bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Characterization of an Interferon Gamma Receptor-Like Protein on Entamoeba histolytica
Authors: Pulido-Ortega Julieta , Talamás-Rohana Patricia , Muñoz-Ortega Martín Humberto , Aldaba-Muruato Liseth Rubí , Martínez-Hernández Sandra Luz , Campos-Esparza María del Rosario , Cervantes-García Daniel , Leon-Coria Aralia , Moreau France , Chadee Kris , Ventura-Juárez Javier
Published: August 2019

Entamoeba histolytica
is an anaerobic parasitic protozoan and the causative agent of amoebiasis.
E. histolytica
expresses proteins that are structurally homologous to human proteins and uses them as virulence factors. We have previously shown that
E. histolytica
binds exogenous interferon gamma (IFN-γ) on its surface, and in this study, we explored whether exogenous IFN-γ could modulate parasite virulence.
Strontium isotope stratigraphy and paleomagnetic age constraints on the evolution history of coral reef islands, northern South China Sea
Authors: Fan Tianlai , Yu Kefu , Zhao Jianxin , Jiang Wei , Xu Shendong , Zhang Yu , Wang Rui , Wang Yinghui , Feng Yuexing , Bian Lizeng , Qian Handong , Liao Weihua
Published: August 2019

Understanding the history of the response of coral reefs to past climate changes can provide valuable information for predicting the future response of modern reefs. However, dating such ancient biotic carbonate is still challenging because of its sensitivity to diagenetic alteration processes, scarcity of well-preserved fossils, and low magnetic mineral content. There have been a long debates about the origin and evolutionary history of coral reefs in the northern South China Sea, mainly due to the lack of direct and reliable age constraints. This provides us with a good opportunity to verify the practicability of different dating approaches, especially the strontium (Sr) isotope analysis of bulk carbonate. Here, we retrieved a 972.55-m-long core from the Xisha Islands to provide a credible chronologic constraint on the carbonate platform evolution. The lithostratigraphy, strontium isotope stratigraphy, and magnetostratigraphy were analyzed throughout the whole reef sequence. The lithostratigraphic results show that the 873.55 m reef sequence developed on an ancient volcaniclastic basement and experienced multiple evolutionary phases. The 87Sr/86Sr results of all 100 bulk carbonate samples vary from 0.708506 to 0.709168 and show a monotonic increase with decreasing depth, except for a few outliers. Trace-element criteria and stable isotope (δ18O and δ13C) methods were applied to these bulk carbonate samples, and results imply that the primary or near-primary seawater 87Sr/86Sr values were likely preserved, although different degrees of diagenetic alteration occurred. In addition, the paleomagnetic results indicate 10 normal polarity and eight reversed polarity magnetozones. Based on the 87Sr/86Sr ratios of the selected 58 samples and paleomagnetic reconstruction of polarity reversals, the bottom of the reef sequence is dated to 19.6 Ma, and the observed polarity chronozones extend from chron C6 (19.722–18.748 Ma) at 866.60 m to present at the top. Based on the new data, we propose a new chronologic framework for the evolutionary history of the reef islands, where: (1) the reefs initiated in the early Miocene (19.6 Ma) and were drowned until 16.26 Ma; (2) during 16.26–10.66 Ma, lagoon to lagoon slope environments prevailed; (3) the lagoon environment progressively transformed into a reef crest environment from 10.66 to 4.36 Ma and 4.36 to 1.59 Ma; and (4) the reef started to be drowned again during 1.59–0 Ma. Our study provides a new and reliable chronologic constraint on the general evolutionary history of the reef islands in the northern South China Sea. Furthermore, the 87Sr/86Sr results from bulk carbonate indicate that strontium isotope stratigraphy is a powerful dating tool only when rigid sample selection, sequential leaching procedures, and strict trace-element and isotopic criteria are applied.
Linking metamorphism, magma generation, and synorogenic sedimentation to crustal thickening during Southern Appalachian mountain building, USA
Authors: Stowell H.H. , Schwartz J.J. , Ingram S.B. , Madden J. , Jernigan C. , Steltenpohl M. , Mueller P.
Published: August 2019

