bluuebunny/crossref_metadata_2025 huggingface dataset:
The increase in energy efficiency of residential buildings of military towns
Authors: Gamayunova Olga , Radaev Anton , Petrichenko Mikhail , Dmitrieva Ekaterina
Published: August 2019

Most of the residential multi-apartment buildings in use in our country do not meet modern regulatory requirements for the level of thermal protection of external enclosing structures. Such buildings require renovation. The objects of the research are residential buildings of KPD-4570 series, which are a typical series of buildings for military towns. The options for improving the energy efficiency of residential construction with the help of selection of heaters that meet the requirements for thermal protection of buildings are proposed. The method of calculating the discounted payback period for insulation costs is presented.
Efficiency evaluation of resourcing innovative processes on a regional level
Authors: Rakhova Maria , Zakirova Maria , Grachev Sergey
Published: August 2019

The purpose of this issue is to analyse how efficient the resource providing innovation processes in Russian regions is. This issue gives a hypothesis that says: the assessment of innovation activity’s full efficiency should be carried out only if three criteria are met: effectiveness, productivity and optimality. An analysis of innovation processes was conducted in the context of regions of the Central Federal District (CFD) for the period of 2010-2017. In most regions, there was a decrease in the estimated parameter over the mentioned period of time. These trends are caused by the decrease in the amount of technological innovation costs with an optimal ratio of the volume ratio of innovative goods made, work and services. The research results can be useful for federal and regional executive authorities. They can formulate and adjust the planned strategy of socio-economic development and calculate the cumulative efficiency indicator of innovation processes.
Identification of concentration points of finance and investment resources in the regions
Authors: Rakhova Maria , Zakirova Maria
Published: August 2019

The purpose of the paper is to assess the sufficiency of the financial and investment resources of the territory to increase its potential, and the possibility of the overflow of this resource to neighboring socio-economic systems. The study substantiates the need to identify the resource potential of the regions in order to determine opportunities for their development and reduce dependence on external economic and political influence. In the paper, in particular, the sufficiency of financial and investment resources of the central federal district is determined, which include the production factor “capital”, including investments in fixed assets, costs for research and development and technological innovations. The research method is based on the normalization, correlation and factor analysis of the initial data, and consists in calculating the accumulation norms and coefficients of significance of the selected resources. The results of identifying concentration points can be applied in the future to assess the prospects for economic development of the regions of the central federal district. The results of research can be useful to federal and regional executive authorities for the formulation and adjustment of the planned development strategy.
Digital transformation method for value mapping in public management
Authors: Petrov Igor , Zemtsov Maxim , Butyrin Andrey
Published: August 2019

This study addresses the issue of developing a model of value proposition in public management field. Value mapping is a vital feature for a digital modelling and analysis methods. The developed method is based on the Alexander Osterwalder business model canvas. An approach makes it possible to track the system intra-relations during a problem solving due to a value proposition and, accordingly, changes in the public management model. It represents an essential part of reference model for public management architecture and reveals the dependence of local municipalities on federal and regional state authorities due to financial shortage.
Balanced system of indicators for the assessment of innovative construction projects efficiency
Authors: Rakhimova Saule , Kunanbayeva Kymbat , Goncharenko Lyudmila , Pigurin Andrey
Published: August 2019

The role of innovations in the construction industry is considered in the article. In the conditions of transition of national economy to the innovative type of development, the indicators that allow estimating the efficiency of innovative activity, where the key aspect is the comprehensive assessment, are important. Innovative projects are especially relevant for the construction industry, which is the key driver of the national economy development. Sustainable construction ensures the development of industries, where innovative projects can partly solve the problems of creating renewable energy sources. The authors offer to expand the list of indicators for the assessment of the innovative project efficiency not only from the financial and investment point of view, but also taking into account quantitative and quality, scientific, technological, operational, marketing indicators, which often are not considered. The assessment of the innovative projects efficiency has to be the central link in the innovation management; so the authors offer to improve the system of the balanced indicators. The balanced system of indicators (BSI) is developed. It is planned to extend and to introduce BSI not only at the level of the enterprises, but also for all the types of economic activity according to their technological effectiveness.
Modeling and assessment of a multi-apartment residential house with a planned overhaul
Authors: Fatullaev Rustam
Published: August 2019

The overhaul potential is an effective mathematical model for evaluating organizational and technological solutions when planning for an overhaul of apartment buildings. The purpose of the study is to create a tool that would allow using the potential of the overhaul of tenants of an apartment building. The difficulty of using the potential of overhaul is the need to transform the qualitative characteristics of a dwelling house before the overhaul will be carried out in quantitative terms. But even after obtaining the value of the overhaul potential, it is necessary to obtain an interpretation of the obtained quantitative indicators in qualitative characteristics. To describe the object in which the overhaul is planned, taking into account all the parameters that may affect the choice of work in quantitative terms, it is necessary to form an organizational and technological model of a residential building in which an overhaul is planned. In turn, in order to interpret the obtained quantitative value of the potential, it is necessary to form a private potential scale.
Public-and-private partnership development under conditions of the imperfect legal regulation
Authors: Polyakova Irina , Vasilyeva Elena
Published: August 2019

