bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of clinical frailty screening in geriatric acute care
Authors: Chua Xin Ying , Toh Sabrina , Wei Kai , Teo Nigel , Tang Terence , Wee Shiou Liang
Published: January 2019

Background

While frailty status is an attractive risk stratification tool, the evaluation of frailty in acute care can be challenging as some inpatients are unable to complete performance‐based tests as part of frailty assessment and some tools may lack discriminative ability and categorize majority of cohorts as “frail”. In this study, we evaluated the feasibility of frailty screening with the simple clinical frailty scale (CFS) by different clinicians, and its association with mortality and rehospitalization in a geriatric acute care setting.

Methods

This study took place in Geriatric Medicine Department of a General Hospital in Singapore. We analysed records of 314 inpatients aged 70 years and older. At baseline, premorbid frailty was assessed using the CFS of the Canadian Study on Health and Aging. Demographic characteristics and other variables were retrieved from their medical records. Primary outcomes were mortality and rehospitalization during the 6‐month follow‐up. Survival analysis was used to compare the time to death and rehospitalization among CFS categories (1‐4: nonfrail, 5‐6: mild‐moderate frail, and 7‐8: severe frail).

Results

CFS showed a high inter‐rater reliability when used by different clinicians. In the Cox proportional hazard model controlling for age, gender, Charlson comorbidity index, modified severity of illness index, and discharge placements, severe frailty determined by CFS (HR = 2.09, 95% CI = 1.01‐4.33, P = 0.047) and CFS scores (HR = 1.27, 95% CI = 1.05‐1.53, P = 0.012) were significantly associated with higher mortality until 6‐month postdischarge, but not rehospitalization.

Conclusion

Frailty status determined by CFS adds to disease severity and comorbidity in predicting short‐term mortality but not rehospitalization in older inpatients who received geriatric acute care in our setting. CFS is reliable and has the potential to be incorporated into routine screening to better identify, communicate, and address frailty in the acute settings.
Reply to: A Body of Work, A Missed Opportunity: Dyadic Research in Older Adults
Authors: Riffin Catherine , Van Ness Peter H. , Iannone Lynne , Fried Terri
Published: January 2019

This letter comments on the letter by Buck et al.
A body of work, a missed opportunity: Dyadic research in older adults
Authors: Buck Harleah G. , Bekelman David , Cameron Jan , Chung Misook , Hooker Stephanie , Pucciarelli Gianluca , Stromberg Anna , Riegel Barbara , Vellone Ercole
Published: January 2019

See the Reply by Riffin et al.
RANK deletion in neuropeptide Y neurones attenuates oestrogen deficiency‐related bone loss
Authors: Lee Nicola J. , Clarke Ireni M. , Zengin Ayse , Enriquez Ronaldo F. , Nagy Vanj , Penninger Josef M. , Baldock Paul A. , Herzog Herbert
Published: January 2019

The RANKL pathway is known to be an important aspect of the pathogenesis of oestrogen deficiency‐induced bone loss. RANK deletion specifically in neuropeptide Y (NPY) neurones has been shown to enhance the ability of the skeleton to match increases in body weight caused by high‐fat diet feeding, likely via the modulation of NPY levels. In the present study, we used ovariectomy in female mice to show that RANK deletion in NPY neurones attenuates bone loss caused by long‐term oestrogen deficiency, particularly in the vertebral compartment. Ovariectomy led to a reduction in NPY expression levels in the arcuate nucleus of NPYcre/+;RANKlox/lox mice compared to NPYcre/+;RANKlox/+ controls. Because NPY deficient mice also displayed a similar protection against ovariectomy‐induced bone loss, modulation of hypothalamic NPY signalling is the likely mechanism behind the protection from bone loss in the NPYcre/+;RANKlox/lox mice.
Utility and performance of bacterial artificial chromosomes‐on‐beads assays in chromosome analysis of clinical prenatal samples, products of conception and blood samples
Authors: Rose Rajiv , Venkatesh Aishwarya , Pietilä Sanna , Jabeen Gazala , Jagadeesh Sujatha M. , Seshadri Suresh
Published: January 2019

Aim

Chromosome analysis of prenatal samples and products of conception (POC) has conventionally been done by karyotyping (KT). Shortcomings of KT like high turnaround time and culture failure led to technology innovations, such as the bacterial artificial chromosomes (BAC)s‐on‐Beads (BoBs)‐based tests, Prenatal BoBs (prenatal samples) and KaryoLite BoBs (POC samples). In the present study, we validated and evaluated the utility of each test on prenatal, POC and blood samples.

Methods

Study A (n = 305; 259 prenatal + 46 blood/POC) and Study B (n = 176; 146 POC/chorionic vill + 30 blood/amniotic fluid) samples were analyzed using Prenatal and KaryoLite BoBs kits, respectively. KT, array‐based Comparative Genomic Hybridization (arrayCGH) and fluorescence in situ hybridization (FISH) were used for comparison of results. Ability of KaryoLite BoBs to identify ring chromosomes was tested.

Results

Prenatal BoBs had zero test failure rate and results of all samples were concordant with KT results. Totally four microdeletions were identified by Prenatal BoBs but not by KT. In Study B, all but two POC samples (one triploid and one tetraploid) were concordant with KT and arrayCGH. Partial chromosomal imbalance detection rate was ~64% and KaryoLite BoBs indicated the presence of a ring chromosome in all four cases. The failure rate of KaryoLite BoBs was 3%.

