bluuebunny/crossref_metadata_2025 huggingface dataset:
Protocol for a multi-centered, stepped wedge, cluster randomized controlled trial of the de-adoption of oral chlorhexidine prophylaxis and implementation of an oral care bundle for mechanically ventilated critically ill patients: the CHORAL study
Authors: Dale Craig M. , Rose Louise , Carbone Sarah , Smith Orla M. , Burry Lisa , Fan Eddy , Amaral Andre Carlos Kajdacsy-Balla , McCredie Victoria A. , Pinto Ruxandra , Quiñonez Carlos R. , Sutherland Susan , Scales Damon C. , Cuthbertson Brian H.
Published: October 2019

Background

Routine application of chlorhexidine oral rinse is recommended to reduce risk of ventilator-associated pneumonia (VAP) in mechanically ventilated patients. Recent reappraisal of the evidence from two meta-analyses suggests chlorhexidine may cause excess mortality in non-cardiac surgery patients and does not reduce VAP. Mechanisms for possible excess mortality are unclear. The CHORAL study will evaluate the impact of de-adopting chlorhexidine and implementing an oral care bundle (excluding chlorhexidine) on mortality, infection-related ventilator-associated complications (IVACs), and oral health status.

Methods

The CHORAL study is a stepped wedge, cluster randomized controlled trial in six academic intensive care units (ICUs) in Toronto, Canada. Clusters (ICU) will be randomly allocated to six sequential steps over a 14-month period to de-adopt oral chlorhexidine and implement a standardized oral care bundle (oral assessment, tooth brushing, moisturization, and secretion removal). On study commencement, all clusters begin with a control period in which the standard of care is oral chlorhexidine. Clusters then begin crossover from control to intervention every 2 months according to the randomization schedule. Participants include all mechanically ventilated adults eligible to receive the standardized oral care bundle. The primary outcome is ICU mortality; secondary outcomes are IVACs and oral health status. We will determine demographics, antibiotic usage, mortality, and IVAC rates from a validated local ICU clinical registry. With six clusters and 50 ventilated patients on average each month per cluster, we estimate that 4200 patients provide 80% power after accounting for intracluster correlation to detect an absolute reduction in mortality of 5.5%. We will analyze our primary outcome of mortality using a generalized linear mixed model adjusting for time to account for secular trends. We will conduct a process evaluation to determine intervention fidelity and to inform interpretation of the trial results.

Discussion

The CHORAL study will inform understanding of the effectiveness of de-adoption of oral chlorhexidine and implementation of a standardized oral care bundle for decreasing ICU mortality and IVAC rates while improving oral health status. Our process evaluation will inform clinicians and decision makers about intervention delivery to support future de-adoption if justified by trial results.

Trial registration

ClinicalTrials.gov, NCT03382730. Registered on December 26, 2017.
Effect of etelcalcetide on cardiac hypertrophy in hemodialysis patients: a randomized controlled trial (ETECAR-HD)
Authors: Dörr Katharina , Kammer Michael , Reindl-Schwaighofer Roman , Lorenz Matthias , Loewe Christian , Marculescu Rodrig , Erben Reinhold , Oberbauer Rainer
Published: October 2019

Background

Fibroblast growth factor 23 (FGF23) is associated with left ventricular hypertrophy (LVH) in patients with chronic kidney disease, and calcimimetic therapy reduces plasma concentrations of FGF23. It remains unknown whether treatment with the calcimimetic etelcalcetide (ETL) reduces LVH in patients on hemodialysis.

Methods/design

This single-blinded randomized trial of 12 months duration will test the effects of ETL compared with alfacalcidol on LVH and cardiac fibrosis in maintenance hemodialysis patients with secondary hyperparathyroidism. Both treatment regimens will be titrated to equally suppress secondary hyperparathyroidism while alfacalcidol treatment causes an increase and ETL a decrease in FGF23, respectively.

Patients treated thrice weekly with hemodialysis for ≥ 3 months and ≤ 3 years with parathyroid hormone levels ≥ 300 pg/ml and LVH will be enrolled in the study.

The primary study endpoint is change from baseline to 12 months in left ventricular mass index (LVMI; g/m2) measured by cardiac magnetic resonance imaging. Sample size calculations showed that 62 randomized patients will be necessary to detect a difference in LVMI of at least 20 g/m2between the two groups at 12 months. Due to the strong association of volume overload and LVH, randomization will be stratified by residual kidney function, and regular body composition monitoring will be performed to control the volume status of patients.

Study medication will be administered intravenously by the dialysis nurses after every hemodialysis session, thus omitting adherence issues.

Secondary study endpoints are cardiac parameters measured by echocardiography, biomarker concentrations of bone metabolism (FGF23, vitamin D, parathyroid hormone, calcium, phosphate, s-Klotho), cardiac markers (pro-brain natriuretic peptide, pre- and postdialysis troponin T) and metabolites of the renin–angiotensin–aldosterone cascade (angiotensin I (Ang I), Ang II, Ang-(1–7), Ang-(1–5), Ang-(1–9), and aldosterone).

Discussion

The causal inference and pathophysiology of LVH regression by FGF23 reduction using calcimimetic treatment has not yet been shown. This intervention study has the potential to discover a new strategy for the treatment of cardiac hypertrophy and fibrosis in patients on maintenance hemodialysis. It might be speculated that successful treatment of cardiac morphology will also reduce the risk of cardiac death in this population.

