bluuebunny/crossref_metadata_2025 huggingface dataset:
HOspital care versus TELemonitoring in high-risk pregnancy (HOTEL): study protocol for a multicentre non-inferiority randomised controlled trial
Authors: van den Heuvel Josephus F M , Ganzevoort Wessel , De Haan-Jebbink Jiska M , van der Ham David P , Deurloo Koen L , Seeber Laura , Franx Arie , Bekker Mireille N
Published: October 2019

Introduction

Pregnant women faced with complications of pregnancy often require long-term hospital admission for maternal and/or fetal monitoring. Antenatal admissions cause a burden to patients as well as hospital resources and costs. A telemonitoring platform connected to wireless cardiotocography (CTG) and automated blood pressure (BP) devices can be used for telemonitoring in pregnancy. Home telemonitoring might improve autonomy and reduce admissions and thus costs. The aim of this study is to compare the effects on patient safety, satisfaction and cost-effectiveness ofhospital care versustelemonitoring (HOTEL) as an obstetric care strategy in high-risk pregnancies requiring daily monitoring.

Methods and analysis

The HOTEL trial is an ongoing multicentre randomised controlled clinical trial with a non-inferiority design. Eligible pregnant women are >26+0 weeks of singleton gestation requiring monitoring because of pre-eclampsia (hypertension with proteinuria), fetal growth restriction, preterm rupture of membranes without contractions, recurrent reduced fetal movements or an intrauterine fetal death in a previous pregnancy.

Randomisation takes place between traditional hospitalisation (planned n=208) versus telemonitoring (planned n=208) until delivery. Telemonitoring at home is facilitated with Sense4Baby CTG devices, Microlife BP monitor and daily telephone calls with an obstetric healthcare professional as well as weekly hospital visits.

Primary outcome is a composite of adverse perinatal outcome, defined as perinatal mortality, 5 min Apgar <7 or arterial cord blood pH <7.05, maternal morbidity (eclampsia, HELLP (hemolysis, elevated liver enzymes, and low platelets) syndrome, thromboembolic event), neonatal intensive care admission and caesarean section rate. Patient satisfaction and preference of care will be assessed using validated questionnaires. We will perform an economic analysis. Outcomes will be analysed according to the intention to treat principle.

Ethics and dissemination

The study protocol was approved by the Ethics Committee of the Utrecht University Medical Center and the boards of all six participating centres. Trial results will be submitted to peer-reviewed journals.

Trial registration number

NTR6076.
Barriers to and enablers of uptake of and adherence to antiretroviral therapy in the context of integrated HIV and tuberculosis treatment among adults in sub-Saharan Africa: a protocol for a systematic literature review
Authors: Momo Kadia Benjamin , Takah Noah Fongwen , Akem Dimala Christian , Smith Adrian
Published: October 2019

Introduction

The scale-up of integrated Human Immunodeficiency Virus (HIV) and tuberculosis (TB) treatment has been an important intervention to curb the burden of HIV and TB co-infection worldwide. Uptake of and adherence to antiretroviral therapy (ART) are key determinants of the quality and therapeutic endpoints of this intervention. This study aims to conduct an up-to-date collection and synthesis of evidence on barriers to and facilitators of uptake of and adherence to ART in HIV/TB integrated treatment programs in sub-Saharan Africa (SSA).

Method

A systematic review of peer-reviewed literature on the uptake of and adherence to ART in the context of integrated therapy for HIV and TB in SSA will be performed. We will review qualitative and quantitative studies reporting on the uptake of and adherence to ART during integrated treatment for TB and HIV among adults. These will include studies that involve HIV-infected TB patients initiating ART and studies involving PLWHA already on ART who are newly diagnosed with TB. Qualitative studies, quantitative studies, randomised trials and observational studies will be included. Six databases including Medline and Embase will be searched for relevant studies published from March 2004 to July 2019. Two authors will independently screen the search output and retrieve full texts of eligible studies. Disagreements between the two authors will be resolved by arbitration by a third author. Data will be abstracted from the eligible studies and synthesis will be done through descriptive synthesis for qualitative data and meta-analysis for quantitative data.

Ethics and dissemination

This study will be a review of the literature and will not involve primary collection of individuals’ data. Amendments to the protocol will be documented in the final review. The final study will be published in a peer-reviewed journal and presented at conferences. The review is expected to contribute to improving strategies to enhance uptake of and adherence to ART in integrated care.

PROSPERO registration number

CRD42019131933.
Cross-sectional study of the health of southern African truck drivers
Authors: Lalla-Edward Samanta Tresha , Fischer Alex Emilio , Venter W D Francois , Scheuermaier Karine , Meel Ruchika , Hankins Catherine , Gomez Gabriela , Klipstein-Grobusch Kerstin , Draaijer Melvin , Vos Alinda G
Published: October 2019

Objectives

Lifestyle and working conditions of truck drivers predisposes them to risk-factors associated with communicable and non-communicable diseases, but little is known about the health status of African truck driver. This study aims to assess a cross-section of truckers in South Africa to describe their health information.

Setting

The study took place across three truck-stop rest areas in the South African provinces of Free State and Gauteng.

Participants

Eligibility criteria included being males aged 18 years and older, full-time employment as a long-distance truck driver. A total of 614 male truck drivers participated; 384 (63%) were Zimbabwean and 325 (55%) completed high-school.

