bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of the nonpulmonary vein foci induced after second‐generation cryoballoon ablation for paroxysmal atrial fibrillation
Authors: Kato Nobutaka , Nitta Junichi , Sato Akira , Inamura Yukihiro , Takamiya Tomomasa , Inaba Osamu , Negi Ken , Takahashi Yoshihide , Goya Masahiko , Sasano Tetuo
Published: December 2019

Introduction

Pulmonary vein isolation (PVI) using cryoballoon is effective for patients with paroxysmal atrial fibrillation (PAF); however, few reports have evaluated the non‐pulmonary vein (PV) foci after cryoballoon ablation. We aimed to evaluate the characteristics of non‐PV foci and predictors of atrial fibrillation (AF) recurrence after cryoballoon ablation.

Methods and Results

This was a single‐center retrospective study of 647 patients with PAF who underwent initial PVI using a second‐generation cryoballoon. After PVI, all patients underwent high‐dose isoproterenol infusion to assess the existence of non‐PV foci. Non‐PV foci were observed in 211 patients (32.6%), which were most frequently observed in the superior vena cava. Higher age (odds ratio [OR] = 1.02; 95% confidence interval [CI] = 1.00‐1.04; P = .025), female sex (OR = 1.65; 95% CI = 1.13‐2.41; P = .009), and lower body mass index (OR = 0.95; 95% CI = 0.89‐1.00; P = .049) were significantly associated with non‐PV foci. The existence of non‐PV foci was an independent predictor of AF recurrence (Hazard's ratio = 1.70; 95% CI = 1.12‐2.60; P = .014). When non‐PV foci were mappable and successfully ablated, patients with non‐PV foci showed similar outcomes with those without non‐PV foci (1‐year AF‐free survival rates of 88.5% vs 91.5%; P = .338). Conversely, when we failed to detect and eliminate non‐PV foci because they had multiple origins and were not consistently inducible (multichanging non‐PV foci), the 1‐year AF‐free survival rate was 56.4% even after substrate modification.

Conclusion

Non‐PV foci were observed in one‐third of patients with PAF after cryoballoon ablation and were associated with AF recurrence. Catheter ablation for non‐PV foci was effective when they were mappable; however, multichanging non‐PV foci were associated with worse prognosis.
Krüppel‐like factor 4 regulates stemness and mesenchymal properties of colorectal cancer stem cells through the TGF‐β1/Smad/snail pathway
Authors: Leng Zhengwei , Li Yong , Zhou Guojun , Lv Xiaojiang , Ai Walden , Li Jianshui , Hou Lingmi
Published: December 2019

Krüppel‐like factor 4 (KLF4) was closely associated with epithelial‐mesenchymal transition and stemness in colorectal cancer stem cells (CSCs)‐enriched spheroid cells. Nonetheless, the underlying molecular mechanism is unclear. This study showed that KLF4 overexpression was accompanied with stemness and mesenchymal features in Lgr5+CD44+EpCAM+ colorectal CSCs. KLF4 knockdown suppressed stemness, mesenchymal features and activation of the TGF‐β1 pathway, whereas enforced KLF4 overexpression activated TGF‐β1, phosphorylation of Smad 2/3 and Snail expression, and restored stemness and mesenchymal phenotypes. Furthermore, TGF‐β1 pathway inhibition invalidated KLF4‐facilitated stemness and mesenchymal features without affecting KLF4 expression. The data from the current study are the first to demonstrate that KLF4 maintains stemness and mesenchymal properties through the TGF‐β1/Smad/Snail pathway in Lgr5+CD44+EpCAM+ colorectal CSCs.
Formulation and evaluation of the topical ethosomal gel of melatonin to prevent UV radiation
Authors: Shukla Richa , Tiwari Gaurav , Tiwari Ruchi , Rai Awani K.
Published: December 2019

Background

Clinically, melatonin (MLT) has variable oral absorption and extensive first‐pass effect, making its oral mode less preferable. Ethosomes are able to permeate intact through the human skin due to its high deformability.

Aim

Present study assessed topical potential of ethosomes loaded with MLT for the prevention of UV radiation.

Methods

Melatonin was encapsulated using different ratios of ethanol, soya lecithin, and cholesterol. Prepared ethosomes were characterized for scanning electron microscopy (SEM), zeta potential, % entrapment efficiency (%EE), in vitro drug release kinetics. Then, optimized formulation was incorporated in gel and evaluated for viscosity, pH, extrudability, homogeneity, skin irritation study, spreadability, in vitro skin permeation study, flux, and stability.

Results

Ethosomes were spherical in structure as confirmed by SEM, and zeta potential was in range of −12.4 mV to −27.4 mV. %EE of the vesicles was in the range of 49.61%‐78.047%. Cumulative percentage drug release from various ethosomal formulations was ranged from 64.82%‐81.01%. F3 was selected as optimized formulation on the basis of highest %EE, zeta potential, and in vitro drug release. An ethosomal gel of optimized formulation F3 was prepared by using carbopol 934 and compared with plain gel formulation. G3 formulation showed pseudoplastic rheological behavior, optimum pH, spreadability and also showed maximum % in vitro drug permeation with flux 13.85 μg/cm2/hr and followed zero‐order release kinetics which was good for topical drug delivery system.

