bluuebunny/crossref_metadata_2025 huggingface dataset:
Adequate access to healthcare and added life expectancy among older adults in China
Authors: Hao Lisha , Xu Xin , Dupre Matthew E. , Guo Aimei , Zhang Xufan , Qiu Li , Zhao Yuan , Gu Danan
Published: April 2020

Background

Adequate access to healthcare is associated with lower risks of mortality at older ages. However, it is largely unknown how many more years of life can be attributed to having adequate access to healthcare compared with having inadequate access to healthcare.

Method

A nationwide longitudinal survey of 27,794 older adults aged 65+ in mainland China from 2002 to 2014 was used for analysis. Multivariate hazard models and life table techniques were used to estimate differences in life expectancy associated with self-reported access to healthcare (adequate vs. inadequate). The findings were assessed after adjusting for a wide range of demographic factors, socioeconomic status, family/social support, health practices, and health conditions.

Results

At age 65, adequate access to healthcare increased life expectancy by approximately 2.0–2.5 years in men and women and across urban-rural areas compared with those who reported inadequate access to healthcare. At age 85, the corresponding increase in life expectancy was 1.0–1.2 years. After adjustment for multiple confounding factors, the increase in life expectancy was reduced to approximately 1.1–1.5 years at age 65 and 0.6–0.8 years at age 85. In women, the net increase in life expectancy attributable to adequate access to healthcare was 6 and 8% at ages 65 and 85, respectively. In men, the net increases in life expectancy were generally greater (10 and 14%) and consistent after covariate adjustments. In contrast, the increase in life expectancy was slightly lower in rural areas (2.0 years at age 65 and 1.0 years at age 85) than in urban areas (2.1 years at age 65 and 1.1 years age 85) when no confounding factors were taken into account. However, the increase in life expectancy was greater in rural areas (1.0 years at age 65 and 0.6 years at age 85) than in urban areas (0.4 years at age 65 and 0.2 years at age 85) after accounting for socioeconomic and other factors.

Conclusions

Adequate access to healthcare was associated with longer life expectancy among older adults in China. These findings have important implications for efforts to improve access to healthcare among older populations in China.
Effect of internal limiting membrane peeling on normal retinal function evaluated by microperimetry-3
Authors: Qi Yue , Wang Zengyi , Li Shi-Ming , You Qisheng , Liang Xida , Yu Yanping , Liu Wu
Published: April 2020

Background

To evaluate the effect of internal limiting membrane (ILM) peeling surrounding macular holes (MH) for the function of retina by microperimetry-3(MP-3).

Methods

This is a prospective, cohort study which included patients with MHs who were treated by 23-gauge 3-port pars plana vitrectomy and ILM peeling with air tamponade. Color fundus photography, retinal optical coherence tomography and MP-3 were performed 1 week before, 1 and 4 months after the operation. In MP-3 examination, a customized follow-up pattern with 45 spots in the central 8° visual field was used. The spots corresponding to the retina surrounding macular holes were selected for comparison of pre- and post-operative function.

Results

We incuded 44 eyes of 44 patients with best corrected visual acuity (BCVA) of 1.06 ± 0.40 (logMAR). All eyes achieved an anatomical success at 4 months. BCVA significantly improved at 1 month (0.53 ± 0.30, P < 0.01) and 4 months (0.31 ± 0.24, P < 0.01), respectively. Mean retinal sensitivity (MRS, dB) of the retina surrounding macular hole was 23.46 ± 3.01 dB at baseline, and significantly increased at 1 month (26.25 ± 2.31 dB, u = − 4.88, P < 0.01) and 4 months (27.14 ± 2.45 dB, t = − 6.29, P < 0.01). Patients with increased MRS are significantly younger than those with deceased MRS (59.72 ± 3.22 years vs. 65.60 ± 8.19 years, P < 0.01). After ILM peeling, the increasing extent of MRS was significantly higher in inferior and nasal retina than in superior and temporal retina at 1 and 4 months (P < 0.05).

Conclusion

ILM peeling in normal retina will not decrease the retinal function in a short-term after surgery.
Thailand medical mobile application for patients triage base on criteria based dispatch protocol
Authors: Sutham Krongkarn , Khuwuthyakorn Pattaraporn , Thinnukool Orawit
Published: April 2020

Background

Before patients are admitted into the emergency department, it is important to undertake a pre-hospital process, both in terms of treatment performance and a request for resources from an emergency unit. The existing system to triage patients in Thailand is not functioning to its full capacity in either the primary medical system or pre-hospital treatment with shortcomings in the areas of speed, features, and appropriate systems. There is a high possibility of issuing a false Initial Dispatch Code (IDC), which will cause the over or underutilisation of emergency resources, such as rescue teams, community hospitals and emergency medical volunteers.

Methods

A usability system design, together with a reliability test, was applied to develop an application to optimise the pre-hospital process, specifically to sort patients, using an IDC to improve the request for emergency resources. The triage mobile application was developed on both iOS and Android operating systems to support patient triage based on Criteria Based Dispatch (CBD). The 25 main symptom categories covered by CBD were used to design and develop the application, and 12 emergency medical staff, including doctors and nurses, were asked to test the system in the aspects of triage protocol correction, triage reliability, usability and user satisfaction.

Results

The results of testing the proposed triage application were compared with the time used to triage by experienced staff and it was found that, in non-trauma cases, it was faster and more effective to use the application for emergency operations and to correct the IDC code representation.

