bluuebunny/crossref_metadata_2025 huggingface dataset:
Tissue Tropism in Streptococcal Infection: Wild-Type M1T1 Group AStreptococcusIs Efficiently Cleared by Neutrophils Using an NADPH Oxidase-Dependent Mechanism in the Lung but Not in the Skin
Authors: Lei Benfang , Minor Dylan , Feng Wenchao , Jerome Maria , Quinn Mark T. , Jutila Mark A. , Liu Mengyao
Published: July 2019

Group AStreptococcus(GAS) commonly causes pharyngitis and skin infections. Little is known why streptococcal pharyngitis usually does not lead to pneumonia and why the skin is a favorite niche for GAS. To partially address these questions, the effectiveness of neutrophils in clearing wild-type (wt) M1T1 GAS strain MGAS2221 from the lung and from the skin was examined in murine models of intratracheal pneumonia and subcutaneous infection.
Point-Counterpoint: Differences between the European Committee on Antimicrobial Susceptibility Testing and Clinical and Laboratory Standards Institute Recommendations for Reporting Antimicrobial Susceptibility Results
Authors: Kahlmeter Gunnar , Giske Christian G. , Kirn Thomas J. , Sharp Susan E.
Published: July 2019

Antibiotic susceptibility test results are among the most important results issued by clinical microbiology laboratories because they routinely guide critical treatment decisions. Interpretations of MIC or disk diffusion test results, such as “susceptible” or “resistant,” are easily understood. Clinical laboratories also need to determine whether and how their reports will reflect more complex situations.
Genome Sequences of Ambystoma Tigrinum Virus Recovered during a Mass Die-off of Western Tiger Salamanders in Alberta, Canada
Authors: Lung Oliver , Nebroski Michelle , Gupta Shivani , Goater Cameron
Published: July 2019

Complete genome sequences of six Ambystoma tigrinum viruses (ATV) were determined directly from tail clips of western tiger salamanders (
Ambystoma mavortium
) from 2013 (high-mortality year) and 2014 (low-mortality year) in Alberta, Canada. The genome lengths ranged from 106,258 to 106,915 bp and contained 108 open reading frames encoding predicted proteins larger than 50 amino acids.
Whole-Genome Sequences of Clinical Enterobacter bugandensis Isolates from Germany
Authors: Falgenhauer Jane , Imirzalioglu Can , Falgenhauer Linda , Yao Yancheng , Hauri Anja M. , Erath Beate , Schwengers Oliver , Goesmann Alexander , Seifert Harald , Chakraborty Trinad , Doijad Swapnil
Published: July 2019

Enterobacter bugandensis
is the most pathogenic species of the genus
Enterobacter
and is a cause of life-threatening infections in neonates. Curiously, it was also detected in samples from the International Space Station. Here, we present complete closed genome sequences of two clinical
E. bugandensis
isolates recognized for the first time in Germany.
Prokaryotic Community Structures in a Thermophilic Anaerobic Digestion Reactor Converting Poly(
l
-Lactic Acid) for a Long Period Revealed by 16S rRNA Gene Amplicon Sequencing
Authors: Yamada Takeshi , Hamada Masako , Kurobe Misaki , Harada Jun , Giri Surya , Tsuji Hideto , Daimon Hiroyuki
Published: July 2019

Little information on poly(
l
-lactic acid) (PLLA) treatment-associated microbiota in thermophilic anaerobic digestion reactors is available. Here, we provide 16S rRNA gene sequence data on microbiota in a thermophilic anaerobic digestion reactor converting PLLA to methane for 336 days. Data comprising 99,566 total high-quality reads were tabulated at the taxonomic class level.
Draft Genome Sequence of
Thermodesulfovibrio
sp. Strain Kuro-1, a Thermophilic, Lactate-Degrading Anaerobe Isolated from a Thermophilic Anaerobic Digestion Reactor
Authors: Yamada Takeshi , Harada Jun , Kurobe Misaki , Giri Surya , Konishi Nobu Masaru , Narihiro Takashi , Tsuji Hideto , Daimon Hiroyuki
Published: July 2019

Thermodesulfovibrio
sp. strain Kuro-1, newly isolated from a thermophilic anaerobic digestion reactor, is a thermophilic anaerobe that can utilize
l
-lactic acid in fermentation, sulfate respiration, and cocultivation with hydrogenotrophic methanogens. Here, we report its draft genome sequence, consisting of a 1.93-Mb sequence with a G+C content of 34.0%.
Thermal history of the Mackenzie Plain, Northwest Territories, Canada: Insights from low-temperature thermochronology of the Devonian Imperial Formation
Authors: Powell Jeremy W. , Issler Dale R. , Schneider David A. , Fallas Karen M. , Stockli Daniel F.
Published: July 2019

