bluuebunny/crossref_metadata_2025 huggingface dataset:
Ein guter Start ins frühe Leben
Authors: Fydrich Sabine
Published: October 2020

Das postnatale Wärmemanagement von Frühgeborenen stellt das versorgende Personal vor große Herausforderungen. Die fehlende Thermoregulation der Frühgeborenen führt ohne unterstützende Interventionen zu einem schnellen Wärmeverlust, der eine Hypothermie mit weiteren Auswirkungen auf die Morbidität und Mortalität der vulnerablen Patientengruppe verursacht. Zur Prävention thermaler Entgleisung bei der Erstversorgung im Kreißsaal können die Implementierung evidenzbasierter Richtlinien und die Edukation des Pflegepersonals dienen.
Das Pflegeinnovationszentrum – Erforschung und Bewertung innovativer Pflegetechnologien
Authors: Kowalski Christian , Cobus Vanessa , Weiß Sebastian , Hein Andreas
Published: October 2020

Dass die pflegerische Versorgung eine immer wichtigere Rolle in unserer Gesellschaft spielt, ist durch die Präsenz und Wichtigkeit des Themas den meisten in der Bevölkerung inzwischen bekannt. Aktuelle Prognosen zeigen, dass der Bedarf an Pflege zukünftig immer weiter steigt und die Versorgung nicht mithalten kann. Neben der eigentlichen Förderung des Pflegeberufsbildes kann auch an anderen Stellen angesetzt werden, nämlich in der Technologieentwicklung. Die Schnittstelle zwischen Technologie und Pflege im Spannungsfeld technikgestützter Innovationen und Anwendbarkeit stellt dabei die jeweiligen Akteure vor eine besondere Herausforderung. Hier versucht das Pflegeinnovationszentrum durch Forschung und Entwicklung zu unterstützen.
Conservative Treatment of Iatrogenic Ascending Aortic Hematoma Post-Rotablator Coronary Procedure
Authors: Doutriaux Maxime , Pariente Benjamin , Zahnan Jad , Marchand Xavier
Published: October 2020

Background Aortic intramural hematoma due to coronary artery dissection is a rare and serious complication during percutaneous coronary intervention.

Case Presentation A 78-year-old female patient was admitted for diagnostic coronarography in the context of stable angina. The coronarography showed an asymmetric and significate calcification in the ostium of the right coronary requiring Rotablator (Boston Scientific) procedure complicated by iatrogenic ascending aortic hematoma. After surgical advice, a conservative approach was decided with total hematoma resorption and recovery 1 week later.

Conclusion With stable patient, conservative treatment may be suitable after aortic hematoma due to coronary dissection.
Inpatient Biophysical Profiles and the Effect on Clinical Decision Making
Authors: Racusin Diana A. , Chauhan Suneet P. , Sibai Baha , Chen Han-Yang , Adimorah Nesochi , Piro Mica , Heye Kristen , Sharp Charlotte , WHNP-BC MSN , Blackwell Sean , Refuerzo Jerrie
Published: October 2020

Objective Our primary objective was to determine whether biophysical profiles (BPP) performed on the antepartum unit result in changes in clinical decision making.

Study Design A retrospective cohort chart review was performed among women who had a BPP during hospital admission. BPP status was categorized as normal (8/8 points) and abnormal (6/8 or less points). The primary outcome, clinical decision making, was the need for prolonged external fetal monitoring (defined as > 2 hours) or decision to proceed with delivery. Secondary outcomes included mode of delivery, indicated preterm delivery, birth weight, 5-minute Apgar's score <7, and neonatal intensive care unit (NICU) admission.

Results Among our cohort (n = 186), 85.5% (n = 159) had a normal BPP. Delivery management was altered in one case (0.54%) by the BPP findings, and there were no BPPs that resulted in need for prolonged monitoring. Compared with women with normal BPP, women with abnormal BPPs were more likely to deliver at <37 weeks, to be admitted to the NICU, or have a 5-minute Apgar's score <7.

Conclusion In-hospital BPPs alter clinical decision making in less than 1% of cases.
Management of COVID-19
Authors: John Mary
Published: October 2020

The SARS-CoV-2 (COVID-19) pneumonia was first seen in Wuhan province, China, in December 2019. Since then, there has been great efforts toward understanding the pathophysiology and management of this disease, which was declared as a pandemic in March 2020. Medications which were initially used have been removed and newer ones are under clinical evaluation. Oxygen therapy, anti-inflammatory and antiviral medication, along with awake proning are currently being used in the management of COVID-19.
Unraveling the photovoltaic properties of gallium nitride nanorods for solar water splitting
Authors: McConnon Aili
Published: October 2020

Researchers use surface photovoltage spectroscopy to measure junction properties in gallium nitride nanowire arrays
Engineering control circuits for molecular robots using synthetic biology
Authors: Wei Ting-Yen , Ruder Warren C.
Published: October 2020

The integration of molecular robots and synthetic biology allows for the creation of sophisticated behaviors at the molecular level. Similar to the synergy between bioelectronics and soft robotics, synthetic biology provides control circuitry for molecular robots. By encoding perception-action modules within synthetic circuits, molecular machines can advance beyond repeating tasks to the incorporation of complex behaviors. In particular, cell-free synthetic biology provides biomolecular circuitry independent of living cells. This research update reviews the current progress in using synthetic biology as perception-action control modules in robots from molecular robots to macroscale robots. Additionally, it highlights recent developments in molecular robotics and cell-free synthetic biology and suggests their combined use as a necessity for future molecular robot development.
Integrating feral cat (Felis catus) control into landscape-scale introduced predator management to improve conservation prospects for threatened fauna: a case study from the south coast of Western Australia
Authors: Comer S. , Clausen L. , Cowen S. , Pinder J. , Thomas A. , Burbidge A. H. , Tiller C. , Algar D. , Speldewinde P.
Published: October 2020

