bluuebunny/crossref_metadata_2025 huggingface dataset:
Age constraints on the Palaeoproterozoic Lomagundi–Jatuli Event in Zimbabwe: Zircon geochronology of the Magondi Supergroup
Authors: Sawada Hikaru , Mugandani Ernest Tafumanei , Sato Tomohiko , Sawaki Yusuke , Sakata Shuhei , Isozaki Yukio , Maruyama Shigenori
Published: May 2019

The ca. 2.2–2.1 Ga Magondi Supergroup on the Zimbabwe Craton in Southern Africa is mainly composed of sedimentary rocks deposited in a rift basin/passive continental margin, which record a unique episode in carbon isotope perturbation called the Lomagundi–Jatuli Event (LJE). This study reports new U–Pb ages of detrital zircons from the Deweras and Lomagundi groups of the Magondi Supergroup, and of igneous zircons from underlying granitoids, to constrain the timing of the LJE and to identify the provenance of the Magondi Supergroup. Most analysed detrital zircon grains range in ages between ca. 2.9 and 2.6 Ga. Three ca. 2.3–2.2 Ga detrital zircons from sandstone of the Deweras Group, with the youngest 207Pb‐206Pb age of 2,216 ± 22 Ma, indicate the onset of LJE in the Zimbabwe Craton was almost simultaneous to that in Fennoscandia and the Superior Craton, supporting the global synchronicity of the LJE.
Nipple Deformation and Peripheral Pressure on the Areola During Breastfeeding
Authors: Alatalo Diana , Jiang Lin , Geddes Donna , Hassanipour Fatemeh
Published: May 2019

Breastfeeding is a complex process where the infant utilizes two forms of pressure during suckling, vacuum and compression. Infant applied compression, or positive oral pressure, to the breast has not been previously studied in vivo. The goal of this study is to use a methodology to capture the positive oral pressure values exerted by infants' maxilla (upper jaw) and mandible (lower jaw) on the breast areola during breastfeeding. In this study, the positive and negative (vacuum) pressure values are obtained simultaneously on six lactating mothers. Parallel to the pressure data measurements, ultrasound images are captured and processed to reveal the nipple deformations and the displacements of infants' tongues and jaw movements during breastfeeding. Motivated by the significant differences in composition between the tissue of the breast and the nipple–areola complex, the strain ratio values of the lactating nipples are obtained using these deformation measurements along with pre- and postfeed three-dimensional (3D) scans of the breast. The findings show an oscillatory positive pressure profile on the breast under both maxilla and mandible, which differs from clinical indications that only the mandible of an infant moves during breastfeeding. The strain ratio varies between mothers, which indicates volume changes in the nipple during feeding and suggests that previous assumptions regarding strain ratio for nonlactating breasts will not accurately apply to breast tissue during lactation.
Gas Turbine Arekret-Cycle Simulation Modeling for Training and Educational Purposes
Authors: Osigwe Emmanuel O. , Pilidis Pericles , Nikolaidis Theoklis , Sampath Suresh
Published: May 2019

This paper presents the modeling approach of a multipurpose simulation tool called gas turbine Arekret-cycle simulation (GT-ACYSS); which can be utilized for the simulation of steady-state and pseudo transient performance of closed-cycle gas turbine plants. The tool analyzes the design point performance as a function of component design and performance map characteristics predicted based on multifluid map scaling technique. The off-design point is analyzed as a function of design point performance, plant control settings, and a wide array of other off-design conditions. GT-ACYSS can be a useful educational tool since it allows the student to monitor gas path properties throughout the cycle without laborious calculations. It allows the user to have flexibility in the selection of four different working fluids, and the ability to simulate various single-shaft closed-cycle configurations, as well as the ability to carry out preliminary component sizing of the plant. The modeling approach described in this paper has been verified with case studies and the trends shown appeared to be reasonable when compared with reference data in the open literature, hence, can be utilized to perform independent analyses of any referenced single-shaft closed-cycle gas turbine plants. The results of case studies presented herein demonstrated that the multifluid scaling method of components and the algorithm of the steady-state analysis were in good agreement for predicting cycle performance parameters (such as efficiency and output power) with mean deviations from referenced plant data ranging between 0.1% and 1% over wide array of operations.
Directional Stiffness Modulation of Parallel Robots With Kinematic Redundancy and Variable Stiffness Joints
Authors: Orekhov Andrew L. , Simaan Nabil
Published: May 2019

Parallel robots have been primarily investigated as potential mechanisms with stiffness modulation capabilities through the use of actuation redundancy to change internal preload. This paper investigates real-time stiffness modulation through the combined use of kinematic redundancy and variable stiffness actuators. A known notion of directional stiffness is used to guide the real-time geometric reconfiguration of a parallel robot and command changes in joint-level stiffness. A weighted gradient-projection redundancy resolution approach is demonstrated for resolving kinematic redundancy while satisfying the desired directional stiffness and avoiding singularity and collision between the legs of a Gough/Stewart parallel robot with movable anchor points at its base and with variable stiffness actuators. A simulation study is carried out to delineate the effects of using kinematic redundancy with or without the use of variable stiffness actuators. In addition, modulation of the entire stiffness matrix is demonstrated as an extension of the approach for modulating directional stiffness.
An Efficient Parking Solution: A Cam-Linkage Double-Parallelogram Mechanism Based 1-Degrees of Freedom Stack Parking System
Authors: Zhang Chengyuan , Zhang Xiaomin , Ye Hongyun , Wei Ming , Ning Xianxiong
Published: May 2019