Conclusions

The triage application will be utilised to support the pre-hospital process and to classify patients’ conditions before they are admitted to the Emergency Department (ED). The application is suitable for users who are not medical emergency staff. Patients with non-trauma symptoms may be a suitable group to use the application in terms of time used to identify IDC for their own symptoms. The use of the application can be beneficial for those who wish to self-identify their symptoms before requesting medical services.
Valuing the cost of improving Chilean primary vaccination: a cost minimization analysis of a hexavalent vaccine
Authors: Olivera Ignacio , Grau Carlos , Dibarboure Hugo , Torres Juan Pablo , Mieres Gustavo , Lazarov Luis , Alvarez Fabián P. , Yescas Juan Guillermo López
Published: April 2020

Background

The phased withdrawal of oral polio vaccine (OPV) and the introduction of inactivated poliovirus vaccine (IPV) is central to the polio ‘end-game’ strategy.

Methods

We analyzed the cost implications in Chile of a switch from the vaccination scheme consisting of a pentavalent vaccine with whole-cell pertussis component (wP) plus IPV/OPV vaccines to a scheme with a hexavalent vaccine with acellular pertussis component (aP) and IPV (Hexaxim®) from a societal perspective. Cost data were collected from a variety of sources including national estimates and previous vaccine studies. All costs were expressed in 2017 prices (US$ 1.00 = $Ch 666.26).

Results

The overall costs associated with the vaccination scheme (4 doses of pentavalent vaccine plus 1 dose IPV and 3 doses OPV) from a societal perspective was estimated to be US$ 12.70 million, of which US$ 8.84 million were associated with the management of adverse events related to wP. In comparison, the cost associated with the 4-dose scheme with a hexavalent vaccine (based upon the PAHO reference price) was US$ 19.76 million. The cost of switching to the hexavalent vaccine would be an additional US$ 6.45 million. Overall, depending on the scenario, the costs of switching to the hexavalent scheme would range from an additional US$ 2.62 million to US$ 6.45 million compared with the current vaccination scheme.

Conclusions

The switch to the hexavalent vaccine schedule in Chile would lead to additional acquisition costs, which would be partially offset by improved logistics, and a reduction in adverse events associated with the current vaccines.
Clinical and cost-effectiveness of oral sodium bicarbonate therapy for older patients with chronic kidney disease and low-grade acidosis (BiCARB): a pragmatic randomised, double-blind, placebo-controlled trial
Authors:   The BiCARB study group
Published: April 2020

Background

Chronic kidney disease with metabolic acidosis is common in older people, but the effectiveness of oral sodium bicarbonate therapy in this group is unclear. We tested whether oral sodium bicarbonate provides net health benefit for older people with advanced chronic kidney disease and serum bicarbonate concentrations < 22 mmol/L.

Methods

Pragmatic multicentre, parallel group, double-blind, placebo-controlled randomised trial. We recruited adults aged ≥ 60 years with estimated glomerular filtration rate of < 30 mL/min/1.73 m2, not receiving dialysis, with serum bicarbonate concentration < 22 mmol/L, from 27 nephrology and geriatric medicine departments in the UK. Participants received oral sodium bicarbonate (up to 3 g/day) or matching placebo given for up to 2 years, randomised in a 1:1 ratio. The primary outcome was between-group difference in the Short Physical Performance Battery (SPPB) at 12 months, adjusted for baseline values, analysed by intention to treat. Secondary outcomes included generic and disease-specific quality of life (EQ-5D and KDQoL tools), anthropometry, renal function, walk distance, blood pressure, bone and vascular health markers, and incremental cost per quality-adjusted life year gained.

Results

We randomised 300 participants between May 2013 and February 2017, mean age 74 years, 86 (29%) female. At 12 months, 116/152 (76%) participants allocated to bicarbonate and 104/148 (70%) allocated to placebo were assessed; primary outcome data were available for 187 participants. We found no significant treatment effect for the SPPB: bicarbonate arm 8.3 (SD 2.5) points, placebo arm 8.8 (SD 2.2) and adjusted treatment effect − 0.4 (95% CI − 0.9 to 0.1, p = 0.15). We found no significant treatment effect for glomerular filtration rate (0.6 mL/min/1.73 m2, 95% CI − 0.8 to 2.0, p = 0.39). The bicarbonate arm showed higher costs and lower quality of life as measured by the EQ-5D-3L tool over 1 year (£564 [95% CI £88 to £1154]); placebo dominated bicarbonate under all sensitivity analyses. Adverse events were more frequent in those randomised to bicarbonate (457 versus 400).

Conclusions

Oral sodium bicarbonate did not improve physical function or renal function, increased adverse events and is unlikely to be cost-effective for use by the UK NHS for this patient group.

Trial registration

European Clinical Trials Database (2011-005271-16) and ISRCTN09486651; registered 17 February 2012.
Performance, metabolic and hormonal responses of grazing Nellore cows to an energy-protein supplementation during the pre-partum phase
Authors: de Lana Ferreira Matheus Fellipe , Rennó Luciana Navajas , Detmann Edenio , Paulino Mário Fonseca , de Campos Valadares Filho Sebastião , Moreira Samira Silveira , Martins Hudson Caio , de Oliveira Bruno Inácio Correa , Marquez Julia Avansi , de Paula Cidrine Isabela
Published: April 2020

Background

Supplementation programs for prepartum beef cows are usually adopted because the nutritional status of the cows upon calving is a main factor impacting reproductive performance of the next production cycle. This study evaluated the effects of 60-d pre-partum energy-protein supplementation on performance, metabolic and hormonal responses during the peripartum phase of grazing beef cows. Thirty-eight pregnant multiparous Nellore cows were assigned to a completely randomized design with two treatments: control (no supplement) and supplementation (1.5 kg of energy-protein per d with 30% crude protein, dry matter basis).

