bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of knee pain, radiographic osteoarthritis and arthroplasty in retired professional footballers compared with men in the general population: a cross-sectional study
Authors: Fernandes Gwen Sascha , Parekh Sanjay Mukund , Moses Jonathan , Fuller Colin , Scammell Brigitte , Batt Mark Edward , Zhang Weiya , Doherty Michael
Published: November 2017

Objectives

To determine the prevalence of knee pain, radiographic knee osteoarthritis (RKOA), total knee replacement (TKR) and associated risk factors in male ex-professional footballers compared with men in the general population (comparison group).

Methods

1207 male ex-footballers and 4085 men in the general population in the UK were assessed by postal questionnaire. Current knee pain was defined as pain in or around the knees on most days of the previous month. Presence and severity of RKOA were assessed on standardised radiographs using the Nottingham Line Drawing Atlas (NLDA) in a subsample of 470 ex-footballers and 491 men in the comparison group. The adjusted risk ratio (aRR) and adjusted risk difference (aRD) with 95% CI in ex-footballers compared with the general population were calculated using the marginal model in Stata.

Results

Ex-footballers were more likely than the comparison group to have current knee pain (aRR 1.91, 95% CI 1.77 to 2.06), RKOA (aRR 2.21, 95% CI 1.92 to 2.54) and TKR (aRR 3.61, 95% CI 2.90 to 4.50). Ex-footballers were also more likely to present with chondrocalcinosis (aRR 3.41, 95% CI 2.44 to 4.77). Prevalence of knee pain and RKOA were higher in ex-footballers at all ages. However, even after adjustment for significant knee injury and other risk factors, there was more than a doubling of risk of these outcomes in footballers.

Conclusions

The prevalence of all knee osteoarthritis outcomes (knee pain, RKOA and TKR) were two to three times higher in male ex-footballers compared with men in the general population group. Knee injury is the main attributable risk factor. Even after adjustment for recognised risk factors, knee osteoarthritis appear to be an occupational hazard of professional football.
Examining the effects of enhanced provider–patient communication on postoperative tonsillectomy pain: protocol of a randomised controlled trial performed by nurses in daily clinical care
Authors: van Vliet Liesbeth M , van Dulmen Sandra , Thiel Bram , van Deelen Gerard W , Immerzeel Stephanie , Godfried Marc B , Bensing Jozien M
Published: November 2017

Introduction

Placebo effects (true biopsychological effects not attributable to the active ingredients of medical technical interventions) can be attributed to several mechanisms, such as expectancy manipulation and empathy manipulation elicited by a provider’s communication. So far, effects have primarily been shown in laboratory settings. The aim of this study is to determine the separate and combined effects of expectancy manipulation and empathy manipulation during preoperative and postoperative tonsillectomy analgesia care on clinical adult patients’ outcomes.

Methods and analysis

Using a two-by-two randomised controlled trial, 128 adult tonsillectomy patients will be randomly assigned to one out of four conditions differing in the level of expectancy manipulation (standard vs enhanced) and empathy manipulation (standard vs enhanced). Day care ward nurses are trained to deliver the intervention, while patients are treated via the standard analgesia protocol and hospital routines. The primary outcome, perceived pain, is measured via hospital routine by a Numeric Rating Scale, and additional prehospitalisation, perihospitalisation and posthospitalisation questionnaires are completed (until day 3, ie, 2 days after the operation). The manipulation is checked using audio recordings of nurse–patient interactions.

Ethics and dissemination

Although communication is manipulated, the manipulations do not cross norms or values of acceptable behaviour. Standard medical care is provided. The ethical committee of the UMC Utrecht and the local OLVG hospital committee approved the study. Results will be published via (inter)national peer-reviewed journals and a lay publication.

Trial registration number

NTR5994; Pre-results.
Progression of disease preceding lower extremity amputation in Denmark: a longitudinal registry study of diagnoses, use of medication and healthcare services 14 years prior to amputation
Authors: Jensen Pia Søe , Petersen Janne , Kirketerp-Møller Klaus , Poulsen Ingrid , Andersen Ove
Published: November 2017

Objectives

Patients with non-traumatic lower extremity amputation are characterised by high age, multi-morbidity and polypharmacy and long-term complications of atherosclerosis and diabetes. To ensure early identification of patients at risk of amputation, we need to gain knowledge about the progression of diseases related to lower extremity amputations during the years preceding the amputation.

Design

A retrospective population-based national registry study.

Setting

The study includes data on demographics, diagnoses, surgery, medications and healthcare services from five national registries. Data were retrieved from 14 years before until 1 year after the amputation. Descriptive statistics were used to describe the progression of diseases and use of medication and healthcare services.

Participants

An unselected cohort of patients (≥50 years; n=2883) subjected to a primary non-traumatic lower extremity amputation in 2010 or 2011 in Denmark.

Results

The prevalence of atherosclerosis, hypertension and diabetes was 70%, 53% and 49%, respectively. Among patients with atherosclerosis, 42% had not received cholesterol-lowering treatment even though 87% had visited their general practitioner within the last year prior to amputation. Further, 16% were diagnosed with diabetes at the time of the amputation. The prevalence of cardiovascular diseases increased from 22% to 70%, atherosclerosis from 5% to 53% and diabetes from 17% to 35% over the 14 years preceding major amputation. Of all patients, 64% had been in contact with the hospital or outpatient clinics within the last 3 years, and 29% received a prescription of opioids 3 years prior to the amputation.

