bluuebunny/crossref_metadata_2025 huggingface dataset:
Early food allergy and respiratory allergy symptoms and attention‐deficit/hyperactivity disorder in Chinese children: A cross‐sectional study
Authors: Jiang Xiaodong , Shen Chun , Dai Yuan , Jiang Fan , Li Shenghui , Shen Xiaoming , Hu Yan , Li Fei
Published: March 2018

Background

The relationship between food allergy and respiratory allergy and attention‐deficit/hyperactivity disorder (ADHD) in children is rarely investigated. The objective of this study was to determine whether early food allergy and respiratory allergy symptoms are associated with the prevalence of ADHD in Chinese school‐age children.

Methods

This cross‐sectional study was conducted in school‐age children using cluster‐stratified methods from 9 cities across China between November and December 2005. A family and social environmental questionnaire including the diagnosis history of ADHD and allergic diseases (food allergy, allergic rhinitis, and bronchial asthma), as well as general information, was completed by parents.

Results

The prevalence of both allergic rhinitis (20.4%) and asthma (11.6%) in the food allergy group was significantly higher than in the non‐food allergy group (9.0% and 2.8%, respectively; both P < .001). The multivariable analysis showed that single food allergy (OR = 1.53, 95% CI: 1.13‐2.05, P = .005), food allergy complicated with allergic rhinitis or asthma (OR = 3.36, 95% CI: 2.19‐5.14, P < .001), and food allergy complicated with allergic rhinitis and asthma simultaneously (OR = 4.08, 95% CI: 2.05‐8.11, P < .001) were independently associated with the increased risk of ADHD.

Conclusions

Early food allergy is associated with ADHD in school‐age children. Early food allergy and respiratory allergy symptoms independently and synergistically contributed to higher risk of ADHD. Monitoring food allergy in early life could help in the early prediction and intervention for the consequent allergy march and ADHD in children.
Cross‐Country Differences in Unemployment: Fiscal Policy, Unions, and Household Preferences in General Equilibrium
Authors: Boone Brecht , Heylen Freddy
Published: March 2018

We develop a five‐period overlapping generations model with individuals who differ by ability and with an imperfect labour market (union wage setting) for individuals of lower ability. The model explains human capital formation, hours worked, and unemployment within one coherent framework. Its predictions match the differences in the unemployment rate across 12 OECD countries remarkably well. A Shapley decomposition of these differences reveals an almost equal role for fiscal policy variables and union preferences. As to fiscal policy, differences in unemployment benefits play a much more important role than tax differences. Differences in households’ taste for leisure are unimportant.
Transfusion‐transmitted malaria masquerading as sickle cell crisis with multisystem organ failure
Authors: Maier Cheryl L. , Gross Phillip J. , Dean Christina L. , Chonat Satheesh , Ip Andrew , McLemore Morgan , El Rassi Fuad , Stowell Sean R. , Josephson Cassandra D. , Fasano Ross M.
Published: March 2018

BACKGROUND

Fever accompanying vaso‐occlusive crisis is a common presentation in patients with sickle cell disease (SCD) and carries a broad differential diagnosis. Here, we report a case of transfusion‐transmitted malaria in a patient with SCD presenting with acute vaso‐occlusive crisis and rapidly decompensating to multisystem organ failure (MSOF).

CASE REPORT

An 18‐year‐old African American male with SCD was admitted after multiple days of fever and severe generalized body pain. He received monthly blood transfusions as stroke prophylaxis. A source of infection was not readily identified, but treatment was initiated with continuous intravenous fluids and empiric antibiotics. The patient developed acute renal failure, acute hypoxic respiratory failure, and shock. He underwent red blood cell (RBC) exchange transfusion followed by therapeutic plasma exchange and continuous veno‐venous hemodialysis. A manual peripheral blood smear revealed intraerythrocytic inclusions suggestive of Plasmodium, and molecular studies confirmed Plasmodium falciparum infection. Intravenous artesunate was given daily for 1 week. A look‐back investigation involving two hospitals, multiple blood suppliers, and state and federal public health departments identified the source of malaria as a unit of RBCs transfused 2 weeks prior to admission.

CONCLUSIONS

Clinical suspicion for transfusion‐related adverse events, including hemolytic transfusion reactions and transfusion‐transmitted infections, should be high in typically and atypically immunocompromised patient populations (like SCD), especially those on chronic transfusion protocols. Manual blood smear review aids in the evaluation of patients with SCD presenting with severe vaso‐occlusive crisis and MSOF and can alert clinicians to the need for initiating aggressive therapy like RBC exchange and artesunate therapy.
Changes in PGE2 signaling after submandibulectomy alter post–tooth extraction socket healing
Authors: Mohn Claudia Ester , Troncoso Gastón Rodolfo , Bozzini Clarisa , Conti María Inés , Fernandez Solari Javier , Elverdin Juan Carlos
Published: March 2018