Results

The supplemented cows had higher ADG pre-partum (P < 0.10), but postpartum ADG did not differ between treatments. Supplementation did not affect BCS and calf BW upon calving, on days 45 and 90, milk yield and composition (P > 0.10). No differences were found for forage intake and neutral detergent fiber digestibility (P > 0.10). The intake and digestibility of CP and OM increased in response to supplementation (P < 0.10). An interaction occurred between supplementation and peripartum days for BUN, βHB, T3 and T4, which had higher concentrations for supplemented cows at pre-partum period (P < 0.10). Concentration of others blood parameters significantly changed along peripartum days (P < 0.10). There was no difference in pregnancy rates and days from calving to conception between treatments (P > 0.10).

Conclusions

Providing an energy and protein supplement to grazing Nellore cows over the last 60 d of gestation improved their pre-partum energy balance. However, no post-partum carryover effects were detected.
Distribution and antimicrobial resistance profiles of bacterial species in stray cats, hospital-admitted cats, and veterinary staff in South Korea
Authors: Jung Woo Kyung , Shin Sook , Park Young Kyung , Lim Suk-Kyung , Moon Dong-Chan , Park Kun Taek , Park Yong Ho
Published: April 2020

Background

Antimicrobial resistance is becoming increasingly important in both human and veterinary medicine. According to the One Health concept, an important step is to monitor the resistance patterns of pathogenic bacteria. In this study, the antimicrobial susceptibility patterns and trends of bacteria isolated from stray cats, hospital-admitted cats, and veterinary staff in South Korea between 2017 and 2018 were investigated.

Results

The minimum inhibitory concentrations of different antibiotics forStaphylococcusspp.,Enterobacteriaceae, andEnterococcusspp. were determined to establish representatives of different antibiotic classes relevant for treatment or surveillance. For Coagulase-positive and Coagulase-negative Staphylococci, resistance to fluoroquinolones was below 13%, but resistance to ampicillin and penicillin was high (20–88%). A total of 9.5, 12.1, and 40.3% of staphylococcal isolates from stray cats, hospital-admitted cats, and veterinary staff, respectively, were confirmed to bemecApositive. ForEnterobacteriaceae, resistance to carbapenems, fluoroquinolones, and 3rd generation cephalosporins was low (0–11.1%). TheEnterococcusspp. isolates showed no resistance to vancomycin. The antimicrobial resistance rates of theStaphylococcusspp. andEnterobacteriaceaeisolates from stray cats were usually lower than those of isolates from hospital-admitted cats and veterinary staff, but theEnterococcusspp. isolates revealed the opposite. Thus, the antimicrobial resistance varied across bacterial species according to the source from which they were isolated.

Conclusions

Resistance to critically important compounds were low. However, the presence of antimicrobial resistance in cat isolates is of both public health and animal health concern.
A comparison of the use of adipose-derived and bone marrow-derived stem cells for peripheral nerve regeneration in vitro and in vivo
Authors: Zhou Li Na , Wang Jia Chuan , Zilundu Prince Last Mudenda , Wang Ya Qiong , Guo Wen Ping , Zhang Sai Xia , Luo Hui , Zhou Jian Hong , Deng Ru Dong , Chen Dong Feng
Published: April 2020

Background

To date, it has repeatedly been demonstrated that infusing bone marrow-derived stem cells (BMSCs) into acellular nerve scaffolds can promote and support axon regeneration through a peripheral nerve defect. However, harvesting BMSCs is an invasive and painful process fraught with a low cellular yield.

Methods

In pursuit of alternative stem cell sources, we isolated stem cells from the inguinal subcutaneous adipose tissue of adult Sprague–Dawley rats (adipose-derived stem cells, ADSCs). We used a co-culture system that allows isolated adult mesenchymal stem cells (MSCs) and Schwann cells (SCs) to grow in the same culture medium but without direct cellular contact. We verified SC phenotype in vitro by cell marker analysis and used red fluorescent protein-tagged ADSCs to detect their fate after being injected into a chemically extracted acellular nerve allograft (CEANA). To compare the regenerative effects of CEANA containing either BMSCs or ADSCs with an autograft and CEANA only on the sciatic nerve defect in vivo, we performed histological and functional assessments up to 16 weeks after grafting.

Results

In vitro, we observed reciprocal beneficial effects of ADSCs and SCs in the ADSC–SC co-culture system. Moreover, ADSCs were able to survive in CEANA for 5 days after in vitro implantation. Sixteen weeks after grafting, all results consistently showed that CEANA infused with BMSCs or ADSCs enhanced injured sciatic nerve repair compared to the acellular CEANA-only treatment. Furthermore, their beneficial effects on sciatic injury regeneration were comparable as histological and functional parameters evaluated showed no statistically significant differences. However, the autograft group was roundly superior to both the BMSC- or ADSC-loaded CEANA groups.

