bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics of the 24-h ambulatory blood pressure monitoring in patients with Parkinson's disease – the SFC BP multicentre study in China
Authors: Chen Shi-Wu , Wang Yu-Kai , Dou Rong-Hua , Xie Xin-Yi , Hu Yong-Bo , Ding Nan , Zhang Guo-Hua , Jing Hai-Fang , Zhao Wei-Dong , Xue Yan , Li Yan , Wang Gang
Published: July 2020

Objectives:

Cardiovascular dysautonomia can be present at early, late and even prodromal stages of Parkinson's disease. This study aimed to describe the characteristics of 24-h ambulatory blood pressure (BP) monitoring and investigate the frequency of cardiovascular dysautonomia in Parkinson's disease without an abnormal BP history.

Methods:

Parkinson's disease patients without history of abnormal BP were consecutively enrolled from three Chinese centres, on whom office BP measurement, neurological evaluations and 24-h ambulatory BP monitoring were performed.

Results:

Totally, 101 Parkinson's disease patients (42.6% women) with an average age of 66.6 ± 8.2 years were included in our cohort, and data analysis revealed that 26 (25.74%) patients suffered from orthostatic hypotension, among whom 18 (69.23%) were symptomatic. Patients with orthostatic hypotension compared with those without had significantly higher nocturnal SBP level, and more severe nonmotor symptoms, autonomic dysfunction and cognitive impairment. Further, 54 out of 101 (53.47%) individuals had a reverse dipping pattern in SBP and/or DBP. Reverse dippers had more cases of orthostatic hypotension (P < 0.001), and more severe nonmotor symptoms. SBP dipping ratio of less than −2.98% generated 76.9% of sensitivity, 69.3% of specificity, 46.5% of positive predictive value (PPV), 89.7% of negative predictive value (NPV) and 77.4% of accuracy, while diastolic dipping ratio of less than −1.80% generated 76.9% of sensitivity, 70.7% specificity, 47.6% of PPV, 89.8% of NPV and 77.8% of accuracy for suspecting orthostatic hypotension.

Conclusion:

Orthostatic hypotension can occur in one-fourth Parkinson's disease patients without abnormal BP history, and reverse dipping was present in more than half of patients with Parkinson's disease. Reverse dipping pattern was helpful to suspect orthostatic hypotension.
Long-term blood pressure variability, incidence of hypertension and changes in renal function in type 2 diabetes
Authors: Viazzi Francesca , Russo Elisa , Mirijello Antonio , Fioretto Paola , Giorda Carlo , Ceriello Antonio , Copetti Massimiliano , Russo Giuseppina T. , Di Bartolo Paolo , Manicardi Valeria , Leoncini Giovanna , De Cosmo Salvatore , Pontremoli Roberto
Published: July 2020

Objectives:

Long-term visit-to-visit SBP variability (VVV) predicts cerebro-cardiovascular and renal events in patients with hypertension. Whether VVV predicts hypertension and/or chronic kidney disease is currently unknown. We assessed the role of VVV on the development of hypertension and changes in renal function in patients with type 2 diabetes and normal blood pressure (NBP) in a real-life clinical setting.

Methods:

Clinical records from 8998 patients with type 2 diabetes, NBP, and normal estimated glomerular filtration rate (eGFR) were analyzed. VVV was measured by SD of the mean SBP recorded in at least four visits during 2 consecutive years before follow-up. Hypertension was defined as SBP at least 140 mmHg and DBP at least 90 mmHg or the presence of antihypertensive treatment. Renal function was defined as worsening of albuminuria status and/or a reduction in eGFR at least 30% from baseline.

Results:

After a mean follow-up time of 3.5 ± 2.8 years, 3795 patients developed hypertension (12.1 per 100 person-years). An increase of 5 mmHg VVV was associated with a 19% (P < 0.0001) and a 5% (P = 0.008) independent increased risk of developing hypertension and worsening of albuminuria, respectively. We found no association between VVV and eGFR decrease from baseline. Patients with VVV in the upper quartile (>12.8 mmHg) showed a 50% increased risk of developing hypertension (P < 0.0001) and an almost 20% increased risk of worsening albuminuria (P = 0.004) as compared with those in the lower one (<6.9 mmHg).

Conclusion:

Increased VVV independently predicts incident hypertension and albuminuria worsening in type 2 diabetes and NBP.
Probable Vertical Transmission of SARS-CoV-2 Infection
Authors: Demirjian Alicia , Singh Cheentan , Tebruegge Marc , Herbert Rachel , Draz Nehal , Mirfenderesky Mariyam , Jones Victoria , Hinstridge Peter , Seneviratne Ranjika , Myers Richard , Ellis Joanna , Miah Shahjahan , Meadows Christopher IS , Kenny Julia , Alonso Alejandra , Handforth Jennifer , Perkins Shona , Butler Mark , Blackburn Frances , Douthwaite Sam , Pillay Deenan , Chand Meera , Zambon Maria
Published: July 2020

Background:

To date, although neonatal infections with severe acute respiratory syndrome coronovirus 2 (SARS-CoV-2) have been described, none of these have been proven to be the result of vertical transmission of SARS-CoV-2.

Methods:

We describe the probable vertical transmission of SARS-CoV-2 in a neonate born to a mother with coronavirus disease 2019 (COVID-19).

Results:

Following cesarean section, the neonate was kept in strict isolation. Molecular tests for SARS-CoV-2 on respiratory samples, blood, and meconium were initially negative, but positive on a nasopharyngeal aspirate on the third day of life. On day 5, the neonate developed fever and coryza, which spontaneously resolved. Viral genomic analysis from the mother and neonate showed identical sequences except for 1 nucleotide.

