bluuebunny/crossref_metadata_2025 huggingface dataset:
STEM EDUCATION FOR SUSTAINABILITY OF EARLY CHILDHOOD IN CHINA
Authors: Zhao Wenxiao
Published: January 2019

Changes in curricula, publication policy and information technology, notably in China have led to concentrations in the role of STEM (science, technology, engineering and mathematics) education in early childhood and applauded to proliferations of imported up-to-date reading materials and mobile apps in English. This paper proposes a longitude study of a Chinese toddler learning STEM by reading picture books and playing with tablet and suggests new horizons in parenting and in STEM education during children's early years. The present study carried out from 2016, when the participant reached one year old, eligible to learn to speak and to concentrate on the picture books read by parents who had filled a language background questionnaire with information on themselves and the participant. Tablet playing brought about for the two-year-old toddler and collections of STEM books in English was added for the second year. Data collection lasted for two years with an iLab video camera, capturing utterances and motions for five minutes per week transcribed by VoiceScript software. Tests were given quarterly at private home by tapping in mobile app "Bilingual Child Learning" which consists of 20 basic STEM themes before scores were collected. Findings indicate that (1) it is accessible for children of very early years to be engaged in English STEM resources, (2) kids' limited English dominance does not impede learning STEM, (3) and to think in English in early STEM contributes to children's English.
Renoprotective Effect of Laminaria japonica Polysaccharide in Adenine-Induced Chronic Renal Failure
Authors: Long Miao , Li Qiang-Ming , Fang Qing , Pan Li-Hua , Zha Xue-Qiang , Luo Jian-Ping
Published: January 2019

Chronic renal failure (CRF) is a major public health problem worldwide. In this work, we investigated the effects of a purified Laminaria japonica polysaccharide (LJP61A) on the renal function using adenine-induced CRF mice model. Results exhibited that adenine treatment caused serious renal pathological damages and elevation of serum creatinine and blood urea nitrogen of mice. However, these changes could be significantly reversed by the administration of LJP61A in a dose-dependent manner. Additionally, LJP61A could dramatically reduce the weight loss, improve the urine biochemical index, and regulate the electrolyte disturbance of CRF mice. These results suggested that the renal functions of adenine-induced CRF mice could be improved by LJP61A, which might be developed to a potential therapeutic agent for CRF patients.
Life Course Approaches to the Causes of Health Disparities
Authors: Jones Nancy L. , Gilman Stephen E. , Cheng Tina L. , Drury Stacy S. , Hill Carl V. , Geronimus Arline T.
Published: January 2019

Reducing health disparities requires an understanding of the mechanisms that generate disparities. Life course approaches to health disparities leverage theories that explain how socially patterned physical, environmental, and socioeconomic exposures at different stages of human development shape health within and across generations and can therefore offer substantial insight into the etiology of health disparities.

Life course approaches are informed by developmental and structural perspectives. Developmental perspectives emphasize how socially patterned exposures to risk factors during sensitive life stages shift health trajectories, whereas structural perspectives emphasize how social identity and position within socially patterned environments disproportionately allocate risk factors and resources, resulting in altered health trajectories.

We conclude that the science of health disparities will be advanced by integrating life course approaches into etiologic and intervention research on health disparities. The following 4 strategies are offered to guide in this process: (1) advance the understanding of multiple exposures and their interactions, (2) integrate life course approaches into the understanding of biological mechanisms, (3) explore transgenerational transmission of health disparities, and (4) integrate life course approaches into health disparities interventions.
Methodological Approaches to Understanding Causes of Health Disparities
Authors: Jeffries Neal , Zaslavsky Alan M. , Diez Roux Ana V. , Creswell John W. , Palmer Richard C. , Gregorich Steven E. , Reschovsky James D. , Graubard Barry I. , Choi Kelvin , Pfeiffer Ruth M. , Zhang Xinzhi , Breen Nancy
Published: January 2019

Understanding health disparity causes is an important first step toward developing policies or interventions to eliminate disparities, but their nature makes identifying and addressing their causes challenging.

Potential causal factors are often correlated, making it difficult to distinguish their effects. These factors may exist at different organizational levels (e.g., individual, family, neighborhood), each of which needs to be appropriately conceptualized and measured. The processes that generate health disparities may include complex relationships with feedback loops and dynamic properties that traditional statistical models represent poorly.

Because of this complexity, identifying disparities’ causes and remedies requires integrating findings from multiple methodologies. We highlight analytic methods and designs, multilevel approaches, complex systems modeling techniques, and qualitative methods that should be more broadly employed and adapted to advance health disparities research and identify approaches to mitigate them.
Nomenclature Inconsistency and Selective Outcome Reporting Hinder Understanding of Stem Cell Therapy for the Knee
Authors: Jones Ian A. , Chen Xiao , Evseenko Denis , Vangsness C. Thomas
Published: January 2019

Background:

The prospect of treating knee cartilage injury/pathology with mesenchymal stem cells (MSCs) has garnered considerable attention in recent years, but study heterogeneity and a lack of randomized controlled trials (RCTs) preclude quantitative analysis. The purpose of this review was to provide clinicians with an overview of RCTs that addresses 2 key areas that have been largely overlooked: nomenclature inconsistency and selective outcome reporting.

