bluuebunny/crossref_metadata_2025 huggingface dataset:
Regression-based normative data for social health scale for the elderly (short version) in eastern China
Authors: Yu Zhe-Bin , Bao Cheng-Zhen , Wu Meng-Yin , Jiang Dan-Jie , Zhang Xiao-Cong , Lin Shu-Juan , Jin Ming-Juan , Wang Jian-Bing , Tang Meng-Ling , Chen Kun
Published: March 2020

Backgrounds

Social Health Scale for the Elderly short version (SHSE-S) is a psychometrically sound instrument that comprehensively assesses the social health status of older adults in China. The aim of the present study was to establish continuous normative data of SHSE-S.

Methods

We conducted a multicenter cross-sectional study among 31 communities in eastern China. Older adults aged 60 years and above were invited to participate in the study. Each participant was interviewed in-person to finish a structured questionnaire. The SHES-S score was calculated and standardized for each participant. We split the sample into generation and validation datasets and compared the distribution of SHSE-S score between two datasets. Multivariable linear regression was used to assess the SHSE-S score and demographic variables. Regression-based norms were built using a four-step process.

Results

A total of 6089 participants (51.2% females) aged 60 years old and above (mean age = 71.3, SD = 8.0) were enrolled as the normative sample. No significant difference was found between the distribution of SHSE-S standardized score in the generation (N = 2392) and validation (N = 3697) datasets. Multivariable linear regression showed that females, higher education levels were positive indicators while aging, living alone, divorced or never married, multimorbidity were negative factors. The regression-based norm which taking demographic factors into account was established and a user-friendly worksheet was also provided to facilitate the scoring and norming of the SHSE-S.

Conclusions

The population-based regression norm of SHSE-S can be a useful tool for assessing the social health status of the Chinese elderly population.
A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis
Authors: Prince Stephanie A. , Cardilli Luca , Reed Jennifer L. , Saunders Travis J. , Kite Chris , Douillette Kevin , Fournier Karine , Buckley John P.
Published: March 2020

Background

Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers).

Objective

The primary objective of this systematic review was to compare self-report versus device measures of SB in adults.

Methods

Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses.

Results

The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66).

Conclusions

Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes.

Systematic review registration

PROSPERO CRD42019118755
A novel TLR7 agonist as adjuvant to stimulate high quality HBsAg-specific immune responses in an HBV mouse model
Authors: Hu Yunlong , Tang Li , Zhu Zhengyu , Meng He , Chen Tingting , Zhao Sheng , Jin Zhenchao , Wang Zhulin , Jin Guangyi
Published: March 2020

Background

The global burden of hepatitis B virus (HBV) infection in terms of morbidity and mortality is immense. Novel treatments that can induce a protective immune response are urgently needed to effectively control the HBV epidemic and eventually eradicate chronic HBV infection.

Methods

We designed and evaluated an HBV therapeutic vaccine consisting of a novel Toll-like receptor 7 (TLR7) agonist T7-EA, an Alum adjuvant and a recombinant HBsAg protein. We used RNA-seq, ELISA and hTLR7/8 reporting assays to characterize T7-EA in vitro and real-time PCR to evaluate the tissue-retention characteristics in vivo. To evaluate the adjuvant potential, we administrated T7-EA intraperitoneally in a formulation with an Alum adjuvant and HBsAg in normal and HBV mice, then, we evaluated the HBsAg-specific immune responses by ELISA and Elispot assays.

Results

T7-EA acted as an hTLR7-specific agonist and induced a similar gene expression pattern as an unmodified TLR7 ligand when Raw 264.7 cells were exposed to T7-EA; however, T7-EA was more potent than the unmodified TLR7 ligand. In vivo studies showed that T7-EA had tissue-retaining activity with stimulating local cytokine and chemokine expression for up to 7 days. T7-EA could induce Th1-type immune responses, as evidenced by an increased HBsAg-specific IgG2a titer and a T-cell response in normal mice compared to mice received traditional Alum-adjuvant HBV vaccine. Importantly, T7-EA could break immune tolerance and induce persistent HBsAg-specific antibody and T-cell responses in an HBV mouse model.

Conclusions

T7-EA might be a candidate adjuvant in a prophylactic and therapeutic HBV vaccine.
Role of Parkin-mediated mitophagy in the protective effect of polydatin in sepsis-induced acute kidney injury
Authors: Gao Youguang , Dai Xingui , Li Yunfeng , Li Guicheng , Lin Xianzhong , Ai Chenmu , Cao Yuanyuan , Li Tao , Lin Bo
Published: March 2020

Background

We have reported that polydatin (PD) alleviates mitochondrial dysfunction in rat models of sepsis-induced acute kidney injury (SI-AKI), but the mechanism is not well understood. Here, we investigated the role of Parkin-mediated mitophagy in the protective effects of PD in SI-AKI in mice.

Methods

Sepsis was induced in the mice by caecal ligation and puncture. Mitophagy was determined by mitochondrial mass. NLRP3 inflammasome activation was determined by NLRP3, ASC and caspase-1. Mitophagy was blocked by treatment with mitochondrial division inhibitor-1 and Parkin knockout.

