bluuebunny/crossref_metadata_2025 huggingface dataset:
Study protocol for the international Systemic Lupus Erythematosus Prospective Observational Cohort Study (SPOCS): understanding lupus and the role of type I interferon gene signature
Authors: Hammond Edward R , Tummala Raj , Berglind Anna , Syed Farhat , Wang Xia , Desta Barnabas , Nab Henk
Published: September 2020

Introduction

The Systemic Lupus Erythematosus (SLE) Prospective Observational Cohort Study (SPOCS) aims to describe the disease course of SLE and its association with type I interferon gene signature (IFNGS) status.

Methods and analysis

SPOCS is an international, multicentre, prospective, observational cohort study designed to follow patients through biannual study visits during a 3-year observation period. Patients ≥18 years old with a physician diagnosis that meets the American College of Rheumatology or Systemic Lupus International Collaborating Clinics SLE classification criteria will be included. SPOCS will comprehensively analyse clinical features, disease progression and treatment, SLE outcomes, health status assessments and quality of life, and healthcare resource utilisation of patients with moderate to severe SLE. A four-gene test will be used to measure IFNGS status; scores will be compared with a pre-established cut-off. Patients will be stratified by low or high IFNGS expression levels. Enrolment began in June 2017, and study completion is expected in 2022. The total number of anticipated patients was initially planned for 1500 patients and was amended to 900 patients owing to slow accrual of eligible patients.

Ethics and dissemination

The ethics committee/institutional review board/independent ethics committee at each study site approved the SPOCS protocol prior to study initiation (protocol number: D3461R00001, version 3.0, 26 June 2019). Study findings will be disseminated through peer-reviewed publications and presentations at scientific meetings.

Trial registration number

NCT03189875.
Effects of coenzyme Q10 on endothelial and cardiac function in patients undergoing haemodialysis: study protocol for a pilot randomised controlled trial
Authors: Xu Yongxing , Li Xinlou , Zuo Xiaowen , Jia Huaping , Han Enhong , Liang Fugui , Xie Lei , Gao Jianjun
Published: September 2020

Introduction

Endothelial and cardiac dysfunction are highly prevalent and are associated with cardiovascular morbidity and mortality among patients undergoing dialysis. For patients undergoing dialysis, no study has explored the effect of supplementation of coenzyme Q10 (CoQ10) on endothelial function. To our best of knowledge, only two small sample studies focused on the efficacy of supplementation of CoQ10 on cardiac function. However, the effect of CoQ10 supplementation on cardiac function remains uncertain in patients who undergo haemodialysis. The aim of this study is to explore whether CoQ10 supplementation can improve endothelial and cardiac function in patients undergoing haemodialysis.

Methods and analysis

This is a pilot randomised controlled study. Eligible patients undergoing haemodialysis in our haemodialysis centre will be randomly allocated to the CoQ10 and control groups. The follow-up time is 12 months. The primary outcome is to assess the change of brachial artery endothelial-dependent flow-mediated dilation, left ventricular systolic function, diastolic function and Myocardial Performance Index at 12 months from baseline. Secondary outcomes are death or hospitalisation due to cardiovascular events, all-cause mortality, change of CoQ10 concentration, the ratio of ubiquinol to ubiquinone, the change of oxidative stress markers (including malondialdehyde and 8-hydroxy-deoxyguanosine) and Left Ventricular Mass Index.

Ethics and dissemination

Risks associated with CoQ10 are minor, even at doses as high as 1800 mg according to previous studies. The trial has received ethics approval from the Medical Ethics Committee for Clinical Trials of Drugs, the 306th Hospital of Chinese PLA. The results of the study are expected to be published in a peer-reviewed journal and presented at academic conferences.

Trial registration number

ChiCTR1900022258.
Constipation and risk of cardiovascular diseases: a Danish population-based matched cohort study
Authors: Sundbøll Jens , Szépligeti Szimonetta Komjáthiné , Adelborg Kasper , Szentkúti Péter , Gregersen Hans , Sørensen Henrik Toft
Published: September 2020

Objectives

To assess the risks of myocardial infarction, stroke, peripheral artery disease, venous thromboembolism, atrial fibrillation or atrial flutter and heart failure in patients with constipation compared with a general population cohort.

Design

Population-based matched cohort study.

Setting

All Danish hospitals and hospital outpatient clinics from 2004 to 2013.

Participants

Patients with a constipation diagnosis matched on age, sex and calendar year to 10 individuals without constipation from the general population.

Main outcomes measures

Comorbidity-adjusted and medication-adjusted hazard ratios (aHRs) for cardiovascular outcomes based on Cox regression analysis.

Results

83 239 patients with constipation were matched to 832 384 individuals without constipation. The median age at constipation diagnosis was 46.5% and 41% were men. Constipation was strongly associated with venous thromboembolism (aHR 2.04, 95% CI 1.89 to 2.20), especially splanchnic venous thrombosis (4.23, 95% CI 2.45 to 7.31). Constipation was also associated with arterial events, including myocardial infarction (1.24, 95% CI 1.14 to 1.35), ischaemic stroke (1.50, 95% CI 1.41 to 1.60), haemorrhagic stroke (1.46, 95% CI 1.26 to 1.69), peripheral artery disease (1.34, 95% CI 1.20 to 1.50), atrial fibrillation or atrial flutter (1.27, 95% CI 1.20 to 1.34) and heart failure (1.52, 95% CI 1.42 to 1.62). The associations were strongest during the first year after the constipation diagnosis and strengthened with an increased number of laxative prescriptions.