The objective of this research is to consider some controversial issues of the development of public-and-private partnership (and concession agreements as its most common form) in Russia. Some complaints made by arising from Federal Antimonopoly Service of the Russian Federation to some infrastructure projects are reviewed. The authors studied dynamics of private investments into infrastructure projects in the conditions of imperfect legal regulation. The assessment of the validity of the position of Federal Antimonopoly Service is given. It is predicted whether the legislative collisions will prevent the growth of private investments into infrastructure. Recommendations on the development of the mechanism of public-and-private partnership with the observance of antimonopoly regulation, as well as recommendation on the improvement of the legislation in this area are developed. The results of the research can be used by both private participants of public-and-private partnership and the federal, regional and municipal authorities, and also by legislators working on the improvement of the legislative regulation in this area.
Medikamentöse Langzeittherapien zur Prognoseverbesserung bei Leberzirrhose und zur Vermeidung von Komplikationen der portalen Hypertension
Authors: Holstege Axel
Published: August 2019

Die portale Hypertension bei Patienten mit Leberzirrhose kann nicht nur durch interventionelle (TIPS: transjugulärer portosystemischer Stent-Shunt) oder operative Shuntanlagen, sondern auch medikamentös beeinflusst werden. Zahlreiche Studien beschäftigten sich mit der Frage, ob diese Substanzen bei dauerhafter Gabe zu einer Prognoseverbesserung bei Patienten mit Leberzirrhose führen können. Nicht selektive Betablocker (NSBB), Statine, Antibiotika, Enoxaparin und Albumin haben viele Angriffspunkte in der Pathogenese der portalen Hypertension oder bei Dekompensation der Leberzirrhose, sodass sie grundsätzlich als Kandidaten für eine Langzeittherapie infrage kommen. Während es für NSBB, Antibiotika und Albumin klare Indikationen in der Versorgung von Patienten mit dekompensierter Leberzirrhose gibt, ist dies weniger geklärt für den Einsatz von Statinen oder Antikoagulanzien. Neuere Untersuchungen ergaben widersprüchliche Ergebnisse, wenn der primäre Endpunkt einer Studie die Prognoseverbesserung oder die Vermeidung einer Dekompensation der Zirrhose durch eine dauerhafte medikamentöse Therapie war. Zum jetzigen Zeitpunkt ergibt sich aufgrund der aktuellen Studienlage keine Veranlassung, das bisherige, in Leitlinien abgesicherte Vorgehen im täglichen Alltag zu ändern. Diese Übersicht gibt einen Überblick zum Einsatz von NSBB, Antibiotika, Statinen, Antikoagulanzien und Albumin bei Komplikationen der portalen Hypertension insbesondere im Hinblick auf ihren dauerhaften Einsatz zur Verbesserung des Überlebens von Patienten mit Leberzirrhose.
Regioselective Radical Alkene Amination Strategies by Using Phosphite-Mediated Deoxygenation
Authors: Lardy Samuel W. , Schmidt Valerie A.
Published: August 2019

Nitrogen-containing compounds are an essential motif in all disciplines of chemistry and the efficient synthesis of these frameworks is a highly sought-after goal. Presented here is a summary of recent efforts conducted by our group to develop radical-mediated amination strategies for the formal synthesis of primary amines from alkenes with exclusive anti-Markovnikov regioselectivity. We have found that N-hydroxyphthalimide is an effective reagent capable of supplying both the N and H atoms for alkene hydroamination in a group transfer radical addition-type mechanism. Furthermore, allyl-oxyphthalimide derivatives are similarly capable of radical group transfers and allow for the aminoallylation of an external alkene.
Krebs-Studie der DGHO: Mehr Krebspatienten – steigender Bedarf an flächendeckenden Versorgungsmodellen
Authors: Heeser Alexandra
Published: August 2019

Fast jeder zweite Deutsche erkrankt im Laufe seines Lebens an einer von etwa 200 Krebsarten. Die neue Studie der Deutschen Gesellschaft für Hämatologie und Medizinische Onkologie (DGHO) zeigt, dass sich mit der demografischen Entwicklung künftig auch die Anforderungen an die Krebsversorgung in Deutschland drastisch verändern werden.
Measurements indicate alpha-quartz’s surface signal should not be neglected in spectroscopy calibration
Authors: Patrick Chris
Published: August 2019

Phase-sensitive sum frequency generation spectroscopy reveals that the contribution from the surface of alpha-quartz to the overall sum frequency response signal is more significant than previously assumed.
Variability in exercise physiology: Can capturing intra‐individual variation help better understand true inter‐individual responses?
Authors: Chrzanowski‐Smith Oliver J. , Piatrikova Eva , Betts James A. , Williams Sean , Gonzalez Javier T.
Published: August 2019

