bluuebunny/crossref_metadata_2025 huggingface dataset:
Universal, school-based interventions to promote mental and emotional well-being: what is being done in the UK and does it work? A systematic review
Authors: Mackenzie Karen , Williams Christopher
Published: September 2018

Objectives

The present review aimed to assess the quality, content and evidence of efficacy of universally delivered (to all pupils aged 5–16 years), school-based, mental health interventions designed to promote mental health/well-being and resilience, using a validated outcome measure and provided within the UK in order to inform UK schools-based well-being implementation.

Design

A systematic review of published literature set within UK mainstream school settings.

Data sources

Embase, CINAHL, MEDLINE, PsycINFO, PsychArticles, ASSIA and Psychological and Behavioural Sciences published between 2000 and April 2016.

Eligibility criteria

Published in English; universal interventions that aimed to improve mental health/emotional well-being in a mainstream school environment; school pupils were the direct recipients of the intervention; pre-post design utilised allowing comparison using a validated outcome measure.

Data extraction and synthesis

12 studies were identified including RCTs and non-controlled pre-post designs (5 primary school based, 7 secondary school based). A narrative synthesis was applied with study quality check.1

Results

Effectiveness of school-based universal interventions was found to be neutral or small with more positive effects found for poorer quality studies and those based in primary schools (pupils aged 9–12 years). Studies varied widely in their use of measures and study design. Only four studies were rated ‘excellent’ quality. Methodological issues such as small sample size, varying course fidelity and lack of randomisation reduced overall study quality. Where there were several positive outcomes, effect sizes were small, and methodological issues rendered many results to be interpreted with caution. Overall, results suggested a trend whereby higher quality studies reported less positive effects. The only study that conducted a health economic analysis suggested the intervention was not cost-effective.

Conclusions

The current evidence suggests there are neutral to small effects of universal, school-based interventions in the UK that aim to promote emotional or mental well-being or the prevention of mental health difficulties. Robust, long-term methodologies need to be pursued ensuring adequate recording of fidelity, the use of validated measures sensitive to mechanisms of change, reporting of those lost to follow-up and any adverse effects. Further high-quality and large-scale research is required across the UK in order to robustly test any long-term benefits for pupils or on the wider educational or health system.
Impact of levothyroxine therapy on obstetric, neonatal and childhood outcomes in women with subclinical hypothyroidism diagnosed in pregnancy: a systematic review and meta-analysis of randomised controlled trials
Authors: Yamamoto Jennifer M , Benham Jamie L , Nerenberg Kara A , Donovan Lois E
Published: September 2018

Objective

To determine in women with subclinical hypothyroidism diagnosed in pregnancy whether levothyroxine treatment compared with control, impacts important obstetrical or childhood outcomes (specifically IQ) in randomised controlled trials.

Design

Systematic review and meta-analysis.

Study eligibility criteria

Randomised trials which met all the following were included: (1) reported original data of women with subclinical hypothyroidism diagnosed in pregnancy (by any prespecified study definition); (2) randomised to either levothyroxine or control (placebo or no treatment); (3) reported obstetrical outcomes and/or childhood neurodevelopmental outcomes and (4) published from 1980 to January 2018 in either English or French language.

Data sources

Medline, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials and ClinicalTrials.gov.

Outcome measures

Obstetrical, neonatal and childhood outcomes including: miscarriage, gestational hypertension, pre-eclampsia, preterm delivery, mode of delivery, neonatal intensive care unit admission, birth weight, gestational age at delivery, childhood IQ and neurodevelopmental scores.

Risk of bias assessment

Cochrane Risk of Bias Tool (Modified) for Quality Assessment of Randomised Controlled Trials

Results

Three trials of low to unclear risk of bias with 1837 participants were included. Two studies were meta-analysed for maternal and neonatal outcomes and two studies for childhood IQ. No statistically significant differences were found for any clinical outcomes with levothyroxine therapy compared with control.

Limitations

Only three trials were identified for inclusion.

Conclusions

This review, based on three randomised trials in women with subclinical hypothyroidism diagnosed in pregnancy, found no evidence of benefit of levothyroxine therapy on obstetrical, neonatal, childhood IQ or neurodevelopmental outcomes. Current trial evidence does not support the treatment of subclinical hypothyroidism diagnosed in pregnancy.

PROSPERO registration number

CRD4201707980.
Explaining variations in test ordering in primary care: protocol for a realist review
Authors: Duddy Claire , Wong Geoffrey
Published: September 2018

Introduction

Studies have demonstrated the existence of significant variation in test-ordering patterns in both primary and secondary care, for a wide variety of tests and across many health systems. Inconsistent practice could be explained by differing degrees of underuse and overuse of tests for diagnosis or monitoring. Underuse of appropriate tests may result in delayed or missed diagnoses; overuse may be an early step that can trigger a cascade of unnecessary intervention, as well as being a source of harm in itself.

Methods and analysis

This realist review will seek to improve our understanding of how and why variation in laboratory test ordering comes about. A realist review is a theory-driven systematic review informed by a realist philosophy of science, seeking to produce useful theory that explains observed outcomes, in terms of relationships between important contexts and generative mechanisms.

