bluuebunny/crossref_metadata_2025 huggingface dataset:
Guidelines on management of cyclic vomiting syndrome in adults by the American Neurogastroenterology and Motility Society and the Cyclic Vomiting Syndrome Association
Authors: Venkatesan Thangam , Levinthal David J. , Tarbell Sally E. , Jaradeh Safwan S. , Hasler William L. , Issenman Robert M. , Adams Kathleen A. , Sarosiek Irene , Stave Christopher D. , Sharaf Ravi N. , Sultan Shahnaz , Li B U. K.
Published: June 2019

The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence‐based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework was used and a professional librarian performed the literature search. The expert committee included the President of the CVSA who brought a patient perspective into the deliberations. The committee makes recommendations for the prophylaxis of CVS, treatment of acute attacks, diagnosis, and overall management of CVS. The committee strongly  recommends that adults with moderate‐to‐severe CVS receive a tricyclic antidepressant (TCA), such as amitriptyline, as a first‐line prophylactic medication and receive topiramate or aprepitant as alternate prophylactic medications. Zonisamide or levetiracetam and mitochondrial supplements (Coenzyme Q10, L‐carnitine, and riboflavin) are conditionally recommended as alternate prophylactic medications, either alone or concurrently with other prophylactic medications. For acute attacks, the committee conditionally recommends using serotonin antagonists, such as ondansetron, and/or triptans, such as sumatriptan or aprepitant to abort symptoms. Emergency department treatment is best achieved with the use of an individualized treatment protocol and shared with the care team (example provided). The committee recommended screening and treatment for comorbid conditions such as anxiety, depression, migraine headache, autonomic dysfunction, sleep disorders, and substance use with referral to appropriate allied health services as indicated. Techniques like meditation, relaxation, and biofeedback may be offered as complementary therapy to improve overall well‐being and patient care outcomes.
Management of cyclic vomiting syndrome in adults: Evidence review
Authors: Sharaf Ravi N. , Venkatesan Thangam , Shah Raj , Levinthal David J. , Tarbell Sally E. , Jaradeh Safwan S. , Hasler William L. , Issenman Robert M. , Adams Kathleen A. , Sarosiek Irene , Stave Christopher D. , Li B U. K. , Sultan Shahnaz
Published: June 2019

Background

This evidence review was conducted to inform the accompanying clinical practice guideline on the management of cyclic vomiting syndrome (CVS) in adults.

Methods

We followed the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework and focused on interventions aimed at prophylactic management and abortive treatment of adults with CVS. Specifically, this evidence review addresses the following clinical questions: (a) Should the following pharmacologic agents be used for prophylaxis of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, or mitochondrial supplements? (b) Should the following pharmacologic agents be used for abortive treatment: triptans or aprepitant?

Results

We found very low_quality evidence to support the use of the following agents for prophylactic and abortive treatment of CVS: amitriptyline, topiramate, aprepitant, zonisamide/levetiracetam, and mitochondrial supplements. We have moderate certainty of evidence for the use of triptans as abortive therapy. We found limited evidence to support the use of ondansetron and the treatment of co_morbid conditions and complementary therapies.

Conclusions

This evidence review helps inform the accompanying guideline for the management of adults with CVS which is aimed at helping clinicians, patients, and policymakers, and should improve patient outcomes.
Cyclic vomiting syndrome: Pathophysiology, comorbidities, and future research directions
Authors: Hasler William L. , Levinthal David J. , Tarbell Sally E. , Adams Kathleen A. , Li B U. K. , Issenman Robert M. , Sarosiek Irene , Jaradeh Safwan S. , Sharaf Ravi N. , Sultan Shahnaz , Venkatesan Thangam
Published: June 2019

Cyclic vomiting syndrome (CVS) is characterized by severe episodic emesis in adults and children. Cannabinoid hyperemesis syndrome is an increasingly recognized CVS‐like illness that has been associated with chronic cannabis use. There are significant gaps in our understanding of the pathophysiology, clinical features, comorbidities, and effective management options of CVS. Recommendations for treating CVS are based on limited clinical data, as no placebo‐controlled, randomized trials have yet been conducted. Diseases associated with CVS, including migraine, mitochondrial disorders, autonomic dysfunction, and psychiatric comorbidities, provide clues about pathophysiologic mechanisms and suggest potential therapies. We review our current understanding of CVS and propose future research directions with the aim of developing effective therapy. Establishing a multicenter, standardized registry of CVS patients could drive research on multiple fronts including developing CVS‐specific outcome measures to broaden our understanding of clinical profiles, to serve as treatment end points in clinical trials, and to provide a platform for patient recruitment for randomized clinical trials. Such a robust database would also facilitate conduct of research that aims to determine the underlying pathophysiological mechanisms and genetic basis for CVS, as well as identifying potential biomarkers for the disorder. Soliciting government and industry support is crucial to establishing the necessary infrastructure and achieving these goals. Patient advocacy groups such as the Cyclic Vomiting Syndrome Association (CVSA), which partner with clinicians and researchers to disseminate new information, to promote ongoing interactions between patients, their families, clinicians, investigators, to support ongoing CVS research and education, must be an integral part of this endeavor.
Health literacy, depression, and stress among Chinese immigrants in South Korea
Authors: An Ji‐Young , Moon Hyunjung , Cha Sunkyung
Published: June 2019

Objectives

This study examined health literacy, depression, and stress in Chinese immigrants living in South Korea, and analyzed factors related to these outcomes.