Exploring individual responses to exercise training is a growing area of interest. Understanding reasons behind true observed inter‐individual responses may help personalise exercise training to maximise the benefits received. While numerous factors have been explored, an often underappreciated consideration in the sport and exercise science field is the influence intra‐individual variation, both in a single measurement and in response to an intervention, may have on training outcomes. Several study designs and statistical approaches are available to incorporate intra‐individual variation into interventions and accordingly provide information on whether ‘true’ inter‐individual responses are present or if they are an artefact of intra‐individual variation. However, such approaches are sparingly applied. Moreover, intra‐individual variation may also be important when true inter‐individual response differences are present. In this perspective piece, the concept of intra‐individual variation is described before briefly summarising study designs and statistical practices to account for intra‐individual variation. We then outline two examples of physiological practices (stratified randomisation and prescribing exercise programmes upon training parameters) to demonstrate why sport and exercise scientists should acknowledge intra‐individual variation prior to the implementation of an intervention, which potentially offers an additional explanation behind observed true inter‐individual responses to training. Repeated testing pre‐implementation of exercise training would conceptually provide more confident estimates of training parameters, which if utilised in a study design will help attenuate biases that may dictate inter‐individual differences. Moreover, the incorporation of intra‐individual differences will facilitate insights into alternative factors that may predict and/or explain true observed individual responses to an exercise training programme.
Pediatric Bacterial Meningitis Surveillance in Niger: Increased Importance of Neisseria meningitidis Serogroup C, and a Decrease in Streptococcus pneumoniae Following 13-Valent Pneumococcal Conjugate Vaccine Introduction
Authors: Kourna Hama Mamadou , Khan Dam , Laouali Boubou , Okoi Catherine , Yam Abdoulaye , Haladou Moussa , Worwui Archibald , Ndow Peter Sylvanus , Nse Obama Ricardo , Mwenda Jason M , Biey Joseph , Ntsama Bernard , Kwambana-Adams Brenda A , Antonio Martin
Published: August 2019

Background

Meningitis is endemic in Niger. Haemophilus influenzae type b (Hib) vaccine and the 13-valent pneumococcal conjugate vaccine (PCV13) were introduced in 2008 and 2014, respectively. Vaccination campaign against Neisseria meningitidis serogroup A was carried out in 2010–2011. We evaluated changes in pathogen distribution using data from hospital-based surveillance in Niger from 2010 through 2016.

Methods

Cerebrospinal fluid (CSF) specimens from children <5 years old with suspected meningitis were tested to detect vaccine-preventable bacterial pathogens. Confirmatory identification and serotyping/grouping of Streptococcus pneumoniae, N. meningitidis, and H. influenzae were done. Antimicrobial susceptibility testing and whole genome sequencing were performed on S. pneumoniae isolates.

Results

The surveillance included 2580 patients with suspected meningitis, of whom 80.8% (2085/2580) had CSF collected. Bacterial meningitis was confirmed in 273 patients: 48% (131/273) was N. meningitidis, 45% (123/273) S. pneumoniae, and 7% (19/273) H. influenzae. Streptococcus pneumoniae meningitis decreased from 34 in 2014, to 16 in 2016. PCV13 serotypes made up 88% (7/8) of S. pneumoniae meningitis prevaccination and 20% (5/20) postvaccination. Neisseria meningitidis serogroup C (NmC) was responsible for 59% (10/17) of serogrouped N. meningitidis meningitis. Hib caused 67% (2/3) of the H. influenzae meningitis isolates serotyped. Penicillin resistance was found in 16% (4/25) of S. pneumoniae isolates. Sequence type 217 was the most common lineage among S. pneumoniae isolates.

Conclusions

Neisseria meningitidis and S. pneumoniae remain important causes of meningitis in children in Niger. The decline in the numbers of S. pneumoniae meningitis post-PCV13 is encouraging and should continue to be monitored. NmC is the predominant serogroup causing N. meningitidis meningitis.
Common Behaviors and Faults When Doffing Personal Protective Equipment for Patients With Serious Communicable Diseases
Authors: Mumma Joel M , Durso Francis T , Casanova Lisa M , Erukunuakpor Kimberly , Kraft Colleen S , Ray Susan M , Shane Andi L , Walsh Victoria L , Shah Puja Y , Zimring Craig , DuBose Jennifer , Jacob Jesse T
Published: August 2019

Background

The safe removal of personal protective equipment (PPE) can limit transmission of serious communicable diseases, but this process poses challenges to healthcare workers (HCWs).

Methods

We observed 41 HCWs across 4 Ebola treatment centers in Georgia doffing PPE for simulated patients with serious communicable diseases. Using human factors methodologies, we obtained the details, sequences, and durations of doffing steps; identified the ways each step can fail (failure modes [FMs]); quantified the riskiness of FMs; and characterized the workload of doffing steps.

Results

Eight doffing steps were common to all hospitals—removal of boot covers, gloves (outer and inner pairs), the outermost garment, the powered air purifying respirator (PAPR) hood, and the PAPR helmet assembly; repeated hand hygiene (eg, with hand sanitizer); and a final handwashing with soap and water. Across hospitals, we identified 256 FMs during the common doffing steps, 61 of which comprised 19 common FMs. Most of these common FMs were above average in their riskiness at each hospital. At all hospitals, hand hygiene, removal of the outermost garment, and removal of boot covers were above average in their overall riskiness. Measurements of workload revealed that doffing steps were often mentally demanding, and this facet of workload correlated most strongly with the effortfulness of a doffing step.

Conclusions

We systematically identified common points of concern in protocols for doffing high-level PPE. Addressing FMs related to hand hygiene and the removal of the outermost garment, boot covers, and PAPR hood could improve HCW safety when doffing high-level PPE.

