bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of a problem‐solving intervention for the indicated prevention of suicidal risk in young Brazilians: Randomized controlled trial
Authors: Xavier Alessandra , Otero Patricia , Blanco Vanessa , Vázquez Fernando L.
Published: June 2019

Objective

The aim of this study was to evaluate the efficacy of a problem‐solving intervention for the prevention of suicidal risk in Brazilian adolescents with elevated suicidal potential and depressive symptoms.

Methods

A randomized controlled trial was conducted involving 100 participants (mean age 17.2 years, 60% women, 46% mixed race), allocated to the problem‐solving intervention (n = 50) or the usual care control group (n = 50). Blinded interviewers conducted assessments at pretreatment, posttreatment, 1, 3, and 6 months of follow‐up. The main outcome was suicidal orientation; secondary outcomes were suicidal risk, suicidal plans and attempts, depressive symptoms, and problem‐solving skills.

Results

At posttreatment and up to 6‐month follow‐up, there was lower suicidal orientation and suicidal risk in the problem‐solving group compared to the control group. There were lower suicidal plans and attempts (0.0% participants vs 2.2% with a suicide plan and 2.2% with both suicide plan and attempt); risk difference was 0.04 (95% CI: 0.01–0.09) and the number needed to treat was 25 (95% CI: 11–70). Significant effects of the intervention on depressive symptoms were found at posttreatment and maintained for 6 months. The change in global and functional problem‐solving skills mediated the reduction in suicide orientation.

Conclusions

Thus, suicidal risk can be successfully prevented in adolescents.
Viremia and viruria of trichodysplasia spinulosa‐associated polyomavirus before the development of clinical disease in a kidney transplant recipient
Authors: Pierrotti Ligia Camera , Urbano Paulo Roberto Palma , Nali Luiz Henrique da Silva , Romano Camila Malta , Bicalho Camila da Silva , Arnone Marcelo , Valente Neusa Sakai , Pannuti Cláudio Sérgio , David‐Neto Elias , Azevedo Luiz Sérgio
Published: June 2019

Trichodysplasia spinulosa (TS) is a rare disease associated with immunosuppression and induced by a polyomavirus denominated Tricodisplasia Polyomavirus (TSPyV). We report a case of TS 6 months after kidney transplantation in a 65 years‐old woman under immunosuppression therapy with prednisone, mycophenolate and tacrolimus. The patient developed follicular papules on the face with a thickening of the skin and alopecia of the eyebrows, leading to distortion of the face and a leonine appearance characteristic of the disease. The skin biopsy confirmed the clinical diagnosis and the presence of TSPyV DNA in the skin was detected. Staining for SV40 was positive. Immunosuppression was changed: mycophenolate was withdrawn, tacrolimus reduced and everolimus added. Intravenous cidofovir and later on leflunomide were added. Although the literature has reported clinical success with topical cidofovir, we were unable to use it because this drug is not available. There was an improvement of skin lesions and on cosmetic appearance. The patient had three rejections (one clinically diagnosed and two other biopsy proven), progressed with renal failure and graft loss. Retrospective analysis of stored urine and blood samples detected TSPyV DNA in some of those samples two months before the TS clinical development. This case highlights the TSPyV detection in blood and urine samples before the development of skin lesions.
Effect of time and storage on toxic or pseudo‐toxic change in canine neutrophils
Authors: Bau‐Gaudreault Liza , Grimes Carolyn N.
Published: June 2019

Background

The presence of toxic change in neutrophils is frequently used as a biomarker of inflammation in dogs.

Objective

We aimed to evaluate the effect of time and storage on toxic change in canine neutrophils.

Methods

One hundred and fifty microliters of EDTA blood were obtained from eight dogs with no toxic neutrophil changes observed on fresh blood smears (T0). Blood was stored at room temperature (RT), in a box with an icepack (ICE), and at 4°C. For each storage condition, smears were prepared 2 (T2), 4 (T4), 8 (T8), and 24 (T24) hours post blood draw. Smears were randomized, and each smear was evaluated for the presence of toxic neutrophil change.

Results

A statistically significant effect of time and storage on the presence of toxic neutrophil change was observed. Compared with T0, the number of neutrophils containing Döhle bodies was significantly higher at T8 and T24 for the RT (P < 0.0001) and ICE (P < 0.0001) samples and at T24 for 4°C samples (P < 0.0001). Additionally, smears were falsely classified as having 1+ toxic change in 0/8 (T2), 1/8 (T4), 3/8 (T8), and 8/8 (T24) for RT samples; 0/8 (T2 and T4), 2/8 (T8), and 5/7 (T24) smears for ICE samples; and 0/8 (T2, T4, and T8) and 2/8 (T24) for 4°C samples.

Conclusions

Smears can be falsely classified as having neutrophils with toxic change as early as 4 hours post blood draw in samples stored at RT, 8 hours when stored with icepacks, and 24 hours when stored at 4°C. Canine blood smears should be prepared and evaluated for toxic neutrophil change as early as possible.
Comparison of cross‐sectional geometrical properties and bone density of the proximal radius between Saint Bernard and other giant breed dogs
Authors: Mejia Sebastian , Iodence Ashley , Griffin Lynn , Withrow Stephen , Puttlitz Christian , Salman Mo , Seguin Bernard
Published: June 2019

Objective

To compare the geometrical properties and bone mineral density (BMD) of the proximal radius between Saint Bernard and other giant breed dogs.

Study design

Observational, cross‐sectional, descriptive study.

Animals

Thirteen client‐owned Saint Bernard dogs and 13 other client‐owned giant breed dogs.