Methods:

RCTs that purported to use stem cells or MSCs to treat knee cartilage were identified with use of PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses). Study variables were compiled, and methodological quality was assessed. The cell treatments and the methods used to characterize them were recorded and compared. Clinical, radiographic, and arthroscopic outcomes were extracted and evaluated qualitatively.

Results:

There was extensive variation among the treatments, adjuvant therapies, and outcome measures. Treatments did not coincide with terminology. Significant differences in clinical outcomes were reported infrequently, and intra-group improvements or inter-group subscore differences were consistently highlighted, particularly when inter-group comparisons were left unreported.

Conclusions:

Overall, there are isolated cases in which positive efficacy results have been published, but our results suggest that the generally positive efficacy conclusions concerning stem cell therapy for knee cartilage pathology may be overstated. Nevertheless, it is important to understand that the efficacy of stem cell therapies should not be considered in aggregate. Cells that are procured or processed differently produce entirely different drugs. When evaluating the efficacy of “stem cell” therapies, clinicians must consider the methodological quality, nomenclature, and inherent distinctness of each treatment.
A Novel, Automated Text-Messaging System Is Effective in Patients Undergoing Total Joint Arthroplasty
Authors: Campbell Kevin J. , Louie Philip K. , Bohl Daniel D. , Edmiston Tori , Mikhail Christopher , Li Jefferson , Khorsand Derek A. , Levine Brett R. , Gerlinger Tad L.
Published: January 2019

Background:

Digital patient engagement platforms are designed to improve the efficacy of the perioperative surgical home, but the currently available solutions have shown low patient and provider adoption. The purpose of this study was to evaluate the effectiveness of a text-messaging (Short Message Service [SMS]) bot with respect to patient engagement following joint replacement procedures in a randomized clinical trial.

Methods:

One hundred and fifty-nine patients (83 patients in the control group and 76 patients in the intervention group) were enrolled in a randomized controlled trial comparing the effectiveness of an SMS bot (intervention group) with the traditional perioperative education process (control group) in patients undergoing primary total knee or hip arthroplasty. There were no significant differences in the demographic characteristics between the 2 groups. The primary outcome of time participating in home-based exercises and the secondary outcomes of knee range of motion, the use of narcotics, visual analog scale (VAS) mood score, telephone calls to the office, patient satisfaction, and visits to the emergency department were measured and were compared between the 2 groups. Continuous outcomes were analyzed using linear regression, and categorical outcomes were analyzed using the Pearson chi-square test.

Results:

Patients in the intervention group exercised for 8.6 minutes more per day: a mean time (and standard deviation) of 46.4 ± 17.4 minutes compared with 37.7 ± 16.3 minutes for the control group (p < 0.001). The intervention group had an improved mood (mean VAS, 7.5 ± 1.8 points compared with 6.5 ± 1.7 points for the control group; p < 0.001), stopped their narcotic medications 10 days sooner (mean time, 22.5 ± 13.4 days compared with 32.4 ± 11.8 days for the control group; p < 0.001), placed fewer telephone calls to the surgeon’s office (mean calls, 0.6 ± 0.8 compared with 2.6 ± 3.4 for the control group; p < 0.001), and had greater knee range of motion 3 weeks after the surgical procedure (mean flexion, 101.2° ± 11.2° compared with 93.8° ± 14.5° for the control group; p = 0.008), but had an equal range of motion at 6 weeks. There was a trend toward fewer visits to the emergency department in the intervention group, but this comparison lacked statistical power.

Conclusions:

An SMS bot can improve clinical outcomes and increase patient engagement in the early postoperative period in patients undergoing hip or knee arthroplasty.

Level of Evidence:

Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
A Surgeon Scorecard Is Associated with Improved Value in Elective Primary Hip and Knee Arthroplasty
Authors: Winegar Angela L. , Jackson Lauren W. , Sambare Tanmaya D. , Liu Tiffany C. , Banks Sean R. , Erlinger Thomas P. , Schultz W. Randall , Bozic Kevin J.
Published: January 2019

Background:

Despite increasing interest in total joint arthroplasty registries, evidence of the impact of physician-level performance on the value of care provided to patients undergoing hip and knee arthroplasty is lacking. The purpose of this study was to examine the effectiveness of an unblinded orthopaedic surgeon-specific value scorecard in improving patient outcomes and reducing hospital costs.

Methods:

We retrospectively analyzed patient outcomes and hospital costs associated with total joint arthroplasties before and 9 months after the introduction of a Surgeon Value Scorecard at an urban tertiary care center. From August 2016 to May 2017, orthopaedic surgeons received an unblinded monthly Surgeon Value Scorecard summarizing a rolling 6-month view of results by surgeon for patients attributed to Diagnosis Related Group 470 (major lower-extremity arthroplasty without comorbidity or complication). Prior to implementation, surgeons were educated on the scorecard and participated in the development of a document outlining the definition and calculation of included metrics. Scorecard metrics were grouped into 5 categories: patient demographic characteristics, patient outcomes (for example, length of stay, discharge disposition, readmissions), patient experience, financial, and operational (for example, operative times). Financial (cost) measures and patient outcomes were selected as the key performance indicators analyzed in this study. Continuous variables were analyzed using the t test when a normal distribution was assumed and using Mann-Whitney tests when a non-normal distribution was assumed. Categorical variables were compared using chi-square tests. Significance was defined as p < 0.05.

