bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of soil temperature and water content on belowground hydraulic conductance and leaf gas exchange in mature trees of three boreal species
Authors: Lintunen Anna , Paljakka Teemu , Salmon Yann , Dewar Roderick , Riikonen Anu , Hölttä Teemu
Published: December 2019

Understanding stomatal regulation is fundamental to predicting the impact of changing environmental conditions on vegetation. However, the influence of soil temperature (ST) and soil water content (SWC) on canopy conductance (gs) through changes in belowground hydraulic conductance (kbg) remains poorly understood, because kbg has seldom been measured in field conditions. Our aim was to (a) examine the dependence of kbg on ST and SWC, (b) examine the dependence of gs on kbg and (c) test a recent stomatal optimization model according to which gs and soil‐to‐leaf hydraulic conductance are strongly coupled. We estimated kbg from continuous sap flow and xylem diameter measurements in three boreal species. kbg increased strongly with increasing ST when ST was below +8°C, and typically increased with increasing SWC when ST was not limiting. gs was correlated with kbg in all three species, and modelled and measured gs were well correlated in Pinus sylvestris (a model comparison was only possible for this species). These results imply an important role for kbg in mediating linkages between the soil environment and leaf gas exchange. In particular, our finding that ST strongly influences kbg in mature trees may help us to better understand tree behaviour in cold environments.
Combining thermal imaging with photogrammetry of an active volcano using UAV: an example from Stromboli, Italy
Authors: Wakeford Zoë E. , Chmielewska Magda , Hole Malcolm J. , Howell John A. , Jerram Dougal A.
Published: December 2019

Volcanoes are a potential hazard to over 750 million people worldwide. Accessing them to install monitoring equipment can be logistically challenging and dangerous. Traditional monitoring equipment is expensive and not available to many local communities. A new, low‐cost method is proposed to address these challenges using a unique 3D thermal photogrammetric modelling workflow. The data acquisition and processing part of this workflow has been tested on Stromboli, a volcano in the Aeolian Islands of Italy. Unmanned aerial vehicles (UAVs) were deployed at the volcano to acquire both visible and thermal infrared imagery. Both datasets were then digitally processed to produce 3D virtual outcrop models. Finally, the two datasets and models were integrated to produce the first 3D thermal photogrammetric model of an active volcano. The result is an easy‐to‐use workflow applicable to any volcano. This low‐cost monitoring system could be deployed in developing countries and remote areas otherwise hindered by limited budgets and poor access.
miR‐16‐5p modulates the radiosensitivity of cervical cancer cells via regulating coactivator‐associated arginine methyltransferase 1
Authors: Zhang Shumao , Wang Weiqing , Wu Xia , Liu Weihua , Ding Fengna
Published: December 2019

This study was to investigate the expression of coactivator‐associated arginine methyltransferase 1 (CARM1) and miR‐16‐5p in cervical cancer (CC), and explore their roles in radioresistance. Western blot and immunohistochemistry were used to detect the expression of CARM1 in tissues and cells. Reverse transcription‐polymerase chain reaction (RT‐PCR) was used to detect the expression of miR‐16‐5p. CC cells received different doses of X‐ray exposure, and then cell counting kit‐8 method and colony formation assay were used to detect cell proliferation. Apoptosis was detected by flow cytometry. Then we used Targetscan database to predict that CARM1 is a potential target of miR‐16‐5p, and further verified the targeting relationship between them by western blot, RT‐PCR and dual luciferase reporter experiments. We demonstrated that CARM1 were highly expressed in CC tissues and radio‐resistant CC cells, while miR‐16‐5p expression was low. Under irradiation, up‐regulation of CARM1 can induce radiotherapy resistance of CC cells, while overexpression of miR‐16‐5p or CARM1 knockdown could inhibit the survival of CC cell and induced apoptosis. CARM1 was verified as a target for miR‐16‐5p. Besides, up‐regulation of CARM1 reversed the increase in radiosensitivity induced by miR‐16‐5p. Collectively, we concluded that miR‐16‐5p promoted the radiosensitivity of CC cells by targeting CARM1.
Periodic limb movements during sleep and blood pressure changes in sleep apnoea: Data from the European Sleep Apnoea Database
Authors: Lombardi Carolina , Parati Gianfranco , Soranna Davide , Zambon Antonella , Sliwinski Paweł , Roisman Gabriel , Pepin Jean‐Louis , Schiza Sophia , Riha Renata , Joppa Pavol , Fietze Ingo , Hedner Jan , Grote Ludger ,   the European Sleep Apnoea Database (ESADA) Collaborators
Published: December 2019

Background and objective

OSA and PLMS are known to induce acute BP swings during sleep. Our current study aimed to address the independent effect of PLMS on BP in an unselected OSA patient cohort.

Methods

This cross‐sectional analysis included 1487 patients (1110 males, no previous hypertension diagnosis or treatment, mean age: 52.5 years, mean BMI: 30.5 kg/m2) with significant OSA (defined as AHI ≥ 10) recruited from the European Sleep Apnoea Cohort. Patients underwent overnight PSG. Patients were stratified into two groups: patients with significant PLMS (PLMSI > 25 events/hour of sleep) and patients without significant PLMS (PLMSI < 25 events/hour of sleep). SBP, DBP and PP were the variables of interest. For each of these, a multivariate regression linear model was fitted to evaluate the relationship between PLMS and outcome adjusting for sociodemographic and clinical covariates (gender, age, BMI, AHI, ESS, diabetes, smoking and sleep efficiency).