Devonian strata from the Mackenzie Plain, Northern Canadian Cordillera, have undergone two major burial and unroofing events since deposition, providing an excellent natural laboratory to assess the effects of protracted cooling history on low-temperature thermochronometers in sedimentary basins. Apatite and zircon (U-Th)/He (AHe, ZHe) and apatite fission track (AFT) thermochronology data were collected from seven samples across the Mackenzie Plain. AFT single grain ages from six samples span the Cambrian to Miocene with few Neoproterozoic dates. Although there are no correlations between Dpar and AFT date or track length distribution, a relationship exists between grain chemistry and age. We calculate the parameter rmr0 from apatite chemistry and distinguish up to three discrete kinetic populations per sample, with consistent Cambrian–Carboniferous, Triassic–Jurassic, Cretaceous, and Cenozoic pooled ages. Fifteen ZHe dates range from 415 ± 33 Ma to 40 ± 3 Ma, and AHe dates from 53 analyses vary from 225 ± 14 Ma to 3 ± 0.2 Ma. Whereas several samples exhibit correlations between date and radiation damage (eU), all samples demonstrate varying degrees of intra-sample date dispersion. We use chemistry-dependent fission track annealing kinetics to explain dispersion in both our AFT and AHe data sets and detail the thermal history of strata that have experienced a protracted cooling history through the uppermost crust. Thermal history modeling of AFT and AHe samples reveals that the Devonian strata across the Mackenzie Plain reached maximum burial temperatures (∼90 °C–190 °C) prior to Paleozoic to Mesozoic unroofing. Strata were reheated to lower temperatures in the Cretaceous to Paleogene (∼65 °C–110 °C), and have a protracted Cenozoic cooling history, with Paleogene and Neogene cooling pulses. This thermal information is compared with borehole organic thermal maturity profiles to assess the regional burial history. Ultimately, these data reflect the complications, and possibilities, of low-temperature thermochronology in sedimentary rocks where detrital variance results in a broad range of diffusion and annealing kinetics.
Cost-effectiveness analysis of a pharmacotherapeutic empowerment strategy for patients with type 2 diabetes mellitus
Authors: Gonçalves Ana Carolina Oliveira , Cazarim Maurílio de Souza , Sanches Cristina , Pereira Leonardo Regis Leira , Camargos Ana Márcia Tomé , Aquino Jéssica Azevedo , Oliveira Baldoni Andre
Published: July 2019

Background

The economic feasibility of pharmacotherapeutic empowerment of patients with type 2 diabetes mellitus (DM2) is still not well established.

Objectives

To evaluate the cost-effectiveness of an individual pharmacotherapeutic empowerment strategy (IPES) for patients with DM2.

Methods

This is a cost-effectiveness study nested in a non-randomized clinical trial with patients ≥18 years of age, of both genders, with low and moderate cardiovascular risks. This study was carried out from the perspective of the municipal health system of Divinópolis in Minas Gerais state, and compared patients submitted to an IPES and patients who received only traditional care, 1 year before the beginning of the intervention (baseline) and 1 year after its completion (follow-up). The costs of the services offered by the municipality were computed, and in the intervention group IPES costs were included. Glycated hemoglobin (A1c) was the effectiveness parameter adopted. Cost-effectiveness ratio analyses, incremental cost-effectiveness ratio (ICER), and sensitivity analysis were performed.

Results

In the analysis of cost-effectiveness, it is observed that a reduction of 0.359 in A1c costs US$708.47 in the intervention group and a reduction of 0.170 costs US$1927.13 in the control group. Thus, the ICER is US$387.66 per patient/year. In the sensitivity analysis, it was observed that the IPES was dominant in 19.8% of the simulated scenarios and cost-effective in 80.2%.

Conclusions

The IPES is an alternative that presents economic feasibility for the municipal public health system scenario. The absence of randomization in patient selection is a limitation of this study.
Opt-out bloodborne virus screening: a cross-sectional observational study in an acute medical unit
Authors: Allen Niamh , Faherty Collette , Davies Andre , Lyons Anne , Scarry Margarent , Bohan Keane Mary , Boyle Nicola , O’Connell Sarah , McCarthy Eithne , Keady Deirbhile , Bergin Colm , Lee John , Fleming Catherine , Gallagher David , Tuite Helen
Published: July 2019

Objective

Recent treatment developments for HIV, hepatitis C virus (HCV) and hepatitis B virus (HBV) have greatly improved prognoses. Current screening practices are mainly risk based and are suboptimal. Improved efforts are critically needed to identify persons with these viruses. The aims of this study were to assess the feasibility of an opt-out bloodborne virus (BBV) screening programme in an acute medical unit (AMU) and to describe the prevalence of HIV, HBV and HCV in this population.

Design and setting

This was a cross-sectional observational study in the AMU of a tertiary referral hospital in Galway, a city in the west of Ireland.

Participants

1936 patients entered the study; 54% were male, mean age was 53.1 years (SD 19.6). During the study period, all patients attending the AMU aged ≧16 years who were having bloods drawn and who had the ability to verbally consent for an additional blood sample met the inclusion criteria for the study.

Results

Over 44 weeks, 1936/4793 (40.4%) patients consented to BBV panel testing. Diagnosed prevalence rates for HIV, HBV and HCV were 0.5/1000, 2/1000 and 1.5/1000, respectively. There was one HIV-positive result; the patient was already engaged in care. Four patients tested positive for HBV surface antigen; one new diagnosis, one previously lost to follow-up and two already engaged in care. Three patients had active HCV infection; two had been lost to follow-up and are now linked back into services.

Conclusion

BBV testing uptake of 40.4% is higher than previous studies in AMU settings that used opt-in strategies, but lower than expected, possibly due to not incorporating testing into routine practice. The diagnosed prevalence of HBV is notable as little data currently exist about its prevalence in Ireland. These data are valuable in order to inform further prevention strategies for these infections in low-prevalence settings.
Development and validation of 15-month mortality prediction models: a retrospective observational comparison of machine-learning techniques in a national sample of Medicare recipients
Authors: Berg Gregory D , Gurley Virginia F
Published: July 2019

Objective

The objective is to develop and validate a predictive model for 15-month mortality using a random sample of community-dwelling Medicare beneficiaries.