Conclusion

Among patients with non-traumatic lower extremity amputation, one-third live with undiagnosed and untreated atherosclerosis and one-sixth suffer from undiagnosed diabetes despite continuous contacts to general practitioner and the hospital. This study emphasises a need for enhanced focus, among both hospital clinicians and general practitioners, on the early identification of atherosclerosis and diabetes.
Preschool children’s context-specific sedentary behaviours and parental socioeconomic status in Finland: a cross-sectional study
Authors: Määttä Suvi , Konttinen Hanna , Haukkala Ari , Erkkola Maijaliisa , Roos Eva
Published: November 2017

Objectives

This study examined the associations of parental socioeconomic status (SES) with preschoolers’ objectively measured sedentary time (SED) over the course of a week and with parent-reported children’s screen and reading times at home as indicators of sedentary behaviours (SB).

Design

Cross-sectional.

Setting

In years 2015 and 2016 in Finland.

Participants

864 children, aged 3–6 years, with their parents.

Outcome measures

Children’s accelerometer data were transformed into average SED minutes per hour in different contexts (preschool, home during preschool days, weekend and total). Parent-reported children’s screen and reading times were expressed as average daily minutes. The SES indicators (maternal and paternal education and relative household income) were grouped into three categories. Linear or logistic regression analyses were used, with municipality, season, and children’s gender and age as covariates. CIs were adjusted for clustering at the preschool group level.

Results

Children with low maternal (β=17.21, 95% CI: 8.71 to 25.71) and paternal (β=10.54, 95% CI: 0.77 to 20.30) education had more overall screen time at home than their more advantaged counterparts. SES differences in overall screen time were mostly explained by TV viewing. Children with low as opposed to high maternal education (β=−2.66, 95% CI: −4.95 to –0.38) had less reading time at home. Children whose fathers were on the middle (β=−1.15, 95% CI: −2.01 to –0.29) educational level had less weekend SED than those with high paternal education. Otherwise, parental SES was not related to objectively measured SED.

Conclusions

The results of this study highlight the fact that the associations between parental SES and preschoolers’ SB are dependent on the indicators of SES and SBs, and vary between different contexts. Generally, parental SES was not associated with SED, whereas some SES differences existed in screen time and reading time at home. Interventions aiming to diminish SES differences in children’s SB should focus on home hours.

Trial registration number

ISRCTN57165350.
Retrospective interrupted time series examining hypertension and diabetes medicines usage following changes in patient cost sharing in the ‘Farmácia Popular’ programme in Brazil
Authors: Emmerick Isabel Cristina Martins , Campos Monica Rodrigues , Luiza Vera Lucia , Chaves Luisa Arueira , Bertoldi Andrea Dâmaso , Ross-Degnan Dennis
Published: November 2017

Objectives

‘Farmácia Popular’ (FP) programme was launched in 2004, expanded in 2006 and changed the cost sharing for oral hypoglycaemic (OH) and antihypertensive (AH) medicines in 2009 and in 2011. This paper describes patterns of usage and continuity of coverage for OH and AH medicines following changes in patient cost sharing in the FP.

Study design

Interrupted time series study using retrospective administrative data.

Methods

Monthly programme participation (PP) and proportion of days covered (PDC) were the two outcome measures. The open cohort included all patients with two or more dispensings for a given study medicine in 2008–2012. The interventions were an increase in patient cost sharing in 2009 and zero patient cost sharing for key medicines in 2011.

Results

A total of 3.6 and 9.5 million patients receiving treatment for diabetes and hypertension, respectively, qualified for the study. Before the interventions, PP was growing by 7.3% per month; median PDC varied by medicine from 50% to 75%. After patient cost sharing increased in 2009, PP reduced by 56.5% and PDC decreased for most medicines (median 60.3%). After the 2011 free medicine programme, PP surged by 121 000 new dispensings per month and PDC increased for all covered medicines (80.7%).

Conclusion

Cost sharing was found to be a barrier to continuity of treatment in Brazil’s private sector FP programme. Making essential medicines free to patients appear to increase participation and continuity of treatment to clinically beneficial levels (PDC >80%).
Do digital innovations for HIV and sexually transmitted infections work? Results from a systematic review (1996-2017)
Authors: Daher Jana , Vijh Rohit , Linthwaite Blake , Dave Sailly , Kim John , Dheda Keertan , Peter Trevor , Pai Nitika Pant
Published: November 2017

Objective

Digital innovations with internet/mobile phones offer a potential cost-saving solution for overburdened health systems with high service delivery costs to improve efficiency of HIV/STI (sexually transmitted infections) control initiatives. However, their overall evidence has not yet been appraised. We evaluated the feasibility and impact of all digital innovations for all HIV/STIs.

Design

Systematic review.

Setting/participants

All settings/all participants.

Intervention

We classified digital innovations into (1) mobile health-based (mHealth: SMS (short message service)/phone calls), (2) internet-based mobile and/or electronic health (mHealth/eHealth: social media, avatar-guided computer programs, websites, mobile applications, streamed soap opera videos) and (3) combined innovations (included both SMS/phone calls and internet-based mHealth/eHealth).

Primary and secondary outcome measures

Feasibility, acceptability, impact.

Methods

We searched databases MEDLINE via PubMed, Embase, Cochrane CENTRAL and Web of Science, abstracted data, explored heterogeneity, performed a random effects subgroup analysis.

