bluuebunny/crossref_metadata_2025 huggingface dataset:
Blood bank preparedness for mass casualty incidents and disasters: a pilot study in the Piedmont region, Italy
Authors: Caramello Valeria , Camerini Odetta , Ricceri Fulvio , Ottone Piero , Mascaro Gennaro , Chianese Rosa , Bodas Moran , Bierens Joost , Della Corte Francesco
Published: March 2019

Background and Objectives

Blood is a critical resource for responding to mass casualty incidents (MCI). The main framework for transfusion preparedness is the American Association of Blood Bank (AABB) Disaster Operation Handbook. A disaster preparedness plan for co‐ordinated blood supply was issued in Italy in 2016.

Aim

To assess the level of preparedness of the Transfusion Centers (TS) in the Piedmont region, to evaluate the applicability of AABB checklist and to evaluate the application of the Italian plan.

Materials and Methods

We surveyed all the Regional Transfusion Centers (TS) using the AABB checklist, addressing 74 priority action items grouped according to 16 preparedness domains. The Italian 2016 plan has been considered the regulatory cut‐off and hospitals were stratified based on the type and the TS workload. A principal component analysis (PCA) was conducted to summarize the variance among centres.

Results

Twenty‐one out of 25 TS agreed to participate. Eighty‐one % were at high and 18% were at medium level of preparedness. All but two centres were above the cut‐off determined by the Italian law. A significant better preparedness was found in medium size hospitals compared to bigger and smaller hospitals. Other than that, the different TS showed a quite homogeneous distribution of preparedness variance.

Conclusions

This study demonstrated a good level of preparedness in the Piemonte TS, above the Italian law requirements in the majority of TS. The AABB checklist could be used to highlight gaps and needs in the regional TS networks in case of emergency crisis.
Microscopic Determination of Remaining Oil Distribution in Sandstones With Different Permeability Scales Using Computed Tomography Scanning
Authors: Yang Yongfei , Yang Haiyuan , Tao Liu , Yao Jun , Wang Wendong , Zhang Kai , Luquot Linda
Published: March 2019

To investigate the characteristics of oil distribution in porous media systems during a high water cut stage, sandstones with different permeability scales of 53.63 × 10−3 μm2 and 108.11 × 10−3 μm2 were imaged under a resolution of 4.12 μm during a water flooding process using X-ray tomography. Based on the cluster-size distribution of oil segmented from the tomography images and through classification using the shape factor and Euler number, the transformation of the oil distribution pattern in different injection stages was studied for samples with different pore structures. In general, the distribution patterns of an oil cluster continuously change during water injection. Large connected oil clusters break off into smaller segments. The sandstone with a higher permeability (108.11 × 10−3 μm2) shows the larger change in distribution pattern, and the remaining oil is trapped in the pores with a radius of approximately 7–12 μm. Meanwhile, some disconnected clusters merge together and lead to a re-connection during the high water cut period. However, the pore structure becomes compact and complex, the residual nonwetting phase becomes static and is difficult to move; and thus, all distribution patterns coexist during the entire displacement process and mainly distribute in pores with a radius of 8–12 μm. For the pore-scale entrapment characteristics of the oil phase during a high water cut period, different enhance oil recovery (EOR) methods should be considered in sandstones correspondent to each permeability scale.
Microscopic Studies of Immiscible Displacement Behavior in Interconnected Fractures and Cavities
Authors: Meng Qingbang , Xu Sai , Cai Jianchao
Published: March 2019

Carbonate rocks are generally highly heterogeneous that make it difficult to accurately assess the behavior of fluid flow and transport in them. In this paper, we experimentally investigate the oil–water displacement in carbonate reservoirs by mimicking the typical pore vugs of carbonates through fabricating glass micromodels. The micromodels were saturated completely with oil, and then water was injected continuously at a constant rate until a steady state was achieved. After that, the injection rate was increased in steps. For each injection rate, water was continuously injected until a steady state was achieved and then increased to the next injection rate. For each injection rate, the displacement process of oil and water in the micromodel was captured by a digital video camera. Experimental results show that water breakthrough occurs in pure-fracture channels earlier than that in fracture-cavity channels. The wettability and pore networks of fractures and vugs have a significant impact on the distribution of trapped oil. Oil is preferential to be trapped in the oil-wet zone and the zone where deviation from the mainstream line starts. Residual oil saturation shows no noticeable change with relatively low injection rates. However, when the injection rate exceeds a critical value, residual oil saturation decreases with an increase in the injection rate.
Study on the Core Groups of First Integrals and Folding Index for Mechanical Systems
Authors: Zhang Suxia , Chen Weiting
Published: March 2019

In applying the Udwadia–Kalaba equation for constrained mechanical systems, a direct proof of the equivalence of first integrals and nonholonomic constraints is given, and it is demonstrated that the generalized force of the system is equivalent to the constraint force derived by all first integrals of the nonholonomic constraints. Furthermore, depending on whether complete information is included in the subsets of the first integrals or not, the concept of “multiple kernel” of the system is introduced, and then the core groups of the first integrals and the folding index, which reveals the “simplicity” of the system, are defined. Finally, the onefold system is discussed in detail, and the judgment method is given. To verify the feasibility of this method and illustrate the application of the multiple kernel theory, three examples are considered. The new concepts and results presented in this paper help reveal the inner structure of the general mechanical system, which forms the foundation of control theory of constraint motions, and the multiple kernel analysis of the complex systems can be a new research area of analytic mechanics in the future.
Multidimensional Approximation of Nonlinear Dynamical Systems
Authors: Gelß Patrick , Klus Stefan , Eisert Jens , Schütte Christof
Published: March 2019

