bluuebunny/crossref_metadata_2025 huggingface dataset:
Assuming one dose per day yields a similar estimate of medication adherence in patients with stroke: An exploratory analysis using linked registry data
Authors: Ung David , Dalli Lachlan L. , Lopez Derrick , Sanfilippo Frank M. , Kim Joosup , Andrew Nadine E. , Thrift Amanda G. , Cadilhac Dominique A. , Anderson Craig S. , Kilkenny Monique F.
Published: July 2020

Purpose

Prescribed daily dose (PDD), the number of doses prescribed to be taken per day, is used to calculate medication adherence using pharmacy claims data. PDD can be substituted by (i) one dose per day (1DD), (ii) an estimate based on the 75th percentile of days taken by patients to refill a script (PDD75) or (iii) the World Health Organization's defined daily dose (DDD). We aimed to compare these approaches for estimating the duration covered by medications and whether this affects calculated 1‐year adherence to antihypertensive medications post‐stroke.

Methods

We conducted a retrospective review of prospective cohort data from the ongoing Australian Stroke Clinical Registry linked with pharmacy claims data. Adherence was calculated as the proportion of days covered (PDC) for 1DD, PDD75 and DDD. Differences were assessed using Wilcoxon rank‐sum tests.

Results

Among 12 628 eligible patients with stroke, 10 057 (80%) were prescribed antihypertensive medications in the year after hospital discharge (78.2% aged ≥65 years, 45.2% female). Overall, the 75th percentile of patient time until next medication refill was 39 days. The greatest variations in dose regimens, estimated using person‐ and dose‐level refill times, were for beta blockers (11.4% taking two tablets/day). There were comparable levels of adherence between 1DD and the PDD75 (median PDC 91.0% vs 91.2%; P = 0.70), but adherence was slightly higher using DDD (92.3%; both P < 0.001). However, this would represent a clinically nonsignificant difference.

Conclusion

Adherence to antihypertensive medications shows similar estimates across standard measures of dosage in patients during the first year after an acute stroke.
Predicting regional hotspots of phylogenetic diversity across multiple species groups
Authors: Franke Sophia , Brandl Roland , Heibl Christoph , Mattivi Angelina , Müller Jörg , Pinkert Stefan , Thorn Simon
Published: July 2020

Aim

The protection of phylogenetic diversity has become a priority in conservation biology, but its achievement requires a detailed understanding of (a) hotspots of phylogenetic diversity on a management‐relevant scale and (b) the land use and climate factors determining local phylogenetic diversity. In this study, we identified spatial patterns of taxonomic and phylogenetic diversity and their environmental drivers.

Location

Bavaria, Germany.

Methods

To map the cross‐taxon phylogenetic diversity, we combined species distribution data obtained from country‐wide monitoring programmes and phylogenetic trees of birds, bats, dragonflies, grasshoppers and butterflies and calculated the phylogenetic diversity standardized by species richness. Generalized additive models were used to test the effects of land use and climate on phylogenetic diversity. We identified hotspots of phylogenetic diversity and assessed the extent to which established protected areas in Bavaria cover these hotspots.

Results

High coverage by urban areas, arable land and water bodies negatively affected the phylogenetic diversity of most species groups. The phylogenetic diversity of birds increased with increasing meadow cover. Climate did not influence the phylogenetic diversity of the studied groups. We identified 10 regional hotspots that contained the highest standardized phylogenetic diversity across the examined species groups. There was a strong mismatch between hotspots of phylogenetic diversity among the species groups. Protected areas (national parks, natural reserves and areas of the Flora‐Fauna‐Habitat Directive) overlapped only to ~9.6% with these hotspots of standardized phylogenetic diversity.

Main conclusions

Cross‐taxon approaches are required to identify hotspots of phylogenetic diversity at a management‐relevant scale. At regional scales, land use was more important than climate in determining phylogenetic diversity. Our study highlights the importance of involving land users into strategies for protecting phylogenetic diversity.
A moral vision for the presidential election
Authors: Stone Ronald H.
Published: July 2020

The essay celebrates the “Mirror of Princes” writing of political philosophy that appeared in Augustine's City of God, the history of Western political philosophy and in the political thought of ancient China. It upholds the tradition of the good ruler while noting the ambiguities of morality in politics. It notes the political power of the American president in the current global context. While emphasizing the need for the good ruler to love the people he serves it focuses on the need for reform in health care, education, and race relations.
Astrocytic‐neuronal crosstalk gets jammed: Alternative perspectives on the onset of neuropsychiatric disorders
Authors: Roman Celia , Egert Luisa , Di Benedetto Barbara
Published: July 2020

Investigating interactions of glia cells and synapses during development and in adulthood is the focus of several research programmes which aim at understanding the neurobiology of brain physiological and pathological processes. Both glia‐specific released and membrane‐bound proteins play essential roles in the development, maintenance and functionality of synaptic connections. Alterations in synaptic contacts in specific brain areas are hallmarks of several brain diseases, such as major depressive disorder, autism spectrum disorder and schizophrenia. Thus, a deeper knowledge about putative astrocyte dysfunctions which might affect the synaptic compartment is warranted to improve treatment options. Here, we present the latest advances about the role of glia cells in orchestrating the arrangement of synapses and neuronal networks in physiological and pathological states. We specifically focus on the role of astrocytes in the phagocytosis of neuronal synapses as a novel mechanism which drives the refinement of neuronal circuits and might be affected in pathological conditions. Finally, we propose this astrocyte‐dependent mechanism as a putative alternative target of pharmacological interventions for the treatment of brain disorders.
Mechanistic characterization of UDP‐glucuronic acid 4‐epimerase
Authors: Borg Annika J. E. , Dennig Alexander , Weber Hansjörg , Nidetzky Bernd
Published: July 2020

