bluuebunny/crossref_metadata_2025 huggingface dataset:
Creating Public Services 4.0: Sustainable Digital Architecture for Public Services in India
Authors: Malhotra Charru , Anand Rashmi , Soni Vivek
Published: October 2020

Public Service Delivery (PSD), a basic responsibility of any democratic nation, is understood as the equitable, transparent and efficient deliverance of various public goods and services to its citizens. Prudent application of digital technologies, particularly Emerging Technologies (ETs) and associated software applications, can serve as a valuable tool to catalyse governance towards Sustainable Development Goals (SDGs). While adhering to the principles of good governance. In view of this, the present study is an attempt to first elucidate some global best practices of ETs such as Artificial Intelligence, blockchain, robotic process automation, Virtual Reality and Augmented Reality to articulate the objectives of similar technology application in inspirational terms for PSD in India. Second, it summarises the challenges about the utilisation and exploitation of such technology implementations in the context of developing countries such as India. Based on learnings emanating from these two objectives, the study establishes that a refurbished approach towards digital governance is the need of the hour. This new approach must be citizen-centric, innovative and citizen-inclusive, as the literature affirms that civic participation is a prerequisite while deploying digital technologies. This inspires the authors to propose a model that is co-created with citizens to address the contextual needs and aspirations of citizenry. The successful implementation of the proposed model insists on the presence of a flexible and responsive legal and regulatory system too. The present study may be useful for public administrators and policy makers in understanding the Indian character of using and creating a sustainable digital architecture for PSD that would go a long way in revamping Public Services 4.0 under the ambit of newer Government 4.0 to achieve SDGs by 2030.
Book review: Rahela Khorakiwala. 2020. From the Colonial to the Contemporary: Images, Iconography, Memories, and Performances of Law in India’s High Courts
Authors: Yesmin Fariya
Published: October 2020

Rahela Khorakiwala. 2020. From the Colonial to the Contemporary: Images, Iconography, Memories, and Performances of Law in India’s High Courts. New Delhi: Bloomsbury Publishing India Pvt. Ltd (Hart Imprint). xvi + 277 pp. Figures, Appendix, Bibliography, Index. ₹889 (hardback).
Lifetime radiation risk of stochastic effects – prospective evaluation for space flight or medicine
Authors: Ulanowski A. , Kaiser J.C. , Schneider U. , Walsh L.
Published: October 2020

The concept of lifetime radiation risk of stochastic detrimental health outcomes is important in contemporary radiation protection, being used either to calculate detriment-weighted effective dose or to express risks following radiation accidents or medical uses of radiation. The conventionally applied time-integrated risks of radiation exposure are computed using average values of current population and health statistical data that need to be projected far into the future. By definition, the lifetime attributable risk (AR) is an approximation to more general lifetime risk quantities and is only valid for exposures under 1 Gy. The more general quantities, such as excess lifetime risk (ELR) and risk of exposure-induced cancer, are free of dose range constraints, but rely on assumptions concerning the unknown total radiation effect on demographic and health statistical data, and are more computationally complex than AR. Consideration of highly uncertain competing risks for other radiation-attributed outcomes are required in appropriate assessments of time-integrated risks of specific outcomes following high-dose (>1 Gy) exposures, causing non-linear dose responses in the resulting ELR estimate.

Being based on the current population and health statistical data, the conventionally applied time-integrated risks of radiation exposure are: (i) not well suited for projections many years into the future because of the large uncertainties in future secular trends in the population-specific disease rates; and (ii) not optimal for application to atypical groups of exposed persons not well represented by the general population. Specifically, medical patients are atypical in this respect because their prospective risks depend strongly on the original diagnosis, the treatment modality, general cure rates, individual radiation sensitivity, and genetic predisposition. Another situation challenging the application of conventional risk quantities is a projection of occupational radiation risks associated with space flight, both due to higher radiation doses and astronauts’ generally excellent health condition due to pre-selection, training, and intensive medical screening.

An alternative quantity, named ‘radiation-attributed decrease of survival’ (RADS), known in past general statistical literature as ‘cumulative risk’, is recommended here for applications in space and medicine to represent the cumulative radiation risk conditional on survival until a certain age. RADS is only based on the radiation-attributed hazard rendering an insensitivity to competing risks or projections of current population statistics far into the future. Therefore, RADS is highly suitable for assessing semi-personalised radiation risks after radiation exposures from space missions or medical applications of radiation.
Pathways to urban transformation: From dispossession to climate justice
Authors: Henrique Karen Paiva , Tschakert Petra
Published: October 2020

Cities in the Global South are quintessential sites for climate adaptation; many are rapidly expanding, struggle with increasing inequalities and experience unprecedented harm from climatic extremes. Despite scholarly recognition that adaptation pathways should reduce multidimensional vulnerabilities and inequalities, current adaptation efforts largely preserve the status quo. Many benefit powerful actors while further entrenching the poor and disadvantaged in cycles of dispossession. We bring together scholarship on adaptation pathways, politics and practice to deconstruct adaptation trajectories. We propose three conceptual steps – acknowledging injustices, embracing deliberation and nurturing responsibility for human and more-than-human others – to chart inclusive pathways towards just climate futures.
A model of electoral alliances in highly fragmented party systems
Authors: Griebeler Marcelo de C , Resende Roberta Carnelos
Published: October 2020

