bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain inflammasomes in stroke and depressive disorders: Regulation by oestrogen
Authors: Slowik A. , Lammerding L. , Hoffmann S. , Beyer C.
Published: May 2017

Neuroinflammation is a devastating pathophysiological process that results in brain damage and neuronal death. Pathogens, cell fragments and cellular dysfunction trigger inflammatory responses. Irrespective of the cause, inflammasomes are key intracellular multiprotein signalling platforms that sense neuropathological conditions. The activation of inflammasomes leads to the auto‐proteolytic cleavage of caspase‐1, resulting in the proteolysis of the pro‐inflammatory cytokines interleukin (IL)1β and IL18 into their bioactive forms. It also initiates pyroptosis, a type of cell death. The two cytokines contribute to the pathogenesis in acute and chronic brain diseases and also play a central role in human aging and psychiatric disorders. Sex steroids, in particular oestrogens, are well‐described neuroprotective agents in the central nervous system. Oestrogens improve the functional outcome after ischaemia and traumatic brain injury, reduce neuronal death in Parkinson′s and Alzheimer′s disease, as well as in amyotrophic lateral sclerosis, attenuate glutamate excitotoxicity and the formation of radical oxygen species, and lessen the spread of oedema after damage. Moreover, oestrogens alleviate menopause‐related depressive symptoms and have a positive influence on depressive disorders probably by influencing growth factor production and serotonergic brain circuits. Recent evidence also suggests that inflammasome signalling affects anxiety‐ and depressive‐like behaviour and that oestrogen ameliorates depression‐like behaviour through the suppression of inflammasomes. In the present review, we highlight the most recent findings demonstrating that oestrogens selectively suppress the activation of the neuroinflammatory cascade in the brain in acute and chronic brain disease models. Furthermore, we aim to describe putative regulatory signalling pathways involved in the control of inflammasomes. Finally, we consider that psychiatric disorders such as depression also contain an inflammatory component that could be modulated by oestrogen.
Three‐Dimensional Shape and Surface Features Distinguish Multiple Sclerosis Lesions from Nonspecific White Matter Disease
Authors: Newton Braeden D. , Wright Katy , Winkler Mandy D. , Bovis Francesca , Takahashi Masaya , Dimitrov Ivan E. , Sormani Maria Pia , Pinho Marco C. , Okuda Darin T.
Published: May 2017

BACKGROUND AND PURPOSE

There remains a need to further refine the ability of clinicians to differentiate multiple sclerosis (MS) from other disease etiologies. Here, we illustrate the value of 3‐dimensional (3D) geometric shape and surface lesion characteristics between disease states.

METHODS

Standardized 3‐Tesla 3D brain magnetic resonance imaging studies were performed on enrolled MS and nonspecific white matter (NSWM) patients. Focal supratentorial lesions were identified, reconstructed using maximum intensity projection, manually segmented, and 3D printed. Printed 3D models were randomly evaluated by three blinded raters for selected shape and surface characteristics. Regression models adjusting for age, disease duration, and individual patient effects were applied to assess lesion characteristics between patient groups. Patient‐level and latent class analyses between groups were performed.

RESULTS

A total of 1,001 supratentorial lesions were analyzed (710 MS; 291 NSWM) from 30 patients (19 with confirmed MS [11 female; median age = 33.6 years, range: 26.9‐54.5], median disease duration = 2.2 years [.4‐19.4]), 11 with verified nonspecific white matter (NSWM) disease without MS (11 female; median age = 55.0 years, range: 27.9‐66.2). Lesions originating from MS in comparison to NSWM patients demonstrated a higher percentage of asymmetry (75.9% vs. 43%; OR: 4.39 [2.37‐8.12]; P < .001), complex surface morphologies (65.9% vs. 27.8%; OR: 2.3 [1.74‐3.05]; P < .001), and were multilobular (11.0% vs. .3%, P < .001), and elongated (12.8% vs. 2.4%, P < .001) in shape. Spatially, these traits were of higher frequency within the juxtacortical, deep white matter, and periventricular regions.

CONCLUSION

Three‐dimensional lesion data may provide new biologic insights related to injury along with offering another approach for determining the origin of lesion types.
Tax competition for foreign direct investments and the nature of the incumbent firm
Authors: Amerighi Oscar , De Feo Giuseppe
Published: May 2017

We investigate tax/subsidy competition for foreign direct investments (FDI) between countries of different size when a domestic firm is the incumbent in the largest market and we study how the nature (public or private) of the incumbent firm affects policy competition. We show that, differently from the case of a private firm, the country hosting the incumbent always benefits from FDI if the domestic firm is a public welfare‐maximizing firm. We also show that the public firm acts as a disciplinary device for the foreign multinational that will always choose the efficient welfare‐maximizing location. An efficiency‐enhancing role of policy competition may then arise only when the domestic incumbent is a private firm, whereas tax competition is always wasteful in the presence of a public firm.
Diet and bite force in red foxes: ontogenetic and sex differences in an invasive carnivore
Authors: Forbes‐Harper J. L. , Crawford H. M. , Dundas S. J. , Warburton N. M. , Adams P. J. , Bateman P. W. , Calver M. C. , Fleming P. A.
Published: May 2017

