bluuebunny/crossref_metadata_2025 huggingface dataset:
Vocational experiences and career support opportunities among Canadian men with moderate and severe haemophilia
Authors: Smith Neale , Lane Shannon J. , King Jennifer , Waterhouse Linda , Bartholomew Claude , Jackson Shannon
Published: February 2019

Aim

The purpose of this research was to provide haemophilia treatment centres (HTCs) with guidance for the potential development of appropriate and timely interventions related to employment and vocational counselling and supports.

Methods

A multi‐method approach was employed, where initial focus groups (n = 13) and review of the literature were used to construct a structured survey instrument (n = 75).

Results

Focus group participants made choices about employment with keen awareness of how their bleeding disorder might limit them physically; they described the role of social networks in career choices; and they wrestled with issues of disclosure. Among survey respondents, 47% per cent of respondents reported that haemophilia had a small negative impact, 27% felt that it had a moderate negative impact and 13% indicated that it had a very large negative impact. One‐third of respondents had at some point received employment‐related advice from a member of their haemophilia treatment centre team. Roughly two‐thirds of respondents suggested that vocational advice would be “somewhat” or “very” useful at present.

Conclusion

Canadian men with haemophilia continue to experience challenges related to employment and career development. There appears to be an opportunity for HTCs to incorporate additional supports on these topics into the range of services which they currently provide.
Clinicopathological factors associated with BRAF‐V600E mutation in colorectal serrated adenomas
Authors: Travaglino Antonio , D'Armiento Francesco P , Cassese Gianluca , Campanino Maria R , Borrelli Giorgio , Pignatiello Sara , Luglio Gaetano , Maione Francesco , De Palma Giovanni D , D'Armiento Maria
Published: February 2019

Serrated adenomas are genetically heterogeneous, and the histological classification into sessile serrated (SSA) adenoma and traditional serrated adenoma (TSA) does not reflect the molecular landscape. The objective of this study was to assess clinical or pathological factors associated with BRAF‐V600E mutation in serrated adenomas. Systematic review and meta‐analysis was performed by searching electronic databases from January 2011 to January 2019 for studies assessing the association of BRAF‐V600E mutation with clinical or pathological features of serrated adenomas. Odds ratio (OR) was calculated for each factor; a P‐value <0.05 was considered significant. Forty studies assessing 3511 serrated adenomas (2375 SSAs and 1136 TSAs) were included. BRAF‐V600E mutation was significantly associated with proximal localisation (OR = 2.71; P < 0.00001) and CIMP‐H status (OR = 4.81; P < 0.0001) in both SSA and TSA, with polyp size <10 mm (OR = 0.41; P = 0.02) in TSA, and with endoscopic pit pattern II‐O (OR = 13.11; P < 0.00001) and expression of MUC5A5 (OR = 4.43; P = 0.003) and MUC6 (OR = 2.28; P < 0.05) in SSA. Conversely, BRAF mutation was not associated with age <70 years (OR = 1.63; P = 0.34), age <60 years (OR = 0.86; P = 0.79), female sex (OR = 0.77; P = 0.12), flat morphology (OR = 1.52; P = 0.16), presence of any dysplasia (OR = 1.01; P = 0.59), serrated dysplasia (OR = 1.23; P = 0.72) and invasive cancer (OR = 0.67; P = 0.32), nuclear β‐catenin expression (OR = 0.73; P = 0.21) and p53 overexpression (OR = 1.24; P = 0.82). In conclusion, BRAF‐V600E mutation is associated with proximal localisation and CIMP‐H status in both SSA and TSA, with size <10 mm only in TSA, and with expression of MUC5A5 and MUC6 and endoscopic pit pattern II‐O at least in SSA. In serrated adenomas, BRAF‐V600E mutation does not seem to be associated with age and sex, with the prevalence of dysplasia and cancer and with the morphology of the dysplastic component.
In vitro potential of flavonoids from tartary buckwheat on antioxidants activity and starch digestibility
Authors: Peng Lian‐Xin , Wei Li‐Juan , Yi Qian , Chen Gui‐Hua , Yao Zhen‐Dong , Yan Zhu‐Yun , Zhao Gang
Published: February 2019

The effects of various flavonoids of Tartary buckwheat (rutin‐enhanced flavonoid extract [REFE and quercetin‐enhanced flavonoid extract [QEFE]) and individual flavonoids (rutin, quercetin and kaempferol) on the antioxidant activity, inhibition of α‐glucosidases and α‐amylase and starch digestibility were evaluated. Quercetin possessed the highest antioxidant activity and inhibition of α‐glucosidases and α‐amylase activity followed by kaempferol and rutin. REFE and QEFE have similar antioxidant and inhibition of α‐amylase activities, but QEFE has much higher α‐glucosidases inhibition than REFE. Tartary buckwheat flour has the lowest content of rapidly digestible starch and predicted glycaemic index (pGI) compared to maize flour, wheat flour and rice flour. Addition of rutin and quercetin to wheat flour showed a weak or no effect on digestion inhibition, but they inhibited starch digestion under solid complex conditions. Our results may help explain the benefits of supplementing the diet with food rich in flavonoids.
A wide temperature insensitive piezoceramics for high‐temperature energy harvesting
Authors: Zhao Haiyan , Hou Yudong , Yu Xiaole , Fu Jing , Zheng Mupeng , Zhu Mankang
Published: February 2019