Highly fragmented party systems are composed of a large number of political groups, many of which have negligible bargaining power when it comes to negotiations of electoral alliances. Inspired by the Brazilian system—one of the most fragmented in the world—we provide a stylized model of electoral alliances in which there is a competition for the support of the small parties. Two leading parties try to entice a small one by simultaneously offering transfers (e.g. government positions, support in other elections, prestige). Through a first-price sealed-bid auction approach, we can analyze the role of two particular factors in alliance formation, namely pragmatism and ideology. Our findings show that, in equilibrium, the favorite party tends to offer lower transfers than the underdog. Furthermore, the closer the leading and the small parties are in terms of ideology, the smaller the transferred amount. When the ideological closeness between the small party and the underdog is sufficiently large—relative to the favorite—the effect may be strong enough to overcome the electoral advantage of the favorite.
Return of spontaneous circulation in patients with out‐of‐hospital cardiac arrest caused by pulmonary embolism using early point‐of‐care ultrasound and timely thrombolytic agent application: Two case reports
Authors: Pyo Su Yeong , Park Gwan Jin , Kim Sang Chul , Kim Hoon , Lee Suk Woo , Lee Ji Han
Published: October 2020

Introduction:

Acute pulmonary embolism is a confirmed cause of up to 5% of out‐of‐hospital cardiac arrest and 5%–13% of unexplained cardiac arrest in patients. However, the true incidence may be much higher, as pulmonary embolism is often clinically underdiagnosed. Thrombolytic therapy is a recognized therapy for pulmonary embolism–associated cardiac arrest but is not routinely recommended during cardiopulmonary resuscitation. Therefore, clinicians should attempt to identify patients with suspected pulmonary embolism. Many point‐of care ultrasound protocols suggest diagnosis of pulmonary embolism for cardiac arrest patients.

Case presentation:

We describe two male patients (60 years and 66 years, respectively) who presented to the emergency department with cardiac arrest within a period of 1 week. With administration of point‐of care ultrasound during the ongoing cardiopulmonary resuscitation in both patients, fibrinolytic therapy was initiated under suspicion of cardiac arrest caused by pulmonary embolism. Both patients had return of spontaneous circulation; however, only the second patient, who received fibrinolytic therapy relatively early, was discharged with a good outcome. In this report, we discussed how to diagnose and manage patients with cardiac arrest–associated pulmonary embolism with the help of point‐of care ultrasound. We also discuss the different clinical outcomes of the two patients based on the experience of the clinicians and the timing of thrombolytic agent application.

Conclusions:

If acute pulmonary embolism is suspected in patients with out‐of‐hospital cardiac arrest, we recommend prompt point‐of care ultrasound examination. Point‐of care ultrasound may help identify patients with pulmonary embolism during cardiopulmonary resuscitation, leading to immediate treatment, although the clinical outcomes may vary.
An extremely rare phenomenon: Angina bullosa hemorrhagica
Authors: Demir Mehmet Cihat , Ağaçkıran İlter
Published: October 2020

Introduction:

Angina bullosa hemorrhagica is a disease without a concomitant hematological or vesiculobullous disorder characterized by painless hemorrhagic bullae in the oral mucosa; it is rarely seen and has a good course.

Case presentation:

A 45‐year‐old female patient was admitted to the emergency department with a painless hemorrhagic bulla that suddenly appeared on the soft palate. A blister, 2 cm in diameter and dark red in color, was seen extending from the hard palate's posterior to the soft palate. Nasolaryngoscopic evaluation was performed, and no additional hemorrhagic bulla was detected. She was discharged with the recommendation of oral mouthwash.

Discussion:

Solitary hemorrhagic bulla, suddenly occurring on the soft palate, is diagnostic for angina bullosa hemorrhagica. Some authors have reported that blisters in the posterior pharynx may progress to acute upper airway obstruction.

Conclusion:

Early nasolaryngoscopic evaluation in angina bullosa hemorrhagica is an excellent option to be considered by the emergency physician to prevent life‐threatening situations.
Students With Learning Disabilities in the Brazilian Juvenile Justice System
Authors: Ranieri Nina , de Carvalho Bauzys Monteiro Mirella
Published: October 2020

This article describes the Brazilian juvenile justice system and the educational rights of incarcerated adolescents with learning disabilities, to discuss how and why they are “invisible” and deprived of adequate treatment for their specific needs. The main reasons reside (a) in the complex national legal structure of the juvenile justice system; (b) in the lack of specific legislation concerning the rights of students with learning disabilities in general and of incarcerated adolescents in particular, both groups not eligible for special education services; and (c) the general difficulty to diagnose learning disabilities, especially in correctional facilities. Paradoxically, despite the complexity of the juvenile justice system legal organization, nationally, there is no specific law on education for incarcerated adolescents; moreover, the lack of data collection on the prevalence of learning disabilities does not allow the federated states to create suitable laws and programs.
Prevention- Versus Promotion-Focus Regulatory Efforts on the Disease Incidence and Mortality of COVID-19: A Multinational Diffusion Study Using Functional Data Analysis
Authors: Kumar V. , Sood Ashish , Gupta Shaphali , Sood Nitish
Published: October 2020

