bluuebunny/crossref_metadata_2025 huggingface dataset:
Scoring methods used in the dietary variety score survey to predict malnutrition among older patients receiving home care
Authors: Yamamoto Kaoru , Tsuji Taeko , Yamasaki Kazuyo , Momoki Chika , Yasui Yoko , Habu Daiki
Published: March 2020

Background

The dietary variety score (DVS), a simple dietary survey method for older adults, investigates the weekly frequency of consumption of the 10 food groups in Japan. The DVS is also associated with nutritional status. The original scoring method applied only to community‐dwelling older adults, not to older patients receiving home care, who have little dietary variety.

Aim

Using three different scoring methods for the DVS, we examined which method was most likely to reflect the nutritional status of older patients receiving home care.

Methods

This cross‐sectional study was carried out on older patients receiving home care. Participant characteristics, the DVS (evaluated using three different scoring methods), and the Mini Nutritional Assessment‐Short Form (MNA®‐SF) survey were researched. A receiver operating characteristic (ROC) analysis was performed to find the cut‐off value for the DVS. Multivariate analysis was performed, with malnutrition as the outcome, to investigate the extent to which the DVS is associated with malnutrition.

Results

We studied 317 participants. The DVS could produce significant ROC curves using modified scoring methods A and B (p = .028 and .042) with nutritional status as the outcome. Cut‐off value, sensitivity and specificity were 30 points, 60.9% and 55.9% in modified scoring method A and 5 points, 79.1%, and 35.6% in modified scoring method B. Results of the multivariate logistic regression analysis, in Model 1 dysphagia (odds ratio [95% confidence interval]: 3.85 [1.70–8.71]) and the DVS of modified scoring method A (2.00 [1.11–3.62]) were significant independent factors. In Model 2, dysphagia (3.57 [1.58–8.07]) and the DVS based on modified scoring method B (2.36 [1.24–4.47]) were significant independent factors.

Conclusions

Modified scoring method B was found to be most suitable for the dietary assessment of older patients receiving home care.

Implications for practice

Even in the absence of registered dietitians, any care staff member who is involved in providing nursing services during home‐visits is capable of administering a dietary survey, when using the easy DVS scoring method.
Ocular axial length and straylight
Authors: Christaras Dimitrios , Rozema Jos J , Ginis Harilaos
Published: March 2020

Purpose

Straylight refers to an optical phenomenon that takes places in the eye and leads to a deterioration of the retinal image. Past clinical findings suggest an increase of straylight with the eye's axial length, but the aetiology of the phenomenon was unclear. The purpose of this work is to demonstrate, through raytracing, simple geometrical optics, and the well‐established inverse‐angle square law for the angular distribution of straylight, why straylight increases when a myopic eye is corrected with spectacles.

Methods

The angular dependence of straylight is investigated using geometrical optics. An expression relating the eye's 2nd nodal point, the ocular axial length and the eye's straylight parameter S is found. Subsequently, using a model of the human eye, the location of the 2nd nodal point is computed using ray tracing for different axial lengths and refractive corrections. Finally, the results are compared against psychophysical data for the straylight parameter, corrected for the subject's age.

Results

When correcting axial myopia using spectacles, the eye's 2nd nodal point shifts towards the retina and away from the scattering plane, leading to an increase in straylight. Meanwhile, straylight should theoretically decrease in hyperopic eyes. Contact lenses keep the 2nd nodal point relative stable, leading to a very minor change in straylight with axial length. Our model has shown good agreement with previously taken straylight measurements in real eyes, explaining the observed change of straylight with ocular axial length.

Conclusion

We proposed an explanation for the underlying optical mechanism for the clinically observed increase of straylight with axial myopia, when corrected with glasses. Our model predicts that the increase can be as high as 0.12 log units for a myopic eye with 10 dioptres, which agrees with prior observations.
Melatonin improves rice salinity stress tolerance by NADPH oxidase‐dependent control of the plasma membrane K+ transporters and K+ homeostasis
Authors: Liu Juan , Shabala Sergey , Zhang Jing , Ma Guohui , Chen Dandan , Shabala Lana , Zeng Fanrong , Chen Zhong‐Hua , Zhou Meixue , Venkataraman Gayatri , Zhao Quanzhi
Published: March 2020

This study aimed to reveal the mechanistic basis of the melatonin‐mediated amelioration of salinity stress in plants. Electrophysiological experiments revealed that melatonin decreased salt‐induced K+ efflux (a critical determinant of plant salt tolerance) in a dose‐ and time‐dependent manner and reduced sensitivity of the plasma membrane K+‐permeable channels to hydroxyl radicals. These beneficial effects of melatonin were abolished by NADPH oxidase blocker DPI. Transcriptome analyses revealed that melatonin induced 585 (448 up‐ and 137 down‐regulated) and 59 (54 up‐ and 5 down‐regulated) differentially expressed genes (DEGs) in the root tip and mature zone, respectively. The most noticeable changes in the root tip were melatonin‐induced increase in the expression of several DEGs encoding respiratory burst NADPH oxidases (OsRBOHA and OsRBOHF), calcineurin B‐like/calcineurin B‐like‐interacting protein kinase (OsCBL/OsCIPK), and calcium‐dependent protein kinase (OsCDPK) under salt stress. Melatonin also enhanced the expression of potassium transporter genes (OsAKT1, OsHAK1, and OsHAK5). Taken together, these results indicate that melatonin improves salt tolerance in rice by enabling K+ retention in roots, and that the latter process is conferred by melatonin scavenging of hydroxyl radicals and a concurrent OsRBOHF‐dependent ROS signalling required to activate stress‐responsive genes and increase the expression of K+ uptake transporters in the root tip.
Antithymocyte globulin in pediatric allogeneic hematopoietic stem cell transplantation: Infusion time and tolerability
Authors: Sevrin François , Gonzales Fanny , Machuron François , de Berranger Eva , Bruno Benedicte
Published: March 2020

