bluuebunny/crossref_metadata_2025 huggingface dataset:
Perceptions towards solar mini‐grid systems in India: A multi‐stakeholder analysis
Authors: Graber Sachiko , Narayanan Tara , Alfaro Jose F. , Palit Debajit
Published: November 2019

This study identifies and assesses the perspectives of four key stakeholder groups towards solar minigrids in rural India. The stakeholders considered are policymakers, minigrid developers and operators, development organizations, and national grid representatives. Recent state and national policies in India have increased the focus on minigrids and their services. In this study, stakeholder interviews were employed to identify the attitudes towards the recent electricity policy, the underlying context for minigrid development, the role of minigrids in rural electrification, and the inclusion of minigrid systems within the larger framework of electricity sector policies by the recent government minigrid policies. Results indicate that stakeholders agree that minigrids, as a rural electricity service, are currently viable to complement the national grid due to their high reliability, performance in remote regions, and diminishing cost per unit. However, stakeholders disagree on the future outcomes, with diverging views on the priority of minigrids as an electrification tool in the face of the expanding central grid, the ideal implementation strategy for minigrids, and the potential for grid‐minigrid interaction. Based on stakeholder feedback, the growth of minigrids in India is likely to be constrained by the confidence in recent policies, necessitating more frequent dialogue among decision makers and a solidified relationship to the national electricity grid.
Labile plasma iron levels in chronic hemodialysis patients treated by intravenous iron supplementation
Authors: Bnaya Alon , Shavit Linda , Malyszko Jacek S. , Malyszko Jolanta , Slotki Itzchak
Published: November 2019

The increased usage of intravenous iron in hemodialysis patients during recent years has led to increasing concern over the potential development of iron overload. Current methods for detecting iron overload, transferrin saturation, and serum ferritin are neither sensitive nor specific. Labile plasma iron (LPI) represents a component of nontransferrin‐bound iron and may be a more accurate indicator of impending iron overload. We studied whether LPI measured can serve as an early indicator of impending iron overload and mortality in hemodialysis patients. Chronic hemodialysis patients from two medical centers in Israel and Poland who received intravenous iron were included. Baseline clinical and laboratory parameters were recorded. LPI was measured before and 48 hours after a single IV administration. Correlation of positive LPI with laboratory parameters and 2‐year mortality was evaluated. One hundred and one hemodialysis patients were included in the study. LPI became positive post‐administration in 18 (17.8%) patients. Ferritin levels >526 ng/mL and monthly iron doses >250 mg were associated with positive LPI after intravenous iron. At a 2‐year follow‐up, higher mortality was observed in the positive LPI group (61.1% compared to 25.3%, P ≤ .05), although this effect was not statistically significant after multivariate adjustment. A substantial number of hemodialysis patients have positive LPI after intravenous iron administration. LPI positively correlates with laboratory parameters that are currently in routine clinical use for detecting iron overload and with higher intravenous iron dose. Further studies should be conducted to establish the clinical implications of LPI monitoring in hemodialysis patients.
Effects of Lactobacillus Casei YBJ02 on Lipid Metabolism in Hyperlipidemic Mice
Authors: Qian Yu , Li Mingyue , Wang Wei , Wang Hongwei , Zhang Yu , Hu Qiang , Zhao Xin , Suo Huayi
Published: November 2019

Traditionally fermented yak yogurt as a Tibetan dairy product is high not only in nutrients but also in probiotics. A probiotic strain with a potential lipid reducing effect was isolated from yak yogurt. An animal model for hyperlipidemia was evaluated using the blood index and expression levels of lipid metabolism‐related proteins in mice to determine the effect of Lactobacillus casei YBJ02 (LC‐YBJ02) on lipid metabolism in hyperlipidemic mice and the underlying mechanism. LC‐YBJ02 at different concentrations exhibited certain inhibitory effects on the increase in blood lipid in mice. Particularly, high concentrations of LC‐YBJ02 can reduce the cholesterol, triglycerides, and low‐density lipoprotein content; however, no significant effect on the high‐density lipoprotein of the body has been reported. LC‐YBJ02 can effectively increase the reduction in cholesterol level by fecal excretion. In this study, the gene‐affecting mouse obesity was determined using experimental results in mice. The expression levels of peroxisome proliferator‐activated receptor γ (PPARγ), CCAAT enhancer binding protein alpha (CEBP)/α, sterol regulatory element binding protein (SREBP)‐1c, and FAS could improve because of the high‐fat diet in kidney fat. Bacteria at different concentrations could also decrease these expression levels. Specifically, the high concentration of LC‐YBJ02 could suppress the expression of PPARγ, CEBP/α, and SREBP‐1c; however, the expression of FAS was not significantly inhibited. PPARγ and FAS expression levels in the liver were low, but no significant difference was indicated. CEBP/α and SREBP‐1c expression in mouse liver was further detected by Western blot analysis; CEBP/α was considerably low and could not be detected. On the basis of these results, LC‐YBJ02 could be used as probiotics through its lipid reduction effects.
Effect of Fractionation and Chemical Characteristics on the Crystallization Behavior of Milk Fat
Authors: Wang Yunna , Li Yan , Yuan Dongdong , Li Yang , Payne Katherine , Zhang Liebing
Published: November 2019

