bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation Between Reduction Quality of Femoral Neck Fracture and Femoral Head Necrosis Based on Biomechanics
Authors: Wang Ying , Ma Jian‐xiong , Yin Tao , Han Zhe , Cui Shuang‐shuang , Liu Zhi‐peng , Ma Xin‐long
Published: April 2019

Objective

To investigate the biomechanical effects of reduction quality on patients after femoral neck fracture internal fixation.

Methods

The data of individual patients with femoral neck fractures were reviewed. Data for patients with simple unilateral femoral neck fractures whose reduction quality was evaluated as good by hip X‐ray films after internal fixation were collected from January 2013 to January 2017. The CT data of the patients was used to reconstruct 3D models of the femur and the screw. The spatial displacement after the operation of femoral neck fracture was measured, which included the displacement of the deepest portion of the femoral head fovea, the displacement of the center of the femoral head, and the rotational angle. The cases were followed up by telephone consultation and clinical review to determine whether the osteonecrosis of the femoral head occurred. Follow‐up time should be more than 18 months after surgery. The cases were grouped according to the results into an osteonecrosis of the femoral head group and a non‐osteonecrosis of the femoral head group. Finally, the differences in postoperative spatial displacement between the two groups were compared and analyzed. In addition, a mechanical analysis of femoral force during gait was performedviafinite element analysis.

Results

Data for 241 patients with femoral neck fractures who were treated with closed reduction and internal fixation were collected. 3D measurement showed the average displacement value, including the center of the femoral head (5.90 ± 3.4 mm), the deepest portion of the femoral head fovea (9.32 ± 4.8 mm), and the rotational angle (16.1° ± 9.4°). After telephone consultation and clinical review, osteonecrosis of the femoral head was diagnosed in 28 (11.62%) of the patients. In the osteonecrosis of the femoral head (ONFH) group, the displacement of the deepest portion of the femoral head fovea was 10.92 ± 9.18 mm; the displacement was 8.86 ± 6.29 mm in the non‐ONFH group. The displacement of the center of the femoral head in the ONFH group was 7.575 ± 5.69 mm and 5.31 ± 4.05 mm in non‐ONFH group. The rotational angle was 20.11° ± 10.27° in the ONFH group and 14.19° ± 11.09° in the non‐ONFH group. The statistical analysis showed that the postoperative spatial displacements, including the displacement of the deepest portion of the femoral head fovea, the displacement of the center of the femoral head, and the rotational angle between the two groups, had statistical differences. Finite element analysis showed that as the spatial displacement increased, the stress, the displacement, and the equivalent strain of the proximal femur also increased.

Conclusion

Poor reduction quality after femoral neck fracture is a risk factor for re‐fracture and femoral head necrosis, and the measurement method of this study can be used to predict the occurrence of femoral head necrosis early after femoral neck fracture.
Molecular detection of WA‐CMS restorers from tropical japonica‐derived lines, their evaluation for fertility restoration and adaptation
Authors: Shidenur Shivakumar , Singh Vikram Jeet , Vinod Kunnummal Kurungara , Gopala Krishnan Subbaiyan , Ghritlahre Surendra Kumar , Bollinedi Haritha , Ellur Ranjith K. , Dixit Brijesh Kumar , Singh Binder , Nagarajan Mariappan , Singh Ashok Kumar , Bhowmick Prolay Kumar
Published: April 2019

Hybrid rice based on wild‐abortive cytoplasmic male sterility (WA‐CMS) is important in boosting rice production, which requires diverse parents to harness heterosis. For this, exploiting the diversity of japonica through tropical japonica (TRJ) lines is an excellent route. In this study, 310 TRJ‐based new plant type (NPT) lines were developed and evaluated for Rf3 and Rf4 genes. Gene‐based (DRRM‐Rf3‐5 and DRRM‐Rf3‐10) and functional marker (RMS‐SF21‐5) targeted Rf3 locus, while gene‐linked (RM6100) and functional marker (RMS‐PPR9‐1) targeted the Rf4 locus. The frequency of the restorer allele of Rf3 gene was lower when compared to that of Rf4. Combined phenotypic and molecular screening using gene‐based and functional markers identified 42 lines that carried Rf3 and/or Rf4 genes. All the selected lines produced fertile F1s when crossed to a WA‐CMS line, “Pusa 6A”, but with varying levels of spikelet fertility. This is the first report of a marker‐cum‐phenotype‐based restorer selection using TRJ‐derived lines. Multilocation evaluation of these lines at three locations indicated better adaptation for grain yield in some of the lines.
Clinical effectiveness and speed of response of electroconvulsive therapy in treatment‐resistant schizophrenia
Authors: Chan Christopher Yi Wen , Abdin Edimansyah , Seow Esmond , Subramaniam Mythily , Liu Jianlin , Peh Chao Xu , Tor Phern Chern
Published: April 2019

Aim

Although electroconvulsive therapy (ECT) has been shown to be efficacious for patients with treatment‐resistant schizophrenia, there has been limited evidence on the rate of response, cognition, and quality‐of‐life outcomes. The primary aims of the present study were thus to examine the effectiveness and speed of response to ECT in a naturalistic retrospective cohort in patients with treatment‐resistant schizophrenia.