Antithymocyte globulin is a major drug in transplantation. rATG has been successfully used to prevent graft‐versus‐host disease in allogeneic HSCT. However, its first infusion is associated with reactions ranging from simple fevers to distributive shocks and may interfere with the transplant conditioning. To evaluate the impact of rATG infusion rate on clinical tolerability, we conducted a retrospective study of all pediatric allogeneic HSCT patients who received rATG (Thymoglobulin®) as part of their conditioning at Lille University Hospital from 2003 to 2018. Until 2012, patients received rATG with a theoretical infusion time of 12 hours (12H group, n = 33). From 2012, they had a theoretical infusion time of 4 hours (4H group, n = 43). Patients from the 12H arm presented more ≥ grade 3 infusion‐related reactions at first dose (70% versus 44%, P = .027), had significantly higher fever (median of 39.6°C versus 39.2°C, P = .002), and needed a greater use of symptomatic treatments. However, they received a slightly higher first dose of rATG (median of 2.7 versus 2.3 mg/kg, P = .042). In view of these results, a rATG infusion time of 4 hours can be a relevant option for pediatric transplant centers to avoid interference with the conditioning regimen and facilitate medical surveillance.
Seasonal variations of epidermal biophysical properties in Kunming, China: A self‐controlled cohort study
Authors: Yang Jianting , Tu Ying , Man Mao‐Qiang , Zhang Yuanjin , Cha Yusi , Fan Xiaoqing , Wang Zixu , Zeng Zixun , He Li
Published: March 2020

Background

Epidermal biophysical properties can be affected by many factors, including body site, age, gender, ethnicity, disease, temperature, humidity, and ultraviolet (UV) radiation. Information about variation of epidermal biophysical properties with seasons is still limited. In the present study, we determined seasonal variation of epidermal biophysical properties of women in Kunming, China.

Materials and Methods

A total of 72 women, aged 22.96 ± 2.11 years, were enrolled in this study. Transepidermal water loss rates (TEWL), stratum corneum (SC) hydration, sebum content, melanin index (MI), erythema index (EI), and L*a* values were measured on the right cheek and the right forearm, using a non‐invasive skin physiological instrument in the spring, summer, autumn, and winter in Kunming, China.

Results

On the cheek, TEWL, SC hydration, sebum, MI, and L*a* values varied greatly with seasons (P < .05). SC hydration, sebum, MI, and a*value peaked in the summer, but went lowest in winter. In contrast, TEWL and L*value went lowest in summer but peaked in winter. Similarly, SC hydration, MI, and L*value also varied with seasons on the forearm (P < .05). In addition, SC hydration, sebum, MI, EI, and a*value of the cheek were higher than that of the forearm (P < .001), but L*values of the cheek were lower than that of the forearm (P < .001). There were no correlations among TEWL and MI, EI, and L*a*values in any season (P > .05).

Conclusions

Both epidermal permeability barrier function, sebum, and skin pigment in healthy women vary seasons in Kunming, China.
Antecedents of Social Media Usage Status: Examination of Predictiveness of Digital Literacy, Academic Performance, and Fear of Missing Out Variables
Authors: Yildiz Durak Hatice , Seferoğlu Süleyman Sadi
Published: March 2020

Objective

The aim of this study is to examine predictiveness of digital literacy, academic performance, and fear of missing out (FoMO) variables on social media usage (SMU) status.

Methods

This relational study was conducted with participation of 1,284 students. For collection of the data a self‐description form and also four other different data collection instruments were utilized. Data were analyzed through descriptive statistics and linear multiple hierarchical regressions analysis.

Results

At the end of the study, demographic variables were observed to be the most important predictor of SMU experiences. The consequence was reached that digital literacy was the most important variable, which predicted SMU frequencies and use of social media environments with purposes of social interaction, communication, and education. Additionally, FoMO is important in terms of explaining the number of friends/followers in social media environments, and students’ use and usage attitudes of social media environments for the purposes of knowing and being known.

Conclusion

In this study, the relationship among the age variable and SMU frequencies and use of social media environments for the purpose of knowing and to be known and for the purpose of education came out to be in a negative direction. In line with these consequences, some practical suggestions can be made on SMU patterns.
Are Clostridioides difficile infections being overdiagnosed in hematopoietic stem cell transplant recipients?
Authors: Ford Clyde D. , Lopansri Bert K. , Coombs Jana , Webb Brandon J. , Asch Julie , Hoda Daanish
Published: March 2020

Background

Because both diarrhea due to other causes and gastrointestinal colonization with toxigenic Clostridioides difficile are common in HSCT, there is a possibility of false‐positive diagnoses of C difficile infections (CDI).

