bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol for a scoping review on the conceptualisation of learning in undergraduate clinical nursing practice
Authors: Stoffels Malou , Peerdeman Saskia M , Daelmans Hester E M , Ket Johannes C F , Kusurkar Rashmi A
Published: February 2019

Introduction

Learning in the clinical setting is a major form of learning in undergraduate nursing education. In spite of this, how nursing students learn in clinical practice is still largely unknown. Moreover, there is no conceptual clarity on learning in practice in the current literature. This paper aims to set up a protocol for a scoping review of the literature in order to map different conceptualisations of learning in practice in undergraduate clinical nursing education in the hospital setting. The operationalisations of different concepts will be compared and the findings of the studies will be synthesised.

Methods and analysis

This scoping review will be guided by the methodological framework proposed by Arksey and O’Malley and refined by Levacet al.and the Joanna Briggs Institute. The search strategy will be developed together with a medical information specialist and the search will be performed in electronic databases (PubMed, EBSCO/ERIC and EBSCO/CINAHL). In a first search, we will identify concepts that are used as an equivalent to learning in practice. Next, we will search for studies operationalising these concepts in undergraduate nursing education. Finally, we will check reference lists for additional publications. Abstracts and full-text studies will independently be screened by two researchers. All studies that have ‘learning in undergraduate clinical nursing practice’ as their main topic and that include a definition and operationalisation of an equivalent to learning in clinical practice, will be considered for inclusion. We will chart different conceptualisations and their theoretical underpinnings, as well as reported learning opportunities, informal and formal aspects of learning, social aspects of learning and gaps in the literature.

Ethics and dissemination

This review will help design future studies on learning in clinical nursing practice using well-defined and agreed on terminology. The results will be disseminated through journal publications and conference presentations.
Retrospective cohort analysis of real-life decisions about end-of-life care preferences in a Southeast Asian country
Authors: Tan Woan Shin , Bajpai Ram , Ho Andy Hau Yan , Low Chan Kee , Car Josip
Published: February 2019

Objective

To describe the end-of-life care preferences of individuals, and to examine the influence of age and gender on these preferences.

Design, setting and participants

A retrospective cohort study was conducted. Participants included all adults (≥21 years old) (n=3380) who had completed a statement of their preferences as part of a national Advance Care Planning (ACP) programme in Singapore. Data were extracted from the national and Tan Tock Seng Hospital ACP database.

Main measures

End-of-life care preferences were obtained from the ACP document and differentiated by health status (healthy, chronically ill or diagnosed with advanced illnesses). To analyse the data, descriptive statistics and logistic regression analysis were used.

Results

Across healthy and chronically ill patients, the majority did not opt for cardiopulmonary resuscitation (CPR) or other life-sustaining measures. Among individuals with advanced illnesses, 94% preferred not to attempt CPR but 69% still preferred to receive some form of active medical treatment. Approximately 40% chose to be cared for, and to die at home. Age and sex significantly predict preferences in those with advanced illnesses. Older age (>=75 years) showed higher odds for home as preferred place of care (OR 1.52; 95% CI 1.23 to 1.89) and place of death (OR 1.29; 95% CI 1.03 to 1.61) and lower odds for CPR (OR 0.31; 95% CI 0.18 to 0.54) and full treatment (OR 0.32; 95% CI 0.17 to 0.62). Being female was associated with lower odds for home as preferred place of care (OR 0.69; 95% CI 0.57 to 0.84) and place of death (OR 0.70; 95% CI 0.57 to 0.85) and higher odds for full treatment (OR 2.35; 95% CI 1.18 to 4.68).

Conclusion

The majority preferred to not proceed with life-sustaining treatments, but there was still a strong preference to receive some form of limited treatment. Better understanding of end-of-life care preferences through ACP can better guide end-of-life care programme planning, and resource allocation decisions.
Do baby boomers feel healthier than earlier cohorts after retirement age? The Lausanne cohort Lc65+ study
Authors: Henchoz Yves , von Gunten Armin , Büla Christophe , Seematter-Bagnoud Laurence , Nanchen David , Démonet Jean-Francois , Blanco Juan-Manuel , Santos-Eggimann Brigitte
Published: February 2019

Objective

Despite the popular belief that baby boomers are ageing in better health than previous generations, limited scientific evidence is available since baby boomers have turned retirement age only recently. This study aimed to compare self-reported health status at ages 65–70 years among three cohorts of older people born before, during and at the end (baby boomers) of the Second World War.

Design

Repeated cross-sectional population-based study.

Setting

Community in a region of French-speaking Switzerland.

Participants

Community-dwelling older adults who enrolled in the Lausanne cohort 65+ study at ages 65–70 years in 2004 (n=1561), 2009 (n=1489) or 2014 (n=1678).

Outcomes

Number of self-reported chronic conditions (from a list of 11) and chronic symptoms (from a list of 11); depressive symptoms; self-rated health (very good, good, average, poor or very poor); fear of disease (not afraid at all, barely afraid, a bit afraid, quite afraid or very afraid); self-perception of ageing; disability in basic and instrumental activities of daily living.

Results

There was no significant difference between cohorts in the number of self-reported chronic conditions and chronic symptoms as well as the presence of difficulty in basic activities of daily living, depressive symptoms, fear of disease and negative self-perception of ageing. In women only, significant differences between cohorts were observed in self-rated health (p=0.005) and disability in instrumental activities of daily living (p=0.003), but these associations did not remain significant in logistic regression models adjusted for sociodemographic characteristics and unhealthy behaviours.

