bluuebunny/crossref_metadata_2025 huggingface dataset:
Call to avert acceleration of COVID-19 from India’s Sabarimala pilgrimage of 25 million devotees
Authors: Nayar K Rajasekharan , Koya Shaffi Fazaludeen , Ramakrishnan Venkitesh , Rao Arathi P , Libu Gnanaseelan Kanakamma , Binub Kanniyan , Ali Althaf , Abdulla Mansoor C , Gupthan Mahesh , Ebrahim Shahul H
Published: September 2020

India has the third-highest COVID-19 burden. Hosting the Sabarimala pilgrimage of an estimated 25 million can compromise the near-mitigated but fragile COVID-19 status of the host State of Kerala, accelerate the ongoing outbreaks in other states of India, and potentially in multiple countries with emigrants from Kerala.
The Veterans Health Administration Whole Health Model of Care: Early Implementation and Utilization at a Large Healthcare System
Authors: Marchand William R , Beckstrom Julie , Nazarenko Elena , Sweeny Renn U , Herrmann Tracy , Yocus McKenzi R , Romesser Jennifer , Roper Jeremy , Yabko Brandon , Parker Ashley
Published: September 2020

Introduction

The U.S. Veterans Health Administration (VHA) is changing the way it provides healthcare to a model known as Whole Health (WH). The aim is to shift from a primarily medical/disease-oriented system to a model that focuses on health promotion and disease prevention; utilizes personalized, proactive, and patient-driven care; and emphasizes the use of complementary and integrative health. This investigation aimed to examine referral and utilization patterns in early implementation at tertiary care VHA medical care system. Specific aims were to evaluate (1) referral patterns, (2) initial treatment engagement, and (3) continuity of treatment engagement.

Materials and methods

This is an institutional review board-approved, retrospective study of the first 561 veterans referred to WH programming in the first 20 months of implementation. Data analyses included a chi-square goodness of fit to compare demographics of veterans who were referred to WH Services with those of local patient population. At this facility, WH offers services in three tracks (General WH, Mindfulness Center [MC], and WH Nutrition), which offer unique services to veterans. A chi-square test for independence was conducted to analyze differences in initial engagement among the WH components, in referrals and retention among WH components by time period, and in demographics or diagnoses among self-referred or veterans referred by a consult. Finally, a regression model was used to assess for predictive factors that might influence continuity of treatment engagement across all the WH tracks.

Results

Key findings indicated potential implementation challenges including disproportionate numbers of referrals from clinical services; poor initial and ongoing treatment engagement; and older, male, and non-service-connected Veterans being less likely to be referred.

Conclusion

Implementation of the WH model of care has the potential to transform the way VHA delivers healthcare and improve the health and lives of veterans. However, a shift of this magnitude is likely to face challenges during implementation. This article reports on initial barriers to implementation, which can guide implementation at other sites as well as future investigations. Further research is needed to replicate these results as well as to determine underlying causal factors. However, if replicated, these results indicate that successful implementation of WH, or similar models of care, will require extensive efforts focused on outreach to, and education of, facility providers and certain patient demographic groups. Finally, efforts will be required to enhance treatment engagement.
Eigengalaxies: describing galaxy morphology using principal components in image space
Authors: Uzeirbegovic Emir , Geach James E , Kaviraj Sugata
Published: September 2020

We demonstrate how galaxy morphologies can be represented by weighted sums of ‘eigengalaxies’ and how eigengalaxies can be used in a probabilistic framework to enable principled and simplified approaches in a variety of applications. Eigengalaxies can be derived from a Principal Component Analysis (PCA) of sets of single- or multiband images. They encode the image space equivalent of basis vectors that can be combined to describe the structural properties of large samples of galaxies in a massively reduced manner. As an illustration, we show how a sample of  10243 galaxies in the Hubble Space Telescope CANDELS survey can be represented by just 12 eigengalaxies. We show in some detail how this image space may be derived and tested. We also describe a probabilistic extension to PCA (PPCA) which enables the eigengalaxy framework to assign probabilities to galaxies. We present four practical applications of the probabilistic eigengalaxy framework that are particularly relevant for the next generation of large imaging surveys: we (i) show how low likelihood galaxies make for natural candidates for outlier detection; (ii) demonstrate how missing data can be predicted; (iii) show how a similarity search can be performed on exemplars; (iv) demonstrate how unsupervised clustering of objects can be implemented.
Active galactic nucleus and dwarf galaxy gas kinematics
Authors: Manzano-King Christina M , Canalizo Gabriela
Published: September 2020

We present spatially resolved kinematic measurements of stellar and ionized gas components of dwarf galaxies in the stellar mass range $10^{8.5}\!-\!10^{10} \, \mathrm{M}_{\odot }$, selected from Sloan Digital Sky Survey DR7 and DR8 and followed up with Keck/Low-Resolution Imaging Spectrometer spectroscopy. We study the potential effects of active galactic nuclei (AGNs) on Galaxy-wide gas kinematics by comparing rotation curves of 26 Galaxies containing AGNs, and 19 control Galaxies with no optical or infrared signs of AGNs. We find a strong association between AGN activity and disturbed gas kinematics in the host Galaxies. While star-forming Galaxies in this sample tend to have orderly gas discs that co-rotate with the stars, 73 per cent of the AGNs have disturbed gas. We find that 5 out of 45 Galaxies have gaseous components in counter-rotation with their stars, and all Galaxies exhibiting counter-rotation contain AGNs. Six out of seven isolated Galaxies with disturbed ionized gas host AGNs. At least three AGNs fall clearly below the stellar–halo mass relation, which could be interpreted as evidence for ongoing star formation suppression. Taken together, these results provide new evidence supporting the ability of AGN to influence gas kinematics and suppress star formation in dwarf galaxies. This further demonstrates the importance of including AGN as a feedback mechanism in galaxy formation models in the low-mass regime.
Estimation of the black hole spin in LMC X-1 using AstroSat
Authors: Mudambi Sneha Prakash , Rao A , Gudennavar S B , Misra R , Bubbly S G
Published: September 2020

