bluuebunny/crossref_metadata_2025 huggingface dataset:
Semistructured interviewing in primary care research: a balance of relationship and rigour
Authors: DeJonckheere Melissa , Vaughn Lisa M
Published: January 2020

Semistructured in-depth interviews are commonly used in qualitative research and are the most frequent qualitative data source in health services research. This method typically consists of a dialogue between researcher and participant, guided by a flexible interview protocol and supplemented by follow-up questions, probes and comments. The method allows the researcher to collect open-ended data, to explore participant thoughts, feelings and beliefs about a particular topic and to delve deeply into personal and sometimes sensitive issues. The purpose of this article was to identify and describe the essential skills to designing and conducting semistructured interviews in family medicine and primary care research settings. We reviewed the literature on semistructured interviewing to identify key skills and components for using this method in family medicine and primary care research settings. Overall, semistructured interviewing requires both a relational focus and practice in the skills of facilitation. Skills include: (1) determining the purpose and scope of the study; (2) identifying participants; (3) considering ethical issues; (4) planning logistical aspects; (5) developing the interview guide; (6) establishing trust and rapport; (7) conducting the interview; (8) memoing and reflection; (9) analysing the data; (10) demonstrating the trustworthiness of the research; and (11) presenting findings in a paper or report. Semistructured interviews provide an effective and feasible research method for family physicians to conduct in primary care research settings. Researchers using semistructured interviews for data collection should take on a relational focus and consider the skills of interviewing to ensure quality. Semistructured interviewing can be a powerful tool for family physicians, primary care providers and other health services researchers to use to understand the thoughts, beliefs and experiences of individuals. Despite the utility, semistructured interviews can be intimidating and challenging for researchers not familiar with qualitative approaches. In order to elucidate this method, we provide practical guidance for researchers, including novice researchers and those with few resources, to use semistructured interviewing as a data collection strategy. We provide recommendations for the essential steps to follow in order to best implement semistructured interviews in family medicine and primary care research settings.
Experiences of new family physicians finding jobs with obstetrical care in the USA
Authors: Eden Aimee R , Barreto Tyler , Hansen Elizabeth Rose
Published: January 2020

Objective

This study aimed to explore how new family medicine graduates who want to include obstetrics in their scope of practice identify and select jobs and to understand how employment influences scope of practice in family medicine, particularly the ability to provide maternity care and deliver babies.

Design

Mixed-methods study including a survey and qualitative interviews conducted in 2017.

Setting

We electronically surveyed US family physicians and followed up with a purposeful subsample of these physicians to conduct in-depth, semistructured telephone interviews.

Participants

1016 US family medicine residency graduates 2014–2016 who indicated that they intended to deliver babies in practice completed a survey; 56 of these were interviewed.

Main outcome measures

The survey measured the reasons for not doing obstetrics as a family physician. To identify themes regarding finding family medicine jobs with obstetrics, we used a team-based, immersion–crystallisation approach to analyse the transcribed qualitative interviews.

Results

Survey results (49% response rate) showed that not finding a job that included obstetrics was the primary reason newly graduated family physicians who intended to do obstetrics were not doing so. Qualitative interviews revealed that family physicians often find jobs with obstetrics through connections or recruitment efforts and make job decisions based on personal considerations such as included geographical preferences, family obligations and lifestyle. However, job-seeking and job-taking decisions are constrained by employment-related issues such as job structure, practice characteristics and lack of availability of family medicine jobs with obstetrics.

Conclusions

While personal reasons drove job selection for most physicians, their choices were constrained by multiple factors beyond their control, particularly availability of family medicine jobs allowing obstetrics. The shift from physician as practice owner to physician as employee in the USA has implications for job-seeking behaviours of newly graduating medical residents as well as for access to healthcare services by patients; understanding how employment influences scope of practice in family medicine can provide insight into how to support family physicians to maintain the scope of practice they desire and are trained to provide, thus, ensuring that families have access to care.
Care and social support from family and community in patients with pulmonary tuberculosis in Pakistan
Authors: Saqib Shahab E , Ahmad Mokbul Morshed , Panezai Sanaullah
Published: January 2020

Objectives

This study aimed to validate the Medical Outcome Study–Social Support Survey (MOS-SSS) instrument in Pakistan and to quantify the nature of care and social support currently extended to patients with pulmonary tuberculosis (TB) in Pakistan.

Design

This is a cross-sectional study design conducted within a period of 3 months from 1 November 2016 to 31 January 2017.

Participants

A total of 269 patients, registered at 11 TB centres and private clinics, were interviewed through an interviewer-administered questionnaire.

Main outcome measures

Cronbach’s alpha was used to measure the internal consistency and reliability of the MOS-SSS survey instrument. Univariate and multivariable logistic regressions have been used to explore the association between care and social support, and socioeconomic factors.