Primary and secondary outcome measures

The trucker survey explored demographics; working conditions; sexual, eating and sleeping behaviours; mental health status, medical history and cardiac risk-factors. Medical assessments included physical measurements, glucose and lipid measurements, ECG, carotid intima-media thickness (CIMT) and cardiac ultrasound.

Results

In the previous month, 554 (91%) participants were sexually active; 522 (86%) had sex with a regular partner; 174 (27%) with a casual partner; 87 (14%) with a sex worker. Average time driving was 10 hours/day, 20 days/month, 302 (50%) never worked night shifts and 74 (12%) worked nights approximately four times per week. 112 (18%) experienced daytime sleepiness and 59 (10%) were ever hospitalised from an accident. Forty-seven (8%, 95% CI 5.3 to 9.5) were HIV-positive, with half taking antiretrovirals. Forty-eight (8%) truckers had some moderate depression, while 21 (4%) suffered from post-traumatic stress disorder. Reported tuberculosis, myocardial infarction, and diabetes were <3%. Prominent cardiac risk-factors included smoking (n=63, 11%), consuming alcohol (>15 drinks/week) (n=54, 9%), overweight/obesity (n=417, 69%), and hypertension (n=220, 36%,95% CI 32.1 to 39.7). ECG results showed 23 (4.9%) and 29 (5.3%) drivers had left ventricular hypertrophy using the Cornell criterion and product, respectively. CIMT measurements indicated nine (4.2%) drivers had a carotid atherosclerotic plaque.

Conclusion

This first holistic assessment of health among southern African male truck drivers demonstrates substantial addressable cardiovascular risk factors, mental health issues and sexual risk behaviours.
Prevalence and diagnostic value of GPs’ gut feelings for cancer and serious diseases: protocol for a prospective observational study of diagnostic validity
Authors: Oliva-Fanlo Bernardino , March Sebastià , Medina David , Martín-Rabadán María , Tamborero Gaspar , Stolper Erik , Esteva Magdalena
Published: October 2019

Introduction

Cancer diagnosis in primary care is an important challenge for general practitioners (GPs) due to the relatively low frequency of any single type of cancer and the heterogeneous signs and symptoms that can be present. In addition to analytical reasoning, GPs may become aware of gut feelings (GFs) as they suspect that a patient may have cancer or another serious disease. We aimed to investigate the prevalence and the predictive value of GFs for the diagnosis of cancer and serious diseases.

Methods and analysis

Prospective observational study of diagnostic validity. Participation will be offered to GPs from Majorca and Zaragoza (Spain). They will recruit all patients with a new reason for encounter during one or two workdays. GPs will complete the Gut Feelings Questionnaire (GFQ). Variables regarding patient, GP and consultation will be collected. Two and 6 months after the first visit, incident diagnoses of cancer or other serious diseases, diagnostic tests performed, referrals and new visits will be recorded. Analysis will include a descriptive analysis of the variables and prevalence of GFs, and the sensitivity, specificity, predictive values and likelihood ratios of the GFs (sense of alarm and sense of reassurance) for diagnosing cancer and other serious diseases, as measured with the GFQ.

Ethics and dissemination

The study has obtained approval from the Majorcan Primary Care Research Committee and from the Balearic Islands Ethical Committee, with reference number IB 3210/16 PI. The results may help GPs to make more accurate decisions about which patients need further examinations to rule out or to confirm a diagnosis of cancer or a serious disease, and which ones do not. The results will be published as part of the PhD project of the first author and in open access journals, and will be presented at medical conferences.
Metabolically healthy obesity and risk of cardiovascular disease, cancer, and all-cause and cause-specific mortality: a protocol for a systematic review and meta-analysis of prospective studies
Authors: Tian Simiao , Liu Yazhuo , Feng Ao , Lou Keli , Dong Huimin
Published: October 2019

Introduction

Metabolically healthy obese phenotype (MHO) refers to obese individuals with an adequate metabolic profile and absence of metabolic syndrome. Many prospective studies have reported the benign condition relating the MHO phenotype and its potential role in reducing risk of cardiovascular disease, total cancer, and all-cause and cause-specific mortality. However, inconsistent results were found and the question remains controversial. We aim to conduct a systematic review and meta-analysis to clarify the associations these associations from relevant prospective studies.

Methods and analysis

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Protocols 2015 statement was used to prepare this protocol. MEDLINE, Web of Science databases, EMBASE and Cochrane Database will be used for literature search from their inception up to December 2019 with restriction of published studies in English. Published prospective studies reporting adjusted relative risk (RR) estimates for the association between MHO phenotype and cardiovascular disease, total cancer, all-cause or cause-specific mortality will be included. The process of study screening, selection and data extraction will be performed independently by two reviewers, and the risk of bias for the studies included will be assessed using the Newcastle-Ottawa Quality Assessment Scale. HRs or RRs for disease events and mortality with 95% CIs will be considered as primary outcomes, and summary HRs/RRs will be pooled using random-effects models. The Cochrane’s Q and the I2statistics will be used to assess and quantify heterogeneity, respectively. Subgroup analysis will also be carried out according to study characteristics to investigate potential sources of heterogeneity.

Ethics and dissemination

As this meta-analysis is performed based on the published studies, no ethical approval and patient safety considerations are required. The findings of the study will be reported and submitted to a peer-reviewed journals for publication.