The experiments reported in this study provided a more comprehensive insight into the effect of chemical composition on the crystallization behavior of milk fat (MF). MF was fractionated between 20 and 40 °C into nine fractions with different melting points and was first subjected to the heating step (L20, L30, L40, and S40) followed by the cooling phase (SS40, SL40, SS30, SL30, and LL40). Furthermore, the species of fatty acids (FAs) and triglycerides (TAGs) of the MF fractions were identified. The thermodynamics, crystallization behavior, and polymorphs were determined using differential scanning calorimetry, pulsed nuclear magnetic resonance, and X‐ray diffraction, respectively. The results indicated that L40 yielded the highest percentage (∼35% of the total MF) of all the fractions. Enthalpies of the melting and crystallization processes of solid fat content in this study were related to the different FA and TAG compositions of MF and its fractions. High melting fractions (HMFs) were enriched with long‐chain saturated fatty acids and tri‐saturated (S3) TAGs, and low melting fractions (LMFs) were enriched with short‐chain unsaturated FAs and tri‐unsaturated (U3) TAGs. Moreover, the various nucleation mechanisms of MF fractions were identified according to the Avrami equation. The polymorphic transformation from a β’ form of double chain length structures to a β form of triple chain length occurred in the native MF and HMFs, whereas the LMFs displayed almost no crystals.

Practical Application

This study represented the first time that nine fractions were obtained using MF fractionation via a heating step, followed by a cooling phase. Furthermore, the chemical composition of MF fractions was investigated. The results obtained from this study might be of specific value in understanding the functional properties of fat‐based dairy food in both storage conditions and real‐time applications.
Community reinforcement and family training and rates of treatment entry: a systematic review
Authors: Archer Marc , Harwood Hannah , Stevelink Sharon , Rafferty Laura , Greenberg Neil
Published: November 2019

Background and Aims

Adaptations with different modes of delivery and target addictions have found highly divergent rates of success for Community Reinforcement Approach and Family Training (CRAFT). This study aims to clarify which (1) treatment components and (2) participant characteristics contribute to rates of identified patient (IP) treatment entry.

Method

Systematic review of CRAFT evaluation studies of all designs (controlled and uncontrolled) with data synthesis and narrative analysis of addiction treatment services and university research departments in North America and Europe.

Results

A total of 691 concerned significant others (CSOs), predominately female spouses/parents, participating in 20 distinct treatment conditions from 14 studies. The main outcome of IP treatment entry rate reported by CSOs up to 12 months after starting CRAFT with key predictors/correlates including IP addiction, IP–CSO relationship, CRAFT modality and integration of treatment for IP. Meta‐analysis found CRAFT to be twice as effective as controls/comparison groups. Multi‐modality treatment, including both individual and group sessions, yielded the highest IP treatment entry rates (77 and 86%), with progressively lower rates for individual (12.5–71%), group (60%) and self‐directed workbook (13.3–40%) modalities. While all five studies targeting gambling addiction had consistently low rates (12.5–23%), other treatment components, including therapist training, treatment fidelity and integrating treatment for the IP, were implicated.

Conclusions

Adaptations of Community Reinforcement Approach and Family Training for different delivery modalities and addictions have yielded widely varying rates of treatment engagement for the identified patient, with those offering the most comprehensive support to the concerned significant other, including individual and group sessions, having highest levels of engagement success.
Nasal epithelial barrier dysfunction increases sensitization and mast cell degranulation in the absence of allergic inflammation
Authors: Kortekaas Krohn Inge , Seys Sven F. , Lund Gitte , Jonckheere Anne‐Charlotte , Dierckx de Casterlé Isabelle , Ceuppens Jan L. , Steelant Brecht , Hellings Peter W.
Published: November 2019

Background

Increased epithelial permeability has been reported in allergic rhinitis, with histamine and type‐2 inflammation being responsible for tight junction dysfunction. The impact of an epithelial barrier defect on allergic sensitization and mast cell (MC) degranulation remains speculative.

Methods

Transepithelial passage of allergens was evaluated on primary human nasal epithelial cell cultures. Active sensitization was attempted by repeated intranasal ovalbumin (OVA) applications in Naïve mice. In a passive sensitization model, mice were injected with IgE to Dermatophagoides pteronyssinus (rDer p)2 and then exposed intranasally to the allergen. Chitosan was used to disrupt nasal epithelial integrity in vitro and in vivo.

Results

Chitosan strongly reduced transepithelial electrical resistance and facilitated transepithelial allergen passage in cultured primary nasal epithelial cells. In vivo, intranasal chitosan affected occludin expression and facilitated allergen passage. After epithelial barrier disruption, intranasal OVA application induced higher OVA‐specific IgG1 and total IgE in serum, and increased eosinophilia and interleukin‐5 in bronchoalveolar lavage (BAL) compared to sham‐OVA mice. Chitosan exposure, prior to rDer p2 allergen challenge in passively sensitized mice, resulted in increased β‐hexosaminidase levels in serum and BAL compared to sham‐rDer p2 mice. Intranasal treatment with the synthetic glucocorticoid fluticasone propionate prevented chitosan‐induced barrier dysfunction, allergic sensitization, and MC degranulation.

