bluuebunny/crossref_metadata_2025 huggingface dataset:
Defining the Specific Pathogen-Free State of Xenopus Using TaqMan Assays
Authors: Hensley Casey L. , Bowes Kaitlin M. , Feldman Sanford H.
Published: October 2020

Colonies of valuable inbred and transgenic laboratory-reared Xenopus frogs maintained for research constitute naïve populations of animals susceptible to some opportunistic infectious diseases. Therefore, it is prudent to characterize any new animal acquisitions before introduction into an existing colony as a biosecurity measure to preclude the concurrent introduction of an infectious microorganism associated with the new animal(s). In addition, some pathogens of Xenopus, such as Chlamydia and Mycobacterium spp, are zoonotic diseases, placing frog aquarists at risk for acquiring an infection. Because it is not cost effective to test for all diseases of Xenopus frogs, we have defined a subset of prevalent infectious microorganisms and developed TaqMan polymerase chain reaction (PCR) assays to detect these agents. The specific pathogens in our test panel were selected from relatively recent publications where they reportedly caused morbidity and/or mortality in Xenopus laevis and/or X. tropicalis. The assays herein do not constitute a comprehensive list of infectious diseases of Xenopus frogs. Therefore, a frog devoid of the infectious agents in our test panel are characterized as “specific pathogen-free.” Three of the described quantitative polymerase chain reaction (qPCR) assays detect many species within their genus (i.e., qPCRs for ranaviruses, Chlamydia spp, and Cryptosporidia spp).
On-campus student accommodation safety measures: provision versus risk analysis
Authors: Simpeh Fredrick , Adisa Solomon
Published: October 2020

Purpose

This paper compares the provision and risk associated with the lack of safety measures in the student accommodations of a university in the Western Cape province, South Africa, with the aim of developing a guide to improve the provision of the safety measures.

Design/methodology/approach

The study adopted a case study research strategy. A questionnaire was used as an instrument to collect quantitative data, whereas an interview was conducted to collect qualitative data. Both descriptive (mean score) and inferential (pairedt-test) statistics were used to analyse the quantitative data, whereas a content analysis was used to analyse the qualitative data.

Findings

Although most of the measures were provided, few critical measures were not adequate or not provided at all. Moreover, the mean scores obtained indicated that there were statistically significant differences between the provision and risk of non-provision of most of the measures. Weapon detector, closed-circuit television (CCTV), water sprinkler system, lift for disabled students, disabled toilet facility, burglar bar on doors, first aid box, medically trained personnel on post and accident logbook were identified as measures requiring urgent attention.

Research limitations/implications

Data were collected only from one university; therefore, the findings of the research study may not be generalised. Thus, a study that can expand the number of participating universities is recommended.

Practical implications

The facilities department and safety unit can use the recommendations provided to improve the safety of the student accommodations. Policymakers could also benefit from the findings of the study.

Originality/value

There is dearth of studies focussing mainly on student accommodation security and safety measures from the infrastructure point of view. Thus, this article contributes to the body of knowledge in this area.
Bitcoin, VIX futures and CDS: a triangle for hedging the international equity portfolios
Authors: Zghal Rania , Ghorbel Ahmed
Published: October 2020

Purpose

In this paper, our aim is to estimate the time varying correlations between Bitcoin, VIX futures and CDS indexes and to examine in what ways these assets can act as beneficial hedge and safe haven mechanisms, useful for facing, or attenuating, the major world equity markets related risks and volatilities.

Design/methodology/approach

Our methodology consists to model each pair equity/asset indices by bivariate symmetric and asymmetric dynamic conditional models (A) DCC to evaluate the portfolio design associated implications on both daily and weekly collected data base, with regard to the period ranging from July, 2010 to January 2018. To assess the extent to which the Bitcoin, VIX futures and sovereign CDS may stand as diversifiers, i.e. as hedging or safe haven instruments against the various stock indexes, we adopt the same method applied by Baur and Lucey (2010).

Findings

Empirical results show that the hedging and safe haven roles associated with the three hedging instruments tend to differ noticeably across time horizons and model used. The interest brought about by treating this issue is twofold. On the one hand, it should provide useful guidelines to investors through helping them opt for the most effective and beneficial strategies, whereby they could efficiently hedge the equity markets related extreme risks and volatilities. On the other hand, it is intended to highlight the applied models' specifications associated impacts.

Research limitations/implications

The interest brought about by treating this issue is twofold. On the one hand, it should provide useful guidelines to investors and financial advisors through helping them opt for the most effective and beneficial of the strategies, whereby they could efficiently hedge the equity markets related extreme risks and volatilities. On the other hand, it is intended to highlight the applied models' specifications associated impacts.

Originality/value

Study of Bitcoin can be considered as safe haven or hedge or diversifier instrument. Compare between Bitcoin, VIX and CDs.
Static modeling and analysis of soft manipulator considering environment contact based on segmented constant curvature method
Authors: Chen Yinglong , Li Wenshuo , Gong Yongjun
Published: October 2020

Purpose

The purpose of this paper is to estimate the deformation of soft manipulators caused by obstacles accurately and the contact force and workspace can be also predicted.