Conclusions

Despite important sociodemographic differences between older baby boomers and earlier cohorts, most health indicators did not suggest any trend towards a compression of morbidity. Future studies comparing these three cohorts at more advanced age are required to further investigate whether differences emerge later in life.
Specific growth rates calculated from CTs in patients with head and neck squamous cell carcinoma: a retrospective study performed in Austria
Authors: Dejaco Daniel , Steinbichler Teresa , Schartinger Volker Hans , Fischer Natalie , Anegg Maria , Dudas Joszef , Posch Andrea , Widmann Gerlig , Riechelmann Herbert
Published: February 2019

Objective

To provide data on specific growth rates (SGRs) of primary tumours (PT-SGR) and largest pathological cervical lymph nodes (LN-SGR) for head and neck squamous cell carcinoma (HNSCC). To explore PT-SGR’s and LN-SGR’s correlation with selected biomarkers epidermal growth factor receptor (EGFR), Ki67 and CD44.

Design and setting

Retrospective study performed at a tertiary oncological referral centre in Innsbruck, Austria.

Participants

Adult patients with incident HNSCC treated with primary radiotherapy (RT) or radiochemotherapy (RCT).

Outcome measures

Volumes of the primary tumour (PT-volume) and largest pathological cervical lymph node (LN-volume) were measured in CT scans obtained at time of diagnosis and subsequent planning CTs immediately prior to RT or RCT. SGRs were calculated assuming an exponential growth function. PT-SGR’s and LN-SGR’s correlation with EGFR, Ki67 and CD44 were explored.

Results

In 123 patients, mean interval between diagnostic and planning CT was 29±21 days. PT-SGR was 1.8±1.8% (mean±SD) per day and was positively correlated with EGFR, Ki67 and CD44 expression (p=0.02; p=0.02; p=0.03). LN-SGR was 1.7±2.0% per day and increased with larger initial LN-volume, was lower in laryngeal cancer (p=0.003) and slowed down with time. LN-SGR was not correlated with EGFR, Ki67 or CD44 expression in primary tumours (p>0.12). New cartilage or bone infiltration occurred in 10 patients and new central lymph node necrosis in 8 patients.

Conclusions

HNSCCs are fast-growing tumours for which treatment must not be delayed. Clinical tumour growth rates are influences by EGFR, KI67 and CD44 expression.
Making headlines: an analysis of US government-funded cancer research mentioned in online media
Authors: Maggio Lauren A , Ratcliff Chelsea L , Krakow Melinda , Moorhead Laura L , Enkhbayar Asura , Alperin Juan Pablo
Published: February 2019

Objective

To characterise how online media coverage of journal articles on cancer funded by the US government varies by cancer type and stage of the cancer control continuum and to compare the disease prevalence rates with the amount of funded research published for each cancer type and with the amount of media attention each receives.

Design

A cross-sectional study.

Setting

The United States.

Participants

The subject of analysis was 11 436 journal articles on cancer funded by the US government published in 2016. These articles were identified via PubMed and characterised as receiving online media attention based on data provided by Altmetric.

Results

16.8% (n=1925) of articles published on US government-funded research were covered in the media. Published journal articles addressed all common cancers. Frequency of journal articles differed substantially across the common cancers, with breast cancer (n=1284), lung cancer (n=630) and prostate cancer (n=586) being the subject of the most journal articles. Roughly one-fifth to one-fourth of journal articles within each cancer category received online media attention. Media mentions were disproportionate to actual burden of each cancer type (ie, incidence and mortality), with breast cancer articles receiving the most media mentions. Scientific articles also covered the stages of the cancer continuum to varying degrees. Across the 13 most common cancer types, 4.4% (n=206) of articles focused on prevention and control, 11.7% (n=550) on diagnosis and 10.7% (n=502) on therapy.

Conclusions

Findings revealed a mismatch between prevalent cancers and cancers highlighted in online media. Further, journal articles on cancer control and prevention received less media attention than other cancer continuum stages. Media mentions were not proportional to actual public cancer burden nor volume of scientific publications in each cancer category. Results highlight a need for continued research on the role of media, especially online media, in research dissemination.
Medicine authentication technology: a quantitative study of incorrect quarantine, average response times and offline issues in a hospital setting
Authors: Naughton Bernard D
Published: February 2019

Objectives

To introduce serialised medicines into an operational hospital dispensary and assess the technical effectiveness of digital medicine authentication (MA) technology under European Union Falsified Medicines Directive (EU FMD) conditions.

Design

Thirty medicine lines were serialised using 2D data matrix labels and introduced into an operational UK National Health Service (NHS) hospital dispensary. Staff were asked to check medicines for two-dimensional (2D) data matrices and scan those products, in addition to their usual medicine preparation and checking processes. Four per cent of the study medicines were labelled with a 2D barcode which generated a pop-up, identifying the medicine as either authenticated elsewhere (falsified), authenticated here, expired or recalled.

Setting

An NHS teaching hospital based in the UK, the same site as the Naughtonet al2016 study.

Participants

General Pharmaceutical Council registered, accredited accuracy checking technicians and pharmacists.

Primary outcome measures

Average response times, offline issues, instances of incorrect quarantine and workarounds. The EU FMD maximum response time is 300 milliseconds (ms).

Results

During the checking stage of medicine preparation, the average response time for MA in this study was 131 ms. However, 4.67% of attempted authentications experienced offline issues, an increase of 4.23% from the previous study. An increase in offline instances existed alongside an increase in incorrect quarantine.