LMC X-1, a persistent, rapidly rotating, extra-galactic, black hole X-ray binary (BHXB) discovered in 1969, has always been observed in its high soft state. Unlike many other BHXBs, the black hole mass, source distance, and binary orbital inclination are well established. In this work, we report the results of simultaneous broad-band spectral studies of LMC X-1 carried out using the data from Soft X-ray Telescope and Large Area X-ray Proportional Counter aboard AstroSat as observed on 2016 November 26 and 2017 August 28. The combined spectrum was modelled with a multicolour blackbody emission (diskbb), a Gaussian along with a Comptonization component (simpl) in the energy range 0.7–30.0 keV. The spectral analysis revealed that the source was in its high soft state (Γ = 2.67$^{+0.24}_{-0.24}$ and Γ = 2.12$^{+0.19}_{-0.20}$) with a hot disc (kTin = 0.86$^{+0.01}_{-0.01}$ and kTin = 0.87$^{+0.02}_{-0.02}$). Thermal disc emission was fitted with a relativistic model (kerrbb) and spin of the black hole was estimated to be 0.93$^{+0.01}_{-0.01}$ and 0.93$^{+0.04}_{-0.03}$ (statistical errors) for the two Epochs through X-ray continuum-fitting, which agrees with the previous results.
A method for classification of red, blue, and green galaxies using fuzzy set theory
Authors: Pandey Biswajit
Published: September 2020

Red and blue galaxies are traditionally classified using some specific cuts in colour or other galaxy properties, which are supported by empirical arguments. The vagueness associated with such cuts are likely to introduce a significant contamination in these samples. Fuzzy sets are vague boundary sets that can efficiently capture the classification uncertainty in the absence of any precise boundary. We propose a method for classification of galaxies according to their colours using fuzzy set theory. We use data from the Sloan Digital Sky Survey (SDSS) to construct a fuzzy set for red galaxies with its members having different degrees of ‘redness’. We show that the fuzzy sets for the blue and green galaxies can be obtained from it using different fuzzy operations. We also explore the possibility of using fuzzy relation to study the relationship between different galaxy properties and discuss its strengths and limitations.
Public Attribution of Responsibility for Disaster Preparedness across Three Levels of Government and the Public: Lessons from a Survey of Residents of the U.S. South Atlantic and Gulf Coast
Authors: Wehde Wesley , Nowlin Matthew C
Published: September 2020

Using survey data collected from residents of counties along the South Atlantic and Gulf Coasts of the United States, we use innovative compositional data analysis techniques to examine individuals’ assignment of responsibility for hurricane preparedness across federal, state, and local officials as well as among household residents and their community. We find that the public assigns limited responsibility for hurricane preparedness to governments. Rather, respondents, especially conservatives and those with low trust in government, view individuals themselves as responsible for preparedness. Our results emphasize the role of ideology and the individualistic culture of American politics. These results also have implications for scholars who study individual attribution responsibility in multi-level systems and who may assume that individuals will assign responsibility to one of the various levels of government; however, focusing on disaster preparation in particular, our study shows that a significant number of individuals may not assign responsibility to government at any level.
Learning about Competitors: Evidence from SME Lending
Authors: Darmouni Olivier , Sutherland Andrew
Published: September 2020

We study how small and medium enterprise (SME) lenders react to information about their competitors’ contracting decisions. To isolate this learning from lenders’ common reactions to unobserved shocks to fundamentals, we exploit the staggered entry of lenders into an information-sharing platform. Upon entering, lenders adjust their contract terms toward what others offer. This reaction is mediated by the distribution of market shares: lenders with higher shares or that operate in concentrated markets react less. Thus, contract terms are shaped not only by borrower or lender fundamentals but also by the interaction between information availability and competition.
Changes in bone formation regulator biomarkers in early axial spondyloarthritis
Authors: Descamps Elise , Molto Anna , Borderie Didier , Lories Rik , Richard Corinne Miceli , Pons Marion , Roux Christian , Briot Karine
Published: September 2020

Objective

The hallmark of advanced axial SpA (axSpA) is spine ankylosis due to excessive ectopic bone formation. This prospective study aimed to describe the changes in serum levels of different regulators [sclerostin, dickkopf-1 (DKK-1)] and markers of bone formation [bone morphogenetic protein 7 (BMP-7)] over 5 years in early axSpA patients and to assess determinants of such changes.

Methods

The DEvenir des Spondyloarthropathies Indifférenciées Récentes cohort is a prospective, multicentre French study of 708 patients with early (>3 months–<3 years) inflammatory back pain suggestive of axSpA. Serum levels of BMP-7, sclerostin and DKK-1 were assessed at baseline and after 2 and 5 years. Changes in bone formation regulators over time were analysed using mixed linear models.

