bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of political relations on international trade: China–Philippines island dispute as a quasi‐natural experiment
Authors: Luo Changyuan , Sun Shiyi , Wan Guanghua
Published: December 2020

In May 2012, with tensions over Huangyan Island taking an increasingly sour turn, China released a document to strengthen inspection and quarantine of fruits imported from the Philippines. To many, this retaliation implied that the former launched economic sanctions against the latter over the growing conflict. As such, this paper takes that tension as a quasi‐natural experiment to examine the impact of deteriorating political relations on trade. We employ difference‐in‐difference to conduct an empirical investigation by using the monthly data of the Philippines’ fruit export. The estimation results show that after the implementation of the document, in comparison with other export destination countries, Philippine banana and pineapple exports to China decreased by 42% and 88%, respectively. However, the sanction effects weakened over time. Extended analyses also find that the Philippines evaded the sanctions to some extent by trans‐shipping through third countries, transferring exports to other countries, and deeply processing fruits. In conclusion, the sanctions were not as effective as expected.
Herramientas de contabilidad financiera intermedia y de inversión
Authors:   Pontificia Universidad Javeriana, Rocío Carvajal Alba , Camacho Zabala Elmer Adrián ,   Pontificia Universidad Javeriana, Rodríguez Castro Braulio Adriano
Published: December 2020

La contabilidad financiera se encuentra soportada en el concepto básico de la estructuración financiera, el cual sugiere que durante una línea de tiempo y un rendimiento esperado se recupera una inversión inicial y los rendimientos, cuyos resultados se enmarcan en una lógica de maximización. Este libro es producto del esfuerzo para establecer elementos y herramientas de apoyo académico que le permitan al estudiante no solo concretar conceptos, sino contextualizarlos, basados en la lógica que establece la actual base de contabilidad financiera. Esperamos contribuya no solo con el quehacer académico contable, sino que trascienda como guía aplicada en las compañías donde nuestros egresados cumplen la misión institucional de ser integrales y generadores de conocimiento y cultura, en una perspectiva crítica e innovadora.
Performance of a Pilot Subsurface Flow Treatment Wetland System, Used for Arsenic Removal from Reverse Osmosis Concentrate, in the Municipality of Julimes, Chihuahua, Mexico
Authors: Olmos-Márquez Mario Alberto , Ochoa-Rivero Jesús Manuel , Alarcón-Herrera María Teresa , Santellano-Estrada Eduardo , Vega-Mares José Humberto , Valles-Aragón María Cecilia
Published: December 2020

The objective of this study was to implement a pilot system of treatment wetlands, using phytoremediation as an alternative technology to remove arsenic from the concentrate of a reverse osmosis system. The pilot system was composed of two subsurface flow constructed wetlands, planted with Eleocharis macrostachya and Shoenoplectus americanus. The wetlands were fed concentrate from a reverse osmosis system for seven months, with an average flow of 962 Ld-1 and an average arsenic concentration of 0.241 mgL-1. Removal rates between 43 % and 86 % were obtained for wetland 1 and between 35 % and 79 % for wetland 2 throughout the experiment. The two plant species developed normally despite the high levels of electrical conductivity in the range of 3584 to 5455 µscm-1 in wetland intake waters. The pilot wetland system removed significant levels of arsenic from the reverse osmosis concentrate, resulting in arsenic levels in the output waters that meet Mexican standard for using water in agricultural irrigation.
The predatory mite Neoseiulus bicaudus (Mesostigmata: Phytoseiidae), a promising biocontrol agent of whitefly Bemisia tabaci (Hemiptera: Aleyrodidae)

Authors: Han Guo-dong , Su Jie , Zhang Ke , Chen Jing , Zhang Jian-ping
Published: December 2020

Neoseiulus bicaudus (Wainstein) (Acari: Phytoseiidae) is a native predatory mite species in Xinjiang, China, and a biological control agent for some small pests, such as Tetranychus turkestani (Acari: Tetranychidae) and Thrips tabaci (Thysanoptera: Thripidae) in greenhouse. However, little is known whether N. bicaudus could be an effective natural enemy of Bemisia tabaci (Gennadius) (Hemiptera: Aleyrodidae). A series of laboratory and greenhouse experiments were conducted to evaluate the efficiency of N. bicaudus on B. tabaci. The present data showed that each stage of N. bicaudus demonstrated type II functional response when fed on B. tabaci. The adult females showed the highest consumption rate and attack rate, and the shortest handling times were obtained when they preyed on eggs and 1st instar nymphs. The 1st instar of B. tabaci was preferred for the feeding of N. bicaudus adult females than eggs, followed by 2nd instar nymphs of B. tabaci. Under greenhouse conditions, this predator effectively suppressed the population growth of B. tabaci throughout the experimental period. Accordingly, N. bicaudus could be an efficient predator for B. tabaci.
China's vaccine gambit
Authors: Cohen Jon
Published: December 2020

With its global campaign to test and promote COVID-19 vaccines, China aims to win friends and cut deals.
The Effects of Soil Depth on the Structure of Microbial Communities in Agricultural Soils in Iowa (United States)
Authors: Hao Jingjie , Chai Yen Ning , Lopes Lucas Dantas , Ordóñez Raziel A. , Wright Emily E. , Archontoulis Sotirios , Schachtman Daniel P.
Published: December 2020

