bluuebunny/crossref_metadata_2025 huggingface dataset:
Penentuan Kifayah adna sebagai Jaminan Nafkah Isteri di dalam Islam: Kajian kes di Lembah Klang, Malaysia (Determining the Minimum Levels of Sufficiency (Kifayah adna) as Wife Guaranteed Maintenance in Islam: The Case Study of Klang Valley Malaysia)
Authors: Ahmad Bahiyah
Published: June 2019

The minimum level of sufficiency (kifayah adna) for a wife guarantees her basic living maintenance in Islam. It is a level forwarded by some Hanafi scholars who considered it the bare minimum maintenance required to meet a wife’s basic needs. An adequate stipend for a wife’s maintenance secures her livelihood. This study interviews a group of mothers and judges. Analysis of the collected data reveals that determining what constitutes kifayah helps resolve various questions and uncertainties in judicial issues such as determining the minimum level of living in the community, over-maintenance issues, fasakh case claims due to a waiver of maintenance or inadequate livelihood and issues pertaining to polygamy. The paper concludes that determining the minimum level of kifayah and ensuring it is practised helps satisfy the basic needs of a wife and avoid her being subjected to harm. It is a clear manifestation of the maqasid al-shariah that seek to preserve life, intellect, religion, wealth and progeny. Its determination guarantees the wife a monthly stipend to ensure her needs are met. This requires periodic socioeconomic studies of society to ensure that the maintenance levels are adequate.
European Populism: A Communicative Aspect
Authors: Chernov Gennadiy
Published: June 2019

This paper deals with the growing populism movement in Europe. This movement is critical of the European Union and its certain economic and immigration policies. The studies dominant in the field look at different communicative aspects of these phenomena. They point at styles and rhetoric related to populism and failures of the pro-EU forces to communicate effectively why these policies are right and populist citizens are wrong.This paper argues that the problem is not in successes or failures of communication per se, but in shutting out many European citizens from the debate in the public sphere. Not finding reflections of the concerns in the media and policies, and having fewer options to relay their messages to elites perceived to be in power in the EU, these citizens become ‘populist citizens’, and they start voting for populist parties in growing numbers.The article concludes that studies of a communicative aspect of populism need not only discuss mediation, but the policies related to this mediation. Policies may be successful only when people accept them after a free debate. That is what was in the heart of the communicative acts in European history.
Postnatal triglyceride accumulation is regulated by mineralocorticoid receptor activation under basal and stress conditions
Authors: Faught Erin , Vijayan Mathilakath M.
Published: June 2019

Key points

Glucocorticoids (GCs) either enhance or reduce obesity in mammals, but limited information exists on the role of corticosteroid receptors in mediating the effect of GCs on lipid metabolism during postnatal development.

Mineralocorticoid receptor (MR) activation leads to triglyceride (TG) accumulation post‐feeding, whereas glucocorticoid receptor (GR) activation reduces TG levels.

The TG profile was inversely related to the lipoprotein lipase (lpl) transcript abundance, and this gene was downregulated by MR activation.

Cortisol plays an important role in adipogenesis during postnatal development in zebrafish, and this includes gene/pathway‐specific signalling by GR, MR and GR/MR interactions.

Ubiquitous MR and GR knockout in zebrafish provides an excellent model to study the mode of action of GCs in regulating lipid metabolism.

Glucocorticoids (GCs) act through two receptors, the mineralocorticoid receptor (MR) and the glucocorticoid receptor (GR), which differ in both their affinity to bind GCs and their function. As MR has 10‐fold higher affinity for GCs compared to GR, it has been postulated that MR activation occurs at basal levels, while stress levels of these steroid hormones activate GR signalling. There is a growing body of evidence that both these receptors are involved in GC‐mediated lipid metabolism. However, the role of GCs in lipogenesis and lipolysis is controversial, as these steroids appear to both enhance and reduce obesity. As lipid synthesis is a critical part of early development, we hypothesized that both MR and GR contribute to lipid regulation by GCs during postnatal growth. Using MR and GR knockout zebrafish, we demonstrate that MR activation, but not GR activation, is involved in triglyceride (TG) accumulation during the larval development post feeding. Lack of MRs did not affect the gene expression of fatty acid synthase (fas), or acyl‐CoA:diacylglycerol acyltransferase 2 (dgat2), but increased lipoprotein lipase (lpl) transcript abundance. Activation of GR with exogenous cortisol decreased TG levels and increased lpl mRNA levels, but these responses require the presence of MR. Larval transcriptome revealed that MR was the primary regulator of genes involved in lipid synthesis, while GR activation favoured lipid catabolism. Our results underscore a key role for MR activation in mediating postnatal lipid accumulation, as well as cooperatively regulating GR‐mediated lipolysis during postnatal stress.
New Insight Into Aspect Ratio's Effect on Secondary Losses of Turbine Blades
Authors: Teia Luis
Published: June 2019