Bite force is often used as a predictive indicator of an animal's feeding ecology, although the premise that there is a direct link between diet and cranial morphology can be difficult to test empirically. Studies that have examined this question tend to rely on generalizations of a species’ diet, and age and sex differences are rarely considered. Red foxes (Vulpes vulpes) are introduced predators in Australia, allowing large sample size collection through culling for comparison of skull morphology (size, morphometry, weight), demographics (age, sex) and diet (stomach contents). Over half (57%) of the 540 animals we sampled were juveniles (<1 year old; dispersing from their natal sites) and most variation in skull morphometry was driven by age; adults had significantly more robust skulls than juveniles, with greater estimated bite force. Sexual dimorphism (body mass and body length) was reflected in longer, heavier skulls of males. We also recorded significant sex and age differences in diet. Sheep carrion comprised 47–65% of diet volume; however, adult females ate less sheep but had more mice and invertebrates in their diet than males or juveniles of both sexes. This dietary separation for adult females does not appear to be directly due to estimated bite force constraints, but probably rather prey availability, which may reflect feeding behaviour and space use patterns. Juveniles (both sexes) showed as much consumption of sheep carrion as adult males, despite their lower estimated bite force than adults. This is the first study that directly compares ontogenetic and sex differences in the diet of a carnivore together with their cranial morphology and estimated bite force, and highlights limitations of inferring diet partitioning from skull morphology alone.
Non‐alcoholic fatty liver and advanced fibrosis in the elderly: Results from a community‐based Polish survey
Authors: Hartleb Marek , Barański Kamil , Zejda Jan , Chudek Jerzy , Więcek Andrzej
Published: May 2017

Background & Aims

Development of non‐alcoholic fatty liver (NAFL) is dependent on metabolic factors occurring at an increased frequency with advancing age. Until now, few studies have explored the prevalence of NAFL in aged populations. Our study aimed to determine the prevalence of NAFL and advanced fibrosis in the elderly population participating in a national survey of a community‐based elderly cohort.

Methods

A total of 3003 participants (mean age 79.6 years, 46.8% male) were enrolled in the study, after applying the following exclusion criteria: individuals younger than 65 years old (n=829) and those with positive serological biomarkers of HBV or HCV infection (n=391), chronic alcohol ingestion (n=727) or incomplete data records (n=745). Based on the fatty liver index (FLI), the participants were classified into three categories: FLI<30 (no NAFL), 30≤FLI<60 (borderline) and FLI≥60 (NAFL). According to the non‐alcoholic fatty liver disease (NAFLD) fibrosis score (NFS), the participants were divided into three advanced fibrosis risk categories: NFS<−1.455 (low risk), −1.455≤NFS≤0.676 (intermediate risk) and NFS>0.676 (high risk).

Results

The prevalence of NAFL in the general population was 37.2%; the prevalence reached 51.4% in participants 65‐70 years of age and decreased with advancing age (P<.0001). The prevalence of advanced fibrosis was 7.79% (14.8% in the NAFL population) and increased with advancing age (P<.005).

Conclusions

The prevalence of NAFL and metabolically driven advanced fibrosis are relatively common in the elderly population, and these hepatic conditions run in adverse directions with advancing age.
The impact of endotoxin on jejunal tissue oxygenation
Authors: Pajk Werner , Stadlbauer Karl‐Heinz , Kleinsasser Axel , Kotzinger Oskar , Ulmer Hanno , Hasibeder Walter , Knotzer Hans
Published: May 2017

Objective

We examined the effects of systemic ETX on jejunal mucoal microcirculatory parameters in anesthetized pigs.

Methods

Jejunal mucosal tissue PO2 was measured employing Clark‐type surface oxygen electrodes. Oxygen saturation of jejunal microvascular hemoglobin was determined by tissue reflectance spectrophotometry. Jejunal microcirculatory blood flow was assessed by laser Doppler flowmetry. Microvascular conductance and rhythmical oscillation of the tissue PO2 were calculated. Systemic hemodynamic variables, mesenteric venous and systemic acid base and blood gas variables, and lactate measurements were recorded. Measurements were taken at BL and after Escherichia coli LPS administration in 20 minutes intervals for 110 minutes.

Results

ETX infusion led to a significant (P<.05) decrease of PO2muc (from 24±4 to 8±4 mm Hg) and microvascular HbO2 (from 41±13 to 24±12%). Microcirculatory conductivity increased in ETX animals, microvascular blood flow remained unchanged (PU; from 228±45 to 232±58). ETX induced an increase in oscillation frequency of mucosal tissue oxygenation.

Conclusions

Endotoxinemia resulted in a significant depression of mucosal tissue oxygenation despite a constant microcirculatory blood flow. This impairment of tissue oxygenation resulted in an increase in the vasomotion pattern in a futile attempt to counteract the undersupply of oxygen to the jejunal tissue.
Prospect theory and public service outcomes: Examining risk preferences in relation to public sector reforms
Authors: Baekgaard Martin
Published: May 2017

