bluuebunny/crossref_metadata_2025 huggingface dataset:
Food pyramid for subjects with chronic pain: foods and dietary constituents as anti-inflammatory and antioxidant agents
Authors: Rondanelli Mariangela , Faliva Milena Anna , Miccono Alessandra , Naso Maurizio , Nichetti Mara , Riva Antonella , Guerriero Fabio , De Gregori Manuela , Peroni Gabriella , Perna Simone
Published: April 2018

Emerging literature suggests that diet constituents may play a modulatory role in chronic pain (CP) through management of inflammation/oxidative stress, resulting in attenuation of pain. We performed a narrative review to evaluate the existing evidence regarding the optimum diet for the management of CP, and we built a food pyramid on this topic. The present review also describes the activities of various natural compounds contained in foods (i.e. phenolic compounds in extra-virgin olive oil (EVO)) listed on our pyramid, which have comparable effects to drug management therapy. This review included 172 eligible studies. The pyramid shows that carbohydrates with low glycaemic index should be consumed every day (three portions), together with fruits and vegetables (five portions), yogurt (125 ml), red wine (125 ml) and EVO; weekly: legumes and fish (four portions); white meat, eggs and fresh cheese (two portions); red or processed meats (once per week); sweets can be consumed occasionally. The food amounts are estimates based on nutritional and practical considerations. At the top of the pyramid there is a pennant: it means that CP subjects may need a specific customised supplementation (vitamin B12, vitamin D,n-3 fatty acids, fibre). The food pyramid proposal will serve to guide dietary intake with to the intent of alleviating pain in CP patients. Moreover, a targeted diet can also help to solve problems related to the drugs used to combat CP, i.e. constipation. However, this paper would be an early hypothetical proposal due to the limitations of the studies.
Systematic derivation of a surface polarisation model for planar perovskite solar cells
Authors: COURTIER N. E. , FOSTER J. M. , O'KANE S. E. J. , WALKER A. B. , RICHARDSON G.
Published: April 2018

Increasing evidence suggests that the presence of mobile ions in perovskite solar cells (PSCs) can cause a current–voltage curve hysteresis. Steady state and transient current–voltage characteristics of a planar metal halide CH3NH3PbI3PSC are analysed with a drift-diffusion model that accounts for both charge transport and ion vacancy motion. The high ion vacancy density within the perovskite layer gives rise to narrow Debye layers (typical width ~2 nm), adjacent to the interfaces with the transport layers, over which large drops in the electric potential occur and in which significant charge is stored. Large disparities between (I) the width of the Debye layers and that of the perovskite layer (~600 nm) and (II) the ion vacancy density and the charge carrier densities motivate an asymptotic approach to solving the model, while the stiffness of the equations renders standard solution methods unreliable. We derive a simplifiedsurface polarisationmodel in which the slow ion dynamics are replaced by interfacial (non-linear) capacitances at the perovskite interfaces. Favourable comparison is made between the results of the asymptotic approach and numerical solutions for a realistic cell over a wide range of operating conditions of practical interest.
Alternative Pasts and Colonial Engagements in the North: The Materiality and Meanings of the Pajala ‘Runestone’ (Vinsavaara Stone), Northern Sweden
Authors: Herva Vesa-Pekka , Ikäheimo Janne , Enbuske Matti , Okkonen Jari
Published: April 2018

The unknown and exotic North fascinated European minds in the early modern period. A land of natural and supernatural wonders, and of the indigenous Sámi people, the northern margins of Europe stirred up imagination and a plethora of cultural fantasies, which also affected early antiquarian research and the period understanding of the past. This article employs an alleged runestone discovered in northernmost Sweden in the seventeenth century to explore how ancient times and northern margins of the continent were understood in early modern Europe. We examine how the peculiar monument of the Vinsavaara stone was perceived and signified in relation to its materiality, landscape setting, and the cultural-cosmological context of the Renaissance–Baroque world. On a more general level, we use the Vinsavaara stone to assess the nature and character of early modern antiquarianism in relation to the period's nationalism, colonialism and classicism.
Multicolour Sunflowers
Authors: MUBAYI DHRUV , WANG LUJIA
Published: April 2018

A sunflower is a collection of distinct sets such that the intersection of any two of them is the same as the common intersectionCof all of them, and |C| is smaller than each of the sets. A longstanding conjecture due to Erdős and Szemerédi (solved recently in [7, 9]; see also [22]) was that the maximum size of a family of subsets of [n] that contains no sunflower of fixed sizek> 2 is exponentially smaller than 2nasn→ ∞. We consider the problems of determining the maximum sum and product ofkfamilies of subsets of [n] that contain no sunflower of sizekwith one set from each family. For the sum, we prove that the maximum is$$(k-1)2^n+1+\sum_{s=0}^{k-2}\binom{n}{s}$$for alln⩾k⩾ 3, and for thek= 3 case of the product, we prove that the maximum is$$\biggl(\ffrac{1}{8}+o(1)\biggr)2^{3n}.$$We conjecture that for all fixedk⩾ 3, the maximum product is (1/8+o(1))2kn.
Density of Chromatic Roots in Minor-Closed Graph Families
Authors: PERRETT THOMAS J. , THOMASSEN CARSTEN
Published: April 2018

