bluuebunny/crossref_metadata_2025 huggingface dataset:
Foreign multinationals in service sectors: A general equilibrium analysis of Brexit
Authors: Latorre María C. , Olekseyuk Zoryana , Yonezawa Hidemichi
Published: September 2020

We examine the role of foreign multinationals in service sectors in the context of Brexit, which is assumed to induce an increase in different types of barriers: (a) FDI barriers to multinationals in services; (b) non‐tariff barriers to trade; and (c) import tariffs between the UK and the rest of the EU. We use a state‐of‐the‐art Melitz approach in manufactures with multinationals operating in imperfectly competitive service sectors in a multiregional general equilibrium framework. We find that the increased FDI barriers in services explain about one third of the total welfare loss of Brexit. Furthermore, our decomposition analysis (by introducing each type of barriers separately) shows that the barriers against the EU service multinationals in the UK are harmful to British manufacturing sectors because they face a reduced (and more expensive) supply of intermediate services.
TRPV1 expressed throughout the arterial circulation regulates vasoconstriction and blood pressure
Authors: Phan Thieu X. , Ton Hoai T. , Gulyás Hajnalka , Pórszász Róbert , Tóth Attila , Russo Rebekah , Kay Matthew W. , Sahibzada Niaz , Ahern Gerard P.
Published: September 2020

Key points

 The functional roles of the capsaicin receptor, TRPV1, outside of sensory nerves are unclear. We mapped TRPV1 in the mouse circulation, revealing extensive expression in the smooth muscle of resistance arterioles supplying skeletal muscle, heart and adipose tissue.

 Activation of TRPV1 in vascular myocytes constricted arteries, reduced coronary flow in isolated hearts and increased systemic blood pressure. These functional effects were retained after sensory nerve ablation, indicating specific signalling by arterial TRPV1.

 TRPV1 mediated the vasoconstrictive and blood pressure responses to the endogenous inflammatory lipid lysophosphatidic acid.

 These results show that TRPV1 in arteriolar myocytes modulates regional blood flow and systemic blood pressure, and suggest that TRPV1 may be a target of vasoactive inflammatory mediators.

The capsaicin receptor, TRPV1, is a key ion channel involved in inflammatory pain signalling. Although mainly studied in sensory nerves, there are reports of TRPV1 expression in isolated segments of the vasculature, but whether the channel localizes to vascular endothelium or smooth muscle is controversial and the distribution and functional roles of TRPV1 in arteries remain unknown. We mapped functional TRPV1 expression throughout the mouse arterial circulation. Analysis of reporter mouse lines TRPV1PLAP‐nlacZ and TRPV1‐Cre:tdTomato combined with Ca2+ imaging revealed specific localization of TRPV1 to smooth muscle of terminal arterioles in the heart, adipose tissue and skeletal muscle. Capsaicin evoked inward currents (current density ∼10% of sensory neurons) and raised intracellular Ca2+ levels in arterial smooth muscle cells, constricted arterioles ex vivo and in vivo and increased systemic blood pressure in mice and rats. Further, capsaicin markedly and dose‐dependently reduced coronary flow. Pharmacological and/or genetic disruption of TRPV1 abolished all these effects of capsaicin as well as vasoconstriction triggered by lysophosphatidic acid, a bioactive lipid generated by platelets and atherogenic plaques. Notably, ablation of sensory nerves did not affect the responses to capsaicin revealing a vascular smooth muscle‐restricted signalling mechanism. Moreover, unlike in sensory nerves, TRPV1 function in arteries was resistant to activity‐induced desensitization. Thus, TRPV1 activation in vascular myocytes enables a persistent depolarizing current, leading to constriction of coronary, skeletal muscle and adipose arterioles and a sustained increase in systemic blood pressure.
Free Response of a Rotational Nonlinear Energy Sink: Complete Dissipation of Initial Energy for Small Initial Rectilinear Displacements
Authors: Ding Ke , Pearlstein Arne J.
Published: September 2020

For two combinations of a dimensionless rotational damping parameter and a dimensionless inertial coupling parameter, we consider free response of a rectilinearly vibrating linearly sprung primary mass inertially coupled to damped rotation of a second mass, for which Gendelman et al. (2012, “Dynamics of an Eccentric Rotational Nonlinear Energy Sink,” ASME J. Appl. Mech. 79(1), 011012) developed equations of motion in the context of a rotational nonlinear energy sink (NES) with no direct damping of the rectilinear motion. For dimensionless initial rectilinear displacements comparable with those considered by Gendelman et al., we identify a region in the motionless projection of the initial condition space (i.e., for zero values of the initial rectilinear and rotational velocities) in which every initial condition leads to a previously unrecognized zero-energy solution, with all initial energy dissipated by rotation. We also show that the long-time nonrotating, rectilinear solutions of the type found by Gendelman et al. are (orbitally) stable only in limited ranges of amplitude. Finally, we show how direct viscous damping of rectilinear motion of the primary mass affects dissipation, and that results with no direct rectilinear dissipation provide excellent guidance for performance when direct rectilinear dissipation occurs. Some applications are discussed.
An experimental device for multi-directional somatosensory perturbation and its evaluation in a pilot psychophysical experiment
Authors: Ogane Rintaro , Selila Lynda , Ito Takayuki
Published: September 2020

