bluuebunny/crossref_metadata_2025 huggingface dataset:
Risks associated with managing asthma without a preventer: urgent healthcare, poor asthma control and over-the-counter reliever use in a cross-sectional population survey
Authors: Reddel Helen K , Ampon Rosario D , Sawyer Susan M , Peters Matthew J
Published: September 2017

Objectives

Overuse of asthma relievers, particularly without anti-inflammatory preventers, increases asthma risks. This study aimed to identify how many reliever-only users have urgent healthcare, explore their attitudes and beliefs about asthma and its treatment, and investigate whether purchasing over-the-counter relievers was associated with worse asthma outcomes than by prescription.

Design and setting

Cross-sectional population-based Internet survey in Australia.

Participants

Of 2686 participants ≥16 years with current asthma randomly drawn from a web-based panel, 1038 (50.7% male) used only reliever medication.

Main outcome measures

Urgent asthma-related healthcare; Asthma Control Test (ACT); patient attitudes about asthma and medications; reliever purchase (with/without prescription).

Results

Of 1038 reliever-only participants, 23.3% had required urgent healthcare for asthma in the previous year, and only 36.0% had a non-urgent asthma review. Those needing urgent healthcare were more likely than those without such events to be male (56.5% vs 49.0%, p=0.003) and current smokers (29.4% vs 23.3%, p=0.009). Only 30.6% had well-controlled asthma (ACT ≥20) compared with 71.0% of those with no urgent healthcare (p<0.0001), and 20.8% used relievers regularly to prevent asthma symptoms (vs 5.5% of those without urgent healthcare). Those with urgent healthcare were more frustrated by their asthma and less happy with how they managed it, and they were less confident about their ability to manage worsening asthma, but just as likely as those without urgent healthcare to manage worsening asthma themselves rather than visit a doctor. Reliever-only users purchasing over-the-counter relievers were no more likely than those purchasing relievers by prescription to have uncontrolled asthma (35.9% vs 40.6%, p=0.23) but were less likely to have had a non-urgent asthma review.

Conclusions

One-quarter of the reliever-only population had needed urgent asthma healthcare in the previous year, demonstrating the importance of identifying such patients. Their attitudes and beliefs suggest opportunities for targeting this population in the community.
The importance of maternal diet quality during pregnancy on cognitive and behavioural outcomes in children: a systematic review and meta-analysis
Authors: Borge Tiril Cecilie , Aase Heidi , Brantsæter Anne Lise , Biele Guido
Published: September 2017

Objectives

This systematic review and meta-analysis provides a quantitative summary of the literature exploring the relationship between maternal diet quality during pregnancy and child cognitive and affective outcomes. We investigate whether there are indications for robust associations and aim to identify methodological strengths and challenges of the current research to provide suggestions of improvement for future research.

Design and participants

Relevant studies were identified through a systematic literature search in relevant databases. All studies investigating maternal diet quality during pregnancy in relation to child cognitive or affective functioning in children of elementary school age or younger were assessed for inclusion.

Results

18 relevant studies, comprising 63 861 participants were identified. The results indicated a small positive association between better maternal diet quality during pregnancy and child functioning. We observed publication bias and significant heterogeneity between studies, where type of diet classification, publication year and outcome domain together accounted for about 30% of this heterogeneity. Trim and fill analysis substantiated the presence of publication bias for studies in the affective domain and showed an adjusted effect size of Hedge’s g=0.088 (p=0.0018) (unadjusted g=0.093 (p=0.03)). We observed no publication bias in the cognitive domain, where results indicated a slightly larger effect size (g=0.14 (p<0.0001)) compared with that of the affective domain. The overall summary effect size was g=0.075 (p<0.0001) adjusted for publication bias (unadjusted g=0.112 (p=0.0001)). Child diet was not systematically controlled for in the majority of the studies.

Conclusion

The results indicated that a better maternal diet quality during pregnancy has a small positive association with child neurodevelopment, with more reliable results seen for cognitive development. These results warrant further research on the association between maternal diet quality during pregnancy and cognitive and affective aspects of child neurodevelopment, whereby it is crucial that future studies account for child diet in the analysis.
Birth outcomes of immigrant women married to native men in the Republic of Korea: a population register-based study
Authors: Song In Gyu , Kim Min Sun , Shin Seung Han , Kim Ee-Kyung , Kim Han-suk , Choi Seulggie , Kwon Soonman , Park Sang Min
Published: September 2017

Objectives

The Republic of Korea (Korea) has experienced a steady increase in the number of births from immigrant women over the last 20 years. However, little is known about the birth outcomes of immigrant women in Korea. This study compared Korean birth data from immigrant and native women who married native men, and explored the factors that affected birth outcomes among immigrant women.

Design

Observational cross-sectional study.

Setting

Nationwide registry-based study in Korea.

Participants

A total of 70 258 records from immigrant women and 1700 976 records from native women were examined using the National Birth Registration Database, from 2010 to 2013.

Independent variable

Native Korean women and immigrant women who married native men.

Outcomes

Proportion of preterm births, post-term births, low birth weights and macrosomia.

