bluuebunny/crossref_metadata_2025 huggingface dataset:
The prevalence of avian haemosporidian parasites in an invasive bird is lower in urban than in non‐urban environments
Authors: Santiago‐Alarcon Diego , Carbó‐Ramírez Pilar , Macgregor‐Fors Ian , Chávez‐Zichinelli Carlos Alberto , Yeh Pamela J.
Published: December 2018

Urbanization affects the ecology of wildlife diseases and although it has been suggested that there are lower risks of infection in urban areas, there have been no experiments to support this conclusion. We assessed haemosporidian prevalence and intensity in House Sparrows Passer domesticus using field and experimental data under contrasting conditions (i.e. urban vs. non‐urban). For experimental data, we kept 32 male House Sparrows in captivity as a proxy of stress, and for field data we sampled 49 House Sparrows (17 females). We made use of microscopy to determine the relative intensity and used the polymerase chain reaction to estimate infection prevalence. We obtained total leucocyte counts, leucocyte differentials, heterophil/lymphocyte ratio (H/L) as a measure of stress, and the Polychromatic Index as a measure of physiological condition (erythropoiesis). We identified a total of 10 haemosporidian lineages. For field samples (both males and females), we found a significantly higher prevalence of infection in non‐urban House Sparrows than in urban ones. Under experimental conditions, non‐urban House Sparrows showed a higher prevalence than urban ones both before and after captivity, with a significant increase in parasite intensity. The number of infected birds increased after captivity for both urban (~ 32%) and non‐urban House Sparrows (~ 19%), indicating either a recrudescence of chronic and relapses of latent infections or the appearance of infections that had been acquired earlier. The H/L ratio was significantly higher for non‐urban than for urban male House Sparrows before captivity. No difference in H/L was found for urban House Sparrows before and after captivity, indicating tolerance to city stressors. Our results showed a significant decrease in H/L for non‐urban birds after captivity, suggesting higher stress in the non‐urban agricultural environment. Haemosporidian infections were not associated with the H/L ratio. Our study provides evidence that highly urbanized areas within cities represent lower haemosporidian infection risks than do non‐urban areas for House Sparrows.
Human polyomavirus 7 (HPyV7)‐associated dermatoses: novel molecular mechanism driven by viral activation of 4E‐BP1 and MEK‐ERK‐cJun
Authors: Wu Julie H. , Narayanan Deepika , Simonette Rebecca A. , Rady Peter L. , Tyring Stephen K.
Published: December 2018

A number of pruritic skin conditions arising in immunocompromised patients are associated with viral infection. Recently, human polyomavirus 7 (HPyV7) has been implicated in the pathogenesis of eruptive pruritic parakeratotic and dyskeratotic dermatoses with distinct “peacock plumage” histology. While expression of HPyV7 viral protein, namely small tumor (sT) antigen, is prominent within lesional tissue, the functional role of HPyV7 in cutaneous pathobiology is not yet known. In this study, we demonstrate a novel role for HPyV7 sT antigen in pathways important for the maintenance of keratinocyte structure and function. In particular, HPyV7 sT was found to dysregulate protein phosphatase 2A through physical interactions that led to activation of MEK/ERK/c‐Jun and 4E‐BP1 (proteins that contribute to disorganized keratinocyte growth as well as hyperproliferative and inflammatory states). Given that HPyV7 actively infects keratinocytes and sT antigen is highly expressed in pruritic dyskeratotic/parakeratotic dermatoses, our data provide important mechanistic evidence supporting a pathogenic role for HPyV7 in cutaneous disease.
An interactional view of social presence: Making the virtual other “real”
Authors: Schultze Ulrike , Brooks Jo Ann M.
Published: December 2018

In IS research, social presence is generally defined as the perceived capacity of a communication medium to convey contextual cues normally available in face‐to‐face settings. However, theorizing social presence as a property of the technology has been challenged for decades. The objective of this paper is to develop a more contemporary, interactional view of social presence. To this end, this paper develops a new conceptualization of how participants form the sense that each other is present. We characterize the development of this sense as a skilful accomplishment that entails interactants' joint construction of each other as “real.” Viewing social presence as contingent on social practice, we seek to answer the following research question: “How is social presence accomplished in virtual environments?” To explicate how virtual others are perceived as becoming socially present, that is, emotionally and psychologically “real” to someone interacting with them, we draw from Goffman's work, particularly his concepts of involvement and involvement obligation. Detailing two examples of social interaction in the virtual world Second Life, our analysis highlights the key role that this moral obligation, intrinsic to everyday social interaction, plays in virtual others becoming perceived as psychoemotionally “there.” By outlining a model of how the sense of a virtual other as “real” is produced in and through social interaction, our work contributes a sociological perspective to the construct of social presence and underscores some of the material and social conditions necessary for users to perceive virtual others as present.
Agronomic performance of winter wheat grown under highly divergent soil moisture conditions in rainfed and water‐managed environments
Authors: Schittenhelm Siegfried , Kottmann Lorenz , Kraft Martin , Matschiner Katja , Langkamp‐Wedde Tina
Published: December 2018