In view of improving the understanding of the loss mechanisms existing on a compact turbine driving a cryogenic engine turbo-pump for a satellite delivering rocket, a new perspective on how the aspect ratio of turbine blades affects the secondary and profile losses is presented. This perspective, originally based on published experimental data, is further developed by a series of back-to-back highly resolved computational fluid dynamics (CFD) numerical simulations, with the aim of acquiring further insight into the dynamics of the secondary vortices, and the intermediate boundary layer flow for varying blade heights. The main outcome redefines the extreme cases and the partition of losses between secondary and profile, and establishes a new critical ultra-low aspect ratio of 0.35 as a threshold distinguishing two different behaviors. The final venue of this new perspective is the possibility to further improve existing off-design turbine loss models, like those presented by Craig–Cox and Ainley–Mathieson.
Mechanical Recycling of Low-Density Polyethylene/Carbon Nanotube Composites and Its Effect on Material Properties
Authors: Stan Felicia , Stanciu Nicoleta-Violeta , Fetecau Catalin , Sandu Ionut-Laurentiu
Published: June 2019

In this paper, the impact of recycling and remanufacturing on the behavior of low-density polyethylene/multi-walled carbon nanotube (LDPE/MWCNT) composites is investigated. LDPE/MWCNT composites with 0.1–5 wt%, previously manufactured by injection molding, were mechanically recycled and remanufactured by injection molding and 3D filament extrusion, and the rheological, electrical, and mechanical properties were analyzed and compared with those of virgin composites under the same conditions. Experimental results demonstrate that the recycled LDPE/MWCNT composites have similar rheological, electrical, and mechanical properties as that of virgin composites, if not better. Therefore, the recycled LDPE/MWCNT composites have a great potential for being used in engineering applications, while reducing the environmental impact.
Multizone Rapid Thermal Processing to Overcome Challenges in Carbon Nanotube Manufacturing by Chemical Vapor Deposition
Authors: Lee Jaegeun , Abdulhafez Moataz , Bedewy Mostafa
Published: June 2019

For the scalable production of commercial products based on vertically aligned carbon nanotubes (VACNTs), referred to as CNT forests, key manufacturing challenges must be overcome. In this work, we describe some of the main challenges currently facing CNT forest manufacturing, along with how we address these challenges with our custom-built rapid thermal processing chemical vapor deposition (CVD) reactor. First, the complexity of the multistep processes and reaction pathways involved in CNT growth by CVD limits the control on CNT population growth dynamics. Importantly, gas-phase decomposition of hydrocarbons, formation of catalyst nanoparticles, and catalytic growth of CNTs are typically coupled. Here, we demonstrated a decoupled recipe with independent control of each step. Second, significant run-to-run variations plague CNT growth by CVD. To improve growth consistency, we designed various measures to remove oxygen-containing molecules from the reactor, including air baking between runs, dynamic pumping down cycles, and low-pressure baking before growth. Third, real-time measurements during growth are needed for process monitoring. We implement in situ height kinetics via videography. The combination of approaches presented here has the potential to transform lab-scale CNT synthesis to robust manufacturing processes.
A Comparative Study of Cohesive Law Shapes in Analytical Modeling of Interfacial Debonding in Lithium-Ion Battery Electrodes
Authors: Lu Bo , Ning Chengqiang , Zhao Yanfei , Song Yicheng , Zhang Junqian
Published: June 2019

To determine the impact of cohesive law shapes on the modeling of interfacial debonding in lithium-ion battery electrodes, analytical methods based on different cohesive models for the debonding process have been developed individually. Three different cohesive laws, namely, triangular, trapezoidal, and rectangular laws, have been employed. To ensure comparability, the cohesive strength and the fracture toughness have been set to be identical for different cohesive laws. The evaluation of debonding onset has suggested that the cohesive law shape affects the modeling results only when the interface is ductile. The largest possible difference for the triangular law and the rectangular law on the debonding onset has been estimated. A discussion for specific electrodes has also been provided.
Facile benchtop reactor design using dendrimer-templating technology for the fabrication of polyethyleneimine-coated CuO nanoparticles on the gram scale
Authors: Ethridge Aiesha L. , Gallagher Miranda J. , Hudson-Smith Natalie V. , Finley Demetrius , Ahsan Ariful , Howard Fairbrother D. , Haynes Christy L. , Hamers Robert J. , Curry Michael L.
Published: June 2019

Although there has been a wealth of methods developed to produce nanoparticles (NPs), many still suffer from common limitations, such as the instability of the formed nanoparticles against self-aggregation and the inability to produce significant quantities of nanoparticles (gram level). In this regard, there is a growing need for the development of cost-effective, reliable, and scalable experimental protocols to synthesize stable nanoparticles with desired morphologies and controlled sizes. Hence, in this work, the authors explore the synthesis of copper oxide (CuO) nanoparticles via the construction of a multifunctional flow reactor that uses both polymer-templating and chemical reduction methods to produce nanoparticles at the gram scale. In particular, this flow reactor takes advantage of dendrimers and other polymers, such as polyethyleneimine, to control the size and morphology of the CuO NPs.
Discriminative feature analysis based on the crossing level for leakage classification in water pipelines
Authors: Tu Luong Thi Ngoc , Kim Jong-Myon
Published: June 2019