One of the key challenges in the development of high‐temperature energy harvesting (HTEH) technology is to clarify the relationship between temperature‐dependent material parameters and device power generation capabilities. However, at present, the research on temperature stability of piezoceramics mainly relies on thermal annealing technology, which cannot follow the actual temperature dependence of the piezoelectricity, and it is even more difficult to predict the temperature stability of HTEH. To shed light on this field, here, (1−x)BiScO3–xPbTiO3 system was chosen for building HTEH material, and the temperature‐dependent electrical parameters, such as d33, εr, and g33, have been measured by multiple in situ techniques. It was found that the synergistic effect of d33 and εr with temperature helps to obtain a stable g33 value in a wide temperature range. Moreover, in the mode of the cantilever‐type energy harvester, a stable output voltage was obtained at x = 0.64 harvester with <20% change over a broad temperature range of 100‐250°C, and it was verified that the temperature stability of g33 is crucial to the operation stability of HTEH devices.
Impact of intended and relative dose intensity of R‐CHOP in a large, consecutive cohort of elderly diffuse large B‐cell lymphoma patients treated with curative intent: no difference in cumulative incidence of relapse comparing patients by age
Authors: Eyre T. A. , Martinez‐Calle N. , Hildyard C. , Eyre D. W. , Plaschkes H. , Griffith J. , Wolf J. , Fields P. , Gunawan A. , Oliver R. , Djebbari F. , Booth S. , McMillan A. , Fox C. P. , Bishton M. J. , Collins G. P. , Hatton C. S. R.
Published: February 2019

Background

The increasing incidence of diffuse large B‐cell lymphoma (DLBCL) in ageing populations places a significant burden on healthcare systems. Co‐morbidity, frailty, and reduced organ and physiological reserve contribute to treatment‐related complications. The optimal dose intensity of R‐CHOP to optimize outcome across different ages with variable frailty and comorbidity burden is unclear.

Objectives and Methods

We examined the influence of intended (IDI) and relative (RDI) dose intensity of the combination of cyclophosphamide and doxorubicin, age and comorbidity on outcomes for DLBCL patients ≥70 years in a representative, consecutive cohort across eight UK centres (2009–2018). We determined predictors of survival using multivariable Cox regression, and predictors of recurrence before death using competing risks regression.

Results

Porgression‐free survival (PFS) and overall survival (OS) were significantly inferior in patients ≥80 vs. 70–79 years (P < 0.001). In contrast, 2‐year cumulative relapse incidence, when accounting for non‐relapse mortality as a competing risk, was no different between 70–79 vs. ≥80 years (P = 0.27) or comorbidity status (CIRS‐G: 0–6 vs. >6) (P = 0.27). In 70–79 years, patients with an IDI ≥80% had a significantly improved PFS and OS (P < 0.001) compared to IDI < 80%. Conversely, in patients ≥80 years, there was no difference in PFS (P = 0.88) or OS (P = 0.75) according to IDI <80% vs. ≥80%. On multivariable analysis, when comparing by age, there was a significantly higher cumulative relapse rate for patients aged 70–79 years with an IDI <80% (vs. >80%) (P = 0.04) but not for patients ≥80 years comparing IDI (P = 0.32).

Conclusion

‘R‐mini‐CHOP' provides adequate lymphoma‐specific disease control and represents a reasonable treatment option in elderly patients ≥80 years aiming for cure.
n‐3 polyunsaturated fatty acids provoke a specific transcriptional profile in rabbit adipose‐derived stem cells in vitro
Authors: Vackova Eкaterina , Bosnakovski Darko , Bjørndal Bodil , Yonkova Penka , Grigorova Natalia , Ivanova Zhenya , Penchev Georgi , Simeonova Galina , Miteva Lyuba , Milanova Anelya , Vachkova Tatyana , Stanilova Spaska , Penchev Georgiev Ivan
Published: February 2019

Adipose‐derived stem cells (ADSCs) possess multipotent properties, and their proper functionality is essential for further development of metabolic disorders. In the current study, we explored the impact of two n‐3 LC‐PUFAs (long‐chain polyunsaturated fatty acids, DHA—docosahexaenoic; C22:6, and EPA—eicosapentaenoic; C20:5) on a specific profile of lipolytic‐related gene expressions in the in vitro‐differentiated subcutaneous and visceral ADSCs from rabbits. The subcutaneous and visceral ADSCs were obtained from 28‐day‐old New Zealand rabbits. The primary cells were cultured up to passage 4 and were induced for adipogenic differentiation. Thereafter, the differentiated cells were treated with 100 µg EPA or DHA for 48 hr. The total mRNA was isolated and target genes expression evaluated by real‐time RCR. The results demonstrated that treatment of rabbit ADSCs with n‐3 PUFAs significantly enhanced mRNA expression of Perilipin A, while the upregulation of leptin and Rab18 genes was seen mainly in ADSCs from visceral adipose tissue. Moreover, the EPA significantly enhanced PEDF (Pigment Derived Epithelium Factor) mRNA expression only in visceral cells. Collectively, the results suggest activation of an additional lipolysis pathway most evident in visceral cells. The data obtained in our study indicate that in vitro EPA up‐regulates the mRNA expression of the studied lipolysis‐associated genes stronger than DHA mainly in visceral rabbit ADSCs.
Safety first: seasonal and diel habitat selection patterns by red deer in a contrasted landscape
Authors: Fattebert J. , Morelle K. , Jurkiewicz J. , Ukalska J. , Borkowski J.
Published: February 2019