Data source

The Centres for Medicare & Medicaid Services’ Limited Data Set files containing the five per cent samples for 2014 and 2015.

Participants

The data analysed contains de-identified administrative claims information at the beneficiary level, including diagnoses, procedures and demographics for 2.7 million beneficiaries.

Setting

US national sample of Medicare beneficiaries.

Study design

Eleven different models were used to predict 15-month mortality risk: logistic regression (using both stepwise and least absolute shrinkage and selection operator (LASSO) selection of variables as well as models using an age gender baseline, Charlson scores, Charlson conditions, Elixhauser conditions and all variables), naïve Bayes, decision tree with adaptive boosting, neural network and support vector machines (SVMs) validated by simple cross validation. Updated Charlson score weights were generated from the predictive model using only Charlson conditions.

Primary outcome measure

C-statistic.

Results

The c-statistics was 0.696 for the naïve Bayes model and 0.762 for the decision tree model. For models that used the Charlson score or the Charlson variables the c-statistic was 0.713 and 0.726, respectively, similar to the model using Elixhauser conditions of 0.734. The c-statistic for the SVM model was 0.788 while the four models that performed the best were the logistic regression using all variables, logistic regression after selection of variables by the LASSO method, the logistic regression using a stepwise selection of variables and the neural network with c-statistics of 0.798, 0.798, 0.797 and 0.795, respectively.

Conclusions

Improved means for identifying individuals in the last 15 months of life is needed to improve the patient experience of care and reducing the per capita cost of healthcare. This study developed and validated a predictive model for 15-month mortality with higher generalisability than previous administrative claims-based studies.
Quality indicators for clinical care of patients with hypertension: scoping review protocol
Authors: Djasri Hanevi , Laras Sekar , Utarini Adi
Published: July 2019

Introduction

Cardiovascular diseases impose significant financial impact on countries implementing universal health coverage (UHC). Hypertension is a primary disease that will lead to more severe conditions without adequate clinical care. The quality of its clinical care must be well assessed in order to measure the effective coverage of people with hypertension in UHC. This study aims to identify indicators that can be used to measure the quality of clinical care provided to patients with hypertension in healthcare facilities.

Methods and analysis

This review will be conducted using the six stages of the scoping review method: identifying the research question, searching for relevant studies, selecting studies, charting the data, collating, summarising and reporting the results, and conducting consultation exercises. The review will include all quality indicators used for clinical care of patients with hypertension at any healthcare facility. All research designs will be included. Search strategies are developed using the medical subject headings and keywords related to hypertension and quality indicators. Several electronic databases, that is, MEDLINE, Cochrane, Scopus and Web of Science, including clinical-guideline databases from Agency for Healthcare Research and Quality, National Institute for Health and Care Excellence, National Health Service Evidence and Medical Information Network Distribution Service, and also grey literature will be used. Two researchers will screen the titles and abstracts and review the full text of selected articles to determine the final inclusion. The results will be summarised quantitatively, using numerical counts, and qualitatively, using thematic analysis. The data extraction will include a complete list and detailed profile of all indicators. Stakeholder consultation will be conducted at the beginning and after preliminary results to translate findings to the potential knowledge users.

Ethical considerations and dissemination

Reviews of published articles are considered secondary analysis and do not need ethical approval. The findings will be disseminated through various strategies, such as policy briefs, conferences, peer-reviewed journals, and on selected websites relevant to the subject.

Study status

Data collection for the scoping review will include publications up to May 2019, and the analysis will start in June 2019.
The NeMo real-time fMRI neurofeedback study: protocol of a randomised controlled clinical intervention trial in the neural foundations of mother–infant bonding
Authors: Eckstein Monika , Zietlow Anna-Lena , Gerchen Martin Fungisai , Schmitgen Mike Michael , Ashcroft-Jones Sarah , Kirsch Peter , Ditzen Beate
Published: July 2019

Introduction

Most mothers feel an immediate, strong emotional bond with their newborn. On a neurobiological level, this is accompanied with the activation of the brain reward systems, including the striatum. However, approximately 10% of all mothers report difficulties to bond emotionally with their infant and display impaired reward responses to the interaction with their infant which might have long-term negative effects for the child’s development. As previous studies suggest that activation of the striatal reward system can be regulated through functional MRI (fMRI)-based neurofeedback (NFB), we have designed and investigate fMRI-NFB training to treat maternal bonding difficulties.

Methods and analysis

In the planned trial, mothers will be presented pictures of their infant and real-time fMRI (rtfMRI), peripheral measures, neural, endocrine, psychophysiological and behavioural measures will be assessed. Mothers with bonding difficulties (n=68) will be randomised to one of two double-blind intervention groups at 4–6 months postpartum. They will participate in three repeated NFB training sessions with rtfMRI-NFB training to increase activation of (a) the ventral striatum or (b) the anterior cingulate. Interview data and real-time mother–infant interaction behaviour pre-intervention, post-intervention and at follow-up will serve as clinical outcome measures.

Ethics and dissemination

Study procedures are in line with the recommendations of the World Medical Association (revised Declaration of Helsinki) and were approved by the Ethics Committee of the Medical Faculty, s-450/2017, Heidelberg University. All participants will provide written informed consent after receiving a detailed oral and written explanation of all procedures and can withdraw their consent at any time without negative consequence. Results will be internationally published and disseminated, to further the discussion on non-pharmacological treatment options in complex mental disorders.