Conclusions

Digital drug screening has the capability of operating with average response times which are below the maximum EU FMD limit of 300 ms. However, there was an increased incidence of offline errors and cases of incorrect quarantine. The practical and legal implications of supplying a substandard or falsified medicine during offline periods without prior authentication or withholding supply until online status resumes are not yet fully understood.
Diagnostic accuracy of the Xpert CT/NG and OSOM Trichomonas Rapid assays for point-of-care STI testing among young women in South Africa: a cross-sectional study
Authors: Garrett Nigel , Mitchev Nireshni , Osman Farzana , Naidoo Jessica , Dorward Jienchi , Singh Ravesh , Ngobese Hope , Rompalo Anne , Mlisana Koleka , Mindel Adrian
Published: February 2019

Objectives

Syndromic management of sexually transmitted infections (STIs) omits asymptomatic infections, particularly among women. Accurate point-of-care assays may improve STI care in low- and middle-income countries (LMICs). We aimed to evaluate the diagnostic performance of the XpertChlamydia trachomatis/Neisseria gonorrhoeae(CT/NG) and OSOMTrichomonas vaginalis(TV) Test as part of a STI care model for young women in South Africa.

Design

Diagnostic evaluation conducted as part of a prospective cohort study (CAPRISA 083) between May 2016 and January 2017.

Setting

One large public healthcare facility in central Durban, KwaZulu-Natal, South Africa

Participants

247 women, aged 18–40 years, attending for sexual and reproductive services to the clinic. Pregnant and HIV-positive women were excluded.

Outcomes

Diagnostic performance of the Xpert CT/NG and OSOM TV assays against the laboratory-based Anyplex II STI-7 Detection. All discordant results were further tested on the Fast Track Diagnostics (FTD) STD9 assay.

Results

We obtained vaginal swabs from 247 women and found 96.8% (239/247) concordance between Xpert and Anyplex for CT and 100% (247/247) for NG. All eight discrepant CT results were positive on Xpert, but negative on Anyplex. FTD STD9 confirmed three positive and five negative results, giving a confirmed prevalence of CT 15.0% (95% CI 10.5 to 19.4), NG 4.9% (2.2–7.5) and TV 3.2% (1.0–5.4). Sensitivity and specificity of Xpert CT/NG were 100% (100-100) and 97.6% (95.6–99.7) for CT and 100% (100-100) and 100% (100-100) for NG. The sensitivity and specificity of OSOM TV were 75.0% (45.0–100) and 100% (100-100).

Conclusion

The Xpert CT/NG showed high accuracy among young South African women and combined with the OSOM TV proved a useful tool in this high HIV/STI burden setting. Further implementation and cost-effectiveness studies are needed to assess the potential role of this assay for diagnostic STI testing in LMICs.

Trial registration number

NCT03407586; Pre-results.
Resuscitative endovascular balloon occlusion of the aorta (REBOA): a scoping review protocol concerning indications—advantages and challenges of implementation in traumatic non-compressible torso haemorrhage
Authors: Bekdache Omar , Paradis Tiffany , Shen Yu Bai He , Elbahrawy Aly , Grushka Jeremy , Deckelbaum Dan L , Khwaja Kosar , Fata Paola , Razek Tarek , Beckett Andrew
Published: February 2019

Introduction

Haemorrhage remains the leading cause of preventable death in trauma. Damage control measures applied to patients in extremis in order to control exsanguinating bleeding from non-compressible torso injuries use different techniques to limit blood flow from the aorta to the rest of the body. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is regaining momentum recently as an adjunct measure that can provide the same results using less invasive approaches. This scoping review aims to provide a comprehensive understanding of the existing literature on REBOA. The objective is to analyse evidence and non-evidence-based medical reports and to describe current gaps in the literature about the best indication and implementation strategies for REBOA.

Methods and analysis

Using the five-stage framework of Arksey and O’Malley’s scoping review methodology as a guide, we will perform a systematic search in the following databases: MEDLINE, EMBASE, BIOSIS, COCHRANE CENTRAL, PUBMED and SCOPUS from the earliest available publications. The aim is to identify diverse studies related to the topic of REBOA. For a comprehensive search, we will explore organisational websites, key journals and hand-search reference lists of key studies. Data will be charted and sorted using a descriptive analytical approach.

Ethics and dissemination

Ethics approval is not necessary as the data are collected from publicly available sources and there will be no consultative phase. The results will be disseminated through presentations at local, national, clinical and medical education conferences and through publication in a peer-reviewed journal.
Occupational exposures and incidence of chronic bronchitis and related symptoms over two decades: the European Community Respiratory Health Survey
Authors: Lytras Theodore , Kogevinas Manolis , Kromhout Hans , Carsin Anne-Elie , Antó Josep Maria , Bentouhami Hayat , Weyler Joost , Heinrich Joachim , Nowak Dennis , Urrutia Isabel , Martínez-Moratalla Jesús , Gullón José Antonio , Vega Antonio Pereira , Raherison Semjen Chantal , Pin Isabelle , Demoly Pascal , Leynaert Bénédicte , Villani Simona , Gíslason Thorarinn , Svanes Øistein , Holm Mathias , Forsberg Bertil , Norbäck Dan , Mehta Amar J , Probst-Hensch Nicole , Benke Geza , Jogi Rain , Torén Kjell , Sigsgaard Torben , Schlünssen Vivi , Olivieri Mario , Blanc Paul D , Watkins John , Bono Roberto , Buist A. Sonia , Vermeulen Roel , Jarvis Deborah , Zock Jan-Paul
Published: January 2019

Objectives

Chronic bronchitis (CB) is an important chronic obstructive pulmonary disease (COPD)-related phenotype, with distinct clinical features and prognostic implications. Occupational exposures have been previously associated with increased risk of CB but few studies have examined this association prospectively using objective exposure assessment. We examined the effect of occupational exposures on CB incidence in the European Community Respiratory Health Survey.