A key task in the field of modeling and analyzing nonlinear dynamical systems is the recovery of unknown governing equations from measurement data only. There is a wide range of application areas for this important instance of system identification, ranging from industrial engineering and acoustic signal processing to stock market models. In order to find appropriate representations of underlying dynamical systems, various data-driven methods have been proposed by different communities. However, if the given data sets are high-dimensional, then these methods typically suffer from the curse of dimensionality. To significantly reduce the computational costs and storage consumption, we propose the method multidimensional approximation of nonlinear dynamical systems (MANDy) which combines data-driven methods with tensor network decompositions. The efficiency of the introduced approach will be illustrated with the aid of several high-dimensional nonlinear dynamical systems.
Association of Physical Activity With Urinary Incontinence in Older Women: A Systematic Review
Authors: Faleiro Deise J.A. , Menezes Enaiane C. , Capeletto Eduardo , Fank Felipe , Porto Rafaela M. , Mazo Giovana Z.
Published: March 2019

Objective: To analyze the scientific evidence on the association of physical activity with urinary incontinence in older women. Design: Searches were performed in MEDLINE, PubMed, CINAHL, Web of Science, SCOPUS, and ScienceDirect. Observational studies were included. The following search terms were used: urinary incontinence, older adult, and physical activity. Methodological quality was assessed using the checklist proposed by Downs and Black. Results: Ten articles were included. Sedentary lifestyle and <150 min/week of physical activity are at risk of developing urinary incontinence. Walking (at least 30 min) and physical activities (600–1,500 and 600 METs/min per week) prevent urinary incontinence. Seven of the 10 studies indicated a good level of methodological quality. Conclusions: Sedentary lifestyle is at risk of urinary incontinence, and walking, moderate and vigorous physical activities are associated with prevention of urinary incontinence.
Nutritional and Pharmacological Interventions to Expedite Recovery Following Muscle-Damaging Exercise in Older Adults: A Narrative Review of the Literature
Authors: Clifford Tom
Published: March 2019

Exercise-induced muscle damage (EIMD) manifests as muscle soreness, inflammation, and reductions in force generating capacity that can last for several days after exercise. The ability to recover and repair damaged tissues following EIMD is impaired with age, with older adults (≥50 years old) experiencing a slower rate of recovery than their younger counterparts do for the equivalent exercise bout. This narrative review discusses the literature examining the effect of nutritional or pharmacological supplements taken to counter the potentially debilitating effects of EIMD in older adults. Studies have assessed the effects of nonsteroidal anti-inflammatory drugs, vitamin C and/or E, or higher protein diets on recovery in older adults. Each intervention showed some promise for attenuating EIMD, but, overall, there is a paucity of available data in this population, and more studies are required to determine the influence of nutrition or pharmacological interventions on EIMD in older adults.
Comparison of Muscle Activity Using Unstable Devices During a Forward Lunge
Authors: Bouillon Lucinda E. , Hofener Michael , O’Donnel Andrew , Milligan Amanda , Obrock Craig
Published: March 2019

Context: Unstable devices in various forms are used as therapeutic adjuncts for prevention or following an injury. A slip-over-the-shoe design with inflatable domes (STEPRIGHT® Stability Trainer) was developed to improve balance. It is unknown how this unstable device affects muscle activity during a closed-chain exercise such as the forward lunge. Objective: To compare muscle activity across 3 surfaces (STEPRIGHT®, Both Sides Up [BOSU®] Balance Trainer, and firm) during a forward lunge. Design: Within-subject, repeated measures. Setting: University physical therapy research laboratory. Participants: A total of 20 healthy, recreationally active subjects (23.4 [1.47] y, 172.7 [14.7] cm, 71.6 [16.8] kg). Intervention: Each subject performed 1 set of 10 repetitions of forward lunge exercise in random order with STEPRIGHT®, BOSU®, and firm surface. Main Outcome Measures: Surface electromyography data, normalized to maximum voluntary isometric contractions (%MVIC), was used to assess muscle activity on rectus femoris, vastus medialis oblique (VMO), biceps femoris, lateral gastrocnemius, fibularis longus, and tibialis anterior. Results: The repeated-measures analysis of variance determined that there was a significant effect for surface type. During the descent of the lunge, the STEPRIGHT® elicited higher rectus femoris (33% [27%] MVIC) compared with BOSU® (22% [14%] MVIC) and VMO (44% [15%] MVIC) on STEPRIGHT® compared with firm (38% [11%] MVIC) (P < .05). During the ascent of the lunge, the rectus femoris (38% [27%] MVIC) using STEPRIGHT® was higher than BOSU® (24% [16%] MVIC), and STEPRIGHT® elicited higher VMO (65% [20%] MVIC) versus BOSU® (56% [19%] MVIC) (P ≤ .01). The STEPRIGHT® for fibularis longus was higher (descent: 51% [20%] MVIC, ascent: 52% [22%] MVIC) than BOSU® (descent: 36% [15%] MVIC, ascent: 33% [16%] MVIC) or firm (descent: 33% [12%] MVIC, ascent: 35% [15%] MVIC) (P < .001). Conclusions: Clinicians may choose to use the STEPRIGHT® for strengthening VMO and fibularis longus muscles, as these were over 41% MVIC or any of the 3 surfaces for endurance training (<25% MVIC) for biceps femoris muscle. This information may be helpful in exercise dosage for forward lunges when using STEPRIGHT®, BOSU®, or a firm surface.
Self-Myofascial Release of the Superficial Back Line Improves Sit-and-Reach Distance
Authors: Williams Whitney , Selkow Noelle M.
Published: March 2019

