bluuebunny/crossref_metadata_2025 huggingface dataset:
The willingness to participate in biomedical research involving human beings in low‐ and middle‐income countries: a systematic review
Authors: Browne Joyce L. , Rees Connie O. , van Delden Johannes J. M. , Agyepong Irene , Grobbee Diederick E. , Edwin Ama , Klipstein‐Grobusch Kerstin , van der Graaf Rieke
Published: December 2018

Objectives

To systematically review reasons for the willingness to participate in biomedical human subjects research in low‐ and middle‐income countries (LMICs).

Methods

Five databases were systematically searched for articles published between 2000 and 2017 containing the domain of ‘human subjects research’ in ‘LMICs’ and determinant ‘reasons for (non)participation’. Reasons mentioned were extracted, ranked and results narratively described.

Results

Ninety‐four articles were included, 44 qualitative and 50 mixed‐methods studies. Altruism, personal health benefits, access to health care, monetary benefit, knowledge, social support and trust were the most important reasons for participation. Primary reasons for non‐participation were safety concerns, inconvenience, stigmatisation, lack of social support, confidentiality concerns, physical pain, efficacy concerns and distrust. Stigmatisation was a major concern in relation to HIV research. Reasons were similar across different regions, gender, non‐patient or patient participants and real or hypothetical study designs.

Conclusions

Addressing factors that affect (non‐)participation in the planning process and during the conduct of research may enhance voluntary consent to participation and reduce barriers for potential participants.
Detection of Mansonella ozzardi among blood donors from highly endemic interior cities of Amazonas state, northern Brazil
Authors: Abrahim Claudia M. M. , Py‐Daniel Victor , Luz Sergio L. B. , Fraiji Nelson A. , Stefani Mariane M. A.
Published: December 2018

BACKGROUND

In the Brazilian Amazon, the filarial nematode Mansonella ozzardi co‐exists with malaria parasites and thick blood smear microscopy is considered the diagnostic gold standard. Transfusion of M. ozzardi microfilariae does not establish new infections, however microfilariae can survive approximately 2 years in blood‐recipients with unknown risk of pathology. Data on transfusion‐transmitted filariasis are lacking. This study investigated M. ozzardi parasitemias in blood donors from decentralized centers of “Fundação Hematologia e Hemoterapia do Estado do Amazonas/HEMOAM,” Northern Brazil.

STUDY DESIGN AND METHODS

Cross‐sectional investigation employing blood smear microscopy (n = 356) and qualitative nested‐M. ozzardi‐PCR (227 out of 356) in donor candidates from 19 hemocenters in interior/rural municipalities of Amazonas state. FINDINGS: Participants were mostly young males. Positivity by microscopy was 7.9% (28 out of 356) and 23.8% by M. ozzardi‐PCR (54 out of 227). Parasitaemias were found in 16 out of 19 municipalities. In 54 M. ozzardi‐positives, 24 were ineligible; among 30 that donated, 27 were interdicted by seropositivity (22 anti‐HBc, 3 anti‐HBc + HBsAg, 1 Chagas+malaria, 1 VDRL). Seropositivty was higher in M. ozzardi‐PCR‐positives vs M. ozzardi‐PCR‐negatives (OR = 15.8, 95% CI 4.5–56.1, p < 0.0001). Three M. ozzardi contaminated blood units were transfused, but no follow‐up information on the recipients is available.

MAIN CONCLUSIONS

Our study provides important baseline data on M. ozzardi among blood donors from the Brazilian Amazon. Further investigations in endemic areas are necessary to clarify possible association between M. ozzardi and other infections and also to elucidate whether there is any significant clinical effect upon transfusion of contaminated blood.
Trade barriers or trade facilitators? The heterogeneous impact of food standards in international trade
Authors: Medin Hege
Published: December 2018

Recent research shows that the effect of food standards can be heterogeneous across sectors or countries: they sometimes act as barriers to trade, but in other cases may lead to increased trade. I present empirical evidence on Norwegian seafood exports showing that foreign food standards, measured by sanitary and phytosanitary notifications to the WTO, generally have a negative impact on total exports, the number of exporters and their average exports. However, for fresh seafood, there is a positive counteracting effect. I present a theoretical explanation for this, suggesting that food standards reduce consumer uncertainty about quality and safety and therefore increase demand.
Maternal HPA‐1a antibody level and its role in predicting the severity of Fetal/Neonatal Alloimmune Thrombocytopenia: a systematic review
Authors: Kjær Mette , Bertrand Gerald , Bakchoul Tamam , Massey Edwin , Baker Jillian M. , Lieberman Lani , Tanael Susano , Greinacher Andreas , Murphy Michael F. , Arnold Donald M. , Baidya Shoma , Bussel James , Hume Heather , Kaplan Cécile , Oepkes Dick , Ryan Greg , Savoia Helen , Shehata Nadine , Kjeldsen‐Kragh Jens ,   International Collaboration for Transfusion Medicine Guidelines
Published: December 2018

Background and Objectives

In Caucasians, fetal/neonatal alloimmune thrombocytopenia (FNAIT) is most commonly due to maternal HPA‐1a antibodies. HPA‐1a typing followed by screening for anti‐HPA‐1a antibodies in HPA‐1bb women may identify first pregnancies at risk. Our goal was to review results from previous published studies to examine whether the maternal antibody level to HPA‐1a could be used to identify high‐risk pregnancies.

Materials and Methods

The studies included were categorized by recruitment strategies: screening of unselected pregnancies or samples analyzed from known or suspected FNAIT patients.