Abstract ContextFeral cat predation has had a significant impact on native Australian fauna in the past 200 years. In the early 2000s, population monitoring of the western ground parrot showed a dramatic decline from the pre-2000 range, with one of three meta-populations declining to very low levels and a second becoming locally extinct. We review 8 years of integrated introduced predator control, which trialled the incorporation of the feral cat bait Eradicat® into existing fox baiting programs. AimsTo test the efficacy of integrating feral cat control into an existing introduced predator control program in an adaptive management framework conducted in response to the decline of native species. The objective was to protect the remaining western ground parrot populations and other threatened fauna on the south coast of Western Australia. MethodsA landscape-scale feral cat and fox baiting program was delivered across south coast reserves that were occupied by western ground parrots in the early 2000s. Up to 500000ha of national parks and natures reserves were baited per annum. Monitoring was established to evaluate both the efficacy of landscape-scale baiting in management of feral cat populations, and the response of several native fauna species, including the western ground parrot, to an integrated introduced predator control program. Key resultsOn average, 28% of radio-collared feral cats died from Eradicat® baiting each year, over a 5-year period. The results varied from 0% to 62% between years. Changes in site occupancy by feral cats, as measured by detection on camera traps, was also variable, with significant declines detected after baiting in some years and sites. Trends in populations of native fauna, including the western ground parrot and chuditch, showed positive responses to integrated control of foxes and cats. ImplicationsLandscape-scale baiting of feral cats in ecosystems on the south coast of Western Australia had varying success when measured by direct knockdown of cats and site occupancy as determined by camera trapping; however, native species appeared to respond favourably to integrated predator control. For the protection of native species, we recommend ongoing baiting for both foxes and feral cats, complemented by post-bait trapping of feral cats. We advocate monitoring baiting efficacy in a well designed adaptive management framework to deliver long-term recovery of threatened species that have been impacted by cats.
Effect of Cd/As flux ratio and annealing process on the transport properties of Cd3As2 films grown by molecular beam epitaxy
Authors: Zhang Sheng Xi , Zhang Jian , Wu Yan , Kang Ting Ting , Li Ning , Qiu X F , Chen P P
Published: October 2020

To study how the Cd/As flux ratio affects the microstructure and transport properties for Cd3As2 films, we used molecular beam epitaxy (MBE) to grow Cd3As2 (224) thin films on CdTe (111)/GaAs (001) virtual substrates. The effects of Cd/As flux ratio, during the grown process, on the electrical properties and surface morphology of the sample was studied. The films grown at lower Cd/As flux ratio have higher electron mobility and longer effective dephasing length. With decreasing Cd/As flux ratio, the magnetoresistance (MR) of the film changes from negative to positive. These results show that a lower beam ratio is beneficial to improve the crystal quality. In order to optimize the electrical properties of the films, the effect of annealing on the electron mobility and MR have been studied. After annealing, the MR changes from negative to positive, the electron mobility increase by 8 times, and the MR increase from 15% to 360% at 9 T. These results indicate that annealing is an effective method to optimize the electrical properties of Cd3As2 epitaxial films.
Effect of pressure on the geometric, electronic structure, elastic, and optical properties of the normal spinel MgFe2O4: a first-principles study
Authors: Kora Hamada H , Taha Mohamed , Abdelwahab Abdalla , Farghali Ahmed A , El-dek S I
Published: October 2020

First-principles computation was used to study the effect of pressure on the elastic properties, magnetic properties, optical properties, and electronic structure of the normal spinel magnesium ferrite (MgFe2O4) at different pressures (0, 10, 20, 50, 70, and 100 GPa). The normal spinel MgFe2O4 has a direct bandgap of 1.62 eV which significantly decreased to 0.42 eV with increasing the pressure to 100 GPa. The values of the elastic constants were coherent with the mechanical stability norms for cubic crystals, which revealed that MgFe2O4 was mechanically stable. The values of Pugh’s ratio indicate that MgFe2O4 is ductile at all pressure values except at 100 Gpa MgFe2O4 shows brittle behavior. The computed values of the Zener anisotropy factor at different pressures were not equal to 1.0, which indicates that MgFe2O4 is elastically anisotropic. The optical properties (refractive index, reflectivity, dielectric function, optical conductivity, and loss function) for the normal spinel MgFe2O4, as well as its magnetic moment, were calculated and discussed at different pressures.
Understanding polyploid banana origins. A commentary on: ‘Unravelling the complex story of intergenomic recombination in ABB allotriploid bananas’
Authors: Tomaszewska Paulina
Published: October 2020

This article comments on:

Alberto Cenci, Julie Sardos, Yann Hueber, Guillaume Martin, Catherine Breton, Nicolas Roux, Rony Swennen, Sebastien Christian Carpentier and Mathieu Rouard, Unravelling the complex story of intergenomic recombination in ABB allotriploid bananas, Annals of Botany, Volume 127, Issue 1, 01 January 2021, Pages 7–20, https://doi.org/10.1093/aob/mcaa032
Chemical Composition and Antimicrobial Activity of Teucrium Capitatum L. Subsp. Lusitanicum (Schreb.) T. Navarro & Rosua Essential Oil
Authors: Debbabi Haïfa , El Mokni Ridha , Jlassi Ibrahim , Joshi Rajesh K , Hammami Saoussen
Published: October 2020