Trial registration

European Clinical Trials Database, EudraCT number 2017-000222-35; ClinicalTrials.gov,NCT03182699. Registered on
NT3P75-2 gene-modified bone mesenchymal stem cells improve neurological function recovery in mouse TBI model
Authors: Wu Ke , Huang Dongdong , Zhu Can , Kasanga Ella A. , Zhang Ying , Yu Enxing , Zhang Hengli , Ni Zhihui , Ye Sheng , Zhang Chunli , Hu Jiangnan , Zhuge Qichuan , Yang Jianjing
Published: October 2019

Background

The attainment of extensive neurological function recovery remains the key challenge for the treatment of traumatic brain injury (TBI). Transplantation of bone marrow-derived mesenchymal stem cells (BMSCs) has been shown to improve neurological function recovery after TBI. However, the survival of BMSCs after transplantation in early-stage TBI is limited, and much is unknown about the mechanisms mediating this neurological function recovery. Secretion of neurotrophic factors, including neurotrophin 3 (NT3), is one of the critical factors mediating BMSC neurological function recovery. Gene mutation of NT3 (NT3P75-2) has been shown to enhance the biological function of NT3 via the reduction of the activation of the P75 signal pathway. Thus, we investigated whether NT3P75-2gene-modified BMSCs could enhance the survival of BMSCs and further improve neurological function recovery after TBI.

Methods

The ability of NT3P75-2induction to improve cell growth rate of NSC-34 and PC12 cells in vitro was first determined. BMSCs were then infected with three different lentiviruses (green fluorescent protein (GFP), GFP-NT3, or GFP-NT3P75-2), which stably express GFP, GFP-NT3, or GFP-NT3P75-2. At 24 h post-TBI induction in mice, GFP-labeled BMSCs were locally transplanted into the lesion site. Immunofluorescence and histopathology were performed at 1, 3, and/or 7 days after transplantation to evaluate the survival of BMSCs as well as the lesion volume. A modified neurological severity scoring system and the rotarod test were chosen to evaluate the functional recovery of the mice. Cell growth rate, glial activation, and signaling pathway analyses were performed to determine the potential mechanisms of NT3P75-2in functional recovery after TBI.

Results

Overall, NT3P75-2improved cell growth rate of NSC-34 and PC12 cells in vitro. In addition, NT3P75-2significantly improved the survival of transplanted BMSCs and neurological function recovery after TBI. Overexpression of NT3P75-2led to a significant reduction in the activation of glial cells, brain water content, and brain lesion volume after TBI. This was associated with a reduced activation of the p75 neurotrophin receptor (P75NTR) and the c-Jun N-terminal kinase (JNK) signal pathway due to the low affinity of NT3P75-2for the receptor.

Conclusions

Taken together, our results demonstrate that administration of NT3P75-2gene-modified BMSCs dramatically improves neurological function recovery after TBI by increasing the survival of BMSCs and ameliorating the inflammatory environment, providing a new promising treatment strategy for TBI.
A time-efficient data offloading method with privacy preservation for intelligent sensors in edge computing
Authors: Xu Zhanyang , Liu Xihua , Jiang Gaoxing , Tang Bowei
Published: October 2019

Over the past years, with the development of hardware and software, the intelligent sensors, which are deployed in the wearable devices, smart phones, and etc., are leveraged to collect the data around us. The data collected by the sensors is analyzed, and the corresponding measures will be implemented. However, due to the limited computing resources of the sensors, the overload resource usage may occur. In order to satisfy the requirements for strong computing power, edge computing, which emerges as a novel paradigm, provides computing resources at the edge of networks. In edge computing, the computing tasks could be offloaded from the sensors to the other sensors for processing. Despite the advantages of edge computing, during the offloading process of computing tasks between sensors, private data, including identity information and address, may be leaked, which threatens personal security. Hence, it is important to avoid privacy leakage in edge computing. In addition, the time consumption of offloading computing tasks affects the using experience of customers, and low time consumption makes contributions to the development of applications which are strict with time. To satisfy the above requirements, a time-efficient offloading method (TEO) with privacy preservation for intelligent sensors in edge computing is proposed. Technically, the time consumption and the offloading of privacy data are analyzed in a formalized way. Then, an improved of Strength Pareto Evolutionary Algorithm (SPEA2) is leveraged to optimize the average time consumption and average privacy entropy jointly. At last, abundant experimental evaluations are conducted to verify efficiency and reliability of our method.
A meta-epidemiological study of subgroup analyses in cochrane systematic reviews of atrial fibrillation
Authors: Paquette Miney , Alotaibi Ahlam Mohammed , Nieuwlaat Robby , Santesso Nancy , Mbuagbaw Lawrence
Published: October 2019

Background

Information on subgroup assessments in systematic reviews (SR) of atrial fibrillation (AF) is limited. This review aims to describe subgroup analyses in AF SRs to inform the design of SRs and randomized trials as well as clinical practice.

Methods

We conducted a cross sectional meta-epidemiological study of Cochrane AF reviews by searching AF (including variants) in the title, abstract, or keyword field without date or language restrictions (Issue 9; September 2018). Two reviewers independently extracted study characteristics to summarize frequency of subgroups pre-specified and conducted and report credibility of subgroup effects claimed.

Results

Of 39 Cochrane reviews identified, 17 met inclusion criteria (including 168 reports of 127 randomized trials) and the majority (16; 94.1%) conducted meta-analysis of outcomes. Most (13; 76.5%) planned pre-specified subgroup analyses; 7 of which (41.2%) conducted subgroups. In these 7 reviews, 56 subgroups were planned, 17 (30.4%) conducted and 6 (10.7%) yielded subgroup effects. Variables such as co-morbid disease, stroke risk factors, prior stroke/transient ischemic attack, age, race, and sex represented 44% (24 subgroups) of all planned subgroups (8 conducted; 14.3%); however, information on covariate selection was lacking. Overall, more subgroups were planned than conducted (mean difference (95% CI) 2.3 (1.2–3.5, p < 0.001)). Of all subgroups conducted, anticoagulant characteristics comprised a third of all subgroup effects (n = 5, 35.7%).