Prospect theory has been widely acknowledged in the social sciences as a frame for understanding how people deal with uncertainty. Yet, little is known about whether key expectations from prospect theory also hold in a public service setting. In this article, I draw on prospect theory to examine under what conditions citizens prefer uncertain – but potentially advantageous – reforms to reforms with more certain outcomes. A population‐based survey experiment with the participation of 1,395 Danish citizens and two consecutive experiments with 1,680 US MTurkers produced a consistent pattern across contexts: citizens to a large extent prefer certain to risky reforms and are more willing to take risks if reforms are associated with gains rather than losses. The latter finding is in opposition to expectations and suggests that the particularities of the public sector should be taken into account when applying insights from prospect theory to this sector.
Artocarpin‐enriched (Artocarpus altilis) Heartwood Extract Provides Protection Against UVB‐induced Mechanical Damage in Dermal Fibroblasts
Authors: Tiraravesit Narisara , Humbert Philippe , Robin Sophie , Tissot Marion , Viennet Céline , Viyoch Jarupa
Published: May 2017

This study aimed to evaluate the protective effect of artocarpin‐enriched (Artocarpus altilis) heartwood extract on the mechanical properties of UVB‐irradiated fibroblasts. Human skin fibroblasts were pretreated with 50 μg/mL−1 extract and later irradiated with UVB (200 mJ/cm−2). They were then cultured within three‐dimensional of free‐floating and tense collagen lattices. The pretreatment of fibroblasts with the extract prior to UVB radiation showed cells protection against UVB‐induced suppression of α‐SMA expression, fibroblast migration and contraction. These results reveal that the extract prevents mechanical damages induced by UVB irradiation in fibroblast‐embedded collagen lattices, and therefore, has a potential as a natural photo‐protectant.
A Boron 2‐(2′‐pyridyl) Imidazole Fluorescence Probe for Bovine Serum Albumin: Discrimination over Other Proteins and Identification of Its Denaturation
Authors: Liu Chunlin , Yang Wei , Du Jinya , Shen Ping , Yang Changying
Published: May 2017

Boron 2‐(2′‐pyridyl) imidazole complex (BOPIM) derivatives, BOPIM‐1 and BOPIM‐2, involving twisted intra‐molecular charge transfer (TICT) characteristic, were investigated to probe bovine serum albumin (BSA). BOPIM‐1 was demonstrated to be an efficient fluorescence probe to discriminate BSA from other proteins including human serum albumin (HSA). The encapsulation of BOPIM‐1 in the hydrophobic subdomain IIA of BSA inhibited the TICT state and resulted in 70‐fold emission enhancement of BOPIM‐1. Besides, it was found that BOPIM‐1 could distinguish denatured BSA from the native, due to the difference of 15 nm emission wavelength at least. The denaturation of BSA leads to the exposure of binding sites and resulted in an increase in the accessibility of the fluorophore to the BSA cavity, which made a great contribution to the further restraint of TICT state of BOPIM‐1. The tracking of BSA denaturizing process was easily achieved, through the change of BOPIM‐1 emission wavelength from 485 to 465 nm. Thus, a promising pharmacological dual‐functional probe was provided for both the selective recognization of BSA and the identification of denatured BSA from the native.
Reliability of resting intramuscular fiber conduction velocity evaluation
Authors: Methenitis S. , Karandreas N. , Terzis G.
Published: May 2017

Characterization of the least number of muscle fibers analyzed for a quick and reliable, evaluation of intramuscular fiber conduction velocity (MFCV) is of importance for sport scientists. The aim of this study was to evaluate the reliability of vastus lateralis' intramuscular MFCV measuring either 25 or 50 different muscle fibers per participant, as well as to compare intramuscular MFCV measured in 25 (C25), 50 (C50), or 140 (C140) muscle fibers. Resting vastus lateralis' MFCV was measured in 21 young healthy males (age 22.1±2.4 years) using intramuscular microelectrodes in different days. Test‐retest reliability of MFCV's parameters was calculated for C25 and C50, while MFCV was compared among C25, C50, and C140. Significant differences of MFCV parameters were observed between C25 condition and those of C50 and C140. The differences in MFCV values between conditions C50 and C140 were non‐significant. A close correlation was found for MFCV between C50 and C140 (r=0.884‐0.988, P=.000). All reliability measures of MFCV measured with 50 fibers were high (eg, ICC=0.813‐0.980, P=.000), in contrast to C25 (eg, ICC=0.023‐0.580 P>.05). In conclusion, an average of 50 different fibers per subject is sufficient to provide a quick and reliable intramuscular evaluation of vastus lateralis MFCV.
Chemosensitive Phox2b‐expressing neurons are crucial for hypercapnic ventilatory response in the nucleus tractus solitarius
Authors: Fu Congrui , Xue Jinyu , Wang Ri , Chen Jinting , Ma Lan , Liu Yixian , Wang Xuejiao , Guo Fang , Zhang Yi , Zhang Xiangjian , Wang Sheng
Published: May 2017

Key points

Central hypercapnic hypoventilation is highly prevalent in children suffering from congenital central hypoventilation syndrome (CCHS).

Mutations of the gene for paired‐like homeobox 2b (Phox2b) are aetiologically associated with CCHS and Phox2b is present in central components of respiratory chemoreflex, such as the nucleus tractus solitarius (NTS).

Injection of the neurotoxin substance P‐saporin into NTS destroys Phox2b‐expressing neurons. Impaired hypercapnic ventilatory response caused by this neurotoxin is attributable to a loss of CO2‐sensitive Phox2b‐expressing NTS neurons.

A subgroup of Phox2b‐expressing neurons exhibits intrinsic chemosensitivity. A background K+ channel‐like current is partially responsible for such chemosensitivity in Phox2b‐expressing neurons.