Determining how microbial properties change across different soils and within the soil depth profile will be potentially beneficial to understanding the long-term processes that are involved in the health of agricultural ecosystems. Most literature on soil microbes has been restricted to the easily accessible surface soils.
Escape of HIV-1 Envelope Glycoprotein from Restriction of Infection by IFITM3
Authors: Drouin Aurélie , Migraine Julie , Durand Marie-Alice , Moreau Alain , Burlaud-Gaillard Julien , Beretta Maxime , Roingeard Philippe , Bouvin-Pley Mélanie , Braibant Martine
Published: December 2020

Interferon-induced transmembrane protein 3 (IFITM3) is a cellular factor that reduces HIV-1 infectivity by an incompletely understood mechanism. This study aimed to elucidate the role of the HIV-1 envelope glycoprotein (Env) in determining viral susceptibility to IFITM3.
Periodic dike intrusions at Kı-lauea volcano, Hawai’i
Authors: Montgomery-Brown Emily K. , Miklius Asta
Published: December 2020

Forecasting heightened magmatic activity is key to assessing and mitigating global volcanic hazards, including eruptions from lateral rift zones at basaltic volcanoes. At Kı-lauea volcano, Hawai’i (United States), planar dikes intrude its east rift zone (ERZ) and repeatedly affect the same segments. Here we show that Kı-lauea’s upper and middle ERZ dikes in the last four decades intruded at regular intervals of ∼8 or ∼14 yr. Segments with shorter recurrence intervals are adjacent to faster-moving parts of the flank, and ∼1–5 MPa of tension accumulates from flank spreading in the time between dike events. Intrusion frequency was neither advanced nor delayed during magma supply variations, supporting the role of long-term flank motion on the timing of dike intrusions. Although fewer historical dikes have occurred near the 2018 CE eruption site in the lower ERZ and the adjacent slowly sliding lower eastern flank, similar tension accumulated between the 1955 and 2018 eruptions. Regular dike intrusion recurrence intervals indicate the importance of including both extrusive and (commonly neglected) intrusive activity in eruption hazard analyses.
Bacille Calmette-Guérin inoculation site changes and cardiac complications in patients with Kawasaki disease
Authors: Takikawa Haruki , Ae Ryusuke , Matsubara Yuri , Matsubara Daisuke , Makino Nobuko , Kosami Koki , Kuwabara Masanari , Sasahara Teppei , Nakamura Yosikazu
Published: December 2020

Objective

To investigate whether redness and crusting at the bacille Calmette-Guérin inoculation site (BCGitis), identified during acute illness owing to Kawasaki disease (KD), is an independent risk factor for development of cardiac complications.

Design

Retrospective cohort study using data from the nationwide KD survey in Japan.

Setting

Survey respondents included hospitals specialising in paediatrics and hospitals with ≥100 beds and a paediatric department throughout Japan.

Patients

We included 17 181 patients with KD across Japan during 2005–2006.

Main outcome measures

BCGitis and cardiac complications resulting from KD.

Results

BCGitis was identified in 7549 (44%) patients with KD. Compared with patients without BCGitis, those with BCGitis were younger, more likely to be male, less likely to have recurrent status and visited a hospital and underwent initial intravenous immunoglobulin (IVIG) treatment earlier after KD onset. In the unadjusted model, patients with BCGitis were significantly less likely to have cardiac complications (crude OR 0.81, 95% CI 0.71 to 0.92). However, after including treatment factors (days of illness at initial IVIG and treatment responsiveness) in the adjusted model, the association was no longer significant (adjusted OR 0.89, 95% CI 0.77 to 1.03), indicating that BCGitis was not an independent factor associated with cardiac complication and might be confounded by treatment factors.

Conclusions

BCGitis was identified in comparatively early illness stages of KD. Our findings indicated that BCGitis was not an independent factor associated with developing cardiac complications but was confounded by prompt initial IVIG administration, which might result in successful treatment and prevention of cardiac complications.
Giant hiatus hernia presenting as a chronic cough masking a sinister diagnosis
Authors: Mukundu Nagesh Navin , Osilli Dixon , Khoo David
Published: December 2020

We present a case of an 82-year-old gentleman with an 18-month history of productive cough. Urgent CT scan of the thorax revealed type 1 hiatus hernia (HH). The patient was managed conservatively with lifestyle modifications to help his reflux symptomology. The patient subsequently presented with acute shortness of breath and vomiting. Repeat CT scan reported a giant incarcerated HH (15 cm). Endoscopy revealed an incidental finding of a 3 cm polypoid lesion in the oesophagus at the level of the carina and histology of biopsies reported an invasive adenocarcinoma. During admission, the patient unfortunately had a hospital acquired infection and cardiac complications which prevented surgical intervention. Patients with suspected HH should be investigated thoroughly with imaging studies including chest X-ray, CT or MRI alongside oesophageal manometry and gastroscopy. Endoscopic evaluation is particularly important as these patients are at higher risk of Barrett’s oesophagus and invasive malignancy.
Pomalidomide and dexamethasone in myelomatous pleural effusion
Authors: Comba Isin Yagmur , Chahin Anthony , Taj Hiffsa , Carilli Allison
Published: December 2020