Conclusion:

This report has important implications for infection control and clinical management of pregnant women with COVID-19 and their newborns.
Brillouin microscopic depth-dependent analysis of corneal crosslinking performed over or under the LASIK flap
Authors: Zhang Hongyuan , Roozbahani Mehdi , Piccinini Andre L. , Hafezi Farhad , Scarcelli Giuliano , Randleman J. Bradley
Published: July 2020

Purpose:

To determine the impact of corneal crosslinking (CXL) performed over the laser in situ keratomileusis (LASIK) flap using the Standard CXL (S-CXL) protocol or under the flap after flap lift (flap-CXL) on regional corneal stiffness using Brillouin microscopy.

Setting:

University of Southern California Keck School of Medicine, Los Angeles, California, and Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Design:

Laboratory ex vivo experiment.

Methods:

After epithelium debridement, LASIK flaps were created on intact fresh porcine eyes with a mechanical microkeratome. Then, S-CXL (riboflavin applied to the corneal surface followed by 3 mW/cm2 ultraviolet exposure with the flap in place for 30 minutes) or flap-CXL (riboflavin applied to the stromal bed after reflecting the flap followed by the same ultraviolet A exposure with the flap replaced) was performed. Depth profile of stiffness variation and averaged elastic modulus of anterior, middle, and posterior stroma were determined by analyzing Brillouin maps. Each eye served as its own control.

Results:

The study was performed on 24 fresh porcine eyes. S-CXL had maximal stiffening impact in the anterior most corneal stroma within the LASIK flap (8.40 ± 0.04 GHz), whereas flap-CXL had lower maximal stiffening impact (8.22 ± 0.03 GHz) (P < .001) that occurred 249 ± 34 μm under the corneal surface. S-CXL increased longitudinal modulus by 6.69% (anterior), 0.48% (middle), and −0.91% (posterior) as compared with flap-CXL, which increased longitudinal modulus by 3.43% (anterior, P < .001), 1.23% (middle, P < .1), and −0.78% (posterior, P = .68).

Conclusions:

The S-CXL technique generated significantly greater stiffening effect in the anterior cornea than a modified protocol with riboflavin administration under the flap (flap-CXL). Minimal stiffening occurred in the middle or posterior cornea with either protocol.
Nursing Care During Neonatal Electroencephalographs
Authors: Podraza Wojciech , Oleksy Barbara , Jezierska Karolina , Podraza Hanna
Published: July 2020

BACKGROUND: Electroencephalography (EEG) enables the precise evaluation of a neonate's condition. Three factors that determine the quality of care during this procedure are knowledge, experience, and attitude. The role of the nurse during EEG recordings was evaluated in this study, and the requirements for successfully performing neonatal EEGs, along with practical suggestions, are presented. METHODS: Evidence in the literature as well as clinical expertise forms the basis for this review. RESULTS: From our observations and practice during EEGs, we found that the following conditions must be met to successfully perform an EEG examination in a newborn: safety, a period of sleep and calm wakefulness of the neonate, good technical conditions, and no external interferences. Key conditions include the maintenance of safety rules and cooperation between nurses, EEG technicians, and parents. CONCLUSION: The EEG examinations in neonates weighing less than 1500 g or those requiring respiratory support should only be performed by a trained neonatal intensive care unit nurse.
Job Insecurity and Financial Concern During the COVID-19 Pandemic Are Associated With Worse Mental Health
Authors: Wilson Jenna M. , Lee Jerin , Fitzgerald Holly N. , Oosterhoff Benjamin , Sevi Bariş , Shook Natalie J.
Published: July 2020

Objective:

To determine whether job insecurity due to COVID-19 and financial concern were associated with worse mental health during the COVID-19 pandemic.

Method:

Participants (N = 474 employed U.S. individuals) completed an online survey from April 6 to 12, 2020. Linear regressions were used to examine factors associated with mental health.

Results:

After accounting for demographic characteristics, health status, other COVID-19 experiences, and anxiety symptoms, greater job insecurity due to COVID-19 was related to greater depressive symptoms. Conversely, after accounting for covariates and depressive symptoms, greater financial concern was related to greater anxiety symptoms. Further, greater job insecurity was indirectly related to greater anxiety symptoms due to greater financial concern.

Conclusions:

Findings suggest that employers should aim to reduce job insecurity and financial concern among employees during the COVID-19 pandemic to address the associated mental health consequences.
Foreign Body Retrieval by Using Flexible Cryoprobe in Children
Authors: Moslehi Mohammad Ashkan
Published: July 2020

Background:

Foreign body aspiration (FBA) can be a life-threatening emergency and the cause of significant morbidity and mortality in children. Although rigid bronchoscopy is considered as the treatment of choice for the retrieval of foreign bodies (FBs) among pediatrics, extraction with the flexible fiberoptic bronchoscope (FFB) has become increased in popularity over the last few years. Recently, though there have been some reports about the use of cryoprobes as tools for the removal of FBs in adults, there is a limited experience concerning pediatrics, especially during the infancy period. The aim of this study is to describe the characteristics of FBs and cryoextraction as the new method of treatment.

Methods:

This retrospective study was conducted on 50 pediatric patients with FBA who were managed by using the flexible cryoprobes to evaluate their outcomes between September 2013 and October 2018.