The present study helps us better understand the mechanism of respiratory deficits in CCHS and potentially locates a brainstem site for development of precise clinical intervention.

The nucleus tractus solitarius (NTS) neurons have been considered to function as central respiratory chemoreceptors. However, the common molecular marker defined for these neurons remains unknown. The present study investigated whether paired‐like homeobox 2b (Phox2b)‐expressing NTS neurons are recruited in hypercapnic ventilatory response (HCVR) and whether these neurons exhibit intrinsic chemosensitivity. HCVR was assessed using whole body plethysmography and neuronal chemosensitivity was examined by patch clamp recordings in brainstem slices or dissociated neurons from Phox2b‐EGFP transgenic mice. Injection of the neurotoxin substance P‐saporin (SSP‐SAP) into NTS destroyed Phox2b‐expressing neurons. Minute ventilation and tidal volume were both reduced by 13% during exposure to 8% CO2 in inspired air when ∼13% of the Phox2b‐expressing neurons were eliminated. However, a loss of ∼18% of these neurons was associated with considerable decreases in minute ventilation by ≥18% and in tidal volume by≥22% when challenged by ≥4% CO2. In both cases, breathing frequency was unaffected. Most CO2‐activated neurons were immunoreactive to Phox2b. In brainstem slices, ∼43% of Phox2b‐expressing neurons from Phox2b‐EGFP mice displayed a sustained or transient increase in firing rate during physiological acidification (pH 7.0 or 8% CO2). Such a response was also present in dissociated neurons in favour of an intrinsic property. In voltage clamp recordings, a background K+ channel‐like current was found in a subgroup of Phox2b‐expressing neurons. Thus, the respiratory deficits caused by injection of SSP‐SAP into the NTS are attributable to proportional lesions of CO2/H+‐sensitive Phox2b‐expressing neurons.
I Use the Student Recreation Center, but I Would Use it More if …: Understanding Male and Female Constraints to Student Recreation Center Use
Authors: Stankowski Christopher L. , Trauntvein Nate E. , Hall Stacey L.
Published: May 2017

Studies have found that there is a positive relationship between the number of student visits to campus recreation and academic outcomes such as rates of graduation and grade point average (Huesman, Brown, Lee, Kellogg, & Radcliffe, 2009). Despite the strong correlation between use of fitness facilities and academic performance some students choose not to visit, while some who use the facilities may not be maximizing such use due to constraints (barriers). The purpose of this study was to understand the constraints to using the campus recreation facility at a midsized New England university. Moreover, this study sought to understand the types of management actions that would help increase use of the recreation center by current users. An online survey was distributed to a random sample ( N = 2,400) of all campus recreation visitors in fall of 2013 using a modified Dillman method of distribution (2009). A total of 882 respondents completed the survey for a response rate of nearly 37%. Important results from this study included that female students were much more likely than male students to report being constrained by not knowing how to use the free weight section safely ( M = 3.40, SD = 1.143; M = 2.68, SD = 1.166, respectively) and that male students suggested that they were more likely to participate than female students ( M = 3.07, SD = 1.182; M = 2.96, SD = 1.235, respectively) at the Student Recreation Center (SRC) if they were not as involved with other activities. This information can be used to guide the expansion planning of future SRC projects and to help improve the participation habits of students at the case institution.
Institutional Type and Campus Recreation Department Staff as a Mediating Factor for Diversity/Multicultural Training
Authors: Kaltenbaugh Lance P. , Parsons Jennifer , Brubaker Kenneth , Bonadio Wesley , Locust Jonathan
Published: May 2017

The main purpose of this study was to identify what factors restrict campus recreation departments from performing diversity/multicultural training. This study addressed the lack of research on diversity/multicultural training programs within campus recreation departments and examined the relationship between type of institution, department size, and the number and types of diversity/multicultural training programs offered in an academic year. Of the 210 campus recreation departments surveyed, 52% indicated they did not have enough time to give the necessary attention to diversity/multicultural training and any related strategies and initiatives. Of the 108 institutions that offer diversity/multicultural training, limited staff (47%), limited expertise/knowledge (46%), and other constraints (41%) hindered their ability to carry out effective diversity/multicultural training. By identifying diversity/multicultural training as a priority, campus recreation administrators could focus on what they are capable of providing given their department's staff, resources, budget, and knowledge of diversity/multicultural training programs.
Campus Recreation Use and Health Behaviors among College Students in Different Academic Disciplines
Authors: Gathman Patrick C. , Grabowski Nicole R. , Carr Julia Wallace , Todd Mikel K.
Published: May 2017

Physical activity, campus recreation (CR) use, body mass index (BMI), and varied health indices were compared between academic discipline groups and sex. Participants ( n = 219) were classified as AD I (kinesiology and physical education majors), AD II (health science majors and nursing majors), and AD III (representative sample of non-health-related majors) to make between-group comparisons based on the amount of emphasis placed on physical activity and health-related content within different disciplines. Significant differences ( p < .05) were found between the academic discipline groups for International Physical Activity Questionnaire scores, CR minutes, CR days, CR time per day, vigorous physical activity (VPA), and perceived-health score; and between sex for BMI, VPA, sitting, fiber intake, and fruit and vegetable intake. The results indicate a positive relationship between the emphasis placed physical activity and health within an academic discipline and the degree to which students participate in physical activity, positive health behaviors, and perceived health.
Dramatic influence of curvature of nanowire on chiral domain wall velocity
Authors: Garg Chirag , Yang See-Hun , Phung Timothy , Pushp Aakash , Parkin Stuart S. P.
Published: May 2017

