bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Effects of Insulin on Cardiac Function in Patients with Diabetes Mellitus: Clinical Applicability and Feasibility
Authors: Daoud Naccache Deeb , Yalonetsky Sergey , Bar-Yoseph Ronen
Published: March 2020

Background. Insulin promotes glucose consumption as the main cardiac energy source, while increasing myocardial efficiency. The short-term effects of insulin on cardiac function and its potential curative role in an acute diabetological cardiology setting remain unknown. Our study evaluated the role of acute insulin administration in the diabetic heart, its corresponding effective blood insulin level, and the time-course applicability of insulin treatment in a routine clinical setting.Methods. We evaluated a case series of six male (48.1 ± 4.9 y/o) patients with controlled diabetes (HbA1c of 6.6 ± 0.3%) and disease duration of 14.4 ± 6.7 yr. Each subject was evaluated for glucose homeostasis, as well as hemodynamic andechocardiographic (systolic and diastolic) parametersatthree points: baseline followed bytwo successive insulin loads in euglycemic hyperinsulinemic clamp study. Results were analysed using Student’st-test.Results. The first insulin load led to a physiologic blood insulin level of 145 ± 36 μU/ml, and both systolic (7 mmHg) blood pressure and diastolic (4 mmHg) blood pressure decreased significantly. Left ventricular fractional shortening (LVFS) increased significantly by 11.8%. Diastolic function parameters of mitral annulus movement of the A′ wave increased relative to baseline by 20.0% (27.8% under the second insulin load), A′ medial increased relative to baseline by 30%, and A′ lateral increased relative to baseline by 17%, displayed by tissue Doppler imaging.Conclusions. Insulin acutely affected the diabetic heart at a physiologic level within a 2 h time course. Insulin mainly increased left ventricular systolic function and, to a second degree, improved left ventricular diastolic functions and atrial systole in diabetic subjects. These results may facilitate the development of insulin-based acute treatment in diabetic patients with cardiac morbidity. This trial is registered withNCT02962921.
Successful Management of a Huge Pulmonary Hydatid Cyst with Lung-Preserving Surgery
Authors: Amirian Armin , Ziaian Bizhan , Erfani Amirhossein , Shahriarirad Reza , Ranjbar Keivan
Published: March 2020

The lung is the second most commonly involved organ in humans by hydatid disease. Management of large pulmonary hydatid cysts is a great challenge for thoracic surgeons. Lung resections should be considered the last choice for huge pulmonary hydatid cysts when the lung expansion is not optimal after cyst removal. Here, we present a case of huge lung hydatid cyst involving the entire right lower lobe which was successfully managed by lung-preserving surgery in which the postoperative course showed gradual resolution of the involved lobe during a one-year follow-up.
PARLAMENTER VE CUMHURBAŞKANLIĞI HÜKÜMET SİSTEMLERİNDEN HAREKETLE BAKAN VE BAKANLIKLARIN KARŞILAŞTIRMALI ANALİZİ
Authors: NACAK Osman
Published: March 2020

Ülkelerin hükümet sistemleriyle kamu yönetimlerinin yapısı ve işleyişi arasında yakın ilişki bulunmaktadır. Bu sebeple bir ülkenin hükümet sisteminde meydana gelen değişim, doğal olarak o ülkenin kamu yönetiminin yapısında ve işleyişinde önemli değişikliklere yol açmaktadır. Türkiye’de 1961 Anayasasından itibaren uygulanan parlamenter hükümet sistemi yerini, 16 Nisan 2017 tarihinde gerçekleştirilen anayasa değişikliği referandumuyla Cumhurbaşkanlığı hükümet sistemine bırakmıştır. Yeni hükümet sistemi, 24 Haziran 2018 tarihinde gerçekleştirilen seçimler sonrasında yürürlüğe girmiş ve Türk Kamu Yönetiminin yapısında ve işleyişinde oldukça önemli değişimlere neden olmuştur. Yaşanan bu değişikliklerden önemli ölçüde etkilenenlerin başında da bakanlar ile bakanlıklar gelmektedir.
Çalışmanın konusu; bakanların statüsü ile bakanlıkların yapısı ve işleyişinde gerçekleşen değişimdir. Çalışmanın amacı; Türkiye’de gerçekleşen hükümet sistemi değişikliğinin bakanların statüsü ile bakanlıkların yapı ve işleyişinde meydana getirdiği değişiklikleri parlamenter ve Cumhurbaşkanlığı hükümet sistemlerinden hareketle karşılaştırmalı bir biçimde analiz etmektir. Çalışmada nitel araştırma, literatür taraması ve içerik analizi yöntemleri kullanılmaktadır.
Age and diabetes mellitus associated with worse outcomes after percutaneous coronary intervention in a multi-ethnic Asian dialysis patient population
Authors: Fam JM , Khoo CY , Lau YH , Lye WK , Cai XJ , Choong LHL , Allen JC , Yeo KK
Published: March 2020

