bluuebunny/crossref_metadata_2025 huggingface dataset:
Multicomponent Interventions for the Prevention of Delirium in Hospitalized Older People: A Meta‐Analysis
Authors: León‐Salas Beatriz , Trujillo‐Martín María M. , Martínez del Castillo Luis Pedro , García‐García Javier , Pérez‐Ros Pilar , Rivas‐Ruiz Francisco , Serrano‐Aguilar Pedro
Published: September 2020

OBJECTIVES

To comprehensively assess the effects of multicomponent interventions for prevention of delirium in hospitalized older people.

DESIGN

Systematic review with meta‐analysis following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses methods.

PARTICIPANTS

All randomized controlled trials were included. Included studies were conducted in hospitalized older people (aged ≥65 years).

MEASUREMENTS

The electronic databases MEDLINE, EMBASE, Web of Science, and Cochrane Central Register of Controlled Trials were consulted (search date: 2015 to March 2019). Predefined criteria were used to determine inclusion of studies and to assess their methodologic quality.

RESULTS

From 1,250 records identified, 10 randomized controlled trials were included (n = 2,850: 1355 medical patients, 1,243 surgical, and 160 intensive care unit). The multicomponent interventions, compared with usual care, reduced the incidence of delirium (risk ratio (RR) = 0.62; 95% confidence interval (CI) = 0.54–0.72; I2 = 0%; k = 10; n = 2,758), duration of delirium (RR = −1.18; 95% CI = −1.95 to −0.40; I2 = 45%; k = 6; n = 276), severity of delirium (standard mean difference = −0.98; 95% CI = −1.46 to −0.49; I2 = 0%; k = 3; n = 82), and pressure ulcers (RR = 0.48; 95% CI = 0.26–0.88; I2 = 0%; k = 2; n = 457).

CONCLUSIONS

This meta‐analysis suggests that multicomponent interventions to prevent delirium are effective in decreasing its incidence, duration, and severity; as well as the incidence of pressure ulcers in hospitalized older people. Therefore, multicomponent interventions hold great promise to impact in the most important and prevalent conditions affecting fragile older people during hospitalization.
A Closer Look at the Behavior of Uncertainty and Disagreement: Micro Evidence from the Euro Area
Authors: RICH ROBERT , TRACY JOSEPH
Published: September 2020

This paper examines point and density forecasts of real GDP growth, inflation, and unemployment from the European Central Bank's Survey of Professional Forecasters. We analyze individual uncertainty measures as well as introduce individual point‐ and density‐based disagreement measures. The analysis indicates forecasters’ uncertainty and disagreement display substantial heterogeneity and persistence, with the latter feature challenging a key prediction of expectations models emphasizing information frictions. We also find that uncertainty is characterized by prominent respondent effects and disagreement by prominent time effects, suggesting these divergent properties underlie the well‐documented weak uncertainty–disagreement linkage. Taken together, our results provide a basis for further development of expectations models.
Unpalatable food for thought: Let marketing research guide effective public obesity interventions
Authors: Holden Stephen S. , Zlatevska Natalina , Parkinson Joy , Cadario Romain , Dubelaar Chris , Lei Jing , Moore Elizabeth , Sayarh Nada , Van Kerckhove Anneleen , Werle Carolina
Published: September 2020

The prevalence of obesity is growing unabatedly despite the considerable efforts directed at the problem. Although abundant research has contributed to our understanding of the multifactorial causes of obesity, there is less attention to research that is relevant for guiding social marketers, public health professionals and policymakers in delivering public health interventions for countering and/or preventing the problem of obesity. This review offers six points for identifying and developing research relevant for guiding community‐wide obesity interventions based on the idea that an applied marketing research perspective offers a better model for identifying effective interventions than more theoretical academic research. Specifically, the research guiding public health and social marketing interventions needs to (1) provide information on ultimate outcomes (weight, health and unintended consequences) more than intermediate outcomes (beliefs, attitudes and behaviour), (2) report on observations collected over the longer term, (3) use natural settings (even at a cost of internal validity), (4) endeavour to overcome observer‐effects, (5) report effect sizes (rather than statistical significance) and (6) use moderator analyses to capture variation in how a population responds to interventions.
Macrophages and scavenger receptors in obesity‐associated non‐alcoholic liver fatty disease (NAFLD)
Authors: Kragh Petersen Sine , Bilkei‐Gorzo Orsolya , Govaere Olivier , Härtlova Anetta
Published: September 2020

With an increase in sedentary lifestyle and dietary over nutrition, obesity has become one of the major public health problems worldwide and is a prevalent predisposing risk factor to non‐alcoholic fatty liver disease (NAFLD), the most common chronic liver disease in Western developed countries. NAFLD represents a series of diseased states ranging from non‐alcoholic fatty liver (NAFL) to steatohepatitis (NASH), which can lead to fibrosis and eventually to cirrhosis and hepatocellular carcinoma. Currently, the only effective treatment to cure end‐stage liver disease is liver transplantation. Macrophages have been reported to play a crucial role in the progression of NAFLD, thereby are a potential target for therapy. In this review, we discuss the current knowledge on the role of macrophages and inflammatory signalling pathways associated with obesity and chronic liver inflammation, and their contribution to NAFLD development and progression.
Homicide and Drug Trafficking in Impoverished Communities in Brazil
Authors: Oliveira Elenice De Souza , Silva Braulio Figueiredo Alves da , Sapori Flavio Luiz , Cardoso Gabriela Gomes
Published: September 2020

