bluuebunny/crossref_metadata_2025 huggingface dataset:
Testosterone replacement therapy
Authors: Barbonetti Arcangelo , D’Andrea Settimio , Francavilla Sandro
Published: February 2020

Background

The aim of testosterone replacement therapy (TRT) is to improve symptoms and signs of testosterone deficiency including decreased libido, erectile dysfunction, depressed mood, anaemia, loss of muscle and bone mass, by increasing serum testosterone levels to physiologic range. TRT has been used in the last 70 years, and overtime, numerous preparations and formulations have been developed to improve pharmacokinetics (PKs) and patient compliance. The routes of delivery approved for use in the Western world include buccal, nasal, subdermal, transdermal and intramuscular (IM).

Objectives

The aim of this narrative review was to describe and compare all available and approved testosterone preparations according to pharmacology, PKs and adverse effects.

Materials and Methods

We have performed an extensive PubMed review of the literature on TRT in clinical practice. Contraindications and monitoring of TRT were analyzed by comparing available guidelines released in the last five years. We provide a review of advantages and disadvantages of different modalities of TRT and how to monitor treatment to minimize the risks.

Results

TRT is associated with multiple benefits highly relevant to the patient. However, the recommendations given in different guidelines on TRT are based on data from a limited number of randomized controlled trials (RCTs), as well as non‐randomized clinical studies and observational studies. This is the case for the safety of a long‐term TRT in late‐onset hypogonadism (LOH). No evidence is provided indeed on the effects of TRT on endpoints such as deterioration of heart failure suggesting a cautious approach to T replacement in older men with a history of heart failure.

Conclusion

Clinicians must consider the unique characteristics of each patient and make the necessary adjustments in the management of LOH in order to provide the safest and most beneficial results.
Pharmacokinetics, pharmacodynamics and safety of the inverse retinoic acid‐related orphan receptor γ agonist AZD0284
Authors: Asimus Sara , Palmér Robert , Albayaty Muna , Forsman Henrik , Lundin Christina , Olsson Marita , Pehrson Rikard , Mo John , Russell Muir , Carlert Sara , Close David , Keeling David
Published: February 2020

Aims

Retinoic acid‐related orphan receptor γ (RORγ), a master regulator of T‐helper 17 (Th17) cell function and differentiation, is an attractive target for treatment of Th17‐driven diseases. This first‐in‐human study aimed to investigate the pharmacokinetics, pharmacodynamics, safety and tolerability of the inverse RORγ agonist AZD0284.

Methods

We conducted a phase I, randomized, single‐blind, placebo‐controlled, two‐part, first‐in‐human study with healthy subjects receiving single (4–238 mg) or multiple (12–100 mg) oral doses of AZD0284 or placebo after overnight fasting. Subjects in the one single dose cohort additionally received a single dose of AZD0284 after a high‐calorie meal. AZD0284 plasma concentrations, as well as inhibition of ex vivo‐stimulated interleukin (IL)‐17A release in whole blood, were frequently measured after both single and multiple dosing.

Results

Eighty‐three men participated in the study. AZD0284 was absorbed rapidly into plasma after oral dosing and exhibited a terminal half‐life of 13–16 hours. Both the area under the concentration‐time curve (AUC) and maximum concentration (Cmax) increased subproportionally with increasing dose (95% confidence intervals of slope parameter were 0.71–0.84 and 0.72–0.88 for AUC and Cmax, respectively). Food intake delayed the absorption of AZD0284 but did not affect the overall exposure or half‐life. AZD0284 showed dose‐dependent reduction of ex vivo‐stimulated IL‐17A release after both single and multiple doses. No significant safety concerns were identified in the study.

Conclusions

AZD0284 was well tolerated, rapidly and dose‐dependently absorbed, and reduced stimulated IL‐17A release after single and multiple dosing. The results of this study support further clinical development of AZD0284.
A critical reflection on accessing women with learning disabilities to participate in research about sensitive subjects through organisational partnerships
Authors: Earle Sarah , Ledger Sue , Tilley Elizabeth , Walmsley Jan , Chapman Rohhss , Townson Lou
Published: February 2020

Accessible summary

This article is about reaching out to people with learning disabilities to participate in research on sensitive topics, like contraception. Contraception is a way to prevent pregnancy.

The article shows that working with organisations can help to find and support people with learning disabilities to take part in research.

The article explores what research teams need to do when working with organisations to find and support research participants.

Background

Contraceptive use by women with learning disabilities differs from that of nondisabled women of a similar age. Women with learning disabilities start contraception earlier and often use it when they are not sexually active. Hence, there is a need to hear directly from these women about their experiences of contraceptive decision‐making. However, accessing women to discuss a sensitive topic such as contraception poses significant challenges to researchers.

Materials and Methods

The study was qualitative in nature and involved conducting semi‐structured interviews with 19 women. This paper reports on the methodological challenges and findings from the project which have wider implications for research on sensitive topics with hard‐to‐reach groups. It reflects critically on the challenges of accessing women with learning disabilities to participate in research on contraception.

Results

Twelve of the 19 participants in our project were recruited through two organisations. Working in partnership with organisations that had a keen interest in the research and endorsed it at senior level enabled us to overcome recruitment challenges. However, working in this way raised gatekeeping issues that impacted upon data collection and may have affected our substantive findings.