Results:

A total of 50 children ranging in age from 7 months to 15 years underwent cryoextraction for the airway FBA retrieval with FFB using a cryoprobe. The main symptoms patients complained of were choking, cyanosis, cough, and noisy breathing. History, clinical examination, and finally radiologic examination were the diagnostic tools. The treatment consisted of FFB using cryoprobes under slight general anesthesia with maintaining the patient’s spontaneous breathing. Using cryoextraction turned to be very useful.

Conclusion:

Using cryoextraction can be a reliable and preferred method with minimal complications for extracting airway FBs among children, especially those that have a friable texture.
The host metabolism following bacterial biofilm: what is the mechanism of action?
Authors: Mirzaei Rasoul , Abdi Milad , Gholami Hamid
Published: July 2020

The interplay of biofilm with host leads to a range of physiological reactions of the interacting members aimed at an adaptation to the novel position. These reactions include metabolic shifts in the influenced host cell, which is most apparent when the biofilm-forming bacteria replicates surround host cells. Whilst the bacteria try to deprive micronutrients of the host, the host cell, in turn, takes many metabolic countermeasures toward the micronutrient steal. During these conflicting interplays, the bacteria stimulate metabolic host cell reactions by means of common cell envelope ingredients and particular factors mediated to virulence. Hence, there is a crucial need for cellular models that more closely reflect the in-vivo infection conditions. The profound comprehension of the metabolic host cell reactions can provide novel interesting concepts for antibacterial treatments. In this review, a summarize of the metabolic changes of the host cells after bacterial biofilm formation is presented.
Scientific Productivity in Rheumatoid Arthritis
Authors: Zhong Mingliang , Xu Canhua , Wu Yaohong , Chen Qin , Chen Rongchun
Published: July 2020

Objectives

Assessment of scientific productivity provides a macroscopic view of research activity in a specific field. However, no analyses of rheumatoid arthritis (RA) have been published to date. Thus, this study aimed to investigate the characteristics of studies published on RA worldwide.

Methods

The Web of Science database was searched for articles on RA published between 2017 and 2019. Analysis parameters included the number of articles, number of times each publication was cited, country, journal, and research output adjusted by population and gross domestic product.

Results

Overall, 16,936 publications were identified. The United States was the largest contributor (17.71%), followed by China (17.17%), Japan (6.37%), the United Kingdom (5.82%), and Italy (4.76%). High-income economies (69.98%) ranked first in productivity, followed by middle- (30%) and low-income economies (0.02%). Significant correlations were found between research productivity and population (r = 0.461, p = 0.000), as well as gross domestic product (r = 0.786, p = 0.000). Publications from the United States received the highest number of total citations (21,669), followed by China (10,952) and the United Kingdom (7846). Austria had the highest average citations (16.18), followed by Norway (8.19) and the United Kingdom (7.98). When normalized by population, the leading country was Denmark, followed by the Netherlands and Sweden. When adjusted by gross domestic product, Denmark ranked first in publications on RA, followed by the Netherlands and Greece.

Conclusion

The United States emerged as the largest contributor to the field of RA research. Countries with large populations and economies tended to have higher research productivity. Multiple countries in Europe performed better in research output when normalized by population and economy sizes.
Autogenous Tooth Bone Graft and Simvastatin Combination Effect on Bone Healing
Authors: Taşdemir Ufuk , Kirtay Mustafa , Keleş Ali , Çil Nazli , Abban Gülçin , Dodurga Yavuz
Published: July 2020

Objective:

Autogenous tooth bone grafts (ATGM) are materials prepared from extracted teeth and have been used for bone augmentation. These graft materials are known to have similar structures and components to bone grafts. In this sense, this study aimed to evaluate all the tooth layers mixed with simvastatin without any demineralization process effect on bone formation.

Methods:

In 60 Wistar albino rats, a standardized 6.0 m-diameter critical size bone defect was created in their calvarium. The study consists of 1 control and 4 experimental groups. In the control group (12 rats), the defects were left empty. The defects were grafted only with ATGM in Group 1, with ATGM mixed with simvastatin in Group 2, autogenous bone graft mixed with simvastatin in Group 3, and with xenogenic bone graft mixed with simvastatin in Group 4. The animals were sacrificed at the 7th and 28th days after operation.

Results:

PCR, micro CT and histological results show that bone formation was enhanced in the experimental groups in comparison to the control group. Group 1 and Group 2 had similar bone formation rate when compared to Group 3 and Group 4 at the 28th day after operation.

Conclusion:

This study concludes that mineralized teeth may be used for defect reconstruction without any demineralization process. Autogenous mineralized tooth bone graft should be mixed with simvastatin for bone regeneration like other grafts.
Opioids After Surgery in the United States Versus the Rest of the World
Authors: Kaafarani Haytham M. A. , Han Kelsey , El Moheb Mohamad , Kongkaewpaisan Napaporn , Jia Zhenyi , El Hechi Majed W. , van Wijck Suzanne , Breen Kerry , Eid Ahmed , Rodriguez Gabriel , Kongwibulwut Manasnun , Nordestgaard Ask T. , Sakran Joseph V. , Ezzeddine Hiba , Joseph Bellal , Hamidi Mohammad , Ortega Camilo , Flores Sonia Lopez , Gutierrez-Sougarret Bernardo J. , Qin Huanlong , Yang Jun , Gao Renyuan , Wang Zhiguo , Gao Zhiguang , Prichayudh Supparerk , Durmaz Said , van der Wilden Gwendolyn , Santin Stephanie , Ribeiro Marcelo A. F. , Noppakunsomboom Napakadol , Alami Ramzi , El-Jamal Lara , Naamani Dana , Velmahos George , Lillemoe Keith D.
Published: July 2020

Objective:

The International Patterns of Opioid Prescribing study compares postoperative opioid prescribing patterns in the United States (US) versus the rest of the world.