Methods

We estimated the probability of a patient being colonized by toxigenic C difficile by testing non‐diarrheal surveillance stools from 223 HSCT recipients and the probability that a specimen submitted for C difficile testing was not CDI by determining the number of clinical tests that returned negative from this cohort. The number of expected false‐positive CDI was estimated using these probabilities and compared with observed clinical test results.

Results

The expected false‐positive and the observed numbers of positive clinical results were similar. The 20 patients diagnosed with CDI were also similar to 142 patients with diarrhea and C difficile‐negative stools in number of stools on day of testing, associated symptoms, and the recorded number of days to formed stools. C difficile colonization was most commonly detected during the first week and CDI during the second. Retrospective analysis of 837 patients showed that 18 stools were submitted for each diagnosis of CDI. Ribotyping of the surveillance samples showed 17 ribotypes.

Conclusions

Although several assumptions could impact the accuracy of our false‐positive CDI estimates, it appears that many HSCT recipients diagnosed with CDI may actually represent colonized status and an alternative cause of diarrhea. Diagnostic stewardship, including limiting CDI diagnoses to patients with positive toxin and restricting stool submissions to patients with more severe symptoms, may decrease the number of false‐positive diagnoses.
The guaiac‐based fecal occult blood test in healthy dogs: Evaluation of the effects of diet, and the ability of the test to detect fecal occult blood
Authors: Pierini Alessio , Bartoletti Francesca , Lubas George , Gori Eleonora , Marchetti Veronica
Published: March 2020

Background

The guaiac‐based fecal occult blood test (gFOBt) has been used for human colorectal cancer screening. It can detect the fecal occult blood (FOB) in dogs after oral administration of 20 mg of hemoglobin/kg body weight of blood and is influenced by diet.

Objectives

The aims were to evaluate the effect of diet and the ability of gFOBt to detect FOB in healthy dogs after oral administration of autologous blood.

Methods

Five healthy dogs were fed Purina Hypoallergenic (HA) and Gastrointestinal (EN) diets. Feces were tested with gFOBt before starting diets and at each defecation (hereafter referred to as fecal collection event) throughout the study period. Every 4 days, increased doses of autologous blood were administered orally. The whole blood of one dog was progressively diluted with a saline solution, and dilutions were directly tested with the gFOBt, until a negative result was found.

Results

Twelve of 185 (6.5%) gFOBt were found to be positive. No associations between diet and gFOBt positivity were found. A significant association was found between the fecal collection event and gFOBt positivity (P < .001) and between doses of blood and gFOBt positivity (P = .048). The lowest dilution ensuring all positive tests was 6.5 µgHgb/mL.

Conclusions

The gFOBt was not influenced by either the HA or EN diets. The gFOBt positivity was associated with the dose of blood and the fecal collection event. However, caution is needed in the interpretation of results due to the lack of an association between gFOBt positivity and increasing doses of blood in the same dog.
Presence ofQacgenes in clinical isolates of methicillin‐resistant and methicillin‐susceptibleStaphylococcus pseudintermediusand their impact on chlorhexidine digluconate susceptibility
Authors: Walker Meagan A. , Singh Ameet , Gibson Tom W. , Rousseau Joyce , Weese J. Scott
Published: March 2020

Objective

To evaluate the presence of quaternary ammonium compound (QAC) (resistance genes,qac A/B,smr,qacG, andqacJ, in clinical isolates of methicillin‐susceptibleStaphylococcus pseudintermedius(MSSP) and methicillin‐resistantS pseudintermedius(MRSP) from dogs and the impact on in vitro chlorhexidine susceptibility.

Study design

Experimental in vitro study.

Sample population

Seventy isolates from dogs colonized or infected with MRSP (n = 50) or MSSP (n = 20).

Methods

Agar dilution was used to determine the minimum inhibitory concentration (MIC) of chlorhexidine digluconate. Real‐time polymerase chain reaction was used to detect the presence ofQACresistance genes,qacA/B,smr,qacG,and qacJgenes.

Results

One or moreqacgenes were identified in 52 of 70 (74%) isolates. Overall, there was no association between chlorhexidine MIC and the presence of one or moreqacgenes (P= .85) or the presence ofqacA/B(P= .31),smr(P= .72) orqacJ (P= .93) individually. There was an association betweenqacGand MIC (P= .012), with a median MIC of 1.5 μg/mL for isolates possessing this gene and 1 μg/mL for those not possessing it.

Conclusion

Quaternary ammonium compound resistance genes were present in MRSP and MSSP isolates. With the exception ofqacG, the presence of these genes was not associated with increased MIC. All isolates exhibited MIC 5000 to 80 000 times lower than the concentration recommended for use.