Methods

Computed tomography (CT) studies of Saint Bernard and other giant breed dogs were reviewed. Multiplanar reconstruction of the CT images was used to determine cross‐sectional variables at the proximal half of the radius, including mean cortical thickness (mCT) and moment of inertia (MOI). Cortical BMD was estimated from Hounsfield unit measurements at each cross‐section and averaged per bone. One‐way analysis of variance was used to detect differences between groups.

Results

Proximal radii of Saint Bernard dogs had a lower cortical/medullary ratio (1.75 vs 2.2, P < .001), mCT (1.96 vs 2.64 mm, P < .001), and MOI in all planes (mediolateral [ML]: 2086.09 vs 2757.69 mm4, P < .001; craniocaudal [CrCd]: 3736.36 vs 4370.28 mm4, P = .025; and polar: 5852.45 vs 7127.97 mm4, P = .002) compared with bones of other breeds. Cross‐sectional BMD did not differ between groups of dogs, but the mean BMD of all cross‐sections was lower in Saint Bernard dogs (1214.27 vs 1289.80 mg/mm3, P = .029).

Conclusion

The proximal radii of Saint Bernard dogs had thinner cortices and lower CrCd, ML, and polar MOI compared with corresponding bones in giant breed dogs.

Clinical significance

The structural properties of the proximal radius of the Saint Bernard differ from those in other giant breeds and could reduce the ability of this region to sustain biomechanical loads. These properties could predispose Saint Bernard dogs to complications after surgical limb‐sparing procedures.
Low prevalence of zoonotic multidrug‐resistant bacteria in veterinarians in a country with prudent use of antimicrobials in animals
Authors: Verkola Marie , Pietola Eeva , Järvinen Asko , Lindqvist Kristian , Kinnunen Paula M. , Heikinheimo Annamari
Published: June 2019

The occurrence of multidrug‐resistant zoonotic bacteria in animals has been increasing worldwide. Working in close contact with livestock increases the risk of carriage of these bacteria. We investigated the occurrence of extended‐spectrum beta‐lactamase (ESBL) and plasmidic AmpC beta‐lactamase producing Enterobacteriaceae (ESBL/pAmpC‐PE) and livestock‐associated methicillin‐resistant Staphylococcus aureus (LA‐MRSA) in Finnish veterinarians (n = 320). In addition to microbiological samples, background information was collected. Bacterial whole genome sequencing was performed to deduce sequence types (STs), spa types and resistance genes of the isolates. In total, 3.0% (9/297) of the veterinarians carried ESBL producing Escherichia coli, with one ESBL producing E. coli isolate producing also AmpC. Seven different STs, sequences of several different plasmid groups as well as several different blaESBL/pAmpC genes existed in different combinations. No carbapenemase or colistin resistance genes were detected. MRSA was detected in 0.3% (1/320) of the samples. The strain belonged to LA‐MRSA clonal complex (CC) 398 (ST398, spa type 011, lacking Panton‐Valentine leukocidin genes). In conclusion, this study shows low carriage of multidrug‐resistant zoonotic bacteria in Finnish veterinarians. However, finding LA‐MRSA for the first time in a sample from a veterinarian in a country with prudent use of animal antimicrobials and regarding the recent rise of LA‐MRSA on Finnish pig farms, a strong recommendation to protect people working in close contact with animals carrying LA‐MRSA CC398 is given. Further studies are needed to explain why the prevalence of LA‐MRSA in veterinarians is lower in Finland than in other European countries.
An inhomogeneous Dirichlet theorem via shrinking targets
Authors: Kleinbock Dmitry , Wadleigh Nick
Published: June 2019

We give an integrability criterion on a real-valued non-increasing function $\unicode[STIX]{x1D713}$ guaranteeing that for almost all (or almost no) pairs $(A,\mathbf{b})$, where $A$ is a real $m\times n$ matrix and $\mathbf{b}\in \mathbb{R}^{m}$, the system $$\begin{eqnarray}\Vert A\mathbf{q}+\mathbf{b}-\mathbf{p}\Vert ^{m}<\unicode[STIX]{x1D713}(T),\quad \Vert \mathbf{q}\Vert ^{n}<T,\end{eqnarray}$$ is solvable in $\mathbf{p}\in \mathbb{Z}^{m}$, $\mathbf{q}\in \mathbb{Z}^{n}$ for all sufficiently large $T$. The proof consists of a reduction to a shrinking target problem on the space of grids in $\mathbb{R}^{m+n}$. We also comment on the homogeneous counterpart to this problem, whose $m=n=1$ case was recently solved, but whose general case remains open.
Theory for spectral broadening of narrowband signals in the atmosphere and experiment with an acoustic source onboard an unmanned aerial vehicle
Authors: Ostashev Vladimir E. , Wilson D. Keith , Finn Anthony , Barlas Emre
Published: June 2019

Narrowband acoustic signals propagating through inhomogeneous moving media, such as atmospheric turbulence, exhibit spectral broadening. This phenomenon has been previously studied with regard to acoustic remote sensing of the atmosphere with sodars and tonal noise of turbofan aircraft engines. In this paper, spectral broadening is studied for line-of-sight sound propagation in a turbulent atmosphere. The averaged power spectral density of a narrowband signal is calculated from a Fourier transform of the temporal mutual coherence function of the sound field. Spectral broadening is characterized by the width of the spectral density. The spectral width is calculated for the Kolmogorov spectra of temperature and wind velocity fluctuations for both horizontal and slanted propagation in the atmosphere. In the latter case, the height-dependence of the wind speed and turbulence parameters is addressed. The spectral width is studied numerically for different meteorological regimes of the atmospheric boundary layer characterized by the friction velocity and the surface sensible heat flux. Theoretical results are compared to experimental data for propagation from an acoustic multi-tone source onboard an unmanned aerial vehicle to a microphone array located on the ground.
Strength–Duration Curves of Radial Nerve in Patients With Lateral Elbow Pain
Authors: de la Cruz Torres Blanca
Published: June 2019