Results

Three prospective studies reported results from screening programmes, and 10 retrospective studies focused on suspected cases of FNAIT. In 8 studies samples for antibody measurement, performed by the monoclonal antibody immobilization of platelet antigen (MAIPA) assay, and samples for determining fetal/neonatal platelet count were collected simultaneously. In these 8 studies, the maternal antibody level correlated with the risk of severe thrombocytopenia. The prospective studies reported high negative predictive values (88–95%), which would allow for the use of maternal anti‐HPA‐1a antibody level as a predictive tool in a screening setting, in order to identify cases at low risk for FNAIT. However, due to low positive predictive values reported in prospective as well as retrospective studies (54–97%), the maternal antibody level is less suited for the final diagnosis and for guiding antenatal treatment.

Conclusion

HPA‐1a antibody level has the potential to predict the severity of FNAIT.
Modelling the risk of transfusion‐transmitted syphilis: a reconsideration of blood donation testing strategies
Authors: Jayawardena Thisuri , Hoad Veronica , Styles Claire , Seed Clive , Bentley Peter , Clifford Vanessa , Lacey Sarina , Gastrell Tessa
Published: December 2018

Background and Objectives

Donor syphilis testing began in the 1940s amidst widespread transfusion‐transmitted syphilis (TTS). Since then, the introduction of penicillin, pre‐donation screening questionnaires and improved storage conditions have contributed to reducing transmission risk. Consequently, universal testing may no longer be cost‐effective. This study analysed alternative options for donor syphilis testing to determine the optimal strategy.

Materials and Methods

A model was developed using conservative parameter estimates for factors affecting TTS and 2009‐2015 Australian donations to calculate risk outcomes (TTS infections, tertiary syphilis in recipients and transfusion‐associated congenital syphilis) and cost‐effectiveness of alternative testing strategies. The strategies modelled were as follows: universal testing, targeted‐testing of high‐risk groups (males ≤50 years old and first‐time donors) and no testing.

Results

The estimated risk of TTS is one in 49·5 million transfusions for universal testing, one in 6 million for targeted‐testing of males ≤50 years old, one in 4 million for targeted‐testing of first‐time donors and one in 2·8 million for no testing. For all strategies, the risk of tertiary and congenital syphilis is <1 in 100 million. Universal testing is the least cost‐effective strategy with an incremental cost‐effectiveness ratio (ICER) estimated at $538·5 million per disability‐adjusted life year averted.

Conclusion

Universal testing is not required to maintain the risk of TTS within tolerable limits and is estimated to greatly exceed acceptable ICERs for blood safety interventions. However, despite a strong economic and risk‐based rationale, given the epidemiology of syphilis in Australia is changing, feedback from critical stakeholders is not currently supportive of reducing testing.
Red cell transfusion thresholds in haematopoietic stem cell transplantation
Authors: Tinmouth Alan , Tay Jason
Published: December 2018

Red cell transfusions are part of the routine supportive care following haematopoietic stem cell transplantation. There is increasing evidence from randomized controlled trials demonstrating that restrictive transfusion thresholds are equivalent to liberal thresholds in other patient populations. However, given the lack of patient‐centred outcomes and the longer transfusion support required for patients with haematologic malignancies, the results of these trials may not be generalizable to haematology–oncology patients. In the recently completed multicentre TRIST trial, we randomized 300 patients requiring an autologous or allogeneic haematopoietic stem cell transplantation to either a restrictive (haemoglobin threshold <70 g/l) or liberal (haemoglobin threshold <90 g/l) red cell transfusion strategy. Our primary outcome was health‐related quality of life measured by FACT‐BMT through day 100 post‐transplant. The median number of red cell units transfused was lower in the restrictive strategy group (2 vs. 4). The FACT‐BMT total score was higher at all time points for patients in the restrictive transfusion group including at baseline (109 vs. 103) and at 100 days (116·3 vs. 109·2). After adjustment for baseline, the FACT‐BMT score at day 100 in the restrictive group was statistically non‐inferior to the liberal group (P < 0·0001). There were no significant differences between the two groups for any other clinical outcomes. Based on the results of the TRIST trial, a restrictive haemoglobin threshold of 70 g/l should become standard practice in haematopoietic stem cell transplant patients, and, given the lack of other clinical studies, all other haematology–oncology inpatients.
Impact of irrigation water quality and envelope materials around drip line on emitter performance in subsurface drip irrigation
Authors: Al‐Mefleh Naji K. , Al‐Raja O’badah F.
Published: December 2018

A field experiment was conducted to study the effect of water quality types of fresh water (FW) and treated wastewater (TWW) and envelope materials of coarse sand (CS), fine sand (FS), and control (CO) on emitter performance, dry matter yield (DMY), and water use efficiency (WUE) under subsurface drip irrigation.The main interaction effect of water quality type and envelope material on coefficient of variation, Christiansen uniformity coefficient, and emission uniformity was not significant (P < 0.05), but they have a significant effect on the average emitter discharge (Qavg), DMY, and WUE. The means of Qavg for FW with CS, FS, and CO were 7.13, 6.94, 2.65 L/h, and for TWW, they were 6.78, 6.84, and 2.35 L/h, respectively. The DMY under FW with CS, FS, and CO was 3083.87, 1367.95, and 417.45 kg/ha, and under the TWW, it was 2409.5, 1347.4, and 417 kg/ha, respectively.
INFLUENCE OF STATIC MIXER ON THE FORMATION OF BIOGRANULES
Authors: Sulaiman Suryati , Aris Azmi , Abd Razak Abdul Syukor , Muda Khalida , Nor Anuar Aznah
Published: December 2018