Conclusion

We conclude that Prenatal BoBs (common aneuploidies and nine microdeletions) together with KT constitutes more comprehensive prenatal testing compared to FISH and KT. KaryoLite BoBs for aneuploidies of all chromosomes is highly successful in POC analysis and the ability to indicate presence of ring chromosomes improves its clinical sensitivity. Both tests are robust and could also be used for different specimens.
US Centers for Disease Control and Prevention‐Based Physical Activity Recommendations Do Not Improve Fitness in Real‐World Settings
Authors: Seibert Tasa , Allen David B. , Eickhoff Jens C. , Carrel Aaron L.
Published: January 2019

BACKGROUND

The US Centers for Disease Control and Prevention (CDC) promotes school‐based strategies to increase physical activity (PA). Implementation feasibility and effect of these interventions on cardiovascular fitness (CVF) is unknown.

METHODS

Forty‐nine low‐SES schools were randomly assigned to either (1) continue routine PA programs (N = 24 schools, 2399 students) or (2) implement 4 CDC‐based PA strategies (N = 25 schools, 2495 students). CVF assessed by PACER (Progressive Aerobic Cardiovascular Endurance Run) was obtained at the beginning and end of the school year. A post‐study questionnaire was administered at each school to assess adherence.

RESULTS

Overall, PACER z‐scores were not augmented by CDC‐based PA strategies. In boys, PACER z‐scores increased similarly in both intervention and control schools. In girls, increased mean PACER z‐score was greater in control schools (p < .01). Fifty‐two percent of intervention school's staff reported inability to implement or sustain 4 CDC‐based PA strategies.

CONCLUSIONS

Planned implementation of school‐based CDC PA strategies did not increase CVF compared to routine PA programming. Lack of efficacy in girls suggests need for sex‐specific targeted strategies. These findings highlight limited efficacy of CDC‐based PA recommendations alone in low‐SES schools. Schools may require additional support to successfully implement recommendations and meaningfully affect health outcomes.
On optimal redistributive capital taxation
Authors: Reinhorn Leslie J.
Published: January 2019

This paper addresses conflicting results regarding the optimal taxation of capital income. Judd proves that in a steady state, there should be no taxation of capital income. Lansing studies a logarithmic example of one of Judd's models and finds that the optimal steady‐state tax on capital income is not always zero—it is positive in some specifications and negative in some others. There appears to be a contradiction. However, I show that Lansing derives his result by relaxing the convergence hypotheses of Judd's theorem. With less restrictive hypotheses, a wider range of primitives (parameter values, initial condition, etc.) satisfy the hypotheses and because each specification of primitives generates its own optimal time path(s) for the model's variables, it follows that a wider range of time paths with a wider range of steady‐state properties is possible. This raises a question. What happens if the convergence hypotheses are weakened further so that they are satisfied by a wider yet range of primitives? I find that at any interior steady state for the model's optimal tax equilibrium, either the capital tax is zero or else the elasticity of marginal utility is unitary which is satisfied identically in Lansing's log example. In effect, Lansing's example illustrates the only way in which an interior steady state can violate the zero tax result.
Speciation in protists: Spatial and ecological divergence processes cause rapid species diversification in a freshwater chrysophyte
Authors: Škaloud Pavel , Škaloudová Magda , Doskočilová Pavla , Kim Jong Im , Shin Woonghi , Dvořák Petr
Published: January 2019

Although eukaryotic microorganisms are extremely numerous, diverse and essential to global ecosystem functioning, they are largely understudied by evolutionary biologists compared to multicellular macroscopic organisms. In particular, very little is known about the speciation mechanisms which may give rise to the diversity of microscopic eukaryotes. It was postulated that the enormous population sizes and ubiquitous distribution of these organisms could lead to a lack of population differentiation and therefore very low speciation rates. However, such assumptions have traditionally been based on morphospecies, which may not accurately reflect the true diversity, missing cryptic taxa. In this study, we aim to articulate the major diversification mechanisms leading to the contemporary molecular diversity by using a colonial freshwater flagellate, Synura sphagnicola, as an example. Phylogenetic analysis of five sequenced loci showed that S. sphagnicola differentiated into two morphologically distinct lineages approximately 15.4 million years ago, which further diverged into several evolutionarily recent haplotypes during the late Pleistocene. The most recent haplotypes are ecologically and biogeographically much more differentiated than the old lineages, presumably because of their persistent differentiation after the allopatric speciation events. Our study shows that in microbial eukaryotes, species diversification via the colonization of new geographical regions or ecological resources occurs much more readily than was previously thought. Consequently, divergence times of microorganisms in some lineages may be equivalent to the estimated times of speciation in plants and animals.
‘What … you can't tell left from right?’ Medical students’ experiences in making laterality decisions
Authors: Gormley Gerard J , Brennan Carl , Dempster Martin
Published: January 2019

Context

Wrong‐sided procedures represent some of the most catastrophic errors in health care. Although errors in laterality are multifaceted in origin, human error is considered to be an important root cause. Evidence suggests that a significant proportion of the population, including medical students, experience difficulty in left–right discrimination (LRD). Given that not all medical students have equal LRD ability, there have been calls to raise awareness of this issue in medical education. The experiences of medical students with LRD, including those who have difficulty, remain unknown.

Objectives

This study was designed to gain deep insights into the lived experiences of medical students in LRD.

Methods

A qualitative study was conducted using hermeneutic phenomenology. Medical students with a wide range of abilities in LRD were invited to participate and to be interviewed. Interviews were transcribed and analysed using template analysis to generate research themes. Members of the research team were continually reflexive when remaining firmly rooted in the data and in the principles of the hermeneutic process.