We prove that the roots of the chromatic polynomials of planar graphs are dense in the interval between 32/27 and 4, except possibly in a small interval around τ + 2 where τ is the golden ratio. This interval arises due to a classical result of Tutte, which states that the chromatic polynomial of every planar graph takes a positive value at τ + 2. Our results lead us to conjecture that τ + 2 is the only such number less than 4.
Pulmonary atresia with intact ventricular septum and congenital left ventricular aneurysm
Authors: Ng Benton , Hickok Rhiannon , Stapleton Gary , Karl Tom
Published: April 2018

Pulmonary atresia with intact ventricular septum and congenital left ventricular aneurysms are both rare, representing <1 and <0.1% of CHD, respectively. The association of left ventricular aneurysms and pulmonary atresia with intact ventricular septum has been documented in the literature, but all the previous case reports have involved children with acquired left ventricular aneurysms. We report an interesting case of a child with both pulmonary atresia with intact ventricular septum and a congenital left ventricular aneurysm. The combination of these two lesions ultimately affected the course of clinical care for the patient.
Three-dimensional echocardiographic evaluation of Ebstein’s anomaly of the tricuspid valve in a patient with hypoplastic left heart syndrome
Authors: Cassidy Courtney , Mitchell Max B. , Jone Pei-Ni
Published: April 2018

We report three-dimensional imaging of a rare finding of Ebstein’s anomaly of the tricuspid valve in a patient with hypoplastic left heart syndrome, which has been previously reported only by two-dimensional echocardiography. A fetal echocardiogram was performed at 19 weeks that showed a moderately hypoplastic left ventricle, severely hypoplastic mitral valve, a severely hypoplastic aortic valve, and a dysplastic tricuspid valve. Post Caesarean delivery at 40 weeks of gestation, a transthoracic echocardiogram confirmed the findings seen on the fetal echocardiogram. A three-dimensional echocardiogram was then performed, which demonstrated an Ebstein tricuspid valve with apical displacement of the septal leaflet, chordal attachments of the valve to the right ventricular outflow tract, and moderate tricuspid regurgitation. The patient underwent a successful heart transplantation.
A protocol to decrease postoperative chylous effusion duration in children
Authors: Winder Melissa M. , Eckhauser Aaron W. , Delgado-Corcoran Claudia , Smout Randall J. , Marietta Jennifer , Bailly David K.
Published: April 2018

Objective

Our primary goal was to decrease time to resolution of postoperative chylothorax as demonstrated by total days of chest tube utilisation through development and implementation of a management protocol.

Methods

A chylothorax management protocol was implemented as a quality improvement project at a tertiary-care paediatric hospital in July, 2015. Retrospective analysis was completed on patients aged 0–17 years diagnosed with chylothorax within 30 days of cardiac surgery in a pre-protocol cohort (February, 2014 to June, 2015, n=20) and a post-protocol cohort (July, 2015 to March, 2016, n=22).

Measurements and results

Patient characteristics were similar before and after protocol implementation. Duration of mechanical ventilation and cardiac ICU and hospital lengths of stay were unchanged between cohorts. Following protocol implementation, total duration of chest tube utilisation decreased from 12 to 7 days (p=0.047) with a decrease in maximum days of chest tube utilisation from 44 to 13 days. Duration of medium-chain triglyceride feeds decreased from 42 days to 31 days (p=0.01). In total, three patients in the post-protocol cohort underwent additional surgical procedures to treat chylothorax with subsequent resolution of chylothorax within 24 hours. There were no chest tube re-insertions or re-admissions related to chylothorax in either the pre- or post-protocol cohorts. Protocol compliance was 81%.

Conclusions

Adoption of a chylothorax management protocol is feasible, and in our small cohort of patients implementation led to a significant decrease in the duration of chest tube utilisation, while eliminating practice variability among providers.
Left ventricular mass of persistent masked hypertension in Hong Kong Chinese adolescents: a 4-year follow-up study
Authors: Yam Man-Ching , So Hung-Kwan , Kwok Sit-Yee , Lo Fung-Cheung , Mok Chi-Fung , Leung Chuk-Kwan , Yip Wai-Kwok , Sung Yn-Tz
Published: April 2018

Objective

In our previous study, the prevalence of childhood masked hypertension was 11%. This study aims to assess the left ventricular mass index of persistent masked hypertension and determine the factors of elevated left ventricular mass index in Hong Kong Chinese adolescents from a community cohort.

Design

Community prospective cohort study, follow-up of a case-control study in community.

Subjects

Patients with masked hypertension at baseline were invited to recheck ambulatory blood pressure for the persistence of masked hypertension.

Results

A total of 144 out of 165 patients with masked hypertension in the 2011/2012 ambulatory blood pressure survey consented to participate in the study. In all, 48 patients were found to have persistent masked hypertension by ambulatory blood pressure rechecking and were matched with normotensive controls by sex, age, and body height. The left ventricular mass (117.3±39.9 g versus 87.0±28.2 g versus 102.0±28.2 g) and left ventricular mass index (30.1±8.4 g/m2.7 versus 23.9±6.3 g/m2.7 versus 25.1±5.7 g/m2.7) were significantly higher in the persistent masked hypertension group (p<0.0001) compared with the patients without persistent masked hypertension and controls. In multivariate linear regression analysis, left ventricular mass index was found to be higher in male gender (β=4.874, p<0.0001) and the patients with persistent masked hypertension (β=2.796, p=0.003). In addition, left ventricular mass index was positively associated with body mass index z-score (β=3.045, p<0.0001) and low-density lipoprotein cholesterol concentration (β=1.634, p=0.015).