Conclusion

Epithelial barrier dysfunction facilitates transepithelial allergen passage, allergic sensitization, and allergen‐induced MC degranulation even in the absence of inflammatory environment. These results emphasize the crucial role of an intact epithelial barrier in prevention of allergy.
Tick paralysis in dogs and cats in Australia: treatment and prevention deliverables from 100 years of research
Authors: Padula AM , Leister EM , Webster RA
Published: November 2019

This review of tick paralysis caused by Ixodes holocyclus in Australia addresses the question: What are the key discoveries that have enabled effective treatment and prevention of tick paralysis in dogs and cats? Critical examination of 100 years of literature reveals that arguably only three achievements have advanced treatment and prevention of tick paralysis in animals. First, the most significant treatment advance was the commercial availability of tick antiserum in the 1930s. Hyperimmune serum currently remains the only specific anti‐paralysis tick therapy available to veterinarians in Australia. Second, advances in veterinary critical care have increased survival rates of the most severely affected dogs and cats. Critical care advancements have been enabled through specialised veterinary hospitals that can provide appropriate care 24 h a day, and advanced training of veterinarians, veterinary nurses and technicians. Third, perhaps that biggest advance of all in the last 100 years of research has been the commercial availability of the isooxazoline class of acaricidal preventatives in Australia specifically for I. holocyclus. This highly effective class of preventatives offers long duration of action, low cost, spot‐on or oral formulations and a low rate of adverse reactions. Animal owners and veterinarians now have the most useful tool of all – a reliable preventative. This review reveals the key events in research over the last 100 years and the tortuous pathway to delivering better treatment and preventative options for this enigmatic Australian parasite.
A model to predict the risk of aspirin/non‐steroidal anti‐inflammatory drugs‐related upper gastrointestinal bleeding for the individual patient
Authors: Petersen Jóhanna , Møller Hansen Jane , de Muckadell Ove B. Schaffalitzky , Dall Michael , Hallas Jesper
Published: November 2019

Upper gastrointestinal bleeding is a feared complication of using non‐steroidal anti‐inflammatory drugs (NSAIDs) or aspirin. Studies predicting the incidence rate for individuals with a given set of characteristics are lacking. The aim of this study was to develop a risk model to predict the incidence rate of upper gastrointestinal bleeding (UGIB) in users of aspirin/NSAID based on presence of well‐defined risk factors for the individual patient.

Methods

The model was developed from data from a case‐control study, sampled from a well‐defined source population, residents of the Funen County 1995‐2006. All cases and controls were characterized in terms of factors known to affect the risk of UGIB. By using census data, we rescaled the control group, so their composition accurately reflected age and sex distribution of the source population. Only persons using NSAIDs or/and aspirin and no PPI were included in the analysis. As reference group, we chose 80‐ to 89‐year‐old women with no ulcer history, using NSAID, but neither aspirin, other platelet inhibitors, vitamin K antagonists, selective serotonin reuptake inhibitors nor corticosteroids.

Results

We identified 1388 cases among non‐users of PPIs. We found a modelled baseline incidence rate of 10.7 per 1000 person‐years for the reference group. The strongest associations were found for ADP inhibitors (OR 5.80), followed by anticoagulants treatment (OR 2.62) and prior ulcer (OR 2.68). The model performed well in terms of calibration and discriminatory power.

Conclusion

This study is the first to describe a model, which estimates the incidence rate of UGIB for patients using aspirin/NSAID, based on the specific combination of risk factors. Risk of upper gastrointestinal bleeding for a given patient can be accurately estimated using this model.
Does the Identity Objection to the future‐like‐ours argument succeed?
Authors: Blackshaw Bruce P.
Published: November 2019

Eric Vogelstein has defended Don Marquis' ‘future‐like‐ours' argument for the immorality of abortion against what is known as the Identity Objection, which contends that for a fetus to have a future like ours, it must be numerically identical to an entity like us that possesses valuable experiences some time in the future. On psychological accounts of personal identity, there is no identity relationship between the fetus and the entity with valuable experiences that it will become. Vogelstein maintains that a non‐sentient fetus nonetheless has a future like ours because it is numerically identical with a future organism that has a mind that bears valuable experiences. Skott Brill, drawing on Jeff McMahan's embodied mind account, denies that human organisms directly have experiences, claiming that they only have experiences derivatively by virtue of their thinking part, and the loss of a future like ours is not transferred to the organism. I show that on McMahan's account, a strong case can be made for the organism having experiences directly, and the subject having these experiences derivatively. This negates Brill's reasoning, although it does imply that non‐sentient fetuses do not have a future like ours in quite the same way as we do. I conclude that this is not problematic for Marquis' argument.
The importance of sex differences in pharmacology research
Authors: Gogos Andrea , Langmead Christopher , Sullivan Jennifer C. , Lawrence Andrew J.
Published: November 2019

LINKED ARTICLES

This article is part of a themed section on The Importance of Sex Differences in Pharmacology Research. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v176.21/issuetoc
[Parenting stress in long‐term foster carers: A longitudinal study]
Authors: Bergsund Hans B. , Wentzel‐Larsen Tore , Jacobsen Heidi
Published: November 2019

Background

Children in foster care tend to exhibit adverse psychosocial functioning, and foster parents tend to experience high levels of stress related to their role as carers.

Methods

The study included 60 foster children and 42 children living in biological families as a comparison group. Caregiver stress was measured using the Parenting Stress Index, while child problem behavior was measured using the Strengths and Difficulties Questionnaire. Children and their primary carer were assessed when the children were 2, 3, and 8 years, respectively.

Results

The results showed higher stress scores for foster parents at all time points, with the difference being most pronounced in stress related to the child. Problem behavior was also higher for foster children at age 8 years. Foster parent stress increased in all domains during the course of the study. Child domain stress was the only significant predictor of child problem behavior.