Results

Serum BMP-7 significantly increased over time, with a median relative change of 223.7% [interquartile range (IQR) 0–10 700 (0.17 pg/ml/month), P < 0.001]. Serum sclerostin significantly increased over time, with a median relative change of 14.8% [IQR −7.9–41.4% (0.001 ng/ml/month), P < 0.001]. Serum DKK-1 did not significantly change over time. Serum BMP-7 increased over time in active disease (Ankylosing Spondylitis Disease Activity Score with CRP ≥1.3, P = 0.01), but the increase was less pronounced with TNF inhibitor (TNFi) use (P < 0.001). No determinant was associated with serum sclerostin change.

Conclusion

Serum BMP-7 change over 5 years was related with inflammation; it was increased in active disease, but the increase was low with TNFi use. Serum sclerostin levels significantly increased over time, but to a lesser degree than for serum BMP-7.

Clinical trial registration

https://clinicaltrials.gov/, NCT01648907.
Asymptomatic Duodenitis and Helicobacter pylori associated Dyspepsia in 2-Year-Old Chronic Malnourished Bangladeshi Slum-Dwelling Children: A Cross-Sectional Study
Authors: Hossain Md Shabab , Das Subhasish , Begum S M Khodeza Nahar , Rahman M Masudur , Mazumder Ramendra Nath , Gazi Md Amran , Fahim Shah Mohammad , Mahfuz Mustafa , Haque Rashidul , Petri William A , Sarker Shafiqul Alam , Ahmed Tahmeed
Published: September 2020

Aim

There is insufficient knowledge on the * duodenal histology and Helicobacter pylori infection in malnourished Bangladeshi children. Therefore, we attempted to explore the prevalence of H. pylori infection and duodenal histopathology in 2-year-old chronic malnourished Bangladeshi slum-dwelling children and investigate their association with dyspeptic symptoms.

Methods

This cross-sectional study was conducted using the data of the Bangladesh Environmental Enteric Dysfunction study in an urban slum of Dhaka, Bangladesh. With a view to address the association of environmental enteric dysfunction (EED) with stunting, upper gastrointestinal endoscopy was performed on 54 chronic malnourished children {31 stunted [length-for-age Z-scores (LAZ) <−2] and 23 at risk of stunting (LAZ <−1 to −2)} aged between 12–24 months and the mucosal biopsies were subjected to histopathological examination after obtaining proper clinical history. Stool antigen for H. pylori (HpSA) was assessed to determine H. pylori status.

Results

In all, 83.3% (45/54) of the children had histopathological evidence of duodenitis. Chronic mild duodenitis was found to be the most prevalent form of duodenitis (53.7%) in the children. Only 8.9% (4/45) of the children with duodenitis had dyspepsia (p < 0.05). The 14.8% (8/54) of the children were found positive for H. pylori infection. Logistic regression analysis revealed children positive for HpSA had significant association with dyspepsia (OR 9.34; 95% CI 1.54–56.80).

Conclusions

The number of chronic malnourished children suffering from duodenitis was found to be very high. Majority of these children was asymptomatic. Children positive for HpSA had significant association with dyspeptic symptoms.
13Postcolonial Theory—New Directions?
Authors: Knudsen Eva Rask , Rahbek Ulla
Published: September 2020

This chapter covers selected research in postcolonial theory published in 2019. It begins with books and edited collections before it focuses on a special journal issue and a book chapter. The work discussed here demonstrates how postcolonialism engages in human geography and in the ongoing refugee and climate crises, and also how it draws attention to the continued need for ethical responses to precarity and subalternity. Concomitantly with this need postcolonial theory points to a reconfiguration of planetarity and a critical stance towards the Western-centric ideas that remain part of the field’s legacy.
Diversity and Cross-Infection Potential ofColletotrichumCausing Fruit Rots in Mixed-Fruit Orchards in Kentucky
Authors: Eaton Madison J. , Edwards Shanice , Inocencio Harrison A. , Machado Franklin J. , Nuckles Etta M. , Farman Mark , Gauthier Nicole A. , Vaillancourt Lisa J.
Published: September 2020

Fungi in the genus Colletotrichum cause apple, blueberry, and strawberry fruit rots, which can result in significant losses. Accurate identification is important because species differ in aggressiveness, fungicide sensitivity, and other factors affecting management. Multiple Colletotrichum species can cause similar symptoms on the same host, and more than one fruit type can be infected by a single Colletotrichum species. Mixed-fruit orchards may facilitate cross-infection, with significant management implications. Colletotrichum isolates from small fruits in Kentucky orchards were characterized and compared with apple isolates via a combination of morphotyping, sequencing of voucher loci and whole genomes, and cross-inoculation assays. Seven morphotypes representing two species complexes (C. acutatum and C. gloeosporioides) were identified. Morphotypes corresponded with phylogenetic species C. fioriniae, C. fructicola, C. nymphaeae, and C. siamense, identified by TUB2 or GAPDH barcodes. Phylogenetic trees built from nine single-gene sequences matched barcoding results with one exception, later determined to belong to an undescribed species. Comparison of single-gene trees with representative whole genome sequences revealed that CHS and ApMat were the most informative for diagnosis of fruit rot species and individual morphotypes within the C. acutatum or C. gloeosporioides complexes, respectively. All blueberry isolates belonged to C. fioriniae, and most strawberry isolates were C. nymphaeae, with a few C. siamense and C. fioriniae also recovered. All three species cause fruit rot on apples in Kentucky. Cross-inoculation assays on detached apple, blueberry, and strawberry fruits showed that all species were pathogenic on all three hosts but with species-specific differences in aggressiveness.
Contribution of Stimulus Variability to Word Recognition in Noise Versus Two-Talker Speech for School-Age Children and Adults
Authors: Buss Emily , Calandruccio Lauren , Oleson Jacob , Leibold Lori J.
Published: September 2020