Trial registration number

DRKS00014570; Pre-results.
A cross-sectional mixed methods protocol to describe correlates and explanations for a long duration of untreated psychosis among patients with first episode psychosis in Uganda
Authors: Mwesiga Emmanuel Kiiza , Nakasujja Noeline , Ongeri Linnet , Semeere Aggrey , Loewy Rachel , Meffert Susan
Published: July 2019

Introduction

Among patients with psychotic disorders, the ‘duration of untreated psychosis’ (DUP) is a predictor of key outcomes such as symptom remission and quality of life. In sub-Saharan Africa, DUP is up to five times longer than in high-income countries, with many patients going without antipsychotic medication for 5 years or longer. One contributor to this high DUP may relate to cultural norms that drive use of alternative and complementary therapies (ACTs) as first-line treatment strategies, rather than biomedical care with antipsychotic medicine. We aim to1determine the prevalence and factors associated with DUP and ACT use in Uganda, and2Identify factors that drive patient and family choices to use ACT as a first-line treatment strategy.

Methods and analysis

We will leverage on an ongoing cohort study at the national psychiatric and teaching hospital in Uganda. The parent study is an observational cohort design following antipsychotic naïve adults with a first episode of psychosis without substance use, HIV/AIDS or syphilis. The embedded study will use a mixed methods design including quantitative assessment of parent study participants with the Nottingham Onset Schedule-DUP to determine the DUP. Qualitative assessment will focus on patient and caregiver perceptions and use of ACT and its impact on DUP among patients with psychosis using in-depth interviews.

Ethics and dissemination

The study has received ethical approval from the school of medicine research and ethics committee of the college of health sciences at Makerere University. It has also received institutional support to perform the study from the Infectious Diseases Institute and Butabika hospital. Besides publication of the work in reputable peer-reviewed journals, we hope that this work will lead to evidence-based discussions on the need for early interventions to reduce DUP in Uganda.
Effect of repetitive transcranial magnetic stimulation (rTMS) for insomnia: a protocol for a systematic review
Authors: He Yu , Sun Nianyi , Wang Zhiqiang , Zou Wenchen
Published: July 2019

Introduction

Repetitive transcranial magnetic stimulation (rTMS), a non-invasive brain stimulation approach, might be a promising technique in the management of insomnia. A systematic review of the available literature on this topic is warranted. The systematic review described in this protocol aims to investigate the efficacy of rTMS as a physical therapy in patients with insomnia.

Methods and analysis

This protocol was developed in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols. We will retrieve relevant literatures across the following electronic bibliographic databases: CENTRAL, PubMed, EMBASE, PsycINFO, CINAHL, PEDro, CBM, CNKI, WANFANG and VIP. A manual search of the reference lists of all relevant articles will be performed for any additional studies. We will include randomised controlled trials published in English and Chinese examining efficacy of rTMS on patients with insomnia. Two reviewers will independently complete the article selection, data extraction and rating. PEDro scale will be used to assess the methodological quality of the included studies. Narrative and quantitative synthesis will be done accordingly.

Ethics and dissemination

Ethical approval will not be required for this review. The results of this review will be disseminated in a peer-review journal.

PROSPERO registration number

CRD42018115033.
Health care professionals’ views towards self-management and self-management education for people with type 2 diabetes
Authors: Ross Jamie , Stevenson Fiona A , Dack Charlotte , Pal Kingshuk , May Carl R , Michie Susan , Yardley Lucy , Murray Elizabeth
Published: July 2019

Objectives

Significant problems with patients engaging with diabetes self-management education (DSME) exist. The role of healthcare professionals (HCPs) has been highlighted, with a lack of enthusiasm, inadequate information provision and poor promotion of available programmes all cited as affecting patients’ decisions to attend. However, little is known about HCPs’ views towards DSME. This study investigates the views of HCPs towards self-management generally and self-management in the context of DSME more specifically.

Design

A qualitative study using semi-structured interviews to investigate HCPs views of type 2 diabetes self-management and DSME. Data were analysed thematically and emergent themes were mapped on to the constructs of Normalisation Process Theory (NPT).

Setting

Two boroughs in London, UK.

Participants

Sampling was purposive to recruit a diverse range of professional roles including GPs, practice nurses, diabetes specialist nurses, healthcare assistants (HCAs), receptionists and commissioners of care.

Results

Interviews were conducted with 22 participants. The NPT analysis demonstrated that while a self-management approach to diabetes care was viewed by HCPs as necessary and, in principle, valuable, the reality is much more complex. HCPs expressed ambivalence about pushing certain patients into self-managing, preferring to retain responsibility. There was a lack of awareness among HCPs about the content of DSME and benefits to patients. Commitment to and engagement with DSME was tempered by concerns about suitability for some patients. There was little evidence of communication between providers of group-based DSME and HCPs or of HCPs engaging in work to follow-up non-attenders.