Selection algorithm based on Kullback–Leibler distance is one of the simplest, fastest, and most effective methods suitable for feature selection of real applications like leak detection systems. However, this method has problems when the training dataset is not large enough. This paper proposes a crossing level value that evaluates the level of overlap between the conditional probability space and the degree of dispersion of each probability to choose the best features before classifying. The evaluation results indicate the proposed method is more stable, more reliable, and has a higher accuracy than the Kullback–Leibler method.
The Lack of Age Representation in the Governance of Rugby Union in England
Authors: White Adam J. , Robinson Stefan , Anderson Eric , Bullingham Rachael , Pollock Allyson , Scoats Ryan
Published: June 2019

Diversity and representation in sport governing bodies has become an issue for both public discussion and academic debate in recent times. Previous work has primarily centered on gender inequalities within the forever changing masculine terrain of sport. However, no work has yet examined the representation and participation of young people in the decision-making structures of sporting bodies. This paper holds up England’s Rugby Union for organizational analysis, using the notion of homologous reproduction as a heuristic framework. In doing so, it explores the reproduction of this governing body for the systematic exclusion of young people in decision-making processes over the last few decades. This framework is then twined with Article 11 of the United Nation’s Convention for the Rights of the Child, to make the case that the RFU desires homologous reproduction in order to avoid dealing with what youth are currently concerned with –head injuries. Given such a high proportion of rugby’s participants being under twenty-five years of age, we conclude the lack of young people within the decision-making process represents a form of willful discrimination.
“Perhaps She Only Had a Banana Available to Throw”: Habitus, Racial Prejudice, and Whiteness on Australian Football League Message Boards
Authors: Cleland Jamie , Parry Keith , Radford David
Published: June 2019

This article presents the findings of 2,415 posts collected from two prominent Australian Football League message boards that responded to a racist incident involving a banana being thrown at Adelaide Crows player, Eddie Betts, in August 2016. It adopts Bourdieu’s concept of habitus to examine the online practice of fans for evidence of racist discourse and the extent to which this was supported or contested by fellow fans. The overall findings are that online debates about race in Australian Rules Football and wider Australian society remain divided, with some posters continuing to reflect racial prejudice and discrimination towards non-whites. However, for the vast majority, views deemed to have racist connotations are contested and challenged in a presentation centering on social change and racial equality.
Sports Participation and Attitudes Toward Race and Ethnicity: A Study of Twelfth-Grade Students in the United States
Authors: Denham Bryan E.
Published: June 2019

Drawing on contact, social identity, and self-categorization theories, this study examines the extent to which adolescent sports participation associates with (a) concern about the treatment of minority groups and (b) worry about race relations in the United States. Based on data gathered in the 2016 Monitoring the Future study of twelfth-grade students, the study finds that females, Hispanic study participants, respondents in the West region, and sports participants expressed greater concern about minority treatment. On the second dependent variable, females, Black study participants, and respondents in the West region indicated greater worry about race relations. The study also examined whether attitudes appeared to vary across baseball/softball, basketball, and soccer participation. Baseball/softball participants, who were predominantly White, expressed less concern about minority groups but did not differ from others on attitudes toward race relations. Additionally, while Black adolescents competing in baseball/softball and soccer worried about race relations at relatively high levels, those competing in basketball expressed significantly less concern. Implications and recommendations for future research are provided.
Subcellular antibiotic visualization reveals a dynamic drug reservoir in infected macrophages
Authors: Greenwood Daniel J. , Dos Santos Mariana Silva , Huang Song , Russell Matthew R. G. , Collinson Lucy M. , MacRae James I. , West Andy , Jiang Haibo , Gutierrez Maximiliano G.
Published: June 2019

Lipid droplets help anti-TB drug efficacy

Improving chemotherapies against intracellular pathogens requires understanding how antibiotic distribution within infected cells affects efficacy. Greenwood
et al.
developed an approach to visualize antibiotics in human macrophages infected with the tubercle bacillus (see the Perspective by Smith and Aldridge). They showed that the antitubercular (anti-TB) drug bedaquiline accumulated in host lipid droplets. Lipid droplets seemed to act as an antibiotic reservoir that could be transferred to bacteria during host lipid consumption. Indeed, alterations in host lipid droplet content affected the anti-TB activity of bedaquiline against intracellular bacilli.

Science
, this issue p.
1279
; see also p.
1234
A global surveillance system for crop diseases
Authors: Carvajal-Yepes M. , Cardwell K. , Nelson A. , Garrett K. A. , Giovani B. , Saunders D. G. O. , Kamoun S. , Legg J. P. , Verdier V. , Lessel J. , Neher R. A. , Day R. , Pardey P. , Gullino M. L. , Records A. R. , Bextine B. , Leach J. E. , Staiger S. , Tohme J.
Published: June 2019

Global preparedness minimizes the risk to food supplies
Passenger hotspot mutations in cancer driven by APOBEC3A and mesoscale genomic features
Authors: Buisson Rémi , Langenbucher Adam , Bowen Danae , Kwan Eugene E. , Benes Cyril H. , Zou Lee , Lawrence Michael S.
Published: June 2019

APOBEC3A hairpin passenger hotspots

Genomic features are often examined at extremes to determine the impact of mutations. These genomic regions span from the trinucleotide context to megabases that underlie chromatin and chromosomal features. Examining mutational dynamics at the mesoscale, the intermediate span of the genome, Buisson
et al.
characterized the mutational dynamics of cancer (see the Perspective by Carter). They found that mutations caused by the APOBEC enzyme in DNA stem-loops, a mesoscale feature of the genome, could drive recurrent mutations. Many of these types of mutations have been identified as likely drivers of cancer. However, APOBEC-generated mutations outside of stem-loops were more likely to be cancer driver mutations, providing a genomic context for separating cancer driver from passenger mutations.