Even in the temperate climates of Europe, increasing early season drought and rising air temperature are presenting new challenges to farmers and wheat breeders. Sixteen winter wheat (Triticum aestivum L.) genotypes consisting of three hybrids, six line cultivars and two breeding lines from Germany as well as five line cultivars from France, Austria, Slovakia, Hungary and the Ukraine (referred to as “exotic” lines) have been included in this study. The genetic materials were evaluated over three growing seasons under a range of soil moisture regimes at the three North German sites Braunschweig (irrigated and drought‐stressed), Warmse (rainfed) and Söllingen (rainfed). The average grain yields in the twelve growth environments (water regime × season combinations) ranged from 6.1 to 13.5 t ha−1. The exotic lines showed little evidence of specific phenological adaptation to drought although they are frequently faced with water scarcity in their countries of origin. The hybrids and German lines exhibited higher regression coefficients (bi) to environmental means than the exotic lines, indicating particular adaptation to favourable growing conditions. The phenotypical correlations of grain yield between the various environments were high, ranging for instance from 0.6 to 0.8 for the irrigated and drought‐stressed environments at Braunschweig. It is thus expected that in the foreseeable future continued selection aiming at high yield potential will suffice as a means to counter the expected increase in droughts.
Releasing latent compassion through an innovative compassion curriculum for Specialist Community Public Health Nurses
Authors: Pettit Ann , McVicar Andrew , Knight‐Davidson Pamela , Shaw‐Flach Adelle
Published: December 2018

Aims

To evaluate the impact of a curriculum based on the Compassionate Mind Model (CMM) designed to facilitate the expression of compassion in Specialist Community Public Health Nurses.

Background

The CMM identifies that fear of compassion creates a barrier to the flow of compassion. There is some evidence linking self‐compassion to compassionate care but no previous research has explored this potential with postregistration specialist community public health nursing students.

Design

Prospective, longitudinal design using focus group interviews.

Methods

Twenty six students (81% of cohort) agreed to participate in a wider evaluation (2014–2015). For this study, two groups were drawn from those participants (total 13 students) who attended audio‐taped group interviews at the course mid‐ and end‐points to explore their perceptions on compassion and compassionate care. Transcripts were analysed thematically.

Findings

Several subthemes were identified. “Cultural change in the NHS”, “Workload and meeting targets” and “Lack of time were barriers to compassionate care, as was negative “Role modelling”. These were collated under a macro‐theme of “A culture lacking in compassion”. Secondly, the subthemes “Actualization of compassion” and “Transformation” were collated within a macro‐theme: “Realization of compassion”. This theme identified realization of latent compassion from their previous roles that in some transferred into students’ personal lives suggesting a transformation beyond professional attitude.

Conclusion

The curriculum facilitated a realization of compassion in students over the period of the course by enhancing their capacity to be self‐compassionate and by actualization of compassion that had previously been suppressed.
Oral health‐related quality of life in patients with disorders of nutrition
Authors: Shay Boaz , Ben Ami Orly , Levy Ianculovici Dana , Zini Avraham , Ianculovici Clariel , Almoznino Galit
Published: December 2018

Background

Researchers demonstrated a correlation between nutrition and health‐related quality of life (HRQoL). Little is known about the correlation between disorders of nutrition (DON) and Oral HRQoL (OHRQoL).

Objectives

(a) To measure OHRQoL in DON patients compared to patients attending nutritional counselling for other reasons (eg, systemic diseases or general dietary counselling) (NCOR) and to healthy controls attending routine dental screenings. (b) To analyse associations between OHRQoL and demographics, health‐related behaviours and nutritional practices. We hypothesised that OHRQoL is impaired in DON patients and correlates with poor health‐related behaviours and nutritional practices

Methods

Demographic, smoking, alcohol and physical activity habits, verbal pain scale, oral health impact profile‐14 (OHIP‐14) and nutritional practice data were collected from 63 DON, 35 NCOR and 100 controls.

Results

Compared to controls, DON patients exhibited poorer OHIP‐14 global scores and had more functional limitation, physical disability, psychological disability, social disability and handicap. OHIP‐14 global score was positively associated with maternal origin, oral symptoms, eggs and eggplant consumption, avoiding seasoning, hot drinks and fibrous food and negatively associated with physical activity and fresh vegetable consumption. In the conceptual hierarchical multiple regression model, verbal pain scale, eggplant consumption and physical activity were mediators in the relationship between DON and OHIP‐14. DON, physical activity and eggplant consumption also directly associated with OHRQoL.

Conclusions

Oral HRQoL was impaired in DON patients and correlated with poor health‐related behaviours and nutritional practices. Routine workup of DON patients should include OHRQoL assessment.
Differential Mucosal Gene Expression Patterns inCandida‐Associated, Chronic Oral Denture Stomatitis
Authors: Offenbacher Steven , Barros Silvana P. , Bencharit Sompop , Yu Ning , Preisser John , Moss Kevin , Loewy Zvi G.
Published: December 2018

Purpose

Denture stomatitis is a common condition manifested by inflammation of the oral mucous membrane beneath a denture. The objective of this study was to compare the transcriptome of human palatal mucosa with chronic oral stomatitis‐associatedCandida albicansinfection to that of healthy oral mucosa.

