bluuebunny/crossref_metadata_2025 huggingface dataset:
Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) in primary care using total diet replacement products: a protocol for a randomised controlled trial
Authors: Jebb Susan A , Astbury Nerys M , Tearne Sarah , Nickless Alecia , Aveyard Paul
Published: December 2018

Introduction

The global prevalence of obesity has risen significantly in recent decades. There is a pressing need to identify effective interventions to treat established obesity that can be delivered at scale. The aim of the Doctor Referral of Overweight People to a Low-Energy Treatment (DROPLET) study is to determine the clinical effectiveness, feasibility and acceptability of referral to a low-energy total diet replacement programme compared with usual weight management interventions in primary care.

Methods and analysis

The DROPLET trial is a randomised controlled trial comparing a low-energy total diet replacement programme with usual weight management interventions delivered in primary care. Eligible patients will be recruited through primary care registers and randomised to receive a behavioural support programme delivered by their practice nurse or a referral to a commercial provider offering an initial 810 kcal/d low-energy total diet replacement programme for 8 weeks, followed by gradual food reintroduction, along with weekly behavioural support for 24 weeks. The primary outcome is weight change at 12 months. The secondary outcomes are weight change at 3 and 6 months, the proportion of participants achieving 5% and 10% weight loss at 12 months, and change in fat mass, haemoglobin A1c, low-density lipoprotein cholesterol and systolic and diastolic blood pressure at 12 months. Data will be analysed on the basis of intention to treat. Qualitative interviews on a subsample of patients and healthcare providers will assess their experiences of the weight loss programmes and identify factors affecting acceptability and adherence.

Ethics and dissemination

This study has been reviewed and approved by the National Health ServiceHealth Research Authority (HRA)Research Ethics Committee (Ref: SC/15/0337). The trial findings will be disseminated to academic and health professionals through presentations at meetings and peer-reviewed journals and to the public through the media. If the intervention is effective, the results will be communicated to policymakers and commissioners of weight management services.

Trial registration number

ISRCTN75092026.
Behaviour change interventions for the management of Raynaud's phenomenon: a systematic review protocol
Authors: Daniels Jo , Pauling John D , Eccelston Christopher
Published: December 2018

Introduction

Raynaud's phenomenon (RP) describes excessive peripheral vasospasm to cold exposure and/or emotional stress. RP episodes are associated with digital colour changes, pain and reduced quality of life. Pharmacological interventions are of low to moderate efficacy and often result in adverse effects such as facial flushing and headaches. Recommended lifestyle and behavioural interventions have not been evaluated. The objectives of the proposed systematic review are to assess the comparative safety and efficacy of behaviour change interventions for RP and identify what we can learn to inform future interventions.

Methods and analysis

Studies eligible for inclusion include randomised controlled trials testing behaviour change interventions with a control comparator. A comprehensive search strategy will include peer review and grey literature up until 30 April 2017. Search databases will include Medline, Embase, PsychINFO and Cochrane. Initial sifting, eligibility, data extraction, risk of bias and quality assessment will be subject to review by two independent reviewers with a third reviewer resolving discrepancies. Risk of bias assessment will be performed using Cochrane risk of a bias assessment tool with quality of evidence assessed using Grading of Recommendations Assessment, Development and Evaluation(GRADE). A meta-analysis will be performed if there are sufficient data. Two subgroup analyses are planned: primary versus secondary RP outcomes; comparison of theoretically informed interventions with pragmatic interventions.

Ethics and dissemination

This review does not require ethical approval as it will summarise published studies with non-identifiable data. This protocol complies with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Findings will be disseminated in peer-reviewed articles and reported according to PRISMA. This review will make a significant contribution to the management of RP where no review of behaviour-change interventions currently exist. The synopsis and protocol for the proposed systematic review is registered in the International Prospective Register of Systematic Reviews (registration number CRD42017049643).
Population-based analysis of patients with COPD in Catalonia: a cohort study with implications for clinical management
Authors: Vela Emili , Tényi Ákos , Cano Isaac , Monterde David , Cleries Montserrat , Garcia-Altes Anna , Hernandez Carme , Escarrabill Joan , Roca Josep
Published: December 2018

Background

Clinical management of patients with chronic obstructive pulmonary disease (COPD) shows potential for improvement provided that patients’ heterogeneities are better understood. The study addresses the impact of comorbidities and its role in health risk assessment.

Objective

To explore the potential of health registry information to enhance clinical risk assessment and stratification.

Design

Fixed cohort study including all registered patients with COPD in Catalonia (Spain) (7.5 million citizens) at 31 December 2014 with 1-year (2015) follow-up.

Methods

A total of 264 830 patients with COPD diagnosis, based on the International Classification of Diseases (Ninth Revision) coding, were assessed. Performance of multiple logistic regression models for the six main dependent variables of the study: mortality, hospitalisations (patients with one or more admissions; all cases and COPD-related), multiple hospitalisations (patients with at least two admissions; all causes and COPD-related) and users with high healthcare costs. Neither clinical nor forced spirometry data were available.

