bluuebunny/crossref_metadata_2025 huggingface dataset:
COVID-19 Pandemic Prediction for Hungary: A Hybrid Machine Learning Approach
Authors: Pinter Gergo , Felde Imre , Mosavi Amir , Ghamisi Pedram , Gloaguen Richard
Published: May 2020

Several epidemiological models are being used around the world to project the number of infected individuals and the mortality rates of the COVID-19 outbreak. Advancing accurate prediction models is of utmost importance to take proper actions. Due to a high level of uncertainty or even lack of essential data, the standard epidemiological models have been challenged regarding the delivery of higher accuracy for long-term prediction. As an alternative to the susceptible-infected-resistant (SIR)-based models, this study proposes a hybrid machine learning approach to predict the COVID-19 and we exemplify its potential using data from Hungary. The hybrid machine learning methods of adaptive network-based fuzzy inference system (ANFIS) and multi-layered perceptron-imperialist competitive algorithm (MLP-ICA) are used to predict time series of infected individuals and mortality rate. The models predict that by late May, the outbreak and the total morality will drop substantially. The validation is performed for nine days with promising results, which confirms the model accuracy. It is expected that the model maintains its accuracy as long as no significant interruption occurs. Based on the results reported here, and due to the complex nature of the COVID-19 outbreak and variation in its behavior from nation-to-nation, this study suggests machine learning as an effective tool to model the outbreak. This paper provides an initial benchmarking to demonstrate the potential of machine learning for future research.
Testing Generalized Einstein-Cartan-Kibble-Sciama Gravity Using Weak Deflection Angle and Shadow Cast
Authors: Övgün Ali , Sakallı İzzet
Published: May 2020

In this paper, we use a new asymptotically flat and spherically symmetric solution in the generalized Einstein-Cartan-Kibble-Sciama (ECKS) theory of gravity to study the weak gravitational lensing and its shadow cast. To this end, we first compute the weak deflection angle of generalized ECKS black hole using the Gauss–Bonnet theorem in plasma medium and in vacuum. Next by using the Newman-Janis algorithm without complexification, we derive the rotating generalized ECKS black hole and in the sequel study its shadow. Then, we discuss the effect of the ECKS parameter on the shadow of the black hole and weak deflection angle. In short, the goal of this paper is to give contribution to the ECKS theory and look for evidences to understand how the ECKS parameter effects the gravitational lensing.
No-Arbitrage Principle in Conic Finance
Authors: Vazifedan Mehdi , Zhu Qiji Jim
Published: May 2020

In a one price economy, the Fundamental Theorem of Asset Pricing (FTAP) establishes that no-arbitrage is equivalent to the existence of an equivalent martingale measure. Such an equivalent measure can be derived as the normal unit vector of the hyperplane that separates the attainable gain subspace and the convex cone representing arbitrage opportunities. However, in two-price financial models (where there is a bid-ask price spread), the set of attainable gains is not a subspace anymore. We use convex optimization, and the conic property of this region to characterize the “No-Arbitrage” principle in financial models with the bid-ask price spread present. This characterization will lead us to the generation of a set of price factor random variables. Under such a set, we can find the lower and upper bounds (supper-hedging and sub-hedging bounds) for the price of any future cash flow. We will show that for any given cash flow, for which the price is outside the above range, we can build a trading strategy that provides one with an arbitrage opportunity. We will generalize this structure to any two-price finite-period financial model.
Expression Pattern of the SARS-CoV-2 Receptor ACE2 and TMPRSS2 in the Respiratory Tract
Authors: Liu Yichuan , Qu Hui-Qi , Tian Lifeng , Hakonarson Hakon
Published: May 2020

To address the expression pattern of the SARS-CoV-2 receptor ACE2 and the viral priming protease, TMPRSS2, in the respiratory tract, this study investigated RNA sequencing transcriptome profiling of samples of airway and oral mucosa. As shown, ACE2 has medium levels of expression in both small airway epithelium and masticatory mucosa, and high levels of expression in nasal epithelium. The expression of ACE2 is low in mucosal associated invariant T (MAIT) cells, and can’t be detected in alveolar macrophages. TMPRSS2 is highly expressed in small airway epithelium and nasal epithelium, and has lower expression in masticatory mucosa. Our results highlights that the nasal mucosa is the most susceptible locus in the respiratory tract for SARS-CoV-2 infection and consequently for subsequent droplet transmission and should be the focus for protection against SARS-CoV-2 infection.
Vimentin as a Multifaceted Player and Potential Therapeutic Target in Viral Infections
Authors: Ramos Irene , Stamatakis Konstantinos , Oeste Clara L. , Pérez-Sala Dolores
Published: May 2020