Results

Analysis yielded four main themes: (i) discriminating right from left: an unconscious or a conscious task? (ii) ‘What … you can't tell right from left?’: an undesirable skill deficit; (iii) concealment, and (iv) ‘But you're going to be a doctor!’: impact on professional identity formation.

Conclusions

This study challenges normative expectations that LRD is an effortless task for all. Individuals who are challenged in LRD must engage in a complex conscious process to determine right from left. For the most part, this process is relatively effortless. However, the context of being a medical student can impose extra demands and heightens the risk associated with potential error. Medical education needs to respond by raising the profile of this challenge, with which many of our medical students are confronted, and by extending support to assist them in the interests of safe patient care.
Validation of a multivariable prediction model for post‐engraftment invasive fungal disease in 465 adult allogeneic hematopoietic stem cell transplant recipients
Authors: Rodríguez‐Veiga Rebeca , Montesinos Pau , García Estefanía , Boluda Blanca , Rojas Rafael , Serrano Josefina , Martínez‐Cuadrón David , Martín Carmen , Sanz Jaime , Tabares Salvador , Piñana José L. , Lorenzo Ignacio , Montoro Juan , Salavert Miguel , Pemán Javier , Jarque Isidro , Solves Pilar , Sanz Guillermo F. , Torres Antonio , Sanz Miguel A.
Published: January 2019

Background

Recently, we reported a simple prognostic score for post‐engraftment invasive fungal disease (IFD) obtained in 404 adult allogeneic hematopoietic stem cell transplant (alloSCT) (training cohort).

Objectives

We aim to validate this score in an external cohort assessing the 1‐year cumulative incidence (CI) of post‐engraftment IFD. Additionally, we analyse the type of IFD and incidence of IFD according to type of prophylaxis.

Patients/methods

We included 465 consecutive adult recipients surviving >40 days who engrafted and were discharged without prior IFD (median age 45 years, range, 14‐69).

Results

Patients classified as low‐risk, 139; intermediate‐risk, 162; and high‐risk, 164 (35% vs 27% in the training cohort, P = 0.03). The CI of probable/proven IFD in the validation cohort was 8% vs 11% in the training cohort (P = 0.006). The only voriconazole prophylaxis used in the training cohort was 100 mg/12 h, 65% vs 27% in the validation cohort, but 38% received 200 mg/12 h. Thus, the validation cohort showed a lower CI of IFD (P = 0.009). The post‐engraftment IFD score was validated, showing a CI of IFD for low‐, intermediate‐ and high‐risk of 3%, 6% and 14%, respectively (P < 0.001).

Conclusion

To our knowledge, this is the first prognostic index to predict the occurrence of post‐engraftment IFD after alloSCT that has been validated in an external cohort.
Inhibition of enhancer of zest homologue 2 is a potential therapeutic target for high‐MYC medulloblastoma
Authors: Natsumeda Manabu , Liu Yang , Nakata Satoshi , Miyahara Hiroaki , Hanaford Allison , Ahsan Sama , Stearns Duncan , Skuli Nicolas , Kahlert Ulf D. , Raabe Eric H. , Rodriguez Fausto J. , Eberhart Charles G.
Published: January 2019

MYC amplification is common in Group 3 medulloblastoma and is associated with poor survival. Group 3 and Group 4 medulloblastomas are also known to have elevated levels of histone H3‐lysine 27‐tri‐methylation (H3K27me3), at least in part due to high expression of the H3K27 methyltransferase enhancer of zest homologue 2 (EZH2), which can be regulated by MYC. We therefore examined whether MYC expression is associated with elevated EZH2 and H3K27me3 in medulloblastoma, and if high‐MYC medulloblastomas are particularly sensitive to pharmacological EZH2 blockade. Western blot analysis of low (DAOY, UW228, CB SV40) and high (DAOY‐MYC, UW228‐MYC, CB‐MYC, D425) MYC cell lines showed that higher levels of EZH2 and H3K27me3 were associated with elevated MYC. In fixed medulloblastoma samples examined using immunohistochemistry, most MYC positive tumors also had high H3K27me3, but many MYC negative ones did as well, and the correlation was not statistically significant. All high MYC lines tested were sensitive to the EZH2 inhibitor EPZ6438. Many low MYC lines also grew more slowly in the presence of EPZ6438, although DAOY‐MYC cells responded more strongly than parent DAOY cultures with lower MYC levels. We find that higher MYC levels are associated with increased EZH2, and pharmacological blockade of EZH2 is a potential therapeutic strategy for aggressive medulloblastoma with elevated MYC.
Maternal obesity in pregnancy impacts offspring cardiometabolic health: Systematic review and meta‐analysis of animal studies
Authors: Menting M. D. , Mintjens S. , van de Beek C. , Frick C. J. , Ozanne S. E. , Limpens J. , Roseboom T. J. , Hooijmans C. R. , van Deutekom A. W. , Painter R. C.
Published: January 2019

Obesity before and during pregnancy leads to reduced offspring cardiometabolic health. Here, we systematically reviewed animal experimental evidence of maternal obesity before and during pregnancy and offspring anthropometry and cardiometabolic health. We systematically searched Embase and Medline from inception until January 2018. Eligible publications compared offspring of mothers with obesity to mothers with a normal weight. We performed meta‐analyses and subgroup analyses. We also examined methodological quality and publication bias. We screened 2543 publications and included 145 publications (N = 21 048 animals, five species). Essential methodological details were not reported in the majority of studies. We found evidence of publication bias for birth weight. Offspring of mothers with obesity had higher body weight (standardized mean difference (SMD) 0.76 [95% CI 0.60;0.93]), fat percentage (0.99 [0.64;1.35]), systolic blood pressure (1.33 [0.75;1.91]), triglycerides (0.64 [0.42;0.86], total cholesterol (0.46 [0.18;0.73]), glucose level (0.43 [0.24;0.63]), and insulin level (0.81 [0.61;1.02]) than offspring of control mothers, but similar birth weight. Sex, age, or species did not influence the effect of maternal obesity on offspring's cardiometabolic health. Obesity before and during pregnancy reduces offspring cardiometabolic health in animals. Future intervention studies should investigate whether reducing obesity prior to conception could prevent these detrimental programming effects and improve cardiometabolic health of future generations.
What if none of the Building Stones at Stonehenge Came from Wiltshire?
Authors: Whitaker Katy A.
Published: January 2019