Results

Multimorbidity, assessed with the adjusted morbidity grouper, was the covariate with the highest impact in the predictive models, which in turn showed high performance measured by the C-statistics: (1) mortality (0.83), (2 and 3) hospitalisations (all causes: 0.77; COPD-related: 0.81), (4 and 5) multiple hospitalisations (all causes: 0.80; COPD-related: 0.87) and (6) users with high healthcare costs (0.76). Fifteen per cent of individuals with highest healthcare costs to year ratio represented 59% of the overall costs of patients with COPD.

Conclusions

The results stress the impact of assessing multimorbidity with the adjusted morbidity grouper on considered health indicators, which has implications for enhanced COPD staging and clinical management.

Trial registration number

NCT02956395.
Adapting to ulcerative colitis to try to live a ‘normal’ life: a qualitative study of patients’ experiences in the Midlands region of England
Authors: McMullan Christel , Pinkney Thomas D , Jones Laura L , Magill Laura , Nepogodiev Dmitri , Pathmakanthan Shri , Cooney Rachel , Mathers Jonathan M
Published: December 2018

Objective

To provide a framework that is able to categorise whether patients are able to adapt to and lead a ‘normal’ life with ulcerative colitis (UC) and to detail the factors that influence this.

Design

Qualitative research study using in-depth semi-structured interviews.

Setting

Four clinical sites in the West and East Midlands regions of England.

Participants

28 adult patients diagnosed with UC for years between 1 and 22.

Results

Medication was rarely sufficient for patients to adapt to UC and live as ‘normal’ a life as possible. Virtually all patients tested and adopted non-medical adaptation methods to improve physical and psychological well-being, to help them carry on working and to prevent embarrassment. In addition, some patients benefited from outside support providing them with practical, emotional and/or financial help. In conjunction with adaptation strategies and the time to adapt, this meant that some patients with severe clinical disease were able to maintain a sense of normality in life. Patients reported that clinicians were not always receptive to discussion of the broader context of life with UC.

Conclusions

Patients’ experience of UC and their ability to adapt in order to maintain a sense of normality in life is a complex interplay of symptoms, adaptation strategies and outside support. Over time patients test out a variety of non-medical adaptation strategies. Awareness of this may help clinicians and researchers to understand patients’ views on the role of medical and other therapies. Further research around the utility of this framework in clinical practice and research is now required.

Trial registration number

ISRCTN56523019, results.
Follow Your Virtual Trainer (FYVT): a randomised controlled trial protocol of IT-based lifestyle intervention programme to promote physical activity and health among middle-aged Hong Kong Chinese
Authors: Hui Stanley Sai-Chuen , Xie Yao Jie , Kwok Ron Chi-Wai , Tam Eric Wing-Cheung , Mak Winnie Wing Sze , Mo Phoenix Kit-Han
Published: December 2018

Introduction

Hong Kong is a highly urbanised city where many people work long hours. The limited time and lack of professional instruction are the typical barriers to exercise. The purpose of this study is to test the effectiveness of an information technology-based lifestyle intervention programme on improving physical activity (PA) level and health status in a sample of middle-aged Hong Kong adults.

Methods and analysis

A two-arm parallel randomised controlled trial named ‘Follow Your Virtual Trainer’ will be conducted among 200 physically inactive Chinese adults aged from 40 to 65 years. Those randomly allocated to an intervention group will be under the instruction of a web-based computer software termed ‘Virtual Trainer (VT)’ to conduct a 3-month self-planned PA programme. A series of online seminars with healthy lifestyle information will be released to the participants biweekly for 3 months. After that, 6 months observation will follow. Those in the control group will only receive a written advice of standard PA recommendation and the textual content of the seminars. The assessments will be implemented at baseline, the 3rd, 6th and 9th months. The primary outcome is PA measured by accelerometer and International Physical Activity Questionnaire. The secondary outcomes include cardiorespiratory fitness, resting energy expenditure, anthropometrics, body composition, blood pressure, health-related quality of life, sleep quality and quantity, fatigue, behaviour mediators and maintenance of PA. The main effectiveness of the intervention will be assessed by a linear mixed model that tests the random effect of treatment on outcomes at the 3rd, 6th and 9th months.

Ethics and dissemination

This trial has been approved by the Joint Chinese University of Hong Kong—New Territories East Cluster Clinical Research Ethics Committee (CRE 2015235). The study results will be presented at scientific conferences and published in peer-reviewed journals.

Trial registration number

NCT02553980.
Outcomes comparison of different surgical strategies for the management of severe aortic valve stenosis: study protocol of a prospective multicentre European registry (E-AVR registry)
Authors: Onorati Francesco , Gherli Riccardo , Mariscalco Giovanni , Girdauskas Evaldas , Quintana Eduardo , Santini Francesco , De Feo Marisa , Sponga Sandro , Tozzi Piergiorgio , Bashir Mohamad , Perrotti Andrea , Pappalardo Aniello , Ruggieri Vito Giovanni , Santarpino Giuseppe , Rinaldi Mauro , Ronaldo Silva , Nicolini Francesco
Published: December 2018

Introduction

Traditional and transcatheter surgical treatments of severe aortic valve stenosis (SAVS) are increasing in parallel with the improved life expectancy. Recent randomised controlled trials (RCTs) reported comparable or non-inferior mortality with transcatheter treatments compared with traditional surgery. However, RCTs have the limitation of being a mirror of the predefined inclusion/exclusion criteria, without reflecting the ‘real clinical world’. Technological improvements have recently allowed the development of minimally invasive surgical accesses and the use of sutureless valves, but their impact on the clinical scenario is difficult to assess because of the monocentric design of published studies and limited sample size. A prospective multicentre registry including all patients referred for a surgical treatment of SAVS (traditional, through full sternotomy; minimally invasive; or transcatheter; with both ‘sutured’ and ‘sutureless’ valves) will provide a ‘real-world’ picture of available results of current surgical options and will help to clarify the ‘grey zones’ of current guidelines.