Background:

Speech-in-speech recognition scores tend to be more variable than the speech-in-noise recognition scores, both within and across listeners. This variability could be due to listener factors, such as individual differences in audibility or susceptibility to informational masking. It could also be due to stimulus variability, with some speech-in-speech samples posing more of a challenge than others. The purpose of this experiment was to test two hypotheses: (1) that stimulus variability affects adults’ word recognition in a two-talker speech masker and (2) that stimulus variability plays a smaller role in children’s performance due to relatively greater contributions of listener factors.

Methods:

Listeners were children (5 to 10 years) and adults (18 to 41 years) with normal hearing. Target speech was a corpus of 30 disyllabic words, each associated with an unambiguous illustration. Maskers were 30 samples of either two-talker speech or speech-shaped noise. The task was a four-alternative forced choice. Speech reception thresholds were measured adaptively, and those results were used to determine the signal-to-noise ratio associated with ≈65% correct for each listener and masker. Two 30-word blocks of fixed-level testing were then completed in each of the two conditions: (1) with the target-masker pairs randomly assigned prior to each block and (2) with frozen target-masker pairs.

Results:

Speech reception thresholds were lower for adults than for children, particularly for the two-talker speech masker. Listener responses in fixed-level testing were evaluated for consistency across listeners. Target sample was the best predictor of performance in the speech-shaped noise masker for both the random and frozen conditions. In contrast, both the target and masker samples affected performance in the two-talker masker. Results were qualitatively similar for children and adults, and the pattern of performance across stimulus samples was consistent, with differences in masked target audibility in both age groups.

Conclusions:

Although word recognition in speech-shaped noise differed consistently across target words, recognition in a two-talker speech masker depended on both the target and masker samples. These stimulus effects are broadly consistent with a simple model of masked target audibility. Although variability in speech-in-speech recognition is often thought to reflect differences in informational masking, the present results suggest that variability in energetic masking across stimuli can play an important role in performance.
Morphologic evolution of recent small sub-cortical infarcts and adjacent white matter in the basal ganglia in a Chinese cohort
Authors: Wang Sha-Sha , Wei Sen , Song Bo , Xu Yu-Ming
Published: September 2020

Background

Data on the evolution of recent small sub-cortical infarcts are limited, especially in the Chinese. Previous studies have reported a large heterogeneity in cavitation and infarct location; therefore, the present study assessed the morphology of small sub-cortical infarcts in the basal ganglia in a Chinese cohort.

Methods

Patients who had experienced a recent, single, small sub-cortical infarct in the basal ganglia and received at least one follow-up magnetic resonance imaging (MRI) scan were retrospectively identified from January 2014 to June 2018. Time to follow-up imaging, baseline infarct size, vascular risk factors, and other clinical data, as well as the morphologic changes of the index infarct and surrounding white matter were recorded. Demographic, clinical and MRI characteristics were respectively compared among three groups (white matter hyper-intensitie [WMH] vs. cavitation vs. absent) and between with and without new WMH formation groups. In addition, logistic regression analyses were performed in investigating the determinate independent predictors for new WMH formation.

Results

Seventy-eight subjects were included with a median follow-up time of 304 days (range: 124–552 days). We found a significant reduction in infarct size at follow-up: 46 of 78 (59.0%) infarctions showed some degree of cavitation, 19 of 78 (24.4%) index lesions resembled non-cavitated WMH, and 13 of 78 (16.7%) infarcts had disappeared at follow-up MRI. No factors were found to be associated with differential outcomes of the infarcts. In addition, 8 of 78 (10.3%) patients demonstrated new WMH formation surrounding the index infarct; white matter progression (odds ratio = 15.95, 95% confidence interval = 1.65–153.99; P = 0.017) was an independent risk factor of new WMH formation.

Conclusions

More than half of the small sub-cortical infarcts in the basal ganglia progressed to cavities, demonstrating that these infarcts can be reduced and go undetected. The presence of new WMH around the infarct may be indicative of the worsening progression of cerebral small vessel diseases. Additionally, white matter progression is an independent risk factor, which may be a potential therapeutic target.
Effect of soy protein containing isoflavones on endothelial and vascular function in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials
Authors: Abshirini Maryam , Omidian Mahsa , Kord-Varkaneh Hamed
Published: September 2020

Importance:

The beneficial role of soy protein in cardiovascular health has been well documented in observational studies. However, evidence from clinical trials on effects of soy protein on endothelial function in postmenopausal women has been conflicting.

Objective:

We aimed to systematically review and conduct a meta-analysis of randomized controlled trials (RCTs) investigating the impact of soy protein supplement containing isoflavones on endothelial function in postmenopausal women.

Evidence review:

We searched PubMed-Medline, SCOPUS, Embase, and Google Scholar until March 2020 to find RCTs evaluating the impact of soy protein supplementation on endothelial function parameters. Random effects model (using DerSimonian-Laird method) was applied to synthesize quantitative data. We performed the leave-one-out method for sensitivity analysis. To quantitatively assess heterogeneity, the I

2
index was applied.