Spatially heterogeneous landscapes provide solutions to the forage‐safety trade‐off when animals can access risky but energetically rewarding patches, or safer but resource‐poor patches. It can be advantageous for an animal to secure access to habitat heterogeneity at a broader scale in order to be able to dynamically adjust finer scale habitat use through time. We tested the hypothesis of a forage‐safety trade‐off optimization tactic in a hunted red deer (Cervus elaphus) population following a large accidental forest fire. We used telemetry data and fitted resource selection functions at the second‐ and third‐order scales. We then integrated the order‐specific probabilities into single, all‐in‐one multi‐level layers that synthetically captured the habitat selection patterns across scales by informing landscape‐scale annual habitat selectivity with finer within‐home‐range seasonal and diel processes. At the landscape scale, red deer anchored their home‐range at the interface of the disturbed and undisturbed patches, thereby securing habitat heterogeneity. This consequently enabled them to modulate within‐home‐range habitat selection depending on the season and the time of the day. In both seasons, red deer consistently used the burnt area for cover more during the day, and foraged in the unburnt forest and open fields at night. Interestingly there were no major seasonal differences in this diel habitat selection patterns. Increased mortality risk during the hunting season did not substantially change their spatial behaviour. We conclude that year‐round avoidance of non‐lethal human disturbance is the main driver of red deer habitat use in this system.
How light conditions influence theoretical pelagic to benthic primary production ratios in small lakes
Authors: Cremona Fabien , Laas Alo , Kõiv Toomas , Sepp Margot , Nõges Peeter , Nõges Tiina
Published: February 2019

Theoretical pelagic primary production of phytoplankton and benthic primary production of periphyton were modelled for two small lakes in Estonia (Northeast Europe). Although located only 500 m apart, the water colour and light attenuation of these two lakes differed markedly. The Secchi depth (SD) in the clear‐water lake was 4.5 m and only 0.47 m in the dark‐water lake. The total phosphorus (TP) concentrations were, respectively, 15 μg/l and 28 μg/l. An empirical model whose inputs were morphometric, light conditions and dissolved organic carbon parameters obtained from in situ measurements was employed for the present study. The model calculated primary production with a time‐step of 10 min, and a spatial resolution of 10 cm, from sunrise to sunset and from lake surface to lake bottom. The primary production of periphyton and phytoplankton was almost equal in the clear lake, whereas only phytoplankton contributed to whole‐lake primary production in the dark lake because of the stronger light attenuation in the water column. The results of the present study indicated the depth‐distribution profiles differed dramatically between the two lakes. The clear lake had a deep, U‐shaped curve, with the productive layer reaching considerable depth soon after sunrise and maintaining a similar profile throughout the light hours. In contrast, the dark lake production declined rapidly with increasing depth, whereas the profile changed over the day reaching the greatest depth at noon.
“There Is a Big Question Mark”: Managing Ambiguity in a Moroccan Maternity Ward
Authors: Newman Jess Marie
Published: February 2019

In Morocco, where extramarital sex and abortion are illegal, single mothers’ ambiguous status before the law inflects medical decision‐making. Leaky boundaries between the court and the hospital required doctors and administrators to work with multiple forms of documentation while anticipating external surveillance. Gaps between everyday experience and legalized forms of identity created confusion across multiple institutions. When discussing single mothers, hospital staff often spoke of “question marks” that flagged tensions between legibility and liability, disappearance and documentation. Managing question marks ramified surveillance and categorization. Ultimately, however, attempts to administratively resolve single mothers’ ambiguity created gaps and inconsistencies that allowed vulnerable patients to disappear from view.
Setting decision‐making criteria: is medical education ready for shared decision making?
Authors: Schut Suzanne , Driessen Erik
Published: February 2019

Schut and Driessen propose that modern assessment requires students to participate in their assessment through shared‐decision making.
Lophozia fuscovirens sp. nov. (Lophoziaceae, Marchantiophyta): the second taxon with brown gemmae within Lophozia s.s
Authors: Bakalin Vadim , Vilnet Anna
Published: February 2019

Lophozia fuscovirens is described as a new species from the southern part of the Kolyma Upland (Russia, northeast Asia) based on results of integrative research including a phylogenetic reconstruction based on ITS1‐2 + trnL‐F sequences. The species is characterized by brown gemmae – a rare feature within Lophozia s.s. A description and illustration of the new species are provided. The origin of L. fuscovirens may be correlated with the long continuity of open landscapes with a relatively wet climate at the southern portion of Megaberingia. The new species may thus be regarded as evidence of speciation originally triggered by glaciations and still going on in the suboceanic‐subcontinental subarctic landscapes that were formed in the Pleistocene.
Upper esophageal sphincter metrics on high‐resolution manometry differentiate etiologies of esophagogastric junction outflow obstruction
Authors: Blais Pierre , Bennett Michael C. , Gyawali C. Prakash
Published: February 2019

Background

Upper esophageal sphincter (UES) metrics on high‐resolution manometry (HRM), particularly nadir UES residual pressure (UES‐RP), are abnormal in achalasia and may help characterize the underlying mechanism or predict management outcome in esophagogastric junction outflow obstruction (EGJOO).