Results

Adjusted ORs (aOR) were calculated for the adverse birth outcomes, and subgroup analyses were performed according to parity and mothers from three Asian countries (China, Vietnam, the Philippines). Multivariate logistic regression analyses were also conducted to evaluate the association of these factors with birth outcomes among immigrant women. Immigrant women had higher OR of post-term births (aOR 1.62; 95% CI 1.44 to 1.83) and low birth weights (aOR 1.17; CI 1.12 to 1.22). Mothers from the Philippines had higher OR of preterm births (aOR 1.26; CI 1.12 to 1.52) and Chinese mothers had higher OR of macrosomia (aOR 1.55; CI 1.44 to 1.66). The OR of post-term births and low birth weights was significantly higher in the first pregnancies of immigrant women.

Conclusions

This study has demonstrated higher proportions of adverse birth outcomes among immigrant women who married Korean men, compared with native women in Korea. Policies reducing the gap in birth outcomes between native and immigrant women are needed.
The association between submarine service and multimorbidity: a cross-sectional study of Korean naval personnel
Authors: Kang Jihun , Song Yun-Mi
Published: September 2017

Objective

We aimed to estimate the prevalence of multimorbidity (≥2 chronic health problems) among Korean submariners and to evaluate the association between submarine service and multimorbidity and disease burden.

Study design and setting

This cross-sectional study included 590 naval personnel who visited a Korean primary care clinic during 2014–2015. Data regarding general characteristics and morbidities were collected from medical records, and disease burden was assessed using the Cumulative Illness Rating Scale (CIRS). Multiple logistic regression analysis was used to evaluate the association between submarine service and multimorbidity and disease burden.

Results

The prevalence of multimorbidity was 11.7% among 180 non-submariners and 32.2% among 410 submariners. The prevalence of multimorbidity and the CIRS scores gradually increased with age. Submarine service was associated with higher risk of multimorbidity and disease burden compared with non-submarine service even after adjusting for age, alcohol consumption, smoking status and naval rank. However, a dose–response relationship was not evident between the duration of submarine service and the risk of multimorbidity as well as high disease burden.

Conclusions

Submarine service was significantly associated with a higher risk of multimorbidity and greater disease burden than non-submarine service. This finding suggests that multidimensional and holistic healthcare approaches are needed for submariners.
Online peer support interventions for chronic conditions: a scoping review protocol
Authors: Munce Sarah Elizabeth Patricia , Shepherd John , Perrier Laure , Allin Sonya , Sweet Shane N , Tomasone Jennifer R , Nelson Michelle L A , Guilcher Sara J T , Hossain Saima , Jaglal Susan
Published: September 2017

Introduction

Peer support is receiving increasing attention as both an effective and cost-effective intervention method to support the self-management of chronic health conditions. Given that an increasing proportion of Canadians have internet access and the increasing implementation of web-based interventions, online peer support interventions are a promising option to address the burden of chronic diseases. Thus, the specific research question of this scoping review is the following:What is known from the existing literature about the key characteristics of online peer support interventions for adults with chronic conditions?

Methods and analysis

We will use the methodological frameworks used by Arksey and O’Malley as well as Levac and colleagues for the current scoping review. To be eligible for inclusion, studies must report on adults (≥18 years of age) with one of the Public Health Agency of Canada chronic conditions or HIV/AIDS. We will limit our review to peer support interventions delivered through online formats. All study designs will be included. Only studies published from 2012 onwards will be included to ensure relevance to the current healthcare context and feasibility. Furthermore, only English language studies will be included. Studies will be identified by searching a variety of databases. Two reviewers will independently screen the titles and abstracts identified by the literature search for inclusion (ie, level 1 screening), the full text articles (ie, level 2 screening) and then perform data abstraction. Abstracted data will include study characteristics, participant population, key characteristics of the intervention and outcomes collected.

Dissemination

This review will identify the key features of online peer support interventions and could assist in the future development of other online peer support programmes so that effective and sustainable programmes can be developed.
COBI (COntinuous hyperosmolar therapy for traumatic Brain-Injured patients) trial protocol: a multicentre randomised open-label trial with blinded adjudication of primary outcome
Authors: Roquilly Antoine , Lasocki Sigismond , Moyer Jean Denis , Huet Olivier , Perrigault Pierre François , Dahyot-fizelier Claire , Seguin Philippe , Sharshar Tarek , Geeraerts Thomas , Remerand Francis , Feuillet Fanny , Asehnoune Karim
Published: September 2017

Introduction

Traumatic brain injury (TBI) is a major cause of death and severe prolonged disability. Intracranial hypertension (ICH) is a critical risk factor of bad outcomes after TBI. Continuous infusion of hyperosmolar therapy has been proposed for the prevention and the treatment of ICH. Whether an early administration of continuous hyperosmolar therapy improves long-term outcomes of patients with TBI is uncertain. The aim of the COBI study (number clinicaltrial.gov 03143751, pre-results stage) is to assess the efficiency and the safety of continuous hyperosmolar therapy in patients with TBI.

Methods and analysis

The COBI (COntinuous hyperosmolar therapy in traumatic Brain-Injured patients) trial is a multicentre, randomised, controlled, open-label, two-arms study with blinded adjudication of primary outcome. Three hundred and seventy patients hospitalised in intensive care unit with a TBI (Glasgow Coma Scale ≤12 and abnormal brain CT scan) are randomised in the first 24 hours following trauma to standard care or continuous hyperosmolar therapy (20% NaCl) plus standard care. Continuous hyperosmolar therapy is maintained for at least 48 hours in the treatment group and continued for as long as is necessary to prevent ICH. The primary outcome is the score on the Extended Glasgow Outcome Scale at 6 months. The treatment effect is estimated with ordinal logistic regression adjusted for prespecified prognostic factors and expressed as a common OR.

