bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytokine profiles in Tibetan macaques following α‐1,3‐galactosyltransferase‐knockout pig liver xenotransplantation
Authors: Zhang Zhuochao , Li Xiao , Zhang Hong , Zhang Xuan , Chen Hui , Pan Dengke , Ji Hongchen , Zhou Liang , Ling Juan , Zhou Jingshi , Yue Shuqiang , Wang Desheng , Yang Zhaoxu , Tao Kaishan , Dou Kefeng
Published: July 2017

Background

Pig‐to‐nonhuman primate orthotopic liver xenotransplantation is often accompanied by thrombocytopenia and coagulation disorders. Furthermore, the release of cytokines can trigger cascade reactions of coagulation and immune attacks within transplant recipients. To better elucidate the process of inflammation in liver xenograft recipients, we utilized a modified heterotopic auxiliary liver xenotransplantation model for xeno‐immunological research. We studied the cytokine profiles and the relationship between cytokine levels and xenograft function after liver xenotransplantation.

Methods

Appropriate donor and recipient matches were screened using complement‐dependent cytotoxicity assays. Donor liver grafts from α1,3‐galactosyltransferase gene‐knockout (GTKO) pigs or GTKO pigs additionally transgenic for human CD47 (GTKO/CD47) were transplanted into Tibetan macaques via two different heterotrophic auxiliary liver xenotransplantation procedures. The cytokine profiles, hepatic function, and coagulation parameters were monitored during the clinical course of xenotransplantation.

Results

Xenograft blood flow was stable in recipients after heterotopic auxiliary transplantation. A Doppler examination indicated that the blood flow speed was faster in the hepatic artery (HA) and hepatic vein (HV) of xenografts subjected to the modified Sur II (HA‐abdominal aorta+HV‐inferior vena cava) procedure than in those subjected to our previously reported Sur I (HA‐splenic artery+HV‐left renal vein) procedure. Tibetan macaques receiving liver xenografts did not exhibit severe coagulation disorders or immune rejection. Although the recipients did suffer from a rapid loss of platelets, this loss was mild. In blood samples dynamically collected after xenotransplantation (post‐Tx), dramatic increases in the levels of monocyte chemoattractant protein 1, interleukin (IL)‐8, granulocyte‐macrophage colony‐stimulating factor, IL‐6, and interferon gamma‐induced protein 10 were observed at 1 hour post‐Tx, even under immunosuppression. We further confirmed that the elevation in individual cytokine levels was correlated with the onset of graft damage. Finally, the release of cytokines might contribute to leukocyte infiltration in the xenografts.

Conclusion

Here, we established a modified auxiliary liver xenotransplantation model resulting in near‐normal hepatic function. Inflammatory cytokines might contribute to early damage in liver xenografts. Controlling the systemic inflammatory response of recipients might prevent early post‐Tx graft dysfunction.
A novel method for the solution of Blasius equation in semi-infinite domains
Authors: Akgül Ali
Published: July 2017

Many known methods fail in the attempt to get analytic solutions of Blasius-type equations. In this work, we apply the reproducing kernel method for ivestigating Blasius equations with two different boundary conditions in semi-infinite domains. Convergence analysis of the reproducing kernel method is given. The numerical approximations are presented and compared with some other techniques, Howarth's numerical solution and Runge-Kutta Fehlberg method.
Sex differences in angiotensin II‐stimulated fluid intake
Authors: Santollo Jessica
Published: July 2017

New Findings

What is the topic of this review?

This report describes sex differences in the responses to angiotensin II, with a focus on fluid intake.

What advances does it highlight?

There are conflicting reports on the direction of the sex difference in fluid intake in response to angiotensin II. This review highlights how accounting for differences in body weight contributes to the discrepancies in the literature. In certain conditions, body weight influences fluid intake in a sex‐specific manner. This review also highlights the divergent effects of oestrogen receptor activation on fluid intake, which are likely to underlie the discussed sex differences.

Sex has a clear effect on the renin–angiotensin–aldosterone system. Although sex differences in the pressor response to angiotensin II (Ang II) are well established, understanding of the sex differences in the fluid intake response to Ang II is clouded by conflicting reports. Here, I suggest that accounting for differences in body weight contributes to the discrepancies in the literature. Our recent findings demonstrate that body weight influences Ang II‐stimulated water intake in certain conditions in male, but not in female rats. When differences in body weight are corrected for in the appropriate circumstances, we found that males consume more water in response to Ang II compared with females. Males and females also show differences in drinking microstructure, i.e. bottle spout lick patterns, which provide clues into the mechanism(s) underlying this sex difference. Oestrogens, which inhibit Ang II‐stimulated fluid intake and circulate at higher concentrations in females, are likely to contribute to this sex difference. This review also discusses the diversity in oestrogen signalling via multiple oestrogen receptor subtypes, which selectively inhibit Ang II‐stimulated fluid intake.
Direct Adaptive Function Approximation Techniques Based Control of Robot Manipulators
Authors: Zirkohi Majid Moradi
Published: July 2017