Many studies demonstrate that homicides are heavily concentrated in impoverished neighborhoods, but not all socially disadvantaged neighborhoods are hotbeds of violence. Conducted in Belo Horizonte, Brazil, this study hypothesizes that the association between high rates of homicide and impoverished areas is influenced by the emergence of a specific type of street drug-dealing common to favelas (slums). The study applies econometric techniques to police data on homicides and drug arrests from 2008 to 2011, as well as 2010 Census data, to test its hypothesis. The findings provide insight into the development of crime prevention policies in areas of high social vulnerability.
COVID-19 propagation mathematical modeling: the case of Senegal
Authors: Diaby Mouhamadou , Diop Oumar , Konte Almamy , Sene Abdou
Published: September 2020

The outburst of the COVID-19 pandemic has raised several questions leading to a complex system in terms of modeling. Indeed, the modeling of the epidemic, at the level of a country, needs considering each of the different sources of contamination as well as the public health authorities strategy, in a specific way. With this in mind, in the present paper, we develop a mathematical model of the COVID-19 epidemic in Senegal. In the model, the population is subdivided into five compartments: susceptible, infected but asymptomatic, symptomatic, quarantined, and recovered immune people. In addition, due to its important impact in the propagation of the disease, we add one more variable: the number of infected objects. Therefore, the model corresponds to a system of six non-linear ordinary differential equations we submit to an analytical study to prove the relevancy of the model,?  simulate the evolution of the epidemic, and retrieve epidemiological parameters, namely the infection rate and the basic reproduction number
Dual-Porosity Dual-Permeability Poroelastodynamics Analytical Solutions for Mandel’s Problem
Authors: Liu Chao
Published: September 2020

Analytical solutions to the classical Mandel’s problem play an important role in understanding Biot’s theory of poroelasticity and validating geomechanics numerical algorithms. In this paper, existing quasi-static poroelastic solutions to this problem are extended to the dual-porosity dual-permeability poroelastodynamics solution which considers inertial effects for a naturally fractured and fluid-saturated sample subjected to a harmonic excitation. The solution can generate the associated elastodynamics and poroelastodynamics solutions as special cases. A naturally fractured Ohio sandstone is selected to demonstrate the newly derived solution. The elastodynamics, poroelastodynamics, and dual-porosity poroelastodynamics solutions are compared to illustrate the effects of fluid–solid coupling and the natural fractures. The rock sample behaves in drained condition at low frequencies when the oscillation has insignificant impedance effects on fluid movement. Compared to the other two solutions, the dual-porosity solution predicts the largest amplitude of displacement at low frequencies when the response is predominantly controlled by the stiffness. The Mandel–Cryer effect is observed in both rock matrix and fractures and occurs at a lower frequency in rock matrix because it is easier to build up pore pressure in lower-permeability rock matrix. At high frequencies, pore fluids are trapped and the rock sample behaves in an undrained state. At the resonance frequencies, the elastodynamics solution provides the largest amplitude of displacement, followed by the poroelastodynamics and dual-porosity poroelastodynamics solution. This is because of the dissipation caused by the presence of both fluid and fractures.
Multimodal Evaluation of the Spatiotemporal Variations of Periprosthetic Bone Properties
Authors: Fraulob Manon , Le Cann Sophie , Voumard Benjamin , Yasui Hirokazu , Yano Keita , Vayron Romain , Matsukawa Mami , Zysset Philippe , Haïat Guillaume
Published: September 2020

Titanium implants are widely used in dental and orthopedic surgeries. However, implant failures still occur because of a lack of implant stability. The biomechanical properties of bone tissue located around the implant need to be assessed to better understand the osseointegration phenomena and anticipate implant failure. The aim of this study was to explore the spatiotemporal variation of the microscopic elastic properties of newly formed bone tissue close to an implant. Eight coin-shaped Ti6Al4V implants were inserted into rabbit tibiae for 7 and 13 weeks using an in vivo model allowing the distinction between mature and newly formed bone in a standardized configuration. Nanoindentation and micro-Brillouin scattering measurements were carried out in similar locations to measure the indentation modulus and the wave velocity, from which relative variations of bone mass density were extracted. The indentation modulus, the wave velocity and mass density were found to be higher (1) in newly formed bone tissue located close to the implant surface, compared to mature cortical bone tissue, and (2) after longer healing time, consistently with an increased mineralization. Within the bone chamber, the spatial distribution of elastic properties was more heterogeneous for shorter healing durations. After 7 weeks of healing, bone tissue in the bone chamber close to the implant surface was 12.3% denser than bone tissue further away. Bone tissue close to the chamber edge was 16.8% denser than in its center. These results suggest a bone spreading pathway along tissue maturation, which is confirmed by histology and consistent with contact osteogenesis phenomena.
Investigation of Smear Formation Mechanism From DLC Film by Heating
Authors: Tani Hiroshi , Lu Renguo , Koganezawa Shinji , Tagawa Norio
Published: September 2020