Conclusion

This research suggested that MLT loaded ethosomes can be potentially used as a topically drug delivery system.
Higher expression levels of aquaporin (AQP)1 and AQP5 in the lungs of arid‐desert living Lepus yarkandensis
Authors: Zhang Jianping , Li Shuwei , Liu Jie , Li Lexing , Deng Fang , Baikeli Buheliqihan , Li Linrui , Ma Xuanye , Liu Guoquan
Published: December 2019

Water transport across epithelial cells that line the airways and alveoli is a crucial component of lung physiology. Aquaporins (AQPs) facilitate water transport across the air space–capillary barrier in the distal lung. However, the roles of lung AQPs in desert animal adaptation to dry airstream environments are still unclear. A hare (Lepus yarkandensis) only lives in the Tarim Basin, and its living environment is an arid climate with rare precipitation. We studied cellular localization and expression levels of AQP1, AQP3, AQP4 and AQP5 in L. yarkandensis lungs by immunohistochemistry, quantitative real‐time polymerase chain reaction and Western blot. The lung of rabbits (Oryctolagus cuniculus) that inhabit in mesic environment was similarly studied. Obtained results in two species of animals were compared to investigate whether AQPs in the lung altered expression in the animal living in arid region. AQP1 was localized to the endothelial cells in capillaries and venules surrounding terminal bronchioles and alveoli. AQP5 was localized to the ciliated columnar cells in terminal bronchioles and the alveolar type I cells in the alveolus. Quantitative real‐time PCR analysis showed higher AQP1 and AQP5 mRNA levels in L. yarkandensis compared to O. cuniculus. Similar results were obtained by Western blot. These results revealed that the higher expression levels of AQP1 and AQP5 played a significant role in water transport in the lungs of arid‐desert living L. yarkandensis and might accelerate water transport from capillary compartments to the airspace.
The impact of driver sleepiness on fixation‐related brain potentials
Authors: Ahlström Christer , Solis‐Marcos Ignacio , Nilsson Emma , Åkerstedt Torbjörn
Published: December 2019

The effects of driver sleepiness are often quantified as deteriorated driving performance, increased blink durations and high levels of subjective sleepiness. Driver sleepiness has also been associated with increasing levels of electroencephalogram (EEG) power, especially in the alpha range. The present exploratory study investigated a new measure of driver sleepiness, the EEG fixation‐related lambda response. Thirty young male drivers (23.6 ± 1.7 years old) participated in a driving simulator experiment in which they drove on rural and suburban roads in simulated daylight versus darkness during both the daytime (full sleep) and night‐time (sleep deprived). The results show lower lambda responses during night driving and with longer time on task, indicating that sleep deprivation and time on task cause a general decrement in cortical responsiveness to incoming visual stimuli. Levels of subjective sleepiness and line crossings were higher under the same conditions. Furthermore, results of a linear mixed‐effects model showed that low lambda responses are associated with high subjective sleepiness and more line crossings. We suggest that the fixation‐related lambda response can be used to investigate driving impairment induced by sleep deprivation while driving and that, after further refinement, it may be useful as an objective measure of driver sleepiness.
A family with nemaline myopathy type 6 caused by hseterozygous mutation (c.1222C>T) in the KBTBD13 gene in China: A case report
Authors: Kang Zhi‐Xia , Wei Xiao‐Jing , Miao Jing , Gao Yan‐Lu , Wang Zi‐Yi , Yu Xue‐Fan
Published: December 2019

Nemaline myopathy (NEM) is a congenital myopathy that typically presents with proximal muscle weakness and hypotonia. To date, 13 genes have been associated with NEM. The Kelch repeat and BTB domain‐containing protein 13 (KBTBD13) gene (KBTBD13)‐related NEM is a rarely reported condition, and not a single case has been reported in Asia. Here, we report the case of a mother and daughter in China with NEM caused by a mutation (c.1222C>T) in KBTBD13. Their shared clinical phenotype is symmetrical muscle weakness in the arms and legs with childhood onset. Muscle magnetic resonance imaging showed the unique replacement mode of muscle with fibro‐fatty tissue. Histopathological examination revealed the presence of fibers containing rod‐shaped structures in the cytoplasm or under the sarcolemma. DNA sequencing analysis detected a heterozygous mutation (c.1222C>T) in KBTBD13 in this family. A founder effect for the variant may exist in the Low Countries of Belgium and the Netherlands, and the mutation may be a hotspot mutation in Europe, as it has not been reported in Asia. Our case study expands the spectrum of KBTBD13‐related NEM.
Assessment of fasted and fed gastrointestinal contraction frequencies in healthy subjects using continuously tagged MRI
Authors: de Jonge Catharina S. , Sprengers André M. J. , van Rijn Kyra L. , Nederveen Aart J. , Stoker Jaap
Published: December 2019

Background

Continuously tagged MRI during free breathing can assess bowel motility at frequencies as low as the slow wave, motility pattern range. This study aimed to evaluate noninvasive gastrointestinal‐tagged MRI for small bowel motility assessment and to observe the physiological response to a 300‐kcal meal challenge in healthy, overnight‐fasted volunteers.

Methods

After overnight fasting, 16 healthy subjects (7 women, mean age 25.5, range 19‐37 years) underwent a free breathing, tagged MRI scan to capture small bowel motility. Each subject underwent a (a) baseline motility scan, (b) food challenge, (c) postchallenge scan, and (d) second postchallenge scan (after 20 minutes). Motility was quantified using a frequency analysis technique for measuring the spectral power of the strain, referred to as motility score. Motility score was assessed in 20 frequency intervals between 1 and 20 contractions per minute (cpm), and the data were analyzed with linear mixed‐effect models.