Present study aimed at evaluating the formation of biogranules using sequencing batch reactors (SBRs) in treating textile wastewater under the influence of static mixer. Three sets of experiment were run with different superficial air velocity (SAV) of 0.5, 1.4 and 2.1 cms-1, each set consisting of two SBR one with and one without static mixer. The developed biogranules in reactors with static mixer (R1M, R2M and R3M) showed good results after approximately 70 days. The biomass in the reactor reached mix liquor suspended solid (MLSS) of 5.75 gL-1 with sludge volume index (SVI) of 107.4 mLg-1 and settling velocity (SV) of 70.3 mh-1 in R1M; MLSS of 7.18 gL-1 with SVI of 29.5 mLg-1 and SV of 80.4 mh-1 for R2M and MLSS of 7.38 gL-1 with SVI of 36.3 mLg-1 and SV of 74.2 mh-1 for R3M. The use of static mixer has contributed to biogranules development with good settling properties.
Investigating the Effect of Medium Liquid Layer Circulation on Temperature Distribution in a Thermoelectric Generator Heat Exchanger Assembly
Authors: Amini Ali , Ekici Özgür , Yakut Kenan
Published: December 2018

Thermoelectric generators (TEGs) are used to produce electricity utilizing two energy reservoirs. Despite the extensive research conducted on thermoelectric (TE) modules, their efficiencies are still low; therefore, any contribution to increase the efficiency of TE modules is valuable. It is known that the efficiency of individual TE modules depends on the temperature difference between their hot and cold faces. In practical applications employing an array of TE modules, the temperature distribution along the flow direction varies, which adversely affects system's efficiency. In this study, it is aimed to attain a homogeneous temperature distribution along a number of TE pieces by focusing on the structure of TEG heat exchanger. The proposed design includes an intermediate layer of liquid that plays a key role in keeping the temperature distribution homogeneous and at the desired temperature difference level. A three-dimensional (3D) computational fluid dynamics (CFD) model was developed for analyzing the circulation of liquid layer and the thermal behavior in the system. Results show decrease in temperature deviation both on cold and hot sides of TE modules, while the decrease is more on the latter. With more homogeneous temperature distribution along the TE surfaces, it is possible to tune the system to operate TE modules in their optimum temperature differences. It is illustrated that the heat transfer rate is increased by 11.71% and the electric power generation is enhanced by 19.95% with the proposed heat exchanger design. The consumption of pumping power has taken into account in the efficiency calculations.
Effects of Target Channel Shapes on Double Swirl Cooling Performance at Gas Turbine Blade Leading Edge
Authors: Zhou Junfei , Wang Xinjun , Li Jun , Hou Weitao
Published: December 2018

In order to further study the effects of the target channel shape on the cooling performance of the double swirl cooling (DSC), five double swirl channels formed by two overlapping elliptic cylinders with different length ratio between the vertical semi-axis and the horizontal semi-axis are applied. Numerical studies are carried out under three Reynolds numbers. The flow characteristics and heat transfer performance of five DSC cases are compared with the benchmark impingement cooling case. The flow losses, cross-flow development, generated vortices, and velocity distributions inside target channels are illustrated, analyzed, and compared. The spanwise averaged Nusselt number, Nusselt number distributions, and thermal performance are discussed and compared. Results indicate that the largest length ratio between the vertical semi-axis and the horizontal semi-axis of the target channel yields the lowest flow loss, largest overall averaged Nusselt number, and best thermal performance. With the decrease in the length ratio, the heat transfer distribution on the target surface becomes more uniform. The maximum enhancement of overall averaged Nusselt number and thermal performance in DSC is about 30% and 33%, respectively.
Transition From Phasic to Tonic Contractility in Airway Smooth Muscle After Birth: An Experimental and Computational Modeling Study
Authors: Wang Kimberley C. W. , Chang Amy Y. , Pillow J. Jane , Suki Béla , Noble Peter B.
Published: December 2018

Fetal airway smooth muscle (ASM) exhibits phasic contractile behavior, which transitions to a more sustained “tonic” contraction after birth. The timing and underlying mechanisms of ASM transition from a phasic to a tonic contractile phenotype are yet to be established. We characterized phasic ASM contraction in preterm (128 day gestation), term (∼150 day gestation), 1–4 month, 1 yr, and adult sheep (5yr). Spontaneous phasic activity was measured in bronchial segments as amplitude, frequency, and intensity. The mechanism of phasic ASM contraction was investigated further with a computational model of ASM force development and lumen narrowing. The computational model comprised a two-dimensional cylindrical geometry of a network of contractile units and the activation of neighboring cells was dependent on the strength of coupling between cells. As expected, phasic contractions were most prominent in fetal airways and decreased with advancing age, to a level similar to the level in the 1–4 month lambs. Computational predictions demonstrated phasic contraction through the generation of a wave of activation events, the magnitude of which is determined by the number of active cells and the strength of cell–cell interactions. Decreases in phasic contraction with advancing age were simulated by reducing cell–cell coupling. Results show that phasic activity is suppressed rapidly after birth, then sustained at a lower intensity from the preweaning phase until adulthood in an ovine developmental model. Cell–cell coupling is proposed as a key determinant of phasic ASM contraction and if reduced could explain the observed maturational changes.
An Improved Design of the Substrate of Stretchable Gallium Arsenide Photovoltaics
Authors: Zhao Jinsheng , Zhang Yizhe , Li Xiangyu , Shi Mingxing
Published: December 2018