Somatosensory stimulation associated with facial skin deformation has been developed and efficiently applied in the study of speech production and speech perception. However, the technique is limited to a simplified unidirectional pattern of stimulation, and cannot adapt to realistic stimulation patterns related to multidimensional orofacial gestures. To overcome this issue, a new multi-actuator system is developed enabling one to synchronously deform the facial skin in multiple directions. The first prototype involves stimulation in two directions and its efficiency is evaluated using a temporal order judgement test involving vertical and horizontal facial skin stretches at the sides of the mouth.
Exercise Spaces in Parks for Older Adults: A Qualitative Investigation
Authors: Lee Janet Lok Chun , Ho Rainbow Tin Hung
Published: September 2020

In response to demographic changes in recent years, an increasing number of parks have established exercise spaces for older adults. However, limited research has been conducted to investigate how older adults utilize, experience, and perceive these spaces. This study aims to explore their experiences of using these spaces and their perspectives on these spaces by using a qualitative descriptive research design. In-depth interviews were conducted with 32 users in three Hong Kong parks with low, medium, and high area-based socioeconomic statuses. The findings highlight that exercise spaces in parks can cultivate a positive environment allowing older adults with varying physical abilities and health statuses to remain active together as well as to support each other socially and emotionally in a natural outdoor setting. The participants’ perspectives on the exercise space discussed in this study suggest that future plans for constructing such spaces in parks might benefit from a co-design approach.
Reprogrammable shape morphing of magnetic soft machines
Authors: Alapan Yunus , Karacakol Alp C. , Guzelhan Seyda N. , Isik Irem , Sitti Metin
Published: September 2020

Heat-assisted directional magnetization enables reprogrammable and high-throughput magnetic soft machines.
Transcriptomic and clonal characterization of T cells in the human central nervous system
Authors: Pappalardo Jenna L. , Zhang Le , Pecsok Maggie K. , Perlman Kelly , Zografou Chrysoula , Raddassi Khadir , Abulaban Ahmad , Krishnaswamy Smita , Antel Jack , van Dijk David , Hafler David A.
Published: September 2020

We have profiled cerebrospinal fluid T cells in healthy individuals and patients with MS using single-cell RNA and TCR sequencing.
A Cyclic Phosphoramidate Prodrug of 2′-Deoxy-2′-Fluoro-2′-
C
-Methylguanosine for the Treatment of Dengue Virus Infection
Authors: Karuna Ratna , Yokokawa Fumiaki , Wang Keshi , Zhang Jin , Xu Haoying , Wang Gang , Ding Mei , Chan Wai Ling , Abdul Ghafar Nahdiyah , Leonardi Andrea , Seh Cheah Chen , Seah Peck Gee , Liu Wei , Srinivasa Rao P. S. , Lim Siew Pheng , Lakshminarayana Suresh B. , Growcott Ellie , Babu Sreehari , Fenaux Martijn , Zhong Weidong , Gu Feng , Shi Pei-Yong , Blasco Francesca , Chen Yen-Liang
Published: September 2020

Monophosphate prodrug analogs of 2′-deoxy-2′-fluoro-2′-
C
-methylguanosine have been reported as potent inhibitors of hepatitis C virus (HCV) RNA-dependent RNA polymerase. These prodrugs also display potent anti-dengue virus activities in cellular assays although their prodrug moieties were designed to produce high levels of triphosphate in the liver. Since peripheral blood mononuclear cells (PBMCs) are among the major targets of dengue virus, different prodrug moieties were designed to effectively deliver 2′-deoxy-2′-fluoro-2′-
C
-methylguanosine monophosphate prodrugs and their corresponding triphosphates into PBMCs after oral administration.
Ancient Adélie penguin colony revealed by snowmelt at Cape Irizar, Ross Sea, Antarctica
Authors: Emslie Steven D.
Published: September 2020

The Ross Sea (Antarctica) is one of the most productive marine ecosystems in the Southern Ocean and supports nearly one million breeding pairs of Adélie penguins (Pygoscelis adeliae) annually. There also is a well-preserved record of abandoned penguin colonies that date from before the Last Glacial Maximum (>45,000 14C yr B.P.) through the Holocene. Cape Irizar is a rocky cape located just south of the Drygalski Ice Tongue on the Scott Coast. In January 2016, several abandoned Adélie penguin sites and abundant surface remains of penguin bones, feathers, and carcasses that appeared to be fresh were being exposed by melting snow and were sampled for radiocarbon analysis. The results indicate the “fresh” remains are actually ancient and that three periods of occupation by Adélie penguins are represented beginning ca. 5000 calibrated calendar (cal.) yr B.P., with the last occupation ending by ca. 800 cal. yr B.P. The presence of fresh-appearing remains on the surface that are actually ancient in age suggests that only recently has snowmelt exposed previously frozen carcasses and other remains for the first time in ∼800 yr, allowing them to decay and appear fresh. Recent warming trends and historical satellite imagery (Landsat) showing decreasing snow cover on the cape since 2013 support this hypothesis. Increased δ13C values of penguin bone collagen further indicate a period of enhanced marine productivity during the penguin “optimum”, a warm period at 4000–2000 cal. yr B.P., perhaps related to an expansion of the Terra Nova Bay polynya with calving events of the Drygalski Ice Tongue.
Concurrent validity of a touchscreen application to detect early cognitive delay
Authors: Twomey Deirdre Marie , Ahearne Caroline , Hennessy Emma , Wrigley Conal , De Haan Michelle , Marlow Neil , Murray Deirdre M
Published: September 2020

Objective

To explore the ability of an interactive screening tool to identify cognitive delay in children aged 18 to 24 months.