UDP‐glucuronic acid (UDP‐GlcA) is a central precursor in sugar nucleotide biosynthesis and common substrate for C4‐epimerases and decarboxylases releasing UDP‐galacturonic acid (UDP‐GalA) and UDP‐pentose products, respectively. Despite the different reactions catalyzed, the enzymes are believed to share mechanistic analogy rooted in their joint membership to the short‐chain dehydrogenase/reductase (SDR) protein superfamily: Oxidation at the substrate C4 by enzyme‐bound NAD+ initiates the catalytic pathway. Here, we present mechanistic characterization of the C4‐epimerization of UDP‐GlcA, which in comparison with the corresponding decarboxylation has been largely unexplored. The UDP‐GlcA 4‐epimerase from Bacillus cereus functions as a homodimer and contains one NAD+/subunit (kcat = 0.25 ± 0.01 s−1). The epimerization of UDP‐GlcA proceeds via hydride transfer from and to the substrate’s C4 while retaining the enzyme‐bound cofactor in its oxidized form (≥ 97%) at steady state and without trace of decarboxylation. The kcat for UDP‐GlcA conversion shows a kinetic isotope effect of 2.0 (±0.1) derived from substrate deuteration at C4. The proposed enzymatic mechanism involves a transient UDP‐4‐keto‐hexose‐uronic acid intermediate whose formation is rate‐limiting overall, and is governed by a conformational step before hydride abstraction from UDP‐GlcA. Precise positioning of the substrate in a kinetically slow binding step may be important for the epimerase to establish stereo‐electronic constraints in which decarboxylation of the labile β‐keto acid species is prevented effectively. Mutagenesis and pH studies implicate the conserved Tyr149 as the catalytic base for substrate oxidation and show its involvement in the substrate positioning step. Collectively, this study suggests that based on overall mechanistic analogy, stereo‐electronic control may be a distinguishing feature of catalysis by SDR‐type epimerases and decarboxylases active on UDP‐GlcA.
Fatigue properties of combined friction stir and adhesively bonded AA6082‐T6 overlap joints
Authors: Maciel Ricardo , Bento Tiago , Braga Daniel F.O. , da Silva Lucas F.M. , Moreira Pedro M.G.P. , Infante Virgínia
Published: July 2020

Even though friction stir welding (FSW) has been shown to produce high performing butt joints, stress concentration at the weld edges in overlap FSW significantly reduces the performance of these joints. By combining FSW and adhesive bonding into a friction stir (FS) weld bonding, joint mechanical performance is greatly improved. Quasistatic and fatigue strength of the proposed FS weld‐bonding joints was assessed and benchmarked against overlap FSW and adhesive bonding. The characterization of the structural adhesive is also presented, including differential scanning calorimetry (DSC) and thermogravimetric analysis (TGA), as well as mechanical characterization with curing temperature. A small process parameter study was made to select proper FSW parameters for AA6082‐T6 overlap FSW and FS weld‐bonded joints. FS weld bonding achieved a significant increase in quasistatic and fatigue strength when compared with overlap FSW, with 79.9% of the fatigue strength of adhesive‐bonded joints at 106 cycles, whereas FSW had 41.6%.
Multiple lines of evidence reveal complex rainbow trout responses to stream habitat enhancements
Authors: Collins Scott F. , Baxter Colden V.
Published: July 2020

Habitat enhancements seek to ameliorate the detrimental effects of environmental degradation and take many forms, but usually entail structural (e.g. logs, cribs, reefs) or biogenic (e.g. carrion additions, vegetation plantings, fish stocking) augmentations with the intent of increasing fish annual production (i.e. accrual of new fish biomass through time). Whether efforts increase fish production or simply attract fish has long been subject to debate.

Streams of the Pacific Northwest are commonly targeted for habitat enhancements to mitigate for the detrimental effects of dams and other forms of habitat degradation on Pacific salmon. Nutrient mitigation (i.e. the practice of artificially fertilising freshwaters) is a form of biogenic habitat enhancement that attempts to mimic the enrichment effects of a natural Pacific salmon spawning event. This approach assumes nutrient augmentations alleviate nutrient limitation of primary producers and/or food limitation of primary and secondary consumers, culminating in increased fish production.

We conducted a multi‐year manipulative experiment and tracked responses of interior rainbow trout (Oncorhynchus mykiss) to annual additions of Pacific salmon carcasses as part of an effort to enhance the productivity of salmonid populations in streams where salmon runs have been lost. We employed an integrated approach to partition the mechanisms driving numerical responses of trout populations across timescales, to assess population turnover, and to track responses to habitat enhancements across individual to population level metrics.