Materials and Methods

Oral palatal biopsies were obtained from 17 healthy and 15C. albicans‐infected stomatitis subjects for whole transcriptome analyses. The presence ofC. albicanswas confirmed by cytology and cultivable methods. The clinical severity of the stomatitis was evaluated by the Newton Classification (Class II or III). For transcriptome analyses a false discovery rate (FDR) of <0.05 was used, and the effects of age, race, and gender were evaluated by principle component analysis (PCA). Specific differentially expressed genes identified by mRNA array data were confirmed by measurements of salivary protein expression using multiplex analyses.

Results

Microarray analysis of mRNA expression indicated that inC. albicansstomatitis there were 3034 genes‐in‐play that were differentially expressed and met the FDR < 0.05 criteria. Two hundred thirty five (235) genes were up‐regulated >2‐fold, and 71 genes were down‐regulated >2‐fold. Five of the 6 most significant gene ontology pathways involve inflammation and activation of the immune response with CD28 and CTLA signaling of T cells. There was strong up‐regulation of TLR2, CD14, MYD88, IKKA, and NFKB as the dominant toll‐like receptor‐signaling pathway. The expression of several extracellularly expressed inflammatory protein genes was up‐regulated in candidiasis, and 2 were confirmed as up‐regulated within the saliva using protein multiplexing analyses.

Conclusions

Neutrophil recruitment and activation, epithelial suppression, and T‐cell activation appear as major pathways in chronic oral candidiasis. Tissue up‐regulation of TLR2 pathways, as well as potentialC. albicansbinding proteins, was observed, whereas keratin and adhesion molecule synthesis were down‐regulated. Several candidate biomarkers to potentially identify the presence of oral candidiasis were differentially expressed in tissues and saliva.
The effect of prepregnancy body mass index on the risk of gestational diabetes mellitus: A systematic review and dose‐response meta‐analysis
Authors: Najafi Farid , Hasani Jalil , Izadi Neda , Hashemi‐Nazari Seyed‐Saeed , Namvar Zahra , Mohammadi Samira , Sadeghi Masoud
Published: December 2018

This study was conducted to investigate the effect of the prepregnancy BMI on the risk of gestational diabetes mellitus (GDM). Five electronic databases, including PubMed, Scopus, Embase, Web of Science, and Google Scholar, were searched for literature published until 1 January 2018. The two‐stage, random effect meta‐analysis was performed to compare the dose‐response relationship between BMI and GDM. As well as studies with categorized BMI, studies that treat BMI as a continuous variable were analysed. A total of 33 observational studies with an overall sample size of 962 966 women and 42 211 patients with GDM were included in analysis. The pooled estimate of GDM risk in the underweight, overweight, and obese pregnant women was 0.68, 2.01, and 3.98 using the adjusted OR and 0.34, 1.52, and 2.24 using the adjusted RR. The GDM risk increased 4% per unit of increase in BMI with both the crude and adjusted OR/RR models. Also, the risk of GDM increased 19% with the crude model and 14% with the adjusted model. The existence of dose‐response relationship between the pre‐pregnancy BMI and GDM can strengthen the scientific background for vigorous public health interventions for the control of pre‐pregnancy BMI as well as the weight gain during pregnancy.
Mental Accounting, Access Motives, and Overinsurance*
Authors: Fels Markus
Published: December 2018

The access motive for insurance posits that insurance derives its value from providing access to a loss remedy that is unaffordable without insurance. I explore the potential of this alternative insurance motive to explain attitudes towards modest risks, and I argue that mental accounting makes the access motive relevant for understanding both the popularity of warranties and the avoidance of deductibles. The value of partial insurance is shown to critically depend on the way in which the insurer pays benefits. This can explain several empirical regularities that are difficult to reconcile within existing models.
Nietzsche on Monism about Objects
Authors: Remhof Justin
Published: December 2018

This article concerns whether Nietzsche is sympathetic to monism about concrete objects, the heterodox metaphysical view that there is exactly one concrete object. I first dispel prominent reasons for thinking that Nietzsche rejects monism. I then develop the most compelling arguments for monism in Nietzsche’s writings and check for soundness. The arguments seem to be supported by the texts, but they have not been developed in the literature. Despite such arguments, I suggest that Nietzsche is actually not sympathetic to monism about objects—but his reasons for siding against monism are not at all obvious. The result should be a new understanding of some of Nietzsche’s fundamental ontological commitments.
A GIS data model for public gardens
Authors: Morgan Brian J. , Greco Steven E.
Published: December 2018

An enterprise GIS data model was developed for use in public gardens, which includes botanical gardens, arboreta, and zoos. The data model defines the representation of geographical phenomena, the attributes of each feature, and the relationships between them in order to support information management and analysis within public gardens. The data model was developed using a three‐stage process consisting of conceptual, logical, and physical design, each guided by stakeholder workshops and software testing. The data model includes the attributes of features necessary to create collection maps and perform collection analysis, and is designed to link to existing plant and animal records management systems (BG‐BASE and ZIMS) through a common key. The Public Garden Data Model consists of three modules (Base Map, Facilities and Infrastructure, and Basic Plant Records), unified into one comprehensive spatial data model for public gardens, and contains 59 feature classes and tables connected by 49 relationship classes.
Urine sediment examination: Potential impact of red and white blood cell counts using different sediment methods
Authors: Chase Julia , Hammond Jeremy , Bilbrough Graham , DeNicola Dennis B.
Published: December 2018

Background

Centrifugation is the primary method used to perform urine sediment analyses, but evaluation of other methods is required to validate centrifugation.

