildebeest (Connochaetes taurinus). Adult cheetahs and leopards were more likely to be seropositive to T. gondii than subadult conspecifics, whereas seroprevalence did not vary with sex, sociality and site. Furthermore, we measured antibodies to N. caninum in 15.4% (2/13) of brown hyenas (Hyaena brunnea) and 2.6% (1/39) of black-backed jackals (Canis mesomelas). Antibodies to B. besnoiti were detected in 3.4% (2/59) of African lions and 20.0% (4/20) of blue wildebeest.

Conclusions

Our results demonstrate that Namibian wildlife species were exposed to apicomplexan parasites at different prevalences, depending on parasite and host species. In addition to serological work, molecular work is also needed to better understand the sylvatic cycle and the clear role of wildlife in the epidemiology of these parasites in southern Africa.
Methylphenidate and galantamine in patients with vascular cognitive impairment–the proof-of-principle study STREAM-VCI
Authors: Leijenaar Jolien F. , Groeneveld Geert Jan , Klaassen Erica S. , Leeuwis Anna E. , Scheltens Philip , Weinstein Henry C. , van Gerven Joop M. A. , Barkhof Frederik , van der Flier Wiesje M. , Prins Niels D.
Published: January 2020

Background

To date, no symptomatic treatment is available for patients with vascular cognitive impairment (VCI). In the proof-of-principle study Symptomatic Treatment of Vascular Cognitive Impairment (STREAM-VCI), we investigated whether a single dose of a monoaminergic drug (methylphenidate) improves executive functioning and whether a single dose of a cholinergic drug (galantamine) improves memory in VCI patients.

Methods

STREAM-VCI is a single-center, double-blind, three-way crossover trial. We included 30 VCI patients (Mini-Mental State Examination (MMSE) ≥ 16 and Clinical Dementia Rating score 0.5–1.0) with cerebrovascular pathology on MRI. All patients received single doses of methylphenidate (10 mg), galantamine (16 mg), and placebo in random order on three separate study visits. We used the NeuroCart®, a computerized test battery, to assess drug-sensitive cognitive effects. Predefined main outcomes, measured directly after a single dose of a study drug, were (i) change in performance on the adaptive tracker for executive functioning and (ii) performance on the Visual Verbal Learning Test-15 (VVLT-15) for memory, compared to placebo. We performed mixed model analysis of variance.

Results

The study population had a mean age of 67 ± 8 years and MMSE 26 ± 3, and 9 (30%) were female. Methylphenidate improved performance on the adaptive tracker more than placebo (mean difference 1.40%; 95% confidence interval [CI] 0.56–2.25; p = 0.002). In addition, methylphenidate led to better memory performance on the VVLT-15 compared to placebo (mean difference in recalled words 0.59; 95% CI 0.03–1.15; p = 0.04). Galantamine did not improve performance on the adaptive tracker and led to worse performance on delayed recall of the VVLT-15 (mean difference − 0.84; 95% CI − 1.65, − 0.03; p = 0.04). Methylphenidate was well tolerated while galantamine produced gastrointestinal side effects in a considerable number of patients.

Conclusions

In this proof-of-principle study, methylphenidate is well tolerated and improves executive functioning and immediate recall in patients with VCI. Galantamine did not improve memory or executive dysfunction. Results might be influenced by the considerable amount of side effects seen.

Trial registration

http://www.clinicaltrials.gov. Registration number: NCT02098824. Registration date: March 28, 2014.
Neurovascular effects of umbilical cord blood-derived stem cells in growth-restricted newborn lambs
Authors: Malhotra Atul , Castillo-Melendez Margie , Allison Beth J. , Sutherland Amy E. , Nitsos Ilias , Pham Yen , McDonald Courtney A. , Fahey Michael C. , Polglase Graeme R. , Jenkin Graham , Miller Suzanne L.
Published: January 2020

Background

Neonatal ventilation exacerbates brain injury in lambs with fetal growth restriction (FGR), characterized by neuroinflammation and reduced blood-brain barrier integrity, which is normally maintained by the neurovascular unit. We examined whether umbilical cord blood stem cell (UCBC) treatment stabilized the neurovascular unit and reduced brain injury in preterm ventilated FGR lambs.

Methods

Surgery was performed in twin-bearing pregnant ewes at 88 days’ gestation to induce FGR in one fetus. At 127 days, FGR and appropriate for gestational age (AGA) lambs were delivered, carotid artery flow probes and umbilical lines inserted, lambs intubated and commenced on gentle ventilation. Allogeneic ovine UCBCs (25 × 106 cells/kg) were administered intravenously to lambs at 1 h of life. Lambs were ventilated for 24 h and then euthanized.

Results

FGR (n = 6) and FGR+UCBC (n = 6) lambs were growth restricted compared to AGA (n = 6) and AGA+UCBC (n = 6) lambs (combined weight, FGR 2.3 ± 0.4 vs. AGA 3.0 ± 0.3 kg; p = 0.0002). UCBC therapy did not alter mean arterial blood pressure or carotid blood flow but decreased cerebrovascular resistance in FGR+UCBC lambs. Circulating TNF-α cytokine levels were lower in FGR+UCBC vs. FGR lambs (p < 0.05). Brain histopathology showed decreased neuroinflammation and oxidative stress, increased endothelial cell proliferation, pericyte stability, and greater integrity of the neurovascular unit in FGR+UCBC vs. FGR lambs.