Chemical composition and antimicrobial activity of Teucrium capitatum L. subsp. lusitanicum essential oil was investigated for the first time in the present study. Qualitative and quantitative analyses of the chemical composition by gas chromatography and mass spectrometry (GC–FID and GC–MS) revealed the presence of 60 compounds representing 97.6% of the whole constituents. The main compounds were germacrene D (47.1%), spathulenol (5.8%), α-selinene (5.3%), germacrene A (2.9%), δ-cadinene (2.8%) and cubenol (2.7%). In vitro, the antimicrobial activity was investigated against five bacterial strains along with the yeast Candida albicans using broth microdilution assay. T. capitatum subsp. lusitanicum essential oil showed significant activity against the gram-positive bacteria Staphylococcus aureus (MIC = MBC = 78 μg mL−1), Bacillus subtilis (MIC = MBC = 156 μg mL−1) and the yeast C. albicans (MIC = MFC = 156 μg mL−1). The great potential of antimicrobial effects is most likely due to the very high percentage of sesquiterpene hydrocarbons particularly to germacrene D, for which the antimicrobial properties have been previously reported.
Availability and Prices of WHO Essential Diagnostics in Laboratories in West Africa: A Landscape Survey of Diagnostic Testing in Northern Ghana
Authors: Ward Caleb L , Guo Marissa Z , Amukele Timothy K , Abdul-Karim Abass , Schroeder Lee F
Published: October 2020

Background

We determined the availability and pricing of laboratory testing in the Northern Region of Ghana to identify current gaps with respect to the WHO's Essential Diagnostics List (EDL).

Methods

A representative sample of facilities offering diagnostic testing within the Northern Region was geographically mapped and evaluated, with random sampling stratified by population density. Data were collected on testing menus, volumes, turn-around times, and out-of-pocket test prices. A total of 27 health centers and 39 clinical laboratories were surveyed between June and August 2019.

Results

Health centers offered a median of 2 of 20 tests recommended by the WHO for facilities without laboratories. The most common tests offered included point-of-care tests for malaria, HIV, and pregnancy. Clinical laboratories offered a median of 11 of 72 tests on the EDL. These facilities most commonly provided testing for malaria, HIV, pregnancy, HBsAg, urinalysis, HCV Ab, syphilis, glucose, and CBC. Urban laboratories had a total of 36 EDL tests available while rural laboratories had 12. Test prices were higher in private compared to public laboratories. National Health Insurance reimbursements were lower than out-of-pocket prices (38%), and when controlling for test price, test availability was negatively associated with this gap in reimbursement.

Conclusions

Availability of diagnostic testing in Ghana’s Northern Region is severely limited compared to the WHO's EDL. The disparity is pronounced in rural facilities. Reimbursement rates should be reset to more closely match out-of-pocket test prices in order to achieve the Universal Health Coverage target of the Sustainable Development Goals.
Case study: diagnosis and operative management of de Garengeot hernia without appendectomy during the COVID-19 pandemic
Authors: Chagares Stephen A , Patel Tushar R , Fotopoulos Nicholas
Published: October 2020

de Garengeot herniae have been reported in <100 cases in literature. They are characterized by an incarcerated femoral hernia containing the appendix. We present the case of a 45-year-old female who, upon emergency intraoperative consultation to a general surgeon while having a right groin exploration by a plastic surgeon, was found to have an appendix incarcerated within a femoral hernia. There was no evidence of appendicitis; thus, appendix was reduced and the hernia was repaired with a mesh plug. The patient did well postoperatively, with no complications and returned to complete activities. This occurred during the coronavirus disease (COVID-19) pandemic. Due to the common failure in preoperative diagnosis, it is important for surgeons to have a clinical suspicion for de Garengeot herniae for patients, presenting with a right groin bulge. Appendectomy may be safely avoided, eliminating appendectomy-associated morbidity and avoiding hospital transfer and the associated risk of COVID-19 exposure.
Differential associations of hypoxia, sleep fragmentation, and depressive symptoms with cognitive dysfunction in obstructive sleep apnea
Authors: Alomri Ridwan M , Kennedy Gerard A , Wali Siraj Omar , Ahejaili Faris , Robinson Stephen R
Published: October 2020

Obstructive sleep apnea (OSA) is characterized by recurrent episodes of partial or complete cessation of breathing during sleep and increased effort to breathe. This study examined patients who underwent overnight polysomnographic studies in a major sleep laboratory in Saudi Arabia. The study aimed to determine the extent to which intermittent hypoxia, sleep disruption, and depressive symptoms are independently associated with cognitive impairments in OSA. In the sample of 90 participants, 14 had no OSA, 30 mild OSA, 23 moderate OSA, and 23 severe OSA. The findings revealed that hypoxia and sleep fragmentation are independently associated with impairments of sustained attention and reaction time (RT). Sleep fragmentation, but not hypoxia, was independently associated with impairments in visuospatial deficits. Depressive symptoms were independently associated with impairments in the domains of sustained attention, RT, visuospatial ability, and semantic and episodic autobiographical memories. Since the depressive symptoms are independent of hypoxia and sleep fragmentation, effective reversal of cognitive impairment in OSA may require treatment interventions that target each of these factors.
A systematic review of mHealth interventions for HIV prevention and treatment among gay, bisexual, and other men who have sex with men
Authors: Nelson Kimberly M , Perry Nicholas S , Horvath Keith J , Smith Laramie R
Published: October 2020