Result

This study validated the use of the MOS-SSS among patients with TB in Pakistan. Findings of the study revealed significant differences among the socioeconomic groups of patients in each subscale of social support. Additionally, results of logistic regressions showed that patients who were older (adjusted OR=6.17, 95% CI 1.55 to 24.59, p≤0.01), male (adjusted OR=2.73, 95% CI 1.49 to 4.98, p≤0.01), widow (adjusted OR=0.17, 95% CI 0.04 to 0.80, p≤0.05), and had a larger household size (adjusted OR=5.69, 95% CI 1.32 to 24.65, p≤0.05), higher monthly income (adjusted OR=2.00, 95% CI 1.11 to 3.60, p≤0.05) and house ownership (adjusted OR=1.99, 95% CI 1.10 to 3.60, p≤0.05) were significant factors associated with the extent of care and social support that the participants received.

Conclusion

To cure TB, this study suggests a coordinated approach that includes not only clinical services to address this issue but also a strong social support system based on family and community necessary throughout the treatment process.
Antimicrobial dispensing practices and determinants of antimicrobial resistance: a qualitative study among community pharmacists in Pakistan
Authors: Saleem Zikria , Hassali Mohamed Azmi , Hashmi Furqan Khurshid , Godman Brian , Saleem Fahad
Published: January 2020

Background

There are concerns with the extent of dispensing of antibiotics among community pharmacists in Pakistan often without a prescription adding to antimicrobial resistance (AMR) rates.

Objective

To explore the determinants of AMR and the pattern of antimicrobial dispensing among community pharmacists.

Design

In this qualitative study design, a semistructured interview guide was developed based on an in-depth review of published papers. Audio-recorded interviews with transcripts were analysed by thematic content analysis.

Setting

Interviews were conducted among community pharmacists in Lahore, Pakistan.

Participants

In order to obtain individual points of view, in-depth face-to-face interviews with purposively selected pharmacists were conducted.

Results

A total of 12 pharmacists were interviewed for the study. After analysis, four major themes emerged: (1) knowledge and perception of community pharmacists about antimicrobials, (2) antimicrobial dispensing practices of community pharmacists, (3) determinants of AMR, (4) potential interventions to control AMR. Most of the pharmacists have limited knowledge about AMR, antimicrobial stewardship programmes and related guidelines. However, all the pharmacists strongly agreed that different appropriate actions should be taken in order to rationalise future antimicrobial use.

Conclusion

The results indicated that irrational antimicrobial dispensing and use is common among community pharmacists in Pakistan owing to lack of knowledge. The community pharmacists perceived that behaviour of patients and the societal environment contributed to irrational antimicrobial use and subsequent development of AMR. They suggested a need for a multidisciplinary framework in order to improve future antimicrobial use and reduce AMR in Pakistan.
From potential to practice: how accelerating access to HPV tests and screen and treat programmes can help eliminate cervical cancer
Authors: Cherniak William , Tyler Nikki , Arora Kriti , Lapidos-Salaiz Ilana , Sczudlo Emma , Lin Amy , Barnhart Matthew , Flanigan John , Silkensen Shannon
Published: January 2020

Human papillomavirus (HPV) vaccination campaigns to prevent cervical cancer are being considered and implemented in countries around the world. While vaccination will protect future generations, it will not help the millions of women currently infected, leading to an estimated 311 000 deaths per year globally. This paper examines a selection of strategies that when applied to both existing and new technologies, could accelerate access to HPV testing. Authors from the US Agency for International Development, the National Institutes of Health, and the Bridge to Health Medical and Dental, a non-governmental organisation, joined forces to propose a scalable and country-directed solution for preventing cervical cancer using an end-to-end approach. Collectively, the authors offer seven evidence-based strategies, that when used alone or in combination have the ability to reduce HPV-caused cervical cancer deaths and disability. These strategies include (1) consistent HPV test intervals to decrease HPV DNA test costs; (2) exploring market shaping opportunities; (3) employing iterative user research methodologies like human-centred design; (4) target product profiles for new HPV tests; (5) encouraging innovation around cervical cancer screen and treat programmes; (6) developing national cancer control plans; and (7) integrating cervical cancer screen and treat services into existing infrastructure. By using the strategies outlined here, in combination with HPV vaccination campaigns, national governments will be able to scale and expand cervical cancer screening programmes and provide evidence-based treatment programmes for HPV-infected women.
Improving patient satisfaction through improved telephone triage in a primary care practice
Authors: Vitale Rebecca , Smith Samantha , Doolittle Benjamin R
Published: January 2020

Objective

The objective of this study was to improve the telephone communication experience for patients in a primary care practice.

Design

An exploratory survey was conducted that revealed suboptimal patient satisfaction with clinic access due to the telephone triage system. Several interventions were designed: a monthly quality meeting was established among clinic staff, all phone interactions were recorded in the electronic medical record (EMR) and clinic appointments were made available several months in advance. A follow-up survey was conducted to evaluate these interventions.

Setting

The study was conducted in a multispecialty, urban-based, resident-faculty practice from November 2016 to November 2017.

Participants

Subjects were recruited in a convenience sample from the waiting room. 200 subjects participated in the initial survey and 215 in the second survey.

Results

After the interventions, patients felt that their questions were answered more frequently than before (p<0.01). They also felt that appointments were easier to make (p=0.03). A similar number of patients reported seeking emergency care because they were unable to reach a provider (33.8% vs 31.9%, p=0.68). The percentage of patients who received a call back within 24 hours increased, but it was not statistically significant (38.6% vs 44%, p=0.13).