Methods

Population samples aged 20–44 were randomly selected in 1991–1993, and followed up twice over 20 years. Participants without chronic cough or phlegm at baseline were analysed. Coded job histories during follow-up were linked to the ALOHA Job Exposure Matrix, generating occupational exposure estimates to 12 categories of chemical agents. Their association with CB incidence over both follow-ups was examined with Poisson models using generalised estimating equations.

Results

8794 participants fulfilled the inclusion criteria, contributing 13 185 observations. Only participants exposed to metals had a higher incidence of CB (relative risk (RR) 1.70, 95% CI 1.16 to 2.50) compared with non-exposed to metals. Mineral dust exposure increased the incidence of chronic phlegm (RR 1.72, 95% CI 1.43 to 2.06). Incidence of chronic phlegm was increased in men exposed to gases/fumes and to solvents and in women exposed to pesticides.

Conclusions

Occupational exposures are associated with chronic phlegm and CB, and the evidence is strongest for metals and mineral dust exposure. The observed differences between men and women warrant further investigation.
Population-based study of amyotrophic lateral sclerosis and occupational lead exposure in Denmark
Authors: Dickerson Aisha S , Hansen Johnni , Specht Aaron J , Gredal Ole , Weisskopf Marc G
Published: January 2019

Objectives

Previous research has indicated links between lead (Pb) exposure and increased risk of neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS). In this study, we evaluated the association between occupational Pb exposures and ALS.

Methods

ALS cases were ascertained through the Danish National Patient Registry from 1982 to 2013 and age and sex-matched to 100 controls. Using complete employment history since 1964 from the Danish Pension Fund, cumulative Pb exposure was estimated for each subject via a Danish job exposure matrix. Associations were evaluated using conditional logistic regression analyses and stratified by sex.

Results

For men with >50% probability of exposure, there was an increase in odds of ALS for exposures in the 60th percentile or higher during any time 5 years prior to diagnosis (aOR: 1.35; 95% CI 1.04 to 1.76) and 10 years prior to diagnosis (aOR: 1.33; 95% CI 1.03 to 1.72). No significant associations were observed in women, and there were no linear trends seen for Pb exposures for either sex.

Conclusions

Our study indicates an association between consistently higher occupational Pb exposures and ALS. These findings support those of previously reported associations between ALS and specific occupations that commonly experience Pb exposure.
Free fatty acids as a marker for predicting periprocedural myocardial injury after coronary intervention
Authors: Wang Yu , Zhang Hui-Wen , Guo Yuan-Lin , Zhu Cheng-Gang , Wu Na-Qiong , Li Jian-Jun
Published: January 2019

Background

Previous studies have revealed that plasma levels of free fatty acids (FFAs) are related to cardiovascular risk. However, whether FFAs could predict periprocedural myocardial injury (PMI) following percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) remains unclear.

Purpose

This study aimed to investigate the relationship of FFAs to PMI in untreated patients with CAD who underwent PCI.

Methods

A total of 374 consecutive patients with CAD without lipid-lowering treatment on admission and with normal preprocedural cardiac troponin I (cTnI) levels who underwent PCI were prospectively enrolled. The baseline characteristics were collected and PMI was evaluated by cTnI analysis within 24 hours. The relation of preprocedural FFA levels to peak cTnI values after PCI was examined.

Results

Preprocedural FFAs were positively correlated with peak cTnI values after PCI in both simple regression model (β=0.119, p=0.021) and multiple regression model (β=0.198, p=0.001). Patients with higher FFA levels had higher postprocedural cTnI levels compared with those with normal FFA levels (0.27±0.68 ng/mL vs 0.66±0.31 ng/mL, p=0.014). In the multivariable model, preprocedural FFA levels were associated with an increased risk of postprocedural cTnI elevation above 1× upper limit of normal (ULN, OR: 1.185, 95% CI 0.997 to 1.223, p=0.019) up to 10× ULN (OR: 1.132, 95% CI 1.005 to 1.192, p=0.003) .

Conclusions

The present study first suggested that elevated FFA levels were associated with an increased risk of PMI in untreated patients with CAD. Further study with large sample size may be needed to confirm our findings.
Medicaid payer status is associated with increased mortality and morbidity after inpatient shoulder arthroplasty: a multistate analysis, 2007–2014
Authors: Like Brian J , White Robert S , Tangel Virginia , Sullivan Kathleen J , Arroyo Noelle S , Stambough Jeffrey B , Turnbull Zachary A
Published: January 2019

Background and objectives

Inpatient shoulder arthroplasty is widely performed around the USA at an increasing rate. Medicaid insurance has been identified as a risk factor for inferior surgical outcomes. We sought to identify the impact of being Medicaid-insured on in-hospital mortality, readmission, complications, and length of stay (LOS) in patients who underwent inpatient shoulder arthroplasty.

Methods

We analyzed 89 460 patient discharge records for inpatient total, partial, and reverse shoulder arthroplasties using data from the Healthcare Cost and Utilization Project’s State Inpatient Databases for California, Florida, New York, Maryland, and Kentucky from 2007 through 2014. We compared patient demographics, present-on-admission comorbidities, and hospital characteristics by insurance payer. We estimated multilevel mixed-effect multivariate logistic regression models and generalized linear models to assess insurance’s effect on in-hospital mortality, readmission, infectious complications, cardiac complications, and LOS; models controlled for patient and hospital characteristics.