An initial explanatory theory will be developed in consultation with a stakeholder group and this ‘programme theory’ will be tested and refined against available secondary evidence, gathered via an iterative and purposive search process. This data will be analysed and synthesised according to realist principles, to produce a refined ‘programme theory’, explaining the contexts in which primary care doctors fail to order ‘necessary’ tests and/or order ‘unnecessary’ tests, and the mechanisms underlying these decisions.

Ethics and dissemination

Ethical approval is not required for this review. A complete and transparent report will be produced in line with the RAMESES standards. The theory developed will be used to inform recommendations for the development of interventions designed to minimise ‘inappropriate’ testing. Our dissemination strategy will be informed by our stakeholders. A variety of outputs will be tailored to ensure relevance to policy-makers, primary care and pathology practitioners, and patients.

Prospero registration number

CRD42018091986
Quick and dirty? A systematic review of the use of rapid ethnographies in healthcare organisation and delivery
Authors: Vindrola-Padros Cecilia , Vindrola-Padros Bruno
Published: September 2018

Background

The ability to capture the complexities of healthcare practices and the quick turnaround of findings make rapid ethnographies appealing to the healthcare sector, where changing organisational climates and priorities require actionable findings at strategic time points. Despite methodological advancement, there continue to be challenges in the implementation of rapid ethnographies concerning sampling, the interpretation of findings and management of field research. The purpose of this review was to explore the benefits and challenges of using rapid ethnographies to inform healthcare organisation and delivery and identify areas that require improvement.

Methods

This was a systematic review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We used the Mixed Methods Appraisal Tool to assess the quality of the articles. We developed the search strategy using the Population, Intervention, Comparison, Outcomes, Settingframework and searched for peer-reviewed articles in MEDLINE, CINAHL PLUS, Web of Science and ProQuest Central. We included articles that reported findings from rapid ethnographies in healthcare contexts or addressing issues related to health service use.

Results

26 articles were included in the review. We found an increase in the use of rapid ethnographies in the last 2‰years. We found variability in terminology and developed a typology to clarify conceptual differences. The studies generated findings that could be used to inform policy and practice. The main limitations of the studies were: the poor quality of reporting of study designs, mainly data analysis methods, and lack of reflexivity.

Conclusions

Rapid ethnographies have the potential to generate findings that can inform changes in healthcare practices in a timely manner, but greater attention needs to be paid to the reflexive interpretation of findings and the description of research methods.

Trial registration number

CRD42017065874.
Anticholinergic drug use and cognitive performances in middle age: findings from the CONSTANCES cohort
Authors: Ziad Abdelkrim , Olekhnovitch Romain , Ruiz Fabrice , Berr Claudine , Bégaud Bernard , Goldberg Marcel , Zins Marie , Mura Thibault
Published: September 2018

Background

Previous studies have shown associations between the use of anticholinergics (AC) and cognitive performance in the elderly, considering AC as a homogeneous set of drugs. The present study aims to assess the relationship between exposure to AC drugs and cognitive performance in middle-aged adults according to AC potency and drug class.

Methods

Our cross-sectional study used baseline data of 34 267 participants aged 45–70 from the Consultants des centres d’examen de santé de la sécurité sociale (CONSTANCES) cohort. The cumulative exposure to AC was measured using national reimbursement databases over the 3-year period preceding assessment of cognitive performance. Eight classes of AC drugs were differentiated. Episodic verbal memory, language abilities and executive functions were evaluated by validated neuropsychological tests. Analyses were controlled on lifestyle and health status variables.

Results

This study showed a negative association between overall cumulative AC exposure and cognitive performances after adjustment. The use of drugs with possible AC effect according to the Anticholinergic Cognitive Burden scale (ACB-1 score) was only associated with executive functions. Analyses of AC exposure across drug classes showed a negative association between the use of AC antipsychotics and all cognitive functions assessed. Heterogeneous associations were found for the use of AC anxiolytics, AC opioids and AC drugs targeting the gastrointestinal tract or metabolism. We did not find significant associations between the use of antihistamines, antidepressants, cardiovascular system or other AC medications and cognitive function.

Conclusion

Association between AC drugs and cognitive performance was highly heterogeneous across drug classes; this heterogeneity will have to be considered by future studies.
Development of clinically apparent synovitis: a longitudinal study at the joint level during progression to inflammatory arthritis
Authors: ten Brinck Robin M , van Steenbergen Hanna W , van der Helm-van Mil Annette H M
Published: September 2018

Introduction

Subclinical inflammation, detected by MRI, in patients with arthralgia is predictive for development of inflammatory arthritis (IA). However, within patients that develop IA, the course of inflammation at the joint level during this transition is unknown. This longitudinal study assessed progression of inflammation at the joint level.

Methods

350 joints (unilateral metacarpophalangeals (MCPs), wrist, metatarsophalangeal (MTP) joints) of 35 patients presenting with clinically suspect arthralgia (CSA) that progressed to IA were studied at presentation with CSA and subsequently when clinical synovitis was first identified at joint examination (median time interval 17 weeks). At both time points, subclinical inflammation (bone marrow oedema, synovitis, tenosynovitis) was evaluated with MRI and joint examination was performed.

Results

At presentation with CSA, 71 joints showed subclinical inflammation. During progression to IA, 20% of these joints had resolution of inflammation, 60% had persistent inflammation and 20% progressed to clinical synovitis. Of all joints that had developed clinical synovitis (n = 45), no prior subclinical inflammation was detected in 69%. Similar results were observed for anticitrullinated protein antibodies (ACPA)-positive and ACPA-negative patients.