Results

We reviewed 99 studies, 63 (64%) were from America/Europe, 36 (36%) from Africa/Asia; 79% (79/99) were clinical trials; 84% (83/99) evaluated impact. Of innovations, mHealth based: 70% (69/99); internet based: 21% (21/99); combined: 9% (9/99).

All digital innovations were highly accepted (26/31; 84%), and feasible (20/31; 65%). Regarding impacted measures, mHealth-based innovations (SMS) significantly improved antiretroviral therapy (ART) adherence (pooled OR=2.15(95%CI: 1.18 to 3.91)) and clinic attendance rates (pooled OR=1.76(95%CI: 1.28, 2.42)); internet-based innovations improved clinic attendance (6/6), ART adherence (4/4), self-care (1/1), while reducing risk (5/5); combined innovations increased clinic attendance, ART adherence, partner notifications and self-care. Confounding (68%) and selection bias (66%) were observed in observational studies and attrition bias in 31% of clinical trials.

Conclusion

Digital innovations were acceptable, feasible and generated impact. A trend towards the use of internet-based and combined (internet and mobile) innovations was noted. Large scale-up studies of high quality, with new integrated impact metrics, and cost-effectiveness are needed. Findings will appeal to all stakeholders in the HIV/STI global initiatives space.
Mental health of South Asian youth in Peel Region, Toronto, Canada: a qualitative study of determinants, coping strategies and service access
Authors: Islam Farah , Multani Amanpreet , Hynie Michaela , Shakya Yogendra , McKenzie Kwame
Published: November 2017

Objectives

This qualitative study set out to understand the mental health challenges and service access barriers experienced by South Asian youth populations in the Peel Region of Toronto, Canada.

Setting

In-depth semistructured interviews were carried out with South Asian youth living in Peel Region (Mississauga, Brampton and Caledon), a suburb of Toronto, Canada, home to over 50% of Ontario’s South Asian population.

Participants

South Asian youth (n=10) engaged in thoughtful, candid dialogue about their mental health and service access barriers.

Primary and secondary outcome measures

Qualitative interview themes related to mental health stressors and mental health service access barriers experienced by youth living in Peel Region were assessed using thematic analysis.

Results

South Asian youth face many mental health stressors, from intergenerational and cultural conflict, academic pressure, relationship stress, financial stress and family difficulties. These stressors can contribute to mental health challenges, such as depression and anxiety and drug use, with marijuana, alcohol and cigarettes cited as the most popular substances. South Asian youth were only able to identify about a third (36%) of the mental health resources presented to them and did not feel well informed about mental health resources available in their neighbourhood.

Conclusions

They offered recommendations for improved youth support directed at parents, education system, South Asian community and mental health system. Institutions and bodies at all levels of the society have a role to play in ensuring the mental health of South Asian youth.
Establishing an anaesthetist-delivered propofol sedation service for advanced endoscopic procedures: implementing the RCA/BSG guidelines
Authors: Smith Ian , Durkin Damien , Lau Kaw Wai , Hebbar Srisha
Published: November 2017

Background

Following recommendations from the Royal College of Anaesthetists and the British Society of Gastroenterology, we report our results of propofol sedation for complex endoscopic procedures delivered by a single consultant anaesthetist over a 5-year period.

Methods

A weekly session was provided in the endoscopy department for procedures that were complex or could previously not be completed successfully. Deep sedation was provided by intermittent propofol bolus doses, supplemented with fentanyl where necessary, titrated to clinical effect. Patients were usually in semiprone or lateral positions and spontaneously breathed air supplemented with nasal oxygen. Service evaluation included patient recall, endoscopist satisfaction with conditions, procedural success and airway-related adverse outcomes.

Results

We completed 1000 procedures, 42.5% of which were endoscopic retrograde cholangiopancreatography, with the remainder comprising a diverse range of endoscopic procedures of 3–156 min duration. Procedural conditions were excellent in 79% of cases, 261 procedures were completed which had been previously abandoned, 246 patients (24.6%) had a better experience than previously and none recalled any part of their procedure. Three patients required transient bag and mask ventilation, and nasal airways were used in 12 patients, but none required tracheal intubation or vasopressor support.

Conclusions

These guidelines facilitated a propofol sedation service with considerable benefits for patients and endoscopists. Provision of deep propofol sedation by an anaesthetist, in patients with an unsecured airway, appears practical, effective and efficient. Small adjustments to the airway were fairly common, but the incidence of adverse events and requirement for airway instrumentation was low.
A 59-year-old woman with visible precordial pulsations
Authors: Moss Alastair J , Pessotto Renzo , Flapan Andrew D
Published: November 2017

Clinical introduction

A retired 59-year-old woman presented to the cardiology clinic concerned with cardiac pulsations that were visible on her chest wall. These were not associated with dyspnoea, syncope or chest discomfort.

Of note, 8 years previously, she complained of recurrent nocturnal diaphoresis and 5 kg weight loss. Blood sampling at that time revealed a microcytic anaemia, reactive thrombocytosis and raised inflammatory markers (erythrocyte sedimentation rate 99 mm/hour, C-reactive protein 161 mg/L). Following an episode of transient diplopia, ophthalmoscopy demonstrated a cotton wool spot in the left inferotemporal retinal arcade. She commenced a 2-year tapering course of 1 mg/kg prednisolone.

