bluuebunny/crossref_metadata_2025 huggingface dataset:
Mixed-method investigation of health consumers’ perception and experience of participation in patient safety activities
Authors: Lee Nam-Ju , Ahn Shinae , Lee Miseon
Published: March 2020

Objectives

This study aimed to examine the factors influencing patient safety behaviours and to explore health customers’ experiences of patient participation in the healthcare system.

Design

A mixed-method sequential explanatory design was employed using a survey and focus group interviews with health consumers.

Setting

The study was conducted in South Korea using an online survey tool.

Participants

Survey data were collected from 493 Korean adults, aged 19 years or older, who had visited hospitals within the most recent 1 year. Focus group interviews were conducted in two groups of six participants each among those of the survey participants who agreed to participate in focus groups.

Main outcome measures

The survey measured the recognition of the importance of participation, extent of willingness to participate and experience of engaging in patient safety activities using a 4-point Likert scale. Qualitative data were collected through focus group interviews to explore health consumers’ experience of patient participation in hospital care, and the data were analysed using content analysis.

Results

The average score for experience of participation in patient safety behaviours (2.13±0.63) was found to be lower than those of recognition of the importance of participation (3.27±0.51) and willingness to participate (2.62±0.52). By integrating the results of the quantitative and qualitative data analysis, the factors associated with the experience of engaging in healthcare behaviour included patient-related factors, illness-related factors, factors involving relationship between patients and healthcare providers, and healthcare environment factors.

Conclusions

To improve patient participation, it is necessary to create a healthcare environment in which patients can speak comfortably and to provide an education programme reflecting the patients’ needs. Also, healthcare providers must consider patients as partners for patient safety. Shared decision-making procedures and patient-centred care and patient safety policies should be established in hospitals.
Improving blood pressure screening and control at an academic health system
Authors: Shaikh Ulfat , Petray Julie , Wisner David H
Published: March 2020

The goal of the University of California Davis Health Blood Pressure (BP) Quality Improvement Initiative was to improve the diagnosis, management and control of high BP. Patients aged 18–85 years were included in the initiative. Lean A3 problem solving was used to implement the following evidence-based interventions based on stakeholder interviews, value stream mapping and the Centers for Disease Control and Prevention’s Million Hearts Initiative: staff training on accurate BP measurement, visual cues and reminders for BP screening, virtual case-based videoconferences, standardised clinical management algorithm, academic detailing visits, clinical decision support tools, access to pharmacists for medication comanagement, clinician workflow modification, patient education and access to home BP monitors. Following implementation of interventions, accurate screening of BP increased from 14% to 87% and BP control increased from 62% to 75%. Strategies that contributed the most to improvements were using a team-based approach, adjusting clinic workflow and frequent communication of results to staff.
Respiratory events associated with concomitant opioid and sedative use among Medicare beneficiaries with chronic obstructive pulmonary disease
Authors: Le Tham Thi , Park Siyeon , Choi Michelle , Wijesinha Marniker , Khokhar Bilal , Simoni-Wastila Linda
Published: March 2020

Background

Opioids and sedatives are commonly prescribed in chronic obstructive pulmonary disease (COPD) patients for symptoms of dyspnoea, pain, insomnia, depression and anxiety. Older adults are advised to avoid these medications due to increased adverse events, including respiratory events. This study examines respiratory event risks associated with concomitant opioid and sedative use compared with opioid use alone in older adults with COPD.

Methods

A 5% nationally representative sample of Medicare beneficiaries with COPD and opioid use between 2009 and 2013 was used for this retrospective cohort study. Current and past concomitant use were identified using drug dispensed within 7 days from the censored date: at respiratory event, at death, or at 12 months post index. Concomitant opioid and sedative use were categorised into no overlap (opioid only), 1 to 10, 11 to 30, 31 to 60 and >60 days of total overlap. The primary outcome was hospitalisation or emergency department (ED) visits for respiratory events (COPD exacerbations or respiratory depression). Propensity score matching was implemented and semi-competing risk models were used to address competing risk by death.

Results

Among 48 120 eligible beneficiaries, 1810 (16.7%) concomitant users were matched with 9050 (83.3%) opioid only users. Current concomitant use of 1 to 10, 11 to 30 and 31 to 60 days was associated with increased respiratory events (HRs (95% CI): 2.8 (1.2 to 7.3), 9.3 (4.9 to 18.2) and 5.7 (2.5 to 12.5), respectively), compared with opioid only use. Current concomitant use of >60 days or past concomitant use of ≤60 days was not significantly associated with respiratory events. Consistent findings were found in sensitivity analyses, including in subgroup analysis of non-benzodiazepine sedatives. Additionally, current concomitant use significantly increased risk of death.

Conclusion

Short-term and medium-term current concomitant opioid and sedative use significantly increased risk of respiratory events and death in older COPD Medicare beneficiaries. Long-term past concomitant users, however, demonstrated lower risks of these outcomes, possibly reflecting a healthy user effect or developed tolerance to the effects of these agents.
Staging achilles tendinopathy using ultrasound imaging: the development and investigation of a new ultrasound imaging criteria based on the continuum model of tendon pathology
Authors: Matthews Wesley , Ellis Richard , Furness James W , Rathbone Evelyne , Hing Wayne
Published: March 2020

Aim

To develop a standardised ultrasound imaging (USI)-based criteria for the diagnosis of tendinopathy that aligns with the continuum model of tendon pathology. Secondary aims were to assess both the intra-rater and inter-rater reliability of the criteria.