Summary of Background Data:

The US is in the middle of an unprecedented opioid epidemic. Diversion of unused opioids contributes to the opioid epidemic.

Methods:

Patients ≥16 years old undergoing appendectomy, cholecystectomy, or inguinal hernia repair in 14 hospitals from 8 countries during a 6-month period were included. Medical records were systematically reviewed to identify: (1) preoperative, intraoperative, and postoperative characteristics, (2) opioid intake within 3 months preoperatively, (3) opioid prescription upon discharge, and (4) opioid refills within 3 months postoperatively. The median/range and mean/standard deviation of number of pills and OME were compared between the US and non-US patients.

Results:

A total of 4690 patients were included. The mean age was 49 years, 47% were female, and 4% had opioid use history. Ninety-one percent of US patients were prescribed opioids, compared to 5% of non-US patients (P < 0.001). The median number of opioid pills and OME prescribed were 20 (0–135) and 150 (0–1680) mg for US versus 0 (0–50) and 0 (0–600) mg for non-US patients, respectively (both P < 0.001). The mean number of opioid pills and OME prescribed were 23.1 ± 13.9 in US and 183.5 ± 133.7 mg versus 0.8 ± 3.9 and 4.6 ± 27.7 mg in non-US patients, respectively (both P < 0.001). Opioid refill rates were 4.7% for US and 1.0% non-US patients (P < 0.001).

Conclusions:

US physicians prescribe alarmingly high amounts of opioid medications postoperatively. Further efforts should focus on limiting opioid prescribing and emphasize non-opioid alternatives in the US.
Risk Factors for Suicide After Bariatric Surgery in a Population-based Nationwide Study in Five Nordic Countries
Authors: Kauppila Joonas H. , Santoni Giola , Tao Wenjing , Lynge Elsebeth , Jokinen Jussi , Tryggvadóttir Laufey , Ness-Jensen Eivind , Pukkala Eero , von Euler-Chelpin My , Lagergren Jesper
Published: July 2020

Objective:

To identify risk factors for suicide after bariatric surgery.

Summary background data:

Bariatric surgery reduces obesity-related mortality. However, it is for unclear reasons is associated with an increased risk of suicide.

Methods:

This population-based cohort study included patients having undergone bariatric surgery in 1982 to 2012 in any of the 5 Nordic countries, with follow-up through 2012. Eleven potential risk factors of suicide (sex, age, comorbidity, surgery type, surgical approach, calendar year of surgery, history of depression or anxiety, psychosis, schizophrenia, mania, or bipolar disorder, personality disorder, substance use, and number of previously documented psychiatric diagnoses) were analyzed using Cox regression.

Results:

Of 49,977 bariatric surgery patients, 98 (0.2%) committed suicide during follow-up. Women had a decreased risk of suicide compared to men (hazard ratio [HR] = 0.48, 95% confidence interval [CI] 0.33–0.77), although age and comorbidity did not influence this risk. Compared to gastric bypass, other types of bariatric surgery had lower risk of suicide (HR = 0.44, 95%CI 0.27–0.99). There was no difference in suicide risk between laparoscopic and open surgical approach. A history of depression or anxiety (HR = 6.87, 95%CI 3.97–11.90); mania, bipolar disorder, psychosis, or schizophrenia (HR = 2.70, 95%CI 1.14–6.37); and substance use (HR = 2.28, 95%CI 1.08–4.80), increased the risk of suicide. More of the above psychiatric diagnoses increased the risk of suicide (HR = 22.59, 95%CI 12.96–39.38 for ≥2 compared to 0 diagnoses).

Conclusions:

Although the risk of suicide is low, psychiatric disorders, male sex, and gastric bypass procedure seem to increase the risk of suicide after bariatric surgery, indicating a role for tailored preoperative psychiatric evaluation and postoperative surveillance.
The Impact of Radiotherapy on Patient-reported Outcomes of Immediate Implant-based Breast Reconstruction With and Without Mesh
Authors: Sewart Emma , Turner Nicholas L. , Conroy Elizabeth J. , Cutress Ramsey I. , Skillman Joanna , Whisker Lisa , Thrush Steven , Barnes Nicola , Holcombe Chris , Potter Shelley
Published: July 2020

Objective:

To explore the impact of PMRT on PROs of IBBR performed with and without mesh.

Summary of Background Data:

PMRT is increasingly given to improve breast cancer outcomes but can adversely impact complications after IBBR.

Little; however, is known about the impact of PMRT on the PROs of IBBR, especially when mesh is used.

Methods:

The implant Breast Reconstruction evAluation prospective cohort study recruited consecutive women undergoing immediate IBBR from 81 UK breast and plastic surgical units. Demographic, operative, oncological, and 3-month complication data were collected, and patients consented to receive validated PRO questionnaires at 18-months. The association between IBBR, PMRT, and PROs were investigated using mixed-effects regression models adjusted for clinically-relevant confounders and including a random-effect to account for potential clustering by center

Results:

A total of 1163 women consented to receive 18-month questionnaires of whom 730 (63%) completed it. Patients undergoing PMRT (214 patients) reported worse PROs in 3 BREAST-Q domains: satisfaction with breasts [–6.27 points, P = 0.008, 95% confidence interval (CI) (–10.91, –1.63)], satisfaction with outcome [–7.53 points, P = 0.002, CI (–12.20, –2.85)] and physical well-being [–6.55 points, P < 0.001, CI (–9.43, –3.67)]. Overall satisfaction was worse in the PMRT group [OR 0.497, P = 0.002, CI (0.32, 0.77)]. These effects were not ameliorated by mesh use.