Conclusions

Constipation was associated with an increased risk of several cardiovascular diseases, in particular venous thromboembolism.
Age distribution and types of breast lesions among Afghan women diagnosed by fine needle aspiration cytology (FNAC) at a tertiary care centre in Afghanistan: a descriptive cross-sectional study
Authors: Saadaat Ramin , Abdul-Ghafar Jamshid , Haidary Ahmed Maseh , Rahmani Soma , Atta Nooria
Published: September 2020

Objectives

In Afghanistan, breast diseases are a common reason for women to visit hospitals. This is the first study in Afghanistan aimed to describe the age distribution and types of breast diseases among patients diagnosed by fine needle aspiration cytology.

Design

Descriptive cross-sectional study.

Setting

French Medical Institute for Mothers and Children, Kabul, Afghanistan.

Participants

The study included 650 patients with breast lesions between 1 April 2015 and 1 April 2019.

Results

The mean age of diagnosis was 35.38 (SD ±13.11) years, ranging from 15 to 75 years. The most common diagnosis was cancer (24% of all cases). The second most common diagnosed lesion was fibroadenoma, constituting 22.4%, and the third most common lesion was fibrocystic changes, with 15.4% of cases. Inflammatory conditions were diagnosed in 9.7% of cases, granulomatous inflammation in 9.1%, lesions only suspicious for malignancy in 5.5%, lipoma in 2.8% and miscellaneous benign lesions in 11.1%. Cancer was diagnosed at the youngest age of 20 years. Cancer was more common on the left side (62%), and only one case (0.9%) was bilateral.

Conclusion

Our study showed that cancer was the most commonly diagnosed lesion and was reported at younger ages too. This suggests that physicians should not ignore any breast lump in younger patients and that the possibility of cancer must be considered. Further country-wide studies are suggested to assess breast cancer and associated risk factors.
Person-centred eHealth intervention for patients on sick leave due to common mental disorders: study protocol of a randomised controlled trial and process evaluation (PROMISE)
Authors: Cederberg Matilda , Ali Lilas , Ekman Inger , Glise Kristina , Jonsdottir Ingibjörg H , Gyllensten Hanna , Swedberg Karl , Fors Andreas
Published: September 2020

Introduction

The number of people dealing with common mental disorders (CMDs) is a major concern in many countries, including Sweden. Sickness absence resulting from CMDs is often long-lasting and advancing return to work is a complex process impacted by several factors, among which self-efficacy appears to be an important personal resource. Person-centred care (PCC) has previously shown positive effects on self-efficacy however this needs to be further investigated in relation to patients with CMDs and in an eHealth context.

Methods and analysis

This study is an open randomised controlled trial comparing a control group receiving standard care with an intervention group receiving standard care plus PCC by telephone and a digital platform. The primary outcome measure is a composite score of changes in sick leave and self-efficacy. Participants will include 220 primary care patients on sick leave due to CMDs and data will mainly be collected through questionnaires at baseline and 3, 6, 12 and 24 months from the inclusion date. Inclusion is ongoing and expected to be completed during the fall of 2020. A process and health economic evaluation will also be conducted.

Ethics and dissemination

This study was approved by the Regional Ethical Review Board in Gothenburg, Sweden. Results will be published in peer-reviewed scientific journals and presented at national and international scientific conferences. This project is part of a broader research programme conducted at the Gothenburg Centre for Person-Centred Care (GPCC), where extensive work is undertaken to disseminate knowledge on and implementation of PCC.

Trial registration number

NCT03404583.
Sex differences in prevalence and determinants of hypertension among adults: a cross-sectional survey of one rural village in Bangladesh
Authors: Islam Jessica Yasmine , Zaman M Mostafa , Ahmed Jasim Uddin , Choudhury Sohel Reza , Khan Hasanuzzaman , Zissan Tashfin
Published: September 2020

Objective

Prevention of mortality due to cardiovascular disease (CVD) through control of hypertension is a public health priority in Bangladesh. Our objective was to assess sex differences in prevalence and determinants of hypertension among adults in one rural area of Bangladesh.

Study design

Cross-sectional.

Setting and participants

From January 2014 to December 2015, we conducted a cross-sectional study of 2600 men and women aged ≥18 years located in one rural district of Bangladesh. We collected data on demographics, behavioural factors, physical measurements and health history.

Primary outcome measures

Our primary outcome was hypertension (systolic blood pressure ≥140 or diastolic blood pressure ≥90 mm Hg).

Results

The average age of participants was 41.6 years and 53.7% were women. Hypertension prevalence was 6.9% (95% CI 5.9 to 7.9), and was significantly higher among women (8.9%) than men (4.5%). The highest prevalence of hypertension was observed among women aged ≥60 years at 21.3% (95% CI 16.6 to 26.7). A higher proportion of men with hypertension were aware of their condition (72.2%) compared with women (52.4%). Determinants of hypertension included older age, higher education, current tobacco use, increasing body mass index, and hyperglycaemia.

Conclusion

Our research suggests that hypertension prevalence is higher among women than men in rural Bangladesh. Sex-specific interventions should be developed to inform adults of the necessary lifestyle changes that may reduce the risk of hypertension and subsequent CVDs.
Comparing physician associates and foundation year two doctors-in-training undertaking emergency medicine consultations in England: a mixed-methods study of processes and outcomes
Authors: Halter Mary , Drennan Vari , Wang Chao , Wheeler Carly , Gage Heather , Nice Laura , de Lusignan Simon , Gabe Jonathan , Brearley Sally , Ennis James , Begg Phil , Parle Jim
Published: September 2020

Objectives

To compare the contribution of physician associates to the processes and outcomes of emergency medicine consultations with that of foundation year two doctors-in-training.