Context:Lateral epicondylalgia (LE) refers to a painful condition at or around the lateral epicondyle of the humerus. LE is one of the most common injuries of the elbow; however, the cause of the pathology is not clear. Patients often experience symptoms consistent with a radial nerve injury; however, data on the involvement of the radial nerve are needed.Objective:To analyze the relationship between electrophysiologic excitability and morphology of the radial nerve in patients with unilateral chronic LE.Design:Cross-sectional study.Setting:Department of Physiotherapy, University of Seville.Patients:A total of 56 elbows (28 right, 28 left) in 28 patients (12 females, 16 males; age 49 [7.37] y) were recruited by convenience sampling.Main Outcome Measures:Strength–duration curves (chronaxia and accommodation index) and cross-sectional area (CSA) of the radial nerve were made in all participants. All parameters were compared between both limbs. Also, pain with palpation in the lateral epicondyle and functional pain of involved extremities was assessed using visual analog scale and the Patient-Rated Tennis Elbow Evaluation, respectively.Results:Symptomatic limb showed higher CSA values of the radial nerve when compared with the asymptomatic limb (P < .001). On the symptomatic limb, duration of symptoms was positively correlated with CSA values. Chronaxia values were all normal and similar between both limbs (P = .35). Regarding accommodation index, 14 (54%) patients showed accommodation indices that suggested pathological radial nerve on the right limb, 4 (14%) on the left limb, 5 (18%) on both limbs, and 4 (14%) had none of the affected nerves. Eight-six percent of patients showed accommodation indices that suggested pathological radial nerve, independently of symptomatic limb. In these cases, affected nerves had higher CSA than the unaffected nerve (P = .01). On the affected nerves, duration of symptoms was positively correlated with accommodation indices.Conclusions:These findings suggest that patients with unilateral chronic LE show a decreased excitability in any radial nerve, independently of the symptomatic limb, and that pathological nerves have higher CSA than the nonpathological nerves.
Fear-Avoidance Beliefs and Health-Related Quality of Life in Post-ACL Reconstruction and Healthy Athletes: A Case–Control Study
Authors: Hoch Johanna M. , Houston Megan N. , Baez Shelby E. , Hoch Matthew C.
Published: June 2019

Context:Many athletes return to sport after anterior cruciate ligament reconstruction (ACLR) with lingering physical or mental health impairments. Examining health-related quality of life (HRQL) and fear-avoidance beliefs across the spectrum of noninjured athletes and athletes with a history of ACLR may provide further insight into targeted therapies warranted for this population.Objective:The purpose of this study was to examine differences in fear-avoidance beliefs and HRQL in college athletes with a history of ACLR not participating in sport (ACLR-NPS), participating in sport (ACLR-PS), and healthy controls (Control) with no history of injury participating in sport.Design:Cross-sectional.Setting:Laboratory.Patients (or Other Participants):A total of 10 college athletes per group (ACLR-NPS, ACLR-PS, and Control) were included. Participants were included if on a roster of a Division I or III athletic team during data collection.Interventions:Participants completed a demographic survey, the modified Disablement in the Physically Active Scale (mDPA) to assess HRQL, and Fear-Avoidance Beliefs Questionnaire (FABQ) to assess fear-avoidance beliefs.Main Outcome Measures:Scores on the mDPA (Physical and Mental) and FABQ subscales (Sport and Physical Activity) were calculated, a 1-way Kruskal–Wallis test and separate Mann–WhitneyUpost hoc tests were performed (P < .05).Results:ACLR-NPS (30.00 [26.00]) had higher FABQ-Sport scores than ACLR-PS (18.00 [26.00];P < .001) and Controls (0.00 [2.50];P < .001). ACLR-NPS (21.50 [6.25]) had higher FABQ-Physical Activity scores than ACLR-PS (12.50 [13.00];P = .001) and Controls (0.00 [1.00];P < .001). Interestingly, ACLR-PS scores for FABQ-Sport (P = .01) and FABQ-Physical Activity (P = .04) were elevated compared with Controls. ACLR-NPS had higher scores on the mDPA-Physical compared with the ACLR-PS (P < .001) and Controls (P < .001), and mDPA-Mental compared with ACLR-PS (P = .01), indicating decreased HRQL.Conclusions:The ACLR-NPS had greater fear-avoidance beliefs and lower HRQL compared with ACLR-PS and Controls. However, the ACLR-PS had higher scores for both FABQ subscales compared with Controls. These findings support the need for additional psychosocial therapies to address fear-avoidance beliefs in the returned to sport population.
Can Myofascial Interventions Have a Remote Effect on ROM? A Systematic Review and Meta-Analysis
Authors: Burk Connor , Perry Jesse , Lis Sam , Dischiavi Steve , Bleakley Chris
Published: June 2019