To solve the difficult parking problem, developing a mechanical parking device is a practical approach. Aiming at longitudinal parking, a novel compact double-stack parking system is put forward based on a 1-DOF (degree of freedom) cam-linkage double-parallelogram mechanism. Due to the unique structure, the whole device can be driven by a single motor to realize three motion periods, including lifting, translation, and fillet transition. Meanwhile, all parts of this compact mechanism can be well contained in the filleted rectangular trajectory. This rectangular trajectory is essential that we no longer need to take out the ground vehicles so as to realize stack parking. Furthermore, to overcome the singularity collinear problem of the parallelogram which may lead to the polymorphic state, the double-parallelogram mechanism is proposed to maintain the orientation of the parking platform. The digital simulation and kinetostatic analysis results demonstrate the feasibility that this novel cam-linkage double-parallelogram mechanism can improve the space utilization of the residential area, alleviate the parking problem, and can be quickly put into application on campuses or streets in a short period.
Combining Ceftriaxone with Doxycycline and Daptomycin Reduces Mortality, Neuroinflammation, Brain Damage, and Hearing Loss in Infant Rat Pneumococcal Meningitis
Authors: Muri Lukas , Perny Michael , Zemp Jonas , Grandgirard Denis , Leib Stephen L.
Published: May 2019

Despite appropriate antibiotic therapy, pneumococcal meningitis (PM) is associated with a case fatality rate of up to 30% in high-income countries. Survivors often suffer from severe lifelong disabilities.
Authentic Modeling of Human Respiratory Virus Infection in Human Pluripotent Stem Cell-Derived Lung Organoids
Authors: Porotto M. , Ferren M. , Chen Y.-W. , Siu Y. , Makhsous N. , Rima B. , Briese T. , Greninger A. L. , Snoeck H.-W. , Moscona A.
Published: May 2019

Respiratory viruses are among the first pathogens encountered by young children, and the significant impact of these viral infections on the developing lung is poorly understood. Circulating viruses are suited to the environment of the human lung and are different from those of viruses grown in cultured cells. We modeled respiratory virus infections that occur in children or infect the distal lung using lung organoids that represent the entire developing infant lung. These 3D lung organoids, derived from human pluripotent stem cells, develop into branching airway and alveolar structures and provide a tissue environment that maintains the authentic viral genome. The lung organoids can be genetically engineered prior to differentiation, thereby generating tissues bearing or lacking specific features that may be relevant to viral infection, a feature that may have utility for the study of host-pathogen interaction for a range of lung pathogens.
Identification of Novel Mobilized Colistin Resistance Gene
mcr-9
in a Multidrug-Resistant, Colistin-Susceptible Salmonella enterica Serotype Typhimurium Isolate
Authors: Carroll Laura M. , Gaballa Ahmed , Guldimann Claudia , Sullivan Genevieve , Henderson Lory O. , Wiedmann Martin
Published: May 2019

Colistin is a last-resort antibiotic that is used to treat severe infections caused by MDR and extensively drug-resistant (XDR) bacteria. The World Health Organization (WHO) has designated colistin as a “highest priority critically important antimicrobial for human medicine” (WHO,
Critically Important Antimicrobials for Human Medicine
,
5th revision
, 2017,
https://www.who.int/foodsafety/publications/antimicrobials-fifth/en/
), as it is often one of the only therapies available for treating serious bacterial infections in critically ill patients. Plasmid-borne
mcr
genes that confer resistance to colistin pose a threat to public health at an international scale, as they can be transmitted via horizontal gene transfer and have the potential to spread globally. Therefore, the establishment of a complete reference of
mcr
genes that can be used to screen for plasmid-mediated colistin resistance is essential for developing effective control strategies.
A “Cultural” Renaissance: Genomics Breathes New Life into an Old Craft
Authors: Carini Paul
Published: May 2019

Sometimes, to move ahead, you must take a look at where you have been. Culturing microbes is a foundational underpinning of microbiology.
Unsafe workout: a weak and painful shoulder in a professional volleyball player
Authors: Ermolao Andrea , Brogi Michela , Baioccato Veronica , Rovai Sara
Published: May 2019

A 29-year-old professional volleyball player started complaining of a dull ache in the right lateral base of the neck. This pain arose during a preseasonal athletic training intense session. After 3 days, he presented deficiency of right scapula adduction, limitation of scapula elevation, right shoulder weakness and local mild pain. He had asymmetrical neckline with drooping of the affected shoulder, lateral displacement and minimal winging of the right scapula. After 1 week, hypothrophy of superior trapezius appeared. An electromyography of right upper limb showed a denervation in the upper, middle and lower components of the right trapezius muscle, due to axonotmesis of spinal accessory nerve (SAN). A subsequent MRI was consistent with muscular suffering caused by early denervation. This case shows idiopathic SAN palsy, likely secondary to an inappropriate use of a weight-lifting machine, where the athlete recovered after an adequate rest and rehabilitation period.
India’s RMNCH+A Strategy: approach, learnings and limitations
Authors: Taneja Gunjan , Sridhar Vegamadagu Suryanarayana-Rao , Mohanty Jaya Swarup , Joshi Anurag , Bhushan Pranav , Jain Manish , Gupta Sachin , Khera Ajay , Kumar Rakesh , Gera Rajeev
Published: May 2019

