bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the linking arm effect on the biological performance of a CD31 agonist directly grafted on L605 CoCr alloy by a plasma-based multistep strategy
Authors: Diaz-Rodriguez Sergio , Loy Caroline , Chevallier Pascale , Noël Céline , Caligiuri Giuseppina , Houssiau Laurent , Mantovani Diego
Published: November 2019

Stents are cardiovascular implants deployed on atherosclerotic arteries that aid in reopening, sustaining, and avoiding their collapse. Nevertheless, postimplantation complications exist, and the risk of the renewal of the plaque subsists. Therefore, enhanced properties are mandatory requirements for clinics. For that purpose, a novel approach allowing the direct-grafting of bioactive molecules on cobalt-chromium devices (L605) has been developed. This original strategy involves the direct plasma functionalization of metallic surfaces with primary amines (–NH2). These groups act as anchor points to covalently graft biomolecules of interest, herein a peptide derived from CD31 (P23) with proendothelialization and antithrombotic properties. However, the biological activity of the grafted peptide could be impacted by its conformation. For this study, glutaric anhydride (GA), a short chain spacer, and polyethylene glycol (PEG) with antifouling properties were used as linking arms (LAs). The covalent grafting of the CD31 agonist on L605 by different LAs (GA-P23 and PEG-P23) was confirmed by XPS and ToF-SIMS analyses. The biological performance of these functionalized surfaces showed that, compared to the electropolished (EP) alloy, grafting the P23 with both LA increases adhesion and proliferation of endothelial cells (ECs) since day 1: EP = 68 ± 10%, GA-P23 = 101 ± 7%, and PEG-P23 = 106 ± 5% of cell viability. Moreover, ECs formed a complete monolayer at the surface, preventing clot formation (hemoglobin-free >80%). The potential of this plasma-based strategy for cardiovascular applications was confirmed by promoting a fast re-endothelialization, by improving the hemocompatibility of the alloy when coupled with the CD31 agonist and by its transfer onto commercial L605 stents, as confirmed by ToF-SIMS.
Subunit cell–level measurement of polarization in an individual polar vortex
Authors: Sun Yuanwei , Abid Adeel Y. , Tan Congbing , Ren Chuanlai , Li Mingqiang , Li Ning , Chen Pan , Li Yuehui , Zhang Jingmin , Zhong Xiangli , Wang Jinbin , Liao Min , Liu Kaihui , Bai Xuedong , Zhou Yichun , Yu Dapeng , Gao Peng
Published: November 2019

We report accurates and informative measurement with subunit cell resolution for local polarization distribution in ferroelectrics.
Avalanches and criticality in self-organized nanoscale networks
Authors: Mallinson J. B. , Shirai S. , Acharya S. K. , Bose S. K. , Galli E. , Brown S. A.
Published: November 2019

Electrical signals in networks of nanoparticles emulate correlated avalanches of signals and criticality in the brain.
TiO
2
metasurfaces: From visible planar photonics to photochemistry
Authors: Wu Yunkai , Yang Wenhong , Fan Yubin , Song Qinghai , Xiao Shumin
Published: November 2019

The applications of TiO
2
metasurfaces are extended from static planar visible photonics to dynamic devices and photochemistry.
Resolving the topological classification of bismuth with topological defects
Authors: Nayak Abhay Kumar , Reiner Jonathan , Queiroz Raquel , Fu Huixia , Shekhar Chandra , Yan Binghai , Felser Claudia , Avraham Nurit , Beidenkopf Haim
Published: November 2019

We used screw dislocations as a tool to probe spectroscopically the topological classification of electronic matter in bismuth.
Dissociating stable nitrogen molecules under mild conditions by cyclic strain engineering
Authors: Han Gao-Feng , Shi Xiang-Mei , Kim Seok-Jin , Kim Jeonghun , Jeon Jong-Pil , Noh Hyuk-Jun , Im Yoon-Kwang , Li Feng , Uhm Young Rang , Kim Chul Sung , Jiang Qing , Baek Jong-Beom
Published: November 2019

The dissociation of stable diatomic nitrogen molecules under mild conditions was realized via cyclic strain engineering.
Alteration of Fermentative Metabolism Enhances Mucor circinelloides Virulence
Authors: Díaz-Pérez Sharel P. , Patiño-Medina J. Alberto , Valle-Maldonado Marco I. , López-Torres Adolfo , Jácome-Galarza Irvin E. , Anaya-Martínez Verónica , Gómez-Ruiz Verónica , Campos-García Jesús , Nuñez-Anita Rosa E. , Ortiz-Alvarado Rafael , Ramírez-Díaz Martha I. , Gutiérrez-Corona J. Félix , Meza-Carmen Víctor
Published: November 2019

The fungus
Mucor circinelloides
undergoes yeast-mold dimorphism, a developmental process associated with its capability as a human opportunistic pathogen. Dimorphism is strongly influenced by carbon metabolism, and hence the type of metabolism likely affects fungus virulence. We investigated the role of ethanol metabolism in
M. circinelloides
virulence.
Three Amino Acid Changes in Avian Coronavirus Spike Protein Allow Binding to Kidney Tissue
Authors: Bouwman Kim M. , Parsons Lisa M. , Berends Alinda J. , de Vries Robert P. , Cipollo John F. , Verheije Monique H.
Published: November 2019

