bluuebunny/crossref_metadata_2025 huggingface dataset:
Non‐equivalence in old‐ and new‐flagellum daughter cells of a proliferative division in Trypanosoma brucei
Authors: Abeywickrema Movin , Vachova Hana , Farr Helen , Mohr Timm , Wheeler Richard J. , Lai De‐Hua , Vaughan Sue , Gull Keith , Sunter Jack D. , Varga Vladimir
Published: July 2019

Differentiation of Trypanosoma brucei, a flagellated protozoan parasite, between life cycle stages typically occurs through an asymmetric cell division process, producing two morphologically distinct daughter cells. Conversely, proliferative cell divisions produce two daughter cells, which look similar but are not identical. To examine in detail differences between the daughter cells of a proliferative division of procyclic T. brucei we used the recently identified constituents of the flagella connector. These segregate asymmetrically during cytokinesis allowing the new‐flagellum and the old‐flagellum daughters to be distinguished. We discovered that there are distinct morphological differences between the two daughters, with the new‐flagellum daughter in particular re‐modelling rapidly and extensively in early G1. This re‐modelling process involves an increase in cell body, flagellum and flagellum attachment zone length and is accompanied by architectural changes to the anterior cell end. The old‐flagellum daughter undergoes a different G1 re‐modelling, however, despite this there was no difference in G1 duration of their respective cell cycles. This work demonstrates that the two daughters of a proliferative division of T. brucei are non‐equivalent and enables more refined morphological analysis of mutant phenotypes. We suggest all proliferative divisions in T. brucei and related organisms will involve non‐equivalence.
Volunteer Management in Charity Storehouses: Experience, Congestion and Operational Performance
Authors: Urrea Gloria , Pedraza‐Martinez Alfonso J. , Besiou Maria
Published: July 2019

We study volunteer management at a charity storehouse operated by a large faith‐based organization. The storehouse runs entirely on volunteer efforts. We investigate the role of volunteer experience and storehouse congestion in the preparation of orders using a multi‐method approach. First, we conduct a field study to explore these relationships and collect data at the level of volunteers’ teams. These teams can pair volunteers with either different levels of experience (mixed pairing) or equal levels of experience (no‐mixed pairing). Second, we estimate the effects of volunteer experience and storehouse congestion on the order processing times empirically. Third, we build a simulation model to study how operational decisions—volunteers’ pairing in teams and whether to allow or impede storehouse congestion—affect two performance metrics: on‐time order preparation rate and additional time to prepare the orders, in steady conditions. Then, we simulate disaster conditions at the storehouse, that is, simultaneous surges in supply of volunteers and demand of orders. Contrary to extant literature on team collaboration, we find that no‐mixed pairing outperforms mixed pairing under disaster conditions with storehouse congestion. In fact, no‐mixed pairing improves the on‐time order preparation by 4.32% and the additional time to prepare the orders by 14.42% compared to mixed pairing. Moreover, under disaster conditions, a “controlled congestion” policy at the storehouse delivers the best performance metrics.
Adolescents with an entity theory of personality are more vigilant to social status and use relational aggression to maintain social status
Authors: Lee Hae Yeon , Yeager David S.
Published: July 2019

The present research proposed that one social‐cognitive root of adolescents' willingness to use relational aggression to maintain social status in high school is an entity theory of personality, which is the belief that people's social status‐relevant traits are fixed and cannot change. Aggregated data from three studies (N = 882) showed that first‐year high school adolescents in the United States who endorsed more of an entity theory were more likely to show cognitive and motivational vigilance to social status, in terms of judgments on a novel social categorization task and reports of goals related to demonstrating social status to peers. Those with an entity theory then showed a greater willingness to use relational aggression, as measured by retrospective self‐reports, responses to a hypothetical scenario, and a choice task. Discussion centers on theoretical and translational implications of the model and of the novel measures.
Extension at the coast of the Makran subduction zone (Iran)
Authors: Normand Raphaël , Simpson Guy , Bahroudi Abbas
Published: July 2019

In the Makran subduction zone, earthquake focal mechanisms and geodetic data indicate that the deforming prism currently experiences N–S compression. However, palaeostress inversions performed on normal faults observed along the coast reveal local stress components consistent with N‐S extension. Previously proposed mechanisms such as gravitational collapse are not favoured by N–S compression and surface uplift. We propose that the observed kinematics result from transient stress reversals following large earthquakes. During the interseismic period (now), the region experiences N–S compression. However, following a large reverse rupture on the subduction interface, stresses in the inner wedge relax, enabling a brief period of extensional faulting before a compressive stress state is re‐established. This mechanism, also observed in other subduction zones, requires low overall stresses in the upper plate and that the margin ruptures in large megathrust earthquakes that result in nearly complete stress drops.
Considering spatiotemporal processes in big data analysis: Insights from remote sensing of land cover and land use
Authors: Comber Alexis , Wulder Michael
Published: July 2019