Results:

After 9 months of unblinded Surgeon Value Scorecard distribution, the mean total costs for total joint arthroplasties decreased by 8.7%, from $17,996 to $16,426 (p < 0.001). The mean total direct variable costs decreased by 17.1% from $10,945 to $9,070 (p < 0.001), and implant costs decreased by 5.3% (p < 0.001). Length of stay also decreased by 0.2 day to 1.7 days (p < 0.001), and, although there was improvement in the home-discharge rate, 30-day readmission rate, and 90-day readmission rate, the differences were not significant (p > 0.05).

Conclusions:

The implementation of a surgeon-specific value scorecard for lower-extremity joint arthroplasties was associated with reduced total and direct variable hospital costs, reduced implant costs, decreased variation in costs, and reduced postoperative length of stay, without compromising clinical outcomes.

Clinical Relevance:

Sharing unblinded clinical and financial outcomes with surgeons may promote a culture of shared accountability and may empower surgeons to improve value-based decision-making in care delivery.
Surgeon Type and Outcomes After Inpatient Ankle Arthrodesis and Total Ankle Arthroplasty
Authors: Chan Jimmy J. , Chan Jesse C. , Poeran Jashvant , Zubizarreta Nicole , Mazumdar Madhu , Vulcano Ettore
Published: January 2019

Background:

Two main treatments for end-stage ankle arthritis are ankle arthrodesis and total ankle arthroplasty (TAA). While both procedures can be performed either by a foot and ankle orthopaedic surgeon or a podiatrist (when within a particular state’s scope of practice), studies comparing the surgical outcomes of the 2 surgeon types are lacking. Therefore, in this study, we compared outcomes by surgeon type for TAA and for ankle arthrodesis.

Methods:

This retrospective cohort study utilized data from the nationwide Premier Healthcare claims database (2011 to 2016) regarding TAA (n = 3,674) and ankle arthrodesis (n = 4,980) procedures. Multivariable models estimated associations between surgeon type (podiatrist versus orthopaedic foot and ankle surgeon) and opioid utilization (in oral morphine equivalents [OMEs]), length of stay, and cost of hospitalization. We report percent change (compared with reference) and 95% confidence intervals (CIs).

Results:

Overall, 76.5% (n = 2,812) and 18.8% (n = 690) of TAA procedures were performed by orthopaedic foot and ankle surgeons and podiatrists, respectively; surgeon type was unknown for 4.7% (n = 172). For ankle arthrodesis, 75.3% (n = 3,752) and 18.3% (n = 912) of the procedures were performed by orthopaedic foot and ankle surgeons and podiatrists, respectively; surgeon type was unknown for 6.3% (n = 316). The proportion of TAA and ankle arthrodesis procedures performed by podiatrists increased over time, from 12.8% and 13.6% in 2011 to 24.6% and 26.0% in 2016, respectively. When adjusting for relevant covariates, procedures performed by podiatrists (compared with orthopaedic foot and ankle surgeons) were associated with increased length of stay: for TAA, +16.7% (95% CI, 7.6% to 26.5%; median, 2 days in both groups) and for ankle arthrodesis, +14.2% (95% CI, 7.9% to 20.9%; median, 3 compared with 2 days) (p < 0.05 for both). In addition, ankle arthrodesis performed by podiatrists was associated with increased cost of hospitalization: +28.5% (95% CI, 22.1% to 35.2%; median, $19,236 compared with $13,433) (p < 0.05). Differences in opioid utilization were nonsignificant in the main analysis: +10.9% (95% CI, −3.1% to 26.8%; median, 345 compared with 250 OMEs) and +2.8% (95% CI, −5.9% to 12.4%; median, 351 compared with 315 OMEs) for TAA and ankle arthrodesis, respectively.

Conclusions:

An increasing trend in the proportion of procedures performed by podiatrists was coupled with apparent increases in length of stay and cost compared with procedures performed by orthopaedic foot and ankle surgeons. Given the increasing demand for these procedures, factors associated with resource utilization, such as type of surgeon, may be increasingly important on the population level.

Level of Evidence:

TherapeuticLevel IV. See Instructions for Authors for a complete description of levels of evidence.
Prevalence and Clinical Features of Mazabraud Syndrome
Authors: Majoor Bas C.J. , van de Sande Michiel A.J. , Appelman-Dijkstra Natasha M. , Leithner Andreas , Jutte Paul C. , Vélez Roberto , Perlaky Tamás , Staals Eric L. , Bovée Judith V.M.G. , Hamdy Neveen A.T. , Dijkstra Sander P.D.
Published: January 2019

Background:

Mazabraud syndrome is a rare disorder, characterized by the presence of fibrous dysplasia (FD) with associated intramuscular myxomas. Data are scarce on the prevalence, clinical features, and natural history of this disorder and outcomes. In this multicenter study, we evaluated a series of patients from 6 European centers.

