bluuebunny/crossref_metadata_2025 huggingface dataset:
Whole family-based physical activity promotion intervention: the Families Reporting Every Step to Health pilot randomised controlled trial protocol
Authors: Guagliano Justin M , Brown Helen Elizabeth , Coombes Emma , Haines Elizabeth S , Hughes Claire , Jones Andrew P , Morton Katie L , van Sluijs Esther
Published: October 2019

Introduction

Family-based physical activity (PA) interventions present a promising avenue to promote children’s activity; however, high-quality experimental research is lacking. This paper describes the protocol for the FRESH (Families Reporting Every Step to Health) pilot trial, a child-led family-based PA intervention delivered online.

Methods and analysis

FRESH is a three-armed, parallel-group, randomised controlled pilot trial using a 1:1:1 allocation ratio with follow-up assessments at 8 and 52 weeks postbaseline. Families will be eligible if a minimum of one child in school Years 3–6 (aged 7–11 years) and at least one adult responsible for that child are willing to participate. Family members can take part in the intervention irrespective of their participation in the accompanying evaluation and vice versa.

Following baseline assessment, families will be randomly allocated to one of three arms: (1) FRESH; (2) pedometer-only or (3) no-intervention control. All family members in the pedometer-only and FRESH arms receive pedometers and generic PA promotion information. FRESH families additionally receive access to the intervention website; allowing participants to select step challenges to ‘travel’ to target cities around the world, log steps and track progress as they virtually globetrot. Control families will receive no treatment. All family members will be eligible to participate in the evaluation with two follow-ups (8 and 52 weeks). Physical (eg, fitness and blood pressure), psychosocial (eg, social support) and behavioural (eg, objectively measured family PA) measures will be collected at each time point. At 8-week follow-up, a mixed methods process evaluation will be conducted (questionnaires and family focus groups) assessing acceptability of the intervention and evaluation. FRESH families’ website engagement will also be explored.

Ethics and dissemination

This study received ethical approval from the Ethics Committee for the School of the Humanities and Social Sciences at the University of Cambridge. Findings will be disseminated via peer-reviewed publications, conferences and to participating families.

Trial registration number

ISRCTN12789422
Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study
Authors: Mata-Cases Manel , Franch-Nadal Josep , Real Jordi , Cedenilla Marta , Mauricio Didac
Published: October 2019

Objectives

To evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.

Design

A cross-sectional study.

Setting

Two hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).

Participants

We included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.

Primary and secondary outcome measures

We collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.

Results

A total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.

Conclusion

Patients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.
Antibiotic stewardship in skin infections: a cross-sectional analysis of early-career GP’s management of impetigo
Authors: Heal Clare , Gorges Hilary , van Driel Mieke L , Tapley Amanda , Davis Josh , Davey Andrew , Holliday L , Ball Jean , Najib Nashwa , Spike Neil , FitzGerald Kristen , Magin Parker
Published: October 2019

Objective

To establish the prevalence and associations of systemic antibiotic prescription for impetigo by early-career general practitioners (GPs) (GP registrars in their first 18 months in general practice).

Design

A cross-sectional analysis of data from the Registrar Clinical Encounters in Training (ReCEnT) study.

Setting

ReCEnT is an ongoing multisite cohort study of Australian registrars’ in-consultation clinical practice across five Australian states.

Participants

Registrars participating in ReCEnT from 2010 to 2017.

Outcome measures

Management of impetigo with systemic antibiotics.

Results

1741 registrars (response rate 96%) provided data from 384 731 problems identified in 246 434 consultations. Impetigo, on first presentation or follow-up, was managed in 930 (0.38%, 95% CI 0.35 to 0.40) consultations and comprised 0.24% (95% CI 0.23 to 0.26) of problems. 683 patients presented with a new diagnosis of impetigo of which 38/683 (5.6%) were not prescribed antibiotics; 239/683 (35.0%) were prescribed solely topical antibiotics; 306/683 (44.8%) solely systemic antibiotics and 100/683 (14.6%) both systemic and topical antibiotics. The most common systemic antibiotic prescribed was cephalexin (53.5%). Variables independently associated with prescription of systemic antibiotics were an inner regional (compared with major city) location (OR 1.82, 95% CI 1.06 to 3.13; p=0.028), seeking in-consultation information or advice (OR 2.17, 95% CI 1.47 to 3.23; p<0.001) and ordering pathology (OR 2.13, 95% CI 1.37 to 3.33; p=0.01).

Conclusions

Australian early-career GPs prescribe systemic antibiotics (the majority broad-spectrum) for a high proportion of initial impetigo presentations. Impetigo guidelines should clearly specify criteria for systemic antibiotic prescription and individual antibiotic choice. The role of non-antibiotic management and topical antiseptics needs to be explored further.
Cross-sectional analysis of place-based and racial disparities in hospitalisation rates by disease category in California in 2001 and 2011
Authors: Raphael Eva , Gaynes R , Hamad Rita
Published: October 2019

Objectives

To study the association of place-based socioeconomic factors with disease distribution by comparing hospitalisation rates in California in 2001 and 2011 by zip code median household income.