Methods

A criteria was developed following a face validity assessment and a total of 31 Achilles tendon ultrasound images were analysed. Intra-rater and inter-rater reliability were assessed for overall tendinopathy stage (normal, reactive/early dysrepair or late dysrepair/degenerative) as well as for individual parameters (thickness, echogenicity and vascularity). Quadratic weighted kappa (kw) was used to report on reliability.

Results

Intra-rater reliability was ‘substantial’ for overall tendinopathy staging (kwrater A; 0.77, 95% CI 0.59 to 0.94, rater B; 0.70, 95% CI 0.52 to 0.89) and ranged from ‘substantial’ to ‘almost perfect’ for thickness (kwrater A; 0.75, 95% CI 0.59 to 0.90, rater B; 0.84, 95% CI 0.71 to 0.98), echogenicity (kwrater A; 0.78, 95% CI 0.62 to 0.95, rater B; 0.73, 95% CI 0.58 to 0.89) and vascularity (kwrater A; 0.86, 95% CI 0.74 to 0.98, rater B; 0.89, 95% CI 0.79 to 0.99). Inter-rater reliability ranged from ‘substantial’ to ‘almost perfect’ for overall tendinopathy staging (kwround 1; 0.75, 95% CI 0.58 to 0.91, round 2; 0.81, 95% CI 0.63 to 0.99), thickness (kwround 1; 0.65, 95% CI 0.48 to 0.83, round 2; 0.77, 95% CI 0.60 to 0.93), echogenicity (kwround 1; 0.70, 95% CI 0.54 to 0.85, round 2; 0.76, 95% CI 0.58 to 0.94) and vascularity (kwround 1; 0.89, 95% CI 0.79 to 0.99, round 2; 0.86, 95% CI 0.74 to 0.98). Inter-rater reliability increased from ‘substantial’ in round 1 (kw0.75, 95% CI 0.58 to 0.91) to ‘almost perfect’ in round 2 (0.81, 95% CI 0.63 to 0.99).

Conclusion

Intra-rater and inter-rater reliability were ‘substantial’ to ‘almost perfect’ when utilising an USI-based criteria to diagnose Achilles tendinopathy. This is the first study to use the continuum model of tendon pathology to develop an USI-based criteria to diagnose tendinopathy.
Habitual tub bathing and risks of incident coronary heart disease and stroke
Authors: Ukai Tomohiko , Iso Hiroyasu , Yamagishi Kazumasa , Saito Isao , Kokubo Yoshihiro , Yatsuya Hiroshi , Muraki Isao , Eshak Ehab S , Sawada Norie , Tsugane Shoichiro
Published: March 2020

Objective

Tub bathing is considered to have a preventive effect against cardiovascular disease (CVD) by improving haemodynamic function. However, no prospective studies have investigated the long-term effects of tub bathing with regard to CVD risk.

Methods

A total of 30 076 participants aged 40–59 years with no history of CVD or cancer were followed up from 1990 to 2009. Participants were classified by bathing frequency: zero to two times/week, three to four times/week and almost every day. The HRs of incident CVD were estimated using Cox proportional hazards models after adjusting for traditional CVD risk factors and selected dietary factors.

Results

During 538 373 person-years of follow-up, we documented a total of 2097 incident cases of CVD, comprising 328 coronary heart diseases (CHDs) (275 myocardial infarctions and 53 sudden cardiac deaths) and 1769 strokes (991 cerebral infarctions, 510 intracerebral haemorrhages, 255 subarachnoid haemorrhages and 13 unclassified strokes). The multivariable HRs (95% CIs) for almost daily or every day versus zero to two times/week were 0.72 (0.62 to 0.84, trend p<0.001) for total CVD; 0.65 (0.45 to 0.94, trend p=0.065) for CHD; 0.74 (0.62 to 0.87, trend p=0.005) for total stroke; 0.77 (0.62 to 0.97, trend p=0.467) for cerebral infarction; and 0.54 (0.40 to 0.73, trend p<0.001) for intracerebral haemorrhage. No associations were observed between tub bathing frequency and risk of sudden cardiac death or subarachnoid haemorrhage.

Conclusion

The frequency of tub bathing was inversely associated with the risk of CVD among middle-aged Japanese.
‘Gun shop projects’ for suicide prevention in the USA: current state and future directions
Authors: Polzer Evan , Brandspigel Sara , Kelly Timothy , Betz Marian
Published: March 2020

Objectives

To describe community-driven suicide prevention partnerships between firearm retailers and public health officials (‘gun shop projects’), including common elements and challenges.

Methods

We conducted qualitative interviews with leaders from state-level and national-level partnerships to determine common features, challenges and strategies used by these groups. Data were coded via theme analysis; two independent coders followed a shared codebook developed in an iterative fashion and with high inter-rater reliability.

Results

Across 10 interviews, data revealed four main themes: (1) community building was a cornerstone of these efforts; (2) appropriate messaging and language were vital to successes; (3) groups employed various educational and outreach campaigns and (4) groups identified common challenges and obstacles.