Context: Decreased hamstring flexibility can lead to a plethora of musculoskeletal injuries, including low back pain, hamstring strains, and patellofemoral pain. Lack of flexibility may be the result of myofascial adhesions. The fascia connected to the hamstrings is part of the superficial back line that runs from the cranium to the plantar aspect of the foot. Any disruption along this chain may limit the flexibility of the hamstring. Objective: To investigate if self-myofascial release (SMR) of the plantar surface of the foot in addition to the hamstring group was more effective at improving the flexibility of the hamstrings when compared with either intervention alone. Design: Cross-over study. Setting: Athletic training facility. Participants: Fifteen college students (5 males and 10 females; age: 20.9 [1.4] y, height: 173.1 [10.3] cm, mass: 80.0 [24.9] kg) who were not older than 30, with no history of low back pain or injury within the past 6 months, no history of leg pain or injury within the past 6 months, no current signs or symptoms of cervical or lumbar radicular pain, no current complaint of numbness or tingling in the lower-extremity, and no history of surgery in the lower-extremity or legs. Interventions: Each participant received each intervention separated by at least 96 hours in a randomized order: hamstring foam rolling, lacrosse ball on the plantar surface of the foot, and a combination of both. Main Outcome Measures: The sit-and-reach test evaluated hamstring flexibility of each participant before and immediately after each intervention. Results: There were no significant differences found among the SMR techniques on sit-and-reach distance (F2,41 = 2.7, P = .08, ). However, at least 20% of participants in each intervention improved sit-and-reach distance by 2.5 cm. Conclusions: SMR may improve sit-and-reach distance, but one technique of SMR does not seem to be superior to another.
Defining Physical Literacy for Application in Australia: A Modified Delphi Method
Authors: Keegan Richard J. , Barnett Lisa M. , Dudley Dean A. , Telford Richard D. , Lubans David R. , Bryant Anna S. , Roberts William M. , Morgan Philip J. , Schranz Natasha K. , Weissensteiner Juanita R. , Vella Stewart A. , Salmon Jo , Ziviani Jenny , Okely Anthony D. , Wainwright Nalda , Evans John R.
Published: March 2019

Purpose: The development of a physical literacy definition and standards framework suitable for implementation in Australia.Method: Modified Delphi methodology.Results: Consensus was established on four defining statements:Core—Physical literacy is lifelong holistic learning acquired and applied in movement and physical activity contexts;Composition—Physical literacy reflects ongoing changes integrating physical, psychological, cognitive, and social capabilities;Importance—Physical literacy is vital in helping us lead healthy and fulfilling lives through movement and physical activity; andAspiration—A physically literate person is able to draw on his/her integrated physical, psychological, cognitive, and social capacities to support health promoting and fulfilling movement and physical activity, relative to the situation and context, throughout the lifespan. The standards framework addressed four learning domains (physical, psychological, cognitive, and social), spanning five learning configurations/levels.Conclusion: The development of a bespoke program for a new context has important implications for both existing and future programs.
Eye on ion channels in immune cells
Authors: Feske Stefan , Concepcion Axel R. , Coetzee William A.
Published: March 2019

A recent cross-disciplinary meeting highlighted the importance of ion channels and fluxes in immunity.
Comparative Analysis of Ionic Strength Tolerance between Freshwater and Marine
Caulobacterales
Adhesins
Authors: Chepkwony Nelson K. , Berne Cécile , Brun Yves V.
Published: March 2019

Most bacteria spend a large part of their life spans attached to surfaces, forming complex multicellular communities called biofilms. Bacteria can colonize virtually any surface, and therefore, they have adapted to bind efficiently in very different environments. In this study, we compare the adhesive holdfasts produced by the freshwater bacterium
C. crescentus
and a relative, the marine bacterium
H. baltica
. We show that
H. baltica
holdfasts have a different morphology and chemical composition and tolerate high ionic strength. Our results show that the
H. baltica
holdfast is an excellent model to study the effect of ionic strength on adhesion and provides insights into the physicochemical properties required for adhesion in the marine environment.
Human Cytomegalovirus DNA Polymerase Subunit UL44 Antagonizes Antiviral Immune Responses by Suppressing IRF3- and NF-κB-Mediated Transcription
Authors: Fu Yu-Zhi , Su Shan , Zou Hong-Mei , Guo Yi , Wang Su-Yun , Li Shu , Luo Min-Hua , Wang Yan-Yi
Published: March 2019