Methods:

All centers affiliated with the European Musculo-Skeletal Oncology Society (EMSOS) were invited to include data on all patients with Mazabraud syndrome who were seen between 1980 and 2015. The study investigated the prevalence of Mazabraud syndrome, the type, severity, and localization of FD lesions in relation to myxomas, the histopathology of myxomas, and results of GNAS-mutation analysis, when available.

Results:

Thirty-two patients (22 female) from 6 centers were included. The prevalence of Mazabraud syndrome was 2.2% in the combined cohort of 1,446 patients with FD, and the syndrome was diagnosed at a mean of 10.1 years after diagnosis of FD. The myxomas were predominantly localized in the upper leg. Excision was performed in 20 patients, recurrence occurred in 6 of these patients (30%) at a median of 8.5 years (range, 1.9 to 16.0 years), and revision surgery was necessary in 5 (25%). High cellularity of myxomas was associated with recurrence (p < 0.05). A GNAS mutation was identified in the myxoma tissue of 5 (83%) of 6 patients with GNAS-mutation analysis.

Conclusions:

This study is the first, to our knowledge, to provide data on the prevalence of Mazabraud syndrome in a relatively large cohort. Although the outcomes of surgical resection were good, a quarter of the patients required revision surgery despite clear resection margins. High cellularity of myxomas was associated with recurrence. GNAS mutations were identified in 83% (5 of 6), emphasizing the shared origin of FD and myxomas. Our data show that patients with FD who have disproportionate complaints, irrespective of FD type, extent, or severity, should be investigated for the possible presence of myxomas.

Level of Evidence:

Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Cognitive Skills Assessment for the Aging Orthopaedic Surgeon
Authors: Hickson Gerald B. , Peabody Terrance , Hopkinson William J. , Reiter Charles E.
Published: January 2019

Physician leaders are increasingly confronted with the challenge of evaluating the performance of surgical colleagues during the last phase of their careers. Identification of physicians with declining cognitive and clinical skills must be balanced against awareness of laws protecting colleagues from discrimination. Responding successfully to this challenge requires appropriate policies, reliable data, standardized evaluation tools, consistent documentation, and the development of compassionate and effective solutions that avoid discriminatory practices. Surgical champions are essential for promoting self-regulation. Performance evaluations should comply with medical staff bylaws and institutional wellness policies.
The Gluteus Medius Tendon and Its Insertion Sites
Authors: Tsutsumi Masahiro , Nimura Akimoto , Akita Keiichi
Published: January 2019

Background:

Gluteus medius tears are a common hip disorder. Despite this, the etiology of these tears and the anatomical background of the gluteus medius tendon remain unclear. This study aimed to clarify the characteristics of the gluteus medius tendon. We hypothesized that the tendinous portions of the gluteus medius have a nonuniform structure contributing to the tear etiology.

Methods:

Twenty-five hips from 15 Japanese cadavers were analyzed. Twenty-one of the hips were analyzed macroscopically, and the other 4 were analyzed histologically. In all of the specimens, the 3-dimensional (3D) morphology of the greater trochanter was examined using microcomputed tomography (micro-CT). In 10 of the 21 hips analyzed macroscopically, the local thickness of the gluteus medius tendon, detached from the greater trochanter, was measured.

Results:

The posterior and anterolateral parts of the gluteus medius tendons were roughly distinguished on the basis of the aspects of the iliac origins. The posterior part of the gluteus medius tendon ran in a fan-like shape and converged onto the superoposterior facet of the greater trochanter. The anterolateral part ran posteroinferiorly toward the lateral facet of the greater trochanter. The thickness was greater in the posterior part than in the anterolateral part, and the border between these 2 parts was relatively thin compared with the other parts. The histological study showed that both the posterior and anterolateral parts inserted onto the greater trochanter via fibrocartilage.

Conclusions:

The gluteus medius tendon consists of thick posterior and thin anterolateral parts, which were identified by the facet or aspect of the bone structures and thinness of their border region.

Clinical Relevance:

Our findings indicate that, given the nonuniform structure of the gluteus medius tendon, the thin anterolateral part may be more prone to tears than the thick posterior part is and tears may generally be limited to the anterolateral part.
Hip-Spine Syndrome: Acetabular Anteversion Angle Is Associated with Anterior Pelvic Tilt and Lumbar Hyperlordosis in Patients with Acetabular Dysplasia
Authors: Okuzu Yaichiro , Goto Koji , Okutani Yuki , Kuroda Yutaka , Kawai Toshiyuki , Matsuda Shuichi
Published: January 2019

Background:

Hip-spine syndrome was originally described by Offierski and MacNab, who argued that the flexion deformity of the hip rotated the pelvis forward, causing the spine symptoms. We additionally hypothesized that in patients who have osteoarthritis (OA) of the hip, the pelvis is tilted anteriorly to compensate for the anterior acetabular coverage defect. We investigated the hip factors associated with anterior pelvic tilt (PT) in patients who had OA of the hip due to acetabular dysplasia.