Conclusions

Persistent masked hypertension in adolescents is associated with elevated left ventricular mass index.
Brexit and Scotland: Centralism, Federalism or Independence?
Authors: Rahmatian Andreas
Published: April 2018

The public debate about the consequences of Brexit in Britain follows certain predictable lines of established academic concepts in British constitutional law. This arguably overlooks the important constitutional complications of Brexit, including the position of Scotland in post-Brexit Britain. This article takes the unorthodox approach of focusing on legal and intellectual history rather than British constitutional law, because in this way one obtains a better understanding of the present British constitutional framework in the context of Europe. The discussion is from a continental European viewpoint and through the eyes of a private and commercial lawyer. The completely different understanding of Britain and Europe about the nature of a constitution and the structure of a state becomes more apparent with Britain’s departure from the EU, which may also influence the future national cohesion of the UK itself, particularly the relationship between England and Scotland after Brexit.
Aspect opinion expression and rating prediction via LDA–CRF hybrid
Authors: LADDHA ABHISHEK , MUKHERJEE ARJUN
Published: April 2018

In this paper, we study the problem of aspect-based sentiment analysis. Our model simultaneously extracts aspect-specific opinion expressions and determines the rating for each aspect in reviews. Previous works have mainly focused on the problem of opinion phrase extraction and aspect rating prediction in a pipelined manner and are not able to capture the dependencies of aspect opinion expression on aspect rating and vice-versa. They are also unable to discover aspect-specific opinion expressions and their associated rating scores. We present a joint modelling approach to extract aspect-specific sentiment expression and aspect rating prediction simultaneously. This paper proposes a novel LDA–CRF hybrid model which employs discriminative conditional random field component for phrase extraction, a regression component for rating prediction and a generative component for grouping aspect–sentiment expressions (aspect-specific opinion expressions) into coherent topics. To show the effectiveness of our approach, we evaluate the performance of the model on both task: (i) aspect-specific opinion expressions and (ii) rating prediction on the dataset of hotel and restaurant reviews from TripAdvisor.com. Experimental results show that both task potentially reinforce each other and joint modeling outperformed state-of-the-art baselines for each individual tasks.
THE REGIME-DEPENDENT EVOLUTION OF CREDIBILITY: A FRESH LOOK AT HONG KONG'S LINKED EXCHANGE RATE SYSTEM
Authors: Blagov Boris , Funke Michael
Published: April 2018

An estimated Markov-switching DSGE modeling framework that allows for parameter shifts across regimes is employed to test the hypothesis of regime-dependent credibility of Hong Kong's linked exchange rate system. The baseline model distinguishes two regimes with respect to the time-series properties of the risk premium. Regime-dependent impulse responses to macroeconomic shocks reveal substantial differences in spreads. To test the sensitivity of the results, a number of robustness checks are performed. The findings contribute to efforts at modeling exchange rate regime credibility as a nonlinear process with two distinct regimes.
Code-switching does not predict Executive Function performance in proficient bilingual children: Bilingualism does
Authors: KANG CARISSA , LUST BARBARA
Published: April 2018

Previous studies of bilingual adults have suggested that bilinguals’ experience with code-switching (CS) contributes to superior executive function (EF) abilities. We tested a highly bilingual developing population in Singapore, a multilingual country where CS occurs pervasively. We obtained CS and EF measures from 43 English–Chinese 8-year-old children (27 females, M = 100 months). We measured spontaneous CS with a novel task and EF in terms of task-switching (Semantic Fluency) and inhibitory control (Stroop task in both languages). Contrary to previous work, CS performance did not significantly predict EF performance in either case. Rather, bilingual language proficiency, i.e., degree of bilingualism (as measured by direct proficiency tests and parents’ estimates of daily language use and exposure of both languages) influenced EF performance. Accordingly, the relationship between CS and EF may be more indirect and non-necessary than previously assumed.
A national FFQ for the Netherlands (the FFQ-NL1.0): development and compatibility with existing Dutch FFQs
Authors: Eussen Simone JPM , van Dongen Martien CJM , Wijckmans Nicole EG , Meijboom Saskia , Brants Henny AM , de Vries Jeanne HM , Bueno-de-Mesquita H Bas , Geelen Anouk , Sluik Diewertje , Feskens Edith JM , Ocké Marga C , Dagnelie Pieter C
Published: April 2018

Objective

In the Netherlands, various FFQs have been administered in large cohort studies, which hampers comparison and pooling of dietary data. The present study aimed to describe the development of a standardized Dutch FFQ, FFQ-NL1.0, and assess its compatibility with existing Dutch FFQs.

Design

Dutch FFQTOOLTM was used to develop the FFQ-NL1.0 by selecting food items with the largest contributions to total intake and explained variance in intake of energy and thirty-nine nutrients in adults aged 25–69 years from the Dutch National Food Consumption Survey (DNFCS) 2007–2010. Compatibility with the Maastricht-FFQ, Wageningen-FFQ and EPICNL-FFQ was assessed by comparing the number of food items, the covered energy and nutrient intake, and the covered variance in intake.