Data are increasingly spatio‐temporal—they are collected some‐where and at some‐time. The role of proximity in spatial process is well understood, but its value is much more uncertain for many temporal processes. Using the domain of land cover/land use (LCLU), this article asserts that analyses of big data should be grounded in understandings of underlying process. Processes exhibit behaviors over both space and time. Observations and measurements may or may not coincide with the process of interest. Identifying the presence or absence of a given process, for instance disentangling vegetation phenology from stress, requires data analysis to be informed by knowledge of the process characteristics and, critically, how these manifest themselves over the spatio‐temporal unit of analysis. Drawing from LCLU, we emphasize the need to identify process and consider process phase to quantify important signals associated with that process. The aim should be to link the seriality of the spatio‐temporal data to the phase of the process being considered. We elucidate on these points and opportunities for insights and leadership from the geographic community.
Braj B. Kachru and Asian Englishes
Authors: Bolton Kingsley
Published: July 2019

This article discusses the range and scope of Braj Kachru's interests in Indian English and Asian Englishes, which were crucial to the development of world Englishes as a whole. The article begins with a discussion of the WE paradigm shift and then proceeds to highlight Kachru's contribution to Asian Englishes before moving on to provide an account of the contemporary dynamics of Asian Englishes from a sociolinguistic perspective. In this context, it is important to note that the field of ‘Asian Englishes’ owes much of its origins and development to the pioneer intellectual work of Braj Kachru from the 1960s onwards.
Effect of Biogas Composition Variations on Engine Characteristics Including Operational Limits of a Spark-Ignition Engine
Authors: Gupta Sachin Kumar , Mittal Mayank
Published: July 2019

Biogas is a promising alternative fuel to reduce the consumption of petroleum-based fuels in internal combustion (IC) engines. In this work, the effect of various biogas compositions on the performance, combustion, and emission characteristics of a spark-ignition (SI) engine is investigated. Additionally, the effect of Wobbe index (WI) of various fuel compositions was also evaluated on the operational limits of the engine. While considering a wide range of biogas compositions (including bio-methane), the percentage of carbon dioxide (CO2) (in a blend of methane and CO2) was increased from 0 to 50% (by volume). A single-cylinder, water-cooled, SI engine was operated at 1500 rpm over a wide range of operating loads with compression ratio of 8.5:1. With the increase in WI of the fuel, both low (limited by coefficient of variation (COV) of indicated mean effective pressure (IMEP)) and high (limited by pre-ignition) operating loads were decreased; however, it was found that the overall operating range was increased. Results also showed that for a given operating load, with the increase of CO2 percentage in the fuel, the brake thermal efficiency was decreased, and the flame initiation and combustion durations were increased. The brake thermal efficiency was decreased from 16.8% to 13.7%, when CO2 was increased from 0% to 40% in methane–CO2 mixture at 8 N·m load. Concerning to emissions, a considerable decrease was noted in nitric oxide, whereas hydrocarbon, carbon monoxide and carbon dioxide emissions were increased, with the increase in CO2 percentage.
Amphibians of the Oriental Region and the Moulouya River Basin of Morocco: distribution and conservation notes
Authors: Mabrouki Youness , Taybi Abdelkhaleq Fouzi , Skalli Ali , Sánchez-Vialas Alberto
Published: July 2019

Monitoring amphibian populations, especially over fragile ecosystems such as arid and semiarid landscapes, helps to detect demographic trends and ecological risks. During several campaigns carried out between 2013 and 2017 across the Moulouya River Basin and the Oriental Region of Morocco, we identified nine amphibian species from the 11 previously recorded. Amphibian population threats were also detected. In this work, we focused on the amphibians of the Oriental Region of Morocco with the aims to (1) update their distribution providing new records, (2) confirm the prevalence of some vulnerable species in the region, and (3) provide an overview of the ecology and conservation status of each species at a regional level.
Just Figures: A Method to Introduce Students to Data Analysis One Figure at a Time
Authors: Massimelli Julia , Denaro Kameryn , Sato Brian , Kadandale Pavan , Boury Nancy
Published: July 2019

Quantitative data analysis skills are basic competencies students in a STEM field should master. In this article, we describe a classroom activity using isolated figures from papers as a simple exercise to practice data analysis skills. We call this approach Just Figures. With this technique, instructors find figures from primary papers that address key concepts related to several of their course learning objectives. These figures are assigned as homework prior to class discussion. In class, instructors teach the lesson and include a 10- to 20-minute discussion of the figures assigned. Frequent and repeated discussion of paper figures during class increased students’ confidence in reading and analyzing data. The Just Figures approach also increased student accuracy when interpreting data. After six weeks of Just Figures practice, students scored, on average, three points higher on a 20-point data analysis assessment instrument than they had done before the Just Figures exercises. In addition, a course in which students consistently practiced Just Figures performed just as well on the data analysis assessment instrument and on a class exam dedicated to paper reading compared with courses where students practiced reading three entire papers. The Just Figures method is easy to implement and can effectively improve student data analysis skills in microbiology classrooms.
Granulomatosis polyangiitis
Authors: Sowida Mustafa
Published: July 2019