Building on the gains of the National Health Mission, India’s Reproductive, Maternal, Newborn, Child and Adolescent Health (RMNCH+A) Strategy, launched in 2013, was a milestone in the country’s health planning. The strategy recognised the interdependence of RMNCH+A Interventions across the life stages and adopted a comprehensive approach to address inequitable distribution of healthcare services for the vulnerable population groups and in poor-performing geographies of the country. Based on innovative approaches and management reforms, like selection of poor-performing districts, prioritisation of high-impact RMNCH+A healthcare interventions, engagement of development partners and institutionalising a concurrent monitoring system the strategy strived to improve efficiency and effectiveness within the public healthcare delivery system of the country. 184 High Priority Districts were identified across the country on a defined set of indicators for implementation of critical RMNCH+A Interventions and a dedicated institutional framework comprising National and State RMNCH+A Units and District Level Monitors supported by the development partners was established to provide technical support to the state and district health departments. Health facilities based on case load and available services across the High Priority Districts were prioritised for strengthening and were monitored by an RMNCH+A Supportive Supervision mechanism to track progress and generate evidence to facilitate actions for strengthening ongoing interventions. The strategy helped develop an integrated systems-based approach to address public health challenges through a comprehensive framework, defined priorities and robust partnerships with the partner agencies. However, lack of a robust monitoring and evaluation framework and sub-optimal focus on social determinants of health possibly limited its overall impact and ability to sustain improvements. Guided by the learnings and limitations, the Government of India has now designed the ‘Aspirational Districts Program’ to holistically address health challenges in poor-performing districts within the overall sociocultural domain to ensure inclusive and sustained improvements.
Effect of liraglutide on body weight and pain in patients with overweight and knee osteoarthritis: protocol for a randomised, double-blind, placebo-controlled, parallel-group, single-centre trial
Authors: Gudbergsen Henrik , Henriksen Marius , Wæhrens Eva Ejlersen , Overgaard Anders , Bliddal Henning , Christensen Robin , Boesen Mikael Ploug , Knop Filip Krag , Astrup Arne , Rasmussen Marianne Uggen , Bartholdy Cecilie , Daugaard Cecilie , Bartels Else Marie , Ellegaard Karen , Heitmann Berit Lilienthal , Kristensen Lars Erik
Published: May 2019

Introduction

With an increasing prevalence of citizens of older age and with overweight, the health issues related to knee osteoarthritis (OA) will intensify. Weight loss is considered a primary management strategy in patients with concomitant overweight and knee OA. However, there are no widely available and feasible methods to sustain weight loss in patients with overweight and knee OA. The present protocol describes a randomised controlled trial evaluating the efficacy and safety of the glucagon-like peptide-1 receptor agonist liraglutide in a 3 mg/day dosing in patients with overweight and knee OA.

Methods and analysis

150 volunteer adult patients with overweight or obesity and knee OA will participate in a randomised, double-blind, placebo-controlled, parallel-group and single-centre trial. The participants will partake in a run-in diet intervention phase (week −8 to 0) including a low calorie diet and dietetic counselling. At week 0, patients will be randomised to either liraglutide 3 mg/day or liraglutide placebo 3 mg/day for 52 weeks as an add-on to dietetic guidance on re-introducing regular foods and a focus on continued motivation to engage in a healthy lifestyle. The co-primary outcomes are changes in body weight and the Knee Injury and Osteoarthritis Outcome Score pain subscale from week 0 to week 52.

Ethics and dissemination

The trial has been approved by the regional ethics committee in the Capital Region of Denmark, the Danish Medicines Agency and the Danish Data Protection Agency. An external monitoring committee (The Good Clinical Practice Unit at Copenhagen University Hospitals) will oversee the trial. The results will be presented at international scientific meetings and through publications in peer-reviewed journals.

Trial registration numbers

2015-005163-16,NCT02905864, U1111-1171-4970

Based on protocol version

V.6; 30 January 2017, 15:30 hours
Tackling the wicked problem of health networks: the design of an evaluation framework
Authors: Cunningham Frances Clare , Ranmuthugala Geetha , Westbrook Johanna Irene , Braithwaite Jeffrey
Published: May 2019

Networks are everywhere. Health systems and public health settings are experimenting with multifarious forms. Governments and providers are heavily investing in networks with an expectation that they will facilitate the delivery of better services and improve health outcomes. Yet, we lack a suitable conceptual framework to evaluate the effectiveness and sustainability of clinical and health networks. This paper aims to present such a framework to assist with rigorous research and policy analysis. The framework was designed as part of a project to evaluate the effectiveness and sustainability of health networks. We drew on systematic reviews of the literature on networks and communities of practice in health care, and on theoretical and evidence-based studies of the evaluation of health and non-health networks. Using brainstorming and mind-mapping techniques in expert advisory group sessions, we assessed existing network evaluation frameworks and considered their application to extant health networks. Feedback from stakeholders in network studies that we conducted was incorporated. The framework encompasses network goals, characteristics and relationships at member, network and community levels, and then looks at network outcomes, taking into account intervening variables. Finally, the short-term, medium-term and long-term effectiveness of the network needs to be assessed. The framework provides an overarching contribution to network evaluation. It is sufficiently comprehensive to account for many theoretical and evidence-based contributions to the literature on how networks operate and is sufficiently flexible to assess different kinds of health networks across their life-cycle at community, network and member levels. We outline the merits and limitations of the framework and discuss how it might be further tested.
Botulinum toxin treatment of spasticity targeted to muscle endplates: an international, randomised, evaluator-blinded study comparing two different botulinum toxin injection strategies for the treatment of upper limb spasticity
Authors: Rekand Tiina , Biering-Sörensen Bo , He Jun , Vilholm Ole Jakob , Christensen Peter Brøgger , Ulfarsson Trandur , Belusa Roger , Ström Torbjörn , Myrenfors Peter , Maisonobe Pascal , Dalager Torben
Published: May 2019

Objectives

The therapeutic effects of botulinum neurotoxin (BoNT) are well documented in upper limb spasticity. However, several factors may influence treatment efficacy, including targeting of neuromuscular junctions (NMJs). We examined whether NMJ-targeted BoNT injections were non-inferior, in terms of efficacy, to current injection practices.