Clinical significance

Despite the presence of QAC genes, chlorhexidine digluconate should be effective against MRSP and MSSP if used correctly.
Examination of Predictive Flame Extinction Boundaries for Bluff Body Stabilized Flames at Elevated Temperature and Pressure Conditions
Authors: Hernandez Candy , McDonell Vincent
Published: March 2020

A correlation for the prediction of flame lean extinction limits for premixed combustion systems by Sullivan-Lewis and McDonell is examined. The correlation was developed with the data collected from Sullivan-Lewis' experiments of methane and hydrogen mixtures at elevated temperatures and pressures, similar to gas turbine conditions. Recent flame stability studies have since appeared in literature and has allowed for inspection of the validity of the predictive flame extinction boundary correlation with new data. The blow-off boundary correlation is also examined with previous flame blow off studies with significant variances of parameters compared to the original study used to build the correlation. The data used for comparison differ with fuel type, equivalence ratios, pressures, temperatures, turbulence intensities, and flameholder geometries. The analysis concludes that the predictive flame extinction correlation developed is able to accurately predict a wide range of extinction conditions reported in the literature. However, it is observed that the correlation is not able to fully capture the behavior of the data for conditions in which turbulence intensities are above 5%.
Mechanical Buckling Analysis of Saturated Porous Functionally Graded Elliptical Plates Subjected to In-Plane Force Resting on Two Parameters Elastic Foundation Based on HSDT
Authors: Sharifan Mohammad Hossein , Jabbari Mohsen
Published: March 2020

In this paper, mechanical buckling analysis of a functionally graded (FG) elliptical plate, which is made up of saturated porous materials and is resting on two parameters elastic foundation, is investigated. The plate is subjected to in-plane force and mechanical properties of the plate assumed to be varied through the thickness of it according to three different functions, which are called porosity distributions. Since it is assumed that the plate to be thick, the higher order shear deformation theory (HSDT) is employed to analyze the plate. Using the total potential energy function and using the Ritz method, the critical buckling load of the plate is obtained and the results are verified with the simpler states in the literature. The effect of different parameters, such as different models of porosity distribution, porosity variations, pores compressibility variations, boundary conditions, and aspect ratio of the plate, is considered and has been discussed in details. It is seen that increasing the porosity coefficient decreases the stiffness of the plate and consequently the critical buckling load will be reduced. Also, by increasing the pores' compressibility, the critical buckling load will be increased. Adding the elastic foundation to the structure will increase the critical buckling load. The results of this study can be used to design more efficient structures in the future.
Coupled vibro-acoustic modeling of a dielectric elastomer loudspeaker
Authors: Garnell Emil , Doaré Olivier , Rouby Corinne
Published: March 2020

Dielectric elastomer membranes are soft electro-active materials capable of large deformations. When inflated over a cavity, the membrane radiates sound and can therefore be used as a loudspeaker. This type of device has been studied both experimentally and numerically. However, most studies on the dynamics of dielectric elastomer membranes either focus on the very low frequency behavior to analyse viscosity effects for example, or try to maximise the overall radiated sound pressure level. Here the mid-frequency range is analysed in detail, by setting up a fully coupled finite element model of an inflated dielectric elastomer membrane. Electrostatics, vibro-acoustics, free-field radiation, and pre-stressed linear dynamics are solved together, to find the fluid loaded resonance modes. The dynamics of the membrane and the sound radiation are then computed using this resonance mode basis. Perfectly matched layers are used to implement the Sommerfeld radiation boundary condition. The model is validated by a comparison with measurements of the pressure radiated by a prototype, and predicts accurately the radiated pressure and the directivity. This model should therefore help the development of optimized dielectric elastomer loudspeakers, with improved frequency responses and directivity.
Structure and Molecular Recognition Mechanism of IMP-13 Metallo-β-Lactamase
Authors: Softley Charlotte A. , Zak Krzysztof M. , Bostock Mark J. , Fino Roberto , Zhou Richard Xu , Kolonko Marta , Mejdi-Nitiu Ramona , Meyer Hannelore , Sattler Michael , Popowicz Grzegorz M.
Published: March 2020

Multidrug resistance among Gram-negative bacteria is a major global public health threat. Metallo-β-lactamases (MBLs) target the most widely used antibiotic class, the β-lactams, including the most recent generation of carbapenems. Interspecies spread renders these enzymes a serious clinical threat, and there are no clinically available inhibitors. We present the crystal structures of IMP-13, a structurally uncharacterized MBL from the Gram-negative bacterium
Pseudomonas aeruginosa
found in clinical outbreaks globally, and characterize the binding using solution nuclear magnetic resonance spectroscopy and molecular dynamics simulations.
Telacebec for Ultrashort Treatment of Buruli Ulcer in a Mouse Model
Authors: Almeida Deepak V. , Converse Paul J. , Omansen Till F. , Tyagi Sandeep , Tasneen Rokeya , Kim Jeongjun , Nuermberger Eric L.
Published: March 2020

Telacebec (Q203) is a new antitubercular drug with extremely potent activity against
Mycobacterium ulcerans
. Here, we explored the treatment-shortening potential of Q203 alone or in combination with rifampin (RIF) in a mouse footpad infection model. The first study compared Q203 at 5 and 10 mg/kg doses alone and with rifampin. Q203 alone rendered most mouse footpads culture negative in 2 weeks. Combining Q203 with rifampin resulted in a relapse-free cure 24 weeks after completing 2 weeks of treatment, compared to a 25% relapse rate in mice receiving RIF with clarithromycin, the current standard of care, for 4 weeks.
Unexpected Abundance and Diversity of Phototrophs in Mats from Morphologically Variable Microbialites in Great Salt Lake, Utah
Authors: Kanik Mert , Munro-Ehrlich Mason , Fernandes-Martins Maria Clara , Payne Devon , Gianoulias Kathryn , Keller Lisa , Kubacki Alexander , Lindsay Melody R. , Baxter Bonnie K. , Vanden Berg Michael D. , Colman Daniel R. , Boyd Eric S.
Published: March 2020