Ethics and dissemination

The COBI trial protocol has been approved by the ethics committee of Paris Ile de France VIII and will be carried out according to the principles of the Declaration of Helsinki and the Good Clinical Practice guidelines. The results of this study will be disseminated through presentation at scientific conferences and publication in peer-reviewed journals. The COBI trial is the first randomised controlled trial powered to investigate whether continuous hyperosmolar therapy in patients with TBI improve long-term recovery.

Trial registration number

Trial registration number isNCT03143751.
Improving access to City and Hackney adult mental health services
Authors: Zekria David , Shah Amar , Malik Yunus , Mehta Deeksha , Alom Forid , Ali Amrus , Kennedy-Scott Charles , Horobin Andrew
Published: September 2017

City and Hackney Adult Mental Health Referral and Assessment Service (CHAMHRAS) is the single point of entry for all mental health referrals to secondary services, with the exception of perinatal referrals, in the City and Hackney region of London, UK. CHAMHRAS was established in 2013 with the objective of providing a one-stop point of referral which screens urgent and non-urgent referrals of adults aged 18–65 to mental health services. This single point of entry simplifies the referral process to secondary mental health services—something service users have requested. It also enables rapid feedback on all referrals taken from general practitioners as well as other sources. The centralised nature of CHAMHRAS has also facilitated the monitoring of waiting times from receipt of referral to first face-to-face assessment across services. It was noted that the waiting time for the majority of patients was exceeding the 28-day target set by local commissioners. Indeed, in December 2014, only 30% of patients were being seen within this time frame. The aim of this quality improvement project has been to decrease the average waiting time from referral to first face-to-face assessment, and concomitantly increase the proportion of patients being assessed within the 28-day target period. The team identified potential sources of delay in the process of handling referrals, from receipt and triage, to forwarding to the relevant secondary service, and have tested change ideas such as the implementation of daily meetings to review referrals and the centralisation of appointment bookings to streamline the processes and minimise delays. The average waiting time from referral to first face-to-face assessment decreased by 34% and the proportion of patients being assessed within 28 days increased accordingly, exceeding 95% in the case of referrals from general practitioners (GP). We have listed changes that we intend to introduce with the aim of bringing waiting times down further.
From research to practice: results of 7300 mortality retrospective case record reviews in four acute hospitals in the North-East of England
Authors: Roberts Anthony Paul , Morrow Gerry , Walkley Michael , Flavell Linda , Phillips Terry , Sykes Eliot , Kirkpatrick Graeme , Monkhouse Diane , Laws David , Gray Christopher
Published: September 2017

Introduction

Monitoring hospital mortality using retrospective case record review (RCRR) is being adopted throughout the National Health Service (NHS) in England with publication of estimates of avoidable mortality beginning in 2017. We describe our experience of reviewing the care records of inpatients who died following admission to hospital in four acute hospital NHS Foundation Trusts in the North-East of England.

Methods

RCRR of 7370 patients who died between January 2012 and December 2015. Cases were reviewed by consultant reviewers with support from other disciplines and graded in terms of quality of care and preventability of deaths. Results were compared with the estimates published in the Preventable Incidents, Survival and Mortality (PRISM) studies, which established the original method.

Results

34 patients (0.5%, 95% CI 0.3% to 0.6%) were judged to have a greater than 50% probability of death being preventable. 1680 patients (22.3%, 95% CI 22.4% to 23.3%) were judged to have room for improvement in clinical, organisational (or both) aspects of care or less than satisfactory care.

Conclusions

Reviews using clinicians within trusts produce lower estimates of preventable deaths than published results using external clinicians. More research is needed to understand the reasons for this, but as the requirement for NHS Trusts to publish estimates of preventable mortality is based on reviews by consultants working for those trusts, lower estimates of preventable mortality can be expected. Room for improvement in the quality of care is more common than preventability of death and so mortality reviews contribute to improvement activity although the outcome of care cannot be changed. RCRR conducted internally is a feasible mechanism for delivering quantitative analysis and in the future can provide qualitative insights relating to inhospital deaths.
Performance of variable selection methods for assessing the health effects of correlated exposures in case–control studies
Authors: Lenters Virissa , Vermeulen Roel , Portengen Lützen
Published: September 2017

Objectives

There is growing recognition that simultaneously assessing multiple exposures may reduce false positive discoveries and improve epidemiological effect estimates. We evaluated the performance of statistical methods for identifying exposure–outcome associations across various data structures typical of environmental and occupational epidemiology analyses.

Methods

We simulated a case–control study, generating 100 data sets for each of 270 different simulation scenarios; varying the number of exposure variables, the correlation between exposures, sample size, the number of effective exposures and the magnitude of effect estimates. We compared conventional analytical approaches, that is, univariable (with and without multiplicity adjustment), multivariable and stepwise logistic regression, with variable selection methods: sparse partial least squares discriminant analysis, boosting, and frequentist and Bayesian penalised regression approaches.

