bluuebunny/crossref_metadata_2025 huggingface dataset:
Use of patient‐reported outcome measures and patient‐reported experience measures in renal units in Australia and New Zealand: A cross‐sectional survey study
Authors: Morton Rachael L , Lioufas Nicole , Dansie Kathryn , Palmer Suetonia C , Jose Matthew D , Raj Rajesh , Salmon Andrew , Sypek Matthew , Tong Allison , Ludlow Marie , Boudville Neil , McDonald Stephen
Published: March 2019

Aim

Patient‐reported outcome measures (PROMs) and patient‐reported experience measures (PREMs) are increasingly used in research to quantify how patients feel and function, and their experiences of care, however, knowledge of their utilization in routine nephrology is limited.

Methods

The Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) PROMs working group conducted a prospective cross‐sectional survey of PROMs/PREMs use among renal ‘parent hospitals’. One survey per hospital was completed (August–November 2017). Descriptive statistics reported type and frequency of measures used and purpose of use.

Results

Survey response rate was 100%. Fifty‐five of 79 hospitals (70%) used at least one PROMs or PREMs for specific patient groups. PROMs were more likely to be collected from patients receiving comprehensive conservative care (45% of hospitals) than dialysis patients (32%, 31% and 28% of hospitals for home haemodialysis, peritoneal dialysis and facility dialysis, respectively). Few renal transplanting hospitals (3%) collected PROMs. The Integrated Palliative Outcome Scale‐Renal (IPOS‐Renal) (40% of units), and the Euro‐Qol (EQ‐5D‐5 L) (25%), were most frequently used. The main reason for collecting PROMs was to inform clinical care (58%), and for PREMs was to fulfil private dialysis/hospital provider requirements (25%). The most commonly reported reason for not using PROMs in 24 hospitals was insufficient staff resources (79%). Sixty‐two hospitals (78%) expressed interest in participating in a registry‐based PROMs trial.

Conclusion

Many renal hospitals in Australia and New Zealand collect PROMs and/or PREMs as part of clinical care with use varying by treatment modality. Resources are a key barrier to PROMs use.
Variation in complement factor H affects complement activation in immunoglobulin A vasculitis with nephritis
Authors: Jia Meng , Zhu Li , Zhai Ya‐Ling , Chen Pei , Xu Bo‐Yang , Guo Wei‐Yi , Shi Su‐Fang , Liu Li‐Jun , Lv Ji‐Cheng , Zhang Hong
Published: March 2019

Background

Immunoglobulin A (IgA) vasculitis with nephritis (IgAVN) and IgA nephropathy (IgAN) are widely considered as related diseases. Considerable evidences support the notion of involvement of complement activation in both IgAVN and IgAN. Our previous studies identified a genetic variant in complement factor H (CFH), rs6677604, as an IgAN‐susceptible variant by genome‐wide association study, and further confirmed its linkage to CFHR3‐1Δ and proved its influence on complement activation and thereby on IgAN susceptibility.

Aim

To explore the role of rs6677604 in complement activation of IgAVN.

Methods

In this study, we enrolled 632 patients with IgAVN, 1178 patients with IgAN and 902 healthy controls. The genotype of rs6677604 was measured by TaqMan allele discrimination assays or was extracted from genome‐wide association study data.

Results

The frequency of the rs6677604‐A allele was significantly higher in IgAVN than in IgAN. However, no significant differences were observed between IgAVN and the controls. Higher complement factor H (FH) levels were observed in IgAVN than IgAN, and positive correlation between circulating FH and C3 levels was present in IgAVN. In both IgAVN and IgAN, rs6677604‐A was associated with less intensity of glomerular C3 deposits. In agreement with the higher frequency of rs6677604‐A in IgAVN, the glomerular C3 deposits of patients with IgAVN were less intense than those in IgAN.

Conclusion

Our findings suggest that genetic variation in CFH (rs6677604) is involved in the phenotype of complement activation in both IgAVN and IgAN. Moreover, rs6677604 might contribute to the difference of complement activation intensity between IgAVN and IgAN.
Interlead electrical delays and scar tissue: Response to cardiac resynchronization therapy in patients with ischemic cardiomyopathy
Authors: Tahri Jasmine Borg , Hansen Thomas Fritz , Storkås Hanne Stavø , Lauridsen Trine Kiilerich , Olsen Flemming Javier , Iversen Allan , Lindhardt Tommi Bo , Bruun Niels Eske , Søgaard Peter , Risum Niels
Published: March 2019

Background

The importance of interlead electrical delays (IEDs) in the presence of scar tissue for response to cardiac resynchronization therapy (CRT) in patients with ischemic cardiomyopathy is poorly described.

Methods

Sixty‐eight CRT patients with ischemic cardiomyopathy and left bundle branch block were included. IEDs, the time between sensing of native impulse at the RV lead and LV lead, were measured at implantation and after 8 months. Magnetic resonance imaging was used for assessment of scar tissue. Echocardiographic response was defined as ≥ 15% decrease in left ventricular end‐systolic volume. New York Heart Association (NYHA) class, Minnesota Living with Heart Failure Questionnaire, and 6‐minute walk‐test were used to assess clinical response.

Results

A total of 44 patients (65 %) were responders to CRT. At implantation, IEDs were significantly longer among responders compared to nonresponders (RV‐LV‐IED: 87 ms ± 33 ms vs 65 ms ± 47 ms, P < 0.05), most evident in patients with QRS < 150 ms. Responders had less myocardial scar tissue than nonresponders (1 ± 0.5 vs 1.4 ± 0.6, P = 0.01). However, in the multivariate model including QRS duration and scar tissue, IEDs were independently associated with LV remodeling after CRT: odds ratio 3.99 [95% confidence interval 1.02–15.7] (P = 0.04).