Design

Open-label prospective evaluator-blinded study.

Setting

Conducted across 20 medical centres in Denmark, Finland, Norway and Sweden (24 September 2012 to 11 March 2015).

Participants

Aged ˃18 years with upper limb spasticity (Modified Ashworth Scale [MAS] score of 2 or 3) following stroke or traumatic brain injury, had received ≥2 consecutive BoNT-A treatment cycles (the latest of which was abobotulinumtoxinA [aboBoNT-A]) and needed BoNT-A retreatment (same modality as previous cycle). Patients requiring aboBoNT-A doses >800units were excluded. In total, 88 patients were randomised (intention-to-treat [ITT] population), most were male (n=58/88, 65.9%) and 54/88 (61.4%) completed the study (per protocol [PP] population).

Interventions

Randomisation (1:1) to receive a single dose of aboBoNT-A (≤800 U) according to either current clinical practice (300 U/mL) or as an NMJ-targeted injection (100 U/mL).

Primary outcome measure

Proportion of patients with a ≥1 level reduction from baseline in MAS score at week 4 post-injection (responders).

Results

In the ITT population, the proportion of responders at elbow flexors was 72.7% in the current practice group and 56.8% in the NMJ-targeted group (adjusted difference −0.1673 [95% CIs: −0.3630 to 0.0284]; p=0.0986). Similar results were observed in the PP population (69.0% vs 68.0%, respectively, adjusted difference 0.0707 [−0.1948 to 0.3362]; p=0.6052).

Conclusions

Owing to the limited number of participants, non-inferiority of NMJ-targeted injections could not be determined. However, there was no statistical difference between groups. Larger studies are needed confirm whether the two techniques offer comparable efficacy.

Trial registration number

NCT01682148.
Type and use of digital technology in learning health systems: a scoping review protocol
Authors: Lessard Lysanne , Grudniewicz Agnes , Sauré Antoine , Szczotka Agnieszka , King James , Fung-Kee-Fung Michael
Published: May 2019

Introduction

Health systems in North America and Europe have been criticised for their lack of safety, efficiency and effectiveness despite rising healthcare costs. In response, healthcare leaders and researchers have articulated the need to transform current health systems into continuously and rapidly learning health systems (LHSs). While digital technology has been envisioned as providing the transformational power for LHSs by generating timely evidence and supporting best care practices, it remains to be ascertained if it is indeed playing this role in current LHS initiatives. This paper presents a protocol for a scoping review that aims at providing a comprehensive understanding of how and to what extent digital technology is used within LHSs. Results will help to identify gaps in the literature as a means to guide future research on this topic.

Methods and analysis

Multiple databases and grey literature will be searched with terms related to learning health systems. Records selection will be done in duplicate by two reviewers applying pre-defined inclusion and exclusion criteria. Data extraction from selected records will be done by two reviewers using a piloted data charting form. Results will be synthesised through a descriptive numerical summary and a mapping of digital technology use onto types of LHSs and phases of learning within LHSs.

Ethics and dissemination

Ethical approval is not required for this scoping review. Preliminary results will be shared with stakeholders to account for their perspectives when drawing conclusions. Final results will be disseminated through presentations at relevant conferences and publications in peer-reviewed journals.
Health morbidity in Brazilian prisons: a time trends study from national databases
Authors: Job Neto Francisco , Miranda Raquel Barbosa , Coelho Ronaldo de Almeida , Gonçalves Cinthya Paiva , Zandonade Eliana , Miranda Angelica Espinosa
Published: May 2019

Objective

The goal of this study was to explore the surveillance data about mandatory reporting diseases, included in the official information systems, and evaluate the historical trend analysis in prisoners in Brazil.

Design

A time trends study was performed using secondary data from prisons’ health units.

Setting

Nationwide representative data of Brazilian prisoners obtained from 2007 to 2014 health and prison information systems database were analysed. These data are carried out by units identified as prison health facilities.

Primary outcome measures

Diseases diagnosis and individual data were available at the National System of Disease Notification (in Portuguese SINAN), Mortality Information System (in Portuguese SIM) and Prison Registration Systems (in Portuguese INFOPEN and GEO prisons). Analyses of the notification data performed in the SINAN at the national level. SINAN was consolidated with SIM, INFOPEN and GEO prison data.

Results

A total of 23 235 cases of compulsory disease notification causing morbidity were reported in prison units in Brazil; of these cases, 20 003 (85.6%) were men and 3362 (14.4%) were women. Over time, the proportion of prisoners increased from 1.92 per 1000 inhabitants in 2007 to 2.77 per 1000 inhabitants in 2014 (rising trend). From a total of 27 states, 12 of them presented a growth in disease notifications, 14 were stable and in only one state was there a decrease in notifications. There was an increase in notifications in the country as a whole. Tuberculosis (64.4%), dengue (9.1%), AIDS (9.0%) and viral hepatitis (5.9%) were among the most frequently reported diseases during the study period.

