bluuebunny/crossref_metadata_2025 huggingface dataset:
Inbreeding depression is difficult to purge in self‐incompatible populations of Leavenworthia alabamica
Authors: Baldwin Sarah J. , Schoen Daniel J.
Published: May 2019

The extent to which inbreeding depression can be purged is a major determinant of mating system evolution and is important to conservation and crop improvement. Studies of inbreeding depression purging have not been conducted in self‐incompatible plants before.

An experimental (‘ancestral’) treatment was first created from self‐incompatible plants of Leavenworthia alabamica. Lines derived from this population were maintained by self‐pollination for three generations in the attempt to create a ‘purged’ population with fewer recessive, deleterious mutations of large effect. Fitness components and the frequency of malformed phenotypes were monitored in progeny derived from selfing and outcrossing in the ancestral and purged treatments.

Fitness component means and inbreeding depression were largely unchanged by three generations of forced self‐pollination, and there was no reduction in the frequency of plants exhibiting malformed phenotypes.

Our findings indicate that inbreeding depression in this species is largely a result of mutations of mild effect, consistent with the observation that self‐incompatibility is maintained in most populations of L. alabamica, despite the presence of genetic variants with weaker self‐incompatibility. Moreover, although population theory suggests that deleterious mutations of large effect should be sheltered from selection in the region of self‐incompatibility locus, our results do not support this prediction.
Treatment of obesity, with a dietary component, and eating disorder risk in children and adolescents: A systematic review with meta‐analysis
Authors: Jebeile Hiba , Gow Megan L. , Baur Louise A. , Garnett Sarah P. , Paxton Susan J. , Lister Natalie B.
Published: May 2019

This review aimed to investigate the impact of obesity treatment, with a dietary component, on eating disorder (ED) prevalence, ED risk, and related symptoms in children and adolescents with overweight or obesity. Four databases were searched to identify pediatric obesity treatment interventions, with a dietary component, and validated pre‐post intervention assessment of related outcomes. Of 3078 articles screened, 36 met inclusion criteria, with a combined sample of 2589 participants aged 7.8 to 16.9 years. Intervention duration ranged from 1 week to 13 months, with follow‐up of 6 months to 6 years from baseline. Prevalence of ED was reported in five studies and was reduced post‐intervention. Meta‐analyses showed a reduction in bulimic symptoms (eight studies, standardized mean difference [SE], −0.326 [0.09], P < 0.001), emotional eating (six studies, −0.149 [0.06], P = 0.008), binge eating (three studies, −0.588 [0.10], P < 0.001), and drive for thinness (three studies, −0.167 [0.06], P = 0.005) post‐intervention. At follow‐up, a reduction in ED risk (six studies, −0.313 [0.13], P = 0.012), emotional eating (five studies, −0.259 [0.05], P < 0.001), eating concern (three studies, −0.501 [0.06], P < 0.001), and drive for thinness (two studies, −0.375 [0.07], P < 0.001) was found. Structured and professionally run obesity treatment was associated with reduced ED prevalence, ED risk, and symptoms.
The long‐term influence of orthodontic treatment on adults’ psychosocial outcomes: An Australian cohort study
Authors: Doğramacı Esma J. , Brennan David S.
Published: May 2019

Objectives

To assess the influence of orthodontic treatment on psychosocial outcomes in 30‐year‐olds. The research hypothesis tested was that participants previously treated orthodontically would have better psychosocial outcomes.

Setting and Sample Population

A prospective longitudinal cohort design was used to follow‐up a sample of 1859 30‐year‐olds from Adelaide, South Australia, who had previously participated in an oral epidemiology study.

Materials and methods

Clinical examination in 1988‐1989 recorded participants’ malocclusion severity. In 2005‐2006, participants were invited to complete a questionnaire collecting data on socio‐demographic characteristics, dental health behaviours, receipt of orthodontic treatment and psychosocial factors. Data were analysed descriptively and by linear regression models.

Results

Data for 448 participants were available; 56% of participants were female. Over a third of participants had received orthodontic treatment. Higher income earners had the best psychosocial outcomes while participants with a basic level of secondary education had the lowest. Regardless of initial malocclusion severity, orthodontic treatment was not associated with better psychosocial outcomes. Instead, a pattern of better psychosocial outcome was observed amongst untreated participants, regardless of malocclusion severity, this being significant for optimism. Adjusted models controlling for socio‐demographic, dental health behaviour and malocclusion severity showed no association between orthodontic treatment and self‐efficacy, health competence or social support. There was, however, a strong association with optimism.

Conclusion

There was no difference in long‐term psychosocial outcomes based on orthodontic treatment. Our study does not support the contention that orthodontic treatment produces better psychosocial functioning later in life.
Characterization of ocular and nasopharyngeal microbiome in allergic rhinoconjunctivitis
Authors: Yau Jennifer Wing‐Ki , Hou Jinpao , Tsui Stephen Kwok Wing , Leung Ting Fan , Cheng Nam Sze , Yam Jason C. , Kam Ka Wai , Jhanji Vishal , Hon Kam Lun
Published: May 2019

Background

Allergic rhinoconjunctivitis (ARC) is a prevalent allergic condition in the pediatric population. Microbial dysbiosis has increasingly been recognized to influence on host immunity and allergic diseases. However, the microbial profile of ARC has not been characterized. This cross‐sectional study aims to evaluate the changes in nasal and ocular surface microbiome of children with ARC.