Conclusions

Working in partnership with organisations can be an effective and practical way of recruiting participants that researchers may otherwise find hard to reach. However, organisational partnerships can be hard to develop and take time. We argue that it is important to reflect openly and honestly about the methodological and ethical issues that may arise when working closely with organisations in sensitive research.
With a little help from my friends: Individual and collaborative performance during trail clearing in leaf‐cutting ants
Authors: Alma Andrea Marina , Farji‐Brener Alejandro G. , Elizalde Luciana
Published: February 2020

Social organisms express collaborative behaviors, allowing them to solve problems that exceed their individual capabilities. Group coordination and environmental context are some of the factors that may determine the performance of individual and collaborative strategies. Using the trail‐clearing behavior of leaf‐cutting ants, we evaluated experimentally for both strategies whether the success probability and clearing time depend on problem characteristics and context. We placed obstacles of different sizes and shapes (problem characteristics), in trails with different foragers' fluxes and soil roughness (context) in 10 field nests of Atta cephalotes, and compared removal success (i.e., if ants could remove obstacles) and time of individual and collaborative strategies. Very large obstacles could only be removed collaboratively, confirming individual limitations for transporting large objects. For all obstacle shapes, collaborative removals were more successful but took longer, suggesting that coordination among individuals delays these actions. Individual strategies were faster, regardless of ant flux. However, as ant flux increased, removal success was higher for collaborative than for individual removals. Lastly, trail roughness had no effect. This work highlights one advantage of sociality, the option of collaboratively solving problems that exceed the individual abilities. In addition, it reveals the associated costs of joint actions, since they can be time‐consuming presumably due to coordination problems.

Abstract in Spanish is available with online material.
European Society of ColoProctology: guideline for haemorrhoidal disease
Authors: van Tol R. R. , Kleijnen J. , Watson A. J. M. , Jongen J. , Altomare D. F. , Qvist N. , Higuero T. , Muris J. W. M. , Breukink S. O.
Published: February 2020

Aim

The goal of this European Society of ColoProctology project was to establish a multidisciplinary, international guideline for haemorrhoidal disease (HD) and to provide guidance on the most effective (surgical) treatment for patients with HD.

Methods

The development process consisted of six phases. In phase one we defined the scope of the guideline. The patient population included patients with all stages of haemorrhoids. The target group for the guideline was all practitioners treating patients with haemorrhoids and, in addition, healthcare workers and patients who desired information regarding the treatment management of HD. The guideline needed to address both the diagnosis of and the therapeutic modalities for HD. Phase two consisted of the compilation of the guideline development group (GDG). All clinical members needed to have affinity with the diagnosis and treatment of haemorrhoids. Further, attention was paid to the geographical distribution of the clinicians. Each GDG member identified at least one patient in their country who could read English to comment on the draft guideline. In phase three review questions were formulated, using a reversed process, starting with possible recommendations based on the GDG’s knowledge. In phase four a literature search was performed in MEDLINE (Ovid), PubMed, Embase (Ovid) and the Cochrane Database of Systematic Reviews. The search was focused on existing systematic reviews addressing each review question, supplemented by other studies published after the time frame covered by the systematic reviews. In phase five data of the included papers were extracted by the surgical resident (RT) and checked by the methodologist (JK) and the GDG. If needed, meta‐analysis of the systematic reviews was updated by the surgical resident and the methodologist using Review Manager. During phase six the GDG members decided what recommendations could be made based on the evidence found in the literature using GRADE.

Results

There were six sections: (i) symptoms, diagnosis and classification; (ii) basic treatment; (iii) outpatient procedures; (iv) surgical interventions; (v) special situations; (vi) other surgical techniques. Thirty‐four recommendations were formulated.

Conclusion

This international, multidisciplinary guideline provides an up to date and evidence based summary of the current knowledge of the management of HD and may serve as a useful guide for patients and clinicians.
Heidegger on Guilt: Reconstructing the Transcendental Argument in Being and Time
Authors: Elgat Guy
Published: February 2020

In the chapter on conscience and guilt in Being and Time, Heidegger makes transcendental claims to the effect that Dasein's Being‐guilty is the condition of possibility of factical guilt—guilt for specific misdeeds. In this article, I reconstruct Heidegger's transcendental argument. To do so, I distinguish factical guilt from (what I call) ontic guilt and ontological guilt and explain why Dasein's ontic guilt is a necessary condition of possibility of Dasein's factical guilt and why ontic guilt, in turn, is necessarily conditioned by Dasein's ontological guilt, or Dasein's ownmost Being‐guilty. In the process, I provide an interpretation of the two “nullities” that constitute Dasein's Being‐guilty according to Heidegger. I end the paper with thoughts on why Dasein's Being‐guilty is only a necessary yet not a sufficient condition of factical guilt in general and factical moral guilt in particular.
Age‐specific findings on endodontic treatments performed by private dentists in Finland in 2012 and 2017: a nationwide register‐based observation
Authors: Vehkalahti M. M. , Palotie U. , Valaste M.
Published: February 2020

Aim

To evaluate age‐specific aspects and changes in volume and content of endodontic treatment for adults visiting private dentists in Finland in 2012 and 2017.