Conclusions

Gun shop project partnerships between firearm retailers and public health officials show promise, with thematic data demonstrating common trends and steps towards successful programme implementation. Evaluative data are needed to determine the impact of these efforts on suicide prevention in local communities.
Different aspects of cognitive function in adult patients with moyamoya disease and its clinical subtypes
Authors: Shi Zhiyong , Wen Yu-Jie , Huang Zheng , Yu Le-Bao , Zhang Dong
Published: March 2020

Objective

Although a few reports suggested that cognitive function impairment could be found in adult patients with moyamoya disease (MMD), there were still many aspects that are unclear. The aim of our study was to assess the cognitive function of adult patients with MMD and its clinical subtypes.

Methods

49 patients with MMD and 23 healthy controls were asked to take cognitive function tests. Cognitive function tests included IQ, prospective memory (PM), immediate memory (IM), verbal fluency (VF), visual breadth, attention, retrospective memory (RM), Stroop test, Wisconsin Card Sorting Test, Trail-Making Test Part A (TMT-A) and Continuous Performance Test (CPT). Independent t-analysis, one-way analysis of variance and Pearson correlation were used to seek for differences between subgroups and the correlation between cognitive variables.

Results

Compared with healthy controls, adult patients with MMD had a comprehensive cognitive impairment, including IQ, PM, VF, attention, RM, Stroop, CPT and TMT-A, with more serious impairment in PM and attention. PM and RM were separated, indicating that they were independent of each other. Pattern of attention was significantly different from healthy controls. Female patients were better than male patients, where significant differences in PM, IM, Stroop and WCST could be found. The haemorrhagic patients exhibited poorer in the dimension of PM and RM than the ischaemic. The headache subtype exhibited poorer than healthy controls. PM, RM, attention and executive function were moderately correlated with each other.

Conclusions

Adult patients with MMD had a wide range of cognitive impairment with more serious impairment in memory and attention. Differences in cognitive function existed between the different subtypes of adult MMD.
Effects of Broussonetia papyrifera-fermented feed on the growth performance and muscle quality of Hu sheep
Authors: Su Yingyu , Chen Guoshun , Cai Yu , Gao Bolan , Zhi Xijun , Chang Fengjiang
Published: March 2020

This study aims to determine the effect of adding different proportions of Broussonetia papyrifera (BP)-fermented feed on Hu sheep. A total of 40 male Hu sheep (weighting 20.6 ± 2.20 kg) were collected and then divided into group I, II, III, and IV, with 0%, 5%, 10%, and 15% of BP-fermented feed to based diet, respectively. After the trial period of 10 and 50 d, the sheep were slaughtered by conventional methods for the chemical analyses. It showed that adding 10% fermented feed could significantly increase the growth performance of the Hu sheep. Adding the fermented feed can improve the protein level, main flavor amino acid content, and fatty acid in the muscle. Based on the headspace solid-phase microextraction and gas chromatography – mass spectrometry methods, a total of 125, 120, 119, and 117 kinds of volatile compounds were identified in group I, II, III, and IV, among which the relative content of the acid compound, ester compound, ketone compound, and aldehydes in group II, III, and IV were higher than that in control group, respectively. Addition of BP-fermented feed could significantly improve growth performance and meat quality of Hu sheep.
Kinetic study and Box–Behnken design approach to optimize the sorption process of toxic azo dye onto organo-modified bentonite
Authors: Guezzen Brahim , Adjdir Mehdi , Medjahed Baghdad , Didi Mohamed A. , Weidler Peter G.
Published: March 2020

Kinetic study was applied for sodium bentonite (Na-B) and hexadecylpyridinium bentonite (HDP-B) under different amounts, namely 50% (50HDP-B), 100% (100HDP-B), and 200% (200HDP-B) with respect to cation exchange capacity (CEC). Pseudo first-order and pseudo second-order kinetic models were performed to optimize the sorption of Congo red (CR) dye from aqueous solution. The experimental data fit the pseudo second order kinetic model well. The sorption capacity (qe) of CR dye by the organo-bentonites at equilibrium was 36.0 mg g−1 (72.1%) for 50HDP-B, 48.05 mg g−1 (96.1%) for 100HDP-B, and 49.2 mg g−1 (98.4%) for 200HDP-B. These results were considerably higher than that found by Na-B. Response surface methodology with three-variable, three-level Box–Behnken design was applied for 100HDP-B to describe the removal of CR dye. The effects of three variables, namely temperature, adsorbent dosage, and initial dye concentration, were studied. Predicted values of adsorption efficiency were found to be in good agreement with the obtained experimental values (R2 = 0.97). A second-order polynomial model successfully described the effects of independent variables on the CR dye removal. At the optimized condition, the toxic azo dye could be quantitatively removed from aqueous solution. The results of the present study suggest that the organo-bentonite can be used as an efficient sorbent for dye removal from aqueous solution.
Evidence of elevation-specific growth changes of spruce, fir, and beech in European mixed mountain forests during the last three centuries
Authors: Pretzsch Hans , Hilmers Torben , Biber Peter , Avdagić Admir , Binder Franz , Bončina Andrej , Bosela Michal , Dobor Laura , Forrester David I. , Lévesque Mathieu , Ibrahimspahić Aida , Nagel Thomas A. , del Río Miren , Sitkova Zuzana , Schütze Gerhard , Stajić Branko , Stojanović Dejan , Uhl Enno , Zlatanov Tzvetan , Tognetti Roberto
Published: March 2020