Design

This is a cross‐sectional, descriptive study.

Sample

Participants were 128 adult Chinese immigrants living in the Jung‐gu District of Seoul, South Korea. The majority of the participants were women and in their 40s; had a high school diploma; and were employed and married. Most had lived in Korea for 5–10 years.

Measurements

Outcome variables were health literacy, depression, and immigrant stress; independent variables were sociodemographic characteristics, language proficiency, health, and behavioral factors. Hierarchical multiple regression models based on the conceptual framework were tested.

Results

The major factor influencing health literacy was perceived economic status (p = 0.021). The factors related to depression were life satisfaction in China (p = 0.032), life satisfaction in Korea (p = 0.040), and stress perception in everyday life (p = 0.001).

Conclusions

As the number of immigrants rises, there is increasing demand for public‐health‐center‐based health promotion programs for immigrants. It is recommended that local public health practitioners, including public health nurses, closely analyze the characteristics of their community and immigrants, and develop and implement customized programs accordingly.
Optimization of the Aflatoxin Monitoring Costs along the Maize Supply Chain
Authors: Focker M. , van der Fels‐Klerx H. J. , Oude Lansink A. G. J. M.
Published: June 2019

An optimization model was used to gain insight into cost‐effective monitoring plans for aflatoxins along the maize supply chain. The model was based on a typical Dutch maize chain, with maize grown in the Black Sea region, and transported by ship to the Netherlands for use as an ingredient in compound feed for dairy cattle. Six different scenarios, with different aflatoxin concentrations at harvest and possible aflatoxin production during transport, were used. By minimizing the costs and using parameters such as the concentration, the variance of the sampling plan, and the monitoring and replacement costs, the model optimized the control points (CPs; e.g., after harvest, before or after transport by sea ship), the number of batches sampled at the CP, and the number of samples per batch. This optimization approach led to an end‐of‐chain aflatoxin concentration below the predetermined limit. The model showed that, when postharvest aflatoxin production was not possible, it was most cost‐effective to collect samples from all batches and replace contaminated batches directly after the harvest, since the replacement costs were the lowest at the origin of the chain. When there was aflatoxin production during storage, it was most cost‐effective to collect samples and replace contaminated batches after storage and transport to avoid the duplicate before and after monitoring and replacement costs. Further along the chain a contaminated batch is detected, the more stakeholders are involved, the more expensive the replacement costs and possible recall costs become.
Randomized clinical study to compare negative pressure wound therapy with simultaneous saline irrigation and traditional negative pressure wound therapy for complex foot infections
Authors: Davis Kathryn E. , La Fontaine Javier , Farrar David , Oz Orhan K. , Crisologo Peter A. , Berriman Sandra , Lavery Lawrence A.
Published: June 2019

The aim of this study was to compare the efficacy of different negative pressure wound therapy (NPWT) devices and NPWT with and without simultaneous irrigation in patients admitted to hospital with moderate and severe foot infections. Ninety patients were randomized in a 12‐week prospective, randomized noninferiority trial to compare wound healing in patients with moderate and severe infected foot wounds treated with NPWT after surgery. Inclusion criteria included ABI > 0.5 or toe pressures >30 PVR/mmHg, >18 years of age and exclusion included active Charcot arthropathy, collagen vascular disease, HIV, and hypercoagulable state. We compared two different traditional devices, NPWT‐K (KCI, VAC Ulta) and NPWT‐C (Cardinal, PRO), and NPWT‐I with saline irrigation (Cardinal, PRO). All patients had therapy delivered at 125 mmHg continuous pressure. In patients who received simultaneous saline irrigation (NPWT‐I), the administration rate was 15 ml per hour. The primary outcome was the proportion of healed wounds in 12 weeks. Secondary outcomes included surgical wound closure, number of surgeries, length of stay, and time to wound healing. Continuous data was presented as mean ± standard deviation. Analysis of variance was used to compare continuous variables and chi‐square to compare dichotomous variables with an alpha of 0.05. There were no differences in outcomes among NPWT‐I, NPWT‐C, and NPWT‐K groups in proportion of healed wounds (63.3%, 50.0%, 46.7% p = 0.39), surgical wound closure (83.3%, 80.0%, 63.3%, p = 0.15), number of surgeries (2.0 ± 0.49, 2.4 ± 0.77, 2.4 ± 0.68, p = 0.06), length of stay (16.3 ± 15.7, 14.7 ± 7.4, 15.3 ± 10.5 days, p = 0.87), time to wound healing (46.2 ± 22.8, 40.9 ± 18.8, 45.9 ± 28.3 days, p = 0.78). We did not identify any significant differences in clinical outcomes or adverse events between patients treated with different NPWT devices or NPWT with and without irrigation.
Analyzing Human Factors Contributing to the Explosion in Texas Tech University Laboratory
Authors: Morshidi Nur Azizah Arryanie , Pethie @ Petihie Haziqah , Norazahar Norafneeza
Published: June 2019