Myelomatous pleural effusion (MPE) is an uncommon clinical entity and occurs in less than 1% of all patients with multiple myeloma. MPE indicates a progression of disease, therefore is associated with a poor prognosis and estimated median survival of <3 months. Treatment of MPE is challenging, and the data regarding the role of novel agents lack in the literature. Herein, we report a relapsed IgA myeloma case of a patient presenting with MPE, who was treated with pomalidomide with a very good partial response.
Flaxseed oil stimulates gynecomastia
Authors: Takenaka Tsuneo , Nagano Mayuko , Yamashita Koji , Kikuchi Kiyoshi
Published: December 2020

Flaxseed oil contains lignans, which exhibit anti-inflammatory and antiatherogenic activities. A 70-year-old male patient presented to our office due to hyperlipidaemia and started to take a tablespoon of flaxseed oil daily. Three months later, he reported left breast swelling and pain. Although the echogram revealed a tumour in the left mammary gland, the breast biopsy was compatible with gynecomastia, showing ductal hyperplasia without evidence of malignancy. His breast epithelia were oestrogen receptor-positive. Potential role of phytoestrogens was discussed.
The time to act is now: pseudo-systematic review
Authors: Ford Nathan , Brigden Grania , Ellman Tom , Mills Edward J
Published: December 2020

Objective

To identify any medical or public health rationale for claims that the time to act is now.

Design

Pseudo-systematic review.

Data sources

PubMed.

Study selection

Studies that included the claim “time is now” in the title, with or without exclamation marks. No language or date restriction was applied.

Results

512 articles were included for review. No relationship was identified between time to act and disease burden, severity, or specialty. Claims that the time to act was Christmas were almost entirely without basis. A clustering of claims that it is time to act in the first quarter of the year suggested a possible association with New Year’s resolutions.

Conclusions

Now is as good a time as any.
The Babinski sign in Renaissance paintings—a reappraisal of the toe phenomenon in representations of the Christ Child: observational analysis
Authors: Sellal François , Tatu Laurent
Published: December 2020

Objective

To investigate systematically the presence of the Babinski sign in paintings of the Christ Child by the greatest painters of the Renaissance.

Design

Observational analysis.

Setting

Large collection of paintings depicting the Christ Child from Flemish, Rhenish, and Italian schools between 1400 and 1550 CE, searched using published catalogues and Google.

Study sample

302 Renaissance paintings (by 19 painters) depicting the Christ Child.

Main outcome measure

Babinski sign, defined as a hallux extension with an amplitude greater than 30°. The presence of foot sole stimulation was also noted.

Results

An unquestionable upgoing toe was apparent in 90 (30%) of the 302 paintings. The Babinski sign was present in more than 60% of Christ Child paintings by Rogier van der Weyden, Hans Memling, Martin Schongauer, and Matthias Grünewald. A bilateral Babinski sign was observed in three paintings. Stimulation of the sole was noted in 48/90 (53%) paintings and was always present in paintings by Andrea del Verrocchio, Leonardo da Vinci, and Giorgione. No association existed between the presence of the Babinski sign and the period during which the painter was active.

Conclusions

Four main factors were noted in relation to the representation of the Babinski sign in paintings of the Christ Child: the physiological toe phenomenon in infants, the representation of the nudity of the Christ by painters during the 15th century to demonstrate the incarnation, Renaissance painters’ need for precise observation of anatomy, and the desire of some Rhenish and Flemish painters to depict very realistic details. Italian Renaissance painters, whether Mannerist or not, tended to idealise the beauty of human body, and they often did not reproduce the Babinski sign.
Modelling interventions to control COVID-19 outbreaks in a refugee camp
Authors: Gilman Robert Tucker , Mahroof-Shaffi Siyana , Harkensee Christian , Chamberlain Andrew T
Published: December 2020

Background

In the absence of effective treatments or vaccines, non-pharmaceutical interventions are the mainstay of control in the COVID-19 pandemic. Refugee populations in displacement camps live under adverse conditions that are likely to favour the spread of disease. To date, only a few cases of COVID-19 have appeared in refugee camps, and whether feasible non-pharmaceutical interventions can prevent the spread of the SARS-CoV-2 virus in such settings remains untested.

Methods

We constructed the first spatially explicit agent-based model of a COVID-19 outbreak in a refugee camp, and applied it to evaluate feasible non-pharmaceutical interventions. We parameterised the model using published data on the transmission rates and progression dynamics of COVID-19, and demographic and spatial data from Europe’s largest refugee camp, the Moria displacement camp on Lesbos, Greece. We simulated COVID-19 epidemics with and without four feasible interventions.

Results

Spatial subdivision of the camp (‘sectoring’) was able to ‘flatten the curve’, reducing peak infection by up to 70% and delaying peak infection by up to several months. The use of face masks coupled with the efficient isolation of infected individuals reduced the overall incidence of infection, and sometimes averted epidemics altogether. These interventions must be implemented quickly in order to be maximally effective. Lockdowns had only small effects on COVID-19 dynamics.