Vimentin is an intermediate filament protein that plays key roles in integration of cytoskeletal functions, and therefore in basic cellular processes such as cell division and migration. Consequently, vimentin has complex implications in pathophysiology. Vimentin is required for a proper immune response, but it can also act as an autoantigen in autoimmune diseases or as a damage signal. Although vimentin is a predominantly cytoplasmic protein, it can also appear at extracellular locations, either in a secreted form or at the surface of numerous cell types, often in relation to cell activation, inflammation, injury or senescence. Cell surface targeting of vimentin appears to associate with the occurrence of certain posttranslational modifications, such as phosphorylation and/or oxidative damage. At the cell surface, vimentin can act as a receptor for bacterial and viral pathogens. Indeed, vimentin has been shown to play important roles in virus attachment and entry of severe acute respiratory syndrome-related coronavirus (SARS-CoV), dengue and encephalitis viruses, among others. Moreover, the presence of vimentin in specific virus-targeted cells and its induction by proinflammatory cytokines and tissue damage contribute to its implication in viral infection. Here, we recapitulate some of the pathophysiological implications of vimentin, including the involvement of cell surface vimentin in interaction with pathogens, with a special focus on its role as a cellular receptor or co-receptor for viruses. In addition, we provide a perspective on approaches to target vimentin, including antibodies or chemical agents that could modulate these interactions to potentially interfere with viral pathogenesis, which could be useful when multi-target antiviral strategies are needed .
AERODYNAMIC CHARACTERISTIC AND AIRPLANE STABILITY AT THE PLERIMENARY DESIGN STAGE
Authors: Sulistyo Meiyanto Eko , Ramadhan Muhammad Ikyu Arqie , Inderawan Ardya Paradipta Sylvano
Published: May 2020

Preliminary Design is the second stage in aircraft design after knowing the needs and specifications at the Conceptual Design stage. This Preliminary Design includes the conceptual design evaluation of aircraft performance in several fields, such as aerodynamics, engine power, and aircraft structure. This Job Training Report illustrates how is taken to conduct aerodynamic and aircraft stability analysis at the plerimenary design stage using NASA's open source software, Open Vehicle Simulation Program (OpenVsp). The aircraft model is simulated until aerodynamic and stability data are obtained which later can be processed for aircraft control design. 
Basic Tutorial on Sliding Mode Control in Speed Control of DC-motor
Authors: Maghfiroh Hari , Sujono Augustinus , Ahmad Musyaffa' , Apribowo Chico Hermanu Brillianto
Published: May 2020

One technology to support production speed is electric motors with high performance, efficiency, dynamic speed and good speed responses. DC motors are one type of electric motor which is used in the industry. Sliding Mode Control (SMC) is the robust non-linear control. The basic theory regarding SMC is presented. The SMC design which is implemented is the speed control of the DC motor is analyzed. The controller is implemented in simulation using MATLAB / Simulink environment. The step response and signal tracking test unit are carried out. The results show that SMC has a better performance compare to PID which is faster settling time and no overshoot and undershoot. 

 
Investigation of Internal Thread Cutting Phenomena in Three Axes by Controlling Helical Interpolate Motion Considering Tool Position Information from Servo-Drive
Authors: Matsui Shota , Ozaki Nobutoshi , Hirogaki Toshiki , Aoyama Eiichi , Yamamoto Takamasa ,   Doshisha University 1-3 Tataramiyakodani, Kyotanabe-shi, Kyoto 610-0394, Japan,   Yamamoto Metal Technos Co., Ltd., Osaka, Japan
Published: May 2020

In this study, the authors investigate improving the precision of a thread by deriving its radial force (thrust force) with a four-component piezoelectric dynamometer and thread cutting by helical interpolation motion using a thread mill. The accuracy of the thread is discussed with respect to changing hardness of the work material. In addition, by recording the position information at the time of thread cutting from the servo guide on the data logger, the relationships among the cutting forces of the four components and the radial force are confirmed by various methods; further, the consistency of these relationships was confirmed.
The Role of Magnesium in the Development of Cardiovascular Diseases and the Possibility of their Prevention and Correction with Magnesium Preparations (Part 2)
Authors: Safaryan A. S. , Sargsyan V. S. , Nebieridze D. V.
Published: May 2020

Data on the effect of magnesium on the homeostasis of the body and on the cardiovascular system, are presented in the article. These data supplement information on studies of the role of magnesium in many body processes. The influence of lifestyle on magnesium metabolism, the pathological processes that cause its deficiency, and the clinical picture of hypomagnesemia are presented in the article. The necessary daily amount of magnesium, ways to restore the magnesium deficiency, both nutritional and with the help of magnesium-containing pharmacological preparations, their form, bioavailability and dosage regimen are discussed. Diseases that occur and/or worsen with hypomagnesemia are considered. Data on the iatrogenic effect of many drugs, including cardiological, removing magnesium from the body and ways to solve this issue, are also presented. Hypomagnesemia exacerbates the course of cardiovascular disease. Elimination of magnesium deficiency can contribute a lot to the prevention of morbidity and the optimization of treatment of patients.
« En magie, demander c’est obtenir »
Authors: Mulat Lucile
Published: May 2020

Dans son dernier roman, Les Sorcières de la République, Chloé Delaume imagine une société où, devenues sorcières après que les déesses de l’Olympe les ont dotées de pouvoirs magiques, les femmes renversent le gouvernement français jugé trop oppressif pour celles-ci et imposent un nouveau régime politique. Si l’intrigue paraît fantasque, le réinvestissement de la figure de la sorcière, incantatrice et jeteuse de sorts, permet de mettre en avant l’idée d’un pouvoir d’action résidant fondamentalement dans la parole. Cet article se propose d’analyser comment cette agentivité discusive se construit précisément dans le texte en observant la parole de la sorcière, de la représentation de son émettrice à l’espace dans lequel sa voix résonne. 

 

Mots-clés :  sorcière, agentivité, pouvoir, parole, Delaume 

Références 

Austin, John L. How to Do Things with Words. Oxford University Press, 1962.  

Bras-Chopard (Le), Armelle. Les Putains du Diable : Le procès en sorcellerie des femmes. Plon, 2006.  

