bluuebunny/crossref_metadata_2025 huggingface dataset:
iConnect CKD – virtual medical consulting: A web‐based chronic kidney disease, hypertension and diabetes integrated care program
Authors: Katz Ivor J , Pirabhahar Saiyini , Williamson Paula , Raghunath Vishwas , Brennan Frank , O'Sullivan Anthony , Youssef George , Lane Cathie , Jacobson Gary , Feldman Peter , Kelly John
Published: May 2017

Aims

Chronic kidney disease patients overwhelm specialist services and can potentially be managed in the primary care (PC). Opportunistic screening of high risk (HR) patients and follow‐up in PC is the most sustainable model of care. A ‘virtual consultation’ (VC) model instead of traditional face to face (F2F) consultations was used, aiming to assess efficacy and safety of the model.

Methods

Seventy patients were recruited from PC sites and hospital clinics and followed for 1 year. The HR patients (eGFR < 30 mL/min/1.73m2 +/− albuminuria >30 mg/mmol/L) were randomized to either VC or F2F. Patients were monitored in 6 monthly follow‐up cycles by a Clinical Nurse Specialist. The specialist team provided virtual or clinical support and included a Nephrologist, Endocrinologist, Cardiologist and Renal ‘Palliative’ Supportive Care.

Results

Sixty one (87%) patients were virtually tracked or consulted with 14 (23%) being HR. At 12 months, there was no difference in outcomes between VC and F2F patients. All patients were successfully monitored. General practitioners reported a high level of satisfaction and supported the model, but found software integration challenging. Patients found the system attractive and felt well managed. Specialist consults occurred within a week, and if a second specialist opinion was required, it took another 2 weeks.

Conclusions

The programme demonstrated safe, expedited and efficient follow up with a clinical and web based programme. Support from the general practitioners and patients was encouraging, despite logistical issues. Ongoing evaluation of VC services will continue and feasibility to larger networks and more chronic diseases remains the long term goal.
Optimization of cord blood unit sterility testing: impact of dilution, analysis delay, and inhibitory substances
Authors: Girard Mélissa , Laforce‐Lavoie Audrey , de Grandmont Marie Joëlle , Cayer Marie‐Pierre , Fournier Diane , Delage Gilles , Thibault Louis
Published: May 2017

BACKGROUND

Different methods are used by cord blood banks to prepare samples for sterility testing. Suboptimal methods can result in the release of contaminated products. In our organization, samples are prepared by diluting the final product in RPMI‐1640 medium. In this work, we have compared our method with different approaches to verify whether optimization should be sought.

STUDY DESIGN AND METHODS

Cord blood units (n = 6 units per bacterial strain) characterized to contain inhibitory substances or not were inoculated (10 colony‐forming units/mL) with Streptococcus agalactiae, Staphylococcus epidermidis, Klebsiella pneumoniae, Escherichia coli, or Bacteroides fragilis. After plasma and red blood cell removal, stem cell concentrates were diluted in RPMI‐1640, thioglycollate, or the unit's plasma. These products, as well as final product, plasma, and red blood cell fractions, were held from 0 to 72 hours at 20 to 24°C before inoculation in culture bottles and detection using the BacT/ALERT 3D system.

RESULTS

Dilution of cell concentrates in RPMI‐1640 allowed bacterial detection in 93.3% of noninhibitory cord blood samples after a 24‐hour storage period. Thioglycollate medium better promoted bacterial growth in inhibitory cord blood samples that were held for 72 hours before testing (66.7%) compared with RPMI‐1640 (45.0%). Less than 33% of all spiked plasma samples were detected by the BacT/ALERT 3D system.

CONCLUSION

Diluting cord blood samples in culture medium containing bacterial growth promoting substances is a suitable option for sterility testing, whereas the use of plasma should be proscribed, because it might lead to false‐negative results. Because inhibitory substances affect bacterial growth, inoculation of culture bottles should be done rapidly after sample preparation.
Angiopoietin‐1 and angiopoietin‐2 protect porcine iliac endothelial cells from human antibody‐mediated complement‐dependent cytotoxicity through phosphatidylinositide 3‐kinase/AKT pathway activation
Authors: Gao Hanchao , Chen Pengfei , Wei Ling , Xu Jia , Liu Lu , Zhao Yanli , Hara Hidetaka , Pan Dengke , Li Zesong , Cooper David K.C. , Cai Zhiming , Mou Lisha
Published: May 2017

Cytokines play crucial roles in inflammation, but their role in xenotransplantation remains elusive. We assessed the role of several cytokines using an in vitro model of human antibody‐mediated complement‐dependent cytotoxicity (CDC). Recombinant human angiopoietin‐1 (Ang‐1) protected porcine iliac endothelial cells (PIECs) from human antibody‐mediated CDC. Interestingly, human angiopoietin‐2 (Ang‐2) had a similar protective effect on PIECs. By flow cytometry analysis, the extent of human IgM and IgG binding to PIECs did not decrease when PIECs were exposed to Ang‐1/Ang‐2. The mRNA level of complement regulators (CD46, CD55, CD59) was not upregulated in PIECs treated with Ang‐1/Ang‐2, both of which activated the PI3K/AKT pathway in PIECs. Wortmannin, which inhibits phosphatidylinositide 3‐kinase (PI3K), suppressed Ang‐1/Ang‐2‐induced AKT phosphorylation and consequent Ang‐1/Ang‐2‐mediated protection of PIECs in human antibody‐mediated CDC model. Moreover, dominant negative AKT also suppressed Ang‐1/Ang‐2‐mediated protection of PIECs in this model. In conclusion, our data suggest that human Ang‐1/Ang‐2 induces the protection of PIECs from human antibody‐mediated CDC by activating the PI3K/AKT pathway. Ang‐1/Ang‐2 is likely to protect porcine endothelial cells and may be beneficial in xenotransplantation research.
The angiotensin II receptor type 1b is the primary sensor of intraluminal pressure in cerebral artery smooth muscle cells
Authors: Pires Paulo W. , Ko Eun‐A. , Pritchard Harry A.T. , Rudokas Michael , Yamasaki Evan , Earley Scott
Published: May 2017