Conclusions

Umbilical cord blood stem cell therapy mitigates perinatal brain injury due to FGR and ventilation, and the neuroprotective benefits may be mediated by stabilization of the neurovascular unit.
Classification, positioning, and tracking of drones by HMM using acoustic circular microphone array beamforming
Authors: Guo Junfeng , Ahmad Ishtiaq , Chang KyungHi
Published: January 2020

This paper addresses issues with monitoring systems that identify and track illegal drones. The development of drone technologies promotes the widespread commercial application of drones. However, the ability of a drone to carry explosives and other destructive materials may pose serious threats to public safety. In order to reduce these threats, we propose an acoustic-based scheme for positioning and tracking of illegal drones. Our proposed scheme has three main focal points. First, we scan the sky with switched beamforming to find sound sources and record the sounds using a microphone array; second, we perform classification with a hidden Markov model (HMM) in order to know whether the sound is a drone or something else. Finally, if the sound source is a drone, we use its recorded sound as a reference signal for tracking based on adaptive beamforming. Simulations are conducted under both ideal conditions (without background noise and interference sounds) and non-ideal conditions (with background noise and interference sounds), and we evaluate the performance when tracking illegal drones.
Mapping the evidence on health equity considerations in economic evaluations of health interventions: a scoping review protocol
Authors: Besar Sa’aid Hafizah , Mathew Sharon , Richardson Marina , Bielecki Joanna M. , Sander Beate
Published: January 2020

Background

Equity in health has become an important policy agenda around the world, prompting health economists to advance methods to enable the inclusion of equity in economic evaluations. Among the methods that have been proposed to explicitly include equity are the weighting analysis, equity impact analysis, and equity trade-off analysis. This is a new development and a comprehensive overview of trends and concepts of health equity in economic evaluations is lacking. Thus, our objective is to map the current state of the literature with respect to how health equity is considered in economic evaluations of health interventions reported in the academic and gray literature.

Methods

We will conduct a scoping review to identify and map evidence on how health equity is considered in economic evaluations of health interventions. We will search relevant electronic, gray literature and key journals. We developed a search strategy using text words and Medical Subject Headings terms related to health equity and economic evaluations of health interventions. Articles retrieved will be uploaded to reference manager software for screening and data extraction. Two reviewers will independently screen the articles based on their titles and abstracts for inclusion, and then will independently screen a full text to ascertain final inclusion. A simple numerical count will be used to quantify the data and a content analysis will be conducted to present the narrative; that is, a thematic summary of the data collected.

Discussion

The results of this scoping review will provide a comprehensive overview of the current evidence on how health equity is considered in economic evaluations of health interventions and its research gaps. It will also provide key information to decision-makers and policy-makers to understand ways to include health equity into the prioritization of health interventions when aiming for a more equitable distribution of health resources.

Systematic review registration

This protocol was registered with Open Science Framework (OSF) Registry on August 14, 2019 (https://osf.io/9my2z/registrations).
Systematic review and meta-analysis protocol for efficacy and safety of Momordica charantia L. on animal models of type 2 diabetes mellitus
Authors: Peter Emanuel L. , Mtewa Andrew G. , Nagendrappa Prakash B. , Kaligirwa Anita , Sesaazi Crispin Duncan
Published: January 2020

Background

Studies on several preclinical models of type 2 diabetes mellitus have been conducted to establish the hypoglycemic activity ofMomordica charantiaL. Concerned with appropriateness of these models, we designed a systematic review to establish the efficacy and safety ofM. charantiaL. in preclinical models of type 2 diabetes mellitus.

Methods

Review authors will search without language restriction in MEDLINE/PubMed, Web of Science, Embase, Scopus, and CINAHL databases through April 2019. Search filters will be applied to enhance search efficiency. The authors will search for gray literature in Google and Google Scholar, OpenGrey, and ProQuest Dissertations & Theses. Two authors will evaluate full texts, extract data, and asses risk of bias independently. The review will include randomized or non-randomized studies that assessed the efficacy or safety ofM. charantiaL. with vehicle control group. The primary endpoint will be fasting blood glucose level. We will use Egger’s test to assess publication biases. Chi-square test andI2will be used to assess heterogeneity in effect size of the primary outcome. Using RevMan software version 5.3, the authors will perform a meta-analysis of quantitative data.

Discussion

The strength of evidence will be rated as high, moderate, low, or very low using GRADE framework for animal studies. This systematic review will potentially improve research practice by identifying risks of bias and design features that compromise translatability and contribute to evidence-based clinical trial design.