Infectious bronchitis virus is the causative agent of infectious bronchitis in chickens. Upon infection of chicken flocks, the poultry industry faces substantial economic losses by diminished egg quality and increased morbidity and mortality of infected animals. While all IBV strains infect the chicken respiratory tract via the ciliated epithelial layer of the trachea, some strains can also replicate in the kidneys, dividing IBV into the following two pathotypes: nonnephropathogenic (example, IBV-M41) and nephropathogenic viruses (including IBV-QX). Here, we set out to identify the determinants for the extended nephropathogenic tropism of IBV-QX. Our data reveal that each pathotype makes use of a different sialylated glycan ligand, with binding sites on opposite sides of the attachment protein. This knowledge should facilitate the design of antivirals to prevent coronavirus infections in the field.
Regime Shifts in a Phage-Bacterium Ecosystem and Strategies for Its Control
Authors: Maslov Sergei , Sneppen Kim
Published: November 2019

Phage-microbe communities play an important role in human health as well as natural and industrial environments. Here we show that these communities can assume several alternative species compositions separated by abrupt regime shifts. Our model predicts these regime shifts in the competition between bacterial strains protected by two different phage defense mechanisms: abortive infection/CRISPR and partial resistance. The history dependence caused by regime shifts greatly complicates the task of manipulation and control of a community. We propose and study a successful control strategy via short population pulses aimed at inducing the desired regime shifts. In particular, we predict that a fast-growing pathogen could be eliminated by a combination of its phage and a slower-growing susceptible host.
Anthropometric measures that identify premature and low birth weight newborns in Ethiopia: a cross-sectional study with community follow-up
Authors: Gidi Netsanet Workneh , Berhane Melkamu , Girma Tsinuel , Abdissa Alemseged , Lim Ruth , Lee Katherine , Nguyen Cattram , Russell Fiona
Published: November 2019

Objective

To investigate foot length (FL), chest circumference (CHC) and mid-upper arm circumference (MUAC) as predictors of low birth weight (LBW) or prematurity, and to describe the agreement between the gestational age (GA) assessments ascertained by the New Ballard Score (NBS) and the Eregie model.

Methods

A hospital-based cross-sectional study with community follow-up in a subset was conducted in Jimma University Medical Center, Ethiopia. GA (NBS and Eregie model), weight, FL, CHC and MUAC were measured at birth. Anthropometrics were repeated at 5 days of age.

Results

The optimal cut-offs indicative of LBW were ≤7.7 cm for FL; ≤31.2 cm for CHC and ≤9.8 cm for MUAC. CHC, MUAC and FL identified LBW with sensitivities (95% CI) of 91.6 (86.9 to 95), 83.7 (77.8 to 88.5) and 84.2 (78.4 to 88.9), and specificities (95% CI) of 85.4 (83.3 to 87.4), 90.2 (88.4 to 91.9) and 73.9 (71.3 to 76.4), respectively. CHC, MUAC and FL identified prematurity with sensitivities of 83.8 (76.7 to 89.4), 83.1 (75.9 to 88.9) and 81.7 (74.3 to 87.7), and specificities of 81.1 (78.9 to 83.3), 63.4 (60.7 to 66.1) and 77.0 (74.6 to 79.3), respectively. The cut-offs identified have comparable diagnostic ability for LBW and prematurity when measurements are repeated on day 5 of age. The GA assessment by the NBS and the Eregie model gave similar results, with the mean difference of 1.2 weeks.

Conclusion

CHC, MUAC and FL taken on day 1 and 5 after birth could be used as diagnostic tools for LBW or prematurity. The Eregie model for GA estimation gives similar results to the NBS.
Biologic therapy for Behçet’s uveitis: a systematic review
Authors: Uke Perpetual , Gorodkin Rachel , Beare Nicholas
Published: November 2019

Background

Biologics are increasingly used in management of Behçet’s Disease (BD) including ocular BD, but the evidence base is limited, mostly from studies of uveitis and BD manifestations.

Objective

To review the evidence base for biologics in the treatment of ocular BD.

Methods

Systematic literature search was made using exploded key words—Behçet’s, ocular, biologics in MEDLINE, Cochrane library, Database of Abstracts Reviews and Effects, Clinical Trials.gov, Science Direct and Google Scholar. There was no limitation on region, language or date (Search updated 16th October 2018). Literature retrieval was restricted to randomised controlled trials (RCTs) of biologics.

Results

Of 237 papers retrieved, eight met the inclusion criteria. RCTs on interferon alpha 2a (INF-α 2a), adalimumab, secukinumab, gevokizumab, rituximab and daclizumab were retrieved (two for adalimumab and gevokizumab). The outcome measures were not met for secukinumab, daclizumab and gevokizumab. Rituximab and INF-α 2a showed promising preliminary results but sufficiently powered RCTs are needed to provide adequate evidence of efficacy. The RCTs on adalimumab did not evaluate efficacy for BD uveitis specifically, hence are of limited value for this review.

Conclusion

Some biologics show promise in treating BD uveitis, but more RCTs are needed for firm conclusions about efficacy. A phase IV study or, registry of adalimumab could provide data on its efficacy in BD uveitis compared to other forms.
Congenital nasolacrimal duct obstruction continues trend for spontaneous resolution beyond first year of life
Authors: Nakayama Tomomichi , Watanabe Akihide , Rajak Saul , Yamanaka Yukito , Sotozono Chie
Published: November 2019

Purpose

To investigate spontaneous resolution of congenital nasolacrimal duct obstruction (CNLDO) beyond 12 months of age in Japanese infants.