Key points

The angiotensin II receptor type 1b (AT1Rb) is the primary sensor of intraluminal pressure in cerebral arteries.

Pressure or membrane‐stretch induced stimulation of AT1Rb activates the TRPM4 channel and results in inward transient cation currents that depolarize smooth muscle cells, leading to vasoconstriction.

Activation of either AT1Ra or AT1Rb with angiotensin II stimulates TRPM4 currents in cerebral artery myocytes and vasoconstriction of cerebral arteries.

The expression of AT1Rb mRNA is ∼30‐fold higher than AT1Ra in whole cerebral arteries and ∼45‐fold higher in isolated cerebral artery smooth muscle cells.

Higher levels of expression are likely to account for the obligatory role of AT1Rb for pressure‐induced vasoconstriction.

Myogenic vasoconstriction, which reflects the intrinsic ability of smooth muscle cells to contract in response to increases in intraluminal pressure, is critically important for the autoregulation of blood flow. In smooth muscle cells from cerebral arteries, increasing intraluminal pressure engages a signalling cascade that stimulates cation influx through transient receptor potential (TRP) melastatin 4 (TRPM4) channels to cause membrane depolarization and vasoconstriction. Substantial evidence indicates that the angiotensin II receptor type 1 (AT1R) is inherently mechanosensitive and initiates this signalling pathway. Rodents express two types of AT1R – AT1Ra and AT1Rb – and conflicting studies provide support for either isoform as the primary sensor of intraluminal pressure in peripheral arteries. We hypothesized that mechanical activation of AT1Ra increases TRPM4 currents to induce myogenic constriction of cerebral arteries. However, we found that development of myogenic tone was greater in arteries from AT1Ra knockout animals compared with controls. In patch‐clamp experiments using native cerebral arterial myocytes, membrane stretch‐induced cation currents were blocked by the TRPM4 inhibitor 9‐phenanthrol in both groups. Further, the AT1R blocker losartan (1 μm) diminished myogenic tone and blocked stretch‐induced cation currents in cerebral arteries from both groups. Activation of AT1R with angiotensin II (30 nm) also increased TRPM4 currents in smooth muscle cells and constricted cerebral arteries from both groups. Expression of AT1Rb mRNA was ∼30‐fold greater than AT1Ra in cerebral arteries, and knockdown of AT1Rb selectively diminished myogenic constriction. We conclude that AT1Rb, acting upstream of TRPM4 channels, is the primary sensor of intraluminal pressure in cerebral artery smooth muscle cells.
Static Pressure Characteristics in a Pin-Fin Channel With Shaped Cylindrical Pins
Authors: Pretorius H. J. , Mahmood G. I. , Meyer J. P.
Published: May 2017

Standard pin-fins in the heat transfer channels are shaped to reduce the pressure penalty and increase the thermal performance. The paper presents experimental results of the wall-static pressure distributions in an array of modified cylindrical short pin-fins in a channel. Standard cylindrical pin-fins with a smooth surface and a similar array configuration are also evaluated as a baseline for comparisons. The pin-fins with a height to diameter ratio of 1.28 are arranged in a staggered array consisting of 13 rows in a rectangular channel of aspect ratio 1:7.8. The cylindrical pins are modified by the machined slots at the tips. The slots in the pins are aligned in the streamwise direction. The static pressure distributions are measured on the endwall between the pin-rows and on the pin surface. The Reynolds number based on the channel hydraulic diameter ranges from 10,000 to 50,000. The slots in the pins reduce the friction factor and wall-static pressure drop between the pin-rows by up to 50%. The objectives of the investigation are to reduce the pressure penalty in the cylindrical pin-fin channel to provide increased thermal performance.
Wave Response of Closed Flexible Bags
Authors: Lader Pål , Fredriksson David W. , Volent Zsolt , DeCew Jud , Rosten Trond , Strand Ida M.
Published: May 2017

Recent environmental considerations, as salmon lice, escape of farmed fish and release of nutrients, have prompted the aquaculture industry to consider the use of closed fish production systems (CFPS). The use of such systems is considered as one potential way of expanding the salmon production in Norway. To better understand the response in waves of such bags, experiments were conducted with a series of 1:30 scaled models of closed flexible bags. The bags and floater were moored in a wave tank and subjected to series of regular waves (wave period between 0.5 and 1.5 s and wave steepness 1/15, 1/30, and 1/60). Three different geometries were investigated; cylindrical, spherical, and elliptical, and the models were both tested deflated (70% filling level) and inflated (100% filling level). Incident waves were measured together with the horizontal and vertical motion of the floater in two points (front and aft). Visual observations of the response were also done using cameras. The main finding from the experiments were that a deflated bag was more wave compliant than an inflated bag, and that the integrity (whether water entered or left the bag over the floater) was challenged for the inflated bags even for smaller waves (identified as wave condition B (1.0 m < H < 1.9 m) in Norwegian Standard NS 9415). A deflated bag is significantly more seaworthy than an inflated bag when it comes to integrity and motion of the floater.
Effects of Tip Gap Size on the Aerodynamic Performance of a Cavity-Winglet Tip in a Turbine Cascade
Authors: Zhong Fangpan , Zhou Chao
Published: May 2017