Methods

Ocular and nasopharyngeal swabs were collected from controls and pediatric ARC cases for 16S rRNA amplicon sequencing. The bacterial community profile was analyzed. The correlation of the microbial diversity with the ARC‐related clinical scores was studied.

Results

A total of 23 patients with ARC and 17 healthy controls were recruited;30 were ocular samples (15 controls vs 15 ARC), while 40 were nasal samples (17controls vs 23 ARC) The alpha diversity of nasopharyngeal microbiome was significantly higher in ARC patients than healthy controls (P < 0.01), but not for ocular microbiome. The clinical scores in all subjects were negatively correlated with the Shannon diversity for ocular (P = 0.014) and positively correlated with nasopharyngeal (P = 0.010) microbiome. While the ocular microbiome remained significantly distinct from nasopharyngeal microbiome in terms of both alpha and beta diversity in both healthy subjects and ARC patients, significant differences of relative abundance of certain phyla (Bacteroidetes, Cyanobacteria, and Deinococcus‐Thermus) and genera (Dolosigranulum and Moraxella) between nasal and ocular surfaces were only detected in healthy controls, but not in the ARC subjects, suggesting the microbial composition at both body sites becoming more similar at disease state.

Conclusion

This study reported (a) a higher alpha diversity in ocular than nasopharyngeal microbiome in both ARC patients and controls, and (b) nasopharyngeal microbiome became more diverse in ARC patients than in controls. Our results suggested an interaction of the microbiome between ocular and nasal compartments in patients with ARC.
Pyrophosphate‐fructose 6‐phosphate 1‐phosphotransferase (PFP1) regulates starch biosynthesis and seed development via heterotetramer formation in rice (Oryza sativa L.)
Authors: Chen Chen , He Bingshu , Liu Xingxun , Ma Xiaoding , Liu Yujie , Yao Hong‐Yan , Zhang Peng , Yin Junliang , Wei Xin , Koh Hee‐Jong , Yang Chen , Xue Hong‐Wei , Fang Zhengwu , Qiao Yongli
Published: May 2019

Pyrophosphate‐fructose 6‐phosphate 1‐phosphotransferase (PFP1) reversibly converts fructose 6‐phosphate and pyrophosphate to fructose 1, 6‐bisphosphate and orthophosphate during glycolysis, and has diverse functions in plants. However, mechanisms underlying the regulation of starch metabolism by PFP1 remain elusive. This study addressed the function of PFP1 in rice floury endosperm and defective grain filling. Compared with the wild type, pfp1‐3 exhibited remarkably low grain weight and starch content, significantly increased protein and lipid content, and altered starch physicochemical properties and changes in embryo development. Map‐based cloning revealed that pfp1‐3 is a novel allele and encodes the regulatory β‐subunit of PFP1 (PFP1β). Measurement of nicotinamide adenine dinucleotide (NAD+) showed that mutation of PFP1β markedly decreased its enzyme activity. PFP1β and three of four putative catalytic α‐subunits of PFP1, PFP1α1, PFP1α2, and PFP1α4, interacted with each other to form a heterotetramer. Additionally, PFP1β, PFP1α1 and PFP1α2 also formed homodimers. Furthermore, transcriptome analysis revealed that mutation of PFP1β significantly altered expression of many essential enzymes in starch biosynthesis pathways. Concentrations of multiple lipid and glycolytic intermediates and trehalose metabolites were elevated in pfp1‐3 endosperm, indicating that PFP1 modulates endosperm metabolism, potentially through reversible adjustments to metabolic fluxes. Taken together, these findings provide new insights into seed endosperm development and starch biosynthesis and will help in the breeding of rice cultivars with higher grain yield and quality.
A fine‐scale genetic linkage map reveals genomic regions associated with economic traits in walnut (Juglans regia)
Authors: Aradhya Mallikarjuna K. , Velasco Dianne , Wang Ji‐Rui , Ramasamy Ramesh , You Frank M. , Leslie Chuck , Dandekar Abhaya , Luo Ming‐Cheng , Dvorak Jan
Published: May 2019

A genetic linkage map of walnut containing 2,220 single nucleotide polymorphisms (SNPs) in 16 linkage groups (LGs) was constructed using an F1 mapping population from a cross between “Chandler” and “Idaho,” two contrasting heterozygous parents. Five quantitative yield traits, lateral fruitfulness, harvest date and three nut traits (shell thickness, nut weight and kernel fill) were then mapped on to linkage groups. A significant quantitative trait locus (QTL) in LG 11 with negative additive effects suggested heterozygote superiority in the expression of lateral bearing. A set of three QTLs explaining ~10% of the variation in harvest date was located in LG 1. Shell thickness, nut weight and kernel fill were under the control of two to three linked pleiotropic QTLs in LG 1 segregating from “Idaho.” The marginal positive additive effects of QTLs for harvest date, shell thickness and nut weight and small negative additive effects for kernel fill suggested that the QTLs had a marginal effect on the expression of these traits.
Toward an understanding of the habenula's various roles in human depression
Authors: Aizawa Hidenori , Zhu Meina
Published: May 2019