International marketing has rarely explored the diffusion patterns of the spread of a disease or analyzed the factors explaining the differences in the disease incidence patterns. The rapid diffusion of the novel coronavirus has engulfed the entire world in a very short time. Many countries experienced different levels of disease incidence and mortality despite implementing similar nonpharmaceutical interventions (NPIs). Drawing on the regulatory focus theory, the authors propose a framework to conceptualize and investigate the comparative efficacy of diverse NPIs that countries could adopt to prevent or curtail the diffusion of the disease incidence and mortality. They categorize these NPIs as prevention focused (containment and closures) or promotion focused (relief measures and public health infrastructure) and discuss the moderating factors that enhance or impede their effectiveness. Employing functional data analysis, the authors examine a comprehensive data set across 70 countries. They find that prevention-focused interventions inhibit disease incidence, while promotion-focused interventions enhance the nation’s ability to respond to medical emergencies and augment people’s ability to isolate themselves and slow the spread. The authors also generate insights on how a reallocation of resources between prevention- and promotion-focused efforts influence the evolution of disease incidence and mortality, with various countries falling in different clusters.
Can ancient and modern stressors be distinguished? A mixed-methods exploration of psychosocial characteristics and health symptoms in young and older adults
Authors: Katsampouris Evangelos , Turner-Cobb Julie M , Barnett Julie C , Arnold Rachel S
Published: October 2020

A novel conceptualisation of stress includes a distinction between ancient (AS) and modern stressors (MS); the notion that established adaptive psychophysiological coping processes may enable individuals to better withstand AS than MS. Two consecutive mixed-methods studies assessed the feasibility of distinguishing between AS and MS in young and older adults, using questionnaires and interviews. MS were positively associated with cold symptoms in older adults; and five psychosocial characteristics were identified to profile AS and MS along a continuum. An evolutionary distinction between AS and MS provides an important psychological dimension in better understanding and assessing stress-health processes.
Efficient storage and processing of large guided wave data sets with random projections
Authors: Kim Sungwon , Shiveley Spencer , Douglass Alexander CS , Zhang Yisong , Sahay Rajeev , Adams Daniel O , Harley Joel B
Published: October 2020

Over the last several decades, structural health monitoring systems have grown into increasingly diverse applications. Structural health monitoring excels with large data sets that can capture the typical variability, novel events, and undesired degradation over time. As a result, the efficient storage and processing of these large, guided wave data sets have become a key feature for successful application of structural health monitoring. This article describes a series of investigations into the use of random projection theory to significantly reduce storage burdens and improve computational complexity while not significantly affecting common damage detection strategies. Random projections are used as a lossy compression scheme that approximately retains metrics of distance or similarity between data records. Random projection compression is evaluated using a large 1,440,000 measurement data set, which was collected over 5 months in an unprotected outdoor environment. Accurate damage detection, after the compression process, is achieved through correlation analysis and singular value decomposition. The results indicate consistent detection performance with over 95% of storage compression and more than a 477 times speed improvement in computational cost for singular value decomposition–based damage detection.
Design method of diffuse transmission free-form surface combined with collimation lens array
Authors: Zhu Zhenmin , Wang Zhiyu , Zhang Fumin
Published: October 2020

Lighting-emitting diodes are widely applied in lighting systems, and diffusers are commonly used in systems for indirect illumination. In this paper, a design method of diffuse transmission free-form surface combined with collimation lens array is proposed. Based on the Lambertian characteristics of lighting-emitting diodes and the principle of collimation lenses, a mathematical model of diffuser with ideal diffuse transmission free-form surface is established. We propose a method of the preset collimation surface to connect the free-form surface and the collimation lens array, and derive the nonlinear algebraic equation of the diffuse transmission free-form surface according to the connection effect of the preset collimation surface. Then, solving the equation numerically by MATLAB, the profile of the diffuse transmission free-form surface is obtained. Finally, the non-sequential ray tracing software TracePro is used to simulate the irradiance distribution of the target plane. The results show better uniformity and higher efficiency comparing with the lighting system using diffuse transmission free-form surface alone and the traditional diffuse transmission lighting system.
“All My Problems Go Away for 90 Minutes”: How Football and Psychotherapy Improves Young Men’s Mental Health
Authors: McGrane Amy , Bird Niamh , Arten Chelsea , O’Sullivan Katriona
Published: October 2020

This qualitative research sought to establish the impact of an 8-week program combining football and one-to-one psychotherapy on young males’ mental health, determining the factors that predict help-seeking behaviors in this group of men. Pre- and post-participation focus groups were used as the method of data collection. Six males (19–35 years old; M = 25.5) completed both pre-intervention and follow-up focus groups. Help-seeking behaviors were influenced by the appeal of football and the perception of the counselor being accessible. Barriers included gender norms, socialization, financial difficulties, and challenging social landscapes. Post-participation focus groups revealed that positive social and counseling relationships facilitated improved mental health. Sport was deemed an acceptable medium to deliver a mental health intervention as it increased social connections and facilitated help-seeking. Findings support previous research indicating that combining sports and psychotherapy positively impacts young males’ mental health.
Enhanced T-type calcium channel 3.2 activity in sensory neurons contributes to neuropathic-like pain of monosodium iodoacetate-induced knee osteoarthritis
Authors: Shin Seung Min , Cai Yongsong , Itson-Zoske Brandon , Qiu Chensheng , Hao Xu , Xiang Hongfei , Hogan Quinn H , Yu Hongwei
Published: October 2020