Conclusion

Improving telephone triage through implementing a monthly quality improvement meeting, optimising use of the EMR and opening schedules several months in advance resulted in several improvements in the patient experience, but did not change use of emergency services. Further interventions, including increased resource allocation, are needed to optimise patient experience.
Comparison of general practice residents’ attitudes and perceptions about training in two programmes in China: a mixed methods survey
Authors: Lian Siqing , Xia Yu , Zhang Jinzhi , Han Xiaoning , Chi Chunhua , Fetters Michael D
Published: January 2020

Objective

To understand general practice (GP) residents’ attitudes about their residency training in China.

Design

Mixed methods survey administered cross-sectionally.

Setting

Two GP training programmes similar in most regards according to current GP training policy of 5 years’ undergraduate degree in medicine and 3 years of postgraduate GP residency training—but differing as the Beijing programme has adopted educational innovations beyond the nationally prescribed standard curriculum used by the second Shenzhen programme.

Participants

105 (85%) of eligible GP trainees, 35 (90%) in the innovative Beijing programme and 70 (83%) in the standard training Shenzhen programme.

Results

Overall, residents felt discrimination because of specialty choice, and that they lacked competency as a general practitioner. Many residents commented faculty had negative teaching attitudes. Beijing residents were more satisfied than Shenzhen residents with their training (p=0.001), and felt teaching faculty had sufficient knowledge (p<0.001), and appropriate attitudes towards teaching (p=0.004). Beijing residents more strongly agreed on five items about good future job prospects (all p<0.05).

Conclusion

These Chinese GP residents identify areas for improvement in their training as well as strengths. Higher satisfaction with faculty teaching and job optimism in Beijing where GP residents receive training from specifically qualified faculty, and can earn special certification, suggest that the educational innovations enhance training and promote positivity about job prospects. These findings imply that GP residents in China face many training challenges that are similar to other international reports, while also implicating benefits of using an innovative curricular approach.
Accuracy of a smartwatch based single-lead electrocardiogram device in detection of atrial fibrillation
Authors: Rajakariar Kevin , Koshy Anoop N , Sajeev Jithin K , Nair Sachin , Roberts Louise , Teh Andrew W
Published: January 2020

Objective

The AliveCor KardiaBand (KB) is an Food and Drug Administration-approved smartwatch-based cardiac rhythm monitor that records a lead-Intelligent ECG (iECG). Despite the appeal of wearable integrated ECG devices, there is a paucity of data evaluating their accuracy in diagnosing atrial fibrillation (AF). We evaluated whether a smartwatch-based device for AF detection is an accurate tool for diagnosing AF when compared with 12-lead ECG.

Methods

A prospective, multi-centre, validation study was conducted in an inpatient hospital setting. The KB paired with a smartwatch, generated an automated diagnosis of AF or sinus rhythm (SR). This was compared with a 12-lead ECG performed immediately after iECG tracing. Where an unclassified or no-analysis tracing was generated, repeat iECG was performed.

Results

439 ECGs (iECGs (n=239) and 12-lead ECG (n=200)) were recorded in 200 patients (AF: n=38; SR: n=162) from three tertiary centres. Sensitivity and specificity using KB was 94.4% and 81.9% respectively, with a positive predictive value of 54.8% and negative predictive value of 98.4%. Agreement between 12-lead ECG and KB diagnosis was moderate when unclassified tracings were included (κ=0.60, 95% CI 0.47 to 0.72). Combining the automated device diagnosis with blinded electrophysiologists (EP) interpretation of unclassified tracings improved overall agreement (EP1: κ=0.76, 95% CI 0.65 to 0.87; EP2: κ=0.74, 95% CI 0.63 to 0.86).

Conclusion

The KB demonstrated moderate diagnostic accuracy when compared with a 12-lead ECG. Combining the automated device diagnosis with EP interpretation of unclassified tracings yielded improved accuracy. However, even with future improvements in automated algorithms, physician involvement will likely remain an essential component when exploring the utility of these devices for arrhythmia screening.

Clinical trial registration

URL:https://www.anzctr.org.au/Unique identifier: ACTRN12616001374459.
Histone deacetylase inhibitors valproic acid and vorinostat enhance trastuzumab-mediated antibody-dependent cell-mediated phagocytosis
Authors: Laengle Johannes , Kabiljo Julijan , Hunter Leah , Homola Jakob , Prodinger Sophie , Egger Gerda , Bergmann Michael
Published: January 2020

Background

The monoclonal antibody (mAb) trastuzumab is part of the standard of care for patients with human epidermal growth factor receptor 2 (HER2)-overexpressing breast cancer. Antibody-dependent cell-mediated phagocytosis (ADCP) and cytotoxicity (ADCC) are major mechanisms of action of the mAb trastuzumab. Histone deacetylase inhibitors (HDACi), such as valproic acid (VPA) or vorinostat (SAHA), exert several immunostimulatory properties, which contribute at least in part to their anticancer effect. However, the impact of HDACi-induced immunostimulatory effects on trastuzumab-mediated anti-tumor immune response is not well characterized.

Methods

We analyzed the ADCP and ADCC activity of peripheral blood mononuclear cells (PBMCs) from age and gender-matched healthy volunteers (n=5) against HDACi-treated HER2-overexpressing breast cancer cells (SKBR3), using a well-established in vitro three-color imaging flow cytometry and flow cytometry approach.