The credibility of subgroups identified (n = 14) was assessed and less than half (43%) represented one of a small number of pre-specified hypothesis and rarely were effects seen within studies (7%). Of 5 reviews that reported subgroup effects, only 3 discussed subgroup effects as part of the overall conclusions; none discussed credibility of subgroup effects.

Conclusions

This meta-epidemiological review of a subset of Cochrane AF reviews suggests that planning and reporting of subgroup analyses in AF reviews can be improved to better inform clinical management. Most pre-specified subgroup analyses were not performed, important variables (such as stroke, bleeding risk, and other comorbidities) were rarely examined and credibility of subgroup effects claimed was low. Future reviews should aim to identify important subgroups in their protocols and use recommended approaches to test subgroup effects in order to better support clinical decision-making.
Analysis of two Legendre spectral approximations for the variable-coefficient fractional diffusion-wave equation
Authors: Chen Wenping , Lü Shujuan , Chen Hu , Jiang Lihua
Published: October 2019

In this paper, we solve the variable-coefficient fractional diffusion-wave equation in a bounded domain by the Legendre spectral method. The time fractional derivative is in the Caputo sense of order $\gamma \in (1,2)$
γ
∈
(
1
,
2
)
. We propose two fully discrete schemes based on finite difference in temporal and Legendre spectral approximations in spatial discretization. For the first scheme, we discretize the time fractional derivative directly by the $L_{1}$

L
1

approximation coupled with the Crank–Nicolson technique. For the second scheme, we transform the equation into an equivalent form with respect to the Riemann–Liouville fractional integral operator. We give a rigorous analysis of the stability and convergence of the two fully discrete schemes. Numerical examples are carried out to verify the theoretical results.
Nontrivial solutions of inverse discrete problems with sign-changing nonlinearities
Authors: Cabada Alberto , Dimitrov Nikolay D.
Published: October 2019

This paper is concerned with the existence of solutions of an inverse discrete problem with sign-changing nonlinearity. This kind of problems includes, as a particular case, nth order difference equations coupled with suitable conditions on the boundary of the interval of definition. It would be valid for the case in which the related Green’s function is positive on a subset of its rectangle of definition.

The existence results follow from spectral theory, as an application of the Krein–Rutman theorem and by means of degree theory.
Pathological margins and advanced cutaneous squamous cell carcinoma of the head and neck
Authors: Phillips T. J. , Harris B. N. , Moore M. G. , Farwell D. G. , Bewley A. F.
Published: October 2019

Objective

The recommended treatment for cutaneous squamous cell cancer (CuSCC) of the head and neck is Mohs surgical excision or wide local excision. Excision is recommended to a gross surgical margin of 4–6 mm however this is based on limited evidence and specify a goal histologic margin. The objective of this study was therefore to examine the reported histological margin distance following WLE of advanced CuSCC and its association with recurrence and survival.

Study design

Retrospective database review.

Setting

All patients included received treatment at UC Davis Department of Otolaryngology-Head and Neck Surgery and/or Radiation Oncology in Sacramento, California.

Subjects and methods

The patients included were treated for advanced CuSCC with primary surgery with or without adjuvant therapy. Kaplan Meier survival curves with log rank analysis were then performed to compare 5-year recurrence free survival, and disease-specific survival for patients with different margin distances.

Results

Total number of subjects was 92. The overall 5-year DSS and RFS was 68.8 and 51.0% respectively. When the pathological margin distance was ≥5 mm, 5-year disease specific survival was improved when compared to margin distance less than 5 mm (94.7 vs 60.7 p = 0.034).

Conclusion

The findings of this study suggest that a histologic margin of at least 5 mm may increase survival in advanced head and neck CuSCC patients.
Time-lapse seismic history matching with an iterative ensemble smoother and deep convolutional autoencoder
Authors: Liu Mingliang , Grana Dario
Published: October 2019

We have developed a time-lapse seismic history matching framework to assimilate production data and time-lapse seismic data for the prediction of static reservoir models. An iterative data assimilation method, the ensemble smoother with multiple data assimilation is adopted to iteratively update an ensemble of reservoir models until their predicted observations match the actual production and seismic measurements and to quantify the model uncertainty of the posterior reservoir models. To address computational and numerical challenges when applying ensemble-based optimization methods on large seismic data volumes, we develop a deep representation learning method, namely, the deep convolutional autoencoder. Such a method is used to reduce the data dimensionality by sparsely and approximately representing the seismic data with a set of hidden features to capture the nonlinear and spatial correlations in the data space. Instead of using the entire seismic data set, which would require an extremely large number of models, the ensemble of reservoir models is iteratively updated by conditioning the reservoir realizations on the production data and the low-dimensional hidden features extracted from the seismic measurements. We test our methodology on two synthetic data sets: a simplified 2D reservoir used for method validation and a 3D application with multiple channelized reservoirs. The results indicate that the deep convolutional autoencoder is extremely efficient in sparsely representing the seismic data and that the reservoir models can be accurately updated according to production data and the reparameterized time-lapse seismic data.
Anesthesia With and Without Nitrous Oxide and Long-term Cognitive Trajectories in Older Adults
Authors: Sprung Juraj , Abcejo Arnoley S. (Arney) , Knopman David S. , Petersen Ronald C. , Mielke Michelle M. , Hanson Andrew C. , Schroeder Darrell R. , Schulte Phillip J. , Martin David P. , Weingarten Toby N. , Pasternak Jeffrey J. , Warner David O.
Published: October 2019

BACKGROUND:

We evaluated the hypothesis that the rate of postoperative decline in global cognition is greater in older adults exposed to general anesthesia with nitrous oxide (N2O) compared to general anesthesia without N2O.