Saliva is very important to oral health, and a salivary deficit has been shown to bring serious problems to oral health. There is scant information about the mechanisms through which salivary glands participate in post–tooth extraction socket healing. Therefore, the aim of the present study was to investigate the effect of submandibulectomy (SMx), consisting of the ablation of submandibular and sublingual glands (SMG and SLG, respectively), on PGE2 signaling and other bone regulatory molecules, such as OPG and RANKL, involved in tooth extraction socket healing. Male Wistar rats, 70 g body weight, were assigned to an experimental (subjected to SMx) or a control group (sham operated). One week later, the animals in both groups underwent bilateral extraction of the first mandibular molars. The effect of SMx on different stages of socket healing after tooth extraction (7, 14, and 30 days) was studied by evaluating some parameters of inflammation, including PGE2 and its receptors, and of bone metabolism, as well as by performing bone biomechanical studies. SMx increased TNFα and PGE2 content as well as cyclooxygenase‐II (COX‐II) expression in tooth socket tissue at almost all the studied time points. SMx also had an effect on mRNA expression of PGE2 receptors at the different time points, but did not significantly alter osteoprotegerin (OPG) and RANKL mRNA expression at any of the studied time points. In addition, an increase in bone mass density was observed in SMx rats compared with matched controls, and the structural and mechanical bone properties of the mandibular socket bone were also affected by SMx. Our results suggest that the SMG/SLG complex regulates cellular activation and differentiation by modulating the production of molecules intervening in tooth extraction socket repair, including the PGE2 signaling system, which would therefore account for the higher density and resistance of the newly formed bone in SMx rat.
Translation and validation of the Chinese powerlessness assessment tool
Authors: Huang Yao , Yang YueLai , Ni Pengwen , Xiao Xian , Ye JunNa , Kui Gang , Xie Ting
Published: March 2018

The objectives of this study were to translate the powerlessness assessment tool (PAT) into Chinese, and to evaluate its psychometric performance. The PAT was translated into Chinese and was evaluated in patients with chronic wounds. Mean PAT scores were compared between various wound types to evaluate the scale's power to differentiate wound severity (PUSH score). There were 154 consecutive patients included in this study. All items were included, and the results of item‐domain correlation (r ranged from 0.838 to 0.967) and small‐group analysis (critical ratio, p < 0.05) were satisfactory. Furthermore, the Chinese PAT also showed good criterion validity when correlated with the Cardiff wound impact schedule (r = 0.726, p < 0.01). Exploratory factor analysis of these items extracted only two domains instead of the hypothesized three domains: self‐perception of behavioral control and decision making (9 items) and emotional responses to perceived control (3 items), explained 82.045% of the variance. Sensitivity was demonstrated between patients with different activity of daily living, wound severity (PUSH score) and wound types. The internal consistency of all scales of the Chinese PAT was consistently high (Cronbach's alpha ranged from 0.939 to 0. 965) and split‐half reliability was 0.901. In conclusion, the validated Chinese PAT has good psychometric properties, and may be used to objectively evaluate the powerlessness experience of Chinese patients with chronic wounds.
Determinants of health seeking behaviour following rabies exposure in Ethiopia
Authors: Beyene T. J. , Mourits M. C. M. , Revie C. W. , Hogeveen H.
Published: March 2018

The objective of this study was to identify factors that determine medical treatment seeking behaviour following potential rabies exposure after being bitten by a suspected dog and the likelihood of compliance to receive sufficient doses of post‐exposure prophylaxis after the visit to a health centre visit. A detailed survey based on case investigation was conducted on suspected rabid dog bite cases in three areas of Ethiopia. Two multivariable logistic regression models were created with a set of putative variables to explain treatment seeking and compliance outcomes. Based on the registered bite cases at each health centre and the set of unregistered bite cases derived by contact tracing, 655 bite victim cases were identified to have occurred between September 2013 and August 2014. Of these evaluated bite incidences, 465 cases were considered to have been caused by a potentially rabid dog. About 77% of these suspected rabid dog bite victims visited a health centre, while 57% received sufficient doses of PEP. The overall likelihood of seeking medical services following rabies exposure was higher for people bitten by dogs of unknown ownership, where the bite was severe, being bitten on the leg, spend of more than 100 USD per month and where the victim lived close to the nearest health centre, while the likelihood of receiving sufficient doses of PEP was sensitive to monthly spending and distance to health centre. However, the evaluated factors did only explain a part of the variation among the three districts. The district in which victims lived appeared to have a relevant influence on the likelihood of seeking medical treatment but did not improve the prediction on the likelihood of treatment compliance. Given the insights obtained from this study, improvements in the rural districts with regard to accessibility of post‐exposure prophylaxis delivering health centres in shorter distance could improve health seeking behaviour. In addition, in rural districts, majority of exposed persons who seek medical treatment tend to comply with treatment regimen, indicating that the promotion of medical treatment through awareness creation campaigns could be beneficial.
Demographic, Social-Emotional and Educational Aspects of Specific and Generalized Social Anxiety Subtypes Among Palestinian Arab Minority Student Teachers in Israel
Authors: Zubeidat Ihab , Dallasheh Waleed , Khalil Abed Alrahman
Published: March 2018