Methods

Retrospective, observational case series. We retrospectively reviewed the clinical records of patients diagnosed with CNLDO beyond 12 months of age at Kyoto Prefectural University Hospital, Kyoto, Japan. This study involved 155 cases of CNLDO in 133 Japanese infants diagnosed with CNLDO. All patients chose intervention with either dacryoendoscopic guided probing and stenting or conservative management. The proportion and age of patients who had spontaneous CLNDO resolution were analysed.

Results

The patients were divided into two groups: (1) 62 patients with 70 obstructed nasolacrimal ducts (45%) in whom spontaneous resolution occurred and (2) 71 patients with 85 obstructed nasolacrimal ducts (55%) who underwent dacryoendoscopic guided probing and stenting. The mean age of spontaneous resolution was 17.8±5.3 months (range: 12.0–35.4 months). Dacryoendoscopic guided probing and stenting were successful in 83/85 (97.6%) of cases.

Conclusions

Spontaneous resolution of CNLDO can occur in 45% of infants over the age of 12 months. Dacryoendoscopic guided stenting also has high success rates in this patient group, and both treatment options can be proposed to caregivers.
Realist evaluations in low- and middle-income countries: reflections and recommendations from the experiences of a foreign researcher
Authors: Gilmore Brynne
Published: November 2019

Realist evaluation, a methodology for exploring generative causation within complex health interventions to understand ‘how, why and for whom’ programmes work, is experiencing a surge of interest. Trends indicate that the proliferation in the use of this methodology also applies to research in low- and middle-income countries (LMICs). The value of using realist evaluation for project evaluation is also being noticed by non-governmental organisations (NGOs) and other programme implementers within such contexts. Yet, there is limited exploration of the use of realist evaluations in LMICs, especially their use by foreign researchers. This paper draws on the author’s experience of conducting two realist evaluations across three different sub-Saharan African settings: Mundemu, Tanzania; Kabale, Uganda and Marsabit, Kenya. The realist evaluations were used as an operations research methodology to study two NGO community health programmes. This paper highlights four main challenges experienced by the author throughout the methodological process: (1) power imbalances prevalent during realist interviews, (2) working through translation and what this means for identfying Context-Mechanism-Outcome Configurations, (3) limited contextual familiarity and being an ‘engaged researcher’ and (4) the use or dependence on ‘WEIRD’ theories (i.e. theories based on the study of Western, Educated, Industrialized, Rich, Democratic people) within testing and refinement. Realist evaluation’s enticing and straightforward slogan of finding ‘what works, for whom and why’ is in contrast to the complexity of the methodology used to generate these results (and often to the results themselves). Striking a balance between theory and pragmatism, while adhering to realist ontological underpinnings of generative causation and retroduction, is no easy task. This paper concludes by providing concrete recommendations for those who want to undertake a realist evaluation, with particular attention to cross-cultural settings, in light of the aforementioned challenges. In doing so, it aims to foster improved methodological rigour and help those engaging in this research methodology to work towards more appropriate and contextually relevant findings.
Self-reported health problems and obesity predict sickness absence during a 12-month follow-up: a prospective cohort study in 21 608 employees from different industries
Authors: Pihlajamäki Minna , Uitti Jukka , Arola Heikki , Ollikainen Jyrki , Korhonen Mikko , Nummi Tapio , Taimela Simo
Published: November 2019

Objectives

To study whether self-reported health problems predict sickness absence (SA) from work in employees from different industries.

Methods

The results of a health risk appraisal (HRA) were combined with archival data of SA of 21 608 employees (59% female, 56% clerical). Exposure variables were self-reported health problems, labelled as ‘work disability (WD) risk factors’ in the HRA, presence of problems with occupational well-being and obesity. Age, socioeconomic grading and the number of SA days 12 months before the survey were treated as confounders. The outcome measure was accumulated SA days during 12-month follow-up. Data were analysed separately for males and females. A Hurdle model with negative binomial response was used to analyse zero-inflated count data of SA.

Results

The HRA results predicted the number of accumulated SA days during the 12-month follow-up, regardless of occupational group and gender. The ratio of means of SA days varied between 2.7 and 4.0 among those with ‘WD risk factors’ and the reference category with no findings, depending on gender and occupational group. The lower limit of the 95% CI was at the lowest 2.0. In the Hurdle model, ‘WD risk factors’, SA days prior to the HRA and obesity were additive predictors for SA and/or the accumulated SA days in all occupational groups.

Conclusion

Self-reported health problems and obesity predict a higher total count of SA days in an additive fashion. These findings have implications for both management and the healthcare system in the prevention of WD.
Effectiveness of topical and ablative therapies in treatment of anogenital warts: a systematic review and network meta-analysis
Authors: Barton Samantha , Wakefield Victoria , O'Mahony Colm , Edwards Steven
Published: November 2019

Objective

To generate estimates of comparative clinical effectiveness for interventions used in the treatment of anogenital warts (AGWs) through the systematic review, appraisal and synthesis of data from randomised controlled trials (RCTs).

Design

Systematic review and network meta-analysis of RCTs. Search strategies were developed for MEDLINE, Embase, the Cochrane Library and the Web of Science. For electronic databases, searches were run from inception to March 2018. The systematic review was carried out following the general principles recommended in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement.

Participants

People aged ≥16 years with clinically diagnosed AGWs (irrespective of biopsy confirmation).