The velocity of domain walls driven by chiral spin-orbit torques is up to 10 times faster around right- than left-handed bends.
Pressure compression of CdSe nanoparticles into luminescent nanowires
Authors: Li Binsong , Bian Kaifu , Zhou Xiaowang , Lu Ping , Liu Sheng , Brener Igal , Sinclair Michael , Luk Ting , Schunk Hattie , Alarid Leanne , Clem Paul G. , Wang Zhongwu , Fan Hongyou
Published: May 2017

Pressure overcomes balanced particle interactions and enables fine-tuning of nanoparticle lattice, forming new luminescent nanowires.
A twofold quantum delayed-choice experiment in a superconducting circuit
Authors: Liu Ke , Xu Yuan , Wang Weiting , Zheng Shi-Biao , Roy Tanay , Kundu Suman , Chand Madhavi , Ranadive Arpit , Vijay Rajamani , Song Yipu , Duan Luming , Sun Luyan
Published: May 2017

A twofold delayed-choice experiment was performed, where the behavior of a quantum system was a posteriori chosen twice.
A New Player in the Biorefineries Field: Phasin PhaP Enhances Tolerance to Solvents and Boosts Ethanol and 1,3-Propanediol Synthesis in Escherichia coli
Authors: Mezzina Mariela P. , Álvarez Daniela S. , Egoburo Diego E. , Díaz Peña Rocío , Nikel Pablo I. , Pettinari M. Julia
Published: May 2017

The microbial production of biofuels and other added-value chemicals is often limited by the intrinsic toxicity of these compounds. The phasin PhaP from the soil bacterium
Azotobacter
sp. strain FA8 is a polyhydroxyalkanoate granule-associated protein that protects recombinant
Escherichia coli
against several kinds of stress. PhaP enhances growth and poly(3-hydroxybutyrate) synthesis in polymer-producing recombinant strains and reduces the formation of inclusion bodies during overproduction of heterologous proteins. In this work, the heterologous expression of this phasin in
E. coli
was used as a strategy to increase tolerance to several biotechnologically relevant chemicals. PhaP was observed to enhance bacterial fitness in the presence of biofuels, such as ethanol and butanol, and other chemicals, such as 1,3-propanediol. The effect of PhaP was also studied in a
groELS
mutant strain, in which both GroELS and PhaP were observed to exert a beneficial effect that varied depending on the chemical tested. Lastly, the potential of PhaP and GroEL to enhance the accumulation of ethanol or 1,3-propanediol was analyzed in recombinant
E. coli
. Strains that overexpressed either
groEL
or
phaP
had increased growth, reflected in a higher final biomass and product titer than the control strain. Taken together, these results add a novel application to the already multifaceted phasin protein group, suggesting that expression of these proteins or other chaperones can be used to improve the production of biofuels and other chemicals.

IMPORTANCE
This work has both basic and applied aspects. Our results demonstrate that a phasin with chaperone-like properties can increase bacterial tolerance to several biochemicals, providing further evidence of the diverse properties of these proteins. Additionally, both the PhaP phasin and the well-known chaperone GroEL were used to increase the biosynthesis of the biotechnologically relevant compounds ethanol and 1,3-propanediol in recombinant
E. coli
. These findings open the road for the use of these proteins for the manipulation of bacterial strains to optimize the synthesis of diverse bioproducts from renewable carbon sources.
Experience of living with cancer and comorbid illness: protocol for a qualitative systematic review
Authors: Cavers Debbie , Cunningham-Burley Sarah , Watson Eila , Banks Elspeth , Campbell Christine
Published: May 2017

Introduction

There are an increasing number of people living with and beyond cancer, whose experience is further complicated by additional long-term health conditions in the context of an ageing population. The supportive care needs of this growing patient group should be recognised and addressed. There is a need to explore the experience of living with cancer and comorbid illness in order to develop optimal models of patient-centred care. This protocol describes a systematic review that aims to identify the qualitative evidence relating to the experience of cancer and comorbid illness for patients, informal carers and professionals, and to highlight areas where more research is needed.

Methods and analysis

A systematic review following PRISMA guidance will be undertaken. Medline, Embase, CINAHL, PsycINFO, ASSIA, Sociological Abstracts, Web of Science, SCOPUS, OpenGrey and ProQuest Dissertations and Theses Global databases will be systematically searched for articles relevant to patient, carer and professional experiences. Two independent reviewers will screen articles for inclusion and evaluate them according to the Critical Appraisal Skills Programme tool. Extracted data will be combined using recognised methods of qualitative synthesis to offer new insights into the topic area and for a patient-centred model of care.