Key results

PD treatment increased the sepsis-induced loss of mitochondrial mass, indicating the upregulation of mitophagy. Furthermore, PD treatment mediated Parkin translocation from the cytoplasm to the mitochondria. This suggests that Parkin-mediated mitophagy is an underlying mechanism. This was confirmed by the suppression of PD-induced mitophagy in Parkin−/− mice and in mice that were treated with a mitophagy inhibitor. PD-induced Parkin translocation and mitophagy were blocked by inhibiting SIRT1; thus, activation of SIRT1 might be an important molecular mechanism that is triggered by PD. Additionally, PD treatment protected against sepsis-induced kidney injury. These effects were blocked by inhibition of Parkin-dependent mitophagy. Furthermore, PD also protected against mitochondrial dysfunction and mitochondria-dependent apoptosis, and the effect was blocked when Parkin-dependent mitophagy was inhibited. Finally, PD suppressed NLRP3 inflammasome activation that was also dependent on Parkin-mediated mitophagy.

Conclusions

These findings indicate that Parkin-mediated mitophagy is important for the protective effect of PD in SI-AKI, and the underlying mechanisms include the inhibition of mitochondrial dysfunction and NLRP3 inflammasome activation.
Robust neuroinflammation and perivascular pathology in rTg-DI rats, a novel model of microvascular cerebral amyloid angiopathy
Authors: Zhu Xiaoyue , Hatfield Joshua , Sullivan Joseph K. , Xu Feng , Van Nostrand William E.
Published: March 2020

Background

Cerebral amyloid angiopathy (CAA) is a common cerebral small vessel disease of the aged and a prominent comorbidity of Alzheimer’s disease (AD). CAA can promote a variety of vascular-related pathologies including neuroinflammation, cerebral infarction, and hemorrhages, which can all contribute to vascular cognitive impairment and dementia (VCID). Our understanding of the pathogenesis of CAA remains limited and further investigation of this condition requires better preclinical animal models that more accurately reflect the human disease. Recently, we generated a novel transgenic rat model for CAA (rTg-DI) that develops robust and progressive microvascular CAA, consistent microhemorrhages and behavioral deficits.

Methods

In the current study, we investigated perivascular pathological processes that accompany the onset and progressive accumulation of microvascular CAA in this model. Cohorts of rTg-DI rats were aged to 3 months with the onset of CAA and to 12 months with advanced stage disease and then quantitatively analyzed for progression of CAA, perivascular glial activation, inflammatory markers, and perivascular stress.

Results

The rTg-DI rats developed early-onset and robust accumulation of microvascular amyloid. As the disease progressed, rTg-DI rats exhibited increased numbers of astrocytes and activated microglia which were accompanied by expression of a distinct subset of inflammatory markers, perivascular pericyte degeneration, astrocytic caspase 3 activation, and disruption of neuronal axonal integrity.

Conclusions

Taken together, these results demonstrate that rTg-DI rats faithfully mimic numerous aspects of human microvascular CAA and provide new experimental insight into the pathogenesis of neuroinflammation and perivascular stress associated with the onset and progression of this condition, suggesting new potential therapeutic targets for this condition. The rTg-DI rats provide an improved preclinical platform for developing new biomarkers and testing therapeutic strategies for microvascular CAA.
Implementation of a gait center training to improve walking ability and vital parameters in inpatient neurological rehabilitation- a cohort study
Authors: Reichl Stephanie , Weilbach Franz , Mehrholz Jan
Published: March 2020

Background

Many studies showed that robot-assisted gait training might improve walking of patients after stroke. The question remains whether patients with other neurological diagnoses can improve their ability to walk by training in a gait center. Aim of the present study was therefore to investigate the effects of a gait center training in inpatient neurological rehabilitation on walking ability.

Methods

We implemented a gait center training in addition to individual inpatient rehabilitation. Our primary outcome was walking ability based on the Functional Ambulation Categories (FAC). Our secondary outcomes were vital capacity and blood pressure. We predefined subgroups of patients with ischemic and hemorrhagic stroke and critical illness myopathy (CIM) and polyneuropathy (CIP).

Results

We included 780 patients from our inpatient rehabilitation center in our cohort study. We analyzed 329 patients with ischemic, 131 patients with hemorrhagic stroke and 74 patients with CIP/ CIM.

A large number of patients were able to improve their ability to walk. At the end of rehabilitation, patients with ischemic stroke and FAC 3 = increased theirFAC scores by 5%, FAC 4 = 4% and FAC 5 = 7%. Patients with hemorrhagic stroke and FAC 3 = increased by 5%, FAC 4 = 11% and FAC 5 = 9% and patients with CIP/CIM increased by FAC 3 = 3%, FAC 4 = 22% and FAC 5 = 26%.

The largest improvement in walking ability during rehabilitation had patients with a FAC = 1 at baseline who improved by a median of 1.4 FAC points (p < 0.001). After adjusting for the number of gait training sessions, the largest improvement in walking ability during rehabilitation had patients with a FAC = 0 at baseline who improved by 1.8 FAC points (p < 0.001).