INTRODUCTION There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society. METHODS A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocardial infarction (AMI) and stroke at two years. RESULTS 274 patients (65.0% male, median age 62.0 years) with 336 lesions (81.8% Type B2) were treated. 431 stents (35.0% drug-eluting stents) with a mean diameter of 2.96 mm and mean length of 21.30 mm were implanted. The MACE rate was 55.8% (n = 153) at two years, from death (36.5%) and AMI (35.0%). In multivariable analysis, age and diabetes mellitus were significant predictors of both mortality (odds ratio [OR] 1.09, 95% confidence interval [CI] 1.05–1.12, p < 0.001; OR 2.65, 95% CI 1.46–4.82, p = 0.001, respectively) and MACE (OR 1.06, 95% CI 1.03–1.08, p < 0.001; OR 1.84, 95% CI 1.07–3.15, p = 0.027, respectively). Left ventricular ejection fraction (LVEF) (OR 0.97, 95% CI 0.95–0.99, p = 0.006) was a significant predictor of mortality but not MACE. CONCLUSION Asian dialysis patients who underwent PCI had a two-year MACE rate of 55.8% due to death and AMI. Age, LVEF and diabetes mellitus were significant predictors of mortality at two years.
Smear-positive pulmonary tuberculosis patients with previously abnormal chest radiographs: missed opportunities for early diagnosis
Authors: Galamay LC , Chee CBE , Khin Mar KW , Lau BQ , Wang YT
Published: March 2020

INTRODUCTION It is vital to diagnose and treat pulmonary tuberculosis (PTB) early, in the interests of the patient and public health. At the Singapore Tuberculosis Control Unit (TBCU), it was not uncommon to discover abnormal chest radiographs (CXRs) predating their PTB diagnosis by months to years in the electronic medical records (EMRs) of sputum acid-fast bacilli smear-positive patients. Our study explored this observation. METHODS The EMRs of sputum smear-positive PTB patients treated at the TBCU from January to July 2014 were viewed for abnormal CXRs preceding their PTB diagnosis. Information in the EMRs pertaining to the indication for the CXRs, radiological reports (including whether the possibility of PTB was stated) and action taken was captured. RESULTS Of the 254 sputum smear-positive patients, 108 had previous CXRs in their EMRs, of whom 39 (36.1%) had previous CXRs compatible with PTB. Most of these were performed in tertiary institutions and for reasons unrelated to PTB. No action was taken in response to these CXRs in 24 (61.5%) patients. 27 (69.2%) patients had abnormal CXRs dating back more than six months, with 12 (30.8%) dating back more than 30 months before the PTB diagnosis. Patients aged ≥ 55 years were significantly more likely to have previous CXRs that were compatible with PTB. CONCLUSION PTB patients may be asymptomatic or have chronic indolent disease and remain undiagnosed for years. There is a need for vigilance within our healthcare system to seize opportunities for early diagnosis and treatment to prevent the spread of this infectious disease in Singapore.
Engaging in an Accurate Assessment of Pluralism in William James
Authors: Edward Hackett J.
Published: March 2020

In this essay, I will respond to the several charges laid at my feet by Robert Talisse and Scott Aikin engaged in their response entitled “Pragmatism and ‘Existential’ Pluralism: A Response to Hackett” (2018) about my article that also appeared in Contemporary Pragmatism entitled “Why James Can Be an Existential Pluralist” (2017). At the heart of my response lies a concern with what I call the principle of hermeneutic charity and the final view James offers us of his entire philosophy. One can recognize the need for historical accuracy and the need to investigate first-order claims that come from historically accurate interpretations.
Perakanthus longipetalus (Rubiaceae), a new combination, and the first record of the genus outside Peninsular Malaysia

Authors: NEO LOUISE , MAHYUNI RIDHA , WONG K.M.
Published: March 2020

Canthium longipetalum Y.H.Tan & S.S.Zhou in Yang et al. (2019: 197) is a species of Rubiaceae recently described from northern Myanmar. This species was identified as belonging to the Vanguerieae tribe, and was placed provisionally in the genus Canthium Lamarck (1783: 602) based on morphological characters including the presence of axillary inflorescences, valvate corolla aestivation, two-locular ovaries, and a two-lobed stigma (Yang et al. 2019). However, the suite of characters cited by the authors to support the placement of their species in Canthium define an overly broad and now-superseded concept of the genus.
Evaluation of Global Water Resources Reanalysis Products in the Upper Blue Nile River Basin
Authors: Koukoula Marika , Nikolopoulos Efthymios I. , Dokou Zoi , Anagnostou Emmanouil N.
Published: March 2020

Water resources reanalysis (WRR) can be used as a numerical tool to advance our understanding of hydrological processes where in situ observations are limited. However, WRR products are associated with uncertainty that needs to be quantified to improve usability of such products in water resources applications. In this study, we evaluate estimates of water cycle components from 18 state-of-the-art WRR datasets derived from different land surface/hydrological models, meteorological forcing, and precipitation datasets. The evaluation was conducted at three spatial scales in the upper Blue Nile basin in Ethiopia. Precipitation, streamflow, evapotranspiration (ET), and terrestrial water storage (TWS) were evaluated against in situ daily precipitation and streamflow measurements, remote sensing–derived ET, and the NASA Gravity Recovery and Climate Experiment (GRACE) product, respectively. Our results highlight the current strengths and limitations of the available WRR datasets in analyzing the hydrological cycle and dynamics of the study basins, showing an overall underestimation of ET and TWS and overestimation of streamflow. While calibration improves streamflow simulation, it results in a relatively poorer performance in terms of ET. In addition, we show that the differences in the schemes used in the various land surface models resulted in significant differences in the estimation of the water cycle components from the respective WRR products, while we noted small differences among the products related to precipitation forcing. We did not identify a single product that consistently outperformed others; however, we found that there are specific WRR products that provided accurate representation of a single component of the water cycle (e.g., only runoff) in the area.
Taking a Systematic Approach to Resident Wellness: A Pilot Study
Authors: Kashat Lawrence , Falcone Todd , Carter Bridgette , Parham Kourosh , Kavanagh Katherine R.
Published: March 2020