Context:Anatomical and in vivo studies suggest that muscles function synergistically as part of a myofascial chain. A related theory is that certain myofascial techniques have a remote and clinically important effect on range of motion (ROM).Objective:To determine if remote myofascial techniques can effectively increase the range of motion at a distant body segment.Evidence Acquisition:In November 2018, the authors searched 3 electronic databases (CENTRAL, MEDLINE, and PEDro) and hand-searched journals and conference proceedings. Inclusion criteria were randomized controlled trials comparing remote myofascial techniques with passive intervention (rest/sham) or local treatment intervention. The primary outcome of interest was ROM. Quality assessment was performed using the PEDro Scale. Three authors independently evaluated study quality and extracted data. RevMan software was used to pool data using a fixed-effect model.Evidence Synthesis:Eight randomized controlled trials, comprising N = 354 participants were included (mean age range 22–36 y; 50% female). Study quality was low with PEDro scores ranging from 2 to 7 (median scores 4.5/10). None of the studies incorporated adequate allocation concealment and just 2 used blinded assessment of outcomes. In all studies, treatments and outcomes were developed around the same myofascial chain (superficial back line). Five studies included comparisons between remote interventions to sham or inactive controls; pooled results for ROM showed trends in favor of remote interventions (standard mean difference 0.23; 95% confidence intervals; −0.09 to 0.55; 4 studies) at immediate follow-ups. Effects sizes were small, corresponding to mean differences of 9% or 5° in cervical spine ROM, and 1 to 3 cm in sit and reach distance. Four studies compared remote interventions to local treatments, but there were few differences between groups.Conclusions:Remote exercise interventions may increase ROM at distant body segments. However, effect sizes are small and the current evidence base is limited by selection and measurement bias.
Kynurenine signaling through the aryl hydrocarbon receptor maintains the undifferentiated state of human embryonic stem cells
Authors: Yamamoto Takako , Hatabayashi Kunitada , Arita Mao , Yajima Nobuyuki , Takenaka Chiemi , Suzuki Takashi , Takahashi Masatoshi , Oshima Yasuhiro , Hara Keisuke , Kagawa Kenichi , Kawamata Shin
Published: June 2019

The tryptophan metabolite kynurenine maintains the undifferentiated state of human embryonic stem cells.
Rapid Evolution of Reduced Susceptibility against a Balanced Dual-Targeting Antibiotic through Stepping-Stone Mutations
Authors: Szili Petra , Draskovits Gábor , Révész Tamás , Bogár Ferenc , Balogh Dávid , Martinek Tamás , Daruka Lejla , Spohn Réka , Vásárhelyi Bálint Márk , Czikkely Márton , Kintses Bálint , Grézal Gábor , Ferenc Györgyi , Pál Csaba , Nyerges Ákos
Published: June 2019

Multitargeting antibiotics, i.e., single compounds capable of inhibiting two or more bacterial targets, are generally considered to be a promising therapeutic strategy against resistance evolution. The rationale for this theory is that multitargeting antibiotics demand the simultaneous acquisition of multiple mutations at their respective target genes to achieve significant resistance. The theory presumes that individual mutations provide little or no benefit to the bacterial host.
Overcoming Iron Deficiency of an Escherichia coli
tonB
Mutant by Increasing Outer Membrane Permeability
Authors: Qiu Nan , Misra Rajeev
Published: June 2019

The work presented here describes a positive genetic selection strategy for isolating mutations that destabilize the outer membrane permeability barrier of
E. coli
. Given the importance of the outer membrane in restricting the entry of antibiotics, characterization of the genes and their products that affect outer membrane integrity will enhance the understanding of bacterial membranes and the development of strategies to bypass the outer membrane barrier for improved drug efficacy.
Genomic Analysis of Emerging Florfenicol-Resistant Campylobacter coli Isolated from the Cecal Contents of Cattle in the United States
Authors: Zhao Shaohua , Mukherjee Sampa , Hsu Chih-Hao , Young Shenia , Li Cong , Tate Heather , Morales Cesar A. , Haro Jovita , Thitaram Sutawee , Tillman Glenn E. , Dessai Uday , McDermott Patrick
Published: June 2019

Campylobacter
is a leading cause of foodborne diarrheal illness worldwide, with more than one million cases each year in the United States alone. The global emergence of antimicrobial resistance in this pathogen has become a growing public health concern. Florfenicol-resistant (FFN
r
)
Campylobacter
has been very rare in the United States. In this study, we employed whole-genome sequencing to characterize 16 multidrug-resistant
Campylobacter coli
isolates recovered from cattle in the United States. A gene [
cfr
(C)] was found to be responsible for resistance not only to florfenicol but also to several other antimicrobials, including linezolid, a critical drug for treating infections by Gram-positive bacteria in humans. The results showed that
cfr
(C) is located in a conjugative pTet MDR/virulence plasmid. This report highlights the power of antimicrobial resistance surveillance to uncover the intricacies of transmissible coresistance and provides information that is needed for accurate risk assessment and mitigation strategies.
Susceptibility to Medium-Chain Fatty Acids Is Associated with Trisomy of Chromosome 7 in
Candida albicans
Authors: Ma Qinxi , Ola Mihaela , Iracane Elise , Butler Geraldine
Published: June 2019

Aneuploidy (changes in chromosome number) and loss of heterozygosity (LOH) occur frequently in the human-pathogenic yeast
Candida albicans
and are associated with adaptation to stress and to antifungal drugs. Aneuploidy and LOH can also be induced during laboratory manipulations, such as during genetic transformation. We find that
C. albicans
strain SN152, commonly used to generate gene deletions, has undergone a major LOH event on chromosome 2. One deletion strain generated in this background has acquired extra copies of chromosomes 5 and 7. We find that trisomy (three copies) of chromosome 7 is associated with sensitivity to fatty acids.
National retrospective cohort study to identify age-specific fatality risks of comorbidities among hospitalised patients with influenza-like illness in Taiwan
Authors: Weng Ting-Chia , Chiu Han-Yi Robert , Chen Shey-Ying , Shih Fuh-Yuan , King Chwan-Chuen , Fang Cheng-Chung
Published: June 2019

Objectives

This study aimed to examine comprehensively the prognostic impact of underlying comorbidities among hospitalised patients with influenza-like illness (ILI) in different age groups and provide recommendations targeting the vulnerable patients.