Conclusions

Implementation of an additional gait center training may significantly improve walking ability in neurological rehabilitation.
Secondary deterioration in patients with normal pressure hydrocephalus after ventriculoperitoneal shunt placement: a proposed algorithm of treatment
Authors: Gutowski Pawel , Rot Sergej , Fritsch Michael , Meier Ullrich , Gölz Leonie , Lemcke Johannes
Published: March 2020

Background

After ventriculoperitoneal shunt surgery for idiopathic normal pressure hydrocephalus (iNPH) with adjustable gravitational valves, a certain proportion of patients develop secondary clinical worsening after initial improvement of clinical symptoms. The aim of this study was to analyze this group of patients with secondary deterioration and to evaluate the performed shunt management.

Methods

For this investigation, we retrospectively reviewed our NPH registry for patients included between 1999 and 2013 with a decrease by a minimum of two points in the Kiefer score in the first year of follow up and an increase of two points in the Kiefer score between the second and the fifth year after shunt surgery (secondary deterioration). Then, we analyzed the patient’s shunt management (adapting the valve pressure setting, shuntography, valve replacement, catheter replacement, implant an adjustable gravitational unit). Additionally, we searched for risk factors for secondary deterioration.

Results

Out of 259 iNPH patients, 53 (20%) patients showed secondary deterioration on an average of 2.7 (2–4 years) years after shunt surgery. Fourteen (26%) patients with secondary deterioration improved after shunt or valve management and 58% remained without clinical benefit after management. We had a drop-out rate of 15% due to incomplete datasets. Our shunt management reduced the rate of secondary deterioration from 20 to 15%. On the basis of our findings, we developed an algorithm for shunt management. Risk factors for secondary deterioration are the age of the patient at the time of shunting, newly diagnosed neurodegenerative diseases, and overdrainage requiring adjusting the valve to higher-pressure levels.

Conclusion

Twenty percent of patients with iNPH were at risk for secondary clinical worsening about 3 years after shunt surgery. About one-fourth of these patients benefited for additional years from pressure level management and/or shunt valve revision. Our findings underline the need for long-term follow-ups and intensive shunt management to achieve a favorable long-term outcome for patients with iNPH and VPS.
Effects of a national quality improvement program on ICUs in China: a controlled pre-post cohort study in 586 hospitals
Authors:   China-NCCQC group, He Huaiwu , Ma Xudong , Su Longxiang , Wang Lu , Guo Yanhong , Shan Guangliang , He Hui Jing , Zhou Xiang , Liu Dawei , Long Yun , Zhao Yupei , Zhang Shuyang
Published: March 2020

Introduction

Patient safety and critical care quality remain a challenging issue in the ICU. However, the effects of the national quality improvement (QI) program remain unknown in China.

Methods

A national ICU QI program was implemented in a controlled cohort of 586 hospitals from 2016 to 2018. The effects of the QI program on critical care quality were comprehensively investigated.

Main results

A total of 81,461,554 patients were enrolled in 586 hospitals, and 1,587,724 patients were admitted to the ICU over 3 years. In 2018, there was a significantly higher number of ICU beds (2016 vs. 2018: 10668 vs. 13,661,P = 0.0132) but a lower doctor-to-bed ratio (2016 vs. 2018: 0.64 (0.50, 0.83) vs. 0.60 (0.45, 0.75),P = 0.0016) and nurse-to-bed ratio (2016 vs. 2018: 2.00 (1.64, 2.50) vs. 2.00 (1.50, 2.40),P = 0.031) than in 2016. Continuous and significant improvements in the ventilator-associated pneumonia (VAP) incidence rate, microbiology detection rate before antibiotic use and deep vein thrombosis (DVT) prophylaxis rate were associated with the implementation of the QI program (VAP incidence rate (per 1000 ventilator-days), 2016 vs. 2017 vs. 2018: 11.06 (4.23, 22.70) vs. 10.20 (4.25, 23.94) vs. 8.05 (3.13, 17.37),P = 0.0002; microbiology detection rate before antibiotic use (%), 2016 vs. 2017 vs. 2018: 83.91 (49.75, 97.87) vs. 84.14 (60.46, 97.24) vs. 90.00 (69.62, 100),P < 0.0001; DVT prophylaxis rate, 2016 vs. 2017 vs. 2018: 74.19 (33.47, 96.16) vs. 71.70 (38.05, 96.28) vs. 83.27 (47.36, 97.77),P = 0.0093). Moreover, the 6-h SSC bundle compliance rates in 2018 were significantly higher than those in 2016 (6-h SSC bundle compliance rate, 2016 vs. 2018: 64.93 (33.55, 93.06) vs. 76.19 (46.88, 96.67)). A significant change trend was not found in the ICU mortality rate from 2016 to 2018 (ICU mortality rate (%), 2016 vs. 2017 vs. 2018: 8.49 (4.42, 14.82) vs. 8.95 (4.89, 15.70) vs. 9.05 (5.12, 15.80),P = 0.1075).

Conclusions

The relationship between medical human resources and ICU overexpansion was mismatched during the past 3 years. The implementation of a national QI program improved ICU performance but did not reduce ICU mortality.
Brain BOLD MRI O2 and CO2 stress testing: implications for perioperative neurocognitive disorder following surgery
Authors: Mutch W. Alan C. , El-Gabalawy Renée , Ryner Lawrence , Puig Josep , Essig Marco , Kilborn Kayla , Fidler Kelsi , Graham M. Ruth
Published: March 2020

Background

Mechanical ventilation to alter and improve respiratory gases is a fundamental feature of critical care and intraoperative anesthesia management. The range of inspired O2and expired CO2during patient management can significantly deviate from values in the healthy awake state. It has long been appreciated that hyperoxia can have deleterious effects on organs, especially the lung and retina. Recent work shows intraoperative end-tidal (ET) CO2management influences the incidence of perioperative neurocognitive disorder (POND). The interaction of O2and CO2on cerebral blood flow (CBF) and oxygenation with alterations common in the critical care and operating room environments has not been well studied.