Results

The univariate analysis of SBP showed an increment of BP equal to 4.70 mm Hg (P < 0.001) in patients with significant PLMS compared to patients without significant PLMS. This increment remained significant after implementing a multivariate regression model (2.64 mm Hg, P = 0.044). No significant increment of BP was observed for DBP and PP.

Conclusion

PLMS is associated with a rise in SBP regardless of AHI, independent of clinical and sociodemographic confounders. A PLMS phenotype may carry an increased risk for cardiovascular disease in OSA patients.
Assessing Heterogeneity in Transition Propensity in Multistate Capture–Recapture Data
Authors: Jeyam Anita , McCrea Rachel , Pradel Roger
Published: December 2019

Multistate capture–recapture models are a useful tool to help to understand the dynamics of movement within discrete capture–recapture data. The standard multistate capture–recapture model, however, relies on assumptions of homogeneity within the population with respect to survival, capture and transition probabilities. There are many ways in which this model can be generalized so some guidance on what is really needed is highly desirable. Within the paper we derive a new test that can detect heterogeneity in transition propensity and show its good power by using simulation and application to a Canada goose data set. We also demonstrate that existing tests which have traditionally been used to diagnose memory are in fact sensitive to other forms of transition heterogeneity and we propose modified tests which can distinguish between memory and other forms of transition heterogeneity.
Systematically variable geometry and architecture of incised‐valley fills controlled by orbital forcing: A conceptual model from the Pennsylvanian Breathitt Group (Kentucky,USA)
Authors: Le Cotonnec Aymeric , Ventra Dario , Hudson Sam , Moscariello Andrea
Published: December 2019

Incised‐valley fills preserved within ancient coastal to shallow‐marine successions represent important archives of environmental and sea‐level change. Most current knowledge about the origin of incised valleys stems from Quaternary case studies; however, research on pre‐Quaternary examples can shed light on valley formation and evolution across longer timespans. This article describes different types of incised‐valley fills from Lower to Middle Pennsylvanian fluvio‐deltaic successions of the Breathitt Group (eastern Kentucky), accumulated in the Central Appalachian Foreland under prevalent glacioeustatic forcing driven by Gondwanan glaciations. Based on well‐established criteria for their recognition, numerous incised‐valley fills were identified from outcrop and subsurface data through more than 300 m of clastic successions consisting of fourth‐order stratigraphic sequences stacked into third‐order composite sequences. Incised‐valley fills were categorized into three archetypes based on lateral extent and aspect ratio (relatively wide versus narrow valley fills), nature of infill (fully continental versus mixed marine and continental facies associations) and relationships to underlying coal zones (truncating versus non‐truncating). The systematic occurrence of each incised‐valley fill type at specific stratigraphic positions within every third‐order sequence suggests control by a periodic allogenic factor. Valley‐fill archetypes are interpreted in terms of variable accommodation‐supply ratios driven by variable duration of formative base‐level cycles. For example, relatively wide incised‐valley fills with alluvial infill evolved during long‐lived cycles whose prolonged base‐level drawdown maintained low accommodation/supply ratios. Deeper valleys with low aspect ratios and mixed marine‐continental infills were generated by short‐lived base‐level drawdown that forced higher accommodation/supply ratios. Available chronological data for the studied successions consent to estimate base‐level cycles spanning 104–5 years that were likely modulated by interference patterns of orbital parameters (obliquity and eccentricity) via global climate and glacioeustatic fluctuations. This conceptual model, relating incised‐valley fill morphometry and internal architecture to orbital forcing patterns, provides a possible approach to predicting and interpreting incised‐valley fill variability through successions accumulated during icehouse conditions.
Cardiorespiratory and muscular fitness in young adult Finnish men between 2003 and 2015
Authors: Vaara Jani P. , Santtila Matti , Vasankari Tommi , Fogelholm Mikael , Mäntysaari Matti , Pihlainen Kai , Vaara Elina , Kyröläinen Heikki
Published: December 2019

Introduction

Physical fitness is strongly related to health and may offer valuable information about public health. We investigated trends in physical fitness, leisure‐time physical activity (LTPA), and anthropometry of young healthy adult Finnish men in representative population‐based samples between 2003 and 2015.

Methods

Three independent cross‐sectional samples of 18‐ to 35‐year‐old Finnish men were assessed in 2003 (n = 889), 2008 (n = 803), and 2015 (n = 690). Cardiorespiratory (VO2max) and muscular fitness (1‐minute sit‐ups and push‐ups), body mass, and height were measured. Self‐reported LTPA was assessed.