The current study is aimed to assess the differences between Palestinian Arab minority student teachers in Israel with specific and generalized social anxiety from various demographic, social-emotional and educational aspects. For this purpose, 543 Palestinian Arab minority student teachers in Israel from Sakhnin College responded to the research tools which measure these aspects and they were divided into three categories (no social anxiety, specific social anxiety, and generalized social anxiety). The findings indicated that the average age of the student teachers with generalized social anxiety was higher than the average age of those with specific social anxiety, while no differences were found between the two categories in certain demographic variables. The study found that average social anxiety, social fear and social avoidance levels were higher among student teachers with generalized social anxiety than among those with specific social anxiety. In addition, there is a statistically significant correlation between levels of social anxiety and levels of depression and motivation for learning, while there are no statistically significant links between levels of social anxiety and levels of self-esteem and perceived social and family support. A regression analysis reveals that the specific social anxiety levels of Palestinian Arab minority student teachers in Israel can be explained by the level of their perceived social and family support and their ages, whereas the levels of their generalized social anxiety can be explained by their depression levels and ages. The practical pedagogical implications suggest that both social anxiety student teachers groups should be exposed to educational- interventional programs in order to be integrated into the educational system.
The Sustainability of Integrating Contactless Occasional Charging in Electric Vehicle Material Handling
Authors: Fekete Patrick , Martin Steve , Kuhn Katja
Published: March 2018

Electric mobility has developed itself to an option to mitigate air pollution and greenhouse gas emissions in cities same as in intralogistics material handling, while significant advances have been made in the research and development of electric vehicles (EV’s). Along with the major challenge of energy storage, another important factor is the efficient design of system energy supply, transfer and consumption. This has had the effect of fundamentally changing perspectives across the mobility and transportation sector.The overarching aim of this research is to examine the impact and potential of using contactless occasional recharging for non-road Electric Vehicles (nrEV) integrated within a manufacturing line, recognising the need to balance the (sometimes competing) demands of delivering reliable and efficient production while respecting environmental and sustainable needs. The integration of a contactless charging infrastructure targets on a reliable energy supply in process inherent break times without changing or interrupting existing production processes.The research investigations based on the Occasional Charging Station Location Model (OCSLM) provide a set of novel results in reference to the impact from interim battery charging to system`s overall sustainability. The application demonstrated a theoretical increase in usable battery energy of 40% to 60% while realising a reduction potential in battery capacity and system cost of between 5% to 45%. However, the use of contactless power transfer based on a standard energy mix resulted in an increase in CO2 emissions of up to 6.89% revealing a negative impact to overall ecology from the use of this energy transfer system.
Estimating the mean of a small sample under the two parameter lognormal distribution
Authors: Hingley Peter
Published: March 2018

Lognormally distributed variables are found in biological, economic and other systems. Here the sampling distributions of maximum likelihood estimates (MLE) for parameters are developed when data are lognormally distributed and estimation is carried out either by the correct lognormal model or by the mis-specified normal distribution. This is designed as an aid to experimental design when drawing a small sample under an assumption that the population follows a normal distribution while in fact it follows a lognormal distribution. Distributions are derived analytically as far as possible by using a technique for estimator densities and are confirmed by simulations. For an independently and identically distributed lognormal sample, when a normal distribution is used for estimation then the distribution of the MLE of the mean is different to that for the MLE of the lognormal mean. The distribution is not known but can be well enough approximated by another lognormal. An analytic method for the distribution of the mis-specified normal variance uses computational convolution for a sample of size 2. The expected value of the mis-specified normal variance is also found as a way to give information about the effect of the model misspecification on inferences for the mean. The results are demonstrated on an example for a population distribution that is abstracted from a survey.
Active nonreciprocal acoustic metamaterials using a switching controller
Authors: Baz Amr
Published: March 2018

A class of active acoustic diodes and metamaterials is developed to control the flow and distribution of acoustic energy in acoustic cavities and systems. Such development departs radically from the currently available approaches where the non-reciprocities are generated by hard-wired designs, favoring one transmission direction which is dictated by the arrangement of the hardware and hence it cannot be reversed, or without the presentation of rigorous control theory analysis. The proposed active nonreciprocal acoustic metamaterial (ANAM) cell consists of a one-dimensional acoustic cavity provided with active flexible boundaries. These boundaries are made from piezoelectric bimorphs interacting with the cavity to monitor the pressures of the propagating acoustic waves. The outer layers of the bimorphs provide the necessary control actions by direct application of the appropriate control voltage on each layer or by proper connection of nonlinearly activated shunted networks of switching resistors. The control of the switching is carried out using a Switching Mode Control (SMC) strategy. In this strategy, a lumped-parameter model of the ANAM cell is developed to predict the nonreciprocal characteristics of the cell by proper selection of the slope of the switching surfaces. Numerical examples are presented to demonstrate the merits of the proposed SMC.
Psychometric Properties of the Test of Gross Motor Development-3 for Children With Visual Impairments
Authors: Brian Ali , Taunton Sally , Lieberman Lauren J. , Haibach-Beach Pamela , Foley John , Santarossa Sara
Published: March 2018

Results of the Test of Gross Motor Development-2 (TGMD-2) consistently show acceptable validity and reliability for children/adolescents who are sighted and those who have visual impairments. Results of the Test of Gross Motor Development-3 (TGMD-3) are often valid and reliable for children who are sighted, but its psychometric properties are unknown for children with visual impairments. Participants (N = 66; Mage = 12.93, SD = 2.40) with visual impairments completed the TGMD-2 and TGMD-3. The TGMD-3 results from this sample revealed high internal consistency (ω = .89–.95), strong interrater reliability (ICC = .91–.92), convergence with the TGMD-2 (r = .96), and good model fit, χ2(63) = 80.10, p = .072, χ2/df ratio = 1.27, RMSEA = .06, CFI = .97. Researchers and practitioners can use the TGMD-3 to assess the motor skill performance for children/adolescents with visual impairments and most likely produce results that are valid and reliable.
Applying Career Construction Theory to Female National Collegiate Athletic Association Division I Conference Commissioners
Authors: Taylor Elizabeth A. , Siegele Jessica L. , Smith Allison B. , Hardin Robin
Published: March 2018