Key Result

The stimulation protocol demonstrated an immediate, food‐induced, motility response in the low‐frequency range (2‐10 cpm), which is consistent with the stomach and small bowel frequency range (3‐12 cpm).

Conclusions and Inferences

This study shows that this MRI tagging technique is able to quantify the fasted‐to‐fed response to a 300‐kcal meal challenge within the specific small bowel motility frequency range in healthy subjects. The food provocation MRI protocol provides a tool to explore the gut's response to a stimulus in specific motility frequency ranges in patients with gastrointestinal dysmotility and functional disorders.
Description and function of a difficult airway service
Authors: Murray David J. , Massy‐Westropp Collette , Narayana‐Reddy Kavya , Marsh Jennifer
Published: December 2019

The goal of the Pediatric Difficult Airway Service (DAS) is to improve the care of children with airway abnormalities primarily through identification of children at risk for failed airway management. The airway service encourages early recognition and provides consultation, a plan for airway management, expertise in airway management, and follow‐up care for children who have a difficult airway. The service has improved the education of healthcare professionals and heightened awareness about the consequences of failed airway management.
Peace Aesthetics: A Patchwork
Authors: Möller Frank
Published: December 2019

This patchwork‐style article on peace aesthetics is based on the twin idea that it is possible to represent peace visually and that such representation can contribute to peace. Indeed, visual depictions of peace can be found across space and over time. However, they radically differ from one another and are not always easily recognizable as images of peace. The article identifies six problem areas with which visual peace research should engage: (i) representations of peace in the visual arts; (ii) photographic approaches to the aftermath of violent conflict, especially to the aftermath‐as‐event; (iii) peace photography as discussed and practiced in photojournalism; (iv) appropriation as a method in visual peace research; (v) digitization and machine–machine cultures; and (vi) the relationship between imaging and imagining. The analysis suggests that peace aesthetics, as a dissident practice, is both political and critical; it is interdisciplinary and based on an episodic understanding of the relationship between images and peace. It combines empirical, theoretical, and conceptual knowledge produced in the social sciences, art history, and media and communication studies, both with one another and with artistic practice.
Transcriptome and binding data indicate that citral inhibits single strand DNA‐binding proteins
Authors: Graña Elisa , Díaz‐Tielas Carla , Sánchez‐Moreiras Adela M. , Reigosa Manuel J. , Celeiro María , Abagyan Ruben , Teijeira Marta , Duke Mary V. , Clerk Tracy , Pan Zhiqiang , Duke Stephen O.
Published: December 2019

The mechanism of phytotoxicity of citral was probed in Arabidopsis thaliana using RNA‐Seq and in silico binding analyses. Inhibition of growth by 50% by citral downregulated transcription of 9156 and 5541 genes in roots and shoots, respectively, after 1 h. Only 56 and 62 genes in roots and shoots, respectively, were upregulated. In the shoots, the downregulation increased at 3 h (6239 genes downregulated, vs 66 upregulated). Of all genes affected in roots at 1 h (time of greatest effect), 7.69% of affected genes were for nucleic acid binding functions. Genes for single strand DNA binding proteins (SSBP) WHY1, WHY 2 and WHY3 were strongly downregulated in the shoot up until 12 h after citral exposure. Effects were strong in the root at just 1 h after the treatment and then at 12 and 24 h. Similar effects occurred with the transcription factors MYC‐2, ANAC and SCR‐SHR, which were also significantly downregulated for the first hour of treatment, and downregulation occurred again after 12 and 24 h treatment. Downregulation of ANAC in the first hour of treatment was significantly (P < 0.0001) decreased more than eight times compared to the control. In silico molecular docking analysis suggests binding of citral isomers to the SSBPs WHY1, WHY2, and WHY3, as well as with other transcription factors such as MYC‐2, ANAC and SCR‐SHR. Such effects could account for the profound and unusual effects of citral on downregulation of gene transcription.
What causes the differences in cavitation resistance of two shrubs? Wood anatomical explanations and reliability testing of vulnerability curves
Authors: Zhao Han , Jiang Zaimin , Ma Jin , Cai Jing
Published: December 2019

Relationships between xylem anatomical traits and cavitation resistance have always been a major content of plant hydraulics. To know how plants cope with drought, it is extremely important to acquire detailed knowledge about xylem anatomical traits and assess the cavitation resistance accurately. This study aims to increase our knowledge in the methods determining cavitation resistance and xylem anatomical traits. We selected a semi‐ring‐porous species, Hippophae rhamnoides L., and a diffuse‐porous species, Corylus heterophylla F., to clarify the reasons for the difference in cavitation resistance based on detailed xylem anatomical traits and reliable vulnerability curves (VCs). Both Cavitron and bench dehydration (BD) were used to construct VCs. Xylem anatomical traits, including pit membrane ultrastructure of these two species, were determined. The VCs obtained by the two different techniques were of different types for H. rhamnoides, its Cavitron VCs might be unreliable because of open‐vessel artifacts. On the basis of BD VCs, H. rhamnoides showed higher cavitation resistance than C. heterophylla, and this is attributed to its low vessel connectivity as well as non‐porous and thicker pit membranes.
Soil microbial communities in restored and unrestored coastal dune ecosystems in California
Authors: Parsons Lorraine S. , Sayre Jordan , Ender Cody , Rodrigues Jorge L. M. , Barberán Albert
Published: December 2019