Conclusion

Despite showing stable tendencies, our results show high rates of diseases in Brazilian prisons. Prison health services should not be isolated but integrated into regional and national health and justice systems.
Adverse pregnancy outcomes and long-term risk of maternal renal disease: a systematic review and meta-analysis protocol
Authors: Barrett Peter M , McCarthy Fergus P , Kublickiene Karolina , Evans Marie , Cormican Sarah , Judge Conor , Perry Ivan J , Kublickas Marius , Stenvinkel Peter , Khashan Ali S
Published: May 2019

Introduction

Adverse pregnancy outcomes, such as hypertensive disorders of pregnancy (HDP), gestational diabetes (GDM) and preterm birth have been linked to maternal cardiovascular disease in later life. Pre-eclampsia (PE) is associated with an increased risk of postpartum microalbuminuria, but there is no clear consensus on whether HDP increases the risk of maternal chronic kidney disease (CKD) and end-stage kidney disease (ESKD). Similarly, it is uncertain whether GDM, preterm birth and delivery of low birth-weight infants independently predict the risk of maternal renal disease in later life. The aims of this proposed systematic review and meta-analysis are to summarise the available evidence examining the association between adverse outcomes of pregnancy (HDP, GDM, preterm birth, delivery of low birth-weight infant) and later maternal renal disease and to synthesise the results of relevant studies.

Methods and analysis

A systematic search of PubMed, EMBASE and Web of Science will be undertaken using a detailed prespecified search strategy. Two authors will independently review the titles and abstracts of all studies, perform data extraction and appraise the quality of included studies using a bias classification tool. Original case–control and cohort studies published in English will be considered for inclusion. Primary outcomes of interest will be CKD and ESKD; secondary outcomes will be hospitalisation for renal disease and deaths from renal disease. Meta-analyses will be performed to calculate the overall pooled estimates using the generic inverse variance method. The systematic review will follow the Meta-analyses Of Observational Studies in Epidemiology guidelines.

Ethics and dissemination

This systematic review and meta-analysis will be based on published data, and thus there is no requirement for ethics approval. The results will be shared through publication in a peer reviewed journal and through presentations at academic conferences.

PROSPERO registration number

CRD42018110891
Sexually transmitted infections in young people and factors associated with HIV coinfection: an observational study in a large city
Authors: Sentís Alexis , Martin-Sanchez Mario , Arando Maider , Vall Martí , Barbera María Jesus , Ocaña Inma , González Cordón Ana , Alsina Mercè , Martin-Ezquerra Gemma , Knobel Hernando , Gurguí Mercè , Vives Alvaro , Coll Josep , Caylà Joan Artur , Garcia de Olalla Patricia
Published: May 2019

Objectives

Young people are a critical target group for sexually transmitted infections (STI) surveillance due to their particular behavioural and social related vulnerability. The aim of this study was to describe the epidemiological characteristics and trends in the incidence of gonorrhoea, syphilis, HIV and venereal lymphogranuloma (LGV) among 15–24-year-olds in Barcelona, and to determine factors associated with HIV coinfection.

Design

We performed a population-based incidence study covering the 2007–2015 period.

Participants

All new cases of STI—HIV, gonorrhoea, infectious syphilis and LGV—notified to the epidemiological surveillance system in Barcelona between 2007 and 2015. 1218 cases were studied: 84.6% were men, 19.3% were 15–19 years old and 50.6% were born in Spain. Among men, 73.7% were men who have sex with men (MSM); among women, 85.6% were women that have sex with men.

Primary and secondary outcomes

Incidence of HIV, gonorrhoea, infectious syphilis and LGV. HIV coinfection.

Results

There was an increase in the incidence of gonorrhoea, from 1.9 cases per 10 000 people in 2007 to 7.6/10 000 in 2015 (p<0.01), in MSM from 27.1 to 228.8/10 000 (p<0.01). The incidence of syphilis increased from 0.4/10 000 in 2007 to 3.1/10 000 in 2015 (significant in men only, p<0.01), in MSM from 18.1 to 116.9/10 000 (p<0.01). The incidence of HIV showed a non-significant increase in men (p=0.27), and that of LGV remained stable (p=0.59). Factors associated with increased risk of HIV coinfection included being MSM (adjusted OR[ORa]=14.14, 95% CI 3.34 to 59.91) and having >10 sexual partners (ORa=4.11, 95% CI 1.53 to 11.01) or STI diagnosis during the previous 12 months (ORa=2.06; 95% CI 1.13 to 3.77).

Conclusions

The incidence of gonorrhoea and syphilis among 15–24-year-olds increased, while HIV infection remained stable but with a high incidence among MSM. Being MSM, having sex with multiple partners and having a diagnosis of an STI in the previous 12 months were factors associated with HIV coinfection.
Is incident rheumatoid arthritis interstitial lung disease associated with methotrexate treatment? Results from a multivariate analysis in the ERAS and ERAN inception cohorts
Authors: Kiely Patrick , Busby A D , Nikiphorou E , Sullivan K , Walsh D A , Creamer P , Dixey J , Young A
Published: May 2019

Objectives

To assess predictive factors for rheumatoid arthritis interstitial lung disease (RA-ILD) in two early rheumatoid arthritis (RA) inception cohorts with a focus on methotrexate (MTX) exposure.