This paper presents the use of human factor analysis and classification system (HFACS) for the explosion in the Texas Tech University laboratory. Human factor issues in the university laboratory were assessed according to four categories in HFACS: unsafe acts, precondition for unsafe acts, unsafe supervision, and organizational influences. The assessment showed that the student committed many errors due to precondition for unsafe acts, in particular no physical hazard evaluation required prior to conducting the experiment. Inadequate supervision in the university laboratory caused the presence of precondition for unsafe acts among students. The trajectory of human factor issues in the categories of unsafe acts, precondition for unsafe acts, and unsafe supervision pointed to the university’s organization. The human factor issues were analyzed according to three subcategories in organizational influences: resource management, organizational climate, and organizational process. The use of HFACS in the explosion in the Texas Tech University laboratory could demonstrate the sequence of failures and human factors leading to the accident.
Water Footprint Assessment of Rice Production in Malaysia Using LCA Approach
Authors: Mohamed Rusli Nurfarhain , Zainon Noor Zainura , Mat Taib Shazwin , Han Pang Chien
Published: June 2019

The demand for rice in year 2030 is projected to be around 533 million ton of milled rice and known to be a high water consuming crop. In Asia alone, irrigated rice consumes as much as 150 billion m3 of water. With water being the most important component for rice production, yielding more rice with less water is therefore a formidable challenge.  The aim of this study is to assess the water footprint of paddy plantation at Muda Rice Granary, Kedah for five consecutive years; 2012 to 2016. By using the life cycle assessment (LCA) approach, the potential environmental impacts due to water consumption in planting and processing rice will be assessed. By integrating water footprint with LCA may assist in analysing environmental impacts associated with direct and indirect water consumption throughout the whole process; starting from raw material extraction, processing or production, distribution, use, and disposal. The methodological framework follows the LCA framework; setting up goal and specifying the scope of study, followed by inventory analysis, water footprint sustainability assessment and finally interpretation or response formulation. The research boundary for this study include the growing phase of paddy; seedling and cultivating of the paddy until the rice milling process. By implementing this water footprint research in paddy field, it will be essential not only in research area but also in agricultural development in Malaysia. Consequently, it will become the baseline for other agricultural in Malaysia in this research area.
RESEARCH TRENDS IN HYDROLOGICAL MODELLING
Authors: Abdullah Jazuri , Muhammad Nur Shazwani , Muhammad Siti Asiah , Mohammad Amin Noor Farahain , Tahir Wardah
Published: June 2019

This paper reviews the hydrological modelling research trends as published in the recent years. Three-round literature review technique was used to study journal papers published that are related to the hydrological modelling. The published papers were searched by using Web of Sciences engine. The first and second round were to examine the published papers as a general perspective in a wide range of hydrological modelling through title and keywords whereas the third round was to establish 139 papers as target publications through abstract and main texts. 139 target papers were analyzed in terms of (1) journals that produced two or more target papers, (2) research origin, (3) authors, (4) research center and (5) most cited papers. The score matric was used to rank these items. The results of analysis produced (1) 6 journals target papers, (2) United states got the highest score with 27.71 score for research origin, (3) Keith Beven got the highest score 8.03 for an active researcher, (4) Lancaster University got the highest score 9.93 for research center and (5) Keith Beven and Andrew Binley had the most cited papers.
EFFECT OF MANIHOT ESCULENTA AQUEOUS EXTRACT AND THERAPEUTIC ULTRASOUND IN ACCELERATING THE WOUND HEALING PROCESS IN VITRO
Authors: Anwar Ulfah , Mohd Bohari Siti Pauliena
Published: June 2019

The aim of this research is to investigate the wound healing process in in vitro by combining the Manihot esculenta aqueous extract and therapeutic ultrasound. Firstly, the optimization seeding densities of HSF cell 1184 in six-well plate, and then followed by the scratch assay experiment. The scratched that made was treated with the remedial treatments (Manihot esculenta aqueous extract only; ascorbic acid+ therapeutic ultrasound; Manihot esculenta aqueous extract+ ascorbic acid; Manihot esculenta aqueous extract+ therapeutic ultrasound and also the combination of these three materials). The rate of wound closure was observed and analysed at a time interval of 0, 2, 4, 6, 8, 10 and 24 h by using image J software. Then, the cells viability were analysed using the MTT assay. The result showed that Manihot esculenta aqueous extract coupled with specific dose therapeutic ultrasound represents a significantly high rate of wound closure at 96.10 % with the cell numbers at 5.44×105 cells/mL when compared to the other combination therapy. The finding of this study revealed that Manihot esculenta aqueous extract 200 µg/mL and the therapeutic ultrasound specific dose (3 MHz, 300 mWatt/cm2, 50% in 5 min) have the potential in accelerating wound healing process of cells in in vitro.
SYNTHESIS OF THIOUREA DERIVATIVES FROM M-METHOXYCINNAMIC ACID AS ANTIANGIOGENIC CANDIDATE
Authors: Ekowati Juni , Hamid Iwan Sahrial , Nofianti Kholis Amalia , Sasaki Shigeru
Published: June 2019