The monosodium iodoacetate knee osteoarthritis model has been widely used for the evaluation of osteoarthritis pain, but the pathogenesis of associated chronic pain is not fully understood. The T-type calcium channel 3.2 (CaV3.2) is abundantly expressed in the primary sensory neurons, in which it regulates neuronal excitability at both the somata and peripheral terminals and facilitates spontaneous neurotransmitter release at the spinal terminals. In this study, we investigated the involvement of primary sensory neuron-CaV3.2 activation in monosodium iodoacetate osteoarthritis pain. Knee joint osteoarthritis pain was induced by intra-articular injection of monosodium iodoacetate (2 mg) in rats, and sensory behavior was evaluated for 35 days. At that time, knee joint structural histology, primary sensory neuron injury, and inflammatory gliosis in lumbar dorsal root ganglia, and spinal dorsal horn were examined. Primary sensory neuron-T-type calcium channel current by patch-clamp recording and CaV3.2 expression by immunohistochemistry and immunoblots were determined. In a subset of animals, pain relief by CaV3.2 inhibition after delivery of CaV3.2 inhibitor TTA-P2 into sciatic nerve was investigated. Knee injection of monosodium iodoacetate resulted in osteoarthritis histopathology, weight-bearing asymmetry, sensory hypersensitivity of the ipsilateral hindpaw, and inflammatory gliosis in the ipsilateral dorsal root ganglia, sciatic nerve, and spinal dorsal horn. Neuronal injury marker ATF-3 was extensively upregulated in primary sensory neurons, suggesting that neuronal damage was beyond merely knee-innervating primary sensory neurons. T-type current in dissociated primary sensory neurons from lumbar dorsal root ganglia of monosodium iodoacetate rats was significantly increased, and CaV3.2 protein levels in the dorsal root ganglia and spinal dorsal horn ipsilateral to monosodium iodoacetate by immunoblots were significantly increased, compared to controls. Perineural application of TTA-P2 into the ipsilateral sciatic nerve alleviated mechanical hypersensitivity and weight-bearing asymmetry in monosodium iodoacetate osteoarthritis rats. Overall, our findings demonstrate an elevated CaV3.2 expression and enhanced function of primary sensory neuron-T channels in the monosodium iodoacetate osteoarthritis pain. Further study is needed to delineate the importance of dysfunctional primary sensory neuron-CaV3.2 in osteoarthritis pain.
Schwann cells and trigeminal neuralgia
Authors: Liao Jia-Yi , Zhou Tian-Hua , Chen Bao-Kang , Liu Zeng-Xu
Published: October 2020

Schwann cells are components of the peripheral nerve myelin sheath, which supports and nourishes axons. Upon injury of the trigeminal nerve, Schwann cells are activated and cause trigeminal neuralgia by engulfing the myelin sheath and secreting various neurotrophic factors. Further, Schwann cells can repair the damaged nerve and thus alleviate trigeminal neuralgia. Here, we briefly describe the development and activation of Schwann cells after nerve injury. Moreover, we expound on the occurrence, regulation, and treatment of trigeminal neuralgia; further, we point out the current research deficiencies and future research directions.
Proceedings From a Canadian Nephrology Forum: Nephrology Is Back
Authors: Levin Adeera , Sapir Daniel , Steele Andrew , Cherney David , Hellstrom Ian C. , Lanktree Matthew B. , Moist Louise , Suri Rita S.
Published: October 2020

Purpose of conference:

On January 18, 2020, the Nephrology is Back learning day forum was held in Toronto, ON, Canada. The objectives of the meeting were to describe recent advances in nephrology for community and academic nephrologists and patients, and to define challenges and opportunities for integration of new data into clinical practice. The intent was to test a unique forum for continuing medical education integrating physician and patient experiences with the goal of encouraging change in practice.

Sources of information:

Program content was based on current literature and clinical experience. Additional information was provided by patient partners who attended the meeting to provide their perspective on current issues in nephrology.

Methods:

A steering committee (A.L., A.S., and D.S.) developed goals and an outline for the content to be covered over the course of the meeting and led the recruitment of speakers. Speakers were asked to develop their presentations independently following direction by the committee, based on primary sources, including their own experiences. Presentations were followed by discussion including both physicians and patients, and participants had an opportunity to evaluate the conference and its outcomes.

Key findings:

We present a unique approach to providing continuing medical education by including both physicians and patients in the learning process. Patient perspectives accompanying presentations around data and other clinical topics provided a much different environment from other knowledge translation exercises. We believe this represents an innovative approach for knowledge translation that allows physicians to address clinical topics in a novel manner, including the integration of new findings into practice and the need to cascade this education to their peers.