Design/methodology/approach

The continuum deformation of the backbone of the soft manipulator under contact is regarded as two constant curvature arcs and the curvatures are different according to the fluid pressure and obstacle location based on piecewise constant curvature framework. Then, this study introduces introduce the moment balance and energy conservation equation to describe the static relationship between driving moment, elastic moment and contact moment. Finally, simulation and experiments are carried out to verify the accuracy of the proposed model.

Findings

For rigid manipulators, environmental contact except for the manipulated object was usually considered as a “collision” which should be avoided. For soft manipulators, an environment is an important tool for achieving manipulation goals and it might even be considered to be a part of the soft manipulator’s end-effector in some specified situations.

Research limitations/implications

There are also some limitations to the presented study. Although this paper has made progress in the static modeling under environmental contact, some practical factors still limit the further application of the model, such as the detection accuracy of the environment location and the deformation of the contact surface.

Originality/value

Based on the proposed kinematic model, the bending deformation with environmental contact is discussed in simulations and has been experimentally verified. The comparison results show the correctness and accuracy of the presented SCC model, which can be applied to predict the slender deformation under environmental contact without knowing the contact force.
COVID-19 pandemic and economic crisis: the Nigerian experience and structural causes
Authors: Ozili Peterson K.
Published: October 2020

Purpose

This paper analyses the COVID-19 situation in Nigeria, its effect on the economy and the structural causes that worsened the coronavirus (COVID-19) crisis.

Design/methodology/approach

This paper uses simple descriptive analysis to examine the COVID-19 situation in Nigeria.

Findings

The findings reveal that the economic downturn in Nigeria was triggered by a combination of declining oil price and spillovers from the COVID-19 outbreak, which not only led to a fall in the demand for oil products but also stopped economic activities from taking place when social distancing policies were enforced. The government responded to the crisis by providing financial assistance to businesses and a small number of households that were affected by the coronavirus (COVID-19) outbreak. The monetary authority adopted accommodative monetary policies and offered a targeted 3.5 trillion loan support to some sectors. These efforts should have prevented the economic crisis from occurring but it did not. Economic agents could not freely engage in economic activities for fear of contracting the COVID-19 disease that was spreading very fast at the time.

Practical implications

The implication of the study is that policymakers should pay attention to three areas of the economy for economic and structural reform. One, policymakers should introduce economic reforms to diversify the economy and reduce Nigeria's dependence on revenue from crude oil export. Two, policymakers in Nigeria should invest in healthcare infrastructure to improve the ability of the national health system to withstand the outbreak of contagious diseases. Three, there is also a need to build appropriate digital infrastructure to facilitate the transition from “face-to-face” business activities to a “digital or online” business activities, which can help to grow the digital economy. Also, policymakers should use legislation to create a robust social welfare safety net for all citizens particularly for unemployed citizens and poor households.

Originality/value

This is the first paper that looks at the economic implication of COVID-19 in a West African country.
How does the cryptocurrency market affect the stock market performance in the MENA region?
Authors: Sami Mina , Abdallah Wael
Published: October 2020

Purpose

This paper examines the impact of cryptocurrency market on the stock market performance in Middle East and North Africa (MENA) region. A comparative analysis is extended to distinguish this impact between Gulf countries and other economies in the region.

Design/methodology/approach

The analysis uses the information of cryptocurrencies and the stock market indices of the Gulf countries for the period 2014–2018 on a daily basis. Two strategies have been implemented to fulfill the goal of the study: first, the tests strategy, which is applied using the cointegration analysis and panel-specific forms of Granger causality; second, the regression strategy, which is applied mainly using the instrument variable with generalized method of moments (IV-GMM) method.

Findings

The results show that there is a significant relationship between the cryptocurrency market and the stock market performance in the MENA region. On the one hand, for the Gulf countries that claim full obedience to the Islamic Sharia rules, each 1% increase in the cryptocurrency returns reduces the stock market performance by 0.15%. On the other hand, for the non-Gulf (other MENA) countries that have flexibility in applying the Islamic Sharia rules or do not follow it, the stock market performance increases by 0.13%, for each 1% increase in the cryptocurrency returns.

Originality/value

The paper proposes two main contributions: First, the paper introduces the cryptocurrency returns as one of the determinants of the stock market performance in the MENA region. This impact is distinguished based on the degree of applying the Islamic Sharia rules and the vision of the government to the stock market. Second, the paper provides an empirical guideline for governments in the MENA region for efficient measures in their stock market, given the important expansion of the cryptocurrency market and the government type.
Business model innovation and growth of manufacturing SMEs: a social exchange perspective
Authors: Chen Jiawen , Liu Linlin , Wang Yong
Published: October 2020

Purpose

This study investigates business model innovation in small- and medium-sized manufacturing enterprises (SMEs) and its impact on firm growth.

Design/methodology/approach

The study was based on analyzing data collected through a questionnaire survey. Structural equation modeling was applied to test the hypotheses.

Findings

Business model innovation has a positive effect on SME growth in the manufacturing sectors. Moreover, growth is also achieved through the indirect effect of business model innovation on customer trust and commitment.