Design

Mixed-methods study: retrospective chart review using 4 months’ anonymised clinical record data of all patients seen by physician associates or foundation year two doctors-in-training in 2016; review of a subsample of 40 records for clinical adequacy; semi-structured interviews with staff and patients; observations of physician associates.

Setting

Three emergency departments in England.

Participants

The records of 8816 patients attended by 6 physician associates and 40 foundation year two doctors-in-training; of these n=3197 had the primary outcome recorded (n=1129 physician associates, n=2068 doctor); 14 clinicians and managers and 6 patients or relatives for interview; 5 physician associates for observation.

Primary and secondary outcome measures

The primary outcome was unplanned re-attendance at the same emergency department within 7 days. Secondary outcomes: consultation processes, clinical adequacy of care, and staff and patient experience.

Results

Re-attendances within 7 days (n=194 (6.1%)) showed no difference between physician associates and foundation year two doctors-in-training (OR 0.87, 95% CI 0.61 to 1.24, p=0.437). If seen by a physician associate, patients were more likely receive an X-ray investigation (OR 2.10, 95% CI 1.72 to 4.24), p<0.001), after adjustment for patient characteristics, triage severity of condition and statistically significant clinician intraclass correlation. Clinical reviewers found almost all patients’ charts clinically adequate. Physician associates were evaluated as assessing patients in a similar way to foundation year two doctors-in-training and providing continuity in the team. Patients were positive about the care they had received from a physician associate, but had poor understanding of the role.

Conclusions

Physician associates in emergency departments in England treated patients with a range of conditions safely, and at a similar level to foundation year two doctors-in-training, providing clinical operational efficiencies.
Prospective multicentre randomised trial comparing the efficacy and safety of single-anastomosis duodeno–ileal bypass with sleeve gastrectomy (SADI-S) versus Roux-en-Y gastric bypass (RYGB): SADISLEEVE study protocol
Authors: Robert Maud , Poghosyan Tigran , Delaunay Dominique , Pelascini Elise , Iceta Sylvain , Sterkers Adrien , Barsamian Charles , Khamphommala Litavan , Bin Dorel Sylvie , Maucort-Boulch Delphine , Czernichow Sebastien , Disse Emmanuel
Published: September 2020

Introduction

Despite the non-negligible weight loss failure rate at midterm, Roux-en-Y gastric bypass (RYGB) remains the reference procedure in the treatment of morbid obesity with metabolic comorbidities. A recently emerged procedure, the single anastomosis duodeno–ileal bypass with sleeve gastrectomy (SADI-S), could be more effective on weight loss with similar morbidity and lower weight loss failure rate than RYGB. We propose the first randomised, open, multicentre superiority trial comparing the SADI-S to RYGB (SADISLEEVE).

Methods and analysis

The main objective is to demonstrate the superiority at 2 years after surgery of the SADI-S compared with RYGB in term of excess weight loss percentage. The secondary objectives are the evaluation of nutritional status, metabolic outcomes, overall complication rates and quality of life, within 2 years after surgery. Key inclusion criteria are obese patients with body mass index (BMI) ≥40 kg/m2 or ≥35 kg/m2 with at least one comorbid condition and candidate to a first bariatric procedure or after failure of sleeve gastrectomy. Patients randomised by minimisation in two arms, based on centre, surgery as a revisional procedure, presence of type 2 diabetes and BMI >50 kg/m2 will be included over 2 years.

A sample size of 166 patients in each group will have a power of 90% to detect a probability of 0.603 that excess weight loss in the RYGB arm is less than excess weight loss in the SADI-S arm with a 5% two-sided significance level. With a drop-out rate of 10%, it will be necessary to include 183 patients per group.

Ethics and dissemination

The study was approved by Institutional Review Board of Centre Hospitalier Universitaire Morvan (CPP1089-HPS1). Study was also approved by the French national agency for drug safety (2018061500148). Results will be reported in peer-reviewed scientific journals.

Trial registration number

NCT03610256.
Mesothelioma and Radical Surgery 2 (MARS 2): protocol for a multicentre randomised trial comparing (extended) pleurectomy decortication versus no (extended) pleurectomy decortication for patients with malignant pleural mesothelioma
Authors: Lim Eric , Darlison Liz , Edwards John , Elliott Daisy , Fennell D A , Popat Sanjay , Rintoul Robert C , Waller David , Ali Clinton , Bille Andrea , Fuller Liz , Ionescu Andreea , Keni Manjusha , Kirk Alan , Koh Pek , Lau Kelvin , Mansy Talal , Maskell Nick A , Milton Richard , Muthukumar Dakshinamoorthy , Pope Tony , Roy Amy , Shah Riyaz , Shamash Jonathan , Tasigiannopoulos Zacharias , Taylor Paul , Treece Sarah , Ashton Kate , Harris Rosie , Joyce Katherine , Warnes Barbara , Mills Nicola , Stokes Elizabeth A , Rogers Chris
Published: September 2020

Introduction

Mesothelioma remains a lethal cancer. To date, systemic therapy with pemetrexed and a platinum drug remains the only licensed standard of care. As the median survival for patients with mesothelioma is 12.1 months, surgery is an important consideration to improve survival and/or quality of life. Currently, only two surgical trials have been performed which found that neither extensive (extra-pleural pneumonectomy) or limited (partial pleurectomy) surgery improved survival (although there was some evidence of improved quality of life). Therefore, clinicians are now looking to evaluate pleurectomy decortication, the only radical treatment option left.