Conclusion

The results of the present study show that ADSCs are a viable alternative stem cell source for treating sciatic nerve injury in lieu of BMSCs.
On substantial fractional difference operator
Authors: Haider Syed Sabyel , ur Rehman Mujeeb
Published: April 2020

In this article, new definitions of fractional substantial sum and difference operators are introduced. Some properties are established and used to generate a fixed point operator for an arbitrary real order substantial system with conditions involving fractional order difference. We inspect solution existence and Ulam–Hyers–Rassias stability. A property missing in the literature for delta Laplace transform, namely delta exponential shift, is established and used for finding delta Laplace transform for the newly introduced substantial fractional sum and difference.
A mixed-dimensional CutFEM methodology for the simulation of fibre-reinforced composites
Authors: Kerfriden P. , Claus S. , Mihai I.
Published: April 2020

We develop a novel unfitted finite element solver for composite materials with quasi-1D fibrous reinforcements. The method belongs to the class of mixed-dimensional non-conforming finite element solvers. The fibres are treated as 1D structural elements that may intersect the mesh of the embedding structure in an arbitrary manner. No meshing of the unidimensional elements is required. Instead, fibre solution fields are described using the trace of the background mesh. A regularised “cut” finite element formulation is carefully designed to ensure that analyses using such non-conforming finite element descriptions are stable. We also design a dedicated primal/dual operator splitting scheme to resolve the coupling between structure and fibrous reinforcements efficiently. The novel computational strategy is applied to the solution of stiff computational models whereby fibrous reinforcements may lose their bond to the embedding material above a certain level of stress. It is shown that the primal-dual 1D/3D CutFEM scheme is convergent and well-behaved in variety of scenarios involving such highly nonlinear structural computations.
Microclimate numerical simulation to obtain the minimum safe distances between a painted wood panel and the inner face of an exterior wall
Authors: Ferrer Santi , Campo-Francés Gema , Ruiz-Recasens Cristina , Oriola-Folch Marta
Published: April 2020

This study provides a detailed understanding of the heat fluxes and temperatures that take place in the channel between the inner face of an exterior wall and the back of a painted wood panel hung on it. This is performed by means of a numerical simulation with a 2 dimensional CFD software. Distributions of temperatures, heat fluxes, and other parameters are quantified for 56 cases where the classical equations—Raithby-Hollands and similar—cannot be applied as these require vertical isothermal plates or isofluxes. Studied scenarios include different panel heights, channel widths, and room heights. Combining these data with outside temperature (− 3 °C) and heating air supply temperature (20 °C), to provide a nearly constant 19.6 °C in the room except in the channel between panel and wall, and with two values of specific humidity in the room, we provide for every studied case, advised distances, for these conditions, between the panel and the wall.
Skeletal stability after 2-jaw surgery via surgery-first approach in facial asymmetry patients using CBCT
Authors: Hwang Dae Seok , Seo Jeong Seok , Choi Hong Seok
Published: April 2020

Background

The purpose of this study is to compare the skeletal stability of two-jaw surgery via surgery-first approach with conventional two-jaw surgery in facial asymmetry patients by measuring the skeletal changes after surgery from a three-dimensional analysis. From January 2010 to January 2014, 40 patients with facial asymmetry who underwent two-jaw surgery in Pusan National University Hospital were included in this study. They were classified into experimental group (n = 20) who underwent two-jaw surgery via surgery-first approach and control group (n = 20) who underwent conventional two-jaw surgery. After selection of 24 landmarks and the construction of horizontal and sagittal, coronal reference planes, changes in 10 linear measurements and 2 angular measurements were compared between the surgery-first approach and conventional groups in the preoperative, immediate postoperative, and postoperative periods. The paired t test and Student t test were used for statistical analysis. The mean and standard deviation of the measurement were calculated for the experimental and control groups.

Results

The statistical analysis showed that changes in skeletal measurements were similar between the surgery-first approach and conventional groups, according to each period. However, U1-SRP measurement showed statistically significant changes in surgery-first approach groups at postsurgical change (T1 to T2). Also, the mean treatment duration in the treatment group was 15.9 ± 5.48 months whereas that in the control group was 32.9 ± 14.05 months.

Conclusion

In facial asymmetry patients, similar results were observed in the postoperative skeletal stability when 2-jaw surgery via surgery-first approach was compared with conventional 2-jaw surgery. However, significant lateral deviation of upper incisor midline was observed. In addition, a shorter average treatment duration was observed. To stabilize the unstable occlusion after surgery, increased wearing of the stent and proactive rubber guidance will be needed.
Plasma BCAA Changes in Patients With NAFLD Are Sex Dependent
Authors: Grzych Guillaume , Vonghia Luisa , Bout Marie-Adélaïde , Weyler Jonas , Verrijken An , Dirinck Eveline , Chevalier Curt Marie Joncquel , Van Gaal Luc , Paumelle Réjane , Francque Sven , Tailleux Anne , Haas Joel T , Staels Bart
Published: April 2020

Context

Plasma branched chain amino acid (BCAA) concentrations correlate positively with body mass index (BMI), measures of insulin resistance (IR), and severity of nonalcoholic fatty liver disease (NAFLD). Moreover, plasma BCAA concentrations also differ between the sexes, which display different susceptibilities to cardio-metabolic diseases.

Objective

Assess whether plasma BCAA concentrations associate with NAFLD severity independently of BMI, IR, and sex.