Conclusions

HCPs have concerns about the appropriateness of DSME for all patients and discussed challenges to engaging with and performing the tasks required to embed the approach within practice. DSME, as a means of supporting self-management, was considered important in theory, but there was little evidence of HCPs seeing their role as extending beyond providing referrals.
Systematic review with a meta-analysis: clinical effects of statins on the reduction of portal hypertension and variceal haemorrhage in cirrhotic patients
Authors: Wan Sizhe , Huang Chenkai , Zhu Xuan
Published: July 2019

Background

Statins may improve outcomes in patients with cirrhosis. We performed a systematic review and meta-analysis to evaluate the effect of statins on patients with cirrhosis and related complications, especially portal hypertension and variceal haemorrhage.

Methods

Studies were searched in the PubMed, Embase and Cochrane library databases up to February 2019. The outcomes of interest were associations between statin use and improvement in portal hypertension (reduction >20% of baseline or <12 mm Hg) and the risk of variceal haemorrhage. The relative risk (RR) with a 95% CI was pooled and calculated using a random effects model. Subgroup analyses were performed based on the characteristics of the studies.

Results

Eight studies (seven randomised controlled trials (RCTs) and one observational study) with 3195 patients were included. The pooled RR for reduction in portal hypertension was 1.91 (95% CI, 1.04 to 3.52; I2=63%) in six RCTs. On subgroup analysis of studies that used statin for 1 month, the RR was 2.01 (95% CI, 1.31 to 3.10; I2=0%); the pooled RR for studies that used statins for 3 months was 3.76 (95% CI, 0.36 to 39.77; I2=75%); the pooled RR for studies that used non-selective beta-blockers in the control group was 1.42 (95% CI, 0.82 to 2.45; I2=64%); the pooled RR for studies that used a drug that was not reported in the control group was 4.21 (95% CI, 1.52 to 11.70; I2=0%); the pooled RR for studies that used simvastatin was 2.20 (95% CI, 0.92 to 5.29; I2=69%); RR for study using atorvastatin was 1.82 (95% CI, 1.00 to 3.30). For the risk of a variceal haemorrhage, the RR based on an observational study was 0.47 (95% CI, 0.23 to 0.94); in two RCTs, the pooled RR was 0.88 (95% CI, 0.52 to 1.50; I2=0%). Overall, the summed RR was 0.64 (95% CI, 0.42 to 0.99; I2=6%).

Conclusion

Statins may improve hypertension and decrease the risk of variceal haemorrhage according to our assessment. However, further and larger RCTs are needed to confirm this conclusion.
Adverse childhood experiences (ACEs) and cardiovascular development from childhood to early adulthood: study protocol of the Niagara Longitudinal Heart Study
Authors: Wade Terrance J , O’Leary Deborah D , Dempster Kylie S , MacNeil Adam J , Molnar Danielle S , McGrath Jennifer , Cairney John
Published: July 2019

Introduction

Recent reviews have found substantial links between a toxic childhood environment including child abuse and severe household dysfunction and adult cardiovascular disease (CVD). Collectively referred to as adverse childhood experiences (ACEs), this toxic environment is prevalent among children, with recent Canadian estimates of child abuse at 27%–32%, and severe household dysfunction at 49%. Based on these prevalence rates, the potential effect of ACEs on CVD is more significant than previously thought. Yet, how ACEs amplify the risk for later CVD remains unclear. Lifestyle risk factors only partially account for this connection, instead directing attention to the interaction between psychosocial factors and physiological mechanisms such as inflammation. The Niagara Longitudinal Heart Study (NLHS) examines how ACEs influence cardiovascular health (CVH) from childhood to early adulthood. Integrating the stress process and biological embedding models, this study examines how psychosocial and physiological factors in addition to lifestyle factors explain the relationship between ACEs and CVH.

Methods

This follow-up study combines three baseline studies from 2007 to 2012 that collected CVH measures including child blood pressure, heart rate, left ventricular structure and function, arterial stiffness indices and baroreflex sensitivity on 564 children. Baseline data also include anthropometric, biological, lifestyle, behavioural, and psychosocial measures that varied across primary studies. Now over 18 years of age, we will recruit and retest as many participants from the baseline studies as possible collecting data on ACEs, CVH, anthropometric, lifestyle and psychosocial measures as well as blood, saliva and hair for physiological biostress markers.

Ethics and dissemination

Ethics approval has been received for the NLHS follow-up. Written consent to participate in the follow-up study is obtained from each participant. Results testing all proposed hypotheses will be submitted for publication in peer-reviewed journals.
Acceptability and implementation challenges of smartphone-based training of community health nurses for visual inspection with acetic acid in Ghana: mHealth and cervical cancer screening
Authors: Asgary Ramin , Cole Helen , Adongo Philip , Nwameme Ada , Maya Ernest , Adu-Amankwah Amanda , Barnett Hannah , Adanu Richard
Published: July 2019

Objective

To explore acceptability and feasibility of smartphone-based training of low-level to mid-level health professionals in cervical cancer screening using visual inspection with acetic acid (VIA)/cervicography.

Design

In 2015, we applied a qualitative descriptive approach and conducted semi-structured interviews and focus groups to assess the perceptions and experiences of community health nurses (CHNs) (n=15) who performed smartphone-based VIA, patients undergoing VIA/cryotherapy (n=21) and nurse supervisor and the expert reviewer (n=2).

Setting

Community health centres (CHCs) in Accra, Ghana.