During the course of treatment, no changes were observed in IEDs among echocardiographic responders.

Conclusion

RV‐LV‐IED was an independent marker of response in CRT patients with ischemic cardiomyopathy even in the presence of scar tissue and may be particularly useful in patients with QRS < 150 ms. CRT did not influence this measurement over time.
Inflammatory linear verrucous epidermal nevus treated successfully with crisaborole ointment in a 5‐year‐old boy
Authors: Barney Emily , Prose Neil S. , Ramirez Mary
Published: March 2019

Inflammatory linear verrucous epidermal nevus (ILVEN) is a chronic, a linear, or whorled array of inflammatory, following the lines of Blaschko. Treatment of ILVEN is challenging with numerous therapies of varying degrees of success reported. We present a case of ILVEN in a 5‐year‐old‐boy, treated successfully with crisaborole 2% ointment. This brief report suggests that there may be additional cellular immunologic pathways responsible for the presentation of ILVEN that may be explained by management with crisaborole use.
Depressive symptoms mediate the association between insomnia symptoms and health‐related quality of life and synergistically interact with insomnia symptoms in older adults in nursing homes
Authors: Zhao Xia , Zhang Dan , Wu Menglian , Yang Yang , Xie Hui , Jia Jihui , Li Yuqin , Su Yonggang
Published: March 2019

Aims

The aim of this study was to elucidate whether depressive symptoms mediate the association between insomnia symptoms and health‐related quality of life (HRQOL) and to explore whether insomnia symptoms and depressive symptoms synergistically interact to affect HRQOL among older adults in nursing homes.

Methods

Older adults living in nursing homes (n = 323) completed Athens Insomnia Scale, the 15‐item Geriatric Depression Scale, and the 36‐item Short Form Health Survey. PROCESS for SPSS was used in the mediation model. Logistic regression analysis was conducted to obtain odds ratios (OR) for insomnia symptoms, depressive symptoms, and HRQOL. The relative excess risk due to interaction, the attributable proportion due to interaction, and the synergy index were assessed.

Results

Insomnia symptoms and depressive symptoms were negatively related to HRQOL. Depressive symptoms mediated the relationship between insomnia symptoms and HRQOL. Compared with the older adults without insomnia symptoms or depressive symptoms, those with only depressive symptoms (OR = 8.36, 95% confidence interval (CI): 3.46–20.18) or insomnia symptoms (OR = 2.24, 95%CI: 1.04–4.83) had a lower HRQOL. Also, the co‐presence of insomnia symptoms and depressive symptoms significantly increased the risk of lowering HRQOL (OR = 25.79; 95%CI: 12.72–52.28). The relative excess risk due to interaction, attributable proportion due to interaction, and synergy index were 16.19, 0.63, and 2.88, respectively.

Conclusions

Depressive symptoms may play a mediating role between insomnia symptoms and HRQOL. Comorbid insomnia symptoms and depressive symptoms synergistically interact to affect HRQOL. It is vital to focus on elderly nursing home residents with insomnia symptoms and/or depressive symptoms and to adopt interventions.
Timing of blood pressure medications and intradialytic hypotension
Authors: Wang Katherine M. , Sirich Tammy L. , Chang Tara I.
Published: March 2019

Intradialytic hypotension (IDH) is a prevalent yet serious complication of hemodialysis, associated with decreased quality of life, inadequate dialysis, vascular access thrombosis, global hypoperfusion, and increased cardiovascular and all‐cause mortality. Current guidelines recommend antihypertensive medications be given at night and held the morning of dialysis for affected patients. Despite little evidence to support this recommendation, more than half of patients on dialysis may employ some form of this method. In this article, we will review the available evidence and clinical considerations regarding timing of blood pressure medications and occurrence of IDH, and conclude that witholding BP medications before hemodialysis should not be a routine practice.
A weighting approach to making inference with probabilistically linked data
Authors: Chipperfield James
Published: March 2019

Record linkage is the act of bringing together records from two files that are believed to belong to the same unit (e.g., a person or business). It is a low‐cost way of increasing the set of variables available for analysis. Errors may arise in the linking process if an error‐free unit identifier is not available. Two types of linking errors include an incorrect link (records belonging to two different units are linked) and a missed record (an unlinked record for which a correct link exists). Naively ignoring linkage errors may mean that analysis of the linked file is biased. This paper outlines a “weighting approach” to making correct inference about regression coefficients and population totals in the presence of such linkage errors. This approach is designed for analysts who do not have the expertise or time to use specialist software required by other approaches but who are comfortable using weights in inference. The performance of the estimator is demonstrated in a simulation study.
Image cytometry as an alternative to flow cytometry for the transplant histocompatibility crossmatch assay
Authors: Ramon Daniel S. , Franks Thomas , Jaramillo Andrés , Paradis Benjamin D. , Chan Leo Li‐Ying
Published: March 2019