Results

VPA and SAHA enhanced trastuzumab-mediated ADCP and trastuzumab-independent cytotoxicity. Mechanistically, VPA upregulated the activating antibody-binding receptor Fc-gamma receptor (FcγR) IIA (CD32A) on monocytes (CD14+). Moreover, VPA and SAHA downregulated the anti-apoptotic protein myeloid leukemia cell differentiation 1 (MCL1) in breast cancer cells. Additionally, VPA and SAHA induced an immunogenic cell death, characterized by the exposure of calreticulin (CALR), as well as decreased the “do not eat me” signal CD47 on tumor cells.

Conclusions

HDACi VPA and SAHA increase trastuzumab-mediated phagocytosis and trastuzumab-independent cytotoxicity. The immunomodulatory activities of those HDACi support a rationale combined treatment approach with mAb for cancer treatment.
Influence of particle-size distribution homogeneity on shearing of soils subjected to internal erosion
Authors: Li Shijin , Russell Adrian R. , Muir Wood David
Published: January 2020

Internal erosion (suffusion) is caused by water seeping through the matrix of coarse soil and progressively transporting out fine particles. The mechanical strength and stress–strain behavior of soils within water-retaining structures may be affected by internal erosion. Some researchers have set out to conduct triaxial erosion tests to study the mechanical consequences of erosion. Prior to conducting a triaxial test they subject a soil sample, which has an initially homogeneous particle-size distribution and density throughout, to erosion by causing water to enter one end of a sample and wash fine particles out the other. The erosion and movement of particles causes heterogeneous particle-size distributions to develop along the sample length. In this paper, a new soil sample formation procedure is presented that results in homogeneous particle-size distributions along the length of an eroded sample. Triaxial tests are conducted on homogeneous samples formed using the new procedure as well as heterogeneous samples created by the more commonly used approach. Results show that samples with homogeneous post-erosion particle-size distributions exhibit slightly higher peak deviator stresses than those that were heterogeneous. The results highlight the importance of ensuring homogeneity of post-erosion particle-size distributions when assessing the mechanical consequences of erosion. Forming samples using the new procedure enables the sample’s response to triaxial loading to be interpreted against a measure of its initially homogenous state.
Synthesis of 2-(aminophenyl)adenine derivatives: a simple protocol using the classical iron powder/acetic acid reduction methodology
Authors: Rocha A. , Proença M.F. , Carvalho M. Alice
Published: January 2020

2-(Nitrophenyl)adenine derivatives were isolated from the reaction of 5-amino-4-amidino-imidazoles with nitrobenzaldehydes. The conversion of the nitro derivatives to 2-(aminophenyl)adenine derivatives was performed using iron/acetic acid as reducing agent, in 70% aqueous ethanol. The products were isolated in good yield and the isolation protocol involves simple filtration and extraction procedures. This methodology is compatible with the presence of functional groups such as amines, ethers, halofluorides, and halochlorides.
Partition function of the Bose–Einstein condensate dark matter and the modified Gross–Pitaevskii equation
Authors: Nazarenko A. V.
Published: January 2020

Intending to describe the dark matter (DM) of dwarf galaxies, we concentrate on one model of the slowly rotating and gravitating Bose–Einstein condensate (BEC). For a deeper understanding of its properties, we calculate the partition function and compare the characteristics derived from it with the results based on the solution of Gross–Pitaevskii equation (GPE). In our approach, which uses Green’s functions of spatial evolution operators, we formulate in a unified way the boundary conditions, important for applying the Thomas–Fermi approximation. Taking this into account, we revise some of the results obtained earlier. We also derive the spatial particle distribution, similar to the model with rotation, by using the deformation of commutation relations for a macroscopic wave function and modifying the GPE. It is shown that such an approach leads to the entropy inhomogeneity and makes the distribution dependent on temperature.
SURFACE-COVERED 1×3 GRATING WITH DIELECTRIC-METAL SLABS UNDER SECOND BRAGG INCIDENCE
Authors: FU CHEN , WANG BO , ZHU WENHUA , WEN KUNHUA , MENG ZIMING , NIE ZHAOGANG , XING XIANGJUN , CHEN LI , LEI LIANG , ZHOU JINYUN
Published: January 2020

This paper designed a novel three-port reflective surface-covered grating with a connecting layer. The grating can be used as a splitter, and the polarized light can be divided into zero order, first order and second order. Through rigorous coupled-wave analysis, the efficiency of the three orders of diffraction light is close to 33% under the condition that the incident light at 1550 nm is incident at the second Bragg angle and the given duty cycle is 0.5. The efficiency and bandwidth of the surface-covered grating are improved compared with that of the surface-relief grating reported in the past. Especially for transverse magnetic polarized light, the beam splitting effect is more uniform, the efficiency ratio of the zeroth order to first order can reach 1.01, and the efficiency ratio of the first order to second order can reach 1.
The classification of certain ASH C*-algebras of real rank zero
Authors: An Qingnan , Elliott George A. , Li Zhiqiang , Liu Zhichao
Published: January 2020