Conclusion

Foster parents are overall more stressed than biological parents, with stress levels increasing over time. Foster children have more behavior problems, and these problems are closely related to their carers' child‐related stress. Further implications for the reduction of parenting stress are discussed.
Rates, knowledge and risk factors of non‐fatal opioid overdose among people who inject drugs in India: A community‐based study
Authors: Saini Romil , Rao Ravindra , Parmar Arpit , Mishra Ashwani K. , Ambekar Atul , Agrawal Alok , Dhingra Neeraj
Published: November 2019

Introduction and Aims

Non‐fatal opioid overdose (NFOO) predicts future fatal opioid overdose and is associated with significant morbidity. There is limited literature on the rates and risk factors for NFOO in people who inject drugs (PWID) from India. We aimed to study the rates of NFOO and documented risk factors for NFOO, as well as knowledge‐level of NFOO among PWID from India.

Design and Methods

Community‐based, cross‐sectional and observational study. We interviewed 104 adult male participants receiving HIV prevention services. Drug use patterns, rates of NFOO and opioid overdose risk factors, knowledge about opioid overdose and its management were assessed.

Results

The mean age of the participants was 27.9 years. The most common opioid used for injecting was heroin followed by buprenorphine. About 45% (n = 47) participants had experienced an opioid overdose at least once in their lifetime. Around 25% (n = 26) participants had overdosed in the past year, while 21% (n = 22) participants had overdosed within the past 3 months. The majority had risk factors that could predispose them to NFOO. No participant was aware of the use of naloxone for opioid overdose.

Discussion and Conclusion

The rates of NFOO as well as risk factors for overdose among PWID from India are high, with poor knowledge on overdose management. There is urgent need for a program to prevent and manage opioid overdose among PWID in India.
S3‐Leitlinie: Durchführung des Epikutantests mit Kontaktallergenen und Arzneimitteln – Kurzfassung Teil 2
Authors: Mahler Vera , Nast Alexander , Bauer Andrea , Becker Detlef , Brasch Jochen , Breuer Kristine , Dickel Heinrich , Drexler Hans , Elsner Peter , Geier Johannes , John Swen Malte , Kreft Burkhard , Köllner Arno , Merk Hans , Ott Hagen , Pleschka Silvia , Portisch Maria , Spornraft‐Ragaller Petra , Weisshaar Elke , Werfel Thomas , Worm Margitta , Schnuch Axel , Uter Wolfgang
Published: November 2019

Der diagnostische Standard zum Nachweis einer bestehenden allergischen Kontaktdermatitis ist der Epikutantest. Die vorliegende Leitlinie richtet sich an Assistenz‐ und Fachärzte der Dermatologie, Allergologie und Ärzte weiterer Fachgruppen in Klinik und Praxis, die an der Indikationsstellung oder Durchführung von Epikutantests bei Patienten mit Kontaktekzemen und weiteren Spättypallergien beteiligt sind, sowie Kooperationspartner der Ärzteschaft (Fachberufe im Gesundheitswesen, Kostenträger).

Die Leitlinie zur Durchführung des Epikutantests mit Kontaktallergenen wurde auf der Basis einer systematischen Literatursuche zu definierten Schlüsselfragen evidenzbasiert und im formellen Konsensusverfahren (S3) von Dermatologen unter Einbindung von Pädiatern, Arbeitsmedizinern, Assistenzpersonal und Patientenvertretern erstellt. Bezüglich der methodischen und inhaltlichen Arbeit, auf denen die Empfehlungen basieren, wird auf Methodenbericht und Evidenztabellen verwiesen. Die Leitlinie stellt allgemeine Aspekte der Epikutantestung sowie medizinrechtliche Aspekte dar. Es werden Empfehlungen gegeben zur Indikationsstellung, Patientenaufklärung, Auswahl von Testsubstanzen und Kammersystemen, Expositionsort, ‐dauer und Ablesezeitpunkten, Interpretation von Testreaktionen, endogenen und exogenen Einflussfaktoren, Testung besonderer Personengruppen (Kinder, Schwangere, Immunsupprimierte) sowie Risiken und unerwünschten Nebenwirkungen bei der Durchführung des Epikutantests mit Kontaktallergenen.
Bar Code Reader – an algorithmic approach to cutaneous occluding vasculopathies? part II medium vessel vasculopathies
Authors: Ratzinger Gudrun , Zelger Bettina G. , Zelger Bernhard W.
Published: November 2019

Aims

Classifications of occluding vasculopathies (except vasculitis [1]) may exhibit some difficulties. Firstly, classifications may follow different principles, e.g. clinicopathologic findings, etiology or pathogenesis. Secondly, authors may not distinguish between vasculitis and occluding vasculopathies. Thirdly, occluding vasculopathies are systemic diseases. Organ‐specific variations make morphologic findings difficult to compare. Moreover, subtle changes are recognized in the skin, but may be invisible in other organs. Our aim was to use the skin and subcutis as a tool and clinicopathological correlation as the basic process for classification.

Methods and results

We first differentiate in the skin between small and medium vessel occluding vasculopathies. Here we focus on medium vessel‐occluding vasculopathies. In the second step we differentiate the vessel subtypes. In the final step, we differentiate according to the time point of the coagulation/reorganization process and the involved inflammatory cells/stromal features. By applying the same procedure to the various entities and visualizing the findings in the style of bar codes, the overlaps and differences in the clinical picture as well as the histopathology become more apparent.