Conclusions

This longitudinal study demonstrated moderate correlations between joints with subclinical inflammation and joints that developed clinical synovitis. These data imply that IA development is a more systemic rather than a locally outgrowing process.
Chinese Stroke Center Alliance: a national effort to improve healthcare quality for acute stroke and transient ischaemic attack: rationale, design and preliminary findings
Authors: Wang Yongjun , Li Zixiao , Wang Yilong , Zhao Xingquan , Liu Liping , Yang Xin , Wang Caiyun , Gu Hongqiu , Zhang Fuying , Wang Chunjuan , Xian Ying , Wang David Z , Dong Qiang , Xu Anding , Zhao Jizong
Published: September 2018

Background

In June 2015, the Chinese Stroke Association (CSA) initiated the Chinese Stroke Center Alliance (CSCA) to establish the national hospital-based stroke care quality assessment and improvement platform. This article outlines its objectives, operational structure, patient population, quality improvement (QI) intervention tools, data elements, data collection methodology and current patient and hospital data.

Methods

The CSCA is a national, hospital-based, multicentre, voluntary, multifaceted intervention and continuous QI initiative. This multifaceted intervention includes stroke centre development, written care protocols, workshops and a monitoring/feedback system of evidence-based performance measures. The data coordinating centre of the CSCA resides at the China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital.

Results

As of July 2017, 1576 hospitals in China have contributed detailed clinical information to serve as a benchmark for the stroke care quality of 433 264 patients with acute stroke/transient ischaemic attacks (TIA), including 352 572 (81.38%) acute ischaemic stroke, 30 362 (7.01%) TIA, 42 080 (9.71%) spontaneous intracranial haemorrhage, 5505 (1.27%) subarachnoid haemorrhage and 2745 (0.63%) not specified stroke.

Conclusion

The CSCA programme is designed to establish a continuous national stroke registry and help healthcare providers develop stroke centres and treat patients in a consistent manner in accordance with accepted national guidelines and, ultimately, improve patient outcomes. It supports the CSA mission to reduce stroke burden in China.
Assessment of the intermediate care unit triage system
Authors: Plate Joost D J , Peelen Linda M , Leenen Luke P H , Houwert R Marijn , Hietbrink Falco
Published: September 2018

Background

An important critique with respect to the utilization of intermediate care units (IMCU) is that they potentially admit patients who would otherwise be cared for on the regular ward. This would lead to an undesired waste of critical care resources. This article aims to (1) describe the caseload at the IMCU and (2) to assess the triage system at the IMCU to determine potentially unnecessary admissions.

Methods

This cohort study included all admissions at the mixed-surgical IMCU from 2001 to 2015. The Therapeutic Intervention Scoring System-28 (TISS-28) was prospectively collected for all admissions to describe the caseload at the IMCU and to identify medical criteria for admission. These were combined with logistical criteria to assess the IMCU triage system.

Results

A total of 8816 admissions were included in the study. The average TISS-28 was 20.19 (95% CI 18.05 to 22.33), corresponding with 3.57 (95% CI 3.19 to 3.94) hours of direct patient-related work per patient per nursing shift. Over time, this increased by an average of 0.27 points/year (p<0.001). Of all admissions, 6539 (74.2%) were medically considered to be justly admitted, and 7093 (80.4%) were logistically considered to be justly admitted. With these criteria combined, a total of 8324 (94.4%) were correctly admitted.

Discussion

Most admissions to the IMCU are medically and/or logistically necessary, as the majority of admitted patients demand a higher level of nursing care than available on the general ward. Continuous triage is thereby essential. These findings support further utilization of the IMCU in our current healthcare system and has important implications for IMCU-related management decisions.

Level of evidence

Level VI.
Morning report decreases length of stay in trauma patients
Authors: Wolfe John D , Gardner James R , Beck William C , Taylor John R , Bhavaraju Avi , Davis Ben , Kimbrough Mary Katherine , Robertson Ronald D , Karim Saleema A , Sexton Kevin W
Published: September 2018

Background

Modern acute care surgery (ACS) programs depend on consistent patient hand-offs to facilitate care, as most programs have transitioned to shift-based coverage. We sought to determine the impact of implementing a morning report (MR) model on patient outcomes in the trauma service of a tertiary care center.

Methods

The University of Arkansas for Medical Sciences (UAMS) Division of ACS implemented MR in October 2015, which consists of the trauma day team, the emergency general surgery day team, and a combined night float team. This study queried the UAMS Trauma Registry and the Arkansas Clinical Data Repository for all patients meeting the National Trauma Data Bank inclusion criteria from January 1, 2011 to April 30, 2018. Bivariate frequency statistics and generalized linear model were run using STATA V.14.2

Results

A total of 11 253 patients (pre-MR, n=6556; post-MR, n=4697) were analyzed in this study. The generalized linear model indicates that implementation of MR resulted in a significant decrease in length of stay (LOS) in trauma patients.

Discussion

This study describes an approach to improving patient outcomes in a trauma surgery service of a tertiary care center. The data show how an MR session can allow for patients to get out of the hospital faster; however, broader implications of these sessions have yet to be studied. Further work is needed to describe the decisions being made that allow for a decreased LOS, what dynamics exist between the attendings and the residents in these sessions, and if these sessions can show some of the same benefits in other surgical services.