The formation of head smear from DLC films on magnetic disks was confirmed by a simulated heating experiment. DLC films of 100-nm thickness were prepared and heated on a hot plate in an environmental gas chamber. Smear on a silicon wafer placed 3 mm above the DLC surface was observed after heating of the DLC film. The smear amount was quantified using the carbon intensity of the smear measured by XPS. In air, the carbon concentration decreased with the heating temperature; however, the carbon concentration increased with temperature in nitrogen. The carbon concentration of the smear in the air environment was smaller than that of nitrogen. As the result of comparison of smears on DLCs with various hydrogen concentrations, more decomposed gas is generated from the DLC film as the amount of hydrogen contained in the DLC increases, and this value increases at lower temperatures. This result suggests that DLC films with low hydrogen concentrations generate a smaller amount of decomposition gas than those with high hydrogen concentrations during heating. In addition, Raman spectra suggest that the DLC degraded by heating and the hydrocarbon gas-like materials were generated from the DLC film because the DLC films include carbon and hydrogen. Because fragments of 250–500 atomic mass units were observed in the TOF-SIMS spectra of smears, the smear is estimated to consist of a hydrocarbon of relatively high molecular weight.
Derivation and Evaluation of a Poincare-Bendixson Theorem Based Target Acceleration Computation Algorithm for Autonomous Driving on Inverse TTC and Time Headway Plane
Authors: Lee Hye-Won , Oh Kwang-Seok , Yoon Young-Min , Yi Kyong-Su
Published: September 2020

This paper describes derivation algorithm and evaluation results of a Poincare-Bendixson theorem based target acceleration computation algorithm for autonomous driving on inverse time to collision and time headway plane. Derivation of target acceleration is needed for longitudinal autonomous driving. Ellipsoidal driving area is derived for considering driver’s driving characteristic and safety in time headway-inverse time to collision (TTC) plane. And target acceleration computation algorithm has been proposed based on Poincare-Bendixson theorem. Ellipsoidal driving areas are divided main driving area and real-time driving area. Main driving area is derived based on limit of inverse TTC and time headway for takeover time and human factor, real-time driving area is derived through current driving point with ratio of main driving area. It is designed to computation the target acceleration after deriving the target direction by applying a specific angle based on the normal to the current driving point through the real-time driving area. Specific angle is arbitrary value applied acceleration limitation of actual vehicle. The performance evaluation of target acceleration computation algorithm is has been conducted in Matlab/Simulink environment. It is expected that the proposed algorithm can be used for longitudinal control algorithm for safety and personalization of autonomous vehicle.
Finger-Like Mechanism Using Bending Shape Memory Alloys
Authors: Ali Hussein F. M. , Baek Hangyeol , Jang Taesoo , Kim Youngshik
Published: September 2020

A biologically inspired finger-like mechanism similar to human musculoskeletal system is developed based on Shape Memory Alloy (SMA). SMA actuators are inspiring the design of a modular finger part with compact and compliant actuation. This paper describes a three-segmented finger-like mechanism. This mechanism is composed of six bending Shape Memory Alloy (SMA) actuators. As a result, our finger mechanism is compact and compliant. The insider three SMA actuator are used for finger flexion while the outsider three SMA actuators are for extension. Each segment of this mechanism can be bent and/or extended independently by actuating a corresponding bending SMA actuator. Furthermore, full bending motion can be achieved by applying coordinated control of the three SMA actuators. Bending and stretching motions of the proposed mechanism are finally demonstrated. The work space of the three-segment finger is studied to verify the reachable points by the end tip. The kinematic model is developed to study the motion of the mechanism. The performance evaluation is executed using force sensor and a temperature monitoring of the corresponding SMA actuators. The simulation and experimental results indicate that the SMA-based finger module can achieve effectively the desired motions as designed.
A New Wireless Power Transfer Circuit With a Single-Stage Regulating Rectifier for Flexible Sensor Patches
Authors: Chang C.-P. , Yen W.-W. , Chao Paul C.-P.
Published: September 2020

A new wireless power transfer circuit with a single-stage regulating rectifier is designed and validated with satisfactory efficiency for flexible sensor patches. Since the battery is bulky and cannot be fabricated on a flexible substrate, the power source of the electronic patch is realized by wireless power transfer. Magnetic resonance transmission power at 13.56 MHz in the ISM band is adopted to make possible wireless power transfer. Furthermore, for high conversion efficiency, a new single-stage regulating rectifier is designed and implemented at the receiver side of the sensor patch. An active switching full-wave bridge rectifier is designed to reduce conduction loss and increase the voltage-conversion rate. A delay lock loop feedback controller overcomes the switching delays at high frequencies that significantly undermine power conversion efficiency. The voltage rectification and regulation are achieved simultaneously in a single-stage rectifier through 1X/0X mode control. The PFM control is adopted to select the switching frequency of the system in order to maximize the transient response during heavy load and to minimize the switching power losses during light load. The circuit is fabricated via the TSMC 0.35 μm process. The output efficiency of the circuitry was improved by 5–10% in light load as compared with the circuit without PFM control, while the peak efficiency reaches favorable 86%.
Ranking of Thermal Asperity (TA) Interaction During Seeking Under Various Fly-Height Conditions
Authors: Srivastava Abhishek , Lamberts Bernd , Li Ning , Knigge Bernhard
Published: September 2020

HDD heads have various interaction mechanisms with thermal asperities (TAs), and protection mechanisms need to be put in place to ensure the head-disk interaction (HDI) resulting from them is eliminated or minimized to the highest extent possible. It is straightforward to not allow the head sit-on-track on cylinders that have such TAs on them, and the same principle can be extended to so-called high TAs (HTAs), whose height is more than the fly height of the head, so heads do not inadvertently interact with the TA even when motion is triggered on another head, since the entire head stack moves together.

