bluuebunny/crossref_metadata_2025 huggingface dataset:
A Prospective Survey of Anaesthetic Critical Events in a Teaching Hospital
Authors: Currie M.
Published: January 2019

A survey of anaesthetic critical events based on voluntary anonymous reports was undertaken over a two and a half year period within a teaching hospital Department of Anaesthesia. At the end of the survey 167 reports were analysed. Human error was a contributing factor in 82% of events. Inadequate preoperative patient assessment or preparation, problems in the area of human/ equipment interface and various stress factors for the anaesthetist featured significantly in the survey. The method enables the collection of objective data on factors contributing to anaesthetic and surgical risk and the formulation and evaluation of potential corrective strategies. It also facilitates harmonious peer review via individual and group feedback activities. The adoption of such a survey on a wider scale is seen as a valuable part of quality assurance in the continuing attempt to increase patient safety.
Prevention of Tachycardia with Atenolol Pretreatment for Carotid Endarterectomy under Cervical Plexus Blockade
Authors: Davies M. J. , Dysart R. H. , Silbert B. S. , Scott D. A. , Cook R. J.
Published: January 2019

A double-blind, randomised, controlled trial of forty patients was carried out to determine if oral atenolol pretreatment would reduce the incidence of tachycardia during carotid endarterectomy performed under cervical plexus block. Twenty patients received a placebo and twenty patients 50 mg of atenolol two hours prior to surgery. The superficial and deep cervical blocks were performed with 1.5% lignocaine containing 1:200,000 adrenaline. The patients were monitored with the V5 lead of the electrocardiogram and intraarterial blood pressure. These measurements were recorded on a correctly calibrated paper recorder. Tachycardia (heart rate > 90 beats per minute for more than three minutes) occurred in thirteen patients in the placebo group and two patients in the atenolol group (P<0.01). There was no difference in the occurrence of bradycardia, hypotension or hypertension between the two groups. It is concluded that atenolol pretreatment is an effective method of reducing the incidence of tachycardia during carotid endarterectomy performed under cervical plexus blockade.
Delayed Onset of Alcuronium Effect in Children with Cyanotic Congenital Heart Disease
Authors: Keneally J. P. , Goonetilleke P. H. , Ramzan I. M.
Published: January 2019

The effect of alcuronium dichloride (0.3 mg/kg) was studied in seven normal children (Group A), nine with acyanotic congenital heart disease (Group B) and eight with cyanotic disease (Group C). The onset of action was recorded using an integrated electromyograph and blood samples taken for later estimation of plasma concentrations of the drug.

The mean time (SD) taken to 75% suppression of twitch height was 1.3(0.8), 1.7(1.0) and 3.8(2.8) minutes, respectively, in each of the three groups. This was significantly slower in Group C compared with both other groups (P<0.05). While six of the Group A patients and seven from Group B reached 95 % paralysis within ten minutes, only two of the cyanosed children achieved this level of relaxation. However, if times to 95% relaxation were extrapolated, there was no significant difference between the groups at 4.5(3.9), 5.8(5.7) and 10.9(6.5) minutes respectively. There was a weak but statistically significant relationship between haematocrit and time to 75% blockade. Maximum twitch depression was similar in all three groups with plasma concentrations at this time being 1.6(0.7), 1.8(0.5) and 2.3(1.4) μg/ml respectively. Again, there was no statistically significant difference between these values.

These results confirm that the clinical onset of relaxation is delayed in children with cyanotic congenital heart disease, possibly because of delayed distribution of alcuronium.
Function of the Dräger Oxylog Ventilator at High Altitude
Authors: Thomas G. , Brimacombe J.
Published: January 2019

We have assessed the performance of the Dräger Oxylog ventilator at high altitude using a decompression chamber and a lung simulator set to mimic the normal and non-compliant lung. In the normal lung, tidal volume increased by 28% at 2040 metres and by 106% at 9120 metres. A lesser change, but in the opposite direction, occurred in respiratory rate. The net effect was a linear increase in minute volume with altitude. At 2040 and 9144 metres minute volume increased by 13% and by 45%, and rate decreased by 10% and 30% respectively. In the abnormal lung stimulation, similar, but slightly less marked, changes occurred in all variables. These changes are of sufficient magnitude to require frequent observation of tidal volume and respiratory rate during aircraft ascent and descent.
Adverse Incident Reporting in Intensive Care
Authors: Hart G. K. , Baldwin I. , Gutteridge G. , Ford J.
Published: January 2019

This prospective, observational, anonymous incident reporting study aimed to identify and correct factors leading to reduced patient safety in intensive care. An incident was any event which caused or had the potential to cause harm to the patient, but included problems in policy or procedure. Reports were discussed at monthly meetings. Of 390 incidents, 106 occasioned “actual” harm and 284 “potential” harm. There was one death, 86 severe complications and 88 complications of minor severity. Most were transient but the effects of 24 lasted up to a week. Most incidents affected cardiovascular and respiratory systems. Incident categories involved drugs, equipment, management or procedures. Incident causes were knowledge-based, rule-based, technical, slip/lapse, no error or unclassifiable.