Level of evidence

Level 4, Care Management.
Defining severe traumatic brain injury readmission rates and reasons in a rural state
Authors: Gardner James , Sexton Kevin W , Taylor John , Beck William , Kimbrough Mary Katherine , Davis Ben , Bhavaraju Avi , Karim Saleema , Porter Austin
Published: September 2018

Background

Readmissions after a traumatic brain injury (TBI) have significant impact on long-term patient outcomes through interruption of rehabilitation. This study examined readmissions in a rural population, hypothesizing that readmitted patients after TBI will be older and have more comorbidities than those not readmitted.

Methods

Discharge data on all patients 15 years and older who were admitted to an Arkansas-based hospital for TBI were obtained from the Arkansas Hospital Discharge Data System from 2010 to 2014. This data set includes diagnoses (principal discharge diagnosis, up to 3 external cause of injury codes, 18 diagnosis codes using the International Classification of Disease, 9th Edition, Clinical Modifications), age, gender, and inpatient costs. Hospital Cost and Utilization Project Clinical Classification and Chronic Condition Indicator were used to identify chronic disease and body systems affected in principal diagnosis.

Results

Of the 3114 cases of significant head trauma, more than two-thirds were attributed to fall injuries, with motor vehicle crashes accounting for 20% of the remainder. The mean length of stay was 6.5 days. 691 of these patients were admitted to an Arkansas hospital in the following year, totaling 1368 readmissions. Of the readmissions, 16.4% of patients were admitted for altered mental status, 12.9% with shortness of breath (SOB), and 9.4% with chest pain. Mental disorders (psychosis, dementia, and depression) and organic nervous symptoms (Alzheimer’s disease, encephalopathy, and epilepsy) were the primary source of readmissions. More than one-third of the patients were admitted in the following year for chronic diseases such as heart failure (8.6%), psychosis (5.2%), and cerebral artery occlusion (4.1%).

Discussion

This study showed that there is a significant rate of readmissions in the year after a diagnosis of TBI. Complications with existing chronic diseases are among the most reported reasons for admission in this time period, demonstrating the effect severe head trauma has on long-term treatment.

Level of evidence

Level IV, Retrospective epidemiological study.
Blueschist facies overprint of late Triassic Tethyan oceanic crust in a subduction–accretion complex in north-central Anatolia, Turkey
Authors: Çelik Ömer Faruk , Özkan Mutlu , Chelle-Michou Cyril , Sherlock Sarah , Marzoli Andrea , Ulianov Alexey , Altıntaş İsmail Emir , Topuz Gültekin
Published: September 2018

The late Cretaceous accretionary complex along the İzmir–Ankara–Erzincan suture zone, northern Turkey, includes various types of metamorphic rock together with radiolarite, sandstone, mudstone, serpentinite, basalt and limestone. Meta-plagiogranite blocks (up to 5 m in diameter) and a meta-gabbro slice (800 × 500 m) cross-cut by meta-plagiogranite are observed in a matrix of serpentinite, mudstone and radiolarian chert. These meta-gabbros and meta-plagiogranites show subduction-related geochemical characteristics. Laser ablation inductively coupled plasma mass spectrometry U–Pb dating of zircons from two meta-plagiogranites yielded 222.3 ± 1.5 and 227.2 ± 1.6 Ma crystallization ages. This study shows that the meta-gabbro and meta-plagiogranite from the accretionary complex are remnants of the metamorphosed equivalents of the late Triassic lower crustal rocks of the subducted Tethyan oceanic crust. They are the oldest lower crustal rocks observed in the İzmir–Ankara–Erzincan suture zone. Both the meta-gabbros and meta-plagiogranites have Na–Ca amphiboles, indicating blueschist facies metamorphism. However, phengites from a blueschist facies rock yielded an
40
Ar/
39
Ar age of 104.3 ± 0.7 Ma, indicating that blueschist metamorphism occurred during the Albian. All these data suggest that the oceanic crust formed during the Norian, metamorphosed during the Jurassic to early Cretaceous and then dismembered during accretionary complex formation in the late Cretaceous.

Supplementary material:
A complete description of the analytical methods
(
electron microprobe, LA-ICP-MS zircon U–Pb and
40
Ar/
39
Ar age analyses, pseudo-section modelling and THERMOCALC) are available at
https://doi.org/10.6084/m9.figshare.6509984

Thematic collection:
This article is part of the ‘Tethyan ophiolites and Tethyan seaways collection’ available at:
https://www.lyellcollection.org/cc/tethyan-ophiolites-and-tethyan-seaways
Redox processes and the role of carbon-bearing volatiles from the slab–mantle interface to the mantle wedge
Authors: Tumiati Simone , Malaspina Nadia
Published: September 2018