On examination, she had a lean physique with a supine blood pressure of 162/60 mm Hg and palpable Corrigan’s pulse. She had a prominent apical pulsation and a loud early diastolic murmur was present at the left sternal edge radiating to the apex. Echocardiography showed severe central aortic regurgitation and a dilated aortic root (see online supplementary figure 1). Cardiac CT was performed to clarify the diagnosis (figure 1).

Supplementary file 1

Figure 1

Contrast-enhanced CT of the thorax at index presentation (A) and 6 months (B). Prospective ECG-gated cardiac CT angiogram (75% R-R interval) performed at 8 years from index presentation (C) with a stretched multiplanar reconstruction of the aortic annulus, aortic root and thoracic aorta (D).

Question

Which of the following diagnoses best explains this presentation?

Ankylosing spondylitis

Takayasu arteritis

Salmonellosis

IgG4-related aortitis

Giant cell aortitis
Imaging the pathoanatomy of amyotrophic lateral sclerosis in vivo: targeting a propagation-based biological marker
Authors: Kassubek Jan , Müller Hans-Peter , Del Tredici Kelly , Lulé Dorothée , Gorges Martin , Braak Heiko , Ludolph Albert C
Published: November 2017

Objective

Neuropathological studies in amyotrophic lateral sclerosis (ALS) have shown a dissemination in a regional sequence in four anatomically defined patterns. The aim of this retrospective study was to see whether longitudinal diffusion tensor imaging (DTI) data support the pathological findings.

Methods

The application of DTI analysis to fibre structures that are prone to be involved at each neuropathological pattern of ALS was performed in a monocentre sample of 67 patients with ALS and 31 controls that obtained at least one follow-up scan after a median of 6 months.

Results

At the group level, longitudinal ALS data showed significant differences for the stage-related tract systems. At the individual level, 27% of the longitudinally scanned patients with ALS showed an increase in ALS stage, while the remaining were stable or were at the highest ALS stage. Longitudinal fractional anisotropy changes in the respective tract systems correlated significantly with the slope of the revised ALS functional rating scale.

Interpretation

The DTI-based protocol was able to image the disease patterns of ALS in vivo cross-sectionally and longitudinally, in support of DTI as a technical marker to image ALS stages.
Effect of Fcγ-receptor 3a (FCGR3A) gene polymorphisms on rituximab therapy in Hungarian patients with rheumatoid arthritis
Authors: Pál Ildikó , Szamosi Szilvia , Hodosi Katalin , Szekanecz Zoltan , Váróczy László
Published: November 2017

Background

Rheumatoid arthritis (RA) treatment includes the use of the anti-CD20 monoclonal antibody rituximab (RTX). RTX acts through Fcγ-receptors (FCGR) on effector natural killer cells and macrophages and it can be administered effectively in RA and in lymphomas. Based on the results of in vitro experiments, its efficacy may depend ofFCGRgene polymorphisms in both diseases.

Aim

As genetic background of diseases and therapeutic efficacy (pharmacogenetics) may vary among different geographical regions, we wished to assess possible relationships betweenFCGR3Apolymorphism and the therapeutic outcome of RTX therapy in a Hungarian RA cohort.

Patients and methods

Altogether, 52 patients, 6 men and 46 women, were included in the study. Peripheral blood samples were used to determineFCGR3Apolymorphism by genotyping using real-time PCR method.

Results

The distribution ofFCGR3Agenotypes was 8 VV, 34 VF and 10 FF. Disease activity score 28 (DAS28) reductions in patients with VV, VF and FF genotypes were 1.98±0.54 (p=0.008 between DAS28 before and after treatment), 2.07±0.23 (p<0.001) and 1.59±0.52 (p=0.014), respectively. Significant differences in DAS28 reductions on treatment were found between VF heterozygotes and FF homozygotes (p=0.032), as well as between heterozygotes and all (VV+FF) homozygotes (p=0.017). Furthermore, significantly more VV (62.5%; p=0.030) and VF (64.7%; p=0.015) patients achieved low disease activity compared with FF subjects (30.0%).

Conclusion

Our results suggest thatFCGR3Apolymorphism may predict more effective disease activity reduction by RTX. Furthermore, carrying the V allele may also be associated with better therapeutic response in Hungarian patients with RA.
Impact of gender on the response and tolerance to abatacept in patients with rheumatoid arthritis: results from the ‘ORA’ registry
Authors: Nourisson Cynthia , Soubrier Martin , Mulliez Aurélien , Baillet Athan , Bardin Thomas , Cantagrel Alain , Combe Bernard , Dougados Maxime , Flipo René-Marc , Schaeverbeke Thierry , Sibilia Jean , Vittecoq Olivier , Ravaud Philippe , Gottenberg Jacques-Eric , Mariette Xavier , Tournadre Anne
Published: November 2017

Objective

The impact of gender on the response and tolerance to abatacept was assessed in a large prospective cohort during 2 years of follow-up.

Methods

From the 1017 patients included in the Orencia and Rheumatoid Arthritis registry, disease activity was assessed at baseline, 6, 12 and 24 months. The relationship between the European League Against Rheumatism (EULAR) response, Disease Activity Score 28 (DAS28) remission, rate of adverse events and gender was explored in multivariate analysis.