The study has identified some human and equipment performance problems in our intensive care unit. Correction of these should lead to a reduction in the future incidence of those events and hence an increased level of patient safety.
Evaluation of a Disposable Device for Patient-Controlled Epidural Analgesia after Caesarean Section
Authors: Kee W. D. Ngan , Lam K. K. , Twyford C. J. , Gin T.
Published: January 2019

We evaluated a disposable device (Baxter PCA Infusor) for patient-controlled epidural analgesia (PCEA) using pethidine in twenty women after lower segment caesarean section. Efficacy, as measured by visual analogue pain scores, was comparable with historical controls from PCEA studies using electronic devices. Three patients reported inadequate analgesia, attributable in two cases to problems with the epidural catheter. PCEA was stopped in one patient because of side-effects. Pethidine consumption ranged from 125 to 1500 mg (median 575 mg) in 48 hours. Plasma concentrations of pethidine varied widely. Disposable devices for PCEA after caesarean section provide an alternative to bolus administration or PCEA using more expensive and cumbersome electronic devices, although we suggest currently available apparatus requires modifications to improve clinical performance.
Midazolam-Flumazenil Topical Anaesthesia for Microlaryngoscopy with Jet Ventilation
Authors: Rushatamukayanunt W. , Tritrakarn T.
Published: January 2019

A comparison between midazolam and midazolam-flumazenil for total intravenous anaesthesia in combination with topical anaesthesia and muscle relaxants was performed in a double-blind, parallel study in 40 patients scheduled for microlaryngoscopy with or without bronchoscopic procedures using jet ventilation with oxygen. A single intravenous injection of midazolam 0.3 mg/kg, lignocaine spray and muscle relaxants provided adequate anaesthesia and good operative conditions throughout the procedures, which took 20 to 30 minutes.

Patients who had placebo at the end of the procedures had a longer recovery and a high incidence of airway obstruction (20%). Administration of flumazenil provided prompt awakening in 19 of 20 patients (95%) within five minutes, resulting in rapid and favourable recovery without resedation or other side-effects, while only three of 20 (15%) patients in the placebo-treated group had improved consciousness within five minutes.

The simplicity and reliability of the midazolam-flumazenil technique is attractive. We consider it worthy of further investigation for wider application in clinical practice.
Laryngeal Mask Insertion following Inhalational Induction in Children: A Comparison between Halothane and Sevoflurane
Authors: Kwek T. K. , Ng A.
Published: January 2019

The aim of this study was to compare laryngeal mask insertion conditions following inhalational induction with either halothane or sevoflurane.

Fifty-eight healthy children scheduled for dental extraction were randomly assigned to receive nitrous oxide 66% in oxygen and 3.0 MAC of either halothane or sevoflurane introduced in a stepwise fashion. The laryngeal masks were inserted when an adequate depth of anaesthesia was attained and the reactions and time to insertion noted.

Inhalational induction was smooth in both halothane and sevoflurane groups. Induction time and time to laryngeal mask insertion were significantly faster with sevoflurane. The conditions for laryngeal mask insertion were generally good with 86.2% and 89.2% in the halothane and sevoflurane groups respectively having had no reactions to insertion. The complications to laryngeal mask insertion encountered were mild. The emergence time from the anaesthetic was found to be shorter for sevoflurane but the difference was not statistically significant.
Lack of Efficacy of Propofol in the Treatment of Early Postoperative Nausea and Vomiting
Authors: Harper I. , Della-Marta E. , Owen H. , Plummer J. , Ilsley A.
Published: January 2019

The anti-nauseant efficacy of low-dose propofol was investigated in a blinded, randomized trial. Patients who complained of nausea and/or vomiting following laparoscopic gynaecological surgery and who requested antiemetic were randomly assigned to receive placebo, propofol 3 mg, propofol 9 mg or propofol 27 mg by intravenous injection. Nausea, vomiting and sedation were recorded by a blinded observer for 90 minutes following administration of the test drug, prior to discharge, and 24 hours following surgery. Rescue antiemetic (droperidol 1.0 mg IV) was available from 10 minutes after administration of test drug. Propofol failed to reduce nausea scores and did not reduce the incidence of vomiting. Numbers of patients receiving rescue antiemetic were similar in the four treatment groups. In the first 10 minutes following test drug administration, sedation scores were increased by propofol in a dose-related manner. We conclude that, in the dose range studied, propofol is ineffective for the treatment of nausea and vomiting occurring soon after laparoscopic gynaecological surgery.
The Third Five-Year Survey of Fellows (by Examination) of the Faculty of Intensive Care, Australian and New Zealand College of Anaesthetists
Authors: Harrison G. A. , Byth P. L. , D'Este C. A.
Published: January 2019

A questionnaire was sent to 126 Fellows who had passed the Fellowship Examination in Intensive Care up to and including the examination of October, 1995. The major objectives were to assess the continuing involvement of Fellows in Intensive Care and obtain feedback on training and the examinations. Only six Fellows failed to respond. Ninety-six per cent of responders had some involvement in Intensive Care and 89% had a current formal Intensive Care appointment. The median percentage of the week spent in the Intensive Care was high. Forty-seven per cent were practising some anaesthesia. Although there was considerable individual variation, the Fellows had not changed their median amount of Intensive Care practice over time.