Limitations:

Because the conference was a one-time event, it has been difficult to assess the actual clinical impact of the knowledge translation exercise and whether physician behaviors have changed as a result of the activity. The conference could also have included broader representation from across Canada.

Implications:

The success of this test forum among both physicians and patient partners suggests that the inclusion of patient partners in learning could have an important role in future educational initiatives.
The Unique Role of Medical Students in Catalyzing Climate Change Education
Authors: Rabin Benjamin M , Laney Emaline B , Philipsborn Rebecca P
Published: October 2020

Climate change is a well-recognized threat to human health with impacts on every organ system and with implications for disease processes across subspecialties. Climate-driven environmental exposures influence the pathophysiologic underpinnings of disease emphasized in the pre-clinical years of medical school. While medical schools are beginning to offer climate change and health electives, medical education is lagging in providing fundamental climate-and-health content to adequately prepare the next generation of physicians for the challenges that they will face in the provision of healthcare and the prevention and treatment of disease. This perspective piece highlights the unique role of medical students in catalyzing the incorporation of climate content into the pre-clinical medical school curriculum and provides topics for disseminated curricular integration with the concepts emphasized in the pre-clinical years of medical education.
Impact of COVID-19 on Canadian Medical Education: Pre-clerkship and Clerkship Students Affected Differently
Authors: Dhillon Jobanpreet , Salimi Ali , ElHawary Hassan
Published: October 2020

The coronavirus pandemic (COVID-19) has altered the undergraduate learning experience for many students across Canada. Medical education is no exception; clinical programs, in-person lectures, and mandatory hands-on activities have been suspended to adhere to social distancing guidelines. As remote teaching becomes the forefront of education, medical curricula have been forced to adapt accordingly in order to fulfill the core competencies of medical training and to provide quality education to medical students. With that in mind, the COVID-19 crisis offers a unique opportunity to evaluate the current “continuity plans” in medical education as they stand. This paper provides the perspective of medical students on how medical education is changing for both pre-clerkship and clerkship students, using their experience at McGill University as an example for the Canadian medical education system. Additionally, we discuss the accommodations put forth by the undergraduate medical education (UGME) office, and reflect on the limitations and sustainable solutions in supporting quality medical education.
Examining the Learning Practice of Emergency Airway Management Within an Academic Medical Center: Implications for Training and Improving Outcomes
Authors: Bittner Edward A , Schmidt Ulrich
Published: October 2020

Emergency airway management (EAM) is a “high stakes” clinical practice, associated with a significant risk of procedure-related complications and patient mortality. Learning within the EAM team practice is complex and challenging for trainees. Increasing concern for patient safety and changes in the structure of medical education have resulted in educational challenges and opportunities for improvement within the EAM team practice. This paper is divided into 3 sections that describe the past, present, and future of the EAM team learning practice within a large academic institution. Section 1 provides a brief overview of the evolution of the existing practice of EAM. Key features, goals, and challenges of the practice are outlined and a recently performed needs analysis to identify areas for improvement is described. Section 2 examines the underlying assumptions regarding learning within the existing practice and explores how these assumptions fit into major theories of learning. Section 3 proposes an idealized learning practice for the EAM team which includes the assumptions regarding learners, design of the learning environment, use of technology to enhance learning, and the means of assessment and measuring success. It is hoped that through this systematic exploration of the EAM team practice, learning efficacy and efficiency will be improved and remain adaptable for challenges in the future.
Embryo-fetal developmental toxicity study of alpha-glycosyl isoquercitrin administered orally to New Zealand White rabbits
Authors: Maronpot Robert R , Leggett Adam M , Donahue Douglas A , Hayashi Shim-mo , Breslin William
Published: October 2020

An embryo-fetal survival and development study was conducted to augment the toxicity database for alpha-glycosyl isoquercitrin (AGIQ), a generally recognized as safe (GRAS) additive and flavor in food and beverages. In Phase I, 24 naturally mated New Zealand white (NZW) female rabbits per group were administered AGIQ by oral gavage at 0, 250, 500, or 1000 mg/kg/day once daily during gestation days 6–28, followed by necropsy. There was no evidence of maternal or fetal toxicity except for equivocal findings of unilateral absent kidney and ureter in one and two unrelated fetuses at 500 and 1000 mg/kg/day, respectively. To more thoroughly assess fetal kidney/ureter development, in Phase II groups of time mated NZW rabbits were administered AGIQ at 0, 500, or 1000 mg/kg/day, under the same conditions as Phase I. No occurrences of absent kidney/ureter were noted in the AGIQ-treated Phase II dams or fetuses; although, one control fetus had unilateral missing kidney/ureter. Given the lack of reproducibility following treatment with AGIQ in Phase II using 48 animals per group, the missing kidney/ureter observations in Phase I were considered unrelated to treatment. Since oral gavage administration of AGIQ to pregnant female NZW rabbits at dose levels of 250, 500, or 1000 mg/kg/day was well-tolerated with no adverse treatment-related effects on the maternal animal, pregnancy, or the developing conceptus, the no-observed-adverse-effect-level (NOAEL) for maternal toxicity and embryo-fetal survival, growth, and development was 1000 mg/kg/day.
Characterization of Ag-exchanged clinoptilolite treated with a plasma jet at atmospheric pressure
Authors: Dikmen Sedef , Şahin Neslihan , Dikmen Zafer , Tanışlı Murat
Published: October 2020