Results

After adjusting for age, education, and smoking, cardiorespiratory fitness was higher in 2003 (mean: 43.5, 95%CI: 42.9‐44.1 mL/kg/min) compared to 2008 (41.3, 95%CI: 40.7‐41.9 mL/kg/min) and 2015 (40.6, 95%CI: 40.0‐41.2 mL/kg/min) (P < .001), whereas no difference was observed between 2008 and 2015. The lowest values in muscular fitness were observed in 2003, while no clear trends were further noticed. The adjusted BMI was higher in 2008 (25.1, 95%CI: 24.9‐25.4) and 2015 (25.3, 95%CI: 25.3, 95%CI: 25.0‐25.6) compared to 2003 (24.5, 95%CI: 24.3‐24.8) (P < .005). In 2015, a higher proportion of individuals exercised at least four times per week compared to 2003 and 2008 (P < .05).

Conclusion

The decrease in cardiorespiratory fitness that took place between 2003 and 2008 plateaued after 2008. The plateau is in accordance with the previously observed trend of 5‐10 years younger Finnish men. Moreover, muscular fitness was for the most part higher in 2008 and 2015 compared to 2003. Efforts directed to promote regular physical activity and improve physical fitness are needed.
Quantity vs. quality: an assessment of the current pipeline for rabies
Authors: Neevel Anne M. G. , Urias Eduardo , Claassen Eric , van de Burgwal Linda H. M.
Published: December 2019

Objectives

To gain insight in the potential of the current pipeline for rabies to decrease the burden of disease by evaluating its relevance to high‐risk countries.

Methods

Rabies‐related patent documents and clinical trials were retrieved from Espacenet and the WHO ICTRP, respectively. Data were cleaned, modulated and categorised into a pre‐defined set of indicators those were used for (statistical) analyses on the number of patent applications, patent quality and type of stakeholders involved for different geographical areas.

Results

Analysis of 583 unique patent families applied for in the period 1954–2017 showed a steep growth in the yearly number of patent applications. A significant portion of new patent applications concern Chinese patents with relatively low quality that are filed by a dispersed group of applicants. Excluding these patents, the number of patent applications has been virtually stable over the years. A shift is seen in public stakeholders becoming more prolific as patent applicants. This shift is also reflected in clinical trials; key sponsors of clinical trials include public and private stakeholders originating from high‐risk rabies countries. The majority of clinical trials investigate adjustments to existing vaccines that may improve accessibility.

Conclusion

The results show a discrepancy between the quantity and quality of rabies patent applications that reflects national patent regulations rather than real progress in decreasing the burden of disease. This is in contrast to clinical trials, which focus on incremental innovations that are tested in clinical trials but may nevertheless have a potentially strong impact in high‐risk countries.
School Board Efficiency in Financial Management and Human Resource in Public Senior High Schools: An Evidence from Ashanti Region, Ghana
Authors: Manu Blessing Dwumah , Zhang Huaisheng , Oduro Daniel , Krampah-Nkoom Anastasia , Mensah Isaac Adjei , Anaba Oswin Aganda , Isaac Adubofour
Published: December 2019

Education reform has led to the replacement of public senior high schools by the governing council, which is responsible for handling and managing the flow of resources in Ghana. Notwithstanding these lawful necessities and government financial provision for schools, it is unfortunate that poor facilities, poor performance and low morale among both teaching and non-teaching staff continue to impede the academic achievement of most Ghanaian public Senior high schools. The purpose of this study was to evaluate the efficiency of Board of Management (BOM) in financial and human resource management in Ashanti region of Ghana. This research adopted descriptive survey design. Thirty-five headmasters and 215 BOM participants from 35 public senior high schools in Ashanti region, Ghana contributed in the study. Using representative survey questionnaire, data were gathered. The study established that, in supervising and managing financial activities in the sampled schools, the BOM was not up to task. Nevertheless, it was observed that, BOM were efficient in managing human resources and its related activities. The study proposes that, the Ministry of Education develop a strategy or framework that obligates the government to provide BOM members with functional training as required by the basic law of education.
Synergity of the Historic Building to the Progress of Tourism in the City of Makassar, Indonesia
Authors: MSi Ahmad Husain
Published: December 2019

The type of qualitative research through the phenomenological approach, the results showed that historical buildings have an appeal for domestic and foreign tourists, so it is necessary to preserve historical buildings Professional who supported some correct information and informant can understand the historical plot of the building, so that it can provide information to the tourism visitors in the city of Makassar.
Caracterización de los determinantes sociales de las Rickettsiosis en El Jigual, Rosas, Cauca en el año 2016. Un estudio de caso cualitativo
Authors: Peña Ríosa Yiyola , López Oscar Eduardo , Borrero Ramírez Yadira
Published: December 2019

Introducción: las Rickettsiosis representan un desafío para la salud pública por su letalidad, complejidad diagnóstica, desconocimiento del personal de salud, las comunidades y difícil control; aunque Colombia ha tenido brotes, no hay estudios sobre los determinantes sociales de las Rickettsiosis. Objetivo: caracterizar los determinantes sociales de las Rickettsiosis en la vereda Jigual (Colombia). Métodos: estudio de caso cualitativo, instrumental, con diseño etnográfico. Resultados: se encontró una población en condiciones de pobreza, con alto índice de necesidades básicas insatisfechas, alta dependencia económica, baja escolaridad, producción agropecuaria artesanal, con ampliación de la frontera agrícola por presión sobre los suelos y percepción de incremento de la temperatura local, con aumento de infestación por garrapatas. No se encontró percepción de riesgo frente al vector en la comunidad; además, la respuesta institucional ha sido desarticulada y discontinua. Discusión: las Rickettsiosis son un reto para la salud pública, debido a la complejidad de las condiciones sociales asociadas y la ausencia de percepción de riesgo; algunos autores coinciden en que los brotes epidémicos están relacionados con rezago social y la percepción de riesgo de exposición al vector.
Carga de enfermedad por tuberculosis en el municipio de Pereira 2010 -2015
Authors: Cerezo Correa María del Pilar , Gómez Forero Diana Paola , Palacios Martínez Yeniffer
Published: December 2019