Short‐term numerical increases by trout were shaped by immigration and subsequently via retention of individuals within treatment reaches. As trout moved into treated stream reaches, individuals foraged, grew, and subsequently moved to other locations such that short‐term increases in fish numbers did not persist from year to year. All told, additions of salmon carcasses alleviated apparent food limitation and thereby increased secondary production of rainbow trout. However, at an annual time scale, increased production manifested as larger individual fish, not more fish within treated reaches. Fish movements and high population turnover within treated stream reaches apparently led to the subsequent dispersal of increased fish production.

We found multiple lines of evidence that indicated that annual additions of salmon carcasses aggregated rainbow trout and enhanced their annual production. Through this replicated management experiment, we documented dynamic individual and population level responses to a form of stream habitat manipulation across weekly and annual timescales.
Genomic‐wide sequencing reveals remarkable connection between widely disjunct populations of the internationally threatened bog buck moth
Authors: Dupuis Julian R. , Geib Scott M. , Schmidt Christian , Rubinoff Daniel
Published: July 2020

Rare, threatened species often suffer from habitat fragmentation, which leads to smaller populations vulnerable to negative impacts including inbreeding depression and collapse of metapopulation dynamics. Therefore, understanding the population structure and relationships of each population of a threatened species is critical for prioritising habitat conservation and reintroduction efforts.

The bog buck moth (Hemileuca sp.) is a lineage previously recognised as several populations of conservation concern in New York state and the Province of Ontario. Recent genomic research discovered that bog buck moth from New York was a highly divergent, distinct entity compared to the group's diversity across North America.

Nevertheless, the Canadian populations have not been evaluated and are geographically disjunct from the nearest New York population by ~170 km. As New York populations are in sharp decline, confirming that the relatively robust Ontario populations are conspecific, and understanding their relationship to New York populations, is a conservation priority.

We integrated genomic data from an Ontario population into a broader dataset containing populations from across the range of the species group. Bog buck moth populations from Ontario and New York were identified as reciprocally monophyletic conspecifics, and other ecologically similar populations of Hemileuca from the western Great Lakes region are confirmed to be a different, widespread species.

These results corroborate the restricted range of the bog buck moth and suggest that Ontario and New York populations have not been in recent contact. Therefore, reintroduction efforts must be developed in the context of this population structure.
Changes in facial signs due to age and their respective weights on the perception of age, on a tired‐look or a healthy glow among differently aged Chinese men
Authors: Flament F. , Abric A. , Amar D. , Ye C. , Caron J. , Negre C.
Published: July 2020

Objective

To determine the respective weights of certain facial signs on the assessment of perceived age, tired‐look and healthy glow on Chinese men of different ages.

Material and methods

Photographs were taken of the faces of 420 Chinese men of different ages, under standardized conditions. These photographs allowed to focus and define 15 facial signs, which were then graded by 15 experts and dermatologists, using standardized scales provided by a reference Skin Aging Atlas. The facial signs were dispatched into 5 clusters, namely wrinkles/texture, ptosis/sagging, pigmentation disorders, vascular disorders and cheek skin pores. A naïve panel, composed of 80 Chinese women, of similar age range were asked, when viewing full‐face photographs, to: (i) attribute on a 0–10 scale their perception of both the tired‐look and healthy glow aspects and (ii) estimate the age of the subject.

Results

With the exception of vascular disorders, the severity of all 4 clusters increased with age, although at different rates. The ptosis/sagging or pigmentation disorders showed a rather regular progression. Although perceived ages and real ages were found to be closely correlated, the vast majority of subjects were judged older by 2–10 years. The changes in facial signs (and their related clusters) were significantly correlated with perceived age, with the exceptions of skin spot density and cheek skin pores. Although the aspects of tired‐look and healthy glow were logically found to be anti‐correlated, tired‐look was more statistically associated with perceived age for the five clusters. Signs of eye contour appear to be closely correlated with the perception of a tired‐look.

Conclusion

Within facial clinical clusters, wrinkles/texture and ptosis/sagging are major factors in the assessment of perceived age in Chinese men. Tired‐look appears to be strongly associated with perceived age.
Comparative secretome profile analysis of cultured immortalized human endometrial stromal cells supplemented with implanted versus nonimplanted blastocyst‐conditioned medium: A preliminary analysis
Authors: Xiong Feng , Yao ZhiHong , Chen PeiLin , Sun Qing , Zhong HuiXian , Wan CaiYun , Zeng Yong
Published: July 2020

Aim

Human endometrial stromal cells (HESCs) were previously shown to be capable of discriminating embryos with different qualities. Here we aimed to compare the specific response of the HESC secretome to implanted blastocyst‐conditioned medium (BCM) versus nonimplanted medium and identify cytokine candidates useful for the assessment of blastocyst implantation.

Methods

Cleavage embryos were individually cultured in one microdrop of medium for blastocyst formation. The BCM was collected after fresh blastocyst transfer on day 5 and used to supplement HESC culture medium. A high‐throughput antibody array covering 440 cytokines was used to detect the secretory proteins of HESCs supplemented with implanted or nonimplanted BCM.

Results

A total of 22 differentially expressed proteins were found out of 440 cytokines in the supernatant of HESCs supplemented with BCM from the implanted group compared to the nonimplanted group, including seven upregulated and 15 downregulated proteins. Gene Ontology enrichment analysis showed that the differentially expressed proteins were mainly involved in cell chemotaxis and motility, and ERK1/2 cascade regulation. Kyoto Encyclopedia of Genes and Genomes analysis suggested that the mitogen‐activated protein kinase and phosphatidylinositol 3 kinase/Akt pathways were mainly involved.