Science
, this issue p.
eaaw2872
; see also p.
1228
Toward a world that values insects
Authors: Basset Yves , Lamarre Greg P. A.
Published: June 2019

Rapid adoption of conservation measures is key to protecting insect populations
Impact-resistant nacre-like transparent materials
Authors: Yin Z. , Hannard F. , Barthelat F.
Published: June 2019

Nacre-inspired toughened glass

Nacre is a biological composite that is present in seashells. This composite contains a small amount of organic material that toughens brittle ceramics, such that a highly regular three-dimensional brick-and-mortar assembly of microscopic mineral tablets is bonded together with biopolymers. Synthetic nacres have not been able to capture the large-scale sliding of the bricks that is key to enhancing toughness. Yin
et al.
applied this model to toughening glass, where square or hexagonal borosilicate glass sheets were bonded together using ethylene-vinyl acetate interlayers (see the Perspective by Datsiou). This generated a structure that allows glass plates to slide past each other. The resulting five-layered glass composite was deformable and impact resistant, while maintaining high stiffness, flexural strength, surface hardness, and transparency.

Science
, this issue p.
1260
; see also p.
1232
Sharing the land between nature and people
Authors: Ellis Erle C.
Published: June 2019

Conserving the planet's ecological heritage requires a new level of societal engagement
A remote region, revealed
The Ice at the End of the World: An Epic Journey into Greenland's Buried Past and Our Perilous Future
Jon Gertner
Random House, 2019. 445 pp.
Authors: Glassley William E.
Published: June 2019

A new tome tells tales of adventurers and scientists who have wrested secrets from Greenland's daunting landscape
Bioinspired improvement of laminated glass
Authors: Datsiou Kyriaki Corinna
Published: June 2019

Laminated glass with a microstructure inspired by nacre has a higher impact resistance
Targeting drugs for tuberculosis
Authors: Smith Trever C. , Aldridge Bree B.
Published: June 2019

Lipid-binding improves the delivery of antibiotics to cells infected with mycobacteria
Science in South Asia
Authors: Shrestha Uttam Babu , Bhadra Anindita
Published: June 2019

South Asian countries are often at odds with each other for political, economic, and emotional reasons. The conflicts are a frustrating contrast to the promise of the region. Covering only 3.5% of Earth's landmass, but inhabited by 23.7% of humanity, the region has the highest rate of economic growth, is rich in knowledge-based institutions, and is home to many indigenous and technological innovations. Sadly, at the same time, South Asian countries have the highest poverty rate, lowest human development index (except for sub-Saharan Africa), the most polluted air, the greatest burden of diseases, and increased vulnerability to climate change. It's time to reinvent science diplomacy in this part of the world to spur collaborations that can help resolve conflicts that are preventing South Asia from achieving its potential.
Auranofin Activity Exposes Thioredoxin Reductase as a Viable Drug Target in
Mycobacterium abscessus
Authors: Ruth Mike Marvin , van Rossum Mara , Koeken Valerie A. C. M. , Pennings Lian J. , Svensson Elin M. , Ruesen Carolien , Bowles Edmee C. , Wertheim Heiman F. L. , Hoefsloot Wouter , van Ingen Jakko
Published: June 2019

Nontuberculous mycobacteria (NTM) are highly drug-resistant, opportunistic pathogens that can cause pulmonary disease. The outcomes of the currently recommended treatment regimens are poor, especially for
Mycobacterium abscessus
. New or repurposed drugs are direly needed. Auranofin, a gold-based antirheumatic agent, was investigated for
Mycobacterium tuberculosis
. Here, we test auranofin against NTM
in vitro
and
ex vivo
. We tested the susceptibility of 63 NTM isolates to auranofin using broth microdilution.
Nucleoside Analogs with Antiviral Activity against Yellow Fever Virus
Authors: Zandi Keivan , Amblard Franck , Amichai Sarah , Bassit Leda , Tao Sijia , Jiang Yong , Zhou Longhu , Ollinger Russell Olivia , Mengshetti Seema , Schinazi Raymond F.
Published: June 2019

Yellow fever virus (YFV) is a human
Flavivirus
reemerging in parts of the world. While a vaccine is available, large outbreaks have recently occurred in Brazil and certain African countries. Development of an effective antiviral against YFV is crucial, as there is no available effective drug against YFV.
Toll-Like Receptors 2 and 4 Modulate Pulmonary Inflammation and Host Factors Mediated by Outer Membrane Vesicles Derived from Acinetobacter baumannii
Authors: Marion Chad R. , Lee Jaewook , Sharma Lokesh , Park Kyong-Su , Lee Changjin , Liu Wei , Liu Pei , Feng Jingjing , Gho Yong Song , Dela Cruz Charles S.
Published: June 2019