Results

The 3-month smartphone-based training and mentorship was perceived as an important and essential complementary process to further develop diagnostic and management competencies. Cervical imaging provided peer-to-peer learning opportunities, and helped better communicate the procedure to and gain trust of patients, provide targeted education, improve adherence and implement quality control. None of the patients had prior screening; they overwhelmingly accepted smartphone-based VIA, expressing no significant privacy issues. Neither group cited significant barriers to performing or receiving VIA at CHCs, the incorporation of smartphone imaging and mentorship via text messaging. CHNs were able to leverage their existing community relationships to address a lack of knowledge and misperceptions. Patients largely expressed decision-making autonomy regarding screening. Negative views and stigma were present but not significantly limiting, and the majority felt that screening strategies were acceptable and effective.

Conclusions

Our findings suggest the overall acceptability of this approach from the perspectives of all stakeholders with important promises for smartphone-based VIA implementation. Larger-scale health services research could further provide important lessons for addressing this burden in low-income and middle-income countries.
Unique cardiovascular risk factors in women
Authors: Young Laura , Cho Leslie
Published: July 2019

Despite an overall reduction in cardiovascular disease (CVD) mortality in the USA, the rate of coronary heart disease and CVD mortality is on the rise in younger women aged 35 to 54 years. This has been attributed to an increasing prevalence of CVD risk factors, which can portend disparate outcomes in women versus men. Women with diabetes and those who smoke have an excess relative risk of CVD when compared with their male counterparts. In addition to these discrepancies in traditional risk factors, a number of clinical conditions unique to women have been shown to increase CVD risks such as pre-eclampsia, gestational diabetes, polycystic ovary syndrome, early menopause and autoimmune diseases. The majority of these sex-specific risk factors can be identified at an early age, allowing for aggressive risk factor modification through lifestyle changes and, in certain patients, medications. The recently published 2018 American College of Cardiology and American Heart Association (ACC/AHA) hypercholesterolaemia and 2019 ACC/AHA primary prevention guidelines reflect this, citing pre-eclampsia, early menopause and autoimmune diseases as ‘risk enhancers’ that if present may favour initiation of statin therapy in borderline or intermediate risk patients. This comprehensive review addresses both traditional and unique risk factors of CVD in women, as well as sex-specific risk stratification and management options.
On the horizon of aging and physical activity research
Authors: Jakobi Jennifer M. , Dempsey Jerome A. , Hellsten Ylva , Monette Richard , Kalmar Jayne M.
Published: July 2019

This viewpoint is the result of a Horizon Round Table discussion of Exercise and Aging held during the 2017 Saltin International Graduate School in Exercise and Clinical Physiology in Gatineau, Quebec. This expert panel discussed key issues and approaches to future research into aging, across human physiological systems, current societal concerns, and funding approaches. Over the 60-min round table discussion, 3 major themes emerged that the panel considered to be “On the Horizon” of aging research. These themes include (i) aging is a process that extends from womb to tomb; (ii) the importance of longitudinal experimental studies; and (iii) the ongoing need to investigate multiple systems using an integrative approach between scientists, clinicians, and knowledge brokers. With a focus on these themes, we aim to identify critical questions, challenges, and opportunities that face scientists in advancing the understanding of exercise and aging.
Survey of management practices used by Brazilian dairy farmers and recommendations provided by 43 dairy cattle nutritionists
Authors: Silva Diego P. , Pedroso Alexandre M. , Pereira Murillo C.S. , Bertoldi Gustavo P. , Watanabe Daniel H.M. , Melo Alan C.B. , Millen Danilo D.
Published: July 2019

This work aimed to survey management practices used by dairy farmers and to report nutritional recommendations adopted by 43 dairy cattle nutritionists in Brazil. The web-based survey consisted of 80 questions. Almost 50% of the participants had clients that produce <1000 kg of milk daily and 48.8% had clients who own fewer than 100 dairy cows. Corn was the primary source of grain (97.4%), and 43.9% of the nutritionists included from 41% to 50% concentrate in lactation diets. The mean roughage inclusion in lactation diets was 50.5% and 79% of the nutritionists reported corn silage as the primary roughage source. Average crude protein and rumen-degradable protein concentrations recommended by the nutritionists for lactation diets were 15.7% and 9%, respectively. Average Ca and P concentrations recommended for lactation diets were 0.70% and 0.41%, respectively. The major health problem reported by 83.9% of the nutritionists was mastitis. The present survey provides an overview of management practices adopted by dairy farmers and nutritional recommendations currently applied by dairy cattle nutritionists in Brazil. The most critical points identified were low milk yield, mastitis as the major health problem, lack of proper mixing and delivery of rations, and destination of male calves.
Characterization of the Hippophae rhamnoides WRKY gene family and functional analysis of the role of the HrWRKY21 gene in resistance to abiotic stresses
Authors: Wang Zhaoyu , Feng Runxia , Zhang Xue , Su Zhi , Wei Jianrong , Liu Jianfeng
Published: July 2019