PROSPERO registration number

CRD42019121766.
Does chronic high-intensity endurance training have an effect on cardiovascular markers of active populations and athletes? Systematic review and meta-analysis
Authors: Tesema Gashaw , George Mala , Hadgu Abera , Haregot Esayas , Mondal Soumitra , Mathivana D
Published: October 2019

Objective

The objective of this study was to ascertain the effects of high-intensity chronic endurance training on cardiovascular markers of active populations and athletes.

Methods

This review was conducted in accordance with the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. We used databases of PubMed, Science Direct, SPORTDiscus, Google Scholar and grey literatures with Mesh and free-text search as well as manual searches to identify relevant studies from June 2017 to September 2019. Weighted standardised mean differences and effect size of the intervention group versus the control group were calculated using a random effect model with 95% CI.

Result

There was significant improvement in high-density lipoprotein with weighted standardised mean difference and effect size=−1.06 (−1.83 to −0.30), p=0.006. We have also observed a significant reduction in low-density lipoprotein and total cholesterol with weighted standardised mean difference and effect size=−0.97 (−1.58 to −0.36), p=0.002, and = −0.78 (−1.34 to −0.22), p=0.007, respectively. There was a significant reduction in interleukin 6 (IL-6) using a fixed effect model with weighted standardised mean difference and effect size=−0.87 (−1.33 to −0.40), p=0.0003 and C reactive protein (CRP) with weighted standardised mean differences and effect size=−0.41 (−0.73 to −0.09), p=0.01.

Conclusion

Chronic high-intensity endurance training improves healthy lipid profiles (increase high-density lipoprotein, decreased low-density lipoprotein and total cholesterol). And decreased inflammatory markers (IL-6 and CRP) independent of age and sex and cannot be associated with an increased risk of developing cardiovascular disease.

PROSPERO registration number

CRD 42017081369.
Medication safety risks to be managed in national implementation of automatic substitution of biological medicines: a qualitative study
Authors: Tolonen Hanna M , Airaksinen Marja SA , Ruokoniemi Päivi , Hämeen-Anttila Katri , Shermock Kenneth M , Kurki Pekka
Published: October 2019

Objectives

To explore relevant Finnish stakeholders’ perceptions on the automatic substitution of biological medicines with particular focus on medication safety and issues that need to be considered to create an appropriate model for automatic biological product substitution.

Design

Qualitative interview study.

Methods

Data were collected in semistructured individual (n=17), pair (n=7) and group (n=8) interviews (32 interviews, 62 participants) in 2018. Participants represented a wide range of stakeholders involved in the pharmacotherapy process: community pharmacists (n=8 interviews), authorities (n=7), prescribers (n=7), pharmaceutical industry and wholesalers (n=6), patients/customers (n=2), hospital pharmacists (n=1) and nurses (n=1). Inductive content analysis was performed.

Results

Benefits of automatic substitution were identified as cost savings, more patients receiving biological treatments and enhanced continuity of treatment. Six major risk categories were identified: (1) the patient’s medication is interrupted or complicated temporarily or permanently, (2) the patient uses two products with the same active substance, (3) the traceability of the product is compromised, (4) the patient cannot get into healthcare in case of problems, (5) the patient does not receive substitution-related advice from a pharmacy and (6) the patient is distracted by the support material he/she receives. Several risk mitigation measures were commonly mentioned: medication and device counselling by pharmacists (n=23), infrequent substitution interval (n=15) and better knowledge on biosimilars among healthcare providers (n=13).

Conclusion

Automatic substitution of biologics is associated with risks that should be prospectively managed before implementing the procedure. The substitution also introduces new tasks and communication needs to those involved in actual medication use process, particularly to community pharmacists who will be responsible for substitution and counselling the patients.
Exploring the concept of pain of Australian children with and without pain: qualitative study
Authors: Pate Joshua W , Noblet Tim , Hush Julia M , Hancock Mark J. , Sandells Renee , Pounder Meg , Pacey Verity
Published: October 2019

Objective

A person’s concept of pain can be defined as how they understand what pain actually is, what function it serves and what biological processes are thought to underpin it. This study aimed to explore the concept of pain in children with and without persistent pain.

Design

In-depth, face-to-face interviews with drawing tasks were conducted with 16 children (aged 8–12 years) in New South Wales, Australia. Thematic analysis was used to analyse and synthesise the data.

Setting

Children with persistent pain were identified from a pain clinic waiting list in Australia, and children without pain were identified through advertising flyers and email bulletins at a university and hospital.

Participants

Eight children had persistent pain and eight children were pain free.

Results

Four themes emerged from the data: ‘my pain-related knowledge’, ‘pain in the world around me’, ‘pain in me’ and ‘communicating my concept of pain’. A conceptual framework of the potential interactions between the themes resulting from the analysis is proposed. The concept of pain of Australian children aged 8–12 years varied depending on their knowledge, experiences and literacy levels. For example, when undertaking a drawing task, children with persistent pain tended to draw emotional elements to describe pain, whereas children who were pain free did not.