The lymphocyte crossmatch is currently the only cell‐based compatibility assay performed by histocompatibility laboratories for transplant purposes. While in many transplant programs the complement‐dependent cytotoxicity crossmatch (CDCXM) remains in use, when available, the flow cytometry crossmatch (FCXM) is the method of choice because of its superior sensitivity and specificity. Unfortunately, the maintenance and cost of a flow cytometer is a considerable limitation for small histocompatibility laboratories. Therefore, in this study, we evaluated the use of the Cellometer Vision CBA image cytometer (Nexcelom Bioscience LLC, Lawrence, Massachusetts) as an alternative instrument to perform the crossmatch assay. The 3‐color FCXM protocol was modified into two separate 2‐color panel image cytometry crossmatches (IXMs), one for T cells and one for B cells. After initial serum and cell incubation, a cocktail consisting of PE/Cy5‐conjugated anti‐human CD3 or CD19 and PE‐conjugated anti‐human IgG F(ab′)2was added to the T cell and B cell panels, respectively. The final cell preparation was added to a separate counting chamber. Images were captured using the Cellometer Vision CBA, an image cytometer designed for cell counting, size analysis and fluorescence intensity measurement. Thirty‐nine IXMs were performed and compared with the FCXM. We obtained a concordance sensitivity of 94.1% and 100% and specificity of 100% and 88.9% for T cells and B cells, respectively. The linearity of the system was verified using dilutions of a sample containing known donor‐specific anti‐HLA antibodies (DSA) against the target cells. This feasibility study demonstrates that the FCXM test could be easily adapted to the Cellometer Vision CBA image cytometer without compromising specificity and sensitivity. The low instrumentation cost, minimal maintenance, and simple operation allow for efficient implementation or transition from the FCXM to the IXM method.
Migrant Economies Beyond Metropolitan Cities: A Context‐Sensitive Case Study
Authors: Räuchle Charlotte , Nuissl Henning
Published: March 2019

Research has highly valued the contribution of migrant economies to the development of mainly top‐scale metropolises. Migrant economies are considered a crucial asset when it comes to positioning cities internationally, revitalising neighbourhoods and generally securing the social, economic and political inclusion of migrants. Nevertheless, there is a major research gap in empirical evidence on migrant economies beyond metropolitan cities and the impact of the local context on the development of migrant economies in these localities. In order to tackle this blind spot, this paper examines how the local context fosters or hinders the development of migrant economies in two low‐scale German cities. The paper conceptualises ‘local context’ as comprising economic, political and socio‐cultural factors. In sum, it finds the local conditions less conducive to the development of migrant economies in the cities under scrutiny, for example, because these economies are not an urban policy issue there.
Density of local cadres and regional economic performance: Evidence from China
Authors: Jiang Wei , Wang Danli , Yang Yixin
Published: March 2019

In this study, we investigated the effect of the present‐day density of local cadres on economic performance in Chinese prefecture‐level cities. Adjusting for common control variables, our estimates show that local cadre density has a significantly positive effect on regional economic performance. This result holds when we employ the local cadre density in 1949, when the Chinese Communist Party assumed power, to instrument for the current local cadre density. We also tested the channels through which local cadres play a role in regional economic development. Our empirical results show that a high local cadre density has a significant effect on attracting economic resources, which promotes regional economic performance.
Anterior segment parameters measured in young healthy cats using a rotating Scheimpflug camera
Authors: Verneuil Marc , Marsot Maud , Ruchon Charly
Published: March 2019

Objective

The purpose of this study is to measure parameters of the anterior segment of normal feline eyes using a rotating Scheimpflug camera in young and adult cats.

Procedure

Sixteen domestic short‐haired (DSH) healthy cats (seven castrated males and nine spayed females) with a mean age of 17 months (SD = 3.5) were anesthetized. Cats were considered immature and adults if they were < or ≥12 months of age, respectively. The keratometric values, the anterior chamber depth (ACD), and central corneal thickness (CCT) of the right eye of each animal were measured using a Pentacam Oculus topographer. The repeatability of the measures was assessed by calculating the coefficient of variation of the successive measures in cats (five repetitions per cat). We performed anANOVAto test the effect of age on the parameters measures.

Results

The meanCCTandACDwere 601.97 ± 38 μm and 5.27 ± 0.04 mm, respectively. No significant differences were observed between adult and young cat's measures. The average keratometric value was 39.6 ± 0.3 D. The mean average cylindrical error was 2.48 ± 0.35 D (43.75% “against‐the‐rule” astigmatism and 43.75% “oblique” astigmatism).

Conclusion

The Oculus Pentacam under clinical conditions giveCCTandACDvalues very similar to those reported in previous studies. Corneal astigmatism measures were markedly elevated (>2 D). Further studies with a larger population of cats of various breeds and ages are needed to confirm or refute these results, using a rotating Scheimpflug camera.
Model-Guided Data-Driven Optimization for Automotive Compression Ignition Engine Systems
Authors: Tan Qingyuan , Chen Xiang , Tan Ying , Zheng Ming
Published: March 2019

Essentially, the performance improvement of automotive systems is a multi-objective optimization problem [1–4] due to the challenges in both operation management and control. The interconnected dynamics inside the automotive system normally requires precise tuning and coordination of accessible system inputs. In the past, such optimization problems have been approximately solved through expensive calibration procedures or an off-line local model-based approaches where either a regressive model or a first-principle model is used. The model-based optimization provides the advantage of finding the optimal model parameters to allow the model to be used to predict the real system behavior reasonably [5]. However, other than the model complexities, there are practically two issues facing the integrity of these models: modeling uncertainty due to inaccurate parameter values and/or unmodeled dynamics, and locally effective range around operating points. As a result, the optimum solutions extracted from the model-based approach could be subject to failure of expected performance [6].
On the Biomechanics of Cardiac S-Looping in the Chick: Insights From Modeling and Perturbation Studies
Authors: Ramasubramanian Ashok , Capaldi Xavier , Bradner Sarah A. , Gangi Lianna
Published: March 2019