Methods

We performed a retrospective database analysis. The primary effectiveness outcome was defined as an improvement of ≥40% from pretreatment scores based on the Brief Psychiatric Rating Scale (BPRS) Psychotic Symptom subscale. Data were included for analysis for all patients with a primary DSM‐5 diagnosis of schizophrenia that was treatment‐resistant and who had had an acute course of ECT initiated for the treatment of schizophrenia between 1 July 2016 and 1 December 2016.

Results

A total of 50 inpatients were included for analysis. The present study revealed that 50% of patients showed at least a 40% reduction in BPRS Psychotic Symptom subscale scores after completion of ECT and that 16.7% of patients responded after the first three sessions, 39.3% after six sessions, 46.4% after nine sessions, and 50% after 12 sessions. The greatest improvement in BPRS scores was between the third and sixth ECT sessions. BPRS scores, Clinical Global Impression, Montreal Cognitive Assessment, and Global Assessment of Functioning showed significant improvement. There was no significant difference in quality‐of‐life outcomes.

Conclusion

Utilizing modern techniques in treatment‐resistant schizophrenia, this study demonstrates the real‐world effectiveness and rate of response of patients receiving ECT.
Advances in genetic improvement for salmon and trout aquaculture: the Chilean situation and prospects
Authors: Lhorente Jean P. , Araneda Marcelo , Neira Roberto , Yáñez José M.
Published: April 2019

Genetic improvement is key to the development of a more efficient aquaculture industry. By 2010, there were 104 breeding programmes for aquaculture species in the world, most of them for fish species. Usually, the breeding goals include traits such as growth rate, disease resistance, maturation and carcass quality. Resistance to specific pathogens has been one of the main objectives of research and development in the genetic improvement programmes of salmonids in Chile and worldwide. In Chile, trait selection has been conducted through the application of selection indexes. New technologies like next generation sequencing and genotyping have helped disentangle the genetic basis and enhance genetic evaluation methods of economically important traits. This work aims to review the advances in genetic improvement for salmon and trout aquaculture with emphasis on the Chilean experience. We focus on the implementation of breeding programmes in the country, definition of breeding objectives, results on genetic parameters and response to selection and incorporation of genomics. Future challenges and opportunities regarding genotype‐by‐environment interactions, climate change and research and development, plus the demonstration of the economic benefit of breeding programmes are also addressed.
Structural racism as the fundamental cause of the academic achievement gap
Authors: Merolla David M. , Jackson Omari
Published: April 2019

Over six decades since the Supreme Court ruled that all American children have the right to a high quality education, the academic achievement gap remains an important social problem in the United States. Researchers interested in understanding the achievement gap generally seek to find the mechanisms that can explain why Black students continue to achieve at lower levels than their White counterparts. This research has shown that differences in socioeconomic status, family cultural resources, school quality and racial composition, and bias and prejudice in schools all act as mechanisms that link race to academic achievement. In this paper, we review studies from the past 10 years on the academic achievement gap. We argue that while all of the factors identified in the literature can add insight to how race structures educational achievement, the fundamental cause of the achievement gap is structural racism, a system of social organization that privileges White Americans and disadvantages Americans of color. We argue that acknowledging structural racism as the fundamental cause of the achievement gap can provide a unifying framework for interpreting findings from studies of specific mechanisms link race to academic outcomes.
Social Networks and Coping with Poverty in Rural Areas
Authors: Klärner Andreas , Knabe André
Published: April 2019

This article draws attention to the spatial dimensions of poverty and the importance of social networks as coping resources for the rural poor. We analyse data from an explorative, mixed‐methods study conducted in rural and urban areas in north‐eastern Germany, and show that spatial contexts shape poor people's social networks. Our quantitative analyses indicate that compared to the urban networks, the rural networks in our sample are smaller, and include more family members and fewer supportive relationships. Our analysis of qualitative interviews with rural poor people yields a typology of strategies for coping with poverty. It also shows that while social networks represent important resources for coping with poverty in rural areas, the support capacities of these networks are weakened by structural changes, the selective out‐migration of younger and better educated individuals, and by the ageing and shrinking of the population.
Academic medicine: the continuing challenges
Authors: Mashar Meghavi , Kilgour James , Nanapragasam Hannah , Lipworth Sam
Published: April 2019

Background

Numbers of academic medicine trainees have been declining internationally. Many countries have taken differing approaches to improving recruitment, with some having established pathways. In the UK, the academic foundation programme (AFP) is one such pathway aimed towards those interested in an academic medical career. Variation exists amongst universities with respect to application and success rates. As a group of AFP doctors, we aimed to explore these issues.

Numbers of academic medicine trainees have been declining internationally

Methods

We created and implemented a 1‐day national course, comprising lectures and small group workshops, geared towards informing applicants about the AFP. It was evaluated via pre‐ and post‐course questionnaires using a Likert scale, ranging from 1 to 5.

We created and implemented a 1‐day national course, comprising lectures and small group workshops, geared towards informing applicants about the AFP

Results

A total of 150 attendees were present from 16 different medical schools; 95% (143/150) of the attendees filled in both questionnaires. Attendees appeared unaware of the stages involved in the application process and felt underprepared. Following the course, learners reported median scores (with interquartile limits) that demonstrated increased overall knowledge, from 2 (1) to 4 (1) (p < 0.01), and increased preparedness, from 2 (1) to 3 (1) (p < 0.01).