Systematic review registration

PROSPERO CRD42019119181
Arbitrary-order economic production quantity model with and without deterioration: generalized point of view
Authors: Rahaman Mostafijur , Mondal Sankar Prasad , Shaikh Ali Akbar , Ahmadian Ali , Senu Norazak , Salahshour Soheil
Published: January 2020

The key objective of this paper is to study and discuss the application of fractional calculus on an arbitrary-order inventory control problem. Using the concepts of fractional calculus followed by fractional derivative, we construct different possible models like generalized fractional-order economic production quantity (EPQ) model with the uniform demand and production rate and generalized fractional-order EPQ model with the uniform demand and production rate and deterioration. Also, we show that the classical EPQ model is the particular case of the corresponding generalized fractional EPQ model. This greatly facilitates the researcher a novel tactic to analyse the solution of the EPQ model in the presence of fractional index. Furthermore, this attempt also provides the solution obtained through the optimization techniques after using the real distinct poles rational approximation of the generalized Mittag-Leffler function.
Intelligent video interview agent used to predict communication skill and perceived personality traits
Authors: Suen Hung-Yue , Hung Kuo-En , Lin Chien-Liang
Published: January 2020

The prediction of individual interpersonal communication skills and personality traits is a critical issue in both industrial and organizational psychology and affective computing. In this study, we invited 114 participants, including 57 interviewers and 57 interviewees, to collect the ground truth of interviewees’ communication skills and personality traits as perceived by real human interviewers in a structured behavioral interview setting. We develop an asynchronous video interview (AVI) platform with an artificial intelligence (AI) decision agent based on a TensorFlow convolutional neural network (CNN), called AVI-AI, that can be used to partially displace human raters’ work in the initial stage of employment screening and to successfully predict a job candidate’s communication skills and personality traits. The experimental results show that AVI-AI can predict not only a candidate’s interpersonal communication skills but also his or her openness, agreeableness, and neuroticism, as perceived by experienced human resource professionals. The interrater reliability values were all acceptable to support the ground truth assumption. However, our AVI-AI could not predict the conscientiousness and extraversion as perceived by the real human raters in this study.
What is security worth to consumers? Investigating willingness to pay for secure Internet of Things devices
Authors: Blythe John M. , Johnson Shane D. , Manning Matthew
Published: January 2020

The Internet of Things (IoT) is considered the next technological revolution. IoT devices include once everyday objects that are now internet connected, such as smart locks and smart fridges, but also new types of devices to include home assistants. However, while this increased interconnectivity brings considerable benefits, it can and does increase people’s exposure to crime risk. This is particularly the case as most devices are developed without security in mind. One reason for this is that there is little incentive for manufacturers to make devices secure by design, and the costs of so doing do not encourage it. The principle aim of the current paper was to estimate the extent to which consumers are willing to pay for improved security in internet connected products. The second aim was to examine whether this is conditioned by their exposure to security-related information. Using an experimental design, and a contingent valuation method, we find that people are willing to pay for improved security and that for some devices, this increases if they are exposed to information about security prior to stating their willingness to pay. The implications of our findings for industry and the secure by design agenda are discussed.
Graphical Flow-based Spark Programming
Authors: Mahapatra Tanmaya , Prehofer Christian
Published: January 2020

Increased sensing data in the context of the Internet of Things (IoT) necessitates data analytics. It is challenging to write applications for Big Data systems due to complex, highly parallel software frameworks and systems. The inherent complexity in programming Big Data applications is also due to the presence of a wide range of target frameworks, with different data abstractions and APIs. The paper aims to reduce this complexity and its ensued learning curve by enabling domain experts, that are not necessarily skilled Big Data programmers, to develop data analytics applications via domain-specific graphical tools. The approach follows the flow-based programming paradigm used in IoT mashup tools. The paper contributes to these aspects by (i) providing a thorough analysis and classification of the widely used Spark framework and selecting suitable data abstractions and APIs for use in a graphical flow-based programming paradigm and (ii) devising a novel, generic approach for programming Spark from graphical flows that comprises early-stage validation and code generation of Spark applications. Use cases for Spark have been prototyped and evaluated to demonstrate code-abstraction, automatic data abstraction interconversion and automatic generation of target Spark programs, which are the keys to lower the complexity and its ensued learning curve involved in the development of Big Data applications.
Big data monetization throughout Big Data Value Chain: a comprehensive review
Authors: Faroukhi Abou Zakaria , El Alaoui Imane , Gahi Youssef , Amine Aouatif
Published: January 2020

Value Chain has been considered as a key model for managing efficiently value creation processes within organizations. However, with the digitization of the end-to-end processes which began to adopt data as a main source of value, traditional value chain models have become outdated. For this, researchers have developed new value chain models, called Data Value Chains, to carry out data driven organizations. Thereafter, new data value chains called Big Data Value chain have emerged with the emergence of Big Data in order to face new data-related challenges such as high volume, velocity, and variety. These Big Data Value Chains describe the data flow within organizations which rely on Big Data to extract valuable insights. It is a set of ordered steps using Big Data Analytics tools and mainly built for going from data generation to knowledge creation. The advances in Big Data and Big Data Value Chain, using clear processes for aggregation and exploitation of data, have given rise to what is called data monetization. Data monetization concept consists of using data from an organization to generate profit. It may be selling the data directly for cash, or relying on that data to create value indirectly. It is important to mention that the concept of monetizing data is not as new as it looks, but with the era of Big Data and Big Data Value Chain it is becoming attractive. The aim of this paper is to provide a comprehensive review of value creation, data value, and Big Data value chains with their different steps. This literature has led us to construct an end-to-end exhaustive BDVC that regroup most of the addressed phases. Furthermore, we present a possible evolution of that generic BDVC to support Big Data Monetization. For this, we discuss different approaches that enable data monetization throughout data value chains. Finally, we highlight the need to adopt specific data monetization models to suit big data specificities.
Towards a better understanding of the role of nectar-inhabiting yeasts in plant–animal interactions
Authors: Klaps Joon , Lievens Bart , Álvarez-Pérez Sergio
Published: January 2020