The aerodynamic performance of a cavity-winglet tip is investigated in a high-pressure turbine cascade by experimental and numerical methods. The winglet tip has geometric features of a cavity and a suction side fore-part winglet. A cavity tip is studied as the baseline case. The aerodynamic performances of the two tips are investigated at three tip gaps of 0.8%, 1.7%, and 2.7% chord. At tip gaps of 1.7% and 2.7% chord, the loss near the blade tip is dominated by the tip leakage vortex (TLV) for both tips, and the winglet tip mainly reduces the loss generated by the tip leakage vortex. In the past, it was concerned that at a small tip gap, the winglet tip could introduce extra secondary loss and show little aerodynamic benefits. The winglet tip used in the current study is also found to be able to effectively reduce the loss at the smallest tip gap size of 0.8% chord. This is because at this small tip gap, the tip leakage vortex and the passage vortex (PV) appear simultaneously for the cavity tip. The winglet tip is able to reduce the pitchwise pressure gradient in the blade passage, which tends to suppress the formation of the passage vortex. The effects of the winglet tip on the flow physics and the loss mechanisms are explained in detail.
How a short pore forming peptide spans the lipid membrane
Authors: Vestergaard Mikkel , Christensen Mikkel , Hansen Sara K. , Grønvall Dennis , Kjølbye Lisbeth R. , Vosegaard Thomas , Schiøtt Birgit
Published: May 2017

Many antimicrobial peptides function by forming pores in the plasma membrane of the target cells. Intriguingly, some of these peptides are very short, and thus, it is not known how they can span the membrane, or whether other mechanisms of cell disruption are dominant. Here, the conformation and orientation of the 14-residue peptaibol SPF-5506-A4 (SPF) are investigated in lipid environments by atomistic and coarse grained molecular dynamics (MD) simulations, circular dichroism, and nuclear magnetic resonance (NMR) experiments. The MD simulations show that SPF is inserted spontaneously in a transmembrane orientation in both 1,2-dimyristoyl-sn-glycero-3-phosphocholine and 1-palmitoyl-2-oleoyl-sn-glycero-3-phosphocholine bilayers resulting in thinning of the bilayers near the peptides, which drives the peptide aggregation. Furthermore, the backbone conformation of the peptide in the bilayer bound state is different from that of the NMR model solved in small bicelles. These results demonstrate that mutual adaption between the peptides and the membrane is likely to be important for pore formation.
Identifying the selectivity of antimicrobial peptides to cell membranes by sum frequency generation spectroscopy
Authors: Golbek Thaddeus W. , Franz Johannes , Elliott Fowler J. , Schilke Karl F. , Weidner Tobias , Baio Joe E.
Published: May 2017

Cationic amphiphilic peptides have been engineered to target both Gram-positive and Gram-negative bacteria while avoiding damage to other cell types. However, the exact mechanism of how these peptides target, bind, and disrupt bacterial cell membranes is not understood. One specific peptide that has been engineered to selectively capture bacteria is WLBU2 (sequence: RRWVRRVRRWVRRVVRVVRRWVRR). It has been suggested that WLBU2 activity stems from the fact that when interacting with bacterial cell membranes the peptide assumes an α-helical structure and inserts itself into the membrane. Alternatively, in the presence of mammalian cell membranes, the peptide assumes an inert β-sheet structure. To test this hypothesis, the authors applied sum frequency generation (SFG) spectroscopy and surface tensiometry to identify the structure of WLBU2 as it interacts with model lipid monolayers that mimic mammalian and bacterial cell membranes. Model mammalian cell membranes were built upon zwitterionic 1,2-dipalmitoyl-sn-glycero-3-phosphocholine lipids while bacterial cell membranes were constructed with negatively charged 1,2-dimyristoyl-sn-glycero-3-phospho-(1′-rac-glycerol) lipids. Observed changes in surface pressure at the peptide–lipid–air interface demonstrate that the peptide has a clear binding preference toward negatively charged bacteria-like lipids. The structure of both the lipids and peptides were characterized by SFG spectra collected at the monolayer interface. Changes in monolayer structure as the peptide binds were observed by tracking the intensities of SFG vibrational modes related to the acyl chains within the lipids. Peptide structures when bound to both types of lipids were determined by SFG spectra collected within the amide I vibrational band. The SFG spectra of WLBU2 interacting with the model mammalian lipid monolayer contain two peaks near 1642 and 1678 cm−1 indicative of an inactive β-sheet structure. SFG spectra collected from the peptide bound to a bacteria-like lipid monolayer contains just a single peak near 1651 cm−1 which corresponds to an active α-helix structure. Combined, the tensiometry and SFG results demonstrate that WLBU2 both possesses a higher binding affinity toward and is in an active α-helix structure when bound to bacterial cell membranes.
Annoyance by transportation noise: The effects of source identity and tonal components
Authors: White Kim , Bronkhorst Adelbert W. , Meeter Martijn
Published: May 2017