Interventions

Topical and ablative treatments recommended by the British Association for Sexual Health and HIV for the treatment of AGWs, either as monotherapy or in combination versus each other.

Outcome measures

Complete clearance of AGWs at the end of treatment and at other scheduled visits, and rate of recurrence.

Results

Thirty-seven RCTs met inclusion criteria. Twenty studies were assessed as being at unclear risk of bias, with the remaining studies categorised as high risk of bias. Network meta-analysis indicates that, of the treatment options compared, carbon dioxide laser therapy is the most effective treatment for achieving complete clearance of AGWs at the end of treatment. Of patient-applied topical treatments, podophyllotoxin 0.5% solution was found to be the most effective at achieving complete clearance, and was associated with a statistically significant difference compared with imiquimod 5% cream and polyphenon E 10% ointment (p<0.05). Few data were available on recurrence of AGWs after complete clearance. Of the interventions evaluated, surgical excision was the most effective at minimising risk of recurrence.

Conclusion

Of the studies assessed, as a collective, the quality of the evidence is low. Few studies are available that evaluate treatment options versus each other.

Trial registration number

CRD42013005457
Effectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy (EMERALD)
Authors: Lois Noemi , Cook Jonathan , Aldington Stephen , Waugh Norman , Mistry Hema , Sones William , McAuley Danny , Aslam Tariq , Bailey Claire , Chong Victor , Ghanchi Faruque , Scanlon Peter , Sivaprasad Sobha , Steel David , Styles Caroline , McNally Christine , Rice Rachael , Prior Lindsay , Azuara-Blanco Augusto
Published: November 2019

Introduction

Diabetic macular oedema (DMO) and proliferative diabetic retinopathy (PDR) are the major causes of sight loss in people with diabetes. Due to the increased prevalence of diabetes, the workload related to these complications is increasing making it difficult for Hospital Eye Services (HSE) to meet demands.

Methods and analysis

Effectiveness of Multimodal imaging for the Evaluation of Retinal oedema And new vesseLs in Diabetic retinopathy (EMERALD) is a prospective, case-referent, cross-sectional diagnostic study. It aims at determining the diagnostic performance, cost-effectiveness and acceptability of a new form of surveillance for people with stable DMO and/or PDR, which entails multimodal imaging and image review by an ophthalmic grader, using the current standard of care (evaluation of patients in clinic by an ophthalmologist) as the reference standard. If safe, cost-effective and acceptable, this pathway could help HES by freeing ophthalmologist time. The primary outcome of EMERALD is sensitivity of the new surveillance pathway in detecting active DMO/PDR. Secondary outcomes include specificity, agreement between new and the standard care pathway, positive and negative likelihood ratios, cost-effectiveness, acceptability, proportion of patients requiring subsequent full clinical assessment, unable to undergo imaging, with inadequate quality images or indeterminate findings.

Ethics and dissemination

Ethical approval was obtained for this study from the Office for Research Ethics Committees Northern Ireland (reference 17/NI/0124). Study results will be published as a Health Technology Assessment monograph, in peer-reviewed national and international journals and presented at national/international conferences and to patient groups.

Trial registration number

NCT03490318andISRCTN10856638.
Studying expressions of loneliness in individuals using twitter: an observational study
Authors: Guntuku Sharath Chandra , Schneider Rachelle , Pelullo Arthur , Young Jami , Wong Vivien , Ungar Lyle , Polsky Daniel , Volpp Kevin G , Merchant Raina
Published: November 2019

Objectives

Loneliness is a major public health problem and an estimated 17% of adults aged 18–70 in the USA reported being lonely. We sought to characterise the (online) lives of people who mention the words ‘lonely’ or ‘alone’ in their Twitter timeline and correlate their posts with predictors of mental health.

Setting and design

From approximately 400 million tweets collected from Twitter in Pennsylvania, USA, between 2012 and 2016, we identified users whose Twitter posts contained the words ‘lonely’ or ‘alone’ and compared them to a control group matched by age, gender and period of posting. Using natural-language processing, we characterised the topics and diurnal patterns of users’ posts, their association with linguistic markers of mental health and if language can predict manifestations of loneliness. The statistical analysis, data synthesis and model creation were conducted in 2018–2019.

Primary outcome measures

We evaluated counts of language features in the users with posts including the words lonely or alone compared with the control group. These language features were measured by (a) open-vocabulary topics, (b) Linguistic Inquiry Word Count (LIWC) lexicon, (c) linguistic markers of anger, depression and anxiety, and (d) temporal patterns and number of drug words. Using machine learning, we also evaluated if expressions of loneliness can be predicted in users’ timelines, measured by area under curve (AUC).

Results

Twitter timelines of users (n=6202) with posts including the words lonely or alone were found to include themes about difficult interpersonal relationships, psychosomatic symptoms, substance use, wanting change, unhealthy eating and having troubles with sleep. Their posts were also associated with linguistic markers of anger, depression and anxiety. A random forest model predicted expressions of loneliness online with an AUC of 0.86.

Conclusions

Users’ Twitter timelines with the words lonely or alone often include psychosocial features and can potentially have associations with how individuals express and experience loneliness. This can inform low-resource online assessment for high-risk individuals experiencing loneliness and interventions focused on addressing morbidities in this condition.
Knowledge and beliefs about dietary inorganic nitrate among UK-based nutrition professionals: development and application of the KINDS online questionnaire
Authors: Shannon Oliver M , Grisotto Giorgia , Babateen Abrar , McGrattan Andrea , Brandt Kirsten , Mathers John C , Siervo Mario
Published: November 2019

Objectives

To examine knowledge and beliefs about the biological roles of dietary inorganic nitrate in UK-based nutrition professionals, and to explore potential differences by participants’ education level.