The habenula is an evolutionarily conserved structure in the vertebrate brain. Lesion and electrophysiological studies in animals have suggested that it is involved in the regulation of monoaminergic activity through projection to the brain stem nuclei. Since studies in animal models of depression and human functional imaging have indicated that increased activity of the habenula is associated with depressive phenotypes, this structure has attracted a surge of interest in neuroscience research. According to pathway‐ and cell‐type‐specific dissection of habenular function in animals, we have begun to understand how the heterogeneity of the habenula accounts for alteration of diverse physiological functions in depression. Indeed, recent studies have revealed that the subnuclei embedded in the habenula show a wide variety of molecular profiles not only in neurons but also in glial cells implementing the multifaceted regulatory mechanism for output from the habenula. In this review, we overview the known facts on mediolateral subdivision in the habenular structure, then discuss heterogeneity of the habenular structure from the anatomical and functional viewpoint to understand its emerging role in diverse neural functions relevant to depressive phenotypes. Despite the prevalent use of antidepressants acting on monoamine metabolisms, ~30% of patients with major depression are reported to be treatment‐resistant. Thus, cellular mechanisms deciphering such diversity in depressive symptoms would be a promising candidate for the development of new antidepressants.
Ethosuximide‐induced drug reaction with eosinophilia and systemic symptoms with mediastinal lymphadenopathy
Authors: Werbel Tyler , Castrovinci Philip , Contestable James
Published: May 2019

Lymphadenopathy is a common sign for drug reaction and eosinophilia with systemic symptoms (DRESS) syndrome, but hilar and mediastinal lymphadenopathy may be underreported. We describe a 7‐year‐old boy who started taking ethosuximide for absence seizures and presented with diffuse rash, fever, elevated transaminases, facial swelling, and hilar and mediastinal lymphadenopathy. His mediastinal lymphadenopathy was concerning for lymphoma, which led to more invasive testing to rule out malignancy. This report highlights an unusual and likely underreported presenting sign of DRESS syndrome in children.
Temporal dynamic modulation of acute stress on error processing in healthy males
Authors: Hu Na , Hu Xueping , Xu Zhenzhen , Li Qing , Long Quanshan , Gu Yan , Chen Antao
Published: May 2019

Error processing is critical for adaptive behaviors. Acute stress has been found to influence error processing. However, the neural dynamic correlates underlying this modulation remain elusive. To address this issue, we recruited 39 healthy male participants, who performed a two‐session task before and after an acute stress test while their behavioral and EEG data were recorded. The participants were randomly exposed to either a stress condition (Maastricht Acute Stress Test) or a control condition. The stress test consisted of several hand immersion tasks (ice‐cold water, 2°C) and mental arithmetic tasks. A color‐word Stroop task was used to investigate the stress effect on error responses. Based on the level of stress‐induced cortisol, the participants in the stress group were further classified as low (N = 13) or high (N = 13) cortisol responders. The results indicated that only in the high cortisol responders, the error‐related negativity (ERN) amplitude was reduced after acute stress. In addition, the ∆ERN in the high cortisol responders was significantly smaller than that in the low cortisol responders. These results suggest that acute stress impairs error detection. However, the error positivity amplitudes increased in the stress group compared to the control group, indicating that acute stress leads to greater error assessment. Taken together, these results suggest that acute stress impairs error detection, which is modulated by individuals’ response level following acute stress, and leads to more emotional and/or motivational responses to the error signal once the error is consciously realized.
Differential effects of instructed and objective feedback reliability on feedback‐related brain activity
Authors: Di Gregorio Francesco , Ernst Benjamin , Steinhauser Marco
Published: May 2019

Feedback reliability refers to the probability that the same decision leads to the same positive or negative feedback in the future. Previous research has shown that unreliable feedback is associated with attenuated feedback‐related brain activity in ERPs, represented by a reduced fronto‐central valence effect (feedback‐related negativity or reward positivity) and a reduced feedback‐related P3. Here, we asked whether these effects reflect top‐down mechanisms or whether they can be explained by implicit feedback‐outcome contingency learning. In two experiments, participants performed a trial‐and‐error learning task while subjective or objective feedback reliability was varied across blocks. In Experiment 1, we manipulated instructed feedback reliability while holding objective feedback reliability constant. Low instructed feedback reliability led to an attenuation of the fronto‐central valence effect and the P3. In Experiment 2, we manipulated objective feedback reliability while holding instructed feedback reliability constant. Here, no modulation of feedback‐related brain activity was observed. These results suggest that effects of feedback reliability are driven by top‐down mechanisms based on explicit knowledge. Specifically, effects on the fronto‐central valence effect could indicate a devaluation of unreliable feedback or a bias on the generation or utilization of reward prediction errors.
Using strip seeding to test how restoration design affects randomness of community assembly
Authors: Gornish Elise S. , Shaw Julea , Gillespie Breahna M.
Published: May 2019