METHODS:

Longitudinal measures of cognitive function were analyzed in nondemented adults, 70–91 years of age, enrolled in the Mayo Clinic Study of Aging. Linear mixed-effects models with time-varying covariates assessed the relationship between exposure to surgery with general anesthesia (surgery/GA) with or without N2O and the rate of long-term cognitive changes. Global cognition and domain-specific cognitive outcomes were defined using z scores, which measure how far an observation is, in standard deviations, from the unimpaired population mean.

RESULTS:

The analysis included 1819 participants: 280 exposed to GA without N2O following enrollment and before censoring during follow-up (median [interquartile range {IQR}] follow-up of 5.4 [3.9–7.9] years); 256 exposed to GA with N2O (follow-up 5.6 [4.0–7.9] years); and 1283 not exposed to surgery/GA (follow-up 4.1 [2.5–6.4] years). The slope of the global cognitive z score was significantly more negative following exposure to surgery/GA after enrollment (change in slope of −0.062 [95% confidence interval {CI}, −0.085 to −0.039] for GA without N2O, and −0.058 [95% CI, −0.080 to −0.035] for GA with N2O, both P < .001). The change in slope following exposure to surgery/GA did not differ between those exposed to anesthesia without versus with N2O (estimated difference −0.004 [95% CI, −0.035 to 0.026], P = .783).

CONCLUSIONS:

Exposure to surgery/GA is associated with a small, but statistically significant decline in cognitive z scores. Cognitive decline did not differ between anesthetics with and without N2O. This finding provides evidence that the use of N2O in older adults does not need to be avoided because of concerns related to decline in cognition.
[Retracted] A New Heterometallic MOF in Cyanosilylation Reaction, Treatment and Care Management Value in Stroke by Reducing Oxidative Stress Damage
Authors: Chen Shu-Rong , Li Yi , Wu Bi-Yu , Xu Hui
Published: October 2019

By employment the heterometallic strategy, a new highly porous metal-organic framework {(Me2NH2)[Mn3K2(TZIA)3(H2O)3]·(DMF)4}n (1) was prepared via corresponding K(I)and Mn(II) salts and hetero-donor organic ligand 5-(1H-tetrazol-5-yl)isophthalic acid (H3TZIA) via solvothermal conditions in water and DMF mixed solvent. X-ray study of a single crystal shows that ionic K+ was immobilized on the surface of pores via trinuclear Mn2+–tetrazole coordination motif. The resulting activated 1a has been explored in detail by BET analysis to probe its porosity. The removal of water molecules in order to generate 1a makes it possible for K+ ions to be applied as an efficient and size-selective multiphase catalyst for cyanosilylation of acetaldehyde under the mild conditions without solvent. Furthermore, ELISA assay was performed to measure IL-18 and IL-1β level in hCMEC/D3 human brain microvascular endothelial cells after compound treatment. Besides, ROS detection and RT-PCR was performed to detect ROS production as well as the related gene expression. Next, the protective effect of the compound was evaluated in animal model in vivo.
Impact of Exercise–Nutritional State Interactions in Patients with Type 2 Diabetes
Authors: VERBOVEN KENNETH , WENS INEZ , VANDENABEELE FRANK , STEVENS AN , CELIE BERT , LAPAUW BRUNO , DENDALE PAUL , VAN LOON LUC J. C. , CALDERS PATRICK , HANSEN DOMINIQUE
Published: October 2019

Introduction

This study examines the role of nutritional status during exercise training in patients with type 2 diabetes mellitus by investigating the effect of endurance-type exercise training in the fasted versus the fed state on clinical outcome measures, glycemic control, and skeletal muscle characteristics in male type 2 diabetes patients.

Methods

Twenty-five male patients (glycated hemoglobin (HbA1c), 57 ± 3 mmol·mol−1 (7.4% ± 0.3%)) participated in a randomized 12-wk supervised endurance-type exercise intervention, with exercise being performed in an overnight-fasted state (n = 13) or after consuming breakfast (n = 12). Patients were evaluated for glycemic control, blood lipid profiles, body composition and physical fitness, and skeletal muscle gene expression.

Results

Exercise training was well tolerated without any incident of hypoglycemia. Exercise training significantly decreased whole-body fat mass (−1.6 kg) and increased high-density lipoprotein concentrations (+2 mg·dL−1), physical fitness (+1.7 mL·min−1·kg−1), and fat oxidation during exercise in both groups (P
TIME < 0.05), with no between-group differences (P
TIME × GROUP > 0.05). HbA1c concentrations significantly decreased after exercise training (P
TIME < 0.001), with a significant greater reduction after consuming breakfast (−0.30% ± 0.06%) compared with fasted state (−0.08% ± 0.06%; mean difference, 0.21%; P
TIME × GROUP = 0.016). No interaction effects were observed for skeletal muscle genes related to lipid metabolism or oxidative capacity.

Conclusions

Endurance-type exercise training in the fasted or fed state do not differ in their efficacy to reduce fat mass, increase fat oxidation capacity, and increase cardiorespiratory fitness and high-density lipoprotein concentrations or their risk of hypoglycemia in male patients with type 2 diabetes. HbA1c seems to be improved more with exercise performed in the postprandial compared with the postabsorptive state.
Effects of Exergaming on Cognition and Gait in Older Adults at Risk for Falling
Authors: OGAWA ELISA F. , HUANG HAIKUN , YU LAP-FAI , GONA PHILIMON N. , FLEMING RICHARD K. , LEVEILLE SUZANNE G. , YOU TONGJIAN
Published: October 2019

Purpose

To test whether an 8-wk exergaming (EG) program would improve cognition and gait characteristics compared with a traditional physical exercise (TPE) program in older adults at risk for falling.