Results

FFQ-NL1.0 comprised 160 food items, v. 253, 183 and 154 food items for the Maastricht-FFQ, Wageningen-FFQ and EPICNL-FFQ, respectively. FFQ-NL1.0 covered ≥85 % of energy and all nutrients reported in the DNFCS. Covered variance in intake ranged from 57 to 99 % for energy and macronutrients, and from 45 to 93 % for micronutrients. Differences between FFQ-NL1.0 and the other FFQs in covered nutrient intake and covered variance in intake were <5 % for energy and all macronutrients. For micronutrients, differences between FFQ-NL and other FFQs in covered level of intake were <15 %, but differences in covered variance were much larger, the maximum difference being 36 %.

Conclusions

The FFQ-NL1.0 was compatible with other FFQs regarding energy and macronutrient intake. However, compatibility for covered variance of intake was limited for some of the micronutrients. If implemented in existing cohorts, it is advised to administer the old and the new FFQ in combination to derive calibration factors.
Legacies of Altruism: Richard Titmuss, Marie Meinhardt, and Health Policy Research in the 1940s
Authors: Oakley Ann
Published: April 2018

During the Second World War, a German economist, Marie Dessauer, later Marie Meinhardt, worked with the British welfare state scholar and policy analyst Richard Titmuss on pioneering studies of social factors and health. Titmuss is remembered today for his role in establishing social policy as an academic discipline, and for his internationally-renowned works on welfare, health and public policy. Meinhardt's career as an economist has been largely forgotten. This was an unusual alliance with far-reaching consequences, as Meinhardt later bequeathed a large sum of money to the London School of Economics, where Titmuss worked, to help fund social policy students and research. This article documents the story of the Titmuss-Meinhardt collaboration, locating it in the context of Titmuss's last and probably best-known work, The Gift Relationship, which analyses the function of altruistic giving in promoting healthy and democratic social relations.
Teenage Mothers and Social Isolation: The Role of Friendship as Protection against Relational Exclusion
Authors: Ellis-Sloan Kyla , Tamplin Amy
Published: April 2018

This article explores links made between teenage mothers and isolation: in particular, the notion of ‘relational exclusion’ (Kidger, 2004). Political conceptualisations of social exclusion often ignore this aspect and instead focus on the economic dynamics of exclusion. As a consequence, policies aimed at addressing the exclusion of teenage parents often focus on education and employment as solutions. This article argues that friendships are overlooked as a source of potential support. It therefore builds on work that has observed teenage mothers’ isolation and loneliness to examine how a teenage pregnancy affects a young woman's friendship networks. It then goes on to expand understanding of how new friendships are formed and the types of support they provide. The article concludes by proposing that social policy has a role in facilitating friendship support through investment, integrating group support with one-to-one methods and tackling stigma.
Rolled Winter Rye–Hairy Vetch Cover Crops for Weed Control in No-till Pumpkin
Authors: Miville David , Leroux Gilles D.
Published: April 2018

Weed control is a challenging aspect of pumpkin production. Winter rye mulches may offer growers a means to manage weeds in pumpkin; however, rye degradation leads to an immobilization of soil nitrogen. Combining winter rye with a nitrogen fixing legume such as hairy vetch is an interesting option that may solve this problem. Twelve combinations including three hairy vetch seeding rates, two termination dates and the use or not of glyphosate before rolling cover crops were studied during the 2013 and 2014 growing seasons at the Laval University Agronomic Station in Saint-Augustin-de-Desmaures, Quebec, Canada to evaluate weed control and effects on pumpkin production. Adding hairy vetch to winter rye provided no benefits because of severe winterkill of the legume. Using glyphosate was necessary to prevent rye regrowth. Pumpkin growth was better and yields were higher than in the plots were no glyphosate was used. Mulches established at flowering (Zadoks 69) provided about 2,000 kg ha−1 more aboveground dry biomass than at early heading (Zadoks 51). This high biomass was essential in glyphosate treated plots in order to maintain excellent weed control throughout the growing season. When compared with the no-mulch weed-free control, yield in Zadoks 69+glyphosate treatment was lower in 2013 but comparable in 2014.
Medizinische Aspekte beim Höhentrekking
Authors: Pichler Hefti Jacqueline , Hefti Urs
Published: April 2018

Zusammenfassung. Trekkingreisen in grosse Höhen bis 5500 m ü. M. erfreuen sich immer grösserer Beliebtheit. Häufig begeben sich unerfahrene Trekker für längere Zeit in unwegsames, für Rettungen schlecht zugängliches Gelände und in Regionen mit limitierter medizinischer Infrastruktur und ungenügenden Hygienestandards. Die spezifischen Kenntnisse der höhen- und reisemedizinischen Herausforderungen wie z. B. Akklimatisation und Reisedurchfall helfen bei der Beratung in der Sprechstunde.
Erfolgreiche antibiotische Behandlung lumbaler Rückenschmerzen
Authors: Rau Monika , Bärlocher Christian , Knechtle Beat
Published: April 2018