Conclusions

Agent-based models are powerful tools for forecasting the spread of disease in spatially structured and heterogeneous populations. Our findings suggest that feasible interventions can slow the spread of COVID-19 in a refugee camp setting, and provide an evidence base for camp managers planning intervention strategies. Our model can be modified to study other closed populations at risk from COVID-19 or future epidemics.
Management of acromioclavicular joint disease by manual therapy versus corticosteroid injections: the protocol of a non-inferiority study
Authors: Michaut Alexia , Planche Lucie , Auzanneau Lucie , Cormier Grégoire
Published: December 2020

Introduction

Degenerative acromioclavicular joint pain accounts for about 4% of shoulder pain. Various medical and non-medical treatment strategies are available for acromioclavicular joint disease but it is difficult to conduct a comparative evaluation of these treatments. The few studies dealing with the medical management of the disease have conducted no comparative assessment of drug therapies, physiotherapy, joint manipulation and corticosteroid injections. The primary goal of this study is to determine whether manual therapy is not inferior to ultrasound-guided injection of a corticosteroid preparation to decrease acromiocalvicular joint pain at 3 months.

Methods and analysis

The acromioclavicular arthropathy managed by manual therapy is a monocentric, comparative, randomised, controlled, non-inferiority study conducted in the Rheumatology Department of Vendée Departmental Hospital, involving two parallel groups receiving either corticosteroid injections or manual therapy. The inclusion criteria are patients who suffer from pain in the shoulder or the proximal part of the arm, with pain located on palpation of the acromioclavicular joint associated with a positive cross-arm test and a positive O’Brien test. Randomisation will be at a 1:1 ratio. The injection group will receive a single ultrasound-guided injection of 1 mL of Diprostène and the manual therapy group will receive between one and three sessions at intervals of one per week. The primary outcome will be to compare the Visual Analogue Scale for pain-activity-related score at 3 months for both groups.

Ethics and dissemination

The study project has been approved by the appropriate ethics committee (Committee for the Protection of Patients Ouest II in Angers, 30 April 2019, with the registration number of 2019/22). In agreement with current French regulations, signed informed written consent will be obtained from each patient. Results of the main trial and of the secondary endpoints will be submitted for publication in a peer-reviewed journal.

Trial registration number

NCT03951480.
Clinical preventive guidelines for school-aged children and adolescents in primary care: a protocol for a systematic review
Authors: Patseadou Magdalini , Pfarrwaller Eva , Haller Dagmar
Published: December 2020

Introduction

Guidelines for clinical preventive services targeting school-aged children and adolescents in primary care are limited, often inconsistent and difficult to apply in clinical contexts. This publication describes the protocol concerning a comprehensive systematic review that primarily aims to collect and synthesise available guidelines for prevention in primary care focused on school-aged children living in high-income regions. A second objective is to assess the quality of identified documents.

Methods and analysis

We will search for reports providing clinical practice guidelines or consensus or expert opinion on preventive actions in paediatric primary care. We will use the WHO definition of prevention. We will focus on children aged 6–18 years living in the European region, the USA, Canada and Australia. We will search PubMed, Embase, Web of Science and Cochrane Library and guidelines-specific databases from 1 January 2010. We will also explore the grey literature using web search engines (Google and Google Scholar). We will finally obtain unpublished information through personal contact with national paediatric societies. We will summarise all identified documents as well as their potential methodological bias. We will further use the Appraisal of Guidelines Research and Evaluation Instrument, version II tool to critically appraise their quality.

Ethics and dissemination

Our findings will contribute to the identification of clinical preventive guidelines for which implementation in routine paediatric primary care should be considered. We intend to disseminate our results through publication in peer-reviewed journals and conference proceedings.

PROSPERO registration number

CRD42020163184.
Randomised controlled trial of paracetamol or ibuprofen, as required for fever and pain in the first year of life, for prevention of asthma at age 6 years: paracetamol or ibuprofen in the primary prevention of asthma in Tamariki (PIPPA Tamariki) protocol
Authors: Tan Eunicia , Braithwaite Irene , McKinlay Christopher , Riley Judith , Hoare Karen , Okesene-Gafa Karaponi , Semprini Alex , Sheridan Nicolette , Grant Cameron , Johnson David , Weatherall Mark , Asher Innes , Beasley Richard , Dalziel Stuart R
Published: December 2020

Introduction

Asthma is one of the most common diseases in the world and is a global public health burden. There is an urgent need for research that leads to evidenced-based primary prevention strategies to reduce the prevalence of asthma. One novel risk factor that might have a role in the pathogenesis of asthma is the use of paracetamol in early life. This trial aims to determine if paracetamol, compared with ibuprofen use, as required for fever and pain in the first year of life, increases the risk of asthma at age 6 years.

Methods and analysis

The Paracetamol and Ibuprofen in Primary Prevention of Asthma in Tamariki trial is a multicentre, open-label, two-arm parallel randomised controlled trial. 3922 infants born at ≥32 weeks’ gestation will be randomly allocated to receive only paracetamol or only ibuprofen for treatment of fever and pain, if required in the first year of life. The primary outcome is asthma at 6 years of age, defined as the presence of wheeze in the preceding 12 months. Secondary outcomes include hospital admissions for bronchiolitis, wheeze or asthma in the first year of life, and within the first 6 years of life; wheeze at 3 years of age; eczema within the first year and at 3 and 6 years of age; atopy at 3 and 6 years of age.

Ethics and dissemination

The trial has been approved by the Northern A Health and Disability Ethics Committee of New Zealand (17/NTA/233). Dissemination plans include publication in international peer-reviewed journals, and presentation at national and international scientific meetings, assimilation into national and international guidelines, and presentation of findings to lay audiences through established media links.