In this paper, using ordered total K-theory, we give a K-theoretic classification for the real rank zero inductive limits of direct sums of generalized dimension drop interval algebras.
The role of pre-subduction sediment diagenesis in a shallow tsunami-generated slip, Sunda Trench, south of Sumatra
Authors: Kawamura Kiichiro , Kuranaga Mebae , Mochizuki Kenta , Kanamatsu Toshiya
Published: January 2020

The progressive development of microfabrics in sediments was investigated in an active subduction zone using cores recovered during the Integrated Ocean Drilling Program Expedition 362. A sequence of Paleocene–Holocene rock was recorded at Site U1480, which is located in the Sunda Trench, south of Sumatra. Hemipelagic clayey sediments from the drilled succession were recovered from a depth of 1327.23 m. Cardhouse fabrics were observed initially, consisting of clay flakes with edge-to-edge (E–E) or edge-to-face (E–F) contacts. These initial microfabrics developed into compacted bookhouse fabrics (which are random and consolidated), and consist of clay flakes with E–F or face-to-face (F–F) contacts as the domain. These microfabrics developed due to individual particle sliding. Bookhouse fabric developed into a shape-preferred orientation of clay minerals with F–F contacts as a shaly fabric due to domain sliding. Finally, clay flakes with F–F contacts deformed into an undulated shape due to further increased overburden pressure. These pervasive fabrics comprising clay flakes stacked with F–F contacts resisted shear deformation due to their strong cohesion. This strong cohesion in the undulated shaly fabric might be an important factor in the locking of shallow tsunami-generating slip in subduction zones.
Low-protein diet during gestation and lactation increases hepatic lipid accumulation through autophagy and histone deacetylase
Authors: Wang Huan , Xu Guanying Bianca , Hernández-Saavedra Diego , Chen Hong , Pan Yuan-Xiang
Published: January 2020

The present study examined the mechanism of a low-protein (LP) diet on hepatic lipid metabolism during gestation and lactation. Timed-pregnant Sprague-Dawley rats were fed a control or an LP diet during gestation and lactation. LP dams had increased hepatic triglyceride accumulation and a significantly higher aspartate/alanine transaminase ratio, accompanied by a decrease in the circulating very low-density/low-density lipoprotein ratio. Microtubule-associated protein 1 light-chain 3β (LC3B) expression was stimulated in LP dams along with increased histone acetylation. LP diet induced colocalization of the LC3 binding motif interacting proteins apolipoprotein B (APOB) or microsomal triglyceride transfer protein (MTTP) with LC3B, suggesting autophagic degradation. Histone deacetylase 3 (HDAC3) is found necessary to prevent lipid accumulation in response to amino acid deprivation in HepG2 cells. LC3B-mediated APOB protein degradation is related to increases in lipid accumulation. HDAC3 regulated LC3B-induced lipid accumulation potentially through autophagic degradation of APOB and MTTP in response to amino acid limitation caused by a low-protein diet.
The Immunotherapeutic Effect of SIRPα-Silenced DCs against Cervical Cancer
Authors: Li Xiaojie , Zhou Wenying , Liang Yanlan , Xu Changzhi , Xie Zhizhi , Liang Jiayin , Hu Bo
Published: January 2020

Signal regulatory proteinα(SIRPα), a transmembrane protein that is predominantly expressed in dendritic cells (DCs) or macrophages, interacts with CD47 that is overexpressed in almost all types of tumor cells. The interaction between SIRPαand CD47 leads to a negative signal that prevents the phenotypic and functional maturation of DC and inhibits phagocytosis. The SIRPαknockdown in DCs that were pulsed with a modified HPV16E7 (HPV16mE7) protein with enhanced antigenicity and reduced transformation activity results in increased cytokine (TNF-α/IL-12/IL-6) secretion, IFN-γsecretion by T lymphocytes, andin vitro/in vivotumoricidal activity against cervical cancer cells. Taken together, these results suggest that SIRPα-silenced DC vaccination presented potential therapeutic implications against cervical cancer.
Numerical and Experimental Failure Analysis of Carbon Fiber-Reinforced Polymer-Based Pyrotechnic Separation Device
Authors: Ren Mingfa , Weng Fei , Sun Jing , Zhang Zhifeng , Ma Zhiguo , Li Tong
Published: January 2020

Current pyrotechnic separation devices are mainly made of metal materials, limiting the capacity of lightweight design in advanced launching vehicles. With the outstanding mechanical properties, such as high mass-specific strength and modulus, carbon fiber-reinforced polymers (CFRPs) have the potential to replace metal materials in pyrotechnic seperaton devices. However, to improve the seperation reliability of these pyrotechnic separation devices, there still needs further understanding on the the failure mode of CFRP composites under linear shaped charge (LSC). In this paper, cutting tests were carried out on CFRPs for the failure analysis of CFRPs under LSC, and nonlinear finite element analysis (FEA) was performed to characterize the evolution of LSC cutting in CFRPs. According to experimental simulation and numerical simulation, it can be found that the three main failure modes in CERPs while subjected to LSC jet are shear failure, delamination failure, and tensile failure. In the early cutting stage, the initial time of damage of the fiber and the matrix near the shaped charge shows less difference and the laminate is directly separated by the energy of high-speed jet. When the jet velocity decreases, the jet morphology collapses and matrix damages precede into the fiber, which would cause tensile failure mode of CFRPs. Meanwhile, the delamination in low jet speed stages is larger than that in the high jet speed stages. These studies on the failure modes of CFRPs under LSC provide important basis for the future design of CFRP-based pyrotechnic separation devices, which is important to the lightweight design of launching vehicles.
Psychobiotics Regulate the Anxiety Symptoms in Carriers of Allele A of IL-1βGene: A Randomized, Placebo-Controlled Clinical Trial
Authors: Gualtieri P. , Marchetti M. , Cioccoloni G. , De Lorenzo A. , Romano L. , Cammarano A. , Colica C. , Condò R. , Di Renzo L.
Published: January 2020