The responders provided feedback on their work patterns in the public and private systems, and their training and examinations. Overall, the training/examination system appears to satisfy Fellows although some fine tuning is required.
Data Collection by Acute Pain Services in Australia and New Zealand
Authors: Turner G. A. , Halliwell R.
Published: January 2019

Forty-three Acute Pain Service units in Australia and New Zealand were surveyed regarding data they collected on their daily rounds. The survey sought to determine what data each unit actually collected and what they considered to be a set of data that would be an acceptable minimal standard for the purpose of audit. The scoring or scaling mechanisms that were used in auditing the various parameters were also ascertained in an attempt to derive a consistent means of comparing data from the various Acute Pain Service groups. The Acute Pain Special Interest Group is currently developing suggestions for a standard data set and associated scoring mechanisms in line with the results of this survey.
Prevalence and Correlates of Sexual Assault Perpetration and Ambiguous Consent in a Representative Sample of College Students
Authors: Walsh Kate , Sarvet Aaron L. , Wall Melanie , Gilbert Louisa , Santelli John , Khan Shamus , Thompson Martie P. , Reardon Leigh , Hirsch Jennifer S. , Mellins Claude A.
Published: January 2019

The primary aim of the current study was to examine the prevalence and correlates of self-reported sexual assault (SA) perpetration, defined as nonconsensual sexualized touching or attempted or completed oral, vaginal, or anal penetration since starting college among men, women, and gender nonconforming (GNC) students. A secondary aim was to examine the prevalence and correlates of self-reported sexual encounters when the respondent was unsure that their partner consented (ambiguous consent). In spring 2016, 1,671 randomly sampled students (67% response rate) at two interconnected urban undergraduate institutions participated in an online survey about sexual experiences and personal and social contextual correlates. Prevalence estimates for SA perpetration and ambiguous consent were estimated and logistic regression was used to test bivariate associations between these two outcomes and a range of potential correlates. Approximately 2% of students self-reported any SA perpetration and 9% reported any ambiguous consent experiences since starting college. Pre-college SA perpetration, past-year SA victimization, belief in and use of nonverbal consent strategies, binge drinking, and depression symptoms were associated with higher odds of both SA perpetration and ambiguous consent while at college. Hookups were associated with higher odds of ambiguous consent; family social support was associated with lower odds of ambiguous consent. Findings of similar correlates for SA perpetration and ambiguous consent point to prevention programming focused on verbal consent strategies, alcohol harm reduction approaches, and pre-college interventions.
Factors Affecting Completion Times: A Comparative Analysis of Smartphone and PC Web Surveys
Authors: Antoun Christopher , Cernat Alexandru
Published: January 2019

This article compares the factors affecting completion times (CTs) to web survey questions when they are answered using two different devices: personal computers (PCs) and smartphones. Several studies have reported longer CTs when respondents use smartphones than PCs. This is a concern to survey researchers because longer CTs may increase respondent burden and the risk of breakoff. However, few studies have analyzed the specific reasons for the time difference. In this analysis, we analyzed timing data from 836 respondents who completed the same web survey twice, once using a smartphone and once using PC, as part of a randomized crossover experiment in the Longitudinal Internet Studies for the Social Sciences panel. The survey contained a mix of questions (single choice, numeric entry, and text entry) that were displayed on separate pages. We included both page-level and respondent-level factors that may have contributed to the time difference between devices in cross-classified multilevel models. We found that respondents took about 1.4 times longer when using smartphones than PCs. This difference was larger when a page had more than one question or required text entry. The difference was also larger among respondents who had relatively low levels of familiarity and experience using smartphones. Respondent multitasking was associated with slower CTs, regardless of the device used. Practical implications and avenues for future research are discussed.
Dynamics research on actively controlled swashplateless rotor
Authors: Jin Yu , Yong Liu , Weidong Yang
Published: January 2019

This study presents the design, dynamic model, and dynamics research of a new cyclic pitch control strategy in motor-driven rotorcraft. In this strategy, the control response and flapping feature of conventional rotor systems can be obtained by imposing (1) a lag-pitch coupling on rotor blade and (2) an additional sinusoidal rotational speed of rotor shaft without any actuators or swashplate. This study establishes a refined nonlinear dynamic model including the effects of pitch motion, and figures out the fundamental dynamic characteristics of this novel configuration. Analyses of its mechanical stability, dynamic responses and stability in hover are also conducted. The model in this research, compared with the previous linear model, improves the predicting accuracies of dynamic responses remarkably. A preliminary understanding of this novel rotor's dynamic mechanisms is gained by this study.
Political Hostility and Local Government Crisis in Bangladesh: Ruling Party’s Supremacy and Opposition Party’s Costs of Being Outside of the State Power
Authors: Farid Uddin Khandakar
Published: January 2019

Bangladesh has a history of political unrest and supremacy of the ruling party. Recently, representatives of the local government were suspended for being accused in cases of political violence. The ruling party is defining the suspensions as a legal process; on the contrary, the opposition political parties are claiming it as political hostility and a way of controlling local governments. There are shortages of research on contemporary political challenges and its consequences. Thus, this study considered local government representative suspensions as a case to exemplify the political hostility and local government crisis in Bangladesh. This study also demonstrated some theoretical points to frame the conceptual thoughts, likewise explained the status and some historical illustration of governmental intrusion over local government. Besides, this study applied the qualitative method to discover the research queries. Consequently, the analysis outlined substantial political supremacy and hostility in Bangladesh and its adverse impact on local governance.
Analytical quality assessment and method comparison of immunoassays for the measurement of serum cobalamin and folate in dogs and cats
Authors: McLeish Susan A. , Burt Kay , Papasouliotis Kostas
Published: January 2019