Flowers offer a wide variety of substrates suitable for fungal growth. However, the mycological study of flowers has only recently begun to be systematically addressed from an ecological point of view. Most research on the topic carried out during the last decade has focused on studying the prevalence and diversity of flower-inhabiting yeasts, describing new species retrieved from floral parts and animal pollinators, and the use of select nectar yeasts as model systems to test ecological hypotheses. In this primer article, we summarize the current state of the art in floral nectar mycology and provide an overview of some research areas that, in our view, still require further attention, such as the influence of fungal volatile organic compounds on the foraging behavior of pollinators and other floral visitors, the analysis of the direct and indirect effects of nectar-inhabiting fungi on the fitness of plants and animals, and the nature and consequences of fungal-bacterial interactions taking place within flowers.
Custom-made 3D printed subperiosteal titanium implants for the prosthetic restoration of the atrophic posterior mandible of elderly patients: a case series
Authors: Mangano Carlo , Bianchi Andrea , Mangano Francesco Guido , Dana Jessica , Colombo Marco , Solop Ivan , Admakin Oleg
Published: January 2020

Purpose

To present the application of custom-made 3D-printed subperiosteal implants for fixed prosthetic restoration of the atrophic posterior mandible of elderly patients.

Methods

Between January 2017 and June 2018, all partially edentulous patients aged over 65 years, with two or more missing teeth in the posterior atrophic mandible, and who did not want to undergo bone regenerative procedures, were included in this study. These patients were rehabilitated with custom-made subperiosteal implants, designed from cone beam computed tomography (CBCT) and fabricated in titanium by means of direct metal laser sintering (DMLS). The outcome measures were fit and stability of the implants at placement, duration of the intervention, implant survival, and early and late complications. All patients were followed for 1 year after surgery.

Results

Ten patients (four males, six females; mean age 69.6, SD ± 2.8, median 69, 95% CI 67.9–71.6) were included in the study. The fit of the implants was satisfactory, with a mean rating of 7 out of 10 (SD ± 1.6, median 7, 95% CI 6–8). Only two implants had insufficient fit, because of the presence of scattering in the CBCT; however, they were adapted to the sites during the interventions. The mean duration of the intervention was 44.3 min (SD ± 19.4, median 37, 95% CI 32.3–56.3). At the one-year follow-up, no implants were lost (survival rate 100%). One implant presented immediate postoperative complications with pain, discomfort and swelling, and two patients experienced late complications, having their provisional restorations fractured during the temporisation phase. All these complications were minor in nature, but the final complication rate amounted to 30% (three of ten patients).

Conclusions

Although this study has limits (small patient sample and short follow-up), DMLS has proven to be an effective method for fabricating accurate subperiosteal implants, with high survival rates. This may represent an alternative treatment procedure in elderly patients with a severely atrophic posterior mandible, since it allows avoidance of regenerative bone therapies. Further studies are needed to confirm these outcomes.
Transcatheter arterial embolization for unruptured renal angiomyolipoma using a 1.8-Fr tip microballoon catheter with a mixture of ethanol and Lipiodol
Authors: Tomita Kosuke , Matsumoto Tomohiro , Kamei Shunsuke , Yamamoto Shota , Suda Satoshi , Zakoji Hidenori , Hasebe Terumitsu
Published: January 2020

Background

To evaluate the efficacy and safety of transcatheter arterial embolization for renal angiomyolipoma using a 1.8-French tip microballoon catheter and a mixture of ethanol and Lipiodol.

Methods

Seven consecutive patients with total of eight angiomyolipomas underwent this procedure between June 2014 and June 2017. A 1.8-French tip microballoon catheter was advanced to the feeding artery of the angiomyolipoma, and transcatheter arterial embolization was performed with a mixture of ethanol and Lipiodol under microballoon inflation. We retrospectively evaluated the characteristics of angiomyolipomas, technical success rate, clinical success rate, renal function, and adverse events. Technical success and clinical success were defined as complete embolization of all feeding arteries and reduction of tumor size, respectively.

Results

The median size of the angiomyolipomas was 46 mm (range, 40–64 mm). Transcatheter arterial embolization was successful in all eight angiomyolipomas. The median volume of the mixture of ethanol and Lipiodol was 6.0 ml (range, 2.0–14 ml). The median ratio of ethanol to Lipiodol was 71% (range, 71–75%). All eight angiomyolipomas shrank with a median shrinkage rate of 34% in diameter (range, 9–63%) and 77% in volume (range, 48–94%). The median follow-up period was 13 months (range, 9–54 months). Clinical success was achieved in all cases. Serum creatinine concentrations and the pre- and post-procedural estimated glomerular filtration rates did not change notably, and there were no major complications.