Discussion

Our findings indicate that recruitment remains challenging, even in countries with established pathways. In the UK, the awareness of these pathways appears to be poor and courses such as ours may remedy that. Further exploration into the most effective methods to increase recruitment is necessary. The effect of institutional disparities in research culture and impact on application success needs investigation. Perhaps medical schools should introduce students to the prospect of academic careers earlier in training. Globally, efforts still need to be concentrated largely towards establishing integrated pathways.
Keep calm and carry on: miRNA biogenesis under stress
Authors: Manavella Pablo A. , Yang Seong W. , Palatnik Javier
Published: April 2019

MicroRNAs (miRNAs) are major post‐transcriptional regulators of gene expression. Their biogenesis relies on the cleavage of longer precursors by a nuclear localized processing machinery. The evolutionary preference of plant miRNAs to silence transcription factors turned these small molecules into key actors during growth and adaptive responses. Furthermore, during their life cycle plants are subject to changes in the environmental conditions surrounding them. In order to face these changes, plants display unique adaptive capacities based on an enormous developmental plasticity, where miRNAs play central roles. Many individual miRNAs have been shown to modulate the plant response to different environmental cues and stresses. In the last few years, increasing evidence has shown that not only individual genes encoding miRNAs but also the miRNA pathway as a whole is subject to regulation in response to external stimulus. In this review, we discuss the current knowledge about the miRNA pathway. We dissect the pathway to analyze the events leading to the generation of these small RNAs and emphasize the regulation of core components of the miRNA biogenesis machinery.
From rice fields to financial assets: Valuing land for microfinance in Cambodia
Authors: Green W. Nathan
Published: April 2019

This paper explores how rural land in Cambodia has been incorporated into global networks of finance capital through the technical and political processes of turning land into a financial asset. Since the 1990s, the Cambodian government and international development institutions have issued land titles to people to formalise land ownership and increase people's access to formal credit. At the same time, Cambodia's commercial microfinance industry has rapidly grown to become one of the largest markets in the world per capita. The industry has expanded in part because microfinance institutions use land title for collateral on household loans as a method to manage the financial risk of their foreign investors and shareholders. In this paper, I draw on ethnographic research conducted withACLEDABank, Cambodia's largest provider of microfinance loans, to examine how the rural land market and microfinance sector are assembled together. I argue that microfinance markets in Cambodia depend on credit officers establishing a capitalist regime of land value. To do so, credit officers engage in daily bricolage, using technologies of representation and data inscription, to create new grids of land evaluation that allow people to treat their land as a financial asset. I also argue that collateral is a kind of technology of control that reworks and respatialises household social reproduction for the benefit of financial accumulation. This paper thus contributes to our theoretical understanding of how land, labour, and finance capital are assembled together, and the political economic ramifications of such an assemblage.
A Multicountry Study on Nursing Students’ Self‐Perceived Competence and Barriers to Evidence‐Based Practice
Authors: Labrague Leodoro J. , McEnroe‐Petitte Denise , D'Souza Melba Sheila , Cecily Helen Shaji John , Fronda Dennis C. , Edet Olaide B. , Ibebuike Julia Enang , Venkatesan Latha , Almazan Joseph U. , Al Amri Majid , Mirafuentes Ephraim C. , Cayaban Arcalyd Rose R. , Al Yahyaei Asma , Bin Jumah Jawaher A.
Published: April 2019

Background

Nursing education and training are essential in the attainment of evidence‐based practice (EBP) competence in nursing students. Although there is a growing literature on EBP among nursing students, most of these studies are confined to a single cultural group. Thus, cross‐cultural studies may provide shared global perspectives and theoretical understandings for the advancement of knowledge in this critical area.

Aims

This study compared self‐perceived EBP competence among nursing students in four selected countries (India, Saudi Arabia, Nigeria, and Oman) as well as perceived barriers to EBP adoption.

Methods

A descriptive, cross‐sectional, and comparative survey of 1,383 nursing students from India, Saudi Arabia, Nigeria, and Oman participated in the study. The Evidence‐Based Practice Questionnaire (EBP‐COQ) and the BARRIERS scale were used to collect data during the months of January 2016 to August 2017.

Results

Cross‐country comparisons revealed significant differences in EBP competence (F = 24.437, p < .001), knowledge (F = 3.621, p = .013), skills (F = 9.527, p < .001), and attitudes (F = 74.412, p < .001) among nursing students. Three variables including nursing students’ gender (β = .301, p < .001), type of institution, (β = −0.339, p = .001), and type of nursing student (β = .321, p < .001) were associated with EBP competence. Barriers to EBP adoption included having no authority to change patient care policies (M = 1.65, SD = 1.05), slow publication of evidence (M = 1.59, SD = 1.01), and paucity of time in the clinical area to implement the evidence (M = 1.59, SD = 1.05).