Conclusions

Gaining an in-depth understanding of a child’s previous pain-related experiences and knowledge is important to facilitate clear and meaningful pain science education. The use of age-appropriate language, in combination with appropriate assessment and education tasks such as drawing and discussing vignettes, allowed children to communicate their individual concept of pain.
Access to maternal healthcare services among Indigenous women in the Chittagong Hill Tracts, Bangladesh: A cross-sectional study
Authors: Akter Shahinoor , Rich Jane Louise , Davies Kate , Inder Kerry Jill
Published: October 2019

Objectives

This study aimed to estimate the prevalence of, and factors associated with, accessing maternal healthcare services (MHC) by Indigenous women in the Chittagong Hill Tracts (CHT), Bangladesh.

Design

This was a cross-sectional survey among Indigenous women of reproductive age.

Setting

Two upazillas (subdistricts) of Khagrachhari hill district of the CHT.

Participants

Indigenous women (15–49 years) within 36 months of delivery were surveyed about accessing MHC services (antenatal care, delivery and postnatal care) for their last pregnancy and delivery.

Primary outcome measures

The primary outcome for this analysis is the prevalence of accessing any MHC service and secondary outcome is factors associated with access to MHC services for Indigenous women during their last pregnancy and childbirth.

Results

Of 438 Indigenous women (220 Chakma, 100 Marma, 118 Tripura) who participated, 75% were aged 16–30 years. With an 89% response rate, a total of 258 (59%) women reported accessing at least one MHC service (Chakma 51.6%, Marma 28%, Tripura 20.5%; p=<0.001). Independent factors associated with accessing MHC after adjusting for clustering were attending secondary school and above (OR 2.4; 95% CI 1.2 to 4.9); knowledge about nearest health facilities (OR 3.8, 95% CI 1.8 to 7.8) and knowledge of pregnancy-related complications (OR 3.0, 95% CI 1.5 to 5.8).

Conclusion

Findings suggest that the prevalence of accessing MHC services is lower among Indigenous women in the CHT compared with national average. MHC access may be improved through better education and awareness raising of local services.
Improving Mood with Physical ACTivity (IMPACT) trial: a cluster randomised controlled trial to determine the effectiveness of a brief physical activity behaviour change intervention on depressive symptoms in young people, compared with psychoeducation, in addition to routine clinical care within youth mental health services—a protocol study
Authors: Parker Alexandra G. , Markulev Connie , Rickwood Debra J. , Mackinnon Andrew , Purcell Rosemary , Alvarez-Jimenez Mario , Yung Alison R. , McGorry Patrick , Hetrick Sarah E. , Jorm Anthony
Published: October 2019

Introduction

Depression is highly prevalent and the leading contributor to the burden of disease in young people worldwide, making it an ongoing priority for early intervention. As the current evidence-based interventions of medication and psychological therapy are only modestly effective, there is an urgent need for additional treatment strategies. This paper describes the rationale of the Improving Mood with Physical ACTivity (IMPACT) trial. The primary aim of the IMPACT trial is to determine the effectiveness of a physical activity intervention compared with psychoeducation, in addition to routine clinical care, on depressive symptoms in young people. Additional aims are to evaluate the intervention effects on anxiety and functional outcomes and examine whether changes in physical activity mediate improvements in depressive symptoms.

Methods and analysis

The study is being conducted in six youth mental health services across Australia and is using a parallel-group, two-arm, cluster randomised controlled trial design, with randomisation occurring at the clinician level. Participants aged between 12 years and 25 years with moderate to severe levels of depression are randomised to receive, in addition to routine clinical care, either: (1) a physical activity behaviour change intervention or (2) psychoeducation about physical activity. The primary outcome will be change in the Quick Inventory of Depressive Symptomatology, with assessments occurring at baseline, postintervention (end-point) and 6-month follow-up from end-point. Secondary outcome measures will address additional clinical outcomes, functioning and quality of life. IMPACT is to be conducted between May 2014 and December 2019.

Ethics and dissemination

Ethical approval was obtained from the University of Melbourne Human Research Ethics Committee on 8 June 2014 (HREC 1442228). Trial findings will be published in peer-reviewed journals and presented at conferences. Key messages will also be disseminated by the youth mental health services organisation (headspace National Youth Mental Health Foundation).

Trial registration number

ACTRN12614000772640.
Validity of estimating physical activity intensity using a triaxial accelerometer in healthy adults and older adults
Authors: Nagayoshi Sho , Oshima Yoshitake , Ando Takafumi , Aoyama Tomoko , Nakae Satoshi , Usui Chiyoko , Kumagai Shuzo , Tanaka Shigeho
Published: October 2019

Background

A triaxial accelerometer with an algorithm that could discriminate locomotive and non-locomotive activities in adults has been developed. However, in the elderly, this accelerometer has not yet been validated. The aim were to examine the validity of this accelerometer in the healthy elderly, and to compare the results with those derived in a healthy younger sample.

Methods

Twenty-nine healthy elderly subjects aged 60–80 years (Elderly), and 42 adults aged 20–59 years (Younger) participated. All subjects performed 11 activities, including locomotive and non-locomotive activities with a Douglas bag while wearing the accelerometer (Active style Pro HJA-750C). Physical activity intensities were expressed as metabolic equivalents (METs). The relationship between the METs measured using the Douglas bag and METs predicted using the accelerometer was evaluated.

Results

A significant correlation between actual and predicted METs was observed in both Elderly (r=0.85, p<0.001) and Younger (r=0.88, p<0.001). Predicted METs significantly underestimated compared with actual METs in both groups (p<0.001). The mean of the errors was −0.6±0.6 METs in Elderly and −0.1±0.5 METs in Younger. The degree of underestimation increased with increasing METs in Elderly (p<0.001). A stepwise multiple regression analysis revealed that predicted METs, age, and weight were related to actual METs in both groups.