Methods

A database of consecutive patients undergoing esophageal HRM from 2008 to 2013 yielded 134 patients (59.8 ± 1.4 years, 68% F) with EGJOO. Final clinical diagnoses and treatment response were extracted from chart review. Esophageal body, UES, and lower esophageal sphincter (LES) metrics were compared between EGJOO and asymptomatic healthy controls (n = 16, 27.7 ± 0.7 years, 56% F). Logistic regression evaluated differences between HRM metrics amongst etiologies of EGJOO grouped into motor versus mechanical disorders.

Key results

Distal contractile integral, distal latency, and nadir UES‐RP were significantly different between EGJOO subgroups (P ≤ 0.01 for each comparison), but only nadir UES‐RP remained independently predictive of subgroups (adjusted odds ratio 1.15, 95% confidence intervals 1.05‐1.27, P < 0.01). Nadir UES‐RP was highest in achalasia variants, and lowest in mechanical EGJOO and controls (P < 0.001). Of 19 patients who underwent LES myotomy, durable benefit was reported by 68.4% over mean 3.6 years of follow‐up. Significantly higher nadir UES‐RP was noted with symptom relief (3.4 vs −0.7 mm Hg with symptom recurrence, 95% confidence intervals of difference = 1.35‐6.83). A threshold UES‐RP of ≥2.0 mm Hg yielded a sensitivity of 84.6% and specificity of 83.3% in predicting symptom resolution following myotomy.

Conclusions and inferences

Nadir UES‐RP offers clues to differentiation of subtypes within EGJOO and may predict symptom outcome from myotomy.
Coordinating supply and demand: plant carbon allocation strategy ensuring survival in the long run
Authors: Gessler Arthur , Grossiord Charlotte
Published: February 2019

This article is a Commentary on Huang et al., 222: 144–158.
Interactions between functionally diverse fungal mutualists inconsistently affect plant performance and competition
Authors: Thakur Madhav P. , Quast Vera , van Dam Nicole M. , Eisenhauer Nico , Roscher Christiane , Biere Arjen , Martinez‐Medina Ainhoa
Published: February 2019

Plants form mutualistic relationship with a variety of belowground fungal species. Such a mutualistic relationship can enhance plant growth and resistance to pathogens. Yet, we know little about how interactions between functionally diverse groups of fungal mutualists affect plant performance and competition. We experimentally determined the effects of interaction between two functional groups of belowground fungi that form mutualistic relationship with plants, arbuscular mycorrhizal (AM) fungi and Trichoderma, on interspecific competition between pairs of closely related plant species from four different genera. We hypothesized that the combination of two functionally diverse belowground fungal species would allow plants and fungi to partition their symbiotic relationships and relax plant–plant competition. Our results show that: 1) the AM fungal species consistently outcompeted the Trichoderma species independent of plant combinations; 2) the fungal species generally had limited effects on competitive interactions between plants; 3) however, the combination of fungal species relaxed interspecific competition in one of the four instances of plant–plant competition, despite the general competitive superiority of AM fungi over Trichoderma. We highlight that the competitive outcome between functionally diverse fungal species may show high consistency across a broad range of host plants and their combinations. However, despite this consistent competitive hierarchy, the consequences of their interaction for plant performance and competition can strongly vary among plant communities.
The challenges to public health nurse practice in rural Ireland
Authors: Farrelly Tom , Flaherty Sinéad , Healy Hannah
Published: February 2019

Objectives

The primary objective was to understand the contemporary public health nurse's (PHN) role and the issues that they face working in rural Ireland.

Design and Sample

This study was based on an ethnographic approach with 13 PHNs working in rural areas in the South West of Ireland.

Measurements

A combination of solicited diaries and semi‐structured interviews referred to as the diary/interview method were employed. Diaries were used by the PHNs to record their working day on a staggered basis from February to April 2017 with the subsequent interviews carried out in June and July 2017.

Results

Working as a PHN in a rural area presented a number of issues such as time spent on traveling as a result of geographical disparity & poor road networks; client transport issues; a sense of working in isolation; communication issues with respect to computer/tablet hardware availability, mobile phone and broadband connectivity and the availability of, and the physical access to services.

Conclusion

PHNs operating in rural communities face a distinct set of challenges that they have a limited ability to address. Legislators, health care providers and policymakers need to create a supportive environment that helps address these challenges in Ireland.
Leishmania braziliensis isolated from disseminated leishmaniasis patients downmodulate neutrophil function
Authors: Cardoso Thiago , Bezerra Caroline , Medina Lilian Silva , Ramasawmy Rajendranath , Scheriefer Albert , Bacellar Olívia , de Carvalho Edgar M.
Published: February 2019

Aims

The polymorphism observed in Leishmania braziliensis is associated with different clinical forms of leishmaniasis. Neutrophils (PMNs) participate in the pathogenesis of leishmania infection, and here, we evaluate neutrophil function after infection with isolates of L. braziliensis from cutaneous leishmaniasis (CL) or disseminated leishmaniasis (DL) patients.

Methods and results

Neutrophils from 30 healthy subjects (HS) were infected with isolates of L. (V.) braziliensis obtained from three CL and three DL patients. They were infected at the ratio of 3:1 parasites per neutrophil, and leishmania uptake was evaluated by microscopy. The neutrophil activation markers and oxidative burst by expression of dihidrorhodamine (DHR) were evaluated by flow cytometry and cytokine production by ELISA. The frequency of infected cells and the number of amastigotes were higher in neutrophils infected with CL isolates compared to DL isolates (P < 0.05). The DHR and CD66b expression after infection with DL isolate was lower than with CL isolates. There was no difference regarding chemokine production.