Conclusion

HESCs specifically responded to BCM from different quality blastocysts, a finding that can be used to develop a novel approach for blastocyst quality assessment.
Is there a relationship between basic birth beliefs and pregnancy‐related anxiety in Turkey
Authors: Durgun Ozan Yeter , Alp Yilmaz Figen
Published: July 2020

Aim

It is important to investigate the relationship between the beliefs about birth as a natural or medical process and the pregnancy‐related anxiety that has a powerful impact on the negative outcomes of labor. This study was aimed at investigating the relationship between basic birth beliefs and pregnancy‐related anxiety in Turkey.

Methods

This descriptive, cross‐sectional and correlational study was conducted in a University hospital located in eastern Turkey.

The study sample included 473 primiparae having completed 14 weeks of pregnancy. The Birth Belief Scale and Pregnancy‐Related Anxiety Questionnaire/PRAQ‐R2 were used to collect the data.

Results

A relationship was found between birth beliefs and pregnancy‐related anxiety. Strong beliefs about birth as a medical process or weak beliefs about birth as a natural process were found to be related with fear of giving birth and worries about bearing a handicapped child.

Conclusion

A relationship was detected between beliefs of pregnant women about birth as a medical and natural process and fear of giving birth, worries about bearing a handicapped child., concern about own appearance. It is highly important to detect the birth beliefs in order to help women have a healthy pregnancy period and to decrease their anxiety levels. Pregnancy‐related anxieties of women must be detected, and their birth beliefs that result in anxiety must not be overlooked during the provision of prenatal healthcare services.
The Impact of School Choice on Public School Budgets: Evidence From Open Enrollment in New York City
Authors: Rothbart Michah W.
Published: July 2020

This paper examines budgetary responses of public schools to competition from school choice, exploiting a discrete change in the choice set available to New York City high school students in 2003–2004. Schools facing increased competition (zoned, unscreened, and those with few applicants) increase per‐pupil expenditures on noninstructional functions, reducing resources for instruction. Thus, schools may face important tradeoffs when competing for applicants, including between quantity and academic quality of applicants and between incentives to reach capacity and to improve academic outcomes. While advocates claim that school choice improves academic achievement, these results may help explain mixed findings in the previous literature.
Pain and disability in women with patellofemoral pain relate to kinesiophobia, but not to patellofemoral joint loading variables
Authors: De Oliveira Silva Danilo , Willy Richard W. , Barton Christian J. , Christensen Kelly , Pazzinatto Marcella F. , Azevedo Fábio M.
Published: July 2020

Background

Altered patellofemoral joint (PFJ) loading and elevated kinesiophobia are commonly reported in people with patellofemoral pain (PFP). However, the relative relationship of these physical‐psychological variables with pain and disability in people with PFP is unknown.

Aim

To explore the relationship of PFJ loading during stair ascent and kinesiophobia, with self‐reported pain and disability in women with PFP.

Methods

Fifty‐seven women with PFP completed the Tampa Scale for Kinesiophobia, a Visual Analog Scale (0‐100 mm) for pain during stair ascent, and the Anterior Knee Pain Scale (disability). Stair ascent mechanics were assessed via three‐dimensional motion analysis while participants ascended an instrumented seven‐step staircase. Peak PFJ contact force and stress, and PFJ contact force and stress loading rates were estimated using a musculoskeletal model. The relationships of PFJ kinetics during stair ascent and kinesiophobia, with the Anterior Knee Pain Scale (disability) and pain during stair ascent, were evaluated with Spearman rank correlation. Variables (kinetics and kinesiophobia) significantly correlating with the dependent variables (pain and disability) were inserted in linear regression models.

Results

Kinesiophobia was moderately associated with self‐reported pain (rho = 0.37) and disability (rho = −0.58) in women with PFP. No PFJ loading variables were found to be associated with self‐reported pain or disability (P > .05). Kinesiophobia explained 14% of the variance of participants’ pain while ascending stairs and 33% of the variance of participant's self‐reported disability.

Conclusion

Addressing kinesiophobia during treatment of women with PFP may be important to reduce self‐reported pain and disability.
Sexuality and digital Space
Authors: Adams‐Santos Dominique
Published: July 2020

Since the Internet's inception, sociologists have sought to understand the role digital spaces play in mediating communication, interaction, and its impact on the broader social world. Sociological literature at the intersection of sexuality and digital space presents a key area of inquiry, charting the generative, and sometimes utopian, aspects of sexuality's insertion into the virtual sphere, as well as the problems and drawbacks of this relationship. By drawing on select empirical studies, this article charts three dominant research strands on sexuality and digital space: (a) the influence of digital platforms in sexual selfhood projects; (b) macro‐level trends and micro‐level practices of desire, attraction, and dating online; and (c) the role of digital platforms in sustaining sexual subcultures. I propose additional approaches and lines of inquiry to further develop research in these areas.
Characterization of the novel HLA‐C*07:862 allele in a North Indian hematopoietic stem cell donor
Authors: Sharma Akanksha , Gautam Shashi Kapoor , Abid Mohd , Alwadhi Ajeet , Kanga Uma
Published: July 2020

One nucleotide change (G > C) in the exon 4 of HLA‐C*07:02:01:01 results in the novel allele, HLA‐C*07:862.
Individualised risk prediction model for new-onset, progression and regression of chronic kidney disease in a retrospective cohort of patients with type 2 diabetes under primary care in Hong Kong
Authors: Yang Lin , Chu Tsun Kit , Lian Jinxiao , Lo Cheuk Wai , Zhao Shi , He Daihai , Qin Jing , Liang Jun
Published: July 2020

Objectives

This study is aimed to develop and validate a prediction model for multistate transitions across different stages of chronic kidney disease (CKD) in patients with type 2 diabetes mellitus under primary care.