Aircraft noise is consistently rated as more annoying than noise from other sources with similar intensity. In three experiments, it was investigated whether this penalty is due to the source identity of the noise. In the first experiment, four samples were played to participants engaged in a working memory task: road traffic noise, an Airbus 320 flyover, and unidentifiable, transformed versions of these samples containing the same spectral content and envelope. Original, identifiable samples were rated as more annoying than the transformed samples. A second experiment tested whether these results were due to the absence of tonal components in the transformed samples. This was partly the case: an additional sample, created from the A320 flyover by filtering out major tonal components, was rated as less annoying than the original A320 sample, but as more annoying than the transformed sample. In a third experiment, participants either received full disclosure of the generation of the samples or no information to identify the transformed samples. The transformed sample was rated as most annoying when the A320 identity was disclosed, but as least annoying when it was not. Therefore, it was concluded that annoyance is influenced by both identifiability and the presence of tonal components.
Ring attractor dynamics in the
Drosophila
central brain
Authors: Kim Sung Soo , Rouault Hervé , Druckmann Shaul , Jayaraman Vivek
Published: May 2017

Representing direction in the fly

A population of cells called compass neurons represents a fruitfly's heading direction. Kim
et al.
used imaging and optogenetics in behaving flies to elucidate the functional architecture of the underlying neuronal network. They observed local excitation and global inhibition between the compass neurons. The features of the network were best explained by a ring attractor network model. Until now, this hypothesized network structure has been difficult to demonstrate in a real brain.

Science
, this issue p.
849
Metagenome-Assembled Genome Sequence of Rhodopseudomonas palustris Strain ELI 1980, Commercialized as a Biostimulant
Authors: Crovadore Julien , Xu Shoutao , Chablais Romain , Cochard Bastien , Lukito Delvia , Calmin Gautier , Lefort François
Published: May 2017

We report here the draft genome sequence of strain ELI 1980 of
Rhodopseudomonas palustris
, commercialized as a biostimulant for agriculture. The genome was reconstructed from the metagenome of a commercial product containing this strain as its major component.
Complete Genome Sequence of Lactobacillus curvatus Strain WiKim38 Isolated from Kimchi
Authors: Lee Se Hee , Jung Min Young , Song Jung-Hee , Lee Moeun , Chang Ji Yoon
Published: May 2017

Lactobacillus curvatus
WiKim38 is a potential probiotic strain isolated from kimchi, a traditional Korean fermented food. The complete genome of the WiKim38 strain consisted of a circular chromosome of 1,940,170 bp in length with a G+C content of 41.93%.
Draft Genome Sequence of Nitrobacter vulgaris Strain Ab
1
, a Nitrite-Oxidizing Bacterium
Authors: Mellbye Brett L. , Davis Edward W. , Spieck Eva , Chang Jeff H. , Bottomley Peter J. , Sayavedra-Soto Luis A.
Published: May 2017

Here, we present the 3.9-Mb draft genome sequence of
Nitrobacter vulgaris
strain Ab
1
, which was isolated from a sewage system in Hamburg, Germany. The analysis of its genome sequence will contribute to our knowledge of nitrite-oxidizing bacteria and acyl-homoserine lactone quorum sensing in nitrifying bacteria.
Resequencing the Genome of Bifidobacterium breve Strain CECT7263
Authors: Martínez Noelia , Luque Roberto , Olivares Mónica M. , Margolles Abelardo , Bañuelos Oscar
Published: May 2017

The probiotic properties of
Bifidobacterium breve
CECT7263, as well as its safety, have been the focus of in several studies since 2008, including the sequencing of its genome in 2012. This study aims to complete the available genomic data to deepen the knowledge of some phenotypic characteristics of this strain.
Complete Genome Sequence of the Uropathogenic Escherichia coli Strain NU14
Authors: Mehershahi Kurosh S. , Chen Swaine L.
Published: May 2017

Escherichia coli
is the most common bacterium causing urinary tract infections in humans. We report here the complete genome sequence of the uropathogenic
Escherichia coli
strain NU14, a clinical pyelonephritis isolate used for studying pathogenesis.
Why do patients seek primary medical care in emergency departments? An ethnographic exploration of access to general practice
Authors: MacKichan Fiona , Brangan Emer , Wye Lesley , Checkland Kath , Lasserson Daniel , Huntley Alyson , Morris Richard , Tammes Peter , Salisbury Chris , Purdy Sarah
Published: May 2017

Objectives

To describe how processes of primary care access influence decisions to seek help at the emergency department (ED).

Design

Ethnographic case study combining non-participant observation, informal and formal interviewing.

Setting

Six general practitioner (GP) practices located in three commissioning organisations in England.

Participants and methods

Reception areas at each practice were observed over the course of a working week (73 hours in total). Practice documents were collected and clinical and non-clinical staff were interviewed (n=19). Patients with recent ED use, or a carer if aged 16 and under, were interviewed (n=29).

Results

Past experience of accessing GP care recursively informed patient decisions about where to seek urgent care, and difficulties with access were implicit in patient accounts of ED use. GP practices had complicated, changeable systems for appointments. This made navigating appointment booking difficult for patients and reception staff, and engendered a mistrust of the system. Increasingly, the telephone was the instrument of demand management, but there were unintended consequences for access. Some patient groups, such as those with English as an additional language, were particularly disadvantaged, and the varying patient and staff semantic of words like ‘urgent’ and ‘emergency’ was exacerbated during telephone interactions. Poor integration between in-hours and out-of-hours care and patient perceptions of the quality of care accessible at their GP practice also informed ED use.