Similar TA interactions also occur when the head seeks across the tracks. Typical short seeks have thermal fly-height control (TFC) turned on while it is turned on during long seeks, which is greater than a few hundred tracks. Heads can also interact with TAs during retract and arrival of the head during such long seeks. Finally, background media scan (BGMS), which is an industry standard, when the drive enters an idle state. Interaction with HTAs can also occur when the drive enters such a state.

Typical seek avoidance attempts to eliminate TA interaction during seeking, however it is not straightforward to determine which of the seek mechanism: TFC On during short seeks, retract/arrival during long seeks, HTA interaction during long seeks with TFC off, or idle TA interaction causes the greatest HDI. Through theoretical analysis and experimental corroboration, this paper intends to rank the various modes of TA interaction, so by developing features for eliminating or minimizing them in that order could help bring the maximum benefit for achieving minimum lifetime reduction of the head due to such interaction.
Optimal Patient Position to Maximize Gluteus Maximus Activation During Prone Hip Extension: A Critically Appraised Topic
Authors: Goins Justin
Published: September 2020

Clinical Question: What is the most optimal position to perform the prone hip extension exercise in order to improve the gluteus maximus to hamstring activation ratio? Clinical Bottom Line: There does not appear to be a specific position recommended to perform the prone hip extension exercise in order to activate the gluteus maximus over the hamstrings.
Speaking science to power
Authors: Servick Kelly
Published: September 2020

A young disease modeling expert has found her voice during the pandemic.
Indigenous Alaskans demand a voice in research on warming
Authors: Stone Richard
Published: September 2020

NSF program struggles to bridge scientists and communities.
Comment on “No consistent ENSO response to volcanic forcing over the last millennium”
Authors: Robock Alan
Published: September 2020

Dee
et al
. (Reports, 27 March 2020, p. 1477) claimed that large volcanic eruptions do not produce a detectable El Niño response. However, they come to the wrong conclusion because they have ignored the fundamental climate response to large volcanic eruptions: Volcanic eruptions cool the surface, thus masking the relative El Niño warming.
Modulating gut microbes
Authors: Wargo Jennifer A.
Published: September 2020

Fecal microbiota transplant and modulation of microbial species show therapeutic promise
Searching for sex differences
Authors: Wilson Melissa A.
Published: September 2020

Evolved sex differences in gene expression are pervasive, but so too is sampling bias
Flossie Wong-Staal (1946–2020)
Authors: Franchini Genoveffa
Published: September 2020

Trailblazing HIV researcher
Genomic Serotyping, Clinical Manifestations, and Antimicrobial Resistance of Nontyphoidal
Salmonella
Gastroenteritis in Hospitalized Children in Ho Chi Minh City, Vietnam
Authors: Duong Vu Thuy , The Hao Chung , Nhu Tran Do Hoang , Tuyen Ha Thanh , Campbell James I. , Minh Pham Van , Phuc Hoang Le , Chau Tran Thi Hong , Ngoc Nguyen Minh , Vi Lu Lan , Mather Alison E. , Baker Stephen
Published: September 2020

Nontyphoidal
Salmonella
(NTS) are among the most common etiological agents of diarrheal diseases worldwide and have become the most commonly detected bacterial pathogen in children hospitalized with diarrhea in Vietnam. Aiming to better understand the epidemiology, serovar distribution, antimicrobial resistance (AMR), and clinical manifestation of NTS gastroenteritis in Vietnam, we conducted a clinical genomics investigation of NTS isolated from diarrheal children admitted to one of three tertiary hospitals in Ho Chi Minh City.
Antigenic Restimulation of Virus-Specific Memory CD8+T Cells Requires Days of Lytic Protein Accumulation for Maximal Cytotoxic Capacity
Authors: Migueles Stephen A. , Rogan Daniel C. , Gavil Noah V. , Kelly Elizabeth P. , Toulmin Sushila A. , Wang Lawrence T. , Lack Justin , Ward Addison J. , Pryal Patrick F. , Ludwig Amanda K. , Medina Renata G. , Apple Benjamin J. , Toumanios Christina N. , Poole April L. , Rehm Catherine A. , Jones Sara E. , Liang C. Jason , Connors Mark
Published: September 2020

Antigen-specific CD8+T cells play a major role in controlling most virus infections, primarily by perforin (PRF)- and granzyme B (GrB)-mediated apoptosis. There is considerable controversy regarding whether PRF is constitutively expressed, rapidly increased similarly to a cytokine, or delayed in its expression with more prolonged stimulation in virus-specific memory CD8+T cells. In this study, the degree of cytotoxic capacity of virus-specific memory CD8+T cells was directly proportional to the content of lytic molecules, which required antigenic stimulation over several days for maximal levels. This appeared to be modulated by increases in GrB transcription and microRNA-mediated posttranscriptional regulation of PRF expression. Clarifying the requirements for maximal cytotoxic capacity is critical to understanding how viral clearance might be mediated by memory cells and what functions should be induced by vaccines and immunotherapies.
Supplemental Material: Large-scale asymmetry in thickness of crustal accretion at the Southeast Indian Ridge due to deep mantle anomalies
Authors: Suo Yanhui , Li Sanzhong , Cao Xianzhi
Published: September 2020