Setting

An online questionnaire was administered to UK-based nutrition professionals, exploring knowledge and/or beliefs across five areas: (1) health and performance effects of nitrate; (2) current and recommended intake values for nitrate; (3) dietary sources of nitrate; (4) methods of evaluating nitrate intake and (5) nitrate metabolism.

Participants

One hundred and twenty-five nutrition professionals.

Primary outcome

Knowledge and beliefs about inorganic nitrate.

Results

Most nutrition professionals taking part in the survey had previously heard of inorganic nitrate (71%) and perceived it to be primarily beneficial (51%). The majority believed that nitrate consumption can improve sports performance (59%) and reduce blood pressure (54%), but were unsure about effects on cognitive function (71%), kidney function (80%) and cancer risk (70%). Knowledge of dietary sources of nitrate and factors affecting its content in food were generally good (41%–79% of participants providing correct answers). However, most participants were unsure of the average population intake (65%) and the acceptable daily intake (64%) of nitrate. Most participants (65%) recognised at least one compound (ie, nitric oxide or nitrosamines) that is derived from dietary nitrate in the body. Knowledge of nitrate, quantified by a 23-point index created by summing correct responses, was greater in individuals with a PhD (p=0.01; median (IQR)=13 (9–17)) and tended to be better in respondents with a masters degree (p=0.054; 13 (8–15)) compared with undergraduate-level qualifications (10 (2–14)).

Conclusions

UK-based nutrition professionals demonstrated mixed knowledge about the physiology of dietary nitrate, which was better in participants with higher education. More efficient dissemination of current knowledge about inorganic nitrate and its effects on health to nutrition professionals will support them to make more informed recommendations about consumption of this compound.
Occurrence and mortality of vasospastic angina pectoris hospitalised patients in Finland: a population-based registry cohort study
Authors: Pikkarainen Essi , Blomster Juuso , Sipilä Jussi , Rautava Päivi , Kytö Ville
Published: November 2019

Objectives

The occurrence and mortality of vasospastic angina pectoris (VAP) is largely unknown in western countries. Our objective was to clarify the occurrence, gender-distribution and mortality of VAP in Finland using a population-based hospital registry.

Methods

We studied consecutive patients aged ≥18 years hospitalized with VAP as the primary cause of admission in Finland during 2004–2014. The data were collected from obligatory nationwide registries. During the study period 1762 admissions were recorded.

Results

Majority of all VAP patients were male (59.7%) and mean age was 65.7±12.0 years. Annual admission rate for VAP was 2.29/100 000 person-years. Men were in higher risk for VAP than women (admission rate 3.00/100 000 vs 1.68/100 000; RR 1.70; p<0.0001). Gender difference was not modified by age. Likelihood of VAP was highest in population aged 70–84 years. Admission rate for VAP decreased notably during the study period. One-year all-cause mortality was 8.0% and 3-year mortality was 15.5% (cardiac mortality 11.1%). Mortality was associated with increasing age, comorbidity burden and lack of detected coronary artery obstruction, but was similar between genders and during the study period.

Conclusions

Men have higher risk for vasospastic angina caused admissions. Likelihood of vasospastic angina admission was highest in aged population. The 3-year all-cause mortality was 15.5%. Mortality was associated with increasing age, comorbidities and non-obstructive VAP diagnosis but was similar between genders.
Understanding data and information needs for palliative cancer care to inform digital health intervention development in Nigeria, Uganda and Zimbabwe: protocol for a multicountry qualitative study
Authors: Okunade Kehinde , Bashan Nkhoma Kennedy , Salako Omolola , Akeju David , Ebenso Bassey , Namisango Eve , Soyannwo Olaitan , Namukwaya Elizabeth , Dandadzi Adlight , Nabirye Elizabeth , Mupaza Lovemore , Luyirika Emmanuel , Ddungu Henry , Chirenje Z Mike , Bennett Michael I , Harding Richard , Allsop Matthew J
Published: November 2019

Introduction

Palliative care is a clinically and cost‐effective component of cancer services in sub-Saharan Africa (SSA). Despite the significant need for palliative cancer care in SSA, coverage remains inadequate. The exploration of digital health approaches could support increases in the quality and reach of palliative cancer care services in SSA. However, there is currently a lack of any theoretical underpinning or data to understand stakeholder drivers for digital health components in this context. This project addresses this gap through engaging with key stakeholders to determine data and information needs that could be supported through digital health interventions.

Methods and analysis

This is a multicountry, cross-sectional, qualitative study conducted in Nigeria, Uganda and Zimbabwe. In-depth interviews will be conducted in patients with advanced cancer (n=20), caregivers (n=15), health professionals (n=20) and policy-makers (n=10) in each of the three participating countries. Data from a total of 195 interviews will transcribed verbatim and translated into English before being imported into NVivo software for deductive framework analysis. The analysis will seek to understand the acceptability and define mechanisms of patient-level data capture and usage via digital technologies.