Results

990 patients, 79.3%female, with at least one follow-up visit were analysed. At baseline, women had longer disease duration, higher disease activity and more often received antitumour necrosis factor (TNF) drugs. The remission was not different between men and women during the follow-up after adjustment on age, disease duration and activity, rheumatoid factor and anti-cyclic citrullinated pyeptide (CCP) positivity, and current disease-modifying antirheumatic drugs (DMARDs), previous TNF blockers and corticosteroids use. The proportion of men and women achieving EULAR good-or-moderate response at any endpoints was similar (52.4% vs 55.5%), as well as time to achieving EULAR response (5.4±4.9 vs 5.6±5.2 months). Moderate EULAR response was more frequent in women at 6 months (OR=1.80, p=0.02) but was no longer significant at 12 or 24 months. During the follow-up, the DAS28, the tender joint count score and the patient global assessment remained higher in women (p=0.001, 0.04 and 0.06, respectively). Drug retention and safety were comparable.

Conclusion

In this large daily practice cohort of established rheumatoid arthritis treated with abatacept, women achieved similar remission and EULAR response than men despite higher disease activity and tender joint count during the treatment course.
Evaluation of the Mycoplasma genitalium Resistance Plus kit for the detection of M. genitalium and mutations associated with macrolide resistance
Authors: Pitt Rachel , Cole Michelle Jayne , Fifer Helen , Woodford Neil
Published: November 2017

Objectives

To compare performance of the ResistancePlus kit (SpeeDx, Australia) with in-house methods for the detection of Mycoplasma genitalium-specific DNA and mutations associated with resistance to macrolide antimicrobials, directly from clinical specimens.

Methods

Assay specificity and sensitivity was analysed using DNA from 46 non-M. genitalium organisms and standard curve analysis, respectively. A panel of archived DNA extracted from 97 M. genitalium-positive clinical specimens, for which the macrolide susceptibility genotype had been previously determined, were tested on the assay and results compared.

Results

Final analytical specificity was 100%. Sensitivity was detected to at least 140 genome copies/µL. The assay detected M. genitalium in 92/97 (94.9%, 95% CI 88.4% to 98.3%) previously positive specimens. The genetic macrolide susceptibility assigned was concordant with previous results in 85/92 (92.4%, 95% CI 85.0% to 96.9%) specimens or 85/97 (87.6%, 95% CI: 79.4% to 93.4%) when the false-negative specimens were included. On seven (7/92, 7.6%) occasions, resistant specimens were called susceptible. Further testing resolved discrepancies for all but five (5.2%) specimens.

Conclusions

The ResistancePlus assay generally performed well in comparison to methods currently employed at the reference laboratory. It detected a range of different mutations; however, a small number of specimens that were genotyped as macrolide resistant by Sanger sequencing were either not detected by the assay or were genotyped as susceptible. This could impact on treatment outcomes if assay results were used for patient management.
A population-based prospective cohort study examining the influence of early-life respiratory tract infections on school-age lung function and asthma
Authors: van Meel Evelien R , den Dekker Herman T , Elbert Niels J , Jansen Pauline W , Moll Henriëtte A , Reiss Irwin K , de Jongste Johan C , Jaddoe Vincent W V , Duijts Liesbeth
Published: November 2017

Background

Early-life respiratory tract infections could affect airway obstruction and increase asthma risk in later life. However, results from previous studies are inconsistent.

Objective

We examined the associations of early-life respiratory tract infections with lung function and asthma in school-aged children.

Methods

This study among 5197 children born between April 2002 and January 2006 was embedded in a population-based prospective cohort study. Information on physician-attended upper and lower respiratory tract infections until age 6 years (categorised into ≤ 3 and >3–6 years) was obtained by annual questionnaires. Spirometry measures and physician-diagnosed asthma were assessed at age 10 years.

Results

Upper respiratory tract infections were not associated with adverse respiratory outcomes. Compared with children without lower respiratory tract infections ≤3 years, children with lower respiratory tract infections ≤3 years had a lower FEV1, FVC, FEV1:FVC and forced expiratory flow at 75% of FVC (FEF75) (Z-score (95% CI): ranging from −0.22 (−0.31 to –0.12) to −0.12 (−0.21 to −0.03)) and an increased risk of asthma (OR (95% CI): 1.79 (1.19 to 2.59)). Children with lower respiratory tract infections >3–6 years had an increased risk of asthma (3.53 (2.37 to 5.17)) only. Results were not mediated by antibiotic or paracetamol use and not modified by inhalant allergic sensitisation. Cross-lagged modelling showed that results were not bidirectional and independent of preschool wheezing patterns.

Conclusion

Early-life lower respiratory tract infections ≤3 years are most consistently associated with lower lung function and increased risk of asthma in school-aged children.
Prevalence of dental disorders in degus and evaluation of diagnostic methods to determine dental disease and its prognosis
Authors: van Bolhuis Hester , van Hoffen Lotte , van Zijll Langhout Martine , van Engeldorp Gastelaars Heleen , Hendriks Wouter , Lamberts Marnix , Kik Marja
Published: November 2017