Serum cobalamin and folate are often measured in cats and dogs as part of laboratory testing for intestinal disease, small intestinal dysbiosis, or exocrine pancreatic deficiency. We performed an analytical validation of human immunoassays for cobalamin and folate measurement (AIA-900 analyzer, Tosoh Bioscience) and compared results with those obtained using chemiluminescence assays (Immulite 2000 analyzer, Siemens Medical Solutions Diagnostics). Accuracy, precision, total observable error (TEobs%), and σ values were calculated for the immunoassays. Correlation and agreement were evaluated with Deming regression, Passing–Bablok regression, and Bland–Altman analysis. Cobalamin intra-assay and inter-assay CVs were 1.8–9.3% and 2.6–6.8%, respectively. Folate intra-assay and inter-assay CVs were 1.5–9.1% and 3.4–8.1%, respectively. TEobs (%) were ≤19 and ≤31 for cobalamin and folate, respectively. Sigma values were 3.60–11.50 for cobalamin and 2.90–7.50 for folate. Regression analysis demonstrated very high or high correlations for cobalamin [ r = 0.98 (dogs), 0.97 (cats)] and folate [ r = 0.88 (dogs), 0.92 (cats)] but Bland–Altman analysis revealed poor agreement for both. The immunoassays had good analytical performance for measuring cobalamin and folate in both species. Results obtained by the 2 analyzers cannot be used interchangeably and should be interpreted using instrument-specific reference intervals. Further studies are required to establish immunoassay-specific reference intervals and to evaluate the diagnostic performance and clinical utility of the analyzer for these analytes.
Problem-Solving Skills of the U.S. Workforce and Preparedness for Job Automation
Authors: Cummins Phyllis A. , Yamashita Takashi , Millar Roberto J. , Sahoo Shalini
Published: January 2019

Automation and advanced technologies have increased the need for a better understanding of the skills necessary to have a globally competitive workforce. This study used data from the Program for the International Assessment of Adult Competencies to compare problem-solving skills in technology-rich environments among adults in South Korea, Germany, Singapore, Japan, Canada, Estonia, the United Kingdom, the United States, and Australia. Overall, the United States had the lowest scores among all countries, and in all countries scores declined with age. The United States had higher proportions of survey participants in the lowest skill category and lower proportions in the top-skill categories. The results of this study suggest changes in the U.S. educational and lifelong learning systems, and policies may be necessary to ensure all adults have the necessary skills in a competitive workforce.
Using Precision Environmental Health Principles in Risk Evaluation and Communication of the Deepwater Horizon Oil Spill
Authors: Jackson Daniel , Huang Meng , Fernando Harshica , Ansari Ghulam , Howarth Marilyn , Mesaros Clementina , Penning Trevor , Elferink Cornelis
Published: January 2019

This article provides a description of the rationale and processes adopted by the Gulf Coast Health Alliance: Health Risks related to the Macondo Spill consortium to evaluate and communicate the risk of exposure to polycyclic aromatic hydrocarbons (PAHs) in seafood over several years following the Deepwater Horizon disaster and subsequent oil spill. We examined gaps in knowledge associated with PAH toxicity following exposure to petrogenic (oil-derived) PAHs by studying the metabolic fate of PAHs and their potential toxicity using sophisticated analytical methods. Using the data generated, we developed a risk communication strategy designed to meet the needs of the stakeholder communities including a consumption guideline calculator, a web-based tool to reconcile seafood consumption with risk of adverse health effects.
The development of a robust symbolic communication system for robots via embodied iterated imitation
Authors: Erbas Mehmet Dincer
Published: January 2019

In this research, real robots are used to model the emergence and development of a symbolic communication system in a group of social agents. It is shown that as the predefined symbols of the language are transmitted among the robots, variations due to embodiment arise in the learned symbols. As a result of these variations, transmissibility of the randomly generated symbols of the language decreases. We introduce multiple cycles of iterated imitation during which the symbols of the language evolve and adapt to the uncertainties in robots’ sensors and actuators. Specific structures emerge in the learned symbols and transmissibility of the language increases. This process is proposed as a model that explains how structural syntax emerges and evolves in a symbolic communication system.
Design of Ergonomic Tools for Commercial Laboratory Technicians
Authors: Nimunkar Amit J. , Marty Benjamin , Musa Kristin , Radwin Robert G.
Published: January 2019

Repetitive tasks performed in a commercial laboratory potentially expose lab technicians to repetitive-motion stresses and strains. Our goal was to reduce or eliminate the risk of injuries through design strategies, such as automation, changes in work flow, system design improvements, or ergonomic assist tools. This article describes six undergraduate biomedical engineering student design innovations conceived for solving challenging ergonomics problems at Covance Laboratories in Madison, Wisconsin. Their designs tackled laboratory procedures for administering substances, sampling blood, removing container lids, vortex mixing, cage opening, and automated bioanalytical test tube uncapping. The successful designs were built, tested, and put into practice.
The Effect of Prevailing Wage Law Repeals and Enactments on Injuries and Disabilities in the Construction Industry
Authors: Li Zhi , Zorigtbaatar Chimedlkham , Pleités Gabriel , Fenn Ari , Philips Peter
Published: January 2019