Methods:

We retrospectively reviewed the medical records of patients who had undergone total hip arthroplasty between January 2009 and December 2017 to identify those who had unilateral secondary OA due to acetabular dysplasia. Patients who had spinal imbalance, a history of spinal or lower limb fracture or surgery, bilateral OA of the hip, or a severely subluxated hip were excluded, leaving 100 eligible patients. We defined the indicators of an anterior acetabular coverage defect, flexion deformity of the hip, and anterior PT as the acetabular anteversion angle (AAA), extension range of motion (ROM), and anterior tilt of the pelvis, respectively. We measured hip factors and spinal parameters on radiographs and the standardized axial and coronal planes on 3-dimensional computed tomography with reference to the anterior pelvic plane. Hip factors associated with PT were investigated.

Results:

Univariate analysis showed a significant correlation between PT and both AAA (r = –0.389, p < 0.001) and combined anteversion angle (r = –0.272, p = 0.03). Multivariate regression analysis identified AAA (β = –0.385, p < 0.001) and extension ROM (β = 0.212, p = 0.0496) as independent factors associated with PT. Lumbar lordosis and pelvic incidence minus lumbar lordosis were significantly correlated with AAA, but sagittal vertical axis was not.

Conclusions:

When treating patients who have acetabular dysplasia, surgeons should recognize the relationship between the anterior acetabular coverage and anterior PT. Correcting hyperlordosis of the lumbar spine can induce progression of hip OA because it may decrease the acetabular anterior coverage.
Continuous intravenous infusion of remifentanil improves the experience of parturient undergoing repeat cesarean section under epidural anesthesia
Authors: Yan Wei , Xiong Yun , Yao Yu , Zhang Feng-jiang , Yu Li-an , Yan Min
Published: January 2019

Background: To observe the effects of intravenous remifentanil on maternal comfort, maternal and neonatal safety during repeat cesarean section under epidural anesthesia.
Methods: A total of 80 parturient undergoing repeat cesarean section were involved in the study. The patients were randomly divided into the intravenous remifentanil-assisted epidural group (group R) and epidural group (group E), respectively (n=40). In group R, the remifentanil was continuously intravenously infused as an adjuvant to epidural anesthesia. In group E, 0.75% ropivacaine epidural or intravenous ketamine was administered as needed. Parturient baseline characteristics, vital signs, VAS scores, and comfort scores during surgery were recorded. Adverse effects were also recorded.
Results: A total of 80 patients were enrolled in the current study and the final analyses included 39 patients in group R and 38 patients in group E. No differences in patients’ baseline characteristics were found between the two groups (p > 0.05). Compared with group E, the comfort score was significantly higher in group R (9.1±1.0 vs. 7.5±1.3, p<0.001), whereas the maximum VAS score was significantly lower in group R (1.8±1.2 vs. 4.0±0.9, p<0.001). Maternal and neonatal adverse effects did not differ between the two groups during surgery (p>0.05).
Conclusions: Continuous intravenous infusion of low-dose remifentanil can significantly improve the experience of parturients undergoing repeat cesarean section under epidural anesthesia, without obvious maternal or neonatal adverse effects.
Keywords: Remifentanil; Epidural anesthesia; Repeat cesarean delivery
Achieving Self-Directed Integrated Cancer Aftercare (ASICA) in melanoma: Protocol for a randomised patient-focused pilot trial of delivering the ASICA intervention as a means to earlier detection of recurrent and second primary melanoma
Authors: Murchie Peter , Masthoff J , Walter FM , Rahman K , Allan JL , Burrows N , Proby C , Lee AJ , Johnston M , Durrani A , Depasquale I , Brant B , Neilson A , Meredith F , Treweek S , Hall S , McDonald A
Published: January 2019

Background: Melanoma is common, 15,906 people in the UK were diagnosed with melanoma in 2015 and incidence has increased five-fold in 30 years. Melanoma affects old and young people with poor prognosis once metastatic. UK guidelines recommends people treated for cutaneous melanoma receive extended outpatient hospital follow-up to detect recurrence or new primaries. Such follow-up to the growing population of melanoma survivors is burdensome for both individuals and health services. Follow-up is important since approximately 20% of patients with early-stage melanoma experience a recurrence and 4-8% develop a new primary, the risk of both is highest in the first five years. ASICA (Achieving Self-directed Integrated Cancer Aftercare) is a digital intervention to increase Total-Skin-Self-Examination (TSSE) by people treated for melanoma, with usual follow-up.
Methods: We aim to recruit 240 adults with a previous first stage 0-2C primary cutaneous melanoma from secondary care in North-East Scotland and the East of England. Participants will be randomised to receive the ASICA intervention (a tablet based digital intervention to prompt and support TSSE) or control group (treatment as usual). Patient-reported and clinical data will be collected at baseline, including the modified Melanoma Worry Scale (MWS), the Hospital Anxiety and Depression Scale (HADs), the EuroQoL EQ-5D-5L, and questions about TSSE practice, intentions, self-efficacy and planning. Participants will be followed up by postal questionnaire at 3, 6 and 12 months following randomisation along with a 12 month review of clinical data. 12 months following randomisation will be considered the primary timepoint for outcome analyses.
Discussion: If the ASICA intervention improves total-skin-self-examination practice in those affected by melanoma, this may lead to improved psychological well-being and earlier detection of recurrent and new primary melanoma. This could impact both patients and NHS resources. This study will determine if a full scale randomised controlled trial can be undertaken in the UK NHS to provide the high-quality evidence needed determine the effectiveness ASICA is a pilot study evaluating the effectiveness of total skin self-examination practice in those affected by melanoma.
Trial Registration: Clinical Trials.gov :Trial registration number NCT03328247. Registered 01 November 2017, https://clinicaltrials.gov/ct2/show/NCT03328247?term=ASICA&rank=1. First participant randomised on 25 January 2018.
Keywords: Primary care, Melanoma, Cancer, Randomised Controlled Trial, Survivorship, Self-directed care, e-health, ASICA.
The multi-objective operation for cascade reservoirs using MMOSFLA with emphasis on power generation and ecological benefit
Authors: Yang Zhe , Yang Kan , Su Lyuwen , Hu Hu
Published: January 2019