A new design has been proposed and numerically analyzed for the polydimethylsiloxane (PDMS) substrate of gallium arsenide (GaAs) photovoltaics. A stack structure is realized by inserting a cube between island and basement, and thus, a support structure of basement-cube-island is formed. Numerical analyses show that, as the deformation of GaAs layer and interfacial stresses are concerned, the height of the stack structure of only island and cube has direct effect on deformation isolation. Especially, the length of the inserted cube can dramatically increase this effect. Therefore, when a cube is inserted between island and basement, a thin photovoltaic film can be realized with reliable performance. As stretch is applied to the film, the thickness of encapsulation is still the dominant factor on deformation of GaAs layer and interfacial stresses, and the length of cube only has slight effect on the influence.
Cardiac left heart morphology and function in newborns with intrauterine growth restriction: relevance for long-term assessment
Authors: Zaharie Gabriela Corina , Hasmasanu Monica , Blaga Ligia , Matyas Melinda , Muresan Daniel , Bolboaca Sorana Daniela
Published: December 2018

Aim: To asses the cardiac morphology and functional changes specific for newborns from intrauterine growth restriction (IUGR) pregnancies.Material and method: A cohort of IUGR infants were evaluated by serial echocardiographies at delivery and at the first and six months follow-ups. IUGR newborn delivery status was compared to that of newborns in the control group according to gestational age (AGA).Results: Left heart measurements were significantly lower in IUGR newborns compared to AGA babies. Left ventricular size increased at follow-up inthe IUGR group (p<0.05). Systolic dysfunction (the myocardial performance index (MPI)> 0.47) was identified in 40% of the neonates in the IUGR group (16/40), respectively 4.76% in the control group. IUGR neonates had a significantly increased proportion of systolic malfunction (p=0.004).Conclusion: IUGR patients had reduced left ventricle dimensions compared to AGA babies. The MPI stands out as a marker of leftheart function in newborns. Systolic dysfunction was a hallmark of the cardiac adaptation in IUGR neonates.
Reliability of quantitative point shear-wave ultrasound elastography on vastus medialis muscle and quadriceps and patellar tendons
Authors: Zardi Enrico Maria , Franceschetti Edoardo , Giorgi Chiara , Palumbo Alessio , Franceschi Francesco
Published: December 2018

Aim: The aim of this work was to evaluate the reliability of pSWE in assessing the stiffness of the vastus medialis muscle and of the quadriceps and patellar tendons.Material and methods: For this purpose, 18 subjects (9 males and 9 females of 57±22 years) in good clinical conditions were included in this study. pSWE examination was conducted by a unique expert operator with more than ten years of experience in musculoskeletal ultrasound. Two sets of five measurements for each muscle and tendon district were bilaterally performed at the same manner, at least fifteen minutes apart. The mean value of the measurements of each set was statistically compared with that of the other set.Results: No significant differences were found comparing the mean value of the measurements of the two sets of evaluation performed in muscle and tendon areas (vastus medialis muscle: p=0.285; quadriceps tendon: p=0.979; patellar tendon: p=0.187). The intraclass correlation coefficient was excellent for all areas (vastus medialis muscle: 0.969; quadriceps and patellar tendons: 0.995 and 0.989, respectively).Conclusion: The pSWE technique demonstrated that it was a reliable method for measuring stiffness in vastus medialis muscle and quadriceps and patellar tendon in subjects who had undergone orthopedic surgery. This opens the possibility of many applications in monitoring stiffness before and after surgery and during rehabilitation.
ORAI1, STIM1/2, and RYR1 shape subsecond Ca
2+
microdomains upon T cell activation
Authors: Diercks Björn-Philipp , Werner René , Weidemüller Paula , Czarniak Frederik , Hernandez Lola , Lehmann Cari , Rosche Annette , Krüger Aileen , Kaufmann Ulrike , Vaeth Martin , Failla Antonio V. , Zobiak Bernd , Kandil Farid I. , Schetelig Daniel , Ruthenbeck Alexandra , Meier Chris , Lodygin Dmitri , Flügel Alexander , Ren Dejian , Wolf Insa M. A. , Feske Stefan , Guse Andreas H.
Published: December 2018

The proteins that generate Ca
2+
signals within the first second after T cell activation are identified.
CD45 exclusion– and cross-linking–based receptor signaling together broaden FcεRI reactivity
Authors: Felce James H. , Sezgin Erdinc , Wane Madina , Brouwer Heather , Dustin Michael L. , Eggeling Christian , Davis Simon J.
Published: December 2018

Exclusion of a phosphatase from regions of antigen-receptor engagement facilitates mast cell activation.
All three IP3receptor isoforms generate Ca2+puffs that display similar characteristics
Authors: Lock Jeffrey T. , Alzayady Kamil J. , Yule David I. , Parker Ian
Published: December 2018

The three IP3R isoforms produce Ca2+puffs with largely indistinguishable features.
Solution Structure, Self-Assembly, and Membrane Interactions of the Matrix Protein from Newcastle Disease Virus at Neutral and Acidic pH
Authors: Shtykova E. V. , Petoukhov M. V. , Dadinova L. A. , Fedorova N. V. , Tashkin V. Yu , Timofeeva T. A. , Ksenofontov A. L. , Loshkarev N. A. , Baratova L. A. , Jeffries C. M. , Svergun D. I. , Batishchev O. V.
Published: December 2018