Design

Serial cross-sectional study testing the association between hospitalisation rates and zip code-level median income, with subgroup analyses by zip code income and race.

Participants/setting

Our study included all hospitalised adults over 18 years old living in California in 2001 and 2011 who were not pregnant or incarcerated. This included all acute-care hospitalisations in California including 1632 zip codes in 2001 and 1672 zip codes in 2011.

Primary and secondary outcomes

We compared age-standardised hospitalisations per 100 000 persons, overall and for several disease categories.

Results

There were 1.58 and 1.78 million hospitalisations in California in 2001 and 2011, respectively. Spatial analysis showed the highest hospitalisation rates in urban inner cities and rural areas, with more than 5000 hospitalisations per 100 000 persons. Hospitalisations per 100 000 persons were consistently highest in the lowest zip code income quintile and particularly among black patients.

Conclusion

Hospitalisation rates rose from 2001 to 2011 among Californians living in low-income and middle-income zip codes. Integrating spatially defined state hospital discharge and federal zip code income data provided a granular description of disease burden. This method may help identify high-risk areas and evaluate public health interventions targeting health disparities.
Mesh fixation technique for inguinal hernia repair: protocol for an umbrella review with integrated and updated network meta-analysis
Authors: Techapongsatorn Suphakarn , Tansawet Amarit , Kasetsermwiriya Wisit , Pattanaprateep Oraluck , Thakkinstian Ammarin
Published: October 2019

Introduction

Inguinal hernia mesh repair is the standard care for symptomatic inguinal hernia. Mesh fixation is used to keep mesh in place for which various mesh fixation techniques have been used in open and laparoscopic inguinal hernia repair, but their effectiveness has remained inconclusive. Therefore, we developed a protocol for an umbrella review in order to summarise the evidences with integrate and update data of different mesh fixation techniques in both open and laparoscopic inguinal hernia repair.

Methods and analysis

Previous systematic reviews and meta-analyses will be identified from Medline, Scopus, Cochrane Databases, EMBASE, Database of Abstracts of Reviews of Effects, PROSPERO Register, CINAHL, JBISRIS, EPPI-Centre, Wiley Online Library and Science Direct database. Two reviewers will independently determine studies for eligibility. Disagreement will be solved by consensus and arbitrated by the third reviewer. Data extraction will also be performed by two independent reviewers. For umbrella review, a descriptive analysis will be applied to describe evidence of mesh fixation effectiveness. Overlapping studies and excess significance test will be performed to assess whether previous evidences are bias. In addition, individual studies from meta-analysis and additional published studies will be pooled using network meta-analyses. We will use I2statistic and Cochran’s Q test to assess heterogeneity. Risk of bias and publication bias, if appropriate, will be evaluated, as well as overall strength of the evidence.

Ethics and dissemination

This protocol has been registered with PROSPERO and approved with Institutional Review Board, Faculty of Medicine Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand (COA 167/2018). The results will be published in peer-reviewed journal.

PROSPERO registration number

CRD42018111773
Burden of musculoskeletal-related disorders resulting from non-fatal road traffic collisions in Africa: a protocol of a systematic review
Authors: Yusuf Mohamed , Gebrye Tadesse , Fatoye Francis
Published: October 2019

Introduction

In addition to their high mortality rates, road traffic collisions (RTC) are considered a burden within those who do survive. In Africa, injuries related to RTC have been identified as the 10th most common cause of disability-adjusted life years lost for all ages and categories. Moreover, non-fatal RTC are the biggest cause associated with the burden of musculoskeletal disorders (MSD) in Africa. Despite this, the epidemiology of MSD related to non-fatal RTC within this region is still unknown.

The objective of this review is to identify and summarise available data regarding the prevalence, incidence and patterns of MSD resulting from non-fatal RTC in Africa.

Methods and analysis

A systematic review of observational epidemiological studies will be conducted. On October 2019, MEDLINE, Embase, CINAHL Plus, PsycINFO, Web of Science, Global Health and African Journals OnLine will be searched for literature that is in English and published between 1990 and 2018. Two reviewers (MY ad TG) will independently screen results and extract the data, with a third reviewer (FF) resolving any discrepancies through discussion. Additionally, two reviewers (MY and TG) will independently assess the quality of the eligible studies using the US National Institutes of Health National Heart, Lung, and Blood Institute Quality Assessment Tool.

Within the eligible studies, data on citation, methods and results will be extracted. Extracted data will be analysed using a narrative synthesis. Findings will be presented in tables, with the main outcomes being prevalence, incidence and disease pattern of MSD and determinants of non-fatal RTC. The final systematic review will be conducted as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline.

Ethics and dissemination

As individual patients will not be involved in this study, no ethical approval will be sought. Findings from this review will be disseminated through peer-reviewed journals and relevant conferences.