Sea buckthorn (Hippophae rhamnoides L.) is a plant with economic and ecological value. It is uniquely capable of growing well under salt and drought stress. WRKY transcription factors play important roles in the ability of plants to resist stress. In this study, 48 HrWRKY genes were identified based on RNA sequencing of H. rhamnoides. Evaluation of expression pattern of HrWRKY1, HrWRKY17, HrWRKY18, HrWRKY21, HrWRKY33-2, HrWRKY40-2, HrWRKY41, and HrWRKY71 suggested that they were involved in abiotic stress. Interestingly, HrWRKY21, one of eight HrWRKY genes, was a positive regulator of abiotic stress tolerance in H. rhamnoides. In addition, most morphological attributes of roots in transgenic Nicotiana tabacum lines (overexpressing HrWRKY21) were also markedly increased compared with the wild-type (WT), including total lengths, specific root lengths, and surface areas. Stress tolerance of transgenic lines was also correlated with higher antioxidant activity (SOD and POD), lower percentage of relative conductivity (REC), and lower activity of malondialdehyde (MDA) under stress conditions. These findings represent a foundation of knowledge about the molecular mechanisms driving resistance to adverse conditions in plants; they are a promising step towards development of tree cultivars with improved tolerance to abiotic stress.
Protective Effects of Apocynum venetum Against Pirarubicin-Induced Cardiotoxicity
Authors: Zhang Yang , Ma Xiao-Yan , Zhang Tong , Qin Meng , Sun Bo , Li Qi , Hu Dian-Wen , Ren Li-Qun
Published: July 2019

Pirarubicin (THP) is an anthracycline antibiotic, frequently used for the treatment of various human cancers. Unfortunately, the clinical effectiveness of THP is limited by its dose-related cardiotoxicity. Apocynum leaf extract is an extract of the dried leaves of Apocynum venetum L. (a member of the Apocynaceae family, AVLE) that has many positive effects on the cardiovascular system and is widely consumed as tea in China. In this study we established a cardiactoxicity rat model, which showed that pretreatment with AVLE attenuated THP-induced myocardial histopathological injury, electrocardiogram abnormalities, and cardiac dysfunction. AVLE also significantly reduced serum levels of malondialdehyde (MDA), brain natriuretic peptide (BNP), creatine kinase (CK-MB), cardiac troponin (CTnT), and lactate dehydrogenase (LDH); and increased serum superoxide dismutase (SOD) levels. Treatment with AVLE or dexrazoxane (DZR) resulted in an increase Cytochrome C (cytc) in the mitochondria and reduced Cytc and cleaved-caspase-3 levels ([Formula: see text]) in cytoplasm. We also found that AVLE significantly reduced voltage-dependent anion channel 1 (VDAC1), adenosine nucleotide transporter 1 (ANT1), and cyclophilin D (CYPD) mRNA expression ([Formula: see text]). Furthermore, AVLE appeared to exert therapeutic effects in a dose-dependent manner. Our study suggests the anti-oxidant and anti-apoptotic properties of AVLE may be responsible for the observed cardioprotective effects.
The Effects of Ginsenosides and Anserine on the Up-Regulation of Renal Aquaporins 1–4 in Hyperuricemic Mice
Authors: Zhang Yalin , Su Han , Zhang Juan , Kong Juan
Published: July 2019

Hyperuricemia is a metabolic disease of the kidney that results in decreased uric acid excretion. Here, we aimed to investigate the effects of ginsenosides and anserine on hyperuricemia and the expression of aquaporin (AQP) 1–4, which are indicators of renal excretion. Ginsenosides and anserine were administered separately or together after the establishment of hyperuricemia with adenine in BALB/c mice. Renal function indexes such as serum uric acid, creatinine, and urea nitrogen were measured in each group of mice, and the expression of AQP1–4 in renal tissues was detected. Serum uric acid and urea nitrogen were decreased in the ginsenoside and the anserine +UA groups. Meanwhile, the uric acid excretion and clearance rate were clearly increased in the co-treatment +UA group ([Formula: see text].05). Moreover, ginsenosides or anserine ginsenosides or anserine alone and treatment with both increased the expression of AQP1–4; however, the synergistic effects were more significantly enhanced ([Formula: see text].01). We provide the first reported evidence that ginsenosides and anserine have synergistic effects on uric acid excretion. The improvement in renal function in hyperuricemic mice after treatment with ginsenosides and anserine may result from up-regulation of AQP1–4 expressions.
Arsenic Disulfide Combined with L-Buthionine-(S, R)-Sulfoximine Induces Synergistic Antitumor Effects in Two-Dimensional and Three-Dimensional Models of MCF-7 Breast Carcinoma Cells
Authors: Zhao Yuxue , Tanaka Sachiko , Yuan Bo , Sugiyama Kentaro , Onda Kenji , Kiyomi Anna , Takagi Norio , Sugiura Munetoshi , Hirano Toshihiko
Published: July 2019

Three-dimensionally (3D) cultured tumor cells (spheroids) exhibit more resistance to therapeutic agents than the cells cultured in traditional two-dimensional (2D) system (monolayers). We previously demonstrated that arsenic disulfide (As2[Formula: see text] exerted significant anticancer efficacies in both 2D- and 3D-cultured MCF-7 cells, whereas 3D spheroids were shown to be resistant to the As2S2treatment. L-buthionine-(S, R)-sulfoximine (BSO), an inhibitor of glutathione (GSH) synthesis, has been regarded to be a potent candidate for combinatorial treatment due to its GSH modulation function. In the present study, we introduced BSO in combination with As2S2at a low concentration to investigate the possible enhancing anticancer efficacy by the combinatorial treatment on 2D- and 3D-cultured MCF-7 cells. Our results presented for the first time that the combination of As2S2and BSO exerted potent anticancer synergism in both MCF-7 monolayers and spheroids. The [Formula: see text] values of As2S2in combinatorial treatment were significantly lower than those in treatment of As2S2alone in both 2D- and 3D-cultured MCF-7 cells ([Formula: see text], respectively). In addition, augmented induction of apoptosis and enhanced cell cycle arrest along with the regulation of apoptosis- and cell cycle-related proteins, as well as synergistic inhibitions of PI3K/Akt signals, were also observed following co-treatment of As2S2and BSO. Notably, the combinatorial treatment significantly decreased the cellular GSH levels in both 2D- and 3D-cultured MCF-7 cells in comparison with each agent alone ([Formula: see text] in each). Our results suggest that the combinatorial treatment with As2S2and BSO could be a promising novel strategy to reverse arsenic resistance in human breast cancer.
Wormhole modeling supported by non-exotic matter
Authors: Samanta Gauranga C. , Godani Nisha
Published: July 2019