Bechtel, Guy, Les quatre femmes de Dieu : La putain, la sorcière, la sainte & Bécassine. Plon, 2000. 

Butler, Judith. Excitable Speech: A Politics of the Performative. Routledge, 1997.  

---. Gender Trouble: Feminism and the Subversion of Identity. Routledge, 1990.  

Delaume, Chloé. Les Sorcières de la République. Seuil, 2016. 

---. Mes biens chères sœurs. Seuil, 2019. 

Despentes, Virginie. King Kong théorie. Grasset & Fasquelle, « Le livre de poche », 2007.  

Federici, Silvia, Caliban et la Sorcière : femmes, corps et accumulation primitive. Traduit par le collectif Senonevero, Entremonde/Senonevero, 2014. 

Gardiner, Judith Kegan, éditrice. Provoking Agents: Gender and Agency in Theory and Practice. University of Illinois Press, 1995.  

Havercroft, Barbara. « Quand écrire, c'est agir : stratégies narratives d'agentivité féministe dans Jounal pour mémoire de France Théoret. » Dalhousie French Studies, vol. 47, Summer 1999, pp. 93-113. 

Hekman, Susan. “Subjects and Agents: The question for Feminism.” Provoking Agents: Gender and Agency in Theory and Practice, édité par Judith Kegan Gardiner, University of Illinois Press, 1995, pp. 94-207.  

Michelet, Jules. La Sorcière. 1862. M. Didier, 1952-56. 

Rose, Gillian. Feminism & Geography: The Limits of Geographical Knowledge. Polity Press, 1993.
Les lettres-objets de Simone de Beauvoir : entretien avec Sylvie Le Bon de Beauvoir
Authors: Schwerdtner Karin
Published: May 2020

Sylvie Le Bon de Beauvoir est la fille adoptive et héritière de Simone de Beauvoir. Elle est également l’éditrice de la correspondance beauvoirienne. Nous lui devons récemment l’Album, conçu pour accompagner la publication des Mémoires (2018) de Beauvoir dans la Pléiade. Les propos ici recueillis de Sylvie Le Bon de Beauvoir portent sur son travail de tri et d’édition, sur les circonstances qui ont amené la publication entre autres des Lettres à Sartre (1990), et sur le cadeau que Simone de Beauvoir nous a fait en conservant ses « lettres reçues ».
Lydia Flem : « L’imagination est ma seule maison ». Entretien autour des lettres (et) objets
Authors: Schwerdtner Karin
Published: May 2020

Lydia Flem est écrivaine, psychanalyste et photographe. Elle est l’auteure notamment de Comment j’ai vidé la maison de mes parents (2004), Lettres d’amour en héritage (2006), La Reine Alice (2011), Journal implicite. Photographies 2008-2012 (2013), et Je me souviens de l'imperméable rouge que je portais l'été de mes vingt ans (2016). Dans le présent entretien, Lydia Flem revient avec nous sur son rapport personnel aux objets, pour la plupart de l'expérience commune, ainsi que sur le rôle qu’ils jouent dans son travail, dans le processus créateur.
OFFRED AS THE VICTIM OF TOTALITARIANISM IN MARGARET ATWOOD’S THE HANDMAID’S TALE
Authors: Deboranti Ribka Transiska , Wedati Mamik Tri
Published: May 2020

This study uses descriptive qualitative method which focusing on the literary work in the novel and interpretation on the analysis. The main data is taken from the novel The Handmaid’s Tale written by Margaret Atwood. This subject of study focus on the influences of totalitarianism held in the Republic of Gilead and how Offred resists totalitarianism in the novel. In order to analyze the text, this study uses the theory of Totalitarianism by Friedrich and Brzeziinski and Hannah Arendt. The result of this analysis depicts the political system of totalitarianism in Gilead influences their societies, especially Offred and the way to resist against the regime. The features of totalitarianism are used to depict the characteristics of totalitarianism that happen in Gilead society. The totalitarianism ideology brings Offred’s action to resist against it.
UNIVERSALIST FEMINISM IN THE FIELD OF AUTHORSHIP (A CASE STUDY ON SIDOARJO WOMEN WRITERS COMMUNITY)
Authors: Fediyanto Niko , Mandarani Vidya , Astutik Yuli
Published: May 2020

This research discusses the community of women writers in Sidoarjo using a feminist sociological perspective. The purpose of this research is to formulate the pattern of relations of this community with the structure of the field of authorship using Bourdieu's perspective. The research method used is qualitative with descriptive patterns. Data were collected using a combination of interview and documentation techniques using library research procedures. The results showed that this community of women writers had an awareness of the existence of dominant-dominated binary opposition structures and included aspects of gender considerations in their authorship strategies, but they chose patterns as used in universalist feminism.
Early prediction of pathologic response to neoadjuvant treatment of breast cancer: use of a cell-loss metric based on serum thymidine kinase 1 and tumour volume
Authors: Tribukait Bernhard
Published: May 2020

Background: After neoadjuvant chemotherapy of breast cancer pathologic complete response (pCR) indicates a favorable prognosis. Among non-selected patients, pCR is, however, achieved in only 10-30%. Early evaluation of tumour response to treatment would facilitate individualized therapy, with ineffective chemotherapy interrupted or changed. The methodology for this purpose is still limited. Tumour imaging and analysis of macromolecules, released from disrupted tumour cells, are principal alternatives.