Objectives

Non‐urine materials were used to examine the repeatability (precision) and effectiveness (recovery) of four sediment methodologies on red blood cell (RBC) and white blood cell (WBC) counts.

Methods

Four urine sediment methods were compared using commercially available quality control material (QCM) and fresh canine RBCs in a diluent. Treatments included (a) 5 mL centrifugation at 390g for 5 minutes; (b) 1.5 mL centrifugation at 3900g for 45 seconds; (c) 60 µL of neat (unspun urine) in a microtiter well; and (d) 30 µL of neat on a slide with a coverslip. A within‐run precision using QCM was followed by a one‐run comparison test performed with a suspension of canine erythrocytes. RBC morphology was also examined.

Results

All results are listed in order of Methods A‐D. Percent coefficients of variation (%CVs) for WBCs were 23.2%, 33.7%, 15.0%, and 27.2%. Red blood cells %CVs were 34.3%, 29.2%, 16.2%, and 24.4%. Average WBC counts in ten fields of view (FOV) ± 1 SD were 26.4 ± 6.1, 14.2 ± 4.8, 32.8 ± 4.9, and 1.6 ± 0.4. Average RBC counts in 10 fields of view (FOV) ± 1 SD were 45.3 ± 15.5, 23.9 ± 7.0, 38.4 ± 6.2, and 2.6 ± 0.6. The one‐run comparison test reports average RBC counts per FOV at 55.2, 23.4, 92.8, and 13.8. The percentages of abnormal RBCs were 92.2%, 74.8%, 7.0%, and 55.1%.

Conclusions

Method C had the best reproducibility, a lower frequency of cell morphology abnormalities, and similar cellular counts to those of Methods A and B.
The Influence of Marketing Factors on the Marketing Strategic Planning in SNOWA Corporation
Authors: Ghahnavieh Ali Ebrahimi
Published: December 2018

The purpose of this research is to evaluate the influence of marketing factors of SNOWA Corporation on its marketing strategic planning. The present study is an applied research using a descriptive-analytic method. The statistical sample of this research includes 300 personnel of SNOWA Corporation. Data were collected applying a standard questionnaire on a five-point Likert scale. CVR and CVI indices were used to evaluate the content validity of the questionnaire, and a Cronbach's Alpha Test was applied to assess its reliability. SPSS Software (factor analysis) and Amos Software (structural equation modelling) were applied to analyse the collected data. The study will help managers accomplish market opportunities efficiently while formulating corporation strategies. Findings further reveal that consideration of marketing factors can give managers valuable information that, if applied correctly, can effectively guarantee corporation's success.
Analytical Form-Finding for Highly Symmetric and Super-Stable Configurations of Rhombic Truncated Regular Polyhedral Tensegrities
Authors: Zhang Li-Yuan , Zhu Shi-Xin , Chen Xiao-Fei , Xu Guang-Kui
Published: December 2018

Tensegrities have exhibited great importance and numerous applications in many mechanical, aerospace, and biological systems, for which symmetric configurations are preferred as the tensegrity prototypes. Besides the well-known prismatic tensegrities, another ingenious group of tensegrities with high symmetry is the truncated regular polyhedral (TRP) tensegrities, including Z-based and rhombic types. Although Z-based TRP tensegrities have been widely studied in the form-finding and application issues, rhombic TRP tensegrities have been much less reported due to the lack of explicit solutions that can produce their symmetric configurations. Our former work presented a unified solution for the rhombic TRP tensegrities by involving the force-density method which yet cannot control structural geometric sizes and may produce irregular shapes. Here, using the structural equilibrium matrix-based form-finding method, we establish some analytical equations, in terms of structural geometric parameters and force-densities in elements, to directly construct the self-equilibrated, symmetric configurations of rhombic TRP tensegrities, i.e., tetrahedral, cubic/octahedral, and dodecahedral/icosahedral configurations. Moreover, it is proved, both theoretically and numerically, that all of our obtained rhombic TRP tensegrities are super-stable and thus can be stable for any level of the force-densities without causing element material failure, which is beneficial to their actual construction. This study helps to readily design rhombic tensegrities with high symmetry and develop novel biomechanical models, mechanical metamaterials, and advanced mechanical devices.
Acoustic analysis of a broadband spiral source for the simultaneous generation of multiple Bessel vortices in air
Authors: Muelas-Hurtado Ruben D. , Ealo Joao L. , Pazos-Ospina Jhon F. , Volke-Sepúlveda Karen
Published: December 2018