The use of mobile health (mHealth) technologies addressing HIV disparities among gay, bisexual, and other men who have sex with men (GBMSM) has increased. A systematic review of mHealth interventions for HIV prevention and treatment among GBMSM was conducted to summarize the current evidence and provide recommendations for future research. PRISMA guidelines were followed (PROSPERO ID: 148452). Studies identified via PubMed, PsychInfo, or Embase were included that (i) were in English, (ii) were published in a peer-reviewed journal prior to July 1, 2019, (iii) presented primary results, (iv) included only GBMSM, and (v) reported the results of an mHealth intervention (e.g., text message, phone/mobile application [app]) to improve HIV prevention or treatment outcomes. Of 1,636 identified abstracts, 16 published studies met inclusion criteria. Eleven studies were conducted in the United States. One study was a fully powered randomized controlled trial (RCT), seven were single-arm pilots with pre–post assessments, four were pilot RCTs, and four tested public health campaigns with post-assessments. Seven developed study-specific apps, five used text messaging, and four used existing social networking apps. Most (81%) targeted prevention outcomes. Nine cited a specific behavioral theory. All studies found that a mHealth approach was feasible and acceptable. All interventions provided evidence of preliminary efficacy or promising trends on primary outcomes. Although mHealth interventions for HIV prevention and treatment appear feasible and acceptable, most published studies are small pilot trials. Additional research assessing the efficacy and mechanisms of mHealth interventions is needed.
Harmful smartphone applications promoting alcohol and illicit substance use: a review and content analysis in the United States
Authors: Ghassemlou Shouron , Marini Christina , Chemi Chemi , Ranjit Yerina S , Tofighi Babak
Published: October 2020

Few studies have conducted analysis of commercially available smartphone applications designed to promote alcohol and illicit substance use. The aim of this review is to determine harmful themes of content in applications promoting alcohol and illicit substance use found using recovery app search terms. A systematic search, via Apple iTunes and Google Play stores, was conducted of applications targeting abstinence or reduced substance use in online app stores (n = 1,074 apps) in March 2018. We conducted a secondary analysis of apps encouraging alcohol and illicit substance use in July 2018. Our initial search yielded 904 apps pertaining to alcohol and illicit substance use. Four reviewers conducted a content analysis of 102 apps meeting inclusion criteria and assessed app design, delivery features, text, and multimedia content pertaining to substance use. The initial coding scheme was refined using a data-driven, iterative method grouping in thematic categories. The number of apps coded to a specific substance include: alcohol (n = 74), methamphetamine (n =13), cocaine (n = 15), heroin (n = 12), and marijuana (n = 15), with nine apps overlapping more than one substance. Key themes identified among apps included: (i) tangibility (alcohol home delivery services); (ii) social networks (builtin social media platforms promoting substance use); (iii) software design (gamification or simulation of substance use); and (iv) aesthetics (sexual or violent imagery). Despite claims of restricting apps promoting substance use, further efforts are needed by online app stores to reduce the availability of harmful content.
Incidence of Nongonococcal Urethritis in Men Who Have Sex With Women and Associated Risk Factors
Authors: Rowlinson Emily , Hughes James P. , Chambers Laura C. , Lowens M. Sylvan , Morgan Jennifer L. , Robinson Tashina S. , Romano Sarah S. , Leipertz Gina L. , Soge Olusegun O. , Golden Matthew R. , Manhart Lisa E.
Published: October 2020

Background

Incidence and risk factors for nongonococcal urethritis (NGU) remain poorly defined. We conducted a cohort study to estimate the incidence of NGU and identify risk factors in men who have sex with women.

Methods

We enrolled cisgender male sexually transmitted disease clinic attendees 16 years or older who reported exclusively female partners. At enrollment and 6 monthly follow-up visits, men underwent a clinical examination, provided urethral swab and urine specimens, completed a sexual behavior survey and biweekly diaries, and were tested for Chlamydia trachomatis (CT) and Mycoplasma genitalium (MG) using Aptima assays (Hologic, Inc). Nongonococcal urethritis was defined as ≥5 polymorphonuclear leukocytes per high-power field plus either urethral symptoms or visible discharge. We estimated the incidence of NGU overall, asymptomatic and symptomatic NGU, non-CT/non-MG NGU, and CT/MG-associated NGU using Poisson regression for clustered outcomes. We performed relative risk binomial regression for clustered data to identify characteristics associated with incident NGU.

Results

From August 2014 to July 2018, 307 participants at risk for NGU contributed 109.4 person-years. Median age was 32 years, and 52% were White. At enrollment, 107 men had NGU; of these, 88% were symptomatic, 27% had CT, and 22% had MG. Fifty men had 60 cases of incident NGU (incidence rate, 56 per 100 person-years; 95% confidence interval, 43–74). Unlike prevalent NGU at enrollment, CT/MG-associated incident NGU was rare (incidence rate, 7; 95% confidence interval [CI], 4–15), and most (78%) incident NGU was asymptomatic. Risk factors for incident NGU were ≤ high school education (adjusted rate ratio [ARR], 2.45; 95% CI, 1.19–5.00), history of CT (ARR, 2.15; 95% CI, 1.08–4.27), history of NGU (ARR, 2.67; 95% CI, 1.27–5.62), and NGU at enrollment (ARR, 2.03; 95% CI, 1.04–3.98). Neither condom use nor having a new partner was associated with incident NGU; Black race was only associated with incident symptomatic and non-CT/non-MG NGU.