Ethics and dissemination

Ethics approvals have been obtained from the Institutional Review Boards of University of Leeds (Ref: MREC 18–032), Research Council of Zimbabwe (Ref: 03507), Medical Research Council of Zimbabwe (Ref: MRCZ/A/2421), Uganda Cancer Institute (Ref: 19–2018), Uganda National Council of Science and Technology (Ref: HS325ES) and College of Medicine University of Lagos (Ref: HREC/15/04/2015). The project seeks to determine optimal mechanisms for the design and development of subsequent digital health interventions to support development, access to, and delivery of palliative cancer care in SSA. Dissemination of these findings will occur through newsletters and press releases, conference presentations, peer-reviewed journals and social media.

Trial registration number

ISRCTN15727711
Doctors’ perspectives on adhering to advance care directives when making medical decisions for patients: an Australian interview study
Authors: Moore Nadia , Detering Karen M , Low Tessa , Nolte Linda , Fraser Scott , Sellars Marcus
Published: November 2019

Objective

Advance care planning (ACP) assists people to identify their goals, values and treatment preferences for future care. Ideally, preferences are documented in an advance care directive (ACD) and used by doctors to guide medical decision-making should the patient subsequently lose their decision-making capacity. However, studies demonstrate that ACDs are not always adhered to by doctors in clinical practice. We aim to describe the attitudes and perspectives of doctors regarding ACD adherence and the utility of ACDs in clinical practice.

Design

Face-to-face semistructured interviews were conducted using three case-based vignettes to explore doctors’ decision-making and attitudes towards ACDs. Transcripts were analysed using a thematic analysis.

Setting

Doctors from a variety of medical specialties and with varying experience levels were recruited from a large tertiary hospital in Melbourne, Australia.

Participants

A total of 21 doctors were interviewed, 48% female (10/21). Most (19/21) reported having experience using ACDs.

Results

Four themes were identified: aligning with patient preferences (avoiding unwanted care, prioritising autonomy and anticipating family opposition), advocating best interests (defining futile care, relying on clinical judgement, rejecting unreasonable decisions and disregarding legal consequences), establishing validity (doubting rigour of the decision-making process, questioning patients’ ability to understand treatment decisions, distrusting outdated preferences and seeking confirmation) and translating written preferences into practice (contextualising patient preferences, applying subjective terminology and prioritising emergency medical treatment).

Conclusions

ACDs provide doctors with opportunities to align patient preferences with treatment and uphold patient autonomy. However, doctors experience decisional conflict when attempting to adhere to ACDs in practice, especially when they believe that adhering to the ACD is not in the patients’ best interests, or if they doubt the validity of the ACD. Future ACP programmes should consider approaches to improve the validity and applicability of ACDs. In addition, there is a need for ethical and legal education to support doctors’ knowledge and confidence in ACP and enacting ACDs.
Marijuana exposures in Colorado, reported to regional poison centre, 2000–2018
Authors: Wang George Sam , Banerji Shireen , Contreras Alexandra Elyse , Hall Katelyn E
Published: November 2019

The objective was to evaluate trends in marijuana exposures reported to the Colorado regional poison centre (RPC). Human exposures cases from the Colorado RPC obtained from 1 January 2000 through 31 December 2018 using generic marijuana exposure codes. There were 2221 marijuana exposures, with an increase in exposures by 11.2 cases per year (p<0.0001). Annual cases remained steady since 2014 (p=0.22), with a 19.4% increase in 2018 compared with 2017. Since 2014, the largest increase was in children age 0–8 years (p<0.0001). Edible marijuana exposures increased by 9.6 exposures per year from 2015 to 2018 (p=0.04). After observing an increase in Colorado RPC marijuana exposure cases in 2010 and 2014, annual exposures have been stable through 2017, with the first increase in legalised recreational sales era in 2018. There are specific concerns for the paediatric population and exposures involving edibles, as these cases continue to increase.
Ensuring a positive relationship with your new graduate starter
Authors: Perrin Hannah
Published: November 2019

As one academic year finishes and the next begins, employers look to the pool of newly graduated vets to fill positions in their practice. This article looks at the changing nature of contemporary practice and how this influences recruitment within the veterinary profession. It discusses what practices value most from their new graduate starters, how to attract the best candidates, as well as how applicants can make themselves more attractive to employers.
Providing fluid therapy to equine colic patients. Part 1
Authors: Auckburally Adam , Petruccione Ilaria , Voss Sarah
Published: November 2019

Background: Fluid therapy is a life‐saving measure, which is fundamental in managing horses with colic. It is essential for the clinician to be familiar with the available options when devising a fluid plan, so that it is both beneficial to the patient and financially viable for the owner. Underpinning this is an understanding of basic physiology associated with body fluid compartments and an awareness of the potential adverse effects of fluid therapy.

Aim of the article: This article, the first in a two‐part series, discusses basic physiological concepts of body fluids, available fluid types and the practicalities of administration in the adult horse. The second part, covering clinical aspects of fluid therapy in adult horses with colic and some of the controversies surrounding fluid rates, fluid types and the management of metabolic acidosis, will be published in a subsequent issue of In Practice
Association of neighbourhood social and physical attributes with depression in older adults in Hong Kong: a multilevel analysis
Authors: Guo Yingqi , Chang Shu Sen , Chan Chee Hon , Chang Qingsong , Hsu Chia-Yueh , Yip Paul S F
Published: November 2019

Background

Previous studies investigating the independent effects of neighbourhood-level factors on depression are rare within the Asian context, especially in the elderly population.