Trial registration number

ACTRN12618000303246; Pre-results.
Study protocol for a network meta-analysis of digital-technology-based psychotherapies for PTSD in adults
Authors: He Longtao , Geng Yanling , Pan Yangu , Tian Jinhui , He Xinyu , Deng Xiangshu , Duan Wenjie , Peng Huamin
Published: December 2020

Introduction

Studies on various types of digital-technology-based psychotherapies (DTPs) have indicated that they are effective for post-traumatic stress disorder (PTSD) symptom relief among adults. The intervention efficacy or effectiveness hierarchy, however, is still not clear. Therefore, we propose to conduct a network meta-analysis to assess the relative effectiveness of various types of DTPs. We aim to establish the differential effectiveness of these therapies in terms of symptom reduction and provide high-quality evidence for treating PTSD.

Methods and analyses

We will search Embase, CINAHL, MEDLINE, HealthSTAR, the Cochrane Library, PsycINFO, PubMed, the Chinese Biomedical Literature Database, clinical trials (eg, ClinicalTrials.gov) and other academic platforms for relevant studies, mainly in English and Chinese (as we plan to conduct a trial on PTSD patients in Wuhan, China, based on the results of this network meta-analysis), from inception to October 2020. Randomised controlled trials (RCTs) and meta-analyses investigating the effectiveness of any DTPs for PTSD patients for any controlled condition will be included. The number of intervention sessions and the research duration are unlimited; the effects for different durations will be tested via sensitivity analysis. For this project, the primary measure of outcome will be PTSD symptoms at the end of treatment using raw scores for one widely used PTSD scale, PCL-5. Secondary outcome measures will include (1) dropout rate; (2) effectiveness at longest follow-up, but not more than 12 months and (3) patients’ functional recovery ratio (such as the return-to-work ratio or percentage of sick leave). Bayesian network meta-analysis will be conducted for all relative outcome measures. We will perform subgroup analysis and sensitivity analysis to see whether the results are influenced by study characteristics. The Grading of Recommendations, Assessments, Development, and Evaluation framework will be adopted to evaluate the quality of evidence contributing to network estimates of the primary outcome.

Ethics and dissemination

The researchers of the primary trials already have had ethical approval for the data used in our study. We will present the results of this meta-analysis at academic conferences and publish them in peer-reviewed journals.

PROSPERO registration number

CRD42020173253.
Treatment strategies for cerebrospinal shunt infections: a systematic review of observational studies
Authors: Robinson Joan L , Freire Dolores , Bialy Liza
Published: December 2020

Objective

A systematic review was conducted of studies comparing time to cerebrospinal fluid (CSF) sterilisation or rate of recurrence with different treatment strategies for CSF shunt infections.

Methods

A librarian-directed search was conducted of Epub Ahead of Print, In-Process & Other Non-Indexed Citations, Ovid Medline Daily and Ovid Medline, Ovid Embase, Wiley Cochrane Library, CINAHL Plus with Full Text via EBSCOhost, Scopus Advanced Search, and Web of Science Core Collection from 1990 to May 2019. Studies of any design that compared outcomes in groups of any age with different management strategies were included. Studies that compared complete versus incomplete shunt removal were excluded. Quality assessment was performed with the Newcastle-Ottawa Scale.

Results

The search identified 2208 records, of which 8 met the inclusion criteria. All were cohort studies of moderate quality. Four studies compared the duration of antibiotics; none demonstrates that a longer course prevented recurrences. Two studies analysed addition of rifampin, with one showing a decrease in recurrences while the other had a small sample size. No studies analysed the addition of intraventricular antibiotics, but one showed equally good results with once versus twice daily administration. One study reported no difference in recurrences with placement of antibiotic-impregnated catheters. Recurrence rates did not differ with shunt replacement minimum of 7 days vs less than 7 days after CSF became sterile. There were no recurrences in either group when shunt replacement was performed after sterile CSF cultures were obtained at 24 vs 48 hours after antibiotics were discontinued. A new shunt entry site did not decrease recurrences.

Discussion

The main limitations are the lack of high-quality studies, the small sample sizes and the heterogeneity which precluded meta-analysis. Addition of rifampin for staphylococcal infections may decrease relapse but requires further study.
Quality of life following a lower limb reconstructive procedure: a protocol for the development of a conceptual framework
Authors: Leggett Heather , Scantlebury Arabella , Sharma Hemant , Hewitt Catherine , Harden Melissa , McDaid Catriona
Published: December 2020

Introduction

Lower limb conditions requiring reconstructive surgery can be either congenital or acquired from trauma, infection or other medical conditions. Patient-reported outcome measures (PROMs) are often used by healthcare professionals to assess the impact of a patient’s condition (and treatment) on quality of life. However, we are not aware of any measures developed specifically for people requiring lower limb reconstructive surgery. Consequently, it is not clear the extent to which current PROMs accurately and specifically measure the outcomes that are important to these patients.