Induction of type I IFNs and inflammatory cytokines plays pivotal roles in host antiviral innate immune responses. Viruses have evolved various mechanisms to interfere with these processes. HCMV causes severe ailments in immunodeficient populations and is a major cause of birth defects. It has been shown that HCMV antagonizes host innate immune defenses, which is important for establishing immune evasion and latent infection. In this study, we identified the HCMV DNA polymerase subunit UL44 as a suppressor of antiviral innate immune responses. Overexpression of UL44 impaired HCMV-triggered induction of type I IFNs and other antiviral genes and thus potentiated viral replication, whereas UL44 deficiency showed opposite effects. Mechanistic studies indicated that UL44 acts by inhibiting the binding of IRF3 and NF-κB to the promoters of downstream antiviral genes. These findings defined an important mechanism of HCMV immune evasion at the transcriptional level, which may provide a therapeutic target for the treatment of HCMV infection.
Viral Factors Important for Efficient Replication of Influenza A Viruses in Cells of the Central Nervous System
Authors: Siegers Jurre Y. , van de Bildt Marco W. G. , Lin Zhanmin , Leijten Lonneke M. , Lavrijssen Rémon A. M. , Bestebroer Theo , Spronken Monique I. J. , De Zeeuw Chris I. , Gao Zhenyu , Schrauwen Eefje J. A. , Kuiken Thijs , van Riel Debby
Published: March 2019

Central nervous system (CNS) disease is one of the most common extrarespiratory tract complications of influenza A virus infections, and the frequency and severity differ between seasonal, pandemic, and zoonotic influenza viruses. However, little is known about the interaction of these viruses with cells of the CNS. Differences among seasonal, pandemic, and zoonotic influenza viruses in replication efficacy in CNS cells,
in vitro
, suggest that the presence of an alternative HA cleavage mechanism and ability to attach are important viral factors. Identifying these viral factors and detailed knowledge of the interaction between influenza virus and CNS cells are important to prevent and treat this potentially lethal CNS disease.
Long-term efficacy and tolerability of TNFα inhibitors in the treatment of non-infectious ocular inflammation: an 8-year prospective surveillance study
Authors: Sharma Srilakshmi M , Damato Erika , Hinchcliffe Ann E , Andrews Colm D , Myint Katie , Lee Richard , Dick Andrew D
Published: March 2019

Background/Aim

To report the efficacy and tolerability of antitumour necrosis factor-alpha therapy (TNF inhibitors [TNFi]) in the management of non-infectious ocular inflammation, including uveitis and scleritis, in adult patients over an 8-year period.

Materials and methods

This is a prospective cohort study of infliximab and adalimumab in the treatment of non-infectious ocular inflammatory disease. 43 of 85 adult patients on TNFi (34 infliximab, 9 adalimumab) for ≥1 year with non-infectious uveitis or scleritis were followed from 2006 to 2014. Clinical assessments, medication, adverse events and history of steroid rescues were collected at 6 monthly intervals. General quality of life (Short Form Health Survey (SF-36)) and visual quality of life (Vision-related quality of life Core Measure (VCM1)) were assessed annually. Outcome measures included rate of sustained remission, rate of relapse, systemic corticosteroid reduction, adverse events, and VCM1 and SF-36 scores.

Results

The median time on infliximab was 3.2 years (IQR 4.3) and on adalimumab was 2.4 years (IQR 1.8). Sustained remission was induced in 39 patients (91%) (0.5 per patient year) after a median of 1.2 years on a TNFi. 22 (51%) experienced one relapse, and 5 (12%) had two relapses. 23 (54%) had at least one adverse event; serious adverse events necessitating hospitalisation or cessation of medication occurred in four (9%) patients. 10 patients (23%) switched from the initiation of TNFi, at 1.7 years after starting, to another TNFi or another class of biologic therapy.

Conclusion

TNFi treatment is associated with long-term drug-induced remission of ocular inflammation, visual stability and corticosteroid reduction. Adverse events were common and no new safety signals occurred. Relapse of inflammation occurs in half of the treated population.
SNP located in an AluJb repeat downstream of TMCO1, rs4657473, is protective for POAG in African Americans
Authors: Verkuil Lana , Danford Ian , Pistilli Maxwell , Collins David W , Gudiseva Harini V , Trachtman Ben T , He Jie , Rathi Sonika , Haider Naqi , Ying Gui-shuang , Chavali Venkata R M , O'Brien Joan Marie
Published: March 2019

Aims

To determine the association of single nucleotide polymorphisms (SNPs) downstream from the TMCO1 gene with primary open-angle glaucoma (POAG) in African Americans (AA).

Methods

AA subjects were recruited for the Primary Open-Angle African American Glaucoma Genetics (POAAGG) study from the Scheie Eye Institute and its satellite sites in Philadelphia. A region containing an AluJb repeat and seven SNPs, including rs4656461 near the TMCO1 gene, were PCR-Sanger sequenced from POAAGG cases (n=1537) and controls (n=1570). Association between POAG and SNPs near TMCO1 was investigated by logistic regression analysis. Phenotypic trait associations with these SNPs were assessed by analysis of variance. Electrophoretic mobility shift assay (EMSA) was performed to assess the affinity of human T-box 5 (TBX5) protein for a predicted binding motif in the TMCO1 region. Dual Luciferase assays were performed by transfecting recombinant plasmids containing the region surrounding the above SNPs in HEK293T and trabecular meshwork cells.

Results

The SNP rs4657473 (C>T) was associated with POAG; the TT genotype was protective (OR 0.20, 95% CI 0.09 to 0.42; p<0.001). No significant associations were found between the TMCO1 variants and phenotypic traits. EMSA confirmed the affinity of TBX5 for a predicted binding motif containing TMCO1 SNP rs4657475. Luciferase assays demonstrated a regulatory function for the genomic region around SNP rs4656561, located within AluJb repeat.