Conclusions

Incidence of NGU was high, predominantly non-CT/non-MG and asymptomatic. Future studies should investigate the etiology and clinical significance of asymptomatic NGU.
Psychometric Evaluation of the Korean Version of Hospital Survey on Patient Safety Culture
Authors: Lee Seung Eun , Havaei Farinaz , Astivia Oscar Lorenzo Olvera , Shin Jeong Ae
Published: October 2020

Objectives

This study evaluated the psychometric properties of the Korean-language version of the Hospital Survey on Patient Safety Culture (HSOPSC) among Korean nurses.

Methods

We analyzed secondary data from 801 direct care nurses working at a tertiary, private, nonprofit, teaching hospital in South Korea. Descriptive statistics, internal consistency coefficients, and intercorrelations were calculated. The latent factor structure of the HSOPSC was examined using exploratory structural equation modeling techniques, which account for the noncontinuous nature of ordinal data.

Results

Although a majority of subscales showed acceptable to good internal consistency, 4 dimensions (staffing, overall perceptions of patient safety, organizational learning–continuous improvement, and nonpunitive response to errors) had reliability levels less than 0.6. The HSOPSC items loaded somewhat diffusely on 3 subscales: staffing, teamwork across units, and organizational learning–continuous improvement. Correlations between the 12 HSOPSC factors indicated discriminant validity. Convergent validity was supported by correlations between the 12 subscales and a single-item outcome variable, namely, patient safety grade. Several items did not load well on their respective subscales, but most items fit the underlying theoretical model implied by the HSOPSC, resulting in an acceptable model fit (confirmatory fit index = 0.985, root mean square error of approximation = 0.034, weighted root mean square residual = 0.54).

Conclusions

Despite the acceptable model fit of the Korean version of HSOPSC, the psychometric properties of this instrument require further investigation to ensure it is an effective tool to measure patient safety culture and identify areas for improvement in the Korean health care system.
Adenosine Deaminase Gene Polymorphism and Baseline Serum Level of Adenosine Deaminase as a Biomarker of Response to Methotrexate in Rheumatoid Arthritis
Authors: Gangadharan Harikrishnan , Singh Ankita , Majumder Sanjukta , Aggarwal Amita
Published: October 2020

Background

Methotrexate (MTX) is the first-line therapy for rheumatoid arthritis (RA), but nearly 30% of RA patients do not respond to it. Methotrexate acts by enhancing the level of adenosine, which gets converted to inosine by the enzyme adenosine deaminase (ADA). We studied whether ADA gene polymorphism and serum levels of total ADA are associated with responsiveness to MTX.

Methods

Two hundred seven disease-modifying antirheumatic drug–naive active RA patients (DAS28-ESR [Disease Activity Score–28 for rheumatoid arthritis with erythrocyte sedimentation rate] ≥3.2) satisfying the European League Against Rheumatism (EULAR)/American College of Rheumatology 2010 criteria were enrolled. Genotyping was done in all patients, and in a subset (n = 59), blood was collected at baseline and at 2 months of MTX treatment for serum total ADA estimation by ELISA. Response at 4 months was assessed by EULAR criteria, and patients were classified as responders or nonresponders. The correlation of baseline clinical parameters, ADA gene polymorphism, and serum total ADA levels with EULAR response was sought.

Results

After 4 months of MTX monotherapy, 172 patients (83.1%) were classified as responders and 35 (16.9%) as nonresponders. Except DAS28-ESR (6.1 [5.43–6.84] in responders vs 5.6 [4.77–6.21] in nonresponders, p = 0.02), other baseline parameters (age, disease duration, ESR, and C-reactive protein level) were similar between responders and nonresponders. Single nucleotide polymorphisms in ADA gene, baseline serum ADA levels (10.52 ± 5.37 ng/mL in responders vs 12.28 ± 5.14 ng/mL in nonresponders), or change in ADA levels after 2 months of MTX therapy did not show any association with MTX response (p = 0.73, p = 0.34, p = 0.55, respectively). Adenosine deaminase genotype did not affect the blood ADA level.

Conclusions

No association was seen between ADA single nucleotide polymorphism rs244076 as well as serum ADA level and response to MTX therapy.
Pretreatment and Coadministration With Methotrexate Improved Durability of Pegloticase Response
Authors: Botson John K. , Peterson Jeff
Published: October 2020

Background/Objective

Pegloticase is used for treatment of refractory gout, which has failed maximal medical management, but only 42% of patients respond completely to treatment because of the presumed development of antidrug antibodies, which rapidly clear the pegloticase molecule. Immunomodulatory medications temper antidrug antibody development in other diseases. The aim of this case series was to investigate the utility of adding methotrexate to a pegloticase regimen to increase the response durability in a real-world practice setting.

Methods

In this multicenter, proof-of-concept, observational case series, refractory tophaceous gouty arthropathy patients being started on pegloticase 8 mg every 2 weeks were identified. The patients began oral methotrexate 15 mg/wk and folic acid 1 mg/d, 1 month prior to the initial pegloticase administration, and continued throughout pegloticase treatment. Responders were defined by demonstrating ≥80% of preinfusion serum uric acid (sUA) levels <6.0 mg/dL between months 3 and 6.