Resident wellness is increasingly recognized as critically important in otolaryngology education, and well‐being education is now a requirement for all residencies. The objectives of this pilot study are to (1) perform a needs assessment to determine the wellness topics most important to the residents, (2) determine systemic barriers to wellness through a structured focus group, and (3) describe a new method to approach resident well‐being. An anonymous survey needs assessment, adapted from a published wellness curriculum, was administered to otolaryngology residents. Residents underwent a structured, anonymous focus group applying Maslow’s hierarchy of needs. The focus group highlighted resident priorities and defined an action plan for the program. This method allows for an individual and systems approach to resident wellness. Involving residents may increase engagement, and this approach can identify barriers to wellness and provide the groundwork for a formal resident wellness curriculum.
Genetic Exceptionalism and Precision Health Promotion
Authors: Terry Paul E.
Published: March 2020

Are social determinants of health overrated? Is parenting overrated? Will the genetics revolution have the same influence on health behavior as powerful determinants such as culture or the environment? In this editorial, I posit that we will learn that genetic testing will have far greater benefits, and fewer harms, when done in conjunction with well-designed health education and lived experiences. I define precision health promotion as the personalized design of lived experiences that foster improved health and well-being for individuals within the context of their organizations, families, and communities. With the need for education and support to augment genetics information will come the need for unequivocal answers about who should know, and who has no business knowing, about your DNA test results.
Testing pragmatic genealogy in political theory: The curious case of John Rawls
Authors: Testini Francesco
Published: March 2020

Starting from the ‘Dewey Lectures’, Rawls presents his conception of justice within a contextualist framework, as an elaboration of the basic ideas embedded in the political culture of liberal-democratic societies. But how are these basic ideas to be justified? In this article, I reconstruct and criticize Rawls’s strategy to answer this question. I explore an alternative strategy, consisting of a genealogical argument of a pragmatic kind – the kind of argument provided by authors like Bernard Williams, Edward Craig and Miranda Fricker. I outline this genealogical argument drawing on Rawls’s reconstruction of the origins of liberalism. Then, I clarify the conditions under which this kind of argument maintains vindicatory power. I claim that the argument satisfies these conditions and that pragmatic genealogy can thus partially vindicate the basic ideas of liberal-democratic societies.
Assessment of Functional Recovery and Subjective Donor-Site Morbidity Following Radial Forearm Flap Reconstruction in Small- to Moderate-Sized Palatal Defects
Authors: Chandrappa Ashok B. , Batth Ritu S. , Vasudevan Srikanth , Yellambalase Anantheswar N. R. , Kumar Pradeep N. , Reddy Sudarshan , Seles J. Nidya
Published: March 2020

Context:

Palatal defects are encountered following tumor extirpation, trauma, or congenitally. Among the known alternatives, radial artery free forearm flap (RAFF) is a versatile flap that confers good results in head and neck reconstruction, but donor-site morbidity has been an issue of discontent among the plastic surgeons. This limitation needs to be studied further and addressed considering the unmatched quality of this tissue.

Aims:

This study aims to weigh the impact of the functional edge of this flap against the unpopular donor-site morbidity on a group of patients.

Settings and Design:

This is a retrospective analysis of recuperation of palatal function and patient concerns with the donor-site function and cosmesis on 7 consecutive patients with small-to-moderate palatal defects reconstructed with RAFF.

Methods and Materials:

Postoperative recovery of speech, palatal movement, and restoration of oromaxillary interface was assessed using objective tests, such as speech intelligibility testing and articulation studies. Simultaneously, subjective donor-site function and cosmesis were assessed using Patient Scar Assessment Scale (PSAS), Upper Extremity Functional Index (UEFI), and donor limb sensory testing.

Results and Conclusion:

Mean PSAS score was 8.28/60, and UEFI score reported was 77/80, which reflect high patient satisfaction with the donor site. Nasoendoscopy shows remarkable restoration of palate anatomy. Intelligibility testing depicts near-normal speech understandability, whereas articulation studies revealed distortions post-palatal reconstruction with RAFF. Radial artery free forearm flap should be considered as the forerunner of reconstruction in palatal defects involving less than 50%.
New perspective on the risk markers for left atrial thrombosis in patients with atrial fibrillation
Authors: Zhang Xuan , Hu Mengjie , Wang Xiying , Zhang Chi , Chen Wanwan , Chen Songzan , Zhou Jintao , Chen Yuxiao , Lou Lian , Chen Guoping , Dong Fanghong , Hu Shenjiang , Zheng Liangrong , Yang Jian
Published: March 2020

Background

Anticoagulant therapy is one of the important aspects of atrial fibrillation (AF) management, which can effectively reduce the formation of left atrial thrombosis (LAT) and the occurrence of embolic events. The CHA2DS2-VASc score is a commonly used risk assessment tool for embolic events, and it has guiding significance for anticoagulant therapy. However, a large number of recent studies have clearly shown that some of the markers that are not included in the score affect the formation of LAT.

Objective

This single-center study probed for risk markers for LAT by analyzing the clinical features of patients who experienced AF.

Methods

We reviewed patients with AF who had undergone a transesophageal echocardiography exam over the past 6 years and used binary logistic regression analysis to identify risk markers other than CHA2DS2-VASc score. For the risk markers found, the propensity score matching (PSM) was used to further evaluate whether it was an independent risk marker for LAT. The newly discovered markers were added to the score, and receiver operating characteristic analysis was used to evaluate whether the ability of the model to predict LAT was improved.