Methods and analysis

The ‘PROLLIT’ (Patient-Reported Outcome Measure for Lower Limb Reconstruction) involves three phases: to explore what is important to patients with regard to quality of life (phase 1), ascertain whether current measures adequately capture these experiences (phase 2) and if not begin, the development of a new PROM (phase 3). The population of interest is people requiring, undergoing or after undergoing reconstructive surgery for a lower limb condition. In this paper, we describe phase 1, which aims to develop a conceptual framework to identify and map what is important to this group with regard to social interactions, employment, perceived health and quality of life after condition onset/injury and throughout recovery. The conceptual framework will be developed through three steps: (step A) a qualitative evidence synthesis, (step B) a qualitative study with patients and staff to explore patient’s views and experiences of lower limb reconstructive surgery and (step C) a round table discussion with key stakeholders where findings from step A and step B will be brought together and used to finalise the conceptual framework.

Ethics consideration and dissemination

Ethical approval has been granted for the qualitative data collection (step B) from South Central Berkshire Research Ethics committee (REF:20/SC/0114). Findings from steps A and B will be submitted for peer-reviewed publication in academic journals, and presented at academic conferences.

PROSPERO registration number

CRD42019139587.

ISRCTN registration number

ISRCTN75201623.
Emergency department falls: a longitudinal analysis of revisits and hospitalisations between patients who fall and patients who did not fall
Authors: Shankar Kalpana N , Lin Feng , Epino Henry , Temin Elizabeth , Liu Shan
Published: December 2020

Objective

Older adult falls are a national issue comprising 3 million emergency department (ED) visits and significant mortality. We sought to understand whether ED revisits and hospitalisations for fallers differed from non-fall patients through a secondary analysis of a longitudinal, statewide cohort of patients.

Design

We performed a secondary analysis using the non-public Patient Discharge Database and the ED data from the California Office of Statewide Health Planning and Development. This is a 5-year, longitudinal observational dataset, which was used to assess outcomes for fallers and non-fall patients, defined as anyone who did not carry a fall diagnosis during this time period.

Setting

2005–2010 non-public Patient Discharge Database and the ED Data from the state of California.

Participants

Older adults 65 years and older

Main outcome measure

ED revisits and hospitalisations for fallers and non-fall patients.

Results

Patients who came to the ED with an index visit of a fall were more likely to be discharged home after their fall (61.1% vs 45.0%, p<0.001). Fallers who were discharged or hospitalised after their index visit were more likely to come back to the ED for a fall related complaint compared with non-fallers (median time: 151 days vs 352 days, p<0.001 and hospitalised: 45 days vs 119 days, p<0.01) and fallers who were initially discharged also returned to the ED sooner for a non-fall related complaint (median time: 325 days vs 352 days, p<0.001).

Conclusion

Fall patients tend to be discharged home more often after their index visit, but returned to the ED sooner compared with their non-fall counterparts. Given a faller’s rates of ED revisits and hospitalisations, EDs should consider a fall as a poor prognostic indicator for future healthcare utilisation.
Perspectives of health workers on the referral of women with obstetric complications: a qualitative study in rural Sierra Leone
Authors: Proos Ryan , Mathéron Hanna , Vas Nunes Jonathan , Falama Abdul , Sery Kamal Patricia , Grobusch Martin Peter , van den Akker Thomas
Published: December 2020

Objectives

Sierra Leone has one of the highest maternal mortality ratios in the world. Timely and well-coordinated referrals are necessary to reduce delays in providing adequate care for women with obstetric complications. This study describes factors affecting timely and adequate referral of women with obstetric complications in rural areas of Sierra Leone as viewed by health workers in rural health facilities.

Design

Qualitative research with semi-structured interviews using open-ended questions. Data were analysed by systematic text condensation.

Setting

Interviews were held in nine peripheral health units in rural Sierra Leone.

Participants

19 health workers including nurses, midwives and clinical health officers participated in nine interviews.

Results

From the interviews, four major themes describing possible factors of delay in referral of women in need of emergency obstetric care emerged: (1) communication between healthcare workers; (2) underlying influences on decision-making; (3) women’s compliance to referral and (4) logistic constraints.

Several factors in rural Sierra Leone are perceived to complicate timely and adequate referral of women in need of emergency obstetric care. Notable among these factors are fear among women for being referred and fear among healthcare workers for having maternal deaths or severe obstetric complications occurring at their own facilities. Furthermore, decision-making of healthcare workers whether to refer a woman or not is negatively influenced by a hierarchical culture with high power distance between healthcare workers.

Conclusion

Factors identified that complicate timely and adequate referral of women in need of emergency obstetric care must be considered in efforts to reduce maternal mortality. Possible interventions that may reduce delay in referral include increased communication by mobile phones between health workers for advice and feedback regarding referrals, involvement of influential stakeholders to increase women’s compliance to referral, and consistent use of standardised management protocols.
Patient-centred care delivered by general practitioners: a qualitative investigation of the experiences and perceptions of patients and providers
Authors: Brickley Bryce , Williams Lauren T , Morgan Mark , Ross Alyson , Trigger Kellie , Ball Lauren
Published: December 2020

Background

Patient-centred care (PCC) is care that is respectful and responsive to the wishes of patients. The body of literature on PCC delivered by general practitioners (GPs) has increased steadily over time. There is an opportunity to advance the work on GP-delivered PCC through qualitative research involving both patients and providers.

Aim

To explore the perceptions and experiences of PCC by patient advocates and GPs.

Design and setting

Qualitative description in a social constructivist paradigm. Participants were sampled from six primary care organisations in south east Queensland/northern New South Wales, Australia.