Design

Children were assessed using the Bayley Scale of Infant and Toddler Development—third edition (BSID-III) and a touchscreen measure of problem-solving (Babyscreen V.1.5). We examined the internal consistency and concurrent validity between the two measures. A BSID-III cognitive composite score (BSID-IIIcc) ≤1 SD below population mean was used to indicate a low average cognitive ability.

Results

87 children with a mean (SD) age of 20.4 (1.3) months who experienced complications at delivery (n=53) and healthy age-matched controls (n=34) were included in the study. A moderate positive correlation between the BSID-IIIcc and the total number of tasks completed on the Babyscreen suggested reasonable concurrent validity (r=0.414, p<0.001). Children with a BSID-IIIcc ≤90 had lower median (IQR) Babyscreen score (7 (6, 8.5) vs 11 (8.5, 13); p=0.003) and a lower median (IQR) age-adjusted z-score (BST z-score) for number of items completed compared with those >90 (−1.08 (−1.5 to −0.46) vs 0.31 (−0.46 to 0.76); p=0.001). The area under the receiver operating characteristic curve for the prediction of a low normal BSID-IIIcc was 0.787 (CI 0.64 to 0.93). A BST z-score of <−0.44 yielded 82.4% sensitivity and 71.4% specificity in identifying children with cognitive delay.

Conclusions

A touchscreen-based application has concurrent validity with the BSID-IIIcc and could be used to screen for cognitive delay at 18–24 months of age.
Congenital dysfibrinogenaemia presented with preterm premature rupture of the membranes and vaginal bleeding
Authors: Schwabkey Zaker I , Sheehan Farrell C , Bellomo Courtney , Raval Mihir
Published: September 2020

A 26-year-old woman was found to have congenital dysfibrinogenaemia after presenting to our hospital with premature rupture of the membranes and vaginal bleeding. Given the absence of clear guidelines for the management of pregnancy complicated by dysfibrinogenaemia, we followed expert consensus that exists among published works, with some modifications. This case was managed by a multidisciplinary team of obstetrics-gynaecology, haematology and paediatric haematology. Here we review how the patient presented, the investigations that led to the diagnosis and the treatment options.
International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health
Authors: Gouttebarge Vincent , Bindra Abhinav , Blauwet Cheri , Campriani Niccolo , Currie Alan , Engebretsen Lars , Hainline Brian , Kroshus Emily , McDuff David , Mountjoy Margo , Purcell Rosemary , Putukian Margot , Reardon Claudia L , Rice Simon M , Budgett Richard
Published: September 2020

Objectives

To develop an assessment and recognition tool to identify elite athletes at risk for mental health symptoms and disorders.

Methods

We conducted narrative and systematic reviews about mental health symptoms and disorders in active and former elite athletes. The views of active and former elite athletes (N=360) on mental health symptoms in elite sports were retrieved through an electronic questionnaire. Our group identified the objective(s), target group(s) and approach of the mental health tools. For the assessment tool, we undertook a modified Delphi consensus process and used existing validated screening instruments. Both tools were compiled during two 2-day meeting. We also explored the appropriateness and preliminary reliability and validity of the assessment tool.

Sport Mental Health Assessment Tool 1 and Sport Mental Health Recognition Tool 1

The International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) was developed for sports medicine physicians and other licensed/registered health professionals to assess elite athletes (defined as professional, Olympic, Paralympic or collegiate level; aged 16 years and older) potentially at risk for or already experiencing mental health symptoms and disorders. The SMHAT-1 consists of: (i) triage with an athlete-specific screening tool, (ii) six subsequent disorder-specific screening tools and (iii) a clinical assessment (and related management) by a sports medicine physician or licensed/registered mental health professional (eg, psychiatrist and psychologist). The International Olympic Committee Sport Mental Health Recognition Tool 1 (SMHRT-1) was developed for athletes and their entourage (eg, friends, fellow athletes, family and coaches).

Conclusion

The SMHAT-1 and SMHRT-1 enable that mental health symptoms and disorders in elite athletes are recognised earlier than they otherwise would. These tools should facilitate the timely referral of those athletes in need for appropriate support and treatment.
Crizanlizumab and comparators for adults with sickle cell disease: a systematic review and network meta-analysis
Authors: Thom Howard , Jansen Jeroen , Shafrin Jason , Zhao Lauren , Joseph George , Cheng Hung-Yuan , Gupta Subhajit , Shah Nirmish
Published: September 2020

Objectives

Treatment options for preventing vaso-occlusive crises (VOC) among patients with sickle cell disease (SCD) are limited, especially if hydroxyurea treatment has failed or is contraindicated. A systematic literature review (SLR) and network meta-analysis (NMA) were conducted to evaluate the efficacy and safety of crizanlizumab for older adolescent and adult (≥16 years old) SCD patients.

Methods

The SLR included randomised controlled trials (RCTs) and uncontrolled studies. Bayesian NMA of VOC, all-cause hospitalisation days and adverse events were conducted.

Results

The SLR identified 51 studies and 9 RCTs on 14 treatments that met the NMA inclusion criteria. The NMA found that crizanlizumab 5.0 mg/kg was associated with a reduction in VOC (HR 0.55, 95% credible interval (0.43, 0.69); Bayesian probability of superiority >0.99), all-cause hospitalisation days (0.58 (0.50, 0.68); >0.99) and no evidence of difference on adverse events (0.91 (0.59, 1.43) 0.66) or serious adverse events (0.93 (0.47, 1.87); 0.59) compared with placebo. The HR for reduction in VOC for crizanlizumab relative to L-glutamine was (0.67 (0.50, 0.88); >0.99). These results were sensitive to assumptions regarding whether patient age is an effect modifier.