Figures S1 and S2, including the previous Euler Poles of Australia relative to Antarctica and the results of the asymmetric anomaly contributed by different factors; Table S1: The parameters of the Euler Poles we used in this study. Dataset (grid format) of our resulted crustal thickness.
Supplemental Material: Early Eocene high-flux magmatism and concurrent high-temperature metamorphism in the Gangdese belt, southern Tibet
Authors: Ma Xuxuan , Tian Zuolin , al. et
Published: September 2020

These materials include mineral and whole-rock geochemical, zircon U-Pb dating, and monazite U-Th/Pb dating data from the Nymo intrusive complex of the Gangdese belt, as well as the compiled whole-rock geochemical data of early Eocene plutonic rocks from the Gangdese belt, southern Tibet.
Outcome of trabeculectomy versus Ahmed glaucoma valve implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome
Authors: Sarker Bipul Kumer De , Malek Mohammad Ibn Abdul , Mannaf Sheikh M A , Iftekhar Quazi Sazzad , Mahatma Mallika , Sarkar Mridul Kumar , Rahman Mostafizur
Published: September 2020

Aims

To compare the surgical outcomes of trabeculectomy versus Ahmed glaucoma valve (AGV) implantation in the surgical management of glaucoma in patients with Sturge–Weber syndrome (SWS).

Methods

A retrospective chart review was performed on 40 eyes of secondary glaucoma in patients with SWS separated into two groups: AGV (N=20) and trabeculectomy with mitomycin C (N=20). Demographic data, intraocular pressure (IOP), visual acuity and the number anti-glaucoma medications (AGM) needed were evaluated prior to and following surgery. Surgical success was defined as an IOP of ≤21 mm Hg, with or without the use of topical AGM. Complete success was achieved when IOP values were obtained without AGM.

Results

Mean follow-up duration was 23.15±2.36 months and 22.95±2.87 months in the AGV and trabeculectomy groups, respectively (p=0.811). Both the AGV (34.50±4.65 mm Hg at baseline to 15.20±3.31 mm Hg at last visit) and trabeculectomy (32.10±5.86 mm Hg to 16.10±3.02 mm Hg) groups achieved a statistically significant fall in IOP following surgery (p=0.000). Kaplan–Meier survival of complete success after 24 months was 80% and 70% after AGV implant and trabeculectomy, respectively, but the difference between two groups was not statistically significant (p=0.442).

Conclusions

Both AGV implant and trabeculectomy appear to be safe and efficacious in controlling glaucoma secondary to SWS, although the potential for serious complications such as choroidal detachment must be anticipated when planning surgeries in patient with SWS, and the authors recommend the maintenance of a stable IOP during and following the surgery to avoid such complications.
Improving concussion education: consensus from the NCAA-Department of Defense Mind Matters Research & Education Grand Challenge
Authors: Kroshus Emily , Cameron Kenneth L , Coatsworth J Douglas , D"Lauro Christopher , Kim Eungjae , Lee Katherine , Register-Mihalik Johna K , Milroy Jeffery J , Roetert E Paul , Schmidt Julianne D , Silverman Ross D , Warmath Dee , Wayment Heidi A , Hainline Brian
Published: September 2020

Early disclosure of possible concussive symptoms has the potential to improve concussion-related clinical outcomes. The objective of the present consensus process was to provide useful and feasible recommendations for collegiate athletic departments and military service academy leaders about how to increase concussion symptom disclosure in their setting. Consensus was obtained using a modified Delphi process. Participants in the consensus process were grant awardees from the National Collegiate Athletic Association and Department of Defense Mind Matters Research & Education Grand Challenge and a multidisciplinary group of stakeholders from collegiate athletics and military service academies. The process included a combination of in-person meetings and anonymous online voting on iteratively modified recommendations for approaches to improve concussion symptom disclosure. Recommendations were rated in terms of their utility and feasibility in collegiate athletic and military service academy settings with a priori thresholds for retaining, discarding and revising statements. A total of 17 recommendations met thresholds for utility and feasibility and are grouped for discussion in five domains: (1) content of concussion education for athletes and military service academy cadets, (2) dissemination and implementation of concussion education for athletes and military service academy cadets, (3) other stakeholder concussion education, (4) team and unit-level processes and (5) organisational processes. Collectively, these recommendations provide a path forward for athletics departments and military service academies in terms of the behavioural health supports and institutional processes that are needed to increase early and honest disclosure of concussion symptoms and ultimately to improve clinical care outcomes.
CyTOF mass cytometry reveals phenotypically distinct human blood neutrophil populations differentially correlated with melanoma stage
Authors: Zhu Yanfang Peipei , Eggert Tobias , Araujo Daniel J , Vijayanand Pandurangan , Ottensmeier Christian Hermann , Hedrick Catherine C
Published: September 2020

Background

Understanding neutrophil heterogeneity and its relationship to disease progression has become a recent focus of cancer research. Indeed, several studies have identified neutrophil subpopulations associated with protumoral or antitumoral functions. However, this work has been hindered by a lack of widely accepted markers with which to define neutrophil subpopulations.