In Europe, mixed mountain forests, primarily comprised of Norway spruce (Picea abies (L.) Karst.), silver fir (Abies alba Mill.), and European beech (Fagus sylvatica L.), cover about 10 × 106 ha at elevations between ∼600 and 1600 m a.s.l. These forests provide invaluable ecosystem services. However, the growth of these forests and the competition among their main species are expected to be strongly affected by climate warming. In this study, we analyzed the growth development of spruce, fir, and beech in moist mixed mountain forests in Europe over the last 300 years. Based on tree-ring analyses on long-term observational plots, we found for all three species (i) a nondecelerating, linear diameter growth trend spanning more than 300 years; (ii) increased growth levels and trends, the latter being particularly pronounced for fir and beech; and (iii) an elevation-dependent change of fir and beech growth. Whereas in the past, the growth was highest at lower elevations, today’s growth is superior at higher elevations. This spatiotemporal pattern indicates significant changes in the growth and interspecific competition at the expense of spruce in mixed mountain forests. We discuss possible causes, consequences, and silvicultural implications of these distinct growth changes in mixed mountain forests.
Quintessences compact star with Durgapal potential
Authors: Estevez-Delgado Gabino , Estevez-Delgado Joaquin , Murguía Aurelio Tamez , Soto-Espitia Rafael , Cleary-Balderas Arthur
Published: March 2020

A compact star model formed by quintessence and ordinary matter is presented, both sources have anisotropic pressures and are described by linear state equations, also the state equation of the tangential pressure for the ordinary matter incorporates the effect of the quintessence. It is shown that depending on the compactness of the star [Formula: see text] the constant of proportionality [Formula: see text] between the density of the ordinary matter and the radial pressure, [Formula: see text], has an interval of values which is consistent with the possibility that the matter is formed by a mixture of particles like quarks, neutrons and electrons and not only by one type of them. The geometry is described by the Durgapal metric for [Formula: see text] and each one of the pressures and densities is positive, finite and monotonic decreasing, as well as satisfying the condition of causality and of stability [Formula: see text], which makes our model physically acceptable. The maximum compactness that we have is [Formula: see text], so we can apply our solution considering the observational data of mass and radii [Formula: see text], [Formula: see text] km which generate a compactness [Formula: see text] associated to the star PSR J0348[Formula: see text]+[Formula: see text]0432. In this case, the interval of [Formula: see text] and its maximum central density [Formula: see text] and in the surface [Formula: see text] of the star are [Formula: see text] and [Formula: see text], respectively, meanwhile the central density of the quintessence [Formula: see text].
Jack of All
Authors: Gunn James E.
Published: March 2020

This article is basically a scientific autobiography from a long and very rewarding career, covering childhood, education, theoretical work, observations, instrumentation, and some social activities. It is not meant to be a review of anything except an incomplete picture of my life, and the relatively few references are to some of my work, work related to mine, and work that had a very large influence on my life and research, so apologies in advance to those I left out in subjects I discuss. I have not in any way attempted to discuss scientific results; those you can go read.

I have used more words on old things than new, with the idea that most readers of this article are much more familiar with the field in the last couple of decades than before. My career spans almost six, and there may be things to learn from antiquity.
Transcription in Living Cells: Molecular Mechanisms of Bursting
Authors: Rodriguez Joseph , Larson Daniel R.
Published: March 2020

Transcription in several organisms from certain bacteria to humans has been observed to be stochastic in nature: toggling between active and inactive states. Periods of active nascent RNA synthesis known as bursts represent individual gene activation events in which multiple polymerases are initiated. Therefore, bursting is the single locus illustration of both gene activation and repression. Although transcriptional bursting was originally observed decades ago, only recently have technological advances enabled the field to begin elucidating gene regulation at the single-locus level. In this review, we focus on how biochemical, genomic, and single-cell data describe the regulatory steps of transcriptional bursts.
Alcohol and Human Health: What Is the Evidence?
Authors: Hendriks Henk F.J.
Published: March 2020

Alcohol consumption has long been a part of human culture. However, alcohol consumption levels and alcohol consumption patterns are associated with chronic diseases. Overall, light and moderate alcohol consumption (up to 14 g per day for women and up to 28 g per day for men) may be associated with reduced mortality risk, mainly due to reduced risks for cardiovascular disease and type-2 diabetes. However, chronic heavy alcohol consumption and alcohol abuse lead to alcohol-use disorder, which results in physical and mental diseases such as liver disease, pancreatitis, dementia, and various types of cancer. Risk factors for alcohol-use disorder are largely unknown. Alcohol-use disorder and frequent heavy drinking have detrimental effects on personal health.
A Rewarding Career Unraveling the Pathogenesis of Viral Infections
Authors: Griffin Diane E.
Published: March 2020

My great-grandparents were immigrants from Sweden and settled as farmers in Iowa and Illinois. My father, the oldest of six children, was the first in his family to go to college and had careers as a petroleum geologist and an academic. My mother, the youngest of four children, had older siblings in education, and she focused on early childhood education. My childhood in Oklahoma with two younger sisters was happy and comfortable, and public school prepared me well. My career trajectory into virology did not involve much if any advance planning but was characterized by recognizing the fascinating puzzles of virus diseases, being in good places at the right time, taking advantage of opportunities as they presented themselves, and being surrounded by great mentors, colleagues, trainees, and family. Most of my career was spent studying two diseases caused by RNA viruses, alphavirus encephalomyelitis and measles, and was enriched with several leadership opportunities.
Structural and functional variations in human bronchial epithelial cells cultured in air-liquid interface using different growth media
Authors: Leung Clarus , Wadsworth Samuel J. , Yang S. Jasemine , Dorscheid Delbert R.
Published: March 2020