Conclusions

This study provides important insight into the implicit role of primary care access on the use of ED. Discourses around ‘inappropriate’ patient demand neglect to recognise that decisions about where to seek urgent care are based on experiential knowledge. Simply speeding up access to primary care or increasing its volume is unlikely to alleviate rising ED use. Systems for accessing care need to be transparent, perceptibly fair and appropriate to the needs of diverse patient groups.
Platelet-to-lymphocyte ratio and neutrophil-to-lymphocyte ratio associated with disease activity in patients with Takayasu’s arteritis: a case-control study
Authors: Pan Lili , Du Juan , Li Taotao , Liao Hua
Published: May 2017

Background

Platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR) have been reported to reflect the inflammatory response and disease activity in a variety of autoimmune diseases.

Objectives

This study aimed to evaluate the value of PLR and NLR as markers to monitor disease activity in Takayasu’s arteritis (TAK).

Methods

A retrospective case–control study involving 88 patients with TAK and 78 healthy controls was performed. We compared the PLR and NLR between patients and healthy controls, and also analysed the correlations between PLR or NLR and indices of TAK disease activity.

Results

Increased PLR and NLR were observed in patients with TAK. PLR was positively correlated with hs-C-reactive protein (hs-CRP) (r=0.239, p=0.010) and erythrocyte sedimentation rate (ESR) (r=0.270, p=0.010). NLR also exhibited a positive relationship with Kerr’s score (r=0.284, p=0.002), hs-CRP (r=0.313, p=0.006) and ESR (r=0.249, p=0.019). A PLR level of 183.39 was shown to be the predictive cut-off value for TAK (sensitivity 37.8%, specificity 93.0%, area under the curve (AUC)=0.691). A NLR level of 2.417 was found to be the predictive cut-off value for TAK (sensitivity 75.6%, specificity 55.8%, AUC=0.697).

Conclusions

PLR and NLR could be useful markers to reflect inflammation and disease activity in patients with TAK.
Alcohol Brief Interventions (ABIs) for male remand prisoners: protocol for development of a complex intervention and feasibility study (PRISM-A)
Authors: Holloway Aisha , Landale Sarah , Ferguson Jennifer , Newbury-Birch Dorothy , Parker Richard , Smith Pam , Sheikh Aziz
Published: May 2017

Introduction

In the UK, a significant proportion of male remand prisoners have alcohol problems. Alcohol Brief Interventions (ABIs) are an effective component of a population-level approach to harmful and hazardous drinking. ABIs have been shown to reduce the aggregate level of alcohol consumed and therefore reduce harm to the individual and to others. However, in relation to remand prisoners, there is no evidence as to how effective ABIs could be. The aims of this study are therefore to explore the feasibility and acceptability of an ABI for adult male remand prisoners and to develop an ABI for this group to be piloted in a future trial.

Methods and analysis

The study will comprise three stages. Stage 1: a cross-sectional survey of adult male remand and convicted prisoners (n=500) at one Scottish prison and one English prison will be undertaken to assess acceptability and feasibility of delivering an ABI, as well as prevalence rates of harmful, hazardous and dependent drinking. Stage 2: in-depth interviews will be conducted with a sample of remand prisoners (n=24) who undertook the survey (n=12 in Scotland; n=12 in England). Two focus groups (one in Scotland and one in England) with six to eight key stakeholders associated with alcohol-related healthcare provision in prisons will be conducted to explore views on barriers, facilitators and levers to ABI delivery. Stage 3: through formal intervention mapping, the analysed data will inform the refinement of an acceptable ABI that is feasible to deliver to male remand prisoners.

Ethics and dissemination

The project has been approved by the National Research Ethics Committee (NRES), National Offender Management System, Health Board Research and Development, Scottish Prison Service and ethics committee at The University of Edinburgh. Results will be published in peer-reviewed journals and presented at local, national and international conferences.
‘Our Care through Our Eyes’. Impact of a co-produced digital educational programme on nurses’ knowledge, confidence and attitudes in providing care for children and young people who have self-harmed: a mixed-methods study in the UK
Authors: Manning Joseph C , Carter Tim , Latif Asam , Horsley Angela , Cooper Joanne , Armstrong Marie , Crew Jamie , Wood Damian , Callaghan Patrick , Wharrad Heather
Published: May 2017

Objectives

(1) To determine the impact of a digital educational intervention on the knowledge, attitudes, confidence and behavioural intention of registered children’s nurses working with children and young people (CYP) admitted with self-harm.

(2) To explore the perceived impact, suitability and usefulness of the intervention.

Intervention

A digital educational intervention that had been co-produced with CYP service users, registered children’s nurses and academics.

Setting

A prospective, uncontrolled, intervention study with preintervention and postintervention measurement, conducted at a large acute NHS Trust in the UK.

Participants

From a pool of 251 registered children’s nurses and 98 participants were recruited to complete the intervention (response rate=39%). At follow-up, 52% of participants completed the postintervention questionnaire, with 65% (n=33) of those reporting to have completed the digital educational intervention.

Primary outcome measures

Attitude towards self-harm in CYP was measured using a 13-item questionnaire; knowledge of self-harm in CYP was measured through an adapted 12-item questionnaire; confidence in different areas of practice was measured through Likert Scale responses; self-efficacy for working with CYP who have self-harmed was measured through an adapted version of the Self-efficacy Towards Helping Scale; clinical behavioural intention was measured by the Continuing Professional Development Reaction Questionnaire. Semistructured interviews were undertaken with a purposive sample of participants.