The reestablishment and enhancement of plant diversity is typically a priority for restoration practitioners. Since diversity and stability can be affected by the magnitude to which randomness drives community dynamics, modifying randomness (via habitat heterogeneity) could provide utility for vegetation managers. We investigated the value of using strip seeding to manipulate the magnitude to which randomness structures plant communities across a grassland in Davis, California. Five years after restoring portions of a degraded site (0, 33, 50, 66, and 100% of an area) to create patches of seeded and unseeded strips, we assessed the amount of Jaccard dissimilarity across quadrats within strips and estimated the magnitude to which randomness contributed to community assembly (termed the nugget). We found higher nuggets in the 66 and 33% seeding treatment levels compared to the 0, 50, and 100% seeding treatment levels. In the 33 and 66% level of the seeding treatment, we also found that unseeded strips, which are regularly exposed to random events of dispersal from seeded strips, had a higher nugget than seeded strips. This work suggests that strategic seeding techniques that enhance habitat heterogeneity can increase the role of randomness in community dynamics. Strip seeding strategies appear to provide utility as a tool to indirectly enhance diversity across a degraded site.
Mesopotamian astrology
Authors: Monroe M. Willis
Published: May 2019

Divination in the Ancient Near East took many forms. One of the most important practices, however, was astrology—the art of observing the sky and weather for signs. The first written evidence for this began in the late third millennium BCE, but it probably existed even earlier. Throughout the early and middle centuries of the second millennium BCE, there are glimpses of astrology preserved in letters and other texts. It was not until the end of the second millennium that the practice began to be codified and written down in standard works. During the Neo‐Assyrian period (911–609 BCE) astrology gained a new level of importance in the royal court with scholars (employed by the court) constantly watching the sky and writing to the king. Finally, during the latter half of the first millennium BCE (the Neo‐Babylonian, Achaemenid, and Hellenistic periods), astrology underwent a period of innovation alongside the continued use of standard practices. Throughout its history, Mesopotamian astrology functioned together with other forms of divination. The examination of an animal's liver, for example, was often used to check the results of an astrological observation. Astrology was one of many ways the messages of the gods could be decoded in the Ancient Near East. It developed a complicated series of texts and skilled practitioners and had a great impact on the fate of its adherents.
HLA‐B*40:62, an HLA‐B*40 variant, detected in a Taiwanese potential unrelated hematopoietic stem cell donor
Authors: Yang Kuo‐Liang , Lin Py‐Yu
Published: May 2019

One nucleotide substitution in codon 140 of HLA‐B*40:01:01 results in a novel allele, HLA‐B*40:62.
Preventing adhesions in laparoscopic surgery: the role of anti‐adhesion agents
Authors: Aref‐Adib Mehrnoosh , Phan Timothy , Ades Alexandre
Published: May 2019

Key content

Surgical injury causes the release of cytokines, growth factors, cell adhesion molecules and histamine, creating an inflammatory response, which can lead to adhesion formation in the peritoneal cavity.

Compared with open surgery, laparoscopy reduces the risk of adhesion formation, but the risk is not completely eliminated.

Adhesion formation is multifactorial and depends on patient healing, surgical technique and equipment factors.

Adhesions after gynaecological surgery can have long‐term consequences including small bowel obstruction, chronic pelvic pain, deep dyspareunia and female subfertility.

There are a variety of anti‐adhesion agents with different properties available for use in laparoscopic surgery.

Learning objectives

To review the pathophysiology of adhesion formation after laparoscopic surgery.

To identify which anti‐adhesive agents are currently available in clinical practice.

To understand the mechanism by which adhesion prevention agents work.

To review the effectiveness and cost implications of anti‐adhesive agents.

Ethical issues

Given the extra cost of anti‐adhesive agents, and the limited information regarding their efficacy, should surgeons be using them in laparoscopic gynaecological surgery?

Is the use of anti‐adhesion agents complementary or detrimental to meticulous surgical technique?
The Impact of Fake News and the Emerging Post-Truth Political Era on Nigerian Polity: A Review of Literature
Authors: Pate Umaru A. , Gambo Danjuma , Ibrahim Adamkolo Mohammed
Published: May 2019

Since the rising to notoriety of the present ‘genre’ of malicious content peddled as ‘fake news’ (mostly over social media) in 2016 during the United States’ presidential election, barely three years until Nigeria’s 2019 general elections, fake news has made dangerously damaging impacts on the Nigerian society socially, politically and economically. Notably, the escalating herder-farmer communal clashes in the northern parts of the country, ethno-religious crises in Taraba, Plateau and Benue states and the furiously burning fire of the thug-of-war between the ruling party (All Progressives Congress, APC) and the opposition, particularly the main opposition party (People’s Democratic Party, PDP) have all been attributed to fake news, untruth and political propaganda. This paper aims to provide further understanding about the evolving issues regarding fake news and its demonic impact on the Nigerian polity. To make that contribution toward building the literature, extant literature and verifiable online news content on fake news and its attributes were critically reviewed. This paper concludes that fake news and its associated notion of post-truth may continue to pose threat to the Nigerian polity unless strong measures are taken. For the effects of fake news and post-truth phenomena to be suppressed substantially, a tripartite participation involving these key stakeholders – the government, legislators and the public should be modelled and implemented to the letter.
Appendicular abscess masquerading as right testicular mass
Authors: Vedamanickam Pon Rachel
Published: May 2019

A 38-year-old man presented with an acute onset of pain and swelling of the right testis. On examination, he was tender in the right iliac fossa (RIF) with a grossly enlarged and tender right testis. Ultrasonography and contrast-enhanced CT of the abdomen and pelvis revealed right epididymo-orchitis, a bulky and inflamed right spermatic cord and a well- defined, thick-walled collection in the RIF.
Assessment of nurses’ competence to care for sexually assaulted trans persons: a survey of Ontario’s Sexual Assault/Domestic Violence Treatment Centres
Authors: Du Mont Janice , Kosa Sarah Daisy , Solomon Shirley , Macdonald Sheila
Published: May 2019

Objective

Our primary objective was to examine the perceived level of competence and need for additional training among nurses engaged in the care of sexually assaulted trans persons. Among these nurses, a secondary objective was to examine the impact of prior trans-specific training on their perceived level of competence.