Methodology

This study utilized register‐based data of private dental care. The observation unit of the aggregated macro‐level data was age group, with 5‐year age groups from 20 to 24 years onwards and the oldest group combining all patients aged 90 years and over. Data from years 2012 and 2017 included all the oral health care of 2.04 million patients receiving reimbursement for treatment by private dentists; a total of 183 932 patients received at least one endodontic treatment and were analysed. The number of teeth receiving endodontic treatment was counted separately as pulp cappings, pulpotomies and root canal fillings according to number of canals filled per tooth. Statistical associations were assessed as correlation coefficients.

Results

The mean age of endodontic patients was 53.6 years in 2012 and 55.9 years in 2017. In both years, 38% were aged from 50 to 64 years. In 2012, 9.9%, and in 2017, 8.0% of patients received at least one endodontic treatment; the older the patients, the fewer received endodontic treatment (r = −0.9). From 2012 to 2017, numbers of all patients and treatments decreased, endodontic patients and treatments even more notably, and in all age groups. Per thousand patients in 2017, 62.1 teeth received root canal treatment and 14.9 pulp capping. Pulp capping comprised 19.2%, pulpotomies 0.8% and root canal fillings 80.0% of teeth receiving endodontic treatment. Of root filled teeth, 45.1% received filling in one canal, 17.0% in two and 37.9% in three or more canals, multi‐canal options being less frequent in older patients (r = −0.94).

Conclusions

Endodontic treatment, received by 9% of adult patients visiting private dentists in Finland, was strongly age‐dependent, showing a decreasing trend with age and time.
The transcription factor ICE1 functions in cold stress response by binding to the promoters of CBF and COR genes
Authors: Tang Kai , Zhao Lun , Ren Yuying , Yang Shuhua , Zhu Jian‐Kang , Zhao Chunzhao
Published: February 2020

A recent paper by Kidokoro et al. (2020) in The Plant Cell reported a transgene‐dependent transcriptional silencing phenomenon in the dominant ice1‐1 Arabidopsis mutant containing the CBF3‐LUC reporter, and questioned whether ICE1 may regulate CBF genes and may be involved in plant cold response. Here, we evaluate available evidence supporting the involvement of ICE1 in plant cold response, and provide ChIP‐seq data showing ICE1 binding to the promoters of CBF genes and other regulatory genes known to be critical for cold response as well as to the promoters of some COR genes.
Toward a conceptual framework for the interdisciplinary function‐focused care in nursing homes
Authors: Kim Mi So , Lee Su Jung , Park Min Sun , Jeong Eun‐hye , Chang Sung Ok
Published: February 2020

Aim

To develop a conceptual framework to structure the shared roles and tasks of interdisciplinary teams for efficient function‐focused care of nursing home (NH) residents.

Methods

A qualitative study using focus groups. Two focus group interviews were conducted on NH practitioners and professors. Focus group 1 consisted of six practitioners with more than 5 years of practical experience in NHs. Focus group 2 consisted of six professors with more than 5 years of educational experience in geriatrics or gerontology and who are capable of adopting theoretical approaches to older adults’ functions.

Results

The post‐acute care‐rehabilitation quality framework furnished the underlying structure for the focus group interview questionnaire to develop the shared interdisciplinary function‐focused care framework. The focus of the framework is how resident care processes should be based on individuality of the residents and include holistic continuous assessments, integration of care, and professional interventions by each discipline. An interdisciplinary process involves setting shared goals, communicating and coordinating roles and tasks of interdisciplinary teams, and providing complementary care. Shared final outcomes are defined as improving residents' independence and quality of life and reducing hospital transfer and admission rates.

Conclusion

In this study, we have developed the first conceptual framework of interdisciplinary function‐focused care in NHs, which will provide an evidence‐based foundation for integrated and continuous function‐focused care for NH residents. The results of this study will contribute to efficient communication among the interdisciplinary teams and improvement of the outcomes of function‐focused care subjects.
Cell proliferation and neurogenesis alterations in Alzheimer’s disease and diabetes mellitus mixed murine models
Authors: Hierro‐Bujalance Carmen , del Marco Angel , José Ramos‐Rodríguez Juan , Infante‐Garcia Carmen , Bella Gomez‐Santos Sara , Herrera Marta , Garcia‐Alloza Monica
Published: February 2020