Conclusion

The degree of correlation between predicted and actual METs was comparable in elderly and younger participants, but the prediction errors were greater in elderly participants, particular at higher-intensity activities, which suggests that different predicting equations may be needed for the elderly.
Mesothelioma mortality in Great Britain: how much longer will dockyards dominate?
Authors: Reynolds Carl J , Minelli Cosetta , Darnton Andrew , Cullinan Paul
Published: October 2019

Objectives

We aimed to investigate whether there has been a geographic shift in the distribution of mesothelioma deaths in Great Britain given the decline of shipbuilding and progressive exposure regulation.

Methods

We calculated age-adjusted mesothelioma mortality rates and estimated rate ratios for areas with and without a dockyard. We compared spatial autocorrelation statistics (Moran’s I) for age-adjusted rates at local authority district level for 2002–2008 and 2009–2015. We measured the mean distance of the deceased’s postcode to the nearest dockyard at district level and calculated the association of average distance to dockyard and district mesothelioma mortality using simple linear regression for men, for 2002–2008 and 2009–2015.

Results

District age-adjusted male mortality rates fell during 2002–2015 for 80 of 348 districts (23%), rose for 267 (77%) and were unchanged for one district; having one or more dockyards in a district was associated with rates falling (OR=2.43, 95% CI 1.22 to 4.82, p=0.02). The mortality rate ratio for men in districts with a dockyard, compared with those without a dockyard was 1.41 (95% CI 1.35 to 1.48, p<0.05) for 2002–2008 and 1.18 (95% CI 1.13 to 1.23, p<0.05) for 2009–2015. Spatial autocorrelation (measured by Moran’s I) decreased from 0.317 (95% CI 0.316 to 0.319, p=0.001) to 0.312 (95% CI 0.310 to 0.314, p=0.001) for men and the coefficient of the association between distance to dockyard and district level age-adjusted male mortality (per million population) from −0.16 (95% CI −0.21 to −0.10, p<0.01) to −0.13 (95% CI −0.18 to −0.07, p<0.01) for men, when comparing 2002–2008 with 2009–2015.

Conclusion

For most districts age-adjusted mesothelioma mortality rates increased through 2002–2015 but the relative contribution from districts with a dockyard fell. Dockyards remain strongly spatially associated with mesothelioma mortality but the strength of this association appears to be falling and mesothelioma deaths are becoming more dispersed.
The utility of impedance cardiography in hemodynamic monitoring of patients with sepsis
Authors: Butz James , Shan Yizhi , Samayoa Andres , Kirton Orlando C , Vu Thai
Published: October 2019

Background

Commonly used biochemical indicators and hemodynamic and physiologic parameters of sepsis vary with regard to their sensitivity and specificity to the diagnosis. The aim of this preliminary study was to evaluate non-invasive impedance cardiography as a monitoring tool of the hemodynamic status of patients with sepsis throughout their initial volume resuscitation to explore the possibility of identifying additional measurements to be used in the future treatment of sepsis.

Methods

Nine patients who presented to the emergency room and received a surgical consultation during a 3-month period in 2016, meeting the clinical criteria of sepsis defined by systemic inflammatory response syndrome in the 2012 Surviving Sepsis Campaign Guidelines, were included in this study. We applied cardiac impedance monitors to each patient’s anterior chest and neck and obtained baseline recordings. Measurements were taken at activation of the sepsis alert and 1 hour after fluid resuscitation with 2 L of intravenous crystalloid solution.

Results

Nine patients met the inclusion criteria. The mean age was 60±17 years and two were female; eight were febrile, five were hypotensive, four were tachycardic, seven were treated for infection, and six had positive blood cultures. Hemodynamic parameters at presentation and 1 hour after fluid resuscitation were heart rate (beats per minute) (97±13 and 93±18; p=0.23), mean arterial pressure (mm Hg) (81±13 and 85±14; p=0.55), systemic vascular resistance (dyne-s/cm−5) (861±162 and 1087±272; p=0.04), afterload measured as systemic vascular resistance index (dyne-s/cm−5/m2) (1813±278 and 2283±497; p=0.04), and left cardiac work index (kg*m/m2) (3.6±1.4 and 3.3±1.3; p=0.69).

Discussion

Through measuring a patient’s systemic vascular resistance and systemic vascular resistance index (afterload), statistical significance is achieved after intervention with a 2 L crystalloid bolus. This suggests that, along with clinical presentation and biochemical markers, impedance cardiography may show utility in providing supporting hemodynamic data to trend resuscitative efforts in patients with sepsis.

Level of evidence

Level IV.
To report, or not to report, animal abuse: the role of perceived self‐efficacy in veterinarians’ decision‐making
Authors: Alleyne Emma , Sienauskaite Ornela , Ford Jade
Published: October 2019

Background

Veterinarians are on the frontline of animal welfare, but little is known about the factors that facilitate their decision to report cases of abuse to authorities. Using perceived self‐efficacy as a basis, the primary aim of this study was to examine the psychological and experiential factors linked to veterinarians’ reporting behaviour.

Methods

We administered questionnaires to 176 veterinarians assessing the amount of training received on detecting/reporting animal abuse, perceived self‐efficacy to report animal abuse, and whether they have reported animal abuse incidents to the relevant authorities.