Trial registration number

CRD42019139538
Detection of a 5-circRNA signature to improve prognostic prediction in gastric cancer
Authors: Wang Fengjiao , Li Xuexin , Zhao Xingkai , Xue Yingwei
Published: October 2019

Gastric cancer (GC) is a commonly diagnosed malignancy with a high mortality rate worldwide. Despite advances in therapeutic approaches, the 5-year survival rate of patients with GC remains poor. A type of non-coding RNA, circular RNA (circRNA), has been discovered. Some circRNAs are dysregulated in cancer and may have important functions. Thus, circRNAs could be candidate biomarkers for disease diagnosis and prognosis. Our study used a reannotation framework to derive expression values of circRNAs from microarray data sets. We used an integrated pipeline including differential expression analysis and Cox regression analyses to detect GC-associated circRNA signatures. We validated results with 54 paired gastric tumor and adjacent normal tissues. Five circRNA signatures were highly associated with patient overall survival and disease-free survival. Real-time PCR experiments on hsa_circ_0103398 and hsa_circ_0127859 in tumors and normal tissues showed that these circRNAs were significantly upregulated in GC. High expression of hsa_circ_0103398 and hsa_circ_0127859 was closely associated with unfavorable survival time. Our findings indicated that a 5-circRNA signature might serve as a candidate prognostic biomarker of GC.
Is ‘best interests’ the right standard in cases like that of Charlie Gard?
Authors: Truog Robert D
Published: October 2019

Savulescu and colleagues have provided interesting insights into how the UK public view the ‘best interests’ of children like Charlie Gard. But is best interests the right standard for evaluating these types of cases? In the USA, both clinical decisions and legal judgments tend to follow the ‘harm principle’, which holds that parental choices for their children should prevail unless their decisions subject the child to avoidable harm. The case of Charlie Gard, and others like it, show how the USA and the UK have strikingly different approaches for making decisions about the treatment of severely disabled children.
Efficacy and safety of topical and systemic medications: a systematic literature review informing the EULAR recommendations for the management of Sjögren’s syndrome
Authors: Brito-Zerón Pilar , Retamozo Soledad , Kostov Belchin , Baldini Chiara , Bootsma Hendrika , De Vita Salvatore , Dörner Thomas , Gottenberg Jacques-Eric , Kruize Aike A. , Mandl Thomas , Ng Wan-Fai , Seror Raphaele , Tzioufas Athanasios G. , Vitali Claudio , Bowman Simon , Mariette Xavier , Ramos-Casals Manuel
Published: October 2019

Objective

To evaluate current evidence on the efficacy and safety of topical and systemic medications in patients with primary Sjögren syndrome (SjS) to inform European League Against Rheumatism treatment recommendations.

Methods

The MEDLINE, EMBASE and Cochrane databases were searched for case-control/prospective cohort studies, randomised controlled trials (RCTs) and systematic reviews.

Results

Current evidence in primary SjS patients fulfilling the 2002 criteria is based on the data from 9 RCTs, 18 prospective cohort studies and 5 case-control studies. Two Cochrane systematic literature reviews (SLRs) have reported that topical treatments for dry mouth and dry eye are safe and effective. Ocular cyclosporine A was safe and effective in two RCTs including 1039 patients with dry eye syndrome. Two Cochrane SLRs on serum tear drops and plugs showed inconsistency in possible benefits, both for symptoms and objective measures. Five RCTs reported significant improvements in oral dryness and salivary flow rates for pilocarpine and cevimeline. An RCT showed no significant placebo-differences for hydroxychloroquine 400 mg/day for the primary outcome (visual analogue scale (VAS) composite of dryness, fatigue and pain). We identified seven RCTs carried out in primary SjS patients. RCTs using infliximab, anakinra and baminercept found no placebo-differences for the primary outcomes. The two largest RCTs randomised 255 patients to receive rituximab or placebo and reported no significant results in the primary outcome (VAS composite), while prospective studies suggested efficacy in systemic disease.

Conclusion

The current evidence supporting the use of the main topical therapeutic options of primary SjS is solid, while limited data from RCTs are available to guide systemic therapies.
Diagnostic value of blood variables following attenuation of congenital extrahepatic portosystemic shunt in dogs
Authors: Vallarino Nicolas , Pil Steven , Devriendt Nausikaa , Or Matan , Vandermeulen Eva , Serrano Gonçalo , Paepe Dominique , Bosmans Tim , de Rooster Hilde
Published: October 2019

Background

The aims of this study were to determine if extrahepatic portosystemic shunt (EHPSS) postoperative closure could be predicted based on preoperative blood analyses and to determine the accuracy of blood variables to evaluate persistence of portosystemic shunting postoperatively (multiple acquired portosystemic shunts (MAPSS) or persistent EHPSS).

Methods

Retrospectively, 62 dogs treated surgically for congenital EHPSS that underwent postoperative trans‐splenic portal scintigraphy or CT angiography three to six months postoperatively were included.

Results

None of the studied preoperative blood variables could unambiguously predict surgical outcome. Elevated postoperative fasting venous ammonia (FA) concentration always indicated surgical failure (persistent shunting or MAPSS), but normal FA did not provide any information on the postoperative shunting status. Paired serum bile acids (SBA) were not reliable enough to confirm or exclude postoperative shunting. In the presence of low normal postoperative FA levels, elevated preprandial SBA was more likely in dogs with persistent shunting (sensitivity of 0.79, specificity of 0.83), whereas postprandial SBA below reference limit was more often observed in case of surgical success (sensitivity of 0.93, specificity of 0.67).