Women’s participation in collegiate sport has increased dramatically since the passage of Title IX, but there has not been a corresponding increase in the percentage of women in administrative positions. Women have, however, been successful obtaining leadership positions in conference offices, as more than 30% of National Collegiate Athletic Association Division I conference commissioners were women in 2016. This research used career construction theory as a framework to explore the experiences of these women. Findings revealed that participants constantly negotiate time spent on personal and professional obligations, and relationships created in the workplace turned into organic mentorship relationships. Participants felt that there were limited amounts of sexism in the workplace, but all discussed experiencing instances of sexism, indicating a culture of gender normalcy. Women may experience increased success in leadership positions at conference offices, compared with on-campus athletic departments, due to limited direct interaction with football and donors.
In situ formation of molecular Ni-Fe active sites on heteroatom-doped graphene as a heterogeneous electrocatalyst toward oxygen evolution
Authors: Wang Jiong , Gan Liyong , Zhang Wenyu , Peng Yuecheng , Yu Hong , Yan Qingyu , Xia Xinghua , Wang Xin
Published: March 2018

Molecularly sized and heterogeneous Ni-Fe sites on graphene serve as efficient electrocatalysts.
Anisotropic, lightweight, strong, and super thermally insulating nanowood with naturally aligned nanocellulose
Authors: Li Tian , Song Jianwei , Zhao Xinpeng , Yang Zhi , Pastel Glenn , Xu Shaomao , Jia Chao , Dai Jiaqi , Chen Chaoji , Gong Amy , Jiang Feng , Yao Yonggang , Fan Tianzhu , Yang Bao , Wågberg Lars , Yang Ronggui , Hu Liangbing
Published: March 2018

Researchers transformed natural wood into a super thermal insulation structural material with aligned cellulose nanofibers.
Structures of respiratory syncytial virus G antigen bound to broadly neutralizing antibodies
Authors: Fedechkin Stanislav O. , George Natasha L. , Wolff Jacob T. , Kauvar Lawrence M. , DuBois Rebecca M.
Published: March 2018

This work describes two conformational epitopes on a conserved domain of the RSV G glycoprotein that activates human CX3CR1.
Anti-HMGB1 Neutralizing Antibody Attenuates Periodontal Inflammation and Bone Resorption in a Murine Periodontitis Model
Authors: Yoshihara-Hirata Chiaki , Yamashiro Keisuke , Yamamoto Tadashi , Aoyagi Hiroaki , Ideguchi Hidetaka , Kawamura Mari , Suzuki Risa , Ono Mitsuaki , Wake Hidenori , Nishibori Masahiro , Takashiba Shogo
Published: March 2018

High mobility group box 1 (HMGB1) is a non-histone DNA-binding protein that is secreted into the extracellular milieu in response to inflammatory stimuli. The secreted HMGB1 mediates various inflammatory diseases, including periodontitis; however, the underlying mechanisms of HMGB1-induced periodontal inflammation are not completely understood. Here, we examined whether anti-HMGB1 neutralizing antibody inhibits periodontal progression and investigated the molecular pathology of HMGB1
in vitro
and
in vivo. In vitro
analysis indicated that HMGB1, granulocyte-macrophage colony-stimulating factor (GM-CSF), and interleukin-1β (IL-1β) were secreted in response to tumor necrosis factor-α (TNF-α) stimuli in human gingival epithelial cells (HGECs) and human monocytic leukemia cells (THP-1) treated with phorbol myristate acetate. Increased levels of GM-CSF and IL-1β were observed in the conditioned media from TNF-α-stimulated HGECs and THP-1
in vitro
. Simultaneous stimulation with TNF-α and anti-HMGB1 antibody significantly decreased TNF-α-induced inflammatory cytokine secretion. Experimental periodontitis was induced in mice using
Porphyromonas gingivalis
-soaked ligatures. The extracellular translocation was confirmed in gingival epithelia in the periodontitis model mice by immunofluorescence analysis. Systemic administration of anti-HMGB1 neutralizing antibody significantly inhibited translocation of HMGB1. The anti-HMGB1 antibody inhibited periodontal inflammation, expression of IL-1β and C-X-C motif chemokine ligand 1 (CXCL1), migration of neutrophils, and bone resorption, shown by bioluminescence imaging of myeloperoxidase activity, quantitative reverse transcription-PCR (RT-PCR), and micro-computed tomography analysis. These findings indicate that HMGB1 is secreted in response to inflammatory stimuli caused by periodontal infection, which is crucial for the initiation of periodontitis, and the anti-HMGB1 antibody attenuates the secretion of a series of inflammatory cytokines, consequently suppressing the progression of periodontitis.
Translating Lung Microbiome Profiles into the Next-Generation Diagnostic Gold Standard for Pneumonia: a Clinical Investigator’s Perspective
Authors: Kitsios Georgios D.
Published: March 2018