The nature of metamorphism, magma compositions, the spatial distribution of plutons, and foreland sediments reflect, in part, the character and thickness of continental crust. We utilized metamorphic pressure-temperature-time (P-T-t) paths, garnet Sm-Nd ages, zircon U-Pb ages, and pluton compositions to estimate paleocrustal thickness and temporal changes in crustal magma sources in the Blue Ridge of the southernmost Appalachians. Garnet Sm-Nd ages for amphibolite-facies metamorphic rocks range from 331 ± 4 to 320 ± 3 Ma. Low- and high-Sr/Y plutons that intruded these metamorphic rocks have zircon U-Pb ages of 390 ± 1 to 365 ± 1 Ma and 349 ± 2 to 335 ± 1 Ma, respectively. Therefore, garnet growth began during regional metamorphism synchronous with or shortly after intrusion of the youngest high-Sr/Y trondhjemite plutons. Phase diagram sections and thermobarometry indicate that garnet growth initiated at ∼5.8 kbar and 540 °C and grew during temperature increases of 60–100 °C and pressure increases of 2–3 kbar. The older, low-Sr/Y magmas are inferred to have been sourced in the crust at depths <∼30 km, insufficient for garnet to be stable. However, the younger, high-Sr/Y magmas are inferred to have been sourced at >30 km depths where garnet was stable. Hafnium isotopic compositions for all the plutons, but one, exhibit a range from negative initial εHf(i) to weakly positive initial εHf(i), indicating incomplete mixing of dominantly crustal sources. Our data require minimum crustal thicknesses of ∼33 km at 331 Ma; however, Alleghanian crustal thicknesses must have locally reached 39 km, based on crustal reconstruction adding the Alleghanian thrust sheet beneath the eastern Blue Ridge. We infer the presence of hot, tectonically thickened crust during intrusion of the early Alleghanian high-Sr/Y plutons and conclude that garnet growth and plutonism reflect a progressive increase in crustal thickness and depth of magma generation. The crustal thickening was synchronous with deposition of Mississippian to early Pennsylvanian sediments in the foreland basin of the Appalachian orogen between 350 and 320 Ma. This crustal thickening may have preceded emplacement of the Alleghanian thrust sheets onto the North American craton.
Successful intravenous administration of argatroban in the management of heparin-resistant and surgery-resistant mesenteric vein thrombosis
Authors: Yokota Yuya , Yoshioka Takashi , Senoh Mayumi , Sunami Kazuharu
Published: August 2019

A 78-year-old woman visited the emergency department with complaints of progressively worsening abdominal pain for a week. Nausea and vomiting started at the time of the visit. An abdominal contrast-enhanced CT (CECT) revealed a filling defect of portal vein, splenic vein and superior mesenteric vein (SMV) which was diagnosed as portal vein and mesenteric venous thrombosis (MVT). Intravenous administration of unfractionated heparin was initiated. However, her symptoms did not improve, and she underwent surgical thrombectomy on the second day of hospitalisation. On the sixth day, CECT revealed the recurrence of thrombi in the portal vein, SMV and along the central venous catheters. We switched heparin to argatroban on the eighth day. After administering argatroban, CECT revealed that the thrombi had almost disappeared by the 40th day. In this case, argatroban was considered effective for heparin-resistant and surgery-resistant portal vein and MVT.
Graves’ disease complicated by fetal goitrous hypothyroidism treated with intra-amniotic administration of levothyroxine
Authors: Machado Catarina Martins , Castro Jorge Manuel , Campos Rosa Arménia , Oliveira Maria João
Published: August 2019

Fetal goitrous hypothyroidism is a rare entity and is caused mainly by maternal treatment of Graves’ disease (GD). We report a case of a 22-year-old woman referred at 12 weeks of gestation due to hyperthyroidism subsequent to recently diagnosed GD. She started treatment with propylthiouracil and, at 21 weeks of gestation, fetal goitre was detected. A cordocentesis confirmed the diagnosis of fetal goitrous hypothyroidism, and intra-amniotic administration of levothyroxine (LT4) was performed and repeated through the pregnancy due to maintenance of fetal goitre. The pregnancy proceeded without further complications and a healthy female infant was born at 37 weeks of gestation, with visible goitre and thyroid function within the normal range at birth. Although there is no consensus on the optimal dose, the number of injections and the interval between them, intra-amniotic LT4 administration is recommended once fetal goitrous hypothyroidism is suspected, in order to prevent long-term complications of fetal hypothyroidism.
Research gaps in the organisation of primary healthcare in low-income and middle-income countries and ways to address them: a mixed-methods approach
Authors: Goodyear-Smith Felicity , Bazemore Andrew , Coffman Megan , Fortier Richard D W , Howe Amanda , Kidd Michael , Phillips Robert , Rouleau Katherine , van Weel Chris
Published: August 2019

Introduction

Since the Alma-Ata Declaration 40 years ago, primary healthcare (PHC) has made great advances, but there is insufficient research on models of care and outcomes—particularly for low-income and middle-income countries (LMICs). Systematic efforts to identify these gaps and develop evidence-based strategies for improvement in LMICs has been lacking. We report on a global effort to identify and prioritise the knowledge needs of PHC practitioners and researchers in LMICs about PHC organisation.

Methods

Three-round modified Delphi using web-based surveys. PHC practitioners and academics and policy-makers from LMICs sampled from global networks. First round (pre-Delphi survey) collated possible research questions to address knowledge gaps about organisation. Responses were independently coded, collapsed and synthesised. Round 2 (Delphi round 1) invited panellists to rate importance of each question. In round 3 (Delphi round 2), panellists ranked questions into final order of importance. Literature review conducted on 36 questions and gap map generated.

Results

Diverse range of practitioners and academics in LMICs from all global regions generated 744 questions for PHC organisation. In round 2, 36 synthesised questions on organisation were rated. In round 3, the top 16 questions were ranked to yield four prioritised questions in each area. Literature reviews confirmed gap in evidence on prioritised questions in LMICs.

Conclusion

In line with the 2018 Astana Declaration, this mixed-methods study has produced a unique list of essential gaps in our knowledge of how best to organise PHC, priority-ordered by LMIC expert informants capable of shaping their mitigation. Research teams in LMIC have developed implementation plans to answer the top four ranked research questions.
Primary care financing: a systematic assessment of research priorities in low- and middle-income countries
Authors: Goodyear-Smith Felicity , Bazemore Andrew , Coffman Megan , Fortier Richard , Howe Amanda , Kidd Michael , Phillips Robert , Rouleau Katherine , van Weel Chris
Published: August 2019

Introduction

Financing of primary healthcare (PHC) is the key to the provision of equitable universal care. We aimed to identify and prioritise the perceived needs of PHC practitioners and researchers for new research in low- and middle-income countries (LMIC) about financing of PHC.