Degus (Octodon degus) are prone to develop dental disease with deleterious health effects. The two studies reported here aimed to determine the prevalence of dental disorders in degus and to identify and evaluate diagnostic tools for determination of prognosis of these disorders. In study A, health data from 225 degus at AAP, Rescue Center for Exotic Animals in the Netherlands, were collated and the prevalence of dental disorders and differences in sex and age at clinical onset of symptoms associated with dental disorders were described. The prevalence was 34.7 per cent and higher (P<0.01) in males than in females. The occurrence of cheek teeth malocclusion was highly positively (P<0.0001) correlated to mortality. In study B, 36 skulls were examined by macroscopic evaluation, radiography and histology. Additionally, the calcium:phosphorus (Ca:P) of mandibular bone in degus with and without dental disorders were determined. There was no significant (P=0.10) difference in Ca:P between the two groups. Quantifying mandibular apical cheek teeth elongation via macroscopic evaluation was highly correlated (P<0.01) to the results obtained via radiography. Examination for apical elongation by palpation and diagnostic imaging should be included in routine health monitoring of degus. Apical elongation appeared to develop before coronal elongation and when cheek teeth malocclusion occurred, prognosis for recovery of dental disease was poor.
Risk of iatrogenic damage to the sciatic nerve in dairy cattle
Authors: Kirkwood Rosanna M , Remnant John G , Payne Richard M , Murphy Alan M , Wapenaar Wendela
Published: November 2017

Sciatic nerve damage in cattle could lead to pain, paralysis and lameness, creating welfare and productivity issues. Damage following intramuscular injection is highlighted in some clinical texts although there is no indication of prevalence. This cross‐sectional study investigated the anatomical size and position of the sciatic nerve in four dairy cattle type cadavers. To evaluate the risk of iatrogenic damage, 54 participants placed needles in the dorsal gluteal region of two cadavers each, as per their routine intramuscular injection method. The distance from needle tip to the sciatic nerve was estimated for each. Sixty‐nine per cent of injections were placed within 5 cm of the sciatic nerve. Direct nerve puncture occurred in the cadaver in poorest body condition. A short questionnaire revealed that 70 per cent of the participants regularly used the dorsal gluteal region for intramuscular injection and 50 per cent commonly used a volume of ≥20 mL at a single site. It is concluded that the sciatic nerve is at considerable risk of iatrogenic damage. The neck should be promoted as the optimum site for intramuscular injection and improved guidelines are required if the gluteal region is to remain in common use. A lateral site, between the tuber coxae and tuber ischium, is recommended.
Estimate of void fraction and air entrainment flux in hydraulic jump using Froude number
Authors: Wang H. , Chanson H.
Published: November 2017

Hydraulic jumps are induced in hydraulic facilities for the purposes of energy dissipation or flow aeration. Presently there is no means for a simple estimate of void fraction distribution and air entrainment flux, without detailed physical modelling. This paper presents a semi-theoretical model to simulate the void fraction and velocity distributions in hydraulic jumps characterized by partially-developed inflow conditions. Relationships were established between the inflow Froude number, jump roller length and key parameters that determine the full expression of void fraction and velocity profiles. The proposed model enables accurate prediction of void fraction, longitudinal velocity, and air flux using the inflow Froude number. The results indicated considerable air flux contribution of free-surface aeration, in addition to the singular air entrainment at the jump toe, for moderate to large Froude numbers. A Froude number between 8 and 9 tended to achieve highest aeration rate with maximum total air flux in the roller.
Is the cosmological constant problem properly posed?
Authors: Mannheim Philip D.
Published: November 2017

In applications of Einstein gravity, one replaces the quantum-mechanical energy–momentum tensor of sources such as the degenerate electrons in a white dwarf or the black-body photons in the microwave background by c-number matrix elements. And not only that, one ignores the zero-point fluctuations in these sources by only retaining the normal-ordered parts of those matrix elements. There is no apparent justification for this procedure, and we show that it is precisely this procedure that leads to the cosmological constant problem. We suggest that solving the problem requires that gravity be treated just as quantum-mechanically as the sources to which it couples, and show that one can then solve the cosmological constant problem if one replaces Einstein gravity by the fully quantum-mechanically consistent conformal gravity theory.
The shape of bouncing universes
Authors: Barrow John D. , Ganguly Chandrima
Published: November 2017

What happens to the most general closed oscillating universes in general relativity? We sketch the development of interest in cyclic universes from the early work of Friedmann and Tolman to modern variations introduced by the presence of a cosmological constant. Then we show what happens in the cyclic evolution of the most general closed anisotropic universes provided by the Mixmaster universe. We show that in the presence of entropy increase its cycles grow in size and age, increasingly approaching flatness. But these cycles also grow increasingly anisotropic at their expansion maxima. If there is a positive cosmological constant, or dark energy, present then these oscillations always end and the last cycle evolves from an anisotropic inflexion point towards a de Sitter future of everlasting expansion.
Mesoporous cellular-structured carbons derived from glucose–fructose syrup and their adsorption properties towards acetaminophen
Authors: Tzvetkov George , Spassov Tony , Kaneva Nina , Tsyntsarski Boyko
Published: November 2017

Here, a series of cellular-structured and predominantly mesoporous carbons were prepared via carbonization of glucose–fructose syrup (GFS) with sulfuric acid and subsequent calcination between 400[Formula: see text]C and 700[Formula: see text]C. Comparative results on the microstructure, chemical and textural properties of the newly produced carbons are presented. Furthermore, their adsorption performance for removal of acetaminophen from water was tested and it was found that the carbon calcined at 700[Formula: see text]C has a maximum adsorption capacity (98.7[Formula: see text]mg[Formula: see text]g[Formula: see text]) among all samples due to its suitable textural properties (BET surface area of 418[Formula: see text]m[Formula: see text]g[Formula: see text] and total pore volume of 0.2[Formula: see text]cm[Formula: see text]g[Formula: see text]). This study demonstrates the potential use of GFS as a precursor in the preparation of carbonaceous materials for removal of biologically-active micropollutants from water.
Extraordinary infrared emittance property of Mo-, W-incorporated Sm0.5Sr0.5CoO3−δ
Authors: Jin Junyang , Fang Zhenggang , Ni Yaru , Lu Chunhua , Xu Zhongzi
Published: November 2017