Objective: To investigate whether a metric of cell-loss, defined as the ratio between serum concentration of thymidine kinase1 (sTK1, ng x ml-1) and tumour volume, can be used for early prediction of pathologic response.

Methods: 104 women with localized breast cancer received neoadjuvant epirubicin/docetaxel in 6 cycles, supplemented with bevacizumab in cycles 3-6. The cell-loss metric was established at baseline (n=104), 48h after cycle 2 (n=104) and prior to cycle 2 (n=57). The performance of the metric was evaluated by association with pathologic tumour response at surgery 4 months later.

Results: Treatment caused a rise in sTK1, a reduction in tumour volume and a marked increase in

the cell-loss metric. Patients were subdivided into quartiles according to the baseline cell-loss

metric. For these groups, baseline means were 0.0016, 0.0042, 0.0062, 0.0178 units. After

subtraction of baselines, means for the quartiles 48h after treatment 2 were 0.002, 0.011, 0.030 and

0.357 units. pCR was achieved in 24/104, their distribution in the quartiles (11%, 11%, 23% and

46%) differed significantly (p=0.01). In 80 patients with remaining tumour, tumour size was

inversely related to the metric (p=0.002). In 57 patients studied before treatment 2, positive and

negative predictive values of the metric were 77.8% and 83.3%, compared to 40.5% and 88.7% 48h

after treatment 2.

Conclusion: A cell-loss metric, based on serum levels of TK1, released from disrupted tumour cells, and tumour volume, reveal tumour response early during neoadjuvant treatment. The metric reflect tumour properties that differ greatly between patients and determine the sensitivity to cytotoxic treatment. The findings point to the significance of cell loss for tumour growth rate. The metric should be considered in personalized oncology and in the evaluation of new therapeutic modalities.
The effect of trajectory of serum uric acid on patients and renal outcomes in patients with stage-3 chronic kidney disease
Authors: Author) Shangfeng Tsai(Former Corresponding , Chen Cheng-Hsu , Wu Ming-Ju , Author) Chia-Lin Lee(New Corresponding
Published: May 2020

The authors have withdrawn this preprint due to author disagreement.
Identification and analysis of CYP450 and UGT supergene family members from the transcriptome of Aralia elata (Miq.) Seem reveal candidate genes for triterpenoid saponin biosynthesis
Authors: Cheng Yao , Liu Hanbing , Tong Xuejiao , Liu Zaimin , Zhang Xin , Li Dalong , Jiang Xinmei , Yu Xihong
Published: May 2020

Background: Members of the cytochrome P450 (CYP450) and UDP-glycosyltransferase (UGT) gene superfamily have been shown to play essential roles in regulating secondary metabolite biosynthesis. However, the systematic identification of CYP450s and UGTs has not been reported in Aralia elata (Miq.) Seem, a highly valued medicinal plant. Results: In the present study, we conducted the RNA-sequencing (RNA-seq) analysis of the leaves, stems, and roots of A. elata, yielding 66,713 total unigenes. Following annotation and KEGG pathway analysis, we were able to identify 64 unigenes related to triterpenoid skeleton biosynthesis, 254 CYP450s and 122 UGTs, respectively. A total of 150 CYP450s and 92 UGTs encoding >300 amino acid proteins were utilized for phylogenetic and tissue-specific expression analyses. This allowed us to cluster 150 CYP450s into 9 clans and 40 families, and then these CYP450 proteins were further grouped into two primary branches: A-type (53%) and non-A-type (47%). A phylogenetic analysis of 92 UGTs and other plant UGTs led to clustering into 16 groups (A-P). We further assessed the expression patterns of these CYP450 and UGT genes across A. elata tissues, with 23 CYP450 and 16 UGT members being selected for qRT-PCR validation, respectively. From these data, we identified CYP716A295 and CYP716A296 as the candidate genes most likely to be associated with oleanolic acid synthesis, while CYP72A763 and CYP72A776 were identified as being the most likely to play roles in hederagenin biosynthesis. We also selected five unigenes as the best candidates for oleanolic acid 3-O-glucosyltransferase. Finally, we assessed the subcellular localization of three CYP450 proteins within Arabidopsis protoplasts, highlighting the fact that they localize to the endoplasmic reticulum.Conclusions: This study presents a systematic analysis of the CYP450 and UGT gene family in A. elata and provides a foundation for further functional characterization of these two multigene families.
In vitro and In vivo recombination of heterologous modules for improving biosynthesis of astaxanthin in yeast
Authors: Qi Dan-Dan , Jin Jin , Liu Duo , Jia Bin , Yuan Ying-Jin
Published: May 2020