Methods

We examine the effects of controlled alterations in both ET O2and CO2on cerebral blood flow (CBF) in awake adults using blood oxygenation level-dependent (BOLD) and pseudo-continuous arterial spin labeling (pCASL) MRI. Twelve healthy adults had BOLD and CBF responses measured to alterations in ET CO2and O2in various combinations commonly observed during anesthesia.

Results

Dynamic alterations in regional BOLD and CBF were seen in all subjects with expected and inverse brain voxel responses to both stimuli. These effects were incremental and rapid (within seconds). The most dramatic effects were seen with combined hyperoxia and hypocapnia. Inverse responses increased with age suggesting greater risk.

Conclusions

Human CBF responds dramatically to alterations in ET gas tensions commonly seen during anesthesia and in critical care. Such alterations may contribute to delirium following surgery and under certain circumstances in the critical care environment.

Trial registration

ClincialTrials.govNCT02126215for some components of the study. First registered April 29, 2014.
More support for Earth’s massive microbiome
Authors: Lennon Jay T. , Locey Kenneth J.
Published: March 2020

Until recently, our planet was thought to be home to ~ 107 species, largely belonging to plants and animals. Despite being the most abundant organisms on Earth, the contribution of microbial life to global biodiversity has been greatly underestimated and, in some cases, completely overlooked. Using a compilation of data known as the Global Prokaryotic Census (GPC), it was recently claimed that there are ~ 106 extant bacterial and archaeal taxa [1], an estimate that is orders of magnitude lower than predictions for global microbial biodiversity based on the lognormal model of biodiversity and diversity-abundance scaling laws [2]. Here, we resolve this discrepancy by 1) identifying violations of sampling theory, 2) correcting for the misuse of biodiversity theory, and 3) conducting a reanalysis of the GPC. By doing so, we uncovered greater support for diversity-abundance scaling laws and the lognormal model of biodiversity, which together predict that Earth is home to 1012 or more microbial taxa.

Reviewers

This article was reviewed by Alvaro Sanchez and Sean M. Gibbons.
A Community-based Assessment of Skin Care, Allergies, and Eczema (CASCADE): an atopic dermatitis primary prevention study using emollients—protocol for a randomized controlled trial
Authors: Eichner Brian , Michaels Le Ann C. , Branca Kelsey , Ramsey Katrina , Mitchell Julie , Morris Cynthia D. , Fagnan Lyle J. , Dolor Rowena J. , Elder Nancy , Hahn David L. , Nease Donald E. , Lapidus Jodi , Cibotti Ricardo , Block Julie , Simpson Eric L.
Published: March 2020

Background

Atopic dermatitis (AD) is a common, chronic skin disorder often beginning in infancy. Skin barrier dysfunction early in life serves as a central event in the pathogenesis of AD. In infants at high risk of developing AD, preventative application of lipid-rich emollients may reduce the risk of developing AD. This study aims to measure the effectiveness of this intervention in a population not selected for risk via a pragmatic, randomized, physician-blinded trial in the primary care setting.

Methods

Infant–parent dyads are recruited from a primary care practice participating through one of four practice-based research networks in Oregon, Colorado, Wisconsin, and North Carolina. Eligible dyads are randomized to the intervention (daily use of lipid-rich emollient) or the control (no emollient) group (n = 625 infants in each) and are followed for 24 months. The primary outcome is the cumulative incidence of physician-diagnosed AD and secondary outcomes include caregiver-reported measures of AD and development of other atopic diseases. Data collection occurs via chart review and surveys, with no study visits required. Data will be analyzed utilizing intention-to-treat principles.

Discussion

AD is a common skin condition in infants that affects quality of life and is associated with the development of other atopic diseases. If a safe intervention, such as application of lipid-rich emollients, in the general population effectively decreases AD prevalence, this could alter the guidance given by providers regarding routine skin care of infants. Because of the pragmatic design, we anticipate that this trial will yield generalizable results.

Trial registration

ClinicalTrials.gov:NCT03409367. Registered on 11 February 2018.
Socio-demographic correlates of availability of adequate iodine in household salt: a community-based cross-sectional study
Authors: Ajema Dessalegn , Bekele Muluken , Yihune Manaye , Tadesse Hiwot , Gebremichael Gebrekiros , Mengesha Melkamu Merid
Published: March 2020

Objective

This study aimed to assess the availability of adequately iodized salt at a household level and associated factors in Arba Minch town, South Ethiopia using the gold standard technique, the iodometric titration.