Microwave-assisted nucleophilic acyl substitution was employed to obtain thiourea derivatives (3a, 3b, 3c) from m-methoxycinnamic acid (1). This synthesis method successfully yielded 60-70% reaction product. In vivo anti-angiogenic evaluation was conducted by chick chorioallantoic membrane model, by which each of the derivative at dose 30, 60, and 90 µg induced by bFGF and compared to celecoxib 60 µg as positive control. It was found that all of the synthesized compound at the tested dose were able to inhibit neovascularization and formation of endothelial cell of new blood vessels by 51-75%. In silico analysis predicted that the anti-angiogenesis mechanism of all the synthesized compounds is through the inhibition of EGFR kinase and COX-2. N atom acts as hydrogen bonding acceptor by residue Gly526 of COX-2. While thiourea moieties of 3a-c have hydrophobic interaction by residues Ser530, Tyr385, and Leu352. In addition, the carbonyl group of thiourea of compound 3a-c inhibit EGFR kinase through the interaction with lys745. The pKCSM data revealed that 3a-c absorbed in intestine by 89-92%, and acut toxicity in rat category 4, suggesting that the compounds show good absorption, and low toxicity. In conclusion, this study successfully synthesized thiourea derivatives, which have anti-angiogenesis activity, tested by CAM model.
A Numerical Study on the Keyhole Formation During Laser Powder Bed Fusion Process
Authors: Shrestha Subin , Kevin Chou Y.
Published: June 2019

The dynamic phenomenon of a melt pool during the laser powder bed fusion (LPBF) process is complex and sensitive to process parameters. As the energy density input exceeds a certain threshold, a huge vapor depression may form, known as the keyhole. This study focuses on understanding the keyhole behavior and related pore formation during the LPBF process through numerical analysis. For this purpose, a thermo-fluid model with discrete powder particles is developed. The powder distribution, obtained from a discrete element method (DEM), is incorporated into the computational domain to develop a 3D process physics model using flow-3d. The melt pool formation during the conduction mode and the keyhole mode of melting has been discerned and explained. The high energy density leads to the formation of a vapor column and consequently pores under the laser scan track. Further, the keyhole shape resulted from different laser powers and scan speeds is investigated. The numerical results indicated that the keyhole size increases with the increase in the laser power even with the same energy density. The keyhole becomes stable at a higher power, which may reduce the occurrence of pores during laser scanning.
Where Do We Start? Guidance for Technology Implementation in Maintenance Management for Manufacturing
Authors: Brundage Michael P. , Sexton Thurston , Hodkiewicz Melinda , Morris KC , Arinez Jorge , Ameri Farhad , Ni Jun , Xiao Guoxian
Published: June 2019

Recent efforts in smart manufacturing (SM) have proven quite effective at elucidating system behavior using sensing systems, communications, and computational platforms, along with statistical methods to collect and analyze the real-time performance data. However, how do you effectively select where and when to implement these technology solutions within manufacturing operations? Furthermore, how do you account for the human-driven activities in manufacturing when inserting new technologies? Due to a reliance on human problem-solving skills, today’s maintenance operations are largely manual processes without wide-spread automation. The current state-of-the-art maintenance management systems and out-of-the-box solutions do not directly provide necessary synergy between human and technology, and many paradigms ultimately keep the human and digital knowledge systems separate. Decision makers are using one or the other on a case-by-case basis, causing both human and machine to cannibalize each other’s function, leaving both disadvantaged despite ultimately having common goals. A new paradigm can be achieved through a hybridized system approach—where human intelligence is effectively augmented with sensing technology and decision support tools, including analytics, diagnostics, or prognostic tools. While these tools promise more efficient, cost-effective maintenance decisions and improved system productivity, their use is hindered when it is unclear what core organizational or cultural problems they are being implemented to solve. To explicitly frame our discussion about implementation of new technologies in maintenance management around these problems, we adopt well-established error mitigation frameworks from human factors experts—who have promoted human–system integration for decades—to maintenance in manufacturing. Our resulting tiered mitigation strategy guides where and how to insert SM technologies into a human-dominated maintenance management process.
A T164S mutation in the dengue virus NS1 protein is associated with greater disease severity in mice
Authors: Chan Kitti Wing Ki , Watanabe Satoru , Jin Jocelyn Y. , Pompon Julien , Teng Don , Alonso Sylvie , Vijaykrishna Dhanasekaran , Halstead Scott B. , Marzinek Jan K. , Bond Peter J. , Burla Bo , Torta Federico , Wenk Markus R. , Ooi Eng Eong , Vasudevan Subhash G.
Published: June 2019

The T164S mutation in the NS1 protein of dengue virus increases disease severity in mice through complement activation.
Anchoring of intratumorally administered cytokines to collagen safely potentiates systemic cancer immunotherapy
Authors: Momin Noor , Mehta Naveen K. , Bennett Nitasha R. , Ma Leyuan , Palmeri Joseph R. , Chinn Magnolia M. , Lutz Emi A. , Kang Byong , Irvine Darrell J. , Spranger Stefani , Wittrup K. Dane
Published: June 2019