The valence of carbon is governed by the oxidation state of the host system. The subducted oceanic lithosphere contains considerable amounts of iron so that Fe
3+
/Fe
2+
equilibria in mineral assemblages are able to buffer the (intensive)
f
O
2
and the valence of carbon. Alternatively, carbon itself can be a carrier of (extensive) ‘excess oxygen’ when transferred from the slab to the mantle, prompting the oxidation of the sub-arc mantle. Therefore, the correct use of intensive and extensive variables to define the slab-to-mantle oxidation by C-bearing fluids is of primary importance when considering different fluid/rock ratios. Fluid-mediated processes at the slab–mantle interface can also be investigated experimentally. The presence of CO
2
(or CH
4
at highly reduced conditions) in aqueous COH fluids in peridotitic systems affects the positions of carbonation or decarbonation reactions and of the solidus. Some methods to produce and analyse COH fluid-saturated experiments in model systems are introduced, together with the measurement of experimental COH fluids composition in terms of volatiles and dissolved solutes. The role of COH fluids in the stability of hydrous and carbonate minerals is discussed comparing experimental results with thermodynamic models and the message of nature.
Tectonic motion in oblique subduction forearcs: insights from the revisited Middle and Upper Pleistocene deposits of Rhodes, Greece
Authors: Cornée Jean-Jacques , Quillévéré Frédéric , Moissette Pierre , Fietzke Jan , López-Otálvaro Gatsby Emperatriz , Melinte-Dobrinescu Mihaela , Philippon Mélody , van Hinsbergen Douwe J.J. , Agiadi Konstantina , Koskeridou Efterpi , Münch Philippe
Published: September 2018

Abstract:
The sedimentary model of coastal deposits in eastern Rhodes over the last 2 Ma is refined and improved in accuracy. New field investigations and U/Th dating of
Spondylus
bivalve shells, combined with micropalaeontological and sedimentological data, allow the recognition of four synthems separated by major erosional surfaces. We present here evidence for two of these erosional surfaces. This new model allows the identification and quantification of the vertical movements recorded by the studied exposures. The history of these vertical motions is characterized by two periods of uplift and two periods of subsidence. Such an evolution is unique at the regional scale in the eastern Hellenic forearc. We interpret these results as reflecting the individualization of Rhodes as a single tectonic block during increasing trench bending. This trench bending is accommodated by an increase in the curvature of the forearc during the last 2 Ma.

Supplementary material:
U/Th dating on spondylid shells, index calcareous nannofossils and Khallithea and Faliraki Road sections are available at
https://doi.org/10.6084/m9.figshare.c.4211357
Nonprobability Sampling and Causal Analysis
Authors: Kohler Ulrich , Kreuter Frauke , Stuart Elizabeth A.
Published: September 2018

The long-standing approach of using probability samples in social science research has come under pressure through eroding survey response rates, advanced methodology, and easier access to large amounts of data. These factors, along with an increased awareness of the pitfalls of the nonequivalent comparison group design for the estimation of causal effects, have moved the attention of applied researchers away from issues of sampling and toward issues of identification. This article discusses the usability of samples with unknown selection probabilities for various research questions. In doing so, we review assumptions necessary for descriptive and causal inference and discuss research strategies developed to overcome sampling limitations.
Activation of TRPV1 channels leads to stimulation of NKCC1 cotransport in the lens
Authors: Shahidullah Mohammad , Mandal Amritlal , Delamere Nicholas A.
Published: September 2018

Lens ion homeostasis is crucial in maintaining water content and, in turn, refractive index and transparency of the multicellular syncytium-like structure. New information is emerging on the regulation of ion transport in the lens by mechanisms that rely on transient receptor potential vanilloid (TRPV) ion channels. We found recently that TRPV1 activation leads to Ca2+/PKC-dependent ERK1/2 signaling. Here, we show that the TRPV1 agonist capsaicin (100 nM) and hyperosmotic solution (350 vs. 300 mosM) each caused an increase of bumetanide-inhibitable Rb uptake by intact porcine lenses and Na-K-2Cl cotransporter 1 (NKCC1) phosphorylation in the lens epithelium. The TRPV1 antagonist A889425 (1 µM) abolished the increases of Rb uptake and NKCC1 phosphorylation in response to hyperosmotic solution. Exposing lenses to hyperosmotic solution in the presence of MEK/ERK inhibitor U0126 (10 µM) or the with-no-lysine kinase (WNK) inhibitor WNK463 (1 µM) also prevented NKCC1 phosphorylation and the Rb uptake responses to hyperosmotic solution. WNK463 did not prevent the increase in ERK1/2 phosphorylation that occurs in response to capsaicin or hyperosmotic solution, suggesting that ERK1/2 activation occurs before WNK activation in the sequence of signaling events. Taken together, the evidence indicates that activation of TRPV1 is a critical early step in a signaling mechanism that responds to a hyperosmotic stimulus, possibly lens shrinkage. By activating ERK1/2 and WNK, TRPV1 activation leads to NKCC1 phosphorylation and stimulation of NKCC1-mediated ion transport.
Aging phenotype(s) in kidneys of diabetic mice are p66ShcA dependent
Authors: Vashistha H. , Marrero L. , Reiss K. , Cohen A. J. , Malhotra A. , Javed T. , Bradley A. , Abbruscato F. , Giusti S. , Jimenez A. , Mehra S. , Kaushal D. , Giorgio M. , Pelicci P. G. , Kakoki M. , Singhal P. C. , Bunnell B. , Meggs L. G.
Published: September 2018