Conclusion

The L. (V.) braziliensis isolates of DL induced lower respiratory burst and neutrophils activation markers compared with CL isolates which may contribute to parasite survival and dissemination in DL patients.
The Nrf2 pathway is required for intracellular replication ofToxoplasma gondiiin activated macrophages
Authors: Pang Yu , Zhang Zhaoxia , Chen Yuntong , Cao Shinuo , Yang Xiuqin , Jia Honglin
Published: February 2019

Reactive oxygen species (ROS) produced by oxidases and nonenzymatic sources are important for host defence against intracellular pathogens. In this study, we knocked out the Nrf2 gene inRAW264.7 cells using theCRISPR/Cas9 system and investigated the antioxidant effects of the Nrf2 pathway in the cells stimulated byIFN‐γ andTNF‐α. The results indicated that the Nrf2 signalling pathway is necessary for maintaining redox homeostasis in activatedRAW264.7 cells. Inactivation of Nrf2 impaired parasite growth. We also found that p62 contributes to Nrf2‐mediated pathways involved inT gondiiinfection. These findings suggest that the Nrf2/Keap1 pathway may be targeted to prevent and treat toxoplasmosis.
Stochastic Counterfactual Risk Analysis for the Vulnerability Assessment of Cyber‐Physical Attacks on Electricity Distribution Infrastructure Networks
Authors: Oughton Edward J. , Ralph Daniel , Pant Raghav , Leverett Eireann , Copic Jennifer , Thacker Scott , Dada Rabia , Ruffle Simon , Tuveson Michelle , Hall Jim W
Published: February 2019

In December 2015, a cyber‐physical attack took place on the Ukrainian electricity distribution network. This is regarded as one of the first cyber‐physical attacks on electricity infrastructure to have led to a substantial power outage and is illustrative of the increasing vulnerability of Critical National Infrastructure to this type of malicious activity. Few data points, coupled with the rapid emergence of cyber phenomena, has held back the development of resilience analytics of cyber‐physical attacks, relative to many other threats. We propose to overcome data limitations by applying stochastic counterfactual risk analysis as part of a new vulnerability assessment framework. The method is developed in the context of the direct and indirect socioeconomic impacts of a Ukrainian‐style cyber‐physical attack taking place on the electricity distribution network serving London and its surrounding regions. A key finding is that if decision‐makers wish to mitigate major population disruptions, then they must invest resources more‐or‐less equally across all substations, to prevent the scaling of a cyber‐physical attack. However, there are some substations associated with higher economic value due to their support of other Critical National Infrastructures assets, which justifies the allocation of additional cyber security investment to reduce the chance of cascading failure. Further cyber‐physical vulnerability research must address the tradeoffs inherent in a system made up of multiple institutions with different strategic risk mitigation objectives and metrics of value, such as governments, infrastructure operators, and commercial consumers of infrastructure services.
“Old age” as a social location: Theorizing institutional processes, cultural expectations, and interactional practices
Authors: Barken Rachel
Published: February 2019

The graying of societies and growing inequality call for increased attention to age relations and their implications for power, status, and constraint in late life. In this paper, I argue old age is a distinct—and devalued—social location that exists amid intersecting relations of inequality. Using an integrative approach, I synthesize selected sociological research on the institutional processes, cultural expectations, and interactional practices underlying the social construction of old age. I then review research in the areas of family care work and employment to illustrate some empirical contexts where age relations intersect with gender, class, race, and ethnicity to structure divergent opportunities and constraints among older people. This paper maps out significant theoretical and substantive signposts in the sociology of old age to build connections across levels of analysis, and to provide a nuanced, comprehensive approach to patterned inequalities in late life.
Investigation of assumptions and approximations in the virtual fields method for a viscoplastic material model
Authors: Jones Elizabeth M. C. , Karlson Kyle N. , Reu Phillip L.
Published: February 2019

The Virtual Fields Method (VFM) is an inverse technique used for parameter estimation and calibration of constitutive models. Many assumptions and approximations—such as plane stress, incompressible plasticity, and spatial and temporal derivative calculations—are required to use VFM with full‐field deformation data, for example, from Digital Image Correlation (DIC). This work presents a comprehensive discussion of the effects of these assumptions and approximations on parameters identified by VFM for a viscoplastic material model for 304L stainless steel. We generated synthetic data from a Finite‐Element Analysis (FEA) in order to have a reference solution with a known material model and known model parameters, and we investigated four cases in which successively more assumptions and approximations were included in the data. We found that VFM is tolerant to small deviations from the plane stress condition in a small region of the sample, and that the incompressible plasticity assumption can be used to estimate thickness changes with little error. A local polynomial fit to the displacement data was successfully employed to compute the spatial displacement gradients. The choice of temporal derivative approximation (i.e., backwards difference versus central difference) was found to have a significant influence on the computed rate of deformation and on the VFM results for the rate‐dependent model used in this work. Finally, the noise introduced into the displacement data from a stereo‐DIC simulator was found to have negligible influence on the VFM results. Evaluating the effects of assumptions and approximations using synthetic data is a critical first step for verifying and validating VFM for specific applications. The results of this work provide the foundation for confidently using VFM for experimental data.
Soil available potassium affected by rice straw incorporation and potassium fertilizer application under a rice–oilseed rape rotation system
Authors: Zhu Dandan , Zhang Jianglin , Wang Zheng , Muhammad Rizwan Khan , Lu Jianwei , Li Xiaokun
Published: February 2019