Conclusion

Transcatheter arterial embolization for renal angiomyolipoma using a 1.8-French tip microballoon catheter with a mixture of ethanol and Lipiodol is effective and safe.
Persistent cloaca: persistence of the challenge
Authors: AbouZeid Amr Abdelhamid , Radwan Ahmed Bassiouny , Eldebeiky Mohamed , Hay Sameh Abdel
Published: January 2020

Background

Persistent cloaca or cloacal anomalies represent a special category of anorectal anomalies affecting the female sex with a reported incidence of about one in 25,000 live birth.

The study included 34 cases of cloaca that were managed at our unit between 2003 through 2017. We retrospectively reviewed patients’ records that included clinical presentation, investigations, operative data, and follow-up notes.

Anatomically, we stratified cloaca into three types according to the level of urogenital confluence. A low confluence (type 1) was defined by being at or below the level of the lower border of pubic symphysis with a short common channel (11 cases). A high confluence (type 3) was defined by being at or above the level of the upper border of pubic symphysis (9 cases). Between the low and high types, we defined an intermediate type (type 2) where the urogenital confluence was behind the mid-portion of pubic symphysis (14 cases).

Results

Renal anomalies were common association: solitary kidney in seven, pelvic kidney in two, and urinary tract dilatation (hydroureteronephrosis) in 12 cases. At follow-up, chronic renal insufficiency was detected in seven cases

The prognosis for urinary continence was excellent in low confluence (type 1) cloaca. On the other hand, urinary incontinence was common among type 3 (high confluence) cloaca (62.5%).

Conclusion

Renal anomalies represent a common association with cloaca and a major cause of morbidity. Efforts should be directed to preserve renal function during the initial management, and to preserve the continence potential following the definitive repair.

Level of evidence

This is a case series with no comparison group (level IV).
Outcome of management of gastroschisis: comparison of improvised surgical silo and extended right hemicolectomy
Authors: Okoro Philemon E. , Ngaikedi Charles
Published: January 2020

Background

Gastroschisis is onea of the major abdominal wall defects encountered commonly in pediatric surgery. Whereas complete reduction and abdominal closure is achieved easily sometimes, a daunting situation arises when the eviscerated bowel loops and other viscera cannot be returned immediately into the abdominal cavity. This situation is a major contributor to the outcome of the treatment of gastroschisis in our region. In our efforts to improve our outcome, we have adopted the technique of extended right hemicolectomy for cases where complete reduction and primary abdominal wall closure is otherwise not possible. This study compared the management outcome of gastroschisis using our improvised silo, and performing an extended right hemicolectomy.

Results

Thirty-nine cases were analyzed. Simple closure could not be achieved in 28 cases. In the absence of standard silos, improvised ones were constructed from the amniotic membrane (3 cases), urine bag (4 cases), and latex gloves (9 cases) giving a total of 16 cases managed with silos. Extended right hemicolectomy was performed in 12 cases.

Conclusions

Given the peculiarities of circumstances in our region regarding human and material resources in the care of gastroschisis patients, an extended right hemicolectomy, to make it possible to close the abdomen primarily in gastroschisis is a more viable option than the use of improvised silo.

Trial registration

This trial was approved by the Ethical Committee of the University of Port Harcourt Teaching Hospital, Nigeria. Reference Number: UPTH/ADM/90/S.II/VOL XI/835. Registered 3 May 2013.
Evaluation of Adolescents’ and Young Adults’ Attitudes Toward Participation in Cancer Clinical Trials
Authors: Lewin Jeremy , Bell Jennifer A. H. , Wang Kate , Forcina Victoria , Tam Seline , Srikanthan Amirrtha , Lin Yu-Chung , Taback Nathan , Mitchell Laura , Gupta Abha A.
Published: January 2020

PURPOSE:

Participation in cancer clinical trials (CCTs) for adolescents and young adults (AYAs) remains the lowest of any patient group with cancer. Little is known about the personal barriers to AYA accrual. The aim of this study was to explore AYA attitudes that influence CCT participation.

METHODS:

A mixed-methods approach was used. AYAs and non-AYAs (≥ 40 years) completed the Cancer Treatment subscale of the Attitudes Toward Cancer Trials Scales and 9 supplementary questions formed from interview analysis. Differences between AYA and non-AYA cohorts were analyzed using the Mann-Whitney U test, and logistic regression models were constructed to evaluate the effect of demographics on perceptions of CCTs.

RESULTS:

Surveys were distributed to 61 AYAs (median age, 29 years; range, 17-39 years) and 74 non-AYAs (median age, 55 years; range, 40-88 years). Compared with non-AYAs, AYAs perceived CCTs to be unsafe/more difficult (Personal Barrier/Safety domain; P = .01). There were no differences based on age in other domains. AYAs were also more concerned with CCT interference in their long-term goals ( P = .04). Multivariable ordered logistic regression identified increased personal barriers in the Personal Barrier/Safety domain for AYAs ( P = .01), in patients with English as a second language (ESL; P < .01), and in patients previously not offered a clinical trial ( P = .03). Long-term goals were identified as a barrier in particular tumor types ( P = .01) and in patients with ESL ( P < .01), with a trend identified in AYAs ( P = .12).