The matrix protein of the Newcastle disease virus (NDV) is one of the most abundant viral proteins that regulates the formation of progeny virions. NDV is an avian pathogen that impacts the economics of bird husbandry due to its resulting morbidity and high mortality rates. Moreover, it belongs to the
Avulavirus
subfamily of the
Paramyxoviridae
family of
Mononegavirales
that include dangerous representatives such as respiratory syncytial virus, human parainfluenza virus, and measles virus. Here, we investigate the solution structure and membrane binding properties of this protein at both acidic and neutral pH to distinguish between possible virus entry pathways and propose a mechanism of assembly of the viral matrix scaffold. This work is fundamental for understanding the mechanisms of viral entry as well as to inform subsequent proposals for the possible use of the virus as an adequate template for future drug or vaccine delivery.
Flexibility
In Vitro
of Amino Acid 226 in the Receptor-Binding Site of an H9 Subtype Influenza A Virus and Its Effect
In Vivo
on Virus Replication, Tropism, and Transmission
Authors: Obadan Adebimpe O. , Santos Jefferson , Ferreri Lucas , Thompson Andrew J. , Carnaccini Silvia , Geiger Ginger , Gonzalez Reiche Ana S. , Rajão Daniela S. , Paulson James C. , Perez Daniel R.
Published: December 2018

A single amino acid change at position 226 in the hemagglutinin (HA) from glutamine (Q) to leucine (L) has been shown to play a key role in receptor specificity switching in various influenza virus HA subtypes, including H9. We tested the flexibility of amino acid usage and determined the effects of such changes. The results reveal that amino acids other than L226 and Q226 are well tolerated and that some amino acids allow for the recognition of both avian and human influenza virus receptors in the absence of other changes. Our results can inform better avian influenza virus surveillance efforts as well as contribute to rational vaccine design and improve structural molecular dynamics algorithms.
Eating disorder or disordered eating: undiagnosed inflammatory bowel disease mimicking eating disorder
Authors: Harris Rachel Elizabeth , Tayler Rachel , Russell Richard K
Published: December 2018

We describe the case of a patient with ongoing weight loss, low mood and previously undisclosed gastrointestinal (GI) symptoms initially diagnosed with an eating disorder and subsequently diagnosed with ulcerative colitis over a year following initial presentation. This patient exhibited disordered eating secondary to the worsening symptoms of undiagnosed inflammatory bowel disease (IBD) and had altered her eating habits to reduce the diarrhoea and rectal bleeding she was experiencing, contributing to significant weight loss.The implications of a delayed diagnosis of IBD or incorrect diagnosis of eating disorder are severe both physically and psychologically. We discuss factors in the assessment of patients which may raise suspicion of organic GI disease such as IBD—an important differential diagnosis in those with non-specific GI symptoms and suspected eating disorder—and highlight baseline investigations which should be performed to ensure a diagnosis of IBD is not missed in these patients.
Prenatal diagnosis of cervical ribs by three-dimensional ultrasound in a foetus with a herniated Dandy-Walker cyst
Authors: Schut Pauline , Verdijk Robert M , Joosten Marieke , Eggink Alex J
Published: December 2018

We present a case report of a foetus with a herniated Dandy-Walker cyst and bilateral rudimentary cervical ribs. The cervical ribs were visualised prenatally by three-dimensional ultrasound and confirmed by post-termination radiography. The prevalence of cervical ribs is higher in deceased fetuses and neonates with or without structural abnormalities compared with healthy individuals and might be regarded as a marker of disadvantageous fetal development. We demonstrate that evaluation of the fetal vertebral pattern by three-dimensional ultrasonography, including the cervical region, is feasible and could provide valuable information regarding fetal and neonatal prognosis.
Clostridium difficilecolitis in the setting of subacute thyroiditis: the chicken or the egg
Authors: Mathew Jacob
Published: December 2018

Subacutethyroiditis is a self-limited inflammatory condition commonly of viral aetiology, that manifests through phases of thyroid hormone changes over a 6–8 month period. A 24-year-old active duty military man, undergoing treatment for recurrentClostridiumdifficileinfection, presented for clinical evaluation and was found to have a thyroid stimulating hormone level of 0.003 mg/dL. Further labs revealed a normal T4, elevated T3 at 5.0 pg/mL and elevated C reactive protein at 3.69 mg/L. The patient was followed with monthly labs and the abnormal thyroid stimulating hormone and triiodothyronine levels resolved after the completion of hisC. difficiletreatment. While subacute thyroiditis has historically been due to viral causes, rarely do we see this condition associated with an intestinal bacterial source.
Clinical characteristics and outcomes of symptomatic and asymptomatic hypoglycemia in hospitalized patients with diabetes
Authors: Cardona Saumeth , Gomez Patricia C , Vellanki Priyathama , Anzola Isabel , Ramos Clementina , Urrutia Maria A , Haw Jeehea Sonya , Fayfman Maya , Wang Heqiong , Galindo Rodolfo J , Pasquel Francisco J , Umpierrez Guillermo E
Published: December 2018

Importance

The frequency and impact of asymptomatic hypoglycemia in hospitalized patients with diabetes is not known.

Objective

We determined the clinical characteristics and hospital outcomes of general medicine and surgery patients with symptomatic and asymptomatic hypoglycemia.

Research design and methods

Prospective observational study in adult patients with diabetes and blood glucose (BG) <70 mg/dL. Participants were interviewed about signs and symptoms of hypoglycemia using a standardized questionnaire. Precipitating causes, demographics, insulin regimen, and complications data during admission was collected.