Patients

Patients visiting the obesity clinic of the Antwerp University Hospital were consecutively recruited from 2006 to 2014.

Design and Setting

A cross-sectional study cohort of 112 obese patients (59 women and 53 men) was divided into 4 groups according to NAFLD severity. Groups were matched for sex, age, BMI, homeostatic model assessment of IR, and hemoglobin A1c.

Main Outcome Measures

Fasting plasma BCAA concentrations were measured by tandem mass spectrometry using the aTRAQ™ method.

Results

In the study cohort, a modest positive correlation was observed between plasma BCAA concentrations and NAFLD severity, as well as a strong effect of sex on plasma BCAA levels. Subgroup analysis by sex revealed that while plasma BCAA concentrations increased with severity of NAFLD in women, they tended to decrease in men. Additionally, only women displayed significantly increased plasma BCAAs with increasing fibrosis.

Conclusion

Plasma BCAA concentrations display sex-dimorphic changes with increasing severity of NAFLD, independently of BMI, IR, and age. Additionally, plasma BCAA are associated with significant fibrosis in women, but not in men. These results highlight the importance of a careful consideration of sex as a major confounding factor in cross-sectional studies of NAFLD.
Neuroendocrine-Immune Crosstalk Shapes Sex-Specific Brain Development
Authors: Arambula Sheryl E , McCarthy Margaret M
Published: April 2020

Sex is an essential biological variable that significantly impacts multiple aspects of neural functioning in both the healthy and diseased brain. Sex differences in brain structure and function are organized early in development during the critical period of sexual differentiation. While decades of research establish gonadal hormones as the primary modulators of this process, new research has revealed a critical, and perhaps underappreciated, role of the neuroimmune system in sex-specific brain development. The immune and endocrine systems are tightly intertwined and share processes and effector molecules that influence the nervous system. Thus, a natural question is whether endocrine-immune crosstalk contributes to sexual differentiation of the brain. In this mini-review, we first provide a conceptual framework by classifying the major categories of neural sex differences and review the concept of sexual differentiation of the brain, a process occurring early in development and largely controlled by steroid hormones. Next, we describe developmental sex differences in the neuroimmune system, which may represent targets or mediators of the sexual differentiation process. We then discuss the overwhelming evidence in support of crosstalk between the neuroendocrine and immune systems and highlight recent examples that shape sex differences in the brain. Finally, we review how early life events can perturb sex-specific neurodevelopment via aberrant immune activation.
Vitamin D Sufficiency Has a Limited Effect on Placental Structure and Pathology: Placental Phenotypes in the VDAART Trial
Authors: He Mai , Mirzakhani Hooman , Chen Ling , Wu Robert , Litonjua Augusto A , Bacharier Leonard , Weiss Scott T , Nelson D Michael
Published: April 2020

Vitamin D insufficiency during pregnancy is widespread. The effects of active vitamin D on the human placenta in vivo are unknown. We test the hypotheses that 25(OH)D sufficiency (arbitrarily defined as 25(OH)D ≥32 ng/mL) modulates placental structure and function in vivo in a population of women whose offspring are at risk for childhood asthma, and that placental pathology is more common in offspring that evolve asthma at age 3. Pregnant volunteers in the St. Louis, MO, cohort of the Vitamin D Antenatal Asthma Reduction Trial (VDAART, NIH grant #HL091528) participated in a nested case–control study and consented for the study of placentas after delivery. Maternal concentrations of 25(OH)D were measured at trial entry and in the third trimester. The histopathology of the placentas from women with sufficient 25(OH)D, versus insufficient, showed no clinically significant differences, but morphometry revealed villi of women with sufficient third-trimester 25(OH)D had a higher villous surface density. Notably, analyses of transcripts, extracted from formalin-fixed paraffin-embedded specimens, revealed higher expression of INTS9, vWF, MACC1, and ARMS2, and diminished expression of the CNTN5 genes in the insufficient group. A larger proportion of placentas showed chronic chorioamnionitis in offspring with versus without asthma at age 3. These findings suggest that maternal 25(OH)D insufficiency has a limited effect on human placental villous histopathology and morphometry, but attenuates a small number of placental gene expression profiles in this selected population. The association of placental chronic chorioamnionitis and offspring asthma is worthy of further study.
Usual care for mental health problems in children with epilepsy: A cohort study
Authors: Welch Alice , Shafran Roz , Heyman Isobel , Coughtrey Anna , Bennett Sophie
Published: April 2020

Background: Epilepsy is one of the most common chronic paediatric conditions. Children and young people with epilepsy are at a significantly higher risk of developing mental health problems relative to the general population, yet the majority of these problems are unrecognised and under-treated in clinical practice. Although there is little epilepsy-specific guidance as to what interventions to use, researchers suggest there is no reason why clinicians should not be using the evidence base. Given the poor prognosis of untreated mental health difficulties, this cohort study sought to identify what psychological treatment young people with epilepsy with mental health needs receive in routine practice.

Methods: Participants were children and young people aged 3 to 18 attending paediatric neurology clinics. The parents of those children who met threshold for impairing symptoms on the Strengths and Difficulties questionnaire were asked to complete the Development and Well-being Assessment (DAWBA), an online clinical assessment designed to generate psychiatric diagnoses. Participants who met clinical threshold for a disorder according to the DAWBA were provided with a bespoke measure asking questions regarding their experience with treatment for mental health support.