Methods and analysis

The MARS 2 study is a UK multicentre open parallel group randomised controlled trial comparing the effectiveness and cost-effectiveness of surgery—(extended) pleurectomy decortication—versus no surgery for the treatment of pleural mesothelioma. The study will test the hypothesis that surgery and chemotherapy is superior to chemotherapy alone with respect to overall survival. Secondary outcomes include health-related quality of life, progression-free survival, measures of safety (adverse events) and resource use to 2 years. The QuinteT Recruitment Intervention is integrated into the trial to optimise recruitment.

Ethics and dissemination

Research ethics approval was granted by London – Camberwell St. Giles Research Ethics Committee (reference 13/LO/1481) on 7 November 2013. We will submit the results for publication in a peer-reviewed journal.

Trial registration numbers

ISRCTN—ISRCTN44351742 and ClinicalTrials.gov—NCT02040272.
Use of compression therapy to treat lower limb wounds across Europe: a scoping review protocol
Authors: Samuriwo Ray , Christiansen Natalia , Hopkins Alison
Published: September 2020

Introduction

Poor lower wound care is an avoidable patient harm. Compression therapy is an effective way of treating non-ischaemic lower limbs wounds, but it is not always used appropriately. There are many guidelines which set out how compression therapy should be used, but there is dearth of evidence about how it is actually used at a population level across Europe.

Aim

The aim of this scoping review is to map the evidence published in English relating to the use of compression therapy to treat lower limb wounds across Europe.

Methods

This scoping review will be conducted in line with the Joanna Briggs Institute and Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols and Scoping Reviews guidance. A search for relevant publications will be conducted on variety of databases and key websites in order to identify a comprehensive range of relevant literature. Peer reviewed empirical papers, theoretical papers and other publications in English relating to the use of compression therapy across Europe will be considered for inclusion.

Ethics and dissemination

Ethical and research governance for this scoping review is not required because we will only gather secondary data. Our results will be disseminated to the widest possible audience through an open access paper in a peer reviewed international journal, conference presentations and a plain English summary. The results of this scoping review will be used by a panel of Key Opinion Leaders from across Europe to develop a driver diagram to underpin subsequent lower limb wound care improvement efforts.
The burden of non-specific chronic low back pain among adults in KwaZulu-Natal, South Africa: a protocol for a mixed-methods study
Authors: Kahere Morris , Ginindza Themba
Published: September 2020

Introduction

Low back pain (LBP) is a major public health concern, affecting individuals of all age groups across the world. In about 90% of LBP cases, there is no specific cause identified and is, therefore, referred to as non-specific LBP. Due to the non-specific nature of LBP, investigations such as radiological and laboratory investigations are unnecessary and results to delayed diagnosis and improper treatment culminating in LBP progressing into chronic LBP (CLBP). LBP is now the leading cause of disability with a significant socioeconomic burden. Despite all these challenges, CLBP is regarded as a trivial condition in low-and-middle-income countries and remains poorly investigated. The distribution of CLBP in Africa is unclear.

Methods and analysis

The research will be conducted in two phases. The initial phase will be an observational, cross-sectional hospital-based study that will be recruiting 650 participants, to determine the prevalence and risk factors of CLBP. A standardised questionnaire will be used to collect baseline data on the socio-demographic characteristics of participants and other variables of interest (exercise history, occupational posture, level of education and the income status). Disability will be assessed using the Oswestry Disability Questionnaire and the psychological risk factors will be assessed using the Illness-Behaviour Questionnaire (IBQ) and the Fear-Avoidance Belief Questionnaire (FABQ). The second phase will be a retrospective, top-down, prevalence-based cost-of-illness study of the 2018–2019 health records, to estimate the burden of CLBP from the healthcare system’s perspective. The SPSS V.25.0 statistical package will be used for data entry and analysis. Statistical analysis will include descriptive statistics by means of graphs and cross tabulations, inferential statistics by means of logistic regression and χ2 test. A p value of 0.05 will be deemed statistically significant.

Ethics and dissemination

This protocol was approved by the University of KwaZulu-Natal’s Biomedical Research Ethics Committee (Ref. No.: BREC/00000205/2019) and the KwaZulu-Natal Department of Health Research Ethics (Ref. No.: KZ_201909_002). This will be the first LBP cost-of-illness study in the sub-Saharan Africa, and, therefore, it will close these knowledge gaps and present important evidence on the estimated burden of CLBP in this context. The results of this study will be presented to the Department of Health and to the respective stakeholders and decision-makers to discuss the findings and draw their attention to the prioritisation of LBP research, its management, prevention programmes and implementation of educational programme and for the planning of cost-containment policies.
Impact of COVID-19 and other pandemics and epidemics on people with pre-existing mental disorders: a systematic review protocol and suggestions for clinical care
Authors: Sergeant Anjali , van Reekum Emma Alaine , Sanger Nitika , Dufort Alexander , Rosic Tea , Sanger Stephanie , Lubert Sandra , Mbuagbaw Lawrence , Thabane Lehana , Samaan Zainab
Published: September 2020

Introduction

The current COVID-19 pandemic has resulted in high rates of infection and death, as well as widespread social disruption and a reduction in access to healthcare services and support. There is growing concern over how the pandemic, as well as measures put in place to curb the pandemic, will impact people with mental disorders. We aim to study the effect of pandemics and epidemics on mental health outcomes for people with premorbid mental disorders.