Linking Evidence to Action

Both academe and hospital administration can play a pivotal role in the successful acquisition of EBP competence in nursing students.
Many odd zeta values are irrational
Authors: Fischler Stéphane , Sprang Johannes , Zudilin Wadim
Published: April 2019

Building upon ideas of the second and third authors, we prove that at least$2^{(1-\unicode[STIX]{x1D700})(\log s)/(\text{log}\log s)}$values of the Riemann zeta function at odd integers between 3 and$s$are irrational, where$\unicode[STIX]{x1D700}$is any positive real number and$s$is large enough in terms of$\unicode[STIX]{x1D700}$. This lower bound is asymptotically larger than any power of$\log s$; it improves on the bound$(1-\unicode[STIX]{x1D700})(\log s)/(1+\log 2)$that follows from the Ball–Rivoal theorem. The proof is based on construction of several linear forms in odd zeta values with related coefficients.
Tránsitos intermediales: las imágenes del cine y la televisión en Mantra
Authors: Bongers Wolfgang
Published: April 2019

En este estudio propongo analizar la construcción de imaginarios audiovisuales en la novela Mantra (2001), del argentino Rodrigo Fresán, identificada como obra clave de la literatura latinoamericana respecto a la relación cine-televisión-literatura. Desde una perspectiva intermedial, cuyos ejes conceptuales se introducen en la primera parte, voy a aproximarme a las formas y los tránsitos en los que circulan y se articulan las imágenes cinematográficas y televisivas en la novela. El análisis tiene el objetivo de identificar la literatura como zona particular de reflexión sobre nuestra cultura audiovisual y transmedial.
Comunicación de un destino experiencial a través de las páginas web. Análisis de Villavicencio – Colombia
Authors: Otero Gómez María Cristina , Centocchi Claudio Fabián , Giraldo Pérez Wilson
Published: April 2019

El objetivo de este artículo es analizar la comunicación que se hace de Villavicencio como destino turístico experiencial, orientada al segmento internacional, a través de las páginas web. Se ha realizado una revisión de la literatura para comprender cómo interactúan los turistas con estas páginas y cómo la información contenida en ellas contribuye en alcanzar la satisfacción gracias a la oferta comunicada. Se realizó una investigación mixta en la cual, por un lado, se aplicaron 156 encuestas, de las cuales se analizaron 33, correspondientes a los turistas que recurrieron al uso de sitios web y, por el otro, se examinaron 15 páginas web. Para el análisis cuantitativo se empleó el software SPSS V18; y para el análisis cualitativo, un abordaje semiótico. Los resultados demostraron que, a pesar de las deficiencias comunicacionales, principalmente en los sitios web oficiales, imperan las calificaciones positivas por parte de los turistas.
Trazos para comunidades discursivas académicas dialógicas y polifónicas
Authors: Chacón Chacón Adriana , Chapetón Castro Claudia Marcela
Published: April 2019

El propósito del presente artículo de discusión teórica es indagar acerca del concepto de Comunidad Discursiva Académica, procurando reflexiones alrededor de las prácticas de lectura y escritura en el contexto universitario a la luz de las teorías y autores que desde distintas perspectivas permiten develar las tensiones y desafíos que estudiantes, profesores, investigadores e instituciones educativas enfrentan en un mundo académico, cada vez más permeado de las lógicas de poder y control. En tal virtud se problematiza el sentido per se de Comunidad y de Discurso, dado que es probable que una concepción reduccionista de estos conceptos haya derivado en prácticas despojadas del carácter dialógico y polifónico que permite tanto la comprensión de las convenciones de las comunidades académicas, como la posibilidad de su deconstrucción o re-significación.
Unconstrained Melting Heat Transfer of Nano-Enhanced Phase-Change Materials in a Spherical Capsule for Latent Heat Storage: Effects of the Capsule Size
Authors: Hu Nan , Zhu Zi-Qin , Li Zi-Rui , Tu Jing , Fan Li-Wu
Published: April 2019

Toward accelerated latent heat storage, the unconstrained melting heat transfer in spherical capsules was revisited experimentally in the presence of nano-enhanced phase-change materials (NePCMs), with an emphasis on the influence of capsule size on the rates of melting, heat transfer, and latent heat storage. It was shown that increasing the size of the spherical capsule leads to two competing effects, i.e., thicker molten layer in the close-contact melting (CCM) region and stronger natural convection. However, the NePCM with a high loading (3 wt % graphite nanoplatelets (GNPs)) is not preferred for all capsule sizes as a result of the significantly deteriorated heat transfer in both CCM and natural convection, because the dramatic viscosity growth at such a high loading leads to increased thermal resistance across the molten layer and loss of natural convection that overweigh the increased thermal conductivity. The 1 wt % NePCM sample was exhibited to be able to facilitate latent heat storage for two cases, i.e., in the smallest capsule having a radius of 14.92 mm at a higher wall superheat of 30 °C and in the intermedium 24.85 mm capsule at a lower wall superheat of only 10 °C. It was suggested that a relatively low loading of a specific NePCM can cause a faster rate of latent heat storage over the baseline case of the matrix phase-change material (PCM), if the capsule size (and the wall superheat) can be adjusted properly to regulate the molten layer thickness and the intensity of natural convection.
Influence of Immune and Nutritional Biomarkers on Illness Risk During Interval Training
Authors: Hanstock Helen G. , Govus Andrew D. , Stenqvist Thomas B. , Melin Anna K. , Sylta Øystein , Torstveit Monica K.
Published: April 2019