The human bronchial epithelium is an important barrier tissue that is damaged or pathologically altered in various acute and chronic respiratory conditions. To represent the epithelial component of respiratory disease, it is essential to use a physiologically relevant model of this tissue. The human bronchial epithelium is a highly organized tissue consisting of a number of specialized cell types. Primary human bronchial epithelial cells (HBEC) can be differentiated into a mucociliated tissue in air-liquid interface (ALI) cultures using appropriately supplemented media under optimized growth conditions. We compared the histology, ciliary length, and function, diffusion, and barrier properties of HBEC from donors with no respiratory disease grown in two different media, PneumaCult-ALI or Bronchial Epithelial Differentiation Medium (BEDM). In the former group, HBEC have a more physiological pseudostratified morphology and mucociliary differentiation, including increased epithelial thickness, intracellular expression of airway-specific mucin protein MUC5AC, and total expression of cilia basal-body protein compared with cells from the same donor grown in the other medium. Baseline expression levels of inflammatory mediators, thymic stromal lymphopoietin (TSLP), soluble ST2, and eotaxin-3 were lower in PneumaCult-ALI. Additionally, the physiological cilia beat frequency and electrical barrier properties with transepithelial electrical resistance were significantly different between the two groups. Our study has shown that these primary cell cultures from the same donor grown in the two media possess variable structural and functional characteristics. Therefore, it is important to objectively validate primary epithelial cell cultures before experimentation to ensure they are appropriate to answer a specific scientific question.
The short-chain free fatty acid receptor FFAR3 is expressed and potentiates contraction in human airway smooth muscle
Authors: Mizuta Kentaro , Sasaki Haruka , Zhang Yi , Matoba Atsuko , Emala Charles W.
Published: March 2020

Emerging evidence suggests that gut microbiota-derived short-chain fatty acids (SCFAs; acetate, propionate, and butyrate) are important modulators of the inflammatory state in diseases such as asthma. However, the functional expression of the Gi protein-coupled free fatty acid receptors (FFAR2/GPR43 and FFAR3/GPR41) has not been identified on airway smooth muscle (ASM). Classically, acute activation of Gi-coupled receptors inhibits cyclic AMP (cAMP) synthesis, which impairs ASM relaxation and can also induce crosstalk between Gi- and Gq-signaling pathways, potentiating increases in intracellular Ca2+ concentration ([Ca2+]i), favoring ASM contraction. In contrast, chronic activation of Gi-coupled receptors can sensitize adenylyl cyclase resulting in increased cAMP synthesis favoring relaxation. We questioned whether the Gi-coupled FFAR2 or FFAR3 is expressed in human ASM, whether they modulate cAMP and [Ca2+]i, and whether SCFAs modulate human ASM tone. We detected the protein expression of FFAR3 but not FFAR2 in native human ASM and primary cultured human airway smooth muscle (HASM) cells. In HASM cells, acute activation of FFAR3 with SCFAs inhibited forskolin-stimulated cAMP accumulation, but chronic activation did not sensitize cAMP synthesis. SCFAs induced [Ca2+]i increases that were attenuated by pertussis toxin, gallein, U73122, or xestospongin C. Acute treatment with SCFAs potentiated acetylcholine-stimulated [Ca2+]i increases and stress fiber formation in cells and contraction of ex vivo human airway tissues. In contrast, chronic pretreatment of human ASM with propionate did not potentiate airway relaxation. Together, these findings demonstrate that FFAR3 is expressed in human ASM and contributes to ASM contraction via reduced cAMP and increased [Ca2+]i.
The role of MIF in chronic lung diseases: looking beyond inflammation
Authors: Florez-Sampedro Laura , Soto-Gamez Abel , Poelarends Gerrit J. , Melgert Barbro N.
Published: March 2020

Macrophage migration inhibitory factor (MIF) is a pleiotropic cytokine that has been associated with many diseases. Most studies found in literature describe MIF as a proinflammatory cytokine involved in chronic inflammatory conditions, but evidence from last years suggests that many of its key effects are not directly related to inflammation. In fact, MIF is constitutively expressed in most human tissues and in some cases in high levels, which does not reflect the pattern of expression of a classic proinflammatory cytokine. Moreover, MIF is highly expressed during embryonic development and decreases during adulthood, which point toward a more likely role as growth factor. Accordingly, MIF knockout mice develop age-related spontaneous emphysema, suggesting that MIF presence (e.g., in younger individuals and wild-type animals) is part of a healthy lung. In view of this new line of evidence, we aimed to review data on the role of MIF in the pathogenesis of chronic lung diseases.
Relationship between impaired parasympathetic vasodilation and hyposalivation in parotid glands associated with type 2 diabetes mellitus
Authors: Sato Toshiya , Mito Kohei , Ishii Hisayoshi
Published: March 2020