Methods and analysis

European Aortic Valve Registry is a prospective observational open registry designed to collect all data from patients admitted for SAVS, with or without coronary artery disease, in 16 cardiac surgery centres located in six countries (France, Germany, Italy, Spain, Switzerland and UK). Patients will be enrolled over a 2-year period and followed up for a minimum of 5 years to a maximum of 10 years after enrolment. Outcome definitions are concordant with Valve Academic Research Consortium-2 criteria and established guidelines. Primary outcome is 5-year all-cause mortality. Secondary outcomes aim at establishing ‘early’ 30-day all-cause and cardiovascular mortality, as well as major morbidity, and ‘late’ cardiovascular mortality, major morbidity, structural and non-structural valve complications, quality of life and echocardiographic results.

Ethics and dissemination

The study protocol is approved by local ethics committees. Any formal presentation or publication of data will be considered as a joint publication by the participating physician(s) and will follow the recommendations of the International Committee of Medical Journal Editors for authorship.

Trial registration number

NCT03143361; Pre-results.
Smartphone-Enhanced Low-Threshold Intervention for adolescents with Anorexia Nervosa (SELTIAN) waiting for outpatient psychotherapy: study protocol of a randomised controlled trial
Authors: Kolar David R , Hammerle Florian , Jenetzky Ekkehart , Huss Michael
Published: December 2018

Introduction

As smartphones are widely distributed nowadays, mental health apps seem to be a promising treatment tool. First self-help apps for eating disorders have been developed recently. However, studies assessing the efficacy of such apps are scarce. A smartphone app could prevent further weight reduction and increase commitment during waiting time for outpatient treatment, especially for adolescents with anorexia nervosa (AN). In this study protocol, a randomised controlled trial to assess the efficacy of a smartphone-enhanced low-threshold intervention for AN during waiting time is described.

Methods and analysis

30 adolescents with AN aged 12–19 years will be recruited at three child and adolescent psychiatry centres in Germany. All participants will be randomised to consultations only or consultations and the use of the Jourvie Research app. The app will be installed either on their own smartphone or on a research device. The participants will receive biweekly to monthly consultations for 3 months to review meal plans and weight management with a clinician. In addition, the Jourvie Research app for meal, behaviour and emotion protocolling will be provided to the intervention group. The protocols will be discussed with a clinician during the consultations. Dialectical behaviour therapy-informed skills for tension regulation to increase compliance with the meal plan will be taught in the intervention group and the app will remind the participant of a skill in a moment of need. The primary outcome is the age-adjusted and height-adjusted weight gain in standard deviation score after 3 months.

Ethics and dissemination

Results will be disseminated at conferences and through peer-reviewed publications. The trial was approved by the ethics review board of the local medical association, Mainz, Germany, under the reference number 837.338.15.

Trial registration number

German clinical trials register, reference number DRKS00008946.
Compassionate care intervention for hospital nursing teams caring for older people: a pilot cluster randomised controlled trial
Authors: Gould Lisa Jane , Griffiths Peter , Barker Hannah Ruth , Libberton Paula , Mesa-Eguiagaray Ines , Pickering Ruth M , Shipway Lisa Jane , Bridges Jackie
Published: December 2018

Objective

Compassionate care continues to be a focus for national and international attention, but the existing evidence base lacks the experimental methodology necessary to guide the selection of effective interventions for practice. This study aimed to evaluate the Creating Learning Environments for Compassionate Care (CLECC) intervention in improving compassionate care.

Setting

Ward nursing teams (clusters) in two English National Health Service hospitals randomised to intervention (n=4) or control (n=2). Intervention wards comprised two medicines for older people (MOPs) wards and two medical/surgical wards. Control wards were both MOPs.

Participants

Data collected from 627 patients and 178 staff. Exclusion criteria: reverse barrier nursed, critically ill, palliative or non-English speaking. All other patients and all nursing staff and Health Care Assistant HCAs were invited to participant, agency and bank staff were excluded.

Intervention

CLECC, a workplace intervention focused on developing sustainable leadership and work-team practices to support the delivery of compassionate care. Control: No educational activity.

Primary and secondary outcome measures

Primary—Quality of Interaction Schedule (QuIS) for observed staff–patient interactions. Secondary—patient-reported evaluations of emotional care in hospital (PEECH); nurse-reported empathy (Jefferson Scale of Empathy).