The classic neuropathological features of Alzheimer's disease (AD) are accompanied by other complications, including alterations in adult cell proliferation and neurogenesis. Moreover recent studies have shown that traditional markers of the neurogenic process, such as doublecortin (DCX), may also be expressed in CD8+ T cells and ionized calcium‐binding adaptor molecule 1 (Iba1+) microglia, in the close proximity to senile plaques, increasing the complexity of the condition. Altered glucose tolerance, observed in metabolic alteratioins, may accelerate the neurodegenerative process and interfere with normal adult cell proliferation and neurogenesis. To further explore the role of metabolic disease in AD, we analyzed cell proliferation and neurogenesis using 5’‐bromo‐2’‐deoxyuridine and DCX immunohistochemistry in three different mouse models of AD and metabolic alterations: APP/PS1xdb/db mice, APP/PS1 mice on a long‐term high‐fat diet, and APP/PS1 mice treated with streptozotozin. As reported previously, an overall reduction in cell proliferation and neurogenesis was observed after streptozotocin administration. In contrast, an increase in cell proliferation and neurogenesis was detected in neurogenic niches in 14‐ and 26‐week‐old APP/PS1xdb/db mice, accompanied by a slight increase in cortical cell proliferation. While a similar trend was observed in animals on a high‐fat diet, differences were not statistically significant. We observed very few DCX+/CD8+ cells and no DCX+/Iba1+ cells were observed in the close proximity to senile plaques in any of the groups. Interestingly, metabolic parameters such as body weight and glucose and insulin levels were identified as reliable predictors of cell proliferation and neurogenesis in APP/PS1xdb/db mice. Furthermore, metabolic parameters were also associated with altered Aβ levels in the cortex and hippocampus of APP/PS1xdb/db mice. Altogether, our data suggest that metabolic disease may also interfere with central complications in AD.

image
SynGAP splice variants display heterogeneous spatio‐temporal expression and subcellular distribution in the developing mammalian brain
Authors: Gou Gemma , Roca‐Fernandez Adriana , Kilinc Murat , Serrano Elena , Reig‐Viader Rita , Araki Yoichi , Huganir Richard L. , de Quintana‐Schmidt Cristian , Rumbaugh Gavin , Bayés Àlex
Published: February 2020

The SynGAP protein is a major regulator of synapse biology and neural circuit function. Genetic variants linked to epilepsy and intellectual disability disrupt synaptic function and neural excitability. SynGAP has been involved in multiple signaling pathways and can regulate small GTPases with very different roles. Yet, the molecular bases behind this pleiotropy are poorly understood. We hypothesize that different SynGAP isoforms will mediate different sets of functions and that deciphering their spatio‐temporal expression and subcellular localization will accelerate understanding their multiple functions. Using isoform‐specific antibodies recognizing SynGAP in mouse and human samples we found distinctive developmental expression patterns for all SynGAP isoforms in five mouse brain areas. Particularly noticeable was the delayed expression of SynGAP‐α1 isoforms, which directly bind to postsynaptic density‐95, in cortex and hippocampus during the first 2 weeks of postnatal development. Suggesting that during this period other isoforms would have a more prominent role. Furthermore, we observed subcellular localization differences between isoforms, particularly throughout postnatal development. Consistent with previous reports, SynGAP was enriched in the postsynaptic density in the mature forebrain. However, SynGAP was predominantly found in non‐synaptic locations in a period of early postnatal development highly sensitive to SynGAP levels. While, α1 isoforms were always found enriched in the postsynaptic density, α2 isoforms changed from a non‐synaptic to a mostly postsynaptic density localization with age and β isoforms were always found enriched in non‐synaptic locations. The differential expression and subcellular distribution of SynGAP isoforms may contribute to isoform‐specific regulation of small GTPases, explaining SynGAP pleiotropy.

image
Living donor liver transplantation in situs inversus totalis with a patient‐specific three‐dimensional printed liver model
Authors: Ishii Takamichi , Fukumitsu Ken , Ogawa Eri , Okamoto Tatsuya , Uemoto Shinji
Published: February 2020

We utilized patient‐specific 3D liver models based on preoperative computed tomography images as intraoperative navigation and describe our experience. A 1‐year and 10‐month‐old girl with situs inversus totalis underwent living donor liver transplantation for biliary atresia. Information on the hepatic artery, portal vein, inferior vena cava, and liver parenchyma was extracted and segmented from computed tomography images using liver analysis software. Laser lithography produced each 3D part of the liver from these data. The 3D models of each part of the liver were molded from polyurethane resin using different colors for each part and combined together, resulting in a patient‐specific liver model. The industrial computed tomography scan of the patient‐specific 3D liver model revealed that the gaps between the liver model and the original data were <0.4 mm in the 90% area, <0.8 mm in the 98% area, and 1.53 mm at the maximum. The 3D liver model was brought into the operative field and used as intraoperative navigation for total liver resection. The procedure was finished successfully without any major intraoperative complications. In conclusion, the 3D model facilitates the identification of vessels during operations; it is possible to promptly share patients' anatomy with the operative team.
Creative futures of Black (British) feminism in austerity and Brexit times
Authors: Gayle Rita
Published: February 2020

This paper will suggest that the cultural production made by Black (British) feminist millennial creative collectives during this period of austerity and Brexit is informed by the Black British archive(s) but seeks to move beyond those borders. The forms of Black cultural content emerging from these collectives offer clues as to what the future of creative Black British culture may become.
Prediction paradigm involving time series applied to total blood issues data from England
Authors: Nandi Anita K. , Roberts David J. , Nandi Asoke K.
Published: February 2020

BACKGROUND

Blood products are essential for modern medicine, but managing their collection and supply in the face of fluctuating demands represents a major challenge. As deterministic models based on predicted changes in population have been problematic, there remains a need for more precise and reliable prediction of demands. Here, we propose a paradigm incorporating four different time‐series methods to predict red blood cell (RBC) issues 4 to 24 weeks ahead.