Setting

We retrieved the anonymised electronic health records of a population-based retrospective cohort in Hong Kong.

Participants

A total of 26 197 patients were included in the analysis.

Primary and secondary outcome measures

The new-onset, progression and regression of CKD were defined by the transitions of four stages that were classified by combining glomerular filtration rate and urine albumin-to-creatinine ratio. We applied a multiscale multistate Poisson regression model to estimate the rates of the stage transitions by integrating the baseline demographic characteristics, routine laboratory test results and clinical data from electronic health records.

Results

During the mean follow-up time of 1.8 years, there were 2632 patients newly diagnosed with CKD, 1746 progressed to the next stage and 1971 regressed into an earlier stage. The models achieved the best performance in predicting the new-onset and progression with the predictors of sex, age, body mass index, systolic blood pressure, diastolic blood pressure, serum creatinine, haemoglobin A1c, total cholesterol, low-density lipoprotein, high-density lipoprotein, triglycerides and drug prescriptions.

Conclusions

This study demonstrated that individual risks of new-onset and progression of CKD can be predicted from the routine physical and laboratory test results. The individualised prediction curves developed from this study could potentially be applied to routine clinical practices, to facilitate clinical decision making, risk communications with patients and early interventions.
Sex differences in the adherence of antihypertensive drugs: a systematic review with meta-analyses
Authors: Biffi Annalisa , Rea Federico , Iannaccone Teresa , Filippelli Amelia , Mancia Giuseppe , Corrao Giovanni
Published: July 2020

Objectives

Poor worldwide rate of blood pressure control is largely due to poor adherence to antihypertensive (AHT) drug treatment. The question of whether sex affects adherence has long been debated but conflicting findings have been reported on this issue. Our objective was to evaluate sex differences in the adherence to AHT therapy.

Research design and methods

Studies were identified through a systematic search of PubMed, CINAHL, PsycINFO, Web of Science and Google Scholar (through January 2020) and manual handsearching of relevant articles. Observational studies reporting adherence to AHT drugs measured by self-report or pharmacy refill prescription-based methods among men and women were included. Summarised estimates of ORs with 95% CIs were calculated using random-effects model and meta-regression models.

Results

From 12 849 potentially relevant publications, 82 studies (15 517 457 men and 18 537 599 women) were included. No significant between-sex differences in adherence to AHT were observed, whether all study-specific estimates were summarised (ORs 1.04, 95% CI 1.00 to 1.09, p=0.07), nor estimates were pooled according to the method for measuring adherence. Among patients aged 65 years or older, lower self-reported adherence was observed in women (ORs 0.84, 95% CI 0.72 to 0.97, p=0.02), while the main result remained unchanged according to other subgroup analyses.

Conclusions

Definitive evidence of sex differences in adherence to AHT therapy cannot be drawn. Our little knowledge about factors affecting adherence, in particular of sex effect among elderly, urgently requires high-quality studies investigating these issues.
Dual burden of underweight and overweight/obesity among adults in Botswana: prevalence, trends and sociodemographic correlates: a cross-sectional survey
Authors: Letamo Gobopamang
Published: July 2020

Objective

To estimate the prevalence and trends in underweight, overweight/obesity and identify their sociodemographic correlates among adults in Botswana from 2007 to 2017.

Design

The study analysed cross-sectional and nationally representative data from 2007 to 2014 Botswana STEPS Surveys and the 2017 Botswana Demographic Survey.

Setting

Botswana.

Participants

Botswana adults aged 25–64 years (n=4003 in 2007, n=2983 in 2014 and n=11 550 in 2017).

Primary outcome

Underweight and overweight/obesity.

Results

The prevalence of underweight decreased from 18.1% (95% CI 12.0% to 26.3%) in 2007 to 11.6% (95% CI 9.5% to 13.9%) in 2014 and further dropped to 8.1% (95% CI 7.5% to 8.8%) in 2017. The prevalence of overweight/obesity increased slightly from 37.4% (95% CI 34.3% to 40.7%) in 2007 to 38.6% (95% CI 35.9% to 41.3%) in 2014 to 47.3% (95% CI 46.1% to 48.4%) in 2017. Underweight was more prevalent among males than females while overweight and obesity were more prevalent among females than males. The key risk factor for underweight was being male (adjusted OR (AOR) 2.21: 95% CI 1.80 to 2.72 in 2007, AOR 1.54: 95% CI 1.06 to 2.22 in 2014 and AOR 1.51: 95% CI 1.45 to 1.58 in 2017). For overweight/obesity, the main risk factors were being female (male AOR 0.23: 95% CI 0.15 to 0.35 in 2007, AOR 0.32: 95% CI 0.25 to 0.42 in 2014 and AOR 0.30: 95% CI 0.29 to 0.31 in 2017), being old (AOR 2.18: 95% CI 1.58 to 3.01 in 2007, AOR 2.37: 95% CI 1.71 to 3.29 in 2014) and AOR 2.10: 95% CI 1.94 to 2.27 in 2017 among those aged 55–64 years) and not working (AOR 1.70: 95% CI 1.20 to 2.42 in 2007, AOR 2.05: 95% CI 1.55 to 2.69 in 2014 and AOR 1.34: 95% CI 1.27 to 1.40 in 2017).