Ethics and dissemination

The review does not require formal ethical review as no direct patient contact or patient identifiable data is used. Conduct of the review has been approved internally by the University of Edinburgh Centre for Population Health Sciences Ethics Review Committee. Results of the review will be published in a generalist peer-reviewed journal and presented at a relevant conference in addition to informing subsequent empirical work by the authors on this topic area.
Deriving literature-based benchmarks for surgical complications in high-income countries: a protocol for a systematic review and meta-analysis
Authors: Brindle Mary E , Roberts Derek J , Daodu Oluwatomilayo , Haynes Alex Bernard , Cauley Christy , Dixon Elijah , La Flamme Claude , Bain Paul , Berry William
Published: May 2017

Introduction

To improve surgical safety, health systems must identify preventable adverse outcomes and measure changes in these outcomes in response to quality improvement initiatives. This requires understanding of the scope and limitations of available population-level data. To derive literature-based summary estimates of benchmarks of care, we will systematically review and meta-analyse rates of postoperative complications associated with several common and/or high-risk operations performed in five high-income countries (HICs).

Methods and analysis

An electronic search of PubMed, Embase, Web of Science, Cochrane Central, the NHS Economic Evaluations Database and Health Technology Assessment database will be performed to identify studies reviewing national surgical complication rates between 2000 and 2016. Two reviewers will screen titles and abstracts and full texts of potentially relevant studies to determine eligibility for inclusion in the systematic review. We will include English-language publications using data from health databases in the USA, Canada, the UK, Australia and New Zealand. We will include studies of patients who underwent hip or knee arthoplasty, appendectomy, cholecystectomy, oesophagectomy, abdominal aortic aneurysm repair, aortic valve replacement or coronary artery bypass graft. Outcomes will include mortality, length of hospital stay, pulmonary embolism, pneumonia, sepsis or septic shock, reoperation, surgical site infection, wound dehiscence/disruption, blood transfusion, bile duct injury, stroke and myocardial infarction. We will calculate summary estimates of cumulative incidence, incidence rate, prevalence and occurrence rate of complications using DerSimonian and Laird random effects models. Heterogeneity in these estimates will be examined using subgroup analyses and meta-regression. We will correlate findings within contemporary clinical databases.

Ethics and dissemination

This study of secondary data does not require ethics approval. It will be presented internationally and published in the peer-reviewed literature. Results will inform a future quality improvement tool and provide benchmarks of surgical complication rates within HICs.

Trial registration

International Prospective Register of Systematic Reviews (PROSPERO). Registration number CRD42016037519.
The impact of demand management strategies on parents’ decision-making for out-of-hours primary care: findings from a survey in The Netherlands
Authors: Giesen Marie-Jeanne , Keizer Ellen , van de Pol Julia , Knoben Joris , Wensing Michel , Giesen Paul
Published: May 2017

Objective

To explore the potential impact of demand management strategies on patient decision-making in medically non-urgent and urgent scenarios during out-of-hours for children between the ages of 0 and 4 years.

Design and methods

We conducted a cross-sectional survey with paper-based case scenarios. A survey was sent to all 797 parents of children aged between 0 and 4 years from four Dutch general practitioner (GP) practices. Four demand management strategies (copayment, online advice, overview medical cost and GP appointment next morning) were incorporated in two medically non-urgent and two urgent case scenarios. Combining the case scenarios with the demand management strategies resulted in 16 cases (four scenarios each with four demand management strategies). Each parent randomly received a questionnaire with three different case scenarios with three different demand strategies and a baseline case scenario without a demand management strategy.

Results

The response rate was 47.4%. The strategy online advice led to more medically appropriate decision-making for both non-urgent case scenarios (OR 0.26; 95% CI 0.11 to 0.58) and urgent case scenarios (OR 0.16; 95% CI 0.08 to 0.32). Overview of medical cost (OR 0.59; 95% CI 0.38 to 0.92) and a GP appointment planned the next morning (OR 0.57; 95% CI 0.34 to 0.97) had some influence on patient decisions for urgent cases, but not for non-urgent cases. Copayment had no influence on patient decisions.

Conclusion

Online advice has the highest potential to reduce medically unnecessary use. Furthermore it enhanced safety of parents' decisions on seeking help for their young children during out-of-hours primary care. Valid online information on health symptoms for patients should be promoted.
Patient flow within UK emergency departments: a systematic review of the use of computer simulation modelling methods
Authors: Mohiuddin Syed , Busby John , Savović Jelena , Richards Alison , Northstone Kate , Hollingworth William , Donovan Jenny L , Vasilakis Christos
Published: May 2017

Objectives

Overcrowding in the emergency department (ED) is common in the UK as in other countries worldwide. Computer simulation is one approach used for understanding the causes of ED overcrowding and assessing the likely impact of changes to the delivery of emergency care. However, little is known about the usefulness of computer simulation for analysis of ED patient flow. We undertook a systematic review to investigate the different computer simulation methods and their contribution for analysis of patient flow within EDs in the UK.

Methods

We searched eight bibliographic databases (MEDLINE, EMBASE, COCHRANE, WEB OF SCIENCE, CINAHL, INSPEC, MATHSCINET and ACM DIGITAL LIBRARY) from date of inception until 31 March 2016. Studies were included if they used a computer simulation method to capture patient progression within the ED of an established UK National Health Service hospital. Studies were summarised in terms of simulation method, key assumptions, input and output data, conclusions drawn and implementation of results.