Methods

A pilot quasi-experimental study was conducted in adults age ≥65 yr at risk for falls, living in senior communities. Participants enrolled (n = 35) in either exercise program offered twice weekly for 8 wk. Cognition and single-task and dual-task gait characteristics were measured before and after the 8-wk exercise intervention. For each outcome, a repeated-measures ANCOVA adjusted for age, gender, and exercise intensity (ratings of perceived exertion, RPE) was used to examine the group–time interaction.

Results

Twenty-nine participants (age, 77 ± 7 yr) completed either the EG program (n = 15) or the TPE program (n = 14). Statistically significant group–time interactions were observed in Trail Making Test Part A (P < 0.05) and single-task gait speed, stride length, swing time percentage, and double support percentage (all P < 0.05), and marginal group differences were observed in Mini-Mental State Examination (P = 0.07), all favoring the EG program. There were no statistically significant group differences in dual-task gait measurements except for swing time percentage and double support percentage, favoring the EG program.

Conclusions

An 8-wk EG program for older adults at risk for falls contributed to modest improvements in a number of cognitive measures and single-task but limited improvements in dual-task gait measures, compared with TPE. These findings support the need for larger trials to determine cognitive and mobility benefits related to EG.
Cardiovascular Testing Detects Underlying Dysfunction in Childhood Leukemia Survivors
Authors: LONG TREYA M. , LEE FELICITY , LAM KAITLYN , WALLMAN KAREN E. , WALWYN THOMAS S. , CHOONG CATHERINE S. , NAYLOR LOUISE H.
Published: October 2019

Purpose

Childhood leukemia survivors commonly develop late-onset cardiovascular disease after treatment with anthracyclines. Resting echocardiogram is the standard procedure for monitoring cardiac health but this method may not be sensitive enough to detect subclinical injury. Exercise echocardiography may provide a viable alternative.

Methods

Nineteen (9 males; age, 19 ± 3 yr) anthracycline-treated survivors of childhood leukemia and 17 (8 males) healthy individuals of similar age (22 ± 2 yr) were recruited. All survivors had normal resting echocardiography upon recruitment. Exercise echocardiography was performed using contemporary imaging techniques. Flow-mediated dilation (FMD), body composition, and cardiorespiratory fitness (V˙O2peak) were assessed to determine predisposition to additional disease.

Results

Mitral valve peak flow velocity in late diastole (interaction, P = 0.007) increased from rest in survivors (P = 0.023) and controls (P = 0.020) immediately postexercise but did not recover again in the survivors (exercise-recovery, P = 0.784) after recuperation. Consequently, E/A ratio (interaction, P < 0.001) was lower in the survivors at recovery (P < 0.001). Survivors had reduced FMD (7.88 ± 1.70 vs 9.65 ± 2.83; P = 0.030), maximal and recovery HR (P = 0.001; P < 0.001), minute ventilation (P < 0.001), and V˙O2peak (absolute, 2.64 ± 0.62 vs 3.14 ± 0.74 L·min−1, P = 0.034; relative, 36.78 ± 11.49 vs 45.14 ± 6.80 mL·kg−1·min−1; P = 0.013) compared with controls. They also had higher total body fat (percentage, P = 0.034; mass, P = 0.024) and fat mass in the central (P = 0.050), peripheral (P = 0.039) and visceral (P < 0.001) regions. Survivors matched controls with regard to height (173.0 ± 7.8 cm vs 173.8 ± 9.1 cm; P = 0.796), body mass (76.16 ± 19.05 kg vs 70.07 ± 13.96 kg; P = 0.287) and body mass index (25.2 ± 5.1 vs 22.9 ± 2.7; P = 0.109).

Conclusions

Exercise echocardiography unmasked subclinical diastolic dysfunction that may indicate late anthracycline toxicity in apparently healthy survivors of childhood leukemia. Presence of secondary risk factors indicates increased predisposition to comorbidities and highlights the importance of assessing cardiovascular health during follow-up.
Daily Changes of Resting Metabolic Rate in Elite Rugby Union Players
Authors: HUDSON JAMES F. , COLE MATTHEW , MORTON JAMES P. , STEWART CLAIRE E. , CLOSE GRAEME L.
Published: October 2019

Introduction

Preparation for competitive contact sport has been extensively researched. There are, however, limited data to guide players as to how the demands of their sport affect the energy requirements of recovery. We aimed to provide novel data on changes in resting metabolic rate (RMR) in contact sport athletes and relate these to the physical demands of training and competition.

Methods

Twenty-two elite professional Premiership Rugby Union players were recruited to the study. Indirect calorimetry (Vyntus CPX canopy; CareFusion) was used to measure RMR each morning of the competitive game week, in a fasted, rested state. External loads for training and game play were monitored and recorded using global positioning systems (Catapult Innovations, Australia), whereas internal loads were tracked using rate of perceived exertion scales. Collisions were reviewed and recorded by expert video analysts for contacts in general play (breakdown and tackle area) or the set piece (scrum or maul).

Results

There were significant (P = 0.005) mean increases in RMR of approximately 231 kcal the morning after (game day [GD] + 1) and 3 d after the game (GD + 3), compared with the day before the game (GD − 1). The players were exposed to internal and external loads during the training week comparable to that of a match day; however, despite the equivocal loads between training and game play, there were no significant increases in RMR after training.