The earliest evidence of life on Earth is from organosedimentary structures, termed microbialites, preserved in 3.481-billion-year-old (Ga) rocks. Phototrophic microbial mats form in association with an ∼700-km
2
expanse of morphologically diverse microbialites in the hypersaline Great Salt Lake (GSL), Utah. Here, we show taxonomically similar microbial mat communities are associated with morphologically diverse microbialites across the lake. Metagenomic sequencing reveals an abundance and diversity of autotrophic and heterotrophic taxa capable of harvesting light energy to drive metabolism. The unexpected abundance of and diversity in the mechanisms of harvesting light energy observed in GSL mat populations likely function to minimize niche overlap among coinhabiting taxa, provide a mechanism(s) to increase energy yield and osmotic balance during salt stress, and enhance fitness. Together, these physiological benefits promote the formation of robust mats that, in turn, influence the formation of morphologically diverse microbialite structures that can be imprinted in the rock record.
Identification of Pathogenicity Island Genes Associated with Loss of Type IV Secretion Function during Murine Infection with Helicobacter pylori
Authors: Hansen Lori M. , Dekalb Dylan J. , Cai Lucy P. , Solnick Jay V.
Published: March 2020

Chronic
Helicobacter pylori
colonization in animal models often leads to downregulation of the type IV secretion system (T4SS), typically by recombination in
cagY
, which is an essential T4SS gene. However, 17 other
cag
pathogenicity island (
cag
PAI) genes, as well as some non-
cag
PAI genes, are also essential for T4SS function. To get a more complete picture of how
H. pylori
regulates the T4SS during animal colonization, we examined
cagY
in 534 mouse-passaged isolates that lost T4SS function, defined as a normalized interleukin-8 (IL-8) value of <0.
Expanding Access to Biospecimens for Lyme Disease Test Development
Authors: Schmitz John L.
Published: March 2020

The laboratory diagnosis of Lyme disease relies upon serologic testing. A standard or modified two-tiered testing algorithm is used to enhance the accuracy of antibody detection. However, this approach suffers from a lack of sensitivity in early Lyme disease. Ongoing efforts to develop more sensitive antibody detection technologies and other diagnostic approaches are dependent upon the availability of quality-assured biospecimens linked to reliable clinical data. In this issue of the
Journal of Clinical Microbiology
, Horn et al.
Flash glucose monitoring reduces glycemic variability and hypoglycemia: real-world data from Spain
Authors: Gomez-Peralta Fernando , Dunn Timothy , Landuyt Katherine , Xu Yongjin , Merino-Torres Juan Francisco
Published: March 2020

Objective

Observations in real-world settings support and extend findings demonstrated in randomized controlled trials that show flash glucose monitoring improves glycemic control. In this study, Spain-specific relationships between testing frequency and glycemic parameters were investigated under real-world settings.

Research design and methods

Deidentified glucose and user scanning data were analyzed and readers were rank ordered into 20 equal sized groups by daily scan frequency. Glucose parameters were calculated for each group: estimated HbA1c, time below range (<70 and ≤54 mg/dL), within range (70–180 mg/dL), and above range (>180 mg/dL). Glycemic variability (GV) metrics were described and data obtained from sensors in Spain and worldwide were compared.

Results

Spanish users (n=22 949) collected 37.1 million glucose scans, 250 million automatically recorded glucose readings, and checked glucose values via a mean of 13 scans/day. Estimated HbA1c, time below 70 mg/dL, at or below 54 mg/dL, above 180 mg/dL, and GV metrics were significantly lower in the highest compared with lowest scan rate group (39.6 to 3.9 scans/day). Time-in-range was higher for the highest versus lowest scan rate group at 15.6 vs 11.5 hours/day, respectively. GV metrics correlated positively with time below 70 mg/dL, at or below 54 mg/dL, above 180 mg/dL, and negatively with time-in-range. The relationship between glucose metrics and scan rate was similar in Spain and worldwide. However, time in hypoglycemia in Spain was higher in the groups with lower scan rates.

Conclusions

As seen in clinical trials, flash glucose monitoring in real-world settings allows frequent glucose checks. High scan rates are associated with the favorable glycemic markers of increased time-in-range and reduced time in hyperglycemia and hypoglycemia, and GV. The same trends, with unique nuances, are observed in both Spanish and global data.
Prevalence of and factors associated with violations of a campus smoke-free policy: a cross-sectional survey of undergraduate students on a university campus in the USA
Authors: Ramachandran Sujith , Bentley Sandra , Casey Ethan , Bentley John P
Published: March 2020

Objective

The aim of this study is to estimate the prevalence of smoking behaviour on campus and to identify the key factors that influence adherence to a campus smoke-free policy.

Design & participants

This study employed a cross-sectional, self-administered survey of undergraduate students at the University of Mississippi. A random sample of all available undergraduate classes was recruited for data collection. Students were provided a survey that included questions on demographics, alcohol use, smoking status, policy awareness, policy attitudes, smoking attitudes, policy support, barriers to policy success and policy violations.