Conclusions

The findings presented in this study indicate coexistence of the double burden of underweight and overweight/obesity among adults aged 25–64 years in Botswana. Although underweight prevalence is on the decline, overweight/obesity is increasing over time. The problem of underweight and overweight/obesity needs immediate and effective interventions.
TRIBOLOGICAL AND CORROSION BEHAVIOR OF SiC/TaXC BILAYER COATINGS PREPARED ON STAINLESS STEEL SURFACE BY DOUBLE GLOW PLASMA SURFACE ALLOYING TECHNIQUE
Authors: YU SHENGWANG , WANG YUEYUE , GAO JIE , HEI HONGJUN , WANG RONG , HE ZHIYONG
Published: July 2020

In this work, SiC/TaxC bilayer coatings were prepared on stainless steel surface by double glow plasma surface alloying technique to improve the wear and corrosion resistance of the substrate. The effect of reaction temperature during the growth of SiC on the microstructure and property of the coating was investigated. The results showed that the surface topography of the coating could be regulated by the reaction temperature during the growth of SiC. Interactional flower-shaped rings, reticulate patterns, nanoparticles and microparticles were observed on the samples prepared at 750∘C, 800∘C, 850∘C and 900∘C, respectively. Tribological performance tests showed that the friction coefficient and specific wear rate of all the coated specimens were significantly decreased than the uncoated ones, indicating that the wear resistance of stainless steel was improved by the SiC/TaxC coating. The construction of the bilayer coating enhanced the corrosion resistance of stainless steel in terms of electrochemical tests. With an increase of the reaction temperature, the wear and corrosion resistance increased at first and then gradually decreased. SiC/TaxC coating prepared at 800∘C exhibited the best overall performance.
The Great Internet TCP Congestion Control Census
Authors: Mishra Ayush , Sun Xiangpeng , Jain Atishya , Pande Sameer , Joshi Raj , Leong Ben
Published: July 2020

In 2016, Google proposed and deployed a new TCP variant called BBR. BBR represents a major departure from traditional congestion control as it uses estimates of bandwidth and round-trip delays to regulate its sending rate. BBR has since been introduced in the upstream Linux kernel and deployed by Google across its data centers. Since the last major study to identify TCP congestion control variants on the Internet was done before BBR, it is timely to conduct a new census to give us a sense of the current distribution of congestion control variants on the Internet. To this end, we designed and implemented Gordon, a tool that allows us to measure the congestion window (cwnd) corresponding to each successive RTT in the TCP connection response of a congestion control algorithm. To compare a measured flow to the known variants, we created a localized bottleneck and introduced a variety of network changes like loss events, changes in bandwidth and delay, while normalizing all measurements by RTT. We built an offline classifier to identify the TCP variant based on the cwnd trace over time.
The exercise pressor response to indoor rock climbing
Authors: Callender Nigel A. , Hart Peter W. , Ramchandani Girish M. , Chaggar Parminder S. , Porter Andrew J. , Billington Charlie P. , Tiller Nicholas B.
Published: July 2020

This case study provides original data on the exercise pressor response to indoor rock climbing and associated training exercises through the use of an indwelling femoral arterial catheter. Our subjects exhibited systolic/diastolic blood pressures that exceeded values often reported during upper-limb resistance exercise. Our data extend the understanding of the cardiovascular stress associated with indoor rock climbing.
Relation of Mitral Annulus and Left Atrial Dysfunction to the Severity of Functional Mitral Regurgitation in Patients with Dilated Cardiomyopathy
Authors: Mihaila Baldea Sorina , Muraru Denisa , Miglioranza Marcelo Haertel , Iliceto Sabino , Vinereanu Dragos , Badano Luigi Paolo
Published: July 2020