Conclusion

The collisions experienced in rugby match play are likely to be responsible for the significant increases in RMR at GD + 1 and GD + 3. Consequently, the measurement of RMR via indirect calorimetry may provide a novel noninvasive measure of the effects of collisions. This study provides a novel insight to the energy requirements of recovering from contact sport.
Football Increases Future Risk of Symptomatic Radiographic Knee Osteoarthritis
Authors: LO GRACE H. , MCALINDON TIMOTHY E. , KRISKA ANDREA M. , PRICE LORI LYN , ROCKETTE-WAGNER BONNY J. , MANDL LISA A. , EATON CHARLES B. , HOCHBERG MARC C. , JACKSON REBECCA D. , KWOH C. KENT , NEVITT MICHAEL C. , DRIBAN JEFFREY B.
Published: October 2019

Introduction

Male youth in the United States commonly participate in gridiron (American) football. There are little data substantiating current popular opinion that it is associated with knee pain or osteoarthritis (OA) later in life. We aimed to evaluate the relationship of football with these outcomes in the Osteoarthritis Initiative (OAI).

Methods

This is a study of male OAI participants with knee x-ray readings, symptom assessments, and completed surveys on lifetime physical activity. The OAI is a multicenter, observational cohort recruited from the community not based on football participation status. A history of exposure to American football was ascertained via self-report. Knee radiographs were scored for Kellgren–Lawrence grade (0–4). Radiographic OA (ROA) was defined as Kellgren–Lawrence ≥ 2 in at least one knee. Frequent knee pain meant at least one knee with frequent knee pain. Symptomatic ROA required at least one knee with both ROA and frequent knee pain.

Results

A total of 1166 men had a mean age of 63.7 (SD, 9.2) yr and body mass index of 28.6 (SD, 4.2) kg·m−2. Thirty-one percent (365/1166) played football at some point in their lives, 95% of whom participated from ages 12 to 18 yr. The ORs for symptomatic ROA from the lowest to highest football participation were 1.2, 1.5, and 2.2, respectively (P for trend = 0.004). Findings were similar for football from ages 12 to 18 yr and for outcomes of knee pain and ROA.

Conclusion

This is the first large epidemiologic study to suggest that football participation, including in the teen years, may be detrimental toward knee health. Prospective studies evaluating football players are warranted.
Midsole Properties Affect the Amplitude of Soft Tissue Vibrations in Heel–Toe Runners
Authors: GIANDOLINI MARLENE , ROMAIN JEAN-PHILIPPE , HORVAIS NICOLAS , NIGG BENNO M.
Published: October 2019

Introduction

Soft tissue vibrations can generate discomfort and may necessitate a greater energy demand to preserve an efficient motion in running. Vibration damping is thus of interest from a comfort and performance standpoint. Our purpose was to assess whether changes in midsole material affect the properties of (a) soft tissue vibrations and (b) myoelectric activity.

Methods

Two midsole conditions were compared. The control condition corresponded to a full ethylene-vinyl acetate foam midsole. The experimental condition was a bimaterial midsole with a material combination of viscous and viscoelastic materials. Twelve participants ran on an indoor track in both conditions while recording the longitudinal acceleration and the EMG activity of vastus medialis (VM) and gastrocnemius medialis (GM). Wavelet transforms were performed for EMG and acceleration signals to assess the intensity of the muscle activity at low and high frequencies (37–128 and 170–395 Hz, respectively) and to calculate the damping coefficient (D) for soft tissue vibrations. The soft tissue vibrations were also characterized by the peak of acceleration (a
peak), the frequency of the power peak (f
peak), and the power of the soft tissue vibrations (PSD[8–55]).

Results

The variables a
peak and PSD[8–55] decreased for VM and GM in the viscous condition. Before heel strike, low-frequency EMG activity decreased for VM, and high-frequency EMG activity tended to decrease for GM in the viscous condition. The damping D was reduced only for VM, and f
peak was unchanged.

Conclusions

A more viscous midsole substantially reduced the amplitude of soft tissue vibrations, but not their frequency. Looking at individual results, it was noted that muscle activity was tuned in response to the acceleration input, and that the damping of soft tissue vibrations was affected by the intensity of muscle activity.
The Growing Challenge of Advanced Liver Disease Due to Alcohol Use in the United States
Authors: Gallegos-Orozco Juan F.
Published: October 2019

Through detailed analyses of the National Health and Nutrition Examination Survey, the Nationwide Inpatient Sample, and the United Network for Organ Sharing registry, the authors provide a view of the epidemiology of the spectrum of alcohol liver disease (ALD) in the United States. Although the prevalence of ALD among the general population has been relatively stable at 8%, over the last decade, there has been an increase in ALD with advanced fibrosis, including increased hospitalizations for liver cirrhosis and its complications, and an increase in ALD as a cause for liver transplant listing, as well as a greater proportion of liver cancer cases associated with ALD.
Análisis Comparativo del Rendimiento de los Módulos Fotovoltaicos Monocristalino y Policristalino bajo Condiciones Climáticas de Fusagasugá
Authors: García Vera Yimy Edisson , Sanabria Pérez Lina Fernanda , Cruz Pardo Luz Angela , Montufar Benavides Carlos Humberto
Published: October 2019

Contexto: Para satisfacer la demanda de energía mundial, la energía solar fotovoltaica ha emergido como una energía renovable, sostenible y amigable con el medio ambiente, usada como alternativa para mitigar el cambio climático causado por uso de energías provenientes de los combustibles fósiles; pensando en ello, es muy importante estudiar el comportamiento de los módulos fotovoltaicos en condiciones reales de funcionamiento.

Método: Se implementan dos sistemas fotovoltaicos autónomos similares, uno con módulo policristalino y otro monocristalino, cada uno con sistema de adquisición de datos de temperatura, humedad, voltaje y corriente, los cuales son adquiridos de forma sincronizada por un periodo de tres meses bajo condiciones climáticas locales de Fusagasugá.

Resultados: Los datos de temperatura, humedad, irradiancia, voltaje y corriente se utilizan para obtener curvas que muestran el rendimiento energético de los módulos policristalinos y monocristalinos.