We examined the relationship between hemodynamics in the three major salivary glands and salivary secretion in urethane-anesthetized and sympathectomized type 2 diabetic and nondiabetic rats via laser speckle imaging and by collecting the saliva. Lingual nerve stimulation elicited rapid increases in glandular blood flow and induced salivary secretion from the three glands in both diabetic and nondiabetic rats. In the parotid gland, the magnitude of blood flow increase and salivary secretion was significantly lower in the diabetic rats when compared with the nondiabetic rats; however, this was not observed in the other glands. Although the intravenous administration of acetylcholine increased blood flow in the parotid gland in a dose-dependent manner, the response was significantly lower in the diabetic rats when compared with the nondiabetic rats. Similarly, mRNA expression levels of M1 and M3 muscarinic acetylcholine receptors in the parotid gland were relatively lower in the diabetic rats compared with the nondiabetic rats. Our results indicate that type 2 diabetes impairs parasympathetic vasodilation and salivary secretion in the parotid gland and suggest that disturbances in the cholinergic vasodilator pathway may contribute to the underlying mechanisms involved in the disruption of parasympathetic nerve-mediated glandular vasodilation.
Phoenixin-20 suppresses food intake, modulates glucoregulatory enzymes, and enhances glycolysis in zebrafish
Authors: Rajeswari Jithine Jayakumar , Blanco Ayelén Melisa , Unniappan Suraj
Published: March 2020

Phoenixin is a 20-amino acid peptide (PNX-20) cleaved from the small integral membrane protein 20 (SMIM20), with multiple biological roles in mammals. However, its role in nonmammalian vertebrates is poorly understood. This research aimed to determine whether PNX-20 influences feeding and metabolism in zebrafish. The mRNAs encoding SMIM20 and its putative receptor, super conserved receptor expressed in brain 3 (SREB3), are present in both central and peripheral tissues of zebrafish. Immunohistochemical analysis confirmed the presence of PNX-like immunoreactivity in the gut and in zebrafish liver (ZFL) cell line. We also found that short-term fasting (7 days) significantly decreased smim20 mRNA expression in the brain, gut, liver, gonads, and muscle, which suggests a role for PNX-20 in food intake regulation. Indeed, single intraperitoneal injection of 1,000 ng/g body wt PNX-20 reduced feeding in both male and female zebrafish, likely in part by enhancing hypothalamic cart and reducing hypothalamic/gut preproghrelin mRNAs. Furthermore, the present results demonstrated that PNX-20 modulates the expression of genes involved in glucose transport and metabolism in ZFL cells. In general terms, such PNX-induced modulation of gene expression was characterized by the upregulation of glycolytic genes and the downregulation of gluconeogenic genes. A kinetic study of the ATP production rate from both glycolytic and mitochondrial pathways demonstrated that PNX-20-treated ZFL cells exhibited significantly higher ATP production rate associated with glycolysis than control cells. This confirms a positive role for PNX-20 on glycolysis. Together, these results indicate that PNX-20 is an anorexigen with important metabolic roles in zebrafish.
Repetita iuvant: repetition facilitates online planning of sequential movements
Authors: Ariani Giacomo , Kwon Young Han , Diedrichsen Jörn
Published: March 2020

Even for overlearned motor skills such as reaching, movement repetition improves performance. How brain processes associated with motor planning or execution benefit from repetition, however, remains unclear. We report the novel finding of repetition effects for sequential movements. Our results show that repetition benefits are tied to improved online planning of upcoming sequence elements. We also highlight how actual movement experience appears to be more beneficial than mental rehearsal for observing short-term repetition effects.
Most hippocampal CA1 pyramidal cells in rabbits increase firing during awake sharp-wave ripples and some do so in response to external stimulation and theta
Authors: Nokia Miriam S. , Waselius Tomi , Sahramäki Joonas , Penttonen Markku
Published: March 2020

We studied hippocampal sharp-wave ripples and theta and CA1 pyramidal cell activity during trace eyeblink conditioning in rabbits. Conditioning trials suppressed ripples while increasing theta for a period of several seconds. A quarter of the cells increased firing in response to the conditioned stimulus and fired extensively during endogenous theta as well as ripples. The role of endogenous theta epochs in off-line memory consolidation should be studied further.
A literature review on the neurophysiological underpinnings and cognitive effects of transcutaneous vagus nerve stimulation: challenges and future directions
Authors: Colzato Lorenza , Beste Christian
Published: March 2020

Brain stimulation approaches are important to gain causal mechanistic insights into the relevance of functional brain regions and/or neurophysiological systems for human cognitive functions. In recent years, transcutaneous vagus nerve stimulation (tVNS) has attracted considerable popularity. It is a noninvasive brain stimulation technique based on the stimulation of the vagus nerve. The stimulation of this nerve activates subcortical nuclei, such as the locus coeruleus and the nucleus of the solitary tract, and from there, the activation propagates to the cortex. Since tVNS is a novel stimulation technique, this literature review outlines a brief historical background of tVNS, before detailing underlying neurophysiological mechanisms of action, stimulation parameters, cognitive effects of tVNS on healthy humans, and, lastly, current challenges and future directions of tVNS research in cognitive functions. Although more research is needed, we conclude that tVNS, by increasing norepineprine (NE) and gamma-aminobutyric acid (GABA) levels, affects NE- and GABA-related cognitive performance. The review provides detailed background information how to use tVNS as a neuromodulatory tool in cognitive neuroscience and outlines important future leads of research on tVNS.
Frontal scalp potentials foretell perceptual choice confidence
Authors: Lim Koeun , Wang Wei , Merfeld Daniel M.
Published: March 2020