Results

Among 250 patients with hypoglycemia, 112 (44.8%) patients were asymptomatic and 138 (55.2%) had symptomatic hypoglycemia. Patients with asymptomatic hypoglycemia were older (59±11 years vs 54.8±13 years, p=0.003), predominantly males (63% vs 48%, p=0.014), and had lower admission glycosylated hemoglobin (8.2%±2.6 % vs 9.1±2.9%, p=0.006) compared with symptomatic patients. Compared with symptomatic patients, those with asymptomatic hypoglycemia had higher mean BG during the episode (60.0±8 mg/dL vs 53.8±11 mg/dL, p<0.001). In multivariate analysis, male gender (OR 2.08, 95% CI 1.13 to 3.83, p=0.02) and age >65 years (OR 4.01, 95% CI 1.62 to 9.92, p=0.02) were independent predictors of asymptomatic hypoglycemia. There were no differences in clinical outcome, composite of hospital complications (27% vs 22%, p=0.41) or in-hospital length of stay (8 days (IQR 4–14) vs 7 days (IQR 5–15), p=0.92)) between groups.

Conclusions

Asymptomatic hypoglycemia was common among insulin-treated patients with diabetes but was not associated with worse clinical outcome compared with patients with symptomatic hypoglycemia. Older age and male gender were independent risk factors for asymptomatic hypoglycemia.
Inconsistent calculation methodology for the eucapnic voluntary hyperpnoea test affects the diagnosis of exercise-induced bronchoconstriction
Authors: Koch Sarah , Sinden Sean Michael , Koehle Michael Stephen
Published: December 2018

Introduction

The eucapnic voluntary hyperpnoea (EVH) challenge is used to screen for exercise-induced bronchoconstriction. Several criteria have been proposed to determine the decrease in lung function (fall index, FI) following EVH. We compared three published FI calculation methods to determine if they affect the diagnostic classification.

Methods

The three FIs were calculated for 126 EVH tests. Spirometry was performed in duplicate at baseline and repeated 3, 5, 10, 15 and 20 min following 6 min of EVH. The higher of the two forced expiratory volume in 1 s (FEV1) measures at all time-points post-hyperpnoea was selected for the calculation of the FIs. The FIAwas determined as the single lowest of the five postchallenge values, and a test was considered positive if FEV1decreased ≥10 %. In FIB, a test was considered positive if FEV1decreased ≥10% at two consecutive post-challenge time-points. The FICwas calculated identically to FIA, but was normalised to the achieved minute ventilation during the EVH challenge.

Results

Calculation method affected the raw FIs with FIBgenerating the smallest and FICgenerating the highest values (p<0.001) and a within-subject range of 7%±10%. The number of positive tests differed between the calculation criteria: FIA: 62, FIB: 48 and FIC: 70, p<0.001. Nineteen participants (15%) tested positive in one or two FI methods only, indicating that the FI method used determined whether the test was positive or negative.

Discussion

Inconsistency in methodology of calculating the FI leads to differences in the diagnostic rate of the EVH test, with potential implications in both treatment and research outcomes.
Injury-related mortality among children younger than 5 years in China during 2009–2016: an analysis from national surveillance system
Authors: Xiang Liangcheng , Wang Ke , Miao Lei , Kang Leni , Li Xiaohong , Zhu Jun , Liang Juan , Li Qi , He Chunhua , Wang Yanping
Published: December 2018

Background

Epidemiology in injury-related mortality among children younger than 5 years was unreported in China recently.

Methods

Data were obtained from China’s Under 5 Child Mortality Surveillance System (U5CMSS) in 2009-2016. Injury-related mortality rates were calculated by residence, age-group, gender and major injury type (drowning, traffic injuries, suffocation, poisoning, falls). The average annual decline rate (AADR) was calculated based on the annual mortality rates by Poisson regression and the relative risk (RR) between urban and rural residence was examined based on the rates of two years for each time point by Cochran-Mantel-Haenszel method.

Results

U5CMSS contained 6503 injury-related deaths of children younger than 5 years during the study period, of which 58.6% were male, 86.0% occurred in rural areas, 65.7% were children aged 12–59 months. Deaths were mainly attributed to suffocation (34.3%), drowning (29.6%), traffic injuries (17.7%), falls (7.2%) or poisoning (4.7%). The injury-related mortality rate dropped from 274.7 to 189.2 per 100 000 live births from 2009 to 2016, giving an AADR of 4.53% (95% CI 3.50% to 5.55%). During 2009–2016, the injury-related mortality rate in rural area was higher than that in urban area, the adjusted RRs (aRRs) in infants and children aged 12–59 months were 3.32–6.04 and 4.31–5.49, respectively.

Conclusion

The rate of injury-related deaths in children younger than 5 years has decreased in China, but it remains high and strong urban–rural disparities still exist. Public health programmes and policy interventions should focus particularly on suffocation among infants and on drowning and traffic injuries among children aged 12–59 months, especially in rural areas.
Comprehensive genomic variation profiling of cervical intraepithelial neoplasia and cervical cancer identifies potential targets for cervical cancer early warning
Authors: Huang Jian , Qian Zhaoyang , Gong Yuhua , Wang Yanzhou , Guan Yanfang , Han Yingxin , Yi Xin , Huang Wanqiu , Ji Liyan , Xu Jiajia , Su Mengyuan , Yuan Qing , Cui Shujian , Zhang Jinling , Bao Chaohui , Liu Weilong , Chen Xi , Zhang Ming , Gao Xiaohuan , Wu Renhua , Zhang Yinxin , Xu Huicheng , Zhu Shida , Zhu Hongmei , Yang Ling , Xu Xun , Zhou Pingyu , Liang Zhiqing
Published: December 2018

Background

To better understand the pathogenesis of cervical cancer (CC), we systematically analysed the genomic variation and human papillomavirus (HPV) integration profiles of cervical intraepithelial neoplasia (CIN) and CC.