Results

Trial proceeded as per protocol, randomisation was acceptable. Some but not all blinding strategies were successful. QuIS observations achieved 93% recruitment rate with 25% of patient sample cognitively impaired. At follow-up there were more total positive (78% vs 74%) and less total negative (8% vs 11%) QuIS ratings for intervention wards versus control wards. Sixty-three per cent of intervention ward patients scored lowest (ie, more negative) scores on PEECH connection subscale, versus 79% of control. This was not a statistically significant difference. No statistically significant differences in nursing empathy were observed.

Conclusions

Use of experimental methods is feasible. The use of structured observation of staff–patient interaction quality is a promising outcome measure inclusive of hard to reach groups.

Trial registration number

ISRCTN16789770.
Comparison of hip function and quality of life of total hip arthroplasty and resurfacing arthroplasty in the treatment of young patients with arthritis of the hip joint at 5 years
Authors: Costa Matthew L , Achten Juul , Foguet Pedro , Parsons Nicholas R
Published: December 2018

Objective

To compare the medium-term clinical effectiveness of total hip arthroplasty and resurfacing arthroplasty.

Design

Single centre, two-arm, parallel group, assessor blinded, randomised controlled trial with 1:1 treatment allocation.

Setting

A large teaching hospital in England.

Participants

122 patients older than 18 years with severe arthritis of the hip joint, suitable for resurfacing arthroplasty of the hip. Patients were excluded if they were considered to be unable to adhere to trial procedures or complete questionnaires.

Interventions

Total hip arthroplasty (replacement of entire femoral head and neck); hip resurfacing arthroplasty (replacement of the articular surface of femoral head only, femoral neck remains intact). Both procedures replaced the articular surface of the acetabulum.

Outcomes

The outcome measures were hip function assessed using the Oxford Hip Score (OHS) and health-related quality of life assessed using the EuroQol (EQ-5D). Patients were followed up annually for a minimum of 5 years. Outcome data were modelled using the generalised estimating equation methodology to explore temporal variations during follow-up.

Results

60 patients were randomly assigned to hip resurfacing arthroplasty and 62 to total hip arthroplasty. 95 (78%) of the 122 original study participants provided data at 5 years. There was a small decrease in both hip functions and quality of life in both groups of patients each year during the 5-year follow-up period. However, there was no evidence of a significant difference between treatments group in the OHS (P=0.333) or the EQ-5D (P=0.501).

Conclusions

We previously reported no difference in outcome in the first year after surgery. The current medium-term results also show no evidence of a difference in hip function or health-related quality of life in the 5 years following a total hip arthroplasty versus resurfacing arthroplasty.

Trial registration number

ISRCTN33354155. UKCRN 4093.
Hyponatraemia, hyperglycaemia and worsening renal function at first blood sample on emergency department admission as predictors of in-hospital death in patients with dyspnoea with suspected acute heart failure: retrospective observational analysis of the PARADISE cohort
Authors: Chouihed Tahar , Buessler Aurélien , Bassand Adrien , Jaeger Deborah , Virion Jean Marc , Nace Lionel , Barbé Françoise , Salignac Sylvain , Rossignol Patrick , Zannad Faiez , Girerd Nicolas
Published: December 2018

Objectives

To assess the prognostic value of hyponatraemia, hyperglycaemia and impaired estimated glomerular filtration rate (eGFR) in predicting in-hospital death in patients with acute heart failure (AHF) admitted for acute dyspnoea in the emergency department.

Design

Retrospective observational study.

Setting

Emergency Department of the University Hospital of Nancy. Data were collected from August 2013 to October 2015.

Participants

The analysis included 405 patients with AHF admitted for acute dyspnoea in an emergency department.

Results

The population was elderly (mean age 82 years), 20.1% had hyponatraemia, 45.1% had hyperglycaemia and 48.6% had eGFR <50 mL/min/1.73 m2. Sixty-one patients (15.1%) died in hospital, mostly due to cardiac aetiology (58.3%). In multivariable analysis adjusted for key potential confounders, adjusted hyponatraemia (OR=2.40, (1.16 to 4.98), p=0.02), hyperglycaemia (OR=2.00, 1.06 to 3.76, p=0.03) and eGFR <50 mL/min/1.73 m2(OR=1.97 (1.00 to 3.80), p=0.04*) were all identified as significant independent predictors of in-hospital death.

Conclusions

Results of basic routine laboratory tests (hyponatraemia, hyperglycaemia and impaired eGFR) performed on admission in the emergency department are independently associated with in-hospital death. These inexpensive tests, performed as early as patient admission in the emergency department, could allow the early identification of patients admitted for AHF who are at high risk of in-hospital death.