Methods

Three-round expert panel consultation using web-based surveys of LMIC PHC practitioners, academics and policy-makers sampled from global networks. Iterative literature review conducted in parallel. First round (Pre-Delphi survey) elicited possible research questions to address knowledge gaps about financing. Responses were independently coded, collapsed and synthesised to two lists of questions. Round 2 (Delphi Round 1) invited panellists to rate importance of each question. In Round 3 (Delphi Round 2), panellists ranked questions in order of importance.

Results

A diverse range of PHC practitioners, academics and policy-makers in LMIC representing all global regions identified 479 knowledge gaps as potentially critical to improving PHC financing. Round 2 provided 31 synthesised questions on financing for rating. The top 16 were ranked in Round 3e to produce four prioritised research questions.

Conclusions

This novel exercise created an expansive and prioritised list of critical knowledge gaps in PHC financing research questions. This offers valuable guidance to global supporters of primary care evaluation and implementation, including research funders and academics seeking research priorities. The source and context specificity of this research, informed by LMIC practitioners and academics on a global and local basis, should increase the likelihood of local relevance and eventual success in implementing the findings.
Patients’ information needs and attitudes about post-treatment surveillance for colorectal cancer in the United States: a multi-perspective, mixed methods study
Authors: Lowenstein Lisa M , Volk Robert J , Cuddy Amanda , Hempstead Andrea P , You Y Nancy , Van Loon Katherine , Millas Stefanos , Meyerhardt Jeffrey A , Gavin Patrick , Chang George J
Published: August 2019

Objective

We sought to determine patients’ informational needs for post-treatment surveillance and elicit clinicians’ and patient advocates’ (ie, stakeholders) opinions regarding what patients should know about post-treatment surveillance in the USA.

Design

A mixed-methods study, using semi-structured interviews followed by a survey study.

Setting

Participants for the interviews were from two large academic medical centres and a safety-net hospital. The stakeholders were recruited from attendees at the Alliance for Clinical Trials in Oncology Network Spring 2016 meeting.

Participants

Participants for the in-depth interviews were purposively sampled. Eligible patients were 6 months to 5 years post curative resection for colorectal cancer and were fluent in English. Participants for the anonymous survey were stakeholders.

Main outcome(s) and measure(s)

The main outcome was patients’ with colorectal cancer informational needs for post-treatment surveillance, using an interview guide. The second outcome was the importance of the identified informational needs using an anonymous survey.

Results

Of the 67 patients approached, 31 were interviewed (response rate=46%), the majority were between 1 and 3 years post-treatment (81%) and diagnosed at stage III (74%). Despite a desire to monitor for cancer recurrence, patients had little understanding of the concept of post-treatment surveillance, equating surveillance with screening and a belief that if a recurrence was found early there would be a higher likelihood of cure. The survey suggested that clinicians (n=38) and patient advocates (n=11) had some differing opinions regarding what patients should know about surveillance to be active in decisions. For example, compared with clinicians, patient advocates felt that patients should know recurrence treatment options (100% vs 58%) and likelihood for cure following recurrence treatment (100% vs 38%).

Conclusions

The results of this exploratory mixed-methods study suggest that novel educational interventions targeting both patients and clinicians are needed to address the informational needs for post-treatment surveillance of colorectal cancer.
Psychometrics properties of the Team Interaction Scale and influencing factors of team interaction of tertiary hospital physicians in China: a cross-sectional study
Authors: Song Wenwen , Li Honghe , Ding Ning , Zhao Weiyue , Shi Lin , Wen Deliang
Published: August 2019

Objectives

To administer a cross-cultural adaptation of the Team Interaction Scale (TIS), test its psychometric properties and investigate influencing factors of team interactions in a physician population in Chinese tertiary hospitals.

Design

Cross-sectional survey.

Settings

Two rounds of surveys, a pilot and a large sampling survey, were conducted in two and nine tertiary hospitals, respectively, in Liaoning Province, China.

Participants

In the pilot survey, 363 of 390 physicians sampled were included in the analysis, resulting in an effective response rate of 93.08%. In the large sampling survey, the effective response rate was 89.10% (3653 of 4100 physicians).

Outcome measures

The TIS and a short version of a burn-out scale were administrated to assess the physician’s team interaction and burn-out. Psychometric properties of TIS were tested by confirmatory factor analysis (CFA), exploratory factor analysis (EFA) and internal consistency analysis. Gender, age, discipline, education level, professional title, hospital scale and burn-out were explored as influencing factors with independent samplet-tests, one-way analyses of variance and a correlation analysis.