We identified ways that doffing protocols for high-level personal protective equipment may fail to protect healthcare workers. Hand hygiene, removing the outermost garment, boot covers, and respirator hood harbored the greatest risk and failed in similar ways across different hospitals.
Applying a Risk-benefit Analysis to Outcomes in Tuberculosis Clinical Trials
Authors: Miyahara Sachiko , Ramchandani Ritesh , Kim Soyeon , Evans Scott R , Gupta Amita , Swindells Susan , Chaisson Richard E , Montepiedra Grace
Published: August 2019

Although it is common to analyze efficacy and safety separately in clinical trials, this could yield a misleading study conclusion if an increase in efficacy is accompanied by a decrease in safety. A risk-benefit analysis is a systematic approach to examine safety and efficacy jointly. Both the “rank-based” and “partial-credit” methods described in this paper allow researchers to create a single, composite outcome incorporating efficacy, safety, and other factors. The first approach compares the distribution of rankings between arms. In the second approach, a score can be assigned to each outcome category, considering its severity and comparing the mean or median scores of arms. The methods were applied to the A5279/Brief Rifapentine-Isoniazid Efficacy for TB Prevention study, and design considerations for future clinical trials are discussed, including the challenge of arriving at a consensus on rankings/scorings. If well designed, a risk-benefit analysis may allow for a superiority comparison and, therefore, avoid setting a noninferiority margin.

Clinical Trials Registration. NCT01404312 (A5279).
Establishment Closures in Germany: The Motherhood Penalty at Job Search Durations
Authors: Frodermann Corinna , Müller Dana
Published: August 2019

This study contributes to the research on motherhood penalties by investigating based on German longitudinal register data whether mothers take longer to search for a job than childless women. We develop a unique research design to test the theory of statistical discrimination as well as the theory of status-based discrimination. We use establishment closures as a starting point that creates equal conditions for all previously employed women. Following a subsequent coarsened exact matching approach, we investigate the job search length of almost 3,000 comparable full-time working childless women and mothers from almost 700 establishments by applying event history techniques. Even after extensive robustness checks that back up the main findings, we can show that mothers have lower transition rates to re-employment than childless women. When including additional information, such as higher age of the youngest child or shorter parental leave durations, both of which serve as indicators of higher labour market attachment, we find reduced differences and buffering effects on the motherhood penalty.
Gtf2i and Gtf2ird1 mutation do not account for the full phenotypic effect of the Williams syndrome critical region in mouse models
Authors: Kopp Nathan , McCullough Katherine , Maloney Susan E , Dougherty Joseph D
Published: August 2019

Williams syndrome (WS) is a neurodevelopmental disorder caused by a 1.5–1.8 Mbp deletion on chromosome 7q11.23, affecting the copy number of 26–28 genes. Phenotypes of WS include cardiovascular problems, craniofacial dysmorphology, deficits in visual–spatial cognition and a characteristic hypersocial personality. There are still no genes in the region that have been consistently linked to the cognitive and behavioral phenotypes, although human studies and mouse models have led to the current hypothesis that the general transcription factor 2 I family of genes, GTF2I and GTF2IRD1, are responsible. Here we test the hypothesis that these two transcription factors are sufficient to reproduce the phenotypes that are caused by deletion of the WS critical region (WSCR). We compare a new mouse model with loss of function mutations in both Gtf2i and Gtf2ird1 to an established mouse model lacking the complete WSCR. We show that the complete deletion (CD) model has deficits across several behavioral domains including social communication, motor functioning and conditioned fear that are not explained by loss of function mutations in Gtf2i and Gtf2ird1. Furthermore, transcriptome profiling of the hippocampus shows changes in synaptic genes in the CD model that are not seen in the double mutants. Thus, we have thoroughly defined a set of molecular and behavioral consequences of complete WSCR deletion and shown that genes or combinations of genes beyond Gtf2i and Gtf2ird1 are necessary to produce these phenotypic effects.
Gross national income and antibiotic resistance in invasive isolates: analysis of the top-ranked antibiotic-resistant bacteria on the 2017 WHO priority list
Authors: Savoldi Alessia , Carrara Elena , Gladstone Beryl Primrose , Azzini Anna Maria , Göpel Siri , Tacconelli Evelina
Published: August 2019

Objectives

To assess the association between country income status and national prevalence of invasive infections caused by the top-ranked bacteria on the WHO priority list: carbapenem-resistant (CR) Acinetobacter spp., Klebsiella spp. and Pseudomonas aeruginosa; third-generation cephalosporin-resistant (3GCR) Escherichia coli and Klebsiella spp.; and MRSA and vancomycin-resistant Enterococcus faecium (VR E. faecium).

Methods

Active surveillance systems providing yearly prevalence data from 2012 onwards for the selected bacteria were included. The gross national income (GNI) per capita was used as the indicator for income status of each country and was log transformed to account for non-linearity. The association between antibiotic prevalence data and GNI per capita was investigated individually for each bacterium through linear regression.

Results

Surveillance data were available from 67 countries: 38 (57%) were high income, 16 (24%) upper-middle income, 11 (16%) lower-middle income and two (3%) low income countries. The regression showed significant inverse association (P<0.0001) between resistance prevalence of invasive infections and GNI per capita. The highest rate of increase per unit decrease in log GNI per capita was observed in 3GCR Klebsiella spp. (22.5%, 95% CI 18.2%–26.7%), CR Acinetobacter spp. (19.2% 95% CI 11.3%–27.1%) and 3GCR E. coli (15.3%, 95% CI 11.6%–19.1%). The rate of increase per unit decrease in log GNI per capita was lower in MRSA (9.5%, 95% CI 5.2%–13.7%).