Conclusions

This NMA provides preliminary evidence comparing the efficacy of crizanlizumab with other treatments for VOC prevention.
Burden of scrub typhus among patients with acute febrile illness attending tertiary care hospital in Chitwan, Nepal
Authors: Thapa Sangita , Hamal Pradip , Chaudhary Navin Kumar , Sapkota Lokendra Bahadur , Singh Jaya Prasad
Published: September 2020

Objectives

Scrub typhus is an emerging neglected tropical disease, reported from many parts of Asia including Nepal. This study aims to determine the seroepidemiology of scrub typhus among febrile patients attending Chitwan Medical College Teaching Hospital (CMC-TH), Bharatpur, Nepal.

Study design and setting

This was a hospital laboratory-based prospective study conducted in CMC-TH (a 750-bed hospital) located in Bharatpur, Chitwan district of Nepal.

Participants

A total of 1797 patients visiting CMC-TH with acute febrile illness (temperature more than 38°C) were enrolled in this study.

Methods

A total of 1797 blood samples were collected from patients presenting with acute febrile illness. The samples were processed for detection of antibody for scrub typhus by ELISA for specific IgM antibody and Weil-Felix test.

Results

Out of 1797 serum sample of febrile patients, 524 (29.2%) were scrub typhus positive. Maximum seropositive cases were from Chitwan district, 271 (51.7%) with predominance among women, 314 (35.9%). Scrub typhus was common among age group 51–60 years (37.2%) and farmers, 182 (37.8%). Highest seropositivity was found in July, 60 (57.7%). Fever was common clinical symptom. Thrombocytopenia was seen in 386 (73.7%) and raised transaminase aspartate aminotransferase, 399 (76.1%) among seropositive cases. Weil-Felix test positive were 397 (22.1%) and IgM ELISA positive were 524 (29.2%). The correlation between IgM ELISA and Weil-Felix test showed statistically significant association (r=0.319, p<0.001).

Conclusion

High prevalence of scrub typhus implies that patients with acute febrile illness should be investigated for scrub typhus with high priority. There is utmost need of reliable diagnostic facilities at all levels of healthcare system in Nepal. Infection with scrub typhus was found high and this calls for an urgent need to introduce vaccine against scrub typhus. More sustain and vigorous awareness programmes need to be promoted for early diagnosis, treatment and control.
Comparative efficacy and safety of intra-articular analgesics after knee arthroscopy: a Bayesian network meta-analysis protocol
Authors: He Yuchen , He Hongyi , Xie Dong-Xing , Li Xiaoxiao , Wang Yilun
Published: September 2020

Introduction

Most of the patients who received arthroscopic knee surgery will suffer moderate to severe pain, which can delay the rehabilitation process and increase the risk of postoperative complications. Therefore, seeking a safe and effective postoperative analgesia is necessary for promoting the application of arthroscopic surgery. This protocol aims to detail a planned systematic review and meta-analysis on the comparative efficacy and safety of single-dose intra-articular injection of analgesics for pain relief after knee arthroscopy.

Method and analysis

PubMed, Embase, Web of Science and Cochrane Library will be searched from inception to 1 June 2020 to retrieve randomised controlled trials (RCTs) that compared the commonly used single-dose intra-articular analgesics (ie, morphine; bupivacaine (including levobupivacaine); ropivacaine and magnesium alone or in combination) with placebo or between each other for postoperative pain relief among patients who had received knee arthroscopy. The primary outcome is pain intensity at 2-hour and 24-hour postoperatively; the secondary outcomes include side effects (eg, knee effusion, nausea, vomiting and flushing), the number of patients requiring supplementary analgesia and the time to first analgesic request. The methodological quality of the included RCTs will be assessed based on the Cochrane risk of bias table. The Bayesian network meta-analysis will be conducted using WinBUGS V.1.4.3.

Ethics and dissemination

Since no private or confidential patient data will be contained in the reporting, approval from an ethics committee is not required. Our study raises no ethical issue, and the results will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42019130876.
Sex-specific differences in children attending the emergency department: prospective observational study
Authors: Zachariasse Joany M , Borensztajn Dorine M , Nieboer Daan , Alves Claudio F , Greber-Platzer Susanne , Keyzer-Dekker Claudia M G , Maconochie Ian K , Steyerberg Ewout W , Smit Frank J , Moll Henriëtte A
Published: September 2020

Objective

To assess the role of sex in the presentation and management of children attending the emergency department (ED).

Design

The TrIAGE project (TRiage Improvements Across General Emergency departments), a prospective observational study based on curated electronic health record data.

Setting

Five diverse European hospitals in four countries (Austria, The Netherlands, Portugal, UK).

Participants

All consecutive paediatric ED visits of children under the age of 16 during the study period (8–36 months between 2012 and 2015).

Main outcome measures

The association between sex (male of female) and diagnostic tests and disease management in general paediatric ED visits and in subgroups presenting with trauma or musculoskeletal, gastrointestinal and respiratory problems and fever. Results from the different hospitals were pooled in a random effects meta-analysis.

Results

116 172 ED visits were included of which 63 042 (54%) by boys and 53 715 (46%) by girls. Boys accounted for the majority of ED visits in childhood, and girls in adolescence. After adjusting for age, triage urgency and clinical presentation, girls had more laboratory tests compared with boys (pooled OR 1.10, 95% CI 1.05 to 1.15). Additionally, girls had more laboratory tests in ED visits for respiratory problems (pooled OR 1.15, 95% CI 1.04 to 1.26) and more imaging in visits for trauma or musculoskeletal problems (pooled OR 1.10, 95% CI 1.01 to 1.20) and respiratory conditions (pooled OR 1.14, 95% CI 1.05 to 1.24). Girls with respiratory problems were less often treated with inhalation medication (pooled OR 0.76, 95% CI 0.70 to 0.83). There was no difference in hospital admission between the sexes (pooled OR 0.99, 95% CI 0.95 to 1.04).