The Mo-, W-incorporated Sm[Formula: see text]Sr[Formula: see text]CoO[Formula: see text] ceramics were prepared by the tape casting and high temperature sintering method. The effects of Mo and W concentration on the structure and optical properties of Sm[Formula: see text]Sr[Formula: see text]CoO[Formula: see text] were investigated in detail. It was found that the Mo-, W-incorporated Sm[Formula: see text]Sr[Formula: see text]CoO[Formula: see text] exhibited extraordinary emittance property in the 3–5[Formula: see text][Formula: see text]m and 8–13[Formula: see text][Formula: see text]m (especially in the 11–13[Formula: see text][Formula: see text]m) wavelength ranges. The results suggest that the novel infrared emittance property of Mo- and W-incorporated Sm[Formula: see text]Sr[Formula: see text]CoO[Formula: see text] could find potential applications in solar thermal or radiative cooling systems.
Fabrication of TiO2/CuO photoelectrode with enhanced solar water splitting activity
Authors: Atabaev Timur Sh. , Lee Dae Hun , Hong Nguyen Hoa
Published: November 2017

A bilayered TiO2/CuO photoelectrode was fabricated on a fluorine-doped tin oxide FTO substrate by spin-coating and pulsed laser deposition methods. The prepared bilayered system was assessed as a photoelectrode for solar water splitting. The fabricated TiO2/CuO photoelectrode exhibited a higher photocurrent density (0.022[Formula: see text]mA/cm2 at 1.23[Formula: see text]V vs. RHE) compared to bare TiO2 photoelectrode (0.013[Formula: see text]mA/cm2 at 1.23[Formula: see text]V vs. RHE). This photocurrent density enhancement was attributed to the improved charge separation combined with the improved sunlight harvesting efficiency of a bilayered structure.
Association of Vitamin D Deficiency and Degree of Coronary Artery Disease in Cardiac Patients with Type 2 Diabetes
Authors: Dziedzic Ewelina A. , Gąsior Jakub S. , Pawłowski Mariusz , Dąbrowski Marek
Published: November 2017

Several modifiable factors may influence cardiac function in diabetic patients. The aim of the study was to evaluate the influence of vitamin D level on the stage of coronary atherosclerosis in cardiac patients diagnosed with type 2 diabetes. The study was performed in 337 consecutive patients undergoing coronarography. The stage of atherosclerosis was evaluated using Coronary Artery Surgery Study Score. The plasma 25(OH)D concentration was determined by an electrochemiluminescence method. Patients without significant lesions in coronary arteries presented the highest 25(OH)D level, significantly higher than patients with one-, two-, and three-vessel coronary artery disease (CAD) (p<0.01). Significantly lower level of the 25(OH)D was observed in patients hospitalized due to acute coronary syndrome (ACS) in comparison to patients hospitalized due to stable CAD (p<0.001). Lower 25(OH)D levels were observed in patients with the history of myocardial infarction (MI) in comparison to patients without previous MI (p<0.001). In cardiac patients with diabetes, the higher number of stenotic coronary arteries is associated with lower values of the 25(OH)D. A group of male cardiac patients with diabetes with significant stenosis in three coronary arteries, hospitalized due to acute coronary syndrome, with a history of previous MI and hyperlipidemia presented the lowest vitamin D level.
Antcin‐H Isolated from Antrodia cinnamomea Inhibits Renal Cancer Cell Invasion Partly through Inactivation of FAK‐ERK‐C/EBP‐β/c‐Fos‐MMP‐7 Pathways
Authors: Chiu Kun-Yuan , Chen Tzu-Hsiu , Wen Chi-Luan , Lai Jin-Mei , Cheng Chi-Chih , Liu Hsiang-Chun , Hsu Shih-Lan , Tzeng Yew-Min
Published: November 2017

Antcin‐H, a natural triterpene, is purified from a famous anticancer medicinal mushroom, Antrodia cinnamomea, in Taiwan. This study showed that antcin‐H inhibited the growth of human renal carcinoma 786‐0 cells; the IC50 value (for 48 h) was 170 μM. Besides, the migration and invasion of 786‐0 cells were suppressed by antcin‐H under noncytotoxic concentrations (<100 μM); these events were accompanied by inhibition of FAK and Src kinase activities, decrease of paxillin phosphorylation, impairment of lamellipodium formation, and upregulation of TIMPs and downregulation of MMPs, especially MMP‐7 expression. Luciferase reporter assay showed that antcin‐H repressed the MMP‐7 promoter activity, in parallel to inhibiting c‐Fos/AP‐1 and C/EBP‐β transactivation abilities. Moreover, antcin‐H suppressed the activity of ERK1/2 and decreased the binding ability of C/EBP‐β and c‐Fos on the upstream/enhancer region of MMP‐7 promoter. Overall, this study demonstrated that the anti‐invasive effect of antcin‐H in human renal carcinoma 786‐0 cells might be at least in part by abrogating focal adhesion complex and lamellipodium formation through inhibiting the Src/FAK‐paxillin signaling pathways and decreasing MMP‐7 expression through suppressing the ERK1/2‐AP‐1/c‐Fos and C/EBP‐β signaling axis. Our findings provide the evidence that antcin‐H may be an active component existing in A. cinnamomea with anticancer effect.
Regionally Specific Regulation of Sensorimotor Network Connectivity Following Tactile Improvement
Authors: Heba Stefanie , Lenz Melanie , Kalisch Tobias , Höffken Oliver , Schweizer Lauren M. , Glaubitz Benjamin , Puts Nicolaas A. J. , Tegenthoff Martin , Dinse Hubert R. , Schmidt-Wilcke Tobias
Published: November 2017