The p66ShcA protein controls cellular responses to oxidative stress, senescence, and apoptosis. Here, we test the hypothesis that aging phenotype(s) commonly associated with the broad category of chronic kidney disease are accelerated in diabetic kidneys and linked to the p66ShcA locus. At the organ level, tissue stem cells antagonize senescent phenotypes by replacing old dysfunctional cells. Using established methods, we isolated a highly purified population of stem cell antigen-1-positive mesenchymal stem cells (Sca-1+ MSCs) from kidneys of wild-type (WT) and p66 knockout (p66 KO) mice. Cells were plated in culture medium containing normal glucose (NG) or high glucose (HG). Reactive oxygen species (ROS) metabolism was substantially increased in WT MSCs in HG medium in association with increased cell death by apoptosis and acquisition of the senescent phenotype. DNA microarray analysis detected striking differences in the expression profiles of WT and p66 KO-MSCs in HG medium. Unexpectedly, the analysis for p66 KO-MSCs revealed upregulation of Wnt genes implicated in self-renewal and differentiation. To test the in vivo consequences of constitutive p66 expression in diabetic kidneys, we crossed the Akita diabetic mouse with the p66KO mouse. Homozygous mutation at the p66 locus delays or prevents aging phenotype(s) in the kidney that may be precursors to diabetic nephropathy.
Relative sensitivity of explicit reaiming and implicit motor adaptation
Authors: Hutter Sarah A. , Taylor Jordan A.
Published: September 2018

It has become increasingly clear that learning in visuomotor rotation tasks, which induce an angular mismatch between movements of the hand and visual feedback, largely results from the combined effort of two distinct processes: implicit motor adaptation and explicit reaiming. However, it remains unclear how these two processes work together to produce trial-by-trial learning. Previous work has found that implicit motor adaptation operates automatically, regardless of task relevance, and saturates for large errors. In contrast, little is known about the automaticity of explicit reaiming and its sensitivity to error magnitude. Here we sought to characterize the automaticity and sensitivity function of these two processes to determine how they work together to facilitate performance in a visuomotor rotation task. We found that implicit adaptation scales relative to the visual error but only for small perturbations—replicating prior work. In contrast, explicit reaiming scales linearly for all tested perturbation sizes. Furthermore, the consistency of the perturbation appears to diminish both implicit adaptation and explicit reaiming, but to different degrees. Whereas implicit adaptation always displayed a response to the error, explicit reaiming was only engaged when errors displayed a minimal degree of consistency. This comports with the idea that implicit adaptation is obligatory and less flexible, whereas explicit reaiming is volitional and flexible.

NEW & NOTEWORTHY This paper provides the first psychometric sensitivity function for explicit reaiming. Additionally, we show that the sensitivities of both implicit adaptation and explicit reaiming are influenced by consistency of errors. The pattern of results across two experiments further supports the idea that implicit adaptation is largely inflexible, whereas explicit reaiming is flexible and can be suppressed when unnecessary.
Vestibular and corticospinal control of human body orientation in the gravitational field
Authors: Zhang Lei , Feldman Anatol G. , Levin Mindy F.
Published: September 2018

Body orientation with respect to the direction of gravity changes when we lean forward from upright standing. We tested the hypothesis that during upright standing, the nervous system specifies the referent body orientation that defines spatial thresholds for activation of multiple muscles across the body. To intentionally lean the body forward, the system is postulated to transfer balance and stability to the leaned position by monotonically tilting the referent orientation, thus increasing the activation thresholds of ankle extensors and decreasing their activity. Consequently, the unbalanced gravitational torque would start to lean the body forward. With restretching, ankle extensors would be reactivated and generate increasing electromyographic (EMG) activity until the enhanced gravitational torque would be balanced at a new posture. As predicted, vestibular influences on motoneurons of ankle extensors evaluated by galvanic vestibular stimulation were smaller in the leaned compared with the upright position, despite higher tonic EMG activity. Defacilitation of vestibular influences was also observed during forward leaning when the EMG levels in the upright and leaned position were equalized by compensating the gravitational torque with a load. The vestibular system is involved in the active control of body orientation without directly specifying the motor outcome. Corticospinal influences originating from the primary motor cortex evaluated by transcranial magnetic stimulation remained similar at the two body postures. Thus, in contrast to the vestibular system, the corticospinal system maintains a similar descending facilitation of motoneurons of leg muscles at different body orientations. The study advances the understanding of how body orientation is controlled.

NEW & NOTEWORTHY The brain changes the referent body orientation with respect to gravity to lean the body forward. Physiologically, this is achieved by shifts in spatial thresholds for activation of ankle muscles, which involves the vestibular system. Results advance the understanding of how the brain controls body orientation in the gravitational field. The study also extends previous evidence of empirical control of motor function, i.e., without the reliance on model-based computations and direct specification of motor outcome.
A New Approach for the Determination of Benzocaine and Procaine in Pharmaceuticals by Single-Sweep Polarography
Authors: Plotycya Serhij , Strontsitska Oksana , Pysarevska Solomiya , Blazheyevskiy Mykola , Dubenska Liliya
Published: September 2018

A new polarographic method for the determination of benzocaine and procaine based on the polarographic reduction of their chemically obtained oxidation products with potassium peroxymonosulfate is developed. Experimental conditions affecting quantitative yield of benzocaine and procaine oxidation products such as рH, oxidation time, reagents’ concentration, and temperature are explored. It is shown that the reduction current changes in a linear fashion (R=0.999) with increasing concentration of anesthetics over a concentration range of 1·10−6- 5·10−5mol L−1. The calculated limits of detection (LOD) for benzocaine and procaine are found to be 5.6·10−6and 6·10−6mol L−1, respectively. In the present study, quantitative polarographic determination of benzocaine in Farisil tablets and “Septolete Plus” lozenges and procaine in solution for injections is performed. The results of the analysis are in good agreement with the product specifications described in the quality certificates. The possibility of quantitative determination of benzocaine and procaine in pharmaceuticals is confirmed.
Study on Permeability Improvement Technology by Injecting Air into the Gas Drainage Borehole in Low‐Permeability Coal Seam
Authors: Hui Li , Chengwei Guo , Yuanfang Sun , Shaoshuai Guo
Published: September 2018