Results

A total of 2246 patients were included in the study. In total, 838 of them were anticoagulated (314 with rivaroxaban, 57 with dabigatran, and 467 with warfarin) and 30 patients (1.33%) had LAT. Regression analysis revealed abnormal uric acid metabolism (abUA) and obesity were risk markers for LAT. Further PSM analysis found that abUA was an independent risk marker for LAT. After including abUA, the CHA2DS2-VASc score was more accurate for LAT prediction (area under the curve difference is 0.0651, 95% confidence interval: 0.0247, 0.1050, Z = 3.158, P = 0.0016).

Conclusions

AbUA is an independent risk marker for LAT. After considering abUA, the CHA2DS2-VASc score for LAT is more accurate.
Cost-efficiency of specialist inpatient rehabilitation for adults with multiple sclerosis: A multicentre prospective cohort analysis of the UK Rehabilitation Outcomes Collaborative national clinical dataset for rehabilitation centres in England
Authors: Turner-Stokes Lynne , Harding Richard , Yu Peihan , Dzingina Mendwas , Gao Wei
Published: March 2020

Background

Rehabilitation is effective for multiple sclerosis, but is it value for money?

Objectives

To evaluate functional outcomes, care needs and cost-efficiency of specialist inpatient rehabilitation for adults with multiple sclerosis (MS).

Methods

A multicentre cohort study of prospectively collected clinical data from the UK Rehabilitation Outcomes Collaborative national clinical database. Data included all adults with MS ( n = 1007) admitted for specialist inpatient (Level 1 or 2) rehabilitation in England, 2010–2018.

Outcome measures

Dependency/care needs: Northwick Park Dependency Scale/Care Needs Assessment, Functional independence: UK Functional Assessment Measure (UK FIM+FAM). Cost-efficiency. Patients were analysed in three dependency groups (High/Medium/Low).

Results

All groups showed significant reduction in dependency between admission and discharge on all measures (paired t-tests: p < 0.001). Mean reduction in care costs/week was greatest in the most dependent patients: High: £519 (95% CI: 447–597), Medium: £148 (76–217), Low: £36 (12–83). Despite longer stays, time taken to offset the cost of rehabilitation was shortest in the most dependent patients: High: 12.9 (12.0–14.1) months; Medium: 29.3 (21.3–51.8); Low: 76.8 (0–36.1). Item-level changes corresponded with clinical experience.

Conclusions

Specialist rehabilitation provided good value for money in patients with MS, yielding improved outcomes and substantial savings in ongoing care costs, especially in high-dependency patients.
Closing the Gap to Postsecondary Success: A High School and University Partnership
Authors: Dahir Carol A.
Published: March 2020

Low-income students, many of whom reside in urban environments, often lack the support they need to prepare for postsecondary education, identify the best fit schools, apply for financial aid, enroll and persist in their studies, and, ultimately, graduate with a degree. Since 2014, a university school counseling department and a New York City high school collaborated to provide targeted and focused college readiness, awareness, and engagement activities to each and every student in the senior class through the direct involvement of school counseling preservice graduate students. The project’s primary goals focused on student outcomes related to an improved graduation rate and postsecondary participation rate, with varying degrees of success. Participants in the high school–university partnership realized the value and importance of engaging students much earlier in career and college planning process.
Creating Superior Customer Value in the Now Economy
Authors: Weinstein Art
Published: March 2020

Companies today must have a customer value mindset and deliver exceptional value. Solid customer relationships ensure retention and improve business performance. This conceptual article explains how to create and manage customer value in changing global markets. Key business sectors and growth prospects in the Now Economy are described. The Now Economy requires companies to master the 5-S formula—speed, service, selection, sociability, and solutions. As millennials are a major part of the digital marketplace, their preferences are explored. A framework for introducing and enhancing customer value based on service, quality, image, and price (S-Q-I-P) is recommended for marketing managers. Customer-centric, strategic implications for relationship management are provided. In addition, a customer value research agenda—related to speed, time, segmentation, product strategy, pricing, and new technologies—is offered to scholars.
Spaces of regional governance: A periodisation approach
Authors: Salder Jacob
Published: March 2020

This paper discusses regional governance and the relationship between spaces of economic governance and notions of regional economy. The region’s prominence in state spatial strategy has run alongside tendencies for spatial reform in pursuit of optimum spatial articulation of economy. Ongoing spatial reform holds implications for structural interpretation, policy priority and intervention practice. To this extent, regional governance can be understood using a periodisation approach, a response framed through specific temporal arrangements influenced by preceding actions, approaches and outcomes. Such changes however do not occur in isolation of prior spatial iterations, presenting both regional demarcation and practice as a dynamic process. This process involves three concurrent episodes of structuring, casting and disruption, creating a periodisation framework. Focusing on the English region of Greater Birmingham and Solihull and its Southern Staffordshire sub-region, I discuss the evolution of regional governance arrangements and through these interpretation and reflection of regional economic structure. I argue periodisation occurs not in punctuated forms but as a dynamic and historically founded relationship influencing reform, appropriating policy, and selectively interpreting structure for organisational interest. These complex relationships create a form of tidal heating through which regions are in a state of constant flux.
Microfriction stir welding of AA 6061-T6 thin sheets using in-house developed fixture
Authors: Nadda Rahul , Babal Meghavari , Jalan Nikhil , Nirala Chandrakant Kumar
Published: March 2020