Results

Based on CFA, a 17-item modified scale was developed following the pilot survey. In the large sampling survey, EFA was conducted with half of the samples, producing six dimensions: ‘Communication’, ‘Coordination’, ‘Mutual help’, ‘Team goals’, ‘Work norms’ and ‘Cohesion and conflict resolution’. Fit of the modified model was confirmed by CFA with the other half of the samples (root mean square error of approximation=0.067, Comparative Fit Index=0.98, Normed Fit Index=0.97, Goodness of Fit Index=0.94, Adjusted Goodness of Fit Index=0.92). A high Cronbach’s α coefficient of 0.98 demonstrated reliability of the modified scale. The Team Interaction Score was significantly lower in younger physicians, in men, in paediatricians and in physicians from larger-scale tertiary hospitals. Team Interaction Scores were negatively associated with burn-out.

Conclusions

The adapted TIS, containing 17 items and six dimensions, was reliable and valid for Chinese tertiary hospital physicians. To address physician burn-out, team interaction should be highlighted.
Health effect research on Hebei Spirit Oil Spill (HEROS) in Korea: a cohort profile
Authors: Park Myung Sook , Choi Kyung-Hwa , Lee Seung-Hwa , Hur Jong-Il , Noh Su Ryeon , Jeong Woo-Chul , Cheong Hae-Kwan , Ha Mina
Published: August 2019

Purpose

The Hebei Spirit Oil Spill occurred on 7 December 2007 and resulted in the spillage of 12 547 kl of crude oil on the coastline near Taean. Historically, this was the largest oil spill in Korean water. The health effect research on Hebei Spirit Oil Spill (HEROS) is a prospective cohort study that aimed to evaluate the long-term health effects of oil spill exposure on residents in the affected community.

Participants

The Taean Environmental Health Center initially enrolled adults, adolescents and children living in Taean in 2009 and 2010. Follow-up surveys of participating adults and children were conducted every other year. By 2017, a total of 9585 adults and 2216 children and adolescents were enrolled. Of these, 294 adults and 102 children and adolescents were included in all subsequent surveys.

Findings to date

Children who lived closer to the oil spill site exhibited a lower level of pulmonary function and higher prevalence of allergic rhinitis, than those who lived further away from the oil spill site. Adults who lived in a highly exposed area or participated in clean-up work had higher urine levels of the oxidative stress biomarkers malondialdehyde and 8-hydroxydeoxyguanosine. Changes in haematological parameters during a 3-year period were observed in residents of both sexes in highly exposed areas, in addition to increases in respiratory diseases and mental health problems in female and male participants, respectively.

Future plans

The findings of this study will better enable policy makers to develop environmental health policies intended to prevent adverse health effects in residents of communities affected by oil spills, as well as policies regarding the management of future oil accidents. The HEROS study will continue to follow participants in future and will be updated to enable an investigation of long-term health effects.
Clinical practice outcomes and differential results in maternal and neonatal morbidity among pregnant women in Spain who are candidates for a normal birth: a cross-sectional study
Authors: Casteleiro Ana , Santibanez M , Paras-Bravo Paula , Pellico-Lopez Amada , Paz-Zulueta María
Published: August 2019

Objective

To determine the percentage of pregnant women who are potential candidates for a normal birth in the region of Cantabria, Spain. Also, to compare the main clinical practice outcome indicators and the rates of maternal and neonatal morbidity among the group of candidate women versus non-candidates.

Design

A cross-sectional study.

Setting

A tertiary Hospital in Cantabria (Northern region of Spain).

Participants

The study population comprised the total number of hospital births that took place between 1 January 2014 and 31 December 2014 (n=3315).

Results

Secondary registers were accessed to review the main indicators of care and the outcome of births. The χ2test or the Student’s t-test were used to compare both groups for the categorical and continuous variables, respectively. In total, 1863 births (56.20%) were candidates for applying the strategy of care for a normal birth. In 50.86% of these candidate births, an episiotomy was performed, compared with 60.96% in the group of non-candidates (p<0.001). Regarding caesarean sections, these were carried out in 19.32% of the candidate births, compared with 26.79% of non-candidate births (p<0.001). Furthermore, there were statistically significant differences between the groups according to the type of birth, the need for instrumental birthing methods, the existence of perineal tears, Apgar scores and the requirement for the infant to be admitted to the neonatal intensive care unit.

Conclusions

Our results suggest a differential clinical practice, in line with the recommendations of the Clinical Practice Guidelines for Care of Normal Birth. Nonetheless, improvements are necessary regarding the care provided to women and infants, as the percentages of episiotomies and caesarean sections are still high when compared with current standards and compared with other reports.
Product attributes important to US adult consumers’ use of electronic nicotine delivery systems: a discrete choice experiment
Authors: Kistler Christine E , Ranney Leah M , Sutfin Erin L , Chrzan Keith , Wretman Christopher J , Enyioha Chineme , Meernik Clare , Berman Micah , Zarkin Gary A , Goldstein Adam O
Published: August 2019

Objective

To understand the importance of electronic nicotine delivery systems (ENDS) product attributes to adult consumers in the USA by age and gender.

Design

Cross-sectional survey with a discrete choice experiment (best–worst, case 2, scaling) of 19 choice tasks in which participants answered what would make them most want to use and least want to use an ENDS product.

Setting and participants

A national sample of adults (aged 18+ years) in the USA who had tried an ENDS product at least once.

Measures

We included 9 ENDS attributes with levels that varied across 19 choice tasks. We performed a multinomial logistic regression to obtain overall importance scores, attribute-level part-worth utilities and most important attribute.