Methods

To identify markers of neutrophil heterogeneity in cancer, we used single-cell cytometry by time-of-flight (CyTOF) coupled with high-dimensional analysis on blood samples from treatment-naïve patients with melanoma.

Results

Our efforts allowed us to identify seven blood neutrophil clusters, including two previously identified individual populations. Interrogation of these neutrophil subpopulations revealed a positive trend between specific clusters and disease stage. Finally, we recapitulated these seven blood neutrophil populations via flow cytometry and found that they exhibited diverse capacities for phagocytosis and reactive oxygen species production in vitro.

Conclusions

Our data provide a refined consensus on neutrophil heterogeneity markers, enabling a prospective functional evaluation in patients with solid tumors.
Development and implementation of a structured leadership programme for junior doctors
Authors: Pervez Anum , Saqib Aaisha , Hare Sarah
Published: September 2020

Introduction

Healthcare performance and quality of care have been shown to improve when clinicians actively participate in leadership roles. However, the training for junior doctors in leadership and management is either not formally provided or requires out of programme training. In this article, we discuss how we devised a leadership training programme for junior doctors at our district general hospital and reflections on how it can be implemented elsewhere.

Methods

A junior doctors leadership programme was developed involving workshops and guidance through delivery of quality improvement projects. A precourse and postcourse questionnaire assessing preparedness to lead was given to trainees to assess the effectiveness of the course.

Results

Using a Likert Scale, trainees provided quantitative self-assessment for precourse and postcourse changes in their leadership skills. There was an overall increase in confidence across key areas such as communication, preparing business cases and understating hierarchies of management teams.

Discussion

The structure of this leadership programme has provided the opportunity to address gaps in leadership skills that trainees encounter, without the need to extend training. This programme is easily reproducible and offers other trusts a guide on how to do so.
Neurointerventions and informed consent
Authors: Holmen Sebastian Jon
Published: September 2020

It is widely believed that informed consent must be obtained from a patient for it to be morally permissible to administer to him/her a medical intervention. The same has been argued for the use of neurointerventions administered to criminal offenders. Arguments in favour of a consent requirement for neurointerventions can take two forms. First, according to absolutist views, neurointerventions shouldneverbe administered without an offender’s informed consent. However, I argue that these views are ultimately unpersuasive. The second, and more plausible, form defences of the consent requirement may take are more moderate in that they accept the use of neurointerventions in some (rare) cases, but not in (most) others. Based on common rationales for consent in medical interventions, I discuss whether four moderate approaches in defence of the informed consent requirement for medical interventions succeed in establishing that informed consent must be obtained from offenders prior to administering neurointerventions to them. I offer novel critical perspectives on approaches that have already received some attention in the literature (ie, bodily integrity and harm), and I critically discuss other approaches to defending informed consent in a medical context that have not yet received due attention (ie, self-ownership and trust). Ultimately, I argue that it is not obvious that any of these considerations support a requirement of offenders’ informed consent to neurointerventions. Lastly, however, I suggest that there is at least one overlooked fact as regards how courts currently employ mandatory neurointerventions, which may support such a requirement.
Maternal request caesareans and COVID-19: the virus does not diminish the importance of choice in childbirth
Authors: Romanis Elizabeth Chloe , Nelson Anna
Published: September 2020

It has recently been reported that some hospitals in the UK have placed a blanket restriction on the provision of maternal request caesarean sections (MRCS) as a result of the COVID-19 pandemic. Pregnancy and birthing services are obviously facing challenges during the current emergency, but we argue that a blanket ban on MRCS is both inappropriate and disproportionate. In this paper, we highlight the importance of MRCS for pregnant people’s health and autonomy in childbirth and argue that this remains crucial during the current emergency. We consider some potential arguments—based on pregnant people’s health and resource allocation—that might be considered justification for the limitation of such services. We demonstrate, however, that these arguments are not as persuasive as they might appear because there is limited evidence to indicate either that provision of MRCS is always dangerous for pregnant people in the circumstances or would be a substantial burden on a hospital’s ability to respond to the pandemic. Furthermore, we argue that even if MRCS was not a service that hospitals are equipped to offer to all pregnant persons who seek it, the current circumstances cannot justify a blanket ban on an important service and due attention must be paid to individual circumstances.
Preoperative cardiac risk factors associated with in-hospital mortality in elderly patients without heart failure undergoing hip fracture surgery: a single-centre study
Authors: Çiçek Vedat , Cinar Tufan , Hayiroglu Mert Ilker , Kılıç Şahhan , Keser Nürgül , Uzun Mehmet , Orhan Ahmet Lütfullah
Published: September 2020

Introduction

In the present study, our aim was to ascertain the preoperative cardiac risk factors related to the in-hospital mortality in the elderly patients (aged over 65 years) who required preoperative cardiology consultation for hip fracture surgery.