Conclusions

The prevalence of invasive infections caused by the WHO top-ranked antibiotic-resistant bacteria is inversely associated with GNI per capita at the global level. Public health interventions designed to limit the burden of antimicrobial resistance should also consider determinants of poverty and inequality, especially in lower-middle income and low income countries.
Pulmonary Coccidioidomycosis Mimicking Aspergillosis Fungus Ball
Authors: Sathirareuangchai Sakda , Whelen A Christian
Published: August 2019

The genus Coccidioides is composed of C. immitis and C. posadasii. Both can cause coccidioidomycosis and are geographically restricted to certain areas of endemicity. The histopathologic features in pulmonary coccidioidomycosis include necrotizing granulomatous inflammation and the presence of spherules, which is considered to be a key diagnostic finding. Cavitary lung disease containing a fungal ball with branching septate hyphae is an unusual funding in pulmonary coccidioidomycosis but is typical for aspergillosis. We present a case of 42 year old man who underwent wedge resection of the lung for a persistent cavitary lesion. The microscopic examination shows a fungal ball composed of acute-angle branching septate hyphae, consistent with a diagnosis of aspergillosis. However, cultures and molecular testing by DNA sequencing of the 28S ribosomal DNA gene confirmed the identification of C. posadasii. This finding highlights the importance of exposure history and organism identification by either conventional cultivation or molecular testing in rendering an accurate diagnosis.
Clinical features and therapeutic response in adult and pediatric patients with American tegumentary leishmaniasis in Rio de Janeiro
Authors: Senna Tatiana C R , Pimentel Maria Inês F , Oliveira Liliane F A , Lyra Marcelo R , Saheki Mauricio N , Salgueiro Mariza M , Valete-Rosalino Cláudia M , Martins Ana Cristina C , Schubach Armando O , Bedoya-Pacheco Sandro J
Published: August 2019

Background

American tegumentary leishmaniasis (ATL) is a neglected disease with wide territorial distribution. Knowledge is scarce in children and adolescents. This study aims to compare the clinical features and response to antimony treatment in pediatric and adult patients with cutaneous leishmaniasis.

Methods

A retrospective cohort study was performed with 659 patients who attended a reference centre in Rio de Janeiro, Brazil, from 2000 to 2015. The pediatric cohort consisted of 131 (20%) patients and the adult cohort consisted of 528 (80%) patients.

Results

The epidemiological profile, antimony therapeutic response and incidence of adverse events (AE) were different in the pediatric cohort compared with the adult cohort. Mucosal form was less frequent in the pediatric cohort (RR:0.49, p=0.011). Lesions in the head, neck and trunk were more frequent in the pediatric cohort (RR:1.49, p=0.043). The effectiveness of antimony treatment was superior in the pediatric cohort (88.3% vs 76.6%) with a shorter healing time (RR:0.49, p=0.009). Pediatric patients had lower proportions of moderate to severe AE compared with adults (RR:0.45, p=0.027). Clinical AE predominated in the adult cohort (RR:0.40, p=0.000) and laboratory AE in the pediatric cohort (RR:1.50, p=0.023).

Conclusions

This study adds to the body of knowledge on differences that exist between different age groups in ATL.
B-cell responses in allergen immunotherapy
Authors: Satitsuksanoa Pattraporn , van de Veen Willem , Akdis Mübeccel
Published: August 2019

Purpose of review

The establishment of long-term clinical tolerance in AIT requires the involvement of basophils, mast cells, allergen-specific regulatory T and B cells, downregulation of effector type 2 responses, and increase in production of specific IgG, particularly immunglobulin G4 (IgG4) antibodies. This review aims to provide an overview of the role of B cells in AIT, their mechanism of action, and their potential for improving AIT.

Recent findings

In-depth research of B cells has paved the way for improved diagnosis and research on allergic diseases. B cells play a central role in allergy and allergen tolerance through the production of immunglobulin E (IgE)-blocking antibodies. However, an increasing body of evidence has emerged supporting a role for B cells in regulating immune responses that extends beyond the production of antibodies. Regulatory B cells play an important role in immunosuppression, mediated by secretion of anti-inflammatory cytokines.

Successful AIT establishes the reinstatement of immune tolerance toward allergens, reduces allergic symptoms, and improves clinical treatments in patients. B cells play a central role in this process through antibody-independent immune regulatory processes in addition to the production of IgE-blocking antibodies.
Sedative/Tranquilizer Misuse is Associated With Alcohol and Illicit Drug Problems, Mental Health Issues, and Impulsivity and Compulsivity in University Students
Authors: Grant Jon E. , Lust Katherine , Chamberlain Samuel R.
Published: August 2019

Background:

This study examined the prevalence of sedative/tranquilizer misuse among university students and its associations with psychosocial correlates.