Cardiac looping is an important embryonic developmental stage where the primitive heart tube (HT) twists into a configuration that more closely resembles the mature heart. Improper looping leads to congenital defects. Using the chick embryo as the experimental model, we study cardiac s-looping wherein the primitive ventricle, which lay superior to the atrium, now assumes its definitive position inferior to it. This process results in a heart loop that is no longer planar with the inflow and outflow tracts now lying in adjacent planes. We investigate the biomechanics of s-looping and use modeling to understand the nonlinear and time-variant morphogenetic shape changes. We developed physical and finite element models and validated the models using perturbation studies. The results from experiments and models show how force actuators such as bending of the embryonic dorsal wall (cervical flexure), rotation around the body axis (embryo torsion), and HT growth interact to produce the heart loop. Using model-based and experimental data, we present an improved hypothesis for early cardiac s-looping.
Portable Device for Measuring Blood Test Hemolyzed Samples Based on Computer Vision and Neural Network
Authors: Lopes Karyn Martinelli , da Silva Flavia Helena , Gil Maldonado Alessandra S. , Santiago Simone Aparecida , Pires Tavani A. , Ferrer Claudia Maria , Mena Sara Josa , Moura Maria Emilia Germani , Domingues Pietro Teruya , Kawakami Lincoln Makoto , de Senzi Zancul Eduardo
Published: March 2019

Hemolysis is a challenging problem and still represents a frequent source of errors in blood test laboratory practice. Due to the broad and heterogeneous bias induced in the measurement of several parameters by hemolysis, inaccurate results may be reported, and the patient may be required to repeat sample collection, delaying diagnosis. Existing automated laboratory devices including hemolysis detection are not suitable for lower volume and smaller sample collection sites. In many situations, hemolysis is still detected by visual inspection of the sample after centrifugation, during the blood test pre-analytical stage. Visual inspection is highly dependent on a qualified workforce, subjective to interpretation discrepancies, and thus difficult to standardize. The paper aims to describe the design and performance of a portable device for measuring hemolyzed samples based on computer vision and neural network. The results indicate that the device provides hemolysis indexes with sufficient accuracy to guide laboratory decision in the blood test pre-analytical stage.
Dynamic Modeling and Projection-Based Reduction Methods for Bladed Disks With Nonlinear Frictional and Intermittent Contact Interfaces
Authors: Mitra Mainak , Epureanu Bogdan I.
Published: March 2019

Turbine bladed disks or blisks, which constitute critical components of most modern turbomachinery, are known for their complex vibratory behavior. The nonlinear dynamics observed in most operational regimes of blisk with contact interfaces are dominated by one of two typical contact behaviors. Frictional contacts are dominated by Coulomb friction forces, while intermittent contacts are characterized by multiple separation events. Other factors such as the dispersion in material or geometric properties across blades, known as mistuning, also affect the dynamics significantly. Presently, probabilistic analysis is the widely accepted design methodology to account for mistuning, which is unknown prior to manufacture. Thus, reduced order modeling of these blisks is essential as high fidelity models are prohibitively expensive for such simulations. This paper provides a technical discussion of dynamic modeling and reviews projection-based techniques used for creation of reduced models of blisks with contacts.
Effects of static stretching duration on muscle stiffness and blood flow in the rectus femoris in adolescents
Authors: Caliskan Emine , Akkoc Orkun , Bayramoglu Zuhal , Gozubuyuk Omer Batin , Kural Doga , Azamat Sena , Adaletli Ibrahim
Published: March 2019

Aims: To compare the effects of 2 and 5 min of passive static stretching (SS) on stiffness and blood flow in the rectus femoris in adolescent athletes using shear wave elastography (SWE) and superb microvascular imaging (SMI).Material and methods: This prospective study included 20 male athletes with median age of 14.5 (12.5–16.5) years. The subjects were divided into two groups based on the SS duration as follows: 2 min (n=10) and 5 min (n=10). At rest and after 2 and 5 min of SS, stiffness and blood flow values were compared in the rectus femoris for each group. Inter-operator reliability was also analysed.Results: There was no significant difference between resting and 2 min of SS in terms of stiffness. The stiffness values decreased significantly from resting to 5 min of SS. The blood flow increased significantly from resting to 2 and 5 min of SS. Inter-operator reliability was moderate to perfect for SWE and SMI measurements (ICC: 0.52–0.83).Conclusions: SWE and SMI can be used to acquire reliable quantitative data about muscle stiffness and blood flow in adolescents. While stiffness parameters significantly decreased from resting after only 5 min, blood flow significantly increased both after 2 and 5 min. For physical rehabilitation protocols, 5 min of SS may be chosen to reduce stiffness. For competitions, 2 min of SS may be sufficient for warm-up exercise because it increases the blood flow optimally. Five min of SS may be preferred for the cool-down exercise to enhance recovery.
Enhancement-mode AlGaN channel high electron mobility transistor enabled by p-AlGaN gate
Authors: Douglas Erica A. , Klein Brianna , Allerman Andrew A. , Baca Albert G. , Fortune Torben , Armstrong Andrew M.
Published: March 2019

This work exhibits the ability to shift the threshold voltage of an Al0.45Ga0.55N/Al0.3Ga0.7N high electron mobility transistor through the implementation of a 100 nm thick p-Al0.3Ga0.7N gate. A maximum threshold voltage of +0.3 V was achieved with a 3 μm gate length. In addition to achieving enhancement-mode operation, this work also shows the capability to obtain high saturated drain current (>50 mA/mm), no gate hysteresis, high ION,MAX/IOFF,MIN ratio of >109, and exceptionally low gate leakage current of 10−6 mA/mm even under high forward bias of Vgs = 8 V.
Lithium ion beams from liquid metal alloy ion sources
Authors: Pilz Wolfgang , Klingner Nico , Bischoff Lothar , Mazarov Paul , Bauerdick Sven
Published: March 2019