STUDY DESIGN AND METHODS

We used daily aggregates of RBC units issued from 2005 to 2011 from the National Health Service Blood and Transplant. We generated a new set of nonoverlapping weekly data by summing the daily data over 7 days and derived the average blood issues per week over 4‐week periods. We used four methods for linear prediction of blood demand by computing the coefficients with the minimum mean squared error and weighted least squares error algorithms.

RESULTS

We optimized the time‐window size, order of the prediction, and order of the polynomial fit for our data set. The four time‐series methods, essentially using different weightings to data points, gave very similar results and predicted mean RBC issues with a standard deviation of the percentage error of 3.0% for 4 weeks ahead and 4.0% for 24 weeks ahead.

CONCLUSION

This paradigm allows prediction of demand for RBCs and could be developed to provide reliable and precise prediction up to 24 weeks ahead to improve the efficiency of blood services and sufficiency of blood supply with reduced costs.
Integrated Support Strategies for Promotion of Students’ Retention and Achievement During First Years of College
Authors: Grace-Odeleye Beverlyn
Published: February 2020

Persistence and increased retention is a major focus in higher educational administration. The first-years of transition to college is a multi-dimensional new academic experience, noncognitive, and social challenges, often a disorienting period which can lead to academic difficulties. This review examines the literature for strategies, institutional policies and approaches for effective retention and first-year students’ success programs supported by evidence that contributes to satisfactory student performance, persistence and retention in post-secondary education. This review aim to develop a knowledgeable perspective on higher educational integrated and collaborative guiding principles for refining student learning and success efforts for improvements in student performance, persistence, and retention. The implications for practice are discussed and recommendations for of institution-wide collaborative critical strategies supported by data proven effective for the promotion, retention and success of first-year students’ success is provided.
Multi-Objective Optimization of Combined Heat and Power Industrial Microgrid
Authors: Mehrabadi Elham Sheikhi , Sathiakumar Swamidoss
Published: February 2020

Microgrids play a critical role in the transition from conventional centralized power systems to the smart distributed networks of the future. To achieve the greatest outputs from microgrids, a comprehensive multi-objective optimization plan is necessary. Among various conflicting planning objectives, emissions and cost are primary concerns in microgrid optimization. In this work, two novel procedures, i.e., non-dominated sorting genetic algorithm-II (NSGA-II) and multi-objective particle swarm optimization (MOPSO), were developed to minimize emissions and cost in combined heat- and power-based (CHP) industrial microgrids (IMGs) simultaneously, by applying the most practical constraints and considering the variable loads. Two different scenarios, the presence and absence of photovoltaics (PV) and PV storage systems, were analyzed. The results concluded that when considering PVs and PV storage systems, the NSGA-II algorithm provides the most optimized solution in minimizing economic and environmental objectives.
Nucleotide Excision Repair Protein Rad23 Regulates Cell Virulence Independent of Rad4 in Candida albicans
Authors: Feng Jia , Yao Shuangyan , Dong Yansong , Hu Jing , Whiteway Malcolm , Feng Jinrong
Published: February 2020

Candida albicans
remains a significant threat to the lives of immunocompromised people. An understanding of the virulence and infection ability of
C. albicans
cells in the mammalian host may help with clinical treatment and drug discovery. The DNA damage response pathway is closely related to morphology regulation and virulence, as well as the ability to survive in host cells. In this study, we checked the role of the nucleotide excision repair (NER) pathway, the key repair system that functions to remove a large variety of DNA lesions such as those caused by UV light, but whose function has not been well studied in
C. albicans
. We found that Rad23, but not Rad4, plays a role in virulence that appears independent of the function of the NER pathway. Our research revealed that the NER pathway represented by Rad4/Rad23 may not play a direct role in virulence but that Rad23 may play a unique role in regulating the transcription of virulence genes that may contribute to the virulence of
C. albicans
.
Does breast reduction surgery improve health-related quality of life? A prospective cohort study in Australian women
Authors: Crittenden Tamara , Watson David I , Ratcliffe Julie , Griffin Philip A , Dean Nicola R
Published: February 2020

Objectives

To assess the health burden of breast hypertrophy and the comparative effectiveness of breast reduction surgery in improving health-related quality of life.

Design

Prospective cohort study.

Setting

A major public tertiary care hospital in Australia.

Participants

Women with symptomatic breast hypertrophy who underwent breast reduction surgery were followed for 12 months. A comparison control cohort comprised women with breast hypertrophy who did not undergo surgery.

Interventions

Bilateral breast reduction surgery for women in the surgical cohort.

Main outcome measures

The primary outcome measure was health-related quality of life measured preoperatively and at 3, 6 and 12 months postoperatively using the Short Form-36 (SF-36) questionnaire. Secondary outcome measures included post-surgical complications.

Results

209 patients in the surgical cohort completed questionnaires before and after surgery. 124 patients in the control hypertrophy cohort completed baseline and 12-month follow-up questionnaires. At baseline, both groups had significantly lower scores compared with population norms across all scales (p<0.001). In the surgical cohort significant improvements were seen across all eight SF-36 scales (p<0.001) following surgery. Within 3 months of surgery scores were equivalent to those of the normal population and this improvement was sustained at 12 months. SF-36 physical and mental component scores both significantly improved following surgery, with a mean change of 10.2 and 9.2 points, respectively (p<0.001). In contrast, SF-36 scores for breast hypertrophy controls remained at baseline across 12 months. The improvement in quality of life was independent of breast resection weight and body mass index.