The present work examines microhardness, tensile strength, and microstructure in microfriction stir welding (µ-FSW) of 0.5 mm thick AA 6061-T6 sheets. The capability of in-house developed work fixture and welding tools to attain nondamaged and continuous welds has been verified through multiple runs at different tool traverse speeds. On examination, it was found that by using the proposed work fixture, weld strength reached up to 57% as that of the base metal when performed at tool traversing speed of 150 mm min–1. The dynamic recrystallization during µ-FSW may lead to the formation of equiaxed grains in stir region and transition zone. The microstructure showed that the thermomechanically affected zone reduced with tool traversing speed.
Clonal hematopoiesis in donors and long-term survivors of related allogeneic hematopoietic stem cell transplantation
Authors: Boettcher Steffen , Wilk C. Matthias , Singer Jochen , Beier Fabian , Burcklen Elodie , Beisel Christian , Ventura Ferreira Monica S. , Gourri Elise , Gassner Christoph , Frey Beat M. , Schanz Urs , Skoda Radek C. , Ebert Benjamin L. , Brummendorf Tim H. , Beerenwinkel Niko , Manz Markus G.
Published: March 2020

Clonal hematopoiesis (CH) is associated with age and an increased risk of myeloid malignancies, cardiovascular risk, and all-cause mortality. We tested for CH in a setting where hematopoietic stem cells (HSCs) of the same individual are exposed to different degrees of proliferative stress and environments, ie, in long-term survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) and their respective related donors (n = 42 donor-recipient pairs). With a median follow-up time since allo-HSCT of 16 years (range, 10-32 years), we found a total of 35 mutations in 23 out of 84 (27.4%) study participants. Ten out of 42 donors (23.8%) and 13 out of 42 recipients (31%) had CH. CH was associated with older donor and recipient age. We identified 5 cases of donor-engrafted CH, with 1 case progressing into myelodysplastic syndrome in both donor and recipient. Four out of 5 cases showed increased clone size in recipients compared with donors. We further characterized the hematopoietic system in individuals with CH as follows: (1) CH was consistently present in myeloid cells but varied in penetrance in B and T cells; (2) colony-forming units (CFUs) revealed clonal evolution or multiple independent clones in individuals with multiple CH mutations; and (3) telomere shortening determined in granulocytes suggested ∼20 years of added proliferative history of HSCs in recipients compared with their donors, with telomere length in CH vs non-CH CFUs showing varying patterns. This study provides insight into the long-term behavior of the same human HSCs and respective CH development under different proliferative conditions.
The impact of driving homogeneity due to automation and cooperation of vehicles on uphill freeway sections
Authors: Makridis Michail , Leclercq Ludovic , Mattas Konstantinos , Ciuffo Biagio
Published: March 2020

Background

This work presents a microsimulation study on the topic on an uphill network, regarding the potential impact of AVs and Cooperative-AVs (Coop-AVs or CAVs), vehicles able to cooperate with the infrastructure. The novelty of the proposed approach is that the simulation of all vehicles is performed with a common hybrid car-following model that takes explicitly into account the variability in the vehicle dynamics and the driving behaviors.

Methods

Simulation of longitudinal movement of the individual vehicles is performed with a common hybrid car-following model that takes explicitly into account the variability in the vehicle dynamics and the driving behaviors. Different homogeneity levels in the vehicles and drivers are tested, while the cooperation is explicitly assessed by proposing a realistic Vehicle to Infrastructure (V2I) logic. Possible reduction in the response times of the vehicles is also studied.

Results

Results with more homogenous vehicle movements have more consistent performance in terms of traffic flow, that is independent of the order that the vehicles enter the network. Finally, the cooperation with the infrastructure can limit high variations in the vehicles’ accelerations and thus potential traffic jams.

Conclusions

Homogenized flows can mitigate or even solve traffic-related problems related to the variability in driving behaviors, such as bottlenecks and stop-and-go waves.
Conserved associations between G-quadruplex-forming DNA motifs and virulence gene families in malaria parasites
Authors: Gage Hunter L. , Merrick Catherine J.
Published: March 2020

Background

The Plasmodium genus of malaria parasites encodes several families of antigen-encoding genes. These genes tend to be hyper-variable, highly recombinogenic and variantly expressed. The best-characterized family is the var genes, exclusively found in the Laveranian subgenus of malaria parasites infecting humans and great apes. Var genes encode major virulence factors involved in immune evasion and the maintenance of chronic infections. In the human parasite P. falciparum, var gene recombination and diversification appear to be promoted by G-quadruplex (G4) DNA motifs, which are strongly associated with var genes in P. falciparum. Here, we investigated how this association might have evolved across Plasmodium species – both Laverania and also more distantly related species which lack vars but encode other, more ancient variant gene families.

Results

The association between var genes and G4-forming motifs was conserved across Laverania, spanning ~ 1 million years of evolutionary time, with suggestive evidence for evolution of the association occurring within this subgenus. In rodent malaria species, G4-forming motifs were somewhat associated with pir genes, but this was not conserved in the Laverania, nor did we find a strong association of these motifs with any gene family in a second outgroup of avian malaria parasites. Secondly, we compared two different G4 prediction algorithms in their performance on extremely A/T-rich Plasmodium genomes, and also compared these predictions with experimental data from G4-seq, a DNA sequencing method for identifying G4-forming motifs. We found a surprising lack of concordance between the two algorithms and also between the algorithms and G4-seq data.