To efficiently develop power generation and solve downstream ecological health protection in Qingjiang basin, multi-objective ecological operation for cascade reservoirs (MOEOCR) model is established in contrast to conventional models that set ecological water requirement as constraint. The basic, suitable and ideal ecological water requirements in Geheyan and Gaobazhou sections are calculated using a requirement level index. Instead of the traditional evolution mode based on population, we introduce a shuffled frog leaping algorithm (SFLA) which evolves independently in sub-populations. Moreover, the SFLA is converted into a modified multi-objective algorithm (MMOSFLA) with strategies including chaotic population initialization, renewed frog grouping method and local search method, and elite frog set evolution based on cloud model. The water level corridor is used to help effectively handle complex constraints. The IGD and GD indexes are used to evaluate quality of solutions acquired by each method. In terms of normal year, the mean IGD and GD of MMOSFLA are 1.2 × 10–1 and 2.75 × 10–2, respectively. The scheduling results verify efficient search ability and convergence performance in solution diversity and distribution in comparison with other methods. Therefore, MMOSFLA is verified to provide an effective way to fulfill hydropower and ecological benefits facing the MOEOCR problem.
Inactivation of health-related microorganisms in water using UV light-emitting diodes
Authors: Oguma Kumiko , Rattanakul Surapong , Masaike Mie
Published: January 2019

UV light-emitting diodes (UV-LEDs) offer various wavelength options, while microorganisms have spectral sensitivity, or so-called action spectra, which can be different among species. Accordingly, matching properly the emission spectra of UV-LEDs and the spectral sensitivity of microorganisms is a reasonable strategy to enhance inactivation. In this study, UV-LEDs with nominal peak emissions at 265, 280 and 300 nm were applied to pathogens including Legionella pneumophila, Pseudomonas aeruginosa, Vibrio parahaemolyticus and feline calicivirus, in comparison with indicator species including Escherichia coli, Bacillus subtilis spores, bacteriophage Qβ and MS2. The results indicated that, for all species tested, 265 nm UV-LED was highest in the fluence-based inactivation rate constant k, followed by 280 nm and 300 nm was much lower. The k value at 280 nm was close to that at 265 nm for feline calicivirus and MS2, suggesting that 280 nm UV-LED can be as good an option as 265 nm UV-LED to inactivate these viruses. Bacteria tended to show fluence-response curves with shoulder and tailing, while viruses followed log-linear profiles at all wavelengths tested. This study indicates the fluence-response profiles and the fluence required for a target inactivation of microorganisms, which would serve as reference data for future study and applications of UV-LEDs.
Can participatory water management improve residents' subjective life quality? A case study from China
Authors: Pan Hulin , Guo Min
Published: January 2019

Public participation is practiced widely in modern water management, but its effect on residents' subjective quality of life (QOL) or happiness has not been revealed. In this research, using the difference-in-difference (DID) model, the effect of participation in water management on residents' subjective QOL or happiness is empirically researched based on data from China. The results show that the positive effect of participatory water management on residents' happiness is quite significant and the extra effect of participation behavior on the participant's happiness is outstanding with the coefficients 0.073 and 0.036 respectively which pass the significance test. In addition, according to the regression coefficients of controlled variables, four demographic variables, namely the age, health, education and income, also produce significant effects on residents' happiness. It is concluded that both the result and procedure of participatory water management can really improve the participants' happiness. Extensive participation should be enhanced actively so as to increase residents' happiness.
The role of reclaimed water for crop irrigation in southeast Spain
Authors: Maestre-Valero J. F. , González-Ortega M. J. , Martínez-Álvarez V. , Martin-Gorriz B.
Published: January 2019

Water shortages have led to measures such as the implementation of reclaimed water (RW) for irrigation in order to sustain agriculture. Waste water requires treatment to become a safe water resource for irrigation. This paper presents an analytical study on the use of RW for irrigation in the southeast of Spain, identifying its strengths and current limitations. It includes official data from 13 waste water treatment plants (WWTPs) belonging to two coastal irrigation districts in the Region of Murcia. The content of essential nutrients in some RWs might allow them to supply a large fraction of the fertilizers required by the crops, thus saving energy and reducing the cost of fertilization. However, the accumulation of chloride, sodium, and boron could damage soils and cause phytotoxicity to crops in the mid-term, reducing yields. Microbiological pollutants in the RW could also endanger human health and hence waste water treatment is required. In the selected WWTPs, all effluents met the minimum requirements established in Water Quality 2.3 by the Royal Decree 1620/2007 and also with the European Classes B and C proposed by COM[2018] 337. Blending RW and other water resources of better quality is recommended for the sustainable use of RW for irrigation.
Enhanced adsorption of nitrate from water by modified wheat straw: equilibrium, kinetic and thermodynamic studies
Authors: Mehdinejadiani Behrouz , Amininasab Seyed Mojtaba , Manhooei Leila
Published: January 2019