Conclusions

Occluding vasculopathies are often not separate entities, but reaction patterns and epiphenomena. Distinguishing them from vasculitides is crucial because of the differences in pathogenesis, therapeutic approach and prognosis.
Impairments, functional limitations, and access to services and education for children with cerebral palsy in Uganda: a population‐based study
Authors: Andrews Carin , Kakooza‐Mwesige Angelina , Almeida Rita , Swartling Peterson Stefan , Wabwire‐Mangen Fred , Eliasson Ann-Christin , Forssberg Hans
Published: November 2019

Aim

To describe the functional limitations and associated impairments of children with cerebral palsy (CP) in rural Uganda, and care‐seeking behaviour and access to assistive devices and education.

Method

Ninety‐seven children with CP (42 females, 55 males; age range 2–17y) were identified in a three‐stage population‐based screening with subsequent medical examinations and functional assessments. Information on school and access to care was collected using questionnaires. The data were compared with Swedish and Australian cohorts of children with CP. We used the χ2test and linear regression models to analyse differences between groups.

Results

Younger children were more severely impaired than older children. Two‐fifths of the children had severe impairments in communication, about half had intellectual disability, and one third had seizures. Of 37 non‐walking children, three had wheelchairs and none had walkers. No children had assistive devices for hearing, seeing, or communication. Care‐seeking was low relating to lack of knowledge, insufficient finances, and ‘lost hope'. One‐third of the children attended school. Ugandan children exhibited lower developmental trajectories of mobility and self‐care than a Swedish cohort.

Interpretation

The needs for children with CP in rural Uganda are not met, illustrated by low care‐seeking, low access to assistive devices, and low school attendance. A lack of rehabilitation and stimulation probably contribute to the poor development of mobility and self‐care skills. There is a need to develop and enhance locally available and affordable interventions for children with CP in Uganda.

What this paper adds

Development of mobility and self‐care skills is lower in Ugandan than Swedish children with cerebral palsy (CP).

Older children in Uganda with CP are less impaired than younger children.

Untreated seizures and impairments of communication and intellect are common.

Access to health services, assistive devices, and education is low.

Caregivers lack knowledge and finances to seek care and often lose hope of their child improving.
Triphasic mitral flow pattern may indicate subclinical left ventricular systolic dysfunction
Authors: Bektaş Osman , Karagöz Ahmet , Bayramoğlu Adil , Günaydın Zeki Yüksel , Kaya Ahmet
Published: November 2019

Purpose

In this study, the presence and severity of left ventricular (LV) systolic dysfunction were investigated by speckle tracking echocardiography (STE) technique in patients with mitral triphasic mitral flow pattern (TMFP). The aim of the study was to evaluate the possible role of TMFP in the ethiopathogenesis of congestive heart failure.

Methods and results

A total of 45 patients who were diagnosed with TMFP and 30 age‐ and gender‐matched healthy volunteers were included in the study. The mean age in the study and control groups was 64 ± 12 and 62 ± 11 (P = .642), respectively. When echocardiographic parameters were evaluated, LV ejection fraction was found to be 63% ± 14 and 64 ± 12 (P = .745), in the study and control groups, respectively. LV end‐diastolic and systolic diameters and LV mass index were also similar (P < .05). When LV diastolic parameters were compared, diastolic dysfunction was detected in 38 (84.4%) patients in the study population and 13 patients (43.3%) in the control group (P < .001). When STE findings were evaluated, both global longitidunal strain and global circumferential strain were significantly lower in the TMFP group when compared to controls (18.3 ± 1.7 vs 21.5 ± 1.5, P < .001 and 17.9 ± 1.6 vs 21.3 ± 2.1, P < .001, respectively).

Conclusion

TMFP results in LV systolic dysfunction. Therefore, these patients may develop congestive heart failure in the long term. It will be rational that the patients with TMFP should be followed up more closely in terms of preventing manifest heart failure symptoms.
Simulation training for ceramic crown preparation in the dental setting using a virtual educational system
Authors: Liu Luwei , Zhou Ruyu , Yuan Siyang , Sun Zhida , Lu Xiaoqing , Li Jin , Chu Fengqing , Walmsley Anthony Damien , Yan Bin , Wang Lin
Published: November 2019

Objectives

The aim was to evaluate the effectiveness of a pre‐clinical training of ceramic crown preparation using the Virtual Educational System for Dentistry.

Material and Methods

Fifty‐seven dental students were recruited to prepare a ceramic crown under the guidance of the Real‐time Dental Training and Evaluation System (RDTES) in order to collect pre‐learning data. They participated in the online virtual learning course independently on the Virtual Learning Network Platform (VLNP). One week later, the students were invited to complete their post‐learning crown preparation with the RDTES. A questionnaire survey explored students' perceived benefits or drawbacks of the virtual educational system. Students were allocated into Group A (n = 15), B (n = 24) and C (n = 18) based on their pre‐learning performance. Differences of assessment results amongst different groups were evaluated by ANOVA and Kruskal‐Wallis tests. The pre‐ and post‐learning assessment results in all groups were compared using paired t tests or Wilcoxon signed rank tests.

Results

The error scores for four assessment items (instrument selection, preparation section, preparation reduction, preparation surface and profile) and total score of outcome assessment after the virtual learning were significantly different with those before the virtual learning (P < 0.05). There were significant interactions between time and student group in the mean scores of process and outcome assessments (P < 0.001), except for the assessment item “damage of adjacent teeth.”