Results

Twenty-one studies met the inclusion criteria. Of these, 19 used discrete event simulation and 2 used system dynamics models. The purpose of many of these studies (n=16; 76%) centred on service redesign. Seven studies (33%) provided no details about the ED being investigated. Most studies (n=18; 86%) used specific hospital models of ED patient flow. Overall, the reporting of underlying modelling assumptions was poor. Nineteen studies (90%) considered patient waiting or throughput times as the key outcome measure. Twelve studies (57%) reported some involvement of stakeholders in the simulation study. However, only three studies (14%) reported on the implementation of changes supported by the simulation.

Conclusions

We found that computer simulation can provide a means to pretest changes to ED care delivery before implementation in a safe and efficient manner. However, the evidence base is small and poorly developed. There are some methodological, data, stakeholder, implementation and reporting issues, which must be addressed by future studies.
Functional lesional neurosurgery for tremor—a protocol for a systematic review and meta-analysis
Authors: Schreglmann Sebastian R , Krauss Joachim K , Chang Jin Woo , Bhatia Kailash P , Kägi Georg
Published: May 2017

Introduction

The recent introduction of incision-less lesional neurosurgery using Gamma Knife and MRI-guided focused ultrasound has revived interest in lesional treatment options for tremor disorders. Preliminary literature researches reveal that the consistency of treatment effects after lesional neurosurgery for tremor has not formally been assessed yet. Similarly, the efficacy of different targets for lesional treatment and incidence of persistent side effects of lesional neurosurgical interventions has not been comprehensively assessed. This work therefore aims to describe a suitable process how to review the existing literature on efficacy and persistent side effects of lesional neurosurgical treatment for tremor due to Parkinson’s disease, essential tremor, multiple sclerosis and midbrain/rubral tremor.

Methods and analysis

We will search electronic databases (Medline, Cochrane) and reference lists of included articles for studies reporting lesional interventions for tremor in cohorts homogeneous for tremor aetiology and intervention (technique and target). We will include cohorts with a minimum number of five subjects and follow-up of 2 months. One investigator will perform the initial literature search and two investigators then independently decide which references to include for final efficacy and safety analysis. After settling of disagreement, data will be extracted from articles using a standardised template. We will perform a random-effect meta-analysis calculating standardised mean differences (Hedge’s g) for comparison in Forest plots and subgroup analysis after assessment of heterogeneity using I2statistics.

Ethics and dissemination

This study will summarise the available evidence on the efficacy of lesional interventions for the most frequent tremor disorders, as well as for the incidence rate of persisting side effects after unilateral lesional treatment. This data will be useful to guide future work on incision-less lesional interventions for tremor.

Systematic review registration

This study has been registered with the PROSPERO database (no. CRD42016048049).
The impact of duty cycle workflow on sign-out practices: a qualitative study of an internal medicine residency program in Maryland, USA
Authors: Lee Soo-Hoon , Desai Sanjay V , Phan Phillip H
Published: May 2017

Objectives

Although JCAHO requires a standardised approach to handoffs, and while many standardised protocols have been tested, sign-out practices continue to vary. We believe this is due to the variability in workflow during inpatient duty cycle. We investigate the impact of such workflows on intern sign-out practices.

Design

We employed a prospective, grounded theory mixed-method design.

Setting

The study was conducted at a residency programme in the mid-Atlantic USA. Two observers randomly evaluated three types of daily sign-outs for 1 week every 3 months from September 2013 to March 2014. The compliance of each observed behaviour to JCAHO’s Handoff Communication Checklist was recorded.

Participants

Thirty one interns conducting 134 patient sign-outs were observed randomly among the 52 in the programme.

Results

In the 06:00 to 07:00 sign-back, the night-cover focused on providing information on overnight events to the day interns. In the 11:00 to 12:00 sign-out, the night-cover focused on transferring task accountability to a day-cover intern before departure. In the 20:00 to 21:00 sign-out, the day interns focused on transferring responsibility of their patients to a night-cover.

Conclusion

Different sign-out periods had different emphases regarding information exchange, personal responsibility and task accountability. Sign-outs are context-specific, implying that across-the-board standardised sign-out protocols are likely to have limited efficacy and compliance. Standardisation may need to be relative to the specific type and purpose of each sign-out to be supported by interns.
Mountain rescue cardiopulmonary resuscitation: a comparison between manual and mechanical chest compressions during manikin cardio resuscitation
Authors: Thomassen Oyvind , Skaiaa Sven Christjar , Assmuss Jorg , Østerås Øyvind , Heltne Jon Kenneth , Wik Lars , Brattebo Guttorm
Published: May 2017

Aim

Chest compression devices are useful during mountain rescue but may cause a delay in transport if not immediately available. The aims of this prospective observational study were to compare manual and mechanical cardiopulmonary resuscitation (CPR) during transport on a sledge connected to a snowmobile with a non-moving setting and to compare CPR quality between manual and two mechanical chest compression devices.

Methods

Sixteen healthcare providers simulated four different combined CPR scenarios on a sledge in a non-moving setting and during transport and two mechanical chest compression devices during transport on the sledge. The study was conducted in May 2015 in a mountain in Norway. The primary outcome measures were compression rate (compressions per minute), compression depth in millimetres, leaning (incomplete chest wall release after compression in millimetres) and chest compression fraction (fraction of total time were compression were performed). The results were analysed by descriptive and graphical methods and paired t-tests were used to compare the differences between techniques.