Conclusions:

PMRT may adversely affect PROs after IBBR irrespective of whether mesh is used. These findings should be discussed with all patients considering IBBR and when indications for PMRT are borderline to enable informed decision-making regarding oncological and reconstructive treatment options.

Trial registration:

ISRCTN37664281.
Satisfaction With Telephone Versus In-Person Interpretation Services in Limited English-Proficient Urogynecology Patients: A Randomized Controlled Trial
Authors: Taylor Danielle Lynn , Sierra Tania , Maheshwari Deepali , Hall Cynthia , Leung Katherine , Flynn Michael
Published: July 2020

Objective

The objective of this study was to determine if in-person interpreters improve patient satisfaction scores compared with phone interpreters for urogynecology office visits in limited English proficient (LEP) patients.

Methods

Portuguese and Spanish LEP subjects were randomized to phone or in-person interpreter, and a 14-item questionnaire was administered with 3 subscales assessing the primary outcome of patient satisfaction with the interpreter, physician, and nursing. Subject demographics, English proficiency, overall health status, and yearly household income were recorded. Sample size calculations indicated that a mean difference of 12 in satisfaction scores could be detected with 44 subjects per arm. Analysis was conducted using descriptive statistics, and comparisons between the intervention versus control group were analyzed using Fisher exact test, Wilcoxon rank sum test, and linear regression.

Results

We enrolled and randomized 106 subjects, and 82 subjects completed the study. There was a statistically significant difference in subject satisfaction between randomization groups, favoring in-person interpreters. In the as-treated analysis, the median satisfaction score for the phone interpreter group was 92.9 and 100 for in-person interpreter group (P < 0.001). Linear regression adjusted for English proficiency showed that there was a difference between median scores of 7.14 (P = 0.002).

Conclusions

Portuguese and Spanish LEP patients experienced higher satisfaction scores for urogynecology office visits when in-person interpreters are used compared with a phone interpreter. Although we found a statistically significant difference between these groups, the clinical significance of our finding is less clear. This topic should continue to be investigated for the field of urogynecology and further studies are needed.
The association between level of trauma care and clinical outcome measures: A systematic review and meta-analysis
Authors: Van Ditshuizen Jan C. , Van Den Driessche Claire R.L. , Sewalt Charlie A. , Van Lieshout Esther M.M. , Verhofstad Michiel H.J. , Den Hartog Dennis
Published: July 2020

BACKGROUND

With implementation of trauma systems, a level of trauma care classification was introduced. Use of such a system has been linked to significant improvements in survival and other outcomes.

OBJECTIVES

The aim of this study was assessing the association between level of trauma care and fatal and nonfatal outcome measures for general and major trauma (MT) populations.

METHODS

A systematic literature search was conducted using six electronic databases up to December 18, 2019. Studies comparing mortality or nonfatal outcomes between different levels of trauma care in general and MT populations (preferably Injury Severity Score of >15) were included. Two independent reviewers performed selection of relevant studies, data extraction, and a quality assessment of included articles. With a random-effects meta-analysis, adjusted and unadjusted pooled effect sizes were calculated for level I versus non–level I trauma centers.

RESULTS

Twenty-two studies were included. Quality of the included studies was good; however, adjustment for comorbidity (32%) and interhospital transfer (38%) was performed less frequently. Nine (60%) of the 15 studies analyzing in-hospital mortality in general trauma populations reported a survival benefit for level I trauma centers. Level I trauma centers were not associated with higher mortality than non–level I trauma centers (adjusted odd ratio, 0.97; 95% confidence interval, 0.61–1.52). Of the 11 studies reporting in-hospital mortality in MT populations, 10 (91%) reported a survival benefit for level I trauma centers. Level I trauma centers were associated with lower mortality than non–level I trauma centers (adjusted odd ratio, 0.77; 95% confidence interval, 0.69–0.87).

CONCLUSION

The association between level of trauma care and in-hospital mortality is evident for MT populations; however, this does not hold for general trauma populations. Level I trauma centers produce improved survival in MT populations. This association could not be proven for nonfatal outcomes in general and MT populations because of inconsistencies in the body of evidence.

LEVEL OF EVIDENCE

Systematic review and meta-analysis, level III.
Impact of helmet laws on motorcycle crash mortality rates
Authors: Notrica David M. , Sayrs Lois W. , Krishna Nidhi , Davenport Katherine P. , Jamshidi Ramin , McMahon Lisa
Published: July 2020

BACKGROUND

Helmets are effective in reducing traumatic brain injury. However, population effects of helmet laws have not been well described. This study assesses the impact of helmet laws on the motorcycle (MC) fatality rate in the United States from 1999 to 2015.

METHODS

Fatality Analysis Reporting System MC fatalities (aged ≥16 years), crash characteristics, and MC-related laws were collected by year for all 50 states from 1999 to 2015 to create a pooled time series. Generalized linear autoregressive modeling was applied to assess the relative contribution of helmet laws to the MC fatality rate while controlling for other major driver laws and crash characteristics.