This study reports on the effects of dielectric barrier discharge-like (DBD-like) plasma jet treatment at atmospheric pressure on Ag cation-exchanged clinoptilolite. In the plasma treatment process, argon plasma was applied to the surface of pellet samples prepared with Ag-clinoptilolite. After DBD-like plasma jet treatment for 30 and 60 min, remarkable colour changes were observed in the pellet samples. These changes indicate that the DBD-like plasma jet application led to the successful reduction of Ag+ to its metallic forms, which was further confirmed by the results of ultraviolet–visible diffuse reflectance spectroscopy. The structural, composition and morphological properties of the DBD-like plasma jet-treated samples were characterized using Fourier-transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy and energy-dispersive X-ray analyses, and they were compared to the untreated Ag-clinoptilolite. The DBD-like plasma jet treatment caused no detectable structural changes in clinoptilolite within the analytical limitations of the methods used. The FTIR spectra show that the plasma treatment causes discharge-induced functional changes in the hydroxyl stretching region. The peaks appearing in the XRD patterns confirmed the reduction of Ag+ to Ag0 after exposure to the plasma. The present study indicates that the reduction of Ag+ cations to their metallic forms can be performed successfully using the proposed method without collapsing the crystal structure of the Ag-clinoptilolite.
TP53 abnormalities correlate with immune infiltration and associate with response to flotetuzumab immunotherapy in AML
Authors: Vadakekolathu Jayakumar , Lai Catherine , Reeder Stephen , Church Sarah E. , Hood Tressa , Lourdusamy Anbarasu , Rettig Michael P. , Aldoss Ibrahim , Advani Anjali S. , Godwin John , Wieduwilt Matthew J. , Arellano Martha , Muth John , Yau Tung On , Ravandi Farhad , Sweet Kendra , Altmann Heidi , Foulds Gemma A. , Stölzel Friedrich , Middeke Jan Moritz , Ciciarello Marilena , Curti Antonio , Valk Peter J. M. , Löwenberg Bob , Gojo Ivana , Bornhäuser Martin , DiPersio John F. , Davidson-Moncada Jan K. , Rutella Sergio
Published: October 2020

Somatic TP53 mutations and 17p deletions with genomic loss of TP53 occur in 37% to 46% of acute myeloid leukemia (AML) with adverse-risk cytogenetics and correlate with primary induction failure, high risk of relapse, and dismal prognosis. Herein, we aimed to characterize the immune landscape of TP53-mutated AML and determine whether TP53 abnormalities identify a patient subgroup that may benefit from immunotherapy with flotetuzumab, an investigational CD123 × CD3 bispecific dual-affinity retargeting antibody (DART) molecule. The NanoString PanCancer IO360 assay was used to profile 64 diagnostic bone marrow (BM) samples from patients with TP53-mutated (n = 42) and TP53-wild-type (TP53-WT) AML (n = 22) and 45 BM samples from patients who received flotetuzumab for relapsed/refractory (R/R) AML (15 cases with TP53 mutations and/or 17p deletion). The comparison between TP53-mutated and TP53-WT primary BM samples showed higher expression of IFNG, FOXP3, immune checkpoints, markers of immune senescence, and phosphatidylinositol 3-kinase-Akt and NF-κB signaling intermediates in the former cohort and allowed the discovery of a 34-gene immune classifier prognostic for survival in independent validation series. Finally, 7 out of 15 patients (47%) with R/R AML and TP53 abnormalities showed complete responses to flotetuzumab (<5% BM blasts) on the CP-MGD006-01 clinical trial (NCT #02152956) and had significantly higher tumor inflammation signature, FOXP3, CD8, inflammatory chemokine, and PD1 gene expression scores at baseline compared with nonresponders. Patients with TP53 abnormalities who achieved a complete response experienced prolonged survival (median, 10.3 months; range, 3.3-21.3 months). These results encourage further study of flotetuzumab immunotherapy in patients with TP53-mutated AML.
Characterization of the ‘Oat-Like Rice’ Caused by a Novel Allele OsMADS1Olr Reveals Vital Importance of OsMADS1 in Regulating Grain Shape in Oryza sativa L.
Authors: Li Penghui , Li Hui , Liu Zhijian , Zhuang Yong , Wei Ming , Gu Yuanyang , Liu Yangxuan , Sun Xiuqiang , Tang Yuying , Yue Lu , Lu Longxiang , Luo Dagang , Huang Weizao , Tu Shengbin , Wang Songhu
Published: October 2020

Background

Grain shape is a critical agronomic trait affecting grain yield and quality. Exploration and functional characterization of grain shape-related genes will facilitate rice breeding for higher quality and yield.