Conclusion

The application of a Virtual Educational System for Dentistry with the VLNP and RDTES in pre‐clinical operative training helps students improve their clinical skills.
Sarus the Goth: from imperial commander to warlord
Authors: Wijnendaele Jeroen W.P.
Published: November 2019

The genesis of the first western kingdoms in early medieval Europe has often been framed as the consequence of barbarian invasions bringing down the Roman empire in its western provinces. This article considers a considerably more corrosive factor in the breakdown of western imperial structures, i.e. the warlordism of its own military personnel, via a case study of the Gothic aristocrat Sarus’ micro‐politics of mobility. This article will show that Sarus is one of the earliest attested cases of men willing to opt out of imperial service and use violence to reintegrate themselves later. Re‐examining the rapidly shifting political circumstances, it will demonstrate that Sarus was increasingly forced to move and take independent violent action, together with his men, in order to survive. This has major implications for a newly developing early medieval European phenomenon: the transformation of regular imperial commanders into irregular warlords.
Grey matter abnormalities in Parkinson’s disease: a voxel‐wise meta‐analysis
Authors: Xu X. , Han Q. , lin J. , Wang L. , Wu F. , Shang H.
Published: November 2019

Background and purpose

The pathophysiology of Parkinson’s disease (PD) remains unclear. Voxel‐based morphometry (VBM) detects local structural differences in brain tissue such as grey matter volume (GMV) between groups, which is helpful in understanding the pathophysiology of PD. Published VBM studies of GMV changes in PD have shown inconsistent results. Therefore, a voxel‐wise meta‐analysis of VBM studies was conducted to detect consistent GMV changes in PD.

Methods

The published literature was searched comparing whole‐brain GMV between PD patients and healthy controls (HCs) using VBM. Coordinates were extracted for the clusters of significant GMV differences between PD patients and HCs. The meta‐analysis was performed by seed‐based d mapping software.

Results

A total of 63 studies with 2867 PD patients and 1990 HCs were included. Significant GMV reductions in some brain regions were detected in PD patients, which were involved in the basal ganglia, theory of mind, vocal and visual networks. These findings remained largely unchanged in the jackknife sensitivity analysis, and no significant heterogeneity or publication bias was detected.

Conclusions

Parkinson’s disease patients have GMV reductions in a number of brain regions involved in specific networks. These findings provide morphological evidence for the pathophysiology of PD.
Efficacy of the combination of doxycycline and azithromycin for the treatment of foals with mild to moderate bronchopneumonia
Authors: Wetzig Maria , Venner Monica , Giguère Steeve
Published: November 2019

Background

Given the importance of rifampin in treatment protocols for tuberculosis in people, its use in veterinary medicine is under increasing scrutiny in some countries and alternatives might be needed in the near future.

Objectives

This study was set up to evaluate whether azithromycin combined with doxycycline is effective for the treatment of bronchopneumonia in foals and noninferior to the combination of azithromycin and rifampin.

Study design

This is a controlled, randomised and double‐blinded clinical trial. Two hundred and forty foals on a farm endemic for infections caused byRhodococcus equiwere involved.

Methods

Foals with ultrasonographic pulmonary lesions (lesion score 10‐15 cm) were allocated to 3 groups: azithromycin‐doxycycline orally (n = 81); azithromycin‐rifampin orally (n = 81); or untreated controls (n = 78). Physical examination and thoracic ultrasonography were performed by individuals unaware of treatment group assignment. Foals that worsened were considered treatment failures and removed from the study.

Results

The proportion of foals that recovered was significantly higher for foals treated with azithromycin‐doxycycline (80 of 81) or azithromycin‐rifampin (81 of 81) compared with that of control foals (57 of 78). The difference in the percentage of efficacy of azithromycin‐rifampin vs azithromycin‐doxycycline was 1.2% (90% CI = −0.78% to 3.5%) which did not cross the predetermined noninferiority limit of 10%. Therefore, azithromycin‐doxycycline was noninferior to azithromycin‐rifampin within the predetermined noninferiority limit.

Main limitations

The study was performed on a single farm, and recovery rates may differ in other locations.

Conclusion

Azithromycin‐doxycycline was noninferior to azithromycin‐rifampin for the treatment of bronchopneumonia in this farm.
SA01 – A Proposed Zircon Reference Material for Microbeam U‐Pb Age and Hf‐O Isotopic Determination
Authors: Huang Chao , Wang Hao , Yang Jin‐Hui , Ramezani Jahandar , Yang Chuan , Zhang Shao‐Bing , Yang Yue‐Heng , Xia Xiao‐Ping , Feng Lian‐Jun , Lin Jie , Wang Tian‐Tian , Ma Qian , He Huai‐Yu , Xie Lie‐Wen , Wu Shi‐Tou
Published: November 2019

A new natural zircon reference material SA01 is introduced for U‐Pb geochronology as well as O and Hf isotope geochemistry by microbeam techniques. The zircon megacryst is homogeneous with respect to U‐Pb, O and Hf isotopes based on a large number of measurements by laser ablation‐inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS) and secondary ion mass spectrometry (SIMS). Chemical abrasion isotope dilution thermal ionisation mass spectrometry (CA‐ID‐TIMS) U‐Pb isotopic analyses produced a mean 206Pb/238U age of 535.08 ± 0.32 Ma (2s, n = 10). Results of SIMS and LA‐ICP‐MS analyses on individual shards are consistent with the TIMS ages within uncertainty. The δ18O value determined by laser fluorination is 6.16 ± 0.26‰ (2s, n = 14), and the mean 176Hf/177Hf ratio determined by solution MC‐ICP‐MS is 0.282293 ± 0.000007 (2s, n = 30), which are in good agreement with the statistical mean of microbeam analyses. The megacryst is characterised by significant localised variations in Th/U ratio (0.328–4.269) and Li isotopic ratio (−5.5 to +7.9‰); the latter makes it unsuitable as a lithium isotope reference material.
Alpine Hydrogeology: The Critical Role of Groundwater in Sourcing the Headwaters of the World
Authors: Hayashi Masaki
Published: November 2019