Most restoration projects involving invasive plant eradication tend to focus on plant removal with little consideration given to how these invasives change soil microbial communities. However, soil microorganisms can determine invasibility of habitats and, in turn, be altered by invasives once established, potentially inhibiting native plant establishment. We studied soil microbial communities in coastal dunes with varying invasion intensity and different restoration approaches (herbicide, mechanical excavation) at Point Reyes National Seashore. Overall, we found evidence of a strong link between bacterial and fungal soil communities and the presence of invasives and restoration approach. Heavily invaded sites were characterized by a lower abundance of putatively identified nitrifiers, fermentative bacteria, fungal parasites, and fungal dung saprotrophs and a higher abundance of cellulolytic bacteria and a class of arbuscular mycorrhizal fungi (Archaeosporomycetes). Changes in soil microbiota did not fully dissipate following removal of invasives using herbicide, with exception of reductions in cellulolytic bacteria and Archaeosporomycetes abundance. Mechanical restoration effectively removed both invasives and soil legacy effects by inverting or “flipping” rhizome‐contaminated surface soils with soils from below and may have inadvertently induced other adverse effects on soils that impeded reestablishment of native dune plants. Land managers should consider additional measures to counteract lingering legacy effects and/or focus restoration efforts in areas where legacy effects are less pronounced.
Fibromyalgia impact and depressive symptoms: Can perceiving a silver lining make a difference?
Authors: Hirsch Jameson K. , Treaster Morgan K. , Kaniuka Andrea R. , Brooks Byron D. , Sirois Fuschia M. , Kohls Niko , Nöfer Eberhard , Toussaint Loren L. , Offenbächer Martin
Published: December 2019

Individuals with fibromyalgia are at greater risk for depressive symptoms than the general population, and this may be partially attributable to physical symptoms that impair day‐to‐day functioning. However, individual‐level protective characteristics may buffer risk for psychopathology. For instance, the ability to perceive a “silver lining” in one’s illness may be related to better mental and physical health. We examined perceived silver lining as a potential moderator of the relation between fibromyalgia impact and depressive symptoms. Our sample of persons with fibromyalgia (N = 401) completed self‐report measures including the Fibromyalgia Impact Questionnaire‐Revised, Depression Anxiety Stress Scales, and the Silver Lining Questionnaire. Moderation analyses covaried age, sex, and ethnicity. Supporting hypotheses, increasing impact of disease was related to greater depressive symptoms, and perceptions of a silver lining attenuated that association. Despite the linkage between impairment and depressive symptoms, identifying positive aspects or outcomes of illness may reduce risk for psychopathology. Therapeutically promoting perception of a silver lining, perhaps via signature strengths exercises or a blessings journal, and encouraging cognitive reframing of the illness experience, perhaps via Motivational Interviewing or Cognitive Behavioral Therapy, may reduce depressive symptoms in persons with fibromyalgia.
After coming out: Parental acceptance of young lesbian and gay people
Authors: Ghosh Apoorva
Published: December 2019

This study examines extant scholarly knowledge on parental acceptance of young lesbian and gay people in traditional heteronormative families. Recent literature shows that parents generally accept their lesbian and gay children. However, parents do not always accept them immediately after they come out. Acceptance takes time, and transitioning to acceptance is often a complex process that depends on parents' access to the necessary resources for coping with the stresses of knowing that their child identifies as lesbian or gay. These resources include counseling or therapy, supportive friends and extended family, and a network of other parents with lesbian and gay children. This study also highlights the need for further research on parental acceptance in nontraditional families and of children with other nonheterosexual identities, such as asexuality, gray ace, bisexuality, or pansexuality. It also calls for an exploration of the complexities of parental acceptance as an ongoing process rather than as a singular event.
Understanding and taking stock of positive emotion disturbance
Authors: Gruber June , Villanueva Cynthia , Burr Emily , Purcell John R. , Karoly Hollis
Published: December 2019

The prevailing view on positive emotions is that they correlate with and confer psychological health benefits for the individual, including improved social, physical and cognitive functioning. Yet an emerging wave of scientific work suggests that positive emotions are also related to a range of suboptimal psychological health outcomes, especially when the intensity, duration, or context do not optimize the individual's goals or meet current environmental demands. This paper provides an overview of the “other side” of positive emotion, by describing and reviewing evidence supporting the emerging field of positive emotion disturbance (PED). We review relevant emotion processes and key themes of PED and apply this framework to example emotional disorders, and discuss implications for psychological change and future research agendas.
Variation in competent and respectful delivery care in Kenya and Malawi: a retrospective analysis of national facility surveys
Authors: Arsenault Catherine , English Mike , Gathara David , Malata Address , Mandala Wilson , Kruk Margaret E.
Published: December 2019

Objective

Although substantial progress has been made in increasing access to care during childbirth, reductions in maternal and neonatal mortality have been slower. Poor‐quality care may be to blame. In this study, we measure the quality of labour and delivery services in Kenya and Malawi using data from observations of deliveries and explore factors associated with levels of competent and respectful care.