Trial registration number

NCT02800122.
Impact of renin-angiotensin system inhibitors on clinical outcomes and ventricular remodelling after transcatheter aortic valve implantation: rationale and design of the RASTAVI randomised multicentre study
Authors: Amat-Santos Ignacio J , Catalá Pablo , Diez del Hoyo Felipe , Fernandez-Diaz Jose A , Alonso-Briales Juan H , Del Trigo María , Regueiro Ander , Juan-Salvadores Pablo , Serra Vicenç , Gutierrez-Ibanes Enrique , Muñoz-García Antonio J , Nombela-Franco Luis , Sabate Manel , Jimenez-Diaz Victor A , García del Blanco Bruno , López Javier , Varela-Falcón Luis H , Sevilla Teresa , Arnold Roman , Revilla Ana , San Roman J Alberto
Published: December 2018

Introduction

Transcatheter aortic valve implantation (TAVI) as a treatment in severe aortic stenosis (AS) is an excellent alternative to conventional surgical replacement. However, long-term outcomes are not benign. Renin-angiotensin system (RAS) blockade has shown benefit in terms of adverse remodelling in severe AS and after surgical replacement.

Methods and analysis

The RAS blockade after TAVI (RASTAVI) trial aims to detect if there is a benefit in clinical outcomes and ventricular remodelling with this therapeutic strategy following the TAVI procedure. The study has been designed as a randomised 1:1 open-label study that will be undertaken in 8 centres including 336 TAVI recipients. All patients will receive the standard treatment. The active treatment group will receive ramipril as well. Randomisation will be done before discharge, after signing informed consent. All patients will be followed up for 3 years. A cardiac magnetic resonance will be performed initially and at 1 year to assess ventricular remodelling, defined as ventricular dimensions, ejection fraction, ventricular mass and fibrosis. Recorded events will include cardiac death, admission due to heart failure and stroke. The RASTAVI Study will improve the management of patients after TAVI and may help to increase their quality of life, reduce readmissions and improve long-term survival in this scenario.

Ethics and dissemination

All authors and local ethics committees have approved the study design. All patients will provide informed consent. Results will be published irrespective of whether the findings are positive or negative.

Trial registration number

NCT03201185.
Factors influencing career progress for early stage clinician-scientists in emerging Asian academic medical centres: a qualitative study in Singapore
Authors: Yoon Sungwon , Koh Woon-Puay , Ong Marcus E H , Thumboo Julian
Published: December 2018

Objectives

To explore the factors that influence career progress for early stage clinician-scientists and to identify ways to mitigate these factors in the context of emerging Asian academic medical centres (AMCs).

Design

Qualitative interviews and thematic data analysis based on grounded theory.

Setting and participants

Five focus group interviews comprising 29 early career clinician-scientists who have received their first national-level career development award in Singapore.

Results

Clinical priorities represented an overarching concern with many reporting the difficulty in delineating responsibilities between clinical care and research. Additionally, there was a prevailing perception of the lack of support for research at the institutional level. Participants tended to identify mentors through their own efforts in a relatively haphazard manner, often owing to the dearth of role models and perceived inadequacy of reward systems for mentoring. Support from mentors was thought to be limited in terms of targeted scientific guidance and long-term commitments to the relationship. Most of the participants expressed concerns about how they could secure the next level of funding with diminishing confidence. Notably, the work-life balance was neither conceptualised as a ‘barrier’ to successful pursuit of research career nor was it translated into the reason for leaving the dual clinical-research career pathway.

Conclusions

Results revealed specific limitations presented by the research environment in newly emerging Asian AMCs. To retain a vibrant clinician-scientist workforce, additional measures are needed, aiming to improve institutional culture of research, build mentoring networks, adopt effective tools for tracking career progress and provide a clear and viable career progression path for clinician-scientist. Further research might explore the cross-cultural differences in managing work-life balance in academic medicine.
Feasibility of Improving Cerebral Autoregulation in Acute Intracerebral Haemorrhage (BREATHE-ICH) study: a protocol for an experimental interventional study
Authors: Minhas Jatinder S , Panerai Ronney B , Robinson Thompson G
Published: December 2018

Introduction

Cerebral autoregulation (CA) is impaired in a multitude of neurological conditions. Increasingly, clinical studies are correlating the nature of this impairment with prognostic markers. In acute intracerebral haemorrhage (ICH), impairment of CA has been associated with worsening clinical outcomes including poorer Glasgow Coma Score and larger haematoma volume. Hypocapnia has been shown to improve CA despite concerns over hypoperfusion and consequent ischaemic risks, and it is therefore hypothesised that hypocapnia (via hyperventilation) in acute ICH may improve CA and consequently clinical outcome. BREATHE-ICH is a CA-targeted interventional study in acute ICH utilising a simple bedside hyperventilatory manoeuvre.

Methods and analysis

Patients with acute ICH within 48 hours of onset will be included. The experimental set-up measures cerebral blood flow (cerebral blood velocity, transcranial Doppler), blood pressure (Finometer) and end tidal carbon dioxide (capnography) at baseline, and in response to hypocapnia (−5 mm and −10 mm Hg below baseline) achieved via a 90 s hyperventilatory manoeuvre. Autoregulation is evaluated with transfer function analysis and autoregulatory index calculations. Important classical endpoints associated with this before and after interventional study include death and disability at 14 days and the proportion of recruited individuals able to comply with the full measurement protocol.

Ethics and dissemination

A favourable opinion was granted by the East Midlands-Nottingham 1 Research Ethics Committee (17/EM/0283). It is anticipated that the results of this study will be presented at national and international meetings, with reports being published in journals during late 2018.