Correlations between inherent, task-free low-frequency fluctuations in the blood oxygenation level-dependent (BOLD) signals of the brain provide a potent tool to delineate its functional architecture in terms of intrinsic functional connectivity (iFC). Still, it remains unclear how iFC is modulated during learning. We employed whole-brain resting-state magnetic resonance imaging prior to and after training-independent repetitive sensory stimulation (rSS), which is known to induce somatosensory cortical reorganization. We investigated which areas in the sensorimotor network are susceptible to neural plasticity (i.e., where changes in functional connectivity occurred) and where iFC might be indicative of enhanced tactile performance. We hypothesized iFC to increase in those brain regions primarily receiving the afferent tactile input. Strengthened intrinsic connectivity within the sensorimotor network after rSS was found not only in the postcentral gyrus contralateral to the stimulated hand, but also in associative brain regions, where iFC correlated positively with tactile performance or learning. We also observed that rSS led to attenuation of the network at higher cortical levels, which possibly promotes facilitation of tactile discrimination. We found that resting-state BOLD fluctuations are linked to behavioral performance and sensory learning, indicating that network fluctuations at rest are predictive of behavioral changes and neuroplasticity.
Tumor Lysis Syndrome in Patients with Hematological Malignancies
Authors: Belay Yohannes , Yirdaw Ketsela , Enawgaw Bamlaku
Published: November 2017

Tumor lysis syndrome is a metabolic complication that may follow the initiation of cancer therapy. It commonly occurs in hematological malignant patients particularly non-Hodgkin’s lymphoma and acute leukemia due to chemotherapy or spontaneously. It is characterized by a biochemical abnormality such as hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia and its clinical outcome is directly related to these biochemical abnormalities. Prevention and treatment of tumor lysis syndrome depend on immediate recognition of patients at risk. Therefore, identifying patients at risk and prophylactic measures are important to minimize the clinical consequences of tumor lysis syndrome. Patients with low risk should receive hydration and allopurinol. On the other hand patients with high risk should receive hydration and rasburicase in an inpatient setting. It is important to start therapy immediately, to correct all parameters before cancer treatment, to assess risk level of patients for TLS, and to select treatment options based on the risk level. In this review a comprehensive search of literatures was performed using MEDLINE/PubMed, Hinari, the Cochrane library, and Google Scholar to summarize diagnostic criteria, incidence, predicting factors, prevention, and treatment options for tumor lysis syndrome in patients with hematological malignancies.
Maternal Cannabinoid Use Alters Cannabinoid (CB1) and Endothelin (ETB) Receptor Expression in the Brains of Dams but Not Their Offspring
Authors: Amlani Aarti , Hornick Mary G. , Cooper Kevin , Prazad Preetha , Donovan Ramona , Gulati Anil
Published: November 2017

According to the 2015 National Survey on Drug Use and Health, cannabis (marijuana) is the most commonly used recreational drug in the US. Among pregnant women aged 14-55 years, 3.4% were cannabis users. Presently, little is known about the neurodevelopmental effect of cannabis use during pregnancy and/or nursing on neonates. Endothelin (ET) is essential for normal development of the central nervous system (CNS). Decreases in ETB receptor expression correlate with a decline in nerve growth factor (NGF) and an increase in vascular endothelial growth factor (VEGF) in postnatal brain. Activation of ETB and cannabinoid 1 (CB1) receptors each promote neurogenesis and enhance angiogenesis, indicating that both ET and CB systems play a critical role during early CNS development. Hence the purpose of this study was to determine whether maternal CB abuse during pregnancy and lactation alters the expression of ETB receptors, CB1 receptors, VEGF, and NGF in the postnatal rat brain. Sixteen pregnant Sprague-Dawley rats were administered either saline or anandamide (AEA) at a dose of 3 mg/kg/day i.p. from gestational day 7 and continued through weaning on postnatal day (PND) 21. Rat pups were subdivided into 4 subgroups and sacrificed on PND 2, 7, 14, and 28. Brain tissue of the pups and dams (sacrificed on PND 21) was analyzed via Western blot for the expression of ETB receptors, CB1 receptors, VEGF, and NGF. AEA-exposed dams had significantly fewer live births (p = 0.027), and their pups presented with significantly lower body weights on PND 7 (p = 0.013) and PND 28 (p = 0.018). There was no significant difference noted in ETB receptor, CB1 receptor, NGF, or VEGF expression in the pup brains. In all pups, brain ETB receptor expression decreased and CB1 receptor expression increased with age. In the AEA-exposed dam brain, however, there was a decrease in ETB receptor (p = 0.043) and an increase in CB1 receptor expression (p = 0.033). AEA exposure during pregnancy appears to affect fetal viability and postnatal weight gain in offspring while not altering the expression patterns of ETB receptors, CB1 receptors, NGF, or VEGF in the pup brain. The observed trend to an increase in CB1 receptor expression concurrent with a decrease in ETB receptor expression in both dams and pups may point to a homeostatic regulation between these 2 systems in CNS development and neuroprotection.