Practical implications

Managers will benefit from understanding how business model innovation can help their companies to overcome resource constraints and achieve sustained growth. When manufacturing SMEs engage in modular or structural changes to their business model, they may find it worthwhile to focus on maintaining a relationship of trust and commitment with their customers.

Originality/value

This study highlights business model innovation as a unique and important, yet underexplored, factor in manufacturing SME growth. The findings also untangle the complex processes of customer relationship management by which business model innovation improves manufacturing competitive advantage for SMEs.
COVID‐19 transmission: economy‐boosting investment should target innovation in pandemic containment strategies to minimize restrictions of civil liberties
Authors: Timmis Kenneth
Published: October 2020

Imposition of restrictions on civil liberties in response to epi/pandemic crises provokes collateral health, economic and social crises. Moreover, as a result of the societal distress engendered, they become less effective over time, reflected in reducing acceptability, public protests, lack of compliance and civil disobedience, as evidenced by current events in some countries. There is an urgent need to evolve new containment strategies that minimize civil liberty restrictions. This requires strategic economic policies to invest in what might be termed pandemic containment innovation, particularly in the development of new means of reducing virus concentrations in closed spaces, and of precision exclusion of virus transmitters from public assemblies. Such innovations and their implementation will in turn create significant employment and boost economies. And, because such investments aim at increasing the resilience of society, healthcare and the economy to pandemics (and indeed outbreaks of respiratory infections in general), they are particularly sustainable.
Unravelling lactate‐acetate and sugar conversion into butyrate by intestinal Anaerobutyricum and Anaerostipes species by comparative proteogenomics
Authors: Shetty Sudarshan A. , Boeren Sjef , Bui Thi P. N. , Smidt Hauke , de Vos Willem M.
Published: October 2020

The d‐ and l‐forms of lactate are important fermentation metabolites produced by intestinal bacteria but are found to negatively affect mucosal barrier function and human health. Both enantiomers of lactate can be converted with acetate into the presumed beneficial butyrate by a phylogenetically related group of anaerobes, including Anaerobutyricum and Anaerostipes spp. This is a low energy yielding process with a partially unknown pathway in Anaerobutyricum and Anaerostipes spp. and hence, we sought to address this via a comparative genomics, proteomics and physiology approach. We compared growth of Anaerobutyricum soehngenii on lactate with that on sucrose and sorbitol. Comparative proteomics revealed complete pathway of butyrate formation from sucrose, sorbitol and lactate. Notably, a gene cluster, lctABCDEF was abundantly expressed when grown on lactate. This gene cluster encodes a lactate dehydrogenase (lctD), electron transport proteins A and B (lctCB), nickel‐dependent racemase (lctE), lactate permease (lctF) and short‐chain acyl‐CoA dehydrogenase (lctG). Investigation of available genomes of intestinal bacteria revealed this new gene cluster to be highly conserved in only Anaerobutyricum and Anaerostipes spp. Present study demonstrates that A. soehngenii and several related Anaerobutyricum and Anaerostipes spp. are highly adapted for a lifestyle involving lactate plus acetate utilization in the human intestinal tract.
A chimeric being from Kyushu, Japan: Amabie's revival during Covid‐19
Authors: MERLI CLAUDIA
Published: October 2020

This article explores how the resurgence of a forgotten chimeric figure from the Japanese history of disasters and epidemics intersects with some central ecological and political discourses in the context of the Covid‐19 pandemic, especially those associated with culinary practices, human rights and relations with other historical epidemics. Presented as a mascot but viewed as an icon of protection, this uncanny little yōkai from southern Japan in the pre‐modern Edo period addresses our lives as they are caught in a suspension of our usual temporal and spatial dimensions. A monster, a hyperobject and an art effigy of our pandemic present.
The ‘superman’ solution: ‘Super soldiers’ and ‘superheroes’ in the United States military
Authors: BICKFORD ANDREW
Published: October 2020

Current US military research focused on the development of pharmacological ‘super soldiers’ – soldiers enhanced through a variety of pharmaceuticals and biomedical technologies to perform far beyond what unenhanced soldiers can do – draws from and often mimics popular or pop‐cultural conceptions of the superhero. These biomedical and pharmacological interventions pose profound ethical problems and possibilities that are solved – in part – by imagining the new US super soldier as a superhero. Drugging soldiers to enhance their ability to fight and survive is a frightening proposition, and one that makes people uncomfortable; the solution is to imagine them as superheroes – as positive representations of the enhanced soldier on the side of good, somehow contained and controllable and fundamentally safe and unfrightening.
Towards truly inclusive science education: a case study of successful curriculum innovation in a special school
Authors: Essex Jane
Published: October 2020

The paper provides a first person account of participant evaluation research of curriculum innovation in a school serving students with profound learning difficulties. It describes how the aspirations of the school leadership team to introduce science, combined with advisory support, overcame the initial anxiety of teaching staff about teaching an unfamiliar subject. The staff position was transformed and they gave a very positive evaluation of their experiences of teaching science, due to the impact of the subject on their students. The introduction of a distinct and inclusive model of science into the curriculum was ultimately found to have significant benefits for both students and staff.
Development and evaluation of a processing sector model for butter manufacture using a mass balance technique at two dairy processing sites
Authors: Parmar Puneet , Lopez‐Villalobos Nicolas , Tobin John T , Murphy Eoin , Crowley Shane V , Kelly Alan L , Shalloo Laurence
Published: October 2020