Collagen-localized cytokines potentiate disparate systemic cancer immunotherapies while minimizing toxicity in many tumor models.
Draft Genome Sequences of Basidiomycetous Epiphytic Phylloplane Yeast Type Strains
Dioszegia crocea
JCM 2961 and
Dioszegia aurantiaca
JCM 2956
Authors: Takashima Masako , Manabe Ri-ichiroh , Ohkuma Moriya
Published: June 2019

We report the draft genome sequences of type strains for
Dioszegia crocea
and its closely related species
Dioszegia aurantiaca
, which should improve our understanding of the epiphytic phylloplane yeasts. These data will also have implications for the plant microbiome, since
Dioszegia
is considered a microbial “hub” taxon.
Post-renal transplant urolithiasis in children: an increasingly diagnosed complication: a retrospective cohort study
Authors: Ma Sophia , Taher Amir , Zhu Benjamin , Durkan Anne Maria
Published: June 2019

Objective

Urolithiasis in renal transplant (RTx) recipients is a potential cause of allograft loss if obstruction is untreated. It is not clear if paediatric transplant recipients are following the global trend for increased prevalence of urolithiasis over time.

Design/Setting/Patients

A retrospective chart review was undertaken to evaluate the frequency, risk factors and characteristics of post-RTx urolithiasis over two decades (1995–2016), in a tertiary Australian paediatric hospital.

Results

Stones were diagnosed in 8 of 142 (5.6%) recipients, 6 of whom were transplanted in the latter decade. All patients were male, with a median age 4.9 years and median weight 11.8 kg. Presentation was with haematuria (n=4), pain (n=2), dysuria (n=2), stone passage (n=1) and asymptomatic (n=1). Time to presentation was bimodal; three stones were identified in the initial 3 months post RTx and the remainder after 31–53 months. Two stones were in association with retained suture material and two patients had recurrent urinary tract infections. The average stone size was 8.4 mm. Five stones were analysed; all contained calcium oxalate, three were mixed, including one with uric acid. Five (83.3%) children had hypercalciuria but none had hypercalcaemia. Cystolithotripsy was the the most common treatment (n=5), in combination with citrate supplementation. No graft was lost due to stones.

Conclusions

Calculi occur with increasing frequency after renal transplantation. Clinicians need a high index of suspicion as symptoms may be atypical in this population. The cause for the increased frequency of stones in transplant recipients is not clear but is in keeping with the increase seen in the general paediatric population.
Observational cross-sectional study on Symptoms Associated to Moisture DAmage at Workplace: the SAMDAW study protocol
Authors: Nynäs Pia , Vilpas Sarkku , Kankare Elina , Karjalainen Jussi , Lehtimäki Lauri , Numminen Jura , Tikkakoski Antti , Kleemola Leenamaija , Uitti Jukka
Published: June 2019

Introduction

Moisture damage (MD) exposure at work has been shown to increase the risk of new onset asthma and exacerbation of asthma. However, most of the studies in this field have been questionnaire studies. A small proportion of MD-exposed workers are diagnosed with asthma. Many patients with MD exposure at work referred to secondary healthcare report intermittent hoarseness, loss of voice or difficulty to inhale, referring to functional or organic problems of the larynx. For accurate treatment, proper differential diagnostics is paramount. We present an ongoing observational study in which we describe the prevalence of respiratory, voice and other symptoms related to MD at work in patients referred to secondary healthcare. Case-control setting will be used to evaluate the frequencies of the background factors, bronchial hyperreactivity and laryngeal findings.

Methods and analysis

The study sample consists of patients with workplace MD exposure and associated respiratory tract and/or voice symptoms referred to Tampere University Hospital. The clinical tests conducted to the study patients included comprehensive lung function tests, laboratory and skin prick tests, imaging and clinical evaluation by specialists of respiratory medicine, oto-rhino-laryngology and phoniatrics. The exposure assessment was performed by an occupational physician. The study patients filled out a questionnaire on previous illnesses and other background factors, which for comparison was also sent to 1500 Finnish-speaking people in the same hospital district randomly selected by the Finnish Population Information System. To explore how common laryngeal disorders and voice symptoms are in general, a part of the tests will be conducted to 50 asymptomatic volunteers.

Ethics and dissemination

The regional ethics committee of Tampere University Hospital approved the study. All study subjects gave their written informed consent, which is required also from the controls. The results will be communicated locally and internationally as conference papers and journal articles.
Barriers to accessing cancer services for adults with physical disabilities in England and Wales: an interview-based study
Authors: Sakellariou Dikaios , Anstey Sally , Gaze Sarah , Girt Eleri , Kelly Daniel , Moore Barbara , Polack Sarah , Pratt Roger , Tyrer Gill , Warren Narelle , Wilkinson Wendy , Courtenay Molly
Published: June 2019

Objectives

The aim of this study was to explore the barriers to accessing cancer services faced by adults with pre-existing physical disabilities.

Design

Cross-sectional, exploratory qualitative study. Data were collected by semistructured interviews and analysed thematically.

Setting

Participants were recruited through statutory and third sector organisations in England and Wales between October 2017 and October 2018.

Participants

18 people with a diagnosis of cancer and a pre-existing physical disability.