Results

Of 660 participants, 81% were white, 51% women and 37% had at least a 4-year college degree with an average age of 42.0 years (SD ±19.4). The attributes had the following importance:harms of use17.6%;general effects14.1%;cessation aid12.6%;purchase price12.1%;monthly cost12.0%;nicotine content11.4%;flavour availability8.4%;device design7.2%;modifiability4.6%.Harms of usewas the most important attribute for all ages and genders (p<0.05); variation in other important attributes existed by age though not by gender.

Conclusion

This study identified the importance of nine ENDS attributes. Perceivedharms of useof ENDS use appeared most important, andmodifiabilitywas least important. Variation by consumer group existed, which may allow for targeted interventions to modify ENDS use.
Transplantation of high-risk donor livers after resuscitation and viability assessment using a combined protocol of oxygenated hypothermic, rewarming and normothermic machine perfusion: study protocol for a prospective, single-arm study (DHOPE-COR-NMP trial)
Authors: de Vries Yvonne , Berendsen Tim A , Fujiyoshi Masato , van den Berg Aad P , Blokzijl Hans , de Boer Marieke T , van der Heide Frans , de Kleine Ruben H J , van Leeuwen Otto B , Matton Alix P M , Werner Maureen J M , Lisman Ton , de Meijer Vincent E , Porte Robert
Published: August 2019

Introduction

Extended criteria donor (ECD) livers are increasingly accepted for transplantation in an attempt to reduce the gap between the number of patients on the waiting list and the available number of donor livers. ECD livers; however, carry an increased risk of developing primary non-function (PNF), early allograft dysfunction (EAD) or post-transplant cholangiopathy. Ischaemia-reperfusion injury (IRI) plays an important role in the development of these complications. Machine perfusion reduces IRI and allows for reconditioning and subsequent evaluation of liver grafts. Single or dual hypothermic oxygenated machine perfusion (DHOPE) (4°C–12°C) decreases IRI by resuscitation of mitochondria. Controlled oxygenated rewarming (COR) may further reduce IRI by preventing sudden temperature shifts. Subsequent normothermic machine perfusion (NMP) (37°C) allows for ex situ viability assessment to facilitate the selection of ECD livers with a low risk of PNF, EAD or post-transplant cholangiopathy.

Methods and analysis

This prospective, single-arm study is designed to resuscitate and evaluate initially nationwide declined ECD livers. End-ischaemic DHOPE will be performed for the initial mitochondrial and graft resuscitation, followed by COR of the donor liver to a normothermic temperature. Subsequently, NMP will be continued to assess viability of the liver. Transplantation into eligible recipients will proceed if all predetermined viability criteria are met within the first 150 min of NMP. To facilitate machine perfusion at different temperatures, a perfusion solution containing a haemoglobin-based oxygen carrier will be used. With this protocol, we aim to transplant extra livers. The primary endpoint is graft survival at 3 months after transplantation.

Ethics and dissemination

This protocol was approved by the medical ethical committee of Groningen, METc2016.281 in August 2016 and registered in the Dutch Trial registration number

Trial registration number

NTR5972,NCT02584283.
Conceptual framework for personal recovery in mental health among children and adolescents: a systematic review and narrative synthesis protocol
Authors: Ballesteros-Urpi Anna , Slade Mike , Manley David , Pardo-Hernandez Hector
Published: August 2019

Introduction

Personal recovery has been defined as ‘a profound personal and unique process for the individual to change their attitudes, values, feelings, goals, abilities and roles in order to achieve a satisfactory, hopeful and productive way of life, with the possible limitations of the illness’. However, research on personal recovery has focused almost exclusively on adults. This project aims to systematically review the available literature on definitions of personal recovery among children and adolescents with mental health conditions and to undertake a narrative synthesis to develop a conceptual framework of recovery.

Methods and analysis

Systematic review and narrative synthesis consisting (1) searching scientific literature databases, (2) handsearching, (3) citation tracking, (4) grey literature searching, (5) web-based searching and expert consultation. We will include qualitative and quantitative studies or systematic reviews providing a definition, theoretical or conceptual framework, domains or dimensions of personal recovery among eligible participants. The study will follow standard systematic review methodology for study selection and data extraction. We will assess quality of the evidence using tools appropriate for each study design. We will develop a new conceptual framework using a modified narrative synthesis approach, as follows: (1) describing eligible studies and conducting a preliminary synthesis, (2) determining relationships within and between studies and (3) determining the robustness of the synthesis.

Ethics and dissemination

We obtained a waiver of approval from our local Research Ethics Committee. Results will be disseminated via publications in international peer-reviewed journals and conference proceedings.

This study will result in a theoretical framework that is based on an exhaustive review of the literature and the input of experts in the field of recovery. We expect that this framework will foster a better understanding of the stages and processes of recovery in children and adolescents with mental health conditions.

PROSPERO registration number

CRD42018064087.
Knowledge acquisition and retention following Saving Children’s Lives course for healthcare providers in Botswana: a longitudinal cohort study
Authors: Meaney Peter Andrew , Joyce Christine Lynn , Setlhare Segolame , Smith Hannah E , Mensinger Janell L , Zhang Bingqing , Kalenga Kitenge , Kloeck David , Kgosiesele Thandie , Jibril Haruna , Mazhani Loeto , de Caen Allan , Steenhoff Andrew P
Published: August 2019

Objectives

Millions of children die every year from serious childhood illnesses. Most deaths are avertable with access to quality care. Saving Children’s Lives (SCL) includes an abbreviated high-intensity training (SCL-aHIT) for providers who treat serious childhood illnesses. The objective of this study was to examine the impact of SCL-aHIT on knowledge acquisition and retention of providers.