Setting

An online survey was distributed to nurses working within 35 hospital-based violence treatment centres in Ontario, Canada.

Respondents

95 nurses completed the survey.

Primary and secondary outcome measures

The perceived level of competence and need for additional training overall and on 31 specific items associated with initial assessment, medical care, forensic examination and discharge and referral, as well as sociodemographic, work experience and prior training information, was collected and summarised using descriptive and inferential statistics.

Results

Almost three-quarters (73.1%) of nurses indicated that they had little or no expertise in caring for trans clients who have been sexually assaulted and 95.7% strongly agreed/agreed that they would benefit from (additional) training. The mean level of competence was 4.00 or greater (strongly agreed/agreed with the statement) for just 9 out of the 31 competencies related to caring for trans clients. Having undergone prior trans-specific training (61.3%) was associated with greater perceived competence in initial assessment (p=0.004) and medical care (p<0.001).

Conclusion

It is of key importance that nurses demonstrate knowledge of and respond competently to the complex and diverse needs of trans survivors of sexual assault. The nurses surveyed overwhelmingly identified a need for additional training to care for sexually assaulted trans clients. It appears that additional training would be beneficial, as prior trans-specific training was associated with higher perceived competence in delivering certain aspects of care.
Transepithelial versus epithelium-off corneal collagen cross-linking for corneal ectasia: protocol for a systematic review, meta-analysis and trial sequential analysis of randomised controlled trials
Authors: Nath Siddharth , Shen Carl , Koziarz Alex , Banfield Laura , Fava Mark A , Hodge William G
Published: May 2019

Introduction

Corneal ectasias are progressive, degenerative ocular diseases defined by abnormal structural changes in the cornea, leading to distortion of vision and substantial reduction in quality of life. Corneal collagen cross-linking (CXL) increases the biomechanical rigidity of the cornea and has been shown to halt ectatic processes. The established CXL protocol requires removal of the corneal epithelium. However, some surgeons have proposed transepithelial approaches to enhance patient recovery and minimise adverse events. Whether novel transepithelial approaches are as effective in arresting ectasia as the established epithelium-off protocol remains unclear. This study will systematically review the evidence on transepithelial CXL approaches and compare it to the epithelium-off protocol.

Methods and analysis

We will include randomised controlled trials (RCTs) comparing transepithelial and epithelium-off CXL for any corneal ectasia. We will search 16 electronic databases including MEDLINE and Embase, as well as the grey literature. Two reviewers will independently screen search results to identify eligible studies, complete data abstraction and conduct quality assessment. We will assess the quality of individual RCTs using the Cochrane risk of bias assessment tool. Our primary outcome will be the change in maximal keratometry at 12 months after treatment, and we will examine 11 additional outcomes. We will summarise our analyses by measures of association (relative risk or odds ratio) and corresponding 95% confidence intervals (CIs) for dichotomous outcomes and weighted mean differences with 95% CIs for continuous outcomes. Prespecified subgroup analyses will be conducted to explore heterogeneity. The overall quality of evidence will be rated using the Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination

Ethics approval is not required for this systematic review as it draws from previously published data. Results of the study will be submitted to a peer-reviewed journal for publication and discussed at conferences and seminars.

PROSPERO registration number

CRD42018102069
Pilot evaluation of the Sleep Ninja: a smartphone application for adolescent insomnia symptoms
Authors: Werner-Seidler Aliza , Wong Quincy , Johnston Lara , O’Dea Bridianne , Torok Michelle , Christensen Helen
Published: May 2019

Objectives

The aim of this study was to test the feasibility, acceptability and preliminary effects of a recently developed smartphone application, Sleep Ninja, for adolescent sleep difficulties.

Setting

The study was conducted online with Australian individuals recruited through the community.

Participants

Participants were 50 young people aged 12–16 years with sleep difficulties.

Design

A single-arm pre–post design was used to evaluate feasibility, acceptability and sleep and mental health variables at baseline and postintervention.

Intervention

Cognitive–behavioural therapy for insomnia informed the development of the Sleep Ninja. The core strategies covered by the app are psychoeducation, stimulus control, sleep hygiene and sleep-related cognitive therapy. It includes six training sessions (lessons), a sleep tracking function, recommended bedtimes based on sleep guidelines, reminders to start a wind-down routine each night, a series of sleep tips and general information about sleep. Users progress through each training session and conclude the 6-week programme with a black belt in sleep.

Outcome measures

Feasibility was evaluated based on consent rates, adherence and attrition, acceptability was assessed using questionnaires and a poststudy interview, and sleep, depression and anxiety variables were assessed at baseline and postintervention.