Setting and participants

A retrospective cohort of 83 227 hospitalised cases with ILI were identified from Taiwan’s National Health Insurance Research Database from January 2005 to December 2010. Cases were stratified into three different age groups: paediatric (0–17 years), adult (18–64 years) and elderly (≧65 years), and their age, sex, comorbidity and past healthcare utilisation were analysed for ILI-associated fatality.

Main outcome measures

ORs for ILI-related fatality in different age groups were performed using multivariable analyses with generalised estimating equation models and adjusted by age, sex and underlying comorbidities.

Results

Hospitalised ILI-related fatality significantly increased with comorbidities of cancer with metastasis (adjusted OR (aOR)=3.49, 95% CI: 3.16 to 3.86), haematological malignancy (aOR=3.02, 95% CI: 2.43 to 3.74), cancer without metastasis (aOR=1.72, 95% CI: 1.54 to 1.91), cerebrovascular (aOR=1.24, 95% CI: 1.15 to 1.33) and heart diseases (aOR=1.19, 95% CI: 1.11 to 1.27) for all age groups. Adult patients with AIDS; adult and elderly patients with chronic kidney disease, tuberculosis and diabetes were significantly associated with elevated risk of death. Severe liver diseases and hypothyroidism among elderly, and dementia/epilepsy among elderly and paediatrics were distinctively associated with likelihood of ILI-related fatality.

Conclusions

Different age-specific comorbidities were associated with increasing risk of death among hospitalised ILI patients. These findings may help update guidelines for influenza vaccination and other prevention strategies in high-risk groups for minimising worldwide ILI-related deaths.
Patient experiences using a novel tool to improve care transitions in patients with heart failure: a qualitative analysis
Authors: Schofield Toni , Bhatia R Sacha , Yin Cindy , Hahn-Goldberg Shoshana , Okrainec Karen
Published: June 2019

Objective

To evaluate the utility of a novel discharge tool adapted for heart failure (HF) on patient experience.

Design

Semistructured interviews assessed the utility of a novel discharge tool adapted for HF; patient-oriented discharge summary (PODS-HF) at 72 hours and 30 days after leaving hospital. Interviews were recorded and transcribed verbatim. Three investigators used directed content analysis to determine themes and subthemes from the narrative data.

Setting

The cardiology ward of an urban academic institution in Canada.

Participants

13 patients and caregivers completed 24 interviews. Eligible patients were >18 years and admitted with a diagnosis of HF.

Results

Analysis revealed six interconnected themes: (1) Utility of discharge instructions: how patients perceive and use written and verbal instructions. Patients receiving PODS-HF identified value in the patient-centred summarised content. (2) Adherence: strategies used by patients to enhance adherence to medications, diet and lifestyle changes. PODS-HF provides a strong visual reminder, particularly early postdischarge. (3) Adaptation: how patients incorporate changes into ‘new norms’. This was more evident by 30 days, and those using PODS-HF had less unscheduled visits and readmissions. (4) Relationships with healthcare providers: patients’ perceptions of the roles of family physicians and specialists in follow-up care. (5) Role of family and caregivers: the pivotal role of caregivers in supporting adherence and adaptation. (6) Follow-up phone calls: the utility of follow-up calls, particularly early after discharge as a means of providing clarification, reassurance and education.

Conclusion

PODS-HF is a useful tool that increases patients’ confidence to self-manage and facilitates adherence by providing relevant written information to reference after discharge.
Healthcare processes of laboratory tests for the prediction of mortality in the intensive care unit: a retrospective study based on electronic healthcare records in the USA
Authors: Zhang Zhongheng , Goyal Hemant , Lange Theis , Hong Yucai
Published: June 2019

Objectives

Healthcare process carries important prognostic information for patients, but the healthcare processes of laboratory tests have not yet been investigated for patients in the intensive care unit (ICU). The study aimed to investigate the effect of healthcare processes of laboratory tests on hospital mortality, with the hypothesis that the addition of healthcare processes could improve the discrimination for mortality outcome.

Design

The study included 12 laboratory tests. There were two dimensions for each laboratory test. One was the pathophysiology value; and the other was the healthcare process variables including the clock hour, the number of measurements and the measurement time from ICU admission. Generalised additive model was employed to investigate the effect of continuous variables on mortality. Generalised linear models with and without healthcare process variables were compared for their discrimination power.

Setting

ICUs in an US-based hospital.

Participants

Adult patients included in the critical care big data Medical Information Mart for Intensive Care.

Primary and secondary outcome measures

The hospital mortality was the primary outcome.

Results

A total of 52 963 adult patients with complete ICU stay information were included for analysis. The mortality rate was 12.3%. Lower number of tests such as 1–3 times were associated with the lowest mortality for most laboratory tests. However, the hematocrit, glucose and potassium required 6–10 measurements for the first 24 hours to reach the lowest mortality rate. In n of the 12 prediction models involving laboratory tests, the addition of healthcare process variables was associated with significantly increased area under receiver operating characteristics.