Results

41.8% (95% CI (confidence interval) 38.6 to 45.1) of households had inadequately iodized salt, and 9.3% (95% CI 7.5 to 11.4) had an iodine content below 10 ppm (parts per million). Compared to households with a monthly income of greater than 2000 ETB (Ethiopian Birr), households with a monthly income between 1000 ETB to 2000 ETB (adjusted odds ratio (AOR) = 0.52, 95% CI 0.390.36 to 00.77) and main food handlers aged 30 years or above compared to those aged less than 20 years of age (aOR = 0.55, 95% CI 0.34 to 0.91) had higher odds of having adequately iodized salt. Food handler’s knowledge and practice were not found to be correlated with the availability of adequately iodized salt in household salt.
Comparison of amyloid PET measured in Centiloid units with neuropathological findings in Alzheimer’s disease
Authors: Amadoru Sanka , Doré Vincent , McLean Catriona A. , Hinton Fairlie , Shepherd Claire E. , Halliday Glenda M. , Leyton Cristian E. , Yates Paul A. , Hodges John R. , Masters Colin L. , Villemagne Victor L. , Rowe Christopher C.
Published: March 2020

Background

The Centiloid scale was developed to standardise the results of beta-amyloid (Aβ) PET. We aimed to determine the Centiloid unit (CL) thresholds for CERAD sparse and moderate-density neuritic plaques, Alzheimer’s disease neuropathologic change (ADNC) score of intermediate or high probability of Alzheimer’s Disease (AD), final clinicopathological diagnosis of AD, and expert visual read of a positive Aβ PET scan.

Methods

Aβ PET results in CL for 49 subjects were compared with post-mortem findings, visual read, and final clinicopathological diagnosis. The Youden Index was used to determine the optimal CL thresholds from receiver operator characteristic (ROC) curves.

Results

A threshold of 20.1 CL (21.3 CL when corrected for time to death, AUC 0.97) yielded highest accuracy in detecting moderate or frequent plaque density while < 10 CL was optimal for excluding neuritic plaque. The threshold for ADNC intermediate or high likelihood AD was 49.4 CL (AUC 0.98). Those cases with a final clinicopathological diagnosis of AD yielded a median CL result of 87.7 (IQR ± 42.2) with 94% > 45 CL. Positive visual read agreed highly with results > 26 CL.

Conclusions

Centiloid values < 10 accurately reflected the absence of any neuritic plaque and > 20 CL indicated the presence of at least moderate plaque density, but approximately 50 CL or more best confirmed both neuropathological and clinicopathological diagnosis of Alzheimer’s disease.
Food allergy among university students: uncharted territory
Authors: Hassan Ali , Alsaihati Amna , Al Shammari Malak , Alaithan Haitham , Al-Johani Wejdan , AlShamlan Nouf , Aljubran Salman
Published: March 2020

Background

Food allergy is a growing global health concern, with limited studies conducted in developing countries. High-risk behavior regarding allergies is common among young adults, making them prone to severe allergic reactions. This study aimed to estimate the prevalence of food allergies among Imam Abdulrahman Bin Faisal University (IAU) students and to determine the rate of high-risk behaviors in this group.

Methods

An online survey was conducted among IAU students enrolled between the academic years of 2008 and 2018. The survey addressed food allergies with respect to age of onset, allergy testing, self-injectable epinephrine (SIE) prescription, associated allergic conditions, and attitude and behavior of university students regarding food avoidance and epinephrine use.

Results

In total, 5497 completed surveys were analyzed; 526 participants were clinically diagnosed with allergies to at least one food item. A SIE device was prescribed for only 129 (24.5%) of the diagnosed individuals, of which only 4.7% carried the device at all times. Thirty-nine individuals (30.2%) reported that they and their family members know the proper epinephrine device technique. Strict avoidance of food allergens was reported by 30.2% of the individuals. Associated allergic conditions were observed in 69.3% of the clinically diagnosed individuals.

Conclusion

Food allergies are prevalent among IAU students, with under-prescription of SIE devices. A high rate of high-risk behaviors with respect to food avoidance and carrying SIE was noted. Interventional strategies are needed to mitigate the risk of severe reactions among these university students.
Assessment of early damage of endometrium after artificial abortion by shear wave elastography
Authors: Jiao Yan , Xue Nianyu , Zou Chunpeng , Shui Xujuan , Wang Hongqing , Hu Chunhong
Published: March 2020

Objectives

This study aimed to investigate the application of shear wave elastography (SWE) in the early damage detection through assessing the endometrial elasticity after artificial abortion.

Methods

A total of nulliparous women (20–30 years) who received ultrasonography in our hospital were recruited between January 2017 and December 2017. These women were divided into normal control group (NC; n = 65), after once artificial abortion group (AOAA; n = 68), after twice artificial abortion group (ATAA; n = 61), and after three times or more (range, 3–6) artificial abortion group (ATTMAA; n = 60). SWE was performed to evaluate the endometrium; Young’s modulus of the endometrium was determined and then the endometrial thickness was measured.

Results

Young’s modulus of the endometrium increased in the order of NC group, AOAA group, ATAA group, and ATTMAA group, and Young’s modulus increased with the increase in the number of artificial abortions (p < 0.05). The endometrial thickness in the ATTMAA group was significantly lower than in the NC group, AOAA group, and ATAA group (p < 0.05), but there was no marked difference among the NC group, AOAA group, and ATAA group (p > 0.05).