Results

We found that perceived self‐efficacy positively correlated with suspecting and reporting animal abuse, number of hours of specialised training, and years working in practice. As hypothesised, we also found that perceived self‐efficacy explained the relationship between specialised training (in hours) and reporting animal abuse.

Conclusions

These findings highlight the psychological impact of specialised training on veterinarians’ reporting behaviour. Simply put, specialist training equips veterinarians with the confidence and self‐efficacy to report suspected cases of animal abuse. The implications for training curriculum and veterinary policy are discussed.
Contrast‐enhanced ultrasound features of hepatocellular carcinoma in dogs
Authors: Banzato Tommaso , Rubini Giuseppe , Orlandi Riccardo , Bargellini Paolo , Bonsembiante Federico , Zotti Alessandro
Published: October 2019

Background

This study aimed to describe the contrast‐enhanced ultrasound (CEUS) features of canine hepatocellular carcinoma (HCC) in relation to cellular differentiation and lesion size.

Methods

Sixty dogs with a cytological diagnosis of HCC and that underwent a CEUS examination were retrospectively selected. The wash‐in and wash‐out patterns of contrast enhancement, along with the time to wash‐in and the time to wash‐out, of each lesion were recorded. A dimensional cut‐off value of 3 cm was adopted for classification.

Results

Cellular differentiation had a significant influence on both wash‐in (chi‐squared=16.99; P<0.001) and wash‐out (chi‐squared=10.9; P=0.004) patterns of contrast enhancement. Lesion size had a lower, but still significant, influence on both wash‐in (chi‐squared=12.7; P=0.005) and wash‐out (chi‐squared=7.42; P=0.024) patterns. A homogeneous hyperenhancement in the arterial phase followed by homogeneous wash‐out were suggestive of a well‐differentiated HCC. The cellular differentiation of lesions with inhomogeneous hyperenhancement or hypoenhancement/no enhancement as well as an inhomogeneous wash‐out or no wash‐out could not be inferred.

Conclusions

No significant difference in the time to wash‐in and the time to wash‐out in relation to cellular differentiation or lesion size was evident. CEUS has the potential to improve efficiency in the diagnosis of HCCs in dogs.
Brain-derived neurotrophic factor is associated with human muscle satellite cell differentiation in response to muscle-damaging exercise
Authors: McKay Bryon R. , Nederveen Joshua P. , Fortino Stephen A. , Snijders Tim , Joanisse Sophie , Kumbhare Dinesh A. , Parise Gianni
Published: October 2019

Muscle satellite cell (SC) regulation is a complex process involving many key signalling molecules. Recently, the neurotrophin brain-derived neurotropic factor (BDNF) has implicated in SC regulation in animals. To date, little is known regarding the role of BDNF in human SC function in vivo. Twenty-nine males (age, 21 ± 0.5 years) participated in the study. Muscle biopsies from the thigh were obtained prior to a bout of 300 maximal eccentric contractions (Pre), and at 6 h, 24 h, 72 h, and 96 h postexercise. BDNF was not detected in any quiescent (Pax7+/MyoD−) SCs across the time-course. BDNF colocalized to 39% ± 5% of proliferating (Pax7+/MyoD+) cells at Pre, which increased to 84% ± 3% by 96 h (P < 0.05). BDNF was only detected in 13% ± 5% of differentiating (Pax7−/MyoD+) cells at Pre, which increased to 67% ± 4% by 96 h (P < 0.05). The number of myogenin+ cells increased 95% from Pre (1.6 ± 0.2 cells/100 myofibres (MF)) at 24 h (3.1 ± 0.3 cells/100 MF) and remained elevated until 96 h (cells/100 MF), P < 0.05. The proportion of BDNF+/myogenin+ cells was 26% ± 0.3% at Pre, peaking at 24 h (49% ± 3%, P < 0.05) and remained elevated at 96 h (P < 0.05). These data are the first to demonstrate an association between SC proliferation and differentiation and BDNF expression in humans in vivo, with BDNF colocalization to SCs increasing during the later stages of proliferation and early differentiation.

Novelty BDNF is associated with SC response to muscle injury. BDNF was not detected in nonactivated (quiescent) SCs. BDNF is associated with late proliferation and early differentiation of SCs in vivo in humans.
Accurate boundary treatment for time-dependent 3D Schrödinger equation under Spherical coordinates
Authors: Zhang Linfeng , Jia Hongfei , Bian Lei , Ran Bin
Published: October 2019

We propose a novel local boundary condition for three-dimensional Schrödinger equation under spherical coordinates. It is based on the approximate linear relationship among the Bessel functions from a free one-dimensional Schrödinger equation. With a variable transform, the novel boundary condition is a simple form of some ordinary differential equations, which relate the grid point near the numerical boundaries. Numerical tests and comparisons demonstrate the effectiveness of the proposed boundary conditions.
Pueraria lobatafor Diabetes Mellitus: Past, Present and Future
Authors: Yang Lihong , Chen Jing , Lu Huanyu , Lai Jiaqi , He Yihan , Liu Shaonan , Guo Xinfeng
Published: October 2019