Conclusion

Our results demonstrate that a SNP downstream of TMCO1, rs4657473, is associated with POAG in an AA population. Our studies suggest a regulatory role for the previously POAG-associated locus near the TMCO1 gene that may affect gene expression.
Precision exercise medicine: understanding exercise response variability
Authors: Ross Robert , Goodpaster Bret H , Koch Lauren G , Sarzynski Mark A , Kohrt Wendy M , Johannsen Neil M , Skinner James S , Castro Alex , Irving Brian A , Noland Robert C , Sparks Lauren M , Spielmann Guillaume , Day Andrew G , Pitsch Werner , Hopkins William G , Bouchard Claude
Published: March 2019

There is evidence from human twin and family studies as well as mouse and rat selection experiments that there are considerable interindividual differences in the response of cardiorespiratory fitness (CRF) and other cardiometabolic traits to a given exercise programme dose. We developed this consensus statement on exercise response variability following a symposium dedicated to this topic. There is strong evidence from both animal and human studies that exercise training doses lead to variable responses. A genetic component contributes to exercise training response variability.

In this consensus statement, we (1) briefly review the literature on exercise response variability and the various sources of variations in CRF response to an exercise programme, (2) introduce the key research designs and corresponding statistical models with an emphasis on randomised controlled designs with or without multiple pretests and post-tests, crossover designs and repeated measures designs, (3) discuss advantages and disadvantages of multiple methods of categorising exercise response levels—a topic that is of particular interest for personalised exercise medicine and (4) outline approaches that may identify determinants and modifiers of CRF exercise response. We also summarise gaps in knowledge and recommend future research to better understand exercise response variability.
Integrated management of type 2 diabetes and gestational diabetes within multi-morbidity conditions in Africa: a systematic review protocol
Authors: Mutabazi Jean Claude , Werfalli Mahmoud M , Rawat Angeli , Musa Ezekiel , Norris Shane A , Murphy Katherine , Trottier Helen , Levitt Naomi , Zarowsky Christina
Published: March 2019

Introduction

Multi-morbidity, defined as the co-existence of more than one chronic condition in one person, has been increasing due to comorbid non-communicable and infectious chronic diseases (CNCICDs). Type 2 diabetes (T2D) and gestational diabetes mellitus (GDM) incidences within the CNCICDs conditions are increasing and overwhelming already weak and under-resourced healthcare systems in Africa. There is then an urgent need for the integrated management of CNCICDs. We aim to review the integrated management of T2D and GDM within multi-morbidity conditions in Africa.

Methods

Studies that have assessed the integrated management of T2D and GDM within multi-morbidity conditions in Africa will be considered based on the Population, Intervention, Comparator and Outcome method: population (adult diagnosed with T2D and GDM, who also have other diseases, non-communicable diseases (NCDs) and infectious, in public primary and secondary healthcare facilities in Africa); Intervention (integrated management of T2D and GDM, also suffering from other diseases in Africa), Comparator (Unintegrated management of T2D and GDM in Africa) and Outcomes (integrated management of T2D and GDM in Africa). The following databases Cochrane Library, MEDLINE, PubMed and SCOPUS, the WHO International Clinical Trials Registry Platform, among others will be searched. Two reviewers (JCM and MW) will independently screen, select eligible studies and extract data. Discrepancies will be resolved by consensus or by a discussion with the third author (AR). Quality of included studies will be assessed using both the newly developed tool, ‘the Cochrane Collaboration Risk of Bias Tool’ and ‘Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I)”. A narrative synthesis of extracted data and meta-analysis, if necessary will be conducted and then reported according to the preferred reporting items for systematic review and meta-analysis.

Ethics consideration and dissemination

By only using the published data, there is no ethics approval required for this study. This systematic review will be included in JCM’s PhD thesis and its findings will also be disseminated through peer-reviewed publication and conference presentation.

PROSPERO registration number

CRD42016046630.
Influence of individual life course and neighbourhood socioeconomic position on dietary intake in African Americans: the Jackson Heart Study
Authors: Gao Yan , Hickson DeMarc A , Talegawkar Sameera , Norwood Arnita Ford , Tucker Katherine L , Sims Mario , Diez Roux Ana V , Griswold Michael
Published: March 2019

Objective

African Americans, especially those in the Southeastern USA, have different dietary behaviours from the general US population, and have the highest prevalence, incidence and mortality of diet-related disease outcomes, such as cardiovascular disease. However, there are scant data regarding factors such as socioeconomic position (SEP) across the life course that influence dietary behaviours in this high-risk population. Our aim was to examine the impact of life course and neighbourhood SEPs on dietary intake among African Americans.

Participants and setting

Data for this cross-sectional analysis came from the community-based Jackson Heart Study (JHS). We analysed a total of 3948 JHS participants (mean age: 55.4±12.5; 63.9% women), who had complete dietary intake and covariate information.

Methods

We examined the associations of childhood SEP (CSEP), adulthood SEP (ASEP) and neighbourhood SEP (NSEP) with 10 selected dietary intake measures, using multilevel log-gamma generalised linear regression models.

Outcome measures

Dietary intake measures include daily saturated fat, sodium, protein, fibre, fruits and vegetables, whole grains, sugar-sweetened beverage, nuts, fish and processed meat.