Conclusion

Blood variables, and more specifically the combination of FA and SBA, are not a valuable alternative to advanced medical imaging to reliably assess the surgical outcome after EHPSS surgery.
HOW DO INVESTORS RESPOND TO TERRITORIAL DISPUTES? EVIDENCE FROM THE SOUTH CHINA SEA AND IMPLICATIONS ON PHILIPPINES ECONOMIC STRATEGY
Authors: CAMBA ALVIN , MAGAT JANICA
Published: October 2019

How do territorial disputes affect bilateral foreign direct investment (FDI) between claimant states? Using a difference model, we find that a regime’s position on the South China Sea (SCS) significantly impacts Chinese FDI. We used a novel dataset on firm registrations in the Philippines, finding that the annual number of new firm entrants with Chinese investment significantly increases when maritime border disputes are stabilized. In contrast, we observe that conflictual relations in the maritime borders tend to decrease the number of new firms. We also notice that disputes do not influence FDI from non-claimant states.
Investigation of phase transition of BTZ black hole with Sharma–Mittal entropy approaches
Authors: Sadeghi J. , Rostami M. , Alipour M. R.
Published: October 2019

In this paper, we use Bekenstein entropy and study thermodynamic quantities and phase transition for the charged BTZ black hole. Then, we apply the Sharma–Mittal (SM) entropy and calculate some thermodynamic quantities. Here, we note that in case of [Formula: see text], the SM entropy is same as the known corrected entropy. Also, we investigate [Formula: see text] critically and phase transition of this corrected black hole and show that the critical points of corrected black hole are similar to Van der Waals fluid. We compare phase transition of corrected and uncorrected entropies to each other. Finally, we study the effect of SM entropy on the global and local stability in the extended phase space. Here, we also compare the obtained results of corrected entropy with respect to uncorrected entropy.
A new car-following model considering recurrent neural network
Authors: Hua Chen
Published: October 2019

A new car-following model is proposed based on recurrent neural network (RNN) to effectively describe the state change and road traffic congestion while the vehicle is moving. The model firstly gives a full velocity difference car-following model according to the driver’s reaction sensitivity and relative velocity, and then takes the vehicle position and velocity as the input parameters to optimize the safe distance between the front and rear vehicles in the car-following model based on RNN model. Finally, the effectiveness of the above model is validated by building a simulation experiment platform, and an in-depth analysis is conducted on the relationship among influencing factors, e.g., relative velocity, reaction sensitivity, headway, etc. The results reveal that, compared with traditional car-following models, the model can quickly analyze the relationship between initial position and velocity of the vehicle in a shorter time and thus obtain a smaller safe distance. In the case of small velocity difference between the front and rear vehicles, the running velocity of the front and rear vehicles is relatively stable, which is conducive to maintaining the headway.
A General Chaotic Circuit Design and Hardware Implementation via the Inductance Integrators
Authors: Xu Wei , Cao Ning
Published: October 2019

This paper presents a scheme for the modified chaotic circuits based on inductance integration. In view of the fact that the DC resistance of an inductor in the circuit cannot be ignored, this way of constructing the circuits is provided that can eliminate its influence on the integral circuits. By means of cascading an inverting adder circuit and inductance integral circuit, the output signal of the integral circuit is fed back to the inverting adder circuit, and its additive term is artificially added to match the actual inductance integrated circuit to achieve integral circuit based on the actual inductor which can offset the effect of its DC resistance. In order to verify the generality of the design, the process of designing Lorenz chaotic circuit is given and its attractors can also be observed from the oscilloscope.
ENTREPRENEURSHIP EDUCATION ENROLLMENT INTENTIONS: THE EFFECT OF ATTITUDES, NORMS AND PERSONALITY
Authors: BURCH TYLER , MURPHY GREG , TOCHER NEIL
Published: October 2019

Entrepreneurship education (EE) has grown exponentially over the past three decades, providing myriad benefits to society. Interestingly though, despite such benefits, scholarly research has rarely focused on who is likely to seek EE. Drawing on Azjen’s theory of planned behavior as well as previous research in education seeking, the current study investigates how individuals’ personality, attitudes and perceived norms affect EE intentions. Results indicate that entrepreneurial norms and attitudes toward both the morality of business and the instrumentality of education are positively associated with EE intentions. Further, results suggest that extraversion and openness to experience are positively associated, whereas conscientiousness is negatively associated with EE intentions. Interestingly, the desire to start one’s own business mediates these effects generally, but mediation analyses also imply that extraversion, openness to experience and instrumentality of education have direct effects on EE intentions regardless of one’s desire to start a business. As such, encouraging these individuals to seek EE may result in a previously unrecognized source of students for EE programs as well as potential business creation that would otherwise not occur. Implications of our study are discussed.
Evaluating Policy and Legal Frameworks of Urban Green Infrastructure Development in Ethiopia
Authors: Molla Mikias Biazen , Ikporukpo C. O. , Olatubara C. O.
Published: October 2019