Results

The variable selection methods consistently yielded more precise effect estimates and generally improved selection accuracy compared with conventional logistic regression methods, especially for scenarios with higher correlation levels. Penalised lasso and elastic net regression both seemed to perform particularly well, specifically when statistical inference based on a balanced weighting of high sensitivity and a low proportion of false discoveries is sought.

Conclusions

In this extensive simulation study with multicollinear data, we found that most variable selection methods consistently outperformed conventional approaches, and demonstrated how performance is influenced by the structure of the data and underlying model.
High circulating angiopoietin-2 levels exacerbate pulmonary inflammation but not vascular leak or mortality in endotoxin-induced lung injury in mice
Authors: Schlosser Kenny , Taha Mohamad , Deng Yupu , McIntyre Lauralyn A , Mei Shirley H J , Stewart Duncan J
Published: September 2017

Background

Elevated plasma levels of angiopoietin-2 (ANGPT2) have been reported in patients with acute lung injury (ALI); however, it remains unclear whether this increase contributes to, or just marks, the underlying vasculopathic inflammation and leak associated with ALI. Here we investigated the biological consequences of inducing high circulating levels of ANGPT2 in a mouse model of endotoxin-induced ALI.

Methods

Transgenic mice (ANGPT2OVR) with elevated circulating levels of ANGPT2, achieved through conditional hepatocyte-specific overexpression, were examined from 3 to 72 hours following lipopolysaccharide (LPS)-induced ALI. An aptamer-based inhibitor was used to neutralise the effects of circulating ANGPT2 in LPS-exposed ANGPT2OVR mice.

Results

Total cells, neutrophils and macrophages, as well as inflammatory cytokines, were significantly higher in bronchoalveolar lavage (BAL) of ANGPT2OVR versus littermate controltTA mice at 48 hours and 6 hours post-LPS, respectively. In contrast, LPS-induced vascular leak, evidenced by total BAL protein levels and lung wet/dry ratio, was unchanged between ANGPT2OVR and controlstTA, while BAL levels of IgM and albumin were decreased in ANGPT2OVR mice between 24 hours and 48 hours suggesting a partial attenuation of vascular leak. There was no significant difference in LPS-induced mortality between ANGPT2OVR and controlstTA. An ANGPT2-neutralising aptamer partially attenuated alveolar cell infiltration while exacerbating vascular leak in LPS-exposed ANGPT2OVR mice, supported by underlying time-dependent changes in the lung transcriptional profiles of multiple genes linked to neutrophil recruitment/adhesion and endothelial integrity.

Conclusions

Our findings suggest that high circulating ANGPT2 potentiates endotoxin-induced lung inflammation but may also exert other pleiotropic effects to help fine-tune the vascular response to lung injury.
Behavior of soil heave inside stiffened caissons being installed in clay
Authors: Zhao Zhifeng , Zhou Mi , Hu Yuxia , Hossain Muhammad Shazzad
Published: September 2017

The length of suction caisson anchors has been increasing to support increasing dimensions and weight of floating facilities, which necessitates employing horizontal ring stiffeners at intervals along the inner wall of the thin skirt of caissons to ensure structural integrity. The addition of these stiffeners has created significant uncertainties regarding soil flow mechanisms, in particular soil heave inside the caisson, which may reduce the caisson final penetration depth and influence the process of installation due to the need to avoid inside soil suction in the pumping equipment. This paper reports results of large-deformation finite element (LDFE) analyses investigating soil heave inside stiffened caissons during installation in nonhomogeneous clay deposits, with the corresponding evolution of soil flow mechanisms and penetration resistance profiles reported by Zhou et al. in 2016. The LDFE analyses have simulated continuous penetration of stiffened caissons from the seabed surface. A detailed parametric study has been undertaken, exploring the relevant range of soil strength nonhomogeneity and normalized strength, stiffened caisson geometry, soil effective unit weight, and caisson roughness. Of particular interest is the influence of stiffeners on soil heave and potential penetration refusal. The results have been validated against previously published centrifuge test data in terms of soil heave and penetration resistance profile, with good agreement obtained. It is shown that the soil normalized strength at the mudline and its nonhomogeneity, caisson diameter relative to the sum of skirt thickness and stiffener width, and caisson penetration depth have significant influence on the inner soil heave and its profile across the caisson radius. An expression, based on the LDFE results is proposed to predict the maximum inner soil heave during installation of stiffened caissons in the field.
Particle breakage in granular materials — a conceptual framework
Authors: Konrad Jean-Marie , Salami Younes
Published: September 2017

A simple, yet complete framework is introduced with the aim of modelling grain breakage in soils and crushable granular materials. The evolution of grain breakage is measured using a specific parameter of the grain-size distribution. The evolution of this new breakage parameter is related to the applied mechanical work, which allows the predictions to be independent of the stress paths. The correlation function proposed is trilinear, and is capable of describing the initiation, development, and stabilization of breakage. The initial state, coupled with three additional parameters, is used to calibrate this function. The three parameters are related to a grain specific quantity representing the strength of the particles that form the granular medium. The theory of fractal fragmentation is adopted, and the final state is considered to be unique and described by a single parameter: the fractal dimension. When tested against experimental results, this model was able to correctly predict the crushable behavior of a sand.
Repeated expansions and fragmentations linked to Pleistocene climate changes shaped the genetic structure of a woody climber,Actinidia arguta(Actinidiaceae)
Authors: Ye Jun-Wei , Jiang Tao , Wang Hong-Fang , Wang Tian-Ming , Bao Lei , Ge Jian-Ping
Published: September 2017