A 22-year-old female patient was admitted to hospital after being referred from the oral medicine clinic where she had been seen for persistent gingivitis and mouth ulcers. She described an insidious history of persistent fevers, dry cough and unexplained weight loss over 4–6 weeks. Imaging showed extensive bilateral pulmonary nodules with mediastinal lymphadenopathy and two lesions in the pancreas. MRI revealed these lesions to be well-defined fluid-filled cysts in the tail of the pancreas, without features of malignancy. Core biopsies taken from her lung nodules demonstrated features of vasculitis with granulomata. This was consistent with her positive immunology for c-antinuclear cytoplasmic antibodies and proteinase-3, which were sent after her fever failed to settle with antibiotic treatment. In keeping with a diagnosis of vasculitis, the patient showed a significant clinical and biochemical response to intravenous methylprednisolone and high-dose daily prednisolone thereafter.
A severe case of sclerosing mesenteritis
Authors: Corado Sofia Costa , Almeida Heitor , Baltazar José Rodrigues
Published: July 2019

Sclerosing mesenteritis is a rare benign disease presenting with chronic inflammation of the mesenteric adipose tissue and variable degrees of fibrosis. A 47-year-old black man presented to the emergency department with symptoms of small bowel obstruction, requiring surgical treatment. The laparotomy revealed a stenosis of the distal ileum with mesenteric thickening and an enterectomy was performed. The postoperative period was complicated by the maintenance of bowel obstruction. The patient underwent a second laparotomy, in which the fibrosing process of the mesentery was much aggravated, and an ileo-colic resection was needed. After knowledge of the histological diagnosis, the patient was started on immunomodulators with clinical improvement. At 26 months of follow-up, patient is asymptomatic under medical treatment. This is the first report, to our knowledge, of a patient with progressive fibrosis in such short period of time requiring surgical re-intervention for bowel obstruction, owing to sclerosing mesenteritis.
An EBV+ lymphoepithelioma-like cholangiocarcinoma in a young woman with chronic hepatitis B
Authors: Gearty Sofia V , Al Jurdi Ayman , Pittman Meredith E , Gupta Renuka
Published: July 2019

Epstein-Barr virus (EBV) is implicated in the tumorigenesis of a variety of malignancies, including Burkitt’s lymphoma, Hodgkin’s disease and nasopharyngeal carcinoma (NPC). EBV+ lymphoepithelioma-like cholangiocarcinoma (LELCC) is a rare type of intrahepatic cholangiocarcinoma with a distinct pathology and poorly understood treatment options. Morphologically, this neoplasm resembles undifferentiated NPC, a commonly EBV+ tumour with a prominent lymphoid infiltrate. Almost all of the current literature regarding LELCC describes early stage tumours that are treated surgically and achieve good outcomes. In contrast, this report documents a late stage LELCC treated unsuccessfully with systemic chemotherapy.
Is quality affordable for community health systems? Costs of integrating quality improvement into close-to-community health programmes in five low-income and middle-income countries
Authors: Kumar Meghan Bruce , Madan Jason J , Achieng Maryline Mireku , Limato Ralalicia , Ndima Sozinho , Kea Aschenaki Z , Chikaphupha Kingsley Rex , Barasa Edwine , Taegtmeyer Miriam
Published: July 2019

Introduction

Countries aspiring to universal health coverage view close-to-community (CTC) providers as a low-cost means of increasing coverage. However, due to lack of coordination and unreliable funding, the quality of large-scale CTC healthcare provision is highly variable and routine data about service quality are not trustworthy. Quality improvement (QI) approaches are a means of addressing these issues, yet neither the costs nor the budget impact of integrating QI approaches into CTC programme costs have been assessed.

Methods

This paper examines the costs and budget impact of integrating QI into existing CTC health programmes in five countries (Ethiopia, Indonesia, Kenya, Malawi, Mozambique) between 2015 and 2017. The intervention involved: (1) QI team formation; (2) Phased training interspersed with supportive supervision; which resulted in (3) QI teams independently collecting and analysing data to conduct QI interventions. Project costs were collected using an ingredients approach from a health systems perspective. Based on project costs, costs of local adoption of the intervention were modelled under three implementation scenarios.

Results

Annualised economic unit costs ranged from $62 in Mozambique to $254 in Ethiopia per CTC provider supervised, driven by the context, type of community health model and the intensity of the intervention. The budget impact of Ministry-led QI for community health is estimated at 0.53% or less of the general government expenditure on health in all countries (and below 0.03% in three of the five countries).

Conclusion

CTC provision is a key component of healthcare delivery in many settings, so QI has huge potential impact. The impact is difficult to establish conclusively, but as a first step we have provided evidence to assess affordability of QI for community health. Further research is needed to assess whether QI can achieve the level of benefits that would justify the required investment.
Interventions to improve water supply and quality, sanitation and handwashing facilities in healthcare facilities, and their effect on healthcare-associated infections in low-income and middle-income countries: a systematic review and supplementary scoping review
Authors: Watson Julie , D'Mello-Guyett Lauren , Flynn Erin , Falconer Jane , Esteves-Mills Joanna , Prual Alain , Hunter Paul , Allegranzi Benedetta , Montgomery Maggie , Cumming Oliver
Published: July 2019

Introduction

Healthcare-associated infections (HCAIs) are the most frequent adverse event compromising patient safety globally. Patients in healthcare facilities (HCFs) in low-income and middle-income countries (LMICs) are most at risk. Although water, sanitation and hygiene (WASH) interventions are likely important for the prevention of HCAIs, there have been no systematic reviews to date.