The sarsen and bluestone stones at Stonehenge (Wiltshire, UK) have played a significant role in the development of twentieth‐century ideas about Neolithic and early Bronze Age social structure. Sarsen and bluestone are not, however, the only rock types used at Stonehenge. The varied stones present at the monument include previously under‐studied material, such as the normally unseen, and largely forgotten, packing stones for Stonehenge's famous settings. By reflecting on more recently developed theoretical frameworks to interpret this variety, this paper exposes the possibility that an alternative to the dominant discourse, in which Stonehenge represents the culmination of Neolithic social evolution, is possible.
Atrial fibrillation history impact on catheter ablation outcome. Findings from the ESC‐EHRA Atrial Fibrillation Ablation Long‐Term Registry
Authors: Stabile Giuseppe , Trines Serge A. , Arbelo Elena , Dagres Nikolaos , Brugada Josep , Kautzner Josef , Pokushalov Evgeny , Maggioni Aldo P. , Laroche Cecile , Anselmino Matteo , Beinart Roy , Traykov Vassil , Blomström Lundqvist Carina ,   on behalf of the ESC‐EHRA Atrial Fibrillation Ablation Long‐Term Registry investigators
Published: January 2019

Background

Atrial fibrillation (AF) promotes atrial remodeling that in turn promotes AF perpetuation. The aim of our study is to investigate the impact of AF history length on 1‐year outcome of AF catheter ablation in a cohort of patients enrolled in the Atrial Fibrillation Ablation Registry.

Methods

We described the real‐life clinical epidemiology, therapeutic strategies, and the short‐ and mid‐term outcomes of 1948 patients (71.9% with paroxysmal AF) undergoing AF ablation procedures, stratified according to AF history duration (<2 years or ≥2 years).

Results

The mean AF history duration was 46.2 ± 57.4 months, 592 patients had an AF history duration <2 years (mean 10.2 ± 5.9 months), and 1356 patients ≥2 years (mean 75.5 ± 63.5 months) (P < 0.001). Patients with AF history duration <2 years were younger; had a lower incidence of hypertension, coronary artery disease, and hypertrophic cardiomyopathy; and had a lower CHA2DS2‐VaSc Score. At 1 year, the logrank test showed a lower incidence of AF recurrence in patients with AF history duration <2 years (28.9%) than in patients with AF history duration ≥2 years (34.0%) (P = 0.037). AF history duration ≥2 years, overall ablation procedure duration, hypertension, and chronic kidney disease were all predictors of recurrences after the blanking period.

Conclusions

In this multicenter registry, performing catheter ablation in patients with an AF history ≥2 years was associated with higher rates of AF recurrences at 1 year. Since cumulative time in AF in not necessarily equivalent to AF history, its role remains to be clarified.
Social Mobility and Labor Market Outcomes Among the Second Generation of Racial Minority Immigrants in Canada*
Authors: Chen Wen‐Hao , Hou Feng
Published: January 2019

Objective

This article examines social mobility among the children of immigrants, whose population has become increasingly diverse over time.

Methods

Using data from Canadian censuses, we focus on group differences by racial minority status in two aspects: (1) intergenerational progress in educational attainment, which indicates the ability to achieve higher education regardless of parents’ education, and (2) the relationship between education and labor market outcomes, which reveals the ability to convert educational qualifications into economic well‐being.

Results

Our analysis in general paints a very positive picture for the children of immigrants regarding the first aspect, while mixed results are evident for the second aspect. In particular, some racial minority groups are characterized by high educational attainment and average earnings, while some experienced low education mobility across generations and low labor market returns to education.

Conclusion

The results suggest that there are divergent paths of socioeconomic integration among the second‐generation racial minority groups.
Predictors of prognosis in children with portal venous gas detected by ultrasound
Authors: Hosokawa Takahiro , Yamada Yoshitake , Tanami Yutaka , Sato Yumiko , Hosokawa Mayumi , Oguma Eiji
Published: January 2019

Aims: To evaluate ultrasound findings in order to determine potential predictors of prognosis in pediatric patients with portal venous gas (PVG) detected by ultrasound.Materials and methods: Thirty-nine children were included and divided into two groups: benign PVG (n=24) and life-threatening PVG (n=15; 6 surgical interventions and 9 deaths). Possible predictors, i.e., the location of PVG in the liver, the distribution of intestinal pneumatosis, ascites and free air were compared between the two groups.Results: A significant difference was noted between the two groups in terms of the distribution of intestinal pneumatosis (limited to the large bowel, benign vs life-threatening = 60.9% (14/23):21.4% (3/14), p=0.040), the absence of ascites (benign vs life-threatening = 79.1% (19/24):40.0% (6/15), p=0.019) and patient age (benign vs life-threatening = 52.5±65.3 months vs 19.7±44.0 months, p=0.019). No significant difference was observed in the location of PVG in the liver, the presence of free air, and sex between the two groups.Conclusions: In pediatric patients with PVG, including various ages and underlying diseases, intestinal pneumatosis limited to the large bowel and absence of ascites were predictors of a benign prognosis. However, despite the presence of these predictors, some patients with PVG required surgical intervention, therebysuggesting that the cause of PVG, such as necrotizing enterocolitis, volvulus, or pancreatitis, must be also carefully evaluated.
Nutrition for Special Populations: Young, Female, and Masters Athletes
Authors: Desbrow Ben , Burd Nicholas A. , Tarnopolsky Mark , Moore Daniel R. , Elliott-Sale Kirsty J.
Published: January 2019