Results

We did not observe a significant difference between moving and non-moving conditions with respect to manual compression rate (p=0.34), compression depth (p=0.50) or leaning (p=0.92). However, both the manual compression depth (p<0.001) and the leaning (p=0.04) showed a significantly larger variance during the moving runs.

Conclusion

Manual chest compression is possible on a snowmobile during transport even in challenging terrain. This experimental study shows that high-quality chest compressions and manual ventilation can be performed in an intubated patient during a short-term transportation on a sledge.
Ischaemic paraspinal myopathy along with myelopathy due to putative fibrocartilaginous embolism in a dog
Authors: Sehl Julia , Gruber Achim D , Lazzerini Kali , Loderstedt Shenja
Published: May 2017

A 10‐year‐old German shepherd dog was presented with peracute onset of non‐ambulatory paraparesis. Clinical signs and neurological examination revealed lack of proprioception and reduced to absent reflexes in both hind limbs, indicating a lesion to spinal cord segments (SCS) L4–S3. In contrast, MRI identified intramedullary signal changes within the SCS T13–L2 and a sharply demarcated zone of signal changes in the adjacent dorsal lumbar musculature on the left side. The findings were consistent with ischaemic myelopathy, most likely due to fibrocartilaginous embolism (FCE). The lesion also included large areas of presumably ischaemic myopathy which was confirmed by histopathology of biopsies from adjacent muscles. On re‐examination, three months after presentation, ambulatory paraparesis remained, proprioceptive deficits improved and spinal reflexes were normal. However, the affected left longissimus lumborum muscle had become markedly atrophic. FCE as the most common cause for ischaemic myelopathy obviously may also induce ischaemic paraspinal myopathy.
On molecular topological properties of diamond-like networks
Authors: Imran Muhammad , Baig Abdul Qudair , Siddiqui Hafiz Muhammad Afzal , Sarwar Rabia
Published: May 2017

The Randić (product) connectivity index and its derivative called the sum-connectivity index are well-known topological indices and both of these descriptors correlate well among themselves and with the π-electronic energies of benzenoid hydrocarbons. The general n connectivity of a molecular graph G is defined as [Formula: see text] and the n sum connectivity of a molecular graph G is defined as [Formula: see text], where the paths of length n in G are denoted by [Formula: see text] and the degree of each vertex vi is denoted by di. In this paper, we discuss third connectivity and third sum-connectivity indices of diamond-like networks and compute analytical closed results of these indices for diamond-like networks.
Security of Cyber-Physical Systems in the Presence of Transient Sensor Faults
Authors: Park Junkil , Ivanov Radoslav , Weimer James , Pajic Miroslav , Son Sang Hyuk , Lee Insup
Published: May 2017

This article is concerned with the security of modern Cyber-Physical Systems in the presence of transient sensor faults. We consider a system with multiple sensors measuring the same physical variable, where each sensor provides an interval with all possible values of the true state. We note that some sensors might output faulty readings and others may be controlled by a malicious attacker. Differing from previous works, in this article, we aim to distinguish between faults and attacks and develop an attack detection algorithm for the latter only. To do this, we note that there are two kinds of faults—transient and permanent; the former are benign and short-lived, whereas the latter may have dangerous consequences on system performance. We argue that sensors have an underlying transient fault model that quantifies the amount of time in which transient faults can occur. In addition, we provide a framework for developing such a model if it is not provided by manufacturers.

Attacks can manifest as either transient or permanent faults depending on the attacker’s goal. We provide different techniques for handling each kind. For the former, we analyze the worst-case performance of sensor fusion over time given each sensor’s transient fault model and develop a filtered fusion interval that is guaranteed to contain the true value and is bounded in size. To deal with attacks that do not comply with sensors’ transient fault models, we propose a sound attack detection algorithm based on pairwise inconsistencies between sensor measurements. Finally, we provide a real-data case study on an unmanned ground vehicle to evaluate the various aspects of this article.
Identifying Communication Patterns between Virtual Machines in Software-Defined Data Centers
Authors: Canali Claudia , Lancellotti Riccardo
Published: May 2017

Modern cloud data centers typically exploit management strategies to reduce the overall energy consumption. While most of the solutions focus on the energy consumption due to computational elements, the advent of the Software-Defined Network paradigm opens the possibility for more complex strategies taking into account the network traffic exchange within the data center. However, a network-aware Virtual Machine (VM) allocation requires the knowledge of data communication patterns, so that VMs exchanging significant amount of data can be placed on the same physical host or on low cost communication paths. In Infrastructure as a Service data centers, the information about VMs traffic exchange is not easily available unless a specialized monitoring function is deployed over the data center infrastructure. The main contribution of this paper is a methodology to infer VMs communication patterns starting from input/output network traffic time series of each VM and without relaying on a special purpose monitoring. Our reference scenario is a software-defined data center hosting a multi-tier application deployed using horizontal replication. The proposed methodology has two main goals to support a network-aware VMs allocation: first, to identify couples of intensively communicating VMs through correlation-based analysis of the time series; second, to identify VMs belonging to the same vertical stack of a multi-tier application. We evaluate the methodology by comparing different correlation indexes, clustering algorithms and time granularities to monitor the network traffic. The experimental results demonstrate the capability of the proposed approach to identify interacting VMs, even in a challenging scenario where the traffic patterns are similar in every VM belonging to the same application tier.