State prevailing wage law repeals have been shown to lower wages and benefits—including benefits providing safety training and associated with worker retention in construction. This study tests whether prevailing wage repeals affect construction injury rates and/or the prevalence of disabilities among construction workers. Controlling for time trends in injuries and disabilities, differences between construction industry subsectors, the business cycle, and time-invariant differences between states, we find that repealing state prevailing wage laws increase construction injury rates across various types of injuries from 11.6% to 13.1% as the seriousness of injuries increases. Disabilities increase by 7.5% to 8.2% depending on the model specification. Conjoining an analysis of the effects of prevailing wage law repeals on injury rates with disability rates in construction provides alternative measures of the effects of prevailing wage laws on construction workplace safety, which addresses a well-known problem of underreporting construction injuries.
Epigenetic control of hypersensitivity in chronic inflammatory pain by the de novo DNA methyltransferase Dnmt3a2
Authors: Oliveira Ana MM , Litke Christian , Paldy Eszter , Hagenston Anna M , Lu Jianning , Kuner Rohini , Bading Hilmar , Mauceri Daniela
Published: January 2019

Chronic pain is a pathological manifestation of neuronal plasticity supported by altered gene transcription in spinal cord neurons that results in long-lasting hypersensitivity. Recently, the concept that epigenetic regulators might be important in pathological pain has emerged, but a clear understanding of the molecular players involved in the process is still lacking. In this study, we linked Dnmt3a2, a synaptic activity-regulated de novo DNA methyltransferase, to chronic inflammatory pain. We observed that Dnmt3a2 levels are increased in the spinal cord of adult mice following plantar injection of Complete Freund’s Adjuvant, an in vivo model of chronic inflammatory pain. In vivo knockdown of Dnmt3a2 expression in dorsal horn neurons blunted the induction of genes triggered by Complete Freund’s Adjuvant injection. Among the genes whose transcription was found to be influenced by Dnmt3a2 expression in the spinal cord is Ptgs2, encoding for Cox-2, a prime mediator of pain processing. Lowering the levels of Dnmt3a2 prevented the establishment of long-lasting inflammatory hypersensitivity. These results identify Dnmt3a2 as an important epigenetic regulator needed for the establishment of central sensitization. Targeting expression or function of Dnmt3a2 may be suitable for the treatment of chronic pain.
Quadriceps Strength and Volitional Activation After Anterior Cruciate Ligament Reconstruction: A Systematic Review and Meta-analysis
Authors: Lisee Caroline , Lepley Adam S. , Birchmeier Thomas , O’Hagan Kaitlin , Kuenze Christopher
Published: January 2019

Context:

Quadriceps function is a significant contributor to knee joint health that is influenced by central and peripheral factors, especially after anterior cruciate ligament reconstruction (ACLR).

Objective:

To assess differences of unilateral quadriceps isometric strength and activation between the involved limb and contralateral limb of individuals with ACLR and healthy controls.

Data Sources:

Web of Science, SportDISCUS, PubMed, CINAHL, and the Cochrane Database were all used during the search.

Study Selection:

A total of 2024 studies were reviewed. Twenty-eight studies including individuals with a unilateral history of ACLR, isometric knee extension strength normalized to body mass, and quadriceps activation measured by central activation ratios (CARs) through a superimposed burst technique were identified for meta-analysis. The methodological quality of relevant articles was assessed using a modified Downs and Black scale. Results of methodological quality assessment ranged from low to high quality (low, n = 10; moderate, n = 8; high, n = 10).

Study Design:

Meta-analysis.

Level of Evidence:

Level 2.

Data Extraction:

Means, standard deviations, and sample sizes were extracted from articles, and magnitude of between-limb and between-group differences were evaluated using a random-effects model meta-analysis approach to calculate combined pooled effect sizes (ESs) and 95% CIs. ESs were classified as weak ( d < 0.19), small ( d = 0.20-0.49), moderate ( d = 0.50-0.79), or large ( d > 0.80).

Results:

The involved limb of individuals with ACLR displayed lower knee extension strength compared with the contralateral limb (ES, –0.78; lower bound [LB], –0.99; upper bound [UB], –0.58) and healthy controls (ES, –0.76; LB, –0.98; UB, –0.53). The involved limb displayed a lower CAR compared with healthy controls (ES, –0.84; LB, –1.18; UB, –0.50) but not compared with the contralateral limb (ES, –0.15; LB, –0.37; UB, 0.07). The ACLR contralateral limb displayed a lower CAR (ES, –0.73; LB, –1.39; UB, –0.07) compared with healthy control limbs but similar knee extension strength (ES, –0.24; LB, –0.68; UB, –0.19).