In the present paper, the modeling of traversable wormholes, proposed by Morris and Thorne [Am. J. Phys. 56, 395 (1988)], is performed within the [Formula: see text] gravity with particular viable case [Formula: see text], where [Formula: see text], [Formula: see text] and [Formula: see text]. The energy conditions are analyzed using the shape function [Formula: see text] defined by Godani and Samanta [Int. J. Mod. Phys. D 28, 1950039 (2018)] and the geometric nature of wormholes is analyzed.
Research on the effect of cavitation on fuel atomization characteristics by molecular dynamics simulation
Authors: Qiu Chao , An Siqi , Shang Yongfeng , Chen Shuxian
Published: July 2019

The atomization characteristic of fuel is an important factor that affects the combustion stability of aero-gas turbine engine, and is of great significance to the safe operation of aircraft. By means of molecular dynamics simulation, the advantages and disadvantages of cavitation on fuel atomization process are analyzed from the point of view of molecular mechanics and molecular motion, and the influence of cavitation intensity on fuel atomization characteristics is revealed. The results show that when the cavitation intensity ranges from 0% and 5%, the cavitation is helpful to improve the atomization characteristics of fuel. Especially when the cavitation intensity is up to 3%, the dispersion of fuel droplets is the best. However, with the increase of the cavitation intensity, the pressure and energy of fuel decrease sharply, and the breakup, spray penetration and dispersion of fuel become worse, which leads to the deterioration of fuel atomization characteristics.
Hollow sine breathers induced by initial wavefront curvature in nonlinear Schrödinger equation
Authors: Yang Zhen-Feng
Published: July 2019

Based on the nonlinear Schrödinger equation, we analytically investigate a hollow sine beam (HSB) with an initial wavefront curvature propagating in strongly nonlocal nonlinear media (SNNM). Analytical evolution expressions of the beam propagation, the size of beam spot and the wavefront curvature of HSBs are derived. It is found that an HSB with an initial wavefront curvature is always presented as a breather on propagation in SNNM. The breathing behavior is discussed in detail. Numerical simulations are also performed to illustrate the typical behaviors.
Image Feature Extraction and Object Recognition Based on Vision Neural Mechanism
Authors: Wei Peng Cheng , Zou Yang
Published: July 2019

As an important branch of artificial intelligence, computer vision plays a huge role in the rapid development of artificial intelligence. From a biological point of view, in the acquisition and processing of information, vision is much more important than hearing, touch, etc., because 70% of the human cerebral cortex is processing visual information. Therefore, advances in computer vision technology are critical to the development of artificial intelligence that is designed to allow machines to think and handle things like humans. The acquisition and processing of visual information has always been the focus of computer vision research, and it is also difficult. The main problem of traditional computer vision technology in the processing of visual information is that the extracted image features are less discriminative, the generalization ability of image features in complex background scenes is insufficient, and the recognition ability on object recognition is poor. In response to these problems, based on the visual neural mechanism, this paper establishes an appropriate computer model for the neuronal cells in the human primary visual cortex, models the recognition response mechanism of the visual ventral system, and performs image feature extraction on the training samples. And object recognition. The results show that compared with the traditional methods, the proposed method effectively improves the discrimination of image features, and the image features extracted under complex background scenes have good generalization ability. On this basis, the training samples can be effectively recognized. The results show that the model based on the visual neural mechanism, the recognition of the edge, orientation and contour of the training sample show the advantages of the biological vision mechanism in object recognition.
STEADY STATE AND SENSITIVITY ANALYSIS OF A NOTCH–DELTA SIGNALING SYSTEM OF ONE SINGLE CELL INTERACTING WITH FIXED ENVIRONMENT
Authors: MOORE MATT , ZHANG YICAN , ZHENG XIAOMING
Published: July 2019

The Notch–Delta signaling pathway is a highly conserved signaling system that partakes in a diverse process of growth, patterns and differentiation. Experiments have shown that Delta from different cells activates this pathway (trans-activation) while Delta from the same cell inhibits this pathway (cis-inhibition). The Notch–Delta interactions could switch a cell to one of the two opposite fates: either Sender (high Delta/low Notch) or Receiver (low Delta/high Notch). We studied a Notch–Delta signaling model from Sprinzak et al., (2010), to investigate the cell fate through steady state analysis. The focus was placed on a fundamental case of one single cell with fixed external Delta and Notch supplies. First, we proved there exists a unique steady state which is asymptotically stable. Second, we derived the increasing/decreasing and asymptotic properties of the steady state with respect to all the parameters. Third, we studied the sensitivity and discovered the cell fate is only sensitive to the production rates of Notch and Delta under strong cis-inhibition. Finally, we applied this model to multi-cellular cases and found that the lateral inhibition pattern could be created with the spatially varied Delta production rate. The Hopf bifurcation is not observed in the current model.