Groundwater discharge in alpine headwaters sustains baseflow in rivers originating in mountain ranges of the world, which is critically important for aquatic habitats, run‐of‐river hydropower generation, and downstream water supply. Groundwater storage in alpine watersheds was long considered negligible, but recent field‐based studies have shown that aquifers are ubiquitous in the alpine zone with no soil and vegetation. Talus, moraine, and rock glacier aquifers are common in many alpine regions of the world, although bedrock aquifers occur in some geological settings. Alpine aquifers consisting of coarse sediments have a fast recession of discharge after the recharge season (e.g., snowmelt) or rainfall events, followed by a slow recession that sustains discharge over a long period. The two‐phase recession is likely controlled by the internal structure of the aquifers. Spatial extent and distribution of individual aquifers determine the groundwater storage‐discharge characteristics in first‐ and second‐order watersheds in the alpine zone, which in turn govern baseflow characteristics in major rivers. Similar alpine landforms appear to have similar hydrogeological characteristics in many mountain ranges across the world, suggesting that a common conceptual framework can be used to understand alpine aquifers based on geological and geomorphological settings. Such a framework will be useful for parameterizing storage‐discharge characteristics in large river hydrological models.
Waste glass in civil engineering applications—A review
Authors: Kazmi Danish , Williams David J. , Serati Mehdi
Published: November 2019

Each year, hundreds of thousands of tons of industrial wastes are being stockpiled, landfilled, and disposed of in storages occupying large areas of land that would otherwise be available for productive use. Recycling of such wastes is now becoming of urgent global interest due to an increasing population, the rise in anthropogenic activities, and the need for more efficient resource and waste management systems. Among many wastes, the generation of glass is dramatically increasing, particularly in the municipal, industrial, and construction sectors. In civil engineering, in general, crushed waste glass has been mainly investigated as a substitute for sand and fine‐grained aggregate in concrete production. In geotechnical engineering, in particular, the application of glass wastes is mainly limited to road pavements or as an additive to different soils for subgrade improvement. While glass wastes are relatively inert and potentially offer several opportunities for recycling as a substitute for diminishing and increasingly expensive sand supplies, their potential use yet remains relatively under‐researched. This paper systematically reviews the current status of knowledge on the use of glass wastes in various civil engineering applications and discusses the suitability assessment of waste glass for use as a sustainable alternative to traditional civil engineering materials.
The Shared Agency of Photography in Gallery Education: Open Eye Gallery Discusses Its Rethinking of Gallery Education, through the Role of Photography as a Tool for Co‐Authorship and Co‐Production
Authors: Wewiora Elizabeth
Published: November 2019

This article describes a current project by Liverpool organisations Open Eye Gallery (Liverpool), Whitby High School (Ellesmere Port), recent partners Liverpool Hope University and Curious Minds. The school is in an area of high socio‐economic deprivation and low level of cultural engagement. The project seeks to support students’ photographic and digital skills, using co‐authored approaches to learning to raise young people’s overall aspiration levels. This article addresses conflicts / ethics of photography, social media and the digital in creative education today but ultimately seeks to champion photography as a tool for increased visual literacy when co‐authored between both school and cultural organisation.
Developing Expertise: Benefits of Generalising Learning from the Graphic Design Project
Authors: Ellmers Grant , Foley Marius
Published: November 2019

The ability to transfer knowledge between design projects has been linked to developing expertise and, as such, is an important skill for designers. However, externalising and analysing the knowledge from the design project in ways that support transfer can be a challenge. This article explores how reflective practice can foster the conditions for knowledge transfer and links these outcomes with design expertise characteristics. A structured and critical approach to reflection was introduced alongside a graphic design project with the aim to foster the conditions for transfer to other projects. A case study strategy of inquiry was employed, drawing on a qualitative research approach, and framed by theories of reflective practice and cognitive psychology. The research demonstrates that graphic design students readily reach an ability to describe, analyse and make judgements from their design experience. However, the types of reflection that supports knowledge transfer from one design experience to another – generalisation and abstraction – are not as apparent. This outcome aligns with the behaviours associated with the expertise characteristics of a novice designer.
Drivers of bromeliad leaf and floral bract variation across a latitudinal gradient in the Atlantic Forest
Authors: Neves Beatriz , Zanella Camila M. , Kessous Igor M. , Uribbe Fernando P. , Salgueiro Fabiano , Bered Fernanda , Antonelli Alexandre , Bacon Christine D. , Costa Andrea F.
Published: November 2019

Aim

Understanding the complex interaction and relative contributions of factors involved in species and trait diversification is crucial to gain insights into the evolution of Neotropical biodiversity. Here, we investigated the drivers of morphological variation in bromeliads along a latitudinal gradient in a biodiversity hotspot.

Location

Atlantic Forest, Brazil.