Results

Data indicated that the Sleep Ninja is a feasible intervention and is acceptable to young people. Findings showed that there were significant improvements on sleep variables including insomnia (within-group effect size d=−0.90), sleep quality (d=−0.46), depression (d=−0.36) and anxiety (d=−0.41).

Conclusions

The Sleep Ninja is a promising intervention that could assist adolescents who experience sleep difficulties. A follow-up randomised controlled trial is now warranted.

Trial registration number

ACTRN12617000141347
End-stage renal disease—financial costs and years of life lost in Panama: a cost-analysis study
Authors: Moreno Velásquez Ilais , Tribaldos Causadias Maribel , Valdés Régulo , Gómez Beatriz , Motta Jorge , Cuero César , Herrera-Ballesteros Víctor
Published: May 2019

Objectives

Central America is a region with an elevated burden of chronic kidney disease (CKD); however, the cost of treatment for end-stage renal disease (ESRD) remains an understudied area. This study aimed to investigate the direct costs associated with haemodialysis (HD) and peritoneal dialysis (PD) in public and private institutions in Panama in 2015, to perform a 5-year budget impact analysis and to calculate the years of life lost (YLL) due to CKD.

Design

A retrospective cost-analysis study using hospital costs and registry-based data.

Setting

Data on direct costs were derived from the public and private sectors from two institutions from Panama. Data on CKD-related mortality were obtained from the National Mortality Registry.

Methods

A budget impact analysis was performed from the payer perspective, and five scenarios were estimated, with the assumption that the mix of dialysis modality use shifts towards a greater use of PD over time. The YLL due to CKD was calculated using data recorded between 1 January 2015 and 31 December 2015. The linear method was utilised for the analyses with the population aged 20–77 years old.

Results

In 2015, the total costs for dialysis in the public sector ranged from ~US$7.9  million (PD) to US$62  million (HD). The estimated costs were higher in the scenario in which a decrease in PD was assumed. The average annual loss due to CKD was 25 501 808.40 US$-YLL.

Conclusion

ESRD represents a major challenge for Panama. Our results suggest that an increased use of PD might provide an opportunity to substantially lower overall ESRD treatment costs.
Four delays of child mortality in Rwanda: a mixed methods analysis of verbal social autopsies
Authors: Roder-DeWan Sanam , Gupta Neil , Kagabo Daniel M , Habumugisha Lameck , Nahimana Evrard , Mugeni Catherine , Bucyana Tatien , Hirschhorn Lisa R
Published: May 2019

Objectives

We sought to understand healthcare-seeking patterns and delays in obtaining effective treatment for rural Rwandan children aged 1–5 years by analysing verbal and social autopsies (VSA). Factors in the home, related to transport and to quality of care in the formal health sector (FHS) were thought to contribute to delays.

Design

We collected quantitative and qualitative cross-sectional data using the validated 2012 WHO VSA tool. Descriptive statistics were performed. We inductively and deductively coded narratives using the three delays model, conducted thematic content analysis and used convergent mixed methods to synthesise findings.

Setting

The study took place in the catchment areas of two rural district hospitals in Rwanda—Kirehe and Southern Kayonza. Participants were caregivers of children aged 1–5 years who died in our study area between March 2013 and February 2014.

Results

We analysed 77 VSAs. Although 74% of children (n=57) had contact with the FHS before dying, most (59%, n=45) died at home. Many caregivers (44%, n=34) considered using traditional medicine and 23 (33%) actually did. Qualitative themes reflected difficulty recognising the need for care, the importance of traditional medicine, especially for ‘poisoning’ and poor perceived quality of care. We identified an additional delay—phase IV—which occurred after leaving formal healthcare facilities. These delays were associated with caregiver dissatisfaction or inability to adhere to care plans.

Conclusion

Delays in deciding to seek care (phase I) and receiving quality care in FHS (phase III) dominated these narratives; delays in reaching a facility (phase II) were rarely discussed. An unwillingness or inability toadhere to treatment plans after leaving facilities (phase IV) were an important additional delay. Improving quality of care, especially provider capacity to communicate danger signs/treatment plans and promote adherence in the presence of alternative explanatory models informed by traditional medicine, could help prevent childhood deaths.
Cash transfer programmes in lower-income and middle-income countries: understanding pathways to nutritional change—a realist review protocol
Authors: Floate Hilary J , Marks Geoffrey C , Durham Jo
Published: May 2019

Introduction

Child malnutrition continues to be a significant global public health concern. Nutrition-related interventions have changed and diversified over the last two decades, with increasing emphasis on nutrition-sensitive programmes that address underlying determinants of child malnutrition. Cash transfer programmes (CTPs) are used with increasing popularity in lower-income and middle-income countries to improve both food/nutrition insecurity and resilience. Available studies, however, provide mixed findings on the outcomes of CTPs for child nutritional status. This review is the first stage of a research project to develop evidence-informed theories of how CTPs affect child malnutrition. These will be empirically tested in the field and contribute to a better understanding of how, why, for whom and in what circumstances CTPs can be implemented to optimise impacts on child nutritional status.