Methods:

Nine thousand four hundred forty-nine students received a 156-item anonymous online survey, which assessed the use of prescription sedative/tranquilizer (ever or past year), alcohol and drug use, mental health issues, and impulsive and compulsive traits. Sedative/tranquilizer misuse was defined as intake of these prescription drugs by individuals who had not been prescribed them.

Results:

Three thousand five hundred twenty-five university students (57.7% women) responded to the survey. The prevalence of past 12-month prescription sedative/tranquilizer misuse was 2.1%, with 2.8% reporting having used more than 12 months ago. Prescription sedative/tranquilizer misuse was associated with the use of multiple other drugs (eg, alcohol, opiates each P < 0.001). Those who misuse sedative/tranquilizers were significantly more likely to have mental health histories (P < 0.001), engage in riskier sexual behavior (ie, earlier sexual acts [P < 0.001] and less frequent use of barrier contraception [P = 0.001]), report low self-esteem (P = 0.001), and endorse traits of impulsivity (P < 0.001) and compulsivity (P < 0.001). Effect sizes were small to medium.

Conclusions:

Misuse of prescription sedative/tranquilizers was reported by 2% to 3% of university students and was associated with a variety of mental health and drug use problems. Clinicians should be aware that certain mental health conditions are more likely in those who misuse sedatives. This study indicates the need for longitudinal research into the effects of chronic sedative use on brain function and mental health, especially in young people. Such research should address the extent to which impulsive traits predispose to various substance use problems, versus the direct effects of sedatives (and other substances) on mental health
Development and Evaluation of a Quick Response Code–Based Nursing Education Program for Operating and Recovery Room Nurses
Authors: Park Eun Woo , Lee Hanna , Yun Eun Kyoung
Published: August 2019

The purpose of this study was to develop and evaluate the effectiveness of a quick response code–based nursing education program to improve the competence of operation and recovery room nurses. An experimental methodological design was used to develop a quick response code–based nursing educational program and analyze its effects and nurses' satisfaction with its use. The quick response code–based nursing education program was developed in five steps based on the ADDIE model: analysis, design, development, implementation, and evaluation. The program was built on smartphones, and a Web site was linked to it. After testing the program for 40 days, nurses' attitudes toward various medical devices were significantly less negative. Nurses were able to use a large number of medical devices and were highly satisfied and willing to engage with the quick response code–based nursing educational program. In the context of nursing education, introducing educational content using quick response codes helps to improve nurses' knowledge and competence in providing high-quality nursing care and medical services.
Causal Effect of Sleep Duration on Body Weight in Adolescents
Authors: Do Young Kyung
Published: August 2019

Background:

A large number of observational epidemiologic studies have reported consistent associations between short sleep duration and increased body weight, particularly in children and adolescents. Causal evidence on the effect of sleep duration on body weight is still limited, however.

Methods:

This study exploits a unique natural experiment that can be argued to have increased sleep duration in an adolescent population in South Korea. In March 2011, authorities in three of the 16 administrative regions decreed restricting the closing hours of hagwon (private tutoring institutes) to 10 pm. Assuming this policy change is a valid instrument for sleep duration, it allows investigation of the causal effect of sleep duration on body weight in a difference-in-differences and instrumental variable framework. We used a nationally representative sample of 191,799 in-school adolescents in 7th–12th grades surveyed in the 2009−2012 Korea Youth Risk Behavior Web-based Survey.

Results:

The policy change was associated with sleep extension and body weight reduction in a subset of general high school 10th−11th graders (around 10% of the sample) whose sleep duration would otherwise have not increased. The main results suggested that a 1-hour increase in sleep duration was associated with a 0.56 kg/m2 reduction in body mass index (95% confidence interval = 0.07, 1.05) and a decreased risk of being overweight or obese by 4.2% points.

Conclusions:

This study provides new population-level, causal evidence that corroborates consistent findings in the epidemiologic literature on the link between short sleep duration and increased body weight.
Risk Factors for Readmission After Cleft Lip Repair
Authors: Chouairi Fouad , Mercier Michael R. , Mets Elbert J. , Alperovich Michael
Published: August 2019

Background:

Cleft lip is the most common craniofacial malformation with an incidence of 1 in 700 live births. Our study sought to evaluate incidences and risk factors readmission following CLP repair using a well-validated national surgical database.

Methods:

All cleft lip repairs performed between 2012 and 2016 were identified in the American College of Surgeons National Surgical Quality Improvement Program Pediatric Database. Patient demographics, surgical variables, and reasons for readmission were analyzed and identified. A binary logistic regression was performed to identify factors independently associated with readmission following cleft lip repair.

Results:

The 4550 cleft lip repairs were identified with a thirty-day readmission rate of 3.8% (173 patients). A higher incidence of readmission was identified among patients with developmental delay (P ≤0.001), seizure disorder (P <0.001), structural central nervous system abnormality (P ≤0.001), steroid use within 30 days (P ≤0.001), a requirement for nutritional support (P <0.001), and ASA of 3 or higher (17.3% vs 9.9%, P <0.001). Readmitted patients were more likely to have deep incisional surgical site infections (P <0.001), deep wound dehiscence (P = 0.002), reoperation (P <0.001), pneumonia (P <0.001), and unplanned intubation (P <0.001).