Methods

As per our prepublished protocol, we systematically searched academic databases, trial registers, WHO databases, grey literature resources and conference abstracts to identify studies assessing the impact of HCF WASH services and practices on HCAIs in LMICs. In parallel, we undertook a supplementary scoping review including less rigorous study designs to develop a conceptual framework for how WASH can impact HCAIs and to identify key literature gaps.

Results

Only three studies were included in the systematic review. All assessed hygiene interventions and included: a cluster-randomised controlled trial, a cohort study, and a matched case-control study. All reported a reduction in HCAIs, but all were considered at medium-high risk of bias. The additional 27 before-after studies included in our scoping review all focused on hygiene interventions, none assessed improvements to water quantity, quality or sanitation facilities. 26 of the studies reported a reduction in at least one HCAI. Our scoping review identified multiple mechanisms by which WASH can influence HCAI and highlighted a number of important research gaps.

Conclusions

Although there is a dearth of evidence for the effect of WASH in HCFs, the studies of hygiene interventions were consistently protective against HCAIs in LMICs. Additional and higher quality research is urgently needed to fill this gap to understand how WASH services in HCFs can support broader efforts to reduce HCAIs in LMICs.

PROSPERO registration number

CRD42017080943.
Association between diabetes-related self-care activities and positive health: a cross-sectional study
Authors: Zhao Fang-Fang , Suhonen Riitta , Katajisto Jouko , Stolt Minna , Leino-Kilpi Helena
Published: July 2019

Objectives

The study aimed to examine the diabetes-related self-care activities (DRSCA) in association with positive health consisting of resilience, subjective well-being (SWB) and disease-related quality of life (DRQoL), and the associations of background information with resilience, SWB and DRQoL.

Design

A cross-sectional study.

Methods

A convenience sample of people with type 2 diabetes (T2DM) was recruited from two tertiary hospitals in eastern China. Self-reported survey data included DRSCA, resilience, SWB, DRQoL, and background information comprising demographics and social support. Data were analysed using hierarchical multiple regression analyses.

Results

Two hundred and forty-six valid questionnaires were analysed. Among the components of positive health, hierarchical multiple regression analysis showed that DRSCA were significantly associated with improved SWB (β=0.140, p=0.020), but not with resilience and DRQoL after adjusting for background information. Participants with higher level of education had higher resilience and men had higher SWB than women. Social support (β=0.186, p=0.003) in Model 1 and resilience (β=0.298, p<0.001) in Model 2 were positively associated with SWB.

Conclusions

This study indicated an association between DRSCA and one component of positive health, namely SWB. This finding could help motivate patients to perform DRSCA and to improve SWB in people with T2DM. In addition, the fact that demographics, for example, gender, were associated with SWB and education was associated with resilience also needs to be accommodated when aiming to improve SWB and build resilience.

Trial registration number

NCT02594748
One-year trial of 12-hour shifts in a non-intensive care unit and an intensive care unit in a public hospital: a qualitative study of 24 nurses’ experiences
Authors: Ose Solveig Osborg , Tjønnås Maria Suong , Kaspersen Silje Lill , Færevik Hilde
Published: July 2019

Objectives

The aim of this study was to provide recommendations to hospital owners and employee unions about developing efficient, sustainable and safe work-hour agreements. Employees at two clinics of a hospital, one a non-intensive care and the other a newborn intensive care unit (ICU), trialled 12-hour shifts on weekends for 1 year.

Methods

We systematically recorded the experiences of 24 nurses’ working 12-hour shifts, 16 in the medical unit and 8 in the ICU for 1 year. All were interviewed before, during and at the end of the trial period. The interview material was recorded, transcribed to text and coded systematically.

Results

The experiences of working 12-hour shifts differed considerably between participants, especially those in the ICU. Their individual experiences differed in terms of health consequences, effects on their family, appreciation of extra weekends off, perceived effects on patients and perceived work task flexibility.

Conclusions

The results indicate that individual preference for working 12-hour shifts is a function of own health situation, family situation, work load tolerance, degree of sleep problems, personality and other factors. If the goal is to recruit and retain nurses, nurses should be free to choose to work 12-hour shifts.
Smartphone-supported Positive Adjustment Coping Intervention (PACI) for couples undergoing fertility treatment: a randomised controlled trial protocol
Authors: Schick Maren , Roesner Sabine , Germeyer Ariane , Moessner Markus , Bauer Stephanie , Ditzen Beate , Wischmann Tewes
Published: July 2019

Introduction

Infertility generally counts as a profound crisis in the lives of couples and as an emotionally stressful experience. For couples undergoing fertility treatment, this is especially true of the waiting period following embryo transfer, which couples say is the most stressful period during treatment. However, at this specific phase, psychosocial counselling is not always available on the spot. The aim of this randomised controlled trial (RCT) study was to test the Positive Adjustment Coping Intervention (PACI), a low-dose, smartphone-supported psychological intervention for women and men undergoing fertility treatment.