Results

Here, we characterized a recessive mutant named Oat-like rice for its unique grain shape which highly resembles oat grains. The Oat-like rice displayed abnormal floral organs, an open hull formed by remarkably elongated leafy lemmas and paleae, occasionally formed conjugated twin brown rice, an aberrant grain shape and a low seed setting rate. By map-based cloning, we discovered that Oat-like rice harbors a novel allele of OsMADS1 gene (OsMADS1Olr), which has a spontaneous point mutation that causes the substitution of an amino acid that is highly conserved in the MADS-box domain of the MADS-box family. Further linkage analysis indicated that the point mutation in the OsMADS1Olr is associated with Oat-like rice phenotype, and expression analysis of the OsMADS1 by qRT-PCR and GUS staining also indicated that it is highly expressed in flower organs as well as in the early stages of grain development. Furthermore, OsMADS1Olr-overexpressing plants showed similar phenotypes of Oat-like rice in grain shape, possibly due to the dominant negative effect. And OsMADS1-RNAi plants also displayed grain phenotypes like Oat-like rice. These results suggested that OsMADS1Olr is responsible for the Oat-like rice phenotype including aberrant grain shape. Moreover, the expression levels of representative genes related to grain shape regulation were apparently altered in Oat-like rice, OsMADS1Olr-overexpressing and OsMADS1-RNAi transgenic plants. Finally, compared with Oat-like rice, OsMADS1Olr-overexpressing and OsMADS1-RNAi plants, mild phenotype of seed-specific OsMADS1-RNAi transgenic plants indicated that OsMADS1 may has has a direct regulation role in grain development and the grain phenotypes of Oat-like rice, OsMADS1Olr-overexpressing and OsMADS1-RNAi plants are majorly caused by the abnormal lemma and palea development.

Conclusions

Altogether, our results showed that grain shape and a low seed setting rate of the notable ‘Oat-like rice’ are caused by a spontaneous point mutation in the novel allele OsMADS1Olr. Furthermore, our findings suggested that OsMADS1 mediates grain shape possibly by affecting the expression of representative genes related to grain shape regulation. Thus, this study not only revealed that OsMADS1 plays a vital role in regulating grain shape of rice but also highlighted the importance and value of OsMADS1 to improve the quality and yield of rice by molecular breeding.
Joint effect of race/ethnicity or location of residence and sex on low density lipoprotein-cholesterol among veterans with type 2 diabetes: a 10-year retrospective cohort study
Authors: Weeda Erin R. , Bishu Kinfe G. , Ward Ralph , Axon R. Neal , Taber David J. , Gebregziabher Mulugeta
Published: October 2020

Background

Cardiovascular (CV) disease is the leading cause of death among United States women. Rural residence and ethnic-minority status are individually associated with increased CV mortality. Managing dyslipidemia is important in the prevention of CV mortality. However, the impact of race/ethnicity and location of residence on sex differences in dyslipidemia management is not well understood. Therefore, we sought to understand the joint effects of race/ethnicity and location of residence on lipid management differences between veteran men and women with type 2 diabetes (T2D).

Methods

Veterans Health Administration and Centers for Medicare and Medicaid Services data were used to perform a longitudinal cohort study of veterans with T2D (2007–2016). Mixed effects logistic regression with a random intercept was used to model the association between sex and low-density lipoprotein (LDL) > 100 mg/dL and its interaction with race/ethnicity and location of residence after adjusting for all measured covariates.

Results

When female sex and rural location of residence were both present, they were associated with an antagonistic harmful effect on LDL. Similar antagonistic harmful effects on LDL were observed when the joint effect of female sex and several minority race/ethnicity groups were evaluated. After adjusting for measured covariates, the odds of LDL > 100 mg/dL were higher for urban women (OR = 2.66, 95%CI 2.48–2.85) and rural women (OR = 3.26, 95%CI 2.94–3.62), compared to urban men. The odds of LDL > 100 mg/dL was the highest among non-Hispanic Black (NHB) women (OR = 5.38, 95%CI 4.45–6.51) followed by non-Hispanic White (NHW) women (OR = 2.59, 95%CI 2.44–2.77), and Hispanic women (OR = 2.56, 95%CI 1.79–3.66).

Conclusion

Antagonistic harmful effects on LDL were observed when both female sex and rural location of residence were present. These antagonistic effects on LDL were also present when evaluating the joint effect of female sex and several minority race/ethnicity groups. Disparities were most pronounced in NHB and rural women, who had 5.4 and 3.3 times the odds of elevated LDL versus NHW and urban men after adjusting for important covariates. These striking effect sizes in a population at high cardiovascular risk (i.e., older with T2D) suggest interventions aimed at improving lipid management are needed for individuals falling into one or more groups known to face health disparities.
Usefulness of preoperative coronary computed tomography angiography in high risk non-cardiovascular surgery old patients with unknown or suspected coronary artery disease
Authors: Li Xue-Ming , Xu Zhong-Zhi , Wen Zhi-Peng , Pei Jiao , Dai Wei , Wang Huai-Ming , Reng Jing , Zhou Peng , Xu Guo-Hui
Published: October 2020

Background

Cumulative evidence has shown that the non-invasive modality of coronary computed tomography angiography (CCTA) has evolved as an alternative to invasive coronary angiography, which can be used to quantify plaque burden and stenosis and identify vulnerable plaque, assisting in diagnosis, prognosis and treatment. With the increasing elderly population, many patients scheduled for non-cardiovascular surgery may have concomitant coronary artery disease (CAD). The aim of this study was to investigate the usefulness of preoperative CCTA to rule out or detect significant CAD in this cohort of patients and the impact of CCTA results to clinical decision-making.