Conclusion

Breast reduction significantly improved quality of life in women with breast hypertrophy. This increase was most pronounced within 3 months of surgery and sustained at 12-month follow-up. This improvement in quality of life is comparable to other widely accepted surgical procedures. Furthermore, women benefit from surgery regardless of factors including body mass index and resection weight.
Using Facebook to tell stories of premature ageing and sexual and reproductive healthcare across the life course for women with cerebral palsy in the UK and USA
Authors: Shah Sonali , Bradbury-Jones C , Taylor Julie
Published: February 2020

Objective

To enhance understanding of the bodily and lifestyle effects of ageing with cerebral palsy (CP) for women, with a particular focus on experiences with sexual and reproductive healthcare (SRH) services in the UK and North America.

Design

A qualitative study underpinned by feminist disability theory and drawing on digital ethnographies to capture health and healthcare experiences for women with CP.

Setting

A global community of 140 women with CP, who are members of the closed international Facebook group,Women Ageing with Cerebral Palsy(WACP).

Participants

Forty-five members of WACP who were based in the UK and North America. The women were aged between 21 and 75.

Methods

Messages posted on WACP between January 2018 and October 2018 were collated and underwent thematic analysis to identify themes relating to effects of ageing and experiences of SRH for women with CP at different points over the female life course.

Results

The breadth of experiences in relation to the effects of ageing and access to reproductive and sexual healthcare for women with CP can be divided into three themes: (1) bodily effects of ageing; (2) lifestyle effects of ageing; (3) experiences of reproductive and sexual healthcare.

Conclusions

Giving women with CP a platform to ‘speak for themselves’ in relation to effects of ageing and SRH provides health professionals with an informed knowledge base on which to draw. This might improve treatment for this growing adult patient community whose experiences have not received attention in health discourse or services. Including these experiences in public medical and social discourse can also bring a new knowledge to girls with CP about what ageing could mean for them so plans can be put in place for their future.
Factors influencing the utilisation of free-standing and alongside midwifery units in England: a qualitative research study
Authors: Walsh Denis , Spiby Helen , McCourt Christine , Grigg Celia , Coleby Dawn , Bishop Simon , Scanlon Miranda , Culley Lorraine , Wilkinson Jane , Pacanowski Lynne , Thornton Jim
Published: February 2020

Objective

To identify factors influencing the provision, utilisation and sustainability of midwifery units (MUs) in England.

Design

Case studies, using individual interviews and focus groups, in six National Health Service (NHS) Trust maternity services in England.

Setting and participants

NHS maternity services in different geographical areas of England Maternity care staff and service users from six NHS Trusts: two Trusts where more than 20% of all women gave birth in MUs, two Trusts where less than 10% of all women gave birth in MUs and two Trusts without MUs. Obstetric, midwifery and neonatal clinical leaders, managers, service user representatives and commissioners were individually interviewed (n=57). Twenty-six focus groups were undertaken with midwives (n=60) and service users (n=52).

Main outcome measures

Factors influencing MU use.

Findings

The study findings identify several barriers to the uptake of MUs. Within a context of a history of obstetric-led provision and lack of decision-maker awareness of the clinical and economic evidence, most Trust managers and clinicians do not regard their MU provision as being as important as their obstetric unit (OU) provision. Therefore, it does not get embedded as an equal and parallel component in the Trust’s overall maternity package of care. The analysis illuminates how implementation of complex interventions in health services is influenced by a range of factors including the medicalisation of childbirth, perceived financial constraints, adequate leadership and institutional norms protecting the status quo.

Conclusions

There are significant obstacles to MUs reaching their full potential, especially free-standing midwifery units. These include the lack of commitment by providers to embed MUs as an essential service provision alongside their OUs, an absence of leadership to drive through these changes and the capacity and willingness of providers to address women’s information needs. If these remain unaddressed, childbearing women’s access to MUs will continue to be restricted.
Implementation of a strategy involving a multidisciplinary mobile unit team to prevent hospital admission in nursing home residents: protocol of a quasi-experimental study (MMU-1 study)
Authors: Nouvenne Antonio , Caminiti Caterina , Diodati Francesca , Iezzi Elisa , Prati Beatrice , Lucertini Stefano , Schianchi Paolo , Pascale Federica , Starcich Bruno , Manotti Pietro , Brianti Ettore , Fabi Massimo , Ticinesi Andrea , Meschi Tiziana
Published: February 2020

Introduction

Nursing home residents represent a particularly vulnerable population experiencing high risk of unplanned hospital admissions, but few interventions have proved effective in reducing this risk. The aim of this research will be to verify the effects of a hospital-based multidisciplinary mobile unit (MMU) team intervention delivering urgent care to nursing home residents directly at their bedside.