Background. Probiotic oral intake, via modulation of the microbiota-gut-brain axis, can impact brain activity, mood, and behavior; therefore, it may be beneficial against psychological distress and anxiety disorders. Inflammatory cytokines can influence the onset and progression of several neurodegenerative mood disorders, and the IL-1βrs16944 SNP is related to high cytokine levels and potentially affects mood disorders. The aim of this study was to examine the combined effect of IL-1βpolymorphism and probiotic administration in mood disorder phenotypes in the Italian population.Methods. 150 subjects were randomized into two different groups, probiotic oral suspension group (POSG) and placebo control group (PCG), and received the relative treatment for 12 weeks. Psychological profile assessment by Hamilton Anxiety Rating Scale (HAM-A), Body Uneasiness Test (BUT), and Symptom Checklist 90-Revised (SCL90R) was administered to all volunteers. Genotyping was performed on DNA extracted from salivary samples.Results. After 12 weeks of intervention, a significant reduction of HAM-A total score was detected in the POSG (p<0.01), compared to the PCG. Furthermore, IL-1βcarriers have moderate risk to develop anxiety (OR=5.90), and in POSG IL-1βcarriers, we observed a reduction of HAM-A score (p=0.02).Conclusions. Consumption of probiotics mitigates anxiety symptoms, especially in healthy adults with the minor A allele of rs16944 as a risk factor. Our results encourage the use of probiotics in anxiety disorders and suggest genetic association studies for psychobiotic-personalized therapy.
Soliton Molecules and Some Novel Types of Hybrid Solutions to (2 + 1)-Dimensional Variable-Coefficient Caudrey-Dodd-Gibbon-Kotera-Sawada Equation
Authors: Yang Shuxin , Zhang Zhao , Li Biao
Published: January 2020

Soliton molecules of the (2 + 1)-dimensional variable-coefficient Caudrey-Dodd-Gibbon-Kotera-Sawada equation are derived by N-soliton solutions and a new velocity resonance condition. Moreover, soliton molecules can become asymmetric solitons when the distance between two solitons of the molecule is small enough. Finally, we obtained some novel types of hybrid solutions which are components of soliton molecules, lump waves, and breather waves by applying velocity resonance, module resonance of wave number, and long wave limit method. Some figures are presented to demonstrate clearly dynamics features of these solutions.
Influence of 8-Week Aerobic Training on the Skin Microcirculation in Patients with Ischaemic Heart Disease
Authors: Szyguła Renata , Wierzbicka Monika , Sondel Grażyna
Published: January 2020

Aim of the paper. Microvascular functional impairment in the skin is considered an early predictor of developing cardiovascular diseases and a recognised risk factor of IHD. This is why the aim of the study is investigating if 8-week aerobic training will improve reactivity of skin microcirculation and the function of endothelium in patients with IHD and if the potential improvement will last with lack of physical activity. Materials and Methods. In the study, 48 men took part with a stabilized and pharmacologically controlled ischaemic disease. The participants were randomly divided into two groups with 24 people in each of them. The research group participated in an aerobic march training. The march was taking place 3 times a week for 30–40 minutes over a period of 8 weeks. In the time of training, the subjects did not practise any other physical activity for 8 weeks. The measurement of skin microcirculation was done by using the laser Doppler flowmeter estimating the values of regular flow and the reactions provoked in response to occlusion and temperature. Signal frequency was also analysed which was received by means of laser Doppler flowmetry in the range from 0.01 to 2 Hz during the regular flow. Results. During the first measurement in relation to the initial values, a decrease in body mass was noted by 2.21 kg on average as well as reduction of systolic and diastolic pressure by 10.4 mmHg and 3.68 mmHg, respectively. The regular flow (RF) increased after the training by 2.21%. The provoked reactions were as follows: hyperemic (PRHmax): an increase occurred by 8.76% and hyperthermic (THmax): an increase occurred by 5.38%. The time needed to achieve PRHmax was reduced by 42% and to achieve THmax, by 22%. The heart rhythm and the signal strength of neurogenic rhythm decreased by approximately 8% and 24%, respectively. The signal strength of endothelial rhythm increased by 19%. In the second measurement, a recourse was noted in the values of indicators under investigation, which were assuming values close to the initial ones. In the control group, the measurement values did not change significantly. Conclusions. 8 weeks of systematic aerobic training provides a significant improvement of endothelium functioning, expressed by reactivity improvement in skin microcirculation in patients suffering from ischaemic heart disease. It points to aerobic training as a nonpharmacological effective cardioprotective factor. The improvement effects of skin vascular bed functioning in the group of patients with IHD are impermanent, and they disappear after the period in which patients did not exercise physical activity.
Consumption of Nuts at Midlife and Healthy Aging in Women
Authors: Freitas-Simoes Tania-Marisa , Wagner Maude , Samieri Cecilia , Sala-Vila Aleix , Grodstein Francine
Published: January 2020