Intensive training periods may negatively influence immune function, but the immunological consequences of specific high-intensity-training (HIT) prescriptions are not well defined. Purpose: To explore whether 3 different HIT prescriptions influence multiple health-related biomarkers and whether biomarker responses to HIT were associated with upper-respiratory-illness (URI) risk. Methods: Twenty-five male cyclists and triathletes were randomized to 3 HIT groups and completed 12 HIT sessions over 4 wk. Peak oxygen consumption () was determined using an incremental cycling protocol, while resting serum biomarkers (cortisol, testosterone, 25[OH]D, and ferritin), salivary immunoglobulin-A (s-IgA), and energy availability (EA) were assessed before and after the training intervention. Participants self-reported upper-respiratory symptoms during the intervention, and episodes of URI were identified retrospectively. Results: Fourteen athletes reported URIs, but there were no differences in incidence, duration, or severity between groups. Increased risk of URI was associated with higher s-IgA secretion rates (odds ratio = 0.90, 90% confidence interval 0.83–0.97). Lower preintervention cortisol and higher EA predicted a 4% increase in URI duration. Participants with higher reported higher total symptom scores (incidence rate ratio = 1.07, 90% confidence interval 1.01–1.13). Conclusions: Although multiple biomarkers were weakly associated with risk of URI, the direction of associations between s-IgA, cortisol, EA, and URI risk were inverse to previous observations and physiological rationale. There was a cluster of URIs in the first week of the training intervention, but no samples were collected at this time point. Future studies should incorporate more-frequent sample time points, especially around the onset of new training regimens, and include athletes with suspected or known nutritional deficiencies.
Acute Resistance Exercise: Physiological and Biomechanical Alterations During a Subsequent Swim Training Session
Authors: Arsoniadis Gavriil G. , Bogdanis Gregory C. , Terzis Gerasimos , Toubekis Argyris G.
Published: April 2019

Purpose: To examine the acute effect of dry-land strength training on physiological and biomechanical parameters in a subsequent swim training session. Methods: Twelve male swimmers (age: 19.0 [2.2] y, peak oxygen uptake: 65.5 [11.4] mL·kg−1·min−1) performed a 5 × 200-m test with progressively increasing intensity. Blood lactate (BL) concentration was measured after each 200-m bout, and the speed corresponding to 4 mmol·L−1 (V4) was calculated. In the experimental (EXP) and control (CON) conditions, swimmers participated in a swim training session consisting of 1000-m warm-up, a bout of 10-second tethered swimming sprint, and 5 × 400 m at V4. In EXP condition, swimmers completed a dry-land strength training session (load: 85% of 1-repetition maximum) 15 minutes before the swimming session. In CON condition, swimmers performed the swimming session only. Oxygen uptake, BL concentration, arm-stroke rate, arm-stroke length, and arm-stroke efficiency were measured during the 5 × 400 m. Results: Force in the 10-second sprint was not different between conditions (P = .61), but fatigue index was higher in the EXP condition (P = .03). BL concentration was higher in EXP condition and showed large effect size at the fifth 400-m repetition compared with CON condition (6.4 [2.7] vs 4.6 [2.8] mmol·L−1, d = 0.63). During the 5 × 400 m, arm-stroke efficiency remained unchanged, arm-stroke length was decreased from the third repetition onward (P = .01), and arm-stroke rate showed a medium increment in EXP condition (d = 0.23). Conclusions: Strength training completed 15 minutes before a swim training session caused moderate changes in biomechanical parameters and increased BL concentration during swimming. Despite these changes, swimmers were able to maintain force and submaximal speed during the endurance training session.
Effects of an Eccentric Hamstrings Training on Components of Physical Performance in Young Female Handball Players
Authors: Chaabene Helmi , Negra Yassine , Moran Jason , Prieske Olaf , Sammoud Senda , Ramirez-Campillo Rodrigo , Granacher Urs
Published: April 2019

Purpose: This study examined the effects of an 8-week Nordic hamstring exercise (NHE) training on components of physical performance in young female handball players. Methods: Participants were allocated to an experimental group (EG; n = 10; age: 15.9 [0.2] y) and a control group (CG; n = 9; age: 15.9 [0.3] y). The EG performed NHE (2–3 sessions/wk) in replacement of some handball-specific drills, whereas the CG followed regular handball training. Pretraining and posttraining tests were carried out for the assessment of sprint speed (5 m, 10 m, and 20 m), jump performance (countermovement jump [CMJ] height), change-of-direction (t test), and repeated-sprint ability (RSA total time [RSAtotal], RSA best time [RSAbest], and RSA fatigue index [RSAFI]). Data were analyzed using magnitude-based inferences. Results: Within-group analyses for the EG showed moderate performance improvements for 5, 10, and 20 m (effect size [ES] = 0.68–0.82), t test (ES = 0.74), and CMJ (ES = 0.85). Trivial to small improvements were observed for RSA (ES = −0.06 to 0.35). For the CG, within-group outcomes showed performance decrements with moderate (t test [ES = 0.71]), small (5 m [ES = 0.46] and RSAbest [ES = 0.20]), and trivial magnitude (10 m [ES = 0.10], 20 m [ES = 0.16], and RSAtotal [ES = 0.00]). Furthermore, trivial to small performance improvements were found for CMJ (ES = 0.10) and RSAFI (ES = 0.5). Between-group analyses revealed small to large effects in favor of EG for 5 m (ES = 1.07), 10 m (ES = 0.66), 20 m (ES = 0.53), t test (ES = 1.38), and RSA (ES = 0.68–0.78). A trivial between-group difference was demonstrated for CMJ (ES = −0.01). Conclusions: The NHE training intervention, in replacement of some handball-specific drills, was more effective than regular handball training in improving physical performance (ie, linear sprint time, jumping, change-of-direction, and RSA) in young female handball players.
TET enzymes augment activation-induced deaminase (AID) expression via 5-hydroxymethylcytosine modifications at the
Aicda
superenhancer
Authors: Lio Chan-Wang J. , Shukla Vipul , Samaniego-Castruita Daniela , González-Avalos Edahi , Chakraborty Abhijit , Yue Xiaojing , Schatz David G. , Ay Ferhat , Rao Anjana
Published: April 2019