Methods and analysis

Four nursing homes based in the Parma province, in Northern Italy, will be involved in this prospective, pragmatic, multicentre, 18-month quasiexperimental study (sequential design with two cohorts). The residents of two nursing homes will receive the MMU team care intervention. In case of urgent care needs, the nursing home physician will contact the hospital physician responsible for the MMU team by phone. The case will be triaged as (a) manageable by phone advice, (b) requiring urgent assessment by the MMU team or (c) requiring immediate emergency department (ED) referral. MMU team is composed of one senior physician and one emergency-medicine resident chosen within the staff of Internal Medicine and Critical Subacute Care Unit of Parma University-Hospital, usually with different specialty background, and equipped with portable ultrasound, set of drugs and devices useful in urgency. The MMU visits patients in nursing homes, with the mission to stabilise clinical conditions and avoid hospital admission. Residents of the other two nursing homes will receive usual care, that is, ED referral in every case of urgency. Study endpoints include unplanned hospital admissions (primary), crude all-cause mortality, hospital mortality, length of stay and healthcare-related costs (secondary).

Ethics and dissemination

The study protocol was approved by the Ethics Committee of Area Vasta Emilia Nord (Emilia-Romagna region). Informed consent will be collected from patients or legal representatives. The results will be actively disseminated through peer-reviewed journals and conference presentations, in compliance with the Italian law.

Trial registration number

ClinicalTrials.gov Registry (NCT 04085679); Pre-results.
Outcomes of transcatheter aortic valve implantations in high-volume or low-volume centres in Germany
Authors: Oettinger Vera , Kaier Klaus , Heidt Timo , Hortmann Markus , Wolf Dennis , Zirlik Andreas , Zehender Manfred , Bode Christoph , von zur Mühlen Constantin , Stachon Peter
Published: February 2020

Objective

Transcatheter aortic valve implantation (TAVI) is the most common aortic valve replacement in Germany. Since 2015, to ensure high-quality procedures, hospitals in Germany and other countries that meet the minimum requirement of 50 interventions per centre are being certified to perform TAVI. This study analyses the impact of these requirements on case number and in-hospital outcomes.

Methods

All isolated TAVI procedures and in-hospital outcomes between 2008 and 2016 were identified by International Classification of Diseases (ICD) and the German Operation and Procedure Classification codes.

Results

73 467 isolated transfemoral and transapical TAVI procedures were performed in Germany between 2008 and 2016. During this period, the number of TAVI procedures per year rose steeply, whereas the overall rates of hospital mortality and complications declined. In 2008, the majority of procedures were performed in hospitals with fewer than 50 cases per year (54.63%). Until 2014, the share of patients treated in low-volume centres constantly decreased to 5.35%. After the revision of recommendations, it further declined to 1.99%. In the 2 years after the introduction of the minimum requirements on case numbers, patients were at decreased risk for in-hospital mortality when treated in a high-volume centre (risk-adjusted OR 0.62, p=0.012). The risk for other in-hospital outcomes (stroke, permanent pacemaker implantation and bleeding events) did not differ after risk adjustment (p=0.346, p=0.142 and p=0.633).

Conclusion

A minimum volume of 50 procedures per centre and year appears suitable to allow for sufficient routine and thus better in-hospital outcomes, while ensuring nationwide coverage of TAVI procedures.
Dynamic programming of 0/1 knapsack problem for network-level pavement asset management system
Authors: Albatayneh Omar , Aleadelat Waleed , Ksaibati Khaled
Published: February 2020

For low volume roads, selecting maintenance and rehabilitation activities have become a major concern for most transportation agencies. At large-scale road networks, the combinatorial explosion of the feasible solution is a major difficulty with treatment activities programming. As part of the Wyoming Technology Transfer Center efforts to develop a comprehensive optimization analysis in Wyoming, this research study developed a user-friendly optimization algorithm, using a dynamic programming implementation of the 0/1 knapsack problem. The developed algorithm utilized the ant colony optimization algorithm, which is one of the swarm intelligence optimization sub-packages, to provide locally-optimal solutions (sub-sets) to select the optimal treatments for road networks at a large scale. Ultimately, a case study of 318 county roads in Wyoming is analyzed, and the results of different scenarios and current network performance are compared. The developed optimization algorithm helps the decision-makers in selecting the optimum set of roads that can maximize the overall pavement performance within a limited maintenance budget.
Coding in the automorphism group of a computably categorical structure
Authors: Turetsky Dan
Published: February 2020

Using new techniques for controlling the categoricity spectrum of a structure, we construct a structure with degree of categoricity but infinite spectral dimension, answering a question of Bazhenov, Kalimullin and Yamaleev. Using the same techniques, we construct a computably categorical structure of non-computable Scott rank.
Groupoids and Coherent States
Authors: di Cosmo F. , Ibort A. , Marmo G.
Published: February 2020

Schwinger’s algebra of selective measurements has a natural interpretation in terms of groupoids. This approach is pushed forward in this paper to show that the theory of coherent states has a natural setting in the framework of groupoids. Thus given a quantum mechanical system with associated Hilbert space determined by a representation of a groupoid, it is shown that any invariant subset of the group of invertible elements in the groupoid algebra determines a family of generalized coherent states provided that a completeness condition is satisfied. The standard coherent states for the harmonic oscillator as well as generalized coherent states for f-oscillators are exemplified in this picture.
Non-Markovian Open Dynamics from Collision Models
Authors: Pathak Vijay , Shaji Anil
Published: February 2020