Methods

We used data from nationally representative health facility assessment surveys. A total of 1100 deliveries in 392 facilities across Kenya and Malawi were observed and quality was assessed using two indices: the quality of the process of intrapartum and immediate postpartum care (QoPIIPC) index and a previously validated index of respectful maternity care. Data from standardised observations of care were analysed using descriptive statistics and multivariable random‐intercept regression models to examine factors associated with variation in quality of care. We also quantified the variance in quality explained by each domain of covariates (patient‐, provider‐ and facility‐level and subnational divisions).

Results

Only 61–66% of basic elements of competent and respectful care were performed. In adjusted models, better‐staffed facilities, private hospitals and morning deliveries were associated with higher levels of competent and respectful care. In Malawi, younger, primipara and HIV‐positive women received higher‐quality care. Quality also differed substantially across regions in Kenya, with a 25 percentage‐point gap between Nairobi and the Coast region. Quality was also higher in higher‐volume facilities and those with caesarean section capacity. Most of the explained variance in quality was due to regions in Kenya and to facility, and patient‐level characteristics in Malawi.

Conclusions

Our findings suggest considerable scope for improvement in quality. Increasing staffing and shifting births to higher‐volume facilities – along with promotion of respectful care in these facilities – should be considered in sub‐Saharan Africa to improve outcomes for mothers and newborns.
Making the Final Shot: The Role of Passion and Integrated Temporal Positivity in Last-Second Sport Performance
Authors: Sverdlik Anna , Vallerand Robert J. , St-Louis Ariane , Tion Michael Sam , Porlier Geneviève
Published: December 2019

The new construct of integrated temporal positivity—defined as the positive, adaptive, and dynamic use of the past, the present, and the future—is posited to promote optimal functioning. Based on the dualistic model of passion, the present research sought to test the hypothesis that harmonious passion, more than obsessive passion, triggers a higher use of integrated temporal positivity that, in turn, leads to one crucial type of sport performance, namely last-second performance. The results of 3 studies conducted with team-sport athletes (Study 1,n = 625; Study 2,n = 285; and Study 3,n = 263) provided clear support for the hypothesis. The results pave the way for future research focusing on the role of adaptive temporal processes in support of sport performance.
MiR-23~27~24–mediated control of humoral immunity reveals a TOX-driven regulatory circuit in follicular helper T cell differentiation
Authors: Wu Cheng-Jang , Cho Sunglim , Huang Hsi-Yuan , Lu Chun-Hao , Russ Jasmin , Cruz Leilani O. , da Cunha Flavia Franco , Chen Mei-Chi , Lin Ling-Li , Warner Lindsey M. , Liao Hsin-Kai , Utzschneider Daniel T. , Quon Sara , Berner Jacqueline , Camara Niels Olsen Saraiva , Zehn Dietmar , Belmonte Juan Carlos Izpisua , Chen Li-Chen , Huang Shiang-Fu , Kuo Ming-Ling , Lu Li-Fan
Published: December 2019

miR-23~27~24 regulates T
FH
cells through targeting multiple genes including TOX, a key transcription factor for T
FH
cell biology.
Sleep fragmentation, microglial aging, and cognitive impairment in adults with and without Alzheimer’s dementia
Authors: Kaneshwaran Kirusanthy , Olah Marta , Tasaki Shinya , Yu Lei , Bradshaw Elizabeth M. , Schneider Julie A. , Buchman Aron S. , Bennett David A. , De Jager Philip L. , Lim Andrew S. P.
Published: December 2019

Poor sleep in older adults is associated with aging of the brain’s resident innate immune cells and impaired cognition.
Rising CO
2
drives divergence in water use efficiency of evergreen and deciduous plants
Authors: Soh Wuu Kuang , Yiotis Charilaos , Murray Michelle , Parnell Andrew , Wright Ian J. , Spicer Robert A. , Lawson Tracy , Caballero Rodrigo , McElwain Jennifer C.
Published: December 2019

A rapid rise in CO
2
has made evergreen trees more waterwise than deciduous trees, especially in cooler parts of the world.
Focusing light inside live tissue using reversibly switchable bacterial phytochrome as a genetically encoded photochromic guide star
Authors: Yang Jiamiao , Li Lei , Shemetov Anton A. , Lee Sangjun , Zhao Yuan , Liu Yan , Shen Yuecheng , Li Jingwei , Oka Yuki , Verkhusha Vladislav V. , Wang Lihong V.
Published: December 2019

A genetically encoded photochromic guide star is used for focusing light inside live tissue by wavefront shaping.
Efficacy of Delafloxacin versus Moxifloxacin against Bacterial Respiratory Pathogens in Adults with Community-Acquired Bacterial Pneumonia (CABP): Microbiology Results from the Delafloxacin Phase 3 CABP Trial
Authors: McCurdy Sandra , Keedy Kara , Lawrence Laura , Nenninger Ashley , Sheets Amanda , Quintas Megan , Cammarata Sue
Published: December 2019

Delafloxacin is a novel fluoroquinolone with activity against Gram-positive, Gram-negative, and atypical pathogens, including fluoroquinolone-nonsusceptible methicillin-resistant
Staphylococcus aureus
(MRSA). The microbiological results of a phase 3 clinical trial in adults with community-acquired pneumonia (CAP) comparing delafloxacin (300 mg intravenously [i.v.] with the option to switch to 450 mg orally every 12 h) to moxifloxacin (400 mg i.v.
Natural recovery from long-lasting generalised dissociative amnesia and of cerebral blood flow
Authors: Mitsui Nobuyuki , Oyanagi Yuka , Kako Yuki , Kusumi Ichiro
Published: December 2019