Results

The findings illustrate that people with physical disabilities in England and Wales face a variety of barriers to accessing cancer services. The overall theme that emerged was that participants experienced a lack of attitudinal and institutional preparation both from healthcare professionals and healthcare facilities. This overall theme is illustrated through three subthemes: lack of acknowledgment of disability, unseeing disability and physical inaccessibility.

Conclusions

As the population ages and increasing numbers of people live with cancer and disability, it is important to develop knowledge to respond to the needs of this population. The mere existence of services does not guarantee their usability. Services need to be relevant, flexible, and accessible and offered in a respectful manner. It is important that healthcare professionals work towards inclusive healthcare provision, enabling the utilisation of services by all. Necessary steps to be taken include better communication between the various professionals and across the different teams involved in patients’ care, raising awareness of how physical disability can affect or interact with cancer-related treatment and creating more accessible physical environments.
Views of prison staff in Scotland on the potential benefits and risks of e-cigarettes in smoke-free prisons: a qualitative focus group study
Authors: Brown Ashley , Sweeting Helen , Semple Sean , Bauld Linda , Demou Evangelia , Logan Greig , Hunt Kate
Published: June 2019

Objective

Electronic cigarettes (e-cigarettes) were introduced into all Scottish prisons in February 2018, some months after prisons began preparing in 2017 for a smoking ban implemented in November 2018. In 2016/2017, prison staff views on the potential benefits and risks of e-cigarettes were explored in advance of the introduction of: (1) a smoking ban and (2) e-cigarettes.

Setting

Fourteen prisons in Scotland.

Participants

Seventeen focus groups and two paired interviews were conducted with 132 staff in 14 Scottish prisons 4–9 months before plans for a smoking ban were announced in July 2017. Both smoking and non-smoking staff were invited to participate.

Results

Prison staff highlighted three potential risks of e-cigarettes in smoke-free prisons: staff health risks from e-cigarette vapour; prisoner health risks from vaping; and risks to both groups from e-cigarette misuse, defects or accidents. Conversely, potential benefits of e-cigarettes in smoke-free prisons centred on: reducing smoking-related health harms to staff and prisoners; helping prisoners to manage without tobacco; and supporting staff to maintain safety and discipline in prison. Staff who participated in focus groups had limited experience of vaping and expressed some uncertainty and misunderstandings about e-cigarettes.

Conclusion

Our findings highlight that scientific uncertainty, misunderstanding about vaping, the complexity of prisons as workplaces and prison tobacco control policy all have implications for staff perceptions of the potential place of e-cigarettes in smoke-free prisons. To alleviate staff concerns, there is a need for reliable information on e-cigarettes. Staff may also require reassurances on whether products are ‘tamper proof’, and rules about vaping indoors.
Cohort profile: l’Actuel Pre-Exposure Prophylaxis (PrEP) Cohort study in Montreal, Canada
Authors: Greenwald Zoë R , Maheu-Giroux Mathieu , Szabo Jason , Robin Judith Alexia B , Boissonnault Michel , Nguyen Vinh-Kim , Thomas Réjean
Published: June 2019

Purpose

Thel’Actuel PrEP Cohortwas established to monitor the uptake, effectiveness, safety and changes in sexual risk behaviours among individuals receiving pre-exposure prophylaxis (PrEP) for the prevention of HIV. This prospective dynamic cohort is based at Clinique médicale l’Actuel, a large sexual health clinic located in Montreal, Canada.

Participants

Since the cohort inception in January of 2013 through June 2018, 2156 individuals consulted for PrEP as participants in the l’Actuel PrEP Cohort. Median age was 35 years (IQR: 29–44 years) and the majority (96%) were men who have sex with men. Among 1551 individuals who initiated PrEP care, the median duration of follow-up was 9.2 months (IQR: 3.7–19.6), with substantial variation based on year of cohort entry. Thel’Actuel PrEP Cohortcontains both daily and intermittent ‘on-demand’ PrEP users and has the largest reported population of intermittent PrEP users (n=406) in North America.

Findings to date

No incident HIV infections have occurred among individuals using PrEP over 1637 person-years of follow-up. However, retention in PrEP care is essential as three individuals who discontinued PrEP subsequently acquired HIV, translating to an HIV incidence of 3.9 cases per 100 person-years (95% CI: 1.3 to 12.1). Among a sample of participants with 1 year of follow-up before and after PrEP initiation (n=109), a moderate increase in sexually transmitted infections was observed following PrEP start.

Future plans

Thel’Actuel PrEP Cohortcontinues to grow with new participants starting PrEP monthly and extended follow-up for existing users. The cohort data will be used for ongoing monitoring of PrEP and for population-level modelling of the impact of PrEP on HIV incidence in Montreal.
CareTrack Aged: the appropriateness of care delivered to Australians living in residential aged care facilities: a study protocol
Authors: Hibbert Peter D , Wiles Louise K , Cameron Ian D , Kitson Alison , Reed Richard L , Georgiou Andrew , Gray Len , Westbrook Johanna , Augustsson Hanna , Molloy Charlotte J , Arnolda Gaston , Ting Hsuen P , Mitchell Rebecca , Rapport Frances , Gordon Susan J , Runciman William B , Braithwaite Jeffrey
Published: June 2019

Introduction

The aged population is increasing rapidly across the world and this is expected to continue. People living in residential aged care facilities (RACFs) represent amongst the sickest and frailest cohort of the aged population, with a high prevalence of chronic conditions and complex comorbidities. Given the vulnerability of RACF residents and the demands on the system, there is a need to determine the extent that care is delivered in line with best practice (‘appropriate care’) in RACFs. There is also a recognition that systems should provide care that optimises quality of life (QoL), which includes support for physical and psychological well-being, independence, social relationships, personal beliefs and a caring external environment. The aims ofCareTrack Agedare to develop sets of indicators for appropriate care and processes of care for commonly managed conditions, and then assess the appropriateness of care delivered and QoL of residents in RACFs in Australia.