In this paper, a simple model-free controller for electrically driven robot manipulators is presented using function approximation techniques (FAT) such as Legendre polynomials (LP) and Fourier series (FS). According to the orthogonal functions theorem, LP and FS can approximate nonlinear functions with an arbitrary small approximation error. From this point of view, they are similar to fuzzy systems and can be used as controller to approximate the ideal control law. In comparison with fuzzy systems and neural networks, LP and FS are simpler and less computational. Moreover, there are very few tuning parameters in LP and FS. Consequently, the proposed controller is less computational in comparison with fuzzy and neural controllers. The case study is an articulated robot manipulator driven by permanent magnet direct current (DC) motors. Simulation results verify the effectiveness of the proposed control approach and its superiority over neuro-fuzzy controllers.
A Frequency-Dependent Filter Design Approach for Norm-Optimal Iterative Learning Control and Its Fundamental Trade-Off Between Robustness, Convergence Speed, and Steady-State Error
Authors: Ge Xinyi , Stein Jeffrey L. , Ersal Tulga
Published: July 2017

This paper focuses on norm-optimal iterative learning control (NO-ILC) for single-input-single-output (SISO) linear time invariant (LTI) systems and presents an infinite time horizon approach for a frequency-dependent design of NO-ILC weighting filters. Because NO-ILC is a model-based learning algorithm, model uncertainty can degrade its performance; hence, ensuring robust monotonic convergence (RMC) against model uncertainty is important. This robustness, however, must be balanced against convergence speed (CS) and steady-state error (SSE). The weighting filter design approaches for NO-ILC in the literature provide limited design freedom to adjust this trade-off. Moreover, even though qualitative guidelines to adjust the trade-off exist, a quantitative characterization of the trade-off is not yet available. To address these two gaps, a frequency-dependent weighting filter design is proposed in this paper and the robustness, convergence speed, and steady-state error are analyzed in the frequency domain. An analytical expression characterizing the fundamental trade-off of NO-ILC with respect to robustness, convergence speed, and steady-state error at each frequency is presented. Compared to the state of the art, a frequency-dependent filter design gives increased freedom to adjust the trade-off between robustness, convergence speed, and steady-state error because it allows the design to meet different performance requirements at different frequencies. Simulation examples are given to confirm the analysis and demonstrate the utility of the developed filter design technique.
Precipitate Microstructure as an Indicator of Stress and Temperature Distributions in a Serviced Gas Turbine Blade
Authors: Guclu Akkoyun Mehmet , Balikci Ercan
Published: July 2017

Superalloys are high temperature materials which are indispensable in many high temperature applications such as the gas turbines. IN738LC is a nickel-based superalloy that is extensively used in the hot sections of the gas turbines. The strengthening in this alloy is provided mainly by the γ′ precipitates. In this research, precipitate size and morphology of a serviced IN738LC polycrystalline turbine blade is investigated. Specimens from the trailing edge, middle, and leading edge positions of the tip, middle, and root sections on their hot (exterior) and cooled (interior) surfaces are analyzed for the precipitate size and morphology. The size and morphology are then linked to the temperature and stress/strain distribution in the blade. In general, the hot surfaces have larger precipitates that indicate a higher temperature exposure. In particular, the precipitate size is larger in the tip and middle sections than the root section, implying that the latter has a lower temperature. As the precipitates transforms to rafts at high temperature and stress/strain, the middle positions of the tip and middle sections, the trailing edge of the tip section, and the leading edge of the middle section are predicted to have high temperature–stress/strain coupling.
Multivariate Time Series Data Mining in Ship Monitoring Database
Authors: Abbasi Hoseini Afshin , Steen Sverre
Published: July 2017

A framework is presented for data mining in multivariate time series collected over hours of ship operation to extract vessel states from the data. The measurements made by a ship monitoring system lead to a collection of time-organized in-service data. Usually, these time series datasets are big, complicated, and highly dimensional. The purpose of time-series data mining is to bridge the gap between a massive database and meaningful information hidden behind the data. An important aspect of the framework proposed is selecting relevant variables, eliminating unnecessary information or noises, and extracting the essential features of the problem so that the vessel behavior can be identified reliably. Principal component analysis (PCA) is employed to address the issues of multicollinearity in the data and dimensionality reduction. The data mining approach itself is established on unsupervised data clustering using self-organizing map (SOM) and k-means, and k-nearest neighbors search (k-NNS) for searching and recovering specific information from the database. As a case study, the results are based on onboard monitoring data of the Norwegian University of Science and Technology (NTNU) research vessel, “Gunnerus.” The scope of this work is limited to detecting ship maneuvers. However, it is extendable to a wide range of smart marine applications. As illustrated in the results, this approach is effective in identifying the prior unknown states of the ship with acceptable accuracy.
Effect of polytypism on the long and short range crystal structure of InAs nanostructures: An EXAFS and Raman spectroscopy study
Authors: Pal Suparna , Rajput Parasmani , Singh Shreyashkar Dev , Sathe Vasant G. , Jha Shambhu Nath
Published: July 2017