TET enzymes promote B cell responses by augmenting
Aicda
expression via DNA modification at cis elements in the
Aicda
locus.
Agricultural Origins of a Highly Persistent Lineage of Vancomycin-Resistant
Enterococcus faecalis
in New Zealand
Authors: Rushton-Green Rowena , Darnell Rachel L. , Taiaroa George , Carter Glen P. , Cook Gregory M. , Morgan Xochitl C.
Published: April 2019

Historical antimicrobial use in NZ agriculture has driven the evolution of ST108, a VRE lineage carrying a range of clinically relevant antimicrobial resistances. The persistence of this lineage in NZ for over a decade indicates that coselection may be an important stabilizing mechanism for its persistence.
Longitudinal extensive transverse myelitis: a rare neurological complication of systemic lupus erythematosus
Authors: Seyedali Sara , Alpert Deborah R
Published: April 2019

We present a 47-year-old woman with recently diagnosed systemic lupus erythematosus who developed progressive numbness and tingling of her upper and lower extremities, followed by weakness and difficulty ambulating. She was diagnosed with longitudinal extensive transverse myelitis involving her entire cervical and thoracic spinal cord. Infectious workup was unrevealing. She failed to respond to pulse–dose intravenous steroids, but slowly improved with the addition of plasmapheresis and cyclophosphamide. Following maintenance treatment with mycophenolate mofetil and slow tapering of oral steroids, she has maintained complete remission with significant recovery of neurological function.
Cough syncope and tracheal compression secondary to a retrosternal goitre: looking for a pulmonary embolism
Authors: Din Waqas Bin Majid , Farrar Eleanor , Liu Cindy , Moor James
Published: April 2019

A 51-year-old man presented acutely with recurrent bouts of coughing associated with transient and brief loss of consciousness consistent with cough syncope, mild stridor and a recent history of a respiratory tract infection. A chest X-ray demonstrated tracheal narrowing. His D-dimer was negative. A non-contrast CT scan of the chest demonstrated a large retrosternal goitre causing tracheal compression, and further investigation with a contrast-enhanced CT scan of the neck and chest demonstrated an incidental finding of a large pulmonary embolus (PE). The full extent of the PE was determined through performing a CT pulmonary angiography. Doppler ultrasound demonstrated a left leg deep vein thrombosis as the primary cause of the PE. His cough syncope improved in response to anticoagulation treatment, to the point where he could be safely discharged home. He had a further significant improvement in symptoms following an elective hemithyroidectomy for retrosternal goitre.
What are the prevalence and factors associated with sexual dysfunction in breastfeeding women? A Brazilian cross-sectional analytical study
Authors: Fuentealba-Torres Miguel , Cartagena-Ramos Denisse , Fronteira Inês , Lara Lúcia Alves , Arroyo Luiz Henrique , Arcoverde Marcos Augusto Moraes , Yamamura Mellina , Nascimento Lucila Castanheira , Arcêncio Ricardo Alexandre
Published: April 2019

Objective

This study determined the prevalence and factors associated with sexual dysfunction in breastfeeding women.

Design

Cross-sectional analytical study.

Setting

Population-based study of individuals living in the northeast region of São Paulo state, Brazil.

Participants

From May to August 2017, 372 women aged ≥18 years were selected who gave exclusive, predominant or complementary breast feeding up to 23 months postpartum, and who did not have contraindications for the resumption of intercourse. Pregnant women, those diagnosed with mental health problems, users of medications that affect sexual function (antihypertensives, antidepressants or antipsychotics) and women unable to read or understand the instructions for the study were excluded.

Primary and secondary outcome measures

The breastfeeding women completed the Female Sexual Function Index, the EUROHIS-QOL 8-item index and a questionnaire to collect participants’ sociodemographic, clinical and interpersonal data. A bivariate analysis was performed, and variables with p values<0.20 were analysed by multivariate logistic regression.

Results

Sexual dysfunction was present in 58.3% of the study population. Factors significantly associated with female sexual dysfunction (FSD) included placing a low importance on sexual intercourse (adjusted OR [AOR]=2.49, 95% CI=1.22 to 5.09), limited communication with the partner (AOR=2.64, 95% CI=1.43 to 4.86), decreased frequency of sexual intercourse (AOR=2.17, 95% CI=1.30 to 3.61) and low quality of life (AOR=2.23, 95% CI=1.33 to 3.74).

Conclusions

The prevalence of FSD appears with a great magnitude in breastfeeding women. The risk factors for sexual dysfunction are biopsychosocial and these findings may lead to improved counselling for prenatal and postnatal care.
Perceptual timing in children with attention-deficit/hyperactivity disorder (ADHD) as measured by computer-based experiments versus real-life tasks: protocol for a cross-sectional experimental study in an ambulatory setting
Authors: Marx Ivo , Reis Olaf , Berger Christoph
Published: April 2019

Introduction

The goal of this study is to get a better understanding of the fundamentals of perceptual timing deficits, that is, difficulties with estimating durations of explicitly attended temporal intervals, in children with attention-deficit/hyperactivity disorder (ADHD). Whereas these deficits were repeatedly demonstrated in laboratory studies using computer-based timing tasks, we will additionally implement a more practical task reflecting real-life activity. In doing so, the research questions of the planned study follow a hierarchically structured path ‘from lab to life’: Are the timing abilities of children with ADHD really disturbed both in the range of milliseconds and in the range of seconds? What causes these deficits? Do children with ADHD rather display a global perceptual timing deficit, or do different ‘timing types’ exist? Are timing deficits present during real-life activities as well, and are they based on the same mechanisms as in computerised tasks?