A detailed characterization and analysis of the acoustic field radiated by an active diffraction grating is presented. This is a spiral-shaped source of constant width of the spiral paths and spacing among them, built with flexible ferroelectrets, which is suitable to operate within a broad range of ultrasonic frequencies. The simultaneous airborne generation of multiple Bessel vortex beams with different topological charges along the propagation axis is thoroughly discussed in terms of the structure of the spiral source and the driving frequency, along with some technical details of the prototype. Finally, the quality of the experimentally generated Bessel vortices is discussed, including the phase structure and the amplitude of the acoustic pressure.
Comparison of the Position-Matching and Position-Reproducing Tasks to Detect Deficits in Knee Position Sense After Reconstruction of the Anterior Cruciate Ligament
Authors: Hoshiba Takuma , Nakata Hiroki , Saho Yasuaki , Kanosue Kazuyuki , Fukubayashi Toru
Published: December 2018

Context: Deficits in knee position sense following reconstruction of the anterior cruciate ligament (ACL) can delay an athlete’s return to sport participation and increase the risk of reinjury. Deficits in position sense postreconstruction have been evaluated using either a position-reproducing or position-matching task. Objective: The aim of our study was to combine both to determine which assessment would be more effective to identify deficits in knee position sense. Design: Longitudinal laboratory-based study. Participants: Eleven athletes (6 men and 5 women; mean age, 20.5 [1.2] y), who had undergone ACL reconstruction with an ipsilateral hamstring autograft, and 12 age-matched controls. Interventions: Position sense was evaluated at 6 and 12 months postreconstruction and once for the control group. In addition, peak isokinetic knee extension and flexion strength, at 60°/s and 180°/s, was assessed for the ACL reconstruction group to evaluate possible influences of muscle strength on knee joint position sense. Main Outcome Measures: The variables include the angular differences between the reference limb and indicator limb, and peak torque values of isokinetic knee extension and flexion. Results: Significant matching differences were identified at 6 months postsurgery on the position-matching task, but not at 12 months postsurgery. No significant between-group and within-subject differences were identified on the position-reproducing task. No significant matching errors were identified for the control group. There was no correlation between errors in position sense and maximum isokinetic strength. Conclusion: The position-matching task is more sensitive than the position-reproducing task to identify deficits in knee position sense over the first year following ACL reconstruction surgery.
A Study on Trunk Muscle Activation of 2 Deep Water Running Styles (High-Knee and Cross-Country Style) and Land Walking
Authors: So Billy Chun-Lung , Yuen Calvin Hong-Nin , Tung Ken Long-Hin , Lam Sheena , Cheng Sammy Lan , Hung Zina Wing-Lam , Leung Rainy Wai-Kwan , Szeto Grace Pui-Yuk
Published: December 2018

Context: Deep water running (DWR) is an aquatic aerobic exercise which involves running in water without the feet touching the bottom of the pool, and it may involve different activation of trunk muscles compared with running or walking on land. This form of exercise is gradually being adopted as a form of therapeutic exercise for people with low back pain. It is proposed that different types of running or walking in water may be a more comfortable form of training for the trunk and abdominal muscles compared with exercising on dry land. Objectives: This study aimed to examine the trunk muscle activation in DWR in 2 different styles—high knee style and cross-country style, and these were compared with walking on land. Participants: Eleven healthy individuals (2 females and 9 males, mean age = 24 [4.6]) were recruited for this study. Outcome Measures: Surface electromyography was used to examine the activities of the right transversus abdominis, rectus abdominis, lumbar multifidus, and lumbar erector spinae muscles in 5 conditions: static standing on land and in water, running in deep water with high knee and cross-country styles, and finally walking on a treadmill. Results: The percentage of maximal voluntary contraction of the transversus abdominis was significantly higher for both running styles in DWR, compared with that of static standing in water. Comparing directly the 2 styles, muscle activity was higher with a high knee action compared to without. The activation of transversus abdominis during high-knee DWR was comparable with that during treadmill walking and this may have clinical implications. Conclusion: The results of this study confirmed that running in deep water with a high knee action activated trunk muscles differently compared with standing or walking on land.
Exercising on Different Unstable Surfaces Increases Core Abdominal Muscle Thickness: An Observational Study Using Real-Time Ultrasound
Authors: Gibbons Timothy J. , Bird Marie-Louise
Published: December 2018

Background: The training of abdominal muscles has a positive impact on the functional capacity of healthy adults, being applied practically in fields of athletics and fitness through rehabilitation for lower back pain. Objective: The study compares abdominal muscle activity while performing graded isometric exercises on stable and unstable surfaces. The authors also examined perceived stability and comfort for the different surfaces. Methods: A total of 30 young, healthy adults performed 3 graded isometric exercises on a Pilates table, foam roller, and Oov (a newly developed tool). Ultrasound investigation measured transversus abdominis, internal oblique abdominis, and external oblique abdominis thickness during each task, comparing muscle thickness between conditions using general linear modeling. Results: Core abdominal activation was greater on the foam roller than the Oov and Pilates table during crook lying (bilateral leg support). Both Oov and foam roller elicited greater contralateral transversus abdominis and internal oblique abdominis thickness than the Pilates table during tabletop and straight leg raises (unilateral leg exercises). For transversus abdominis only, the foam roller elicited more muscle thickness than the Oov during straight leg raises. The Oov was rated more comfortable than the foam roller. Discussion: Exercises performed on the Oov and foam roller elicit core greater abdominal muscle thickness than those performed on a Pilates table. Unilateral leg exercises in a supine position elicit more contralateral muscle thickness than those with bilateral leg support. Conclusions: These results provide information to support choices in exercise progression from flat stable to more unstable surfaces and from those with bilateral foot support to unilateral foot support. The Oov was more comfortable that the foam roller, and this may help with exercise adherence.
The Effectiveness of Deep Oscillation Therapy on Reducing Swelling and Pain in Athletes With Acute Lateral Ankle Sprains
Authors: Hausmann Matt , Ober Jacob , Lepley Adam S.
Published: December 2018