Results

The prevalence of past 30-day smoking was 23%. More than 63% of current smokers report ever smoking on campus, but less than 10% ever received a warning or a ticket for their violation. Nearly all respondents (92.5%) reported witnessing someone smoking on campus, and 22% reported witnessing someone receiving a ticket. Barriers to policy success include lack of reminders about the policy, lack of support from students and University administrators, and insufficient fines. Smoking behaviour (OR: 7.96; 95% CI: 5.13 to 12.36), beliefs about policy adherence (OR: 0.52; 95% CI: 0.40 to 0.69), support for the policy (OR: 0.71; 95% CI: 0.55 to 0.91) and attitudes against smoking behaviour (OR: 0.35; 95% CI: 0.25 to 0.49) were all significantly associated with self-reported policy violations.

Conclusions

This study found that violations of the campus smoke-free policy were fairly frequent and the policy has been largely ineffective, indicating a need for other interventions. Approaches to improve adherence to the policy should address barriers such as reminders about the policy, better policy enforcement and support from the administration.
Association of magnesium intake with type 2 diabetes and total stroke: an updated systematic review and meta-analysis
Authors: Zhao Binghao , Zeng Lianli , Zhao Jiani , Wu Qian , Dong Yifei , Zou Fang , Gan Li , Wei Yiping , Zhang Wenxiong
Published: March 2020

Objective

The detailed associations between type 2 diabetes (T2D) and total stroke and magnesium intake as well as the dose–response trend should be updated in a timely manner.

Design

Systematic review and meta-analyses.

Data sources

PubMed, Embase, Cochrane Library, Web of Science and ClinicalTrials.gov were rigorously searched from inception to 15 March 2019.

Eligibility criteria

Prospective cohort studies investigating these two diseases were included.

Data synthesis

Relative risk (RR) and 95% CI in random effects models as well as absolute risk (AR) were pooled to calculate the risk of T2D and stroke. Methodological quality was assessed by the Newcastle-Ottawa Scale.

Results

Forty-one studies involving 53 cohorts were included. The magnitude of the risk was significantly reduced by 22% for T2D (RR 0.78 (95% CI 0.75 to 0.81); p<0.001; AR reduction 0.120%), 11% for total stroke (RR 0.89 (95% CI 0.83 to 0.94); p<0.001; AR reduction 0.281%) and 12% for ischaemic stroke (RR 0.88 (95% CI 0.81 to 0.95); p=0.001; AR reduction 0.246%) when comparing the highest magnesium intake to the lowest. The inverse association still existed when studies on T2D were adjusted for cereal fibre (RR 0.79; p<0.001) and those on total stroke were adjusted for calcium (RR 0.89; p=0.040). Subgroup analyses suggested that the risk for total and ischaemic stroke was significantly decreased in females, participants with ≥25 mg/m2body mass index and those with ≥12-year follow-up; the reduced risk in Asians was not as notable as that in North American and European populations.

Conclusions

Magnesium intake has significantly inverse associations with T2D and total stroke in a dose-dependent manner. Feasible magnesium-rich dietary patterns may be highly beneficial for specific populations and could be highlighted in the primary T2D and total stroke prevention strategies disseminated to the public.

PROSPERO registration number

CRD42018092690.
Using trigger tools to identify triage errors by ambulance dispatch nurses in Sweden: an observational study
Authors: Spangler Douglas , Edmark Lennart , Winblad Ulrika , Colldén-Benneck Jessica , Borg Helena , Blomberg Hans
Published: March 2020

Objectives

This study aimed to assess whether trigger tools were useful identifying triage errors among patients referred to non-emergency care by emergency medical dispatch nurses, and to describe the characteristics of these patients.

Design

An observational study of patients referred by dispatch nurses to non-emergency care.

Setting

Dispatch centres in two Swedish regions.

Participants

A total of 1089 adult patients directed to non-emergency care by dispatch nurses between October 2016 and February 2017. 53% were female and the median age was 61 years.

Primary and secondary outcome measures

The primary outcome was a visit to an emergency department within 7 days of contact with the dispatch centre. Secondary outcomes were (1) visits related to the primary contact with the dispatch centre, (2) provision of care above the primary level (ie, interventions not available at a typical local primary care centre) and (3) admission to hospital in-patient care.

Results

Of 1089 included patients, 260 (24%) visited an emergency department within 7 days. Of these, 209 (80%) were related to the dispatch centre contact, 143 (55%) received interventions above the primary care level and 99 (38%) were admitted to in-patient care. Elderly (65+) patients (OR 1.45, 95% CI 1.05 to 1.98) and patients referred onwards to other healthcare providers (OR 1.58, 95% CI 1.15 to 2.19) had higher likelihoods of visiting an emergency department. Six avoidable patient harms were identified, none of which were captured by existing incident reporting systems, and all of which would have received an ambulance if the decision support system had been strictly adhered to.

Conclusion

The use of these patient outcomes in the framework of a Global Trigger Tool-based review can identify patient harms missed by incident reporting systems in the context of emergency medical dispatching. Increased compliance with the decision support system has the potential to improve patient safety.
Mindfulness-based programme for residents: study protocol of a randomised controlled trial
Authors: Aeschbach Vanessa Marie-Jane , Fendel Johannes Caspar , Göritz Anja Simone , Schmidt Stefan
Published: March 2020

Introduction

Residency is a stressful phase associated with high prevalence of mental distress. Besides impaired personal health, mental distress in residents has an impact on the quality of patient care and produces economic costs. Therefore, there is demand for interventions that improve resident physicians’ mental health. The aim of the present study is to examine the effects of a mindfulness-based intervention that has been tailored to residents’ needs. Specifically, mindfulness has been supplemented by a focus on the concept of Muße.