Introduction and Objectives. Patients with dilated cardiomyopathy (DCM) and functional mitral regurgitation (FMR) present altered geometry and dynamics of the mitral annulus (MA). We aimed to further assess the relationship between the MA dysfunction, FMR severity, and LA dysfunction in patients with ischemic and nonischemic DCM by using three-dimensional transthoracic echocardiography (3DTTE). Methods. 56 patients (58 ± 17 years, 42 men) with DCM and FMR and 52 controls, prospectively enrolled, underwent 3DTTE dedicated for mitral valve (MV), LA, and left ventricle (LV) quantitative analysis. Results. Patients with FMR vs. controls presented increased MA size and sphericity during the entire systole, whereas MA fractional area change (MAFAC) and MA displacement were decreased (15 ± 5 vs. 28 ± 5%; and 5 ± 3 vs. 10 ± 2 mm, p<0.001). In patients with moderate/severe FMR, MA diameters correlated with PISA radius, EROA, and regurgitant volume (Rvol), as also did the MA area (with PISA radius, EROA, and Rvol: r = 0.48, r = 0.58, and r = 0.47, p<0.05). MAFAC correlated inversely with EROA and Rvol (r = −0.32 and r = −0.35, p<0.05), with both active and total LA emptying fractions and with LV ejection fraction as well. In a stepwise multivariate regression model, decreased MAFAC and increased LA volume independently predicted patients with severe FMR. Conclusions. Patients with DCM and FMR have MA geometry remodeling and contractile dysfunction, correlated with the severity of FMR. MA contractile dysfunction correlated with both LA and left LV pumps dysfunctions and predicted patients with severe FMR. Our results provide new insights that might help with better selection of patients for MV transcatheter procedures.
Repair of Tendon Disruption Using a Novel Synthetic Fiber Implant in Dogs and Cats: The Surgical Procedure and Three Case Reports
Authors: Buttin Philippe , Goin Bastien , Cachon Thibaut , Viguier Eric
Published: July 2020

Surgical management of tendon rupture is challenging. One concern is to provide adequate tensile strength to prevent distraction during weight-bearing and gap formation following repair, associated with an increased risk of repair failure. Additional challenges may arise from the nature or the chronicity of the lesion. In the event of avulsion, when the tendon is torn off at the bone insertion, its reinsertion on the bone is generally difficult and may even be impossible in the presence of an avulsion fracture, especially when the bone fragment is too small or fragmented. Repair management is also complicated in chronic cases, as degeneration of the tendon may lead to excessive scar tissue formation, tendon retraction, and muscle atrophy, resulting in a large gap and inadequate tissue for reconstruction. The authors describe the surgical procedure for implanting a novel implant, illustrated by three characteristic clinical cases: (1) an acute Achilles tendon avulsion; (2) a chronic patellar tendon rupture; and (3) a chronic avulsion fracture of the triceps tendon. In these three cases, complete recovery of the function was observed at the last clinical evaluation (6 or 8 months), and no complication was noted. A splinted dressing (6 to 8 weeks) was used successfully in two cases. A resin cast (8 weeks) was preferred in case 1, a very active dog. In conclusion, this novel implant represents a simple procedure for the effective repair of chronic tendon rupture, as well as an effective tendon reinsertion on the bone and adequate support for bone tendon healing in the treatment of tendon avulsion, even in cases of fragmented bone fracture. The thinness of the implant facilitates its insertion into the native tendon, while the bone-screw-implant interface provides immediate and lasting mechanical support. This may facilitate the healing process and potentially shorten the period of immobilization.
Effect of Laryngeal Mask Airway Insertion on Intraocular Pressure Response: Systematic Review and Meta-Analysis
Authors: Obsa Mohammed Suleiman , kanche Zewde Zema , Olana Fite Robera , Tura Tilahun Saol , Adema Bulcha Guye , Kinfe Aseb Arba , kercho Melkamu Worku , Paulos chanko Kebreab , Shanka Getahun Molla , Lencha Atkuregn Alemayehu , Asnake Azeze Gedion , Hanfore Lolemo Kelbiso , Adulo Nefsu Awoke , Dessu Blen Kassahun , Wolde Getahun Dendir , Workie Shimelash Bitew
Published: July 2020

Background. Use of laryngeal mask airway as an alternative to the endotracheal tube has attracted the attention of several workers with regard to intraocular pressure changes. However, the previous studies have reported different results while comparing intraocular pressure, following insertion of laryngeal mask airway or the endotracheal tube. Therefore, this systematic review and meta-analysis was aimed to generate the best possible evidence on the intraocular pressure response to endotracheal tube intubation and laryngeal mask airway insertion. Methods. Electronic databases like PubMed, CINAHL, EMBASE, Google Scholar, Cochrane library databases, and Mednar were used. All original peer-reviewed papers which reported the mean and standard deviation of IOP before and after airway instrumentation in both groups were included. Two reviewers independently extracted the data using a standardized data extraction format for eligibility and appraised their quality. Data were analyzed using the STATA version 14 software. The pooled standard mean difference was estimated with the random-effect model. Heterogeneity between studies was assessed by the I2 statistics test. A subgroup analysis was done to assess the source of variation between the studies. Result. A total of 47 research papers were reviewed, of which, six studies were finally included in this systematic review and meta-analysis. The overall pooled standard mean difference of intraocular pressure was 1.30 (95% CI, 0.70, 1.90), showing that LMA insertion is better than ETT intubation to maintain stable intraocular pressure. A random-effect model was employed to estimate the pooled standard mean differences due to severe heterogeneity (I2 79.45,  p ≤ 0.001). Conclusion. The available information suggests that the LMA provides lesser intraocular pressure response in comparison with the conventional tracheal tube.
Risk Analysis and Route Optimization of Dangerous Goods Transportation Based on the Empirical Path Set
Authors: Wang Haixing , Liang Qianqian
Published: July 2020