In recent years, focused ion beam (FIB) processing has been developed into a well-established and promising technique in nearly all fields of nanotechnology for patterning and prototyping on the μm-scale and below. Liquid metal alloy ion sources (LMAIS) represent a promising alternative to expand the FIB application fields besides all other source concepts. The need of light elements like Li was investigated using various alloys. A promising candidate is a Ga35Bi60Li5 based LMAIS, which is introduced in more detail and which operates stably for more than 1000 μA h. It enables a highly resolved imaging with (4.0 ± 0.6) nm edge resolution (20%–80%) and patterning using Li, Ga, or heavy polyatomic Bi clusters, all coming from one ion source.
Bivariate direction finding using two perpendicular bi-directional (“figure-8”) sensors of (possibly) unequal orders
Authors: Su Da , Wong Kainam Thomas , Wu Yue Ivan
Published: March 2019

A “figure-8” sensor is so labeled because its spatial pattern resembles the character “8” with regard to the sensor's axis. This figure-8 pattern narrows as the sensor's order increases. Using two such figure-8 directional sensors of higher order, oriented perpendicularly to each other—this paper pioneers closed-form signal-processing algorithms to estimate an incident signal's azimuth-elevation bivariate direction-of-arrival. Monte Carlo simulations verify these proposed algorithms' efficacy and statistical closeness to the corresponding Cramér-Rao bounds.
Carbohydrate-dependent B cell activation by fucose-binding bacterial lectins
Authors: Wilhelm Isabel , Levit-Zerdoun Ella , Jakob Johanna , Villringer Sarah , Frensch Marco , Übelhart Rudolf , Landi Alessia , Müller Peter , Imberty Anne , Thuenauer Roland , Claudinon Julie , Jumaa Hassan , Reth Michael , Eibel Hermann , Hobeika Elias , Römer Winfried
Published: March 2019

Fucose-specific bacterial lectins bind to and stimulate mouse B cells, inducing an immune response in vivo.
Desynchronization of the molecular clock contributes to the heterogeneity of the inflammatory response
Authors: Allen Nancy C. , Philip Naomi H. , Hui Lucy , Zhou Xu , Franklin Ruth A. , Kong Yong , Medzhitov Ruslan
Published: March 2019

Differences in the phase of the circadian clock contribute to heterogeneity in the inflammatory response of macrophages.
Identification of Burkholderia pseudomallei by Use of the Vitek Mass Spectrometer
Authors: Gassiep I. , Armstrong M. , Norton R. E.
Published: March 2019

Burkholderia pseudomallei
is the causative agent of melioidosis. This condition most often presents as pneumonia and bacteremia, with mortality rates of 9% to 70%.
Adenovirus 5 E1A Interacts with E4orf3 To Regulate Viral Chromatin Organization
Authors: Soriano Andrea Michelle , Crisostomo Leandro , Mendez Megan , Graves Drayson , Frost Jasmine Rae , Olanubi Oladunni , Whyte Peter F. , Hearing Patrick , Pelka Peter
Published: March 2019

To successfully replicate, human adenovirus needs to carry out a rapid yet ordered transcriptional program that executes and drives viral replication. Early in infection, the viral E1A proteins are the key activators and regulators of viral transcription. Here we report, for the first time, that E1A works together with E4orf3 to perfect the viral transcriptional program and identify a novel mechanism by which the virus can adjust viral gene expression by modifying its genome’s nucleosomal organization via cooperation between E1A and E4orf3.
Evidence for both Intermittent and Persistent Compartmentalization of HIV-1 in the Female Genital Tract
Authors: Mabvakure Batsirai M. , Lambson Bronwen E. , Ramdayal Kavisha , Masson Lindi , Kitchin Dale , Allam Mushal , Abdool Karim Salim , Williamson Carolyn , Passmore Jo-Ann , Martin Darren P. , Scheepers Cathrine , Moore Penny L. , Harkins Gordon W. , Morris Lynn
Published: March 2019

Most HIV-1 infections in sub-Saharan Africa are acquired heterosexually through the genital mucosa. Understanding the properties of viruses replicating in the female genital tract, and whether these properties differ from those of more commonly studied viruses replicating in the blood, is therefore important. Using longitudinal CVL and plasma-derived sequences from four HIV-1 subtype C-infected women, we found fewer viral migrations from the genital tract to plasma than in the opposite direction, suggesting a mucosal sieve effect from the genital tract to the blood compartment. Evidence for both persistent and intermittent compartmentalization between the genital tract and plasma viruses during chronic infection was detected in two of four individuals, perhaps explaining previously conflicting findings. In cases where compartmentalization occurred, comparison of CVL- and plasma-derived HIV sequences indicated that distinct features of viral populations in the CVL may affect the efficacy of microbicides and vaccines designed to provide mucosal immunity.
Complete Genome Sequences of Two Porcine Deltacoronavirus Strains from Henan Province, China
Authors: Liang Qingqing , Li Bingxiao , Zhang Honglei , Hu Hui
Published: March 2019

In 2016 and 2018, two porcine deltacoronavirus (PDCoV) strains, CH-01 and HNZK-02, were identified from fecal samples of piglets with diarrhea in Henan Province, China. The full-length genomic sequence analysis indicated that these two strains had high nucleotide identities with the other Chinese PDCoV epidemic strains.
Complete Genome Sequence of
Aeromonas
Phage ZPAH7 with Halo Zones, Isolated in China
Authors: Islam Mohammad Sharifull , Raz Assaf , Liu Yang , Elbassiony Khalid Ragaei Abdraboh , Dong Xingxing , Zhou Peng , Zhou Yang , Li Jinquan
Published: March 2019