The genetic structure of temperate plants was extremely affected by climate changes during the Pleistocene. In East Asia, however, there are a limited number of phylogeography studies of widely distributed species. Actinidia arguta (Sieb. & Zucc.) Planch. ex Miq. (Actinidiaceae), a widely distributed woody climber, was chosen for this study. Twelve haplotypes were obtained using five chloroplast fragments. No haplotypes were shared on two sides of the Qinling–Dabie mountain ranges, indicating a phylogeographic break. The break was further revealed by analysis of molecular variance, spatial analysis of molecular variance, and ecological niche modelling. The most recent common ancestor of all haplotypes showed that global cooling and aridity of the Asian interior at the Pliocene–Pleistocene boundary may triggered this divergence. Two monophyletic lineages (north and south lineage) were revealed by Bayesian phylogeny and the maximum parsimony network. In the north lineage, mismatch analysis indicated an ancient spatial expansion. Distant distribution of closely related haplotypes indicated subsequent allopatric fragmentation. The widespread haplotype H2 implied another significant range expansion. In the south lineage, a considerable rise in sea level of the East China Sea may have triggered population fragmentation. The nested clade analysis also indicated that expansion and allopatric fragmentation were the main processes shaping the haplotype distributions. So, repeated range expansions and fragmentations have shaped the present genetic structure of A. arguta.
An analogy study on ESIPT reaction for 3BHC sensor between polar DMF and nonpolar toluene
Authors: Yang Dapeng , Jia Min , Wu Jingyuan , Song Xiaoyan , Zhang Qiaoli
Published: September 2017

A comparison about excited state intramolecular proton transfer (ESIPT) mechanism of a new sensor 3-(1,3-benzothiazol-2-yl)-2-hydroxynaphthalene-1-carbaldehyde (3BHC) in polar solvent dimethylformamide (DMF) and nonpolar solvent toluene have been investigated within the framework of the time-dependent density functional theory (TD-DFT) method. The reproduced previous experimental absorption and emission spectra via our calculations reveals the reasonability of the DFT and TD-DFT theoretical level. The staple bond lengths, bond angles, and corresponding infrared vibrational spectra demonstrate that the intramolecular hydrogen bond of 3BHC should be strengthened in both polar DMF and nonpolar toluene. Two kinds of ESIPT mechanisms for different solvents have been put forward; there is a low potential barrier in the ESIPT process in the DMF solvent, whereas there is almost a nonbarrier for the ESIPT process in the toluene solvent. Hence, we could conclude that the ESIPT process of 3BHC sensor is more likely to occur in the nonpolar solvent upon the photoexcitation, based on which, the excited state behavior of 3BHC could be controlled.
Franklin and Lonsdale: two role models for our time
Authors: Maynard-Casely Helen E.
Published: September 2017

The achievements in science and activism of Prof. Ursula Franklin are related to the similar achievements of Dame Prof. Kathleen Lonsdale. The life works of these two women demonstrate that a scientist need not restrict the impact of their knowledge just to the laboratory. Franklin and Lonsdale are thus cited as role models for us all, as science struggles to continue to inform society.
DIY meteorology: Use of citizen science to monitor snow dynamics in a data-sparse city
Authors: Appels Willemijn M. , Bradford Lori , Chun Kwok P. , Coles Anna E. , Strickert Graham
Published: September 2017

Cities are under pressure to operate their services effectively and project costs of operations across various timeframes. In high-latitude and high-altitude urban centers, snow management is one of the larger unknowns and has both operational and budgetary limitations. Snowfall and snow depth observations within urban environments are important to plan snow clearing and prepare for the effects of spring runoff on cities’ drainage systems. In-house research functions are expensive, but one way to overcome that expense and still produce effective data is through citizen science. In this paper, we examine the potential to use citizen science for snowfall data collection in urban environments. A group of volunteers measured daily snowfall and snow depth at an urban site in Saskatoon (Canada) during two winters. Reliability was assessed with a statistical consistency analysis and a comparison with other data sets collected around Saskatoon. We found that citizen-science-derived data were more reliable and relevant for many urban management stakeholders. Feedback from the participants demonstrated reflexivity about social learning and a renewed sense of community built around generating reliable and useful data. We conclude that citizen science holds great potential to improve data provision for effective and sustainable city planning and greater social learning benefits overall.
Roles of Autophagy in Ischemic Heart Diseases and the Modulatory Effects of Chinese Herbal Medicine
Authors: Wang Dawei , Yu Weiqing , Liu Yuntao , Zhong Guofu , Zhao Zhen , Yan Xia , Liu Qing
Published: September 2017