Taxon

A species complex in the genus Vriesea (Bromeliaceae).

Methods

We measured shape and size variation for 208 floral bracts and 176 leaves in individuals from 14 localities using geometric morphometrics. We compiled data for two chloroplast regions (matK and trnL‐F) from 89 individuals to assess genetic diversity, population structure and phylogenetic relationships. We tested the influence of climate, altitude and genetic distance on morphological traits using linear statistical models.

Results

Temperature seasonality is a main driver of floral bract shape. Together with precipitation, it also explains changes in leaf size across the latitudinal gradient. Shifts in morphological traits are correlated with genetic structure and partly support the recent taxonomic delimitation proposed for the species complex. The species started to diversify in the Pliocene ca. 5 Mya. We detected a phylogeographical break in species distribution into northern and southern clades between the Bocaina region and the southern portion of the Atlantic Forest.

Main Conclusions

We identify how geography and environmental changes through time shape floral bracts and leaves in similar ways. At highly seasonal sites with lower annual precipitation (in the southern subtropical portion of the Atlantic Forest), leaves are larger and floral bracts are wide‐elliptic, making them better suited for increased water accumulation. In contrast, at less seasonal sites (in the tropical north, where rainfall is more abundant and temperatures are higher), leaves are narrower and floral bracts are lanceolate‐shaped, facilitating water drainage. The biogeographical break we identified suggests a role of tectonic activity and climatic oscillations in promoting species divergence and diversification.
Blood pressure related to age: The India ABPM study
Authors: Kaul Upendra , Omboni Stefano , Arambam Priyadarshini , Rao Srinivas , Kapoor Sunil , Swahney Jitendra P. S. , Sharma Kamal , Nair Tiny , Chopda Manoj , Hiremath Jagdish , Ponde Chandrashekhar K. , Oomman Abraham , Srinivas Budanur C. , Suvarna Viraj , Jasuja Sanjiv , Borges Eric , Verberk Willem J.
Published: November 2019

The present paper reports trends in office blood pressure (BP) measurement (OBPM) and ambulatory blood pressure measurement (ABPM) with age in a large multi‐center Indian all comers’ population visiting primary care physicians. ABPM and OBPM data from 27 472 subjects (aged 51 ± 14 years, males 68.2%, treated 45.5%) were analyzed and compared. Individual differences between OBPM and ABPM patterns were compared for patients according to 10‐year age categories. Results showed that systolic (S) BP values started to increase with age from the age of 40, BP variability (SD) increased from the age of 30 years. Diastolic (D) BP values started to decrease from the age of 50 years. Mean OBPM values were higher than daytime ABPM values (all P < .001) in all age‐groups. The prevalence of white coat hypertension (WCH) and masked hypertension (MH) was based on OBPM and daytime, 24‐hour, and nighttime average BPs together. WCH decreased with age from 15.1% and 12.4% in treated and untreated subjects at the youngest age to 7.2% and 6.9% in the oldest age, respectively. MH prevalence was higher for untreated than for treated subjects but remained similar for all age‐groups (range of 18.6%‐21.3%). The prevalence of reverse dippers increased with age from the youngest to oldest group with 7.3%‐34.2% (P < .001 for trend). Dippers prevalence decreased from 42.5% to 17.9% from the youngest to oldest age‐groups, respectively (P < .001 for trend). These findings confirm that BP patterns show clear differences in trends with age, particularly regarding nighttime BP.
Externalising pathways to alcohol‐related problems in emerging adulthood
Authors: Hammerton Gemma , Edwards Alexis C. , Mahedy Liam , Murray Joseph , Maughan Barbara , Kendler Kenneth S. , Hickman Matthew , Heron Jon
Published: November 2019

Background

Both ‘early‐onset persistent’ and ‘adolescent‐onset’ conduct problems (CPs) are associated with alcohol‐related problems in emerging adulthood. The escalation of early CPs into criminal behaviour and heavy alcohol consumption prior to emerging adulthood are both likely to be important pathways.

Methods

Data were analysed from 3,038 young people in a UK birth cohort, the Avon Longitudinal Study of Parents and Children. The exposure was developmental trajectories of CPs (‘low’, ‘childhood‐limited’, ‘adolescent‐onset’ and ‘early‐onset persistent’) between ages 4 and 13 years. The mediator was latent classes representing heavy alcohol consumption and/ or criminal behaviour at age 15 years. For the outcome, a quadratic latent growth curve was estimated to capture nonlinear change in alcohol‐related problems between ages 18 and 23 years.

Results

Those with ‘early‐onset persistent’ [b(95% CI) = 1.16 (0.17, 2.14)] and ‘adolescent‐onset’ CPs [b(95% CI) = 1.31 (0.17, 2.45)] had higher levels of alcohol‐related problems at age 18 years compared to those with ‘low’ CPs’, but there was little evidence of an association with alcohol‐related problems after age 19 years. There was evidence for an indirect effect of ‘early‐onset persistent’ CPs [b(95% CI) = 1.12 (0.52, 1.72)] on alcohol‐related problems at age 18 years via the latent classes of alcohol and criminal behaviour in adolescence. This was not found for ‘adolescent‐onset’ CPs [b(95% CI) = 0.35 (−0.36, 1.07)].

Conclusions

Strong associations exist between early CPs, adolescent alcohol consumption and criminal behaviour and alcohol‐related problems at age 18 years. Associations between early CPs and alcohol‐related problems weakened considerably across emerging adulthood.