Methods and analysis

We will extract recommendations from clinical practice guidelines and, using expert review, convert these into sets of indicators for 15 common conditions and processes of care for people living in RACFs. We will recruit RACFs in three Australian states, and residents within these RACFs, using a stratified multistage sampling method. Experienced nurses, trained in theCareTrack Agedmethods (‘surveyors’), will review care records of recruited residents within a 1-month period in 2019 and 2020, and assess the care documented against the indicators of appropriate care. Surveyors will concurrently assess residents’ QoL using validated questionnaires.

Ethics and dissemination

The study has been reviewed and approved by the Human Research Ethics Committee of Macquarie University (5201800386). The research findings will be published in international and national journals and disseminated through conferences and presentations to interested stakeholder groups, including consumers, national agencies, healthcare professionals, policymakers and researchers.
Stepped-wedge randomised trial to evaluate population health intervention designed to increase appropriate anticoagulation in patients with atrial fibrillation
Authors: Wang Shirley V , Rogers James R , Jin Yinzhu , DeiCicchi David , Dejene Sara , Connors Jean M , Bates David W , Glynn Robert J , Fischer Michael A
Published: June 2019

Background

Clinical guidelines recommend anticoagulation for patients with atrial fibrillation (AF) at high risk of stroke; however, studies report 40% of this population is not anticoagulated.

Objective

To evaluate a population health intervention to increase anticoagulation use in high-risk patients with AF.

Methods

We used machine learning algorithms to identify patients with AF from electronic health records at high risk of stroke (CHA2DS2-VASc risk score ≥2), and no anticoagulant prescriptions within 12 months. A clinical pharmacist in the anticoagulation service reviewed charts for algorithm-identified patients to assess appropriateness of initiating an anticoagulant. The pharmacist then contacted primary care providers of potentially undertreated patients and offered assistance with anticoagulation management. We used a stepped-wedge design, evaluating the proportion of potentially undertreated patients with AF started on anticoagulant therapy within 28 days for clinics randomised to intervention versus usual care.

Results

Of 1727 algorithm-identified high-risk patients with AF in clinics at the time of randomisation to intervention, 432 (25%) lacked evidence of anticoagulant prescriptions in the prior year. After pharmacist review, only 17% (75 of 432) of algorithm-identified patients were considered potentially undertreated at the time their clinic was randomised to intervention. Over a third (155 of 432) were excluded because they had a single prior AF episode (transient or provoked by serious illness); 36 (8%) had documented refusal of anticoagulation, the remainder had other reasons for exclusion. The intervention did not increase new anticoagulant prescriptions (intervention: 4.1% vs usual care: 4.0%, p=0.86).

Conclusions

Algorithms to identify underuse of anticoagulation among patients with AF in healthcare databases may not capture clinical subtleties or patient preferences and may overestimate the extent of undertreatment. Changing clinician behaviour remains challenging.
Group singing in bereavement: effects on mental health, self-efficacy, self-esteem and well-being
Authors: Fancourt Daisy , Finn Saoirse , Warran Katey , Wiseman Theresa
Published: June 2019

Objectives

Bereavement is associated with negative affective, cognitive, behavioural and physiological responses. However, factors, such as coping, self-efficacy and self-esteem, can buffer negative effects of grief, and can be increased through mutual support interventions, such as shared leisure activities. This study used a non-randomised controlled design to explore the effects of group choir singing on mental health among people who have been bereaved due to cancer.

Methods

A total of 58 adults bereaved in the last 5 years who had not started psychological therapy in the last 12 weeks or medication for anxiety or depression in the last month were recruited and elected to join a choir (n=29) or participate in the non-intervention control group (n=29). Joining a choir involved engaging in 90 min weekly singing and social sessions for 12 weeks with a post-intervention assessment at week 24. We used linear mixed effects models adjusted for demographics, health-related variables, musical engagement and time since bereavement to model changes over time between the two groups in symptoms of anxiety, depression, well-being, self-efficacy and self-esteem.

Results

Participants who sang in a choir had more stable symptoms of depression and levels of well-being, as well as gradual improvements in their sense of self-efficacy and self-esteem over the 24 weeks. In contrast, those in the control group showed gradual increases in depressive symptoms, reductions in levels of well-being and self-esteem and no improvement in their self-efficacy. These results were independent of all covariates.

Conclusions

Weekly group singing could be a promising mutual support intervention for people experiencing grief.