Policy monitoring and evaluation are important elements of the policy cycle, this help to initiate policy-makers to assess the proper implementation and adjust it as appropriate. This paper aims to evaluate the existing policy, strategies, and institutional arrangement on the development of urban green infrastructure in the three study areas; namely Hawassa, Wolayita Sodo, and Bodity town. Analyzing policy documents, key informant interview, and questionnaire survey were used to collect the required data. Descriptive statistics and policy analysis were also used to analyze the collected data from different sources. The study revealed that different strategies and standards were developed by the federal government, but it is not practically exercised at the regional and local level. The majority of government officials and experts agreed that existing policies and strategies related to UGI is not properly implemented. On the other hand, lack of policy and strategies are the major limitation in the development and management of UGI. Almost majority of the respondents confirmed that weak institutional arrangement has contributed to the poor implementation of UGI development. Lack of attention and awareness, the weak institutional arrangement is the main responsible factors for the absence of proper policy and poor implementation of strategies concerning UGI. Thus, actions needed for all the development of proper policies and strategies to improve UGI development.
Severe Case of Plasmodium falciparum Malaria in a Pregnant Woman from Nigeria
Authors: Yagnik Kruti , Farooqi Bilal , Mandernach Molly W. , Cannella Anthony P. , Kalyatanda Gautam
Published: October 2019

Human malaria has arguably affected more of human history than any other pathogen. Pregnant women have a higher risk of developing severe malaria as well as the risk of severe complications. We present a case of severe malaria in a pregnant patient from sub-Saharan Africa who was treated successfully with artesunate. A 28-year-old Nigerian woman with a 20-week intrauterine pregnancy presented with a five-day history of fever and diffuse joint pains. Evaluation of peripheral thin blood smear demonstrated a parasitemia of 9.8%. The patient was admitted to the intensive care unit, and oral clindamycin/quinine was initiated until intravenous artesunate was obtained. The patient completed four doses of IV artesunate, and after the 4th dose of artesunate, no blood parasites were seen on peripheral smear. The patient was discharged home and, upon clinic follow-up, did not have any further complications associated with either her disease or therapy. A review on the treatment of severe malaria in all trimesters of pregnancy supports the WHO recommendation for intravenous artesunate as the drug of choice. This case illustrates the importance of recognizing malaria in pregnant women from endemic countries and shows that artesunate compounds can be used safely in pregnancy, particularly with high parasitemia.
Diabetes Prevention: Knowledge and Perception of Risk among Italian Population
Authors: Pelullo Concetta P. , Rossiello Riccardo , Nappi Roberto , Napolitano Francesco , Di Giuseppe Gabriella
Published: October 2019

The risk perception for developing diabetes has not been well established. The aim of this study is to evaluate knowledge and perception of risk for developing diabetes. A cross-sectional study was conducted among a sample of 527 parents of children attending public schools in Naples (Italy). A self-administered anonymous questionnaire was used to collect the data. In total, 97.3% of participants have heard about diabetes, but only 16.7% knew the main risk and protective factors. This knowledge was statistically significantly higher in those who had close relatives with diabetes. Moreover, those who had middle school or lower and high school education, compared with those who had a college degree or higher, were less knowledgeable. The mean total value of the risk perception for developing diabetes was 1.9. Females those who had more than 40 years of age, those who needed of additional information, those who had a higher BMI, those who had close relatives with diabetes, those who had at least one chronic disease, and those who reported a lower value of self-rated health status were more likely to perceive a higher risk for developing diabetes. Moreover, this perception was statistically significantly lower among those who had a middle school or lower and high school education, compared with those who had a college degree or higher. The knowledge about diabetes needs to be improved, and the low risk perception for developing diabetes among the sample is worrying given the severity of the disease and the preventive measures available.
Prevalence and Predictors of Obesity among 7- to 17-Year-Old Schoolchildren in Urban Arusha, Tanzania
Authors: Chomba Haji , Martin Haikael D. , Kimywe Judith
Published: October 2019