Esta investigación estimó la carga de enfermedad por tuberculosis en Pereira, en el periodo 2010-2015. Se incluyeron los pacientes del programa de tuberculosis. Se calcularon incidencias e indicadores de carga de enfermedad. Se utilizaron tarjetas de manejo, seguimiento y tratamiento, libros de pacientes, historias clínicas y registros de defunciones del DANE; el procesamiento se hizo con la plantilla de la Organización Mundial de la Salud, y en hojas de cálculo de Excel. En el periodo ingresaron al programa 1796 casos; Los AVPP (años de vida potencialmente perdidos), 3753,61. Comparando 2010 y 2015, los casos aumentaron 4,2 veces en hombres y 3,2 veces en mujeres. Los AVAD (años de vida ajustados por discapacidad) fueron mayores en hombres, el 67% entre los 30 y 69 años, la mayor diferencia entre sexos se dio en el 2015. Se perdieron 8711,2 AVISA (años de vida saludable perdidos). En conclusión, la carga de enfermedad por tuberculosis en Pereira es mayor por AVPP en hombres, en edades entre 15 y 69 años, y aumentó considerablemente entre 2010 y 2015.
International Migration and Health in the Countries of Origin. The Effect on Households with Migrants and/or Recipients of Remittances, and on Returned Migrants. A Systematic Review
Authors: Tovar Cuevas Luis Miguel , Victoria Paredes María Teresa , Zarama Camilo , Arellano Morales Matheo
Published: December 2019

This work represents a systematic literature review that studies the effect of international migration on the health of households in the countries of origin and of returned migrants. The effect is due to: 1) remittances, 2) transfer of ideas, habits and behavioral norms, and 3) the previous migratory experience of returned migrants. Aspects of health that may be affected are fertility rate, general health condition, access to health services, mental health, life expectancy, anthropometric measures and nutrition, health expenditure, risk factors or health protectors. The search included articles and documents published between January 2000 and August 2017, written in English or Spanish, included in the databases Jstor, Proquest, IDEAS-RePec, Scielo, Google Scholar and PubMed. Based on quantitative and qualitative methodologies, the 85 selected articles, found positive and/or negative effects on health of children, adolescents, women, older adults and returned migrants. This systematic review offers a broad look of the effects of international migration on the health of the ones who stay, which results useful for policy makers and researchers. Not all findings are consistent and therefore, further research on the matter is necessary, considering qualitative approaches.
Boundary integral equations for sound radiation from a harmonically vibrating body moving uniformly in a free space
Authors: Sheng Xiaozhen , Peng Yuhao , Xiao Xinbiao
Published: December 2019

In this high-speed transit era, the prediction of sound radiation from a moving and vibrating object is an important research topic. A typical example is a high-speed train wheel that not only moves fast in the railway direction but, due to wheel/rail interaction, also vibrates at high frequency, generating a complex sound field. By making use of sound spectra generated by moving harmonic compact sources, three-dimensional (3D) boundary integral equations are established in this paper for sound radiation from a harmonically vibrating body moving uniformly in a free space. The 3D boundary integral equations are reduced to 2D ones for a special case in which the body is axisymmetric and moves in its axial direction. The 2D boundary element method is applied to solve the 2D boundary integral equations and to produce results for a pulsating and moving sphere. Results show that the moving speed of the pulsating sphere has a significant effect on the generated sound field. This means that, for sounds radiated from a high-speed train wheel vibro-acoustically, the motion of the wheel has to be taken into account.
The Cryptic Plasmid Improves
Chlamydia
Fitness in Different Regions of the Gastrointestinal Tract
Authors: Ma Jingyue , He Conghui , Huo Zhi , Xu Ying , Arulanandam Bernard , Liu Quanzhong , Zhong Guangming
Published: December 2019

The cryptic plasmid is important for chlamydial colonization in the gastrointestinal tract. We used a combination of intragastric, intrajejunal, and intracolon inoculations to reveal the impact of the plasmid on chlamydial colonization in distinct regions of gastrointestinal tract. Following an intragastric inoculation, the plasmid significantly improved chlamydial colonization. At the tissue level, plasmid-positive
Chlamydia
produced infectious progenies throughout gastrointestinal tract.
Rap Protein Paralogs of Bacillus thuringiensis: a Multifunctional and Redundant Regulatory Repertoire for the Control of Collective Functions
Authors: Gastélum Gabriela , de la Torre Mayra , Rocha Jorge
Published: December 2019