Zusammenfassung. Wir berichten über einen 74-jährigen Mann, der plötzlich einschiessende und in der Folge zur Bettlägrigkeit führende lumbale Schmerzen spürte. Ein MRT zeigte die Progredienz einer bereits bekannten Spinalkanalstenose L2/3 mit aktivierten Osteochondrosen und Spondylarthrosen. Eine Facettengelenksinfiltration brachte keine Schmerzlinderung, ebenso wenig wie die Durchführung eines Sakralblocks. Bei persistierenden Schmerzen wurde die lumbale Operation geplant, vorgängig zur Operation bei Status nach Myokardinfarkt musste eine Koronar-CT durchgeführt werden. Bei Niereninsuffizienz war die Bestimmung des Kreatinins notwendig. Bei der Blutabnahme wurde zudem das CRP bestimmt, das erhöht war. Bei Verdacht auf das Vorliegen einer Prostatitis aufgrund des erhöhten PSA-Wertes wurde eine antibiotische Behandlung begonnen. Zwei Tage nach Beginn der Antibiose zeigte sich die Schmerzlinderung, und die Operation konnte abgesagt werden.
Gute ambulante Versorgung verzögert den Heimeintritt bei Menschen mit Demenz in der Stadt Zürich
Authors: Dyntar Daniela , Geschwindner Heike , Theill Nathan , Negatsch Siegfried , Meier Andreas , Gmünder Regula , Schelling Hans Rudolf , Wettstein Albert , Bieri-Brüning Gabriela
Published: April 2018

Zusammenfassung. Die Stadt Zürich hat ein gut ausgebautes ambulantes Angebot für Menschen mit Demenz. Dieses soll den Zeitpunkt der Institutionalisierung von Demenzkranken in der Stadt hinauszögern können. Anhand des Mini Mental Status (MMS) und der Cognitive Performance Scale (CPS) untersucht diese Studie den Schweregrad der Demenz beim Heimeintritt in zwei grossen Pflegezentren der Stadt Zürich in den Jahren 2009, 2010 und 2013. MMS- und CPS-Scores dieser Jahre wurden retrospektiv analysiert (n = 375). Die Resultate zeigen im Jahr 2013 einen höheren mittleren CPS- (M = 2,88 vs. 3,06) und einen tieferen MMS-Wert (M = 15,43 vs. 12,67) als im Jahr 2009, was einem späteren Heimeintritt, also erst in fortgeschrittenen Demenzstadien, entspricht.
Waldenström macroglobulinemia treatment algorithm 2018
Authors: Gertz Morie A.
Published: April 2018

Waldenström macroglobulinemia is often an indolent disorder, and many patients are candidates for observation with careful monitoring. For symptomatic patients, one must distinguish between those patients whose symptoms are related to immunologic manifestations associated with the IgM monoclonal protein and those that have symptoms related to progressive marrow and nodal infiltration with lymphoplasmacytic lymphoma. In Waldenström macroglobulinemia, the driver for therapy in the majority of patients is progressive anemia, secondary to bone marrow replacement by lymphoplasmacytic lymphoma. Recent introduction of MYD88 mutational analysis has been very useful for diagnostic purposes but is unclear what effect it might have on the prognosis or response rate to therapy. An algorithm is provided on the management of asymptomatic individuals and the sequence used for chemotherapeutic intervention of symptomatic patients.
Rheumatoid arthritis: pathological mechanisms and modern pharmacologic therapies
Authors: Guo Qiang , Wang Yuxiang , Xu Dan , Nossent Johannes , Pavlos Nathan J. , Xu Jiake
Published: April 2018

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that primarily affects the lining of the synovial joints and is associated with progressive disability, premature death, and socioeconomic burdens. A better understanding of how the pathological mechanisms drive the deterioration of RA progress in individuals is urgently required in order to develop therapies that will effectively treat patients at each stage of the disease progress. Here we dissect the etiology and pathology at specific stages: (i) triggering, (ii) maturation, (iii) targeting, and (iv) fulminant stage, concomitant with hyperplastic synovium, cartilage damage, bone erosion, and systemic consequences. Modern pharmacologic therapies (including conventional, biological, and novel potential small molecule disease-modifying anti-rheumatic drugs) remain the mainstay of RA treatment and there has been significant progress toward achieving disease remission without joint deformity. Despite this, a significant proportion of RA patients do not effectively respond to the current therapies and thus new drugs are urgently required. This review discusses recent advances of our  understanding of RA pathogenesis, disease modifying drugs, and provides perspectives on next generation therapeutics for RA.
High prevalence of diabetes among migrants in the United Arab Emirates using a cross-sectional survey
Authors: Sulaiman Nabil , Albadawi Salah , Abusnana Salah , Mairghani Maisoon , Hussein Amal , Al Awadi Fatheya , Madani Abdulrazak , Zimmet Paul , Shaw Jonathan
Published: April 2018

In 2011, the United Arab Emirates (UAE) had the 10th highest diabetes prevalence globally, but this was based on data that excluded migrants who comprise 80% of the population. This study assessed diabetes prevalence across the UAE population. A random sample of migrants was recruited from the visa renewal centers. Data were collected using interviews, anthropometric measurements and fasting blood for glucose, lipids and genetic analyses. 2724 adults completed the questionnaires and blood tests. Of these, 81% were males, 65% were ≤40 years old and 3% were above 60 years. Diabetes, based on self-report or fasting plasma glucose ≥7.0 mmol/l, showed a crude prevalence of 15.5%, of whom 64.2% were newly diagnosed. Overall age- and sex-adjusted diabetes prevalence, according to the world mid-year population of 2013, was 19.1%. The highest prevalence was in Asians (16.4%) and non-Emirati Arabs (15.2%) and lowest in Africans and Europeans (11.9%). It increased with age: 6.3% in 18–30 years and 39.7% in 51 to 60 years. Lower education, obesity, positive family history, hypertension, dyslipidemia, snoring, and low HDL levels, all showed significant associations with diabetes. The high diabetes prevalence among migrants in the UAE, 64% of which was undiagnosed, necessitates urgent diabetes prevention and control programs for the entire UAE population.
Chicken Interferon-induced Protein with Tetratricopeptide Repeats 5 Antagonizes Replication of RNA Viruses
Authors: Santhakumar Diwakar , Rohaim Mohammed Abdel Mohsen Shahaat , Hussein Hussein A. , Hawes Pippa , Ferreira Helena Lage , Behboudi Shahriar , Iqbal Munir , Nair Venugopal , Arns Clarice W. , Munir Muhammad
Published: April 2018