Adolescent, female, and masters athletes have unique nutritional requirements as a consequence of undertaking daily training and competition in addition to the specific demands of age- and gender-related physiological changes. Dietary education and recommendations for these special population athletes require a focus on eating for long-term health, with special consideration given to “at-risk” dietary patterns and nutrients (e.g., sustained restricted eating, low calcium, vitamin D and/or iron intakes relative to requirements). Recent research highlighting strategies to address age-related changes in protein metabolism and the development of tools to assist in the management of Relative Energy Deficiency in Sport are of particular relevance to special population athletes. Whenever possible, special population athletes should be encouraged to meet their nutrient needs by the consumption of whole foods rather than supplements. The recommendation of dietary supplements (particularly to young athletes) overemphasizes their ability to manipulate performance in comparison with other training/dietary strategies.
The Effect of 1,3-Butanediol on Cycling Time-Trial Performance
Authors: Shaw David M. , Merien Fabrice , Braakhuis Andrea , Plews Daniel , Laursen Paul , Dulson Deborah K.
Published: January 2019

This study investigated the effect of the racemic β-hydroxybutyrate (βHB) precursor, R,S-1,3-butanediol (BD), on time-trial (TT) performance and tolerability. A repeated-measures, randomized, crossover study was conducted in nine trained male cyclists (age, 26.7 ± 5.2 years; body mass, 69.6 ± 8.4 kg; height, 1.82 ± 0.09 m; body mass index, 21.2 ± 1.5 kg/m2; VO2peak,63.9 ± 2.5 ml·kg−1·min−1; Wmax, 389.3 ± 50.4 W). Participants ingested 0.35 g/kg of BD or placebo 30 min before and 60 min during 85 min of steady-state exercise, which preceded a ∼25- to 35-min TT (i.e., 7 kJ/kg). The ingestion of BD increased blood D-βHB concentration throughout exercise (0.44–0.79 mmol/L) compared with placebo (0.11–0.16 mmol/L; all p < .001), which peaked 1 hr following the TT (1.38 ± 0.35 vs. 0.34 ± 0.24 mmol/L; p < .001). Serum glucose and blood lactate concentrations were not different between trials (all p > .05). BD ingestion increased oxygen consumption and carbon dioxide production after 20 min of steady-state exercise (p = .002 and p = .032, respectively); however, no further effects on cardiorespiratory parameters were observed. Within the BD trial, moderate to severe gastrointestinal symptoms were reported in five participants, and low levels of dizziness, nausea, and euphoria were reported in two participants. However, this had no effect on TT duration (placebo, 28.5 ± 3.6 min; BD, 28.7 ± 3.2 min; p = .62) and average power output (placebo, 290.1 ± 53.7 W; BD, 286.4 ± 45.9 W; p = .50). These results suggest that BD has no benefit for endurance performance.
Presleep Protein Supplementation Does Not Improve Recovery During Consecutive Days of Intense Endurance Training: A Randomized Controlled Trial
Authors: Larsen Mads S. , Clausen Dagmar , Jørgensen Astrid Ank , Mikkelsen Ulla R. , Hansen Mette
Published: January 2019

Recent studies demonstrate that protein ingestion immediately before sleep improves muscle recovery during the night following resistance exercise. Whether this feeding strategy benefits recovery from endurance training has yet to be established. The aim of this study was to investigate the effects of whey protein isolate ingested every night before sleep on subsequent performance and circulatory markers of muscular recovery during a week of intensified endurance training mimicking a training camp. In a parallel design, 32 trained runners underwent a 1-week intervention with a rigorously controlled diet (carbohydrate = 7.2 g·kg−1·day−1, protein = 1.8 g·kg−1·day−1, and fat = 1.0 g·kg−1·day−1) and exercise program (11 sessions) while receiving either a protein (0.5 g·kg−1·day−1) or carbohydrate (0.5 g·kg−1·day−1) beverage every night before sleep. Blood samples were obtained on the morning of Days 1, 4, 7, and 8 and analyzed for markers of muscle damage (creatine kinase, lactate dehydrogenase, and myoglobin). The postintervention 5-km time-trial performance was significantly impaired in both groups (11 ± 24 s, p < .01). Plasma creatine kinase (227% ± 221%, p < .01), lactate dehydrogenase (18% ± 22%, p < .01), and myoglobin (72% ± 62%, p < .01) increased gradually throughout the week with no difference between the groups (p > .05). In conclusion, the presleep protein ingestion did not reduce the decline in performance or ameliorate the rise of circulatory markers of muscle damage during a week of intensified training when compared with the isocaloric carbohydrate ingestion.
How to shine in Indonesian science? Game the system
Authors: Rochmyaningsih Dyna
Published: January 2019

Researchers object to a metric that was easy to manipulate.
Secreted amyloid-β precursor protein functions as a GABA
B
R1a ligand to modulate synaptic transmission
Authors: Rice Heather C. , de Malmazet Daniel , Schreurs An , Frere Samuel , Van Molle Inge , Volkov Alexander N. , Creemers Eline , Vertkin Irena , Nys Julie , Ranaivoson Fanomezana M. , Comoletti Davide , Savas Jeffrey N. , Remaut Han , Balschun Detlef , Wierda Keimpe D. , Slutsky Inna , Farrow Karl , De Strooper Bart , de Wit Joris
Published: January 2019

A physiological function for sAPP?