The
Bacillus cereus
group of bacteria includes species of high economic, clinical, biological warfare, and biotechnological interest, e.g.,
B. anthracis
in bioterrorism,
B. cereus
in food intoxications, and
B. thuringiensis
in biocontrol. Knowledge about the ecology of these bacteria is hindered by our limited understanding of the regulatory circuits that control differentiation and specialization processes. Here, we uncover the participation of eight Rap quorum-sensing receptors in collective functions of
B. thuringiensis
. These proteins are highly multifunctional and redundant in their functions, linking ecologically relevant processes such as sporulation, biofilm formation, spreading, extracellular proteolytic activity, and probably other functions in species from the
B. cereus
group.
A Complex for Diagnostics of Laser Radiation of Semiconductor Targets Excited by a High-Frequency-Modulated Electron Beam
Authors: Nasibov A. S. , Berezhnoi K. V. , Tasmagulov I. D. , Yalandin M. I. , Sadykova A. G. , Ul’maskulov M. R. , Shunailov S. A.
Published: December 2019

Abstract—A complex of equipment for diagnosing the parameters of laser radiation of semiconductor targets, which are excited by high-frequency-modulated electron-beam pulses, is described. The ability to control the shape and duration of laser radiation in the picosecond range via high-frequency modulation of an accelerating-voltage pulse was demonstrated experimentally. A train of laser-radiation pulses with a maximum intensity of up to 2 × 107 W/cm2 was obtained on a cadmium sulfide target (λ = 525 nm).
Plant-based dietary approach to stage 3 chronic kidney disease with hyperphosphataemia
Authors: Campbell Thomas M , Liebman Scott E
Published: December 2019

A 69-year-old man with type 2 diabetes, hypertension and stage 3 chronic kidney disease (CKD), hyperphosphataemia and borderline hyperkalaemia presented to an office visit interested in changing his diet to improve his medical conditions. He adopted a strict whole-foods, plant-based diet, without calorie or portion restriction or mandated exercise, and rapidly reduced his insulin requirements by >50%, and subsequently saw improvements in weight, blood pressure and cholesterol. His estimated glomerular filtration rate (eGFR) increased from 45 to 74 mL/min after 4.5 months on the diet and his microalbumin/creatinine ratio decreased from 414.3 to 26.8 mg/g. His phosphorus level returned to the normal range. For individuals with CKD, especially those with obesity, hypertension, or diabetes, a strict, ad libitum whole-food, plant-based diet may confer significant benefit, although one must consider potential limitations of a creatinine-based GFR equation in the face of significant weight loss.
Kounis syndrome uncovers severe coronary disease: an unusual case of acute coronary syndrome secondary to allergic coronary vasospasm
Authors: Conti Luca , Gatt Kelly , Zammit Christopher , Cassar Karen
Published: December 2019

Acute coronary syndrome occurring during the course of a type I hypersensitivity reaction constitutes Kounis syndrome. We report a case of a 64-year-old man who presented with a non-ST elevation myocardial infarction and peripheral blood eosinophilia. He had rhinitis and constitutional symptoms for several days prior to presentation. Blood investigations revealed moderate eosinophilia and elevated IgE levels. A cardiac MRI showed generalised oedema with a subtle wall motion abnormality in basal inferior/inferolateral wall, and subendocardial high signal on late gadolinium enhancement suggesting a localised myocardial infarction. A coronary angiogram then revealed triple vessel disease. A diagnosis of Kounis syndrome was made. Within days of starting appropriate treatment, the patient’s eosinophil count returned to normal with improvement of clinical picture.
Factors associated with HIV in younger and older adult men in South Africa: findings from a cross-sectional survey
Authors: Govender Kaymarlin , Beckett Sean Edward , George Gavin , Lewis Lara , Cawood Cherie , Khanyile David , Tanser Frank , Kharsany Ayesha BM
Published: December 2019

Objective

This study investigated the behavioural, psychosocial and biological factors associated with HIV in a younger group of men (15 to 24 years) compared with an older group of men (25 to 35 years).

Design

A household-based, cross-sectional study was conducted.

Setting

Men were randomly selected using a two-stage random sampling method in KwaZulu-Natal, South Africa, between June 2014 and June 2015.

Participants

Overall, we interviewed 1472 younger men and 1138 older men. Only participants who could speak English or Zulu, were able to provide informed consent and who were expected to be living in the study area for the next 12 months were enrolled into the study.

Primary and secondary outcomes

HIV status was the primary outcome for the study. Men’s HIV status was derived from blood samples collected in the study which were tested for HIV antibodies.

Results

HIV prevalence was higher among older men (35.4%, 95% CI: 31.7 to 39.1) than younger men (7.6%, 95% CI: 6.2 to 9.4, p<0.01). Older men, who completed secondary school had a lower likelihood of being HIV positive (adjusted OR (AOR): 0.41, 95% CI: 0.27 to 0.63, p<0.001) and those with greater food insecurity had a higher likelihood of being HIV positive (AOR: 1.57, 95% CI: 1.05 to 2.34, p=0.04). Younger men with a higher number of lifetime sexual partners had a higher likelihood of being HIV positive (AOR: 1.04, 95% CI: 0.99 to 1.09, p=0.09).