Methods and analysis

This study applies a randomised controlled multimethod design. Residents assigned to the intervention group will participate in an 8-week mindfulness course followed by a 4-month maintenance phase, whereas residents assigned to the control group will read text-based information about mindfulness on a weekly basis for the duration of 8 weeks. The intervention is focussed on a transfer of learnt techniques into the daily routine and is targeted to promote residents’ self-care as well as on building empathic relationships. Participants will be assessed before, directly after the intervention, after the maintenance phase as well as at follow-up 6 months after the intervention group completes the intervention. Assessments will consist of self-report measures, physiological data, qualitative interviews, third-party reports as well as implicit and projective measures and will focus on both psychopathology and salutogenesis. The primary outcome will be burnout. Data will be analysed using linear mixed modelling.

Ethics and dissemination

The study was approved by the ethics committee of the Medical Center - University of Freiburg and is funded by the German Research Foundation as part of the interdisciplinary Collaborative Research Center ‘SFB Muße 1015’. The results of this study will be published in scientific journals and disseminated through the study’s website, and conferences.

Trial registration number

DRKS00014015.
Impact of a short version of the CONSORT checklist for peer reviewers to improve the reporting of randomised controlled trials published in biomedical journals: study protocol for a randomised controlled trial
Authors: Speich Benjamin , Schroter Sara , Briel Matthias , Moher David , Puebla Iratxe , Clark Alejandra , Maia Schlüssel Michael , Ravaud Philippe , Boutron Isabelle , Hopewell Sally
Published: March 2020

Introduction

Transparent and accurate reporting is essential for readers to adequately interpret the results of a study. Journals can play a vital role in improving the reporting of published randomised controlled trials (RCTs). We describe an RCT to evaluate our hypothesis that asking peer reviewers to check whether the most important and poorly reported CONsolidated Standards of Reporting Trials (CONSORT) items are adequately reported will result in higher adherence to CONSORT guidelines in published RCTs.

Methods and analysis

Manuscripts presenting the primary results of RCTs submitted to participating journals will be randomised to either the intervention group (peer reviewers will receive a reminder and short explanation of the 10 most important and poorly reported CONSORT items; they will be asked to check if these items are reported in the submitted manuscript) or a control group (usual journal practice). The primary outcome will be the mean proportion of the 10 items that are adequately reported in the published articles. Peer reviewers and manuscript authors will not be informed of the study hypothesis, design or intervention. Outcomes will be assessed in duplicate from published articles by two data extractors (at least one blinded to the intervention). We will enrol eligible manuscripts until a minimum of 83 articles per group (166 in total) are published.

Ethics and dissemination

This pragmatic RCT was approved by the Medical Sciences Interdivisional Research Ethics Committee of the University of Oxford (R62779/RE001). If this intervention is effective, it could be implemented by all medical journals without requiring large additional resources at journal level. Findings will be disseminated through presentations in relevant conferences and peer-reviewed publications. This trial is registered on the Open Science Framework (https://osf.io/c4hn8).
Practical laboratory considerations amidst the COVID-19 outbreak: early experience from Singapore
Authors: Tan Shaun S , Yan Benedict , Saw Sharon , Lee Chun Kiat , Chong Ai Teng , Jureen Roland , Sethi Sunil
Published: March 2020

The coronavirus disease 2019 (COVID-19) is a zoonotic viral infection originating from Wuhan, China in December 2019. The World Health Organization has classified this pandemic as a global health emergency due to its virulent nature of transmission, which may lead to acute respiratory distress syndrome. Singapore’s health ministry has responded with enhanced surveillance of COVID-19 for all suspected pneumonia cases, further increasing the volume of testing via real-time reverse transcription PCR, as well as samples necessitating stringent infectious control. Collectively, this has implications on the total testing process, laboratory operations and its personnel due to biosafety concerns. Turnaround time for routine testing may also be affected. The aim of this article is to present our tertiary institution’s early experience with managing this emerging crisis and offer practical considerations for the preanalytical, analytical and postanalytical phases of laboratory testing in this cohort of patients.
Perceived addiction to vaping among youth and young adult regular vapers
Authors: Camara-Medeiros Alexia , Diemert Lori , O'Connor Shawn , Schwartz Robert , Eissenberg Thomas , Cohen Joanna E
Published: March 2020

Background

The prevalence of e-cigarette use among youth and young adults has increased markedly in recent years; however, little is known about young people’s perceptions of e-cigarette addiction. This study examines factors associated with self-reported addiction to e-cigarette use among this population.

Methods

In 2018, 1048 Canadians aged 16–25 years were recruited through online social media platforms to complete a survey. Quota sampling was used to oversample regular e-cigarette users (vaping at least weekly); these 578 regular users were included in this analysis. Self-perceived addiction was assessed by asking participants if they felt they were ‘very’, ‘somewhat’ or ‘not at all’ addicted to e-cigarettes. A proportional odds model was employed to identify factors associated with the ordinal outcome.

Results

Almost half of regular users perceived themselves to be ‘not at all addicted’, 41% felt they were ‘somewhat addicted’ and 13% felt they were very addicted to e-cigarettes. Women, former cigarette smokers, daily vapers and those vaping for more than a year were more likely to report higher levels of perceived addiction. Similarly, high sensation-seeking youth, those reading blogs and websites about vaping, those frequently dripping and those using higher nicotine strengths had a greater likelihood of higher perceived addiction than their respective counterparts.