RESULTS

Universal helmet laws were associated with a 36% to 45% decline in the motorcycle crash mortality rate during the study period across all age cohorts (unstandardized regression coefficients are reported): 16 to 20 years, B = −0.45 (p < 0.05); 21 to 55 years, B = −0.42 (p < 0.001); 56 to 65 years, B = −0.38 (p < 0.04); and older than 65 years, B = −0.36 (p < 0.02). Partial helmet laws were associated with a 1% to 81% increase in the fatality rate compared with states with no helmet laws and a 22% to 45% increase compared with universal laws. Helmet usage did not attenuate the countervailing effect of weaker partial laws for 16 to 20 years (B = 0.01 [p < 0.001]). Other laws associated with a declining motorcycle crash mortality rate included the following: social host/overservice laws, 21 to 55 years (B = −0.38 [p < 0.001]); 56 to 65 years (B = −0.16 [p < 0.002]), and older than 65 years (B = −0.12 [p < 0.003]); laws reducing allowable blood alcohol content, 21 to 55 years (B = −4.9 [p < 0.02]); and laws limiting passengers for new drivers 16 to 20 years (B = −0.06 [p < 0.01]).

CONCLUSION

During the period of the study, universal helmet laws were associated with a declining mortality rate, while partial helmet laws were associated with an increasing mortality rate. Other state driver laws were also associated with a declining rate. In addition to universal helmet laws, advocating for strict alcohol control legislation and reevaluation of licenses in older riders could also result in significant reduction in MC-related mortality.

LEVEL OF EVIDENCE

Prognostic and epidemiological, level III.
Improving brain age estimates with deep learning leads to identification of novel genetic factors associated with brain aging
Authors: Ning Kaida , Duffy Ben A. , Franklin Meredith , Matloff Will , Zhao Lu , Arzouni Nibal , Sun Fengzhu , Toga Arthur W.
Published: July 2020

Brain aging trajectories among those of the same chronological age can vary significantly. Statistical models have been created for estimating the apparent age of the brain, or predicted brain age, with imaging data. Recently, convolutional neural networks (CNNs) have shown the potential to more accurately predict brain age. We trained a CNN on 16,998 UK Biobank subjects, and in validation tests found that it was more accurate than a regression model for predicting brain age. A genome-wide association study was conducted on CNN-derived predicted brain age whereby we identified single nucleotide polymorphisms from four independent loci significantly associated with brain aging. One locus has been previously reported to be associated with brain aging. The three other loci were novel. Our results suggest that a more accurate brain age prediction enables the discovery of novel genetic associations, which may be valuable for identifying other lifestyle factors associated with brain aging.
Outbreak of Covid-19 worldwide is on the decline -----Recurrent Neural Reinforcement Learning and Health Interventions to Curb the Spread of Covid-19 in the world
Authors: Ge Qiyang , Hu Zixin , Zhang Kai , Li Shudi , Lin Wei , Jin Li , Xiong Momiao
Published: July 2020

As the Covid-19 pandemic soars around the world, there is urgent need to forecast the expected number of cases worldwide and the length of the pandemic before receding and implement public health interventions for significantly stopping the spread of Covid-19. Widely used statistical and computer methods for modeling and forecasting the trajectory of Covid-19 are epidemiological models. Although these epidemiological models are useful for estimating the dynamics of transmission of epidemics, their prediction accuracies are quite low. Alternative to the epidemiological models, the reinforcement learning (RL) and causal inference emerge as a powerful tool to select optimal interventions for worldwide containment of Covid-19. Therefore, we formulated real-time forecasting and evaluation of multiple public health intervention problems into off-policy evaluation (OPE) and counterfactual outcome forecasting problems and integrated RL and recurrent neural network (RNN) for exploring public health intervention strategies to slow down the spread of Covid-19 worldwide, given the historical data that may have been generated by different public health intervention policies. We applied the developed methods to real data collected from January 22, 2020 to July 30, 2020 for real-time forecasting the confirmed cases of Covid-19 across the world. We observed that the number of new cases of Covid-19 worldwide reached a peak (407,205) on July 24, 2020 and forecasted that the number of laboratory-confirmed cumulative cases of Covid-19 will pass 20 million as of August 22, 2020. The results showed that outbreak of Covid-19 worldwide has peaked and is on the decline
Achieving functional neuronal dendrite structure through sequential stochastic growth and retraction
Authors: Castro André Ferreira , Baltruschat Lothar , Stürner Tomke , Bahrami Amirhoushang , Jedlicka Peter , Tavosanis Gaia , Cuntz Hermann
Published: July 2020

Class I ventral posterior dendritic arborisation (c1vpda) proprioceptive sensory neurons respond to contractions in theDrosophilalarval body wall during crawling. Their dendritic branches run along the direction of contraction, possibly a functional requirement to maximise membrane curvature during crawling contractions. Although the molecular machinery of dendritic patterning in c1vpda has been extensively studied, the process leading to the precise elaboration of their comb-like shapes remains elusive. Here, to link dendrite shape with its proprioceptive role, we performed long-term, non-invasive,in vivotime-lapse imaging of c1vpda embryonic and larval morphogenesis to reveal a sequence of differentiation stages. We combined computer models and dendritic branch dynamics tracking to propose that distinct sequential phases of targeted growth and stochastic retraction achieve efficient dendritic trees both in terms of wire and function. Our study shows how dendrite growth balances structure–function requirements, shedding new light on general principles of self-organisation in functionally specialised dendrites.

In brief

An optimal wire and function trade-off emerges from noisy growth and stochastic retraction duringDrosophilaclass I ventral posterior dendritic arborisation (c1vpda) dendrite development.

Highlights

C1vpda dendrite outgrowth follows wire constraints.

Stochastic retraction of functionally suboptimal branches in a subsequent growth phase.

C1vpda growth rules favour branches running parallel to larval body wall contraction.