Results

Ten sequential patients, aged 35 to 80 years, identified between May 2017 and June 2018, from 3 separate infusion centers were followed for up to 10 months. All patients maintained methotrexate 15 mg/wk without dose adjustments. There were 143 total pegloticase infusions. All 10 patients completed a full course of pegloticase treatment with 100% response and no infusion reactions. No patients stopped pegloticase therapy because of increased sUA, loss of response, or gout flares.

Conclusions

Pretreatment and coadministration of methotrexate with pegloticase resulted in 100% maintenance of pegloticase sUA response with no infusion reactions. These data support the potential use of immunomodulation with methotrexate to improve durability of pegloticase response in the treatment of refractory gout.
MiR-34a regulates Schwann cell proliferation and migration by targeting CNTN2
Authors: Zou Dexin , Zhou Xiaobin , Liu Jianqing , Zhao Yong , Jiang Xiaobing
Published: October 2020

The proliferation and migration of Schwann cells contribute to axonal outgrowth and functional recovery after peripheral nerve injury. Previously, several microRNAs were abnormally expressed after peripheral nerve injury and they played important roles in peripheral nerve regeneration. However, the role and underlying mechanism of miR-34a in peripheral nerve injury remain largely unknown. The levels of miR-34a and contactin-2 (CNTN2) were detected by quantitative real-time PCR. 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyl-tetrazolium bromide and transwell assays were used to examine cell proliferation and migration, respectively. The protein level of CNTN2 was measured by western blot. The binding sites of miR-34a and CNTN2 were predicted by the online software and confirmed by dual-luciferase reporter assay and RNA immunoprecipitation (RIP) assay. Following sciatic nerve injury, the expression of miR-34a was downregulated in the crushed nerve segment, reaching a minimum at the seventh day. Knockdown of miR-34a enhanced the axon outgrowth of dorsal root ganglion neurons. Moreover, miR-34a overexpression evidently inhibited the proliferation of Schwann cells, whereas its knockdown showed the opposite effects. In addition, CNTN2 was a direct target of miR-34a and its expression was negatively regulated by miR-34a in the crushed nerve segment. Besides, CNTN2 overexpression or knockdown could reverse the effects of miR-34a upregulation or downregulation on proliferation and migration of Schwann cells, respectively. Collectively, miR-34a inhibited the proliferation and migration of Schwann cells via targeting CNTN2, which might provide a new approach to peripheral nerve regeneration.
A bacterial inflammation sensor regulates c-di-GMP signaling, adhesion, and biofilm formation
Authors: Perkins Arden , Tudorica Dan A. , Teixeira Raphael D. , Schirmer Tilman , Zumwalt Lindsay , Ogba O. Maduka , Cassidy C. Keith , Stansfeld Phillip J. , Guillemin Karen
Published: October 2020

The reactive oxygen species produced during inflammation through the neutrophilic respiratory burst play profound roles in combating bacterial pathogens and regulating the microbiota. Among these, the neutrophilic oxidant bleach, hypochlorous acid (HOCl), is the most prevalent and strongest oxidizer and kills bacteria through non-specific oxidation of proteins, lipids, and DNA. Thus, HOCl can be viewed as a host-specific cue that conveys important information about what bacterial physiology and lifestyle programs may be required for successful colonization. Nevertheless, bacteria that colonize animals face a molecular challenge in how to achieve highly selective detection of HOCl due to its reactive and transient nature and chemical similarity to more benign and non-host-specific oxidants like hydrogen peroxide (H2O2). Here, we report that in response to increasing HOCl levels E. coli regulates biofilm production via activation of the diguanylate cyclase DgcZ. We show the molecular mechanism of this activation to be specific oxidation of a conserved cysteine that coordinates the zinc of its regulatory chemoreceptor zinc-binding (CZB) domain, forming a zinc-cysteine redox switch 685-fold more sensitive to oxidation by HOCl over H2O2. Dissection of the signal transduction mechanism through quantum mechanics, molecular dynamics, and biochemical analyses reveal how the cysteine redox state alters the delicate equilibrium of competition for Zn++ between the CZB domain and other zinc binders to relay the presence of HOCl through activating the associated GGDEF domain to catalyze c-di-GMP. We find biofilm formation and HOCl-sensing in vivo to be regulated by the conserved cysteine, and point mutants that mimic oxidized CZB states increase production of the biofilm matrix polymer poly-N-acetylglucosamine and total biofilm. We observe CZB-regulated diguanylate cyclases and chemoreceptors in phyla in which host-associated bacteria are prevalent and are possessed by pathogens that manipulate host inflammation as part of their colonization strategy. A phylogenetic survey of all known CZB sequences shows these domains to be conserved and widespread across diverse phyla, suggesting CZB origin predates the bacterial last universal common ancestor. The ability of bacteria to use CZB protein domains to perceive and thwart the host neutrophilic respiratory burst has implications for understanding the mechanisms of diseases of chronic inflammation and gut dysbiosis.
A novel probabilistic hesitant fuzzy portfolio selection model with value-at-risk and safety level of score
Authors: Deng Xue , Li Weimin
Published: October 2020

Purpose

This paper aims to propose two portfolio selection models with hesitant value-at-risk (HVaR) – HVaR fuzzy portfolio selection model (HVaR-FPSM) and HVaR-score fuzzy portfolio selection model (HVaR-S-FPSM) – to help investors solve the problem that how bad a portfolio can be under probabilistic hesitant fuzzy environment.