Methods and analysis

The effectiveness of PACI is tested by means of a prospective two-arm RCT. During the 14-day waiting period between oocyte puncture/oocyte thawing and pregnancy test, participants are randomly assigned to one of the two groups, and both women and men receive daily text messages on their smartphones. One group receives text messages with statements reflecting positive-adjustment coping attitudes, the other group messages containing cognitive distractions. The primary outcome of this study is the reduction of psychosocial burden during the waiting period of reproductive treatment. Furthermore, we want to assess whether there are differences between the interventions in a pre-post assessment. The secondary outcomes are information on perceived effectiveness and practicability of the intervention one month after the waiting period.

Ethics and dissemination

Ethical approval has been obtained from the Ethics Committee of Heidelberg University Faculty of Medicine (S-074/2017). Study findings are planned for dissemination via peer-reviewed journal articles and at national and international conferences.

Trial registration number

NCT03118219; Pre-results.

Protocol version

Version 2.0 dated 18/02/2019.
Acupuncture for cancer pain: protocol for a pilot pragmatic randomised controlled trial
Authors: He Yihan , May Brian H , Zhang Anthony Lin , Guo Xinfeng , Liu Yihong , Qu Yanchun , Chang Xuesong , Lu Chuan-jian , Xue Charlie Changli , Zhang Haibo
Published: July 2019

Introduction

Although acupuncture has been recommended for alleviating cancer pain by clinical guidelines, the level of the supporting evidence needs to be improved. A pragmatic randomised controlled trial (pRCT) in a hospital setting would provide real-world assessments of the overall clinical effects of acupuncture. This pilot trial aims to explore the feasibility and provide data for sample size calculations for a pRCT evaluating the effectiveness of acupuncture as an adjunctive therapy to routine medical care for cancer pain.

Methods and analysis

Thirty patients with cancer admitted to the oncology department with moderate or severe pain will be recruited. Participants will be randomised at a ratio of 1:1 to the adjunctive acupuncture group or a control group which receives routine pain management without acupuncture. The standardised section of the acupuncture protocol will be developed based on the results of reviews of the literature, recommendations in clinical guidelines and interviews with clinical experts. The acupuncturist will be allowed to tailor the protocol according to the individual situation of each participant. Primary outcomes relevant to the feasibility of conducting a fully powered trial include: numbers and proportions of participants recruited, screened, consented and randomised; numbers and reasons for withdrawals and dropouts; numbers and types of adverse events; feasibility of implementing the trial procedures; evaluation of the comprehensiveness and ease-of-use of the case report form. Secondary outcomes are clinical measurements of the effectiveness of the treatment that are intended for use in the full-scale trial. Analysis of feasibility will be descriptive and pain intensity measures will be analysed using mixed-effects regression.

Ethics and dissemination

Ethics approval was obtained from the Institutional Ethics Committee of Guangdong Provincial Hospital of Chinese Medicine (approval no: Z2017-184-01) and RMIT University Human Research Ethics Committee (reference no: 21361). Results will be disseminated in a peer-reviewed journal, and trial participants will be informed via email and/or phone calls.

Trial registration number

ChiCTR1800017023
Coverage and factors associated with full immunisation among children aged 12–59 months in Bangladesh: insights from the nationwide cross-sectional demographic and health survey
Authors: Sarker Abdur Razzaque , Akram Raisul , Ali Nausad , Sultana Marufa
Published: July 2019

Objective

To estimate the coverage and factors associated with full immunisation coverage among children aged 12–59 months in Bangladesh.

Study design

The study is cross sectional in design. Secondary dataset from Bangladesh Demographic and Health Survey was used for this analysis. Immunisation status was categorised as ‘fully immunised’ if the children had received all the eight recommended vaccine doses otherwise ‘partially/unimmunised’.

Settings

Bangladesh.

Participant

Children aged 12–59 months were the study participants. Participants were randomly selected through a two-stage stratified sampling design. A total of 6230 children were eligible for the analysis.

Results

About 86% of the children (5356 out of 6230) were fully immunised. BCG has the highest coverage rate (97.1%) followed by oral polio vaccine 1 (97%) and pentavalent 1 (96.6%), where the coverage rate was the lowest for measles vaccine (88%). Coverage was higher in urban areas (88.5%) when compared with rural ones (85.1%). Full immunisation coverage was significantly higher among children who lived in the Rangpur division (adjusted OR (AOR)=3.46; 95% CI 2.45 to 4.88, p<0.001), were 48–59 months old (AOR=1.32; 95% CI 1.06 to 1.64, p=0.013), lived in a medium size family (AOR=1.56; 95% CI 1.32 to 1.86, p<0.001), had parents with a higher level of education (AOR=1.96; 95% CI 1.21 to 3.17, p=0.006 and AOR=1.55; 95% CI 1.05 to 2.29, p=0.026) and belonged to the richest families (AOR=2.2; 95% CI 1.5 to 3.21, p<0.001). The likelihood of being partially or unimmunised was higher among children who had the father as their sole healthcare decision-maker (AOR=0.69; 95% CI 0.51 to 0.92, p<0.012).