This study represents the first attempt to chemically modify wheat straw (WS) using 3-chloropropyltrimethoxysilane (CPTMS) and (1,4-diazabicyclo[2.2.2]octane) (DABCO). Field emission scanning electron micrographs (FESEM), energy dispersive spectroscopy (EDS), thermogravimetric analysis (TGA) and Fourier transform infrared (FTIR) spectra confirmed the successful morphological and structural modification of WS and the thermal stability of the modified WS (MWS). The MWS was used to remove nitrate from water. The optimum conditions of nitrate adsorption onto MWS were examined by conducting batch experiments. The results indicated that 85% of nitrate was removed under the conditions of initial nitrate concentration = 20 mg L−1, initial solution pH = 7, contact time = 10 min, MWS dosage = 2 g L−1 and temperature ≈ 25 °C. The kinetic adsorption data were best fitted to the general order model and the adsorption process occurred in three distinct stages. The equilibrium adsorption data were well described by the Langmuir isotherm. Additionally, separation factor values were smaller than 1, implying that the adsorption process was favorable. The presence of competing anions impeded the nitrate adsorption in the order of sulfate > chloride > bicarbonate> phosphate. Thermodynamic parameters suggested that the adsorption process was exothermic, feasible and spontaneous in nature. Overall, the MWS could achieve efficient removal of nitrate under the simplest operating conditions.
A study by response surface methodology (RSM) on optimization of phosphorus adsorption with nano spherical calcium carbonate derived from waste
Authors: Deng Shuo , Chen Yinguang
Published: January 2019

A nano spherical CaCO3 (NSC) derived from solid waste (precipitated from tris(α-chloropropyl) phosphate and triethyl phosphate mixed wastewater) was prepared as adsorbent for phosphorus removal from aqueous solution. Response surface methodology (RSM) was used to develop an approach for the evaluation of phosphorus adsorption process, and Box-Behnken design was performed to investigate the effects of various experimental parameters (temperature, contact time, initial pH and dosage of absorbent) on phosphorus adsorption. The model results of experimental data gave a high correlation coefficient (R2 = 0.9658), and a predictive model of quadratic polynomial regression equation and optimum level values were established successfully. It was found that the adsorption efficiency and adsorption capacity reached 97.05% and 123.79 mg/g, respectively, under conditions of temperature of 45 °C, initial pH 5.3, contact time of 11 h, and absorbent amount of 392 mg/L. X-ray diffraction (XRD) analysis testified new phase, Ca10(PO4)6CO3, was produced in the adsorption process. Apart from that, adsorption behavior fitted well with the Langmuir isotherm model and logistic growth model. The thermodynamic study indicated that phosphorus removal by NSC as adsorbent was a spontaneous, endothermic, and mainly chemical adsorption process.
Preparation of a novel Cu-Sn-Bi cathode and performance on nitrate electroreduction
Authors: Gao Weichun , Gao Lulu , Meng Jing , Li Dan , Guan Yinyan , Cui Li , Shen Xinjun , Liang Jiyan
Published: January 2019

Cu-Sn-Bi layer coated on Ti substrate was prepared using electrodeposition method and applied as cathode material for electrochemical reduction of nitrate in this research. Linear sweep voltammetry (LSV), chronoamperometry (CA), scanning electron microscope (SEM), energy dispersive spectrometry (EDS), X-ray diffraction (XRD) were used to scrutinize the electrochemical performance and the cathode materials. LSV results illustrated that Cu-Sn-Bi cathode possessed the ability for nitrate reduction. Preparation conditions including deposition time, current density, temperature and the content of Bi were optimized based on NO3–N removal and byproducts selectivity. Results showed that the cathode with Bi content of 3.18 at.%, and electrodepositing at current density of 6 mA cm−2, 35 °C for 30 min achieved the best performance during the experiment. The increase of Bi content could improve the electrocatalytic activity and stability of the cathode. Compared with other common researched cathodes (Cu and Fe), Cu-Sn-Bi (3.18 at.%) exhibited better performance, i.e. the highest NO3–N removal of 88.43% and the selectivity of harmless N2 was 77.80%. The kinetic studies showed that the reduction of nitrate on Cu-Sn-Bi followed pseudo-first-order kinetics.
Computational Method for the Identification of Molecular Metabolites Involved in Cereal Hull Color Variations
Authors: Zhang Yunhua , Dong Dong , Li Dai , Lu Lin , Li JiaRui , Zhang YuHang , Chen Lijuan
Published: January 2019

Background:

Cereal hull color is an important quality specification characteristic. Many
studies were conducted to identify genetic changes underlying cereal hull color diversity. However,
these studies mainly focused on the gene level. Recent studies have suggested that metabolomics can
accurately reflect the integrated and real-time cell processes that contribute to the formation of
different cereal colors.