Background. Childhood obesity is currently increasing at an alarming rate worldwide. Childhood obesity research has not been reported in urban Arusha before. This is therefore the first study to investigate the prevalence and predictors of childhood obesity in urban Arusha. Methods. A cross-sectional study was conducted involving 451 schoolchildren. Overweight was defined to range from 85th to 94th BMI percentile for age and sex while obesity was defined as above 94th BMI percentile for age and sex. Chi-square test was used for comparison between child sex and sociobehaviors, and multiple logistic regression was used to determine the significant predictor factors at P values = 0.05. Results. The overall prevalence of overweight and obesity was 17.7% (80/451) with 12.6% (57/451) being obese and 5.1% (23/451) being overweight. Results from univariate logistic regression showed child sex, random sleeping time, and random eating habit were the significant predictor factors. However, when all the predictor factors were used in the final multiple logistic regression model, only random sleeping time and random eating habit of different food items irrespective of their nature were significant at P=0.000, AOR = 4.47, and 95% CI = 2.00–10.01, and P=0.012, AOR = 2.54, and 95% CI = 1.23–5.33, respectively. Conclusions. The prevalence of obesity was as higher as twice the prevalence observed in other previous studies in Tanzania. Being a girl, random sleeping time and random eating habit were independent predictors. In addition to larger sample sizes, longitudinal studies are needed in order to track individuals and population level trends in BMI over time.
VLPs Derived from the CCMV Plant Virus Can Directly Transfect and Deliver Heterologous Genes for Translation into Mammalian Cells
Authors: Villagrana-Escareño María V. , Reynaga-Hernández Elizabeth , Galicia-Cruz Othir G. , Durán-Meza Ana L. , De la Cruz-González Viridiana , Hernández-Carballo Carmen Y. , Ruíz-García Jaime
Published: October 2019

Virus-like particles (VLPs) are being used for therapeutic developments such as vaccines and drug nanocarriers. Among these, plant virus capsids are gaining interest for the formation of VLPs because they can be safely handled and are noncytotoxic. A paradigm in virology, however, is that plant viruses cannot transfect and deliver directly their genetic material or other cargos into mammalian cells. In this work, we prepared VLPs with the CCMV capsid and the mRNA-EGFP as a cargo and reporter gene. We show, for the first time, that these plant virus-based VLPs are capable of directly transfecting different eukaryotic cell lines, without the aid of any transfecting adjuvant, and delivering their nucleic acid for translation as observed by the presence of fluorescent protein. Our results show that the CCMV capsid is a good noncytotoxic container for genome delivery into mammalian cells.
Effect of Water Quality on the Germination of Okra (Abelmoschus esculentus) Seeds
Authors: Nana Rasmata , Maïga Ynoussa , Ouédraogo Razacswendé Fanta , Kaboré Wendpouiré Ginette Bertille , Badiel Badoua , Tamini Zoumbiessé
Published: October 2019

Okra (Abelmoschus esculentus), a fruit vegetable consumed in several countries, especially in Africa, contributes to the fight against poverty and malnutrition due to its nutritional value. However, in Burkina Faso, its cultivation during the dry season that lasts about 9 months remains dependent on the availability of water resources. Thus, during this period that lasts about 9 months, because of this situation, okra producers are dealing with very diversified sources of water. However, the rehydration of seeds, which is the first step towards germination, depends mainly of the water. Therefore, the aim of the present study was to test the germinability of okra seeds under different irrigation waters in order to propose alternative sources. Thus, seeds of three ecotypes of okra (B2, G259, and L2) were germinated using five water types (dam water, wastewater from the sewage treatment plant (WTP), well water, dishwashing greywater, and distilled water). The results showed a significant influence of the water type on the germination velocity and the growth speed of the radicle. Indeed, using wastewater from the WTP, the germination velocity was very significantly lower than those obtained with the other sources (P<0.0001). Furthermore, seeds irrigated with WTP wastewater germinated less than other water types. Nevertheless, the germination rate obtained with dishwashing greywater (86.93 ± 0.14%), which is not used generally in agricultural production, is comparable to the rates obtained with other water types. Furthermore, the study showed a significant effect of the ecotype on the germination rate (P≤0.001). In addition, dam water significantly enhanced root growth compared to WTP (P<0.0001). In view of the results and because of water scarcity in Sahelian regions, dishwashing greywater, which is generally discarded, could be collected and used for the germination of okra.
A Health Records Review of Outpatient Referrals from the Emergency Department
Authors: Prudhomme Nicholas , Kwok Edmund S. H. , Olejnik Laura , White Shannon , Thiruganasambandamoorthy Venkatesh
Published: October 2019

Objectives. Many patients discharged home from the emergency department (ED) require urgent outpatient consultation with a specialty service. We sought to identify the best- and worst-performing services with regard to time to outpatient consultation, the proportion of patients lost to follow-up, the rate of related return ED visits prior to consultation, and common strategies used by our top-performing clinics. Methods. We conducted a health records review of The Ottawa Hospital ED visits during four 1-week periods. All consecutive adult outpatient consultation requests were included for chart review and were followed up to 12 months. Outcome measures included demographics, referral attendance rates, incomplete referrals, return ED visits, and time intervals. Services with at least 15 consultation requests were included for data analysis and qualitative mapping of their referral processes. Results. Of the 963 patients who met inclusion criteria, 803 (83.4%) attended their appointment, while 160 (16.6%) were lost to follow-up. The overall median time to successful consultation was 9 days (IQR = 2–27). 92 (9.6%) patients returned to the ED with a related complaint. The top-performing clinics included ophthalmology, orthopedics, and thrombosis (median = 1, 8, 1 days; incomplete consultation = 3%, 4%, 6%; return ED visits = 0%, 6%, 2% respectively). The bottom-performing clinics included otorhinolaryngology, neurology, and gynecology (median = 47, 39, 27 days; incomplete consultation = 50%, 41%, 37%; return ED visits = 11%, 15%, 26%, respectively). Processes incorporated by top-performing clinics included reserving appointment slots for emergency referrals, structured referral forms, and centralized booking. Conclusions. We found a substantial variability in both the waiting times and reliability of outpatient referrals from the ED. Top-performing clinics incorporate common referral processes.
Vibration Analysis of Composite Multilayer Floor of High‐Speed Train
Authors: Han Ying , Sun Wenjing , Zhou Jinsong , Gong Dao
Published: October 2019