Clinical Scenario: Ankle sprains are the most prevalent athletic-related musculoskeletal injury treated by athletic trainers, often affecting activities of daily living and delaying return to play. Most of these cases present with pain and swelling in the ankle, resulting in decreased range of motion and strength deficits. Due to these impairments, proper treatment is necessary to avoid additional loss of play and prevent future injuries. Recently, there has been an increased use of deep oscillation therapy by clinicians to manage pain and swelling following a variety of injuries, including ankle sprains. However, very little evidence has been produced regarding the clinical effectiveness of deep oscillation therapy, limiting its application in therapeutic rehabilitation of acute lateral ankle sprains. Clinical Question: Is deep oscillation therapy effective in reducing pain and swelling in patients with acute lateral ankle sprains compared with the current standard of care protection, rest, ice, compression, and elevation? Summary of Key Findings: The literature was searched for studies of level 2 evidence or higher that investigated deep oscillation therapy on pain and inflammation in patients with lateral ankle sprains. Three randomized control trials were located and appraised. One of the 3 studies demonstrate a reduction in pain following 6 weeks of deep oscillation therapy compared with the standard of care or placebo interventions. The 2 other studies, 1 utilizing a 5-day treatment and the other a 1 time immediate application, found no differences in deep oscillation therapy compared with the standard of care. Clinical Bottom Line: There is inconclusive evidence to support the therapeutic use of deep oscillation therapy in reducing pain and swelling in patients with acute lateral ankle sprains above and beyond the current standard of care. In addition, the method of treatment application and parameters used may influence the effectiveness of deep oscillation therapy. Strength of Recommendation: Level B.
Antimicrobial Susceptibility Testing for Polymyxins: Challenges, Issues, and Recommendations
Authors: Ezadi Fereshteh , Ardebili Abdollah , Mirnejad Reza
Published: December 2018

Polymyxins, including polymyxin B and polymyxin E (colistin), are now increasingly being used worldwide to treat patients with multidrug-resistant (MDR) Gram-negative bacterial infections. This necessitates that laboratories employ an accurate and reliable method for the routine performance of polymyxin susceptibility testing.
The Human Sodium Iodide Symporter as a Reporter Gene for Studying Middle East Respiratory Syndrome Coronavirus Pathogenesis
Authors: Chefer Svetlana , Seidel Jurgen , Cockrell Adam S. , Yount Boyd , Solomon Jeffrey , Hagen Katie R. , Liu David X. , Huzella Louis M. , Kumar Mia R. , Postnikova Elena , Bohannon J. Kyle , Lackemeyer Matthew G. , Cooper Kurt , Endlich-Frazier Ariel , Sharma Heema , Thomasson David , Bartos Christopher , Sayre Philip J. , Sims Amy , Dyall Julie , Holbrook Michael R. , Jahrling Peter B. , Baric Ralph S. , Johnson Reed F.
Published: December 2018

Advanced medical imaging such as single photon emission computed tomography with computed tomography (SPECT/CT) enhances fields such as oncology and cardiology. Application of SPECT/CT, magnetic resonance imaging, and positron emission tomography to infectious disease may enhance pathogenesis studies and provide alternate biomarkers of disease progression. The experiments described in this article focus on insertion of a SPECT/CT-compatible reporter gene into MERS-CoV to demonstrate that a functional SPECT/CT reporter gene can be inserted into a virus.
Protein Microarray Analysis of the Specificity and Cross-Reactivity of Influenza Virus Hemagglutinin-Specific Antibodies
Authors: Nakajima Rie , Supnet Medalyn , Jasinskas Algis , Jain Aarti , Taghavian Omid , Obiero Joshua , Milton Donald K. , Chen Wilbur H. , Grantham Michael , Webby Richard , Krammer Florian , Carter Darrick , Felgner Philip L. , Davies D. Huw
Published: December 2018

Seasonal influenza is a serious public health problem because the viral infection spreads easily from person to person and because of antigenic drift in neutralizing epitopes. Influenza vaccination is the most effective way to prevent the disease, although challenging because of the constant evolution of influenza virus subtypes. Our high-throughput protein microarrays allow for interrogation of subunit-specific IgG and IgA responses to 283 different HA proteins comprised of HA1 and HA2 domains as well as full-length HA proteins. This provides a tool that allows for novel insights into the response to exposure to influenza virus antigens. Data generated with our technology will enhance our understanding of the factors that improve the strength, breadth, and durability of vaccine-mediated immune responses and develop more effective vaccines.
Maternal olmesartan exposure causing neonatal failure
Authors: Pérez-Iranzo Antonio , Ferreres Ana Nos , Bou Aranzazu Jarque
Published: December 2018

Although angiotensin II receptor blockers (ARBs) are contraindicated during pregnancy, new cases are currently being reported.