Background: Astaxanthin is a kind of tetraterpene and has strong antioxygenic property. The biosynthesis of astaxanthin in engineered microbial chassis has greater potential than its chemical synthesis and extraction from natural producers in an ﻿environmental-friendly way. However, the cost-offsetting production of astaxanthin in engineered microbes is still constrained by the poor efficiency of astaxanthin synthesis pathway as a heterologous pathway.Results: To address the bottleneck of limited production of astaxanthin in microbes, we developed in vitro and in vivo recombination methods respectively in engineered yeast chassis to optimize the combination of heterologousβ-carotene ketolase (crtW) and hydroxylase (crtZ) modules that were selected from different species. As a result, the in vitro and in vivo recombination methods enhanced the astaxanthin yield respectively to 2.11~8.51 folds and 3.0~9.71 folds compared to the initial astaxanthin pathway, according to the different combination of particular genes. The highest astaxanthin producing strain yQDD022 was constructed by in vivo method and produced 6.05 mg/g DCW of astaxanthin. Moreover, it was proved that the in vivo recombination method showed higher DNA-assembling efficiency than the in vitro method and contributed to higher stability to the engineered yeast strains.Conclusions: The in vitro and in vivo recombination methods of heterologous modules provide simple and efficient ways to improve the astaxanthin yield in yeast. Both the two methods enable high-throughput screening of heterologous pathways through recombination of certain crtW and crtZ derived from different species. This study not only exploited the underlying optimal combination of crtZ and crtW for astaxanthin synthesis, but also provided a general approach to evolve a heterologous pathway for the enhanced accumulation of desired biochemical products.
Induced neuroprotection by remote ischemic perconditioning as a new paradigm in ischemic stroke at the acute phase, a systematic review
Authors: Purroy Francisco , García Cristina , Mauri Gerard , Pereira Cristina , Torres Coral , Vazquez-Justes Daniel , Vicente-Pascualº Mikel , Vena Ana , Arque Gloria
Published: May 2020

Remote ischemic conditioning during cerebral ischemia (remote ischemic perconditioning, RIPerC) refers to the application of several cycles of brief ischemia and reperfusion (I/R) commonly to a limb, and it represents a new paradigm in neuroprotection with multiple mechanisms of action in ischemic stroke (IS) patients during acute phase. Some clinical trials just finished and a few others are still ongoing; gather the current knowledge and pull it down to influence the present and future studies was the goal of this paper. For that, a systematic review of published research papers and/or registered clinical trials since 2000 was performed. Nineteen studies were identified and only four studies were completed. All of them have demonstrated that RIPerC is safe, feasible and well tolerated in IS patients. However, a high heterogeneity of clinical trial characteristics was observed: five (26.3%) randomized clinical trials (RCTs) included only thrombolytic-treated patients, three (15.8%) RCTs only thrombectomy-treated patients, and five (26.3%) RCTs required radiological confirmation of IS. Temporal inclusion criteria vary from 4h to 48h. Most of the clinical trials used 4 cycles of RIPerC in the upper non-affected limb. Interestingly, only three (16.7%) RCTs applied RIPerC during the transportation at the ambulance. In studies that endovascular therapy was applied, neuroimaging outputs were the main endpoints; functional outcome is also the main endpoint in large-medium size studies. This review summarizes the completed and ongoing clinical trials on RIPerC in IS patients, where RIPerC has been used alone or in combination with recanalization therapies. Ongoing clinical trials will provide new information on the best RIPerC intervention strategy and potentially improve the functional outcome of IS patients; definition of new RIPerC strategies would ideally aim at enhancing tissue preservation, promoting neurological recovery, and stratify patients to improve treatment feasibility.
The impact of body mass index on adaptive immune cells in the human bone marrow
Authors: Pangrazzi Luca , Naismith Erin , Miggitsch Carina , Arana Jose’ Antonio Carmona , Keller Michael , Grubeck-Loebenstein Beatrix , Weinberger Birgit
Published: May 2020

Background. Obesity has been associated with chronic inflammation and oxidative stress. Both conditions play a determinant role in the pathogenesis of age-related diseases, such as immunosenescence. Adipose tissue can modulate the function of the immune system with the secretion of molecules influencing the phenotype of immune cells. The importance of the bone marrow (BM) in the maintenance of antigen-experienced adaptive immune cells has been documented in mice. Recently, some groups have investigated the survival of effector/memory T cells in the human BM. Despite this, whether high body mass index (BMI) may affect immune cells in the BM and the production of molecules supporting the maintenance of these cells it is unknown.Methods. Using flow cytometry, the frequency and the phenotype of immune cell populations were measured in paired BM and PB samples obtained from persons with different BMI. Furthermore, the expression of BM cytokines was assessed. The influence of cytomegalovirus (CMV) on T cell subsets was additionally considered, dividing the donors into the CMV- and CMV+ groups.Results. Our study suggests that increased BMI may affect both the maintenance and the phenotype of adaptive immune cells in the BM. While the BM levels of IL-15 and IL-6, supporting the survival of highly differentiated T cells, and oxygen radicals increased in overweight persons, the production of IFNγ and TNF by CD8+ T cells was reduced. In addition, the frequency of B cells and CD4+ T cells positively correlated with BMI in the BM of CMV- persons. Finally, the frequency of several T cell subsets, and the expression of senescence/exhaustion markers within these subpopulations, were affected by BMI. In particular, the levels of bona fide memory T cells may be reduced in overweight persons.Conclusion. Our work suggests that, in addition to aging and CMV, obesity may represent an additional risk factor for immunosenescence in adaptive immune cells. Metabolic interventions may help in improving the fitness of the immune system in the elderly.
Underdiagnoses of Rickettsia in patients hospitalized with acute fever in Indonesia: Observational study results
Authors: Lokida Dewi , Hadi Usman , Lau Chuen-Yen , Kosasih Herman , Liang C. Jason , Rusli Musofa , Sudarmono Pratiwi , Lukman Nurhayati , Laras Kanti , Asdie Rizka Humardewayantie , Murniati Dewi , Susila I Made , Mubin Risna Halim , Karyana Muhammad , Gasem Muhammad Hussein , Alisjahbana Bachti
Published: May 2020