Material and Methods

The present study was a retrospective, single-centre study, which enrolled consecutive elderly patients without heart failure scheduled for hip fracture surgery in our institution. In all patients, an anesthesiologist performed a detailed preoperative evaluation and decided the need for the cardiac consultation. Patients underwent preoperative cardiac evaluation by a trained cardiologist using the algorithms proposed in the recent preoperative guidelines. The in-hospital mortality was the main outcome of the study.

Results

In total, 277 elderly patients undergoing hip fracture surgery were enrolled in this analysis. The overall in-hospital mortality rate was 12.1% (n=30 cases). In a multivariate analysis, we found that insulin dependency, cancer, urea, presence of atrial fibrillation (AF) (OR: 3.906; 95% CI 1.470 to 10.381; p=0.006) and pulmonary artery systolic pressure (PASP) (OR: 1.057; 95% CI 1.016 to 1.100; p=0.006) were the predictors of in-hospital mortality. The receiver operating characteristic curve analysis revealed that the optimal value of PASP in predicting the in-hospital mortality was 35 mm Hg (area under the curve=0.71; 95% CI 0.60 to 0.81, p<0.001) with sensitivity of 87.7% and specificity of 59.5%.

Conclusion

The present research found that the preoperative cardiac risk factors, namely AF and PASP, might be associated with increased in-hospital mortality in elderly patients without heart failure undergoing hip fracture surgery.
Association of heated tobacco product use with smoking cessation in Chinese cigarette smokers in Hong Kong: a prospective study
Authors: Luk Tzu Tsun , Weng Xue , Wu Yongda Socrates , Chan Hiu Laam , Lau Ching Yin , Kwong Anthony Cho-shing , Lai Vienna Wai-yin , Lam Tai Hing , Wang Man Ping
Published: September 2020

Introduction

Heated tobacco products (HTPs) are increasingly popular worldwide, but whether they aid or undermine cigarette abstinence remains uncertain. We examined the predictors of HTP initiation and the prospective association of HTP use with cigarette abstinence in community-based smokers in Hong Kong.

Design

Secondary analysis of a randomised clinical trial aimed to evaluate the effectiveness of brief advice and referral for smoking cessation. The interventions were not related to HTP use.

Participants and settings

1213 carbon monoxide-verified daily cigarette smokers with intentions to quit or reduce smoking proactively recruited from community sites throughout Hong Kong

Main exposure

Current (past 7 day) use of HTP at baseline.

Main outcome

Self-reported 7-day point-prevalence cigarette abstinence at 6 months (exclusive use of HTP permitted).

Results

At baseline, 201 (16.6%) and 60 (4.9%) were ever and current HTP users, respectively. During the 6-month follow-up period, 110 of 1012 (10.9%) never users at baseline initiated HTPs. Younger age and higher education significantly predicted initiation. After adjusting for sociodemographic, smoking-related and quitting-related factors, current HTP use at baseline was not associated with cigarette abstinence at 6 months (adjusted prevalence ratio (aPR) 1.08, 95% CI 0.63 to 1.85). The results were similar in persistent users from baseline to 1-month/3-month follow-up (vs non-users; aPR 1.14, 95% CI 0.57 to 2.29). Use of smoking cessation service between baseline and 3-month follow-up significantly predicted cigarette abstinence (aPR 1.70, 95% CI 1.26 to 2.30).

Conclusion

HTP use was not associated with cigarette abstinence at 6 months in a community-based cohort of smokers with intentions to quit or reduce smoking.

Trial registration details

ClinicalTrials.gov, NCT03565796.
Seven days of hot water heat acclimation does not modulate the change in heart rate variability during passive heat exposure
Authors: Gendron Philippe , Gravel Hugo , Barry Hadiatou , Gagnon Daniel
Published: September 2020

We examined if the change in heart rate variability during passive heat exposure is modified by hot water heat acclimation (HA). Sixteen healthy adults (28 ± 5 years, 5 females/11 males) underwent heat exposure in a water-perfused suit, before and after 7 days of HA (60 min at rectal temperature ≥38.6 °C). During passive heat exposure, heart rate, the standard deviation of NN intervals (SDNN), the square root of the mean squared differences of successive NN intervals (RMSSD), and the power in the high-frequency range (HF) were measured. No difference in heart rate (P = 0.22), SDNN (P = 0.87), RMSSD (P = 0.79), and HF (P = 0.23) was observed at baseline. The increase in HR (pre-HA, 43 ± 10; post-HA, 42 ± 9 bpm; P = 0.57) and the decrease of SDNN (pre-HA, −54.1 ± 41.0; post-HA, −52.2 ± 36.8 ms; P = 0.85), RMSSD (pre-HA, −70.8 ± 49.5; post-HA, −72.7 ± 50.4 ms; P = 0.91) and HF (pre-HA, −28.0% ± 14.5; post-HA, −23.2% ± 17.1%; P = 0.27) were not different between experimental visits at fixed increases in esophageal temperature. These results suggest that 7 consecutive days of hot water HA does not modify the change in heart rate variability indices during passive heat exposure.