The butter manufacturing process at two different commercial dairy processing sites in Ireland was evaluated using a mass balance approach to develop, evaluate and validate a processing sector model of the flow of milk fat from intake to final product. The mass balance was represented as a function of fat intake = fat in products + fat losses + recycled fat. Representative samples of all products, namely whole milk, cream, skim milk, butter, buttermilk and cleaning‐in‐place streams (cream silo flush, butter churn residue and sludge), were collected from two different sites. Milk fat levels and product quantities were measured to obtain the fat outputs. Total fat losses at the end of butter production ranged between 1.90% and 2.25% of the total fat input for both sites. Three different scenarios were examined to evaluate the model: S1 (Animal Breed) high genetic merit (Elite) and national average (NA) Holstein Friesian (HF) cows were evaluated, for their effect on the net value of milk; S2 (Product Portfolio) a mixed product portfolio of cheese, butter and skim milk powder (SMP) was compared to a product portfolio comprised of butter alone; and S3 (Process Efficiency) the impact of varying process losses on net values of milk and the quantities of products produced was simulated. The value per 1000 L of milk for S1 was €410.69 and €393.20 for Elite and NA cow’s milk, respectively. For S2, the butter‐only product portfolio returned €355.10, whereas the mixed‐products portfolio returned €369.60. Lastly, S3 corresponding returns for 1%, 2.2% and 5% losses was €365.90, €361.47 and €351.12, respectively.
Psychotropic medication use for paediatric mental health patients in an emergency department
Authors: O'Donnell Sinead M , Carison Anna , Hill Ashley , Say Daniela , Hiscock Harriet , Babl Franz E
Published: October 2020

Objective

There is paucity of evidence for psychotropic medication use in children and adolescents presenting with mental health (MH) problems to the ED. We set out to describe paediatric psychotropic medication use in the ED.

Methods

We conducted a retrospective electronic medical record review of ED patients with MH discharge codes at a tertiary paediatric ED in 2018. We assessed the epidemiology and management of patients who received a psychotropic medication. We calculated the odds ratios (ORs with 95% confidence intervals [CIs]) of key demographic factors of medicated versus non‐medicated MH patients.

Results

During 2018 there were 1695 MH‐related presentations to the ED. Of these, 280 presentations resulted in the patient receiving a psychotropic medication (16.5%). Medicated children with MH illness were more likely to be male (OR 1.50, 95% CI 1.16–1.96), have a more acute triage category (OR 3.37, 95% CI 2.28–4.98), have an ED length of stay greater than 12 h (OR 3.96, 95% CI 2.56–6.13) and present after hours (OR 1.51, 95% CI 1.16–1.96). Most had a diagnosis of acute behavioural disturbance or suicidal ideation. A variety of treatment regimens were used but children primarily received a single oral agent (diazepam or olanzapine). Parenteral medications were given in 8.6%. No adverse events were recorded.

Conclusion

A minority of children with MH presentations to the ED were medicated. It will require multicentre research to determine the most effective and safe acute psychotropic agents for oral and parenteral use in children in the ED.
Estimating the proportion of patients who transition to long‐term opioid use following oxycodone initiation in the emergency department
Authors: Nguyen Jennie P , Harding Andrew M , Greene Shaun L
Published: October 2020

Objective

To report the number of patients discharged from ED with oxycodone immediate release (IR) over 12 months and estimate the proportion who potentially transition to long‐term opioid use and subsequent injectable heroin use.

Methods

Retrospective observational data were collected from a major tertiary‐referral metropolitan ED in Melbourne, Australia, describing the number of patients discharged with an oxycodone IR prescription and proportion of discharge scripts filled. These data were projected against published data reporting trends on patients' trajectory to long‐term opioid use, to subsequently estimate the proportion of patients from this cohort that may transition to injectable heroin use.

Results

Of the 87 551 ED presentations in 2018, there were 4843 prescriptions written for oxycodone IR for 4102 different patients. An estimated 279 patients may become long‐term opioid users following initial ED presentation. Of these 279 patients, 1.4 patients may potentially transition to injectable heroin use.

Conclusion

Modelling opioid use behaviour in an ED population demonstrated the potential development of unintentional long‐term opioid use, and associated harms. Prospective study is required to fully understand trajectories of patients dispensed outpatient therapy from Australian EDs.
Ursolic acid alleviates lipid accumulation by activating the AMPK signaling pathway in vivo and in vitro
Authors: Cheng Jing , Liu Ying , Liu Yaojie , Liu Dong , Liu Yang , Guo Yatu , Wu Zijian , Li Heyu , Wang Hao
Published: October 2020