Gegen (Radix Puerariae Lobatae), the root of Pueraria lobata, is an edible and medicinal herb which has been used in treating diabetic symptoms in the orient for thousands of years. We present an evidence map of the efficacy and safety of Gegen and Gegen formulas (GGFs) that use Gegen as an essential herb for diabetes, and also its mechanism of actions. We comprehensively searched the ancient medical records to identify empirical evidence; conducted a systematic review (SR) based on moderate- to high-quality randomized controlled trials (RCTs) to synthesize the clinical evidence; and reviewed the possible mechanisms of its antidiabetic effects. Empirical application of Gegen in treating diabetic symptoms dated back to more than 2000 years ago. Common herbs used in RCTs that accompany with Gegen included Radix et Rhizoma Glycyrrhizae, Radix et Rhizoma Ginseng, Rhizoma Dioscoreae, Poria, and Radix Ophiopogonis. The combinations used today are consistent with their usage in ancient times. Results of the SR showed that GGFs could benefit patients with type 2 diabetes for blood glucose control. When in combination with hypoglycemic agents or insulin, GGFs enhanced the glucose-lowering effect as well as the lipid-lowering effects. Also, the incidence and the risk of adverse events (AE), especially the hypoglycemic episodes, were lower in the combination group. No serious or life-threatening AE was reported. The experimental evidence presented that Gegen and GGFs might exert and enhance the anti-diabetic effects through activation of multiple mechanisms, such as reducing insulin resistance, increasing insulin release, inhibiting glucose absorption and reabsorption, and improving insulin sensitivity, glucose uptake, and metabolism.
An Expanded Model of Success Factors for NPD Performance
Authors: Guimaraes Tor , Paranjape Ketan , Walton Mike
Published: October 2019

Purpose: The literature prescribing important determinants of new product development success can be grouped into six main areas addressing organization culture, strategic leadership, competitive intelligence, management of technology, specific characteristics of the company’s NPD process, and the company’s absorptive capacity to use available knowledge to produce and commercialize new products. This study expands and tests an expanded model for enhancing the company’s new product development success. Design/methodology/approach: A field test using a mailed questionnaire to collect information from 311 manufacturing companies has been used to test the proposed model. To eliminate possible multicollinearity among the independent variables, a multivariate regression analysis was used. Findings: The results provide conclusive evidence about the importance of these success factors individually and in combination to explain the inter-company variance in success performing new product development. Research limitation/implications: Despite the relatively broad scope of the proposed model, other factors may also be important, should be identified, and tested in future studies. Practical implications: The items used for measuring each of the main constructs provide more specific insights regarding how managers should go about developing these success factors within their organizations. Originality/value: While the study is grounded in the literature of what until now have been relatively isolated areas of knowledge, it proposed and empirically tested a unique and increasingly integrated model for these areas considered important to new product development.
Application of photodynamic therapy drugs for management of glioma
Authors: Dubey Sunil K. , Pradyuth Sai K. , Saha Ranendra N. , Singhvi Gautam , Alexander Amit , Agrawal Mukta , Shapiro Bruce A. , Puri Anu
Published: October 2019

Human gliomas are one of the most prevalent and challenging-to-treat adult brain tumors, and thus result in high morbidity and mortality rates worldwide. Current research and treatments of gliomas include surgery associated with conventional chemotherapy, use of biologicals, radiotherapy, and medical device applications. The selected treatment options are often guided by the category and aggressiveness of this deadly disease and the patient’s conditions. However, the effectiveness of these approaches is still limited due to poor drug efficacy (including delivery to desired sites), undesirable side effects, and high costs associated with therapies. In addition, the degree of leakiness of the blood–brain barrier (BBB) that regulates trafficking of molecules in and out of the brain also modulates accumulation of adequate drug levels to tumor sites. Active research is being pursued to overcome these limitations to obtain a superior therapeutic index and enhanced patient survival. One area of development in this direction focuses on the localized application of photodynamic therapy (PDT) drugs to cure brain cancers. PDT molecules potentially utilize multiple pathways based on their ability to generate reactive oxygen species (ROS) upon photoactivation by a suitable light source. In this communication, we have attempted to provide a brief overview of PDT and cancer, photoactivation pathways, mechanism of tumor destruction, effect of PDT on tumor cell viability, immune activation, various research attempted by applying PDT in combination with novel strategies to treat glioma, role of BBB and clinical status of PDT therapy for glioma treatment.
Peripherally substituted soluble nickel phthalocyanines: Synthesis, characterization, aggregation behavior and antioxidant properties
Authors: Yazıcı Senem Çolak , Kahraman Sibel , Yıldız Salih Z. , Yılmaz Mahmut D.
Published: October 2019

Tetra-zwitterionic-substituted nickel(II) phthalocyanine derivatives were newly synthesized starting from nonionic 2(3),9(10),16(17),23(24)-tetrakis-[2-([Formula: see text]-((3-dimethylamino)propyl)carbamate)oxyethyl)phthalocyaninato nickel (II). The novel compounds have been characterized by a combination of UV-vis, FT-IR and mass spectroscopies and elemental analysis. The critical micelle concentrations of the prepared compounds were measured, and the antioxidant activities were analyzed with radical scavenging ability of 1,1-diphenyl-2-picrylhydrazyl (DPPH) and with 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS). The zwitterionic molecules showed aggregated spectra in the UV-vis region, and they might be good surfactant candidates for the detergent industry with their appropriate critical micelle concentration (CMC) properties in water. The compounds exhibited ABTS radical scavenging activity and thus they have antioxidant activity.
A fast double greedy algorithm for non-monotone DR-submodular function maximization
Authors: Gu Shuyang , Shi Ganquan , Wu Weili , Lu Changhong
Published: October 2019