Phage ZPAH7, isolated from a sediment sample from a fish farm, is a novel lytic phage belonging to the
Podoviridae
family. It produces large plaques (3.5 ± 0.2 mm) with halo zones (10.5 ± 0.5 mm), suggesting it has the ability to depolymerize exopolysaccharides and biofilms.
Draft Genome Sequence of a Novel Lactate-Fermenting Bacterial Strain of the Family
Sporomusaceae
within the Class
Negativicutes
Authors: Aoyagi Tomo , Kashiwabara Yuta , Kurasawa Hibiki , Amachi Seigo , Nakajima Nobuyoshi , Hori Tomoyuki , Yamamura Shigeki
Published: March 2019

Here, we report a draft genome sequence of the
Sporomusaceae
bacterial strain FL31, a novel lactate-fermenting bacterium of the family
Sporomusaceae
within the class
Negativicutes
. This genome furthers our understanding of the physiological functions of this taxonomic group in natural environments.
Preschool respiratory hospital admissions following infant bronchiolitis: a birth cohort study
Authors: Skirrow Helen , Wincott Thomas , Cecil Elizabeth , Bottle Alex , Costelloe Ceire , Saxena Sonia
Published: March 2019

Background

Bronchiolitis causes significant infant morbidity worldwide from hospital admissions. However, studies quantifying the subsequent respiratory burden in children under 5 years are lacking.

Objective

To estimate the risk of subsequent respiratory hospital admissions in children under 5 years in England following bronchiolitis admission in infancy.

Design

Retrospective population-based birth cohort study.

Setting

Public hospitals in England.

Patients

We constructed a birth cohort of 613 377 infants born between 1 April 2007 and 31 March 2008, followed up until aged 5 years by linking Hospital Episode Statistics admissions data.

Methods

We compared the risk of respiratory hospital admission due to asthma, wheezing and lower and upper respiratory tract infections (LRTI and URTI) in infants who had been admitted for bronchiolitis with those who had not, using Cox proportional hazard regression. We adjusted hazard ratios (HR) for known respiratory illness risk factors including living in deprived households, being born preterm or with a comorbid condition.

Results

We identified 16 288/613 377 infants (2.7%) with at least one admission for bronchiolitis. Of these, 21.7% had a further respiratory hospital admission by age 5 years compared with 8% without a previous bronchiolitis admission (HR (adjusted) 2.82, 95% CI 2.72 to 2.92). The association was greatest for asthma (HR (adjusted) 4.35, 95% CI 4.00 to 4.73) and wheezing admissions (HR (adjusted) 5.02, 95% CI 4.64 to 5.44), but were also significant for URTI and LRTI admissions.

Conclusions

Hospital admission for bronchiolitis in infancy is associated with a threefold to fivefold risk of subsequent respiratory hospital admissions from asthma, wheezing and respiratory infections. One in five infants with bronchiolitis hospital admissions will have a subsequent respiratory hospital admission by age 5 years.
Unusual cause of severe neonatal hyperbilirubinaemia: a twin case
Authors: Khandelwal Shikha , Pandita Aakash , Gupta Girish , Singh Anita
Published: March 2019

We present twins born to the 31-year-old, multigravida mother, who were referred to our centre at 90 hours of life for severe hyperbilirubinaemia. Twin 1 had already received two double volume exchange transfusions at 55 and 83 hours of life, in view of the persistent rise in bilirubin despite receiving phototherapy. Twin 2 had received phototherapy and 1 packed red blood cell transfusion in view of the fall in haematocrit. Mother’s blood group was B positive and that of both twins was O positive. Both the twins were started on intensive phototherapy and their serum bilirubin and haematocrit were evaluated. On investigation, a minor blood incompatibility was found. Double volume exchange transfusion was done for twin 2 at 100 hours of life in view of the rapid rise in serum bilirubin. Both the babies were monitored for their serum bilirubin and treated for sepsis and discharged after 15 days.
Leptomeningeal leukaemia misdiagnosed as tubercular meningitis
Authors: Elavarasi Arunmozhimaran , Dash Deepa , Warrier Anand R , Jain Deepali
Published: March 2019

Chronic meningitis is a common syndrome with multiple aetiological causes. It can be associated with visionproblems as well as multifocal involvement of the central nervous system. Often it presents with constitutional symptoms as well. The intervention commonly practised in a tropical country like India is starting antitubercular therapy with corticosteroids. This practice though may be correct in a majority of situations, may lead to diagnostic delay and may be fatal.
Swept source optical coherence tomography angiography in patients treated with hydroxychloroquine: correlation with morphological and functional tests
Authors: Forte Raimondo , Haulani Hanan , Dyrda Agnieszka , Jürgens Ignasi
Published: March 2019

Purpose

To evaluate swept source optical coherence tomography angiography (SS-OCTA) in patients treated with hydroxychloroquine (HCQ) for more than 5 years and to compare results with the tests currently recommended for screening of HCQ retinopathy.

Methods

In this controlled pilot study, consecutive patients treated with HCQ for more than 5 years underwent SS-OCTA, SS-OCT B-scan and en-face C-scan, fundus autofluorescence (FAF), 10–2 automated visual field (AVF) testing and multifocal electroretinography (mfERG). On SS-OCTA, evaluation of the retinal superficial capillary plexus, middle capillary plexus, and deep capillary plexus (DCP) and the choriocapillaris (CC) was obtained.