Methods and analysis

With our predefined search strategy, we will search five databases for studies reporting on mental health outcomes in people with pre-existing mental disorders during pandemic and epidemic settings. Search dates are planned as follows: 5 May 2020 and 23 July 2020. The following databases will be searched: MEDLINE/PubMed, CINAHL, PsycINFO, MedRxiv and EMBASE. Data will be screened and extracted in duplicate by two independent reviewers. Studies involving non-clinical populations or patients diagnosed with a mental disorderduringa pandemic/epidemic will be excluded. We will include data collected from all pandemics and epidemics throughout history, including the present COVID-19 pandemic. If possible, study findings will be combined in meta-analyses, and subgroup analyses will be performed. We hope that this review will shed light on the impact of pandemics and epidemics on those with pre-existing mental disorders. Knowledge generated may inform future intervention studies as well as healthcare policies. Given the potential implications of the current pandemic measures (ie, disruption of healthcare services) on mental health, we will also compile a list of existing mental health resources.

Ethics and dissemination

No ethical approval is required for this protocol and proposed systematic review as we will only use data from previously published papers that have themselves received ethics clearance and used proper informed consent procedures.

Systematic review registration

PROSPERO registration number: CRD42020179611.
Early impact of COVID-19 pandemic on paediatric surgical practice in Nigeria: a national survey of paediatric surgeons
Authors: Ogundele Ibukunolu Olufemi , Alakaloko Felix M , Nwokoro Collins C , Ameh Emmanuel A
Published: September 2020

Introduction

The novel coronavirus disease has had significant impact on healthcare globally. Knowledge of this virus is evolving, definitive care is not yet known and mortality is increasing. We assessed its initial impact on paediatric surgical practice in Nigeria, creating a benchmark for recommendations and future reference.

Methods

Survey of 120 paediatric surgeons from 50 centres to assess sociodemographics and specific domains of impact of COVID-19 on their services and training in Nigeria. Valid responses were represented as categorical data and presented in percentages. Duplicate submissions for centres were excluded by combining and taking the mean of responses from centres with multiple respondents.

Results

Response rate was 74 (61%). Forty-six (92%) centres had suspended elective surgeries. All centres continued emergency surgeries but volume reduced in March by 31%. Eleven (22%) centres reported 13 suspended elective cases presenting as emergencies in March, accounting for 3% of total emergency surgeries. Twelve (24%) centres adopted new modalities for managing selected surgical conditions: non-operative reduction of intussusception in 1 (2%), antibiotic management of uncomplicated acute appendicitis in 5 (10%) and more conservative management of trauma and replacement of laparoscopic appendectomy with open surgery in 3 (6%), respectively. Low perception of adequacy of personal protective equipment (PPE) was reported in 35 (70%) centres. Forty (80%) centres did not offer telemedicine for patients’ follow-up. Twenty-nine (58%) centres had suspended academic training. Perception of safety to operate was low in 37 (50%) respondents, indifferent in 24% and high in 26%.

Conclusion

Majority of paediatric surgical centres reported cessation of elective surgeries while continuing emergencies. There was, however, an acute decline in the volume of emergency surgeries. Adequate PPE needs to be provided and preparations towards handling backlog of elective surgeries once the pandemic recedes. Further study is planned to more conclusively understand the full impact of this pandemic on children’s surgery.
MIP does not save the impairment argument against abortion: a reply to Blackshaw and Hendricks
Authors: Crummett Dustin
Published: September 2020

Perry Hendricks’ original ‘impairment argument’ against abortion relied on ‘the impairment principle’ (TIP): ‘if it is immoral to impair an organism O to the nth degree, then,ceteris paribus, it is immoral to impair O to the n+1 degree.’ Since death is a bigger impairment than fetal alcohol syndrome (FAS), Hendricks reasons that, by TIP, if causing FAS is immoral, then,ceteris paribus, abortion is immoral. Several authors have argued that this conclusion is uninteresting, since theceteris paribusclause is not satisfied in actual cases of abortion: women have reasons for wanting abortions which do not apply to drinking during pregnancy, so all else is not equal, and the conclusion is irrelevant to the morality of actual abortions. In a recent article in this journal, Hendricks and Bruce Blackshaw try to evade this criticism by replacing TIP with the ‘modified impairment principle’ (MIP): ‘if it is immoral to impair an organism O to the nth degree for reason R, then, provided R continues to hold (or is present), it is immoral to impair O to the n+1 degree.’ MIP allows us to derive theultima faciewrongness of abortion (not just itsceteris paribuswrongness) because MIP lacks aceteris paribusclause. But I argue that this lack also renders MIP false: MIP faces counterexamples and implausibly produces genuine moral dilemmas. Since the moral principle on which it relies is false, the modified impairment argument fails. I close by considering what a principle would need to do for the impairment argument to succeed.
Oesophageal muscular hypertrophy and pulsion diverticulum in a Friesian horse
Authors: Beaulieu Alexandra , Stachewski Zakia Luiza , Ludwig Latasha , Kenney Daniel , Rätsep Emily , Nykamp Stephanie
Published: September 2020