Design

Multicentre prospective early RA inception cohort studies; the early RA study (ERAS) and the early RA network (ERAN).

Setting

Secondary care, ERAS nine centres, ERAN 23 centres in England, Wales and Ireland.

Participants

Patients with new diagnosis of RA, n=2701. Standardised data including demographics, drug therapies and clinical outcomes including the presence of RA-ILD were collected at baseline, within 3–6 months, at 12 months and annually thereafter.

Primary and secondary outcome measures

Primary outcome was the association of MTX exposure on RA-ILD diagnosis. Secondary outcomes were the association of demographic, comorbid and RA-specific factors on RA-ILD diagnosis and the association of MTX exposure on time to RA-ILD diagnosis.

Results

Of 92 eligible ILD cases, 39 occurred in 1578 (2.5%) MTX exposed and 53 in 1114 (4.8%) non-MTX exposed cases. The primary analysis of RA-ILD cases only developing after any conventional synthetic disease-modifying antirheumatic drug treatment (n=67) showed MTX exposure not to be associated with incident RA-ILD (OR 0.85, 95% CI 0.49 to 1.49, p=0.578) and a non-significant trend for delayed ILD diagnosis (OR 0.54, 95% CI 0.28 to 1.06, p=0.072). In an extended analysis including RA-ILD cases present at RA diagnosis (n=92), MTX exposure was associated with a significantly reduced risk of incident RA-ILD (OR 0.48, 95% CI 0.3 to 0.79, p=0.004) and longer time to ILD diagnosis (OR 0.41, 95% CI 0.23 to 0.75, p=0.004). Other independent baseline associations with incident RA-ILD were higher age of RA onset, ever smoking, male gender, rheumatoid nodules and longer time from first RA symptom to first outpatient visit.

Conclusions

MTX treatment was not associated with an increased risk of RA-ILD diagnosis. On the contrary, evidence suggested that MTX may delay the onset of ILD.
First reported detection of biofilm formation byCampylobacter fetusduring investigation of a case of prosthetic valve endocarditis
Authors: Lynch Caoimhe , O'Connor James A , O'Brien Deirdre , Vaughan Carl , Bolton Declan , Coffey Aidan , Lucey Brigid
Published: May 2019

Aims

Campylobacter fetussubspfetus(CFF) can cause intestinal illness, particularly in immunocompromised humans, with the potential to cause severe systemic infections. CFF is a zoonotic pathogen with a broad host range among farm animals and humans, inducing abortion in sheep and cows. The current paper describes a strain of CFF isolated from a patient with prosthetic valve endocarditis in Mercy University Hospital, Cork, Ireland, during 2017. Only five cases ofC. fetusas a cause of prosthetic valve endocarditis have been reported in the literature, with no reports of biofilm formation within the species.

Methods

The aetiological strain was speciated and subspeciated by the VITEK 2 NH card and matrix-assisted laser desorption ionisation time-of-flight mass spectrometry. CFF biofilm formation was analysed using a crystal violet staining method.C. jejuniNational Collection of Type Cultures (NCTC) 11168 was used as a positive control organism. Strains were incubated statically in Mueller-Hinton broth and Mueller-Hinton broth supplemented with 0.025% sodium deoxycholate for 3 and 7 days at 37°C, microaerobically.

Results

The CFF strain formed stronger attached biofilms on polystyrene plates on day 3 (72 hours) than theC. jejuniNCTC 11168 control strain, but were weaker than the control strain on day 7 in Mueller-Hinton broth. Monoculture of thisC. fetusisolate was found to exist in three defined forms of biofilms (attached, air–liquid interface and floccules).

Conclusions

This clinically significantC. fetusisolate showed considerable biofilm-forming capability, which we suggest conferred a survivalist advantage, contributing to the genesis of infective prosthetic valve endocarditis.
Comparative effectiveness of ACE inhibitors and angiotensin receptor blockers in patients with prior myocardial infarction
Authors: Ko Dennis , Azizi Paymon , Koh Maria , Chong Alice , Austin Peter , Stukel Therese , Jackevicius Cynthia
Published: May 2019

Objective

Although ACE inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) are commonly prescribed for patients with coronary artery disease, whether these medications are similarly effective is still a subject of intense debate. Our objective was to compare the clinical effectiveness of ACEIs and ARBs in patients with prior myocardial infarction (MI).

Methods

All residents older than 65 years, alive on 1 April 2012, with a prior MI were included. Propensity weighting was used to balance potentially confounding baseline covariates between the treatment groups. The primary outcome was a composite of cardiovascular death, hospitalisation for MI or unstable angina at 3 years.

Results

Our cohort included 59 353 patients with MI; their mean age was 77 years and 40% were women. In the propensity-weighted cohort, the primary outcome occurred in 6.5% in the ACEI group and 5.7% in the ARB group at 1 year (HR comparing ACEI with ARB 1.14, 95% CI 1.05 to 1.23, p<0.001). At 3 years, the primary outcome occurring in 16.0% with ACEIs and 15.1% with ARBs (HR 1.07; 95% CI 1.02 to 1.12; p<0.001). A significant interaction with sex was observed, with women prescribed ACEIs having a higher hazards (HR 1.17; 95% CI 1.10 to 1.26) compared with ARBs, while no significant difference was seen among men (HR 1.00; 95% CI 0.93 to 1.06, interaction p<0.001).