Background: Reports of human rickettsial infection in Indonesia are limited. This study sought to characterize the epidemiology of human rickettsioses amongst patients hospitalized with fever at 8 tertiary hospitals in Indonesia. Methods: Acute and convalescent blood from 975 hospitalized non-dengue patients was tested for Rickettsia IgM and IgG by ELISA. Specimens from cases with seroconversion or increasing IgM and/or IgG titers were tested for Rickettsia IgM and IgG by IFA and Rickettsia genomes using primers for Rickettsia (R.) sp, R. typhi, and Orientia tsutsugamushi. Testing was performed retrospectively on stored specimens; results did not inform patient management. Results: R. typhi, R. rickettsii, and O. tsutsugamushi IgG antibodies were identified in 269/872 (30.8%), 36/634 (5.7%), and 19/504 (3.8%) of samples, respectively. For the 103/975 (10.6%) non-dengue patients diagnosed with acute rickettsial infection, presenting symptoms included nausea (72%), headache (69%), vomiting (43%), lethargy (33%), anorexia (32%), arthralgia (30%), myalgia (28%), chills (28%), epigastric pain (28%), and rash (17%). No acute rickettsioses cases were suspected during hospitalization. Discharge diagnoses included typhoid fever (44), dengue fever (20), respiratory infections (7), leptospirosis (6), unknown fever (6), sepsis (5), hepatobiliary infections (3), UTI (3), and others (9). Fatalities occurred in 7 (6.8%) patients, mostly with co-morbidities.Conclusions: Rickettsial infections are consistently misdiagnosed, often as leptospirosis, dengue, or Salmonella typhi infection. Clinicians should include rickettsioses in their differential diagnosis of fever to guide empiric management; laboratories should support evaluation for rickettsial etiologies; and public policy should be implemented to reduce burden of disease.
Impacts of stigma and discrimination in the workplace on people living with psychosis
Authors: Hampson Margaret E , Watt Bruce D , Hicks Richard Edward
Published: May 2020

Background. Employment holds many benefits for people living with psychosis. However, significant barriers to employment for this cohort appear to exist, notably stigma and discrimination against people living with serious mental health conditions. We asked: Would a qualitative sample including multiple stakeholder groups reveal similar results and if so, what would be the main impacts of such stigma and discrimination? Method. This analysis used data from a qualitative study that had applied focus groups and interviews to investigate the employment barriers and support needs of people living with psychosis, including views of the multiple stakeholders (such as those living with mental health conditions, health professionals, and employers). Results: The analyses confirmed the most frequently referenced barriers to employment were stigma and discrimination. The main impacts of workplace stigma and discrimination on people living with psychosis involved five areas: work avoidance, reluctance to disclose mental health conditions to employers, work-related stress, and reduced longevity of employment. Conclusions. As in earlier studies, the main barriers to employment for those living with psychosis were stigma and discrimination, and significant impacts from such stigma and discrimination were found in this study. The findings indicate a need to provide support mechanisms and to change the culture of workplaces to improve employment opportunities and outcomes for people living with psychosis.
Assessing inequalities and regional disparities in child nutrition outcomes in India using MANUSH – a more sensitive yardstick
Authors: Jain Ayushi , Agnihotri Satish Balram
Published: May 2020

Background: India is strongly committed to reducing the burden of child malnutrition, which has remained a persistent concern issue. Findings from recent surveys indicate co-existence of child undernutrition, micronutrient deficiency and overweight/obesity, i.e. the triple burden of malnutrition in children below five years. While considerable efforts are being made to address this challenging issue, and several composite indices are being explored to inform policy actions, the methodology used for creating such indices, i.e., linear averaging, has its limitations. Briefly put, it could mask the uneven improvement across different indicators by discounting the ‘lagging’ indicators, and hence not incentivising a balanced improvement. signifying negative implications on policy discourse for improved nutrition. To address this gap, we attempt to develop a composite index for estimating the triple burden of malnutrition in India, using a more sensitive measure, MANUSH. Methodology: Data from publicly available nation-wide surveys - National Family Health Survey (NFHS) and Comprehensive National Nutrition Survey (CNNS), was used for this study. First, we addressed the robustness of MANUSH method of composite indexing over conventional aggregation methods. Second, using MANUSH scores, we assessed the triple burden of malnutrition at the subnational level over different periods NHFS- 3(2005-06), NFHS-4 (2015-16) and CNNS (2106-18). Using mapping and spatial analysis tools, we assessed neighbourhood dependency and formation of clusters, within and across states. Result: MANUSH method scores over other aggregation measures that use linear aggregation or geometric mean. It does so by fulfilling additional conditions of Shortfall and Hiatus Sensitivity, implicitly discounting cases where the improvement in worst-off dimension is lesser than the improvement in best-off dimension, or where, even with an overall improvement in the composite index, the gap between different dimensions does not reduce. MANUSH scores helped in revealing the gaps in the improvement of nutrition outcomes among different indicators and, the rising inequalities within and across states and districts in India. Significant clusters (p<0.05) of high burden and low burden districts were found, revealing geographical heterogeneities and sharp regional disparities. A MANUSH based index is useful in context-specific planning and prioritising different interventions, an approach advocated by the newly launched National Nutrition Mission. Conclusion: MANUSH based index emphasises balanced development in nutritional outcomes and is hence relevant for diverse and unevenly developing economy like India.
Impact of Diabetes Mellitus on Mortality in Patients with Acute Heart Failure: A Prospective Cohort Study
Authors: Kong Min Gyu , Jang Se Yong , Jang Jieun , Cho Hyun-Jai , Lee Sangjun , Lee San Eun , Kim Kye Hun , Yoo Byung-Su , Kang Seok-Min , Baek Sang Hong , Choi Dong-Ju , Jeon Eun-Seok , Kim Jae-Joong , Cho Myeong-Chan , Chae Shung Chull , Oh Byung-Hee , Lim Soo , Park Sue K. , Lee Hae-Young
Published: May 2020