Autophagy is an evolutionarily conserved degradation process which eliminates dysfunctional proteins and cytoplasmic components to maintain homeostasis for cell survival. Increasing evidence has demonstrated the modulatory role of autophagy in ischemic heart diseases (IHDs). Traditionally, this process has been recognized as having protective functions, such as inhibiting atherosclerosis progression and reducing cell death during the ischemic phase. However, recent studies have suggested its dual roles in myocardial ischemia/reperfusion (MIR) injury. Excessive autophagy may play a deleterious role in cardiac function, due to overwhelming clearance of cellular constituents and proteins. Hence modulation of autophagy to increase cardiomyocyte survival and improve cardiac function is meaningful for the treatment of IHD. Chinese herbal medicine, including extractive compounds and patented drugs, has shown its potential role in treating IHD by addressing autophagy-related mechanisms. This review summarizes the updated knowledge on the molecular basis and modulatory role of autophagy in IHD and the recent progress of Chinese herbal medicine in its treatment.
Magnolol Reduces Renal Ischemia and Reperfusion Injury via Inhibition of Apoptosis
Authors: Tang Chia-Yu , Lai Chang-Chi , Huang Po-Hsun , Yang An-Han , Chiang Shu-Chiung , Huang Po-Chao , Tseng Kuo-Wei , Huang Cheng-Hsiung
Published: September 2017

Magnolol, a constituent of the bark of Magnolia officinalis, has been reported to decrease myocardial stunning and infarct size. In this study, we investigated whether magnolol can reduce renal ischemia and reperfusion (I/R) injury. Renal I/R, induced by a 60-min occlusion of bilateral renal arteries and a 24-h reperfusion, significantly increased blood urea nitrogen (BUN) and creatinine levels, and caused histological damage to the kidneys of rats. Apoptosis, as evaluated by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) staining and caspase-3 activation, was significantly increased in the kidneys. Furthermore, serum levels of tumor necrosis factor-[Formula: see text] (TNF-[Formula: see text]), interleukin-1β (IL-1β), and interleukin-6 (IL-6) were significantly elevated, while the interleukin-10 (IL-10) level was suppressed. However, intravenous pretreatment with magnolol at doses of 0.003[Formula: see text]mg/kg and 0.006[Formula: see text]mg/kg 10[Formula: see text]min before renal I/R significantly limited the increases of BUN, creatinine, the histological damage, and apoptosis in the kidneys. The increases in TNF-[Formula: see text], IL-1β, and IL-6, and the decrease in IL-10 were also significantly inhibited. Additionally, magnolol increased Bcl-2 and decreased Bax in the kidneys. Phosphorylation of the prosurvival kinases, including Akt and extracellular signal-regulated kinases 1 and 2 (ERK1/2), was elevated, while phosphorylation of the pro-apoptotic mitogen-activated protein kinases, including p38 and c-Jun N-terminal kinase (JNK), was suppressed. In conclusion, magnolol reduces renal I/R injury. The underlying mechanisms for this effect might be related to the prevention of apoptosis, possibly via the inhibition of both extrinsic and intrinsic apoptotic pathways, including the reduction of TNF-[Formula: see text] production and the modulation of pro- and anti-apoptotic signaling elements.
Nonlinear Characteristics Analysis of a Rotor-Bearing-Brush Seal System
Authors: Wei Yuan , Chen Zhaobo , Dowell Earl H.
Published: September 2017

The vibration response and nonlinear dynamic behavior of a rotor-bearing-brush seal system were investigated with a new seal force model of the brush seal. The nonlinear oil–film force model was adopted based on a short bearing assumption. The dimensionless equation of motion was solved using the fourth order Runge–Kutta method. The effects of key parameters including rotor speed, installation spacing of the brush seal, disk eccentricity, disk mass, and journal mass on the nonlinear dynamic characteristics of rotor-bearing-brush seal system were determined and compared under different operating conditions with a bifurcation diagram, time history, axis orbit, poincaré map, frequency spectrum, and spectrum cascade. The results showed that the system response contained various nonlinear phenomena, such as periodic motion, multi-periodic motion, and quasi-periodic motion. The interaction of the rotor speed, installation spacing of the brush seal, disk eccentricity, disk mass, and journal mass could seriously affect the stability and working condition of the system. This study provides a theoretical support for the selection of key design parameters and further understanding of the nonlinear characteristics of rotor-bearing-seal systems with a brush seal.
Dynamic Response of a Nonuniform Timoshenko Beam with Elastic Supports, Subjected to a Moving Spring-Mass System
Authors: Tan Guojin , Wang Wensheng , Cheng Yongchun , Wei Haibin , Wei Zhigang , Liu Hanbing
Published: September 2017

This paper is concerned with the dynamic response of a nonuniform Timoshenko beam with elastic supports subjected to a moving spring-mass system. The modal orthogonality of nonuniform Timoshenko beams and the corresponding overall matrix of undetermined coefficients are derived. Then the natural frequencies and mode shapes of nonuniform Timoshenko beams are obtained by the Runge–Kutta method and cubic spline interpolation method. By using the Newmark-[Formula: see text] method and the mode summation method, the vibration equation of Timoshenko beams subjected to a moving spring-mass system was established. A comparison of results between the proposed method and finite element method reveals that this method possesses favorable accuracy for dynamic response analysis. In numerical examples, the effects of the support spring and moving spring-mass system on Timoshenko beams have been examined in detail.
Multi-omic network-based interrogation of rat liver metabolism following gastric bypass surgery featuring SWATH proteomics
Authors: Sridharan Gautham Vivek , D’Alessandro Matthew , Bale Shyam Sundhar , Bhagat Vicky , Gagnon Hugo , Asara John M. , Uygun Korkut , Yarmush Martin L. , Saeidi Nima
Published: September 2017