Conclusion:

Individuals with ACLR have bilateral CAR deficits and involved limb strength deficits that persist years after surgery. Deficits in quadriceps function may have meaningful implications for patient-reported and objective outcomes, risk of reinjury, and long-term joint health after ACLR.
Clinical and hemodynamic benefit of macitentan and riociguat upfront combination in patients with pulmonary arterial hypertension
Authors: Sulica Roxana , Sangli Swathi , Chakravarti Aloke , Steiger David
Published: January 2019

In this open‐label study, we evaluated the effect of upfront macitentan and riociguat combination in newly diagnosed pulmonary arterial hypertension (PAH) patients. In 15 consecutive PAH patients, we collected clinical and hemodynamic data at baseline, visit 1 (median 4 months) and visit 2 (median 12 months). Survival and transplantation status were analyzed over 36 months. Statistical analysis included student t‐test and 95% confidence interval (CI) (t‐statistic or Clopper‐Pearson). Kaplan‐Meier was used to estimate survival rate. There were 11/15 women (mean age 56 years), in World Health Organization (WHO) functional class (FC) III (n = 14) or IV (n = 1). The 6 min walk distance increased from 281.6 m (baseline) to 315.7 m (visit 1) and visit 2 (313.9 m), representing a 34‐ and 32‐m change (P < 0.05), respectively, associated with Borg score improvements. Brain natriuretic peptide decreased: 318.2 pg/mL (baseline) to 122.0 pg/mL (visit 1) and 98.6 pg/mL (visit 2) (P < 0.05). WHO FC improved in eight patients (53%, 95% CI 27%–79%). Pulmonary vascular resistance (9.2 to 5.7 Wood Units) and mean pulmonary artery pressure (47.3 to 38.9 mmHg) decreased; cardiac index increased (2.3 to 3.0 L/min/m2) (baseline to visit 2, all P < 0.05). All patients had intermediate and high risk score (baseline); at 1‐year follow‐up, dual therapy led to reduction to low risk score in 7/15 (47%) patients. There were no unexpected or serious side effects. Three patients died due to unrelated causes; one patient received a lung transplant. Transplant‐free survival rate (36 months) was 85%. Preliminary evidence is provided for effectiveness of initial macitentan and riociguat combination therapy in PAH.
A survey of Canadian and Australian pharmacists’ stigma of suicide
Authors: Murphy Andrea L , O’Reilly Claire L , Ataya Randa , Doucette Steve P , Martin-Misener Ruth , Rosen Alan , Gardner David M
Published: January 2019

Background:

There is limited information available regarding community pharmacists’ stigma of suicide. Pharmacists regularly interact with people at risk of suicide and stigmatizing attitudes may impact care.

Objective:

To measure community pharmacists’ stigma of suicide.

Method:

Pharmacists in Canada and Australia completed an online survey with the Stigma of Suicide Scale–Short Form. Data were analysed descriptively and with univariate and multivariate analyses.

Results:

Three hundred and ninety-six pharmacists returned completed surveys (Canada n = 235; Australia n = 161; female 70%; mean age = 38.6 ± 12.7 years). The rate of endorsement of stigmatizing terms was low overall. Canadian and Australian pharmacists differed (p < 0.05) for several variables (e.g. age, friend or relative with a mental illness, training in mental health crisis). Pharmacists without someone close to them living with a mental illness were more likely to strongly agree/agree with words describing those who die by suicide as pathetic, stupid, irresponsible, and cowardly. Those without a personal diagnosis of mental illness strongly agreed/agreed with the terms immoral, irresponsible, vengeful, and cowardly. More Australian pharmacists strongly agreed/agreed that people who die by suicide are irresponsible, cowardly, and disconnected. Independent variables associated with a higher stigma were male sex, Australian, and negative perceptions about suicide preventability.

Conclusion:

Community pharmacists frequently interact with people at risk of suicide and generally have low agreement of stigmatizing terms for people who die by suicide. Research should focus on whether approaches such as contact-based education can minimize existing stigma.
Blood group alters platelet binding kinetics to von Willebrand factor and consequently platelet function
Authors: Dunne Eimear , Qi Qin M. , Shaqfeh Eric S. , O’Sullivan Jamie M. , Schoen Ingmar , Ricco Antonio J. , O’Donnell James S. , Kenny Dermot
Published: January 2019

Blood type O is associated with a lower risk of myocardial infarction. Platelets play a critical role in myocardial infarction. It is not known whether the expression of blood group antigens on platelet proteins alters platelet function; we hypothesized that platelet function would be different between donors with blood type O and those with non-O. To address this hypothesis, we perfused blood from healthy type O donors (n = 33) or non-O donors (n = 54) over pooled plasma derived von Willebrand factor (VWF) protein and purified blood type–specific VWF at arterial shear and measured platelet translocation dynamics. We demonstrate for the first time that type O platelets travel farther at greater speeds before forming stable bonds with VWF. To further characterize these findings, we used a novel analytical model of platelet interaction. Modeling revealed that the kinetics for GPIb/VWF binding rate are significantly lower for type O compared with non-O platelets. Our results demonstrate that platelets from type O donors interact less with VWF at arterial shear than non-O platelets. Our results suggest a potential mechanism for the reduced risk of myocardial infarction associated with blood type O.
Applying quantitative appraisal analysis to the study of institutional discourse: the case of EU migration documents
Authors: Tupala Mira
Published: January 2019

This article addresses the methodological issues related to applying the appraisal framework quantitatively with a corpus of institutional texts. The aim is to explore how to best annotate evaluative expressions in official institutional documents which are usually considered as factual and formal rather than attitudinal and affectual. Using a corpus of migration documents of the European Union as a point of reference, I outline a way of analysis in which each case of appraisal is systematically accounted for and annotated accurately with regard to the socio-cultural context of the EU, serving to deepen and widen the scope of the appraisal analysis. Ultimately, the study of evaluative patterns used in institutional discourse can reveal the ways in which evaluation is integrated into the structures of formal institutional language and how evaluation towards different phenomena (e.g. migration) is constructed.
Bioactive calcium phosphate materials and applications in bone regeneration
Authors: Jeong Jiwoon , Kim Jung Hun , Shim Jung Hee , Hwang Nathaniel S. , Heo Chan Yeong
Published: January 2019

Background

Bone regeneration involves various complex biological processes. Many experiments have been performed using biomaterials in vivo and in vitro to promote and understand bone regeneration. Among the many biomaterials, calcium phosphates which exist in the natural bone have been conducted a number of studies because of its bone regenerative property. It can be directly contributed to bone regeneration process or assist in the use of other biomaterials. Therefore, it is widely used in many applications and has been continuously studied.