CONCLUSION:

Age-related differences in attitudes toward CCTs suggest that tailored approaches to CCT accrual are warranted. Patient-centered delivery of information regarding CCTs, particularly in patients with ESL and who are trial naïve, may improve accrual.
Thigh Muscle Fat Infiltration Is Associated With Impaired Physical Performance Despite Remission in Cushing’s Syndrome
Authors: Martel-Duguech Luciana , Alonso-Jiménez Alicia , Bascuñana Helena , Díaz-Manera Jordi , Llauger Jaume , Nuñez-Peralta Claudia , Biagetti Betina , Montesinos Paula , Webb Susan M , Valassi Elena
Published: January 2020

Context

Muscle weakness is common in patients with Cushing’s syndrome (CS) and may persist after the resolution of hypercortisolism. Intramuscular fatty infiltration has been associated with the deterioration of muscle performance in several conditions.

Objectives

To quantify the degree of fatty infiltration in the thigh muscles of “cured” CS patients and evaluate the relationship between intramuscular fatty infiltration and physical performance.

Design

This was a cross-sectional study.

Setting

Tertiary referral center.

Patients

Thirty-six women with CS in remission, and 36 controls matched for age, BMI, menopausal status, and level of physical activity.

Main Outcome Measures

We analyzed the percentage fat fraction (FF) of the thigh muscles in the anterior, posterior, and combined anterior and posterior compartments using MRI and 2-point Dixon sequence. We assessed muscle function and strength using the following tests: gait speed (GS), timed up and go (TUG), 30-second chair stand, and hand grip strength.

Results

Fat fraction in all the compartments analyzed was increased in patients as compared with controls. The performance on TUG, 30-second chair stand, and GS was more impaired in CS patients versus controls. In patients, greater FF was negatively associated with performance on functional tests. Fat fraction in the combined anterior and posterior compartments predicted performance on TUG (ß 0.626, P < 0.000) and GS (ß -0.461, P = 0.007), after adjusting for age, BMI, menopausal status, and muscle mass.

Conclusions

Thigh muscle fatty infiltration is increased in “cured” CS patients and is associated with poorer muscle performance. Future studies are needed to establish therapeutic strategies to improve muscle weakness in these patients.
Myeloid-Derived Growth Factor Promotes Intestinal Glucagon-Like Peptide-1 Production in Male Mice With Type 2 Diabetes
Authors: Wang Li , Li Yixiang , Guo Bei , Zhang Jiajia , Zhu Biao , Li Huan , Ding Yan , Meng Biying , Zhao Hui , Xiang Lin , Dong Jing , Liu Min , Zhang Junxia , Xiang Lingwei , Xiang Guangda
Published: January 2020

Myeloid-derived growth factor (MYDGF), which is produced by bone marrow–derived cells, mediates cardiac repair following myocardial infarction by inhibiting cardiac myocyte apoptosis to subsequently reduce the infarct size. However, the function of MYDGF in the incretin system of diabetes is still unknown. Here, loss-of-function and gain-of-function experiments in mice revealed that MYDGF maintains glucose homeostasis by inducing glucagon-like peptide-1 (GLP-1) production and secretion and that it improves glucose tolerance and lipid metabolism. Treatment with recombinant MYDGF increased the secretion and production of GLP-1 in STC-1 cells in vitro. Mechanistically, the positive effects of MYDGF are potentially attributable to the activation of protein kinase A/glycogen synthase kinase 3β/β-catenin (PKA/GSK-3β/β-catenin) and mitogen-activated protein kinase (MAPK) kinases/extracellular regulated protein kinase (MEK/ERK) pathways. Based on these findings, MYDGF promotes the secretion and production of GLP-1 in intestinal L-cells and potentially represents a potential therapeutic medication target for type 2 diabetes.
Microbial Reconstitution Reverses Early Female Puberty Induced by Maternal High-fat Diet During Lactation
Authors: Wang Mengjie , Zhang Youjie , Miller David , Rehman Naveen O , Cheng Xi , Yeo Ji-Youn , Joe Bina , Hill Jennifer W
Published: January 2020

Recent work shows that gut microbial dysbiosis contributes to the risk of obesity in children whose mothers consume a high-fat diet (HFD) during both gestation and lactation or during gestation alone. Obesity predisposes children to developing precocious puberty. However, to date, no study has examined how maternal HFD (MHFD) during lactation regulates the gut microbiota (GM), pubertal timing, and fertility of offspring. Here, we found that MHFD during lactation markedly altered the GM of offspring. The pups developed juvenile obesity, early puberty, irregular estrous cycles, and signs of disrupted glucose metabolism. Remarkably, permitting coprophagia between MHFD and maternal normal chow offspring successfully reversed the GM changes as well as early puberty and insulin insensitivity. Our data suggest that microbial reconstitution may prevent or treat early puberty associated with insulin resistance.
Analysis of 1478 Cases of Hypospadias Repair: The Incidence of Requiring Repeated Anesthetic Exposure as Well as Exploration of the Involvement of Trainees on Case Duration
Authors: Adler Adam C. , Chandrakantan Arvind , Sawires Youstina , Lee Andrew D. , Hart Margaret , Koh Chester J. , Janzen Nicolette K. , Austin Paul F. , Andropoulos Dean B.
Published: January 2020

BACKGROUND:

Recently, there has been significant focus on the effects of anesthesia on the developing brain. Concern is heightened in children <3 years of age requiring lengthy and/or multiple anesthetics. Hypospadias correction is common in otherwise healthy children and may require both lengthy and repeated anesthetics. At academic centers, many of these cases are performed with the assistance of anesthesia and surgical trainees. We sought to identify both the incidence of these children undergoing additional anesthetics before age 3 as well as to understand the effect of trainees on duration of surgery and anesthesia and thus anesthetic exposure (AE), specifically focusing on those cases >3 hours.