Method

Purposive sampling was used to recruit English-speaking adult participants who were either practising GPs or patient advocates. Focus group sessions explored participants’ perceptions and experiences of PCC. Data were analysed thematically using a constant-comparative approach.

Results

Three focus groups with 15 patient advocates and three focus groups with 12 practising GPs were conducted before thematic saturation was obtained. Five themes emerged: (1) understanding of PCC is varied and personal, (2) valuing humanistic care, (3) considering the system and collaborating in care, (4) optimising the general practice environment and (5) needing support for PCC that is embedded into training.

Conclusion

Patient advocates’ and GPs’ understanding of PCC are diverse, which can hinder strategies to implement and sustain PCC improvements. Future research should explore novel interventions that expose GPs to unique feedback from patients, assess the patient-centeredness of the environment and promote GP self-reflection on PCC.
Depression, periodontitis, caries and missing teeth in the USA, NHANES 2009–2014
Authors: Aldosari Muath , Helmi Mohammad , Kennedy Erinne N , Badamia Riddhi , Odani Satomi , Agaku Israel , Vardavas Constantine
Published: December 2020

Purpose

This study aimed to investigate the association between self-reported depressive symptoms and oral diseases in US adults, including periodontitis, caries, missing teeth and untreated dental caries.

Design

This study was designed as a secondary data analysis of a cross-sectional survey. We conducted descriptive, multivariable logistic and Poisson regression analyses on weighted data.

Setting

US National Health and Nutrition Examination Survey 2009–2014 data.

Participants

Individuals aged ≥30 years who completed a periodontal examination and depression screening (n=9799).

Results

21.6% (28.9 million) of adults aged ≥30 years reported depressive symptoms, with a higher prevalence among females, current smokers and participants with lower income and education status. More than half of the adults with moderate depressive symptoms had periodontal diseases, and more than one-third had teeth with untreated dental caries. After adjusting for sociodemographics, behavioural factors, having diabetes and psychotherapeutic medication use, depressive symptoms were associated with poorer oral health. Severe depressive symptoms were associated with higher odds of mild periodontitis (2.20; 99% CI 1.03 to 4.66). For those with mild depressive symptoms, the mean number of missing teeth was 1.20 (99% CI 1.06 to 1.37) times the average of non-symptomatic individuals; and 1.38 times (99% CI 1.15 to 1.66) among individuals with moderate depressive symptoms.

Conclusions

Depressive symptoms were associated with mild periodontitis and a greater number of missing teeth, while having teeth with untreated dental caries was attributed to sociodemographic factors. Awareness of oral health status among patients with depressive symptoms can inform both dental and mental health providers to develop tailored treatment and help patients achieve overall wellness.
Translational applications of computational modelling for patients with cardiac arrhythmias
Authors: Bifulco Savannah F , Akoum Nazem , Boyle Patrick M
Published: December 2020

Cardiac arrhythmia is associated with high morbidity, and its underlying mechanisms are poorly understood. Computational modelling and simulation approaches have the potential to improve standard-of-care therapy for these disorders, offering deeper understanding of complex disease processes and sophisticated translational tools for planning clinical procedures. This review provides a clinician-friendly summary of recent advancements in computational cardiology. Organ-scale models automatically generated from clinical-grade imaging data are used to custom tailor our understanding of arrhythmia drivers, estimate future arrhythmogenic risk and personalise treatment plans. Recent mechanistic insights derived from atrial and ventricular arrhythmia simulations are highlighted, and the potential avenues to patient care (eg, by revealing new antiarrhythmic drug targets) are covered. Computational approaches geared towards improving outcomes in resynchronisation therapy have used simulations to elucidate optimal patient selection and lead location. Technology to personalise catheter ablation procedures are also covered, specifically preliminary outcomes form early-stage or pilot clinical studies. To conclude, future developments in computational cardiology are discussed, including improving the representation of patient-specific fibre orientations and fibrotic remodelling characterisation and how these might improve understanding of arrhythmia mechanisms and provide transformative tools for patient-specific therapy.
The metabolic and performance effects of carbohydrate timing in resistance trained males undergoing a carbohydrate restricted diet
Authors: Krings Ben M. , Waldman Hunter S. , Shepherd Brandon D. , McAllister Matthew J. , Fountain Brent J. , Lamberth John G. , Smith JohnEric W.
Published: December 2020

The purpose of this investigation was to examine the importance of carbohydrate (CHO) timing while consuming a carbohydrate restricted diet (CRD) and completing a high-intensity exercise program. Eighteen males completed 6 weeks of training with the first 2 weeks serving as familiarization. During the final 4 weeks, subjects were randomized into 2 groups and completed 3 days of resistance training and 2 days of high-intensity interval training, while consuming a CRD (∼25%, ∼25%, and ∼50%, CHO, protein, and fat, respectively). The supplemented group (n = 9) ingested 30 g of CHO during exercise and 40 g of CHO immediately after each training session. The non-supplemented group (n = 9) consumed a non-caloric placebo during exercise. Pre- and post-testing measures included back squat and bench press 1-repetition maximums (1-RM), peak oxygen consumption (V̇O2peak), anaerobic power, body composition, fasted glucose, insulin, and total testosterone. Both groups significantly improved back squat and bench press 1-RM, V̇O2peak, and power output (p < 0.05), but there were no differences in blood markers or body composition. Our data suggests that CHO timing does not negatively impact training adaptations during a high-intensity exercise regimen when dietary CHO intake is restricted, but that favorable adaptations can be made while consuming a CRD.