Mainbody

Calcium phosphate has been widely used in bone regeneration applications because it shows osteoconductive and in some cases osteoinductive features. The release of calcium and phosphorus ions regulates the activation of osteoblasts and osteoclasts to facilitate bone regeneration. The control of surface properties and porosity of calcium phosphate affects cell/protein adhesion and growth and regulates bone mineral formation. Properties affecting bioactivity vary depending on the types of calcium phosphates such as HAP, TCP and can be utilized in various applications because of differences in ion release, solubility, stability, and mechanical strength. In order to make use of these properties, different calcium phosphates have been used together or mixed with other materials to complement their disadvantages and to highlight their advantages. Calcium phosphate has been utilized to improve bone regeneration in ways such as increasing osteoconductivity for bone ingrowth, enhancing osteoinductivity for bone mineralization with ion release control, and encapsulating drugs or growth factors.

Conclusion

Calcium phosphate has been used for bone regeneration in various forms such as coating, cement and scaffold based on its unique bioactive properties and bone regeneration effectiveness. Additionally, several studies have been actively carried out to improve the efficacy of calcium phosphate in combination with various healing agents. By summarizing the properties of calcium phosphate and its research direction, we hope that calcium phosphate can contribute to the clinical treatment approach for bone defect and disease.
Cosmeceutical activities of ethanol extract and its ethyl acetate fraction from coffee silverskin
Authors: Xuan Song Hua , Lee Keon Soo , Jeong Hyo Jin , Park Young Min , Ha Ji Hoon , Park Soo Nam
Published: January 2019

Background

Coffee silverskin is a thin film that covers the raw coffee bean. In general, coffee silverskin, which detaches during the coffee roasting process, is disposed as firelighters or dispatched to landfills and can cause serious environmental pollution. The aim of this study was to investigate the feasibility of using coffee silverskin as a functional material in cosmetics by evaluating its bioactive ingredients, antioxidative activity, cytoprotective effect, matrix metalloproteinase-1 (MMP-1)-inhibiting effect, and anti-melanogenesis effect.

Results

To this end, a 50% ethanol (EtOH) extract and its ethyl acetate (EtOAc) fraction were prepared from coffee silverskin; caffeine was found to be the major compound in the extract. Both the 50% EtOH extract and its EtOAc fraction exhibited antioxidant activities. However, the EtOAc fraction showed a greater radical-scavenging activity and reducing power than that shown by the 50% EtOH extract. Furthermore, the EtOAc fraction increased cell viability in a UVB-irradiated human keratinocyte injury model and significantly suppressed UVB-induced MMP-1 expression and α-melanocyte-stimulating hormone (α-MSH)-stimulated melanin production in HaCaT keratinocytes and B16F1 melanocytes, respectively. Interestingly, caffeine, the major component of the EtOAc fraction, did not show an inhibitory effect. Thus, the antioxidant capacity of the coffee silverskin extract may be attributable to some compounds that exhibit a high antioxidant capacity even at low concentrations or the total antioxidant capacity of various constituent phenolic compounds.

Conclusion

Our findings indicate that coffee silverskin has the potential for application as a natural functional material in multifunctional cosmetics.
Regulation of Ribosome Biogenesis During Skeletal Muscle Hypertrophy
Authors: Kim Hyo-Gun , Guo Bin , Nader Gustavo A.
Published: January 2019

An increase in ribosomal capacity is a hallmark of the hypertrophying muscle. We review evidence demonstrating that transcription of ribosomal RNA genes is necessary for the increase in ribosomal capacity, and this is critical for muscle growth in human and animal models of hypertrophy.
Regulation of Body Temperature by Autonomic and Behavioral Thermoeffectors
Authors: Schlader Zachary J. , Vargas Nicole T.
Published: January 2019

Thermoregulation is accomplished via autonomic and behavioral responses. Autonomic responses may influence decisions to behaviorally thermoregulate. For instance, in addition to changes in body temperature, skin wettedness and involuntary muscle contraction, which occur subsequent to sweating and shivering, likely modulate thermal behavior. This autonomic-behavioral interaction provides the rationale for our hypothesis that thermoregulatory behavior decreases the requirement for autonomic responses.
Metallothionein expression on oysters (Crassostrea cuculata and Crassostrea glomerata) from the southern coastal region of East Java
Authors: Hertika Asus Maizar Suryanto , Kusriani Kusriani , Indrayani Erlinda , Yona Defri , Putra Renanda Baghaz Dzulhamdhani Surya
Published: January 2019

Background:This study aimed to analyse levels of heavy metals (Pb, Hg and Cd) in the aquatic body, gills and stomach of the oystersCrassostrea cuculataandCrassostrea glomerata, the metallothionein (MT) level in the gills and stomach of both oysters, and relationships between heavy metals level (Pb, Hg and Cd) in the gills and stomach to MT level in both types of oysters.