Background: Although more than one-third of the patients with acute heart failure (AHF) have diabetes mellitus (DM), it is unclear if DM has an adverse impact on clinical outcomes. This study compared the outcomes in patients hospitalized for AHF stratified by DM and left ventricular ejection fraction (LVEF). Methods: The Korean Acute Heart Failure registry prospectively enrolled and followed 5,625 patients from March 2011 to February 2019. The primary endpoints were in-hospital and overall all-cause mortality. We evaluated the impact of DM on these endpoints according to HF subtypes and glycemic control. Results: During a median follow-up of 3.5 years, there were 235 (4.4%) in-hospital mortalities and 2,500 (46.3%) overall mortalities. DM was significantly associated with increased overall mortality after adjusting for potential confounders (adjusted hazard ratio [HR] 1.11, 95% confidence interval [CI], 1.03–1.22). In the subgroup analysis, DM was associated with higher a risk of overall mortality in heart failure with reduced ejection fraction (HFrEF) only (adjusted HR 1.14, 95% CI 1.02–1.27). Inadequate glycemic control (HbA1c ≥7.0% within 1 year after discharge) was significantly associated with a higher risk of overall mortality compared with adequate glycemic control (HbA1c <7.0%) (44.0% vs. 36.8%, log-rank p=0.016). Conclusions: DM is associated with a higher risk of overall mortality in AHF, especially HFrEF. Well-controlled diabetes (HbA1c <7.0%) is associated with a lower risk of overall mortality compared to uncontrolled diabetes.Trial registration:ClinicalTrial.gov, NCT01389843. Registered July 6, 2011. https://clinicaltrials.gov/ct2/show/NCT01389843
Lipid profile and left ventricular geometry pattern in obese children
Authors: Bjelakovic Bojko , Stefanutti Claudia , Vukovic Vladimir , Kavaric Nebojsa , Saranac Ljiljana , Klisic Aleksandra , Lukic Stevo , Stankovic Sanja , Jovic Maja , Prijic Sergej , Bjelakovic Marko , Banach Maciej
Published: May 2020

Background: Left ventricular hypertrophy (LVH) is an important risk factor for cardiovascular and all-cause mortality. Previous studies reported conflicting results concerning the relationship between serum lipid levels and left ventricular geometry pattern. We sought to explore the relationship between standard serum lipid profile measures with left ventricular geometry pattern in obese children.Patients and methods: In this cross-sectional study, a total of 70 obese children were examined. Fasting blood samples were taken to measure total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), triglycerides (TGs), glucose, and insulin. Based on these values TG/HDL ratio, BMI and HOMA index were calculated. We also measured the average 24-hour ambulatory systolic blood pressure (SBP) and two-dimensional (2/D) transthoracic echocardiography was performed to determine left ventricular mass index (LVMI) and relative wall thickness (RWT). Multiple regression analyses were conducted to explore relationships between study variables and the LVMI or RWT as outcome variables. The final model with LVMI included TG/HDL ratio, BMI, 24h-average SBP, age and sex, while for the RWT we included BMI, insulin, age and sex.Results: Our study included 70 children (65.71% boys and 34.29% girls) median age (14 years, IQR=12-16)." We demonstrated independent and positive association of TG/HDL ratio, BMI and 24h-average SBP with LVMI (effect=3.65, SE=1.32, p<0.01; effect=34.90, SE=6.84, p<0.01; effect=0.32, SE=0.12, p<0.01, respectively). On the other hand, in model with RWT as outcome variable, only BMI and insulin were significantly linked (BMI: effect=13.07, SE=5.02, p=0.01 Insulin: effect=2.80, SE=0.97).Conclusion: Increased TG/HDL ratio in obese children is associated with the development of eccentric left ventricular hypertrophy while increased BMI and insulin were associated with concentric left ventricular hypertophy.
Psychosocial Family Interventions for Relatives of People Living with Psychotic Disorders in the Arab World: Systematic Review
Authors: Sawafi Aziza Saleh Al , Lovell Karina , Renwick Laoise , Husain Nusrat
Published: May 2020

Aim and objectives: To synthesise the available evidence about culturally-adapted psychosocial family interventions in the Arab world. The review identifies the content and characteristics of these interventions, determines the strategies used to adapt them to the Arab culture successfully, assesses the feasibility and acceptability of the interventions, and evaluates the effectiveness of these interventions for service users and their families. Background: Family interventions in schizophrenia are evidence-based and have been adapted to different cultures to improve their effectiveness and acceptability in different settings. The Arab world has a unique set of sociocultural norms and values that cannot be ignored when developing or implementing such interventions. There is a lack of research on the feasibility of delivering family interventions for schizophrenia in the Arab region. Design: A systematic review Method: Five electronic databases were searched including MEDLINE, CINAHL, Cochrane Library, PsycINFO and EMBASE for articles written in Arabic and English from inception to August 2019. Data were extracted and synthesised narratively. Result: Five studies were retrieved from the search: two randomized control studies, two non-randomized studies and one qualitative study. There is a paucity of evidence about culturally- adapted family interventions in the Arab region. However, the cultural adaptation process was comprehensive, and the implementation was feasible and acceptable. The methodological quality of the included studies was generally poor, so there is a risk of overestimating the effect of the interventions due to lack of rigour and the presence of bias. Conclusion: The present review provided the foundation for future work about family interventions in the Arab world, and confirmed the feasibility of implementing such interventions in the Arab world with minor modifications. Furthermore, the data suggested that any alternative family-oriented intervention for schizophrenia is likely to be better than standard care in improving the outcome for patients and their families.
Alterations in Esophageal MicroRNAs Expression in Primary Esophageal Achalasia by Next-Generation Sequencing
Authors: Gholipour Mahin , Mikaeli Javad , Mowla Seyed Javad , Bakhtiarizadeh Mohammad Reza , Jazi Marie Saghaeian , Javid Naeme , Fazlollahi Narges , Khoshnia Masoud , Behnampour Naser , Moradi Abdolvahab
Published: May 2020