Data from 147 field trials were collected to study the influence of straw incorporation on soil potassium (K) under an intensive rice–oilseed rape rotation system, while pot experiments were conducted to evaluate the effects of rice straw incorporation on soil K availability. A significant correlation was observed between the soil available K and the relative yield (RRY) and the relative K uptake (RKU) of oilseed rape, with R2 values ranging from 0.07 to 0.08 and from 0.10 to 0.11, respectively, when data were fitted to a logarithmic equation model. In approximately 30% of trials, RRY reached 90%, while soil test available K values were below the critical limit, indicating that soil K values at the time of sampling (within 1 week of rice harvest) underestimated the actual soil K supply capacity. The pot experiment results showed that soil available K was affected by straw incorporation and soil type in the fallow period. The NH4OAc‐K and NaBPh4‐K concentrations of soils increased at first, and then, plateaued after 28 days. Straw incorporation significantly influenced the critical soil K concentration, which is important for making accurate K fertilizer recommendation. These results suggested that straw K should be seriously considered in making K fertilizer recommendations. Extending the sampling time from 1 to 3 weeks after the harvesting of rice to stabilize the effects of straw incorporation may help achieve a more accurate evaluation of soil available K.
HLA‐C*07:465, a novel HLA‐C*07 variant, detected in a Singaporean Chinese individual
Authors: Kaur Ashminder , Cho Louise , Cereb Nezih , Lin Py‐Yu , Yang Kuo‐Liang
Published: February 2019

One nucleotide replacement in codon 50 of HLA‐C*07:02:01:01 results in a novel allele, HLA‐C*07:465.
Genetic diversity and population structure of Plasmodium falciparum in Kenyan–Ugandan border areas
Authors: Nderu David , Kimani Francis , Karanja Evaline , Thiong'o Kelvin , Akinyi Maureen , Too Edwin , Chege William , Nambati Eva , Wangai Laura N. , Meyer Christian G. , Velavan Thirumalaisamy P.
Published: February 2019

Kenya has, in the last decade, made tremendous progress in the fight against malaria. Nevertheless, continued surveillance of the genetic diversity and population structure of Plasmodium falciparum is required to refine malaria control and to adapt and improve elimination strategies. Twelve neutral microsatellite loci were genotyped in 201 P. falciparum isolates obtained from the Kenyan–Ugandan border (Busia) and from two inland malaria‐endemic sites situated in western (Nyando) and coastal (Msambweni) Kenya. Analyses were done to assess the genetic diversity (allelic richness and expected heterozygosity, [He]), multilocus linkage disequilibrium () and population structure. A similarly high degree of genetic diversity was observed among the three parasite populations surveyed (mean He = 0.76; P > 0.05). Except in Msambweni, random association of microsatellite loci was observed, indicating high parasite out‐breeding. Low to moderate genetic structure (FST = 0.022–0.076; P < 0.0001) was observed with only 5% variance in allele frequencies observed among the populations. This study shows that the genetic diversity of P. falciparum populations at the Kenyan–Ugandan border is comparable to the parasite populations from inland Kenya. In addition, high genetic diversity, panmixia and weak population structure in this study highlight the fitness of Kenyan P. falciparum populations to successfully withstand malaria control interventions.
A Partial Safety Factor Method for System Reliability Prediction With Outsourced Components
Authors: Hu Zhengwei , Du Xiaoping
Published: February 2019

System reliability is usually predicted with the assumption that all component states are independent. This assumption may not accurate for systems with outsourced components since their states are strongly dependent and component details may be unknown. The purpose of this study is to develop an accurate system reliability method that can produce complete joint probability density function (PDF) of all the component states, thereby leading to accurate system reliability predictions. The proposed method works for systems whose failures are caused by excessive loading. In addition to the component reliability, system designers also ask for partial safety factors for shared loadings from component suppliers. The information is then sufficient for building a system-level joint PDF. Algorithms are designed for a component supplier to generate partial safety factors. The method enables accurate system reliability predictions without requiring proprietary information from component suppliers.
Operation of a carbon nanotube field-emission cathode in low Earth orbit
Authors: Ohkawa Yasushi , Okumura Teppei , Iki Kentaro , Okamoto Hiroyuki , Kawamoto Satomi
Published: February 2019

A carbon nanotube-based field-emission cathode (FEC) has been researched and developed by the Japan Aerospace Exploration Agency mainly for space-debris removal systems with electrodynamic tether (EDT) propulsion. An in-orbit experiment to demonstrate the EDT technologies including the FEC was planned and conducted in early 2017. The FEC operated well without any critical trouble during the one-week mission period. The data obtained include its electron emission capability to space plasma and its durability in low Earth orbit, which suggest the prospect of using the FEC in space.
Maternal immunity and antibodies to dengue virus promote infection and Zika virus–induced microcephaly in fetuses
Authors: Rathore Abhay P. S. , Saron Wilfried A. A. , Lim Ting , Jahan Nusrat , St. John Ashley L.
Published: February 2019