Results: 16 of the 46 parents who completed the DAWBA reported that they had experienced previous or current support for their child’s mental health difficulties. The mental health support offered to families was highly variable, inadequate and often not clearly compliant with existing UK National Institute for Health and Clinical Excellence (NICE) guidelines for mental health treatment in children and young people.

Conclusions: The present study demonstrates the inconsistency and inadequacy of mental health provision for children and young people with epilepsy. Future work should explore reasons for the treatments offered failing to adhere to existing guidance for mental health difficulties in children, as well as possible solutions to this.
Post-Ebola Community Health Worker programme performance in Kenema District, Sierra Leone: A long way to go!
Authors: Thomas Harold , Hann Katrina , Vandi Mohamed , Sesay Joseph Bengalie , Alpha Koi Sylvester , Najjemba Robinah
Published: April 2020

Background: The devastating 2014-2015 Ebola outbreak in Sierra Leone could erode the gains of the health system including the Community Health Worker (CHW) programme. We conducted a study to ascertain if the positive trend in reporting cases of malaria, pneumonia and diarrhoea treated by CHWs in the post-Ebola period has been sustained 18 months post-Ebola.

Methods: We conducted a retrospective cross-sectional study using aggregated CHW programme data (2013-2017) from all Primary Health Units in Kenema district. Data was extracted from the District Health Information System and analysed using STATA. Data in the pre- (June 2013-April 2014), during- (June 2014-April 2015) and post-Ebola recovery (June 2016-April 2017) periods was compared and analysed for reporting completeness; Rapid Diagnostic Tests (RDTs) performed and cases of malaria, diarrhoea and pneumonia treated per month. Differences across periods were tested using two-sample t-test with significance set at 0.05.

Results: CHW reporting increased from pre-Ebola by 8% (p-value=0.29) intra-Ebola and 19% (p-value=0.012) post-Ebola. Compared to the pre-Ebola period, in the post-Ebola recovery period, there was a significant increase in the mean monthly reported RDTs of 35% (p-value=0.020); malaria treatments 66% (p-value<0.001); and pneumonia treatments increased by 80% (p-value=0.004). Conversely, the mean monthly diarrhoea cases treated decreased by 20% (p-value=0.16) in the post-Ebola period.

Conclusion: The resiliency demonstrated by the CHW programme during and immediately after the Ebola outbreak has been sustained in the post-Ebola recovery period. Continued programme investments in supportive supervision and financial incentives for CHWs will be critical to ensure uninterrupted contribution towards Sustainable Development Goal 3.
Near-Optimal A-B Testing
Authors: Bhat Nikhil , Farias Vivek F. , Moallemi Ciamac C. , Sinha Deeksha
Published: April 2020

We consider the problem of A-B testing when the impact of the treatment is marred by a large number of covariates. Randomization can be highly inefficient in such settings, and thus we consider the problem of optimally allocating test subjects to either treatment with a view to maximizing the precision of our estimate of the treatment effect. Our main contribution is a tractable algorithm for this problem in the online setting, where subjects arrive, and must be assigned, sequentially, with covariates drawn from an elliptical distribution with finite second moment. We further characterize the gain in precision afforded by optimized allocations relative to randomized allocations, and show that this gain grows large as the number of covariates grows. Our dynamic optimization framework admits several generalizations that incorporate important operational constraints such as the consideration of selection bias, budgets on allocations, and endogenous stopping times. In a set of numerical experiments, we demonstrate that our method simultaneously offers better statistical efficiency and less selection bias than state-of-the-art competing biased coin designs.

This paper was accepted by Noah Gans, stochastic models and simulation.
Significados e experiências culturais em amamentação entre mulheres de dois países [Meaning and cultural experiences of breastfeeding among women from two countries] [Significados y experiencias culturales en lactancia entre mujeres de dos países]
Authors: Pastorelli Pernelle Paula Laurencine , Oliveira Eliane Caldas do Nascimento , Silva Laura Johanson da , Silva Leila Rangel da , Silva Maíra Domingues Bernardes
Published: April 2020

Objetivo: identificar as experiências culturais relacionadas às decisões maternas para a amamentação entre dois países, visando compreender seus significados. Método: pesquisa qualitativa através de estudo de caso, sendo realizadas nove entrevistas semiestruturadas, com mulheres brasileiras e francesas, no período de abril a dezembro de 2017. Aplicou-se a análise temática de Bardin aos depoimentos. O projeto da pesquisa teve anuência de Comitê de Ética em Pesquisa. Resultados: quatro categorias emergiram da análise dos depoimentos: escolha, cultura e influências; entre benefícios e prazer; idealismo da amamentação; relação com o corpo: dor, pudor e sexualidade. Conclusão: as entrevistadas brasileiras apontam para uma valorização da mulher que amamenta e uma culpabilização daquela que não o faz. E para as francesas a sociedade veicula a ideia de que amamentação significa falta de liberdade. Nos dois lados ainda falta a mulher se apropriar dos seus desejos.ABSTRACTObjective: to identify the cultural experiences related to maternal breastfeeding decisions between two countries, aiming to understand their meanings. Methods: qualitative research through case study. Nine semi-structured interviews were conducted with Brazilian and French women, from April to December 2017. Bardin's thematic analysis was applied to the statements. The study was approved by ethics research committee. Results: four categories emerged: choice, culture and influences; between benefits and pleasure; breastfeeding idealism; relationship with the body: pain, shame and sexuality. Conclusion: in Brazil there is an appreciation of women who breastfeed and a blame for those who do not. In France society conveys the idea that breastfeeding means lack of freedom. In both countries the woman still needs to take ownership of her wishes.RESUMENObjetivo: identificar las experiencias culturales relacionadas con las decisiones de lactancia materna entre dos países, con el objetivo de comprender sus significados. Método: investigación cualitativa a través del estudio de caso. Fueron nueve entrevistas semiestructuradas con mujeres brasileñas y francesas, de abril a diciembre de 2017. El análisis temático de Bardin se aplicó a los datos. La investigación tuvo anuencia del Comité de Ética en Investigación.  Resultados: cuatro categorías emergieron: elección, cultura e influencias; entre beneficios y placer; idealismo de la lactancia materna; relación con el cuerpo: dolor, pudor y sexualidad. Conclusion: en Brasil, hay valorización de la mujer que amamanta y  culpabilización de aquella que no lo hace. En Francia, la sociedad vehicula la idea de que la lactancia significa falta de libertad. En los dos países todavía falta la mujer apropiarse de sus deseos.
Leading the way on reducing risk in care homes
Authors: Lowthian Martin
Published: April 2020