A 40-year-old man presented with generalised dissociative amnesia. At 2 weeks after onset, N-isopropyl-[123I]p-iodoamphetamine-single-photon emission CT imaging of the brain revealed hypoperfusion in the right medial temporal area. Organic brain damage was ruled out. His inability to recall information was attributed to psychological stress related to his employment. Consistent with this diagnosis, his generalised dissociative amnesia lasted 6 years and 10 months; however, he recovered from amnesia naturally on starting a new job. Perfusion of his right medial temporal area also returned to normal levels. Longitudinal reports for generalised dissociative amnesia with natural recovery are exceedingly rare. It is important to confirm whether dissociative amnesia and cerebral blood flow recover in parallel, even in cases where dissociative amnesia is long-lasting.
Factors influencing the effect of mindfulness-based interventions on diabetes distress: a meta-analysis
Authors: Guo Jia , Wang Hongjuan , Luo Jiaxin , Guo Yi , Xie Yun , Lei Beimei , Wiley James , Whittemore Robin
Published: December 2019

To review the evidence and determine the factors influencing the effect of mindfulness-based interventions (MBI) on diabetes distress. A systematic search of nine databases (PubMed, Cochrane Library, Web of Science, PsycINFO, Embase, China Knowledge Resource Integrated, VIP Data, SinoMed Data, and Wan Fang Data) was conducted. Randomized controlled trials of MBIs for adults with diabetes that evaluated the effect of the interventions on diabetes distress were retrieved. Meta-analysis was conducted by using Review Manager V.5.3, a Cochrane Collaboration tool. Subgroup analyses were conducted for exploring factors influencing the effect of MBIs on diabetes distress. A total of 10 articles, consisting of eight studies with 649 participants, were included. The results from subgroup analyses on the studies revealed five factors that influenced the effect of MBIs on diabetes distress compared with control group. Participants with elevated baseline diabetes distress showed a moderate effect size of 0.48 of decreasing diabetes distress when receiving MBIs (p=0.005); the MBIs based on mindfulness-based stress reduction therapy alleviated diabetes distress of the participants with a large effect size of 0.58 (p<0.0001); the MBIs delivered in group format decreased the diabetes distress with a moderate effect size of 0.36 (p=0.03); the MBIs with home practice assignment alleviated the diabetes distress with a moderate effect size of 0.42 (p=0.05). The long-term rather than short-term effect of MBIs on diabetes distress reduction has been identified with large effect size of 0.56 (p=0.04). MBIs improve outcomes in adults with diabetes who have elevated diabetes distress at baseline, using mindfulness-based stress reduction therapy, using a group format to deliver the intervention, and assigning home practice. MBIs improve diabetes distress significantly more at long-term follow-up compared with short-term follow-up. MBIs could be considered as an adjunct treatment in adults with diabetes to reduce diabetes distress.
Effects of implementing evidence-based appropriateness guidelines for epidural steroid injection in chronic low back pain: the EAGER (Esi Appropriateness GuidElines pRotocol) study
Authors: Johnson Scott M , Hutchins Troy , Peckham Miriam , Anzai Yoshimi , Ryals Elizabeth , Davidson H Christian , Shah Lubdha
Published: December 2019

Objective

Chronic low back pain is very common and often treated with epidural steroid injections (ESIs). As ESI referrals had been rapidly increasing at our Veterans’ Administration hospital, we were concerned that they were supplanting more comprehensive care. The objective was to determine how referral patterns and multidisciplinary care might change with the implementation of evidence-based guidelines.

Methods

In this retrospective observational study, multidisciplinary evidence-based guidelines were implemented in 2014 (EAGER: Esi Appropriateness GuidElines pRotocol) as part of the ordering process for an ESI. Time series analysis was performed to assess the primary outcome of subspecialty referral pattern, that is, the number of patients receiving referrals to ancillary services which might serve to provide a more comprehensive approach to their back pain. Secondary outcomes included patient-level changes (ie, body mass index, number of injections, opioid use), which were compared before and after protocol implementation.

Results

Comparing preimplementation and postimplementation protocol periods, referrals to physical medicine/rehabilitation increased 11.7% (p=0.003) per year and integrative health increased 2.1% (p<0.001) per year among the 2294 individual patients who received ESI through the neurointerventional radiology service. Of 100 randomly selected patients for patient-level analysis, the median body mass index decreased from 31.57 to 30.22 (p=<0.001) and the mean number of injections decreased from 1.76 to 0.73 (p<0.001). The percentage of patients using oral opioid analgesics decreased from 72% to 49% (p=<0.001).

Conclusion

Implementation of evidence-based guidelines for ESI referral helps guide patients into a more comprehensive care pathway for chronic low back pain and is correlated with patient-level changes such as decreased body mass index and decreased opioid usage.
EBN Perspectives, Mental Health
Authors: Green Laura , Barrett David
Published: December 2019

EBN Perspectives brings together key issues from the commentaries in one of our nursing topic themes
How can pain management in the emergency department be improved? Findings from multiple case study analysis of pain management in three UK emergency departments
Authors: Sampson Fiona C , O’Cathain Alicia , Goodacre Steve
Published: December 2019

Introduction

Inadequate pain management in EDs is a worldwide problem, yet there has been little progress in understanding how pain management can be improved. There is only weak evidence and limited rationale to support interventions to improve pain management. We used naturalistic, qualitative methods to understand the factors that influence how pain is managed within the adult ED.