Infection of fetuses with Zika virus during pregnancy and congenital defects are enhanced by maternal immunity to dengue virus.
Cryo-EM structure of phosphodiesterase 6 reveals insights into the allosteric regulation of type I phosphodiesterases
Authors: Gulati Sahil , Palczewski Krzysztof , Engel Andreas , Stahlberg Henning , Kovacik Lubomir
Published: February 2019

We report the cryo-EM structure of rod photoreceptor phosphodiesterase 6.
Effect of autologous adipose-derived mesenchymal stem cell therapy in the treatment of acromioclavicular joint osteoarthritis
Authors: Freitag Julien , Wickham James , Shah Kiran , Tenen Abi
Published: February 2019

The aim of this case report is to evaluate the efficacy of mesenchymal stem cell (MSC) therapy in the treatment of small joint osteoarthritis (OA). Acromio-clavicular (AC) joint OA is an under-diagnosed and yet frequent source of shoulder pain. MSCs have shown evidence of benefit in the treatment of knee OA. This is the first report to describe the use of MSC therapy in OA of the upper limb. A 43-year-old patient presents with painful AC joint OA and undergoes MSC therapy. The patient reported pain and functional improvement as assessed by the Disability of Arm, Shoulder and Hand Score and Numeric Pain Rating Scale. Imaging at 12 months showed structural improvement with reduction in subchondral oedema, synovitis and subchondral cysts. This case is the first to show the benefit of MSC therapy in the treatment of small joint arthropathy and also of the upper limb.

Trial registration number: Australian New Zealand Clinical Trials Registry (ACTRN12617000638336).
Pre-hospital advanced airway management for adults with out-of-hospital cardiac arrest: nationwide cohort study
Authors: Izawa Junichi , Komukai Sho , Gibo Koichiro , Okubo Masashi , Kiyohara Kosuke , Nishiyama Chika , Kiguchi Takeyuki , Matsuyama Tasuku , Kawamura Takashi , Iwami Taku , Callaway Clifton W , Kitamura Tetsuhisa
Published: February 2019

Objective

To determine survival associated with advanced airway management (AAM) compared with no AAM for adults with out-of-hospital cardiac arrest.

Design

Cohort study between January 2014 and December 2016.

Setting

Nationwide, population based registry in Japan (All-Japan Utstein Registry).

Participants

Consecutive adult patients with out-of-hospital cardiac arrest, separated into two sub-cohorts by their first documented electrocardiographic rhythm: shockable (ventricular fibrillation or pulseless ventricular tachycardia) and non-shockable (pulseless electrical activity or asystole). Patients who received AAM during cardiopulmonary resuscitation were sequentially matched with patients at risk of AAM within the same minute on the basis of time dependent propensity scores.

Main outcome measures

Survival at one month or at hospital discharge within one month.

Results

Of the 310 620 patients eligible, 8459 (41.2%) of 20 516 in the shockable cohort and 121 890 (42.0%) of 290 104 in the non-shockable cohort received AAM during cardiopulmonary resuscitation. After time dependent propensity score sequential matching, 16 114 patients in the shockable cohort and 236 042 in the non-shockable cohort were matched at the same minute. In the shockable cohort, survival did not differ between patients with AAM and those with no AAM: 1546/8057 (19.2%) versus 1500/8057 (18.6%) (adjusted risk ratio 1.00, 95% confidence interval 0.93 to 1.07). In the non-shockable cohort, patients with AAM had better survival than those with no AAM: 2696/118 021 (2.3%) versus 2127/118 021 (1.8%) (adjusted risk ratio 1.27, 1.20 to 1.35).

Conclusions

In the time dependent propensity score sequential matching for out-of-hospital cardiac arrest in adults, AAM was not associated with survival among patients with shockable rhythm, whereas AAM was associated with better survival among patients with non-shockable rhythm.
Duration of antibiotic treatment for common infections in English primary care: cross sectional analysis and comparison with guidelines
Authors: Pouwels Koen B , Hopkins Susan , Llewelyn Martin J , Walker Ann Sarah , McNulty Cliodna AM , Robotham Julie V
Published: February 2019

Objective

To evaluate the duration of prescriptions for antibiotic treatment for common infections in English primary care and to compare this with guideline recommendations.

Design

Cross sectional study.

Setting

General practices contributing to The Health Improvement Network database, 2013-15.

Participants

931 015 consultations that resulted in an antibiotic prescription for one of several indications: acute sinusitis, acute sore throat, acute cough and bronchitis, pneumonia, acute exacerbation of chronic obstructive pulmonary disease (COPD), acute otitis media, acute cystitis, acute prostatitis, pyelonephritis, cellulitis, impetigo, scarlet fever, and gastroenteritis.

Main outcome measures

The main outcomes were the percentage of antibiotic prescriptions with a duration exceeding the guideline recommendation and the total number of days beyond the recommended duration for each indication.

Results

The most common reasons for antibiotics being prescribed were acute cough and bronchitis (386 972, 41.6% of the included consultations), acute sore throat (239 231, 25.7%), acute otitis media (83 054, 8.9%), and acute sinusitis (76 683, 8.2%). Antibiotic treatments for upper respiratory tract indications and acute cough and bronchitis accounted for more than two thirds of the total prescriptions considered, and 80% or more of these treatment courses exceeded guideline recommendations. Notable exceptions were acute sinusitis, where only 9.6% (95% confidence interval 9.4% to 9.9%) of prescriptions exceeded seven days and acute sore throat where only 2.1% (2.0% to 2.1%) exceeded 10 days (recent guidance recommends five days). More than half of the antibiotic prescriptions were for longer than guidelines recommend for acute cystitis among females (54.6%, 54.1% to 55.0%). The percentage of antibiotic prescriptions exceeding the recommended duration was lower for most non-respiratory infections. For the 931 015 included consultations resulting in antibiotic prescriptions, about 1.3 million days were beyond the durations recommended by guidelines.