A 13‐year‐old Friesian stallion was referred for evaluation of acute coughing and bilateral nasal discharge. Thoracic radiographs revealed dilation of the terminal portion of the oesophagus, forming a thin‐walled outpouching containing soft tissue opaque material and gas. A diagnosis of oesophageal obstruction with an impacted diverticulum was made. Caudal oesophageal muscularis hypertrophy and an impacted oesophageal diverticulum were found on postmortem examination. Histological abnormalities included a thick caudal oesophageal tunica muscularis and an oesophageal diverticulum composed of mucosa, submucosa and adventitia. Muscular hypertrophy of the oesophagus with diverticulum formation should be considered in Friesian horses presenting with clinical signs of oesophageal obstruction. In this case, thoracic radiographs contributed to a premortem diagnosis, guided medical management and provided information on prognosis. Thoracic radiography can be used as a complementary test in the diagnosis of oesophageal obstruction when endoscopy is available and is a useful diagnostic alternative when endoscopy is not an option.
Evidence of near year-around spawning in Atlantic cod off southern Newfoundland: implications for management
Authors: Rose George A. , Rowe Sherrylynn
Published: September 2020

Management of Atlantic cod (Gadus morhua) off southern Newfoundland (Northwest Atlantic Fisheries Organization (NAFO) Subdivision 3Ps) entails allocated quotas and restrictions on fishing during late winter and springtime to protect presumed spawning aggregations. We present data collected from research trawls and handlines (1995–2014) indicating spawning inshore may occur near year-around with limited resting from December to February and with more contracted spring spawning possible offshore. A mixed general linear model with binomial error, using year as a random factor, recognized month and length as significant impacts on proportions of females spawning, but not gear or inshore–offshore location. Composite data indicated that females in spawning condition may be present inshore (∼10%–20% of adult females) from March to October. During 1997–1999, with 8–9 months sampled each year, protracted annual spawning schedules and interannual variability were evident. At present, the fishery primarily employs gillnets inshore and otter trawls offshore, with spring spawning closures offering only partial and inconsistent protection. Behavioural interference might be reduced by employing less intrusive longlines, as historically practiced in this fishery.
Herbicide mixtures control glyphosate-resistant kochia (Bassia scoparia) in chemical fallow, but their longevity warrants careful stewardship
Authors: Torbiak Alysha T. , Blackshaw Robert E. , Brandt Randall N. , Hall Linda M. , Hamman Bill , Geddes Charles M.
Published: September 2020

Glyphosate-resistant kochia [Bassia scoparia (L.) A.J. Scott], the first known glyphosate-resistant weed in western Canada, was confirmed initially in chemical fallow fields located in Warner County, AB, in 2011. Further selection, lack of control, and rampant spread of this biotype contributed to its increased incidence, now present in about 50% of kochia populations sampled in Alberta. In 2014 and 2015, herbicide mixtures were evaluated based on control of glyphosate-resistant and susceptible kochia in chemical fallow fields near Lethbridge and Coalhurst, AB. The most consistent control (≥80% visual control in all environments with ≥80% biomass reduction in 2014) was observed with glyphosate + dicamba (450 + 580 g a.e.·ha−1), glyphosate + dicamba/diflufenzopyr (450 + 150/50 g a.i./a.e.·ha−1), glyphosate + saflufenacil (450 + 50 g a.i./a.e.·ha−1), and glyphosate + carfentrazone + sulfentrazone (450 + 9 + 105 g a.i./a.e.·ha−1). Reduced efficacy was observed for several herbicide mixtures when they were applied to glyphosate-resistant compared with glyphosate-susceptible kochia accessions. Effective modes of action mixed with glyphosate include synthetic auxins (group 4), a combination of a synthetic auxin and an auxin transport inhibitor (group 19), or protoporphyrinogen oxidase inhibitors (group 14). In response to glyphosate-resistant kochia, many farmers in this region shifted their herbicide programs resulting in greater reliance on synthetic auxins; likely contributing to the recent discovery of auxinic herbicide-resistant kochia biotypes in Alberta in 2017. Careful herbicide stewardship is warranted to mitigate further selection of multiple herbicide-resistant kochia, suggesting an important role for integrated weed management.
Probing anomalous tqh couplings via single top production in associated with the Higgs boson at the HE-LHC and FCC-hh
Authors: Zhang Yan-Ju , Shen Jie-Fen
Published: September 2020

We investigate the prospects for discovering the Flavour Changing Neutral Current (FCNC) tqh couplings via the process $$pp\rightarrow th$$

p
p
→
t
h

at the proposed High Energy Large Hadron Collider (HE-LHC) and Future Circular Collider in hadron-hadron mode (FCC-hh) including the realistic detector effects. The relevant SM backgrounds are considered in the cut based analysis to obtain the limits on the the branching ratios of $$t\rightarrow qh~(q=u,c)$$

t
→
q
h

(
q
=
u
,
c
)

, followed by the leptonic decay channel of the top quark and diphoton decay channel of the Higgs boson. The upper limits on the FCNC branching ratios at 95% confidence level (CL) and the $$5\sigma $$

5
σ

discovery reach for the different integrated luminosities are obtained. It is shown that at the 27 TeV HE-LHC with an integrated luminosity of 15 ab$$^{-1}$$

-
1

and at the 100 TeV FCC-hh with an integrated luminosity of 30 ab$$^{-1}$$

-
1

, the BR($$t\rightarrow uh$$

t
→
u
h

) (BR($$t\rightarrow ch$$

t
→
c
h

)) can be probed, respectively, to $$4.4~(6.4)\times 10^{-5}$$

4.4

(
6.4
)