Conclusions

Despite previous concerns regarding ARBs, we found that they had slightly lower rates of adverse clinical cardiovascular outcomes among older patients with MI compared with ACEIs. The observed difference in clinical outcomes may be related to a sex difference in effectiveness.
Sympathetic blocks for complex regional pain syndrome: a survey of pain physicians
Authors: Zhu Xiaoying , Kohan Lynn R , Morris Joshua D , Hamill-Ruth Robin J
Published: May 2019

Background

Sympathetic blocks (SB) are commonly used to treat pain from complex regional pain syndrome (CRPS). However, there are currently no guidelines to assist pain physicians in determining the best practices when using and performing these procedures.

Methods

A 32-question survey was developed on how SBs are used and performed to treat CRPS. The survey was conducted online via SurveyMonkey. The responses were statistically analyzed using descriptive statistics, and comparing academic versus non-academic, and fellowship versus non-fellowship-trained physicians.

Results

A total of 248 pain physicians responded with a response rate of 37%. Forty-four percent of respondents schedule the first SB at the first clinic visit; 73% perform one to three consecutive blocks; over 50% will repeat the block if a patient receives at least 50% pain relief from the previous one lasting 1–7 days.

Fifty-four percent of respondents perform stellate ganglion blocks (SGB) at the C6 vertebral level, 41% at C7; 53% perform lumbar sympathetic blocks (LSB) at L3 level, 39% at L2; 50% use fluoroscopy to guide SGB, 47% use ultrasound. More respondents from academic than non-academic centers use ultrasound for SGB. About 75% of respondents use a total volume of 5–10 mL for SGB and 10–20 mL for LSB. The most commonly used local anesthetic is 0.25% bupivacaine. About 50% of respondents add other medications, mostly steroids, for these blocks.

Conclusion

Our study showed a wide variation in current practice among pain physicians in treating CRPS with SBs. There is a clear need for evidence-based guidelines on when and how to perform SBs for CRPS.
Mycoplasma genitaliumincidence, persistence, concordance between partners and progression: systematic review and meta-analysis
Authors: Cina Manuel , Baumann Lukas , Egli-Gany Dianne , Halbeisen Florian S , Ali Hammad , Scott Pippa , Low Nicola
Published: May 2019

Background

Mycoplasma genitaliumis increasingly seen as an emerging sexually transmitted pathogen, and has been likened toChlamydia trachomatis, but its natural history is poorly understood. The objectives of this systematic review were to determineM. genitaliumincidence, persistence, concordance between sexual partners and the risk of pelvic inflammatory disease (PID).

Methods

We searched Medline, EMBASE, LILACS, IndMed and African Index Medicus from 1 January 1981 until 17 March 2018. Two independent researchers screened studies for inclusion and extracted data. We examined results in forest plots, assessed heterogeneity and conducted meta-analysis where appropriate. Risk of bias was assessed for all studies.

Results

We screened 4634 records and included 18 studies; six (4201 women) reported on incidence, five (636 women) on persistence, 10 (1346 women and men) on concordance and three (5139 women) on PID. Incidence in women in two very highly developed countries was 1.07 per 100 person-years (95% CI 0.61 to 1.53, I20%). Median persistence ofM. genitaliumwas estimated from one to three months in four studies but 15 months in one study. In 10 studies measuringM. genitaliuminfection status in couples, 39%–50% of male or female sexual partners of infected participants also hadM. genitaliumdetected. In prospective studies, PID incidence was higher in women withM. genitaliumthan those without (risk ratio 1.73, 95% CI 0.92 to 3.28, I20%, two studies).

Discussion

Incidence ofM. genitaliumin very highly developed countries is similar to that forC. trachomatis, but concordance might be lower. Taken together with other evidence about age distribution and antimicrobial resistance in the two infections,M. genitaliumis not the new chlamydia. Synthesised data about prevalence, incidence and persistence ofM. genitaliuminfection are inconsistent. These findings can be used for mathematical modelling to investigate the dynamics ofM. genitalium.

Registration numbers

CRD42015020420, CRD42015020405
Scalar field effective action for the spontaneous symmetry breaking in gravity
Authors: Akhavan Amin
Published: May 2019

In this paper, we obtain the quantum effective action for a scalar field which has been used for a special kind of symmetry breaking in gravity. Precisely by making use of some renormalization conditions, we calculate the one-loop path integral of canonical momentum. Moreover, we show that by introducing some new renormalization conditions, one can redefine the new degrees of freedom corresponding to a massive vector field.
TRIBOLOGICAL PERFORMANCE OF MODIFIED FLOCCULENT GRAPHITE AS LUBRICANT ADDITIVES
Authors: XUE CHUAN YI , WANG SHOU REN , LENG JIN FENG , WANG YONG , WANG GAO QI
Published: May 2019

In this research, graphite has been found to have excellent tribological properties as a lubricant additive. To reduce high friction and wear in cylinder liner piston ring friction pairs, modified flocculent graphite have been prepared via chemical technology. The morphology and microstructure of modified flocculent graphite were investigated via SEM, EDS, XRD and IR. In this study, varying concentrations (0.1, 0.5, and 0.9 wt.%) within modified flocculent graphite were dispersed at 350 SN lubricant for Gasoline Engine. Suspension stability of the lubricating oils with modified flocculent graphite and graphite as determined by ultraviolet-visible light (UV-VIS) spectrophotometry. The friction and wear characteristics of lubricants containing materials of modified flocculent graphite were evaluated under reciprocating test conditions to simulate contact. The morphology and microstructure of the friction pair tribofilms produced during frictional contact were investigated via SEM, EDS and a 3D surface profiler. The results show that scratching, pits, furrows and adhesive wear took place, respectively, on the worn surfaces of friction pairs. But, modified flocculent graphite showed excellent friction reducing and anti-wear performance and subsequently has great potential for the application of anti-wear.
Reconstruction of f(T) gravity in the context of standard Chaplygin gas as tachyon scalar field and study of the stability against gravitational perturbation
Authors: Chattopadhyay Surajit , Karmakar Soumyodipta
Published: May 2019