Findings:

From a total of 267 studies identified from the initial search 15 and 5 studies were considered appropriate for inclusion into the systematic review and meta-analysis, respectively. In the meta-analysis, an insignificant enhancement in flow-mediated dilation (FMD) after soy protein supplementation (0.882%; 95% CI: −1.059 to 2.822; P = 0.373) was found. However, subgroup analysis showed that supplementation of isolated soy protein had significant effect on FMD (3.39%; 95% CI: 0.733-6.01; P = 0.01).

Conclusions and Relevance:

Our findings suggest that soy protein supplementation does not lead to meaningful improvement in FMD in postmenopausal women. However, this finding is based on a limited number of studies. Additional high-quality large-scale RCTs are warranted.
Long-term resveratrol supplementation improves pain perception, menopausal symptoms, and overall well-being in postmenopausal women: findings from a 24-month randomized, controlled, crossover trial
Authors: Thaung Zaw Jay Jay , Howe Peter R.C. , Wong Rachel H.X.
Published: September 2020

Objective:

Following concerns about hormone therapy, postmenopausal women need alternative options to manage menopause-related symptoms and improve their well-being. A 14-week pilot study has shown that supplementation with resveratrol, a phytoestrogen with circulatory benefits, can improve aspects of well-being including chronic pain, which is a common complaint in postmenopausal women. We aimed to confirm these benefits in a larger, long-term study.

Methods:

The Resveratrol for Healthy Ageing in Women study, a 24-month randomized, double-blind, placebo-controlled, two-period crossover intervention trial of resveratrol supplementation (75 mg BID) was conducted in 125 healthy postmenopausal women to evaluate effects on cognitive performance (results published elsewhere). Aspects of well-being including pain perception, mood and depressive symptoms, menopausal symptoms, sleep quality, and quality of life were assessed with questionnaires as secondary outcomes of the study. Cerebrovascular responsiveness to hypercapnia was measured as a surrogate marker of cerebrovascular function.

Results:

Resveratrol supplementation reduced composite pain score (P < 0.001), especially in overweight individuals; this was associated with improvements in cerebrovascular responsiveness to hypercapnia (R = −0.329, P = 0.014). Somatic menopausal symptoms (P = 0.024) and general well-being (P = 0.010) were also improved after resveratrol supplementation.

Conclusions:

These results confirm the pilot study finding that resveratrol supplementation can reduce chronic pain in age-related osteoarthritis and improve menopause-related quality of life in postmenopausal women. These improvements are sustained by supplementation for at least 12 months and are associated with enhancement of circulatory function.

Clinical Trial Registration:

ACTRN12616000679482p

Video Summary:

http://links.lww.com/MENO/A638.
Long-term Retention of Plutonium in the Respiratory Tracts of Two Acutely-exposed Workers: Estimation of Bound Fraction
Authors: Poudel Deepesh , Avtandilashvili Maia , Bertelli Luiz , Klumpp John A. , Tolmachev Sergei Y.
Published: September 2020

Inhalation of plutonium is a significant contributor of occupational doses in plutonium production, nuclear fuel reprocessing, and cleanup operations. Accurate assessment of the residence time of plutonium in the lungs is important to properly characterize dose and, consequently, the risk from inhalation of plutonium aerosols. This paper discusses the long-term retention of plutonium in different parts of the respiratory tract of two workers who donated their bodies to the US Transuranium and Uranium Registries. The post-mortem tissue radiochemical analysis results, along with the urine bioassay data, were interpreted using Markov Chain Monte Carlo and the latest biokinetic models presented in the Occupational Intakes of Radionuclides series of ICRP publications. The materials inhaled by both workers were found to have solubility between that of plutonium nitrates and oxides. The long-term solubility was also confirmed by comparison of the activity concentration in the lungs and the thoracic lymph nodes. The data from the two individuals can be explained by assuming a bound fraction (fraction of plutonium deposited in the respiratory tract that becomes bound to lung tissue after dissolution) of 1% and 4%, respectively, without having to significantly alter the particle clearance parameters. Effects of different assumptions about the bound fraction on radiation doses to different target regions was also investigated. For inhalation of soluble materials, an assumption of fb
of 1%, compared to the ICRP default of 0.2%, increases the dose to the most sensitive target region of the respiratory tract by 258% and that to the total lung by 116%. Some possible alternate methods of explaining higher-than-expected long-term retention of plutonium in the upper respiratory tract of these individuals—such as physical sequestration of material into the scar tissues and possible uptake by lungs—are also briefly discussed.
The Methodology Used to Assess Doses from the First Nuclear Weapons Test (Trinity) to the Populations of New Mexico
Authors: Bouville André , Beck Harold L. , Thiessen Kathleen M. , Hoffman F. Owen , Potischman Nancy , Simon Steven L.
Published: September 2020