Severe bacterial pneumonia is a major global cause of morbidity and mortality, yet current diagnostic approaches rely on identification of causative pathogens by cultures, which require extended incubation periods and often fail to detect relevant pathogens. Consequently, patients are prescribed broad-spectrum antibiotics in a “one-size-fits-all” manner, which may be inappropriate for their individual needs and promote antibiotic resistance.
Synergy among Microbiota and Their Hosts: Leveraging the Hawaiian Archipelago and Local Collaborative Networks To Address Pressing Questions in Microbiome Research
Authors: Hynson Nicole A. , Frank Kiana L. , Alegado Rosanna A. , Amend Anthony S. , Arif Mohammad , Bennett Gordon M. , Jani Andrea J. , Medeiros Matthew C. I. , Mileyko Yuriy , Nelson Craig E. , Nguyen Nhu H. , Nigro Olivia D. , Prisic Sladjana , Shin Sangwoo , Takagi Daisuke , Wilson Samuel T. , Yew Joanne Y.
Published: March 2018

Despite increasing acknowledgment that microorganisms underpin the healthy functioning of basically all multicellular life, few cross-disciplinary teams address the diversity and function of microbiota across organisms and ecosystems. Our newly formed consortium of junior faculty spanning fields such as ecology and geoscience to mathematics and molecular biology from the University of Hawai‘i at Mānoa aims to fill this gap.
Data and Statistical Methods To Analyze the Human Microbiome
Authors: Waldron Levi
Published: March 2018

The Waldron lab for computational biostatistics bridges the areas of cancer genomics and microbiome studies for public health, developing methods to exploit publicly available data resources and to integrate -omics studies.
The novel use of botulinum toxin A for the treatment of Raynaud’s phenomenon in the toes
Authors: Dhaliwal Kiran , Griffin Michelle , Denton Christopher P , Butler Peter E M
Published: March 2018

Raynaud’s phenomenon is a vasospastic disorder of the digital vessels triggered by exposure to cold or stress. It is most commonly observed in the hands, but also frequently affects the toes. We present three cases of patients with severe Raynaud’s phenomenon in the toes, secondary to scleroderma. The diagnosis of Raynaud’s syndrome and scleroderma was established according to the 2010 American College of Rheumatology and European League Against Rheumatism criteria. Patients were treated with 10 units of botulinum toxin injected into each foot. Two millilitres was injected into the base of each toe in both the left and right feet. Six weeks postinjection into the toes, patients reported an improvement of cold intolerance, colour change and frequency and severity of Raynaud’s attacks. The effects were reported to last up to 5 months. To our knowledge, these are the first reported cases of the treatment of Raynaud’s phenomenon in the toes with botulinum toxin A.
Using an internet intervention to support self-management of low back pain in primary care: findings from a randomised controlled feasibility trial (SupportBack)
Authors: Geraghty Adam W A , Stanford Rosie , Stuart Beth , Little Paul , Roberts Lisa C , Foster Nadine E , Hill Jonathan C , Hay Elaine M , Turner David , Malakan Wansida , Leigh Linda , Yardley Lucy
Published: March 2018

Objective

To determine the feasibility of a randomised controlled trial of an internet intervention for low back pain (LBP) using three arms: (1) usual care, (2) usual care plus an internet intervention or (3) usual care plus an internet intervention with additional physiotherapist telephone support.

Design and setting

A three-armed randomised controlled feasibility trial conducted in 12 general practices in England.

Participants

Primary care patients aged over 18 years, with current LBP, access to the internet and without indicators of serious spinal pathology or systemic illness.

Interventions

The ‘SupportBack’ internet intervention delivers a 6-week, tailored programme, focused on graded goal setting, self-monitoring and provision of tailored feedback to encourage physical activity. Additional physiotherapist telephone support consisted of three brief telephone calls over a 4-week period, to address any concerns and provide reassurance.

Outcomes

The primary outcomes were the feasibility of the trial design including recruitment, adherence and retention at follow-up. Secondary descriptive and exploratory analyses were conducted on clinical outcomes including LBP-related disability at 3 months follow-up.

Results

Primary outcomes: 87 patients with LBP were recruited (target 60–90) over 6 months, and there were 3 withdrawals. Adherence to the intervention was higher in the physiotherapist-supported arm, compared with the stand-alone internet intervention. Trial physiotherapists adhered to the support protocol. Overall follow-up rate on key clinical outcomes at 3 months follow-up was 84%.

Conclusions

This study demonstrated the feasibility of a future definitive randomised controlled trial to determine the clinical and cost-effectiveness of the SupportBack intervention in primary care patients with LBP.

Trial registration number

ISRCTN31034004; Results.
Healthcare use for children with complex needs: using routine health data linked to a multiethnic, ongoing birth cohort
Authors: Bishop Chrissy Frances , Small Neil , Parslow Roger , Kelly Brian
Published: March 2018

Objectives

Congenital anomaly (CA) are a leading cause of disease, death and disability for children throughout the world. Many have complex and varying healthcare needs which are not well understood. Our aim was to analyse the healthcare needs of children with CA and examine how that healthcare is delivered.