The present paper reports a study on the [Formula: see text] gravity reconstruction scheme in the context of considering standard Chaplygin gas as tachyon scalar field model of dark energy. The solution for reconstructed [Formula: see text] gravity has been obtained from reconstructed potential and scalar field of tachyon based on the standard Chaplygin gas. It has been observed that the equation of state parameter due to the reconstructed torsion contribution to the density and pressure behaves like quintom and is consistent with the observational value of the equation of state parameter for the current universe. The reconstructed [Formula: see text] has then been tested for gravitational perturbation by deriving the frictional term, the effective mass and the sound speed parameter for the gravitational potential and it has been found to be stable against gravitational perturbations through positive value of the squared speed of sound. Finally, statefinder diagnostics has been carried out and the reconstructed [Formula: see text] gravity is found to interpolate between dust and [Formula: see text]CDM phases of the universe.
Hydrogen bond directed molecular recognition in water in a strapped-porphyrin-cyclodextrin assembly
Authors: Kitagishi Hiroaki , Ohara Kazuki , Shimoji Daiki , Vonesch Maxime , Weiss Jean , Wytko Jennifer A.
Published: May 2019

A water soluble, phenanthroline-strapped zinc porphyrin bearing four arylsulfonate groups formed a stable host–guest complex with two per-[Formula: see text]-methylated [Formula: see text]-cyclodextrin cavities. In the host–guest assembly, the zinc porphyrin was capable of binding imidazole within the cavity between the zinc(II) ion and the phenanthroline strap in an aqueous medium. The formation of a hydrogen bond between the imidazole NH and the nitrogen atoms of the phenanthroline was an essential element of the binding event, as shown by comparative binding studies with a non-strapped tetrasulfonated zinc porphyrin and with [Formula: see text]-methylimidazole. This hydrogen bonding in an aqueous medium was possible due to the protected hydrophobic environment created by the cyclodextrins around the phenanthroline strap. This type of binding event may provide a biomimetic approach to study water soluble heme protein models.
Gaussian fluctuations for linear spectral statistics of deformed Wigner matrices
Authors: Ji Hong Chang , Lee Ji Oon
Published: May 2019

We consider large-dimensional Hermitian or symmetric random matrices of the form [Formula: see text], where [Formula: see text] is a Wigner matrix and [Formula: see text] is a real diagonal matrix whose entries are independent of [Formula: see text]. For a large class of diagonal matrices [Formula: see text], we prove that the fluctuations of linear spectral statistics of [Formula: see text] for [Formula: see text] test function can be decomposed into that of [Formula: see text] and of [Formula: see text], and that each of those weakly converges to a Gaussian distribution. We also calculate the formulae for the means and variances of the limiting distributions.
Investigation of Epoxidized Palm Oils as Green Processing Aids and Activators in Rubber Composites
Authors: Lee DongJu , Song Sung Ho
Published: May 2019

Epoxidized palm oil (EPO) is environmentally friendly, biodegradable, and a relatively less costly processing aid. In this study, we investigated the suitability of EPO in place of aromatic processing oils in styrene butadiene rubber. The curing properties, mechanical properties, abrasion resistance, and heat buildup properties of rubber composites with EPO were compared with those of the standard with aromatic oils. The rubber composites with EPO showed enhanced mechanical properties including modulus, tensile strength, and elongation at break. This is ascribed to the improved dispersion of fillers in the rubber matrix and interaction between the filler and the polymer. Furthermore, EPO in the rubber matrix showed remarkable abrasion resistance, rebound resilience, and heat buildup at low loadings. EPO in a rubber composite presents feasibility as a renewable raw material that can serve as an alternative to petrochemical oils in various applications.
The Mitochondrial Permeability Transition in Mitochondrial Disorders
Authors: Šileikytė Justina , Forte Michael
Published: May 2019

Mitochondrial permeability transition pore (PTP), a (patho)physiological phenomenon discovered over 40 years ago, is still not completely understood. PTP activation results in a formation of a nonspecific channel within the inner mitochondrial membrane with an exclusion size of 1.5 kDa. PTP openings can be transient and are thought to serve a physiological role to allow quick Ca2+release and/or metabolite exchange between mitochondrial matrix and cytosol or long-lasting openings that are associated with pathological conditions. While matrix Ca2+and oxidative stress are crucial in its activation, the consequence of prolonged PTP opening is dissipation of the inner mitochondrial membrane potential, cessation of ATP synthesis, bioenergetic crisis, and cell death—a primary characteristic of mitochondrial disorders. PTP involvement in mitochondrial and cellular demise in a variety of disease paradigms has been long appreciated, yet the exact molecular entity of the PTP and the development of potent and specific PTP inhibitors remain areas of active investigation. In this review, we will (i) summarize recent advances made in elucidating the molecular nature of the PTP focusing on evidence pointing to mitochondrial FoF1-ATP synthase, (ii) summarize studies aimed at discovering novel PTP inhibitors, and (iii) review data supporting compromised PTP activity in specific mitochondrial diseases.