The mechanism underlying the effect of ursolic acid (UA) on lipid metabolism remains unclear. This study aimed to explore the mechanisms of UA in reducing lipid accumulation in free fatty acids‐cultured HepG2 cells and in high‐fat‐diet‐fed C57BL/6J mice. In vivo, UA effectively alleviated liver steatosis and decreased the size of adipocytes in the epididymis. It also significantly decreased the total cholesterol (TC) and triglyceride (TG) contents in the liver and plasma in C57BL/6 mice. In vitro, UA (20 µM) significantly reduced lipid accumulation; the intracellular TC contents decreased from 0.078 ± 0.0047 to 0.049 ± 0.0064 µmol/mg protein, and TG contents from 0.133 ± 0.005 to 0.066 ± 0.0047 µmol/mg protein, in HepG2 cells. Furthermore, UA reduced the mRNA expression related to fat synthesis, enhanced the mRNA expression related to adipose decomposition, and dramatically upregulated the protein expression of P‐AMPK in vivo and in vitro. Of note, these protective effects of UA on a high‐fat environment were blocked by the AMPK inhibitor (compound C) in vitro. In addition, the molecular docking results suggested that UA could be docked to the AMPK protein as an AMPK activator. These results indicated that UA lowered the lipid content probably via activating the AMPK signaling pathway, thereby inhibiting lipid synthesis and promoting fat decomposition.

Practical Application

Ursolic acid (UA) widely exists in vegetables and fruits. This study highlighted a lipid‐lowing mechanism of UA in HepG2 cells and C57BL/6J mice. The data indicated that UA might be used in lipid‐lowering functional foods.
Effect of natron administration on the antioxidant status and lipid profile of rats
Authors: Saidu Yusuf , Olaosebikan Rihanat Olawumi , Isa Suleiman Ahmed , Malami Ibrahim , Muhammad Suleiman Alhaji
Published: October 2020

Natron consumption has been implicated in the pathogenesis of peripartum cardiomyopathy. This work evaluates the effect of natron on the antioxidant status and lipid profile of postpartum rats administered graded doses of natron for four consecutive weeks. After treatment, the rats were assessed for antioxidant status, malondialdehyde level, and lipid profile. The results revealed that natron caused a significant decrease (P ˂ 0.05) in the activity of catalase in rats administered with 300 mg/kg of natron compared to control. The activities of superoxide dismutase and glutathione peroxidase decreased in a dose‐dependent manner; however, the difference was not statistically significant when compared with control. Serum levels of antioxidant minerals were also significantly decreased (P ˂ 0.05) at higher doses of natron in comparison to control. There was a significant increase (P < 0.05) in the malondialdehyde level in rats administered with 200 and 300 mg/kg of natron when compared with control. Natron at higher doses caused a significant increase (P ˂ 0.05) in the level of the lipid profile parameters except for high‐density lipoprotein‐cholesterol that decrease significantly (P ˂ 0.05). This study demonstrated that the administration of natron at high doses induced dyslipidemia and oxidative stress in postpartum rats.

Practical Application

This research reports the implication of a high intake of natron to health and to establish the relationship between natron intake and peripartum cardiomyopathy (PPCM) using an animal model. Natron has health benefits; however, its consumption at high doses should be discouraged as it can lead to oxidative stress (OS) and dyslipidemia. The results suggest that OS due to natron may contribute to the pathogenesis of PPCM. A high concentration of natron can be used to induce an animal model of PPCM, which would be of practical application in studying the molecular basis and possible discovery of therapeutics for the disease.
Early experiences of COVID‐19 infected, middle‐aged patients
Authors: Lee Jessica , Yam Mitchell , Young Noel , Iredell Jonathan
Published: October 2020

This case report describes our early radiological experiences of middle‐aged patients with COVID‐19 at Westmead Hospital, Sydney. We found limited relationship between initial CT imaging appearances and progression to severe disease. The most effective use of imaging in COVID‐19 is yet to be determined.
Distinguishing among complex evolutionary models using unphased whole‐genome data through random forest approximate Bayesian computation
Authors: Ghirotto Silvia , Vizzari Maria Teresa , Tassi Francesca , Barbujani Guido , Benazzo Andrea
Published: October 2020

Inferring past demographic histories is crucial in population genetics, and the amount of complete genomes now available should in principle facilitate this inference. In practice, however, the available inferential methods suffer from severe limitations. Although hundreds complete genomes can be simultaneously analysed, complex demographic processes can easily exceed computational constraints, and the procedures to evaluate the reliability of the estimates contribute to increase the computational effort. Here we present an approximate Bayesian computation framework based on the random forest algorithm (ABC‐RF), to infer complex past population processes using complete genomes. To this aim, we propose to summarize the data by the full genomic distribution of the four mutually exclusive categories of segregating sites (FDSS), a statistic fast to compute from unphased genome data and that does not require the ancestral state of alleles to be known. We constructed an efficient ABC pipeline and tested how accurately it allows one to recognize the true model among models of increasing complexity, using simulated data and taking into account different sampling strategies in terms of number of individuals analysed, number and size of the genetic loci considered. We also compared the FDSS with the unfolded and folded site frequency spectrum (SFS), and for these statistics we highlighted the experimental conditions maximizing the inferential power of the ABC‐RF procedure. We finally analysed real data sets, testing models on the dispersal of anatomically modern humans out of Africa and exploring the evolutionary relationships of the three species of Orangutan inhabiting Borneo and Sumatra.
BCAR1 promotes proliferation and cell growth in lung adenocarcinoma via upregulation of POLR2A
Authors: Mao Chun‐guo , Jiang Sha‐sha , Shen Cheng , Long Tan , Jin Hua , Tan Qun‐You , Deng Bo
Published: October 2020

Background

This study was designed to investigate the effects of a novel carcinogenetic molecule, p130cas (breast cancer antiestrogen resistance protein 1 or BCAR1) on proliferation and cell growth in lung adenocarcinoma. The study also aimed to identify the possible underlying signal networks of BCAR1.