Conclusiones: Los resultados de este estudio pueden ayudar a predecir el comportamiento de salida de un sistema fotovoltaico, principalmente cuando las condiciones clim´aticas como humedad, temperatura y radiación cambian. Se evidencia un mejor desempeño del módulo monocristalino que el policristalino.
Determinación de las Ponderaciones de los Criterios de Sustentabilidad Hidroeléctrica mediante la Combinación de los Métodos AHP y GP Extendida
Authors: Gómez Romero José Andrés , Soto Flores Rocío , Garduño Román Susana
Published: October 2019

Contexto: La hidroelectricidad es una tecnología madura y de larga duración, pero ha presentado problemas ambientales y sociales, para hacerle frente a estos problemas se crearon iniciativas de sustentabilidad hidroeléctrica desde hace más de dos décadas. En México los proyectos hidroeléctricos presentan problemas ambientales y sociales que ocasionan retrasos en su construcción o retrasos en su entrada a operación. El objetivo de este estudio fue determinar las ponderaciones de los criterios de sustentabilidad hidroeléctrica mediante métodos multicriterio de toma de decisiones a un grupo de expertos.

Método: Mediante la combinación de los métodos multicriterio Analítico Jerárquico del Proceso y la Programación por Metas se obtuvo la opinión de un grupo de expertos en la planeación de proyectos hidroeléctricos.

Resultados: Una vez aplicada la combinación de los métodos AHP-GP se ponderaron las perspectivas de sustentabilidad hidroeléctrica con lo que se encontró que la solución más cercana a la opinión de todos los grupos fue la emitida por el grupo de expertos en gobernanza.

Conclusiones: Los resultados indican que al cuestionar a un grupo heterogéneo de expertos se observó que se presentaron acuerdos significativos entre los grupos, lo cual llamó la atención por tratarse de grupos de expertos con especialidades diferentes.
Pessoa com deficiência: inclusão e acessibilidade na sociedade contemporânea
Authors: Costa Amaral Lucas
Published: October 2019

Com o surgimento das gerações dos direitos fundamentais: direitos civis, políticos e sociais, a sociedade passa por um período de reestruturação e inicia um longo processo de inclusão que se perpetua até hoje. Nesta evolução, as distintas classes sociais que compõem a sociedade, passam em igualdade, a se tornarem detentoras de direitos e garantias que irão servi-las como meio para uma convivência harmônica nas relações sociais. Neste sentido, surge em 24 de outubro de 1989, promulgada pelo então Presidente Sarney, a Lei nº 7.853. A primeira lei criada com o intuito de disciplinar uma proposta de proteção à pessoa com deficiência, conferindo ao Ministério Público a tarefa de defesa aos direitos coletivos deste grupo social. Desde então, o ordenamento jurídico brasileiro relacionado à proteção da pessoa com deficiência tem evoluído. Novas políticas públicas têm sido implementadas neste sistema a fim de conscientizar a população e promover a integração destes indivíduos nos meios sociais, haja vista a grande população pertencente à esta comunidade. No Brasil, cerca de 24% da população é composta por pessoas com deficiência, percentual este, que equivale à 45 milhões de brasileiros com algum tipo de deficiência, seja auditiva, visual, intelectual, psicofísica ou múltipla. Neste atual contexto, a pesquisa analisa a possibilidade de melhoria nos aspectos sociais contemporâneos que envolvem o processo de inclusão da pessoa com deficiência e expõem métodos utilizados para efetivação do exercício de direitos, como: a promoção de acessibilidade e a disponibilização de incentivos financeiros por parte do poder público, por meio de um sistema normativo em constante evolução.
EXIGIBILIDADE DA ATIVIDADE JURÍDICA PARA POLICIAIS MILITARES: UMA RELEITURA CONSTITUCIONAL ENVOLVENDO CONCURSO PÚBLICO
Authors: Nogueira Cross Priscila , Lago Laone
Published: October 2019

O presente artigo faz uma releitura constitucional acerca da exigência da atividade jurídica para ingresso nas carreiras da Magistratura e do Ministério Público, o que exigiu uma reinterpretação da Resolução nº 75 do Conselho Nacional de Justiça – CNJ, especialmente quanto aos graduados da Polícia Militar Estadual do Rio de Janeiro, historicamente tolhidos ao acesso das referidas carreiras. Uma leitura direta e literal da exigência de atividade jurídica, segundo preceitua o artigo 93, inciso I, da Constituição da República Federativa do Brasil de 1988 – CRFB/88, e nos termos regulamentares fixados pelo Conselho Nacional de Justiça – CNJ, inviabiliza o acesso de militares estaduais graduados às carreiras da magistratura e do ministério público, o que, ao que tudo indica, ofende tanto o princípio constitucional da isonomia quanto os da razoabilidade e da proporcionalidade. Diante desse cenário, melhores reflexões e esclarecimentos se fizeram necessários, especialmente para aferir se referida exigência ainda se sustenta, face interpretação conforme a Constituição.
A SITUAÇÃO JURÍDICA DOS REFUGIADOS NO BRASIL
Authors: Torres da Cruz Andreia , Cavaliere Tavares Felipe
Published: October 2019

O presente estudo trata acerca da situação jurídica do refugiado no Brasil, partindo do conceito de refúgio e sua evolução histórica, explorando a legislação internacional, especialmente o Estatuto do Refugiado (Convenção de Genebra de 1951) e o Protocolo de 1967  e discorrendo  sobre a representatividade e influência das leis internacionais na edição das normas brasileiras, tais como o Estatuto Jurídico do Refugiado (Lei nº 9474/1997) e a nova Lei de Migração, de nº 13445/2017. A pesquisa versa, ainda, acerca da efetiva aplicação das leis em atenção aos princípios fundamentais dos direitos humanos em relação aos indivíduos que buscaram refúgio em nosso país e finaliza com as ações implementadas pelos setores públicos e pela sociedade civil em união com empresas privadas e organizações não governamentais a fim de promover a integração social dessas pessoas enquanto no território nacional.
MEDIDA PROTETIVA A MULHERES VÍTIMAS DE AGRESSÃO
Authors: Da Silveira Alves Juliana
Published: October 2019