Although the pathological role of the amyloid-β precursor protein (APP) in Alzheimer's disease is well studied, the physiological role of this protein has remained elusive. Rice
et al.
found that the secreted ectodomain of APP (sAPP) binds to GABA
B
R1a, the metabotropic receptor for the inhibitory neurotransmitter γ-aminobutyric acid (GABA) (see the Perspective by Korte). Binding suppressed synaptic vesicle release and modulated synaptic transmission and plasticity in mice. A short, 17–amino acid peptide in APP bound to GABA
B
R1a's sushi 1 domain, conferring structure to this unstructured domain. Therapeutics targeting this interaction could potentially benefit a range of neurological disorders in which GABA signaling is implicated.

Science
, this issue p.
eaao4827
; see also p.
123
Chronic TLR7 and TLR9 signaling drives anemia via differentiation of specialized hemophagocytes
Authors: Akilesh Holly M. , Buechler Matthew B. , Duggan Jeffrey M. , Hahn William O. , Matta Bharati , Sun Xizhang , Gessay Griffin , Whalen Elizabeth , Mason Michael , Presnell Scott R. , Elkon Keith B. , Lacy-Hulbert Adam , Barnes Betsy J. , Pepper Marion , Hamerman Jessica A.
Published: January 2019

Unmasking an agent of inflammatory anemia

Infectious and autoimmune diseases are associated with anemia and thrombocytopenia. A severe form of inflammatory cytopenia called macrophage activation syndrome (MAS) may occur during rheumatological disorders and viral infections. Akilesh
et al.
show that monocyte recognition of self- or pathogen-derived nucleic acids via Toll-like receptors 7 and 9 (TLR7 and TLR9) drives MAS-like disease in mice. TLR7 or TLR9 signaling in monocytes causes these cells to differentiate into inflammatory hematophagocytes (iHPCs), which are similar to but distinct from red pulp macrophages. Preventing iHPC differentiation by depleting monocytes relieves MAS-like symptoms. When mice were subjected to a model of malarial anemia, MyD88- and endosomal TLR-dependent iHPC differentiation also occurred. Thus, iHPCs may play a role in both MAS-driven and malarial anemia, as well as thrombocytopenia.

Science
, this issue p.
eaao5213
Cheap oil vs. climate change
Energy Kingdoms
Jim Krane
Columbia University Press, 2019. 220 pp.
Authors: Aczel Miriam R.
Published: January 2019

The Gulf struggles to reform subsidies as temperatures and domestic energy demand rise
The future is fiber
Fiber: The Coming Tech Revolution—And Why America Might Miss It
Susan Crawford
Yale University Press, 2018. 260 pp.
Authors: Mayer-Schönberger Viktor
Published: January 2019

Faster, cheaper, and more versatile than traditional telecom hardware, U.S. fiber networks still face policy hurdles
Neuronal function of Alzheimer's protein
Authors: Korte Martin
Published: January 2019

Cleavage products of an Alzheimer's disease protein are involved in synaptic homeostasis
Recognition of the amyloid precursor protein by human γ-secretase
Authors: Zhou Rui , Yang Guanghui , Guo Xuefei , Zhou Qiang , Lei Jianlin , Shi Yigong
Published: January 2019

The machinery behind amyloid peptides

β-Amyloid peptides, which are derived from amyloid precursor protein (APP), form the plaques in the brain that are characteristic of Alzheimer's disease. Zhou
et al.
report a high-resolution structure of a transmembrane segment of APP bound to human γ-secretase, the transmembrane protease that cleaves APP to give β-amyloid peptides (see the Perspective by Lichtenthaler and Güner). Disease-associated mutations within presenilin-1, the catalytic subunit of APP, likely affect how the substrate is bound and thus which peptides are generated, with some being more amyloidogenic. It may now be possible to exploit the features of substrate binding to design inhibitors.

Science
, this issue p.
eaaw0930
; see also p.
690
Superior Dispersal Ability Can Lead to Persistent Ecological Dominance throughout Succession
Authors: Boynton Primrose J. , Peterson Celeste N. , Pringle Anne
Published: January 2019

Microbial communities are ubiquitous and occupy nearly every imaginable habitat and resource, including human-influenced habitats (e.g., fermenting food and hospital surfaces) and habitats with little human influence (e.g., aquatic communities living in carnivorous plant pitchers). We studied yeast communities living in pitchers of the carnivorous purple pitcher plant to understand how and why microbial communities change over time. We found that dispersal ability is not only important for fungal communities early in their existence, it can also determine which species is dominant (here, the yeast
Candida pseudoglaebosa
) long after the species and its competitors have arrived. These results contrast with observations from many human-influenced habitats, in which a good competitor eventually outcompetes good dispersers, since humans often design these habitats to favor a specific competitor. This study will help microbiologists understand the qualities of microbial species that enable takeover of new habitats in both natural and human-influenced environments.
Bacterial Community Assembly in a Typical Estuarine Marsh with Multiple Environmental Gradients
Authors: Yao Zhiyuan , Du Shicong , Liang Chunling , Zhao Yueji , Dini-Andreote Francisco , Wang Kai , Zhang Demin
Published: January 2019