Convex combinations of completely positive (CP) as well as CP-divisible, continuous time dynamical maps arising from collision models are investigated. While the individual maps are both CP and Markovian we find that convex combinations remain CP but not necessarily Markovian. Examples of such combinations for qubit dynamical maps arising from collisional models are worked out and the invertibility, CP-divisibility, P-divisibility as well as Markovian properties of such maps are explored.
Translational Advances in Pediatric Nutrition and Gastroenterology: New Insights from Pig Models
Authors: Burrin Douglas , Sangild Per Torp , Stoll Barbara , Thymann Thomas , Buddington Randal , Marini Juan , Olutoye Oluyinka , Shulman Robert J.
Published: February 2020

Pigs are increasingly important animals for modeling human pediatric nutrition and gastroenterology and complementing mechanistic studies in rodents. The comparative advantages in size and physiology of the neonatal pig have led to new translational and clinically relevant models of important diseases of the gastrointestinal tract and liver in premature infants. Studies in pigs have established the essential roles of prematurity, microbial colonization, and enteral nutrition in the pathogenesis of necrotizing enterocolitis. Studies in neonatal pigs have demonstrated the intestinal trophic effects of akey gut hormone, glucagon-like peptide 2 (GLP-2), and its role in the intestinal adaptation process and efficacy in the treatment of short bowel syndrome. Further, pigs have been instrumental in elucidating the physiology of parenteral nutrition–associated liver disease and the means by which phytosterols, fibroblast growth factor 19, and a new generation of lipid emulsions may modify disease. The premature pig will continue to be a valuable model in the development of optimal infant diets (donor human milk, colostrum), specific milk bioactives (arginine, growth factors), gut microbiota modifiers (pre-, pro-, and antibiotics), pharmaceutical drugs (GLP-2 analogs, FXR agonists), and novel diagnostic tools (near-infrared spectroscopy) to prevent and treat these pediatric diseases.
Reaction of Adsorbed CO with Methanol and Ethanol on Pt Electrode: Estimation of Rate Constants
Authors: Iida Keisuke , Mukouyama Yoshiharu
Published: February 2020

It is well accepted that adsorbed CO (COad) on Pt electrode reacts with water (or oxygenated species). We have recently found that COad also reacts with methanol and ethanol to form methyl formate (COad + CH3OH → HCOOCH3) and ethyl formate (COad + C2H5OH → HCOOC2H5), respectively, by using surface-enhanced infrared absorption spectroscopy and high-performance liquid chromatography. In the present report, we estimate the rate constants of the reactions by considering that the reactions proceed via Langmuir-Hinshelwood mechanism. The rate constants are estimated to be in the order of 0.1 s-1.
Marangoni Motion of a Nitrobenzene Droplet on Au Electrode during Sn Electrodeposition: Factors Creating Interfacial Tension Gradient
Authors: Kurohagi Masayuki , Mukouyama Yoshiharu
Published: February 2020

A nitrobenzene (NB) droplet moves like amoeba on the surface of an Au electrode during the Sn electrodeposition in HNO3 solution. As explained in our previous paper (J. Electrochem. Soc., 165, H473 (2018)), the motion is due to a Marangoni effect (i.e. a hydrodynamic flow induced by an interfacial tension gradient). The mechanism of the Marangoni motion, which has been proposed in the previous paper, is complicated because some processes such as reduction of nitrate ions, that of NB, and transfer of aniline occurs at the same time. In this report, the proposed mechanism is verified by simple experiments, and the factors inducing the Marangoni motion are discussed.
Assessment of MgHf4P6O24 Electroceramic Oxide Electrolyte in High-Temperature Electrochemical Sensor for Sensing Mg in Non-Ferrous Alloys
Authors: Adamu Mohammed
Published: February 2020

In this paper, the electrochemical impedance analysis of MgHf4P6O24 electroceramic oxide electrolyte on platinised pellets of 13mm diameter (Ø) and 3.8mm thickness depicts the electrical properties of Mg2+-cation conducting species in the characterised solid-state electrolytes measured using the two-probe analysis at 182-764oC, and from 100mHz to 32MHz, were evaluated. In this analysis, promising ionic conductivity of 4.52 x 10-4 Scm-1 for MgHf4P6O24 electroceramic electrolyte was exhibited at 747oC, thereby maintaining both materials and operational stability at 1000oC ≤ T/oC≤1300.In addition to this, the design, fabrication and testing of solid-state Mg-sensors using the electrochemical method have been achieved. The novel high-temperature Mg-sensors were designed using the highly conducting Mg2+-cation solid-state electrolyte by incorporating a biphasic powder mixture of MgCr2O4 + Cr2O3 as ceramic solid-state reference electrode in air, which has shown promising trend after successfully sensing the Mg dissolved in molten Al at 700±5oC. A linear dependence of emf on logarithm of Mg concentration was achieved. The transport number, tmg2+ = 0.84±0.03 was achieved which indicates that the conducting specie in MgHf4P6O24 solid-state electrolyte is Mg2+-cation. The solid-state electrolyte has the potential for application in high-temperature electrochemical sensors and other devices.