Trinity was the first test of a nuclear fission device. The test took place in south-central New Mexico at the Alamogordo Bombing and Gunnery Range at 05:29 AM on 16 July 1945. This article provides detailed information on the methods that were used in this work to estimate the radiation doses that were received by the population that resided in New Mexico in 1945. The 721 voting precincts of New Mexico were classified according to ecozone (plains, mountains, or mixture of plains and mountains), and size of resident population (urban or rural). Methods were developed to prepare estimates of absorbed doses from a range of 63 radionuclides to five organs or tissues (thyroid, active marrow, stomach, colon, and lung) for representative individuals of each voting precinct selected according to ethnicity (Hispanic, White, Native American, and African American) and age group in 1945 (in utero, newborn, 1–2 y, 3–7 y, 8–12 y, 13–17 y, and adult). Three pathways of human exposure were included: (1) external irradiation from the radionuclides deposited on the ground; (2) inhalation of radionuclide-contaminated air during the passage of the radioactive cloud and, thereafter, of radionuclides transferred (resuspended) from soil to air; and (3) ingestion of contaminated water and foodstuffs. Within the ingestion pathway, 13 types of foods and sources of water were considered. Well established models were used for estimation of doses resulting from the three pathways using parameter values developed from extensive literature review. Because previous experience and calculations have shown that the annual dose delivered during the year following a nuclear test is much greater than the doses received in the years after that first year, the time period that was considered is limited to the first year following the day of the test (16 July 1945). Numerical estimates of absorbed doses, based on the methods described in this article, are presented in a separate article in this issue.
World Gastroenterology Organisation Global Guidelines
Authors: Farthing Michael , Albonico Marco , Bisoffi Zeno , Bundy Donald , Buonfrate Dora , Chiodini Peter , Katelaris Peter , Kelly Paul , Savioli Lorenzo , Mair Anton Le
Published: September 2020

Strongyloides stercoralis is a soil-transmitted helminth, but it has a unique life cycle that can be completed in the human host, in a process known as autoinfection. Worldwide, the burden of disease is substantial (300 to 400 million infections). Strongyloidiasis is mainly prevalent in the tropics and subtropics, but there is as yet no global public health strategy for controlling the parasite.
Dexmedetomidine for early postoperative cognitive dysfunction after video-assisted thoracoscopic lobectomy in elderly male patients with lung cancer
Authors: Shi Hai-Xia , Du Xue-Jiang , Wu Fan , Hu Ya-Juan , Mi Wei-Dong
Published: September 2020

This retrospective study explored the efficacy and safety of dexmedetomidine in treating early postoperative cognitive dysfunction (EPPNCD) after video-assisted thoracoscopic lobectomy (VATL) in elderly male patients with lung cancer (LC).

This study included a total of 80 elderly male patients with LC who received VATL. All of them were equally assigned to a treatment group and a control group, with 40 patients each group. The primary outcome included cognitive dysfunction, as evaluated by mini-mental state examination scale. The secondary outcomes consisted of incidence of EPPNCD, lung function (as measured by forced vital capacity, forced expiratory volume in 1 second, peak expiratory flow, and maximal voluntary ventilation), and adverse events. All outcome data were analyzed before and 3 days after surgery.

After surgery, all patients in the treatment group exerted better efficacy in mini-mental state examination scale (P < .01) and incidence of EPPNCD (P = .03), than patients in the control group. However, no significant differences were detected in forced vital capacity (P = .65), forced expiratory volume in 1 second (P = .50), peak expiratory flow (P = .73), and maximal voluntary ventilation (P = .27) between 2 groups. In addition, there is similar safety profile between 2 groups.

The findings of this study showed that dexmedetomidine may benefit EPPNCD after VATL in elderly male patients with LC. Future studies are needed to warrant the present conclusions.
Analysis of the efficacy of holmium laser and pneumatic ballistic in the treatment of impacted ureteral calculi
Authors: Chunlin Yang , Wanlin Du , Jinhua Du
Published: September 2020

To explore the safety and effectiveness of ureteroscopic holmium laser lithotripsy (UHLL) and ureteroscopic pneumatic lithotripsy (UPL) in the treatment of impacted ureteral calculi (IUC).

Clinical data of 280 patients in our hospital from April 2016 to May 2019 were retrospectively collected and analyzed, including 136 cases of UHLL group and 144 cases of UPL group. The general clinical data, operation time, intraoperative bleeding volume, hospital stay, stone-free rate (SFR), and surgical complications were collected and analyzed in 2 group.

Compared with UPL group, the operation time of UHLL group was significantly reduced (27.25 ± 8.39 vs 34.32 ± 10.57, P < .05), but the hospitalization cost was significantly increased (9.25 ± 0.75 vs 8.24 ± 0.51, P < .05). In terms of total SFR, the UHLL group was significantly higher than the UPL group (93.38% vs 83.33%, P = .011). For proximal IUC, compared with the UPL group, the SFR of the UHLL group was significantly increased (88.33% vs 70.31%, P = 0.005). For distal IUC, there was no significant difference in SFR (97.37% vs 93.75%, P = .638) between the UHLL group and UPL group. There were no significant differences in the complications of local mucosal injury, hematuria, febrile urinary tract infection, ureteral perforation, and urinary sepsis in the 2 groups (P > .05). However, the UHLL group was significantly lower in stone residual rate than the UPL group (6.61% vs 16.67%, P = .001).

This study found that UHLL and UPL are safe and effective in the treatment of IUC, but UHLL has the advantages of shorter operation time and high SFR in the treatment of IUC.
The effect of Tai Chi practice on immunological function in cancer survivors
Authors: Wang Xuejiao , Xu Lei , Dai Ning , Yang Xingzhe , He Qingyun , Tan Libo , Wang Ruochong , Li Feng
Published: September 2020

Background:

Tai Chi has been reported to be potentially effective for health and well-being of cancer survivors. It is worth to assess the effectiveness and safety of Tai Chi on immunological function in people with cancer.