A 32-week preterm neonate was admitted after C-section due to maternal oligohydramnios. He presented with Potter phenotype, pulmonary hypoplasia with pneumothorax, systemic hypotension and anuria. He required chest drain insertion and continuous positive airway pressure (CPAP), volume expansion plus inotropic support with persistent renal failure. Mother confirmed olmesartan intake during entire pregnancy. Peritoneal dialysis was started with improvement in renal markers and progressive recovery of renal function. He has been followed up until the age of 2 years, observing improved renal function with a glomerular filtration rate (GFR) of 58 mL/min/1.72 m2.

Both angiogenesis-converting enzyme inhibitor and ARBs affect nephrogenesis; ARBs being more harmful due to its higher activity. Although some patients may recover normal renal function, its teratogen effect may have fatal consequences. Thus, it is important to emphasise its harmful effects in neonates to avoid new cases.
Point-of-care washing of allogeneic red blood cells for the prevention of transfusion-related respiratory complications (WAR-PRC): a protocol for a multicenter randomised clinical trial in patients undergoing cardiac surgery
Authors: Warner Matthew A , Welsby Ian J , Norris Phillip J , Silliman Christopher C , Armour Sarah , Wittwer Erica D , Santrach Paula J , Meade Laurie A , Liedl Lavonne M , Nieuwenkamp Chelsea M , Douthit Brian , van Buskirk Camille M , Schulte Phillip J , Carter Rickey E , Kor Daryl J
Published: December 2018

Introduction

The transfusion-related respiratory complications, transfusion-related acute lung injury (TRALI) and transfusion-associated circulatory overload (TACO), are leading causes of transfusion-related morbidity and mortality. At present, there are no effective preventive strategies with red blood cell (RBC) transfusion. Although mechanisms remain incompletely defined, soluble biological response modifiers (BRMs) within the RBC storage solution may play an important role. Point-of-care (POC) washing of allogeneic RBCs may remove these BRMs, thereby mitigating their impact on post-transfusion respiratory complications.

Methods and analysis

This is a multicenter randomised clinical trial of standard allogeneic versus washed allogeneic RBC transfusion for adult patients undergoing cardiac surgery testing the hypothesis that POC RBC washing is feasible, safe, and efficacious and will reduce recipient immune and physiologic responses associated with transfusion-related respiratory complications. Relevant clinical outcomes will also be assessed. This investigation will enrol 170 patients at two hospitals in the USA. Simon’s two-stage design will be used to assess the feasibility of POC RBC washing. The primary safety outcomes will be assessed using Wilcoxon Rank-Sum tests for continuous variables and Pearson chi-square test for categorical variables. Standard mixed modelling practices will be employed to test for changes in biomarkers of lung injury following transfusion. Linear regression will assess relationships between randomised group and post-transfusion physiologic measures.

Ethics and dissemination

Safety oversight will be conducted under the direction of an independent Data and Safety Monitoring Board (DSMB). Approval of the protocol was obtained by the DSMB as well as the institutional review boards at each institution prior to enrolling the first study participant. This study aims to provide important information regarding the feasibility of POC washing of allogeneic RBCs and its potential impact on ameliorating post-transfusion respiratory complications. Additionally, it will inform the feasibility and scientific merit of pursuing a more definitive phase II/III clinical trial.

Registration

ClinicalTrials.gov registration number isNCT02094118(Pre-results).
Radical cystectomy (bladder removal) against intravesical BCG immunotherapy for high-risk non-muscle invasive bladder cancer (BRAVO): a protocol for a randomised controlled feasibility study
Authors: Oughton Jamie B , Poad Heather , Twiddy Maureen , Collinson Michelle , Hiley Victoria , Gordon Kathryn , Johnson Mark , Jain Sunjay , Noon Aidan P , Chahal Rohit , Simms Matt , Dooldeniya Mohantha , Koenig Phillip , Goodwin Louise , Brown Julia M , Catto James W F
Published: December 2018

Introduction

High-risk non-muscle invasive bladder cancer (HRNMIBC) is a heterogeneous disease that can be difficult to predict. While around 25% of cancers progress to invasion and metastases, the remaining majority of tumours remain within the bladder. It is uncertain whether patients with HRNMIBC are better treated with intravesical maintenance BCG (mBCG) immunotherapy or primary radical cystectomy (RC). A definitive randomised controlled trial (RCT) is needed to compare these two different treatments but may be difficult to recruit to and has not been attempted to date. Before undertaking such an RCT, it is important to understand whether such a comparison is possible and how best to achieve it.

Methods and analysis

BRAVO is a multi-centre, parallel-group, mixed-methods, individually randomised, controlled, feasibility study for patients with HRNMIBC. Participants will be randomised to receive either mBCG immunotherapy or RC. The primary objective is to assess the feasibility and acceptability of performing the definitive phase III trial via estimation of eligibility and recruitment rates, assessing uptake of allocated treatment and compliance with mBCG, determining quality-of-life questionnaire completion rates and exploring reasons expressed by patients for declining recruitment into the study. We aim to recruit 60 participants from six centres in the UK. Surgical trials with disparate treatment options find recruitment challenging from both the patient and clinician perspective. By building on the experiences of other similar trials through implementing a comprehensive training package aimed at clinicians to address these challenges (qualitative substudy), we hope that we can demonstrate that a phase III trial is feasible.