Design/methodology/approach

It is strictly proved that the higher the probability threshold, the higher the HVaR in HVaR-S-FPSM. Numerical examples and a case study are used to illustrate the steps of building the proposed models and the importance of the HVaR and score constraint. In case study, the authors conduct a sensitivity analysis and compare the proposed models with decision-making models and hesitant fuzzy portfolio models.

Findings

The score constraint can make sure that the portfolio selected is profitable, but will not cause the HVaR to decrease dramatically. The investment proportions of stocks are mainly affected by their HVaRs, which is consistent with the fact that the stock having good performance is usually desirable in portfolio selection. The HVaR-S-FPSM can find portfolios with higher HVaR than each single stock and has little sacrifice of extreme returns.

Originality/value

This paper fulfills a need to construct portfolio selection models with HVaR under probabilistic hesitant fuzzy environment. As a downside risk, the HVaR is more consistent with investors’ intuitions about risks. Moreover, the score constraint makes sure that undesirable portfolios will not be selected.
An integrated vision-based system for efficient robot arm teleoperation
Authors: Wu Xin , Yang Canjun , Zhu Yuanchao , Wu Weitao , Wei Qianxiao
Published: October 2020

Purpose

This paper aims to present a natural human–robot teleoperation system, which capitalizes on the latest advancements of monocular human pose estimation to simplify scenario requirements on heterogeneous robot arm teleoperation.

Design/methodology/approach

Several optimizations in the joint extraction process are carried on to better balance the performance of the pose estimation network. To bridge the gap between human joint pose in Cartesian space and heterogeneous robot joint angle pose in Radian space, a routinized mapping procedure is proposed.

Findings

The effectiveness of the developed methods on joint extraction is verified via qualitative and quantitative experiments. The teleoperation experiments on different robots validate the feasibility of the system controlling.

Originality/value

The proposed system provides an intuitive and efficient human–robot teleoperation method with low-cost devices. It also enhances the controllability and flexibility of robot arms by releasing human operator from motion constraints, paving a new way for effective robot teleoperation.
The effect and associated mechanism of action of phosphodiesterase 4 (PDE4) inhibitor on CD4+ lymphocyte proliferation
Authors: Kim Shin Young , An Tai Joon , Rhee Chin Kook , Park Chan Kwon , Kim Ji Hye , Yoon HyoungKyu
Published: October 2020

PDE4 inhibitors are involved in anti‐inflammatory and immunomodulatory responses. Recently, they have been getting attention as a new class of drugs treating inflammatory airway diseases. The T lymphocyte is a major cell type present in the inflammatory infiltrate in the airway wall in patients with chronic obstructive pulmonary disease (COPD), and a previous study found that treatment with a PDE4 inhibitor significantly suppressed T cell proliferation. However, the mechanism of action of PDE4 inhibitors has not been elucidated. The present study aimed to investigate major signal transduction pathways of T lymphocyte and identify the phase, during which PDE4 inhibitors affect T cell proliferation. Isolated splenic CD4+ T cells were grown under stimulation with an anti‐CD3/CD28 antibody, and/or treated with roflumilast‐n‐oxide (RNO). A western blot assay was performed using major antibodies including anti‐p‐38, anti‐p‐PI3K, anti‐p‐JNK, anti‐p‐ERK 1/2, anti‐NFAT1 (NFATc2), and anti‐NF‐kB antibodies. Additional experiments conducted on the pathway showed significant change following RNO treatment, thus providing further evidence for signal transduction pathway concerning PDE4 inhibitors. T cell proliferation was suppressed by RNO treatment. In the pathways involved in T cell proliferation, only expression of anti‐NFAT1 antibody was suppressed by RNO treatment. In additional experiments on the NFAT pathway, the very first phase (TCR signalling) remained unchanged on treatment with RNO, but RNO treatment increased IP3R expression and suppressed calcineurin activity. Calcineurin activity, reduced by RNO, increased on treatment with an IP3 receptor agonist. PED4 inhibitor, roflumilast is speculated to suppress T cell proliferation by interfering with IP3‐IP3R binding to inhibit calcium emission, blocking pathway activation from this phase onward, eventually decreasing the level of a growth factor for T cell proliferation, IL‐2.
Teaching systemic concepts through reality television
Authors: Gambrel Laura Eubanks , Sude Michael E. , Burge Abigail , Bandemer Sydney
Published: October 2020

Learning specific systems theory concepts can be challenging for marriage and family therapy students and trainees due to the abstract nature of these concepts. Experiential teaching strategies, such as using reality television programmes in the classroom, can help students to learn and apply these concepts. Because of the familiarity many students have with reality television, this medium can lessen the barriers to engagement that can arise from other forms of media. In this article, we discuss how to incorporate reality television shows into the classroom as one way to increase engagement and learning of systemic concepts, specifically those related to structural family therapy. We discuss a way to teach systems theory based on reality television either through an in‐class activity or assessment of learning. We also consider the ethical concerns about using such media in family therapy training. We conclude with tips for facilitators and student feedback.