Multivariate regression identified seizure disorder (OR = 3.3; 95% CI = 1.3–8.3; P = 0.012) and steroid use within 30 days (OR = 3.8; 95% CI = 1.1–12.2; P = 0.030) as independently associated with readmission. The mean time of readmission was 9 days after operation.

Conclusion:

Patients with seizure disorder and steroid use were significantly more likely to be readmitted. Physicians should be cautious with management of patients with these risk factors.
Clinical Trial of Manual Reduction of Temporomandibular Joint Dislocation After Inhalation of Nitrous Oxide
Authors: Liu Mingwen , Liu Min , Lv Kun
Published: August 2019

Objective:

The aim of this study was to evaluate the efficiency of inhaled nitrous oxide (N2O) for manual reduction of acute nontraumatic temporomandibular joint (TMJ) dislocation in the supine position technique.

Methods:

This clinical trial included a total of 51 patients presenting with acute nontraumatic TMJ dislocation. The patients were grouped randomly. The supine position technique was applied in both N2O group (experimental group) and control group (without N2O). The visual analogue scale scores (VAS scores) of the pain perception and the operation time were recorded.

Results:

All patients with dislocated mandible were successfully managed. The VAS scores of pain perception were significantly reduced in N2O group. It was 1.63 compared to 4.00 in control group. The average operation time was also significantly reduced in N2O group (Supplemental Digital Content, Table 2, http://links.lww.com/SCS/A716). It was 129.92 seconds compared to 170.04 seconds in control group.

Conclusion:

Inhalation of N2O helps to reduce the pain perception and the operation time of manual reduction of acute nontraumatic TMJ dislocation using the supine position technique. It is beneficial to both patients and doctors.
Staged Biliary Reconstruction After Orthotopic Liver Transplantation: A Practical Surgical Strategy for High-Acuity Adult Recipients
Authors: Pearson Terra , Zimmerman Michael A. , Kim Joohyun , Palines Patrick A. , Eriksen Calvin M. , Wong Melissa , Selim Motaz A. , Markovic Daniela , Hong Johnny C.
Published: August 2019

Background.

Biliary complications (BC) following orthotopic liver transplantation (OLT) is strongly associated with inferior patient outcomes and increased healthcare cost. BC in high-acuity patients can be lethal. While the utility of staged biliary reconstruction after liver transplantation (SBRALT) has been reported in adult and pediatric OLT, biliary outcome data are scarce. We sought to evaluate the clinical utility and outcomes of SBRALT in high-acuity transplant recipients.

Methods.

We conducted an analysis from our prospective database of 149 adult OLT between January 1, 2012, and September 30, 2017. Mean follow-up was 26 months. Variables were compared for Group I: one-stage OLT with biliary reconstruction (N = 58) versus Group II: SBRALT (N = 91).

Results.

Compared with Group I, patients in Group II had higher acuity of illness: median model for end-stage liver disease scores (19 vs 35 P = 0.002), requirement for pretransplant intensive care unit (29.3% vs 54.9%, P = 0.022), pretransplant renal replacement therapy (15.5% vs 48.4%), estimated blood loss (2000 vs 4750 mL, P < 0.001), and intraoperative packed red blood cells transfusion (4 vs 10 units, P < 0.001). For Group II, biliary reconstruction was performed between 1 and 6 days after OLT. Hepaticojejunostomy was performed in 8.6% (Group I) and 26.4% (Group II), P = 0.010. For Groups I and II, BC rates (8.6% vs 7.7%, P = 0.955) and 1-year graft failure-free survival rates (89.7% vs 88.2%, P = 0.845) were comparable.

Conclusions.

Graft failure-free survival and biliary outcomes of SBRALT in high-acuity recipients are excellent and comparable to one-stage OLT for low-risk patients. SBRALT is a practical surgical strategy in complex OLT.
Long-term dietary intervention reveals resilience of the gut microbiota despite changes in diet and weight
Authors: Fragiadakis Gabriela K , Wastyk Hannah C. , Robinson Jennifer L. , Sonnenburg Erica D. , Sonnenburg Justin L. , Gardner Christopher D.
Published: August 2019

With the rising rates of obesity and associated metabolic disorders, there is a growing need for effective long-term weight loss strategies, coupled with an understanding of how they interface with host physiology. While diet is a critical and promising area of focus, it has been difficult to identify diets that are broadly effective in long-term weight management. To explore the interaction between specific diets and bacteria within the gut, we tracked microbiota composition over a 12-month period as part of a larger dietary intervention study of participants consuming either a low-carbohydrate or low-fat diet. While baseline microbiota composition was not predictive of weight loss, each diet resulted in substantial changes in the microbiota three months after the start of the intervention; some of these changes were diet-specific and others tracked with weight loss. After these initial shifts, the microbiota returned near its original baseline state for the remainder of the intervention, despite participants maintaining their diet and weight loss for the entire study. These results suggest a resilience to perturbation of the microbiome’s starting state. When considering the established contribution of obese-associated microbiotas to weight gain in animal models, microbiota resilience may need to be overcome for long-term alterations to host physiology.
Neuroimaging contrast across the cortical hierarchy is the feature maximally linked to behavior and demographics
Authors: Han Feng , Gu Yameng , Brown Gregory L , Zhang Xiang , Liu Xiao
Published: August 2019