Conclusion

In childhood, boys represent the majority of ED visits and they receive more inhalation medication. Unexpectedly, girls receive more diagnostic tests compared with boys. Further research is needed to investigate whether this is due to pathophysiological differences and differences in disease course, whether girls present signs and symptoms differently, or whether sociocultural factors are responsible.
Childhood overweight and obesity and back pain risk: a cohort study of 466 997 children
Authors: Palmer Antony J , Poveda Jose Luis , Martinez-Laguna Daniel , Reyes Carlen , de Bont Jeroen , Silman Alan , Carr Andrew J , Duarte-Salles Talita , Prieto-Alhambra Daniel
Published: September 2020

Objectives

To assess the association between age, sex, socioeconomic group, weight status and back pain risk in a large general population cohort of children.

Design and setting

A dynamic cohort of children aged 4 years in the Information System for Research in Primary Care (SIDIAP) electronic primary care records data in Catalonia. Multivariable Cox models were fitted to explore the association between back pain and weight status categories according to the WHO 2007 growth reference groups (body mass index for age z-score). Models were adjusted for age, sex, socioeconomic status and nationality.

Participants

Children seen at age 4 years at paediatric primary care clinics between 1 January 2006 and 31 December 2013 and followed up until 31 December 2016 or age 15 years.

Outcome measures

Incident back pain registered by paediatricians at primary care using the International Statistical Classification of Diseases and Health Related Problems, 10th Edition code M54.

Results

466 997 children were followed for a median 5.0 years (IQR 5.1). In multivariable models, overweight and obesity increased back pain risk, with adjusted HRs of 1.18 (95% CI 1.09 to 1.27) and 1.34 (95%CI 1.19 to 1.51) for overweight and obesity, respectively. Females were at greater risk of back pain than males with adjusted HR 1.40 (95%CI 1.35 to 1.46). Adjusted HR was 1.43 (95%CI 1.33 to 1.55) for back pain in children from the most deprived socioeconomic groups compared with the least deprived socioeconomic groups.

Conclusions

Maintaining a healthy weight from an early age may reduce the prevalence of back pain in both children and adults. Overweight female children from deprived socioeconomic groups are at greatest risk of back pain and represent a target population for intervention.
Death and dying in prehospital care: what are the experiences and issues for prehospital practitioners, families and bystanders? A scoping review
Authors: Myall Michelle , Rowsell Alison , Lund Susi , Turnbull Joanne , Arber Mick , Crouch Robert , Pocock Helen , Deakin Charles , Richardson Alison
Published: September 2020

Objective

To identify the factors that shape and characterise experiences of prehospital practitioners (PHPs), families and bystanders in the context of death and dying outside of the hospital environment where PHPs respond.

Design

A scoping review using Arksey and O’Malley’s five-stage framework. Papers were analysed using thematic analysis.

Data sources

MEDLINE; Embase; CINAHL; Scopus; Social Sciences Citation Index (Web of Science), ProQuest Dissertations & Theses A&I (Proquest), Health Technology Assessment database; PsycINFO; Grey Literature Report and PapersFirst were searched from January 2000 to May 2019.

Eligibility criteria for selecting studies

Qualitative and mixed methods studies reporting the experiences of PHPs, families and bystanders of death and dying in prehospital settings as a result of natural causes, trauma, suicide and homicide, >18 years of age, in Europe, USA, Canada, Australia and New Zealand.

Results

Searches identified 15 352 papers of which 51 met the inclusion criteria. The review found substantial evidence of PHP experiences, except call handlers, and papers reporting family and bystander experiences were limited. PHP work was varied and complex, while confident in clinical work, they felt less equipped to deal with the emotion work, especially with an increasing role in palliative and end-of-life care. Families and bystanders reported generally positive experiences but their support needs were rarely explored.

Conclusions

To the best of our knowledge this is the first review that explores the experiences of PHPs, families and bystanders. An important outcome is identifying current gaps in knowledge where further empirical research is needed. The paucity of evidence suggested by this review on call handlers, families and bystanders presents opportunities to investigate their experiences in greater depth. Further research to address the current knowledge gaps will be important to inform future policy and practice.
Use and impact of social prescribing: a mixed-methods feasibility study protocol
Authors: Jani Anant , Liyanage Harshana , Hoang Uy , Moore Lucy , Ferreira Filipa , Yonova Ivelina , Tzortziou Brown Victoria , de Lusignan Simon
Published: September 2020

Introduction

Social prescribing aims to address social determinants of health, which account for 80%–90% of health outcomes, but the evidence base behind it is limited due to a lack of data linkingsocial prescribing activity and outcomes.

Methods and analysis

The objective of the quantitative component of this feasibility studyisto identify the characteristics of individuals who receive social prescriptions and describe the use and estimate the impact of social prescribing; the latter will be done on a homeless subgroup. We will use the Oxford Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC) primary care sentinel network, whose general practicescover a population of over 4 000 000 patients. Social prescribing data will be extracted onall recorded patients for 5 years up to 31 January 2020. The objective for the qualitative component of the study isto explore approaches to understand the contextual factors that will have influenced our quantitative findings to identify mechanisms to encourage adoption of social prescribing in primary care while improving data quality. Itwill comprise up to three 90–120 minute advisory group meetings for six to eight participants. Participants will be recruited based on their experience of delivering primary care within Oxfordshire and Surrey. The advisory group outputs will be analysed using framework analysis and will be used to create a survey instrument consisting of statements that surveyees, who will consist of primary care practitioners within the RCGP RSC, can agree or disagree with.