Conclusions

G4-forming motifs are uniquely strongly associated with Plasmodium var genes, suggesting a particular role for G4s in recombination and diversification of these genes. Secondly, in the A/T-rich genomes of Plasmodium species, the choice of prediction algorithm may be particularly influential when studying G4s in these important protozoan pathogens.
Identification and integrated analysis of glyphosate stress-responsive microRNAs, lncRNAs, and mRNAs in rice using genome-wide high-throughput sequencing
Authors: Zhai Rongrong , Ye Shenghai , Zhu Guofu , Lu Yanting , Ye Jing , Yu Faming , Chu Qiren , Zhang Xiaoming
Published: March 2020

Background

Glyphosate has become the most widely used herbicide in the world. Therefore, the development of new varieties of glyphosate-tolerant crops is a research focus of seed companies and researchers. The glyphosate stress-responsive genes were used for the development of genetically modified crops, while only the EPSPS gene has been used currently in the study on glyphosate-tolerance in rice. Therefore, it is essential and crucial to intensify the exploration of glyphosate stress-responsive genes, to not only acquire other glyphosate stress-responsive genes with clean intellectual property rights but also obtain non-transgenic glyphosate-tolerant rice varieties. This study is expected to elucidate the responses of miRNAs, lncRNAs, and mRNAs to glyphosate applications and the potential regulatory mechanisms in response to glyphosate stress in rice.

Results

Leaves of the non-transgenic glyphosate-tolerant germplasm CA21 sprayed with 2 mg·ml− 1 glyphosate (GLY) and CA21 plants with no spray (CK) were collected for high-throughput sequencing analysis. A total of 1197 DEGs, 131 DELs, and 52 DEMs were identified in the GLY samples in relation to CK samples. Genes were significantly enriched for various biological processes involved in detoxification of plant response to stress. A total of 385 known miRNAs from 59 miRNA families and 94 novel miRNAs were identified. Degradome analysis led to the identification of 32 target genes, of which, the squamosa promoter-binding-like protein 12 (SPL12) was identified as a target of osa-miR156a_L + 1. The lncRNA-miRNA-mRNA regulatory network consisted of osa-miR156a_L + 1, two transcripts of SPL12 (LOC_Os06g49010.3 and LOC_Os06g49010.5), and 13 lncRNAs (e.g., MSTRG.244.1 and MSTRG.16577.1).

Conclusion

Large-scale expression changes in coding and noncoding RNA were observed in rice mainly due to its response to glyphosate. SPL12, osa-miR156, and lncRNAs (e.g., MSTRG.244.1 and MSTRG.16577.1) could be a novel ceRNA mechanism in response to glyphosate in rice by regulating transcription and metal ions binding. These findings provide a theoretical basis for breeding glyphosate-tolerant rice varieties and for further research on the biogenesis of glyphosate- tolerance in rice.
The different dietary sugars modulate the composition of the gut microbiota in honeybee during overwintering
Authors: Wang Hongfang , Liu Chunlei , Liu Zhenguo , Wang Ying , Ma Lanting , Xu Baohua
Published: March 2020

Background

The health of honeybee colonies is critical for bee products and agricultural production, and colony health is closely associated with the bacteria in the guts of honeybees. Although colony loss in winter is now the primary restriction in beekeeping, the effects of different sugars as winter food on the health of honeybee colonies are not well understood. Therefore, in this study, the influence of different sugar diets on honeybee gut bacteria during overwintering was examined.

Results

The bacterial communities in honeybee midguts and hindguts before winter and after bees were fed honey, sucrose, and high-fructose syrup as winter-food were determined by targeting the V3-V4 region of 16S rDNA using the Illumina MiSeq platform.

The dominant microbiota in honeybee guts were the phyla Proteobacteria (63.17%), Firmicutes (17.61%; Lactobacillus, 15.91%), Actinobacteria (4.06%; Bifidobacterium, 3.34%), and Bacteroidetes (1.72%). The dominant taxa were conserved and not affected by season, type of overwintering sugar, or spatial position in the gut. However, the relative abundance of the dominant taxa was affected by those factors. In the midgut, microbial diversity of the sucrose group was higher than that of the honey and high-fructose syrup groups, but in the hindgut, microbial diversity of the honey and high-fructose groups was higher than that in the sucrose group. Sucrose increased the relative abundance of Actinobacteria (Bifidobacteriales Bifidobacteriaceae) and Alphaproteobacteria (Rhizobiales and Mitochondria) of honeybee midgut, and honey enriched the Bacteroidetes and Gammaproteobacteria (Pasteurellales) in honeybee hindgut. High-fructose syrup increased the relative abundance of Betaproteobacteria (Neisseriales: Neisseriaceae) of the midgut.

Conclusion

The type of sugar used as winter food affected the relative abundance of the dominant bacterial communities in honeybee guts, not the taxa, which could affect the health and safety of honeybee colonies during overwintering. The presence of the supernal Alphaproteobacteria, Bifidobacteriales, and Lactobacillaceae in the gut of honeybees fed sucrose and cheaper than honey both indicate that sucrose is very suitable as the overwintering food for honeybees.
A multi-centre, parallel-group, randomised controlled trial to assess the efficacy and safety of eurythmy therapy and tai chi in comparison with standard care in chronically ill elderly patients with increased risk of falling (ENTAiER): a trial protocol
Authors: Kienle G. S. , Werthmann P. G. , Grotejohann B. , Kaier K. , Steinbrenner I. , Voigt-Radloff S. , Huber R.
Published: March 2020

Background

In elderly poeple, multimorbidity and polypharmacy increase while sensory, motor and cognitive functions decrease. Falls occur in 30% of people aged 65 years and older at least once per year, with injuries at 10–20%. Reducing falls and enhancing physical, emotional and cognitive capacities are essential for healthy aging despite chronic disease. Eurythmy therapy (EYT) and Tai Chi train balance, mobility and concentrative and sensory capacities.