Salt marshes represent highly dynamic ecosystems where the atmosphere, continents, and the ocean interact. The bacterial distribution in this ecosystem is of great ecological concern, as it provides essential functions acting on ecosystem services. However, ecological processes mediating bacterial assembly are poorly understood for salt marshes, especially the ones located in estuaries. In this study, the distribution and assembly of bacterial communities in an estuarine marsh located in south Hangzhou Bay were investigated. The results revealed an intricate interplay between stochastic and deterministic processes mediating the assembly of bacterial communities in the studied gradient system. Collectively, our findings illustrate the main drivers of community assembly, taking into consideration changes in sediment abiotic variables and potential biotic interactions. Thus, we offer new insights into estuarine bacterial communities and illustrate the interplay of ecological processes shaping the assembly of bacterial communities in estuarine marsh ecosystems.
Peptide-Based Inhibitors of Fimbrial Biogenesis in Porphyromonas gingivalis
Authors: Alaei Sarah R. , Park Jin Ho , Walker Stephen G. , Thanassi David G.
Published: January 2019

Periodontitis is a progressive inflammatory disease that affects roughly half of American adults. Colonization of the oral cavity by the Gram-negative bacterial pathogen
Porphyromonas gingivalis
is a key event in the initiation and development of periodontal disease.
The Conserved Role of YidC in Membrane Protein Biogenesis
Authors: Shanmugam Sri Karthika , Dalbey Ross E.
Published: January 2019

YidC insertase plays a pivotal role in the membrane integration, folding, and assembly of a number of proteins, including energy-transducing respiratory complexes, both autonomously and in concert with the SecYEG channel in bacteria. The YidC family of proteins is widely conserved in all domains of life, with new members recently identified in the eukaryotic endoplasmic reticulum membrane. Bacterial and organellar members share the conserved 5-transmembrane core, which forms a unique hydrophilic cavity in the inner leaflet of the bilayer accessible from the cytoplasm and the lipid phase. In this chapter, we discuss the YidC family of proteins, focusing on its mechanism of substrate insertion independently and in association with the Sec translocon.
Catastrophic antiphospholipid syndrome causing ST-segment elevation myocardial infarction with non-obstructive coronary arteries
Authors: Cranley James , Krishnan Unni , Tweed Katharine , Duehmke Rudolf Martin
Published: January 2019

A 51-year-old woman with known primary antiphospholipid syndrome presented with a 4-day history of chest and abdominal pain, inferior ST-segment elevation on a 12-lead ECG and a subtherapeutic international normalised ratio. In view of a significantly raised high-sensitivity troponin I assay, inferior wall hypokinesis on transthoracic echocardiography and despite unobstructed epicardial vessels on emergency coronary angiography, a diagnosis of myocardial infarction was made. Furthermore, the patient also developed both bilateral adrenal haemorrhages leading to acute adrenal insufficiency and microvascular thrombotic renal disease concurrently. The patient therefore fulfilled the diagnostic criteria for catastrophic antiphospholipid syndrome presenting with cardiac, endocrine and renal involvement. Early diagnosis permitted appropriate treatment with anticoagulation, dual antiplatelet therapy, secondary prevention and corticosteroid replacement therapy and led to a full recovery. This case highlights first the importance of adequate anticoagulation in antiphospholipid syndrome and, second, the potentially fatal, multiorgan complication of failure to do so.
Nocardialung abscess in an immunocompetent adolescent
Authors: Soares Diana , Reis-Melo Ana , Ferraz Catarina , Guedes Vaz Luisa
Published: January 2019

The authors report a case of a lung abscess caused byNocardiasp. in a previously healthy adolescent. A 17-year-old young man presented with tonsillitis that did not respond to β-lactamic antibiotic, dyspnoea and thoracic pain. The X-ray revealed a cavitation in the right pulmonary upper lobe. He was admitted and completed a 14-day empirical antimicrobial therapy for a pulmonar abscess, although no clinical recovery was observed. He then underwent pulmonary biopsy of the lesion and PCR analysis of the collected pulmonary tissue, which revealed the presence ofNocardia. This case emphasises the importance of considering nocardiosis in the differential diagnosis of a lung abscess, particularly if no response to empirical therapy is obtained.
Managing the health of the eSport athlete: an integrated health management model
Authors: DiFrancisco-Donoghue Joanne , Balentine Jerry , Schmidt Gordon , Zwibel Hallie
Published: January 2019

Objectives

eSport is a form of electronic gaming, also known as professional or competitive video gaming, and is growing at a rapid pace worldwide. Over 50 US colleges have established varsity gaming teams over the past three years; some colleges offer eSport scholarships as they do for traditional sports. There is little objective research on the health habits of these players who are often placed under the direction of the athletics department on college campuses, and there is currently no health management model on how to treat these new athletes.

Methods

Anonymous electronic surveys were sent to 65 collegiate eSport players from nine universities across the USA and Canada inquiring about gaming and lifestyle habits, and musculoskeletal complaints due to eSport competition.

Results

Players practiced between 3 and 10 hours per day. The most frequently reported complaint was eye fatigue (56%), followed by neck and back pain (42%). eSport athletes reported wrist pain (36%) and hand pain (32%). Forty per cent of participants do not participate in any form of physical exercise. Among the players surveyed, only 2% had sought medical attention.