Results

In age, sex and total energy intake adjusted models, most dietary intakes were associated with these three SEP measures. After additional adjustment for other SEP measures, most of the significant associations with CSEP and NSEP were attenuated, except for the associations of fibre with CSEP (relative rate [RR] [95% CI] 1.05 [1.00–1.10]) and whole grains with NSEP (RR [95% CI] 1.28 [1.02–1.61]). The associations (shown as RR [95% CI]) between ASEP and sugar-sweetened beverage: 0.70 (0.59–0.83), processed meat: 0.75 (0.63–0.90), sodium: 0.99 (0.94–1.00), fibre: 1.10 (1.03–1.16), protein: 1.05 (1.01–1.09), fruits and vegetables: 1.21 (1.11–1.32), nuts: 2.13 (1.59–2.87), and fish: 1.57 (1.27–1.95) generally persisted after additional adjustment for both CSEP and NSEP. However, the association between ASEP and whole grains was attenuated.

Conclusions

High ASEP may have a more beneficial influence on dietary practices in African Americans than CSEP or NSEP.
Association between access to social service resources and cardiometabolic risk factors: a machine learning and multilevel modeling analysis
Authors: Berkowitz Seth A , Basu Sanjay , Venkataramani Atheendar , Reznor Gally , Fleegler Eric W , Atlas Steven J
Published: March 2019

Objectives

Interest in linking patients with unmet social needs to area-level resources, such as food pantries and employment centres in one’s ZIP code, is growing. However, whether the presence of these resources is associated with better health outcomes is unclear. We sought to determine if area-level resources, defined as organisations that assist individuals with meeting health-related social needs, are associated with lower levels of cardiometabolic risk factors.

Design

Cross-sectional.

Setting

Data were collected in a primary care network in eastern Massachusetts in 2015.

Participants and primary and secondary outcome measures

123 355 participants were included. The primary outcome was body mass index (BMI). The secondary outcomes were systolic blood pressure (SBP), low-density lipoprotein (LDL) cholesterol and haemoglobin A1c (HbA1c). All participants were included in BMI analyses. Participants with hypertension were included in SBP analyses. Participants with an indication for cholesterol lowering were included in LDL analyses and participants with diabetes mellitus were included in HbA1c analyses. We used a random forest-based machine-learning algorithm to identify types of resources associated with study outcomes. We then tested the association of ZIP-level selected resource types (three for BMI, two each for SBP and HbA1c analyses and one for LDL analyses) with these outcomes, using multilevel models to account for individual-level, clinic-level and other area-level factors.

Results

Resources associated with lower BMI included more food resources (−0.08 kg/m2per additional resource, 95% CI −0.13 to −0.03 kg/m2), employment resources (−0.05 kg/m2, 95% CI −0.11 to −0.002 kg/m2) and nutrition resources (−0.07 kg/m2, 95% CI −0.13 to −0.01 kg/m2). No area resources were associated with differences in SBP, LDL or HbA1c.

Conclusions

Access to specific local resources is associated with better BMI. Efforts to link patients to area resources, and to improve the resources landscape within communities, may help reduce BMI and improve population health.
Lifestyle and comorbid conditions as risk factors for community-acquired pneumonia in outpatient adults (NEUMO-ES-RISK project)
Authors: Rivero-Calle Irene , Cebey-López Miriam , Pardo-Seco Jacobo , Yuste José , Redondo Esther , Vargas Diego A , Mascarós Enrique , Díaz-Maroto Jose Luis , Linares-Rufo Manuel , Jimeno Isabel , Gil Angel , Molina Jesus , Ocaña Daniel , Martinón-Torres Federico
Published: March 2019

Introduction

Information about community-acquired pneumonia (CAP) risk in primary care is limited. We assess different lifestyle and comorbid conditions as risk factors (RF) for CAP in adults in primary care.

Methods

A retrospective-observational-controlled study was designed. Adult CAP cases diagnosed at primary care in Spain between 2009 and 2013 were retrieved using the National Surveillance System of Primary Care Data (BiFAP). Age-matched and sex-matched controls were selected by incidence density sampling (ratio 2:1). Associations are presented as percentages and OR. Binomial regression models were constructed to avoid bias effects.

Results

51 139 patients and 102 372 controls were compared. Mean age (SD) was 61.4 (19.9) years. RF more significantly linked to CAP were: HIV (OR [95% CI]: 5.21 [4.35 to 6.27]), chronic obstructive pulmonary disease (COPD) (2.97 [2.84 to 3.12]), asthma (2.16 [2.07,2.26]), smoking (1.96 [1.91 to 2.02]) and poor dental hygiene (1.45 [1.41 to 1.49]). Average prevalence of any RF was 82.2% in cases and 69.2% in controls (2.05 [2.00 to 2.10]). CAP rate increased with the accumulation of RF and age: risk associated with 1RF was 1.42 (1.37 to 1.47) in 18–60-year-old individuals vs 1.57 (1.49 to 1.66) in >60 years of age, with 2RF 1.88 (1.80 to 1.97) vs 2.35 (2.23, 2.48) and with ≥ 3 RF 3.11 (2.95, 3.30) vs 4.34 (4.13 to 4.57).

Discussion

Prevalence of RF in adult CAP in primary care is high. Main RFs associated are HIV, COPD, asthma, smoking and poor dental hygiene. Our risk stacking results could help clinicians identify patients at higher risk of pneumonia.
Porphyromonas, a potential predictive biomarker ofPseudomonas aeruginosapulmonary infection in cystic fibrosis
Authors: Keravec Marlène , Mounier Jérôme , Guilloux Charles-Antoine , Fangous Marie-Sarah , Mondot Stanislas , Vallet Sophie , Gouriou Stéphanie , Le Berre Rozenn , Rault Gilles , Férec Claude , Barbier Georges , Lepage Patricia , Héry-Arnaud Geneviève
Published: March 2019

Introduction

Pseudomonas aeruginosapulmonary infections are the primary cause of morbi-mortality in patients with cystic fibrosis (CF). In this cohort study, the objective was to identify candidate biomarkers ofP. aeruginosainfection within the airway microbiota.