Results

For those who completed the intervention (n=33), improvements were observed in knowledge (effect size, ES: 0.69), confidence, and in some domains relating to attitudes (effectiveness domain-ES: 0.49), and clinical behavioural intention (belief about consequences-ES:0.49; moral norm-ES: 0.43; beliefs about capability-ES: 0.42). Qualitative findings suggest participants experienced skill development, feelings of empowerment and reflection on own practice.

Conclusions

The effect of the intervention is promising and demonstrates the potential it has in improving registered children’s nurse’s knowledge, confidence and attitudes. However, further testing is required to confirm this.
Feasibility of administrative data for studying complications after hip fracture surgery
Authors: Sheehan Katie Jane , Sobolev Boris , Guy Pierre , Tang Michael , Kuramoto Lisa , Belmont Philip , Blair James A , Sirett Susan , Morin Suzanne N , Griesdale Donald , Jaglal Susan , Bohm Eric , Sutherland Jason M , Beaupre Lauren
Published: May 2017

Purpose

There is limited information in administrative databases on the occurrence of serious but treatable complications after hip fracture surgery. This study sought to determine the feasibility of identifying the occurrence of serious but treatable complications after hip fracture surgery from discharge abstracts by applying the Agency for Healthcare Research and Quality (AHRQ) Patient Safety Indicator 4 (PSI-4) case-finding tool.

Methods

We obtained Canadian Institute for Health Information discharge abstracts for patients 65 years or older, who were surgically treated for non-pathological first hip fracture between 1 January 2004 and 31 December 2012 in Canada, except for Quebec. We applied specifications of AHRQ Patient Safety Indicators 04, Version 5.0 to identify complications from hip fracture discharge abstracts.

Results

Out of 153 613 patients admitted with hip fracture, we identified 12 383 (8.1%) patients with at least one postsurgical complication. From patients with postsurgical complications, we identified 3066 (24.8%) patient admissions to intensive care unit. Overall, 7487 (4.9%) patients developed pneumonia, 1664 (1.1%) developed shock/myocardial infarction, 651 (0.4%) developed sepsis, 1862 (1.1%) developed deep venous thrombosis/pulmonary embolism and 1919 (1.3%) developed gastrointestinal haemorrhage/acute ulcer.

Conclusions

We report that 8.1% of patients developed at least one inhospital complication after hip fracture surgery in Canada between 2004 and 2012. The AHRQ PSI-4 case-finding tool can be considered to identify these serious complications for evaluation of postsurgical care after hip fracture.
A mixed methods survey of social anxiety, anxiety, depression and wig use in alopecia
Authors: Montgomery Kerry , White Caroline , Thompson Andrew
Published: May 2017

Objectives

This study aimed to examine levels of social anxiety, anxiety and depression reported by people with alopecia as a result of a dermatological condition and associations with wig use. The study also sought to report on experiences of wearing wigs in social situations and the relationship with social confidence.

Design

A cross-sectional survey was sent by email to the Alopecia UK charity mailing list and advertised on social media.

Participants

Inclusion criteria were a diagnosis of alopecia, aged 13 or above and sufficient English to complete the survey. Exclusion criteria included experiencing hair loss as a result of chemotherapy treatment or psychological disorder. Participants (n=338) were predominantly female (97.3%), Caucasian (93.5%) and aged between 35 and 54 years (49.4%) with a diagnosis of alopecia areata (82.6%).

Main outcome measures

The Social Phobia Inventory measured symptoms of social anxiety, and the Hospital Anxiety and Depression Scale was used to measure symptoms of anxiety and depression. Survey questions were designed to measure the use of wigs. Open-ended questions enabled participants to comment on their experiences of wearing wigs.

Results

Clinically significant levels of social anxiety (47.5%), anxiety (35.5%) and depression (29%) were reported. Participants who reported worries about not wearing a wig reported significantly higher levels of depression: t(103)=3.40, p≤0.001; anxiety: t(109)=4.80, p≤0.001; and social anxiety: t(294)=3.89, p≤0.001. Wearing wigs was reported as increasing social confidence; however, the concealment it afforded was also reported as both reducing fear of negative evaluation and maintaining anxiety.

Discussion

Overall, 46% of participants reported that wearing a wig had a positive impact on their everyday life with negative experiences related to fears of the wig being noticed. Psychological interventions alongside wig provision would be beneficial for people living with alopecia.
An Emergency Medicine Research Priority Setting Partnership to establish the top 10 research priorities in emergency medicine
Authors: Smith Jason , Keating Liza , Flowerdew Lynsey , O'Brien Rachel , McIntyre Sam , Morley Richard , Carley Simon
Published: May 2017

Defining research priorities in a specialty as broad as emergency medicine is a significant challenge. In order to fund and complete the most important research projects, it is imperative that we identify topics that are important to all clinicians, society and to our patients. We have undertaken a priority setting partnership to establish the most important questions facing emergency medicine. The top 10 questions reached through a consensus process are discussed.
Interaction of multiple corrosion defects on burst pressure of pipelines
Authors: Mondal Bipul Chandra , Dhar Ashutosh Sutra
Published: May 2017