Methods

841 older patients (age 69.5 ± 5.8 years, 74.6% males) with high risk non-cardiovascular surgery including 771 patients with unknown CAD and 70 patients with suspected CAD who underwent preoperative CCTA were retrospectively enrolled. Multivariate logistic regression analysis was performed to determine predictors of significant CAD and the event of cancelling scheduled surgery in patients with significant CAD.

Results

677 (80.5%) patients had non-significant CAD and 164 (19.5%) patients had significant CAD. Single-, 2-, and 3- vessel disease was found in 103 (12.2%), 45 (5.4%) and 16 (1.9%) patients, respectively. Multivariate analysis demonstrated that positive ECG analysis and Agatston score were independently associated with significant CAD, and the optimal cutoff of Agatston score was 195.9. The event of cancelling scheduled surgery was increased consistently according to the severity of stenosis and number of obstructive major coronary artery. Multivariate analysis showed that the degree of stenosis was the only independent predictor for cancelling scheduled surgery. In addition, medication using at perioperative period increased consistently according to the severity of stenosis.

Conclusions

In older patients referred for high risk non-cardiovascular surgery, preoperative CCTA was useful to rule out or detect significant CAD and subsequently influence patient disposal. However, it might be unnecessary for patients with negative ECG and low Agatston score.

Trial registration Retrospectively registered.
Team-based care improves quality of diabetes care -Family Practice Integrated Care Project in Taiwan
Authors: Chang Jerry Che-Jui , Hwang Shinn-Jang , Chen Tzeng-Ji , Chiu Tai-Yuan , Yang Hsiao-Yu , Chen Yu-Chun , Huang Cheng-Kuo , Jan Chyi-Feng
Published: October 2020

Background

The Family Practice Integrated Care Project (FPICP) is a team-based program in Taiwan initiated in 2003. This study investigates the influence of FPICP on the quality of diabetes care.

Methods

This population-based cohort study used Taiwan’s National Health Insurance Administration data on FPICP (fiscal year 2015–2016, with follow-up duration of one year). Participants included diabetic patients aged ≥30 in primary care clinics.

We used conditional logistic regression modeling of patient characteristics and annual diabetes examinations and compared FPICP participants with non-participating candidates. Main outcome measures included completion of annual diabetes examinations, including glycated hemoglobin (A1c), low-density lipoprotein (LDL), urine microalbumin (MAU), routine urinalysis (UR), and fundus examination (FE).

Results

The sample included 298,208 FPICP participants and 478,778 non-participating candidates. After 1:1 propensity score matching, the examination completion rates for FPICP participants and non-participants, respectively, were 94.4% versus 93.6% in A1c, 84.2% versus 83.8% in LDL, 61.9% versus 60.1% in MAU, 59.2% versus 58.0% in UR, and 30.1% versus 32.4% in FE.

Conclusion

Our findings indicate that a program like FPICP helps improve the quality of diabetes care through regular examinations of Alc, LDL, MAU, and UR.
Comparing proton pump inhibitors with histamin-2 receptor blockers regarding the risk of osteoporotic fractures: a nested case-control study of more than 350,000 Korean patients with GERD and peptic ulcer disease
Authors: Park Joo-Hyun , Lee Jessie , Yu Su-Yeon , Jung Jin-Hyung , Han Kyungdo , Kim Do-Hoon , Rhee Jinnie
Published: October 2020

Background

Patients with peptic ulcer disease (PUD) and gastroesophageal reflux disease (GERD) are more likely to receive long-term therapy with proton pump inhibitors (PPIs). This study aimed to investigate the risk of osteoporotic fractures in PPI users compared to histamine-2 receptor antagonist (H2RA) users and the association between fractures and the duration and regular use of PPI.

Methods

A population-based, nationwide nested case-control study from January 2006 to December 2015 was performed using Korean National Health Insurance Service claims data. We included patients ≥50 years of age, without previous fractures, newly prescribed with PPI or H2RA, and diagnosed with PUD or GERD from 2006 to 2015. Patients with osteoporotic fracture (n = 59,240) were matched with the non-fracture control group (n = 296,200) at a 1:5 ratio based on sex, age, cohort entry date, follow-up duration, and bisphosphonate use. The osteoporotic fractures were defined using the diagnostic codes of claims data (M80, M81, M82, M484, M485, S220, S221, S320, S327, S422, S423, S525, S526, S72).

Results

The higher the cumulative use of PPIs, the higher the osteoporotic fracture risk (P for trend < 0.001). The risk of osteoporotic fracture in the patients whose cumulative use of PPI was more than 1 year was higher than that of others (OR: 1.42, 95% CI: 1.32–1.52). Patients who regularly used PPI in the recent 1 year had a higher risk of osteoporotic fracture than exclusive H2RA users (OR: 1.37, 95% CI: 1.26–1.50).

Conclusions

The risk of osteoporotic fracture increased with the duration of PPI use, especially when PPI was used for ≥1 year and regularly in the recent 1 year.