Comprehensive growth model reproduces c1vpda developmentin silico.
Disentangling Increased Testing from Covid-19 Epidemic Spread
Authors: Lengerich Benjamin , Neiswanger Willie , Lengerich Eugene J. , Xing Eric P.
Published: July 2020

To design effective disease control strategies, it is critical to understand the incidence of diseases. In the Covid-19 epidemic in the United States (caused by outbreak of the SARS-CoV-2 virus), testing capacity was initially very limited and has been increasing at the same time as the virus has been spreading. When estimating the incidence, it can be difficult to distinguish whether increased numbers of positive tests stem from increases in the spread of the virus or increases in testing. This has made it very difficult to identify locations in which the epidemic poses the largest public health risks. Here, we use a probabilistic model to quantify beliefs about testing strategies and understand implications regarding incidence. We apply this model to estimate the incidence in each state of the United States, and find that: (1) the Covid-19 epidemic is likely to be more widespread than reported by limited testing, (2) the Covid-19 epidemic growth in the summer months is likely smaller than it was during the spring months, and (3) the regions which are at highest risk of Covid-19 epidemic outbreaks are not always those with the largest number of positive test results.
Stable sub-micrometre high-flux probe for soft X-ray ARPES using a monolithic Wolter mirror
Authors: Senba Yasunori , Kishimoto Hikaru , Takeo Yoko , Yumoto Hirokatsu , Koyama Takahisa , Mimura Hidekazu , Ohashi Haruhiko
Published: July 2020

A focusing optics that can provide a sub-micrometre high-flux probe for soft X-ray micrometre-scale angle-resolved photoemission spectroscopy (ARPES) is proposed. A monolithic Wolter-type mirror with a large acceptance, achromatism and small comatic aberration was designed and evaluated. A focused beam size of 0.4 µm (vertical) × 4 µm (horizontal), a high throughput of 59% and a high tolerance of 1.6 mrad to the pitching error were realized at a photon energy of 1000 eV. A Wolter-type mirror can be practically employed as a stable sub-micrometre focusing mirror with high throughput in ARPES applications.
A solid solution of ethyl andd3-methyl 2-[(4-methylpyridin-2-yl)amino]-4-(pyridin-2-yl)thiazole-5-carboxylate
Authors: Beuchel Andreas , Goddard Richard , Imming Peter , Seidel Rüdiger W.
Published: July 2020

The synthesis of ethyl 2-[(4-methylpyridin-2-yl)amino)-4-(pyridin-2-yl)thiazole- 5-carboxylateviathe Hantzsch reaction and partialin situtransesterification during recrystallization from methanol-d4to thed3-methyl ester, resulting in the title solid solution, ethyl 2-[(4-methylpyridin-2-yl)amino)-4-(pyridin-2-yl)thiazole-5-carboxylate–d3-methyl 2-[(4-methylpyridin-2-yl)amino)-4-(pyridin-2-yl)thiazole-5-carboxylate (0.88/0.12), 0.88C17H16N4O2S·0.12C16D3H11N4O2S, is reported. The refined ratio of ethyl tod3-methyl ester in the crystal is 0.880 (6):0.120 (6). The pyridine ring is significantly twisted out of the plane of the approximately planar picoline thiazole ester moiety. N—H...N hydrogen bonds between the secondary amino group and the pyridine nitrogen atom of an adjacent symmetry-related molecule link the molecules into polymeric hydrogen-bonded zigzag tapes extending by glide symmetry in the [001] direction. There is structural evidence for intramolecular N...S chalcogen bonding and intermolecular weak C—H...O hydrogen bonds between adjacent zigzag tapes.
[5,10,15,20-Tetrakis(pentafluorophenyl)porphyrinato]zinc(II) benzene disolvate
Authors: Lin Zeyuan , Li Jianfeng
Published: July 2020

Single crystals of the title zinc porphyrinato complex, [Zn(C44H8F20N4)]·2C6H6, were obtained by the solvent evaporation method. The molecular complex exhibits point group symmetry \overline1 with the central ZnII atom located on an inversion centre. The porphyrinato core is approximately planar, and the cation has no other ligating atoms than the four porphyrinato N atoms. π–π interactions between benzene solvent molecules and [Zn(TFPP)] units lead to multilayer packing structures. In addition, intermolecular C—H...F hydrogen bonding is observed between [Zn(TFPP)] molecules.
Diethyl 3,3′-[(3-fluorophenyl)methylene]bis(1H-indole-2-carboxylate)
Authors: Jiang Hong , Li Yu-Long , Zhou Jin , Sun Hong-Shun , Zhang Qing-Yu , Shi Xing-Hao , Zhang Zhi-Yuan , Ling Tian
Published: July 2020

In the title compound, C29H25FN2O4, the mean planes of the indole ring systems are approximately perpendicular to one another [dihedral angle = 88.3 (4)°]. The benzene ring is twisted with respect to the indole ring systems by 49.8 (5) and 77.6 (3)°. In the crystal, pairs of N—H...O hydrogen bonds link the molecules into the inversion dimers which are further linked into supramolecular chains propagating along the [110] direction.
Design of the rainfall index annual forage program
Authors: ShalekBriski Abby , Brorsen Wade , Rogers James K. , Biermacher Jon T. , Marburger David , Edwards Jeff
Published: July 2020

Purpose

The authors determine the effectiveness of the Rainfall Index Annual Forage Program (RIAFP) in offsetting yield risk of winter annual forage growers. The authors also evaluate the effectiveness in reducing risk of potential alternative weather indices.