The intracellular actions of interferon (IFN)-regulated proteins, including IFN-induced proteins with tetratricopeptide repeats (IFITs), attribute a major component of the protective antiviral host defense. Here we applied genomics approaches to annotate the chicken IFIT locus and currently identified a single IFIT (chIFIT5) gene. The profound transcriptional level of this effector of innate immunity was mapped within its unique cis-acting elements. This highly virus- and IFN-responsive chIFIT5 protein interacted with negative sense viral RNA structures that carried a triphosphate group on its 5′ terminus (ppp-RNA). This interaction reduced the replication of RNA viruses in lentivirus-mediated IFIT5-stable chicken fibroblasts whereas CRISPR/Cas9-edited chIFIT5 gene knockout fibroblasts supported the replication of RNA viruses. Finally, we generated mosaic transgenic chicken embryos stably expressing chIFIT5 protein or knocked-down for endogenous chIFIT5 gene. Replication kinetics of RNA viruses in these transgenic chicken embryos demonstrated the antiviral potential of chIFIT5 in ovo. Taken together, these findings propose that IFIT5 specifically antagonize RNA viruses by sequestering viral nucleic acids in chickens, which are unique in innate immune sensing and responses to viruses of both poultry and human health significance.
High Basolateral Glucose Increases Sodium-Glucose Cotransporter 2 and Reduces Sirtuin-1 in Renal Tubules through Glucose Transporter-2 Detection
Authors: Umino Hiroyuki , Hasegawa Kazuhiro , Minakuchi Hitoshi , Muraoka Hirokazu , Kawaguchi Takahisa , Kanda Takeshi , Tokuyama Hirobumi , Wakino Shu , Itoh Hiroshi
Published: April 2018

Under diabetic conditions, sodium–glucose cotransporter 2 (SGLT2) for glucose uptake in proximal tubules (PTs) increases, whereas NAD+-dependent protein deacetylase silent mating type information regulation 2 homolog 1 (Sirtuin-1; SIRT1) for PT survival decreases. Therefore, we hypothesized that increased glucose influx by SGLT2 reduces SIRT1 expression. To test this hypothesis,db/dbmice with diabetes and high-glucose (HG)-cultured porcine PT LLC-PK1 cells in a two-chamber system were treated with the SGLT2 inhibitor canagliflozin. We also examined SIRT1 and SGLT2 expression in human kidney biopsies. Indb/dbmice, SGLT2 expression increased with concomitant decreases in SIRT1, but was inhibited by canagliflozin. For determination of the polarity of SGLT2 and SIRT1 expression, LLC-PK1 cells were seeded into Transwell chambers (pore size, 0.4 µm; Becton Dickinson, Oxford, UK). HG medium was added to either or to both of the upper and lower chambers, which corresponded to the apical and basolateral sides of the cells, respectively. In this system, the lower chamber with HG showed increased SGLT2 and decreased SIRT1 expression. Canagliflozin reversed HG-induced SIRT1 downregulation. Gene silencing and inhibitors for glucose transporter 2 (GLUT2) blocked HG-induced SGLT2 expression upregulation. Gene silencing for the hepatic nuclear factor-1α (HNF-1α), whose nuclear translocation was enhanced by HG, blocked HG-induced SGLT2 expression upregulation. Similarly, gene silencing for importin-α1, a chaperone protein bound to GLUT2, blocked HG-induced HNF-1α nuclear translocation and SGLT2 expression upregulation. In human kidney, SIRT1 immunostaining was negatively correlated with SGLT2 immunostaining. Thus, under diabetic conditions, SIRT1 expression in PTs was downregulated by an increase in SGLT2 expression, which was stimulated by basolateral HG through activation of the GLUT2/importin-α1/HNF-1α pathway.
Ganetespib targets multiple levels of the receptor tyrosine kinase signaling cascade and preferentially inhibits ErbB2-overexpressing breast cancer cells
Authors: Lee Harry , Saini Nipun , Howard Erin W. , Parris Amanda B. , Ma Zhikun , Zhao Qingxia , Zhao Ming , Liu Bolin , Edgerton Susan M. , Thor Ann D. , Yang Xiaohe
Published: April 2018