Based on the empirical path set generated from the track data of dangerous goods vehicles, we present a new method for the risk analysis and path optimization of dangerous goods transportation. First of all, by exploring the travel rules of dangerous goods transport vehicles hidden in the track data, combined with the path set generation algorithm, the method of determining the empirical path set of dangerous goods transport is studied. Secondly, based on the empirical path set, mainly considering the travel rules of vehicles and people on the road, as well as the distribution of population and environment-sensitive areas along the road, a dual objective path selection model is proposed to comprehensively measure the risk and cost of road transportation under time-varying conditions. On this basis, given the principle of avoiding high-risk transportation paths, a comprehensive method of integrating multiple algorithms is proposed to solve the model. Finally, taking a road network as an example, the practicability and effectiveness of the proposed method are verified. The method proposed takes both practicability and safety into account. Based on the experience path set, considering the time-varying characteristics, the decision-maker could choose the appropriate transportation path of dangerous goods according to different preferences, so as to better solve the problem of path selection for dangerous goods transportation.
Pull‐In and Snap‐Through Analysis of Electrically Actuated Viscoelastic Curved Microbeam
Authors: Akrami-Nia Ehsan , Ekhteraei-Toussi Hamid
Published: July 2020

Microbeams are key elements in most of the micro‐electromechanical systems (MEMS). Electromechanical instability of microbeams in turn plays an important role in their applications. The shape and mechanical properties of microbeams dictate their functional characteristics. Focusing on their instability‐based working mechanism, one can appreciate that viscoelasticity of MEMS materials cannot be neglected. Consequently, the analysis of instability in viscoelastic curved microbeams is an essential demand. In this research, assuming a clamped‐clamped initially curved microbeam, the effects of viscoelastic behavior on the snap‐through and pull‐in instabilities are investigated. The standard inelastic linear solid model is used for the simulation of viscoelastic behavior. Integrodifferential governing equation of the curved viscoelastic microbeam is obtained by assuming modified couple stress theory and using Hamilton’s principle. By applying the Galerkin method, the obtained governing equation is discretized, converted to a nonlinear differential equation, and solved by MATLAB software. Through a quasi‐static analysis, the voltage and location of snap‐through and pull‐in instabilities are identified. The effects of different viscoelastic parameters including the creep moduli and relaxation coefficient upon the snap‐through and pull‐in instabilities are investigated. The effects of different short‐ and long‐term creeping characteristics of viscoelastic microbeam are studied and discussed in detail.
Effects of Vitamin D Supplementation on General and Central Obesity: Results from 20 Randomized Controlled Trials Involving Apparently Healthy Populations
Authors: Duan Leizhen , Han Ling , Liu Qin , Zhao Yili , Wang Lei , Wang Yan
Published: July 2020

Background: The obesity pandemic has been paralleled by a high prevalence of vitamin D deficiency (VDD). There is growing epidemiological evidence linking low vitamin D status with obesity events. In addition, observational studies also show that obesity may increase the risk of VDD. However, there is insufficient knowledge to understand whether there is a causality between the two. Moreover, the impact of vitamin D supplementation on obesity indices has shown inconsistent outcomes. Objective: This meta-analysis aimed to assess whether vitamin D supplementation modified general and central obesity indices in apparently healthy populations. Methods: A systematic retrieval of relevant randomized controlled trials (RCTs) was undertaken using Pubmed, Embase, Web of Knowledge and Chinese National Knowledge Infrastructure databases. The pooled weighted mean difference (WMD) and 95% confidence intervals (CI) were used to assess the changes in body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and 25-hydroxyvitamin D (25[OH]D) from baseline. Results: Twenty RCTs involving 3,153 participants reporting either BMI, WC, WHR or 25(OH)D met the inclusion criteria. When compared with placebo, vitamin D supplementation had no significant decreases in BMI (WMD = –0.09 kg/m2, 95% CI –0.19 to 0.01, p = 0.08), WC (WMD = –0.71 cm, 95% CI –1.58 to 0.16, p = 0.112) or WHR (WMD = 0.00, 95% CI –0.01 to 0.01, p = 0.749). However, in the subgroups of females, Asia region studies and intervention duration ≥6 months, a beneficial and significant reduction in BMI and WC was noted (all p < 0.026). On the other hand, pooled results showed that there was a significant increase in serum 25(OH)D levels (WMD = 13.20 ng/mL, 95% CI 9.83–16.58, p < 0.001) after vitamin D intervention. No publication bias was found in our study. Conclusions: Overall, supplementation with vitamin D produced no significant effect on the BMI, WC or WHR of healthy adults.
An Overview of the DSM-5 Alternative Model of Personality Disorders
Authors: Krueger Robert F. , Hobbs Kelsey A.
Published: July 2020

Authoritative classification systems for psychopathology such as the DSM and ICD are shifting toward more dimensional approaches in the field of personality disorders (PDs). In this paper, we provide a brief overview of the dimensionally oriented DSM-5 alternative model of PDs (AMPD). Since its publication in 2013, the AMPD has inspired a substantial number of studies, underlining its generative influence on the field. Generally speaking, this literature illustrates both the reliability and validity of the constructs delineated in the AMPD. The literature also illustrates empirical challenges to the conceptual clarity of the AMPD, such as evidence of substantial correlations between indices of personality functioning (criterion A in the AMPD) and maladaptive personality traits (criterion B in the AMPD). Key future directions pertain to linking the AMPD literature with applied efforts to improve the lives of persons who suffer from PDs, and surmounting challenges germane to the evolution of the DSM itself.