Ethics and dissemination

The study has ethical approval (16/YH/0268). Findings will be made available to patients, clinicians, the funders and the National Health Service through traditional publishing and social media.

Trial registration number

ISRCTN12509361; Pre results.
Evaluation of a complex intervention (Engager) for prisoners with common mental health problems, near to and after release: study protocol for a randomised controlled trial
Authors: Kirkpatrick Tim , Lennox Charlotte , Taylor Rod , Anderson Rob , Maguire Michael , Haddad Mark , Michie Susan , Owens Christabel , Durcan Graham , Stirzaker Alex , Henley William , Stevenson Caroline , Carroll Lauren , Quinn Cath , Brand Sarah Louise , Harris Tirril , Stewart Amy , Todd Roxanne , Rybczynska-Bunt Sarah , Greer Rebecca , Pearson Mark , Shaw Jenny , Byng Richard
Published: December 2018

Introduction

The ‘Engager’ programme is a ‘through-the-gate’ intervention designed to support prisoners with common mental health problems as they transition from prison back into the community. The trial will evaluate the clinical and cost-effectiveness of the Engager intervention.

Methods and analysis

The study is a parallel two-group randomised controlled trial with 1:1 individual allocation to either: (a) the Engager intervention plus standard care (intervention group) or (b) standard care alone (control group) across two investigation centres (South West and North West of England). Two hundred and eighty prisoners meeting eligibility criteria will take part. Engager is a person-centred complex intervention delivered by practitioners and aimed at addressing offenders’ mental health and social care needs. It comprises one-to-one support for participants prior to release from prison and for up to 20 weeks postrelease. The primary outcome is change in psychological distress measured by the Clinical Outcomes in Routine Evaluation-Outcome Measure at 6 months postrelease. Secondary outcomes include: assessment of subjective met/unmet need, drug and alcohol use, health-related quality of life and well-being-related quality of life measured at 3, 6 and 12 months postrelease; change in objective social domains, drug and alcohol dependence, service utilisation and perceived helpfulness of services and change in psychological constructs related to desistence at 6 and 12 months postrelease; and recidivism at 12 months postrelease. A process evaluation will assess fidelity of intervention delivery, test hypothesised mechanisms of action and look for unintended consequences. An economic evaluation will estimate the cost-effectiveness.

Ethics and dissemination

This study has been approved by the Wales Research Ethics Committee 3 (ref: 15/WA/0314) and the National Offender Management Service (ref: 2015–283). Findings will be disseminated to commissioners, clinicians and service users via papers and presentations.

Trial registration number

ISRCTN11707331; Pre-results.
Cost-effectiveness of a community-delivered multicomponent intervention compared with enhanced standard care of obese adolescents: cost-utility analysis alongside a randomised controlled trial (the HELP trial)
Authors: Panca Monica , Christie Deborah , Cole Tim J , Costa Silvia , Gregson John , Holt Rebecca , Hudson Lee D , Kessel Anthony S , Kinra Sanjay , Mathiot Anne , Nazareth Irwin , Wataranan Jay , Wong Ian Chi Kei , Viner Russell M , Morris Stephen
Published: December 2018

Objective

To undertake a cost-utility analysis of a motivational multicomponent lifestyle-modification intervention in a community setting (the Healthy Eating Lifestyle Programme (HELP)) compared with enhanced standard care.

Design

Cost-utility analysis alongside a randomised controlled trial.

Setting

Community settings in Greater London, England.

Participants

174 young people with obesity aged 12–19 years.

Interventions

Intervention participants received 12 one-to-one sessions across 6 months, addressing lifestyle behaviours and focusing on motivation to change and self-esteem rather than weight change, delivered by trained graduate health workers in community settings. Control participants received a single 1-hour one-to-one nurse-delivered session providing didactic weight-management advice.

Main outcome measures

Mean costs and quality-adjusted life years (QALYs) per participant over a 1-year period using resource use data and utility values collected during the trial. Incremental cost-effectiveness ratio (ICER) was calculated and non-parametric bootstrapping was conducted to generate a cost-effectiveness acceptability curve (CEAC).

Results

Mean intervention costs per participant were £918 for HELP and £68 for enhanced standard care. There were no significant differences between the two groups in mean resource use per participant for any type of healthcare contact. Adjusted costs were significantly higher in the intervention group (mean incremental costs for HELP vs enhanced standard care £1003 (95% CI £837 to £1168)). There were no differences in adjusted QALYs between groups (mean QALYs gained 0.008 (95% CI −0.031 to 0.046)). The ICER of the HELP versus enhanced standard care was £120 630 per QALY gained. The CEAC shows that the probability that HELP was cost-effective relative to the enhanced standard care was 0.002 or 0.046, at a threshold of £20 000 or £30 000 per QALY gained.

Conclusions

We did not find evidence that HELP was more effective than a single educational session in improving quality of life in a sample of adolescents with obesity. HELP was associated with higher costs, mainly due to the extra costs of delivering the intervention and therefore is not cost-effective.

Trial registration number

ISRCTN99840111.