Methods:

All relevant randomized controlled trials (RCT) will be reviewed on Tai Chi for immunological function in cancer survivors. Literature searching will be conducted until March 9, 2019 from major English and Chinese databases: Cochrane Library, Excerpta Medica Database (EMBASE), PubMed, CINAHL, Sprotdicus, American Association for Cancer Research Journals, Sino-Med database, China National Knowledge Infrastructure, Chinese Science and Technique Journals Database, and Wanfang Data Chinese database. Two authors will conduct data selection and extraction independently. Quality assessment will be conducted using the risk of bias tool recommended by the Cochrane Collaboration. We will conduct data analysis using Cochrane's RevMan software (V.5.3). Forest plots and summary of findings tables will illustrate the results from a meta-analysis if sufficient studies with the same outcomes are identified. Funnel plots will be developed to evaluate reporting bias.

Results:

This review will summarize the evidence on Tai Chi for immunological function in cancer survivors.

Conclusions:

We hope that the results of this study will provide significant evidence to assess the value Tai Chi practice on immunological function in cancer survivors.

Ethics and dissemination:

Ethics approval is not required as this study will not involve patients. The results of this study will be submitted to a peer-reviewed journal for publication.
Expression and clinical significance of aquaporin-1, vascular endothelial growth factor and microvessel density in gastric cancer
Authors: Zhang Yudong , Qu Hao
Published: September 2020

To investigate the expression and clinical significance of aquaporin-1 (AQP1), vascular endothelial growth factor (VEGF) and microvessel density (MVD) in gastric cancer.

A total of 79 gastric cancer patients who were admitted into Beijing Chao-Yang Hospital from January, 2018 to December, 2019 were involved in this study. Tumor specimens and para-cancerous normal tissues (> 2 cm away from the tumor) of all the enrolled patients were collected. Immunohistochemistry were performed to identify the expression of AQP1, VEGF, and MVD and the correlation between AQP1, VEGF, MVD, and clinicopathological parameters was analyzed.

The expression of AQP1, VEGF and MVD in gastric cancer tissue was increased significantly compared with those in para-cancerous tissue (P < .05). AQP1, VEGF, and MVD were closely correlated with gastric cancer differentiation, lymph node metastasis, vascular tumor thrombosis and clinical stage (P < .05). Spearman correlation analysis showed that AQP1 was positively associated with VEGF expression (r = 0.497, P < .05). MVD was enhanced in VEGF or AQP1 positive cancer tissues compared with that in VEGF or AQP1 negative tissue (P < .05).

Synergistic effect among AQP1, VEGF, and MVD is involved in occurrence and development of gastric cancer.
Association of serum osteocalcin levels with glucose metabolism in trauma patients
Authors: Yang Yanping , Zhong Weixi , Huang Jianyin , Geng Lei , Feng Qiming
Published: September 2020

Osteocalcin (OC) is an endocrine hormone that regulates glucose metabolism.

The aim of this study was to investigate the relationship between serum OC levels and glucose metabolism after trauma.

This was a retrospective study of trauma patients admitted to the Department of Emergency Medicine between October 2017 and April 2019. Age, height, weight, injury severity score, and previous medical history were recorded. Serum N-terminal mid-fragment of OC (N-MID OC), hemoglobin Alc (HbA1c), fasting plasma glucose (FPG), fasting insulin (FINS), C-peptide, and other biochemical indicators were measured. Differences between the HbA1c-L (HbA1c <6.5%) and HbA1c-H (HbA1c ≥6.5%) groups were compared. The association of N-MID OC with indicators of glucose metabolism was analyzed.

Out of 394 trauma patients, leukocyte and FPG levels in the HbA1c-H group (n = 93) were higher (P < .05), while N-MID OC levels were lower (P = .011) than the HbA1c-L group (n = 301). N-MID OC was negatively correlated with HbA1c in the total population (r = -0.273, P < .001) as well as in the HbA1c-L (r = -0.289, P < .001) and HbA1c-H (r = -0.390, P < 0.001) groups, and was positively correlated with C-peptide in the HbA1c-H group (r = 0.395, P < .001). The different quartiles in the HbA1c-L showed that N-MID OC declined with increasing HbA1c, which was higher than N-MID OC levels in the HbA1c-H group. Multiple linear regression analysis revealed that serum HbA1c was independently associated with serum OC levels after trauma (β=-1.608, P < .001).

This study strongly suggests the importance of serum OC on glucose metabolism in trauma patients. HbA1c is independently associated with serum OC levels.
Treatment to reduce vascular calcification in hemodialysis patients using vitamin K (Trevasc-HDK)
Authors: Haroon Sabrina-Wong-Peixin , Tai Bee-Choo , Ling Lieng-Hsi , Teo Lynette , Davenport Andrew , Schurgers Leon , Teo Boon-Wee , Khatri Priyanka , Ong Ching-Ching , Low Sanmay , Yeo Xi-Er , Tan Jia-Neng , Subramanian Srinivas , Chua Horng-Ruey , Tan Swee-Yaw , Wong Weng-Kin , Lau Titus-Wai-Leong
Published: September 2020

Introduction:

End stage renal failure patients on hemodialysis have significant vascular calcification This is postulated to be related to sub-clinical vitamin K deficiency, which is prevalent in hemodialysis patients. Vitamin K deficiency result in the failure of the matrix GLA protein (MGP) to undergo carboxylation. MGP is a natural local inhibitor of vascular calcification and the lack of functional carboxylated MGP may contribute to increase vascular calcification. Vitamin K supplement should therefore correct this anomaly and decrease the rate or severity of vascular calcification in this population of patients on long-term maintenance hemodialysis. Our study seeks to evaluate the prevalence and the progression of vascular calcification in a cohort of maintenance hemodialysis patients. It will also evaluate the efficacy of vitamin K supplementation in reducing the progression of vascular calcification in this group of patients.