Results

We included 10 patients under HCQ treatment (20 eyes, mean age 38.91±11.73 years) and 18 healthy control patients (36 eyes, mean age 38.87±8.6 years). Mean duration of HCQ treatment was 10.0±3.25 (5–15) years and HCQ cumulative dose/body weight was 15.86±5.56 g/kg. The HCQ group showed a reduction of the vessel density in the 1 mm central, in the nasal and temporal subfields of DCP and in the 1 mm central subfield of CC, an increased foveal avascular zone in the three capillary plexuses, a greater frequency of CC flow voids and a reduced foveal choroidal thickness (p<0.05). Best-corrected visual acuity (BCVA), mfERG, SS-OCT B-scan and C-scan, AVF and FAF were normal in 20/20 eyes (100%).

Conclusions

In patients treated with HCQ for more than 5 years, choroidal thinning and flow abnormalities at SS-OCTA in the retinal capillary plexuses and CC may be observed even if BCVA, FAF, mfERG, AVF and SS-OCT are normal.
Association between physical activity and sedentary behaviour on carotid atherosclerotic plaques: an epidemiological and histological study in 90 asymptomatic patients
Authors: Mury Pauline , Mura Mathilde , Della-Schiava Nellie , Chanon Stéphanie , Vieille-Marchiset Aurélie , Nicaise Virginie , Chirico Erica N , Collet-Benzaquen Diane , Lermusiaux Patrick , Connes Philippe , Millon Antoine , Pialoux Vincent
Published: March 2019

Objective

Carotid atherosclerotic plaques are a source of emboli for stroke. ‘Unstable’ carotid atherosclerotic plaques may have intraplaque haemorrhages, neovessels, prevalent macrophages, excessive calcium deposits, a large lipid core and a thin fibrous cap. Regular physical activity (PA) may lower the risk of plaques becoming unstable. We evaluated the association of both PA and sedentary behaviour (SB) with carotid plaque histopathology.

Methods

90 asymptomatic patients who were undergoing carotid endarterectomy for carotid artery narrowing identified on ultrasound reported their PA and SB by questionnaires. We calculated PA intensity in MET (metabolic equivalent of task)-min/week. For analysis, the population was divided into tertiles according to PA (T1PA: the less PA patients; T2PA: the intermediate PA patients; T3PA: the most physically active patients) (T1PA<T2PA<T3PA) and SB (T1SB: the less sedentary behaviour patients; T2SB: the intermediate sedentary behaviour patients; T3SB: the most sedentary behaviour patients) (T1SB<T2SB<T3SB). PA was categorised as one of four PA intensities (600, 900, 1600 and 3000 MET-min/week). We obtained the carotid artery plaque at surgery and performed histological analysis of intraplaque haemorrhages (present/absent), neovessels, macrophages, lipid core, calcium deposits and the fibrous cap.

Results

Intraplaque haemorrhage was less frequent in the most physically active tertile (T3PA, 48%) versus T1PA (74%) and in the least sedentary tertile T1SB (50%) versus T3SB (71%). The intraplaque haemorrhage was less frequent in those who exercised more than 900 MET-min/week (59% vs 47% for >900 and <900 MET-min/week, respectively). All the other features that associate with plaque instability (eg, neovessels, macrophages, etc) did not differ by level of PA or SB.

Conclusion

In this cross-sectional study of asymptomatic patients who underwent endarterectomy (i) higher reported PA, (ii) intensity of PA and (iii) lower reported SB were associated with lower prevalence of intraplaque haemorrhage. This could be a mechanism whereby PA protects against cerebrovascular disease (stroke) and death.
Enhanced Recovery After Surgery implementation in practice: an ethnographic study of services for hip and knee replacement
Authors: Drew Sarah , Judge Andrew , Cohen Rachel , Fitzpatrick Raymond , Barker Karen , Gooberman-Hill Rachael
Published: March 2019

Objectives

Enhanced Recovery After Surgery (ERAS) programmes aim to improve care quality by optimising components of the care pathway and programmes for hip and knee replacement exist across the UK. However, there is variation in delivery and outcomes. This study aims to understand processes that influence implementation using the Consolidated Framework for Implementation Research (CFIR) to inform the design and delivery of services.

Design

An ethnographic study using observations and interviews with staff involved in service delivery. Data were analysed using a thematic analysis, followed by an abductive approach whereby themes were mapped onto the 31 constructs and 5 domains of the CFIR.

Setting

Four hospital sites in the UK delivering ERAS services for hip and knee replacement.

Participants

38 staff participated including orthopaedic surgeons, nurses and physiotherapists.

Results

Results showed 17 CFIR constructs influenced implementation in all five domains. Within ‘intervention characteristics’, participants thought ERAS afforded advantages over alternative solutions and guidance was adaptable. In the ‘outer setting’, it was felt ERAS should be tailored to patients and education used to empower them in their recovery. However, there were concerns about postdischarge support and tensions with primary care. Within the ‘inner setting’, effective multidisciplinary collaboration was achieved by transferring knowledge about patients along the care pathway and multidisciplinary working practices. ERAS was viewed as a ‘message’ that had to be communicated consistently. There were concerns about resources and high volumes of patients. Staff access to information varied. At the domain ‘characteristics of individuals’, knowledge and beliefs impacted on implementation. Within ‘process’, involving opinion leaders in development and ‘champions’ who acted as a central point of contact, helped to engage staff. Formal and informal feedback helped to develop services.