Methods and analyses

A quasi-experimental study with two groups of male children aged 8–12 years (ADHD; controls) and with a cross-sectional design will be used to address our research questions. Statistical analyses of the dependent variables will comprise (repeated) measures analyses of variance, stepwise multiple regression analyses and latent class models. With an estimated dropout rate of 25%, power analysis indicated a sample size of 140 subjects (70 ADHD, 70 controls) to detect medium effect sizes.

Ethics and dissemination

Ethics approval was obtained from the ethics committee of the Faculty of Medicine, University of Rostock. Results will be disseminated to researcher, clinician and patient communities in peer-reviewed journals and at scientific conferences, at a meeting of the local ADHD competence network and on our web page which will summarise the study results in an easily comprehensible manner.

Trial registration number

DRKS00015760
‘It’s a powerful message’: a qualitative study of Australian healthcare professionals’ perceptions of asthma through the medium of drawings
Authors: Cheung Melissa Mei Yin , Saini Bandana , Smith Lorraine
Published: April 2019

Objectives

This study aimed to explore healthcare professionals’ (HCPs’) perspectives of asthma through their drawings, and their responses when viewing patients’ drawings of their experiences of asthma.

Design

A qualitative exploratory study with a purposive, convenience sample of participants. Participants were asked to first express their perspectives of asthma in a drawing, which was followed by a review of drawings made by patients with asthma.

Setting

Primary and tertiary HCPs from Sydney, Australia.

Participants

Twenty-three HCPs from a range of health professions.

Results

The HCPs illustrated their perspective of asthma through drawings which were largely biomedically framed, depicting physiological and clinical aspects of asthma. In contrast, their discussion around the patients’ drawings centred on the person more than the condition. The patients’ drawings triggered the HCPs to revisit their personal expectations of their patients’ illness experience; prompted differing degrees of acknowledgement and empathy regarding the patient experience; and encouraged clinical reflexivity.

Conclusions

Our findings provide support for the educational application of patients’ drawings in bringing HCPs closer to the patient lived experience. The drawings fostered deeper insight into patient perspectives of asthma and stimulated critical reflection on current healthcare practices.
Current barriers, facilitators and future improvements to advance quality of abortion care: views of women
Authors: Smith Jodie Louise , Cameron Sharon
Published: April 2019

Background

Barriers to accessing abortion care continue to exist even in settings where abortion is legal. We aimed to determine current barriers faced by women seeking abortion, factors that facilitate access to care, and what future improvements women would like made to abortion care in Scotland.

Methods

A self-administered anonymous questionnaire of women requesting abortion care at a community abortion service in Edinburgh. Women selected the top three options from predefined lists of barriers to seeking abortion, facilitators of care, and future service improvements.

Results

154/165 (93%) questionnaires were completed by women presenting for abortion. The most commonly ranked number one barrier to seeking an abortion (n = 49; 32%) was ‘being scared about what the abortion process involved’. The highest ranked facilitator of care was information provided to women via the abortion clinic website. The most commonly chosen number one response for potential improvement to abortion services was the option to get an early medical abortion from a general practitioner, which was chosen by 70 (45%) women.

Conclusions

This study suggests that lack of knowledge and information surrounding the abortion process and the ease with which women can receive abortion care are areas of concern. Efforts are needed to reduce waiting times, to ensure that high-quality, standardised information is widely and publicly available regarding what women can expect during the abortion process, and to expand provision of early medical abortion within the community, in order to improve abortion care.
Use of cholesterol and soluble tumour markers CEA and syndecan-2 in pleural effusions in cases of inconclusive cytology
Authors: Gulyas Miklos , Fillinger Janos , Kaposi Andras D , Molnar Miklos
Published: April 2019

Aims

In order to improve diagnostics in pleural effusions, additional value of effusion cholesterol, carcinoembryonic antigen (CEA) and syndecan-2 assays to cytology was studied.

Methods

Biomarkers were measured in effusion supernatants from 247 patients, of whom 126 had malignant pleural involvement, and their additional diagnostic efficacy to cytology was assessed.

Results

Syndecan-2 measurement, although gave detectable concentrations in all effusions with highest median value in mesotheliomas, was non-discriminative between different pathological conditions. CEA concentrations exceeding 5 ng/mL cut-off point indicated carcinomas, regardless of pleural involvement, which gave a sensitivity of 62% and specificity of 100% for carcinoma. Cholesterol concentration over 1.21 mmol/L cut-off value indicated neoplastic pleural involvement with 99% sensitivity and ‘merely’ 69% specificity, the latter mainly due to raised levels being associated also with benign inflammatory effusions. Combined CEA and cholesterol determinations increased the sensitivity for diagnosing carcinomatosis from 70% with cytology alone to 84% and established the correct diagnosis in 16 of 31 carcinomatosis cases with inconclusive cytology. Cholesterol measurement alone, with elevated level, in combination with absence of substantial number of inflammatory cells in effusion sediment proved to be a magnificent marker for neoplastic pleural involvement with 99% efficacy, and recognised all 36 such cases with inconclusive cytology.