The strength of pipeline with multiple corrosion patches depends on the number of corrosion patches within an area on the pipe surface, the locations of corrosion patches along the longitudinal and circumferential directions of the pipe. In this paper, the strength and deformation characteristics of corroded pipeline are investigated using finite element analysis. Pipes with different diameters and different depths of corrosion patches are considered. The spacing of the corrosion patches is varied along longitudinal, diagonal, and circumferential directions of the pipes. The study shows that the limiting spacing for interaction of corrosion patches depends predominantly on pipe wall thickness, corrosion depth, and the location of the defects. The diameter of the pipe has some influence on the interaction for large diameter pipes. A new interaction rule for the limiting spacing for interaction is developed for longitudinally spaced corrosion patches. For circumferentially spaced corrosion patches, the ASME recommendation for the limiting spacing is found to be reasonable.
The microstructure and properties of sol-enhanced Sn–TiO2 nanocomposite coatings
Authors: Wang Yuxin , Hu Bo , Tay See Leng , Hou Fengyan , Gao Wei , Xiong Chao
Published: May 2017

Sn coatings were widely used in electronic and device industries due to their unique properties. Sn–TiO2 sol-enhanced nanocomposite coatings were prepared in order to improve the mechanical properties of Sn coatings. The microstructure, mechanical properties and conductivity of sol-enhanced Sn–TiO2 nanocomposite coatings were systematically investigated. The results show that after adding an optimum quantity of TiO2 nanoparticles, the nanohardness of Sn–TiO2 coatings was increased by 75% while the conductivity remained unaltered when compared with a pure Sn coating. The effect of TiO2 sol addition on the properties of coatings was discussed.
Prediction of corrosion fatigue crack initiation behavior of A7N01P-T4 aluminum alloy welded joints
Authors: An J. , Chen J. , Gou G. , Chen H. , Wang W.
Published: May 2017

Through investigating the corrosion fatigue crack initiation behavior of A7N01P-T4 aluminum alloy welded joints in 3.5 wt.% NaCl solution, corrosion fatigue crack initiation life is formulated as [Formula: see text] and the mechanism of corrosion fatigue crack initiation is proposed. SEM and TEM tests revealed that several corrosion fatigue cracks formed asynchronously and the first crack does not necessarily develop into the leading crack. The uneven reticular dislocations produced by fatigue loading are prone to piling up and tangling near the grain boundaries or the second phases and form the “high dislocation-density region” (HDDR), which acts as an anode in microbatteries and dissolved to form small crack. Thus the etching pits, HDDR near the grain boundaries and second phases are confirmed as the main causes inducing the initiation of fatigue crack.
Cosmological law of universal gravitation
Authors: Eingorn Maxim
Published: May 2017

Without exceeding the limits of the conventional ΛCDM paradigm, we argue for Yukawa law of interparticle interaction as the law of gravitation in the real expanding inhomogeneous universe. It covers the whole space and comes up to take place of Newtonian gravity, which is restricted exclusively to sub-horizon distances. The large-scale screening of gravitational interaction between every two nonrelativistic massive particles is ensured by the homogeneous cosmological background (specifically, by the nonzero average rest mass density of nonrelativistic matter). We take advantage of the uniform matter distribution case (i.e. the homogeneous universe limit) to demonstrate superiority of Yukawa gravity. Attention is also devoted to the concrete particular case of inhomogeneity.
Categorical Inequality: Schools As Sorting Machines
Authors: Domina Thurston , Penner Andrew , Penner Emily
Published: May 2017

Despite their egalitarian ethos, schools are social sorting machines, creating categories that serve as the foundation of later life inequalities. In this review, we apply the theory of categorical inequality to education, focusing particularly on contemporary American schools. We discuss the range of categories that schools create, adopt, and reinforce, as well as the mechanisms through which these categories contribute to production of inequalities within schools and beyond. We argue that this categorical inequality frame helps to resolve a fundamental tension in the sociology of education and inequality, shedding light on how schools can—at once—be egalitarian institutions and agents of inequality. By applying the notion of categorical inequality to schools, we provide a set of conceptual tools that can help researchers understand, measure, and evaluate the ways in which schools structure social inequality.
Autophagy as a double-edged sword in pulmonary epithelial injury: a review and perspective
Authors: Li Zhou-Yang , Wu Yin-Fang , Xu Xu-Chen , Zhou Jie-Sen , Wang Yong , Shen Hua-Hao , Chen Zhi-Hua
Published: May 2017

Pulmonary epithelial cells form the first line of defense of human airways against foreign irritants and also represent as the primary injury target of these pathogenic assaults. Autophagy is a revolutionary conserved ubiquitous process by which cytoplasmic materials are delivered to lysosomes for degradation when facing environmental and/or developmental changes, and emerging evidence suggests that autophagy plays pivotal but controversial roles in pulmonary epithelial injury. Here we review recent studies focusing on the roles of autophagy in regulating airway epithelial injury induced by various stimuli. Articles eligible for this purpose are divided into two groups according to the eventual roles of autophagy, either protective or deleterious. From the evidence summarized in this review, we draw several conclusions as follows: 1) in all cases when autophagy is decreased from its basal level, autophagy is protective; 2) when autophagy is deleterious, it is generally upregulated by stimulation; and 3) a plausible conclusion is that the endosomal/exosomal pathways may be associated with the deleterious function of autophagy in airway epithelial injury, although this needs to be clarified in future investigations.
CD44highalveolar type II cells show stem cell properties during steady-state alveolar homeostasis
Authors: Chen Qian , Suresh Kumar Varsha , Finn Johanna , Jiang Dianhua , Liang Jiurong , Zhao You-yang , Liu Yuru
Published: May 2017