Ethics and dissemination

All RCGP RSC data are pseudonymised at the point of data extraction. No personally identifiable data are required for this investigation. This protocol follows the Good Reporting of a Mixed Methods Study checklist. The study results will be published in a peer-reviewed journal and the dataset will be available to other researchers.
Postnatal consultations with an obstetrician after critical perinatal events: a qualitative study of what women and their partners experience
Authors: Høgh Stinne , Navne Laura Emdal , Johansen Marianne , Svendsen Mette Nordahl , Sorensen Jette Led
Published: September 2020

Objective

The objective of this study was to explore women’s and their partners’ experiences with attending postnatal consultations with an obstetrician after critical perinatal events.

Design

Qualitative interview study. We did semi-structured individual narrative interviews exploring the lived experiences. Interviews were analysed using a phenomenological approach and the thematic analysis was validated by a transdisciplinary group of anthropologists, obstetricians and a midwife.

Setting

Department of obstetrics at a large hospital in Denmark.

Participants

We did a qualitative study with 17 participants (10 women and 7 partners) who had experienced critical perinatal events.

Results

Five major themes were identified: (1) a need to gain understanding and make sense of the critical perinatal events, (2) a need for relational continuity, (3) the importance of discussing emotional effects as well as physical aspects of occurred events, (4) preparing for future pregnancies and (5) closure of the story.

Most of the participants emphasised the importance of knowing the obstetrician undertaking the postnatal consultation. The majority of the participants described a need to discuss the emotional effects of the experience as well as the physical aspects of occurred events. The postnatal consultation served as an approach to obtain a positive closure of their birth story and to feel confident about potential future pregnancies.

Conclusions

This interview-based study suggests that postnatal consultation with an obstetrician might be an important tool for women and their partners in understanding the course of events during the critical birth experience and in processing it and preparing for future pregnancies. It appears to be important to assign an obstetrician whom they already know and to encourage them to discuss not only physical aspects of what happened but also the emotional effects of the experience.
Adoptive transfer of zoledronate-expanded autologous Vγ9Vδ2 T-cells in patients with treatment-refractory non-small-cell lung cancer: a multicenter, open-label, single-arm, phase 2 study
Authors: Kakimi Kazuhiro , Matsushita Hirokazu , Masuzawa Keita , Karasaki Takahiro , Kobayashi Yukari , Nagaoka Koji , Hosoi Akihiro , Ikemura Shinnosuke , Kitano Kentaro , Kawada Ichiro , Manabe Tadashi , Takehara Tomohiro , Ebisudani Toshiaki , Nagayama Kazuhiro , Nakamura Yukio , Suzuki Ryuji , Yasuda Hiroyuki , Sato Masaaki , Soejima Kenzo , Nakajima Jun
Published: September 2020

Background

Not all non-small cell lung cancer (NSCLC) patients possess drug-targetable driver mutations, and response rates to immune checkpoint blockade therapies also remain unsatisfactory. Therefore, more effective treatments are still needed. Here, we report the results of a phase 2 clinical trial of adoptive cell therapy using zoledronate-expanded autologous Vγ9Vδ2 T-cells for treatment-refractory NSCLC.

Methods

NSCLC patients who had undergone at least two regimens of standard chemotherapy for unresectable disease or had had at least one treatment including chemotherapy or radiation for recurrent disease after surgery were enrolled in this open-label, single-arm, multicenter, phase 2 study. After preliminary testing of Vγ9Vδ2 T-cell proliferation, autologous peripheral blood mononuclear cells were cultured with zoledronate and IL-2 to expand the Vγ9Vδ2 T-cells. Cultured cells (>1×109) were intravenously administered every 2 weeks for six injections. The primary endpoint of this study was progression-free survival (PFS), and secondary endpoints included overall survival (OS), best objective response rate (ORR), disease control rate (DCR), safety and immunomonitoring. Clinical efficacy was defined as median PFS significantly >4 months.

Results

Twenty-five patients (20 adenocarcinoma, 4 squamous cell carcinoma and 1 large cell carcinoma) were enrolled. Autologous Vγ9Vδ2 T-cell therapy was administered to all 25 patients, of which 16 completed the foreseen course of 6 injections of cultured cells. Median PFS was 95.0 days (95% CI 73.0 to 132.0 days); median OS was 418.0 days (179.0–479.0 days), and best overall responses were 1 partial response, 16 stable disease (SD) and 8 progressive disease. ORR and DCR were 4.0% (0.1%–20.4%) and 68.0% (46.5%–85.1%), respectively. Severe adverse events developed in nine patients, mostly associated with disease progression. In one patient, pneumonitis and inflammatory responses resulted from Vγ9Vδ2 T-cell infusions, together with the disappearance of a massive tumor.

Conclusions

Although autologous Vγ9Vδ2 T-cell therapy was well tolerated and may have an acceptable DCR, this trial did not meet its primary efficacy endpoint.