Mechanical properties of floor prototypes made for high‐speed trains from composite multilayer floor structures of different materials and thicknesses were tested. Based on the test results, the equivalent mechanical parameters of different layers of the panels, core materials, etc., were calculated, and the multilayer mixed finite element model of the floor was built and verified. The multilayer mixed floor model was introduced into the car body of a high‐speed train, and the test signals of the high‐speed train were used as inputs to calculate the vibration response of composite floor structure. Vibration spectra of the high‐speed train composite floor made of different materials and structures were compared and analyzed. The results show that the calculation of the floor vibration response of the vehicle car body within the framework of the equivalent model of the multilayer structure based on the mechanical performance test is an effective method to evaluate vibration characteristics. The vibration isolation performance of the stainless steel panel floor is better than that of the aluminum alloy panel, but its large mass is not favorable in lightweight body design. The vibration energy of birch core material floor is significantly smaller than the alder core material of the same size. The vibration isolation performance of the floor enhanced with the increase in the thickness of the outer metal panel, but when the outer metal panel thickness exceeds 0.8 mm, the influence becomes small. Therefore, the stainless steel‐birch core composite floor with a large panel thickness has the best vibration isolation performance and can be used for the floor above the bogie and the suspended excitation source. Then, an optimal analysis considering mass and vibration characteristics was carried out, and the results show that there exists an optimal solution for the high‐speed train. Regarding the overall design basis of the vehicle, the aluminum alloy panel lightweight structure can be used in combination with other general parts.
4-Phenylbutyric Acid Reduces Endoplasmic Reticulum Stress in Chondrocytes That Is Caused by Loss of the Protein Disulfide Isomerase ERp57
Authors: Rellmann Yvonne , Gronau Isabel , Hansen Uwe , Dreier Rita
Published: October 2019

Objective. The integrity of cartilage depends on the correct synthesis of extracellular matrix (ECM) components. In case of insufficient folding of proteins in the endoplasmic reticulum (ER) of chondrocytes, ECM proteins aggregate, ER stress evolves, and the unfolded protein response (UPR) is initiated. By this mechanism, chondrocytes relieve the stress condition or initiate cell death by apoptosis. Especially persistent ER stress has emerged as a pathogenic mechanism in cartilage diseases, such as chondrodysplasias and osteoarthritis. As pharmacological intervention is not available yet, it is of great interest to understand cartilage ER stress in detail and to develop therapeutics to intervene. Methods. ERp57-deficient chondrocytes were generated by CRISPR/Cas9-induced KO. ER stress and autophagy were studied on mRNA and protein level as well as by transmission electron microscopy (TEM) in chondrocyte micromass or cartilage explant cultures of ERp57 KO mice. Thapsigargin (Tg), an inhibitor of the ER-residing Ca2+-ATPase, and 4-Phenylbutyric acid (4-PBA), a small molecular chemical chaperone, were applied to induce or inhibit ER stress. Results. Our data reveal that the loss of the protein disulfide isomerase ERp57 is sufficient to induce ER stress in chondrocytes. 4-PBA efficiently diffuses into cartilage explant cultures and diminishes excessive ER stress in chondrocytes dose dependently, no matter if it is induced by ERp57 KO or stimulation with Tg. Conclusion. ER-stress-related diseases have different sources; therefore, various targets for therapeutic treatment exist. In the future, 4-PBA may be used alone or in combination with other drugs for the treatment of ER-stress-related skeletal disorders in patients.
Broken File Retrieval in the Lower Right First Molar Using an Ultrasonic Instrument and Endodontic Micro Forceps
Authors: Meidyawati Ratna , Suprastiwi Endang , Setiati Hasti Dwi
Published: October 2019

Broken files affect cleaning, shaping, and filling processes of the root canal, thereby causing maintenance failure. Objective. This report explains how to remove broken files using ultrasonic instruments and endodontic micro forceps. Case Report. A 25-year-old female patient had incomplete root canal treatment at the lower right first molar 1 week ago. There were radiolucency in the bifurcation and apical root and the presence of broken files in the 1/3 coronal mesiolingual root. The retrieval started by making a staging platform with an ET20 ultrasonic tip. Endodontic micro forceps were used including a screw wedge that works by clamping the file fragments through a mechanical lock and pulling them to the coronal. Conclusion. It is possible to successfully remove broken files from the root canal using ultrasonic instruments and endodontic micro forceps.
Data-Hiding Scheme Using Multidirectional Pixel-Value Differencing on Colour Images
Authors: Kim Pyung-Han , Yoon Eun-Jun , Ryu Kwan-Woo , Jung Ki-Hyun
Published: October 2019