The authors present a study on growth mechanism and crystalline structure of zinc blende (ZB)/wurtzite (WZ) polytypic InAs nanostrutures grown on Si-substrate using x-ray diffraction, Raman spectroscopy, and extended x-ray absorption fine structure (EXAFS) spectroscopy. A significant change in the bond length is observed in the short range crystal structure as an effect of the interfacial strain, and the structure exhibits disorder due to twin defect/stacking fault formation at the homointerfaces of ZB/WZ segments in the polytypic crystalline structure, which is related to the ZB:WZ phase ratio. The average ratio of ZB and WZ crystal phase present in the nanostructures is estimated through EXAFS technique. This study opens up an alternate pathway for quantitative estimation of crystal phases over a large area of polytypic samples with distribution in size as well as morphology. Raman spectroscopy study uses E2H and transverse-optical phonon modes to identify the WZ and ZB structural phases of these polytypic nanostructures. It reveals that the interfacial strain shifts the transverse and longitudinal optical phonon frequency significantly and the frequency shifts are proportional to the concentration ratio of ZB and WZ crystal phases. The ZB:WZ ratio derived from EXAFS technique is correlated with Raman spectroscopy results. The long range crystalline structure of the nanostructures is also explored using x-ray diffraction technique, and the observations are corroborating with EXAFS and Raman spectroscopy results. The present study not only elucidate in-depth understanding of the local structure of polytypic InAs but also suggests that careful engineering of interfacial strain through controlled growth can further improve the performance of the polytypic ZB/WZ homointerface based optoelectronic devices.
Substrate preparation effects on defect density in molecular beam epitaxial growth of CdTe on CdTe (100) and (211)B
Authors: Burton George L. , Diercks David R. , Perkins Craig L. , Barnes Teresa M. , Ogedengbe Olanrewaju S. , Jayathilaka Pathiraja A. , Edirisooriya Madhavie , Wang Alice , Myers Thomas H. , Gorman Brian P.
Published: July 2017

Recent studies have demonstrated that growth of CdTe on CdTe (100) and (211)B substrates via molecular beam epitaxy (MBE) results in planar defect densities 2 and 3 orders of magnitude higher than growth on InSb (100) substrates, respectively. To understand this shortcoming, MBE growth on CdTe substrates with a variety of substrate preparation methods is studied by scanning electron microscopy, secondary ion mass spectrometry, x-ray photoelectron spectroscopy, cross sectional transmission electron microscopy, and atom probe tomography (APT). Prior to growth, carbon is shown to remain on substrate surfaces even after atomic hydrogen cleaning. APT revealed that following the growth of films, trace amounts of carbon remained at the substrate/film interface. This residual carbon may lead to structural degradation, which was determined as the main cause of higher defect density.
Diagnosis of a Chiari Malformation After a Concussion in a Junior College Football Player With a History of Chronic Headaches: A Case Report
Authors: Ando Takeaki , Gehr Shannon , McGrath Melanie L. , Rosen Adam B.
Published: July 2017

The purpose of this report is to present the case of a National Junior Collegiate Athletic Association football player diagnosed with Chiari malformation postconcussion. A Chiari malformation is characterized by the cerebellum presenting below the level of the foramen. The uniqueness of this case stems from the patient’s health history, length of symptoms, and diagnosis. The effectiveness of treatment options, and the primary means to reduce the risk of catastrophic head injury in those with Chiari malformations are debatable. Clinicians should be familiar with the potential for the presence of a Chiari malformation with persistent symptoms postconcussion.
Houston, We Still Have a Problem
Authors: Buchheit Martin
Published: July 2017

Apollo 13 was initially looking like it would be the smoothest flight ever. After the explosion of an oxygen tank, however, the astronauts were close to spending the rest of their lives in rotation around the planet. This well-known incident is used to further discuss the link, or lack thereof, between sport-science research and current field practices. There is a feeling that the academic culture and its publishing requirements have created a bit of an Apollo 13–like orbiting world (eg, journals and conferences) that is mostly disconnected from the reality of elite performance. The author discusses how poor research discredits our profession and provides some examples from the field where the research does not apply. In fact, the reality is that sport scientists often do not have the right answers. Some perspectives to improve translation are finally discussed, including a rethink of the overall publishing process: promotion of relevant submission types (eg, short-paper format, short reports, as provided by IJSPP), improvement of the review process (faster turnaround, reviewers identified to increase accountability, and, in turn, review quality), and media types (eg, free downloads, simplified versions published in coaching journals, book chapters, infographics, dissemination via social media). When it comes to guiding practitioners and athletes, instead of using an evidence-based approach, we should rather promote an “evidence-led” or “informed-practice” approach—one that appreciates context over simple scientific conclusions.
Do Irish Adolescents Have Adequate Functional Movement Skill and Confidence?
Authors: O’Brien Wesley , Duncan Michael J. , Farmer Orlagh , Lester Diarmuid
Published: July 2017