Design/methodology/approach

The RIAFP is designed to compensate forage producers when yield losses occur. Prior research found weak correlation between the rainfall index and actual winter annual forage yields. The authors use long-term small-plot variety trials of rye, ryegrass, wheat, triticale and oats with rainfall recorded on site and measure the correlation of the index with actual rainfall and actual yields. The alternative indices include frequency of precipitation events and of days with temperature below freezing.

Findings

The correlation between actual rainfall and the current RMA index was strongly positive as in previous research. Correlations between forage yields and monthly intervals of the current RMA index were mostly statistically insignificant, and many had an unexpected sign. All indices had some correlations that were inconsistent across time intervals and forage variety. The inconsistent signs suggest a nonlinear relationship with weather and forage yield, indicating that rainfall can be too much or too little. The number of days below freezing has the most potential of the three measures examined.

Practical implications

Producers should view the winter forage RIAFP as a risk-increasing income-transfer farm program. A product to reduce the risk for forage producers may need to use a crop growth simulation model or another approach that can capture the nonlinearity.

Originality/value

Considerably more data were considered than in past research. Past research did not consider alternative weather indices. The program should be continued if its goal is to serve as disguised income transfer, but it should be discontinued if its goal is to reduce risk.
Mediated effect of export assistance on export performance of Serbian manufacturing SMEs
Authors: Njegić Katarina , Damnjanović Jelena , Komnenić Biserka
Published: July 2020

Purpose

The purpose of this paper was to examine the intervening role of export-related resources in the relationship between export assistance (EA) and export performance (EP) as well as the role of competitive intensity as a driver for the adoption of EA programmes by small and medium-sized enterprises (SMEs).

Design/methodology/approach

The proposed model was tested on the sample of 119 SMEs that export from the Republic of Serbia. The data were gathered through an online survey. In order to test the hypotheses, partial least squares structural equation modelling (PLS-SEM) was used.

Findings

The results revealed that export-related resources (intellectual, relational and managerial resources) fully mediate the relationship between EA and EP. It was shown that competitive intensity in export markets had a positive effect on the amount of EA that SMEs receive from the government, EU and other organisations.

Research limitations/implications

The number of firms that participated in the survey is small. Furthermore, the responses may be biased due to the auto-selection of SMEs. The research included only SMEs from different manufacturing industries. Thus, the implications of the research cannot be applied to the service sector.

Practical implications

The findings of the conducted research are relevant for the managers of SMEs since they show the importance of using EA as an external resource. The use of EA improves EP through the enhancement of intellectual, relational and managerial resources. The results of this study also support further government investment in EA as it was found that EA is an effective tool for the improvement of EP of SMEs.

Originality/value

The effect of EA on EP was tested in Serbia, the research context in which this effect was not tested before. Besides, the proposed model gives insights into the factors that affect engagement in EA programmes, which is a topic rarely examined in the literature.
Evaluation of the future adaptive reuse of Mashrooteh house using the adaptSTAR model
Authors: Sharifi Ali Asghar , Farahinia Amir Hossein
Published: July 2020

Purpose

The concept of adaptive reuse is an effective strategy in enhancing the heritage assets economic, cultural and social values. The main purpose of this research is to determine how to increase the life of the heritage buildings thereby improving their sustainability and reducing energy consumption and waste, while preserving them from the risk of obsolescence.

Design/methodology/approach

The qualitative method has been used in this research to evaluate the functional quality and sustainability of Mashrooteh house by using the adaptSTAR model with its scoring sheet with respective design criteria. Predicting and evaluating the sustainability and adaptability of the historic Mashrooteh house in Tabriz will ensure its reuse and increase its adaptability and future life.

Findings

Findings have shown that to increase the adaptability and future life of Mashrooteh house, it requires the improvement of the physical, legal, technological and functional criteria in order to provide suitable conditions for increasing the environmental and functional sustainability of this heritage building, while improving the quality of its spaces.

Originality/value

With the emphasis on conservation of national heritage as well as promoting sustainable development, the overall service life of these structures can be extended. The significance of this study lies in recognizing the incompatibilities and potential of viable approaches to rehabilitate the volatile condition of Mashrooteh house. The result of this study will add value to existing sustainable reuse database in Tabriz and other countries in the Middle East region.
Entrepreneurial collaboration for R&D alliance performance: a role of social capital configuration
Authors: Seo Ribin
Published: July 2020

Purpose

Despite increasing research on the social nature of entrepreneurial collaboration in the context of alliances, its performance implication has been under debate. The present study tests a theoretical framework to elucidate the mediated relationship between social capital (SC) and research and development (R&D) alliance performance through the entrepreneurial orientation (EO) of alliance firms.

Design/methodology/approach

Based on the authors’ literature review, SC is conceptualized as the sum of actual and potential assets, including structural, relational and cognitive capital, embedded within the networks of alliance partners. Alliance performance is regarded as a combination of technological performance and business performance, corresponding to the mutual and private benefits of R&D alliances, respectively. This study hypothesizes the potential impact of SC on alliance performance and the mediating role of EO in the relationship.

Findings

The results from an analysis of 218 Korean ventures that participated in R&D alliance projects as focal alliance partners show that each SC dimension drives alliance firms to enact EO, which eventually leads to increased performance in technology and business. Specifically, EO contributes to translating the implications of SC for technological performance partially and for business performance completely.

Originality/value

This study links fragmented theoretical perspectives in research, shedding new light on the importance of social nature in the context of R&D alliances, which conditions entrepreneurial collaboration for better alliance performance. The findings suggest that practitioners should adopt an ambidextrous approach to the SC–EO interface at the alliance level, which opens a gateway to achieve greater performance by alliance.