Este trabalho apresenta crítica ao veto da possibilidade de delegado de polícia aplicar medida protetiva com relação a agressões contra mulher, mostrando os pontos relevantes desse veto e o que mudaria atualmente com essa possibilidade e a importância da Lei Maria da Penha, sendo imprescindível o saber de todos. Essa possibilidade seria uma modernização e um avanço, aprimorando o direito das mulheres que são vítimas de agressão, pois muitas mulheres que sofrem violência tem certa dificuldade de ir até a delegacia justamente pelo fato de que terão que voltar aos seus lares sem nenhuma medida protetiva, que é justamente isso que elas buscam e muitas das vezes até sofrem agressões novamente e por esses motivos muitas deixam de buscar o amparo e de denunciar esses agressores.
OS CRIMES DE COLARINHO BRANCO: UMA ANÁLISE ACERCA DA CRIMINALIDADE ECONÔMICA À LUZ DA TEORIA DA ASSOCIAÇÃO DIFERENCIAL
Authors: Pimenta Pereira Rejane , Pessôa Ulisses
Published: October 2019

Tendo em vista a necessidade de se refletir sobre uma (nova) realidade que assola a população brasileira atual, qual seja, reiteradas práticas de crimes contra a ordem econômica, o presente artigo científico vislumbra apresentar estudos acerca dos crimes de colarinho branco e a criminalidade econômica à luz da Teoria da Associação Diferencial. Teoria esta que foi desenvolvida por Edwin Sutherland, proporcionando à Criminologia um grande aparato de críticas ao fenômeno criminal — que, anteriormente, tinha como caráter exclusivamente biológico —, bem como traduzir uma grande discussão dentro da perspectiva social. Para tanto, faz-se necessário indagar sobre se realmente seria a delinquência sempre oriunda da pobreza, bem como promover reflexões sobre a forma como o Estado tem atuado para investigar e sancionar delitos praticados por homens de colarinho branco, o perfil desse criminoso que pratica atos contra a administração pública e os possíveis prejuízos aos interesses da coletividade. Isso porque acredita-se ser de suma importância analisar essa realidade obscura, que tem ganhado contornos e dado notoriedade aos tribunais. Um artigo pautado em levantamento de dados bibliográficos e que objetiva promover reflexões interdisciplinares sobre Criminologia e Direito Penal Econômico perante o ordenamento jurídico brasileiro em consonância com as garantias e direitos fundamentais.
ETIQUETAMENTO E CONTROLE SOCIAL: ANÁLISE CRÍTICA DA CRIMINALIZAÇÃO DA POBREZA NO BRASIL
Authors: De França Pinheiro Nathalia , Pessôa Ulisses
Published: October 2019

O controle social é um mecanismo de coação que objetiva a padronização do comportamento. No Brasil, o controle formal é exercido pelo poder legal, de forma que a lei rege o funcionamento da sociedade. Entretanto, tendo em vista que os agentes estatais, na maioria das vezes, representam apenas os próprios interesses, há uma constante utilização da criminalização de determinadas condutas para privilegiar a minoria que figura no poder e excluir aqueles que pertencem à classe baixa. Portanto, o presente estudo visa analisar de maneira crítica como a pobreza tem sido atrelada ao controle do sistema penal brasileiro, a partir de dados estatísticos e sociológicos.
Optical Properties of Porous Silicon p-Si (100)
Authors: Gentsar P.O. , Vuichyk M.V. , Isaev M.V. , Lischuk P.O.
Published: October 2019

In this paper the reflectance spectra and transmission spectra of p-Si (100) porous silicon (PS) and silicon wires in the spectral range of 200 ÷ 1800 nm were investigated. Pore size of PS was 5 μm (lpor Si layer) and 50 μm (lpor Si layer) with porosity of 45 %, 55 % and 65 %. The length of silicon wires varies from 5.5 μm, to 50 μm with a porosity of 60 %. The decrease in the band gap of p-Si (100) porous silicon and silicon wires which grown on both sides of p-Si (100) as compared to the single crystal p-Si (100) is explained by the quantum-sized effect that occurs in the investigated objects.
Silver nanoparticles synthesis using AH leaf extract and its antimicrobial activity
Authors: Manjare Satish B , Paranjape Priyanka P , Gurav Vijay L , Shinde Poonam P , Chavan Rohit R , Thopate Shankar R
Published: October 2019

Crystallized silver nanoparticles (AgNPs) were synthesized by using the eco-friendly Artocarpus heterophyllus biomaterial. The synthesis of AgNPs was a green approach and a rapid method. The AgNPs were characterized by field-emission scanning electron microscopy (FE-SEM), Fourier transform infrared spectroscopy, X-ray diffraction and inductively coupled plasma atomic emission spectroscopy. The FE-SEM analysis showed that the size of the synthesized AgNPs ranged around 45 nm. The plant leaves acted as both a reducing and a capping agent. The synthesized AgNPs showed an absorption peak at 400–440 nm. The biosynthesized AgNPs were tested for their antimicrobial activity against both the gram-positive bacterium Staphylococcus aureus and the gram-negative bacterium Escherichia coli and the fungus Aspergillus niger. The method used in the present work is simple, rapid, single-step, environment-friendly and very cheap and is an alternative to the current physicochemical methods. The antimicrobial activity of biosynthesized AgNPs suggests their possible application in the medical and pharmaceutical industry.