Recent research has shown that post-primary Irish youth are insufficiently active and fail to reach a level of proficiency across basic fundamental movement skills. The purpose of the current research was to gather cross-sectional data on adolescent youth, differentiated by gender, specifically to inform the development of a targeted movement-oriented intervention. Data were collected on adolescents (N = 219; mean age : 14.45 ± 0.96 years), within two, mixed-gender schools. Data collection included actual and perceived movement measurements comprised of fundamental movement skills, the functional movement screen, perceived movement confidence, and perceived functional confidence. Overall, levels of actual mastery within fundamental and functional movement were low, with significant gender differences observed. Adolescent males scored higher in the overall fundamental movement skill domain (male mean score = 70.87 ± 7.05; female mean score = 65.53 ± 7.13), yet lower within the functional movement screen (male mean score = 13.58 ± 2.59), in comparison to their female counterparts (female mean score = 14.70 ± 2.16). There were high levels of perceived confidence reported within fundamental and functional movement scales. Future intervention strategies should combat the low levels of actual movement skill proficiency, while identifying the reasons for higher perceived movement confidence within adolescents.
Quadriceps and Patient-Reported Function in ACL-Reconstructed Patients: A Principal Component Analysis
Authors: Norte Grant E. , Hertel Jay N. , Saliba Susan A. , Diduch David R. , Hart Joseph M.
Published: July 2017

Context: Assessment of physical function for individuals after anterior cruciate ligament reconstruction (ACL-R) is complex and warrants the use of diverse evaluation strategies. To maximize the efficiency of assessment, there is a need to identify tests that provide the most meaningful information about this population. Objective: To investigate underlying constructs of quadriceps muscle function that uniquely describe aspects of performance in patients after ACL-R and establish clinical thresholds for measures able to classify patients with and without ACL-R. Design: Cross-sectional. Setting: Research laboratory. Patients (or Other Participants): Seventy-two patients with a primary, unilateral ACL-R (32 males and 40 females, age = 26.0 [9.3] y, time since surgery = 46.5 [58.0] mo) and 30 healthy controls (12 males and 18 females, age = 22.7 [4.6] y). Intervention(s): Quadriceps function was assessed bilaterally during 1 study visit. Main Outcome Measures: Isokinetic strength (peak torque, total work, and average power) at 90° and 180°/s, maximal voluntary isometric contraction torque, fatigue index, central activation ratio, Hoffmann reflex, and active motor threshold. Principal component analyses were performed for the involved limb, contralateral limb, and limb symmetry. Receiver–operator characteristic curve analyses were conducted to determine the diagnostic utility of each variable. Binary logistic regression was used to predict group membership (ACL-R vs healthy). Results: Three components of peripheral, central, and combined (peripheral and central) muscle function were identified, explaining 70.7% to 80.5% of variance among measures of quadriceps function. Total knee-extensor work at 90°/s (≥18.4 J/kg), active motor threshold (≥39.5%), and central activation ratio (≥94.7%) of the involved limb were strong predictors of patient status and correctly classified 83.5% of patients with ACL-R (P < .001). Conclusions: Unique constructs of peripheral, central, and combined muscle function exist in patients with ACL-R. Total knee-extensor work at 90°/s, active motor threshold, and central activation ratio consistently explained a significant portion of variance in measures of quadriceps function, demonstrated acceptable to excellent diagnostic utility, and predicted group membership with 72.8% to 83.5% accuracy.
Effects of Peroneal Muscles Fatigue on Dynamic Stability Following Lateral Hop Landing: Time to Stabilization Versus Dynamic Postural Stability Index
Authors: Malmir Kazem , Olyaei Gholam Reza , Talebian Saeed , Jamshidi Ali Ashraf , Ganguie Majid Ashraf
Published: July 2017

Context: Dynamic stability is a necessary requirement in many sports competitions. Muscle fatigue, which can impair stability, may be occurred in many sports competitions in which lateral movements and landing repeated frequently. Objective: To assess the effects of peroneal muscles fatigue on dynamic stability following lateral hop landing through measuring time to stabilization (TTS) and dynamic postural stability index (DPSI). Design: Quasi-experimental. Setting: Laboratory study. Participants: A total of 20 recreationally active, healthy males with no lower-extremity injury during the previous 6 months participated in this study. Intervention: Participants performed a lateral hop on a force plate before and immediately after a fatigue intervention using a Biodex dynamometer. For inducing fatigue, the participant made a prolonged eversion effort with 40% of the maximal voluntary contraction. Fatigue was met when the eversion torque declined by 50% of the initial value. TTS and DPSI were calculated using sequential averaging method and relevant formulas, respectively. Main Outcome Measures: Premeasures and postmeasures of TTS in the anteroposterior, mediolateral and vertical directions, resultant vector of TTS, stability indices in the anteroposterior, mediolateral and vertical directions, and DPSI. Results: Means of the DPSI or its components did not change significantly due to fatigue (P > .05). Means of the TTS in the anteroposterior and mediolateral directions, and the mean of the resultant vector of the TTS increased significantly after fatigue (P < .05). Conclusions: The question that the dynamic stability is affected or not affected by fatigue depends on which of the TTS or DPSI is used for analysis. The TTS may be a sensitive measure to detect subtle changes in postural stability due to fatigue. But, the DPSI which may be changed after a more strenuous fatigue may be related to actual fatiguing situations.
Re-Assembling Sport for Development and Peace Through Actor Network Theory: Insights from Kingston, Jamaica
Authors: Darnell Simon C. , Giulianotti Richard , David Howe P. , Collison Holly
Published: July 2017