Methods

A 3-year prospective multicentre study (PYOMUCO study) was conducted in Western France and included patients initiallyP. aeruginosafree for at least 1 year. A 16S-targeted metagenomics approach was applied on iterative sputum samples of a first set of patients (n=33). The composition of airway microbiota was compared according to theirP. aeruginosastatus at the end of the follow-up (colonised vs non-colonised), and biomarkers associated withP. aeruginosawere screened. In a second step, the distribution of a candidate biomarker according to the two groups of patients was verified by qPCR on a second set of patients (n=52) coming from the same cohort and its load quantified throughout the follow-up.

Results

Porphyromonas(mainlyP. catoniae) was found to be an enriched phylotype in patients uninfected byP. aeruginosa(p<0.001). This result was confirmed by quantitative PCR. Conversely, in patients who becameP. aeruginosa-positive,P. catoniaesignificantly decreased beforeP. aeruginosaacquisition (p=0.014).

Discussion

Further studies on replication cohorts are needed to validate this potential predictive biomarker, which may be relevant for the follow-up in the early years of patients with CF. The identification of infection candidate biomarkers may offer new strategies for CF precision medicine.
The moral argument for heritable genome editing requires an inappropriately deterministic view of genetics
Authors: Horton Rachel , Lucassen Anneke M
Published: March 2019

Gyngell and colleagues consider that the recent Nuffield Council report does not go far enough: heritable genome editing (HGE) is not just justifiable in a few rare cases; instead, there is a moral imperative to undertake it. We agree that there is a moral argument for this, but in the real world it is mitigated by the fact that it is not usually possible to ensure a better life. We suggest that a moral imperative for HGE can currently only be concluded if one first buys into an overly deterministic view of a genome sequence, and the role of variation within in it, in the aetiology of the disease: most diseases cannot simply be attributed to specific genetic variants that we could edit away. Multiple, poorly understood genetic and environmental factors interact to influence the expression of diseases with a genetic component, even well understood ‘monogenic’ disorders. Population-level genome analyses are now demonstrating that many genetic ’mutations' are much less predictive than previously thought
1
. Furthermore, HGE might introduce new risks just as it reduces old ones; or remove protections not yet clearly delineated.
Rib fractures in the elderly: physiology trumps anatomy
Authors: Schmoekel Nathan , Berguson Jon , Stassinopoulos Jerry , Karamanos Efstathios , Patton Joe , Johnson Jeffrey L
Published: March 2019

Introduction

Rib fractures in elderly patients are associated with increased morbidity and mortality. Predicting which patients are at risk for complications is an area of debate. Current models use anatomic, physiologic or laboratory parameters in isolation to answer this question. The ‘RibScore’ is an anatomic model that assesses fracture severity. Given that frailty is a major driver of adverse outcomes in the elderly, we hypothesize that the combined analysis of fracture severity, physiologic reserve and current pulmonary function are better predictors of respiratory compromise in this population.

Methods

This is a retrospective chart review of 263 trauma patients age ≥55 from January 2014 to June 2017. Criteria included blunt mechanism and ≥ 1 rib fracture identified by CT. Variables indicating adverse pulmonary outcomes were defined by: pneumonia, respiratory failure and tracheostomy. Three models were assessed: (1) RibScore, (2) Modified Frailty Index (mFI) and (3) initial partial pressure of carbondioxide (PaCO2).

Results

A total of 263 patients met inclusion criteria. 13% developed pulmonary complications. Increased RibScore, mFI and PaCO2were each statistically associated with risk of complications. Receiver operating characteristics area under the curve analysis of individual models predicted complications with the following concordance statistic (CS): anatomic (RibScore) yielded a CS of 0.79 (95% CI 0.69 to 0.89); physiologic (mFI) yielded a CS of 0.83 (95% CI 0.75 to 0.91) and laboratory (PaCO2) yielded a CS of 0.88 (95% CI 0.80 to 0.95). The PaCO2had the highest discriminative ability of the three individual models. Combining all three models yielded the best performance with a CS of 0.90 (95% CI 0.81 to 0.97).

Discussion

The RibScore maintains discriminative ability in the elderly. However, models based on mFI and PaCO2individually outperform the RibScore. A combination of all three models yields the highest discriminative ability. This combined approach is best for assessing the severity of rib fractures and prediction of complications in the elderly.

Level of evidence

Prognostic Study, Level III.
Water–energy nexus for water distribution systems: a literature review
Authors: Sharif Muhammad Nadeem , Haider Husnain , Farahat Ashraf , Hewage Kasun , Sadiq Rehan
Published: March 2019