Methods

First, we evaluated proliferation, cell colony formation, apoptosis, and cell cycle after BCAR1 was knocked out (KO) using CRISPR‐Cas9 technology in H1975 and H1299 human lung adenocarcinoma cells. Subsequently, BCAR1 was upregulated in 293T cells and immunoprecipitation‐mass spectrometry (IP‐MS) was used with bioinformatics analysis to screen for potential networks of BCAR1 interacting proteins. Ultimately, we validated the correlated expressions of BCAR1 and a selected hub gene, RNA polymerase II subunit A (POLR2A), in 54 lung adenocarcinoma tissues, as well as in H1975 and H1299 cells.

Results

Cell proliferation of H1975 and H1299 was significantly inhibited following BCAR1‐KO. Colony formation of H1975 cells was also significantly decreased following BCAR1‐KO. IP‐MS demonstrated 419 potential proteins that may interact with BCAR1. Among them, 68 genes were significantly positively correlated to BCAR1 expression, as verified by TCGA. Six hub genes were revealed by PPI String. High expression of POLR2A, MAPK3, MOV10, and XAB2 predicted poor prognosis in lung adenocarcinoma, as verified by the K‐M plotter database. POLR2A and MAPK3 are involved in both catalytic activity and transferase activity. POLR2A and BCAR1 were significantly increased in lung cancer tissues as compared with matched normal tissues. High expression of POLR2A was significantly positively correlated to BCAR1 overexpression and predicted poor prognosis in 54 lung cancer cases. POLR2A expression was significantly decreased following BCAR1‐KO in H1975 and H1299 cells.

Conclusions

BCAR1 promotes proliferation and cell growth, probably via upregulation of POLR2A and subsequent enhancement of catalytic and transferase activities. However, additional robust studies are required to elucidate the mechanisms involved.
Pay for Performance and Treatment Outcome in Agonist Treatment for Opioid Use Disorder
Authors: Loscalzo Emily , Levit Alexander , Sterling Robert C. , Weinstein Stephen P.
Published: October 2020

Background and Objectives

Pay for performance (P4P) models have become more popular in reimbursement for medical services, including treatment for substance use disorders. However, studies have not examined whether P4P has an impact on treatment outcome in the individual in opioid agonist treatment (OAT). Thus, the present study was conducted at the individual level, rather than the programmatic level, to determine whether meeting the P4P early engagement criteria (four services in the initial 14 days of treatment and/or eight services within the initial 30 days of treatment) resulted in reduced opioid, benzodiazepine, and cocaine use.

Methods

We performed a retrospective study of 63 patients enrolled in OAT for opioid use disorder. χ2 analyses were conducted crossing P4P early engagement criteria status and urine drug screen (UDS) results for opioid, cocaine, and/or benzodiazepine use at 6 and 12 months postadmission. Methadone dosage and treatment retention were also considered. The odds ratio was used to determine the directionality of significant results.

Results

Significant relationships were revealed between patients meeting 30‐day P4P early engagement criteria and opioid negative UDS, and with retention in treatment at 6 and 12 months. Methadone dosage was significant at a 6‐month follow‐up.

Discussion and Conclusions

Since significant associations between opioid use and P4P as well as opioid use and methadone dose were revealed, findings partially supported hypothesis.

Scientific Significance

P4P and methadone dosage may have some benefit to individuals in OAT in attaining short‐term abstinence from opioids. P4P may be less useful in helping individuals achieve abstinence from other substances of abuse. (Am J Addict 2020;00:00–00)
Distribution of private dental practices and dentists 2011 and 2018: Analysis by regional area
Authors: Jean Gillian , Kruger Estie , Tennant Marc
Published: October 2020

Objective

The aim of this study was to determine whether there has been a change in access to private dental services in regional and remote areas of Australia by comparing the distribution of private dental practices and dentists in 2011 to the distribution in 2018 according to state and territory and the Accessibility/Remoteness Index of Australia Plus.

Design and setting

A database of dental practices and dentists in Australia was compiled from open‐access sources for 2011 and 2018; dental practices were mapped by state, Accessibility/Remoteness Index of Australia Plus and Statistical Area 2 census district and linked to population data.

Main outcome measures

Change in number of private dental practices, mean number of dentists per private practice, population per dental practice and mean number of dentists per population by geographic location from 2011 to 2018.

Results

There were more dental practices in rural and remote areas in 2018 than in 2011. The percentage of Statistical Area 2s without a private dental practice was lower in 2018 but remained high in rural areas and increased with remoteness—inner regional 23.1%; outer regional 31.6%; and remote and very remote 48%. Growth in registered dentist numbers did not match population growth, and on average, there were less dentists per practice in inner regional and remote and very remote areas by the end of the study.