Setting

76 participating centres who provide primary and secondary care in Kweneng District, Botswana.

Participants

Doctors and nurses expected by the District Health Management Team to provide initial care to seriously ill children, completed SCL-aHIT between January 2014 and December 2016, submitted demographic data, course characteristics and at least one knowledge assessment.

Methods

Retrospective, cohort study. Planned and actual primary outcome was adjusted acquisition (change in total knowledge score immediately after training) and retention (change in score at 1, 3 and 6 months), secondary outcomes were pneumonia and dehydration subscores. Descriptive statistics and linear mixed models with random intercept and slope were conducted. Relevant institutional review boards approved this study.

Results

211 providers had data for analysis. Cohort was 91% nurses, 61% clinic/health postbased and 45% pretrained in Integrated Management of Childhood Illness (IMCI). A strong effect of SCL-aHIT was seen with knowledge acquisition (+24.56±1.94, p<0.0001), and loss of retention was observed (−1.60±0.67/month, p=0.018). IMCI training demonstrated no significant effect on acquisition (+3.58±2.84, p=0.211 or retention (+0.20±0.91/month, p=0.824) of knowledge. On average, nurses scored lower than physicians (−19.39±3.30, p<0.0001). Lost to follow-up had a significant impact on knowledge retention (−3.03±0.88/month, p=0.0007).

Conclusions

aHIT for care of the seriously ill child significantly increased provider knowledge and loss of knowledge occurred over time. IMCI training did not significantly impact overall knowledge acquisition nor retention, while professional status impacted overall score and lost to follow-up impacted retention.
Guidance on how to develop complex interventions to improve health and healthcare
Authors: O"Cathain Alicia , Croot Liz , Duncan Edward , Rousseau Nikki , Sworn Katie , Turner Katrina M , Yardley Lucy , Hoddinott Pat
Published: August 2019

Objective

To provide researchers with guidance on actions to take during intervention development.

Summary of key points

Based on a consensus exercise informed by reviews and qualitative interviews, we present key principles and actions for consideration when developing interventions to improve health. These include seeing intervention development as a dynamic iterative process, involving stakeholders, reviewing published research evidence, drawing on existing theories, articulating programme theory, undertaking primary data collection, understanding context, paying attention to future implementation in the real world and designing and refining an intervention using iterative cycles of development with stakeholder input throughout.

Conclusion

Researchers should consider each action by addressing its relevance to a specific intervention in a specific context, both at the start and throughout the development process.
Improving intravenous fluid prescribing in the Eastern Cape in South Africa
Authors: Luce Cate , Soffair Rosie , Parrish Andy
Published: August 2019

Intravenous fluids are an essential component of patient care, but a 2013 National Institute for Health and Care Excellence (NICE) guideline noted that inappropriate prescribing or administration may lead to actual or potential patient harm in up to 20% of patients.1 This project aimed to improve prescribing documentation and communication between nurses and doctors regarding intravenous fluid management. This was done through the introduction of a fluid chart, in combination with teaching on appropriate fluid management. It was initiated within the medical department of Cecelia Makiwane Hospital in East London, South Africa. 309 patients were included and data were analysed over a 6-month period. The outcome measures were the standards of intravenous fluid prescribing set by the NICE guidelines. The process measure was the use of the new chart. Baseline data highlighted that there was no standardised location for fluid prescriptions within the bedside notes. Following the intervention, 81% of fluid prescriptions were on a fluid chart. The percentage of fluid scripts with a 24-hour fluid prescription, a recorded indication and recorded input increased after the intervention. Seventy six per cent of patients received more than 50% of the fluids prescribed following the intervention compared with 22% at baseline. These results indicated an increase in the doctor’s awareness of appropriate fluid prescribing and an improvement in the communication between doctors and nurses regarding the patient’s fluid management. The engagement of local stakeholders and staff was fundamental to the success of the project and allowed for this change in practice. Fluid management is a vital part of care in many specialties; therefore, a toolkit has been created to allow similar quality improvement projects to be implemented across other hospitals around the Eastern Cape.
Nursing roles for in-hospital cardiac arrest response: higher versus lower performing hospitals
Authors: Guetterman Timothy C , Kellenberg Joan E , Krein Sarah L , Harrod Molly , Lehrich Jessica L , Iwashyna Theodore J , Kronick Steven L , Girotra Saket , Chan Paul S , Nallamothu Brahmajee K
Published: August 2019

Background

Good outcomes for in-hospital cardiac arrest (IHCA) depend on a skilled resuscitation team, prompt initiation of high-quality cardiopulmonary resuscitation and defibrillation, and organisational structures to support IHCA response. We examined the role of nurses in resuscitation, contrasting higher versus lower performing hospitals in IHCA survival.

Methods

We conducted a descriptive qualitative study at nine hospitals in the American Heart Association’s Get With The Guidelines-Resuscitation registry, purposefully sampling hospitals that varied in geography, academic status, and risk-standardised IHCA survival. We conducted 158 semistructured interviews with nurses, physicians, respiratory therapists, pharmacists, quality improvement staff, and administrators. Qualitative thematic text analysis followed by type-building text analysis identified distinct nursing roles in IHCA care and support for roles.