Pneumonia due to Gram-negative bacteria is associated with high mortality.
Acinetobacter baumannii
is a Gram-negative bacterium that is associated with hospital-acquired and ventilator-associated pneumonia. Bacteria have been described to release outer membrane vesicles (OMVs) that are capable of mediating systemic inflammation. The mechanism by which
A. baumannii
OMVs mediate inflammation is not fully defined.
Changes in Endogenous and Exogenous Koala Retrovirus Subtype Expression over Time Reflect Koala Health Outcomes
Authors: Quigley Bonnie L. , Phillips Samuel , Olagoke Olusola , Robbins Amy , Hanger Jonathan , Timms Peter
Published: June 2019

The long-term survival of the koala is under serious threat, with this iconic marsupial being declared “vulnerable” by the Australian Government and officially listed as a threatened species. KoRV is clearly contributing to the overall health status of koalas, and research into this virus has been lacking detailed study of the multiple subtypes at both the proviral and expressed viral levels over time. By designing new subtype-specific assays and following well-defined koala cohorts over time, this study has generated a new more complete picture of KoRV and its relationship to koala health outcomes in the wild. Only by building a comprehensive picture of KoRV during both koala health and disease can we bring meaningful koala health interventions into better focus.
A survey of Sierra Nevada magmatism using Great Valley detrital zircon trace-element geochemistry: View from the forearc
Authors: DeGraaff Surpless Kathleen , Clemens-Knott Diane , Barth Andrew P. , Gevedon Michelle
Published: June 2019

The well-characterized Sierra Nevada magmatic arc offers an unparalleled opportunity to improve our understanding of continental arc magmatism, but present bedrock exposure provides an incomplete record that is dominated by Cretaceous plutons, making it challenging to decipher details of older magmatism and the dynamic interplay between plutonism and volcanism. Moreover, the forearc detrital record includes abundant zircon formed during apparent magmatic lulls, suggesting that understanding the long-term history of arc magmatism requires integrating plutonic, volcanic, and detrital records. We present trace-element geochemistry of detrital zircon grains from the Great Valley forearc basin to survey Sierra Nevadan arc magmatism through Mesozoic time. We analyzed 257 previously dated detrital zircon grains from seven sandstone samples of volcanogenic, arkosic, and mixed compositions deposited ca. 145–80 Ma along the length of the forearc basin. Detrital zircon trace-element geochemistry is largely consistent with continental arc derivation and shows similar geochemical ranges between samples, regardless of location along strike of the forearc basin, depositional age, or sandstone composition. Comparison of zircon trace-element data from the forearc, arc, and retroarc regions revealed geochemical asymmetry across the arc that was persistent through time and demonstrated that forearc and retroarc basins sampled different parts of the arc and therefore recorded different magmatic histories. In addition, we identified a minor group of Jurassic detrital zircon grains with oceanic geochemical signatures that may have provenance in the Coast Range ophiolite. Taken together, these results suggest that the forearc detrital zircon data set reveals information different from that gleaned from the arc itself and that zircon compositions can help to identify and differentiate geochemically distinct parts of continental arc systems. Our results highlight the importance of integrating multiple proxies to fully document arc magmatism, demonstrating that detrital zircon geochemical data can enhance understanding of a well-characterized arc, and these data may prove an effective means by which to survey an arc that is inaccessible and therefore poorly characterized.
Active perinatal care of preterm infants in the German Neonatal Network
Authors: Humberg Alexander , Härtel Christoph , Rausch Tanja K. , Stichtenoth Guido , Jung Philipp , Wieg Christian , Kribs Angela , von der Wense Axel , Weller Ursula , Höhn Thomas , Olbertz Dirk M. , Felderhoff-Müser Ursula , Rossi Rainer , Teig Norbert , Heitmann Friedhelm , Schmidtke Susanne , Bohnhorst Bettina , Vochem Matthias , Segerer Hugo , Möller Jens , Eichhorn Joachim G , Wintgens Jürgen , Böttger Ralf , Hubert Mechthild , Dördelmann Michael , Hillebrand Georg , Roll Claudia , Jensen Reinhard , Zemlin Michael , Mögel Michael , Werner Claudius , Schäfer Stefan , Schaible Thomas , Franz Axel , Heldmann Michael , Ehlers Silke , Kannt Olaf , Orlikowsky Thorsten , Gerleve Hubert , Schneider Katja , Haase Roland , Böckenholt Kai , Linnemann Knud , Herting Egbert , Göpel Wolfgang
Published: June 2019

Objective

To determine if survival rates of preterm infants receiving active perinatal care improve over time.

Design

The German Neonatal Network is a cohort study of preterm infants with birth weight <1500 g. All eligible infants receiving active perinatal care are registered. We analysed data of patients discharged between 2011 and 2016.

Setting

43 German level III neonatal intensive care units (NICUs).

Patients

8222 preterm infants with a gestational age between 22/0 and 28/6 weeks who received active perinatal care.

Interventions

Participating NICUs were grouped according to their specific survival rate from 2011 to 2013 to high (percentile >P75), intermediate (P25–P75) and low (<P25) survival. We compared these survival rates with data in 2014–2016.

Main outcome measures

Death by any cause before discharge.

Results

Total survival increased from 85.8% in 2011–2013 to 87.4% in 2014–2016. This increase was due to reduced mortality of NICUs with low survival rates in 2011–2013. Survival increased in these centres from 53% to 64% in the 22–24 weeks strata and from 73% to 84% in the 25–26 weeks strata.