Practitioner points

Systemic concepts can be abstract and difficult for MFT trainees to understand

Experiential learning can provide opportunities for deeper learning through application

Integrating reality television into MFT training can be an accessible and enjoyable way for trainees to deepen their learning of systems concepts

Using reality television in teaching, both to demonstrate concepts and assess learning, can improve students’ understanding and application of systems concepts
The Culture of Fasting in Early Stuart Parliaments*
Authors: Mears Natalie
Published: October 2020

The fasts, proposed and observed by parliament in the first half of the 17th century, have always been defined as opportunities for propaganda. This article focuses, instead, on their cultural and religious meanings: why MPs believed that the act of fasting itself was important and what they hoped it would achieve. It argues that fasts were proposed for two reasons: to forge unity between parliament and the king at a time of growing division, with the aim of making parliamentary sessions more productive and successful, and to provide more direct resolution to the nation's problems by invoking divine intervention. Fast motions commanded widespread support across parliament because they were rooted in the dominant theory of causation – divine providence – and reflected the gradual conventionalisation of fasting in the late 16th and early 17th centuries. However, this consensus seemed to wane in the early 1640s as divisions between Charles I and some of his most vocal MPs widened, while the fast day observed on 17 November 1640 was used by some MPs to express their opposition to Charles's religious policy, especially regarding the siting of the communion table/altar and the position from where the service was to be read. The article concludes by reflecting on how a study of parliamentary fasting can contribute to wider debates on commensality and abstinence.
Long‐term morbidity in major affective and schizoaffective disorders following hospitalization in first psychotic episodes
Authors: Salvatore Paola , Khalsa Harimandir K. , Tohen Mauricio , Baldessarini Ross J.
Published: October 2020

Objective

To evaluate morbidity during long‐term follow‐up with clinical treatment of affective and schizoaffective disorder subjects followed from hospitalization for first major psychotic episodes.

Methods

We followed adult subjects systematically at regular intervals from hospitalization for first‐lifetime episodes of major affective and schizoaffective disorders with initial psychotic features. We compiled % of days with morbidity types from detailed records and life charts, reviewed earliest antecedent morbidities, compared both with final diagnoses and initial presenting illness types, and evaluated morbidity risk factors with regression modeling.

Findings

With final diagnoses of bipolar‐I (BD‐I, n = 216), schizoaffective (SzAffD, 71), and major depressive (MDD, 42) disorders, 329 subjects were followed for 4.47 [CI: 4.20–4.47] years. Initial episodes were mania (41.6%), mixed states (24.3%), depression (19.5%), or apparent nonaffective psychosis (14.6%). Antecedent morbidity presented 12.7 years before first episodes (ages: SzAffD ≤ BD‐I < MDD). Long‐term % of days ill ranked SzAffD (83.0%), MDD (57.8%), BD‐I (45.0%). Morbidity differed by diagnosis and first‐episode types, and was predicted by first episodes and suggested by antecedent illnesses. Long‐term wellness was greater with BD‐I diagnosis, first episode not mixed or psychotic nonaffective, rapid onset, and being older at first antecedents, but not follow‐up duration.

Conclusions

Initially, psychotic BD‐I, SzAffD, or MDD subjects followed for 4.47 years from first hospitalization experienced much illness, especially depressive or dysthymic, despite ongoing clinical treatment. Antecedent symptoms arose years before index first episodes; antecedents and first episode types predicted types and amounts of long‐term morbidity, which ranked: SzAffD > MDD > BD‐I.
Histo‐morphology of the thyroid gland during the larval development of Pleurodema borellii (Anura, Leptodactylidae)
Authors: Cruz Julio César
Published: October 2020

The thyroid gland is essential in anurans, since thyroid hormones (TH) are the main regulators of larval development. Its absence or inactivity interrupts development and precludes metamorphosis. Histological changes are important diagnostic criteria for evaluating thyroid gland activity. However, there is a large larval diversity where the development of the thyroid gland development has not been studied. Pleurodema borellii is an anuran from northwest of Argentina with typical omnivorous pond tadpoles that can be easily raised in captivity. This study explores the histo‐morphological changes of the thyroid gland architecture during larval development. Histological parameters indicate peak glandular activity in parallel with the intensity of the metamorphic transformations. These parameters regress towards the end of metamorphosis, indicating low TH release. P. borellii's thyroid gland does not appear to have relevant activity in post‐metamorphic juvenile stages. This study is a first step towards understanding endocrine regulation during the development of Pleurodema borellii, and a reference to future studies in this species involving thyroid‐dependent processes.
The ethics of grandfather clauses in healthcare resource allocation
Authors: Wester Gry , Gibson Rand Leah Zoe , Lu Christine , Sheehan Mark
Published: October 2020

A grandfather clause is a provision whereby an old rule continues to apply to some existing situation while a new rule applies to all future cases. This paper focuses on the use of grandfather clauses in health technology appraisals (HTAs) issued by the National Institute for Health and Care Excellence (NICE) in the United Kingdom. NICE provides evidence‐based guidance on healthcare technologies and public health interventions that influence resource allocation decisions in the National Health Service (NHS) and the broader public sector in England and Wales. In this context, a grandfather clause is included when NICE does not recommend treatment with a given technology. The grandfather clause provides an exemption from the general recommendation for patients who have already started treatment with the technology in question, before the publication of the NICE guidance. In this paper we first lay out the contexts in which grandfather clauses occur in NICE guidance, and then consider ethical arguments against and in support of grandfather clauses and the continuation of treatment. We argue that NICE’s current practice of automatic inclusion of a grandfather clause is ethically problematic and unfair. While the inclusion of a grandfather clause may be appropriate and justified in specific cases, we argue that inclusion of such a clause should be considered as part and parcel of the decision making process on a case by case basis, rather than adopted as the default.