Conclusions

There were significant variations of child immunisation coverage across socioeconomic and demographic factors. These findings will inform innovative approaches for immunisation programmes, and the introduction of relevant policies, including regular monitoring and evaluation of immunisation coverage—particularly for low-performing regions, so that the broader benefit of immunisation programmes can be achieved in all strata of the society.
How is poststroke fatigue understood by stroke survivors and carers? A thematic analysis of an online discussion forum.
Authors: Thomas Karen , Gamlin Chloe , De Simoni Anna , Mullis Ricky , Mant Jonathan
Published: July 2019

Objective

To understand poststroke fatigue from the perspective of stroke survivors and caregivers expressed in an online discussion forum.

Design

The search terms ‘tiredness’, ‘fatigue’, ‘tired’, ‘weary’ and ‘weariness’ were used to identify relevant posts. Thematic analysis performed by two independent researchers who coded all forum posts and identified pertinent themes. Posts were coded in relation to two research questions: (1) how is poststroke fatigue described? and (2) what coping strategies are suggested to target poststroke fatigue? Each theme was then summarised by a lead quotation in forum users’ own words.

Setting

UK-based web forum hosted by Stroke Association, TalkStroke. Archives from 2004 to 2011 were accessed.

Participants

65 stroke survivors and caregivers (mean age 54 years, 61% female) contributed to 89 relevant posts that included a relevant search term. This included 38 stroke survivors, 23 individuals with family or carer role and 4 others unidentified.

Results

Six themes were generated: (1) medicalisation of poststroke fatigue: ‘a classic poststroke symptom’, (2) a tiredness unique to stroke: ‘a legacy of stroke’, (3) normalisation and acceptance of poststroke fatigue: ‘part and parcel of stroke’, (4) fighting the fatigue: ‘an unwelcome guest’, (5) survivors’ and caregivers’ biological explanations: ‘the brain healing’ and (6) coping mechanisms: ‘pace yourself’. Forum users also repeatedly commented that poststroke fatigue was ‘not understood by the profession’.

Conclusion

This is the first study to employ data from an online forum to characterise poststroke fatigue. Our data are considered naturalistic owing to the absence of a researcher guiding the discussion and thus generates useful insights for healthcare professionals. Findings suggest a requirement for consistent understanding and explanation to be provided by healthcare professionals. The beliefs outlined here highlight the gap between clinical and community knowledge. Further research to translate understanding of patient and carer perspective into improved management of poststroke fatigue is required.
Evaluating the effectiveness and cost-effectiveness of health facility-based and community-based index-linked HIV testing strategies for children: protocol for the B-GAP study in Zimbabwe
Authors: Dziva Chikwari Chido , Simms Victoria , Dringus Stefanie , Kranzer Katharina , Bandason Tsitsi , Vasantharoopan Arthi , Chikodzore Rudo , Sibanda Edwin , Mutseta Miriam , Webb Karen , Engelsmann Barbara , Ncube Gertrude , Mujuru Hilda , Apollo Tsitsi , Weiss Helen Anne , Ferrand Rashida
Published: July 2019

Introduction

The number of new paediatric infections per year has declined in sub-Saharan Africa due to prevention-of-mother-to-child HIV transmission programmes; many children and adolescents living with HIV remain undiagnosed. In this protocol paper, we describe the methodology for evaluating an index-linked HIV testing approach for children aged 2–18 years in health facility and community settings in Zimbabwe.

Methods and analysis

Individuals attending for HIV care at selected primary healthcare clinics (PHCs) will be asked if they have any children aged 2–18 years in their households who have not been tested for HIV. Three options for HIV testing for these children will be offered: testing at the PHC; home-based testing performed by community workers; or an oral mucosal HIV test given to the caregiver to test the children at home. All eligible children will be followed-up to ascertain whether HIV testing occurred. For those who did not test, reasons will be determined, and for those who tested, the HIV test result will be recorded. The primary outcome will be uptake of HIV testing. The secondary outcomes will be preferred HIV testing method, HIV yield, prevalence and proportion of those testing positive linking to care and having an undetectable viral load at 12 months. HIV test results will be stratified by sex and age group, and factors associated with uptake of HIV testing and choice of HIV testing method will be investigated.