Conclusions

SWE increases with increasing number of abortions, which may indicate the damage that is done to the endometrium earlier than measurement of the endometrial thickness do.
Multisource SWIPT-based coded cooperation:rate compatible codes and codeword splitting protocol
Authors: Zhang Shunwai , Kong Lingjun , Li Jun
Published: March 2020

To achieve a high reliable and energy-saving green communication, we investigate a multisource simultaneous wireless information and power transfer (SWIPT)-based coded cooperation where the relay can realize information decoding and energy harvesting. Firstly, a class of naturally rate compatible low-density parity-check (LDPC) codes–quasi-cyclic repeat-accumulate (QC-RA) codes is introduced, and the joint parity-check matrix corresponding to the QC-RA codes employed by the multiple sources and relay is deduced. Based on the joint parity-check matrix, we jointly design the QC-RA codes to cancel all the short girth cycles. Then, by exploiting the rate compatible characteristic of QC-RA codes, we propose a new SWIPT protocol—codeword splitting protocol for the proposed system, which has the characteristics of lower complexity, higher efficiency, no strictly bit synchronization limitation, and less hardware requirement. The results show that the bit error rate (BER) performance of the proposed system employing jointly designed QC-RA codes clearly outperforms that of general RA codes. Theoretical analysis and numerical simulations also demonstrate the superiority of the proposed codeword splitting protocol.
Digital signature scheme for information non-repudiation in blockchain: a state of the art review
Authors: Fang Weidong , Chen Wei , Zhang Wuxiong , Pei Jun , Gao Weiwei , Wang Guohui
Published: March 2020

Blockchain, as one of the most promising technology, has attracted tremendous attention. The interesting characteristics of blockchain are decentralized ledger and strong security, while non-repudiation is the important property of information security in blockchain. A digital signature scheme is an effective approach to achieve non-repudiation. In this paper, the characteristics of blockchain and the digital signature to guarantee information non-repudiation are firstly discussed. Secondly, the typical digital signature schemes in blockchain are classified and analyzed, and then the state-of-the-art digital signatures are investigated and compared in terms of application fields, methods, security, and performance. Lastly, the conclusions are given, and some future works are suggested to stir research efforts in this field. Our works will facilitate to design efficient and secure digital signature algorithms in blockchain.
Central limit theorem for a fractional stochastic heat equation with spatially correlated noise
Authors: Li Yumeng
Published: March 2020

In this paper, we study the central limit theorem for a perturbed stochastic heat equation in the whole space $\mathbb{R}^{d}$Rd, $d\ge 1$d≥1. This equation is driven by a Gaussian noise, which is white in time and correlated in space, and the differential operator is a fractional derivative operator. Burkholder’s inequality plays an important role in the proof.
Levofloxacin-ceftazidime administration regimens combat Pseudomonas aeruginosa in the hollow-fiber infection model simulating abnormal renal function in critically ill patients
Authors: Zhao L , Li X , He X , Jian L
Published: March 2020

Background

The purpose of this study was to investigate the bactericidal effects of levofloxacin and ceftazidime as both monotherapy and combination therapy, and to determine their effects on resistance suppression in patients with normal and abnormal (Ccr:16–20 mL/min) renal function. Common clinical administration regimens to provide reference values were further evaluated.

Methods

The 7-d hollow-fiber infection model was used to inject the Pseudomonas aeruginosa standard strain (ATCC27853), which simulated common clinical administration regimens for patients with different renal function. Ten regimens were stratified into 2 categories based on renal function, and each category contained 3 monotherapy regimens and 2 combination therapy regimens. Total and resistant populations were quantified. Drug concentrations were determined by high-performance liquid chromatography (HPLC).

Results

Monotherapy regimens resulted in about 0.5-log-CFU/mL bacterial kill in the total population at 6 or 8 h, whilst combination regimens resulted in 2- to 3-log-CFU/mL within 2 days. For levofloxacin monotherapy regimens in patients with normal renal function, resistance emergence was seen after 6 h, and was seen at 0 h in the ceftazidime monotherapy regimen, as well as in all regimens of patients with abnormal renal function. Although resistant subpopulation in combination regimens with abnormal renal function began to increase at 0 h, there was a definite downward trend after 8 h, while resistant population in the normal renal function group increased after 16 h.

Conclusions

Combination therapy had greater bactericidal efficacy and resistance inhibition compared with monotherapy. Studying combination regimens in randomized clinical trials is warranted.
Mid-life predictors of late-life depressive symptoms; determining risk factors spanning two decades in the Women’s Heathy Ageing Project
Authors: Campbell Katherine E. , Gorelik Alexandra , Szoeke Cassandra E. , Dennerstein Lorraine
Published: March 2020

Background

Data available from longitudinal studies of adequate duration to explore midlife risk factors for late life higher depressive symptom scores in women is lacking. This study examines midlife (mean ages 50 years and 60 years) predictors of late life (mean age 70 years) depressive symptom scores to enrich our understanding of the role of changing risk factors across the lifespan.

Methods

This investigation was an assessment of the long-term impact of lifestyle and health variables on depressive symptoms. Data were drawn from an epidemiological prospective study of women’s healthy ageing spanning two decades. Variables included assessment of mood, demographics, physical health, smoking status, attitudes towards ageing and menopause, alcohol consumption and employment. Analysis was conducted to determine the set of strongest predictors assessed in 1992 (mean age 50 years) and in 2002 (mean age 60 years) in relation to higher CESD-SF scores measured in 2012 (mean aged 70 years (n = 249)). A cross-sectional analysis determining concurrent associations at mean age 70 years was also conducted.