Results

Nurses played three major roles in IHCA response: bedside first responder, resuscitation team member, and clinical or administrative leader. We found distinctions between higher and lower performing hospitals in support for nurses. Higher performing hospitals emphasised training and competency of nurses at all levels; provided organisational flexibility and responsiveness with nursing roles; and empowered nurses to operate at a higher scope of clinical practice (eg, bedside defibrillation). Higher performing hospitals promoted nurses as leaders—administrators supporting nurses in resuscitation care at the institution, resuscitation team leaders during resuscitation and clinical champions for resuscitation care. Lower performing hospitals had more restrictive nurse roles with less emphasis on systematically identifying improvement needs.

Conclusion

Hospitals that excelled in IHCA survival emphasised mentoring and empowering front-line nurses and ensured clinical competency and adequate nursing training for IHCA care. Though not proof of causation, nurses appear to be critical to effective IHCA response, and how to support their role to optimise outcomes warrants further investigation.
Reliability of Ultrashort Electrocardiographic Indices in Hypertension: The Quest for a Clinically Applicable Prognostic Marker
Authors: Politi Keren , Kaminer Keren , Nussinovitch Udi
Published: August 2019

Heart rate variability (HRV) is an accepted clinical tool for evaluating autonomic nervous system function and a marker of adverse cardiac outcome. Although 5 min long HRV recordings are considered methodologically acceptable, it remains impractical in most clinical settings. Also, while some ultrashort HRV (usHRV) parameters were found useful in healthy individuals, their applicability to patients with cardiovascular risk factors is largely unknown. Therefore, our goal was to evaluate the reliability of ultrashort ECG (usECG) indices for HRV among patients with hypertension. One-hundred and two patients with essential hypertension were included. HRV was recorded for 5 min in strictly monitored settings. HRV parameters from randomly chosen 1 min and 10 s series were analyzed. Excellent correlations were found between 1 min SD of RR interval (SDNN) (intraclass correlation coefficient (ICC) 0.973), 10 s SDNN (ICC 0.92) and 5 min SDNN results. An excellent correlation was also found between 1 min root  mean square of successive differences in RR intervals (RMSSD) (ICC 0.992), 10 s RMSSD (ICC 0.982) and 5 min RMSSD. Logarithmic transformation of ultrashort 1 min HRV-triangular index using the natural logarithm (Ln) also had excellent correlation with 5 min measurements (ICC 0.9). Also, excellent correlations were found between 10 s and 1 min Ln(RMSSD), 10 s Ln(RMSSD) and 5 min measurements. Other HRV parameters measured from 1 min and 10 s periods showed lower correlations. In conclusion, evaluation of SDNN, RMSSD or Ln(RMSSD) from 10 s ECG recordings can be used to estimate autonomic nervous system function in patients with hypertension. These appealing markers can be readily calculated from any standard ECG tracing. The prognostic significance of ultrashort SDNN and ultrashort RMSSD in patients with cardiovascular risk factors needs to be determined in future prospective cohort studies.
Mark Alasdair O'Brien
Authors: Vere Wendy
Published: August 2019

A wonderful friend, father, academic, vet, musician and artist.
Jerome Sullivan
Authors: Sullivan Peter B.
Published: August 2019

A mixed practitioner whose early life experiences shaped him as a kind and loyal man.
Shorter trawls improve size selection of northern shrimp
Authors: Ingólfsson Ólafur Arnar , Jørgensen Terje
Published: August 2019

Discards of small northern shrimp (Pandalus borealis) are a problem in the Skagerrak northern shrimp trawl fishery. To reduce catches of small shrimp, we studied the effect of trawl belly length on size selectivity in November 2017 and June 2018 onboard 15 and 27 m double-rigged shrimp trawlers. The selectivity of the vessels’ standard trawl was compared with a trawl differing only in the belly length, being 37% shorter. The trawls had 40 mm bottom panels and cod ends of 35 mm mesh sizes. Eleven and 14 hauls were made, respectively, in 2017 aboard the 15 m vessel and in 2018 aboard the 27 m vessel. The trawls fished shrimp above 19 mm carapace length equally, while catch rates of shrimp below 15.5–16 mm carapace length in the shorter trawl were more than halved. The results were consistent between the two vessels. In short, modifying trawl length is a simple design modification that can reduce catches of small shrimp. Bycatch of Norway pout (Trisopterus esmarkii) was slightly reduced in the shorter trawl, unrelated to fish length.
Semantic Concept Extraction for Eyebrow Shapes via AFS Clustering
Authors: Du Tao , Li Danyang , Ren Yan , Lu Chong , Liu Wanquan
Published: August 2019