Conclusions

Simultaneous measurement of CEA and cholesterol concentrations in effusion, or at least cholesterol alone, in combination with non-inflammatory fluid cytology, provides additional specific information about neoplastic pleural involvement, and can therefore be used as an adjunct to cytology, above all, in inconclusive cases.
Day case complex devices: the state of the UK
Authors: Waight Michael , Elawady Abdula , Gage Heather , Touray Morro , Adhya Shaumik
Published: April 2019

Objective

Complex cardiac devices including implantable cardioverter defibrillator (ICD) and cardiac resynchronisation therapy (CRT) devices can safely be implanted as a day case procedure as opposed to overnight stay. We assess how common day case complex device therapy is and the cost implications of more widespread adoption across the UK.

Methods

A freedom of information request was sent to all centres performing complex cardiac devices across the UK to assess the adoption of this technique. Cost implications were assessed using Department of Health National Schedule of Reference Costs 2016–2017.

Results

100 UK centres were surveyed, 80% replied. Eighty per cent of UK centres already implant complex cardiac devices as a day case to some extent. 64.06% of centres have a protocol for this. 12.82% of centres do <25% of complex devices as a day case. 15.38% do 25%–50% as day case. 17.95% do 50%–75% as day case and 33.33% do >75% as day case. There was no relationship between centre volume and the proportion of devices done as a day case as opposed to overnight stay. The cost saving of performing a complex device as a day case as opposed to overnight stay was £412 per ICD, £525 per CRT-pacemaker and £2169 per CRT-defibrillator.

Conclusions

Day case complex devices are already widespread across the UK, however, there is scope for increase. An increase in proportion of day case devices could translate to £5 583 265 in savings annually for the National Health Service if all centres performed 75% of devices as a day case.
Development and first validation of a patient-reported experience measure in chronic obstructive pulmonary disease (PREM-C9)
Authors: Hodson Matthew , Roberts C Michael , Andrew Sharon , Graham Laura , Jones Paul W , Yorke Janelle
Published: April 2019

We developed a chronic obstructive pulmonary disease (COPD) patient-reported experience measure (PREM-C9). 174 patients with COPD (86 [49%] with a confirmed diagnosis and 88 [51%] with a self-reported diagnosis of COPD) completed a 38-item list, COPD Assessment Test (CAT) and Hospital Anxiety and Depression Scale (HADS). Hierarchical and Rasch analysis produced a 9-item list (PREM-C9). It demonstrated fit to the Rasch model (χ² p=0.33) and correlated moderately with CAT (r=0.42), HAD-anxiety (r=0.30) and HAD-depression (r=0.41) (p<0.05). A substudy confirmed its ability to detect change prepulmonary and postpulmonary rehabilitation. The PREM-C9 is a simple, valid measure of experience of patients living with COPD, validated in this study population with mild to very severe disease; it may be a useful measure in research and clinical audits.
Neural respiratory drive predicts long-term outcome following admission for exacerbation of COPD: a post hoc analysis
Authors: Patout Maxime , Meira Leonor , D’Cruz Rebecca , Lhuillier Elodie , Kaltsakas Georgios , Arbane Gill , Suh Eui-Sik , Hart Nicholas , Murphy Patrick Brian
Published: April 2019

Neural respiratory drive (NRD), as reflected by change in parasternal muscle electromyogram (EMGpara), predicts clinical deterioration and safe discharge in patients admitted to hospital with an acute exacerbation of COPD (AECOPD). The clinical utility of NRD to predict the long-term outcome of patients following hospital admission with an AECOPD is unknown. We undertook a post hoc analysis of a previously published prospective observational cohort study measuring NRD in 120 patients with AECOPD. Sixty-nine (57.5%) patients died during follow-up (median 3.6 years). Respiratory failure was the most common cause of death (n=29; 42%). In multivariate analysis, factors independently associated with an increased mortality included NRD (HR 2.14, 95% CI 1.29 to 3.54, p=0.003), age (HR 2.03, 95% CI 1.23 to 3.34, p=0.006), PaCO2at admission (HR 1.83, 95% CI 1.06 to 3.06, p=0.022) and long-term oxygen use (HR 2.98, 95% CI 1.47 to 6.03, p=0.002). NRD at hospital discharge could be measured in order to assess efficacy of interventions targeted to optimise COPD and reduce mortality following an AECOPD.

Original clinicaltrial.gov number:NCT01361451
Lung function in children with sickle cell disease from Central Africa
Authors: Arigliani Michele , Kitenge Robert , Castriotta Luigi , Ndjule Pathy , Barbato Vincenzo , Cogo Paola , Tshilolo Leon
Published: April 2019

Lung function in patients with sickle cell anaemia (SCA) living in sub-Saharan Africa is largely unknown. Anthropometry and spirometry were cross-sectionally evaluated in patients with SCA (HbSS) aged 6–18 years and in schoolchildren from the Democratic Republic of the Congo. The Global Lung Initiative 2012 spirometry reference values were used. A total of 112 patients and 377 controls were included. Twenty-six per cent of patients with SCA had spirometry findings suggestive of a restrictive pattern and 41% had a FEV1z-score <5th percentile. Wasting, increasing age and female sex were independently associated with increased risk of restrictive spirometry pattern in patients with SCA. Longitudinal studies could clarify the prognostic meaning of these findings.