Conclusions

The study showed that healthcare processes of laboratory tests were independently associated with hospital mortality. The addition of healthcare processes to the pathophysiology value could increase the discrimination for mortality outcome.
Effects of exposure to direct and secondhand hookah and e-cigarette aerosols on ambient air quality and cardiopulmonary health in adults and children: protocol for a panel study
Authors: Shearston Jenni , Lee Lily , Eazor James , Meherally Saher , Park Su Hyun , Vilcassim MJ Ruzmyn , Weitzman Michael , Gordon Terry
Published: June 2019

Introduction

Use of alternative nicotine delivery systems, such as electronic cigarettes and hookahs, has increased dramatically in the USA, but limited research has been conducted on the secondhand effects of these products, especially in children. The objective of this study is to assess the cardiopulmonary effects of e-cigarette and hookah use in vaping and smoking adults, and in non-smoking/non-vaping adults and children exposed to secondhand particles and gases.

Methods and analysis

This study uses a pre/post design, with four groups: two control groups (non-smoking/non-vaping and cigarette smoking) and two test groups (hookah smoking and e-cigarette vaping). Participants will be recruited by household, so that each home includes one smoking or vaping adult and one non-smoking/non-vaping adult and/or child (5–18 years). Non-smoking/non-vaping homes include an adult and child who do not smoke or vape and do not live with individuals who do. Air quality measures will be completed during a household smoking or vaping session (ambient air for non-smoking/non-vaping group), while cardiopulmonary measures and biological samples will be taken directly before and after the smoking/vaping session, and again 24 hours later, for all participants. Air quality measures include carbon monoxide, black carbon, particulate matter, trace elements, nicotine and carbonyls; cardiopulmonary measures include heart rate variability, blood pressure, pulmonary function and exhaled carbon monoxide; biological samples will assess cotinine, inflammatory cytokines and biomarkers in urine, saliva and nasal mucosa.

Ethics and dissemination

This study was approved by the Institutional Review Board at New York University School of Medicine (s16-02226 and s17-01143). Special attention was given to the inclusion of children, who are likely significantly impacted by the use of these products at home, and thus should be included in research. Results of the study will be distributed at conferences, in peer-reviewed journals and to relevant public health authorities for use in developing policy.
Detection and characterisation of optic nerve and retinal changes in primary congenital glaucoma using hand-held optical coherence tomography
Authors: Pilat Anastasia V , Shah Sonal , Sheth Viral , Purohit Ravi , Proudlock Frank A , Abbott Joseph , Gottlob Irene
Published: June 2019

Objective

To investigate (1) the feasibility of scanning the optic nerve (ON) and central retina with hand-held optical coherence tomography (HH-OCT) without sedation or anaesthesia in primary congenital glaucoma (PCG), (2) the characteristics of ON changes in comparison with adult primary open-angle glaucoma (POAG) in comparison with matched controls, (3) the sensitivity and specificity of ON parameters for diagnosis, and (4) changes of foveal morphology.

Methods and analysis

HH-OCT (Envisu 2300; Leica Microsystems) was used to investigate ON and foveal morphology of 20 children with PCG (mean age 4.64±2.79) and 10 adult patients with POAG (mean age 66.8±6.94), and compared with age-matched, gender-matched and ethnicity-matched healthy controls without sedation or anaesthesia.

Results

HH-OCT yielded useful data in 20 out of 24 young children with PCG. Patients with PCG had significantly deeper cup changes than patients with POAG (vs respective age-matched controls, p=0.014). ON changes in PCG are characterised by significant increase in cup depth (165%), increased cup diameter (159%) and reduction in rim area (36.4%) as compared with controls with high sensitivity (81.5, 74.1% and 88.9%, respectively) and specificity (85.0, 80.0% and 75.0%, respectively). Patients with PCG have a significantly smaller width of the macula pit (p<0.001) with non-detectable external limiting membrane.

Conclusion

HH-OCT has the potential to be a useful tool in glaucoma management for young children. We have demonstrated the use of HH-OCT in confirming a diagnosis of glaucoma within the studied cohort and found changes in disc morphology which characterise differently in PCG from POAG.
The validity of three malnutrition screening markers among older patients with cancer
Authors: Zhang Xiaotao , Pang Linda , Sharma Shreela V , Li Ruosha , Nyitray Alan G , Edwards Beatrice J
Published: June 2019

Background

Malnutrition is common in older adults with cancer and is associated with adverse clinical outcomes. We assessed and compared the validity of three tools commonly used to screen for malnutrition: The Mini Nutritional Assessment (MNA), weight loss and body mass index (BMI).

Methods

In this retrospective study, we reviewed patients over age 65 with a diagnosis of cancer who were treated at the MD Anderson Cancer Center between 1 January 2013 and 31 March 2017. All patients in this study were evaluated by a trained geriatrician as part of a comprehensive geriatric assessment (CGA). Malnutrition was diagnosed by both CGA and clinical examination. The sensitivity, specificity and Cohen’s κ of each tool was also compared with the clinical diagnosis.

Results

A total of 454 older patients with cancer who had malnutrition information available were included in the analyses. The median age was 78%, and 42% (n=190) were clinically diagnosed with malnutrition at baseline. When the MNA was performed, 105 out of 352 patients (30%) were malnourished, and 122 (35%) at risk of malnutrition. Weight loss >3 kg was seen in 183 out of 359 (51%) patients, and BMI <20 kg/m2was found in 30 of the 454 (7%) patients. MNA had the highest validity (area under curve (AUC)=0.83) and reliability (κ=0.67), weight loss had moderate validity (AUC=0.73) and reliability (κ=0.46), while BMI had the lowest validity (AUC=0.55) and reliability (κ=0.55).