Ethics and dissemination

Ethical approval for this study was granted by the Medical Research Council of Zimbabwe, the London School of Hygiene and Tropical Medicine and the Institutional Review Board of the Biomedical Research and Training Institute. Study results will be presented at national policy meetings and national and international research conferences. Results will also be published in international peer-reviewed scientific journals and disseminated to study communities at the end of study.
Wavelet and principal component analysis of electromyographic activity and slow component of oxygen uptake during heavy and severe cycling exercise
Authors: Qi Liping , Ma Xiao-Chi , Zhou Dong-Dong , Guan Shuo , Gao Feng-Shan , Cong Pei-Xin
Published: July 2019

The aim of the study was to investigate whether the slow component of oxygen uptake was concurrent with the recruitment of large α-motoneuron muscle fibres by using wavelet and principal component analysis (PCA) of electromyography (EMG) during heavy and severe cycling exercise. Eleven male subjects participated in the study. After establishing each subject’s maximum value of oxygen uptake through an incremental test on the cycle ergometer, the subjects performed 6-min cycling tests at heavy and severe intensity. EMG signals were collected from rectus femoris, biceps femoris long head, tibialis anterior, and medial gastrocnemius and processed by combined use of wavelet and PCA analysis. The time delays to the onset of slow component occurred significantly earlier during severe (105.22 ± 5.45 s) compared with during heavy (138.78 ± 15.09 s) exercise. ANOVA with repeated measures showed that for all muscles tested, the angle θ formed by the first and second principal components decreased significantly between time windows during heavy and severe exercise. However, significant increases of EMG mean power frequency (MPF) were found only during heavy exercise. Our results show the concurrence of the oxygen uptake slow component with the additional recruitment of muscle fibres, presumably less efficient large α-motoneuron fibres.

Novelty The expected rise in MPF may be offset by muscle fatigue occurring in the later time windows of the slow component during severe exercise. The gradual shift to higher EMG frequencies throughout the slow-component phase was reflected in the progressive and significant decrease of angle θ.
Heart rate variability mediates motivation and fatigue throughout a high-intensity exercise program
Authors: Crawford Derek A. , Heinrich Katie M. , Drake Nicholas B. , DeBlauw Justin , Carper Michael J.
Published: July 2019

High-intensity exercise interventions are often promoted as a time-efficient public health intervention to combat chronic disease. However, increased physical effort and subsequent fatigue can be barriers to long-term maintenance of high-intensity exercise programs. The purpose of the present study was to determine if heart rate variability (HRV) mediated state traits related to exercise program adherence. Fifty-five healthy men and women (ages 19–35 years) used a commercially available smartphone application to monitor daily HRV status throughout a 6-week high-intensity exercise intervention. Participants reported state motivation to exercise and global physical fatigue immediately prior to each exercise session. Temporary shifts toward increased parasympathetic reactivation (p = 0.030) resulted in significant increases in daily fatigue (p < 0.001) and decreases in motivation to exercise (p = 0.028). Through modulation of exercise volume, in response to these temporary shifts in HRV, these effects were reversed (p < 0.001) via increased parasympathetic withdrawal (p = 0.018). For the first time, these data demonstrate a mediating effect of HRV on adherence-related trait states throughout a high-intensity exercise program. Applied strategies, such as appropriately timed exercise volume moderation, may be able to leverage this effect and help facilitate long-term exercise program maintenance.

Novelty These data establish a link between expected shifts in HRV throughout high-intensity exercise programs with motivation to participate and physical fatigue. Modulation of training volume, in response to these shifts, can optimize adherence-related behavioral responses during high-exercise programs.
Principles of structural geology on rocky planets
Authors: Klimczak Christian , Byrne Paul K. , Şengör A.M. Celâl , Solomon Sean C.
Published: July 2019

Although Earth is the only known planet on which plate tectonics operates, many small- and large-scale tectonic landforms indicate that deformational processes also occur on the other rocky planets. Although the mechanisms of deformation differ on Mercury, Venus, and Mars, the surface manifestations of their tectonics are frequently very similar to those found on Earth. Furthermore, tectonic processes invoked to explain deformation on Earth before the recognition of horizontal mobility of tectonic plates remain relevant for the other rocky planets. These connections highlight the importance of drawing analogies between the rocky planets for characterizing deformation of their lithospheres and for describing, applying appropriate nomenclature, and understanding the formation of their resulting tectonic structures. Here we characterize and compare the lithospheres of the rocky planets, describe structures of interest and where we study them, provide examples of how historic views on geology are applicable to planetary tectonics, and then apply these concepts to Mercury, Venus, and Mars.
Experimental study on single point incremental forming of Inconel 718
Authors: Pratheesh Kumar S. , Elangovan S. , Mohanraj R.
Published: July 2019

The contemporary sheet metal industry employs forming methods that use a precise die and punch to form components with precise tolerances. In mass production, the high cost of manufacturing dies and punches is absorbed by the number of components formed, whereas this is not the case for low volume production where it increases the manufacturing cost of the products. To overcome the demand for the development of manufacturing technologies that are both agile and meet industrial requirements, an incremental sheet metal forming experiment was carried out on Inconel 718. The incremental sheet metal forming process in the research stage needs to be improved both in terms of accuracy and product quality. The main process parameters involved in the study are incremental depth, rotational speed, and feed rate of the forming tool. Based on the process parameters, experiments are conducted using the Taguchi L9 orthogonal array design and responses such as geometrical accuracy, surface roughness, and thinning are studied. The forming limit and micro-structural study allow us to understand the forming behavior of Inconel 718, which will enhance the applicability of the material.
Intelligent Motion Planning and Control for Robotic Joints Using Bio-Inspired Spiking Neural Networks
Authors: Hulea Mircea , Burlacu Adrian , Caruntu Constantin-Florin
Published: July 2019