Conclusion

eSport players, just like athletes in traditional sports, are susceptible to overuse injuries. The most common complaint was eye fatigue, followed by neck and back pain. This study shows eSport athletes are also prone to wrist and hand pain. This paper proposes a health management model that offers a comprehensive medical team approach to prevent and treat eSport athletes.
Poly I:C-based rHBVvac therapeutic vaccine eliminates HBV via generation of HBV-specific CD8+ effector memory T cells
Authors: Zhao Hua-Jun , Han Qiu-Ju , Wang Guan , Lin Ang , Xu Dong-Qing , Wang Ya-Qun , Zhao Lian-Hui , Tian Zhi-Gang , Zhang Jian
Published: January 2019

Objective

Chronic hepatitis B (CHB) virus infection is a global health problem. Finding a cure for CHB remains a challenging task.

Design

In this study, poly I:C was employed as an adjuvant for HBV therapeutic vaccine (referred to as pHBV-vaccine) and the feasibility and efficiency of pHBV-vaccine in CHB treatment were evaluated in HBV-carrier mice.

Results

We found that pHBV-vaccine decreased HBsAg and HBV DNA efficiently and safely in HBV-carrier mice. Further investigation showed that pHBV-vaccine promoted maturation and antigen presentation ability of dendritic cells in vivo and in vitro. This vaccine successfully restored the exhaustion of antigen-specific CD8+ T cells and partly broke the immune tolerance established in HBV-carrier mice. pHBV-vaccine also enhanced the proliferation and polyfunctionality of HBV-specific CD11ahi CD8αlo cells. Importantly, we observed that T cell activation molecule KLRG1 was only expressed on HBV specific CD11ahi CD8αlo cells. Furthermore, pHBV-vaccine reduced the expression of Eomes and increased the serum IL-12 levels, which in turn promoted the generation of effector memory short-lived effector cells (SLECs) to exhibit a critical role in HBV clearance. SLECs induced by pHBV-vaccine might play a crucial role in protecting from HBV reinfection.

Conclusions

Findings from this study provide a new basis for the development of therapeutic pHBV-vaccine, which might be a potential candidate for clinical CHB therapy.
Pyromellitic dianhydride (PMDA) may cause occupational asthma
Authors: Madsen Milene Torp , Skadhauge Lars Rauff , Nielsen Anders Daldorph , Baelum Jesper , Sherson David Lee
Published: January 2019

Introduction

Anhydrides are widely used as cross-linking agents in epoxy resins and alkyd production, for example, as coatings and adhesives in plastic products. Sensitisation to several anhydrides is known to cause occupational asthma. There are indications that the lesser known pyromellitic dianhydride (PMDA) can cause irritative respiratory symptoms and possibly asthma. We report three cases of workers from a plastic foil manufacturing plant, who developed asthma when exposed to PMDA during specific inhalation challenge (SIC).

Methods

SIC was performed over 2 days according to recommendations of European Respiratory Society. Lactose powder was used in control challenges and a mixture of 10% PMDA and 90% lactose powder in active challenges.

Results

All cases experienced a delayed decrease in forced expiratory flow in 1 s (FEV1) 4–12 hours after active challenge. FEV1decreased by 19%, 15% and 16%, respectively. After 21 hours, FEV1decreased by 24% in one worker.

Discussion

Respiratory symptoms after working hours may represent delayed work-related asthma. During SIC, the three patients developed lower respiratory symptoms and a delayed decrease in FEV1which suggest sensitisation. The mechanism of anhydride-related asthma is not well understood. Anhydrides are known irritants and hence an irritative response cannot be excluded. The company improved ventilation and enforced the use of respiratory protection equipment, and finally phased out PMDA. Occupational workplace risk identification may help to identify exposures. SIC can contribute to improving working conditions, by identifying and confirming asthmogens in the environment.
Electroplating and brazing joining of 5083 aluminum alloy to CFRP
Authors: Guo K. , Liu Y. , Gou G. , Zhang W. , Gao W. , Wang Wanjng
Published: January 2019

This study has analyzed the welding joint of carbon fiber reinforced plastics (CFRP) and aluminum alloys. The surface of CFRP and 5083 Al alloy was modified by electroplating with nickel at first. Then the effect of electroplating parameters on coating was explored. SEM images revealed that the coating gradually became well but then began to fall off with the current density and the plating time increased. CFRP and aluminum alloys were brazed at 285[Formula: see text]C and held for 20 s. Shear test was used to evaluate the strength of the joint and the strength was probably 7.56 MPa. SEM and EDS tests showed that there existed diffusion of the elements in the welding process and the joint reached the bonding of atomic or molecular sizes. Thus, this experiment achieved the tight brazing joining between thermoset CFRP and aluminum alloys providing the joining method of the application for CFRP.
Effect of mechanical-annealing on the mechanical properties of a Zr-based bulk metallic glass
Authors: Deng P. , Wang X. C. , Zhang F. , Qin X. M. , Gao P. , Sui Y. D. , Tan J.
Published: January 2019

The mechanical-annealing referred in this work is also named pre-strain, which is widely investigated in TRIP steel, stainless steel, magnesium alloy and aluminum alloy. In this case, we used preloading to input energy into a bulk metallic glass (BMG) to observe the changes in the structure and mechanical properties. We selected Zr[Formula: see text]Co[Formula: see text]Al[Formula: see text] BMG as a model material owning to its outstanding glass forming ability and excellent mechanical properties. The samples were kept at a constant pressure of 1900, 1700 and 1500 MPa (below the yield strength) for 40, 55 and 70 h. The study found out that the density of those samples increased after being pre-loaded. Then, the samples underwent aging treatment at room-temperature for more than 30 days after unloading. After re-compressing the samples, the results show that the yield strength and fracture strength of the samples decreased, and the amplitude of the serrated plastic flow increased during the plastic stage. Our finding might have some implications for understanding the plastic deformation of BMGs.