Results

Medicaid-insured patients had greater odds than patients with private insurance, other insurance, and Medicare of inpatient mortality (OR: 4.61, 95% CI 2.18 to 9.73, p<0.001) and 30-day and 90-day readmissions (OR: 1.94, 95% CI 1.57 to 2.38, p<0.001; OR: 1.65, 95% CI 1.42 to 2.38, p<0.001, respectively). Compared with private insurance, other insurance, and Medicare patients, Medicaid patients had increased likelihood of developing infectious complications and were expected to have longer LOS.

Conclusions

Our study supports our hypothesis that among inpatient shoulder arthroplasty patients, those with Medicaid insurance have worse outcomes than patients with private insurance, other insurance, and Medicare. These results are relatively consistent with previous findings in the literature.
Pain management after laparoscopic hysterectomy: systematic review of literature and PROSPECT recommendations
Authors: Lirk Philipp , Thiry Juliette , Bonnet Marie-Pierre , Joshi Girish P , Bonnet Francis
Published: February 2019

Background and objectives

Laparoscopic hysterectomy is increasingly performed because it is associated with less postoperative pain and earlier recovery as compared with open abdominal hysterectomy. The aim of this systematic review was to evaluate the available literature regarding the management of pain after laparoscopic hysterectomy.

Strategy and selection criteria

Randomized controlled trials evaluating postoperative pain after laparoscopic hysterectomy published between January 1996 and May 2018 were retrieved, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, from the EMBASE and MEDLINE databases and the Cochrane Register of Controlled Trials. Efficacy and adverse effects of analgesic techniques were assessed.

Results

Of the 281 studies initially identified, 56 were included. Of these, 31 assessed analgesic or anesthetic interventions and 25 assessed surgical interventions. Acetaminophen, non-steroidal anti-inflammatory drugs, and dexamethasone reduced opioid consumption. Limited evidence hindered recommendations on alpha-2-agonists. Inconsistent evidence was found in the studies investigating pregabalin and transversus abdominis plane block, and no evidence was found for intraperitoneal local anesthetics, port site infiltration, or single-port laparoscopy. Measures to lower peritoneal insufflation pressure or humidify or heat insufflated gas seem to reduce the incidence of shoulder pain, but not abdominal pain.

Conclusions

The baseline analgesic regimen for laparoscopic hysterectomy should include acetaminophen, a non-steroidal anti-inflammatory drug, dexamethasone, and opioids as rescue analgesics.
Intermittent bolus versus continuous infusion techniques for local anesthetic delivery in peripheral and truncal nerve analgesia: the current state of evidence
Authors: Jagannathan Ram , Niesen Adam D , D'Souza Ryan S , Johnson Rebecca L
Published: February 2019

Manually delivered intermittent bolus (MIB) and programmable intermittent bolus (PIB), alternatives to continuous infusion (CI), involve administering a set volume of solution at a set interval of time. The benefits of intermittent bolus techniques in truncal and peripheral nerve blockade (TPNB) are unclear, and studies have largely demonstrated conflicting results. Using MEDLINE, Embase, Google Scholar, and the Cochrane Library, we conducted an evidenced-based review of published randomized controlled trials comparing intermittent bolus and CI methods in TPNB. In total, 13 randomized controlled trials were identified and evaluated. Outcomes data addressed in these studies included assessments of pain, opioid and local anesthetic consumption, patient satisfaction, adverse events, and physical therapy metrics. The overall quality of current evidence was found to be low given the small sample sizes, heterogeneity of data, and the variations in intermittent bolus techniques between studies. At this time, we found limited supportive data to endorse MIB or PIB over CI in TPNB. While unable to provide data-driven conclusions for local anesthetic delivery methods at this time, we propose that future studies and quantitative analysis between techniques should be on an anatomic, site-specific basis, with greater focus on evaluation of opioid use, adverse events, patient satisfaction, and rehabilitative metrics.
Prevalence and risk factors of anogenital human papillomavirus infection in a community sample of men who have sex with men in Taiwan: baseline findings from a cohort study
Authors: Strong Carol , Zou Huachun , Ko Nai-Ying , Liang Ya-Lun , Ku Wen-Wei , Lee Chia-Wen
Published: January 2019

Objectives

Men who have sex with men (MSM) are a highly neglected population in the current recommendation of girls-only human papillomavirus (HPV) vaccination programmes in many countries. To better assess the cost effectiveness of HPV vaccination among men requires data on the prevalence of HPV infection in MSM using a community sample, which is still sparse in several regions. We examined the prevalence of and factors associated with anogenital HPV infection among MSM in Taiwan.

Methods

MSM 20 years of age and older were recruited from the community and social media in Taiwan in 2015–2016 and screened for HPV infection to detect 37 genotypes. MSM were seen at baseline and were/will be seen at 6, 12, 24 and 36 months. Men completed a questionnaire regarding their sexual experiences. Multivariable regression analyses were conducted to identify associated behavioural risk factors using the baseline data.