Background: Molecular knowledge regarding the primary esophageal achalasia is essential for early diagnosis and treatment of this neurodegenerative motility disorder. So, there is a need to find the main microRNAs (miRNAs) contributing to the mechanisms of achalasia.Methods: This study was conducted to determine some patterns of deregulated miRNAs in the achalasia. This case-control study was performed on 52 patients with achalasia and 50 non-achalasia controls. The miRNA expression profiling was conducted on the esophageal tissue samples obtained from the patients with achalasia and non-achalasia patients controls using the Next-Generation Sequencing (NGS). Differential expression of miRNAs was analyzed by the edgeR software. The selected dysregulated miRNAs were additionally confirmed using the quantitative Reverse Transcription Polymerase Chain Reaction (qRT-PCR). Potential target genes of the downregulated and upregulated miRNAs were also predicted to understand the putative role of the miRNAs in the development of the achalasia. Results: Totally, 15 miRNAs were identified that were significantly altered in the tissues of the patients with achalasia compared to the controls. Among them, three miRNAs including miR-133a-5p, miR-143-3p, and miR-6507-5p were upregulated. Also, six miRNAs including miR-215-5p, miR-216a-5p, miR-216b-5p, miR-217, miR-7641, and miR-194-5p were downregulated significantly. The predicted targets for the dysregulated miRNAs showed significant disease-associated pathways like neuronal cell apoptosis, neuromuscular balance, nerve growth factor signaling, and immune response regulation. Gene expression analysis confirmed significant downregulation of the hsa-miR-217 (p-value = 0.004) in the Lower Esophageal Sphincter (LES) of the patients with achalasia with significant enrichment in the myelination process ontology. The results of this study provide the first integrated miRNA expression profile in the achalasia using the NGS. Our findings introduced 15 candidate miRNAs as achalasia-associated non-coding RNAs and also confirmed the downregulation of the hsa-miR-217 in the achalasia disease. Conclusions: Our results may serve as a basis for more future functional studies to investigate the role of candidate miRNAs in the etiology of achalasia and their application in diagnosis and probably treatment of the disease.
Correlation study between flash dual source CT perfusion imaging and regional lymph node metastasis of non-small cell lung cancer
Authors: Huang Tingting , Sun Hui , Luo Xianli , Zhang Xuemei , Jin Kaiyuan , Wang Feng , Sun Lv , Cheng Nianlan , Wu Shuo , Lou Qin , Li Bangguo
Published: May 2020

Background: To explore the correlation of flash dual source computed tomography perfusion imaging (CTPI) and regional lymph node metastasis of non-small cell lung cancer (NSCLC), and to evaluate the value of CT perfusion parameters in predicting regional lymph node metastasis of NSCLC. Methods: 120 consecutive patients with NSCLC confirmed by postoperative histopathology were underwent flash dual source CT perfusion imaging in pre-operation. The CT perfusion parameters of NSCLC, such as blood flow (BF), blood volume (BV), mean transit time (MTT) and permeability (PMB) were obtained by the image post-processing. Then microvessel density (MVD), luminal vascular number (LVN), luminal vascular area (LVA) and luminal vascular perimeter (LVP) of NSCLC were counted by immunohistochemistry. These cases were divided into group A (patients with lymph node metastasis, 58 cases) and group B (patients without lymph node metastasis, 62 cases) according to their pathological results. The CT perfusion parameters and the microvessel parameters were contrastively analysed between the two groups. Receiver operating characteristic (ROC) curve was used to assess the diagnostic efficiency of CT perfusion parameters in predicting regional lymph node metastasis of NSCLC in pre-operation. Results: Group A presented signiﬁcantly lower LVA, BF and higher MTT, PMB than Group B (P<0.05), while BV, LVN, LVP and MVD were no significant difference (P>0.05). Correlation analysis showed that BF was correlated with LVA and LVP (P<0.05), while BV, MTT and PMB were not correlated with LVN, LVA and LVP (P>0.05). All the perfusion parameters were not correlated with MVD. According to the ROC curve analysis, when BF<85.16 ml/100 ml/min as a cutoff point to predict regional lymph node metastasis of NSCLC, the sensitivity, speciﬁcity, accuracy, positive predictive value and negative predictive value were 60.8%, 81.7%, 71.5%, 75.6% and 69.5% respectively. Conclusion: Flash dual source CT perfusion imaging can non-invasively indicate the luminal vascular structure of tumor and BF can be used as one of the important indexes in predicting regional lymph node metastasis of NSCLC in pre-operation.