As staffing shortages continue to put pressure on residential care homes, Martin Lowthian looks at what providers can do to mitigate the risks associated with growing workloads
Molecular identification of bio-fluids in gas phase using infrared spectroscopy
Authors: Apolonski Alexander , Roy Susmita , Lampe Renée , Sankar Maiti Kiran
Published: April 2020

Bio-fluids are the source of a large number of metabolites. Identification and quantification of them can be an efficient step for understanding the internal chemistry of the body as well as for developing objective diagnostics of diseases. Several techniques have been developed so far; however, their metabolite identification and/or quantification are not reliable enough for acceptance by clinicians. As another promising step in this direction, we push infrared spectroscopy of bio-fluids in gas phase. Here we discuss features of breath and urine headspace realized with Fourier transform infrared spectroscopy. Molecular identification procedures based on component analysis of gas samples are proposed. In this paper, we show that aggregate data from different bio-fluids in gas phase can strengthen the diagnostics of the body state and disease.
Optical lock-in camera for gravitational wave detectors
Authors: Cao Huy Tuong , Brown Daniel D. , Veitch Peter J. , Ottaway David J.
Published: April 2020

Knowledge of the intensity and phase profiles of spectral components in a coherent optical field is critical for a wide range of high-precision optical applications. One of these is interferometric gravitational wave detectors, which rely on the optical beats between these fields for precise control of the experiment. Here we describe an optical lock-in camera and show that it can be used to record optical beats at MHz or greater frequencies with higher spatial and temporal resolution than previously possible. This improvement is achieved using a Pockels cell as a fast optical switch to transform each pixel on a sCMOS array into an optical lock-in amplifier. We demonstrate that the optical lock-in camera can record fields with 2 Mpx resolution at 10 Hz with a sensitivity of -62 dBc when averaged over 2s.
Evaluating semi-analytical algorithms for estimating inherent optical properties in the South China Sea
Authors: Deng Lin , Zhou Wen , Cao Wenxi , Wang Guifen , Zheng Wendi , Xu Zhantang , Li Cai , Yang Yuezhong , Xu Wenlong , Zeng Kai , Hu Shuibo
Published: April 2020

Using large amounts of bio-optical data collected in the South China Sea (SCS) from 2003 to 2016, this study checks the consistency between well-known semi-analytical algorithms (SAAs)—the quasi-analytical algorithm (QAA) and the default generalized inherent optical property (GIOP-DC)—in retrieving the non-water absorption coefficient (anw(λ)), phytoplankton absorption coefficient (aph(λ)) and particulate backscattering coefficient (bbp(λ)) from remote-sensing reflectance (Rrs(λ)) data at 412, 443, 490, 531, and 555 nm. The samples from the SCS are further separated into oligotrophic and mesotrophic water types for the comparison of the SAAs. Several findings are made: First, the values of anw(λ) derived from the two SAAs deliver similar performance, with R2 values ranging from 0.74 to 0.85 and 0.74 to 0.87, implying absolute percent error differences (APDs) from 37.93% to 74.88% and from 32.32% to 71.75% for the QAA and GIOP-DC, respectively. The QAA shows a value of R2 between 0.64 and 0.91 and APDs between 43.57% to 83.53%, while the GIOP-DC yields R2 between 0.76 to 0.89 and APDs between 44.65% to 79.46% when estimating aph(λ). The values of bbp(λ) derived from the QAA are closer to the in-situ bbp(λ) values, as indicated by the low values of the normalized centered root-mean-square deviation and normalized standard deviation, which are close to one. Second, a regionally tuned estimation of aph(λ) is proposed and recommended for the SCS. This consistency check of inherent optical properties products from SAAs can serve as reference for algorithm selection for further applications, including primary production, carbon, and biogeochemical models of the SCS, and can provide guidance for improving aph(λ) estimation.
Bedürfniskarten im Coaching
Authors: Schiemann Sandra J. , König Vicky , Brantl Maximilian M. A. , Jonas Eva
Published: April 2020