Gas extraction cycle is too long in low‐permeability coal seam. In order to solve the problem, the basic principle about gas drainage drilling for gas injection technology is studied to increase permeability. And the mathematical model is established. Gas is injected into the low‐permeability coal seam by numerical simulation. The results indicate that the best condition is a negative pressure drainage at 26 kPa and a gas injection pressure at 0.6 MPa in the vertical direction and in the horizontal direction of the injection hole. In Shanxi Daping Coal Mine 3113 working face, the field test is implemented. As a result, the test is successful. During the 14 d gas injection constantly, gas content of coal seam is reduced from 12.33 m3/t to 7.12 m3/t, greatly reducing the risk of coal and gas outburst elimination time required.
Management of Small Bowel Perforation by a Bizarre Foreign Body in a 55-Year-Old Woman
Authors: D’Auria Francesca , Consalvo Vincenzo , Canero Antonio , Russo Maria , Rescigno Carmela , Lombardi Domenico
Published: September 2018

Introduction. Ingestion of foreign bodies including dentures, fishbone, screw, and/or surgical devices can be a cause of morbidity, and it rarely could be fatal. Presentation of Case. We present the first hitherto reported case of mussel shell ingestion, which caused acute abdominal pain in a 55-year-old woman. The shell pierced ileal loops, and it was found in the abdominal cavity. Discussion. The accidental or voluntary ingestion of a foreign body is an uncommon event compared to the other causes of bowel perforation. It is fundamental to immediately remove the intestinal fluid, repair the tear, and prevent sepsis, because each delay in diagnosis can lead to a worst outcome. Conclusion. In case of bowel perforation, it important for surgeons, who are dealing with these acute care patients, to be aware of different designs and constructions of possible foreign bodies, in order to be prepared to deal with different possible scenarios and be able to manage them properly.
Risk Factors Associated with the Occurrence of Autoimmune Diseases in Adult Coeliac Patients
Authors: Conti Laura , Lahner Edith , Galli Gloria , Esposito Gianluca , Carabotti Marilia , Annibale Bruno
Published: September 2018

Objectives. Autoimmune diseases (AD) may be associated with coeliac disease (CD), but specific risk factors have been poorly investigated. The aim of this study was to assess the spectrum of AD and its specific risk factors associated in a series of adult coeliac patients. Materials and Methods. We performed a single-center case-control study including adult newly diagnosed CD patients. To evaluate the risk factors of the association between AD and CD, 341 coeliac patients included were categorized on the basis of AD presence: 91 cases with at least one AD and 250 controls without AD were compared for clinical, serological, and histological features. Eighty-seven cases were age-gender-matched with 87 controls. Results. Among 341 CD patients, 26.6% of CD patients had at least one AD. Endocrine and dermatological diseases were the most prevalent AD encountered: autoimmune thyroiditis was present in 48.4% of cases, psoriasis in 17.6%, and type I diabetes and dermatitis herpetiformis in 11%, respectively. At logistic regression, factors associated with AD were a positive 1st-degree family history of AD (OR 3.7, 95% CI 1.93–7), a body mass index ≥ 25 kg/m2 at CD diagnosis (OR 2.95%, CI 1.1–3.8), and long standing presentation signs/symptoms before CD diagnosis (>10 years) (OR 2.1, 95% CI 1.1–3.7). Analysis on age-gender-matched patients confirmed these results. Conclusions. CD patients with family history of AD, overweight at CD diagnosis, and a delay of CD diagnosis had an increased risk of having another AD. The benefit of CD screening in these specific subsets of patients with AD awaits further investigation.
Comparison of the Techniques of Secondary Intraocular Lens Implantation after Penetrating Keratoplasty
Authors: Krysik Katarzyna , Dobrowolski Dariusz , Wroblewska-Czajka Ewa , Lyssek-Boron Anita , Wylegala Edward
Published: September 2018