×

10

-
5

and $$1.3~(1.6) \times 10^{-5}$$

1.3

(
1.6
)

×

10

-
5

at the 95% CL.
Development of ultra-pure NaI(Tl) detectors for the COSINE-200 experiment
Authors: Park B. J. , Choi J. J. , Choe J. S. , Gileva O. , Ha C. , Iltis A. , Jeon E. J. , Kim D. Y. , Kim K. W. , Kim S. K. , Kim Y. D. , Ko Y. J. , Lee C. H. , Lee H. S. , Lee I. S. , Lee M. H. , Lee S. H. , Ra S. J. , Son J. K. , Shin K. A.
Published: September 2020

The annual modulation signal observed by the DAMA experiment is a long-standing question in the community of dark matter direct detection. This necessitates an independent verification of its existence using the same detection technique. The COSINE-100 experiment has been operating with 106 kg of low-background NaI(Tl) detectors providing interesting checks on the DAMA signal. However, due to higher backgrounds in the NaI(Tl) crystals used in COSINE-100 relative to those used for DAMA, it was difficult to reach final conclusions. Since the start of COSINE-100 data taking in 2016, we also have initiated a program to develop ultra-pure NaI(Tl) crystals for COSINE-200, the next phase of the experiment. The program includes efforts of raw powder purification, ultra-pure NaI(Tl) crystal growth, and detector assembly techniques. After extensive research and development of NaI(Tl) crystal growth, we have successfully grown a few small-size (0.61–0.78 kg) thallium-doped crystals with high radio-purity. A high light yield has been achieved by improvements of our detector assembly technique. Here we report the ultra-pure NaI(Tl) detector developments at the Institute for Basic Science, Korea. The technique developed here will be applied to the production of NaI(Tl) detectors for the COSINE-200 experiment.
The kinetic gas universe
Authors: Hohmann Manuel , Pfeifer Christian , Voicu Nicoleta
Published: September 2020

A description of many-particle systems, which is more fundamental than the fluid approach, is to consider them as a kinetic gas. In this approach the dynamical variable in which the properties of the system are encoded, is the distribution of the gas particles in position and velocity space, called 1-particle distribution function (1PDF). However, when the gravitational field of a kinetic gas is derived via the Einstein-Vlasov equations, the information about the velocity distribution of the gas particles is averaged out and therefore lost. We propose to derive the gravitational field of a kinetic gas directly from its 1PDF, taking the velocity distribution fully into account. We conjecture that this refined approach could possibly account for the observed dark energy phenomenology.
Possible formation of ring galaxies by torus-shaped magnetic wormholes
Authors: Kirillov A. A. , Savelova E. P.
Published: September 2020

We present the hypothesis that some of ring galaxies were formed by relic magnetic torus-shaped wormholes. In the primordial plasma before the recombination magnetic fields of wormholes trap baryons whose energy is smaller than a threshold energy. They work as the Maxwell’s demons collecting baryons from the nearest (horizon size) region and thus forming clumps of baryonic matter which have the same torus-like shapes as wormhole throats. Such clumps may serve as seeds for the formation of ring galaxies and smaller objects having the ring form. Upon the recombination torus-like clumps may decay and merge. Unlike galaxies, such objects may contain less or even no dark matter in halos. However the most stringent feature of such objects is the presence of a large-scale toroidal magnetic field. We show that there are threshold values of magnetic fields which give the upper and lower boundary values for the baryon clumps in such protogalaxies.
On dark and singular solitons and other solutions with anti-cubic law of nonlinearity in optical metamaterials
Authors: Seadawy Aly R. , Zafar A. , Raheel M.
Published: September 2020

In today’s life, time is money, so everyone wants rapid communications in one’s life. The optical fibers are the most prominent sources for rapid communications that are described by the nonlinear Schrödinger equations. So, it is very important to investigate the optical solitons solutions. In this paper, the solitons of optical metamaterials along anticubic law of nonlinearity are retrieved. To obtain the required solutions of the aforesaid model, the modified extended tanh expansion scheme is applied successfully. As a result, a series of different kinds of solitons solutions, such as dark and singular solitons and periodic solutions, are secured and verified by the aid of MATHEMATICA. The numerical simulations of certain solutions are made to analyze the influence of the parameters involved.
First-principles study of the vacancy and layer defects in Ti3SiC2
Authors: Zhang Jian-Rong , Liu Wei-Ming , Ma Li-Dong , Yang Qion , Chen Yan-Wei , Yang Yang-Yang , Shu Ya-Feng , Tao Ke-Wei , Yang Lei , Duan Wen-Shan
Published: September 2020

First-principles calculations are performed to study the effects of defect on the structure and electronic properties of Ti3SiC2. The calculations show that the formation energy of Si vacancy is minimal compared with the Ti or C vacancies in Ti3SiC2. The defects of Si layer also can be formed under high-temperature or irradiation environments. The C-layers or Ti-layers are almost impossible to form. If the Si vacancy or Si layers are formed, they prefer to be substituted by the O and H atoms to form the MXene structure, and the unit cell of Ti3SiC2 lattice constant decreases in c-direction. However, it has quite slight effect on electronic properties of Ti3SiC2. The He impurities are almost impossible to occupy the Si vacancies, because the formation energy are 50.860 eV for one layer of Si atoms substituted by the He atoms. This type of defect leads to the lattice constant of Ti3SiC2 in c-direction increasing considerably. Therefore, Ti3SiC2 is a suitable candidate for nuclear materials because of the high-formation energies of He impurities under irradiation environment.
The polylog quotient and the Goncharov quotient in computational Chabauty–Kim Theory I
Authors: Corwin David , Dan-Cohen Ishai
Published: September 2020