Conclusion

Given that the HIV prevalence is higher in the older men, community based interventions need to target older men for medical circumcision and support HIV positive men to improve their material conditions early. For younger men intervening to reduce HIV risk behaviours at a young age before these behaviours become entrenched should be central to HIV prevention programmes.
Validation study of randomly selected cases of PTSD diagnoses identified in a Swedish regional database compared with medical records: is the validity sufficient for epidemiological research?
Authors: Hollander Anna-Clara , Askegård Klara , Iddon-Escalante Claudia , Holmes Emily A , Wicks Susanne , Dalman Christina
Published: December 2019

Objectives

In Sweden, the patients’ diagnoses are recorded in administrative registers. The research value of these registers is determined by their diagnostic validity, that is, if the diagnosis recorded meets the relevant diagnostic criteria. The aim of the study was to assess the validity of post-traumatic stress disorder (PTSD)-diagnoses as compared with case notes in medical records (MRs) and to test if there was a difference in validity by gender, migration status and those with and without psychotic symptoms. We hypothesised that the validity would be sufficient, using bothDiagnostic and Statistical Manual of Mental Disorders(DSM)-IV and DSM-5 but higher according to DSM-IV than DSM-5, and that the validity would be the same for men and women, but different for Swedish-born and migrants, and for those with and without psychotic symptoms.

Design and setting

A validation of the register-diagnoses using MRs from treatment centres within the Region of Stockholm to examine whether patients with a register-diagnosis of PTSD fulfilled DSM criteria of PTSD according to the case notes in their MRs.

Participants

A random sample of 187 patients aged 18–64, who had been diagnosed with PTSD (F43.1 in the ICD-10) were drawn from the Region of Stockholm’s MR database 2013–2015.

Primary outcome measure

Validity of the PTSD diagnoses according to DSM-IV and DSM-5 as proportions of true positives with 95% CI.

Results

The hypothesised sufficient validity of the PTSD diagnoses was confirmed. Although the point-estimates for DSM-IV were higher than for DSM-5, the hypothesis that there would be significant differences in validity between DSM-IV and DSM-5 was not confirmed. There were no significant validity differences by gender, migration status and for those with and without psychotic symptoms.

Conclusions

This study has found that validity of the PTSD diagnoses in the register of the Region of Stockholm to be sufficient for epidemiological research.
Study design and protocol for a comprehensive evaluation of a UK massive open online course (MOOC) on quality improvement in healthcare
Authors: Smith-Lickess Sian K , Woodhead Tricia , Burhouse Anna , Vasilakis Christos
Published: December 2019

Introduction

Massive open online courses (MOOCs) offer a flexible approach to online and distance learning, and are growing in popularity. Several MOOCs are now available, to help learners build on their knowledge in a number of healthcare topics. More research is needed to determine the effectiveness of MOOCs as an online education tool, and explore their long-term impact on learners’ professional practice. We present a protocol describing the design of comprehensive, mixed-methods evaluation of a MOOC, ‘QualityImprovement (QI) inHealthcare: the Case for Change’, which aims to improve learner’s knowledge and understanding of QI approaches in healthcare, and to increase their confidence in participating, and possibly leading QI projects.

Methods and analysis

A pre-post study design using quantitative and qualitative methods will be used to evaluate the QI MOOC. Different elements of the RE-AIM (reach, effectiveness and maintenance) and Kirkpatrick (reaction, learning and behaviour) models will be used to guide the evaluation. All learners who register for the course will be invited to participate in the QI MOOC evaluation study. Those who consent will be asked to complete a presurvey to assess baseline QI knowledge (self-report and objective) and perceived confidence in engaging in QI activities. On completion of the course, participants will complete a postsurvey measuring again knowledge and perceived confidence. Feedback on the course content and how it can be improved. A subset of participants will be invited to take part in a follow-up qualitative interview, 3 months after taking the course, to explore in depth how the MOOC impacted their behaviour in practice.

Ethics and dissemination

The study has been approved by the University of Bath Human Research Ethics Committee (reference: 2958). Study findings will be published in peer-reviewed journals, and disseminated at conference and departmental presentations, and more widely using social media, microblogging sites and periodicals aimed at healthcare professionals.
Assessment of the use of Unna boot in the treatment of chronic venous leg ulcers in adults: systematic review protocol
Authors: Paranhos Thalita , Paiva Caroline S B , Cardoso Fernanda C I , Apolinário Priscila P , Figueiredo Azevedo Flavia , Saidel Maria G B , Oliveira Henrique C , Dini Ariane P , Kumakura Ana R S O , Melo Lima Maria H
Published: December 2019

Introduction

Chronic venous insufficiency (CVI) is an anomaly of the normal functioning of the venous system caused by valvular incompetence with or without the obstruction of venous flow. This condition can affect either or both of the superficial and the deep venous systems. Venous dysfunction can even result in congenital or acquired disorders, and its complications include venous leg ulcers (VLUs). The objective of this systematic review is to determine the effectiveness of Unna boot in the treatment of wound healing of VLU by assessing the quality of the available evidence.