Novelty: Carbohydrate restricted dieting has no negative impact on resistance training adaptations. Short-term high-intensity interval training is effective in increasing peak oxygen consumption.
Do methanotrophs drive phosphorus mineralization in soil ecosystem?
Authors: Mohanty Santosh Ranjan , Kumar Adarsh , Parmar Rakesh , Dubey Garima , Patra Ashok , Kollah Bharati
Published: December 2020

Experiments were carried out to elucidate linkage between methane consumption and mineralization of phosphorous (P) from different P sources. The treatments were (i) no CH4 + no P amendment (absolute control), (ii) with CH4 + no P amendment (control), (iii) with CH4 + inorganic P as Ca3(PO4)2, and (iv) with CH4 + organic P as sodium phytate. P sources were added at 25 µg P·(g soil)−1. Soils were incubated to undergo three repeated CH4 feeding cycles, referred to as feeding cycle I, feeding cycle II, and feeding cycle III. CH4 consumption rate k (µg CH4 consumed·(g soil)−1·day−1) was 0.297 ± 0.028 in no P amendment control, 0.457 ± 0.016 in Ca3(PO4)2, and 0.627 ± 0.013 in sodium phytate. Rate k was stimulated by 2 to 6 times over CH4 feeding cycles and followed the trend of sodium phytate > Ca3(PO4)2 > no P amendment control. CH4 consumption stimulated P solubilization from Ca3(PO4)2 by a factor of 2.86. Acid phosphatase (µg paranitrophenol released·(g soil)−1·h−1) was higher in sodium phytate than the no P amendment control. Abundance of 16S rRNA and pmoA genes increased with CH4 consumption rates. The results of the study suggested that CH4 consumption drives mineralization of unavailable inorganic and organic P sources in the soil ecosystem.
Antrodia cinnamomea Inhibits Growth and Migration of Lung Cancer Cells through Regulating p53-Bcl2 and MMPs Pathways
Authors: Tan Yi , Johnson Michael , Zhou Jiong , Zhao Yi , Kamal Mohammad Amjad , Qu Xianqin
Published: December 2020

Antrodia cinnamomea has been shown to possess antitumor activity. This study investigated the effects and mechanisms of Antrodia cinnamomea extract (ACE) on growth and migration of human non-small cell lung cancer A549 cells. The effect of ACE on cell viability was determined by MTT assay and fluorescent live-cell imaging. The apoptotic effect of ACE was determined by cell cycle distribution using flow cytometry. A P53-mediated apoptosis pathway was identified by measuring protein expression of p53 and Bcl-2 with Western blotting. Additionally, mRNA expression of p53 and Bcl-2 and Bax was detected by qRT-PCR. The effect of ACE on cancer cell migration was confirmed by a wound-healing assay. Expression of MMP-2 and MMP-9 at the protein and gene levels was determined by western blot and qRT-PCR analysis. This study demonstrates the inhibitory effect of ACE on A549 cell proliferation in a dose-response manner with an [Formula: see text]. It was determined that ACE concentration at [Formula: see text] induced cell cycle arrest at S phase in A549 cells. The apoptosis-regulating protein p53 expression was enhanced and also associated with the downregulation of Bcl-2 in ACE treatment cells. The mRNA expression of p53 and Bcl-2 associated with Bxa was consistent with protein expression. The inhibition of migration of cancer cells treated with ACE was clearly evident. At the same time, suppression of expression of MMP-2 and MMP-9 at protein and mRNA levels was observed. The findings of this study highlight ACE as a potential agent of adjuvant therapy for lung cancer.
MTL: Memristor Ternary Logic Design
Authors: Luo Li , Dong Zhekang , Hu Xiaofang , Wang Lidan , Duan Shukai
Published: December 2020

The nanoscale implementations of ternary logic circuits are particularly attractive because of high information density and operation speed that can be achieved by using emerging memristor technologies. Memristor is a nanoscale device with nonvolatility and adjustable multilevel states, which creates an intriguing opportunity for the implementation of ternary logic operations. This paper proposes a novel memristor-based design for stateful ternary logic, including AND, OR, NOT, NAND, NOR, and COPY operations. In the proposed memristor ternary logic (MTL) design, the resistance of memristor is the only logic state variable for representing the input and output. By sensing the value of the input memristors, the resistance of the output memristor changes accordingly. Furthermore, the MTL gates are not only capable of performing logic operations, but also storing logic values. To illustrate the potential of the methodology, a single-input-three-output ternary decoder is designed by using the proposed ternary logic circuits. Simulation results verify the effectiveness of the presented design.
Chaotification of First-Order Partial Difference Equations
Authors: Liang Wei , Guo Haihong
Published: December 2020

This paper is concerned with chaotification of first-order partial difference equations. Two criteria of chaos for the difference equations with general controllers are established, and all the controlled systems are proved to be chaotic in the sense of Li–Yorke or of both Li–Yorke and Devaney by applying the coupled-expanding theory of general discrete dynamical systems. The controllers used in this paper can be easily constructed, facilitating the chaotification of first-order partial difference equations. For illustration, two illustrative examples are provided.