Polylogarithms are those multiple polylogarithms that factor through a certain quotient of the de Rham fundamental group of the thrice punctured line known as the polylogarithmic quotient. Building on work of Dan-Cohen, Wewers, and Brown, we push the computational boundary of our explicit motivic version of Kim’s method in the case of the thrice punctured line over an open subscheme of [Formula: see text]. To do so, we develop a greatly refined version of the algorithm of Dan-Cohen tailored specifically to this case, and we focus attention on the polylogarithmic quotient. This allows us to restrict our calculus with motivic iterated integrals to the so-called depth-one part of the mixed Tate Galois group studied extensively by Goncharov. We also discover an interesting consequence of the symmetry-breaking nature of the polylog quotient that forces us to symmetrize our polylogarithmic version of Kim’s conjecture. In this first part of a two-part series, we focus on a specific example, which allows us to verify an interesting new case of Kim’s conjecture.
Endoscopic ultrasound-guided sampling and profiling of portal circulation in human patients for metabolic research studies and biomarker assessment
Authors: Ryou Marvin , Stylopoulos Nicholas
Published: September 2020

The technical aspects, feasibility, and safety of endoscopic ultrasound (EUS)-guided needle access for portal venous blood collection are presented in this technical report. Despite the very small diameter of the endoscopic needle, portal blood samples have the same quality as those collected from systemic circulation. As a proof of the concept and the utility of this technique in metabolic research and biomarker assessment and discovery, we present a pilot metabolite profiling study of portal venous blood in a small cohort of patients with cirrhosis and a comparison with a group without cirrhosis.
High-fat diet induces fibrosis in mice lacking CYP2A5 and PPARα: a new model for steatohepatitis-associated fibrosis
Authors: Chen Xue , Acquaah-Mensah George K. , Denning Krista L. , Peterson Jonathan M. , Wang Kesheng , Denvir James , Hong Feng , Cederbaum Arthur I. , Lu Yongke
Published: September 2020

PPARα is upregulated in cyp2a5−/− mice, but HFD-induced steatosis is still deteriorated. PPARα abrogation makes cyp2a5−/− mice more sensitive to HFD-induced steatosis, liver inflammation, and fibrosis, suggesting that PPARα upregulation in cyp2a5−/− mice is a compensation response. HFD-induced liver inflammation, fibrosis, and nitrotyrosine formation in pparα−/−/cyp2a5−/− mice are all within clusters of lipid droplets, and lipid droplets are all within CYP2E1-positive area.
Severe acute pancreatitis: capillary permeability model linking systemic inflammation to multiorgan failure
Authors: Komara Nicole L. , Paragomi Pedram , Greer Phil J. , Wilson Anette S. , Breze Cameron , Papachristou Georgios I. , Whitcomb David C.
Published: September 2020

Acute pancreatitis is a sudden inflammatory response to pancreatic injury that may spread to systemic inflammation, multiorgan failure, and death in some patients. With the use of the predictions of a new mechanistic model, we compared patients with severe acute pancreatitis with or without multiorgan failure. All biomarkers of capillary leak and clinical features of multiorgan failure were accurately predicted. This provides a new paradigm for understanding and developing new treatments for patients with severe acute pancreatitis.
G551D mutation impairs PKA-dependent activation of CFTR channel that can be restored by novel GOF mutations
Authors: Wang Wei , Fu Lianwu , Liu Zhiyong , Wen Hui , Rab Andras , Hong Jeong S. , Kirk Kevin L. , Rowe Steven M.
Published: September 2020

G551D is a major disease-associated gating mutation in the cystic fibrosis transmembrane conductance regulator (CFTR) protein, an ATP- and phosphorylation-dependent chloride channel. G551D causes severe cystic fibrosis (CF) disease by disrupting ATP-dependent channel opening; however, whether G551D affects phosphorylation-dependent channel activation is unclear. Here, we use macropatch recording and Ussing chamber approaches to demonstrate that G551D impacts on phosphorylation-dependent activation of CFTR, and PKA-mediated phosphorylation regulates the interaction between the x-loop in nucleotide-binding domain 2 (NBD2) and cytosolic loop (CL) 1. We show that G551D not only disrupts ATP-dependent channel opening but also impairs phosphorylation-dependent channel activation by largely reducing PKA sensitivity consistent with the reciprocal relationship between channel opening/gating, ligand binding, and phosphorylation. Furthermore, we identified two novel GOF mutations: D1341R in the x-loop near the ATP-binding cassette signature motif in NBD2 and D173R in CL1, each of which strongly increased PKA sensitivity both in the wild-type (WT) background and when introduced into G551D-CFTR. When D1341R was combined with a second GOF mutation (e.g., K978C in CL3), we find that the double GOF mutation maximally increased G551D channel activity such that VX-770 had no further effect. We further show that a double charge-reversal mutation of D1341R/D173R-CFTR exhibited similar PKA sensitivity when compared with WT-CFTR. Together, our results suggest that charge repulsion between D173 and D1341 of WT-CFTR normally inhibits channel activation at low PKA activity by reducing PKA sensitivity, and negative allostery by the G551D is coupled to reduced PKA sensitivity of CFTR that can be restored by second GOF mutations.