Trial registration number

NCT03324321.
Study protocol for Vitality: a proof-of-concept randomised controlled trial of exercise training or complex mental and social activities to promote cognition in adults with chronic stroke
Authors: Best John R , Eng Janice J , Davis Jennifer C , Hsiung Robin , Hall Peter A , Middleton Laura E , Graf Peter , Goldsmith Charles H , Liu-Ambrose Teresa
Published: December 2018

Introduction

Cerebrovascular disease—such as stroke—is the second most common cause of dementia (ie, vascular dementia). Specifically, a stroke increases one’s risk for dementia by a factor of two. Thus, stroke survivors represent a target population in need of intervention strategies to promote cognitive function and prevent dementia. The current standard of care in stroke rehabilitation does not adequately address the significant cognitive consequences of stroke, especially for those who are in the chronic phase (ie, >12 months since an index stroke). Two potential intervention strategies are: (1) exercise training and (2) cognitive and social enrichment activities.

Methods and analysis

The aim of this proof-of-concept randomised controlled trial is to determine whether a 6-month targeted exercise training programme or a 6-month cognitive and social enrichment programme can efficaciously and efficiently improve cognitive function in older adults with chronic stroke compared with a 6-month stretch and tone programme (ie, control). The primary measurement periods will be baseline, month 6 (postintervention) and month 12 (6-month follow-up). The primary outcome measure will be performance on the Alzheimer’s Disease Assessment Scale-Cognitive-Plus (ADAS-Cog-Plus), a global measure of cognitive performance using multidimensional item response theory to summarise scores from the 13-item ADAS-Cog and other standard cognitive assessments. The primary analysis will compare changes in ADAS-Cog-Plus performance from baseline to month 6. Proof-of-concept outcomes relating to intervention feasibility will be analysed descriptively. The economic evaluation will examine the incremental costs and health outcome benefits generated by both interventions versus the control.

Ethics and dissemination

Ethical approval has been obtained from the University of British Columbia’s Clinical Research Ethics Board (H13-00715, 26 July 2013). Any modifications to the protocol will require a formal amendment to the protocol and approval by the Research Ethics Board. Outcomes of this randomised controlled trial and the statistical code to generate those outcomes will be disseminated through publication in peer-reviewed journals as well as conference presentations.

Trial registration number

NCT01916486.
Cyclic and post-cycling anchor response in geocell-reinforced sand
Authors: Moghaddas Tafreshi S.N. , Rahimi M. , Dawson A.R. , Leshchinsky B.
Published: December 2018

Plate anchors are commonly used to resist static, cyclic, and monotonic post-cyclic uplift loads. Under cyclic loading, progressive sudden failure may occur, characterized by accumulated displacement — even under loads significantly less than the static capacity. Despite extensive usage of geocell materials for increasing cyclic resilience, the influence of geocell reinforcements on cyclic uplift capacity is not well understood. In this study, a series of near-full-scale experimental tests, with and without geocell, are presented. Results show that the unreinforced system fails cyclically under a load that is almost 70% of its ultimate uplift capacity (Pu), but use of geocell enables stable cyclic resistance of over 100% Pu. For the given soil and configurations, a cyclic displacement rate that reaches less than 0.05 mm/cycle tends to highlight a likely stable response. Evaluation of the soil’s response to cyclic loading demonstrates that, with increasing loading cycles, the loading is increasingly transmitted through the soil close to the anchor in the unreinforced case, but that the reinforced case is less prone to this phenomenon. The monotonic post-cycling capacity of both reinforced and unreinforced anchors decreases after application of cyclic loading; however, the unreinforced scenario demonstrates larger decreases in capacity, particularly in the residual capacity.
Makran continental margin sedimentation during the Late Holocene
Authors: Lahijani H.A.K. , Amjadi S. , Pourkerman M. , Naderi A. , Hosseindoost M. , Habibi P.
Published: December 2018

Sedimentation in the Makran active margin is governed by a complex interaction of atmospheric, tectonics, and hydrodynamic setting of the northern flank of the Gulf of Oman. The mixed clastic carbonate sediments in the tectonically and hydrodynamically active environment have complicated the distribution pattern. The region is suffering from basic sedimentological data, and specifically, the sedimentation history of the Holocene deposits has been rarely studied in the Iranian coast. To deal with this deficiency, surface and core sediment samples from the Iranian continental shelf and upper slope of the Gulf of Oman have been studied using standard sedimentological techniques. The overall sediment distribution pattern demonstrates that the grain size gradually decreases from the shoreline to the deeper zones. However, some medium- to coarse-grained sand patches can be found in the deeper parts, especially in the middle part of the studied area that can be related to sediment supply of ephemeral rivers discharging into the sea in rainy seasons and (or) high-energy events (i.e., turbidites and tsunamis during the Holocene). Several horizons of the coarse-grained detrital sediments are detectable in the upper slope sediment cores. The coarse-grained materials are received from the hinterland during flash floods and could be accumulated due to mass wasting events. The elevated amount of organic materials in the upper slope indicates a deficit of dissolved oxygen that leads to preservation of organic materials in the bottom sediments.
Bayesian information updating procedures for Pacific salmon run size indicators: evaluation in the presence and absence of auxiliary migration timing information
Authors: Staton Benjamin A. , Catalano Matthew J.
Published: December 2018