Although ErbB2-targeted therapeutics have significantly improved ErbB2+ breast cancer patient outcomes, therapeutic resistance remains a significant challenge. Therefore, the development of novel ErbB2-targeting strategies is necessary. Importantly, ErbB2 is a sensitive client protein of heat shock protein 90 (HSP90), which regulates client protein folding, maturation, and stabilization. HSP90 inhibition provides an alternative therapeutic strategy for ErbB2-targeted degradation. In particular, ganetespib, a novel HSP90 inhibitor, is a promising agent for ErbB2+ cancers. Nevertheless, the anti-cancer efficacy and clinical application of ganetespib for ErbB2+ breast cancer is largely unknown. In our study, we examined the anti-cancer effects of ganetespib on ErbB2+ BT474 and SKBR3 breast cancer cells, and isogenic paired cancer cell lines with lentivirus-mediated ErbB2 overexpression. Ganetespib potently inhibited cell proliferation, cell cycle progression, survival, and activation/phosphorylation of ErbB2 and key downstream effectors in ErbB2+ breast cancer cells. Moreover, ganetespib decreased the total protein levels of HSP90 client proteins and reduced ErbB2 protein half-life. ErbB2-overexpressing cancer cells were also more sensitive to ganetespib-mediated growth inhibition than parental cells. Ganetespib also strikingly potentiated the inhibitory effects of lapatinib in BT474 and SKBR3 cells. Ultimately, our results support the application of ganetespib-mediated HSP90 inhibition as a promising therapeutic strategy for ErbB2+ breast cancer.
Application of Nanomaterials to Molecularly Imprinted Polymers
Authors: Bossi Alessandra Maria , Cenci Lucia , Tognato Riccardo
Published: April 2018

The combination of nanomaterials, with their specific and particular physico-chemical properties, with the selective recognition abilities of molecularly imprinted polymers (MIPs) yields nano-composites that could find application in a variety of areas, from micro-electronics to analytical chemistry and to nano-medicine. Herein, the integration of nanomaterials to MIPs is discussed with particular attention paid to magnetic nanomaterials and conductive nanotubes. The derivatization methods are illustrated, the enhancement of the analytical performances of the resulting composites is evaluated, and the main niches of applications and the achieved results are critically discussed.
Degradation induced by hot carrier and cold carrier in 65‐nm NMOSFETs with enclosed gate and two‐edged gate layouts
Authors: Shen Jingyu , Zhang Ming , Li Wei , Fan Xue , Li Jianjun , Tan Can
Published: April 2018

In this work, performance degradation of 65 nm N‐channel metal‐oxide‐semiconductor field effect transistors (NMOSFETs) with enclosed gate and two‐edged gate layouts under hot carrier stress and constant voltage stress is investigated. Compared with the cold carrier, the hot carrier effect (HCE) causes more serious degradation in threshold voltage and transconductance. It is shown that cold carrier contribution is reversible, while HCE damage is permanent, it cannot be reversed by application of the annealing bias. Meanwhile, an enclosed gate NMOSFET is proved to have higher resistance to HCE than two‐edged gate NMOSFET fabricated in the same 65 nm complementary metal‐oxide‐semiconductor (CMOS) technology according to the results of experiments. That is, the enclosed gate NMOSFET not only provides total‐dose radiation tolerance but also improves the hot carrier reliability of advanced CMOS circuits. The contributions of the two types of carriers to the degradation of transistor performance are analysed. The physical mechanism of HCE reliability of different geometry MOSFETs is studied.
Bronchopulmonary Dysplasia: Can We Agree on a Definition?
Authors: Jain Deepak , Bancalari Eduardo
Published: April 2018

The advances in obstetric and neonatal care over the last half century have resulted in changes in pathophysiology and clinical presentation of bronchopulmonary dysplasia (BPD). In contrast to the original description of BPD by Northway et al as a severe lung injury in relatively mature preterm infants, the most common form of BPD currently is characterized by chronic respiratory insufficiency in extremely preterm infants. This evolution in the presentation of BPD, along with changes in respiratory support strategies such as increased use of nasal cannula oxygen, has presented a unique challenge to find a definition that describes the severity of lung damage and predict the long-term respiratory outcomes with some accuracy.

The limitations of current definitions of BPD include inconsistent correlation with long-term respiratory outcomes, inability to classify infants dying from severe respiratory failure prior to 36 weeks' postmenstrual age, and potential inappropriate categorization of infants on nasal cannula oxygen or with extrapulmonary causes of respiratory failure. In the long term, the aim for a new definition of BPD is to develop a classification based on the pathophysiology and objective lung function evaluation providing a more accurate assessment for individual patients. Until then, a consensus definition that encompasses current clinical practices, provides reasonable prediction of later respiratory outcomes, and is relatively simple to use should be achieved.
Capacities and Competences for Drug Evaluation in European Neonatal Intensive Care Units: A Survey and Key Issues for Improvement
Authors: Elie Valery , Neyro Virginia , Ha Phuong , Aurich Beate , Leroux Stephanie , Jacqz-Aigrain Evelyne
Published: April 2018

Background Multicenter neonatal clinical trials aim to provide evidence-based drug evaluation, but recruiting neonates requires collaboration, standard procedures, and trained neonatologists.

Methods A questionnaire based on a previous Delphi study was sent to European neonatal intensive care units (NICUs) to collect their research experience and identify areas for improvement.

Results Of 247 NICUs,79 (32%) responded: 69 were level III units and 10 were level II units. In level III centers, 62% had medical staff dedicated to research and 65% conducted regular in-house audits. Similarities were observed in the median number of trials per year (level II: 2; level III: 5), Good Clinical Practice training (level II: 78%; level III: 66%), and standard operating procedures (level II: 63%; level III: 71%). Most NICUs had access to scientific advice for trial design, conduct, data management, and regulatory aspects. Involvement of patient advocacy groups was more common in level II units (level II: 75%; level III: 59%). A “quality” score of 34 “quality” research items was calculated for all centers (mean: 23.2 ± 6.2; range: 6–34).