In this paper, a revised directional triangle-area curve representation method (DTAR) is proposed to address the problem of eyebrow semantic shape characterization via curve representation. First, 11 or 12 DTAR values are selected to describe eyebrows via considering the eyebrow corner information roughly, and then the corresponding DTAR curves are acquired via the cubic spline interpolation based on these selected points. Second, a descriptor of the landmarks is developed to represent selected reference eyebrows, and the corresponding DTAR curves are obtained for the selected reference eyebrows. Lastly, a similarity notion based on AFS is introduced via measuring the membership degrees of each eyebrow shape similar to the given reference shapes, and then one can describe each eyebrow shape by using two given reference eyebrow shapes via computing the membership degrees representing the relative similarities. To illustrate the effectiveness of the proposed approach, we use the AR and BJUT databases for experiments to demonstrate the consistency comparison with human perceptions. The experimental results show that the extracted semantic notions of eyebrow shapes obtained by the proposed approach are much better than those by only utilizing 11 DTAR values or 12 DTAR values directly in terms of the consistency with human perceptions.
Lattice hydrodynamic model-based feedback control method with traffic interruption probability
Authors: Zhai Cong , Wu Weitiao
Published: August 2019

Connected vehicles are expected to become commercially available by the next decade, while traffic interruption is not uncommon in the real traffic environment. In this paper, we propose a feedback control method for lattice hydrodynamic model considering the traffic interruption probability effect. The stability criterion of the new model is explored through linear stability analysis of transfer function. When the stability conditions are not satisfied, a delay feedback controller is used to control the discharging flow to suppress traffic congestion. The impact of gain coefficient and delay time on the performance is discussed. We verify the effectiveness of the devised delay feedback controller by simulations. Results show that the traffic interruption probability effect has a considerable impact on the stability of traffic flow, while the controller is effective in suppressing traffic congestion.
Structures of exact and solitary optical solutions for the higher-order nonlinear Schrödinger equation and its applications in mono-mode optical fibers
Authors: Lu Dianchen , Seadawy Aly R. , Khater Mostafa M. A.
Published: August 2019

In this research, we give a new structure of solutions for the higher-order nonlinear Schrödinger equation and its applications to mono-mode optical fibers. To achieve this, we implement two recent methods, namely, the generalized Kudryashov method and generalized Riccati equation mapping method. The new optical soliton solutions for the higher-order nonlinear Schrödinger equation which refers to an optical field are obtained. The obtained solutions demonstrate the adequacy, strength, and effectiveness of both methods used and also show their ability to deal with different forms and patterns of the nonlinear partial differential equation.
Design Guidelines for MEMS Optical Accelerometer based on Dependence of Sensitivities on Diaphragm Dimensions
Authors: Jindal Sumit Kumar , Priya Srishti , Kshipra Prasadh S.
Published: August 2019

This work deals in specifying the design considerations while constructing a Micro Electro Mechanical Systems (MEMS) optical accelerometer working on capacitive sensing technique. Sensitivity is one of the most demanded characteristics of any sensor. The sensor considered is a MEMS capacitive accelerometer in which both displacement and capacitance are the primary sensing characteristics. This differential capacitive accelerometer causes change in displacement due to applied acceleration and further produces change in capacitance. So, the main focus in this work is to improve or select the suitable diaphragm dimensions of the differential capacitor in order to get optimal capacitive and displacement sensitivity. This is done for an Optical MEMS (MOEMS) based sensor where slight change has a large-scale impact. The electrical signal is converted to optical by adding an Optical Interferometer. Mach–Zehnder Interferometer (MZI) is used to carry out the intensity modulation which also gives protection in inflammable surroundings. This makes the system suitable for working in high temperature regions.
Modeling and Simulation of Bifurcation Dynamics of a Double Spatial Pendulum Excited by a Rotating Obstacle
Authors: Kudra Grzegorz , Szewc Michał , Ludwicki Michał , Awrejcewicz Jan
Published: August 2019

This work focuses on analyzing the dynamical behavior of a mechanical system consisting of a double spatial pendulum in contact with a movable obstacle. The pendulum’s ability to move in space is achieved by the use of special Cardan–Hook joints as the links of the pendulum. The mechanical system is equipped with a special movable obstacle, i.e. a rotating circular plate situated below the pendulum, which limits the space of admissible positions. A significant part of this work is devoted to the modeling of the contact between the pendulum and the obstacle. In this regard, a special class of reduced models is derived with the resultant friction force and moment acting on the finite size of the contact area along with a compliant model of impact based on the Hertz stiffness. Finally, the effective model suitable for fast and realistic numerical simulations is obtained. The contact model is tested numerically and the effect of its parameters on the system bifurcation dynamics is investigated.
Water Flow Driven Sensor Networks for Leakage and Contamination Monitoring in Distribution Pipelines
Authors: Pal Amitangshu , Kant Krishna
Published: August 2019

In this article, we introduce the concept of Water Flow Driven Sensor Networks for leakage and contamination monitoring in urban water distribution systems. The unique aspect of our work is that the sensor network can be deployed in the underground water network with only access to connection points (through manholes) and driven only by water harvested energy without the need for AC power or frequent battery changes. Although water systems may be affected by a large variety of contaminants, only a few sensors can be practically deployed. Thus, many types of contaminants are sensed via “proxy sensing,” which may not be 100% reliable. The main problems addressed are (a) adaptation of the network to the available energy to maximize leak/contamination detection and (b) minimal artificial water circulation or leakage to improve detectability during periods of almost zero natural water flow. The article shows, through extensive simulations, that the proposed approach can drastically reduce the leakage/contamination reporting time (from 3.5h up to ∼6min), and the adaptation can reduce this circulation by ∼33% and yet enhance the collected/transmitted data by 30%.