Conclusions

Our data support previous reports that active perinatal care of very immature infants improves outcomes at the border of viability and survival rates at higher gestational ages. The high total number of surviving infants below 24 weeks of gestation challenges national recommendations exclusively referring to gestational age as the single criterion for providing active care. However, more data are needed before recommendations for parental counselling should be reconsidered.

Trial registration

Approval by the local institutional review board for research in human subjects of the University of Lübeck (file number 08–022) and by the local ethic committees of all participating centres has been given.
Association between gallbladder agenesis and choledochal cyst: cause or coincidence?
Authors: Aneiros Castro Belén , Cano Novillo Indalecio , García Vázquez Araceli , De Miguel Moya Mónica
Published: June 2019

This case report describes an extremely rare association between gallbladder agenesis and choledochal cyst (CC). A 9-year-old girl presented with recurrent abdominal pain in the right upper quadrant. Radiological studies revealed a CC type IVa and an agenesis of gallbladder and cystic duct. Due to the possibility of biliary neoplasm, the patient underwent cyst resection and hepaticoduodenostomy. Histopathological findings showed inflamed fibrous tissue covered by biliary epithelium with no evidence of malignancy.
Cohort profile: the Hortega Study for the evaluation of non-traditional risk factors of cardiometabolic and other chronic diseases in a general population from Spain
Authors: Tellez-Plaza Maria , Briongos-Figuero Laisa , Pichler Gernot , Dominguez-Lucas Alejandro , Simal-Blanco Fernando , Mena-Martin Francisco J , Bellido-Casado Jesus , Arzua-Mouronte Delfin , Chaves Felipe Javier , Redon Josep , Martin-Escudero Juan Carlos
Published: June 2019

Purpose

The Hortega Study is a prospective study, which investigates novel determinants of selected chronic conditions with an emphasis on cardiovascular health in a representative sample of a general population from Spain.

Participants

In 1997, a mailed survey was sent to a random selection of public health system beneficiaries assigned to the University Hospital Rio Hortega’s catchment area in Valladolid (Spain) (n=11 423, phase I), followed by a pilot examination in 1999–2000 of 495 phase I participants (phase II). In 2001–2003, the examination of 1502 individuals constituted the Hortega Study baseline examination visit (phase III, mean age 48.7 years, 49% men, 17% with obesity, 27% current smokers). Follow-up of phase III participants (also termed Hortega Follow-up Study) was obtained as of 30 November 2015 through review of health records (9.5% of participants without follow-up information).

Findings to date

The Hortega Study integrates baseline information of traditional and non-traditional factors (metabolomic including lipidomic and oxidative stress metabolites, genetic variants and environmental factors, such as metals), with 14 years of follow-up for the assessment of mortality and incidence of chronic diseases. Preliminary analysis of time to event data shows that well-known cardiovascular risk factors are associated with cardiovascular incidence rates, which add robustness to our cohort.

Future plans

In 2020, we will review updated health and mortality records of this ongoing cohort for a 5-year follow-up extension. We will also re-examine elder survivors to evaluate specific aspects of ageing and conduct geolocation to study additional environmental exposures. Stored biological specimens are available for analysis of new biomarkers. The Hortega Study will, thus, enable the identification of novel factors based on time to event data, potentially contributing to the prevention and control of chronic diseases in ageing populations.
Dietary intake, physical activity and muscle strength among adolescents: the Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study
Authors: Ng Ai Kah , Hairi Noran Naqiah , Jalaludin Muhammad Yazid , Majid Hazreen Abdul
Published: June 2019

Objective

To examine the role of dietary intake and physical activity in muscle strength among adolescents.

Design

Cross-sectional analysis.

Setting

The Malaysian Health and Adolescents Longitudinal Research Team (MyHeART) study.

Participants

Fifteen-year-old secondary school children who have given consent and who participated in the MyHeART study in 2014.

Primary outcome measure

Muscle strength was measured in relation to dietary intake (energy and macronutrients) and physical activity by using a hand grip dynamometer.

Results

Among the 1012 participants (395 male; 617 female), the hand grip strength of the males was higher than that of the females (27.08 kg vs 18.63 kg; p<0.001). Also, males were more active (2.43vs2.12; p<0.001) and consumed a higher amount of energy (2047 kcal vs 1738 kcal; p<0.001), carbohydrate (280.71 g vs 229.31 g; p<0.001) and protein (1.46 g/kg body weight (BW) vs 1.35 g/kg BW; p<0.168). After controlling for ethnicity, place of residency and body mass index, there was a positive relationship between hand grip strength and the intake of energy (r=0.14; p=0.006), carbohydrate (r=0.153; p=0.002) and fat (r=0.124; p=0.014) and the physical activity score (r=0.170; p=0.001) and a negative relationship between hand grip strength and the intake of protein (r=−0.134; p=0.008), for males. However, this was not observed among females.

Conclusions

Energy, carbohydrate and fat intakes and physical activity score were positively correlated with hand grip strength while protein intake was negatively correlated with hand grip strength in males but not in females.
Are Australians ready for warning labels, marketing bans and sugary drink taxes? Two cross-sectional surveys measuring support for policy responses to sugar-sweetened beverages
Authors: Miller Caroline L , Dono Joanne , Wakefield Melanie A , Pettigrew Simone , Coveney John , Roder David , Durkin Sarah J , Wittert Gary , Martin Jane , Ettridge Kerry A
Published: June 2019

Objective

To assess public support for 10 potential policy initiatives to reduce sugar-sweetened beverage (SSB) consumption.