Results

A total of 253 MSM were recruited; 87 % were below 35 years of age. Diagnosis of HIV was reported in 4% of men; just over 20% had three or more anal sex partners in the past year. The prevalence of any tested HPV type was 29.4% at the anal site and 11% at the penile site. One quarter of MSM were infected with any of the 9-valent vaccine HPV types. Anal HPV detection was associated with having three or more receptive anal sex partners in the past year (adjusted odds ratio (aOR)=2.92, 95% CI 1.29 to 6.61) and having older sex partners (aOR=2.51, 95% CI 1.07 to 5.90).

Conclusions

Our data provide the base to calculate the reproductive rate for HPV transmission in a low-risk community sample and cost-effectiveness to include men in HPV vaccination policies. Adding evidence from a community sample adds comprehensiveness for future estimates of disease transmission and vaccine effectiveness.
Delphi study among international expert panel to develop waterpipe-specific health warning labels
Authors: Asfar Taghrid , Schmidt Michael , Ebrahimi Kalan Mohammad , Wu Wensong , Ward Kenneth D , Nakkash Rima T , Thrasher James , Eissenberg Thomas , Ben Romdhane Habiba , Maziak Wasim
Published: January 2019

Background

Waterpipe (WP) smoking is increasing globally. The rise of WP has been fuelled by widespread misperception of reduced-harm compared to cigarettes. Health warning labels (HWLs) are one strategy to communicate smoking-related risks and address reduced-harm misperceptions. Therefore, the development of WP-specific HWLs represents a priority for WP control.

Methods

A panel of experts in WP science developed 28 WP-specific HWLs corresponding to five themes (health risks, addiction, harm to others, WP-specific harm, WP harm compared to cigarettes). Subsequently, a three-round Delphi study was conducted among international expert panel to reach consensus on a set of the most effective HWLs for each theme. Levels of agreement between participants were assessed using interquartile deviations, and the rank between the tied HWLs was based on the median.

Results

Starting with 28 candidate HWLs stratified according to five WP-related themes, our international expert panel reached consensus on the 13 most important WP-specific HWLs. Labels with the highest agreement were related to oral and heart disease, WP’s harmful effects on newborn children and the amount of smoke inhaled from WP compared to cigarettes.

Conclusion

This study is the first to systematically develop and evaluate potential WP-specific HWLs based on the scientific evidence about WP’s harmful effects, scientific understanding of HWL for cigarettes and the opinions of experts in WP science, tobacco control and health communication. The final selected HWLs can be adapted based on the context and policy landscape of the target country and can be further fine-tuned based on feedback from WP smokers and non-smokers.
Co-tame polynomial automorphisms
Authors: Edo Eric , Lewis Drew
Published: January 2019

A polynomial automorphism of [Formula: see text] over a field of characteristic zero is called co-tame if, together with the affine subgroup, it generates the entire tame subgroup. We prove some new classes of automorphisms of [Formula: see text], including nonaffine [Formula: see text]-triangular automorphisms, are co-tame. Of particular interest, if [Formula: see text], we show that the statement “Every [Formula: see text]-triangular automorphism is either affine or co-tame” is true if and only if [Formula: see text]; this improves upon positive results of Bodnarchuk (for [Formula: see text], in any dimension [Formula: see text]) and negative results of the authors (for [Formula: see text], [Formula: see text]). The main technical tool we introduce is a class of maps we term translation degenerate automorphisms; we show that all of these are either affine or co-tame, a result that may be of independent interest in the further study of co-tame automorphisms.
Obesity “complements” preeclampsia
Authors: Olson Kelsey N. , Redman Leanne M. , Sones Jenny L.
Published: February 2019

Preeclampsia (PE) is a devastating adverse outcome of pregnancy. Characterized by maternal hypertension, PE, when left untreated, can result in death of both mother and baby. The cause of PE remains unknown, and there is no way to predict which women will develop PE during pregnancy. The only known treatment is delivery of both the fetus and placenta; therefore, an abnormal placenta is thought to play a causal role. Women with obesity before pregnancy have an increased chance of developing PE. Increased adiposity results in a heightened state of systemic inflammation that can influence placental development. Adipose tissue is a rich source of proinflammatory cytokines and complement proteins, which have been implicated in the pathogenesis of PE by promoting the expression of antiangiogenic factors in the mother. Because an aggravated inflammatory response, angiogenic imbalance, and abnormal placentation are observed in PE, we hypothesize that maternal obesity and complement proteins derived from adipose tissue play an important role in the development of PE.
Dynamic Contrast-Enhanced MR with Quantitative Perfusion Analysis of Small Bowel in Vascular Assessment between Inflammatory and Fibrotic Lesions in Crohnʼs Disease: A Feasibility Study
Authors: Ippolito Davide , Lombardi Sophie , Talei Franzesi Cammillo , Drago Silvia Girolama , Querques Giulia , Casiraghi Alessandra , Pecorelli Anna , Riva Luca , Sironi Sandro
Published: February 2019