Water and energy are interdependent on each other. Energy is required to supply water to a system while, at the same time, water is needed for power generation in any natural or artificial system. This relationship is often called the water–energy nexus (WEN). In a water supply system, energy is consumed for source water extraction, transmission, treatment, and distribution. About 7%–8% of the world’s total generated energy is used for drinking water production and distribution. A major portion of this energy is used for distribution, i.e., pumping, chlorination, and maintenance activities, and hence is the focus of this review. Most of the world’s energy is generated by fossil fuels (oil, gas, and coal), which results in greenhouse gas (GHG) emissions. Here we review studies conducted to assess and evaluate the energy consumption and the related GHG emissions in water distribution systems (WDSs). This review covers the basic concepts and studies on WEN, energy saving solutions, renewable energy resources for water pumping, optimization of design, and the life cycle assessment (LCA) of large WDSs. Most of the reviewed studies suggest a trade-off between energy cost and the associated GHG emissions when selecting fixed-speed pumps over variable-speed pumps for large WDSs. To mitigate CO2 emissions, renewable energy resources like solar, wind, and mini-water turbines for water pumping have been discussed and mini-water turbines were found to be energy efficient solutions. The energy-focused LCA model has been studied to investigate the environmental impacts, GHG emissions, operational energy, and various life cycle stages of pipe manufacturing (embodied energy) in the network. Case studies of real world WDSs are reviewed and the potential research gaps are identified. Most life cycle studies have focused on the areas of pipe replacement, the life cycle cost of the system, the operational energy, and the reduction of GHG emissions, whereas less attention has been paid to the geographical and socio-economic issues along with the areas of human health, water resource diversity, and the hydraulic characteristics of WDSs.
An ElGamal-like Secure Channel Free Public Key Encryption with Keyword Search Scheme
Authors: Hwang Min-Shiang , Lee Cheng-Chi , Hsu Shih-Ting
Published: March 2019

The idea of public key encryption with keyword search (PEKS), proposed by Boneh et al., enables one to send a trapdoor containing a encrypted keyword to query data without revealing the keyword. In Boneh et al.’s design, the trapdoor has to be transferred through a secure channel, which is both costly and inefficient. Baek et al. then proposed an efficient secure channel free public key encryption scheme with keyword search (SCF-PEKS). After that, vast amounts of research have focused on the protection against the off-line keyword guessing attack (OKGA) by enhancing the model. However, most of the PEKS/SCF-PEKS schemes developed so far are constructed by applying bilinear pairing and are susceptible to off-line keyword guessing attacks. In this paper, we propose a new SCF-PEKS scheme based on the ElGamal cryptosystem. The proposed scheme is not only secure against off-line keyword guessing attacks but also improves the efficiency.
Explicit Communication Among Stigmergic Robots
Authors: Dieudonné Yoann , Dolev Shlomi , Petit Franck , Segal Michael
Published: March 2019

In this paper, we investigate avenues for the exchange of information (explicit communication) among deaf and mute mobile robots scattered in the plane. We introduce the use of movement-signals (analogously to flight signals and bees waggle) as a mean to transfer messages, enabling the use of distributed algorithms among robots. We propose one-to-one deterministic movement protocols that implement explicit communication among semi-synchronous robots. We first show how the movements of robots can provide implicit acknowledgment in semi-synchronous systems. We use this result to design one-to-one communication among a pair of robots. Then, we propose two one-to-one communication protocols for any system of [Formula: see text] robots. The former works for robots equipped with observable IDs that agree on a common direction (sense of direction). The latter enables one-to-one communication assuming robots devoid of any observable IDs or sense of direction. All protocols (for either two or any number of robots) assume that no robot remains inactive forever. However, they cannot avoid that the robots move either away or closer to each others, by the way requiring robots with an infinite visibility. In this paper, we also present how to overcome these two disadvantages (some activity of every robot and infinite visibility).

Our protocols enable the use of distributing algorithms based on message exchanges among swarms of stigmergic robots. They also allow robots to be equipped with the means of communication to tolerate faults in their communication devices.
Ethnobotany, Phytochemistry and Pharmacological Properties of Eucommia ulmoides: A Review
Authors: Wang Chao-Yong , Tang Li , He Jian-Wu , Li Jing , Wang Yuan-Zhong
Published: March 2019

Eucommia ulmoides Oliver, a single species of Eucommia genus belonging to the Eucommiaceae family, is an endemic in China and has been used in traditional Chinese medicine for nearly two thousand years. Records from different historical periods highlight E. ulmoides and its officinal botanical parts, usefulness in adaptation to disease and its central role in Chinese medicine theory. There are also historical collection documents for minorities in China. Tearing the leaves, bark and fruit produces strands of latex; a description of E. ulmoides’s morphological features is recorded in this paper. This review summarizes 204 natural compounds isolated from this plant, which are divided into seven categories: lignans, iridoids, flavonoids, phenols, steroids, terpenes and others. These components possess wide-ranging pharmacological efficacies, such as antihypertensive, antihyperglycemic, antihyperlipidemia, anti-oxidative, anti-osteoporosis, antitumor, immunomodulatory and neuroprotective activities. This review aims to provide a reference for extensive researches of E. ulmoides crude drugs, especially for quality control, biosynthesis and structure modification of active ingredients and pharmacological mechanism.
Features of description of composite system’s motion in twist-deformed spacetime
Authors: Gnatenko Kh. P.
Published: March 2019

Composite system made of N particles is considered in twist-deformed spacetime. It is shown that in the space the motion of the center-of-mass of the system depends on the relative motion. Influence of deformation on the motion of the center-of-mass of composite system is less than on the motion of individual particles and depends on the system’s composition. We conclude that if we consider commutation relations for coordinates of a particle to be inversely proportional to its mass, the commutation relations for coordinates of composite system do not depend on its composition and are proportional inversely to system’s total mass, besides the motion of the center-of-mass is independent of the relative motion. In addition, we find that inverse proportionality of parameters of noncommutativity to mass is important for considering coordinates in twist-deformed space as kinematic variables and for preservation of the weak equivalence principle.