Conclusions

Findings demonstrate successful implementation involves empowering patients to work towards recovery, providing postdischarge support and promoting successful multidisciplinary team working.
Voluntary home and car smoke-free rules in Japan: a cross-sectional study in 2015
Authors: Shojima Kensaku , Tabuchi Takahiro
Published: March 2019

Objectives

Recently, the Tokyo Metropolitan Assembly passed an ordinance prohibiting smoking in private homes and cars if children are present. However, no previous study has investigated existing, voluntary home and car smoke-free rules in Japan. Therefore, we examined prevalence and determinants of comprehensive home and car smoke-free rules.

Design

A cross-sectional study.

Setting

Internet survey data with adjustments using inverse probability weighting for ‘being a respondent in an internet survey’.

Participants

5600 respondents aged 15–69 years in 2015 were analysed to estimate weighted percentages and prevalence ratios (PRs) with 95% CIs of having comprehensive home and car smoke-free rules.

Main outcome measures

Respondents who answered ‘smoking is never allowed’ in their home and car were defined as having home and car smoke-free rules.

Results

Overall, 47.0% (95% CI=45.8% to 48.3%) of respondents implemented comprehensive home and car smoke-free rules. People who agreed with ‘smoking relieves stress’ were less likely to have comprehensive smoke-free rules (PR=0.76, 0.71 to 0.82), especially among ever-users of electronic nicotine delivery systems (PR=0.49, 0.30 to 0.81). Higher education was significantly associated with higher PR for comprehensive smoke-free rules (PR=1.30, 1.19 to 1.41). Living with children was significantly associated with higher PR for smoke-free rules among current smokers than not living with children (PR=2.91, 1.99 to 4.27).

Conclusions

In Japan, about 50% of respondents had voluntary smoke-free rules in the home and car. Information on current voluntary smoke-free rules will be useful as baseline information on home and car smoke-free status before enforcement of the 2018 Tokyo home and car smoke-free legislation.
A transformative translational change programme to introduce genomics into healthcare: a complexity and implementation science study protocol
Authors: Taylor Natalie , Best Stephanie , Martyn Melissa , Long Janet C , North Kathryn N , Braithwaite Jeffrey , Gaff Clara
Published: March 2019

Introduction

Translating scientific advances in genomic medicine into evidence-based clinical practice is challenging. Studying the natural translation of genomics into ‘early-adopting’ health system sectors is essential. We will (a) examine 29 health systems (Australian and Melbourne Genomics Health Alliance flagships) integrating genomics into practice and (b) combine this learning to co-design and test an evidence-based generalisable toolkit for translating genomics into healthcare.

Methods and analysis

Twenty-nine flagships integrating genomics into clinical settings are studied as complex adaptive systems to understand emergent and self-organising behaviours among inter-related actors and processes. The Effectiveness–Implementation Hybrid approach is applied to gather information on the delivery and potential for real-world implementation. Stages ‘1’ and ‘2a’ (representing hybrid model 1) are the focus of this protocol. The Translation Science to Population Impact (TSci Impact) framework is used to study policy decisions and service provision, and the Theoretical Domains Framework (TDF) is used to understand individual level behavioural change; both frameworks are applied across stages 1 and 2a. Stage 1 synthesises interview data from 32 participants involved in developing the genomics clinical practice systems and approaches across five ‘demonstration-phase’ (early adopter) flagships. In stage 2a, stakeholders are providing quantitative and qualitative data on process mapping, clinical audits, uptake and sustainability (TSci Impact), and psychosocial and environmental determinants of change (TDF). Findings will be synthesised before codesigning an intervention toolkit to facilitate implementation of genomic testing. Study methods to simultaneously test the comparative effectiveness of genomic testing and the implementation toolkit (stage 2b), and the refined implementation toolkit while simply observing the genomics intervention (stage 3) are summarised.

Ethics and dissemination

Ethical approval has been granted. The results will be disseminated in academic forums and used to refine interventions to translate genomics evidence into healthcare. Non-traditional academic dissemination methods (eg, change in guidelines or government policy) will also be employed.
Cohort profile: the Prospective Research In Stress-Related Military Operations (PRISMO) study in the Dutch Armed Forces
Authors: van der Wal Sija J , Gorter Rosalie , Reijnen Alieke , Geuze Elbert , Vermetten Eric
Published: March 2019

Purpose

The Prospective Research in Stress-Related Military Operations (PRISMO) study was initiated to gain a better understanding of the long-term impact of military deployment on mental health, and to map the different biological and psychological factors that contribute to the development of stress-related mental health symptoms.

Participants

The PRISMO cohort consists of a convenience sample of Dutch military personnel deployed to Afghanistan between 2005 and 2008. Baseline data collection resulted in the recruitment of 1032 military men and women. Combat troops as well as non-combat support troops were recruited to increase the representativeness of the sample to the population as a whole.

Findings to date

The prevalence of various mental health symptoms increases after deployment in PRISMO cohort members, but symptom progression over time appears to be specific for various mental health symptoms. For post-traumatic stress disorder, we found a short-term symptom increase within 6 months after deployment (8.2%), and a long-term symptom increase at 5 years after deployment (12.9%). Several biological vulnerability factors associated with the development of stress-related conditions after deployment were identified, including predeployment glucocorticoid receptor sensitivity and predeployment testosterone level. Thus far, 34 publications have resulted from the cohort.

Future plans

Various analyses are planned that will include the prevalence of mental health symptoms at 10 years postdeployment, as well as trajectory analyses that capture the longitudinal development of symptoms. Furthermore, we will use a machine learning approach to develop predictive and network models for several mental health symptoms, incorporating biological, psychological and social factors.