Aim. To assess the feasibility of dynamic contrast-enhanced perfusion-MRI in characterization of active small-bowel inflammation and chronic mural fibrosis in patients with Crohnʼs disease (CD). Methods. We analyzed a total of 37 (11 women; 23–69 years) patients with known biopsy proven CD, who underwent MR-enterography (MRE) study, performed on a 1.5 T MRI system (Achieva, Philips), using a phased array sense body multicoil, after oral administration of 1.5–2 L of PEG solution. MRE protocol included T1 weighted, SSh T2, sBTFE, and gadolinium-enhanced THRIVE sequences acquired on coronal and axial planes. A dedicated workstation was used to generate perfusion color maps, on which we drown ROI on normal bowel and on pathological segment, thus obtaining related perfusion parameters: relative arterial, venous, and late enhancement (RAE, RVE, and RLE), maximum enhancement (ME), and time to peak (TTP). Results. Quantitative perfusion analysis showed a good correlation with local degree of Crohn’s inflammation activity. Twenty-nine out of 37 patients showed active inflammatory disease (reference standard of active disease: wall bowel thickness and layered enhancement) with following perfusion parameters: REA (%) = 116.1, RVE (%) = 125.3, RLE (%) = 127.1, ME (%) = 1054.7, TTP (sec) = 157. The same parameters calculated in patients with mural fibrosis were as follows: RAE (%): median = 56.4; RVE (%): 81.2; RLE (%): 85.4; ME (%):809.6; TTP (sec): 203.4. A significant difference (p<0.001) between inflamed and fibrotic bowel wall vascularity, regarding all perfusion parameters evaluated, was found, with higher values in active CD localizations. Conclusion. Vascular assessment of perfusion kinetics of bowel wall by dynamic contrast perfusion-MR analysis may represent a complementary diagnostic tool that enables a quantitative evaluation of local inflammation activity in CD patients.
Pathological Implications of Receptor for Advanced Glycation End-Product (AGER) Gene Polymorphism
Authors: Serveaux-Dancer Marine , Jabaudon Matthieu , Creveaux Isabelle , Belville Corinne , Blondonnet Raïko , Gross Christelle , Constantin Jean-Michel , Blanchon Loïc , Sapin Vincent
Published: February 2019

The receptor for advanced glycation end-products (RAGE) is a cell surface transmembrane multiligand receptor, encoded by the AGER gene. RAGE presents many transcripts, is expressed mainly in the lung, and involves multiple pathways (such as NFκB, Akt, p38, and MAP kinases) that initiate and perpetuate an unfavorable proinflammatory state. Due to these numerous functional activities, RAGE is implicated in multiple diseases. AGER is a highly polymorphic gene, with polymorphisms or SNP (single-nucleotide polymorphism) that could be responsible or co-responsible for disease development. This review was designed to shed light on the pathological implications of AGER polymorphisms. Five polymorphisms are described: rs2070600, rs1800624, rs1800625, rs184003, and a 63 bp deletion. The rs2070600 SNP may be associated with the development of human autoimmune disease, diabetes complications, cancer, and lung diseases such as chronic obstructive pulmonary disease and acute respiratory distress syndrome. The rs1800624 SNP involves AGER gene regulation and may be related to reduced risk of heart disease, cancer, Crohn’s disease, and type 1 diabetes complications. The rs1800625 SNP may be associated with the development of diabetic retinopathy, cancer, and lupus but may be protective against cardiovascular risk. The rs184003 SNP seems related to coronary artery disease, breast cancer, and diabetes. The 63 bp deletion may be associated with reduced survival from heart diseases during diabetic nephropathy. Here, these potential associations between AGER polymorphisms and the development of diseases are discussed, as there have been conflicting findings on the pathological impact of AGER SNPs in the literature. These contradictory results might be explained by distinct AGER SNP frequencies depending on ethnicity.
Two Transcutaneous Stimulation Techniques in Shoulder Pain: Transcutaneous Pulsed Radiofrequency (TPRF) versus Transcutaneous Electrical Nerve Stimulation (TENS): A Comparative Pilot Study
Authors: Lin Mu-Lien , Chiu Hung-Wei , Shih Zao-Ming , Lee Po-Ying , Li Pei-Zhi , Guo Chin-Hong , Luo Yuan-Jie , Lin Shen-Chieh , Lin Kwan-Yu , Hsu Yu-Ming , Pang Angela , Pang Weiwu
Published: February 2019

Objective. To compare the safety and efficacy of 2 transcutaneous stimulation techniques, transcutaneous pulsed radiofrequency (TPRF) versus transcutaneous electrical nerve stimulation (TENS), in chronic shoulder tendonitis. Design. A prospective, randomized, and double-blind clinical trial. Setting. Academic pain service of a city hospital. Subjects. Fifty patients with sonography-confirmed shoulder tendonitis. Methods. Fifty patients were randomly allocated into two groups for electrical stimulation treatment with 3-month follow-ups: Group 1 n=25, TENS and Group 2 n=25, TPRF. Both groups underwent either treatment for 15 minutes every other day, three times total. Our primary goals were to find any treatment comfort level, adverse event, and changes in Constant–Murley shoulder (CMS) scores. The secondary goals were finding the changes in pain, enjoyment of life, and general activity (PEG) scores. Results. For primary goals, no adverse events were noted throughout this study. No differences were found between groups for treatment tolerability (3.20 + 0.87 vs. 2.16 + 0.75). Statistically significant lower PEG scores were noticeable with the TPRF group after the course (12.73 + 5.79 vs. 24.53 + 10.21, p=0.013). Their statistical significance lasted for 3 months although the difference gap diminished after 1 month. CMS scores were significantly higher in the TPRF group (70.84 + 6.74 vs. 59.56 + 9.49, p=0.007) right after treatment course but the significance did not last. Conclusions. In treating chronic shoulder tendinitis using two transcutaneous stimulation techniques, both TPRF and TENS are safe and effective. TPRF is superior to TENS.
Parametric Investigation of Dual‐Mass Flywheel Based on Driveline Start‐Up Torsional Vibration Control
Authors: He Liupeng , Xia Changgao , Chen Sida , Guo Jiwei , Liu Yi
Published: January 2019