Background. Nut consumption may reduce age-related diseases and lead to better health and well-being in aging. Many conditions of aging develop over decades, and thus earlier lifestyle factors may particularly influence later health. Methods. In 1998 and 2002, we administered food frequency questionnaires to assess nut consumption (peanuts, walnuts, and other nuts and peanut butter) in women in the Nurses’ Health Study in their 50 s/early 60 s. In 2012, those who survived beyond 65 years with no chronic diseases, no reported memory impairment, no physical disabilities, and intact mental health were considered “healthy agers.” We used multivariable logistic regression to estimate odds ratios for healthy versus usual aging, controlled for sociodemographic, behavioral, dietary, and other potential confounding factors. Results. Of 33,931 participants at midlife, 16% became “healthy agers.” After age adjustment, we observed a significant association between total nut consumption at midlife and higher odds of healthy aging, with strongest associations observed excluding peanut butter (odds ratio (OR) = 1.46, 95% confidence interval (CI) 1.32–1.62, ≥3 servings/week versus none). Findings were attenuated after further control for covariates, including overall diet quality (OR = 1.14, 95% CI 1.02–1.28, P trend = 0.05). For nut types, we found statistically significantly higher odds of healthy aging across peanuts, walnuts, and other nuts after age adjustment. After full control for confounders, only walnut consumption remained associated with healthy aging (P trend = 0.0001); for example, the OR was 1.20 (95% CI 1.00–1.44) for ≥2 servings/week versus none. Conclusions. Women consuming nuts at midlife have a greater likelihood of overall health and well-being at older ages. Nut consumption may represent a simple intervention to explore and promote healthy aging.
Elevated GTP Cyclohydrolase I Pathway in Endothelial Progenitor Cells of Overweight Premenopausal Women
Authors: Wu Shaohong , He Hao , Liu Ge-Xiu , Li Xiao-Peng , Yao Shun , Su Huan-Xing , Li Xiang , Ren Zi , Zeng Haitao , Liao Jinli
Published: January 2020

Background/Aims. Sexual differences exist in endothelial progenitor cells (EPCs), and various cardiovascular risk factors are associated with the preservation of endothelial function in premenopausal women. However, it is unclear whether differences in endothelial function and circulating EPCs exist between overweight premenopausal women and age-matched men. Methods. We compared EPC counting and functions in normal-weight and overweight premenopausal women and men, evaluated endothelial function in each group, and detected the expression of the guanosine triphosphate cyclohydrolase I (GTPCH I) pathway. Results. The number of EPCs was lower in the male group than in the female group, regardless of normal-weight or overweight status, and there was no significant difference between the different weight groups among females or males. Endothelial function and EPC migration and proliferation were preserved in overweight premenopausal women compared with overweight men as were nitric oxide (NO) levels in plasma and secreted by EPCs. Endothelial function, the circulating EPC population, and NO levels were not different between normal-weight and overweight premenopausal women. Flow-mediated dilatation was significantly correlated with EPC function, plasma NO levels, and EPC-secreted NO. Conclusions. This investigation provides the first evidence for sex-based differences in EPC activity and endothelial function in overweight middle-aged individuals; these differences are associated with alterations in NO production and may partly occur through downregulation of the GTPCH I pathway. The present results provide new insights into the mechanism underlying the preserved endothelial function in overweight premenopausal women and may uncover a potential therapeutic target for endothelial repair in overweight population.
Health-Related Quality of Life among Patients with Hepatitis C Virus Infection: A Cross-Sectional Study in Jianping County of Liaoning Province, China
Authors: Zhang Hairui , Ren Ran , Liu Jinlin , Mao Ying , Pan Guowei , Men Ke , Ma Li
Published: January 2020