Methods

Data for 29 099 older adults aged 65 years or above who have received health examinations at elderly health centres in Hong Kong in 2008–2011 were analysed. Using multilevel regression modelling, the cross-sectional associations of neighbourhood social attributes (neighbourhood poverty, ethnic minority, residential stability and elderly concentration) and physical (built) attributes (recreational services and walkability) with depression outcomes (depressive symptoms and depression) after adjusting for individual-level characteristics were investigated. Gender interaction effects were also examined.

Results

Neighbourhood poverty was associated with both depressive symptoms and depression in the elderly. Neighbourhood elderly concentration, recreational services and walkability were associated with fewer depressive symptoms. The association between neighbourhood poverty and elderly depressive symptoms was found in women only and not in men.

Conclusion

Policies aimed at reducing neighbourhood poverty, increasing access to recreational services and enhancing walkability might be effective strategies to prevent depression in older adults in the urban settings.
The introduction of plastic and reconstructive surgery to the University of Glasgow undergraduate medical core curriculum.
Authors: Higgins Gillian , Thomson Suzanne Emma
Published: November 2019

Misperceptions of plastic surgery remain common among medical students and the medical community. This creates barriers in recruitment to specialty and patient referral. Before this study, there was no formal plastic surgery teaching in University of Glasgow undergraduate medical core curriculum. A plastic surgery teaching pilot was implemented for fourth year students. Oncoplastic breast surgery was used as an example of gold standard multidisciplinary reconstructive surgery. Surveys collected data before and after provision of teaching across four parameters; identification of plastic surgery subspecialties, understanding of plastic surgery, opinion of the pilot and curriculum, career preferences and gender. The response rate was 57% (n=160). The most and least recognised subspecialties were burns (48% (n=75)) and perineal and lower limb reconstruction (0% (n=0)), respectively, with more students identifying aesthetic surgery (16% (n=26)) than hand (9% (n=15)) or skin cancer surgery (6% (n=9)). The majority (129 (81%)) thought plastic surgery was poorly represented in their curriculum and wanted further information (98 (61%)). Reported understanding of plastic surgery significantly improved (p≤0.00005). Those interested in surgical careers increased from 39% (n=63) to 41% (n=66) with more males than females reporting interest (p≤0.05). This study introduced plastic and reconstructive surgery into the undergraduate curriculum and led to further increased plastic surgery teaching. It improved student understanding, desire to gain more experience in the specialty and interest in surgical careers. Teaching students about subspecialties is vital to dispel misconceptions, ensure appropriate referrals and ignite interest in those with aptitude for surgical careers.
Delivery of long-term-injectable agents for TB by lay carers: pragmatic randomised trial
Authors: Cohen Danielle B , Mbendera Kuzani , Maheswaran Hendramoorthy , Mukaka Mavuto , Mangochi Helen , Phiri Linna , Madan Jason , Davies Geraint , Corbett Elizabeth , Squire Bertel
Published: November 2019

Background

People with recurrent or drug-resistant TB require long courses of intramuscular injections. We evaluate a novel system in which patient-nominated lay carers were trained to deliver intramuscular injections to patients in their own homes.

Methods

A pragmatic, individually randomised non-inferiority trial was conducted at two hospitals in Malawi. Adults starting TB retreatment were recruited. Patients randomised to the intervention received home-based care from patient-nominated lay people trained to deliver intramuscular streptomycin. Patients receiving standard care were admitted to hospital for 2 months of streptomycin. The primary outcome was successful treatment (alive and on treatment) at the end of the intervention.

Results

Of 456 patients screened, 204 participants were randomised. The trial was terminated early due to futility. At the end of the intervention, 97/101 (96.0%) in the hospital arm were still alive and on treatment compared with 96/103 (93.2%) in the home-based arm (risk difference −0.03 (95% CI −0.09 to 0.03); p value 0.538). There were no differences in the proportion completing 8 months of anti-TB treatment; or the proportion experiencing 2-month sputum culture conversion. The mean cost of hospital-based management was US$1546.3 per person, compared to US$729.2 for home-based management. Home-based care reduced risk of catastrophic household costs by 84%.

Conclusions

Although this trial failed to meet target recruitment, the available data demonstrate that training patient-nominated lay people has potential to provide a feasible solution to the operational challenges associated with delivering long-term-injectable drugs to people with recurrent or drug-resistant TB in resource-limited settings, and substantially reduce costs. Further data under operational conditions are required.

Trial registration number

ISRCTN05815615.
Things can only get better
Authors: Dean Rachel
Published: November 2019

Research waste reduces the usefulness of research. Rachel Dean describes the problem in veterinary science and suggests a way to increase the use of research results by practitioners.
Field-free molecular alignment of carbon dioxide molecules measured with above-threshold ionization yields
Authors: Kaya Gamze
Published: November 2019

We present measurements of above-threshold ionization (ATI) of CO2 in a pump-probe experiment where the pump pulse creates a rotational wave packet and the linearly polarized probe pulse generates the ATI spectrum as a function of the pump-probe delay time, which sweeps over the revival time of field-free alignment and its quarter fractions. The observed alignment signals, which are the electron yields of ATI by a probe pulse as a function of a delay between the pump and probe pulse, are compared with the calculated alignment parameter [Formula: see text]. The results are explained by nuclear spin statistics and the wave packet evolution of the CO2 molecule in terms of the highest occupied molecular orbital.
Relating the 4-year lemming (Lemmusspp. andDicrostonyxspp.) population cycle to a 3.8-year lunar cycle and ENSO
Authors: Archibald H.L.
Published: November 2019