Methods

In eight trial sites (academic or community hospitals), 550 outpatients aged 65 years and older with chronic disease and increased risk of falling (history of imbalance, Berg Balance Scale (BBS) score ≤ 49) will be randomly assigned (1:1:1) to receive either EYT or Tai Chi (each provided in one-hour group sessions, twice, later once per week plus practice at home, for over 24 weeks) added to standard care or standard care alone. Standard care includes a detailed written recommendation on fall prevention and the visit of a primary care doctor. Seniors living a reclusive life or economically disadvantaged elderly will be particularly addressed. A motivation and communication concept supports the trial participants’ compliance with trial procedures and practicing. Public and patient representatives are involved in the planning and conduction of the trial. Falls will be documented daily in a diary by the participants. These falls as well as injuries and complications will be ascertained during monthly phone visits. The falls efficacy scale, BBS, cognition (MoCA), Mood (GDS-15), quality of life (SF12), instrumental activities of daily living (IADL), use of medical and non-medical services (FIMA) and adherence will be assessed at months 3, 6, and 12 and inner correspondence with practices (ICPH) at month 6. The trial is funded by the Federal Ministry of Education and Research (BMBF 01GL1805).

Discussion

This study will determine whether EYT and Tai Chi reduce falls, injurious falls, fear of falling and healthcare utilisation and improve mobility, cognition, mood, quality of life and functional independence. A reduction of fall risk and fear of falling and an improvement of mobility, autonomy, quality of life, mood, and cognition are highly relevant for older people to cope with aging and diseases and to reduce healthcare costs.

Trail registration

www.drks.de. DRKS00016609. Registered 30th July 2019.
Bacterial otitis media in sub-Saharan Africa: a systematic review and meta-analysis
Authors: Tesfa Tewodros , Mitiku Habtamu , Sisay Mekonnen , Weldegebreal Fitsum , Ataro Zerihun , Motbaynor Birhanu , Marami Dadi , Teklemariam Zelalem
Published: March 2020

Background

Otitis media is inflammation of the middle ear, comprising a spectrum of diseases. It is the commonest episode of infection in children, which often occurs after an acute upper respiratory tract infection. Otitis media is ranked as the second most important cause of hearing loss and the fifth global burden of disease with a higher incidence in developing worlds like Sub-Saharan Africa and South Asia. Therefore, this systematic review is aimed to quantitatively estimate the current status of bacterial otitis media, bacterial etiology and their susceptibility profile in sub-Saharan Africa.

Methods

A literature search was conducted from major databases and indexing services including EMBASE (Ovid interface), PubMed/MEDLINE, Google Scholar, ScienceDirect, Cochrane Library, WHO African Index-Medicus and others. All studies (published and unpublished) addressing the prevalence of otitis media and clinical isolates conducted in sub-Saharan Africa were included. Format prepared in Microsoft Excel was used to extract the data and data was exported to Stata version 15 software for the analyses. Der-Simonian-Laird random-effects model at a 95% confidence level was used for pooled estimation of outcomes. The degree of heterogeneity was presented with I2statistics. Publication bias was presented with funnel plots of standard error supplemented by Begg’s and Egger’s tests. The study protocol is registered on PROSPERO with reference number ID: CRD42018102485 and the published methodology is available fromhttp://www.crd.york.ac.uk/CRD42018102485.

Results

A total of 33 studies with 6034 patients were included in this study. All studies have collected ear swab/discharge samples for bacterial isolation. The pooled isolation rate of bacterial agents from the CSOM subgroup was 98%, patients with otitis media subgroup 87% and pediatric otitis media 86%. A univariate meta-regression analysis indicated the type of otitis media was a possible source of heterogeneity (p-value = 0.001). The commonest isolates wereP. aeruginosa(23–25%),S. aureus(18–27%),Proteusspecies (11–19%) andKlebsiellaspecies. High level of resistance was observed against Ampicillin, Amoxicillin-clavulanate, Cotrimoxazole, Amoxicillin, and Cefuroxime.

Conclusion

The analysis revealed that bacterial pathogens likeP. aeruginosaandS. aureusare majorly responsible for otitis media in sub-Saharan Africa. The isolates have a high level of resistance to commonly used drugs for the management of otitis media.
ABCG2 rs2231142 variant in hyperuricemia is modified by SLC2A9 and SLC22A12 polymorphisms and cardiovascular risk factors in an elderly community-dwelling population
Authors: Liu Jia , Yang Wei , Li Yun , Wei Zhanyun , Dan Xiaojuan
Published: March 2020

Background

The ABCG2 rs2231142 single nucleotide polymorphism (SNP) is one of the most significant genetic variants associated with hyperuricemia (HUA) in Asian populations. However, the risk of ABCG2 rs2231142 variants for HUA could interact with other important HUA risk variants and cardiovascular factors. This study investigated the effects of the combined association among ABCG2 rs2231142 and multiple HUA genetic variants or cardiovascular risk factors on HUA risk and serum uric acid (sUA) levels in an elderly Chinese population.