Methods

We used a multiple case study design incorporating 143-hour non-participant observation, documentary analysis and semistructured interviews with 37 staff and 19 patients at three EDs in the North of England between 2014 and 2016. We analysed data using thematic analysis.

Results

Our analysis demonstrated that pain management was not well aligned with the core priorities of the ED and was overlooked when other works took priority. We identified that (1) pain management was not perceived to be a key organisational priority for which staff were held accountable and staff had limited awareness of their performance, (2) pain management was not a core component of ED education and training, (3) ED processes and structures were not aligned with pain management and pain reassessment was overlooked unless staff escalated pain management outside of normal processes and (4) staff held embedded beliefs that conceptualised pain management as distinct from core priorities and limited their capacity to improve. However, EDs were able to improve pain management by aligning processes of pain management with other core works, particularly patient flow (eg, nurse-initiated analgesia at triage).

Implications

EDs may be able to improve pain management by ensuring pain management processes align with key ED priorities. Undertaking multifaceted changes to structures and processes may enable staff to improve pain management and develop a culture in which pain management can be prioritised more easily. Future interventions need to be compatible with the wider work of the ED and enable patient flow in order to be adopted and maintained.
Blunt chest trauma in the elderly: an expert practice review
Authors: Birse Fraser , Williams Helen , Shipway David , Carlton Edward
Published: December 2019

Trauma in the elderly (>65 years) is an increasingly common presentation to the ED. A fall from standing height is the most common mechanism after which such patients present, and rib fracture is the most common non-spinal fracture. Thoracic injury in patients aged over 65 is associated with significant morbidity and mortality. There are currently no universally applied guidelines for assessment, investigation and management of such patients. In this expert practice review, we discuss the evidence base and options for clinical management in this vulnerable patient group.
Cohort study of medical cannabis authorisation and healthcare utilisation in 2014–2017 in Ontario, Canada
Authors: Eurich Dean , Lee Cerina , Zongo Arsene , Minhas-Sandhu Jasjett K , Hanlon John G , Hyshka Elaine , Dyck Jason
Published: December 2019

Background

The impact of medical cannabis on healthcare utilisation between 2014 and 2017 in Ontario, Canada. With cannabis legalisation in Canada and some states in the USA, high-quality longitudinal cohort research studies are of urgent need to assess the impact of cannabis use on healthcare utilisation.

Methods

A matched cohort study of 9925 medical cannabis authorised adult patients (inhaled (smoked or vaporised) or orally consumed (oils)) at specialised cannabis clinics, and inclusion of 17 732 controls (not authorised) between 24 April 2014 and 31 March 2017 from Ontario, Canada. Interrupted time series and multivariate Poisson regression analyses were conducted. Medical cannabis impact on healthcare utilisation was measured over 6 months: all-cause physician visits, all-cause hospitalisation, ambulatory care sensitive conditions (ACSC)-related hospitalisations, all-cause emergency department (ED) visits and ACSC-related ED visits.

Results

For medical cannabis patients compared with controls, there was an initial (within the first month) increase in physician visits (additional 4330 visits per 10 000 patients). However, a numerical reduction was noted over the 6-month follow-up, and no statistical difference was observed (p=0.126). Likewise, in hospitalisations and ACSC ED visits, there was an initial increase (44 per 10 000 people, p<0.05) but no statistical difference after follow-up (p=0.34). Conversely, no initial increase in all-cause ED visits was observed with a slight decrease (19 visits per 10 000 patients, p=0.014) in follow-up.

Conclusions

An initial increase (within first month) in healthcare utilisation may be expected among medical cannabis users that appears to wane over time. Proactive follow-up of patients using medical cannabis is warranted to minimise initial risks to patients and actively assess potential benefits/harms of ongoing use.
Life cycle assessment of asphalt pavement maintenance and rehabilitation techniques: a study for the City of St. John’s
Authors: Alam Md Rakibul , Hossain Kamal , Butt Ali Azhar , Caudle Tim , Bazan Carlos
Published: December 2019

Although pavement maintenance and rehabilitation (M&R) techniques are usually examined in economic terms, there is a growing need to address their environmental footprints. The objective of this study is to assess the environmental impacts of M&R techniques. Life cycle assessment (LCA) can help in the decision-making process of selecting suitable maintenance techniques based on their environmental impacts. This study investigates: patching, rout & sealing, hot in-place recycling, and cold in-place recycling. Global warming potential (GWP), acidification potential, human health particulate, eutrophication potential, ozone depletion potential, and smog potential are estimated as environmental impacts for each maintenance activity. Materials, equipment use (for construction and M&R), and transportation were the main elements considered. A sensitivity test is performed to identify the significant factors for the LCA. The study concluded that GWP was the most important impact category. Rout & sealing and cold in-place recycling produced the lowest GWP emissions. Notably, pavement patching and hot in-place recycling showed significant detrimental environmental impacts.
A lattice Boltzmann model for the nonlinear thermistor equations
Authors: Liu Jiao , Chai Zhenhua , Shi Baochang
Published: December 2019