Methods:

In this study, we exploited published metabolomics databases and applied several
advanced computational methods, such as minimum redundancy maximum relevance (mRMR),
incremental forward search (IFS), random forest (RF) to investigate cereal hull color at the metabolic
level. First, the mRMR was applied to analyze cereal hull samples represented by metabolite
features, yielding a feature list. Then, the IFS and RF were used to test several feature sets,
constructed according to the aforementioned feature list. Finally, the optimal feature sets and RF
classifier were accessed based on the testing results.

Results and Conclusion:

A total of 158 key metabolites were found to be useful in distinguishing
white cereal hulls from colorful cereal hulls. A prediction model constructed with these metabolites
and a random forest algorithm generated a high Matthews coefficient correlation value of 0.701.
Furthermore, 24 of these metabolites were previously found to be relevant to cereal color. Our study
can provide new insights into the molecular basis of cereal hull color formation.
Constructing a Risk Prediction Model for Lung Cancer Recurrence by Using Gene Function Clustering and Machine Learning
Authors: Zhong Jing , Chen Jian-Ming , Chen Song-Lin , Yi Yun-Feng
Published: January 2019

Objective:

A significant proportion of patients with early non-small cell lung cancer
(NSCLC) can be cured by surgery. The distant metastasis of tumors is the most common cause of
treatment failure. Precisely predicting the likelihood that a patient develops distant metastatic risk
will help identify patients who can further intervene, such as conventional adjuvant chemotherapy
or experimental drugs.

Methods:

Current molecular biology techniques enable the whole genome screening of
differentially expressed genes, and rapid development of a large number of bioinformatics methods
to improve prognosis.

Results:

The genes associated with metastasis do not necessarily play a role in the pathogenesis of
the disease, but rather reflect the activation of specific signal transduction pathways associated
with enhanced migration and invasiveness.

Conclusion:

In this study, we discovered several genes related to lung cancer resistance and
established a risk model to predict high-risk patients.
The Adverse Events Rate of Endothelial Progenitor Cell Capturing Stent in the Treatment of CAD Patients
Authors: Xu Wei-Yuan , Tang Wei-Liang , Yuan Min , Sun Yong , Xu Feng , Peng Fang
Published: January 2019

Background:

Circulating endothelial progenitor cells (EPCs) have regenerative capacities
and play an important role in vessel wall homeostasis. When attracted to the site of vessel wall
injury, EPCs rapidly differentiate into a functional layer as part of the healing process. The Genous
TM endothelial progenitor cell (EPC) capturing stent is coated with anti-human CD34+ antibodies
which combine with circulating EPCs from the peripheral blood to the stent surface.

Objective:

This meta-analysis aims to explore the Genous TM endothelial progenitor cell capturing
stent in coronary artery disease (CAD) adverse event rate after one-year follow-up.

Methods:

PubMed, EMBASE and, Google Scholar databases were searched for eligible studies.
CAD survival data and clinicopathological features were analyzed by expected shortfall (ES) and
95% CI. Fixed-effect model and random-effect model are used for summary statistics.

Results:

12 studies, including 15985 coronary artery disease (CAD) patients who received PCI
treatment were included in this study. After 1-year follow-up, the rate of adverse event showed that
the target vessel failure (TVF) was 8.5% (7.6%-17.4%), target vessel revascularization was 4.1%
(TVR, 0-15.6%), target lesion revascularization was 4.2% (TLR, 3.7%-22%), myocardial infarction
was 2.0% (MI, 1.8%-5.2%), major adverse cardiac events was 8.7% (MACE, 6.4%-28%), and the
all-cause death was 4.0% (0-9.2).

Conclusion:

After one-year follow-up, the incidence rate of Genous stent adverse events was stable
in CAD patients. The study showed a better evaluation of Genous stent, and it provides a better
reference for CAD clinical treatment.
Line of Progression: Indian Regulatory Framework for Nutraceuticals and Dietary Supplements
Authors: Bansal Rohit , Dhiman Anju
Published: January 2019

Introduction:

Nutraceuticals although is a widely accepted term and now well understood, there exists several nomenclature and definitions across the countries. The present article discussed the progression of Indian food product regulations over the years, mainly emphasizing on regulations of nutraceuticals and dietary supplements.

Regulatory Progression in India:

The regulatory structure of nutraceuticals in India has evolved after the establishment of Food Safety and Standard act in 2006, which brought together preexisting eight laws to one single law regulated by Food Safety and Standard Authority of India (FSSAI). After the introduction of this act, the regulatory framework of food products progressed year by year with continuous amendments to this Act. The major milestone in the field of nutraceuticals was in 2016 with the introduction of regulations of functional food and nutraceuticals. Under these regulations, various guidelines were laid down for nutraceuticals in terms of their safety standards, health claims along with permissible limits of active ingredients and excipients for the safe and effective use.

Conclusion:

India has progressed in the development of a strong regulatory framework for nutraceuticals; however, to effectively implement these guidelines and for ensuring the safe and nutritious food, a robust system and a better-coordinated actions are required.