The alveolar epithelium is composed of type I cells covering most of the gas-blood exchange surface and type II cells secreting surfactant that lowers surface tension of alveoli to prevent alveolar collapse. Here, we have identified a subgroup of type II cells expressing a higher level of cell surface molecule CD44 (CD44hightype II cells) that composed ~3% of total type II cells in 5–10-wk-old mice. These cells were preferentially apposed to lung capillaries. They displayed a higher proliferation rate and augmented differentiation capacity into type I cells and the ability to form alveolar organoids compared with CD44lowtype II cells. Moreover, in aged mice, 18–24 mo old, the percentage of CD44hightype II cells among all type II cells was increased, but these cells showed decreased progenitor properties. Thus CD44hightype II cells likely represent a type II cell subpopulation important for constitutive regulation of alveolar homeostasis.
Operation Everest II and the 1978 Habeler/Messner ascent of Everest without bottled O2: what might they have in common?
Authors: Wagner Peter D.
Published: May 2017

In 1978, Peter Habeler and Reinhold Messner climbed Everest without supplemental O2. Subsequently, Oelz et al. (Oelz O, Howald H, Di Prampero PE, Hoppeler H, Claassen H, Jenni R, Bühlmann A, Ferretti G, Brückner JC, Veicsteinas A, Gussoni M, Cerretelli P. J Appl Physiol (1985) 60: 1734–1742, 1986) assessed their cardiopulmonary function, finding no advantageous physiological attributes to explain their success, and leading West (West JB. High Life: A History of High-Altitude Physiology and Medicine. New York: Oxford University, 1998) to suggest that grit and determination were more important. In 1985, Charlie Houston, John Sutton, and Al Cymerman hosted a scientific project assessing a simulated ascent of Everest (OE II) at the U.S. Army Research Institute of Environmental Medicine. Included were measurements of O2 transport. In particular, mixed venous Po2 was measured at/near maximal exercise, for calculating pulmonary O2-diffusing capacity. A serendipitous observation was made: while both V̇o2max and mixed venous Po2 fell with altitude (as expected), it was how they fell—in direct proportion—that was remarkable. It later became clear that this reflected diffusion limitation of O2 transport from muscle microvessels to the mitochondria, and that this last step in O2 transport plays a major role in limiting V̇o2max. Thus, how Habeler and Messner made it up Everest without bottled O2 and no special cardiopulmonary attributes might be explained if their muscle O2-diffusing capacity, which depends largely on muscle capillarity, was unusually high. Oelz et al. mention that muscle capillary density was substantially—40%—above normal, but did not suggest that this accounted for the climbersʼ success. Therefore, high muscle capillarity, enhancing diffusive unloading of O2, may have been a major enabling physiological attribute for Habeler and Messner and that OE II, by chance, played a key role in bringing this to light.
Cardiac metabolic imaging: current imaging modalities and future perspectives
Authors: van de Weijer Tineke , Paiman Elisabeth H. M. , Lamb Hildo J.
Published: May 2017

In this review, current imaging techniques and their future perspectives in the field of cardiac metabolic imaging in humans are discussed. This includes a range of noninvasive imaging techniques, allowing a detailed investigation of cardiac metabolism in health and disease. The main imaging modalities discussed are magnetic resonance spectroscopy techniques for determination of metabolite content (triglycerides, glucose, ATP, phosphocreatine, and so on), MRI for myocardial perfusion, and single-photon emission computed tomography and positron emission tomography for quantitation of perfusion and substrate uptake.
Beta-Blocker Drug Use and Survival among Patients with Pancreatic Adenocarcinoma
Authors: Udumyan Ruzan , Montgomery Scott , Fang Fang , Almroth Henrik , Valdimarsdottir Unnur , Ekbom Anders , Smedby Karin E. , Fall Katja
Published: May 2017

Preclinical studies have suggested that β-adrenergic signaling is involved in pancreatic cancer progression. Prompted by such studies, we investigated an association between beta-blocker drug use with improved cancer-specific survival in a large, general population-based cohort of patients with pancreatic ductal adenocarcinoma (PDAC). All patients diagnosed with a first primary PDAC in Sweden between 2006 and 2009 were identified through the Swedish Cancer Register (n = 2,394). We obtained information about use of beta-blockers and other medications through linkage with the national Prescribed Drug Register. Cancer-specific mortality was assessed using the Swedish Cause of Death Register. We used multivariable Cox regression adjusted for sociodemographic factors, tumor characteristics, comorbidity score, and other medications to estimate HRs and 95% confidence intervals (CI) for cancer-specific mortality associated with beta-blocker use during the 90-day period before cancer diagnosis. A total of 2,054 (86%) died, with pancreatic cancer recorded as the underlying cause of death during a maximum of 5-year follow-up (median 5 months). Patients who used beta-blockers (n = 522) had a lower cancer-specific mortality rate than nonusers (adjusted HR, 0.79; 95% CI, 0.70–0.90; P < 0.001). This observed rate reduction was more pronounced among patients with localized disease at diagnosis (n = 517; adjusted HR, 0.60; 95% CI, 0.43–0.83; P = 0.002), especially for users with higher daily doses (HR, 0.54; 95% CI, 0.35–0.83; P = 0.005). No clear rate differences were observed by beta-blocker receptor selectivity. Our results support the concept that beta-blocker drugs may improve the survival of PDAC patients, particularly among those with localized disease. Cancer Res; 77(13); 3700–7. ©2017 AACR.