Methods and analysis

A literature search in PubMed, CINAHL, Scopus, Web of Science, Cochrane Library, BVS/BIREME, Embase, ProQuest, BDTD, Thesis and Dissertation Catalog, Sao Paulo Research Foundation/Thesis and dissertation, OPEN THESIS, A service of the US National Institute of Health, Center for Reviews and Dissemination-University of New York and SciElo published in the last 10 years, the period from January 1999 to March 2019. The review will include primary studies (original), and Controlled Trials or Observational studies (cross-sectional, case–control or longitudinal studies) with VLU. The exclusion will include leg ulceration due to different causes, such as pressure, arterial, diabetic or mixed-aetiology leg ulcers. Data synthesis will be performed using a narrative summary and quantitative analysis.

Ethics and dissemination

This systematic review does not require approval by the ethics committee, as individual patient data will not be collected. Dissemination of findings will be through publications in peer-reviewed journals and/or via conference presentations.

PROSPERO registration number

CRD42019127947
Qualitative exploration of women’s experiences of intramuscular pethidine or remifentanil patient-controlled analgesia for labour pain
Authors: Moran Victoria Hall , Thomson Gillian , Cook Julie , Storey Hannah , Beeson Leanne , MacArthur Christine , Wilson Matthew
Published: December 2019

Objectives

To explore women’s experiences of remifentanil or pethidine for labour pain and infant feeding behaviours at 6weeks post partum.

Design

Qualitative postnatal sub-study to the randomised controlled trial of remifentanil intravenous patient controlled analgesia (PCA) versus intramuscular pethidine for pain relief in labour (RESPITE). Semistructured telephone interviews were conducted at 6 weeks post partum, and thematic analysis was undertaken.

Setting

Women recruited to the RESPITE trial from seven UK hospitals.

Participants

Eighty women consented and 49 (30 remifentanil group and 19 pethidine group) completed the interview.

Results

Eight themes emerged which encompassed women’s antenatal plans for pain management (Birth Expectations) through to their future preferences for pain relief (Reflections for Future Choices). Many women who used remifentanil felt it provided effective pain relief (Effectiveness of Pain Relief), whereas women in the pethidine group expressed more mixed views. Both groups described side effects, with women using pethidine frequently reporting nausea (Negative Physiological Responses) and women using remifentanil describing more cognitive effects (Cognitive Effects). Some women who used remifentanil reported restricted movements due to technical aspects of drug administration and fear of analgesia running out (Issues with Drug Administration). Women described how remifentanil enabled them to maintain their ability to stay focused during the birth (Enabling a Sense of Control). There was little difference in reported breastfeeding initiation and continuation between pethidine and remifentanil groups (Impact on Infant Behaviour and Breastfeeding).

Conclusions

Qualitative insights from a follow-up study to a trial which explored experiences of intravenous remifentanil PCA with intramuscular pethidine injection found that remifentanil appeared to provide effective pain relief while allowing women to remain alert and focused during labour, although as with pethidine, some side effects were noted. Overall, there was little difference in reported breastfeeding initiation and duration between the two groups.

Trial registration number

ISRCTN29654603.
Association between Carbohydrate Quality Index and general and abdominal obesity in women: a cross-sectional study from Ghana
Authors: Suara Sufyan Bakuri , Siassi Fereydoun , Saaka Mahama , Rahimi Foroshani Abbas , Sotoudeh Gity
Published: December 2019

Objectives

The relationships between carbohydrate intake and risk of obesity have been widely investigated. However, there are limited data on the associations between their relative proportions and quality contained in the same diet on risk of obesity, especially in low-income and middle-income countries. The aim of this study was to assess the relationship between an overall Carbohydrate Quality Index (CQI) and general and abdominal obesity in women.

Setting and participants

In this cross-sectional study, data from 277 women in Ghana were analysed. Dietary information was obtained from 2-day 24 hours dietary recalls. CQI was calculated from the four indices dietary fibre, Glycaemic Index, whole grains/total grains ratio and solid carbohydrates/total carbohydrates ratio.

Outcome measures

Body mass index, waist circumference (WC), waist-to-height ratio (WHtR) and Conicity Index were measured.

Results

After adjusting for covariates, the chance for general obesity (OR 0.25, 95% CI 0.10 to 0.65) and abdominal obesity measured by WC (OR 0.22, 95% CI 0.08 to 0.58) were significantly lower in the topmost quintile of CQI in comparison with the lowest quintile. In addition, the OR for higher WHtR (OR 0.27, 95% CI 0.11 to 0.69) was significantly lower among participants in the fifth quintile of CQI compared with those in the first quintile.

Conclusions

The present study demonstrates that there is an inverse association between dietary CQI and both general and abdominal obesity. These findings suggest that CQI may be used for the improvement of dietary intake to prevent obesity.
Are neuromuscular adaptations present in people with recurrent spinal pain during a period of remission? A protocol for a systematic review
Authors: Devecchi Valter , Gallina Alessio , Heneghan Nicola R , Rushton Alison B , Falla Deborah
Published: December 2019

Introduction

The course of spinal pain (neck or low back pain) is often described as episodic and intermittent, with more than one-third of people continuing to experience episodic symptoms 1 year after first onset. Although ongoing neuromuscular adaptations could contribute to recurrent episodes of pain, no systematic review has synthesised evidence of ongoing neuromuscular changes in people with recurrent spinal pain during a period of symptom remission.