Conclusion

There has been an improvement in spatial access to private dental services in regional areas of Australia, but slower rate of growth of dentist numbers compared to population growth resulted in poorer access to dental services and large population numbers must still travel outside their local Statistical Area 2 census district to access dental care.
Theoretical analysis of policies to improve the recruitment and retention of rural physicians
Authors: Danish Alya , Champagne François , Blais Régis
Published: October 2020

The lack of success in resolving the shortage of rural physicians in Organisation for Economic Cooperation and Development countries has been attributed to the weakness of implemented policies. This research examines the theoretical plausibility of policies to improve the recruitment and retention of rural physicians, first, by modelling the policies; and then, by describing how they might achieve their intended outcome based on a theoretical analysis. A theory‐driven method relying on published research and expert analysis is used. A conceptual model is created to represent the policies and their underlying assumptions. Then, the functional mechanism of the policies is defined. This research demonstrates that financial, educational and tailored interventions might improve rural physician recruitment and retention, but that regulatory interventions are unlikely to do this. The majority of the policies implemented in Organisation for Economic Cooperation and Development countries are therefore theoretically plausible.
Thirty‐day outcomes after gynecologic oncology surgery: A single‐center experience of enhanced recovery after surgery pathways
Authors: Bernard Laurence , McGinnis Justin M. , Su Jane , Alyafi Mohammad , Palmer Delia , Potts Leonard , Nancekivell Kelly‐Lynn , Thomas Heidi , Kokus Heather , Eiriksson Lua R. , Elit Lorraine M. , Jimenez Waldo G. F. , Reade Clare J. , Helpman Limor
Published: October 2020

Introduction

The purpose of the study is to evaluate the impact of an enhanced recovery after surgery (ERAS) program implemented in a Gynecologic Oncology population undergoing a laparotomy at a Canadian tertiary care center.

Material and methods

Prospectively collected data, using the American College of Surgeons’ National Surgical Quality Improvement Program dataset (ACS NSQIP), was used to compare 30‐day postoperative outcomes of gynecologic oncology patients undergoing a laparotomy before and after the 2018 implementation of an ERAS program in a Canadian regional cancer center. Patient demographics, surgical variables and postoperative outcomes of 187 patients undergoing surgery in 2019 were compared with those of 441 patients undergoing surgery between January 2016 and December 2017. Student’s t, Mann‐Whitney U and Chi‐square tests, as well as multivariate linear and logistic regressions were used to evaluate baseline characteristics and 30‐day postoperative complications.

Results

Length of stay was significantly shortened in the study population after introducing the ERAS protocol, from a mean of 4.7 (SD = 3.8) days to a mean of 3.8 (SD = 3.2) days (P = .0001). The overall complication rate decreased from 24.3% to 16% (P = .02). Significant decreases in the rates of postoperative infections (adjusted odds ratio [OR] 0.56, 95% confidence interval [CI] 0.31‐0.99) and cardiovascular complications (adjusted OR 0.27, 95% CI 0.09‐0.79) were noted, without a significant increase in readmission rate (adjusted OR 0.50, 95% CI 0.21‐1.07).

Conclusions

Introducing an ERAS program for gynecologic oncology patients undergoing laparotomy was effective in shortening length of stay and the overall complication rate without a significant increase in readmission. Advocacy for broader implementation of ERAS among gynecologic oncology services and ongoing discussion on challenges and opportunities in the implementation process are warranted to improve patient outcomes and experiences.
Right ventricular outflow tract reconstruction with Medtronic Freestyle valve in the Ross procedure: A systematic review with meta‐analysis
Authors: Van den Eynde Jef , Sá Michel Pompeu B. O. , Callahan Connor P. , Dimagli Arnaldo , Vervoort Dominique , Kampaktsis Polydoros N. , Zhigalov Konstantin , Ruhparwar Arjang , Weymann Alexander
Published: October 2020

Cryopreserved pulmonary homografts (PH) are the current gold standard for right ventricular outflow tract (RVOT) reconstruction in the Ross procedure. Unfortunately, their use is limited by a relatively scarce availability and high cost. Porcine stentless xenografts (SX) such as the Medtronic Freestyle SX are increasingly being used, although it is unclear whether the hemodynamic performance and the long‐term durability are satisfactory. The present systematic review followed the Preferred Reporting Items for Systematic reviews and Meta‐Analysis statement. The pooled treatment effects were calculated using a weighted DerSimonian‐Laird random‐effects model. We also evaluated the effect of time after RVOT reconstruction on valve gradients using meta‐regression. Six studies with a total of 156 patients met the inclusion criteria. The pooled estimates for the pooled follow‐up of 37 months were: 1.3% operative mortality, 94.8% overall survival, 7.5% structural valve deterioration, 5.2% reintervention, 73.3% asymptomatic, and 1.5% moderate or severe pulmonary insufficiency. Peak valve gradients were significantly correlated with time after RVOT, increasing during follow‐up. Three studies compared PH with SX, one concluded that the SX is an acceptable alternative for RVOT reconstruction, whereas two concluded that this valvular substitute had inferior performance. The Freestyle SX can be considered as an alternative to PH, although it might be associated with more reinterventions, higher peak valve pressure gradients, and pulmonary valve dysfunction.
Outcomes of left ventricular unloading with a transseptal cannula during extracorporeal membrane oxygenation in adults
Authors: Kim Ah‐Ram , Park Hanbit , Lee Sang‐Eun , Ahn Jung‐Min , Park Duk‐Woo , Lee Seung‐Whan , Kim Jae‐Joong , Park Seung‐Jung , Hong Jung Ae , Kang Pil‐Je , Jung Sung‐Ho , Kim Min‐Seok
Published: October 2020