Trial registration number

UMIN000006128
Are veterinary inspections the best way to improve animal welfare during transport?
Authors: Herskin Mette S. , Overstreet Katy , Anneberg Inger
Published: September 2020

Mette S. Herskin, Katy Overstreet and Inger Anneberg argue that increased veterinary inspection may not lead to better animal welfare during transport and suggest that other tools should be considered.
Evaluation of currently registered herbicides for fall bearing year red sorrel (Rumex acetosella L.) management in lowbush blueberry (Vaccinium angustifolium Aiton)
Authors: White Scott N. , Menapati Rakesh , McLean Nancy
Published: September 2020

Red sorrel is a common creeping herbaceous, perennial weed species in lowbush blueberry fields and reproduces asexually via ramets from creeping roots. Ramets emerge throughout the season but remain vegetative due to a vernalisation requirement for flowering. This weed may therefore be managed with fall herbicide applications, but few currently registered herbicides have been evaluated for fall red sorrel management in lowbush blueberry. The objectives of this research were to (i) determine the effect of various herbicide treatments on red sorrel shoot and root biomass in the greenhouse, (ii) determine the effect of fall bearing year herbicide applications on overwintered red sorrel ramet density in the field, (iii) determine if reduced overwintered ramet density reduces flowering ramet density in the field, and (iv) estimate the potential for red sorrel to recover from fall bearing year herbicide applications. Dicamba, tribenuron-methyl, and glufosinate reduced red sorrel shoot and root biomass in the greenhouse and reduced overwintered ramet density in the field. Clopyralid, sulfentrazone, and flumioxazin reduced shoot and root biomass in the greenhouse but exhibited limited efficacy in the field. Nicosulfuron + rimsulfuron and glyphosate were ineffective in both the greenhouse and field. Dichlobenil and pronamide reduced overwintered ramet density in the field. Reduction of overwintered ramet density did not consistently reduce flowering ramet density. Dichlobenil reduced seedling density at two sites, but no herbicide consistently reduced summer non-bearing year ramet density. Fall herbicide applications alone, therefore, do not appear to maintain red sorrel suppression in lowbush blueberry fields.
Particle physics violating crypto-nonlocal realism
Authors: Shi Yu , Yang Ji-Chong
Published: September 2020

It has been well established that quantum mechanics (QM) violates Bell inequalities (BI), which are consequences of local realism (LR). Remarkably QM also violates Leggett inequalities (LI), which are consequences of a class of nonlocal realism called crypto-nonlocal realism (CNR). Both LR and CNR assume that measurement outcomes are determined by preexisting objective properties, as well as hidden variables (HV) not considered in QM. We extend CNR and LI to include the case that the measurement settings are not externally fixed, but determined by HV. We derive a new version of LI, which is then shown to be violated by entangled $$B_d$$

B
d

mesons, if charge–conjugation–parity (CP) symmetry is indirectly violated, as indeed established. The experimental result is quantitatively estimated by using the indirect CP violation parameters, and the maximum of a suitably defined relative violation is about $$2.7\%$$

2.7
%

. Our work implies that particle physics violates CNR. Our LI can also be tested in other systems such as photon polarizations.
The identification problem for BSDEs driven by possibly non-quasi-left-continuous random measures
Authors: Bandini Elena , Russo Francesco
Published: September 2020

In this paper, we focus on the so-called identification problem for a BSDE driven by a continuous local martingale and a possibly non-quasi-left-continuous random measure. Supposing that a solution [Formula: see text] of a BSDE is such that [Formula: see text] where [Formula: see text] is an underlying process and [Formula: see text] is a deterministic function, solving the identification problem consists in determining [Formula: see text] and [Formula: see text] in terms of [Formula: see text]. We study the over-mentioned identification problem under various sets of assumptions and we provide a family of examples including the case when [Formula: see text] is a non-semimartingale jump process solution of an SDE with singular coefficients.
DYNAMIC RESPONSE AND FIRST PASSAGE OF SMA TRACHEAL STENT IN COUGH PROCESS
Authors: WANG TIAN , ZHU ZHI-WEN
Published: September 2020

The high-order nonlinear terms are applied to express the strain–stress curves of shape memory alloy (SMA) materials, and a new type of SMA model is proposed. Cough process is regarded as a strong stochastic process, and the mechanical model of an SMA tracheal stent in cough process is proposed where the large deformation caused by cough is considered. The system’s natural frequency is obtained, and its dynamic response is analyzed. The analysis and simulation results show that when the intensity of outside excitation increased 3.5 times (from 0.2 to 0.7), the system’s first-passage time was advanced by 19%, which means that the increase of the cough intensity will cause the loss of the stent; the large-amplitude vibration can be eliminated by selecting materials with appropriate parameters, which means the loss of tracheal stent can be avoided even in strong cough. This paper provides a new way to avoid the stent’s loss.
INVERSE PROBLEM ALGORITHM APPLICATION TO SEMI-QUANTITATIVE ANALYSIS OF 272 PATIENTS WITH ISCHEMIC STROKE SYMPTOMS: CAROTID STENOSIS RISK ASSESSMENT FOR FIVE RISK FACTORS
Authors: LIN YA-HUI , CHIU SHAO-WEN , LIN YING-CHE , LIN CHIEN-CHUNG , PAN LUNG-KWANG
Published: September 2020