We employed a data-driven canonical correlation analysis to investigate the population covariance of whole-brain cortical thickness, resting-state functional connectivity, and hundreds of behavioral/demographic measures in a large cohort of individuals. We found that the maximal thickness-behavior correlation and the maximal connectivity-behavior correlation are largely converged along the same direction across subjects, which is characterized by very specific modulations of all three modalities. Along this direction, individuals tend to have more positive and less negative behavioral/demographic traits, and more importantly, their functional connectivity and cortical thickness show a similar divergent modulation across the cortical hierarchy: thinner cortex and stronger functional connectivity at the higher-order cognitive regions whereas thicker cortex and weaker connectivity at the lower-order sensory/motor areas. These findings provide a unique link between structural and functional brain organizations and human behavior. Specifically, they suggest that the cross-hierarchy contrast of structural and functional brain measures may be a specific feature linked to the overall goodness of behavior and demographics.
DNA methylation change in neurotrophic genes with aging and delirium evidenced from three independent cohorts
Authors: Saito Taku , Braun Patricia R. , Daniel Sophia , Jellison Sydney S. , Hellman Mandy , Shinozaki Eri , Lee Sangil , Cho Hyunkeun R. , Yoshino Aihide , Toda Hiroyuki , Shinozaki Gen
Published: August 2019

INTRODUCTION

We previously reported the association between DNA methylation (DNAm) of pro-inflammatory cytokine genes and aging. Neurotrophic factors are also known to be associated with aging and neurocognitive disorders. Thus, we hypothesized that DNAm of neurotrophic genes change with aging, especially in delirium patients.

METHODS

DNAm were analyzed using HumanMethylationEPIC BeadChip Kit in 3 independent cohorts; blood from 383 Grady Trauma Project subjects, brain from 21 neurosurgery patients, and blood from 87 inpatients with and without delirium.

RESULTS

Both blood and brain samples showed that most of the DNAm of neurotrophic genes were positively correlated with aging. Furthermore, DNAm of neurotrophic genes were positively correlated with aging in delirium cases than in non-delirium controls.

DISCUSSION

These findings support our hypothesis that the neurotrophic genes may be epigenetically modulated with aging, and this process may be contributing to the pathophysiology of delirium.
Scientific instrument Femtosecond X-ray Experiments (FXE): instrumentation and baseline experimental capabilities
Authors: Galler Andreas , Gawelda Wojciech , Biednov Mykola , Bomer Christina , Britz Alexander , Brockhauser Sandor , Choi Tae-Kyu , Diez Michael , Frankenberger Paul , French Marcus , Görries Dennis , Hart Matthiew , Hauf Steffen , Khakhulin Dmitry , Knoll Martin , Korsch Timo , Kubicek Katharina , Kuster Markus , Lang Philipp , Alves Lima Frederico , Otte Florian , Schulz Sebastian , Zalden Peter , Bressler Christian
Published: August 2019

The European X-ray Free-Electron Laser (EuXFEL) delivers extremely intense (>1012 photons pulse−1 and up to 27000 pulses s−1), ultrashort (<100 fs) and transversely coherent X-ray radiation, at a repetition rate of up to 4.5 MHz. Its unique X-ray beam parameters enable novel and groundbreaking experiments in ultrafast photochemistry and material sciences at the Femtosecond X-ray Experiments (FXE) scientific instrument. This paper provides an overview of the currently implemented experimental baseline instrumentation and its performance during the commissioning phase, and a preview of planned improvements. FXE's versatile instrumentation combines the simultaneous application of forward X-ray scattering and X-ray spectroscopy techniques with femtosecond time resolution. These methods will eventually permit exploitation of wide-angle X-ray scattering studies and X-ray emission spectroscopy, along with X-ray absorption spectroscopy, including resonant inelastic X-ray scattering and X-ray Raman scattering. A suite of ultrafast optical lasers throughout the UV–visible and near-IR ranges (extending up to mid-IR in the near future) with pulse length down to 15 fs, synchronized to the X-ray source, serve to initiate dynamic changes in the sample. Time-delayed hard X-ray pulses in the 5–20 keV range are used to probe the ensuing dynamic processes using the suite of X-ray probe tools. FXE is equipped with a primary monochromator, a primary and secondary single-shot spectrometer, and a timing tool to correct the residual timing jitter between laser and X-ray pulses.
Dynamic characteristics of a jumping robot with coordinated quadruped legs
Authors: Zhong Jun , Ma Ruqi
Published: August 2019

Purpose

Jumping robots with coordinated multiple legs have been a hot research subject during the past years because of their excellent abilities in fast moving and obstacle-climbing. However, dynamics of jumping process of these coordinated legged robots are complex because of collisions between coordinated legs and the ground. This paper aims to analyze features of jumping process and to present the kinematic and dynamic models of a novel sole-type quadruped jumping robot with variable coordinated joints.

Design/methodology/approach

A complete jumping period of is divided into several subphases according to contact status of different coordinated legs to the ground. Continuous dynamics and discrete dynamics are established in different subphases. Simulations are performed in MATLAB software and ADAMS environment.

Findings

Comparison between two-set simulated results acquired from ADAMS and MATLAB demonstrates the validity of kinematic and dynamic equations.

Originality/value

The established dynamics establish the foundation of further research in motion planning and controller design of coordinated multiple legs.