We evaluated the benefit of left ventricular (LV) unloading using a percutaneous transseptal left atrial (LA) drain catheter via femoral vein incorporated into the ECMO venous circuit. This single‐center retrospective observational study analyzed clinical outcomes of the LA venting group (N = 62) who underwent percutaneous transseptal LA drain placement comparing with the conventionally treated control group (N = 62) with an arterial pulse pressure below 10 mm Hg for at least 24 hours from December 2012 to August 2018. The ECMO weaning rate (61.3% vs. 38.7%, P = .012) and cardiac transplantation rate (29.0% vs. 11.3%, P = .014) were higher in the LA venting group than in the control group. Inhospital mortality was not significantly different (56.5% vs. 69.4%, P = .191). Pulmonary congestion mostly improved after LA decompression (61.3%, P = .003). A serum lactate level at 24 hours after LA venting of more than 2.2 mmol/L was associated with poor outcomes. LA venting via transseptal cannula reduced pulmonary venous congestion and achieved higher rates of successful ECMO weaning and cardiac transplantation. Placement of a transseptal venous drain cannula should be considered in patients with uncontrolled pulmonary edema secondary to severe LV loading undergoing VA‐ECMO.
Febrile children in the Emergency Department: Frequency and predictors of poor outcome
Authors: Long Elliot , Solan Tom , Stephens David J. , Schlapbach Luregn J. , Williams Amanda , Tse Wai Chung , Babl Franz E.
Published: October 2020

Aim

To evaluate the frequency and predictors of poor outcome in febrile children presenting to the Emergency Department.

Methods

Retrospective observational study from the Emergency Department of The Royal Children's Hospital, Melbourne, Australia. All children with presenting complaint of fever or triage temperature >38°C over a 6‐month period were included. Poor outcome was defined as: new organ dysfunction or the requirement for organ support therapy (inotrope infusion, mechanical ventilation, renal replacement therapy and extra‐corporeal life support). Predictors evaluated were as follows: initial vital signs, blood tests and clinical scores. Odds ratio, sensitivity, specificity and area under the receiver‐operating characteristics curve were calculated for each predictor variable.

Results

Between Jan‐June 2019, 6217 children met inclusion criteria. Twenty‐seven (0.4%) developed new organ dysfunction, 10 (0.2%) required organ support therapy (inotrope infusion in 5, mechanical ventilation in 6, renal replacement therapy in 1, extra‐corporeal life support in 1). Odds of new organ dysfunction, requirement for inotropic support and mechanical ventilation were higher with abnormal initial vital signs, blood tests and clinical scores, though overall test characteristics were poor due to infrequency.

Conclusion

Poor outcomes were uncommon among febrile children presenting to the Emergency Department. Vital signs, blood tests and clinical scores were poor predictors.
Population pharmacokinetic and optimization of polymyxin B dosing in adult patients with various renal functions
Authors: Yu Xu‐Ben , Jiao Zheng , Zhang Chun‐Hong , Dai Ying , Zhou Zi‐Ye , Han Lu , Wen Xin , Sheng Chang‐Cheng , Lin Guan‐Yang , Pan Jing‐Ye
Published: October 2020

Aims

Current FDA‐approved label recommends that the dosage of polymyxin B should be adjusted according to renal function. However, the correlation between polymyxin B pharmacokinetics (PK) and creatinine clearance (CrCL) is poor. This study aimed to develop a population PK model of polymyxin B in adult patients with various renal functions and to identify a dosing strategy.

Methods

A retrospective PK study was performed in 32 adult patients with various renal function. Nonlinear mixed effects modelling was applied to build a population PK model of polymyxin B followed by Monte Carlo simulations which designed polymyxin B dosing regimens across various renal function.

Results

Polymyxin B PK analyses included 112 polymyxin B concentrations at steady state from 32 adult patients, in which 71.9% of them were critically ill. In the final PK model, CrCL was the significant covariate on CL (typical value 1.59 L/h; between‐subject variability 13%). The mean (SD) individual empirical Bayesian estimate of CL was 1.75 (0.43) L/h. In addition, a new dosing strategy combining the PK/pharmacodynamic (PD) targets and Monte Carlo simulation indicated that the reduction of polymyxin B dose in patients with renal insufficiency improved the probability of achieving optimal exposure. For severe infections caused by organisms with minimum inhibitory concentration (MIC) ≥ 2 mg/L, a high daily dose of polymyxin B might be possible for bacterial eradication, but the risk of nephrotoxicity is increased.

Conclusions

Renal function plays a significant role in polymyxin B PK, and the dose of polymyxin B should be adjusted according to CrCL in patients with renal insufficiency.