Methods

We performed whole-genome sequencing or whole-exome sequencing of 102 tumour-normal pairs and human papillomavirus probe capture sequencing of 45 CCs, 44 CIN samples and 25 normal cervical samples, and constructed strict integrated workflow of genomic analysis.

Results

Mutational analysis identified eight significantly mutated genes in CC including four genes (FAT1,MLL3,MLL2andFADD), which have not previously been reported in CC. Targetable alterations were identified in 55.9% of patients. In addition, HPV integration breakpoints occurred in 97.8% of the CC samples, 70.5% of the CIN samples and 42.8% of the normal cervical samples with HPV infection. Integrations of high-risk HPV strains in CCs, including HPV16, 18, 33 and 58, also occurred in the CIN samples. Moreover, gene mutations were detected in 52% of the CIN specimens, and 54.8% of these mutations occurred in genes that also mutated in CCs.

Conclusion

Our results lay the foundation for a deep understanding of the molecular mechanisms and finding new diagnostic and therapeutic targets of CC.
Resilience-based intervention for UK military recruits: a randomised controlled trial
Authors: Jones Norman , Whelan Chantelle , Harden Larissa , Macfarlane Andrea , Burdett Howard , Greenberg Neil
Published: December 2018

Objectives

We evaluated a military resilience intervention which aimed to help UK military recruits to manage their personal health and well-being more effectively.

Methods

Trainers within six pre-existing training teams were randomly allocated by team to deliver a resilience-based intervention (SPEAR) or usual training (control) during recruit training. 23 trainers delivered SPEAR; 18 delivered the control training. 707 recruits participated (n=358 SPEAR and n=349 controls). Outcome measures were obtained before and after recruit training and 3 months later. Measures of post-traumatic stress disorder (PTSD), common mental disorder (CMD) symptoms, alcohol use, homesickness and mental health stigmatisation were obtained at baseline. Repeat baseline scales plus measures of help-seeking, cohesion, leadership and training impact were obtained at the two follow-up points.

Results

Response rates were 91.7% (baseline), 98.1% (post) and 73.6% (follow-up). Following adjustment for potential confounders, levels of PTSD, CMD symptoms, alcohol misuse, help-seeking and homesickness were not significantly different between groups at any measurement point. Stigmatisation was significantly lower among SPEAR recipients at baseline but was not significantly different at the two follow-up points. Following adjustment for mental health confounders, there were no significant between-group differences in perceptions of leadership and cohesion and in ratings of six training outcomes at the two follow-up points.

Conclusions

We found no evidence that resilience-based training had any specific benefit to the health and well-being of UK military recruits.
Modelling optimal diets for quality and cost: examples from Inuit and First Nations communities in Canada
Authors: Willows Noreen , Johnson-Down Louise , Kenny Tiff-Annie , Chan Hing Man , Batal Malek
Published: December 2018

This review summarizes aspects of the 2017 Canadian Nutrition Society symposium, “Modelling diets for quality and cost: examples from Inuit and First Nations in Canada”. Indigenous peoples in Canada experience a high prevalence of nutrition-related chronic disease because of the poor quality and high cost of their food supply. Since European colonization, they have transitioned from a diet of minimally processed traditional foods (game, fish, and plants) procured using pursuits such as hunting, fishing, gathering, and horticulture to a diet comprised mostly of processed market foods. This nutrition transition is the result of factors such as colonial policies and practices; climate change; environmental degradation; contaminants in traditional foods; and limited availability of, or access to, economical and healthful market foods. Presenters Malek Batal and Laurie Chan characterized the contemporary diets of First Nations and Inuit populations and demonstrated novel methods for modelling more optimal diets using 2 datasets: the First Nations Food, Nutrition, and Environment Study and the Inuit Health Survey. It was demonstrated how the NOVA classification characterized the portion of the diet consisting of processed foods. Dietary components were then manipulated to reduce ultra-processed food and drink intake to increase the Healthy Eating Index score. Linear programming was explained as a way to mathematically design theoretical diets that aim to optimize food cost, nutrition quality, and contaminant level of traditional foods. While diet-modelling methodologies have limitations, they provide a basis for engaging Indigenous peoples and governments to develop nutrition goals and policies anchored in contemporary food realities.
Influence of a multistrain probiotic on body composition and mood in female occupational shift workers
Authors: Smith-Ryan Abbie E. , Mock Meredith G. , Trexler Eric T. , Hirsch Katie R. , Blue Malia N.M.
Published: December 2018