METHODS:

We analyzed all cases of hypospadias repair from December 2011 through December 2018 at Texas Children’s Hospital. In all, 1326 patients undergoing isolated hypospadias repair were analyzed for anesthesia time, surgical time, provider types involved, AE, caudal block, and additional AE related/unrelated to hypospadias.

RESULTS:

For the primary aim, a total of 1573 anesthetics were performed in children <3 years of age, including 1241 hypospadias repairs of which 1104 (89%) were completed with <3 hours of AE. For patients with <3 hours of AE, 86.1% had a single surgical intervention for hypospadias. Of patients <3 years of age, 17.3% required additional nonrelated surgeries. There was no difference in anesthesia time in cases performed solely by anesthesia attendings versus those performed with trainees/assistance (16.8 vs 16.8 minutes; P = .98). With regard to surgery, cases performed with surgical trainees were of longer duration than those performed solely by surgical attendings (83.5 vs 98.3 minutes; P < .001). Performance of surgery solely by attending surgeon resulted in a reduced total AE in minimal alveolar concentration (MAC) hours when compared to procedures done with trainees (1.92 vs 2.18; P < .001). Finally, comparison of patients undergoing initial correction of hypospadias with subsequent revisions revealed a longer time (117.7 vs 132.2 minutes; P < .001) and AE during the primary stage.

CONCLUSIONS:

The majority of children with hypospadias were repaired within a single AE. In general, most children did not require repeated AE before age 3. While presence of nonattending surgeons was associated with an increase in AE, this might at least partially be due to differences in case complexity. Moreover, the increase is likely not clinically significant. While it is critical to maintain a training environment, attempts to minimize AE are crucial. This information facilitates parental consent, particularly with regard to anesthesia duration and the need for additional anesthetics in hypospadias and nonhypospadias surgeries.
Assessing the role of historical temperature regime and algal symbionts on the heat tolerance of coral juveniles
Authors: Quigley K. M. , Randall C. J. , van Oppen M. J. H. , Bay L. K.
Published: January 2020

The rate of coral reef degradation from climate change is accelerating and, as a consequence, a number of interventions to increase coral resilience and accelerate recovery are under consideration. Acropora spathulata coral colonies that survived mass bleaching in 2016 and 2017 were sourced from a bleaching-impacted and warmer northern reef on the Great Barrier Reef (GBR). These individuals were reproductively crossed with colonies collected from a recently bleached but historically cooler central GBR reef to produce pure- and crossbred offspring groups (warm - warm, warm - cool, and cool - warm). We tested whether corals from the warmer reef produced more thermally tolerant hybrid and purebred offspring compared with crosses produced with colonies sourced from the cooler reef and whether different symbiont taxa affect heat tolerance. Juveniles were infected with Symbiodinium tridacnidorum, Cladocopium goreaui, Durusdinium trenchii and survival, bleaching, and growth were assessed at 27.5 and 31°C. The contribution of host genetic background and symbiont identity varied across fitness traits. Offspring with either both or one parent from the northern population exhibited a 13 to 26-fold increase in survival odds relative to all other treatments where survival probability was significantly influenced by familial cross identity at 31°C but not 27.5°C (Kaplan-Meier p=0.001 versus 0.2). If in symbiosis with D. trenchii, a warm sire and cool dam provided the best odds of juvenile survival. Bleaching was predominantly driven by Symbiodiniaceae treatment, where juveniles hosting D. trenchii bleached significantly less than the other treatments at 31°C. The greatest overall fold-benefits in growth and survival at 31°C occurred in having at least one warm dam and in symbiosis with D. trenchii. Juveniles associated with D. trenchii grew the most at 31°C, but at 27.5°C, growth was fastest in juveniles associated with C. goreaui. In conclusion, selective breeding with warmer GBR corals in combination with algal symbiont manipulation can assist in increasing thermal tolerance on cooler but warming reefs. Such interventions have the potential to improve coral fitness in warming oceans.
HCT116 colorectal liver metastases exacerbate muscle wasting in a mouse model for the study of colorectal cancer cachexia
Authors: Huot Joshua R. , Novinger Leah J. , Pin Fabrizio , Bonetto Andrea
Published: January 2020