Results

An increase in positive mood at 50 and 60 years was associated with a 0.3 (95% CI 0.1–0.5) and 0.4 (95%CI 0.1–0.8) point reduction in CESD score at 70 years respectively. An increase in Hassles score at age 50 was associated with a 0.18-point increase in CESD (95% CI 0.01–0.05) 20 years later. However, no relationship was observed between Hassles score at 60 and CESD 10 years later. Analysis of concurrent risk factors demonstrated that bothersome symptom frequency and higher anxiety were associated with higher depressive symptom scores when women were 70 years.

Conclusion

Low levels of positive mood were consistently associated with depressive symptoms scores 10 and 20 years later, suggesting clinical interventions aimed at improving positive affect may be particularly useful across the midlife.
Research trends in measurement and intervention tools for self-regulated learning for e-learning environments—systematic review (2008–2018)
Authors: Araka Eric , Maina Elizaphan , Gitonga Rhoda , Oboko Robert
Published: March 2020

For the last one decade, research in self-regulated learning (SRL) and educational psychology has proliferated. Researchers and educators have focused on how to support leaners grow their SRL skills on both face-to-face and e-learning environments. In addition, recent studies and meta-analysis have greatly contributed to the domain knowledge on the use of SRL strategies and how they contribute and boost academic performance for learners. However, there is little systematic review on the literature on the techniques and tools used to measure SRL on e-learning platforms. This review sought to outline recent advances and the trends in this area to make it more efficient for researchers to establish the empirical studies and research patterns among different studies in the field of SRL. The findings from this study are concurrent with existing empirical evidence that traditional methods designed for classroom supports are being used for measuring SRL on e-learning environments. Few studies have used learner analytics and educational data mining (EDM) techniques to measure and promote SRL strategies for learners. The paper finally points out the existing gaps with the tools presently used to measure and support SRL on learning management systems and recommends further studies on the areas of EDM which can support SRL.
Pathogenic Germline DNA Repair Gene and HOXB13 Mutations in Men With Metastatic Prostate Cancer
Authors: Boyle Julie L. , Hahn Andrew W. , Kapron Ashley L. , Kohlmann Wendy , Greenberg Samantha E. , Parnell Timothy J. , Teerlink Craig C. , Maughan Benjamin L. , Feng Bing-Jian , Cannon-Albright Lisa , Agarwal Neeraj , Cooney Kathleen A.
Published: March 2020

PURPOSE

Germline mutations in DNA repair (DR) genes and susceptibility genes CDKN2A and HOXB13 have previously been associated with prostate cancer (PC) incidence and/or progression. However, the role and prevalence of this class of mutations in metastatic PC (mPC) are not fully understood.

PATIENTS AND METHODS

To evaluate the frequency of pathogenic/likely pathogenic germline variants (PVs/LPVs) in men with mPC, this study sequenced 38 DR genes, CDKN2A, and HOXB13 in a predominantly white cohort of 317 patients with mPC. A PC registry at the University of Utah was used for patient sample acquisition and retrospective clinical data collection. Deep target sequencing allowed for germline and copy number variant analyses. Validated PVs/LPVs were integrated with clinical and demographic data for statistical correlation analyses.

RESULTS

All pathogenic variants were found in men self-reported as white, with a carrier frequency of 8.5% (DR genes, 7.3%; CDKN2A/ HOXB13, 1.2%). Consistent with previous reports, mutations were most frequently identified in the breast cancer susceptibility gene BRCA2. It was also found that 50% of identified PVs/LPVs were categorized as founder mutations with European origins. Correlation analyses did not support a trend toward more advanced or earlier-onset disease in comparisons between carriers and noncarriers of deleterious DR or HOXB13 G84E mutations.

CONCLUSION

These findings demonstrate a lower prevalence of germline PVs/LPVs in an unselected, predominantly white mPC cohort than previously reported, which may have implications for the design of clinical trials testing targeted therapies. Larger studies in broad and diverse populations are needed to more accurately define the prevalence of germline mutations in men with mPC.
Metabolically Healthy Obesity
Authors: Blüher Matthias
Published: March 2020

Obesity contributes to reduced life expectancy, impaired quality of life, and disabilities, mainly in those individuals who develop cardiovascular diseases, type 2 diabetes, osteoarthritis, and cancer. However, there is a large variation in the individual risk to developing obesity-associated comorbid diseases that cannot simply be explained by the extent of adiposity. Observations that a proportion of individuals with obesity have a significantly lower risk for cardiometabolic abnormalities led to the concept of metabolically healthy obesity (MHO). Although there is no clear definition, normal glucose and lipid metabolism parameters—in addition to the absence of hypertension—usually serve as criteria to diagnose MHO. Biological mechanisms underlying MHO lower amounts of ectopic fat (visceral and liver), and higher leg fat deposition, expandability of subcutaneous adipose tissue, preserved insulin sensitivity, and beta-cell function as well as better cardiorespiratory fitness compared to unhealthy obesity.