We report novel neural correlates of predecisional choice confidence in frontal scalp potential in humans. In conjunction with the centroparietal choice-action event-related potential component, this new frontal choice confidence component further elucidates the dynamics of the frontoparietal decision-making neural circuitry.
Influence of Sexually Transmitted Infections in Pregnant Adolescents on Preterm Birth and Chorioamnionitis
Authors: Fuchs Esther , Dwiggins Maggie , Lokken Erica , Unger Jennifer A. , Eckert Linda O.
Published: March 2020

Background. Adolescents have an increased risk of preterm birth (PTB) and sexually transmitted infections (STIs). We examined the prevalence and impact of STIs (gonorrhea, chlamydia, and trichomonas) on PTB and chorioamnionitis in pregnant adolescents. Methods. This retrospective cohort study utilized the first pregnancy delivered at an urban hospital among patients≤19 years old over a 5-year period. Poisson regression with robust standard errors was used to estimate prevalence ratios (PR) and 95% confidence intervals (CI) of the association between STIs and PTB (<37 weeks) and chorioamnionitis identified by clinical or placental pathology criteria. Results. 739 deliveries were included. 18.8% (n=139) of births were preterm. The overall prevalence of STIs during pregnancy was 16.5% (Chlamydia trachomatis: 13.1%, n=97; Trichomonas vaginalis: 3.7%, n=27; and Neisseria gonorrheae: 3.1%, n=23). Detection of C. trachomatis, T. vaginalis, or N. gonorrheae was not associated with increased PTB. While infection with N. gonorrheae and C. trachomatis did not increase the likelihood of any chorioamnionitis, infection with T. vaginalis significantly increased the likelihood of any chorioamnionitis diagnosis (aPR 2.19, 95% CI 1.26-3.83). Conclusion. In this adolescent population with a high rate of PTB, in whom most received appropriate STI treatment, we did not find an association between STI during pregnancy and an increased rate of PTB. However, an infection with T. vaginalis was associated with an increased likelihood of chorioamnionitis. Early detection of STIs may prevent adverse pregnancy outcomes. Continued vigilance in STI screening during pregnancy, including consideration of universal Trichomonas vaginalis screening, is merited in this high-risk population.
Investigation of Nonlinear Characteristics of a Gear Transmission System in a Braiding Machine with Multiple Excitation Factors
Authors: Yao Lingling , Meng Zhuo , Bu Jianqiu , Sun Yize
Published: March 2020

In this study, we attempt to analyze the influence of different excitation factors on the dynamic behavior of a gear transmission system in a braiding machine. In order to observe nonlinear characteristics, a mathematical model is established with a six-degrees-of-freedom gear system for consideration of multiple excitation factors. Iterative results are used to study the nonlinear characteristics of the gear system with respect to contact temperature, varying levels of friction, and disturbance of yarn tension using bifurcation diagrams, maximum Lyapunov exponents, phase diagrams, Poincare maps, and the power spectrum. The numerical results show that excitation factors such as temperature and surface friction, among others, have considerable influence on the nonlinear characteristics of the gear system in a braiding machine, and the model is evaluated to show the key regions of sensitivity. The analysis of associated parameters can be helpful in the design and control of braiding machines.
Tai Chi is Effective in Delaying Cognitive Decline in Older Adults with Mild Cognitive Impairment: Evidence from a Systematic Review and Meta‐Analysis
Authors: Yang Jingjing , Zhang Lulu , Tang Qianyun , Wang Fengling , Li Yu , Peng Hua , Wang Shuhong
Published: March 2020

To determine whether Tai Chi (TC) is effective in slowing cognitive decline in older populations with mild cognitive impairment (MCI), we performed a systematic review and meta‐analysis of randomized controlled trials (RCTs) on Tai Chi and MCI. We searched eight electronic databases (PubMed, PsycINFO, Wanfang, Web of Science, MEDLINE, CNKI, EBSCO, and the Cochrane Central Register of Controlled Trials) for appropriate RCTs published up to August 2019. For those studies included, the data were extracted, methodological quality was evaluated, and then meta‐analysis was performed using Review Manager software (version 5.3). A total of 11 of the studies were available for systematic review, which together included 1061 participants, met the inclusion criteria, and ten of these were included in the meta‐analysis. For most RCTs, the methodological quality was moderate. The meta‐analysis revealed that Tai Chi could significantly improve global cognitive function; memory and learning; mental speed and attention; ideas, abstraction, figural creations, and mental flexibility; and visuospatial perception. The present review adds to the evidence showing that Tai Chi is potentially beneficial in improving cognitive functions among elderly people with MCI. However, strictly designed and well‐reported RCTs are required.
Experimental Investigation on Seismic Behaviours of Reinforced Concrete Columns under Simulated Acid Rain Environment
Authors: Zheng Hao , Zheng Shansuo , Zhang Yixin , Cai Yonglong , Ming Ming , Zhou Jingliang
Published: March 2020