This paper details an intelligent motion planning and control approach for a one-degree of freedom joint of a robotic arm that can be used to implement anthropomorphic robotic hands. This intelligent control method is based on bio-inspired electronic neural networks and contractile artificial muscles implemented with shape memory alloy (SMA) actuators. The spiking neural network (SNN) includes several excitatory neurons that naturally determine the contraction force of the actuators, and unevenly distributed inhibitory neurons that regulate the excitatory activity. To validate the proposed concept, the experiments highlight the motion planning and control of a single-joint robotic arm. The results show that the electronic neural network is able to intelligently activate motion and hold with high precision the mobile link to the target positions even if the arm is slightly loaded. These results are encouraging for the development of improved biologically plausible neural structures that are able to control simultaneously multiple muscles.
Generalized Center Problems with Outliers
Authors: Chakrabarty Deeparnab , Negahbani Maryam
Published: July 2019

We study the ℱ-center problem with outliers: Given a metric space (
X
,
d
), a general down-closed family ℱ of subsets of
X
, and a parameter
m
, we need to locate a subset
S
∈ ℱ of centers such that the maximum distance among the closest
m
points in
X
to
S
is minimized. Our main result is a
dichotomy theorem
. Colloquially, we prove that there is an efficient 3-approximation for the ℱ-center problem with outliers if and only if we can efficiently optimize a
poly-bounded
linear function over ℱ subject to a partition constraint. One concrete upshot of our result is a polynomial time 3-approximation for the knapsack center problem with outliers for which no (true) approximation algorithm was known.
Full-Range Liver Fat Fraction Estimation in Magnitude MRI Using a Signal Shape Descriptor
Authors: Costa Yuri A. , Filho Carlos P. , Flores Gabriela A. , Rodrigues Evandro L. L. , Paiva Fernando F.
Published: July 2019

Current methods for estimation of proton density fat fraction (PDFF) of the liver using magnitude magnetic resonance (MR) imaging face the challenge of correctly estimating it when fat is the dominant molecule; i.e., PDFF is more than 50%. Therefore, the accuracy of the methods is limited to half-range operation. We introduce a method based on neural networks for regression capable of estimating over the full range of fat fractions. We built a neural network based on the angles and distances between the data in the discrete MR signal (ADALIFE), using these as features associated with different PDFFs and as input for the network. Tests were performed using ADALIFE and Multi-interference, a state-of-the-art method to estimate PDFFs, with simulated signals at various signal-to-noise (SNR) values. Results were compared in order to verify repeatability and agreement using Bland-Altman and REC curves. Results for Multi-interference were similar to its in vivo literature, showing the relevance of a simulation. ADALIFE was able to correctly estimate fat fractions up to 100%, breaking the current paradigm for full-range estimation using only offline postprocessing. Within half range, our method outperformed Multi-interference in repeatability and agreement, with narrower limits of agreement and lower expected error at any SNR.
Relationship between Neovascular Density in Swept Source-Optical Coherence Tomography Angiography and Signs of Activity in Exudative Age-Related Macular Degeneration
Authors: Stattin Martin , Forster Julia , Daniel Ahmed , Graf Alexandra , Krepler Katharina , Ansari-Shahrezaei Siamak
Published: July 2019

Purpose. To assess the relationship between signs of activity in exudative neovascular age-related macular degeneration (nAMD) following anti-vascular endothelial growth factor (anti-VEGF) treatment and morphology of choroidal neovascularization (CNV) based on neovascular density as imaged using swept source-optical coherence tomography angiography (SS-OCTA) in a qualitative manner. Methods. A single-cohort retrospective data analysis from one tertiary eye care center. Seventy-seven eyes of 72 patients were included and their charts reviewed which had been started on intravitreal injections with anti-VEGF for nAMD at least one year prior to enrollment. Clinically active disease was evaluated by slit-lamp fundus examination and spectral domain-OCT B-scans. Morphological appearance in SS-OCTA was characterized based on 5 different criteria and subsequently divided into 3 groups: predominantly hyperdense, minimally hyperdense, and hypodense lesions. Results. Fifty-eight eyes (75%) were considered clinically active and 19 eyes (25%) clinically inactive. CNV was depicted in 71 eyes (92%) by SS-OCTA and separated accordingly into predominantly hyperdense (32%), minimally hyperdense (34%), and hypodense lesions (34%). A borderline significant difference in the probability of neovascular activity for predominantly hyperdense lesions compared to hypodense lesions was detected (p=0.05). Conclusions. Hyperdense choroidal neovascularization based on qualitative assessment of flow density showed a significant relation to active disease. Inactivity could not be matched adequately. This study demonstrated the potential usefulness of SS-OCTA for guidance of treatment in age-related macular degeneration.