Methods and analysis

This realist review is informed by available standards for realist reviews and follows a five-step process. In step 1, an initial scoping of literature identified potential contextual factors and underlying mechanisms that influence nutritional outcomes, and potential theories developed to address our research question. In step 2, a systematic literature search using multiple databases will be undertaken with papers screened using defined inclusion/exclusion criteria. In step 3, included studies will be appraised, data extracted into a bespoke data extraction tool and used to test and further refine our explanatory framework. The fourth step will synthesise, using a mix of inductive and deductive analytical processes to identify patterns, link chains of inference and tracking and linking of articles. The final step involves dissemination of a preliminary theory for feedback prior to empirically testing it in Kenya and Ethiopia where large-scale CTPs are being implemented.

Ethics and dissemination

This review will not involve primary data collection. Findings will be presented in accordance with Realist and Meta-Narrative Evidence Synthesis: Evolving Standards guidelines and published in a peer-reviewed journal.

Trial registration number

CRD42018110735.
Rifled carotid: Internal carotid artery thrombosis from prolonged carrying of a military rifle
Authors: Ahmad Faiz MH , Nanda S K , R S , Grewal D S
Published: May 2019

Background

Traumatic carotid artery thrombosis is uncommon and it usually results from penetrating injuries and less commonly secondary to blunt trauma. It can lead to delayed clinical presentation, which leads to delay in the diagnosis. Soldiers in combat scenario also can present with such an illness, which results from varied modes of injuries. Our case illustrates an unusual cause of carotid thrombosis.

Case presentation

Our patient is a 37-year-old soldier who developed neck pain and headache following a 5 km training run with rifle on the shoulder and subsequently developed left upper limb weakness and evaluation revealed extracranial right internal carotid thrombosis. He was managed with anticoagulants and antiplatelets with complete resolution of the thrombosis and complete recovery of the weakness.

Conclusion

Blunt trauma to the neck in the form of carrying a rifle for a prolonged duration can result in injury to the carotid vessels leading to delayed neurological presentation. Educating the troops regarding such a mode of illness will prevent such a catastrophic nature of vascular injury resulting in ischaemic stroke.
Characterization of the western white pine TIR-NBS-LRR (PmTNL2) gene by transcript profiling and promoter analysis
Authors: Liu Jun-Jun , Xiang Yu
Published: May 2019

Proteins with nucleotide-binding site (NBS) and leucine-rich repeats (LRRs) have been reported to play important roles in plant disease resistance, growth, and development. However, no comprehensive analysis of this protein family has been performed in conifers. Here we report that the Pinus monticola PmTNL2 gene is a member of the NBS-LRR superfamily. Quantitative reverse transcription-PCR (qRT-PCR) analysis revealed that the PmTNL2 transcript was expressed in a tissue-specific pattern with extensive regulation by various environmental stimuli in western white pine seedlings, suggesting its wide involvement in stress defense and diverse developmental processes. In silico analysis of the PmTNL2 promoter region revealed multiple cis-regulatory elements characterized with potential functions for development-, light-, and stress-regulated transcript expression. Expression patterns were largely confirmed by PmTNL2 promoter-directed reporter gene expression using stable transgenic Arabidopsis plants. Notably, the PmTNL2 promoter activity was highly expressed in shoot apical and floral meristems and was induced strongly with vascular specificity by pathogen infection. Our data has provided a fundamental insight into both expression regulation and putative functions of the PmTNL2 gene in the context of plant growth and development, as well as in responses to environmental stressors. Promoter application as a potential tool for tree improvement was further discussed.
A novel green synthesis of γ-Al2O3nanoparticles using soluble starch
Authors: Gao Huiying , Zhang Mengyao , Yang Hua , Li Zhiyong , Li Yankun , Chen Lan
Published: May 2019

In this research, nanocrystalline [Formula: see text]-[Formula: see text] powders have been synthesized by a novel mechanochemical method, through thermal decomposition of the ammonium aluminum carbonate hydroxide (AACH) precursor. The route involved using low-cost [Formula: see text] and [Formula: see text] as raw materials and environmental-friendly soluble starch as an effective dispersant. The precursor and product were characterized by simultaneous thermogravimetric and differential thermal analysis (TG-DTA), X-ray diffraction (XRD), transmission electron microscopy (TEM) and scanning electron microscopy (SEM). The results show that spherical [Formula: see text]-[Formula: see text] nanoparticles without hard agglomeration and with particle size in the range of 20–30 nm can be obtained. The crystallite size of products measured from XRD, SEM and TEM were in good agreement. This novel mechanochemical method combined with the use of environmentally benign starch has the advantages of simple operation, low calcination temperature and environmental safety, and will have good prospects for commercial production.
Weighted Densely Connected Convolutional Networks for Reinforcement Learning
Authors: Xia Min , Song Wenzhu , Sun Xudong , Liu Jia , Ye Tao , Xu Yiqing
Published: May 2019