Conclusions

For clinical practice, MNA should be incorporated for standard assessment/screening for these older patients with cancer.
The nature of suffering and its relief: a proposal for a redefinition
Authors: Kioko Paul Muleli , Requena Meana Pablo
Published: June 2019

Recent advances in our understanding of the nature of suffering and its different dimensions have exposed certain deficits in the current definition of suffering. These shortcomings have impacted negatively on the appropriate formulation of precise treatment objectives for each dimension of suffering within the overall framework of the goals of medicine. Existential suffering offers a clear example where the lack of a universally accepted definition has led to confusion regarding what should constitute appropriate relief for this particular dimension of suffering. In this thought piece, we propose a redefinition of suffering based on three elements: first, suffering refers to a specific state of a person (the essence of suffering); second, this state is characterised by a specific psychosomatic anguish reaction (the manifestation of suffering) and third, this reaction is in response to a perceived threat to the integrity of the person (the cause of suffering). The proposed definition allows for an important and clear distinction to be made between the primary and symptomatic relief of suffering and the role of medicine in each form of relief. The terms of the proposed definition and the distinction between primary and symptomatic relief provide useful tools for further research regarding the different dimensions of suffering and its relief.
Advanced dementia: an integrated homecare programme
Authors: Hum Allyn , Tay Ri Yin , Wong Yoko Kin Yoke , Ali Noorhazlina Binte , Leong Ian Yi Onn , Wu Huei Yaw , Chin Jing Jih , Lee Angel Onn Kei , Koh Mervyn Yong Hwang
Published: June 2019

Objectives

We established an integrated palliative homecare programme for advanced dementia. This study explores patients’ symptoms and quality-of-life and their association with enteral feeding, evaluates the impact of the programme on these parameters and examines familial caregiver burden.

Methods

This is a prospective cohort study. Patients at Functional Assessment Stage 7, with an albumin level <35 g/L, pneumonia or enteral feeding were recruited. At baseline and regular intervals, the multidisciplinary homecare team used the Pain Assessment in Advanced Dementia, Mini Nutritional Assessment and Neuropsychiatric Inventory Questionnaire (NPI-Q) to identify patients’ symptoms, and the Quality of Life in Late-Stage Dementia (QUALID) tool to assess quality-of-life as primary outcomes, stratified by feeding status. The Zarit Burden Interview (ZBI) investigated caregiver burden, stratified by living arrangement and availability of stay-in help. Mann-Whitney U and χ2tests compared continuous and categorical variables respectively between groups while Wilcoxon signed-rank test compared assessment scores at baseline and on review.

Results

At baseline, 49.2% of the 254 patients had pain, 92.5% were malnourished and 85.0% experienced neuropsychiatric challenges. Patients on enteral feeding had lower NPI-Q score (median=3; IQR 1–6) than orally fed patients ((median=4; IQR 2–7), p=0.004) and higher QUALID score (median=25; IQR 21–30 vs median=21; IQR 17–25 for orally fed patients), p<0.0001, indicating a better quality-of-life for orally fed patients. Both symptoms and quality-of-life improved significantly for the 53 patients reviewed at the fifth month. Median ZBI score for caregivers was 26 (IQR 15–36). Having stay-in help reduced it from 39.5 (IQR 25–49) to 25 (IQR 15–35), p=0.001.

Conclusion

An integrated multidisciplinary palliative homecare team with geriatric training that is accessible all-hours addressed the needs of home-dwelling patients with advanced dementia, improved their quality-of-life and supported families to care for them at home.
Association of maximal systolic blood pressure with poor outcome in patients with hyperattenuated lesions on immediate NCCT after mechanical thrombectomy
Authors: Ding Xinfa , Xu Chao , Zhong Wansi , Gong Xiaoxian , Zhou Ying , Chen Zhicai , Lou Min
Published: June 2019

Background and purpose

This study aimed to investigate the relationship between blood pressure(BP) management and clinical outcome in patients with hyperattenuated lesions on non-contrast CT (NCCT) immediately after mechanical thrombectomy (MT).

Methods

We retrospectively reviewed our prospectively collected cohort for consecutive patients with acute ischemic stroke (AIS) who received MT between October 2013 and July 2018. Hourly systolic BP (SBP) and diastolic BP (DBP) values were recorded for 24 hours following MT, and then maximum SBP (SBPmax) and DBP (DBPmax) values were identified. Poor outcome was defined as 3-month modified Rankin score (mRS) 3–6 and parenchymal hemorrhage (PH) was defined according to the European Cooperative Acute Stroke Study (ECASS) II trial. Associations of BP parameters with poor outcome and PH were determined using binary logistic regression models. Receiver operating characteristics (ROC) curve analysis was used to determine the predictive value of BP.

Results

Initially 262 patients with AIS who received MT were reviewed and 148 patients with hyperattenuated lesions on immediate NCCT were enrolled in the final cohort for analysis. Binary logistic regression showed that every 10 mm Hg increase in SBPmaxwas independently associated with a poor outcome (OR 1.426; 95% CI 1.095 to 1.855; p=0.008) and PH (OR 1.025; 95% CI 1.005 to 1.480; p=0.044). SBP ≤140 mm Hg during the post-procedural 24-hour period was associated with lower odds of a poor outcome and PH compared with the other group.