Design

A 2014 historical data set, which employed a face-to-face survey in one Australian state (study 1), provided the basis for comparison with our 2017 nationally representative, cross-sectional, computer-assisted telephone interviewing population survey (study 2).

Participants

Study 1: South Australians, 15+ years (n=2732); study 2: Australians, 18+ years (n=3430).

Primary outcome measures: levels of support for SSB-specific policy initiatives. For the 2017 national study (study 2), demographic characteristics, body mass index, knowledge of potential harms caused by consuming SSBs and SSB consumption were included in multivariable regression analyses.

Results

In 2017, all 10 potential policy initiatives received majority support (60%–88% either ‘somewhat’ or ‘strongly’ in favour). Initiatives with educative elements or focused on children received high support (>70%), with highest support observed for text warning labels on drink containers (88%) and government campaigns warning of adverse health effects (87%). Higher support was observed for SSB tax paired with using funds for obesity prevention (77%) than a stand-alone tax (60%). Support for policy initiatives was generally greater among those who believed SSB daily consumption could cause health problems in adults (4%–18% absolute difference) and/or in children (8%–26% absolute difference) and lower among SSB high consumers (7+ drinks per week; 9%–29% absolute difference). State-specific data comparison indicated increased support from 2014 to 2017 for taxation (42%vs55%; χ2=15.7, p<0.001) and graphic health warnings (52%vs68%; χ2=23.4. p<0.001).

Conclusions

There is strong public support for government action, particularly regulatory and educational interventions, to reduce SSB consumption, which appears to have increased since 2014. The findings suggest that framing policies as protecting children, presenting taxation of SSBs in conjunction with other obesity prevention initiatives and education focused on the harms associated with SSB consumption will increase support.
A publicly well-accepted measure versus an academically desirable measure of health inequality: cross-sectional comparison of the difference between income quintiles with the slope index of inequality
Authors: Khang Young-Ho , Lim Dohee , Bahk Jinwook , Kim Ikhan , Kang Hee-Yeon , Chang Youngs , Jung-Choi Kyunghee
Published: June 2019

Objectives

The difference between income quintiles in health is relatively well accepted by the general public as a measure of health inequality. However, the slope index of inequality (SII) in health reflects the patterns of all social groups, including the middle 60%, and it could therefore be considered more academically desirable. If these two measures are closely correlated, the widespread use of the difference between income quintiles in health would be better supported. This study was conducted to compare differences between income quintiles in life expectancy (LE) and healthy life expectancy (HLE) with the SII.

Design

Cross-sectional comparison using correlational analysis of district level income differences in LE and HLE with associated SII.

Setting

All 252 subnational districts of Korea.

Participants

A total of 342 439 895 subjects (171 287 729 men, 171 152 166 women) and 1 753 476 deaths (970 928 men, 782 548 women) between 2008 and 2014 were analysed.

Primary and secondary outcome measures

Difference in LE and HLE by income quintile and associated SII.

Results

The Pearson correlation coefficients between differences between income quintiles and the SII were generally high: 0.97 (95% CI 0.96 to 0.98) for LE in men and women combined and 0.96 (95% CI 0.94 to 0.97) for HLE in men and women combined. In most districts, the SII was greater than the difference between income quintiles.

Conclusion

Differences between income quintiles were closely correlated with the SII. The widespread use of differences between income quintiles in health as a measure of health inequality may be preferable for communicating results of health inequality measurements to the public.
Transmitral inflow wave and progression from paroxysmal to permanent atrial fibrillation in Asian people
Authors: Nakagawa Takashi , Hara Hisao , Yamamoto Masaya , Matsushita Yumi , Hiroi Yukio
Published: June 2019

Objective

Paroxysmal atrial fibrillation could progress to permanent atrial fibrillation. Whether the transmitral inflow waves could be used to predict progression from paroxysmal atrial fibrillation to permanent atrial fibrillation is unknown. Therefore, we investigated the association between the transmitral inflow waves and progression of paroxysmal atrial fibrillation.

Method

We performed a retrospective study by analysing clinical and echocardiographic data from 88 patients with paroxysmal atrial fibrillation. We excluded patients who had structural heart disease, significant valvular disease, cardiomyopathy, cardiac device implantation or a left ventricular ejection fraction <50%.

Result

The patients with progression to permanent atrial fibrillation were more likely to be male and had lower peak A velocity than those without progression. After adjusting for covariates, lower peak A velocity remained the independent predictor of progression to permanent atrial fibrillation (p=0.025).