A weighted densely connected convolution network (W-DenseNet) is proposed for reinforcement learning in this work. The W-DenseNet can maximize the information flow between all layers in the network by cross layer connection, which can reduce the phenomenon of gradient vanishing and degradation, and greatly improves the speed of training convergence. The weight coefficient introduced in W-DenseNet, the current layer received all the previous layers’ feature maps with different initial weights, which can extract feature information of different layers more effectively according to tasks. According to the weight adjusted by learning, the cross-layer connection is pruned to remove the cross-layer connection with smaller weight, so as to reduce the number of cross-layer. In this work, GridWorld and FlappyBird games are used for simulation. The simulation results of deep reinforcement learning based on W-DenseNet are compared with the traditional deep reinforcement learning algorithm and reinforcement learning algorithm based on DenseNet. The simulation results show that the proposed W-DenseNet method can make the results more convergent, reduce the training time, and obtain more stable results.
An Efficient Fully Homomorphic Encryption Scheme for Private Information Retrieval in the Cloud
Authors: Wang Xun , Luo Tao , Li Jianfeng
Published: May 2019

Information retrieval in the cloud is common and convenient. Nevertheless, privacy concerns should not be ignored as the cloud is not fully trustable. Fully Homomorphic Encryption (FHE) allows arbitrary operations to be performed on encrypted data, where the decryption of the result of ciphertext operation equals that of the corresponding plaintext operation. Thus, FHE schemes can be utilized for private information retrieval (PIR) on encrypted data. In the FHE scheme proposed by Ducas and Micciancio (DM), only a single homomorphic NOT AND (NAND) operation is allowed between consecutive ciphertext refreshings. Aiming at this problem, an improved FHE scheme is proposed for efficient PIR where homomorphic additions and multiplications are based on linear operations on ciphertext vectors. Theoretical analysis shows that when compared with the DM scheme, the proposed scheme allows multiple homomorphic additions and a single homomorphic multiplication to be performed. The number of allowed homomorphic additions is determined by the ratio of the ciphertext modulus to the upper bound of initial ciphertext noise. Moreover, simulation results show that the proposed scheme is significantly faster than the DM scheme in the homomorphic evaluation for a series of algorithms.
SYNTHESIS, CHARACTERIZATION AND THERMAL PROPERTIES OF 2,2′-DIBENZIMIDAZOLYL BUTANE AS A NOVEL CORROSION INHIBITORS FOR MILD STEEL IN SULFURIC ACID
Authors: EL AADAD H. , GALAI M. , CHAHINE A. , TOUHAMI M. EBN
Published: May 2019

This work aims at synthesis and characterization of 2,2[Formula: see text]-dibenzimidazolyl butane as an effective corrosion inhibitor of mild steel in sulfuric acid solution. A simple and efficient method for its synthesis in described. The chemical structure and surface morphology of 2,2[Formula: see text]-dibenzimidazolyl butane were characterized by mass spectrometry (MS), Fourier transform infrared (FTIR), Raman, 1H, [Formula: see text]C NMR spectroscopy and transmission electron microscopy (TEM). Its thermal decomposition and its variation in mass was studied by thermogravimetric analysis (TGA) coupled with differential thermal analysis (DTA). The molecular mass of 2,2[Formula: see text]-dibenzimidazolyl butane was determined to be at 290[Formula: see text]g/mol and its degradation was achieved at 455∘C. Then, the corrosion inhibition efficiency of 2,2[Formula: see text]-dibenzimidazolyl butane was studied with various concentrations in 0.5 M H2SO4 solution for mild steel by the potentiodynamic polarization and the electrochemical measurements. According to the results of electrochemical impedance spectroscopy, the inhibition efficiency decreased with concentration and reached its maximum (95.5%) at 100[Formula: see text]ppm. The polarization measurements showed that the prepared inhibitor acts as a cathodic type inhibitor. The mass loss tests are in accordance with the results of electrochemical measurements.
INFLUENCE OF THE MECHANICAL PROPERTIES ON THE WEAR BEHAVIOR OF a-C FILMS: AN ENERGY DESCRIPTION
Authors: GUO LI , ZHANG MINGJIONG , HU JIANQIANG , LU ZHIBIN , ZHANG GUANGAN , XU XIN
Published: May 2019

An energy dissipation model was raised, including the influence of film properties, counterpart, contact stress and adhesion strength between film and substrate. A new plastic deformation-tendency index was introduced. The new index was more appropriate in predicting the wear behavior of a-C films than hardness and H/E. Particularly, the critical value of the new index existed for film failure in the friction test. Realizing the limitation of the model, some improvement directions of the model were also discussed in this study.
Effects of Slenderness and Fundamental Frequency on the Dynamic Response of Adjacent Structures
Authors: Barrios Gonzalo , Nanayakkara Vinuka , De Alwis Pramodya , Chouw Nawawi
Published: May 2019

In conventional seismic design, the structure is often assumed to be fixed at the base. However, this assumption does not reflect reality. Furthermore, if the structure has close neighbors, the adjacent structures will alter the response of the structure considered. Investigations on soil–structure interaction and structure–soil–structure interaction have been performed mainly using numerical models. The present work addresses the dynamic response of adjacent single-degree-of-freedom models on a laminar box filled with sand. Impulse loads and simulated ground motions were applied. The standalone condition was also studied as a reference case. Models with different fundamental frequencies and slenderness were considered. Results from the impulse tests showed that the top displacement of the models with an adjacent structure was reduced compared with that of the standalone case. Changes in the fundamental frequency of the models due to the presence of an adjacent model were also observed. Results from ground motions showed amplification of the maximum acceleration and the top displacement of the models when both structures have a similar fundamental frequency.