The purpose of this paper was to systematically investigate the influence of acid rain environments on the seismic behaviour of a reinforced concrete (RC) column. Six RC column specimens with shear span ratios of 2.84 were tested under low cyclic reversed loads after being subjected to accelerated corrosion tests in an artificial climate. The corrosion level and stirrup ratio were used as the control variables. The corrosion ratios of the longitudinal rebars ranged from 0 to 13.17%, and the corrosion ratios of the stirrups varied from 0 to 6.75%. The seismic behaviours of the column specimens were analysed with respect to visual damage, failure mode, hysteresis behaviour, load‐carrying capacity, deformation capacity, stiffness degradation, and energy dissipation behaviour. The test results showed that the appearance characteristics of the six column specimens exhibited varying degrees of visual damage as a result of the simulated acid rain exposure. All six specimens were dominated by similar flexural‐shear failures under low cyclic reversed loads, regardless of the distinctions in the corrosion levels or stirrup ratios. For the specimens with the same ratios of stirrup, as the corrosion level increased, the load‐carrying capacity, deformation capacity, stiffness, and energy dissipation capacity were continuously decreased. For the specimens with the same levels of corrosion, the higher the stirrup ratio was, the stronger the restraint effect of the stirrups on the concrete, and the seismic behaviours of the specimens were obviously improved.
Epidemiology and Direct Medical Cost of Osteoporotic Hip Fracture in Chile
Authors: Quevedo Iván , Ormeño Juan C. , Weissglas Bunio , Opazo Cristóbal
Published: March 2020

The osteoporotic hip fracture is associated with a high impact on morbidity, mortality, and health expenditure. The Chilean health system is made up of a mixed care system, with the public system called FONASA and the private system called ISAPRE. The people with lower incomes are listed on FONASA and correspond to 80.8% of the population. The aims of this study were to describe the incidence of hip fracture in the Chilean population from the age of 45 years and to estimate the direct medical cost of this disease. The records of the Department of the Health Statistics and Information of the Ministry of Health were used, from which the number of national hospital discharges due to hip fractures was obtained (codes S720, S721, and S722 of the ICD-10), in adults aged 45 years or older, by sex, from 2006 to 2017. The cost of osteoporotic hip fracture treatment in the public health system was obtained from the data of the surgical treatment according to the payment method associated with diagnosis (PAD bonus). A surgical intervention budget was used in a private clinic to calculate the direct cost of osteoporotic hip fracture in the private system. Between 2006 and 2017, the number of hospital discharges due to osteoporotic hip fracture in adults aged 45 years and older has increased progressively, registering 9.583 hospital discharges for this cause in 2017, which corresponds to 50% more than those recorded in 2006, with a 3 : 1 F/M ratio. The mean annual rate of hip fractures is 148.7 per 100,000 inhabitants aged above 45 years. The individual cost of managing an osteoporotic hip fracture in the public system was USD$ 3,919, and USD$ 9,092 in the private health system. The incidence of hip fracture was comparable with data from Southern European countries and from neighboring countries, such as Argentina and Uruguay. Hospitalization cost of hip fracture in Chile was 34 million USD per year. Hip fracture constitutes a serious healthcare problem in Chile, and efforts for the prevention and management of osteoporosis are needed.
Intelligent Mobile Applications: A Systematic Mapping Study
Authors: Rachad Taoufik , Idri Ali
Published: March 2020

Smart mobiles as the most affordable and practical ubiquitous devices participate heavily in the enhancement of our daily life by the use of many convenient applications. However, the significant number of mobile users in addition to their heterogeneity (different profiles and contexts) obligates developers to enhance the quality of their apps by making them more intelligent and more flexible. This is realized mainly by analyzing mobile user’s data. Machine learning (ML) technology provides the methodology and techniques needed to extract knowledge from data to facilitate decision-making. Therefore, both developers and researchers affirm the benefits of combining ML techniques and mobile technology in several application fields as e-health, e-learning, e-commerce, and e-coaching. Thus, the purpose of this paper is to have an overview of the use of ML techniques in the design and development of mobile applications. Therefore, we performed a systematic mapping study of papers published on this subject in the period between 1 January 2007 and 31 December 2019. A total number of 71 papers were selected, studied, and analyzed according to the following criteria, year, sources and channel of publication, research type, and methods, kind of collected data, and finally adopted ML models, tasks, and techniques.
Does a Train-the-Trainer Approach for Enhancing Healthcare Professionals’ Skills in Patient Education during Inpatient Medical Rehabilitation Improve Patient Outcomes?
Authors: Ullrich Anneke , Inhestern Laura , Wehrmann Jochen , Raida Martin , Köhler Matthias , Bergelt Corinna
Published: March 2020

This study is aimed at identifying the impact of a team-based train-the-trainer program (TTT-P) to enhance healthcare professional (HCP) skills in patient education during medical rehabilitation. Focusing on patient-reported outcomes, a prospective, sequential two-cohort study was conducted in the fields of psychosomatic and oncological rehabilitation. Two hundred fifteen patients were evaluated before (Cohort 1) and 196 post implementation of TTT-P (Cohort 2). Patients of both cohorts completed validated questionnaires on self-management (heiQ®), general self-efficacy (GSE scale), and quality of life (WHOQOL-Bref) at the beginning, at the end, and at the 6-month follow-up to analyze short- and intermediate-term effects. Analyses were conducted separately for the psychosomatic and oncological setting. Results showed that TTT-P had no impact on patient outcomes in both rehabilitation settings. Patients did report positive outcomes as a result of the whole inpatient rehabilitation programs, though effects at follow-up were mostly small to medium size. Concerning self-management competencies, cancer patients gained less benefit during rehabilitation than psychosomatic patients. In conclusion, TTT-P did not result in measurable improvements at the patient level, likely because of the limited nature of the intervention. However, these populations of rehabilitants took benefit from participating in a multimodal rehabilitation program, of which patient education is one part.