Background. Patients with chronic liver disease (CLD) have extrahepatic manifestations and impaired health-related quality of life (HRQOL), and hepatitis C virus (HCV) infection is a leading cause of CLD, cirrhosis, and hepatocellular carcinoma (HCC). This study is aimed at assessing HRQOL in patients with HCV infection in the rural areas and identifying factors associated with impairment of HRQOL. Methods. A cross-sectional study was conducted in a county of Liaoning Province in northeast China. HRQOL of patients with HCV infection was assessed using the chronic liver disease questionnaire (CLDQ) and EuroQol-5 dimensions (EQ-5D). Data were transformed to score comparisons of six major CLDQ domains, EQ index, and visual analog scale (VAS). Results. A total of 397 (93.4%) subjects, including 67 healthy subjects (HSs), 314 patients with chronic hepatitis C (CHC), and 16 patients with liver cirrhosis (LC) completed the study. The overall quartile CLDQ scores for HSs, patients with CHC, and patients with LC were 6.4 (6.0, 6.7), 5.8 (4.6, 6.4), and 4.1 (3.0, 6.0), respectively. The quartile scores of EQ index for the three groups were 1.0 (1.0, 1.0), 1.0 (0.8, 1.0), and 0.9 (0.6, 1.0), respectively. The median scores of EQ VAS for the three groups were 85.0, 60.0, and 60.0, respectively. Female sex, patients with family history of hepatitis, other comorbid chronic diseases, drinking, and disease duration≥10 years were associated with significant improvement in overall CLDQ scores, and family history of hepatitis and other comorbid chronic diseases were considered predictive factors for EQ index and VAS, respectively. Conclusions. Compared with HSs, HCV infection had a greater negative impact on HRQOL in patients with CHC and LC. The significant factors associated with HRQOL include female sex, patients with a family history of hepatitis, other comorbid chronic diseases, drinking, and disease duration≥10 years. Patients with HCV infection in the rural areas should be paid careful attention regarding their HRQOL with proper health education and disease management.
Mobile Health Technologies May Be Acceptable Tools for Providing Social Support to Tuberculosis Patients in Rural Uganda: A Parallel Mixed-Method Study
Authors: Musiimenta Angella , Tumuhimbise Wilson , Atukunda Esther C. , Mugaba Aaron T. , Muzoora Conrad , Armstrong-Hough Mari , Bangsberg David , Davis J. Lucian , Haberer Jessica E.
Published: January 2020

Background. Social support has been shown to mitigate social barriers to medication adherence and improve tuberculosis (TB) treatment success rates. The use of mobile technology to activate social support systems among TB patients, however, has not been well explored. Moreover, studies that tie supportive SMS (Short Message Service) texts to electronic monitoring of TB medication adherence are lacking. Objective. To explore TB patients’ current access to social support and perceptions of utilizing real-time adherence monitoring interventions to support medication adherence. Methods. We purposively selected TB patients who owned phones, had been taking TB medications for ≥1 month, were receiving their treatment from Mbarara Regional Referral Hospital, and reported having ≥1 social supporter. We interviewed these patients and their social supporters about their access to and perceptions of social support. We used STATA 13 to describe participants’ sociodemographic and social support characteristics. Qualitative data were analyzed using content analysis to derive categories describing accessibility and perceptions. Results. TB patients report requesting and receiving a variety of different forms of social support, including instrumental (e.g., money for transport and other needs and medication reminders), emotional (e.g., adherence counselling), and informational (e.g., medication side effects) support through mobile phones. Participants felt that SMS notifications may motivate medication adherence by creating a personal sense of obligation to take medications regularly. Participants anticipated that limited financial resources and relationship dynamics could constrain the provision of social support especially when patients and social supporters are not oriented about their expectations. Conclusion. Mobile telephones could provide alternative approaches to providing social support for TB medication adherence especially where patients do not stay close to their social supporters. Further efforts should focus on optimized designs of mobile phone-based applications for providing social support to TB patients and training of TB patients and social supporters to match their expectations.
Morphology of Mitochondria in Syncytial Annelid Female Germ-Line Cyst Visualized by Serial Block-Face SEM
Authors: Urbisz Anna Z. , Student Sebastian , Śliwińska Małgorzata A. , Małota Karol
Published: January 2020

Mitochondria change their morphology and distribution depending on the metabolism and functional state of a cell. Here, we analyzed the mitochondria and selected structures in female germ-line cysts in a representative of clitellate annelids – the white worm Enchytraeus albidus in which each germ cell has one cytoplasmic bridge that connects it to a common cytoplasmic mass. Using serial block-face scanning electron microscopy (SBEM), we prepared three-dimensional ultrastructural reconstructions of the entire selected compartments of a cyst at the advanced stage of oogenesis, i.e. the nurse cell, cytophore, and cytoplasmic bridges of all 16 cells (15 nurse cells and oocyte). We revealed extensive mitochondrial networks in the nurse cells, cytophore and mitochondria that pass through the cytoplasmic bridges, which indicates that a mitochondrial network can extend throughout the entire cyst. The dynamic hyperfusion state was suggested for such mitochondrial aggregations. We measured the mitochondria distribution and revealed their polarized distribution in the nurse cells and more abundant accumulation within the cytophore compared to the nurse cell. A close association of mitochondrial networks with dispersed nuage material, which seems to be the structural equivalent of a Balbiani body, not described in clitellate annelids so far, was also revealed.
Antigravity, an Answer to Nature’s Phenomena including the Expansion of the Universe
Authors: Gamini Piyadasa C. K.
Published: January 2020

The gravitational attraction force being proportional to the mass has been experimentally shown for several hundred years now, but no gravitational repulsion has been identified within the accepted scientific reasoning. Here, we show that the gravitational repulsion force, similar to the gravitational attraction among particles has also been in existence in nature but, yet to be recognized. The results of experiments are shown in detail and are discussed in the recent series of-publications. It is also shown here that this gravitational repulsion force is proportional to the temperature which is an indicator of thermal energy of the particle, similar to the gravitational attraction that is proportional to the mass of the particle. The situations where heavy particles such as iodine, tungsten, and thorium in vacuum move against gravitational force have already been shown qualitatively. The increase in time-of-fall of water droplets (slowing down of fall) with rise in temperature is also quantitatively discussed. This article discusses two major phenomena observable in nature, clouds and the expansion of universe, which could be more preciously explained by the concept of antigravity.