Design

Secondary analysis of observational data from the Born in Bradford study, a large prospective birth cohort, linked to primary care data and hospital episode statistics. Negative binomial regression with 95% CIs was performed to predict healthcare use. The authors conducted a subanalysis on referrals to specialists using paper medical records for a sample of 400 children.

Setting

Primary, secondary and tertiary healthcare services in a large city in the north of England.

Participants

All children recruited to the birth cohort between March 2007 and December 2011. A total of 706 children with CA and 10 768 without CA were included in the analyses.

Primary and secondary outcome measures

Healthcare use for children with and without CA aged 0 to <5 years was the primary outcome measure after adjustment for confounders.

Results

Primary care consultations, use of hospital services and referrals to specialists were higher for children with CA than those without. Children in economically deprived neighbourhoods were more likely to be admitted to hospital than consult primary care. Children with CA had a higher use of hospital services (β 1.48, 95% CI 1.36 to 1.59) than primary care consultations (β 0.24, 95% CI 1.18 to 0.30). Children with higher educated mothers were less likely to consult primary care and hospital services.

Conclusions

Hospital services are most in demand for children with CA, but also for children who were economically deprived whether they had a CA or not. The complex nature of CA in children requires multidisciplinary management and strengthened coordination between primary and secondary care.
Impact of particulate matter on mothers and babies in Antwerp (IPANEMA): a prospective cohort study on the impact of pollutants and particulate matter in pregnancy
Authors: Van den Eeden Lena , Lambrechts Nathalie , Verheyen Veerle , Berth Mario , Schoeters Greet , Jacquemyn Yves
Published: March 2018

Introduction

Air pollution is a hot topic and is known to cause multiple health issues. Especially pregnant women seem to be vulnerable to environmental issues. There are data suggesting that exposure contributes to hypertensive disorders.

This study aims to evaluate the effects of exposure to particulate matter (PM) and outdoor air pollutants on the clinical pregnancy outcome for mother and child and to determine which biochemical changes in maternal, placental and cord blood best explain this effect.

Methods and analysis

This study is a prospective cohort study. We aim to recruit 200 pregnant women. The outcome measurements will include maternal parameters, labour parameters and neonatal parameters.

Multiple samples will be analysed such as maternal urine samples (8-oxo-deoxyguanosine), maternal blood samples (routine blood sampling, biomarkers of pre-eclampsia and transcript markers), maternal hair samples, neonatal blood samples (transcript markers) combined with extensive questionnaires.

Ethics and dissemination

We obtain informed consent from each participant prior to enrolment in the study.

The study has received approval by the Ethical Committee of the Antwerp University Hospital (14/40/411).

IPANEMA is the first prospective study to assess the impact of PM on mothers and babies in Antwerp, Belgium.

Findings from this study will contribute to improve knowledge on the impact of exposure to air pollution on mothers and babies and will also define biomarkers as predictors for pregnant women at risk.

Trial registration

ClinicalTrials.gov: 14/40/411. Registered 22-10-2015.
Consumption of ultra-processed foods and associated sociodemographic factors in the USA between 2007 and 2012: evidence from a nationally representative cross-sectional study
Authors: Baraldi Larissa Galastri , Martinez Steele Euridice , Canella Daniela Silva , Monteiro Carlos Augusto
Published: March 2018

Objectives

To compare ultra-processed food consumption across sociodemographic groups and over time (2007–2008, 2009–2010, 2011–2012) in the USA.

Design

Cross-sectional study.

Setting

National Health and Nutrition Examination Survey (NHANES) 2007–2012.

Participants

All individuals aged ≥2 years with at least one 24-hour dietary recall were included (n=23 847).

Main outcome measures

Average dietary contribution of ultra-processed foods (expressed as a percentage of the total caloric value of the diet), obtained after classifying all food items according to extent and purpose of industrial food processing using NOVA classification.

Data analysis

Linear regression was used to evaluate the association between sociodemographic characteristics or NHANES cycles and dietary contribution of ultra-processed foods.

Results

Almost 60% of calories consumed in the period 2007–2012 came from ultra-processed foods. Consumption of ultra-processed foods decreased with age and income level, was higher for non-Hispanic whites or non-Hispanic blacks than for other race/ethnicity groups and lower for people with college than for lower levels of education, all differences being statistically significant. Overall contribution of ultra-processed foods increased significantly between NHANES cycles (nearly 1% point per cycle), the same being observed among males, adolescents and high school education-level individuals.

Conclusions

Ultra-processed food consumption in the USA in the period 2007–2012 was overall high, greater among non-Hispanic whites or non-Hispanic blacks, less educated, younger, lower-income strata and increased across time.
Assessing the impact of TRAP laws on abortion and women’s health in the USA: a systematic review
Authors: Austin Nichole , Harper Sam
Published: March 2018

Introduction

Targeted Regulation of Abortion Providers (TRAP) laws impose extensive and sometimes costly requirements on abortion providers and facilities, potentially leading to barriers to care. Understanding the impact of these laws is important given their prevalence in the USA, but no review to date has summarised the available evidence. We conducted a systematic review of literature on TRAP laws and their impact on abortion trends and women’s health.

Methods

We searched MEDLINE, PubMed and EconLit for original, quantitative studies where the exposure was at least one TRAP policy and the outcome was abortion and/or any women’s physical or mental health outcome.