Some recent appraisals of Sport for Development and Peace (SDP) research have found it to be deterministic and ideological, and lacking sophistication and specificity with regards to theory and method. Notably, such criticisms dovetail with the foundations of Actor Network Theory (ANT). Based on fieldwork in Kingston, Jamaica, we draw on ANT to ‘re-assemble’ the understanding of SDP programs by examining their constitutive elements. The results illustrate the connections necessary for SDP to cohere, and the range of actors in the field, including international funders, funds themselves, and concepts regarding sport’s development utility. Investigating these assemblages facilitates a non-deterministic understanding of the ways in which sport is mobilized in the service of development and peace, while allowing for a nuanced and empirically sound assessment of power and agency.
The Duari hernia and recognition of the femoral vein compression sign
Authors: Goh Ian Y , Sandstrom Anna Louise , Stapleton Troy , Aseervatham Ratna , Grieve David A
Published: July 2017

Femoral hernias can be difficult to diagnose and are at high risk of strangulation. This report is of a rare case of an irreducible femoral hernia containing caecum and appendix presenting as an emergency. To the authors’ knowledge, there have only been three cases reported, the first described by Duari. This case was incorrectly diagnosed preoperatively as an inguinal hernia, so the CT diagnosis of femoral hernias is reviewed, in particular demonstrating the radiological use of the femoral vein compression sign.
Thrombotic microangiopathy associated with intravenous injection of extended-release oxycodone
Authors: Robson Kate J , Clucas Danielle , Filshie Robin , Nandurkar Harshal
Published: July 2017

We describe the case of a 35-year-old man presenting with thrombotic microangiopathy (TMA) and renal impairment following, as he later disclosed, intravenous injection of oral formulation tamper-resistant extended-release oxycodone hydrochloride (Oxycontin). Recurrent misuse of this agent was associated with relapsing TMA despite treatment with terminal complement inhibitor eculizumab. Cases of TMA have been reported in the USA in association with intravenous misuse of extended-release oxymorphone (Opana ER) after the introduction of a new non-crushable formulation in 2012. There are two reported accounts of TMA associated with tamper-resistant Oxycontin, which became available in Australia in 2014. This is the first documented case in which eculizumab was used. This case illustrates the practical diagnostic challenges in identifying TMA disorders, and the importance of a detailed drug history. It also highlights the need to clarify what role, if any, eculizumab therapy has in cases of drug-associated TMA.
Developing patient education to enhance recovery after colorectal surgery through action research: a qualitative study
Authors: Poland Fiona , Spalding Nicola , Gregory Sheila , McCulloch Jane , Sargen Kevin , Vicary Penny
Published: July 2017

Objectives

To understand the role of preoperative education for patients undergoing colorectal surgery by involving patients, carers and staff in: (1) identifying its perceived value and deficits for enhanced recovery; (2) modifying current education practices to address educational deficits; and (3) evaluating these changes for preparing patients to enhance their recovery.

Design

Qualitative study of three cycles of action research using mixed methods within a 24-month naturalistic enquiry to identify, implement and evaluate changes through observations, questionnaires, semistructured longitudinal interviews, focus groups and documentation review.

Setting

A UK 1200-bed National Health Service (NHS) hospital providing colorectal surgery in a small city in a rural county.

Participants

Ninety-sevenpatients having colorectal surgery, 19 carers and 22 clinical staff.

Results

Themes identified were: (1) knowledge and engagement; (2) situated understanding and confidence building; and (3) partnership and proactive involvement in enhancing recovery. All patients articulated needs to prepare mentally and physically to plan for colorectal surgery and rehabilitation. Patients and carers wanted to counter uncertainty about medical procedures: likely bodily changes, recovery timescales and future. They therefore sought as much personalised, relevant information as possible about their disease, planned surgery and recovery. Staff implemented preoperative education to more specifically inform and respond multimodally to individual needs.

Conclusions

Patients wanted to be proactively involved in managing their recovery to re-engage with their everyday lives. Preoperative education supported this through developing patients’ situated understanding of hospital and bodily processes related to colorectal surgery. Situated understanding was achieved through educational product to give knowledge and processes promoting engagement. Multimodal, comprehensive and timely preoperative education on the whole patient pathway facilitates active engagement. Situated understanding increased patients’ confidence to work in partnership with healthcare professionals and proactively self-manage recovery.
Consequences of maternal morbidity on health-related functioning: a systematic scoping review
Authors: Machiyama Kazuyo , Hirose Atsumi , Cresswell Jenny A , Barreix Maria , Chou Doris , Kostanjsek Nenad , Say Lale , Filippi Véronique
Published: July 2017

Objectives

To assess the scope of the published literature on the consequences of maternal morbidity on health-related functioning at the global level and identify key substantive findings as well as research and methodological gaps.

Methods

We searched for articles published between 2005 and 2014 using Medline, Embase, Popline, CINAHL Plus and three regional bibliographic databases in January 2015.

Design

Systematic scoping review

Primary outcome

Health-related functioning

Results

After screening 17 706 studies, 136 articles were identified for inclusion. While a substantial number of papers have documented mostly negative effects of morbidity on health-related functioning and well-being, the body of evidence is not spread evenly across conditions, domains or geographical regions. Over 60% of the studies focus on indirect conditions such as depression, diabetes and incontinence. Health-related functioning is often assessed by instruments designed for the general population including the 36-item Short Form or disease-specific tools. The functioning domains most frequently documented are physical and mental; studies that examined physical, mental, social, economic and specifically focused on marital, maternal and sexual functioning are rare. Only 16 studies were conducted in Africa.