This study sought to investigate the effects of a multistrain probiotic on body composition, regional adiposity, and a series of associated metabolic health outcomes. Female health care workers employed on a rotating-shift schedule (n = 41) completed baseline anthropometric assessments; a fasted blood draw; questionnaires to assess anxiety, depression (Hospital Anxiety and Depression Scale), and fatigue (Chalder Fatigue Survey); and an exercise fatigue test. Identical post-tests occurred following 6 weeks of daily supplementation with placebo (PLA) or probiotics (2.5 × 109 CFU/g) containing 9 bacterial strains (PRO; Ecologic Barrier) combined with a prebiotic carrier matrix. PRO attenuated fat mass increases (change (Δ), 0.14 kg; confidence interval (CI) –0.46 to 0.75 kg) compared with PLA (Δ, 0.79 kg; CI 0.03–1.54 kg), whereas modest reductions in visceral adiposity resulted for both PRO and PLA. Metabolic biomarkers (total cholesterol, high-density lipoprotein, glucose, adiponectin, C-reactive protein, interleukin-6, leptin) were not influenced by either treatment (p > 0.05). Nonsignificant, but potentially clinically relevant, improvements in anxiety (Δ, –2.3 ± 2.63) and fatigue (Δ, –4.8 ± 5.5) were observed with PRO; exercise performance was unaffected. Results indicate a potential protective effect of probiotics against fat mass gain. Probiotics may alleviate anxiety and fatigue in shift-working females.
Assessing the utility of sulfur isotope values for understanding mercury concentrations in water and biota from high Arctic lakes
Authors: Lescord Gretchen L. , Clayden Meredith G. , Kidd Karen A. , Kirk Jane L. , Wang Xiaowa , O’Driscoll Nelson J. , Muir Derek C.G.
Published: December 2018

Methylmercury (MeHg) biomagnifies through aquatic food webs resulting in elevated concentrations in fish globally. Stable carbon and nitrogen isotopes are frequently used to determine dietary sources of MeHg and to model its biomagnification. However, given the strong links between MeHg and sulfur cycling, we investigated whether sulfur isotopes (δ34S) would improve our understanding of MeHg concentrations ([MeHg]) in Arctic lacustrine food webs. Delta34S values and total mercury (THg) or MeHg were measured in water, sediments, and biota from six lakes near Resolute Bay, NU, Canada. In two lakes impacted by historical eutrophication, aqueous sulfate δ34S was ∼8‰ more positive than sedimentary δ34S, suggestive of bacterial sulfate reduction in the sediment. In addition, aqueous δ34S showed a significant positive relationship with aqueous [MeHg] across lakes. Within taxa across lakes, [THg] in Arctic char muscle and [MeHg] in their main prey, chironomids, were positively related to their δ34S values across lakes, but inconsistent relationships were found across entire food webs among lakes. Across lakes, nitrogen isotopes were better predictors of biotic [THg] and [MeHg] than δ34S within this dataset. Our results suggest some linkages between Hg and S biogeochemistry in high Arctic lakes, which is an important consideration given anticipated climate-mediated changes in nutrient cycling.
Modeling the impacts of dams and stocking practices on an endangered Atlantic salmon (Salmo salar) population in the Penobscot River, Maine, USA
Authors: Stevens Justin R. , Kocik John F. , Sheehan Timothy F.
Published: December 2018

Dams challenge Atlantic salmon (Salmo salar) conservation, while hatcheries are a common but poorly evaluated recovery tool. We developed a spatially explicit smolt survival model for the Penobscot River, Maine, USA, population. By partitioning survival through dams (with flow dependency), free-flowing river reaches, and the estuary (with dam dependency), the model quantified how these factors influenced the number of fish entering the ocean. Given historical impounded conditions, 74%–22% of hatchery smolts released entered the ocean annually from 1970 to 2012. Of 19.7 million smolts stocked, 7.7 million entered the ocean (39%). Survival was most variable at dams (range 95% to 63%), followed by in-river (range 98% to 70%) and estuary (range 88% to 82%). Overall, lower-river stocking sites resulted in significantly higher numbers at ocean entry because of fewer dam encounters and shorter migrations. Higher flows also resulted in reduced losses. By reconstructing these freshwater and estuary dynamics, the model provides a more accurate estimate of ocean recruitment annually and can be used for scenario planning of future stocking locations relative to predicted flows while being adaptable to new survival rates.
A Study of Integer Sorting on Multicores
Authors: Gerbessiotis Alexandros V.
Published: December 2018

Integer sorting on multicores and GPUs can be realized by a variety of approaches that include variants of distribution-based methods such as radix-sort, comparison-oriented algorithms such as deterministic regular sampling and random sampling parallel sorting, and network-based algorithms such as Batcher’s bitonic sorting algorithm.

In this work we present an experimental study of integer sorting on multicore processors. We have implemented serial and parallel radix-sort for various radixes, deterministic regular oversampling, and random oversampling parallel sorting, including new variants of ours, and also some previously little explored or unexplored variants of bitonic-sort and odd-even transposition sort. The study uses multithreading and multiprocessing parallel programming libraries with the same C language code working under Open MPI, MulticoreBSP, and BSPlib. We first provide some general high-level observations on the performance of these implementations. If we can conclude anything is that accurate prediction of performance by taking into consideration architecture dependent features such as the structure and characteristics of multiple memory hierarchies is difficult and more often than not untenable. To some degree this is affected by the overhead imposed by the high-level library used in the programming effort.

Another objective is to model the performance of these algorithms and their implementations under the MBSP (Multi-memory BSP) model. Despite the limitations mentioned above, we can still draw some reliable conclusions and reason about the performance of these implementations using the MBSP model, thus making MBSP useful and usable.
Fully three-dimensional analysis of a photonic crystal assisted silicon on insulator waveguide bend
Authors: Eti N. , Çetin Z. , Sözüer H. S.
Published: December 2018

A detailed numerical study of low-loss silicon on insulator (SOI) waveguide bend is presented using the fully three-dimensional (3D) finite-difference time-domain (FDTD) method. The geometrical parameters are optimized to minimize the bending loss over a range of frequencies. Transmission results for the conventional single bend and photonic crystal assisted SOI waveguide bend are compared. Calculations are performed for the transmission values of TE-like modes where the electric field is strongly transverse to the direction of propagation. The best obtained transmission is over 95% for TE-like modes.