Methods:

This will be a single-center randomized, prospective and open-label interventional clinical trial of end stage renal failure patients on hemodialysis. We aim to recruit 200 patients. Eligible patients will be randomized to either the standard care arm or active treatment arm. Active treatment arm patients will receive standard care plus supplementation with oral vitamin K2 isoform 360 mcg 3 times weekly for a total duration of 18 months. Primary outcome measured will be absolute difference in coronary artery calcification score at 18-month between control and intervention arms. Secondary outcomes will be to compare absolute difference in aortic valve calcification, percentage of patients with regression of coronary artery calcification of at least 10%, absolute difference in aortic and systemic arterial stiffness, mortality from any cause and major adverse cardiovascular over the same period.

Discussion:

Evidence of successful regression or retardation of vascular calcification will support the conduct of larger and longer-term trials aimed at reducing cardiovascular disease mortality and major adverse cardiovascular events in this high-risk population using a safe and inexpensive strategy

Trial registration:

ClinicalTrials.gov NCT02870829. Registered on 17 August 2016 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT02870829

National University Hospital's Institutional Review Board (2015/01000)
The efficacy of colchicine in the management of coronavirus disease 2019
Authors: Elshafei Mohamed Nabil , Khalil Ahmed , El-Bardissy Ahmed , Danjuma Mohammed , Ahmed Mohamed Badie , Mohamed Mouhand F.H.
Published: September 2020

Background:

Severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infection is a recently emerged viral infection causing predominantly mild upper respiratory symptoms. However, in some instances, it might result in acute respiratory distress syndrome (ARDS) that poses a significant mortality risk. ARDS is postulated to be mediated by a surge of pro-inflammatory cytokines and chemokines, leading to a dysregulated hyper inflammatory response. Colchicine being an anti-inflammatory agent, might mitigate this dysregulated response. Thus, in the absence of therapeutic options available to manage coronavirus disease 2019 (COVID-19), it is imperative to ascertain the effect of colchicine on improving outcomes in COVID-19 patients.

Method:

We will perform a systematic review including a search of the following databases: PubMed, EMBASE, MEDLINE, Clinicaltrials.gov, Cochrane library, and google scholar since inception. We will include randomized controlled trials exploring the effect of colchicine on the efficacy and safety outcomes of COVID-19 patients. Subsequently, we will perform a meta-analysis utilizing the random-effects to ascertain the effect of colchicine on reducing COVID-19 related mortality (primary endpoint) and other efficacy and safety outcomes.

Results:

Our review results are anticipated in early 2021 (based on the completion of several ongoing randomized controlled trial). Our review results will be published in a peer-reviewed journal.

Conclusion:

This systematic review and meta-analysis, is exploring the effect of colchicine on the efficacy and safety outcomes of COVID-19 patients. If colchicine proved to be effective, it would be a significant milestone in the management of COVID-19, a disease with limited available therapeutic options.

PROSPERO registration number:

CRD42020191086
Long-term safety and efficacy of mirogabalin in Asian patients with postherpetic neuralgia
Authors: Kato Jitsu , Matsui Norimitsu , Kakehi Yoshihiro , Murayama Emiko , Ohwada Shoichi
Published: September 2020

Objective:

Postherpetic neuralgia (PHN) is a condition that results from nerve dysfunction following an episode of acute herpes zoster (shingles). Mirogabalin is a novel, selective oral α2δ ligand that demonstrated safety and efficacy in a multicenter, randomized, double-blind, placebo-controlled 14-week study in Asian patients with PHN. This 52-week, open-label extension study investigated the long-term safety and efficacy of flexible-dosage mirogabalin in Asian patients with PHN.

Methods:

This open-label extension study enrolled patients who completed the placebo-controlled study. Patients started with a dose of 5 mg mirogabalin twice daily (BID), which was followed by a flexible dose of 10 or 15 mg BID. During the study, patients assessed their pain using the Short-Form McGill Pain Questionnaire (SF-MPQ). Adverse events were monitored throughout the study.

Results:

Of 239 enrolled patients, 184 (77.0%) completed the study and 185 patients (77.4%) received the 15 mg BID dose most during the treatment duration. Most treatment-emergent adverse events (TEAEs) were mild or moderate. The most common TEAEs were nasopharyngitis, somnolence, dizziness, weight increased, and edema. All SF-MPQ scales decreased from baseline to week 52.

Conclusions:

This study showed the safety and stable pain management of a long-term flexible dosing regimen of mirogabalin 10 or 15 mg twice daily for 52 weeks in patients with PHN.

Clinical Trial Registered at ClinicalTrials.gov:

NCT02318719.

Summary for Table of Contents:

Mirogabalin—a novel α2δ oral ligand—was shown to be effective and well tolerated for treating postherpetic neuralgia (PHN) in an Asian multicenter, randomized, double-blind, placebo-controlled, 14-week study. This open-label, 52-week study was conducted as an extension of the double-blind study to demonstrate long-term safety and efficacy of mirogabalin.