Morbidly obese patients often elect for Roux-en-Y gastric bypass (RYGB), a form of bariatric surgery that triggers a remarkable 30% reduction in excess body weight and reversal of insulin resistance for those who are type II diabetic. A more complete understanding of the underlying molecular mechanisms that drive the complex metabolic reprogramming post-RYGB could lead to innovative non-invasive therapeutics that mimic the beneficial effects of the surgery, namely weight loss, achievement of glycemic control, or reversal of non-alcoholic steatohepatitis (NASH). To facilitate these discoveries, we hereby demonstrate the first multi-omic interrogation of a rodent RYGB model to reveal tissue-specific pathway modules implicated in the control of body weight regulation and energy homeostasis. In this study, we focus on and evaluate liver metabolism three months following RYGB in rats using both SWATH proteomics, a burgeoning label free approach using high resolution mass spectrometry to quantify protein levels in biological samples, as well as MRM metabolomics. The SWATH analysis enabled the quantification of 1378 proteins in liver tissue extracts, of which we report the significant down-regulation of Thrsp and Acot13 in RYGB as putative targets of lipid metabolism for weight loss. Furthermore, we develop a computational graph-based metabolic network module detection algorithm for the discovery of non-canonical pathways, or sub-networks, enriched with significantly elevated or depleted metabolites and proteins in RYGB-treated rat livers. The analysis revealed a network connection between the depleted protein Baat and the depleted metabolite taurine, corroborating the clinical observation that taurine-conjugated bile acid levels are perturbed post-RYGB.
Prevalence of Anxiety among Hungarian Subjects with Parkinson’s Disease
Authors: Kovács Márton , Makkos Attila , Weintraut Rita , Karádi Kázmér , Janszky József , Kovács Norbert
Published: September 2017

Although anxiety is one of the most frequent symptoms of Parkinson’s disease (PD), only a few clinical tools can efficiently and reliably detect its presence. The aim of the present study was to validate the Hungarian patient-rated version of Parkinson Anxiety Scale (PAS). A total of 190 PD patients were enrolled into the clinimetric validation phase of the study and another 590 participated in the cross-sectional screening phase. The presence of anxiety disorder was diagnosed based on the Diagnostic and Statistical Manual of Mental Disorders criteria. The cutoff value for PAS which best discriminated the presence of anxiety from the absence was 12.5 points (sensitivity of 88.6%, specificity of 79.9). The area under the curve was 0.847 whereas the ROC analysis yielded the statistical significance level (p<0.001). The optimal threshold values for mild (Hoehn and Yahr Stage, HYS 1 and 2), moderate (HYS 3), and severe (HYS 4 and 5) disease stages were 10.5, 12.5, and 13.5 points, respectively. Based on the general threshold anxiety occurred in 35.8% of the patients (persistent anxiety: 29.2%, episodic anxiety: 20.7%, and avoidant anxiety disorder: 16.8%). We demonstrate that the PAS is a valid, highly reliable, and sensitive tool for assessing anxiety.
Molecular Mechanisms and Treatment Strategies in Diabetic Nephropathy: New Avenues for Calcium Dobesilate—Free Radical Scavenger and Growth Factor Inhibition
Authors: Haller Hermann , Ji Linong , Stahl Klaus , Bertram Anna , Menne Jan
Published: September 2017

Diabetic nephropathy is one of the most important microvascular complications of diabetes mellitus and is responsible for 40–50% of all cases of end stage renal disease. The therapeutic strategies in diabetic nephropathy need to be targeted towards the pathophysiology of the disease. The earlier these therapeutic strategies can bring about positive effects on vascular changes and prevent the vasculature in patients with diabetes from deteriorating, the better the renal function can be preserved. Studies evaluating anti-inflammatory and antioxidative strategies in diabetic nephropathy demonstrate the need and value of these novel treatment avenues. CaD is an established vasoactive and angioprotective drug that has shown a unique, multitarget mode of action in several experimental studies and in different animal models of diabetic microvascular complications. On the molecular level, CaD reduces oxidative stress and inhibits growth factors such as fibroblast growth factor and vascular endothelial growth factors. Recent findings have demonstrated a strong rationale for its use in reducing urine albumin excretion rate and markers of inflammation as well as improving endothelial function. Its beneficial effects make it an attractive therapeutic compound especially in the early stages of the disease. These findings, although promising, need further confirmation in prospective clinical trials with CaD.
Systems Study on the Antirheumatic Mechanism of Tibetan Medicated-Bath Therapy Using Wuwei-Ganlu-Yaoyu-Keli
Authors: Wang Tianhong , Yang Jian , Chen Xing , Zhao Kehui , Wang Jing , Zhang Yi , Zhao Jing , Ga Yang
Published: September 2017