Preseason forecasts of Pacific salmon run size are notoriously uncertain and are thus often updated using various abundance indices collected during the run. However, interpretation of these in-season indices is confounded by uncertainty in migration timing. We assessed the performance of two Bayesian information-updating procedures for Kuskokwim River Chinook salmon (Oncorhynchus tshawytscha), one that uses auxiliary run timing information and one that does not, and compared the performance with methods that did not involve updating. We found that in-season Bayesian updating provided more accurate run size estimates during the time when harvest decisions needed to be made, but that the incorporation of run timing forecasts had little utility in terms of providing more accurate run size estimates. The latter finding is conditional on the performance of the run timing forecast model we used; a more accurate timing forecast model might yield a different conclusion. The Bayesian approach we developed provided a probabilistic expression of run size beliefs, which could be useful in a transparent risk-assessment framework for setting and altering harvest targets during the season.
Habitat heterogeneity stimulates regeneration of bryophytes and vascular plants on disturbed minerotrophic peatlands
Authors: Caners Richard T. , Crisfield Varina , Lieffers Victor J.
Published: December 2018

Wooded rich fens (WRF), characterized by high variation in surface topography and numerous plant species organized along microtopographic gradients, are abundant in continental western Canada. In regions where in situ oil sands exploration (OSE) prevails, however, winter operations eliminate the surface vegetation and mechanically flatten the exposed peat. This results in saturated or flooded soils during the growing season and eliminates plant species dependent on naturally elevated microhabitats, with implications for peatland recovery. In northeastern Alberta, we redeveloped hummock topography on replicate WRF after OSE by extracting blocks of frozen peat from peatland surfaces in the winter. Peat mounds and adjacent unmounded flattened areas were left to regenerate naturally and were sampled four to five summers later. Mounds facilitated the colonization of many peatland plants not adapted to waterlogged soils. For bryophytes, mean richness and diversity of liverworts, Sphagnum, and true mosses were higher in mounded plots than in unmounded plots. For vascular plants, woody plants (trees and shrubs) had higher richness, cover, and diversity (trees only) in mounded plots. Peat mounding may be effective for stimulating vegetation development on OSE-degraded WRF. All mounds, however, will require lateral expansion by hummock-forming mosses to provide the habitat volume required for development of large woody plants.
Quantum wave-packet studies on ion–molecule reaction with and without Coriolis-coupling effect
Authors: Wang Xian-Long , Gao Feng , Xu Ting , Meng Qing-Tian , Gao Shou-Bao
Published: December 2018

The time-dependent quantum scattering calculation with Chebyshev wave packet propagation scheme has been carried out based on an accurate electronic potential energy surface of H2O+(X4A″). Due to the influence of the deep potential well, the reaction probability of [Formula: see text] shows resonance structures regardless of the Coriolis-coupling (CC) effect or centrifugal sudden (CS) approximation. In the range of collision energy 0.0–1.0 eV, the integral cross section obtained by the CS approximation calculation is smaller than that by the CC calculation, which indicates that the CC effect plays a significant role in the title reaction.
Interannual repeatability of eggshell phenotype in individual female Common Murres (Uriaaalge)
Authors: Hauber Mark E. , Luro Alec , McCarty C.J. , Barateli Ketti , Cassey Phillip , Hansen Erpur S. , Dale James
Published: December 2018

The recognition of own progeny is critical in group-living organisms that provide parental care for their young. The colonial seabird Common Murre (Uria aalge (Pontoppidan, 1763); also known as the Common Guillemot) does not build a nest, so direct cues must be available for the parents to recognize their own egg. However, only anecdotal evidence exists that, as seen in other avian lineages where examined, eggshells of Common Murres are also consistent in most aspects of their appearance between different breeding attempts by each female. Using digital photography, we quantified several eggshell traits of a handful of captive Common Murres across multiple years. Individual female Common Murre eggs were significantly repeatable in background colour, maculation coverage, spot shape, and shell size. Laying individually consistent and recognizable eggshells across breeding attempts may benefit Common Murres by reducing both the cost of relearning and the risk of misidentifying their own eggs. More generally, these data also add to the growing knowledge of individually consistent eggshell genesis by the avian reproductive system.
Pharmacological Effects and Mechanisms of Chinese Medicines Modulating NLRP3 Inflammasomes in Ischemic Cardio/Cerebral Vascular Disease
Authors: Li Yueying , Liu Yuntao , Yan Xia , Liu Qing , Zhao Yong-Hua , Wang Da-Wei
Published: December 2018