This paper is aimed to investigate the influence of dual‐mass flywheel (DMF) kinetic parameters on driveline torsional vibration in engine start‐up process, which prescribes the design requirements under start‐up condition for DMF matching. On the basis of driveline excitation analysis during engine start‐up, the analytical model of DMF driveline torsional vibration system is built and simulated. The vehicle start‐up test is conducted and compared with the simulation results. On account of the partial nonstationary characteristic of driveline during start‐up, the start‐up process is separated into 3 phases for discussing the influence of DMF rotary inertia ratio, hysteresis torque, and nonlinear torsional stiffness on attenuation effect. The test and simulation results show that the DMF undergoes severe oscillation when driveline passes through resonance zone, and the research model is verified to be valid. The DMF design requirements under start‐up condition are obtained: the appropriate rotary inertia ratio (the 1st flywheel rotary inertia‐to‐the 2nd flywheel rotary inertia ratio) is 0.7∼1.1; the interval of DMF small torsion angle should be designed as being with small damping, while large damping is demanded in the interval of large torsion angle; DMF should be equipped with low torsional stiffness when working in start‐up process.
Research on the Overtopping‐Induced Breaching Mechanism of Tailings Dam and Its Numerical Simulation
Authors: Deng Zhao , Wu Shiqiang , Fan Ziwu , Yan Zhikun , Wu Jingxiu
Published: February 2019

The centrifugal model test system is utilized to reappear the breaching process of a tailings dam. The results show that there are significant differences in breaching processes between tailings dams and earth‐rockfill dams. Influenced by the special physical and mechanical properties of tailings, the breaching processes of tailings dams are of short duration, and the flood flow through the breach increase rapidly. Based on the centrifugal test results, considering the special physical and mechanical properties of tailings, a mathematical model for tailings dam breaching is established. In the model, the vertical undercutting and horizontal expansion are simulated utilizing the erosion rate formula which is derived from shear stress principle of water flow; limit equilibrium method is used to analyze the breach slope stability. In addition, the model adopts iterative calculation method to simulate the whole breaching process. The analysis results show that, the proposed model is applicable in modeling the dam breaching process for tailings dam due to overtopping.
Nexplanon Subdermal Implant: Assessment of Sexual Profile, Metabolism, and Bleeding in a Cohort of Italian Women
Authors: Guida Maurizio , Farris Manuela , Aquino Carmen Imma , Rosato Elena , Cipullo Lucio M. A. , Bastianelli Carlo
Published: January 2019

Objectives. To evaluate the impact on metabolism, bleeding, and sexual function of Nexplanon, a subdermal implant. Study Design. We recruited women (n=101) receiving the Nexplanon implant at two university centers in Italy between 2011 and 2016 into this prospective, observational, multicenter research trial. Participants completed the Interview for Ratings of Sexual Function (IRSF) and the Female Sexual Function Index (FSFI) questionnaires before and 3 and 6 months after the implant was inserted. In addition, all blood parameters were assessed at these visits. All women were given a menstrual diary card and a pictorial blood assessment chart to record daily any vaginal bleeding. Results. The studied metabolic parameters remained in the normal range, showing no alarming modifications: minimal statistical reductions (in aspartate aminotransferase, alanine aminotransferase, total cholesterol, triglycerides, and activated partial thromboplastin time) and increases (in glucose and prothrombin activity) were observed. Changes in IRSF score over 6 months showed a significant increase in pleasure, personal initiative, orgasm, intensity of orgasm, and satisfaction, and a significant decrease in anxiety and discomfort. Mean Body Mass Index decreased, and the weekly frequency of sexual intercourse increased. Conclusions. Nexplanon showed not only a lower metabolic and bleeding impact, but also important positive effects on sexual function. It expands the range of possibilities for women, 38 and couples, in the modern concepts of sexual and reproductive wellbeing.
Study of Dynamic Brittle Fracture of Composite Lamina Using a Bond-Based Peridynamic Lattice Model
Authors: Guo Jushang , Gao Weicheng , Liu Zhenyu , Yang Xiongwu , Li Fengshou
Published: February 2019

We proposed a bond-based peridynamic lattice model for simulating dynamic brittle fracture of 2D composite lamina. Material orthogonal anisotropy was represented by rotating topological lattice structure instead of fiber directions. Analytical derivation and numerical implementation of the proposed model were given based on energy equivalence. Benchmark composite lamina tests are used to validate the capability of modeling dynamic fracture of the method. The peridynamic lattice model is found to be robust and successful in modeling dynamic brittle fracture of 2D composite lamina and can be extended to composite laminates by applying 3D lattice structure.
Biomedical Potentialities of Silver Nanoparticles for Clinical Multiple Drug-Resistant Acinetobacter baumannii
Authors: Chen Minghui , Yu Xiaoxu , Huo Qianyu , Yuan Qin , Li Xue , Xu Chen , Bao Huijing
Published: February 2019

Multidrug-resistant A. baumannii is increasingly recognized as a significant problem in hospitals and causes high morbidity and mortality. Here, we studied the antibacterial effects of AgNPs on clinically isolated multiple drug-resistant A. baumannii, and search for the potential antibacterial mechanism. Based on the results from the colony-forming unit (CFU) method, flow cytometry (FC), and a BrdU ELISA, we conclude that AgNPs can simultaneously induce apoptosis and inhibit new DNA synthesis in bacteria in a concentration-dependent manner. This study presents the first discussion of an antibacterial effect by AgNPs in clinically isolated, multidrug-resistant A. Baumannii and provides a new strategy for the use of silver nanoparticles in the multidrug-resistant A. Baumannii clinical problem.