This study proposes the inverse problem algorithm (IPA) with five risk factors applied to the semi-quantitative analysis of carotid stenosis 272 patients with suspected ischemic stroke. The IPA is known to provide a substantiated machine learning-based prediction of the expected outcomes by solving an inverse matrix of variable coefficients. In case of carotid stenosis prediction, such risk factors as patient’s age, mean arterial pressure (MAP), glucose AC, low-density lipoprotein-cholesterol (LDL-C), and C-Reactive protein (CRP) were assessed for the main group of 217 patients. Their results were processed by the STATISTICA program with a customized loss function ([Formula: see text]), yielding the first-order nonlinear semi-empirical formula with 16 terms. The loss function was calculated via the total mismatch between the theoretical predictions and true carotid stenosis cases (%) for all 217 patients. Thus, the carotid stenosis (%) compromised solution array [[Formula: see text]] was optimized using [Formula: see text] individual data points via the proposed algorithm. The results showed a complete regression with loss function [Formula: see text]=2.3543, variance [Formula: see text]=87.46%, and correlation coefficient [Formula: see text]. The reference group of 55 more patients with the same preliminary diagnosis and symptoms was selected to validate the method predictive feasibility, which was found quite satisfactory. The decreasing order of three dominant risk factors was as follows: CRP, glucose AC, and MAP, whereas age and LDL-C weakly influenced the program computation results. The IPA showed a strong convergence by its default characteristic. The reduction of the number of variables in computation deteriorated the prediction accuracy, exhibiting the algorithm’s high sensitivity to the number of variables.
Photodynamic activity of 2,6-dibrominated dimethylaminophenylbuta-1,3-dienylBODIPY dyes
Authors: Kubheka Gugu , Babu Balaji , Prinsloo Earl , Kobayashi Nagao , Mack John , Nyokong Tebello
Published: September 2020

Mono- and disubstituted 2,6-dibromo-dimethylaminophenylbuta-1,3-dienylBODIPY dyes were successfully prepared, and their in vitro photodynamic activities against MCF-7 breast cancer cells were evaluated with a Thorlabs M660L4 660 nm LED (336 J · cm[Formula: see text]. The IC[Formula: see text] value of the monophenylbuta-1,3-dienylBODIPY was ca. 2.1 [Formula: see text]M, while that of the diphenylbuta-1,3-dienylBODIPY was > 50 [Formula: see text]M. Both dyes exhibited minimal dark toxicity. The results demonstrate that monosubstituted 2,6-dibromo-dimethylaminophenylbuta-1,3-dienylBODIPY dyes merit further in-depth study for use as photosensitizer dyes in photodynamic therapy.
Measurement of Longevity Risk of Life Annuity Based on C-ROSS Framework
Authors: Zhao Ming , Li Ziwen , Cai Yinge , Li Weiting
Published: September 2020

This paper constructs a model to measure longevity risk and explains the reasons for restricting the supply of annuity products in life insurance companies. According to the Lee–Carter Model and the VaR-based stochastic simulation, it can be found that the risk margin of the first type of longevity risk for ignoring the improvement of mortality rate is about 7%, and the risk margin of the second type of longevity risk for underestimating mortality improvement is about 7%. Therefore, the insurer needs to use cohort life table pricing premium and gradually prepares longevity risk capital during the insurance period.
An Iterative Doppler Velocity Log Error Calibration Algorithm Based on Newton Optimization
Authors: Guangcai Wang , Xu Xiaosu , Yao Yiqing
Published: September 2020

The performance of the inertial navigation system/Doppler velocity log (INS/DVL) is mainly degraded by DVL error. An optimization-based algorithm is widely used and effective on calibrating DVL error. In this algorithm, the loss function established is a quadratic function of DVL attitude error; however, the existing optimization-based calibration method is just of first-order generally, so that it is not able to reach the best calibration efficiency. In order to improve the efficiency, an iterative calibration algorithm based on the second-order Newton optimization is proposed innovatively to calibrate the DVL error. In addition, the Wolfe principle is introduced to limit its loss function’s oscillation around the extreme point to improve the efficiency and accuracy of the Newton optimization. The excellent efficiency and accuracy of the proposed calibration scheme are validated by simulation and field tests.
Physiological Characteristics of Type 1 Diabetes Patients during High Mountain Trekking
Authors: Matejko Bartłomiej , Gawrecki Andrzej , Wróbel Marta , Hohendorff Jerzy , Benbenek-Klupa Teresa , Zozulińska-Ziółkiewicz Dorota , Malecki Maciej T. , Klupa Tomasz
Published: September 2020

In this study, the aim was to provide observational data from an ascent to the summit of Mount Damavand (5670 meters above sea level (m.a.s.l), Iran) by a group of people with type 1 diabetes (T1DM), with a focus on their physiological characteristics. After a 3-day expedition, 18 T1DM patients, all treated with personal insulin pumps, successfully climbed Mount Damavand. Information was collected on their physiological and dietary behaviors, as well as medical parameters, such as carbohydrate consumption, glucose patterns, insulin dosing, and the number of hypo- and hyperglycemic episodes during this time frame. The participants consumed significantly less carbohydrates on day 3 compared to day 1 (16.4 vs. 23.1 carbohydrate units;

p
=
0.037

). Despite this, a gradual rise in the mean daily glucose concentration as measured with a glucometer was observed. Interestingly, the patients did not fully respond to higher insulin delivery as there was no significant difference in mean daily insulin dose during the expedition. There were more hyperglycemic episodes (≥180 mg/dL) per patient on day 3 vs. day 1 (

p
<
0.05

) and more severe hyperglycemic episodes (>250 mg/dL) per patient on days 2 (

p
<
0.05

) and 3 (

p
<
0.05

) vs. day 1. In summary, high mountain trekking is feasible for T1DM patients with good glycemic control and no chronic complications. However, some changes in dietary preferences and an observable rise in glucose levels may occur. This requires an adequate therapeutic response.