Conclusions

Many assessments have not been comprehensive and have paid little attention to important functioning domains for pregnant and postpartum women. The development of a comprehensive instrument specific to maternal health would greatly advance our understanding of burden of ill health associated with maternal morbidity and help set priorities. The lack of attention to consequences on functioning associated with the main direct obstetric complications is of particular concern.

Review registration

CRD42015017774
Quality of life, treatment satisfaction and efficacy of non-biological systemic therapies in patients with plaque psoriasis: study protocol for a prospective observational study
Authors: Fink Christine , Schank Timo E , Trenkler Nina , Uhlmann Lorenz , Schäkel Knut
Published: July 2017

Introduction

Psoriasis vulgaris often leads to a significant impaired quality of life and dissatisfaction with the existing therapeutic approaches. However, patients’ quality of life and treatment satisfaction are of utmost importance, since it is positively related to therapy adherence and encourages patient’s compliance. The study described herein evaluates the quality of life, treatment satisfaction and efficacy during the initial 6 months of treatment with a non-biological systemic agent in a real-life clinical setting.

Methods and analysis

This observational study compares quality of life, treatment satisfaction and the efficacy of non-biological systemic therapy between 60 patients suffering from plaque psoriasis receiving the non-biological systemic therapies with apremilast, methotrexate and fumaric acid esters.

Ethics and dissemination

Ethics approval was provided by the ethics committee of the medical faculty of the University of Heidelberg. Ethics approval number is S-298/2015. The design and the final results of the study will be published and made available to the public.

Trial registration number

German Clinical Trial Register (DRKS): DRKS00008721 (https://www.germanctr.de/).
A comparison of effectiveness between oral rapid testing and routine serum-based testing for HIV in an outpatient dental clinic in Yuxi Prefecture, China: a case–control study
Authors: Li Shifu , Su Shu , Li Shunxiang , Gao Liangmin , Cai Ying , Fu Jincui , Guo Chunyuan , Lu Wei , Cheng Feng , Jing Jun , Chen Liang , Zhang Lei
Published: July 2017

Objective

To compare the outcomes of routine provider-initiated HIV testing and counselling (PITC) and oral rapid HIV testing for dental clinic outpatients in a hospital.

Design

We employed a case–control study design and recruited dental outpatients into routine serum-based and oral rapid testing groups. We compared the acceptance, completion and result notification rate between groups.

Setting

A dental outpatient clinic in the Yuxi People's Hospital, Yunnan.

Participants

A total of 758 and 816 dental outpatients were enrolled for routine and oral rapid testing, respectively.

Results

The percentage of participants willing to receive routine HIV testing was 28.1% (95% CI 24.9% to 31.3%) and 96.1% (95% CI 94.8% to 97.4%,χ2=186.4, p<0.001) for the rapid testing. Among accepted participants, the percentage of participants who received HIV testing was 26.8% (95% CI 20.9% to 32.7%) in the routine testing group and 100.0% in the oral rapid HIV testing group (χ2=77.5, p<0.001). About 93.0% of routine testers returned for the test results on the next day, whereas all rapid testers received their test results on the same day (χ2=34.6, p<0.001). These correspond to an overall completion rate of 7.0% (95% CI 5.2% to 8.8%) and 96.1% (95% CI 94.8% to 97.4%, p<0.001), respectively. Among the 545 patients who declined routine serum-based HIV testing, the main reasons included, an unnecessary hassle (254/545, 46.6%), having been previously tested (124/545, 22.8%) and self-perceived low risk of HIV infection (103/545, 18.9%). In contrast, only 32 individuals declined oral rapid testing, and having received a previous test was the primary reason. Three patients in the rapid testing group were later confirmed HIV-positive, yielding an HIV prevalence of 0.38%.

Conclusion

Oral rapid HIV testing is a feasible and efficient approach in a clinical setting.
198: THE EFFECT OF INSTRUCTING PELVIC FLOOR MUSCLE TRAINING FOR CONTROLLING URINARY INCONTINENCE AND ITS RESULTING STRESS, ANXIETY AND DEPRESSION IN PATIENTS WITH MULTIPLE SCLEROSIS
Authors: Shareinia Habib , Rafii Forough , Sarraf Payam , Seyedalshohahadaee Mahnaz
Published: July 2017

Background and aims:

Urinary disorders are common problems in patients with multiple sclerosis (MS). Urinary incontinence largely affects the physical, social, and emotional characteristics and activities of these patients. The aim of this study was to identify the effect of pelvic floor muscle Training on urinary incontinence and its resulting stress, anxiety and depression in MS patients.

Methods:

The present clinical trial with a pre-post design was conducted on 50 MS patients presenting to the MS clinic of Imam Khomeini Hospital in Tehran (Iran) who had been selected by convenience sampling method. Participants received instructions on pelvic floor muscle exercises and then practiced them for three consecutive months. The International Consultation on Incontinence Questionnaire – Urinary Incontinence Short Form (ICIQ-UI SF) was used to measure participants' urinary incontinence and the 21-item Depression, Anxiety and Stress Scale (DASS-21) then used to measure their depression, anxiety and stress, both before the intervention and at the end of the third month of exercising. The data obtained were analyzed in SPSS16 using descriptive statistics and the dependentttest.