Cardio/cerebral-vascular diseases seriously threaten human health and are the leading cause of death. As such, there is great interest in identifying a potential mechanism that controls the development process of cardio/cerebral vascular diseases. Present studies demonstrate that inflammasomes play an important role in the process of ischemic cardio/cerebral vascular diseases (ICCVDs). Among the pathological process of ICCVDs, inflammasomes activated the sterile inflammatory response that accelerated the development of diseases and aggravated the acute lesion of tissue. As the most thoroughly studied inflammasome, the NLRP3 inflammasome has been proven to be a potential therapeutic target for ICCVDs. In this review, we summarized the mechanisms of Chinese herbal medicine which can affect ICCVDs via the regulation of the NLRP3 inflammasome. Our study discovers that active compounds of Chinese medicines have a negative effect on NLRP3 in different ICCVDs models. Astragaloside IV may influence the receptor of the cell membrane to inhibit NLRP3 activation. Resveratrol, colchicinesis, salvianolic acid B, chrysophanol and sulforaphane may directly damage the formation of NLRP3 by inhibiting ASC or Caspase-1. Most of the active natural compounds can negatively regulate the downstream products of NLRP3 inflammasome such as IL-18 and IL1[Formula: see text]. In addition, Chinese medicines such as sinomenine, ruscogenin, resveratrol, arctigenin and cepharanthineas may downregulate NLRP3 inflammasome by inducing autophagy activation. Due to the advantages of multi-target effects, Chinese herbal medicine can be treated as a splendid therapy for ICCVDs by inhibiting NLRP3 inflammasome.
Polydatin Attenuates Atherosclerosis in ApoE−∕− Mice through PBEF Mediated Reduction of Cholesterol Deposition
Authors: Huang Zhiyong , Tian Guangyong , Cheng Saibo , Zhao Dandan , Zhang Yu , Jia Yuhua , Zhou Fenghua
Published: December 2018

Cholesterol metabolism becomes imbalanced during the formation of macrophage-derived foam cells. Pre-B-cell colony-enhancing factor (PBEF) has recently been found to affect lipid deposition and inflammation in atherosclerosis. Here, we aimed to study the effects and molecular mechanism of Polydatin on atherosclerosis in ApoE-knockout (ApoE[Formula: see text]) mice. Thirty ApoE[Formula: see text] mice were fed a high-fat diet (HFD) for 12 weeks, and then treated with Polydatin for another 12 weeks. Whole aortas and cryosections were stained with oil red O. Blood lipid, PBEF and cytokine levels were measured by ELISA. The mRNAs of cholesterol metabolism-related genes were determined by qRT-PCR and protein levels by Western blotting. Cell cholesterol content and viability were determined in macrophages and RAW 264.7 cells. PBEF siRNA was used to study the effect of Polydatin on cholesterol metabolism in macrophages incubated with ox-LDL. Polydatin lowered blood lipids and decreased atherosclerotic lesions in ApoE[Formula: see text] mice. The expression of cytokines and the mRNA of cholesterol metabolism-related genes were markedly regulated by Polydatin. Meanwhile, PBEF mRNA and protein were both greatly down-regulated by Polydatin. In vitro, Polydatin protected RAW 264.7 cells treated by ox-LDL and inhibited cholesterol uptake by macrophages. The PBEF siRNA result indicates that Polydatin can modulate cholesterol metabolism in macrophages, partly through down-regulation of PBEF. In conclusion, Polydatin relieves atherosclerosis injury in ApoE[Formula: see text] mice, mainly through down-regulation of PBEF and inhibition of PBEF-inducing cholesterol deposits in macrophages.
Analysis of melting curves of MgO and LiF using the Lindemann law
Authors: Sunil K. , Sharma S. B. , Sharma B. S.
Published: December 2018

We have determined the melting slopes as a function of pressure for MgO up to a pressure of 135 GPa, and for LiF up to a pressure of 100 GPa using the Lindemann law. Values of melting temperature have also been calculated from the melting slopes using Euler’s finite difference calculus method. It is found that the melting slope decreases continuously with the increase in pressure giving a nonlinear pressure dependence of the melting temperature. Values of bulk modulus and the Grüneisen parameter appearing in the Lindemann law of melting have been determined using the Stacey reciprocal K-primed equation of state and the Shanker reciprocal gamma relationship. The results for melting temperatures of MgO and LiF at different pressures are compared with the available experimental data. Values of melting temperatures at different pressures determined from the Al’tshuler relationship for the volume dependence of the Grüneisen parameter have also been included in the comparison presented.
In vivo mice brain microcirculation monitoring based on contrast-enhanced SD-OCT
Authors: Yang Shaozhuang , Liu Liwei , Chang Yixin , Zhang Ningning , Liu Kun , Hong Liang , Chen Bingling , Zhao Yue , Hu Rui , Qu Junle
Published: December 2018

In this paper, we proposed a contrast-enhanced homemade spectral domain optical coherence tomography (SD-OCT) method for monitoring of brain microcirculation. We used the polyethylene glycol (PEG)-ylated gold nanorods (GNRs) as a contrast-enhanced agent, obtained clearly 2D and 3D OCT images of blood vessels and dynamic changes of probes in mouse blood vessels. Owing to high scattering of the PEG-GNRs, more tiny blood vessels can be imaged and the OCT signal can be enhanced by 5.87 dB after injection of PEG-GNRs for 20[Formula: see text]min, the enhancement then declined gradually for 60[Formula: see text]min. Our results demonstrate an effective technique for the enhanced imaging of blood vessels in vivo, especially for studies of the brain microcirculation, which could be serviced for disease mechanism research and therapeutic drug monitoring.