We study the problem of maximizing non-monotone diminish return (DR)-submodular function on the bounded integer lattice, which is a generalization of submodular set function. DR-submodular functions consider the case that we can choose multiple copies for each element in the ground set. This generalization has many applications in machine learning. In this paper, we propose a [Formula: see text]-approximation algorithm with a running time of [Formula: see text], where [Formula: see text] is the size of the ground set, [Formula: see text] is the upper bound of integer lattice. Discovering important properties of DR-submodular function, we propose a fast double greedy algorithm which improves the running time.
Outer-convex domination in graphs
Authors: Dayap Jonecis A. , Enriquez Enrico L.
Published: October 2019

Let [Formula: see text] be a connected simple graph. A set [Formula: see text] of vertices of a graph [Formula: see text] is an outer-convex dominating set if every vertex not in [Formula: see text] is adjacent to some vertex in [Formula: see text] and [Formula: see text] is a convex set. The outer-convex domination number of [Formula: see text], denoted by [Formula: see text], is the minimum cardinality of an outer-convex dominating set of [Formula: see text]. An outer-convex dominating set of cardinality [Formula: see text] will be called a [Formula: see text]-[Formula: see text]. In this paper, we initiate the study and characterize the outer-convex dominating sets in the join of the two graphs.
Cytotoxicity effects and ionic diffusion of single-wall carbon nanotubes in cell membrane
Authors: Lai Xin , Roberts Eric
Published: October 2019

While carbon nanotubes have been put into massive practical industrial, environmental and biomedicine applications, the cytotoxicity effects or the effect to the ionic channels they bring into the living cells need to be thoroughly investigated. In this work, molecular dynamic simulations have been carried out to investigate the ionic diffusion through the single wall armchair carbon nanotube embedded right inside the cell membrane. By modeling a two-membrane system, we build a virtual cytoplasm environment including a cell chamber and an extracellular space, in which a certain amount of solute is dissolved. The system is first brought to its equilibrium by deployment of minimization and then simulated. The results suggested that carbon nanotubes (CNTs) with size less than (12, 12) shall be less cytotoxic since it does not bring any ionic diffusion through the CNT channel, so as to maintain active cytoplasm environment. Another phenomenon we observed is a notable shifting angle of the carbon nanotube which was normal to the surface of cell membrane initially. In general, the inclination angle of the carbon nanotube increases with its radius.
Trajectory Planning Based on Screw Theory with Consideration of the Optimal Berth Position for a Space Robot
Authors: Wang Yong , Liao Ying , Gong Kejie
Published: October 2019

Trajectory planning is a prerequisite for the tracking control of a free-floating space robot. There are usually multiple planning objectives, such as the pose of the end-effector and the base attitude. In efforts to achieve these goals, joint variables are often taken as exclusive operable parameters, while the berth position is neglected. This paper provides a novel trajectory planning strategy that considers the berth position by applying screw theory and an optimization method. First, kinematic equations at the position level are established on the basis of the product of exponential formula and the conservation of the linear momentum of the system. Then, generalized Jacobian matrices of the base and end-effector are derived separately. According to the differential relationship, an ordinary differential equation for the base attitude is established, and it is solved by the modified Euler method. With these sufficient and necessary preconditions, a parametric optimization strategy is proposed for two trajectory planning cases: zero attitude disturbance and attitude adjustment of the base. First, the berth position is transformed into the desired position of the end-effector, and its constraints are described. Joint variables are parameterized using a sinusoidal function combined with a five-order polynomial function. Then, objective functions are constructed. Finally, a genetic algorithm with a modified mutation operator is used to solve this optimization problem. The optimal berth position and optimized trajectory are obtained synchronously. The simulation of a planar dual-link space robot demonstrates that the proposed strategy is feasible, concise, and efficient.
Evaluation of Coupling Coordination among the Urban Physical Environment, Economy, and Population: A Case Study of 36 Main Cities in China
Authors: Chen Min , Sun Zhihao , Wang Yuanjie , Guo Shuaifeng
Published: October 2019

In the past three decades, about 0.93% of people moved from rural areas to cities per year in China. Therefore, understanding of the relationships among urban physical environment (UPE), economic development, and population growth are significant for China to realize sustainable urban development. Based on the concept and connotation of UPE and ecocity, the UPE evaluation system was constructed containing 6 first‐level of indicators (i.e., climate, quality of ambient air and atmosphere, freshwater, wastewater, built environment, and noise pollution) and 13 second‐level indicators. An entropy weight‐TOPSIS model was developed in order to evaluate the UPE system, using the data of China’s 36 main cities from 2003 to 2016. The coupling coordination degree (CCD) among the UPE, economy, and population was measured by a ternary CCD model. The results showed that (1) the UPE of 36 main cities showed periodic fluctuations throughout the 14 years, and the coastal cities and southern cities had superior UPE than the inland cities and northern cities, respectively; (2) the vast majority of cities’ CCD had experienced steady upward trends. UPE, economy, and population promoted mutually in most of the cities, but in a few super cities, the economic development and population growth exceeded the capacity of UPE. Meanwhile, the CCD gaps between the northern and southern cities were significantly widened.