Data hiding is a technique that hides the existence of secret data from malicious attackers. In this paper, we propose a new data-hiding scheme using multidirectional pixel-value differencing, which can embed secret data in two directions or three directions on colour images. The cover colour image is divided into nonoverlapping blocks, and the pixels of each block are decomposed into R, G, and B channels. The pixels of each block perform regrouping, and then the minimum pixel value within each block is selected. The secret data can be embedded into two directions or three directions based on the minimum pixel value by using the difference value for the block. The pixel pairs with the embedded secret data are put separately into two stego images for secret data extraction on receiver sides. In the extraction process, the secret data can be extracted using the difference value of the two stego images. Experimental results show that the proposed scheme has the highest embedding capacity when the secret data are embedded into three directions. Experimental results also show that the proposed scheme has a high embedding capacity while maintaining the degree of distortion that cannot be perceived by human vision system for two directions.
Fuzzy Logic Optimization of Composite Brake Control Strategy for Load‐Isolated Electric Bus
Authors: Xin Yafei , Zhang Tiezhu , Zhang Hongxin , Zhao Qinghai , Zheng Jian , Wang Congcong
Published: October 2019

To improve the energy recovery rate and increase the driving range of load‐isolated electric buses, a composite brake control strategy based on fuzzy logic optimization is proposed. Considering the influence of the battery SOC value and the braking intensity on the braking ratio, a fuzzy controller is designed for small and medium braking strengths to optimize the control strategy. The vehicle simulation model of the load‐isolated electric bus was built with the AVL CRUISE software platform. The AVL CRUISE‐Simulink cosimulation was carried out under the original control strategy and the optimized control strategy. The simulation results show that, under the premise of ensuring the stability of braking, the driving range of the vehicle with the optimized control strategy is increased by 7.74% and the energy recovery rate is increased by 11.05%.
Epigenetic EGFR Gene Repression Confers Sensitivity to Therapeutic BRAFV600E Blockade in Colon Neuroendocrine Carcinomas
Authors: Capdevila Jaume , Arqués Oriol , Hernández Mora Jose Ramón , Matito Judit , Caratù Ginevra , Mancuso Francesco M. , Landolfi Stefania , Barriuso Jorge , Jimenez-Fonseca Paula , Lopez Lopez Carlos , Garcia-Carbonero Rocio , Hernando Jorge , Matos Ignacio , Paolo Nuciforo , Hernández-Losa Javier , Esteller Manel , Martínez-Cardús Anna , Tabernero Josep , Vivancos Ana , Palmer Héctor G.
Published: October 2019

Purpose:

The limited knowledge of the molecular alterations that characterize poorly differentiated neuroendocrine carcinomas has limited the clinical development of targeted agents directed to driver mutations. Here we aim to identify new molecular targets in colon neuroendocrine carcinomas (co-NEC) and proof the efficacy of matching drugs.

Experimental Design:

We performed a multi-omic analysis of co-NEC to identify genetic or epigenetic alterations that could be exploited as effective drug targets. We compared co-NEC samples with colorectal carcinomas (CRC) to identify neuroendocrine-specific traits. Patients with co-NEC and patient-derived xenografts were treated with a BRAFV600E-blocking drug to demonstrate sensitivity.

Results:

co-NEC and CRC are similar in their mutational repertoire, although co-NECs are particularly enriched in BRAFV600E mutations. We report for the first time that V600EBRAF-mutant co-NECs may benefit from BRAF inhibition in monotherapy and how EGFR status is essential to predict innate sensitivity and acquired resistance by a differential methylation of its gene regulatory regions.

Conclusions:

The identification of V600E BRAF mutations in high-grade co-NECs has allowed the description of radiological responses to combination therapy of BRAF and MEK inhibitors in basket clinical trials. However, the molecular rationale for this treatment combination was based on the presence of the BRAF mutation and the efficacy observed in other cancer types such as melanoma. Future drug development in this setting should test BRAF inhibitors upfront and the addition of anti-EGFR antibodies instead of MEK inhibitors for an efficient blockade of acquired resistance.
Response of Estrogen-Receptor-Positive Metastatic Breast Cancer to Olaparib in Late-Line Therapy
Authors: Kumeta Toko , Matsunuma Ryoichi , Yamaguchi Kei , Hayami Ryosuke , Tsuneizumi Michiko
Published: October 2019

Monotherapy with olaparib provides significant benefits over standard therapy in patients with a germline BRCA mutation and human epidermal growth factor receptor 2 (HER2) negative metastatic breast cancer, who had two or fewer previous chemotherapeutic regimens for metastatic disease. Olaparib was approved on July 2, 2018, in Japan for the treatment of patients with metastatic breast cancer with a BRCA mutation and HER2-negative status. Thus, the current experience with this drug is relatively limited. In this article, we report a case of luminal-type metastatic breast cancer harboring a BRCA1 mutation detected through BRACAnalysis (Myriad Genetics). Despite the late-line treatment, in this patient, olaparib was effective against metastatic breast cancer.