Results:

About 45 (90%) participants practiced pelvic floor muscle exercises up until the end of the third month. The frequency and amount of urine leakage and the effect of urinary incontinence on the quality of life differed significantly in the patients after the instructions compared to before (P<0.001). The mean score of stress (P<0.001), anxiety (P=0.04) and depression (P=0.003) decreased significantly after the intervention.

Conclusion:

According to the findings, instructing pelvic floor muscle exercises is effective in reducing urinary incontinence and its resulting stress, anxiety and depression in MS patients. These exercises are therefore recommended as a non-pharmacological, non-invasive and cost-effective method for controlling urinary incontinence in MS patients.
Promoting Optimal Physical Exercise for Life (PROPEL): aerobic exercise and self-management early after stroke to increase daily physical activity—study protocol for a stepped-wedge randomised trial
Authors: Mansfield Avril , Brooks Dina , Tang Ada , Taylor Denise , Inness Elizabeth L , Kiss Alex , Middleton Laura , Biasin Louis , Fleck Rebecca , French Esmé , LeBlanc Kathryn , Aqui Anthony , Danells Cynthia
Published: July 2017

Introduction

Physical exercise after stroke is essential for improving recovery and general health, and reducing future stroke risk. However, people with stroke are not sufficiently active on return to the community after rehabilitation. We developed the Promoting Optimal Physical Exercise for Life (PROPEL) programme, which combines exercise with self-management strategies within rehabilitation to promote ongoing physical activity in the community after rehabilitation. This study aims to evaluate the effect of PROPEL on long-term participation in exercise after discharge from stroke rehabilitation. We hypothesise that individuals who complete PROPEL will be more likely to meet recommended frequency, duration and intensity of exercise compared with individuals who do not complete the programme up to 6 months post discharge from stroke rehabilitation.

Methods and analysis

Individuals undergoing outpatient stroke rehabilitation at one of six hospitals will be recruited (target n=192 total). A stepped-wedge design will be employed; that is, the PROPEL intervention (group exercise plus self-management) will be ‘rolled out’ to each site at a random time within the study period. Prior to roll-out of the PROPEL intervention, sites will complete the control intervention (group aerobic exercise only). Participation in physical activity for 6 months post discharge will be measured via activity and heart rate monitors, and standardised physical activity questionnaire. Adherence to exercise guidelines will be evaluated by (1) number of ‘active minutes’ per week (from the activity monitor), (2) amount of time per week when heart rate is within a target range (ie, 55%–80% of age-predicted maximum) and (3) amount of time per week completing ‘moderate’ or ‘strenuous’ physical activities (from the questionnaire). We will compare the proportion of active and inactive individuals at 6 months post intervention using mixed-model logistic regression, with fixed effects of time and phase and random effect of cluster (site).

Ethics and dissemination

To date, research ethics approval has been received from five of the six sites, with conditional approval granted by the sixth site. Results will be disseminated directly to study participants at the end of the trial, and to other stake holders via publication in a peer-reviewed journal.

Trial registration number

NCT02951338; Pre-results.
Lipid-lowering drugs and risk of new-onset diabetes: a cohort study using Japanese healthcare data linked to clinical data for health screening
Authors: Ooba Nobuhiro , Setoguchi Soko , Sato Tsugumichi , Kubota Kiyoshi
Published: July 2017

Objective

To investigate whether lipid-lowering drugs are associated with new-onset diabetes after adjusting for baseline clinical risk factors for diabetes.

Design

A retrospective cohort study.

Setting

Japanese employees of large corporations and their dependents using health insurance claims data linked to clinical and laboratory data for annual health screenings.

Participants

All persons aged 20 to 74 years with dyslipidaemia between 1 January 2005 and 31 March 2011. We defined the index date as the first date when the person met the criteria for dyslipidaemia. Persons were excluded if they had lipid-lowering drugs, or had a diagnosis, a treatment or a laboratory test result (haemoglobin A1c ≥6.5% or fasting blood glucose ≥126 mg/dL) indicating diabetes during the 6-month period before the index date.

Main outcome measures

New-onset diabetes.

Results

We identified 68 620 persons with dyslipidaemia. During the mean follow-up period of 1.96 years, 3674 persons started treatment with a lipid-lowering drug: 979 with a low potency statin, 2208 with a high potency statin and 487 with a fibrate. Of 3674 new users of a lipid-lowering drug, 3621 had a period of non-use of any lipid-lowering drugs before starting a lipid-lowering drug. Among statin users, the incidence rate of new-onset diabetes was 124.6 per 1000 person-years compared with 22.6 per 1000 person-years in non-users. After adjusting for confounding factors including clinical data in health screening using Cox proportional hazards models, the HR was 1.91 (95% CI 1.38 to 2.64) for low potency statins and 2.61 (2.11 to 3.23) for high potency statins.