Trial registration number

NCT02756780.
SMCHD1 mutation spectrum for facioscapulohumeral muscular dystrophy type 2 (FSHD2) and Bosma arhinia microphthalmia syndrome (BAMS) reveals disease-specific localisation of variants in the ATPase domain
Authors: Lemmers Richard J L F , van der Stoep Nienke , Vliet Patrick J van der , Moore Steven A , San Leon Granado David , Johnson Katherine , Topf Ana , Straub Volker , Evangelista Teresinha , Mozaffar Tahseen , Kimonis Virginia , Shaw Natalie D , Selvatici Rita , Ferlini Alessandra , Voermans Nicol , van Engelen Baziel , Sacconi Sabrina , Tawil Rabi , Lamers Meindert , van der Maarel Silvère M
Published: June 2019

Background

Variants in the Structural Maintenance of Chromosomes flexible Hinge Domain-containing protein 1 (SMCHD1) can cause facioscapulohumeral muscular dystrophy type 2 (FSHD2) and the unrelated Bosma arhinia microphthalmia syndrome (BAMS). In FSHD2, pathogenic variants are found anywhere in SMCHD1 while in BAMS, pathogenic variants are restricted to the extended ATPase domain. Irrespective of the phenotypic outcome, both FSHD2-associated and BAMS-associated SMCHD1 variants result in quantifiable local DNA hypomethylation. We compared FSHD2, BAMS and non-pathogenic SMCHD1 variants to derive genotype–phenotype relationships.

Methods

Examination of SMCHD1 variants and methylation of the SMCHD1-sensitive FSHD locus DUX4 in 187 FSHD2 families, 41 patients with BAMS and in control individuals. Analysis of variants in a three-dimensional model of the ATPase domain of SMCHD1.

Results

DUX4 methylation analysis is essential to establish pathogenicity of SMCHD1 variants. Although the FSHD2 mutation spectrum includes all types of variants covering the entire SMCHD1 locus, missense variants are significantly enriched in the extended ATPase domain. Identification of recurrent variants suggests disease-specific residues for FSHD2 and in BAMS, consistent with a largely disease-specific localisation of variants in SMCHD1.

Conclusions

The localisation of missense variants within the ATPase domain of SMCHD1 may contribute to the differences in phenotypic outcome.
Investigation of some radiation interaction parameters for bacteria isolated from the soil in the low energy region
Authors: Akman F. , Enez B. , Fincan S. Agüloğlu , Akdemir F. , Geçibesler I.H.
Published: June 2019

The purpose of this work, investigation of radiation attenuation characteristics, such as mass attenuation coefficient (μ/ρ), molar extinction coefficient (ε), effective atomic number (Zeff), and electron density (NE), of isolated bacteria from soil samples taken from Diyarbakır in Turkey. The experiments were performed using a narrow beam geometry with the help of the a high-resolution Si(Li) detector and three different radioactive sources at 15 different photon energies. The ε, Zeff, and NE values for some bacteria isolated from soil, such as Bacillus megaterium, Bacillus simplex, Bacillus subtilis, and commercially purchased Geobacillus stearothermophilus bacterium, were obtained from the measured μ/ρ results in the energy range from 13.94 to 88.04 keV. The experimental values were checked with two different theoretical results and good agreement was observed among them. The results show that Bacillus simplex bacterium has the highest values of μ/ρ and Zeff and Bacillus subtilis bacterium has the biggest values of ε and NE among the present bacteria.
Fast time series detrending with applications to heart rate variability analysis
Authors: Andrecut M.
Published: June 2019

In this paper, we discuss a new fast detrending method for the nonstationary RR time series used in Heart Rate Variability (HRV) analysis. The described method is based on the diffusion equation, and we show numerically that it is equivalent to the widely used Smoothing Priors Approach (SPA) and Wavelet Smoothing Approach (WSA) methods. The speed of the proposed method is comparable to the WSA method and it is several orders of magnitude faster than the SPA method, which makes it suitable for very long time series analysis.
Semi-classical calculations of the α decay half-lives for even–even nuclei
Authors: Soylu A.
Published: June 2019

The half-lives of the [Formula: see text] decay for even–even nuclei having [Formula: see text] (164 nuclei) have been calculated by using the Wentzel–Kramers–Brillouin (WKB) method together Bohr–Sommerfeld (BS) quantization condition for cosh potential in two-different forms with and without the isospin effects for six different parameter sets. By comparing the obtained results with the experimental values, the rms deviations have been computed. It is obtained that when the cosh potential is used in 2 different type forms, the rms values are also changed and the better one for obtaining the half-lives is cosh-2 form. Even if the isospin-dependent potential does not have so much effect on rms values in this sort of WKB with BS calculations with cosh potential forms, considering the isospin effect together the isospin-dependent nuclear diffuseness parameter have a strong influence on the rms values. New hindrance factor formula based on liquid drop model was used in order to show the influence of hindrance factor on the [Formula: see text] decay half-lives. It is pointed out that this new function of the hindrance factor does not depend on the magic numbers, it contains fewer free parameters and using of this improves the calculations positively. New estimates by using present model have also been made for even–even nuclei having with [Formula: see text] which do not have the measured [Formula: see text] decay half-lives yet and they have been compared the results of the ImSahu model. The present results would provide useful information and knowledge for the explanation of half-lives of [Formula: see text] decay of nuclei and future possible experimental studies.