In this paper, we propose a general and efficient lattice Boltzmann (LB) model for solving the nonlinear thermistor equations, where the nonlinear diffusion and Poisson equations are solved by two LB equations. Through Chapman–Enskog analysis, the nonlinear thermistor equations can be recovered correctly from the present LB model. We then test the model through some numerical simulations, and find that the numerical results are in good agreement with analytical solutions. Additionally, the numerical results also show that the present LB model has a second-order convergence rate in space.
Study on turbulence drag reduction of riblet plate in hypersonic turbulent flows
Authors: Zhou Hao , Li Xinliang , Yu Changping
Published: December 2019

This paper focuses on turbulence drag reduction of riblet plate in hypersonic turbulent flows. We use direct numerical simulation (DNS) and large eddy simulation (LES) to simulate three-dimensional spatially-developing boundary layer over the flat plate and riblet plate with a free-stream Mach number [Formula: see text]. The results reveal the influence of different riblet heights [Formula: see text] and riblet distances [Formula: see text] on drag reduction effect. The drag reduction effect increases with the increase of riblet height and the decrease of riblet distance within suitable range of parameter values. Through analysis, it can be seen that the riblet plate affects the turbulent contribution of the skin friction by suppressing or destroying the large-scale vortex structure. Combined with the actual engineering design requirements, we can use the riblet plate with appropriate parameters to achieve the purpose of turbulence control.
Considerations on the design of a rare isotope beam facility based on superconducting heavy ion linacs
Authors: Kim Jongwon , Mustapha Brahim
Published: December 2019

To establish an accelerator facility based on superconducting linear accelerator (linac) for nuclear and applied sciences in Korea, the rare isotope science project started in December 2011 under the auspices of the Institute for Basic Science (IBS). The layout of the facility has been mostly frozen since 2013 and civil construction began in 2016. On the other hand, an alternative linac design option was recently investigated in collaboration with the linac development group of Argonne National Lab in search of a further optimized configuration. A new linac lattice was developed and evaluated against realistic machine errors using TRACK. The beam optics simulations and error analysis then proved the soundness of this alternative design. In addition, beam optics of the injector was studied for simultaneous acceleration of both stable and rare isotope beams with the use of an electron beam ion source (EBIS). Also considered are alternative options of high-power cyclotrons as ISOL driver in order to enhance the capability of rare isotope beam production and fully exploit the superconducting linac facility built at high cost.
Advances in global optimization of high brightness beams
Authors: Qiang Ji
Published: December 2019

High brightness electron beams play an important role in accelerator-based applications such as driving X-ray free electron laser (FEL) radiation. In this paper, we report on advances in global beam dynamics optimization of an accelerator design using start-to-end simulations and a new parallel multi-objective differential evolution optimization method. The global optimization results in significant improvement of the final electron beam brightness.
Challenges in extracting pseudo-multipoles from magnetic measurements
Authors: Russenschuck S. , Caiafa G. , Fiscarelli L. , Liebsch M. , Petrone C. , Rogacki P.
Published: December 2019

Extracting the coefficients of Fourier–Bessel series, known as pseudo-multipoles or generalized gradients, from magnetic measurements of accelerator magnets involves technical and mathematical challenges. First, a novel design of a short, rotating-coil magnetometer is required that does not intercept any axial field component of the magnet. Moreover, displacing short magnetometers, step-by-step along the magnet axis, yields a convolution of the local multipole field errors and the sensitivity (test function) of the induction coil. The deconvolution must then contend with the limited signal-to-noise ratio of the measured quantities, which are integrated voltages corresponding to spatial flux distributions. Finally, the compensation schemes, as implemented on long coils and based on scaling laws derived for the integrated field harmonics, cannot be applied to short magnetometers intercepting only a local field distribution. All this requires careful design of experiment to derive the optimal length of the induction coil, the step-size of the scan, and the highest order of pseudo-multipoles in the field reconstruction. This paper presents the theory of the measurement method, the data acquisition and deconvolution, and the design and production of a saddle-shaped, rotating-coil magnetometer.
Simulations of coherent electron cooling with two types of amplifiers
Authors: Ma Jun , Wang Gang , Litvinenko Vladimir
Published: December 2019

The SPACE code is a parallel, relativistic, three-dimensional, electromagnetic, particle-in-cell code developed for the simulations of beam dynamics and interactions. The SPACE code can perform simulations with various beam distributions, different types of boundary conditions, and flexible beam line, as well as provide sufficient processing routines for data analyses and visualization. Self-consistent, highly resolved and realistic simulations were performed using the SPACE code to study the coherent electron cooling (CeC) experiment with two types of amplifiers, the free electron laser (FEL) and plasma-cascade micro-bunching amplifiers.
Simulation of the CBETA 4-pass FFAG ERL using field maps — exclusively
Authors: Méot F. , Berg J. S. , Brooks S. , Trbojevic D. , Tsoupas N. , Crittenden J.
Published: December 2019

The Cornell-BNL Electron Test Accelerator (CBETA), a four-pass, 150 MeV energy recovery linac (ERL), is now in construction at Cornell. Commissioning commenced on March 2019. A particularity of CBETA is that a single channel loop recirculates the four energies (42, 78, 114 and 150 MeV). The return loop arcs are based on fixed-field alternating gradient (FFAG) optics. The loop is comprised of 107 quadrupole-doublet cells, built using Halbach permanent magnet technology. Spreader and combiner sections (4 independent beam lines each) connect the 36 MeV linac to the FFAG arcs. We introduce here a start-to-end simulation of the 4-pass ERL, based entirely, and exclusively, on the use of magnetic field maps to model the optical components.