Results

Six articles met our inclusion criteria. The most common outcome was population-level abortion trends; studies also assessed the effect of TRAP laws on gestational age at presentation and measures of self-perceived burden. While certain TRAP laws (eg, admitting privilege requirements) appeared to have an effect on abortion outcomes, the impact of other laws – or combinations of laws – was unclear, due in part to heterogeneity between studies with respect to study design, geography, and exposure definition.

Conclusions

TRAP laws may have an impact on the experience of obtaining an abortion in the USA. However, our review revealed a paucity of empirical research on their population and individual-level impact, as well as some disagreement about the effect of different TRAP laws on subsequent abortion outcomes. Future research should prioritise the specific TRAP laws that may have a uniquely strong effect on state-level abortion rates and other outcomes.
Day case ‘treat and transfer’ ERCP service under general anaesthesia
Authors: El-Sherif Yasser , Hunt John , Suddle Abid , Prater Brian , Reffitt David , Devlin John , Harrison Phillip , Joshi Deepak
Published: March 2018

Objective

General anaesthesia (GA) has been increasingly used for advanced endoscopic procedures in particular endoscopic retrograde cholangiopancreatography (ERCP). Given the increasing pressure on many hospitals, the delivery of such service on a regular basis may not always be possible. We established a new day case ‘GA ERCP’ service. We describe our experience in evaluating the safety and overall feasibility of this new service.

Design

Prospective database has been interrogated for the period from March 2015 to December 2016. We documented patients’ demographics, ERCP indications, American Society of Anesthesiologists (ASA) status, Cotton grade and complications.

Results

67 patients were referred to endoscopy unit at King’s College Hospital (KCH), for urgent day case GA ERCP from nine referring hospitals. The main indications were failed ERCP under sedation 47.8% (32/67), and unavailability of ERCP locally 41.8% (28/67). A total of 64 patients were actually transferred to KCH; 57.8% (37/64) women with a median age 55.8 years (range 23–90). 78.1% (50/64) of patients had a virgin papilla, with 39% (25/64) were ASA ≥3. The Cotton grade was ≥ 3 in 50% (32/64) patients. ERCP was completed successfully in 87.5% (56/64). For patients with previous failed ERCP, repeat ERCP under GA was successful in 75% (24/32). All patients were safely discharged back to their referring hospitals after the short observation period post-ERCP.

Conclusions

Urgent inpatient transfers between hospitals for performing ERCP under GA as a day case is safe and feasible. The new GA ERCP pathway can be replicated by other UK centres.
UK military doctors; stigma, mental health and help-seeking: a comparative cohort study
Authors: Jones Norman , Whybrow D , Coetzee R
Published: March 2018

Introduction

Studies suggest that medical doctors can suffer from substantial levels of mental ill-health. Little is known about military doctors’ mental health and well-being; we therefore assessed attitudes to mental health, self-stigma, psychological distress and help-seeking among UK Armed Forces doctors.

Methods

Six hundred and seventy-eight military doctors (response rate 59%) completed an anonymous online survey. Comparisons were made with serving and ex-military personnel (n=1448, response rate 84.5%) participating in a mental health-related help-seeking survey. Basic sociodemographic data were gathered, and participants completed measures of mental health-related stigmatisation, perceived barriers to care and the 12-Item General Health Questionnaire. All participants were asked if in the last three years they had experienced stress, emotional, mental health, alcohol, family or relationship problems, and whether they had sought help from formal sources.

Results

Military doctors reported fewer mental disorder symptoms than the comparison groups. They endorsed higher levels of stigmatising beliefs, negative attitudes to mental healthcare, desire to self-manage and self-stigmatisation than each of the comparison groups. They were most concerned about potential negative effects of and peer perceptions about receiving a mental disorder diagnosis. Military doctors reporting historical and current relationship, and alcohol or mental health problems were significantly and substantially less likely to seek help than the comparison groups.

Conclusions

Although there are a number of study limitations, outcomes suggest that UK military doctors report lower levels of mental disorder symptoms, higher levels of stigmatising beliefs and a lower propensity to seek formal support than other military reference groups.
Post-stroke mRNA expression profile of MMPs: effect of genetic deletion of MMP-12
Authors: Nalamolu Koteswara Rao , Chelluboina Bharath , Magruder Ian B , Fru Diane N , Mohandass Adithya , Venkatesh Ishwarya , Klopfenstein Jeffrey D , Pinson David M , Boini Krishna M , Veeravalli Krishna Kumar
Published: March 2018

Background and purpose

Recent reports from our laboratory demonstrated the post-ischaemic expression profile of various matrix metalloproteinases (MMPs) in rats and the detrimental role of MMP-12 in post-stroke brain damage. We hypothesise that the post-stroke dysregulation of MMPs is similar across species and that genetic deletion of MMP-12 would not affect the post-stroke expression of other MMPs. We tested our hypothesis by determining the pre-ischaemic and post-ischaemic expression profile of MMPs in wild-type and MMP-12 knockout mice.

Methods

Focal cerebral ischaemia was induced in wild-type and MMP-12 knockout mice by middle cerebral artery occlusion procedure by insertion of a monofilament suture. One hour after ischaemia, reperfusion was initiated by removing the monofilament. One day after reperfusion, ischaemic brain tissues from various groups of mice were collected, and total RNA was isolated and subjected to cDNA synthesis followed by PCR analysis.