Conclusion

For most common infections treated in primary care, a substantial proportion of antibiotic prescriptions have durations exceeding those recommended in guidelines. Substantial reductions in antibiotic exposure can be accomplished by aligning antibiotic prescription durations with guidelines.
Improving resource mobilisation for global health R&D: a role for coordination platforms?
Authors: Beyeler Naomi , Fewer Sara , Yotebieng Marcel , Yamey Gavin
Published: February 2019

Achieving many of the health targets in the Sustainable Development Goals will not be possible without increased financing for global health research and development (R&D). Yet financing for neglected disease product development fell from 2009-2015, with the exception of a one-time injection of Ebola funding. An important cause of the global health R&D funding gap is lack of coordination across R&D initiatives. In particular, existing initiatives lack robust priority-setting processes and transparency about investment decisions. Low-income countries (LICs) and middle-income countries (MICs) are also often excluded from global investment initiatives and priority-setting discussions, leading to limited investment by these countries. An overarching global health R&D coordination platform is one promising response to these challenges. This analysis examines the essential functions such a platform must play, how it should be structured to maximise effectiveness and investment strategies for diversifying potential investors, with an emphasis on building LIC and MIC engagement. Our analysis suggests that a coordination platform should have four key functions: building consensus on R&D priorities; facilitating information sharing about past and future investments; building in accountability mechanisms to track R&D spending against investment targets and curating a portfolio of prioritised projects alongside mechanisms to link funders to these projects. Several design features are likely to increase the platform’s success: public ownership and management; separation of coordination and financing functions; inclusion of multiple diseases; coordination across global and national efforts; development of an international R&D ‘roadmap’ and a strategy for the financial sustainability of the platform’s secretariat.
The costs of diabetes treatment in low- and middle-income countries: a systematic review
Authors: Moucheraud Corrina , Lenz Cosima , Latkovic Michaella , Wirtz Veronika J
Published: February 2019

Introduction

The rising burden of diabetes in low- and middle-income countries may cause financial strain on individuals and health systems. This paper presents a systematic review of direct medical costs for diabetes (types 1 and 2) in low- and middle-income countries.

Methods

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, databases (PubMed, International Bibliography of Social Science, EconLit) were searched for publications reporting direct medical costs of type 1 and 2 diabetes. Data were extracted from all peer-reviewed papers meeting inclusion criteria, and were standardised into per-patient-visit, per-patient-year and/or per-complication-case costs (2016 US$).

Results

The search yielded 584 abstracts, and 52 publications were included in the analysis. Most articles were from Asia and Latin America, and most focused on type 2 diabetes. Per-visit outpatient costs ranged from under $5 to over $40 (median: $7); annual inpatient costs ranged from approximately $10 to over $1000 (median: $290); annual laboratory costs ranged from under $5 to over $100 (median: $25); and annual medication costs ranged from $15 to over $500 (median: $177), with particularly wide variation found for insulin. Care for complications was generally high-cost, but varied widely across countries and complication types.

Conclusion

This review identified substantial variation in diabetes treatment costs; some heterogeneity could be mitigated through improved methods for collecting, analysing and reporting data. Diabetes is a costly disease to manage in low- and middle-income countriesand should be a priority for the global health community seeking to achieve Universal Health Coverage.
Integrating community health workers into the formal health system to improve performance: a qualitative study on the role of on-site supervision in the South African programme
Authors: Tseng Yu-hwei , Griffiths Frances , de Kadt Julia , Nxumalo Nonhlanhla , Rwafa Teurai , Malatji Hlologelo , Goudge Jane
Published: February 2019

Objectives

To explore the role of on-site supervision in community health worker (CHW) programmes and CHW integration into the health system. We compared the functioning of CHW teams reporting to a clinic-based nurse with teams supervised by a community-based nurse. We also consider whether a junior nurse can provide adequate supervision, given the shortage of senior nurses.

Design

A case study approach to study six CHW teams with different configurations of supervision and location. We used a range of qualitative methods: observation of CHW and their supervisors (126 days), focus group discussions (12) and interviews (117).

Setting

South Africa where a national CHW programme is being implemented with on-site supervision.

Participants

CHWs, their supervisors, clinic managers and staff, district managers, key informants from the community and CHW clients.

Results

Effective supervisors supported CHWs through household visits, on-the-job training, debriefing, reviewing CHWs’ daily logs and assistance with compiling reports. CHWs led by senior nurses were motivated and performed a greater range of tasks; junior nurses in these teams could better fulfil their role. Clinic-based teams with senior supervisors were better integrated and more able to ensure continuity of care. In contrast, teams with only junior supervisors, or based in the community, had less engagement with clinic staff, and were less able to ensure necessary care for patients, resulting in lower levels of trust from clients.

Conclusion

Senior supervisors raised CHW skills, and successfully negotiated a place for CHWs in the health system. Collaboration with clinic staff reduced CHWs’ marginalisation and increased motivation. Despite being clinic-based, teams without senior supervisors had lower skill levels and were less integrated into the health system.