Whereas the absence of metabolic abnormalities may reduce the risk of type 2 diabetes and cardiovascular diseases in metabolically healthy individuals compared to unhealthy individuals with obesity, it is still higher in comparison with healthy lean individuals. In addition, MHO seems to be a transient phenotype further justifying therapeutic weight loss attempts—even in this subgroup—which might not benefit from reducing body weight to the same extent as patients with unhealthy obesity. Metabolically healthy obesity represents a model to study mechanisms linking obesity to cardiometabolic complications. Metabolically healthy obesity should not be considered a safe condition, which does not require obesity treatment, but may guide decision-making for a personalized and risk-stratified obesity treatment.
Historical Legacies and African Development
Authors: Michalopoulos Stelios , Papaioannou Elias
Published: March 2020

As Africa’s role on the global stage is rising, so does the need to understand the shadow of history on the continent’s economy and polity. We discuss recent works that shed light on Africa’s colonial and precolonial legacies. The emerging corpus is remarkably interdisciplinary. Archives, ethnographic materials, georeferenced censuses, surveys, and satellite imagery are some of the sources often combined to test influential conjectures put forward in African historiography. Exploiting within-country variation and employing credible, albeit mostly local, identification techniques, this recent literature has uncovered strong evidence of historical continuity as well as instances of rupture in the evolution of the African economy. The exposition proceeds in reverse chronological order. Starting from the colonial period, which has been linked to almost all of Africa’s postindependence maladies, we first review works that uncover the lasting legacies of colonial investments in infrastructure and human capital and quantify the role of various extractive institutions, such as indirect rule and oppression associated with concessionary agreements. Second, we discuss the long-lasting impact of the “Scramble for Africa,” which led to ethnic partitioning and the creation of artificial modern states. Third, we cover studies on the multifaceted legacy of the slave trades. Fourth, we analyze the contemporary role of various precolonial, ethnic-specific, institutional, and social traits such as political centralization. We conclude by offering some thoughts on what we view as open questions. ( JEL F54, N17, N37, N47, O10, O43)
Zero human deaths from dog-mediated rabies by 2030: perspectives from quantitative and mathematical modelling
Authors:   WHO Rabies Modelling Consortium
Published: March 2020

Dog-mediated rabies continues to kill tens of thousands of people every year in low- and middle-income countries despite being an entirely vaccine-preventable disease. WHO and partners have launched a global campaign to reach zero human deaths from dog-mediated rabies by 2030. The primary tools for reaching this target are mass dog vaccination to interrupt transmission in domestic dog populations that maintain infection, appropriate post-exposure prophylaxis (PEP) for rabies-exposed persons to prevent the fatal onset of disease, together with education to support their effective uptake. Models have been developed to assess the feasibility, impact and cost-effectiveness of these measures. From these models, we argue that the 2030 target of zero human rabies deaths is achievable, but will require concerted effort, engagement and investment. A proposed Gavi investment in human rabies vaccines has potential to drive progress towards the 2030 target; however, concomitant investment is needed to scale up mass dog vaccination or this target will be missed. Predicted economic benefits of mass dog vaccination vary according to national PEP provisioning and healthcare access. Integrated Bite Case Management can enhance surveillance and rationalize PEP use, but needs adapting to and integrating within local health systems and international reporting systems to improve PEP accountability, monitor impacts and support verification of disease freedom. Modelling approaches need refining to project realistic and geographically specific timelines for achieving targets. Model iterations informed by data on the implementation of interventions can be used to evaluate progress and guide future strategies. Critically such models are needed to advocate for investment, since the greatest risk to the ‘Zero by 30’ strategy is the limited long-term cross-sectoral or targeted financing to support countries to deliver and sustain mass dog vaccination.
Channel Auctions
Authors: Azevedo Eduardo M. , Pennock David M. , Waggoner Bo , Weyl E. Glen
Published: March 2020

Standard auction formats feature either an upper bound on the equilibrium price that descends over time (as in the Dutch auction) or a lower bound on the equilibrium price that ascends over time (as in the English auction). We show that in some settings with costly information acquisition, auctions featuring both (viz., a narrowing channel of prices) outperform the standard formats. This Channel auction preserves some of benefits of both the English (truthful revelation) and Dutch (security for necessary information acquisition) auctions. Natural applications include housing, online auction sites like eBay, recording transactions on blockchains, and spectrum rights.

This paper was accepted by Joshua Gans, business strategy.
The Isolated Choice Effect and Its Implications for Gender Diversity in Organizations
Authors: Chang Edward H. , Kirgios Erika L. , Rai Aneesh , Milkman Katherine L.
Published: March 2020

We highlight a feature of personnel selection decisions that can influence the gender diversity of groups and teams. Specifically, we show that people are less likely to choose candidates whose gender would increase group diversity when making personnel selections in isolation (i.e., when they are responsible for selecting a single group member) than when making collections of choices (i.e., when they are responsible for selecting multiple group members). We call this the isolated choice effect. Across six preregistered experiments (n = 3,509), we demonstrate that the isolated choice effect has important consequences for group diversity. When making sets of hiring and selection decisions (as opposed to making a single hire), people construct more gender-diverse groups. Mediation and moderation studies suggest that people do not attend as much to diversity when making isolated selection choices, which drives this effect.

This paper was accepted by Yuval Rottenstreich, decision analysis.