Bildkarten werden in vielen Coachings eingesetzt, damit die KlientInnen besser ihre Gedanken, Emotionen und/oder Ziele veranschaulichen können. Die Frage ist, ob Bildkarten auch dabei helfen können, damit verbundene grundlegende Bedürfnisse zu erkennen. Daher haben wir in zwei Vorstudien ein Bedürfniskarten-Set entwickelt, das auf den drei psychologischen Grundbedürfnissen nach Autonomie, Kompetenz und sozialer Eingebundenheit (entsprechend der Selbstbestimmungstheorie) basiert. Um zu sehen, wie die Bedürfniskarten auf Coaches wirken, haben wir 332 Coaches befragt, ob bzw. wie sie Bildkarten anwenden sowie wie sie die entwickelten 30 Bedürfniskarten bezüglich der drei Grundbedürfnisse auf einer Adjektivskala einschätzen. Die Ergebnisse zeigten, dass Bildkarten sehr häufig im Coaching verwendet werden und der Einsatz von Bildkarten dabei vorwiegend der Visualisierung und Verankerung von Zielen und Emotionen dient. Darüber hinaus wurden die von uns entwickelten Bedürfniskarten von den Coaches überwiegend den jeweils dazugehörigen Bedürfnissen passend zugeordnet. Eine Zuordnung auf Seiten der Klienten steht noch aus.
Silencing the voice of Bahrain? Regime-critical media and Bahrain’s London diaspora
Authors: Fibiger Thomas
Published: April 2020

This article discusses the role of a politically mobilized diaspora in the media and politics of Bahrain. The political turmoil of several decades has resulted in the exile of a sizeable community of Bahrainis, and many key activists have settled in London. From here they continue to work with a variety of political activities and a variety of media to put pressure on both Gulf and European regimes. The article traces the development of media forms, from a print newspaper formed out of the diasporic experience, via a particular community-driven homepage opened in Bahrain in 1998, whose creator fled to London after the 2011 ‘Arab Spring’ uprising, to the diversity of the social media that now dominates. In this regard, the role of digital surveillance, and subsequent demobilization and increasing silence, are key to the discussion.
Examining virtual identity profiles of social network users with respect to certain variables
Authors: Barut Tuğtekin Esra , Dursun Özcan Özgür
Published: April 2020

In the present study, a measurement tool was developed to determine the virtual identities of social network users, and the virtual identities of these social network users were examined with respect to gender, time spent on social networks, number of their social network profiles and visibility using the relational survey model. The study was carried out with a total of 671 social network users, 252 females and 419 males. The research data were collected using the Social Network Identity Management Scale developed within the scope of the study. The five-point Likert-type scale made up of four factors and 23 items was found to explain 55.29 % of the total variance (Cronbach Alpha =.93). At the end of the research process, a 23-item Social Network Identity Management Scale’s validity and reliability were confirmed. The finding obtained in the study demonstrated that the virtual identities of the users with more than one profile differed within the context of such sub-dimensions of the scale as liking and privacy. In addition, it was found that the changes in the virtual identities increased depending on the time spent on social networks.
Neurog2Acts as a Classical Proneural Gene in the Ventromedial Hypothalamus and Is Required for the Early Phase of Neurogenesis
Authors: Aslanpour Shaghayegh , Han Sisu , Schuurmans Carol , Kurrasch Deborah M.
Published: April 2020

The tuberal hypothalamus is comprised of the dorsomedial, ventromedial, and arcuate nuclei, as well as parts of the lateral hypothalamic area, and it governs a wide range of physiologies. During neurogenesis, tuberal hypothalamic neurons are thought to be born in a dorsal-to-ventral and outside-in pattern, although the accuracy of this description has been questioned over the years. Moreover, the intrinsic factors that control the timing of neurogenesis in this region are poorly characterized. Proneural genes, includingAchate-scute-like 1(Ascl1) andNeurogenin 3(Neurog3) are widely expressed in hypothalamic progenitors and contribute to lineage commitment and subtype-specific neuronal identifies, but the potential role of Neurogenin 2 (Neurog2) remains unexplored. Birthdating in male and female mice showed that tuberal hypothalamic neurogenesis begins as early as E9.5 in the lateral hypothalamic and arcuate and rapidly expands to dorsomedial and ventromedial neurons by E10.5, peaking throughout the region by E11.5. We confirmed an outside-in trend, except for neurons born at E9.5, and uncovered a rostrocaudal progression but did not confirm a dorsal-ventral patterning to tuberal hypothalamic neuronal birth. In the absence ofNeurog2, neurogenesis stalls, with a significant reduction in early-born BrdU+cells but no change at later time points. Further, the loss ofAscl1yielded a similar delay in neuronal birth, suggesting thatAscl1cannot rescue the loss ofNeurog2and that these proneural genes act independently in the tuberal hypothalamus. Together, our findings show thatNeurog2functions as a classical proneural gene to regulate the temporal progression of tuberal hypothalamic neurogenesis.

SIGNIFICANCE STATEMENTHere, we investigated the general timing and pattern of neurogenesis within the tuberal hypothalamus. Our results confirmed an outside-in trend of neurogenesis and uncovered a rostrocaudal progression. We also showed thatNeurog2acts as a classical proneural gene and is responsible for regulating the birth of early-born neurons within the ventromedial hypothalamus, acting independently ofAscl1. In addition, we revealed a role forNeurog2in cell fate specification and differentiation of ventromedial -specific neurons. Last,Neurog2does not have cross-inhibitory effects onNeurog1,Neurog3, andAscl1. These findings are the first to reveal a role forNeurog2in hypothalamic development.