In clinical practice at Tibetan area of China, Traditional Tibetan Medicine formula Wuwei-Ganlu-Yaoyu-Keli (WGYK) is commonly added in warm water of bath therapy to treat rheumatoid arthritis (RA). However, its mechanism of action is not well interpreted yet. In this paper, we first verify WGYK’s anti-RA effect by an animal experiment. Then, based on gene expression data from microarray experiments, we apply approaches of network pharmacology to further reveal the mechanism of action for WGYK to treat RA by analyzing protein-protein interactions and pathways. This study may facilitate our understanding of anti-RA effect of WGYK from perspective of network pharmacology.
Optimizing Delivery Characteristics of Curcumin as a Model Drug via Tailoring Mean Diameter Ranges of Cellulose Beads
Authors: Voon Lee Ken , Pang Suh Cem , Chin Suk Fun
Published: September 2017

Spherical cellulose beads with tailored mean diameter between micrometer (20–80 μm) and nanometer (40–200 nm) ranges were fabricated from regenerated cellulose of paper wastes via water-in-oil (W/O) microemulsion and nanoprecipitation processes, respectively. The mean diameter ranges of cellulose beads were precisely controlled via modulating fabrication parameters such as stirring speed, surfactant concentration, cellulose concentration, and reaction temperature. By tailoring their mean diameter ranges and using curcumin as a model drug, cellulose beads with enhanced loading capacities and optimized release kinetic profiles of curcumin were fabricated.
Quadriceps Tendon Rupture in an Adolescent Athlete
Authors: Zuke William A. , Go Beatrice , Weber Alexander E. , Forsythe Brian
Published: September 2017

Quadriceps tendon rupture is an uncommon injury that usually occurs in middle-aged and elderly men with a history of chronic illnesses. We report the case of a 17-year-old healthy adolescent male baseball player who sustained this injury as a result of sudden deceleration in his left knee. He initially reported to the emergency department and then presented to our practice, where he was diagnosed with a quadriceps tendon tear. Preoperatively, he was unable to perform a single straight-leg raise. During surgical repair, the free edge of the quadriceps tendon was mobilized and anchored into the superior pole of the patella, followed by sutures to ensure reinforcement of the quadriceps footprint. His postoperative course progressed normally, demonstrating full range of motion at 3 months and return to team training at 5 months. Unlike previously reported quadriceps tendon ruptures in adolescents, to our knowledge, this is the first report of a patient who sustained such an injury without previous trauma to his knee or quadriceps mechanism. It is possible that weakened tendon integrity from repeated microtrauma during training combined with the sudden weight change distribution may have resulted in the injury. As urgent surgical intervention is necessary to ensure efficient recovery and return to sport, the sports medicine practitioner must remain educated and vigilant on caring for these patients.
Resistin as a Prooxidant Factor and Predictor of Endothelium Damage in Patients with Mild Acute Pancreatitis Exposed to Tobacco Smoke Xenobiotics
Authors: Ściskalska Milena , Marek Grzegorz , Grzebieniak Zygmunt , Milnerowicz Halina
Published: September 2017

Objectives. The study was aimed to assess the influence of tobacco smoke exposure on the intensity of inflammation measured by IL-6, α1-antitripsin (AAT) and α1-acid glycoprotein (AGP) concentrations, and Cd level and oxidative stress intensity measured by advanced oxidation protein product (AOPP) concentration in the blood of healthy subjects and AP patients during hospitalization. Endothelin-1 (ET-1) and resistin concentrations, markers of endothelium injury, were determined. Results. An increased IL-6 concentration in healthy smokers compared to nonsmokers and AP patients compared to controls was shown. An increased AAT and AGP concentrations during hospitalization of AP patients were noted, in both smokers (AAT, AGP) and nonsmokers (AAT). In comparison to control groups, in AP patients, a 2-fold increased resistin concentration correlating with ET-1 concentration and decreased albumin concentration accompanied by increased AOPP concentration were demonstrated. AOPP concentration was higher in smokers with AP compared to nonsmokers and gradually enhanced during their hospitalization. Conclusions. Tobacco smoke exposure can have a proinflammatory effect in both healthy subjects and AP patients. Increased resistin concentration in AP patients negatively correlating with albumin concentration has prooxidative effect on this protein resulting in enhanced AOPP level. Increased resistin concentration can intensify AAT and AGP production during AP.
Novel Variants of a Histogram Shift-Based Reversible Watermarking Technique for Medical Images to Improve Hiding Capacity
Authors: Kelkar Vishakha , Tuckley Kushal , Nemade Hitesh
Published: September 2017

In telemedicine systems, critical medical data is shared on a public communication channel. This increases the risk of unauthorised access to patient’s information. This underlines the importance of secrecy and authentication for the medical data. This paper presents two innovative variations of classical histogram shift methods to increase the hiding capacity. The first technique divides the image into nonoverlapping blocks and embeds the watermark individually using the histogram method. The second method separates the region of interest and embeds the watermark only in the region of noninterest. This approach preserves the medical information intact. This method finds its use in critical medical cases. The high PSNR (above 45 dB) obtained for both techniques indicates imperceptibility of the approaches. Experimental results illustrate superiority of the proposed approaches when compared with other methods based on histogram shifting techniques. These techniques improve embedding capacity by 5–15% depending on the image type, without affecting the quality of the watermarked image. Both techniques also enable lossless reconstruction of the watermark and the host medical image. A higher embedding capacity makes the proposed approaches attractive for medical image watermarking applications without compromising the quality of the image.