Conclusion

More than half of youth and young adult regular e-cigarette users felt they had some level of addiction. The findings identify possible opportunities for targeted programming for education and treatment, as well as potential opportunities for policy change such as maximum allowable nicotine strengths.
Trends in affordability of tobacco products before and after the transition to GST in India
Authors: John Rijo M , Dauchy Estelle
Published: March 2020

Objective

To estimate the trends in affordability of bidis, cigarettes and smokeless tobacco (SLT) in India and examine the impact of transition from the earlier indirect taxation system to the new goods and services tax (GST) on the affordability.

Methods

Retail price data and per-capita gross domestic product data were used to examine the trends in affordability of cigarettes, bidis and SLT from 2007–2008 to 2018–2019. Relative income price defined as the share of real per-capita income required to purchase a given quantity of a product was used to measure affordability. Changes in affordability were decomposed to disaggregate the effects of real prices or income changes.

Findings

On average, cigarettes, bidis and SLT have become increasingly affordable over the past 10 years. Bidis were found to be nine times more affordable than cigarettes. The GST has accentuated the increase in the affordability of cigarettes and SLT, and did not significantly alter the high affordability of bidis. In general, states with high (low) value-added tax rates during the pre-GST period experienced increases (decreases) in tobacco products’ affordability after GST.

Conclusion

Bidis continue to be highly affordable while the affordability of cigarettes and SLT increased mainly due to lack of any tax changes after GST and the growth in per-capita income. To effectively reduce affordability, significant increase in either the excise taxes and/or the compensation cess—a temporary duty in addition to GST—is warranted. Compensation cess should also be applied on bidis to address the huge tobacco use problem in India.
Willow tree algorithms for pricing VIX derivatives under stochastic volatility models
Authors: Ma Changfu , Xu Wei , Kwok Yue Kuen
Published: March 2020

VIX futures and options are the most popular contracts traded in the Chicago Board Options Exchange. The bid-ask spreads of traded VIX derivatives remain to be wide, possibly due to the lack of reliable pricing models. In this paper, we consider pricing VIX derivatives under the consistent model approach, which considers joint modeling of the dynamics of the S&P index and its instantaneous variance. Under the affine jump-diffusion formulation with stochastic volatility, analytic integral formulas can be derived to price VIX futures and options. However, these integral formulas invariably involve Fourier inversion integrals with cumbersome hyper-geometric functions, thus posing various challenges in numerical evaluation. We propose a unified numerical approach based on the willow tree algorithms to price VIX derivatives under various common types of joint process of the S&P index and its instantaneous variance. Given the analytic form of the characteristic function of the instantaneous variance of the S&P index process in the Fourier domain, we apply the fast Fourier transform algorithm to obtain the transition density function numerically in the real domain. We then construct the willow tree that approximates the dynamics of the instantaneous variance process up to the fourth order moment. Our comprehensive numerical tests performed on the willow tree algorithms demonstrate high level of numerical accuracy, runtime efficiency and reliability for pricing VIX futures and both European and American options under the affine model and 3/2-model. We also examine the implied volatility smirks and the term structures of the implied skewness of VIX options.
Do competition and revenue diversification have significant effect on risk-taking? Empirical evidence from BRICS banks
Authors: Gupta Anupam Das , Moudud-Ul-Huq Syed
Published: March 2020

This study of two-step system generalized methods of moments (2GMM) of dynamic panel data addresses some critical insights of competition and revenue diversification of BRICS banks. The key findings are: (i) There is a significant positive association of market competition in risk-taking. (ii) Revenue diversification of banks supports the portfolio investment theory in risk management, which means that diversified sources of income have apparent influence in risk. (iii) Size has found a heterogeneous effect on risk-taking in the competitive market. (iv) Although, country-wise results of each country are in line with BRICS results in most of the cases, however, few exceptions are also observed in the examination of competition, revenue diversification and size in credit risk and stability of banks. Finally, the study evidences the nonlinear relationship of competition, revenue diversification, and risk.
The geomagnetic field's imprint on the twentieth century's climate variability
Authors: Kilifarska N. A. , Bakhmutov V. G. , Melnyk G. V.
Published: March 2020

The existing controversy regarding the climatic response to given changes in the geomagnetic field intensity (e.g. climate cooling or warming in periods of geomagnetic field strengthening) raises scepticism about the existence of any relationship between both variables. The main shortcomings of the recent understanding of the geomagnetic field–climate relationship are the expectations for: (i) its universal character over the globe; and (ii) the zonal homogeneity of this relationship. This paper offers a new conceptual framework aimed at resolving the existing controversy and explaining the mechanism for the appearance of geomagnetic footprints on climatic records.

We show that particles trapped in the Earth's radiation belts are subject to geomagnetic lensing in the parts of their trajectories closest to the surface, being focused or defocused at different regions over the world. The irregularly distributed ionization, created in such a way near the tropopause, activates various ion–molecular reactionships which affect the atmospheric composition there. Thus, the regional changes in the ozone and water vapour are furthermore projected onto the surface temperature and pressure. Consequently, the geomagnetic field–climate relationship is not a rigid but, rather, a flexible one because it is mediated by the near-tropopause ionization, ozone and humidity, with each of them being subject to the other's influence.