Methods and analysis

This protocol is developed and reported following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-P, the Update of the Cochrane Back and Neck Group guidelines and the Methodological Expectations of Cochrane Intervention Reviews. PubMed, Web of Science, MEDLINE, EMBASE, CINAHL, ZETOC, Google Scholar, grey literature sources and key journals will be searched up to September 2019. Observational studies investigating neuromuscular changes in people with recurrent spinal pain during a period of remission will be included. Neuromuscular function will be considered under five outcome domains of muscle activity, spine kinematics, muscle properties, sensorimotor control and neuromuscular performance. Two independent reviewers will search, screen studies, extract data and assess risk of bias (Newcastle-Ottawa Scale). Data will be synthesised per outcome domain. Where clinical and methodological homogeneity across studies exists, a random-effects meta-analysis will be conducted. Otherwise, results will be synthesised narratively. The overall quality of evidence will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation guidelines.

Ethics and dissemination

Findings of this review may aid the identification of factors that could contribute to spinal pain recurrence and aid the development of interventions for secondary prevention aimed at the restoration of optimal neuromuscular function. The results will be submitted for publication in a peer-reviewed journal and presented at conferences. No ethical approval was required.

PROSPERO registration number

CRD42019141527.
Cluster randomised controlled trial to determine the effect of peer delivery HIV self-testing to support linkage to HIV prevention among young women in rural KwaZulu-Natal, South Africa: a study protocol
Authors: Adeagbo Oluwafemi Atanda , Mthiyane Nondumiso , Herbst Carina , Mee Paul , Neuman Melissa , Dreyer Jaco , Chimbindi Natsayi , Smit Theresa , Okesola Nonhlanhla , Johnson Cheryl , Hatzold Karin , Seeley Janet , Cowan Frances , Corbett Liz , Shahmanesh Maryam
Published: December 2019

Introduction

A cluster randomised controlled trial (cRCT) to determine whether HIV self-testing (HIVST) delivered by peers either directly or through incentivised peer-networks, could increase the uptake of antiretroviral therapy and pre-exposure prophylaxis (PrEP) among young women (18 to 24 years) is being undertaken in an HIV hyperendemic area in KwaZulu-Natal, South Africa.

Methods and analysis

A three-arm cRCT started mid-March 2019, in 24 areas in rural KwaZulu-Natal. Twenty-four pairs of peer navigators working with ~12 000 young people aged 18 to 30 years over a period of 6 months were randomised to: (1) incentivised-peer-networks: peer-navigators recruited participants ‘seeds’ to distribute up to five HIVST packs and HIV prevention information to peers within their social networks. Seeds receive an incentive (20 Rand = US$1.5) for each respondent who contacts a peer-navigator for additional HIVST packs to distribute; (2) peer-navigator-distribution: peer-navigators distribute HIVST packs and information directly to young people; (3) standard of care: peer-navigators distribute referral slips and information. All arms promote sexual health information and provide barcoded clinic referral slips to facilitate linkage to HIV testing, prevention and care services. The primary outcome is the difference in linkage rate between arms, defined as the number of women (18 to 24 years) per peer-navigators month of outreach work (/pnm) who linked to clinic-based PrEP eligibility screening or started antiretroviral, based on HIV-status, within 90 days of receiving the clinic referral slip.

Ethics and dissemination

This study was approved by the Institutional Review Boards at the WHO, Switzerland (Protocol ID: STAR CRT, South Africa), London School of Hygiene and Tropical Medicine, UK (Reference: 15 990–1), University of KwaZulu-Natal (BFC311/18) and the KwaZulu-Natal Department of Health (Reference: KZ_201901_012), South Africa. The findings of this trial will be disseminated at local, regional and international meetings and through peer-reviewed publications.

Trial registration number

NCT03751826; Pre-results.
Breast cancer patients’ return to work (B-CARE): protocol of a longitudinal mixed-methods study aiming to explore medical and occupational rehabilitation of patients with breast cancer in Germany
Authors: Hiltrop Kati , Heidkamp Paula , Kowalski Christoph , Ernstmann Nicole
Published: December 2019

Introduction

In recent years, research has been done on determinants of return to work (RTW) in cancer survivors and their long-term work outcomes. Nevertheless, little is known about the survivors’ evaluation of these outcomes in terms of job satisfaction and voluntariness. Hence, B-CARE aims at filling the research gap by providing a longitudinal cohort study investigating medical and occupational rehabilitation including an evaluation by breast cancer survivors.

Methods and analysis

A mixed-methods approach, combining a quantitative survey with qualitative semi-structured interviews, is used to study breast cancer survivors 5–6 years after diagnosis. These data will be linked to data from prior waves of patients during hospitalisation and 10 and 40 weeks after hospital discharge as well as routine data from the German Statutory Pension Insurance Scheme and German Cancer Society if available. The actual survey focuses on determinants of medical rehabilitation use, RTW, subsequent employment patterns post care as well as the voluntariness of and satisfaction with job changes.

Ethics and dissemination

A positive vote from the ethics committee of the Medical Faculty of the University of Bonn has been obtained. Data protection regulations will be adhered to for all handled data. Personal identifiers of participants will be pseudonymised. Dissemination strategies include a workshop to discuss results among stakeholders such as representatives of the German Statutory Pension Insurance Scheme, social workers and self-help groups.

Trial registration number

German Clinical Trials Register (DRKS00016982); Pre-results.