Conclusions

Control of maximal SBP within 24 hours might be related to a low rate of PH and poor outcome in patients with hyperattenuated lesions on immediate NCCT after intervention.
The quantum transmission characteristic of one-dimensional photonic crystals
Authors: Pan Qing , Wu Xiang-Yao , Liu Xiao-Jing , Zhang Xiao-Ru , Liu Ji-Ping , Liu Han , Yang Fu-Quan , Ma Ji , Yuan Hong-Chun
Published: June 2019

In this paper, we have given the quantum transfer matrix, quantum dispersion relation, quantum transmissivity and reflectivity of one-dimensional photonic crystals with the quantum theory of photon. We have studied the quantum transmission characteristic of different structure one-dimensional photonic crystals, which include mirror and nonmirror structures, with and without defect, and the defects are active and inactive media. On that basis, we compared the dispersion relation, transmissivity and reflectivity of quantum with classical for one-dimensional photonic crystals, and found they are identical, which indicate the quantum theory approach of photonic crystals is true, it can further study the quantum topological property of photonic crystals, such as quantum Zak phase, Chern number and quantum edge state and so on.
A Novel Approach to Publishing Tasks for Collaboratively Crowdsourcing Workflows
Authors: Tang Wenjun , Chen Rong , Guo Shikai
Published: June 2019

In recent years, crowdsourcing has gradually become a promising way of using netizens to accomplish tiny tasks on, or even complex works through crowdsourcing workflows that decompose them into tiny ones to publish sequentially on the crowdsourcing platforms. One of the significant challenges in this process is how to determine the parameters for task publishing. Still some technique applied constraint solving to select the optimal tasks parameters so that the total cost of completing all tasks is minimized. However, experimental results show that computational complexity makes these tools unsuitable for solving large-scale problems because of its excessive execution time. Taking into account the real-time requirements of crowdsourcing, this study uses a heuristic algorithm with four heuristic strategies to solve the problem in order to reduce execution time. The experiment results also show that the proposed heuristic strategies produce good quality approximate solutions in an acceptable timeframe.
Nucleation of Gold Nanoparticles in a Solution via Laser Hell: Simulation and Experiments
Authors: Fisenko S. P. , Bobb J. A. , Rodrigues C. J. , El-Shall M. S. , Tibbetts K. M.
Published: June 2019

Theoretical and experimental results on the formation of gold nanoparticles under the influence of pulsed nanosecond laser irradiation of aqueous AuCl[Formula: see text] solution are presented. It is shown that high monodispersity of nanoparticles ensemble is related to the strong dependence of total absorbance of laser radiation on nanoparticles diameter and the conductive heat transfer to surrounding medium.
Influence of Ion Beam-Assisted Deposition on the Wetting Properties of Al-1.0 at.% Cr Alloy Films
Authors: Tashlykova-Bushkevich I. I. , Yakovenko J. S. , Bushkevich I. A.
Published: June 2019

The surface microstructure and wettability of Al-1.0 at.% Cr alloy films obtained by ion-beam-assisted deposition on glass substrates have been investigated using atomic force microscopy, scanning electron microscopy and the sessile drop method. In the passive deposition regime, the surface roughness of the films increased from 8.9[Formula: see text]nm to 21.6[Formula: see text]nm with an increase in coating time from 3[Formula: see text]h to 9[Formula: see text]h. A quantitative analysis of the morphology evolution of the films during their growth was performed. The results revealed that Al-1.0 at.% Cr alloy films are hydrophilic. The mechanism of heterogeneous water wetting of Al-1.0 at.% Cr alloy films was considered, when the increasing surface roughness accounts for a decrease of hydrophilicity.
Mechanochemical Synthesis of Intermetallic Compounds in the Gallium–Iridium System
Authors: Vitiaz P. , Lyakhov N. , Grigoreva T. , Pavlov E.
Published: June 2019

The interaction between a solid inert metal Ir and an active liquid metal Ga during mechanical activation in a high-energy planetary mill is studied by X-ray diffraction and scanning electron microscopy with high-resolution energy dispersive X-ray microanalysis. The effect of mechanical activation on the formation of GaxIry intermetallic compounds and GaxIry/Ir composites and their solubility in acids was investigated. The subsequent extraction of Ga from intermetallic compounds and composites in the mixture of concentrated acids [Formula: see text] makes it possible to produce nanoscale Ir.
Leveraging Wrist-Mounted Wearables for Lane-Change Detection
Authors: Xia Ming , Sun Jian , Wang Xiaoyan , Sun Peiliang , Chen Yufeng
Published: June 2019

Aggressive driving, such as frequent lane changes, endangers other persons or property but is challenging to be continuously tracked by existing traffic surveillance systems. In this paper, we use wrist-mounted wearables, such as a smartwatch to monitor the driver’s forearm acceleration and to detect lane changes. Because the forearm acceleration of lane changes can be significantly affected by traveling speed and steering angle, our system transforms the time-domain acceleration data to the frequency domain for clearly depicting the signal distribution over a range of frequencies. To further improve detection accuracy, we develop an adaptive algorithm which dynamically determines the target frequency band and adjusts the signal energy evaluation threshold based on current traveling speed. The algorithm will also examine the signal energy distribution over other frequencies besides the target frequency band to avoid false alarms when driving on road curves. We have evaluated our system in real driving environments, including both the low-speed local roads and high-speed expressways, and the results show that the system achieves high detection accuracy at low computational complexity.
ASIC STA Path Verification Using Semi-Supervised Learning
Authors: Obert James , Mannos Tom J.
Published: June 2019

To counter manufacturing irregularities and ensure ASIC design integrity, it is essential that robust design verification methods are employed. It is possible to ensure such integrity using ASIC static timing analysis (STA) and machine learning. In this research, uniquely devised machine and statistical learning methods which quantify anomalous variations in Register Transfer Level (RTL) or Graphic Design System II (GDSII) format are discussed. To measure the variations in ASIC analysis data, the timing delays in relation to path electrical characteristics are explored. It is shown that semi-supervised learning techniques are powerful tools in characterizing variations within STA path data and have much potential for identifying anomalies in ASIC RTL and GDSII design data.
Protecting the 2020 census
Authors: Kugler Logan
Published: June 2019

A new framework is being used to secure the 2020 U.S. Census from database reconstruction attacks.