Methods:The research method utilized was a descriptive method. The oyster samples were taken from three stations: Sendang Biru, Popoh and Prigi beaches. MT values were assessed using confocal laser scanning microscopy. The heavy metal levels were assessed using atomic absorption spectrophotometry method.

Results:Both oyster heavy metal content obtained in the southern coastal waters exceeded the safe limit set by the State Minister of Environment No. 51 of 2004. In general, the expression of MT was found to be higher in gastric tissue compared to gill tissue.

Conclusions:The relationship between levels of the heavy metals Pb, Hg, and Cd in oyster gills and stomach has a strong relationship with MT levels in the gills and stomach in both types of oysters.
Costs, cost-effectiveness and detection rate of glaucoma screening in cataract camps in urban India: A study protocol
Authors: Sabherwal Shalinder , John Denny , Dubey Suneeta , Mukherjee Saptarshi , Menon Geetha R. , Majumdar Atanu
Published: January 2019

India has an estimated 12 million people affected with glaucoma; however, no organised screening programme exists. Cases are usually detected opportunistically. This study documents the protocol for detecting glaucoma in suspects in cataract camps conducted by Shroff Charity Eye Hospital in North India. We report a prospective study design from patients attending cataract camps where glaucoma screening will be integrated. The eligible population for glaucoma screening is non-cataract patients. Patients will undergo glaucoma screening by a trained optometrist using a pre-determined glaucoma screening algorithm. Specific diagnostic cut-off points will be used to identify glaucoma suspects. Suspected patients will be referred to the main hospital for confirmatory diagnosis and treatment. This group will be compared to a cohort of patients arriving from cataract camps conducted by the institute in similar areas and undergoing examination in the hospital. The third arm of the study includes patients arriving directly to the hospital for the first time. Cost data will be captured from both the screening components of cataract-only and glaucoma screening-integrated camps for screening invitation and screening costs. For all three arms, examination and treatment costs will be captured using bottom-up costing methods at the hospital. Detection rates will be calculated by dividing the number of new cases identified during the study by total number of cases examined. Median, average and range of costs across the three arms will be calculated for cost comparisons. Finally, cost-effectiveness analysis will be conducted comparing cost per case detected across the three arms. This is the first such study conducted in India. The study protocol will be useful for researchers and practitioners for conducting similar economic evaluation studies in their context. The protocol publication will be a good step to ensure transparency of methods of reporting of economic evaluation studies in LMICs.
Genetic and environmental determinants of stressful life events and their overlap with depression and neuroticism
Authors: Clarke Toni-Kim , Zeng Yanni , Navrady Lauren , Xia Charley , Haley Chris , Campbell Archie , Navarro Pau , Amador Carmen , Adams Mark J. , Howard David M. , Soler Aleix , Hayward Caroline , Thomson Pippa A. , Smith Blair H. , Padmanabhan Sandosh , Hocking Lynne J. , Hall Lynsey S. , Porteous David J. ,   Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium, Deary Ian J. , McIntosh Andrew M.
Published: January 2019

Background: Stressful life events (SLEs) and neuroticism are risk factors for major depressive disorder (MDD). However, SLEs and neuroticism are heritable and genetic risk for SLEs is associated with risk for MDD. We sought to investigate the genetic and environmental contributions to SLEs in a family-based sample, and quantify genetic overlap with MDD and neuroticism.

Methods: A subset of Generation Scotland: the Scottish Family Health Study (GS), consisting of 9618 individuals with information on MDD, past 6 month SLEs, neuroticism and genome-wide genotype data was used in the present study. We estimated the heritability of SLEs using GCTA software. The environmental contribution to SLEs was assessed by modelling familial, couple and sibling components. Using polygenic risk scores (PRS) and LD score regression (LDSC) we analysed the genetic overlap between MDD, neuroticism and SLEs.

Results: Past 6-month life events were positively associated with lifetime MDD status (β=0.21, r2=1.1%, p=2.5 x 10-25) and neuroticism (β =0.13, r2=1.9%, p=1.04 x 10-37) at the phenotypic level.  Common SNPs explained 8% of the phenotypic variance in personal life events (those directly affecting the individual) (S.E.=0.03, p= 9 x 10-4). A significant effect of couple environment was detected accounting for 13% (S.E.=0.03, p=0.016) of the phenotypic variation in SLEs. PRS analyses found that reporting more SLEs was associated with a higher polygenic risk for MDD (β =0.05, r2=0.3%, p=3 x 10-5), but not a higher polygenic risk for neuroticism. LDSC showed a significant genetic correlation between SLEs and both MDD (rG=0.33, S.E.=0.08 ) and neuroticism (rG=0.15, S.E.=0.07).

Conclusions: These findings suggest that SLEs should not be regarded solely as environmental risk factors for MDD as they are partially heritable and this heritability is shared with risk for MDD and neuroticism. Further work is needed to determine the causal direction and source of these associations.
A CONFLICT OF INTEREST IN THE CIVIL SERVICE
Authors: Курочкин Илья , Kurochkin Ilya , Столяров Дмитрий , Stolyarov Dmitriy
Published: January 2019

The author reveals the concept of the conflict of interests of the civil servant of the Russian Federation. Examples of the most probable situations in which a civil servant may find himself in the course of his official duties are given