Aim. To conduct a retrospective analysis of secondary IOL implantation in patients who underwent PK with no simultaneous IOL implantation. Materials and Methods. The retrospective study of the secondary implantation of IOLs was conducted in 46 eyes that underwent a primary operation with PK and cataract/lens extraction with no IOL implantation due to capsule rupture or combining corneal or intraocular complications. The minimum period from PK was 12 months. All secondary IOL implantations were performed from January 2011 to August 2017. Aphakic postkeratoplasty patients were treated using one of the surgical techniques for secondary IOL implantation. In-the-bag IOL implantation was possible if the posterior capsule was complete. If the lens capsule remnants were sufficient to provide secure IOL support, an in-the-sulcus IOL implantation was performed. Scleral fixation was offered in eyes with extensive capsular deficiency or the presence of the vitreous body in anterior chamber. BCVA and expected and achieved refraction were evaluated; we included using two biometry devices, and results were compared. Results. The corrected distance visual acuity (CDVA) before surgery ranged from 0.1 to 0.8 (mean 0.54 ± 0.17). After secondary IOL implantation, CDVA ranged from 0.2 to 0.8 (mean 0.43 ± 0.14) at postoperative 1 month and from 0.3 to 0.9 (mean 0.55 ± 0.15) at postoperative 6 months (p<0.05). Comparison of the final refraction using two methods of biometry showed no statistically significant difference in the group that underwent scleral fixation of the IOL, similar to the findings for the in-the-bag and in-the-sulcus IOL implantation groups. In the scleral-fixation group, p=0.55 for the USG biometry technique and p=0.22 for the OB technique. p values for the IOL-implantation group were p=0.49 and p=0.44, respectively. Conclusion. Both implantation methods are safe for the patients. Final refraction is depending on the technique and indication to keratoplasty. Both biometry techniques deliver precise data for IOL choice.
Biochemical Changes and Biological Origin of Key Odor Compound Generations in Pig Slurry during Indoor Storage Periods: A Pyrosequencing Approach
Authors: Jang Yu Na , Jung Min Woong
Published: September 2018

Production of odors is a complex process. Many bacterial species are involved in the production of an extensive array of key odor compounds in stored pig slurry. Understanding of basic microbial communities and their role during storage periods is an essential way to control and prevent the odors generations. In this aspect, the pig slurry samples were taken directly from deep pits of finisher pig building every two weeks, their biochemical changes were analysed, and the indigenous bacterial communities that involve in offensive odor producing compounds were identified. The SCFA, BCFA, phenols, and indoles levels altered drastically in the slurry during storage periods. The COD, BOD, SS, P2O5, TKN, and NH4-N were increased in the stored slurry. Bacterial ecology indicatesFirmicutesandBacteroidetesphyla were dominantly found in pig slurry. Odorants produced in pig slurry were correlated with bacterial communities. Phenols, indoles, SCFA, and BCFA productions were positively correlated with bacteria species which comes under phyla ofFirmicutesandBacteroidetes.It seems that bacterial species underFirmicutesandBacteroidetesphyla play an important role in the offensive odor compounds production. Taken together, the prevention of these phyla bacterial growth and early discharge of pig slurry might reduce the offensive odor production.
Unusual Operation of the Junction Transistor Based on Dynamical Behavior of Impurities
Authors: Baca Arroyo Roberto
Published: September 2018

The dynamical behavior of impurities into the silicon junction transistor has been studied using an empirical methodology to investigate its behavior knowing only the physical parameters of materials together with practical behavior of their passive components. The operating modes suggested with equations governing circuit performance are derived considering transient analysis. The relationship between material properties and equivalent circuit is discussed from a physical viewpoint. Theoretical solution of the equations yields a graphical response as approximation of the experimental results obtained from a proposed circuit built with an inductor and an NPN silicon MPSH10 transistor. Hence, the impurities-controlled electrical properties indicate that the observed unusual operation can be a good strategy to optimize signal processing in electronics.
Assessment of Diarrhea and Its Associated Factors in Under-Five Children among Open Defecation and Open Defecation-Free Rural Settings of Dangla District, Northwest Ethiopia
Authors: Ayalew Abireham Misganaw , Mekonnen Worku Tefera , Abaya Samson Wakuma , Mekonnen Zeleke Abebaw
Published: September 2018

Background. Open defecation (OD) is a widespread problem in the developing world. This practice facilitates the transmission of diarrheal diseases. In Ethiopia, still the national open defecation rate in 2014 was 34.1% (37.9% in rural and 8.7% in urban). Objective. To assess diarrheal morbidity in under-five children and its associated factors in Dangla district, Northwest Ethiopia, 2016. Methods. A community-based comparative cross-sectional study design with a multistage random sampling technique was applied. The total sample size was 550 (275 ODF and 275 OD). Descriptive and inferential statistics were done. Results. A total of 525 participants were interviewed making the response rate 95.45%. The prevalence of diarrhea was 9.9% in ODF and 36.1% in OD kebeles. In ODF kebeles, child immunization (AOR = 0.037; 95% CI: 0.006–0.243), latrine presence (AOR = 0.036; 0.006–0.233), water shortage (AOR = 8.756; 95% CI: 1.130–67.831), and solid waste disposal (AOR = 0.143; 95% CI: 0.020–0.998) have statistically significant association with diarrhea occurrence. While in OD kebeles child immunization (AOR = 0.032; 95 CI: 0.008–0.123), water access of 7.5–15 liters/day (AOR = 0.029; 95% CI: 0.006–0.152), water shortage (AOR = 18.478; 95% CI: 4.692–72.760), and proper solid waste disposal (AOR = 0.023; 95% CI: 0.005–0.117) have significant association with diarrhea occurrence. Conclusions. The overall prevalence of under-five diarrhea was low in ODF kebeles as compared with OD kebeles. The study showed that child immunization, latrine presence, water shortage in household, and solid waste disposal practices had statistically significant association with diarrhea occurrence in ODF kebeles, while water access at the individual level, water shortage in household, child immunization, and solid waste disposal have statistically significant association with diarrhea occurrence in OD kebeles. Integrated efforts are needed from the Ministry of Health together with line ministries and developmental partners in improving latrine utilization at household level, water shortage in households, and solid waste disposal practices.