Novelty: It remains unclear if HA alters the change in heart rate variability that occurs during passive heat exposure. At matched levels of thermal strain, 7 consecutive days of hot water immersion did not modulate the change in indices of heart rate variability during passive heat exposure.
Phosphate efflux as a test of plasma membrane leakage in Saccharomyces cerevisiae cells
Authors: Trilisenko Ludmila , Valiakhmetov Airat , Kulakovskaya Tatiana
Published: September 2020

Plasma membrane integrity is a key to cell viability. Currently, the main approach to assessing plasma membrane integrity is the detection of penetration of special dyes, such as trypan blue and propidium iodide, into the cells. However, this method needs expensive equipment: a fluorescent microscope or a flow cytometer. Besides, staining with propidium iodide occasionally gives false-positive results. Here, we suggest the phosphate (Pi) leakage assay as an approach to assess the increase in permeability of the plasma membrane of yeast cells. We studied the dependence of phosphate efflux and uptake into Saccharomyces cerevisiae cells on the composition of the incubation medium, time, and ambient pH. The difference in optimal conditions for these processes suggests that Pi efflux is not conducted by the Pi uptake system. The Pi efflux in water correlated with the proportion of cells stained with propidium iodide. This indicated that Pi efflux is associated with cytoplasmic membrane disruption in a portion of the yeast cell population. The assay of Pi efflux was used to evaluate membrane disruption in S. cerevisiae cells treated with some heavy metal ions and detergents.
Panax notoginsengfor Cerebral Ischemia: A Systematic Review
Authors: Yang Fei , Ma Qing , Matsabisa Motlalepula G. , Chabalala Hlupheka , Braga Fernão Castro , Tang Minke
Published: September 2020

Panax notoginseng is the most widely used Chinese medicinal herb for the prevention and treatment of ischemic diseases. Its main active ingredients are saponins, including ginsenoside Rb1, ginsenoside Rg1, and notoginsenoside R1, among others. This review provides an up-to-date overview on the pharmacological roles of P. notoginseng constituents in cerebral ischemia. The saponins of P. notoginseng induce a variety of pharmacological effects in the multiscale mechanisms of cerebral ischemic pathophysiology, including anti-inflammatory activity, reduction of oxidative stress, anti-apoptosis, inhibition of amino acid excitotoxicity, reduction of intracellular calcium overload, protection of mitochondria, repairing the blood–brain barrier, and facilitation of cell regeneration. Regarding cell regeneration, P. notoginseng not only promotes the proliferation and differentiation of neural stem cells, but also protects neurons, endothelial cells and astrocytes in cerebral ischemia. In conclusion, P. notoginseng may treat cerebrovascular diseases through multiple pharmacological effects, and the most critical ones need further investigation.
Aeolian Vibration Control of Power Transmission Line Using Stockbridge Type Dampers — A Review
Authors: Wang Zhisong , Li Hong-Nan , Song Gangbing
Published: September 2020

Due to its inherent low damping, a power transmission line is prone to wind induced vibration. Vibration control is needed to suppress the aeolian vibration of the transmission-line to reduce the fatigue and to extend its service life. Though patented in 1928, more than 90 years ago, the Stockbridge damper or its variants are still commonly used for vibration suppression of conductors in modern day power transmission systems because of their advantages of simple structure, low cost, reliable operation and effective vibration suppression. This paper offers a comprehensive review of the development, modeling, analysis, and design of the Stockbridge-type dampers and their applications in Aeolian vibration control of power transmission lines. A Stock bridge-type damper is a dumbbell-shaped device that consists of a short messenger cable with two masses at the ends and a clamp at the middle to attach to a conductor. The friction among the strands in the messenger cable dissipations energy. A Stock bridge-type damper is essentially a tuned mass damper. For the modeling of a Stockbridge damper alone, the classis linear mechanics analysis, the nonlinear analysis, and finite element method (FEM) are reviewed. For the modeling of the combined damper and conductor system, this paper mainly reviews the Energy Balance Principle (EBP) that is relatively easy to use and can obtain the energy dissipated by the damper. Two important design issues, the damper parameter sensitivity analysis and damper location optimization, are discussed in this paper. This paper also briefly reviews the experimentation and fatigue related to a Stockbridge damper. In addition, this paper provides an outlook of future development, analysis, and application of Stockbridge-type dampers for conductor vibration control.
Weighted PI index of tensor product and strong product of graphs
Authors: Gopika C. , Geetha J. , Somasundaram K.
Published: September 2020

The Weighted Padmakar–Ivan (PI) index of a connected, simple graph [Formula: see text] is given by [Formula: see text], where [Formula: see text] denotes the number of equidistant vertices of the edge [Formula: see text]. In this paper, weighted PI index of tensor product and strong product of some graphs are obtained.
SELFISH BUREAUCRATS AND POLICY HETEROGENEITY IN NORDHAUS’ DICE
Authors: TOL RICHARD S. J.
Published: September 2020

Nordhaus’ seminal DICE model assesses first-best climate policy, a useful but unrealistic yardstick. I propose a measure of policy inefficacy if carbon prices are heterogeneous and use observed prices to recalibrate the DICE model. I introduce a Niskanen-inspired model of climate policy with selfish bureaucrats, and calibrate it to carbon dioxide emissions in the European Union and the policy models used by the IPCC. This model also implies a measure of policy inefficacy that I use to recalibrate DICE. The optimal global mean temperature is 1∘C perhaps 2∘C higher in the recalibrated than in the original DICE model.