Colorectal cancer (CRC) is often accompanied by formation of liver metastases (LM) and skeletal muscle wasting, i.e. cachexia. Despite affecting the majority of CRC patients, cachexia remains underserved, understudied and uncured. Animal models for the study of CRC-induced cachexia, in particular models containing LM, are sparse; therefore, we aimed to characterize two new models of CRC cachexia. Male NSG mice were injected subcutaneously (HCT116) or intrasplenically (mHCT116) with human HCT116 CRC tumor cells to disseminate LM, whereas experimental controls received saline (n=5-8/group). Tumor growth was accompanied by loss of skeletal muscle mass (HCT116: −20%; mHCT116: −31%; quadriceps muscle) and strength (HCT116: −20%; mHCT116: −27%), with worsened loss of skeletal muscle mass in mHCT116 compared with HCT116 (gastrocnemius: −19%; tibialis anterior: −22%; quadriceps: −21%). Molecular analyses revealed elevated protein ubiquitination in HCT116, whereas mHCT116 also displayed elevated Murf1 and atrogin-1 expression, along with reduced mitochondrial proteins PGC1α, OPA1, mitofusin 2 and cytochrome C. Further, elevated IL6 levels were found in the blood of mHCT116 hosts, which was associated with higher phosphorylation of STAT3 in skeletal muscle. To clarify whether STAT3 was a main player in muscle wasting in this model, HCT116 cells were co-cultured with C2C12 myotubes. Marked myotube atrophy (–53%) was observed, along with elevated phospho-STAT3 levels (+149%). Conversely, inhibition of STAT3 signaling by means of a JAK/STAT3 inhibitor was sufficient to rescue myotube atrophy induced by HCT116 cells (+55%). Overall, our results indicate that the formation of LM exacerbates cachectic phenotype and associated skeletal muscle molecular alterations in HCT116 tumor hosts.
Exertion-Related Illness: The Critical Roles of Leadership and Followership
Authors: O'Connor Francis G. , Grunberg Neil E. , Harp Jacob B. , Duster Patricia A.
Published: January 2020

Exertion-related illness (ERI), despite aggressive efforts with both prevention and emergency action planning, continues to be a considerable threat to both athletes and warfighters. Numerous case reports and series have served to elucidate risk factors, which have in turn become the focus of prevention strategies. While this approach has assisted in mitigating athlete risk, recent institutional guidance has identified the need for greater protection of athletes by accountability of training programs and the recognition of periods of distinct athlete vulnerability. These recommendations, in addition to observations from lessons learned from the aforementioned cluster reports of ERI, have a strong call-out for the role of leadership as both a culprit for injury and a potential mechanism for prevention. This commentary introduces a leader-follower framework and explores this model in the evolution of ERI and offers recommendations as to how we move forward toward making progress in prevention.
Evaluation and Management of Sports-Related Eye Injuries
Authors: Toldi James P. , Thomas Justin L.
Published: January 2020

Ocular injuries occur at a high rate in the United States and are a common complaint in the emergency department (ED). The CDC estimates that the annual rate for all-cause ocular injuries presenting to the ED is approximately 37.6 per 10,000 (1). The personal impact of ocular injury is an obvious one which necessitates urgent evaluation and possibly emergent ophthalmologic evaluation for vision preserving intervention. Specific sports and recreational activities increase the risk of injury; these include sports involving projectiles (i.e., target shooting, racquet sports, hockey pucks, lacrosse) as well as combat sports (i.e., martial arts, boxing, wrestling). Sideline physicians should be aware of the sports setting and be prepared for ocular injuries with the proper sideline equipment. Prompt recognition, management, and referral can lead to decreased morbidity in this select population.
Tibial Acceleration during Running Is Higher in Field Testing Than Indoor Testing
Authors: MILNER CLARE E. , HAWKINS JILLIAN L. , AUBOL KEVIN G.
Published: January 2020

Tibial acceleration is frequently measured in runners, and recent advances in wireless technology have led to field studies measuring tibial acceleration outside the laboratory. However, it is unknown whether laboratory and field measures of tibial acceleration differ within runners. In addition, the relationship between peak axial acceleration and the more recent measure peak resultant tibial acceleration has not been determined.

Purpose

This study aimed to determine whether laboratory and field measures of tibial acceleration are comparable, and whether peak axial and peak resultant tibial acceleration are interchangeable.

Methods

Nineteen healthy rearfoot striking runners between 18 and 45 yr of age participated. A precision accelerometer was aligned with the vertical axis of the distal tibia and firmly attached. Data were collected in the following conditions during running at 3.0 m·s−1 ± 5%: traditional overground laboratory gait analysis contacting force plates, treadmill, outdoor grass, and outdoor sidewalk. Acceleration data were filtered and normalized to gravity. Peaks for variables of interest were extracted from the first 40% of stride for 10 trials per condition. Differences among conditions were determined.

Results

Peak positive acceleration was lower in laboratory and treadmill compared with grass and sidewalk conditions. However, laboratory and treadmill were similar in magnitude, as were grass and sidewalk. Peak resultant acceleration was consistently higher than peak axial acceleration, with the same pattern among conditions. Laboratory acceleration measures explained at best only half of the variance in the field conditions and did not explain the variance for grass.

Conclusion

Tibial impact acceleration magnitude is influenced by testing procedures in runners. These findings support measuring tibial impact acceleration in the field to determine new metrics associated with injury.