Conclusion Research experience and processes vary across Europe. Harmonizing research practices and setting standards will allow building a European neonatal network for effective, safe, and quality neonatal drug development.
Through Patients' Eyes: Regulation, Technology, Privacy, and the Future
Authors: Petersen Carolyn
Published: April 2018

Privacy is commonly regarded as a regulatory requirement achieved via technical and organizational management practices. Those working in the field of informatics often play a role in privacy preservation as a result of their expertise in information technology, workflow analysis, implementation science, or related skills. Viewing privacy from the perspective of patients whose protected health information is at risk broadens the considerations to include the perceived duality of privacy; the existence of privacy within a context unique to each patient; the competing needs inherent within privacy management; the need for particular consideration when data are shared; and the need for patients to control health information in a global setting. With precision medicine, artificial intelligence, and other treatment innovations on the horizon, health care professionals need to think more broadly about how to preserve privacy in a health care environment driven by data sharing. Patient-reported privacy preferences, privacy portability, and greater transparency around privacy-preserving functionalities are potential strategies for ensuring that privacy regulations are met and privacy is preserved.
The Safe and Effective Use of Shared Data Underpinned by Stakeholder Engagement and Evaluation Practice
Authors: Georgiou Andrew , Magrabi Farah , Hyppönen Hannele , Wong Zoie , Nykänen Pirkko , Scott Philip , Ammenwerth Elske , Rigby Michael
Published: April 2018

Objectives: The paper draws attention to: i) key considerations involving the confidentiality, privacy, and security of shared data; and ii) the requirements needed to build collaborative arrangements encompassing all stakeholders with the goal of ensuring safe, secure, and quality use of shared data.

Method: A narrative review of existing research and policy approaches along with expert perspectives drawn from the International Medical Informatics Association (IMIA) Working Group on Technology Assessment and Quality Development in Health Care and the European Federation for Medical Informatics (EFMI) Working Group for Assessment of Health Information Systems.

Results: The technological ability to merge, link, re-use, and exchange data has outpaced the establishment of policies, procedures, and processes to monitor the ethics and legality of shared use of data. Questions remain about how to guarantee the security of shared data, and how to establish and maintain public trust across large-scale shared data enterprises. This paper identifies the importance of data governance frameworks (incorporating engagement with all stakeholders) to underpin the management of the ethics and legality of shared data use. The paper also provides some key considerations for the establishment of national approaches and measures to monitor compliance with best practice.

Conclusion: Data sharing endeavours can help to underpin new collaborative models of health care which provide shared information, engagement, and accountability amongst all stakeholders. We believe that commitment to rigorous evaluation and stakeholder engagement will be critical to delivering health data benefits and the establishment of collaborative models of health care into the future.
Balancing Health Information Exchange and Privacy Governance from a Patient-Centred Connected Health and Telehealth Perspective
Authors: Kuziemsky Craig , Gogia Shashi , Househ Mowafa , Petersen Carolyn , Basu Arindam
Published: April 2018

Objectives: Connected healthcare is an essential part of patient-centred care delivery. Technology such as telehealth is a critical part of connected healthcare. However, exchanging health information brings the risk of privacy issues. To better manage privacy risks we first need to understand the different patterns of patient-centred care in order to tailor solutions to address privacy risks.

Methods: Drawing upon published literature, we develop a business model to enable patient-centred care via telehealth. The model identifies three patient-centred connected health patterns. We then use the patterns to analyse potential privacy risks and possible solutions from different types of telehealth delivery.

Results: Connected healthcare raises the risk of unwarranted access to health data and related invasion of privacy. However, the risk and extent of privacy issues differ according to the pattern of patient-centred care delivery and the type of particular challenge as they enable the highest degree of connectivity and thus the greatest potential for privacy breaches.

Conclusion: Privacy issues are a major concern in telehealth systems and patients, providers, and administrators need to be aware of these privacy issues and have guidance on how to manage them. This paper integrates patient-centred connected health care, telehealth, and privacy risks to provide an understanding of how risks vary across different patterns of patient-centred connected health and different types of telehealth delivery.
Ethics Certification of Health Information Professionals
Authors: Kluge Eike-Henner , Lacroix Paulette , Ruotsalainen Pekka
Published: April 2018

Objectives: To provide a model for ensuring the ethical acceptability of the provisions that characterize the interjurisdictional use of eHealth, telemedicine, and associated modalities of health care delivery that are currently in place.

Methods: Following the approach initiated in their Global Protection of Health Data project within the Security in Health Information Systems (SiHIS) working group of the International Medical Informatics Association (IMIA), the authors analyze and evaluate relevant privacy and security approaches that are intended to stem the erosion of patients' trustworthiness in the handling of their sensitive information by health care and informatics professionals in the international context.

Results: The authors found that while the majority of guidelines and ethical codes essentially focus on the role and functioning of the institutions that use EHRs and information technologies, little if any attention has been paid to the qualifications of the health informatics professionals (HIPs) who actualize and operate information systems to deal with or address relevant ethical issues.

Conclusion: The apparent failure to address this matter indicates that the ethical qualification of HIPs remains an important security issue and that the Global Protection of Health Data project initiated by the SiHIS working group in 2015 should be expanded to develop into an internationally viable method of certification. An initial model to this effect is sketched and discussed.