Results

Although the post-stroke expression profile of MMPs in the ischaemic brain of mice is different from rats, there is a clear species similarity in the expression of MMP-12, which was found to be predominantly upregulated in both species. Further, the post-stroke induction or inhibition of various MMPs in MMP-12 knockout mice is different from their respective expression profile in wild-type mice. Moreover, the brain mRNA expression profile of various MMPs in MMP-12 knockout mice under normal conditions is also different to their expression in wild-type mice.

Conclusions

In the ischaemic brain, MMP-12 upregulates several fold higher than any other MMP. Mice derived with the genetic deletion of MMP-12 are constitutive and have altered MMP expression profile both under normal and ischaemic conditions.
Acute beetroot juice administration improves peak isometric force production in adolescent males
Authors: Bender David , Townsend Jeremy R. , Vantrease William C. , Marshall Autumn C. , Henry Ruth N. , Heffington Stephen H. , Johnson Kent D.
Published: March 2018

The purpose of this study was to examine the effects of acute beetroot juice (BR) administration on repeated sprint performance and isometric force production in adolescent males. Twelve male adolescents (age, 16.8 ± 1.0 years; height, 178.8 ± 9.2 cm; mass, 74.8 ± 12.5 kg; peak height velocity, 2.53 ± 1.2 years) participated in this double-blind, placebo-controlled, crossover designed study. Participants consumed 2 × 70 mL of BR (∼12.9 mmol NO3−; Beet It Sport) or a nitrate-depleted placebo (PL) at 2.5 h prior to performing isometric mid-thigh pulls (IMTP) and 4 repeated 20-s Wingate sprints interspersed with 4 min of rest. Sprint data were analyzed by a 2 × 4 (group × time) repeated-measures ANOVA while a dependent t test was used to compare conditions for IMTP peak force. A significant main effect for time (p < 0.05) was observed for peak power (PP), average power (Pavg), and fatigue index (FI) across sprints. Compared with sprint 1, sprint 4 resulted in significant decreases in PP (p < 0.000; −16.6%) and Pavg (p = 0.000; −21.8%) and FI was significantly elevated (p < 0.000; 15.2%). No significant group × time interactions were observed between conditions for PP (p = 0.402), Pavg (p = 0.479), or FI (p = 0.37). IMTP peak force was significantly higher (p = 0.004; 13.9%) following BR consumption compared with PL. The repeated sprint protocol resulted in significant fatigue while BR did not influence sprint performance. However, it appears BR administration may improve peak force production in adolescent males.
An extended car-following model considering the acceleration derivative in some typical traffic environments
Authors: Zhou Tong , Chen Dong , Liu Weining
Published: March 2018

Based on the full velocity difference and acceleration car-following model, an extended car-following model is proposed by considering the vehicle’s acceleration derivative. The stability condition is given by applying the control theory. Considering some typical traffic environments, the results of theoretical analysis and numerical simulation show the extended model has a more actual acceleration of string vehicles than that of the previous models in starting process, stopping process and sudden brake. Meanwhile, the traffic jams more easily occur when the coefficient of vehicle’s acceleration derivative increases, which is presented by space-time evolution. The results confirm that the vehicle’s acceleration derivative plays an important role in the traffic jamming transition and the evolution of traffic congestion.
Saliency Optimization and Integration Via Iterative Bootstrap Learning
Authors: Li Liming , Chai Xiaodong , Zhao Shuguang , Zheng Shubin , Su Shengchao
Published: March 2018

This paper proposes an effective method to elevate the performance of saliency detection via iterative bootstrap learning, which consists of two tasks including saliency optimization and saliency integration. Specifically, first, multiscale segmentation and feature extraction are performed on the input image successively. Second, prior saliency maps are generated using existing saliency models, which are used to generate the initial saliency map. Third, prior maps are fed into the saliency regressor together, where training samples are collected from the prior maps at multiple scales and the random forest regressor is learned from such training data. An integration of the initial saliency map and the output of saliency regressor is deployed to generate the coarse saliency map. Finally, in order to improve the quality of saliency map further, both initial and coarse saliency maps are fed into the saliency regressor together, and then the output of the saliency regressor, the initial saliency map as well as the coarse saliency map are integrated into the final saliency map. Experimental results on three public data sets demonstrate that the proposed method consistently achieves the best performance and significant improvement can be obtained when applying our method to existing saliency models.
Balancing Control of a Mobile Manipulator with Two Wheels by an Acceleration-Based Disturbance Observer
Authors: Bae Yeong-Geol , Jung Seul
Published: March 2018

This paper presents the balancing control performance of a mobile manipulator built in the laboratory as a service robot called Korean robot worker (KOBOKER). The robot is designed and implemented with two wheels as a mobile base and two arms with six degrees-of-freedom each. Kinematics and dynamics of the robot are analyzed. For the balancing control performance, two wheels are controlled independently by the time-delayed control method based on the inertia model of the robot. The acceleration information obtained directly from the sensor is used for the modified disturbance observer structure called an acceleration-based disturbance observer (AbDOB). Experimental studies of the balancing control of the robot are conducted to compare the control performances by both a PID control method and an AbDOB.