Conclusion

The A velocity could be useful for predicting progression to permanent atrial fibrillation in Asian people.
The significance of ‘severity’
Authors: Hausman Daniel
Published: June 2019

This essay considers whether permitting the cost-effectiveness of healthcare to govern its allocation is ethically objectionable on the grounds that it fails to give sufficient weight to the severity of people’s health states. After documenting the popular sentiment that appears to support this criticism, the essay considers how to implement prioritising severity, focusing on Erik Nord’s work. The remainder of the essay scrutinises the ethical arguments supporting policies prioritising severity and challenges those who would prioritise severity to define a notion of severity whose prioritisation they can defend.
Ethical position of medical practitioners who refuse to treat unvaccinated children
Authors: Forster Melanie
Published: June 2019

Recent reports in Australia have suggested that some medical practitioners are refusing to treat children who have not been vaccinated, a practice that has been observed in the USA and parts of Europe for some years. This behaviour, if it is indeed occurring in Australia, has not been supported by the Australian Medical Association, although there is broad support for medical practitioners in general having the right to conscientious objection. This paper examines the ethical underpinnings of conscientious objection and whether the right to conscientious objection can be applied to the refusal to treat unvaccinated children. The implications of such a decision will also be discussed, to assess whether refusal to treat unvaccinated children is ethically justifiable. The best interests of both existing and new patients are crucially important in a doctor’s practice, and the tension between these two groups of patients are contemplated in the arguments below. It is argued that on balance, the refusal to treat unvaccinated children constitutes unjustified discrimination.
Borderline personality disorder: an update for neurologists
Authors: Hall Katherine , Moran Paul
Published: June 2019

The value and challenges of establishing and maintaining a successful doctor–patient relationship are thrown into sharp relief in the treatment of people with borderline personality disorder. We present an overview of this common and important condition, its epidemiology, cause, common comorbidities and neurological associations. We then propose a practical, psychologically informed framework for enhancing the therapeutic alliance for the jobbing neurologist in managing these patients.
Comparison of the isotopic composition of fish otolith-bound organic N with host tissue
Authors: Lueders-Dumont Jessica A. , Sigman Daniel M. , Johnson Beverly J. , Jensen Olaf P. , Oleynik Sergey , Ward Bess B.
Published: June 2019

The15N/14N ratio of the fish-native organic matter preserved in fish otoliths (or δ15Noto) may allow for reconstruction of fish trophic history and changes in food webs. To support this application, ground-truthing data are needed on the relationships among the δ15N of diet, of fish tissue (e.g., white muscle tissue, δ15Nwmt), and δ15Noto. Using a highly sensitive method for N isotope analysis, δ15Notowas compared with δ15Nwmtin 24 teleost species. Within a species, the difference between δ15Notoand δ15Nwmt(Δδ15No-w) varied little across individuals, confirming the utility of δ15Nototo reconstruct δ15Nwmtchanges for a given species. Across species, δ15Notoand δ15Nwmtwere highly correlated. However, Δδ15No-wvaried systematically across species. Phylogeny, the concentrations of total N and amino acids, and life history were ruled out as the main cause for the observed variation in Δδ15No-w. δ15Notowas lowest relative to δ15Nwmtin species producing larger otoliths. We propose that δ15Notois elevated by isotopically fractionating metabolism of the organic matrix, which is less important when otolith growth is fast and thus when the otolith is large.
Trash or treasure? Use of sagittal otoliths partially composed of vaterite for hatchery stock discrimination in steelhead
Authors: Budnik Richard R. , Farver John R. , Gagnon Joel E. , Miner Jeffrey G.
Published: June 2019

Sagittal otoliths are normally deposited as the CaCO3 polymorph aragonite; however, a proportion of otoliths transitions to vaterite during growth. This transition can complicate otolith chemistry analyses, as differences in the crystalline structure (aragonite or vaterite) of otoliths causes variation in otolith chemistry signatures. To address this issue, we introduce a method to utilize sagittal otoliths partially composed of vaterite for stock discrimination. Using this method, we determined the hatchery origins of yearlings from five Lake Erie hatcheries by using Ba, Mg, Mn, and Sr concentrations in vaterite sections of steelhead (Oncorhynchus mykiss) otoliths. We then compared the classification accuracy of our vaterite method with a method in which otoliths composed entirely of aragonite were used. Overall, quadratic discriminant function analyses revealed similar classification success when elemental concentrations from vaterite (95% accuracy) and aragonite (94% accuracy) otolith regions were used. The methods introduced here could likely be used for other fish species that have otoliths that transition to vaterite as long as an adequate number of juvenile fish are available to develop vaterite otolith chemistry signatures.
Developing landscape connectivity in commercial boreal forests using minimum spanning tree and spatial optimization
Authors: Heinonen Tero
Published: June 2019

Currently, habitat connectivity is poorly integrated in forest-planning calculations related to decision-making in commercial boreal forests. This study developed a method that utilizes graph theory and minimum spanning tree (MST) to improve the connectivity of broadleaf-rich habitats in such forests. The location of created habitat corridors could change over time, and the method did not require adjacency between the stands that constituted the MST. Losses in net present value (NPV) due to improved connectivity were also examined. The planning area was located in southern Finland and included 1040 forest stands. Treatment schedules for the stands were created using simulation software, and heuristic optimization methods were used to find optimal treatments for the stands to meet the specified objectives. Incorporating even-flow harvest removals and NPV in an objective function provided real-world conditions in the optimization framework. The developed method clearly improved the connectivity of broadleaf-rich patches. The monetary losses of improved connectivity were moderate compared with the ecological-based connectivity benefits gained with the method. The developed MST method can be applied to any desired forest feature and modified to work in various situations related to connectivity problems.