Conclusion

The use of statins was associated with a 1.9-fold to 2.6-fold increase in the risk of new-onset diabetes in a Japanese population of working age, despite adjusting for clinical risk factors for diabetes.
Improving patient safety through better teamwork: how effective are different methods of simulation debriefing? Protocol for a pragmatic, prospective and randomised study
Authors: Freytag Julia , Stroben Fabian , Hautz Wolf E , Eisenmann Dorothea , Kämmer Juliane E
Published: July 2017

Introduction

Medical errors have an incidence of 9% and may lead to worse patient outcome. Teamwork training has the capacity to significantly reduce medical errors and therefore improve patient outcome. One common framework for teamwork training is crisis resource management, adapted from aviation and usually trained in simulation settings. Debriefing after simulation is thought to be crucial to learning teamwork-related concepts and behaviours but it remains unclear how best to debrief these aspects. Furthermore, teamwork-training sessions and studies examining education effects on undergraduates are rare. The study aims to evaluate the effects of two teamwork-focused debriefings on team performance after an extensive medical student teamwork training.

Methods and analyses

A prospective experimental study has been designed to compare a well-established three-phase debriefing method (gather–analyse–summarise; theGAS method) to a newly developed and more structured debriefing approach that extends the GAS method withTeamTAG(teamwork techniques analysis grid). TeamTAG is a cognitive aid listing preselected teamwork principles and descriptions of behavioural anchors that serve as observable patterns of teamwork and is supposed to help structure teamwork-focused debriefing. Both debriefing methods will be tested during an emergency room teamwork-training simulation comprising six emergency medicine cases faced by 35 final-year medical students in teams of five. Teams will be randomised into the two debriefing conditions. Team performance during simulation and the number of principles discussed during debriefing will be evaluated. Learning opportunities, helpfulness and feasibility will be rated by participants and instructors. Analyses will include descriptive, inferential and explorative statistics.

Ethics and dissemination

The study protocol was approved by the institutional office for data protection and the ethics committee of Charité Medical School Berlin and registered under EA2/172/16. All students will participate voluntarily and will sign an informed consent after receiving written and oral information about the study. Results will be published.
P101 Cutting the time to treatment of chlamydia trachomatis (CT) and neisseria gonorrhoeae (NG) with near-patient molecular diagnostics: the utility of the cepheid genexpert system
Authors: Mandlik Emily , Plaha Komal , Jones Rachael , Rayment Michael
Published: July 2017

Introduction

The Cepheid GeneXpert® provides near-patient molecular detection of CT/NG, with results available in 90 minutes. Previous studies have illustrated the benefits to asymptomatic individuals and their partners in reducing time to treatment.

Methods

A case-control study was undertaken to investigate the impact of introducing GeneXpert to a Level 3 symptomatic service. 100 patients diagnosed with CT+/-NG before and after introduction were identified. Time from attendance to treatment was measured. Using self-report over the previous three months and assuming that rate of new sexual partners remained the same and spaced equally in time, we modelled the number of partners spared exposure due to earlier treatment of CT/NG.

Results

Characteristics of the study populations, and of the time to treatment and partners spared analyses are shown in the table:

Abstract P101 Table 1

Time to treatment

Pre-implementation of GeneXpert (n=100)Post-implementation of GeneXpert (n=100)Male (%)4061Age (median [range])28.1 [15–69]30.6 [14–70]MSM/WSW (%)33/037/1Symptomatic (%)5028Time to treatment (days (mean) [SD])9.5 [13.23]3.3 [4.94]Sexual partners in preceding 3 months (mean [SD])2.1 [1.71]4.0 [10.48]Partners exposed in interval between test and treatment/100 index cases19.99.12

The time from testing to treatment was reduced by 6.2 days. The number of partners exposed/100 index patients was 19.9 pre-GeneXpert and 9.12 post-GeneXpert.

Discussion

Use of GeneXpert reduced time to treatment by 66%, and 54% fewer partners were exposed to CT/NG. This study supports the personal and public health benefits of innovative, near-patient molecular diagnostics coupled with effective recall mechanisms.
Using autonomous video to estimate the bottom-contact area of longline trap gear and presence–absence of sensitive benthic habitat
Authors: Doherty Beau , Johnson Samuel D.N. , Cox Sean P.
Published: July 2017

Bottom longline hook and trap fishing gear can potentially damage sensitive benthic areas (SBAs) in the ocean; however, the large-scale risks to these habitats are poorly understood because of the difficulties in mapping SBAs and in measuring the bottom-contact area of longline gear. In this paper, we describe a collaborative academic–industry–government approach to obtaining direct presence–absence data for SBAs and to measuring gear interactions with seafloor habitats via a novel deepwater trap camera and motion-sensing systems on commercial longline traps for sablefish (Anoplopoma fimbria) within SGaan Kinghlas – Bowie Seamount Marine Protected Area. We obtained direct presence–absence observations of cold-water corals (Alcyonacea, Antipatharia, Pennatulacea, Stylasteridae) and sponges (Hexactinellida, Demospongiae) at 92 locations over three commercial fishing trips. Video, accelerometer, and depth sensor data were used to estimate a mean bottom footprint of 53 m2 for a standard sablefish trap, which translates to 3200 m2 (95% CI = 2400–3900 m2) for a 60-trap commercial sablefish longline set. Our successful collaboration demonstrates how research partnerships with commercial fisheries have potential for massive improvements in the quantity and quality of data needed for conducting SBA risk assessments over large spatial and temporal scales.