Methods

A total of 1206 participants over 65 years old were enrolled in this study. Physical and laboratory examinations were performed for all participants. The ABCG2 rs2231142, SLC2A9 rs3733591, and SLC22A12 rs893006 SNPs were assayed using a standardized protocol. Logistic regression analysis and liner regression were adjusted respectively to account for the association between ABCG2 rs2231142 and other genetic variants, as well as between cardiovascular risk factors and HUA risk and sUA levels.

Results

The prevalence of HUA was 14.71% in the elderly community-dwelling population. The ABCG2 rs2231142 risk T allele was associated with HUA risk (odds ratio (OR) = 1.63, 95% confidence interval (CI): 1.27–2.11; p = 1.65 × 10− 4) and with increased sUA levels (Beta = 0.16, p = 6.75 × 10− 9) in the whole study population. Linear regression analysis showed that the mean sUA level increased linearly with the number of risk alleles of the three candidate genetic variants (Beta = 0.18, p = 1.94 × 10− 12) The joint effect of the ABCG2 rs2231142 T allele and cardiovascular risk factors (obesity, hypertension and dyslipidemia) was also associated with increased HUA risk and sUA levels. Each copy of the risk T allele was significantly associated with enhanced HUA risk in patients with hypertriglyceridemia (OR = 2.52, 95% CI: 1.33–4.60; p = 0.003) compared to controls.

Conclusion

Our findings reinforce the importance of the ABCG2 rs2231143 variant as a crucial genetic locus for HUA in Chinese populations and demonstrated the combined effects of multiple genetic risk variants and cardiovascular risk exposures on HUA risk and increased sUA level.
Immunological effects of nivolumab immunotherapy in patients with oral cavity squamous cell carcinoma
Authors: Xiong Ying , Neskey David M. , Horton Joshua D. , Paulos Chrystal M. , Knochelmann Hannah M. , Armeson Kent E. , Young M. Rita I.
Published: March 2020

Background

Although checkpoint blockades have become widely used, the immunological impact in cancer patients, especially those with oral cavity squamous cell carcinoma (OCSCC), has not been well studied.

Methods

The present study assessed the immunological impact of anti-PD-1 (nivolumab) treatment in 10 patients with OCSCC. This involved phenotypic analyses of peripheral blood T-cell subpopulations and their expression of immune mediators prior to and following nivolumab treatment. The focus was on immunological effects of treatment without regard to possible clinical responses.

Results

Nivolumab caused a decline in the frequency of blood CD4+ cells but did not affect their expression of IFN-γ. However, nivolumab increased the proportion of CD4+ cells expressing the Treg-supporting factor Foxp3. Nivolumab treatment caused an increase in the proportion of CD8+ cells. While their expression of granzyme B increased, it did not attain significance. Analyses of CD8+ cell subpopulations showed nivolumab caused an increase in levels of unconventional CD8dimCD3+ T-cells. It also caused an increase in expression of granzyme B by these unconventional T-cells as well as by the conventional CD8hiCD3+ cells. The CD8hiCD3+ subpopulation also had a near-significant increase in IFN-γ expression. Treatment with nivolumab had no effect on the levels of the NK containing CD8dimCD3− subpopulation of cells or their expression of IFN-γ or granzyme B.

Conclusions

These results show nivolumab causes opposing effects on CD4+ and CD8+ cell populations, with CD4+ cell levels declining but increasing the proportion of Treg cells, and unconventional CD8+ T-cell levels increasing with increased expression of immune mediators by CD8+ T-cell subpopulations.
Age-related differences in breast cancer mortality according to race/ethnicity, insurance, and socioeconomic status
Authors: San Miguel Yazmin , Gomez Scarlett Lin , Murphy James D. , Schwab Richard B. , McDaniels-Davidson Corinne , Canchola Alison J. , Molinolo Alfredo A. , Nodora Jesse N. , Martinez Maria Elena
Published: March 2020

Background

We assessed breast cancer mortality in older versus younger women according to race/ethnicity, neighborhood socioeconomic status (nSES), and health insurance status.

Methods

The study included female breast cancer cases 18 years of age and older, diagnosed between 2005 and 2015 in the California Cancer Registry. Multivariable Cox proportional hazards modeling was used to generate hazard ratios (HR) of breast cancer specific deaths and 95% confidence intervals (CI) for older (60+ years) versus younger (< 60 years) patients separately by race/ethnicity, nSES, and health insurance status.

Results

Risk of dying from breast cancer was higher in older than younger patients after multivariable adjustment, which varied in magnitude by race/ethnicity (P-interaction< 0.0001). Comparing older to younger patients, higher mortality differences were shown for non-Hispanic White (HR = 1.43; 95% CI, 1.36–1.51) and Hispanic women (HR = 1.37; 95% CI, 1.26–1.50) and lower differences for non-Hispanic Blacks (HR = 1.17; 95% CI, 1.04–1.31) and Asians/Pacific Islanders (HR = 1.15; 95% CI, 1.02–1.31). HRs comparing older to younger patients varied by insurance status (P-interaction< 0.0001), with largest mortality differences observed for privately insured women (HR = 1.51; 95% CI, 1.43–1.59) and lowest in Medicaid/military/other public insurance (HR = 1.18; 95% CI, 1.10–1.26). No age differences were shown for uninsured women. HRs comparing older to younger patients were similar across nSES strata.

Conclusion

Our results provide evidence for the continued disparity in Black-White breast cancer mortality, which is magnified in younger women. Moreover, insurance status continues to play a role in breast cancer mortality, with uninsured women having the highest risk for breast cancer death, regardless of age.