Reported peak years of lemming (Lemmus spp. and Dicrostonyx spp.) and Arctic fox (Vulpes lagopus (Linnaeus, 1758)) abundance were compiled from the literature for 12 locations spanning 127 years. The mean period of the 34 reported lemming and Arctic fox cycles from 1868 to 1994 was 3.8 years, suggesting that the period of the 4-year cycle is actually 3.8 years. Peak population years were predicted using a simple model based on a 3.8-year lunar cycle. For nearly 130 years, reported years of peak abundance of lemmings and Arctic foxes were significantly correlated with and have persistently stayed in phase with predicted peak years of abundance. Over the same period, predicted peak years of lemming abundance have been closely aligned with peak (i.e., La Niña) years of the January–March Southern Oscillation Index (SOI). From 1952 to 1995, peak flowering in Norway tended to occur close to trough June–August SOI (El Niño) years. The hypothesis proposed is that the 3.8-year lunar cycle governs the timing of the lemming cycle, but it does not cause the population cycling itself. If this hypothesis is true, then the heretofore unexplained source of the persistent periodicity and quasi-metronomic regularity of the lemming cycle is identified.
Solitary wave and elliptic function solutions of sinh-Gordon equation and its applications
Authors: Lu Dianchen , Seadawy Aly R. , Arshad M.
Published: November 2019

The [Formula: see text]-Gordon model is an important model in special nonlinear partial differential equations (PDEs) which is arising in solid-state physics, mathematical physics, fluid dynamics, fluid flow, differential geometry, quantum theory, etc. The exact solutions in the type of solitary wave and elliptic functions solutions are created of [Formula: see text]-Gordon model by employing modified direct algebraic scheme. Moments of a few solutions are also depicted graphically. These solutions helps the physicians and mathematicians to understand the physical phenomena of this model. This technique can be utilized on other models to launch further exclusively novel solutions for other categories of nonlinear PDEs occurring in mathematical Physics.
Holographic superconductor from a noncommutative-inspired anti-de Sitter–Einstein–Born–Infeld black hole
Authors: Maceda Marco , Patiño-López Sergio
Published: November 2019

Using a noncommutative-inspired anti-de Sitter–Einstein–Born–Infeld black hole with both noncommutative mass and charge distributions, we analyse a holographic superconductor in the context of the AdS/CFT correspondence. We show that the coupling of the Born–Infeld parameter and the noncommutative perturbations provides an enhancing mechanism for higher values of the expectation value of the condensate. Furthermore, we remark that noncommutativity counter-balances the nonlinearity of the electrodynamics to maintain the universal ratio of [Formula: see text].
Erratum: Vertex connectivity of the power graph of a finite cyclic group II
Authors: Chattopadhyay Sriparna , Patra Kamal Lochan , Sahoo Binod Kumar
Published: November 2019

We retract [1, Lemma 3.4] as the statement is incorrect. In consequence, we correct the statements of Theorems 1.2 and 4.5 and their proofs.
Monocationic porphyrin dyads with fullerene as the electron-accepting material
Authors: Takao Yuko , Moriwaki Kazuyuki , Mizuno Takumi , Ohno Toshinobu
Published: November 2019

Dyad compounds in which a fullerene [Formula: see text] was covalently linked to a monocationic porphyrin at a N,N[Formula: see text]-bridge substituent, were synthesized by condensation reaction. The low solubility of a dyad containing tetraphenylporphyrin (TPP) derivative was improved by using octaethylporphyrin (OEP) derivatives and introduction of an alkyl substituent to the porphyrin derivatives. The energy levels of the frontier orbitals, estimated experimentally using potentiometric data and the optical energy band gaps obtained by the UV-vis spectra, were sufficiently low to be comparable to acceptor materials. They varied depending on the peripheral substituents on the porphyrin unit. DSC analysis of the drop-cast films of the P3HT/dyad blends showed that the film containing the OEP dyad, annealed at a higher temperature, had more amorphous fractions than the films containing the TPP dyad.
Efficient Face Alignment with Fast Normalization and Contour Fitting Loss
Authors: Liu Zhiwei , Zhu Xiangyu , Tang Ming , Lei Zhen , Wang Jinqiao
Published: November 2019

Face alignment is a key component of numerous face analysis tasks. In recent years, most existing methods have focused on designing high-performance face alignment systems and paid less attention to efficiency. However more face alignment systems are now applied on low-cost devices, such as mobile phones. In this article, we design a common efficient framework that can team with any face alignment regression network and improve the overall performance with nearly no extra computational cost. First, we discover that the maximum regression error exists in the face contour, where landmarks do not have distinct semantic positions, and thus are randomly labeled along the face contours in training data. To address this problem, we propose a novel contour fitting loss that dynamically adjusts the regression target during training so the network can learn more accurate semantic meanings of the contour landmarks and achieve better localization performance. Second, we decouple the complex sample variations in face alignment task and propose a Fast Normalization Module (FNM) to efficiently normalize considerable variations that can be described by geometric transformation. Finally, a new lightweight network architecture named Lightweight Alignment Module (LAM) is also proposed to achieve fast and precise face alignment on mobile devices. Our method achieves competitive performance with state-of-the-arts on 300W and AFLW2000-3D benchmarks. Meanwhile, the speed of our framework is significantly faster than other CNN-based approaches.