bluuebunny/crossref_metadata_2025 huggingface dataset:
Rho-associated protein kinase inhibitor induced morphological changes in type VI collagen in the human trabecular meshwork
Authors: Okamoto Mizu , Nagahara Miyuki , Tajiri Takuma , Nakamura Naoya , Fukunishi Nahoko , Nagahara Kentaro
Published: June 2019

Aims

To investigate morphological changes in type VI collagen in the human trabecular meshwork associated with the rho kinase inhibitor ripasudil.

Methods

This cross-sectional study evaluated the effects of ripasudil eye drop administration (RA) or no ripasudil eye drop administration (NRA) in patients with primary open-angle glaucoma (POAG; age range 60–80 years) who underwent conventional outflow reconstruction between December 2015 and September 2016 at Tokai University Hachioji Hospital. The juxtacanalicular tissue was removed and imaged using transmission electron microscopy. Type VI collagen comprises cross-banded aggregates with transverse bands 30 nm apart repeating every 105 nm. The transverse bands are called the outer rod-like region (ORR) and the intervals are called the inner rod-like region (IRR). The waveform intensity in the type VI collagen was analysed in electron micrographs using Fourier transformation to detect the IRR and ORR borders.

Results

Ten eyes of 10 patients were included (n=5/group). The baseline characteristics did not differ significantly between groups. ORR width was significantly smaller in the RA group (37.85±3.43 nm) than in the NRA group (50.62±5.23 nm, p<0.05), whereas IRR width was significantly greater in the RA group (70.68±10.84 nm) than in the NRA group (58.19±5.34 nm, p<0.05). Morphological changes in the type VI collagen total width tended to correlate with the duration of ripasudil administration (r=0.9, p=0.08).

Conclusions

Ripasudil administration in patients with POAG induced morphological changes in type VI collagen. Patients with POAG administered RA had a significantly smaller ORR width and a significantly greater IRR width than patients with POAG not administered RA.
Small interface changes have dramatic impacts: how mandatory fields in electronic medical records increased pertussis vaccination rates in Australian obstetric patients
Authors: Orefice Roberto , Quinlivan Julie A
Published: June 2019

Introduction

Electronic health records have been widely introduced into clinical practice. The aim of this study was to determine whether a small interface change could improve compliance with a key quality indicator, namely antenatal pertussis vaccination.

Methods

Audits were performed between 1–31 July 2015 and 1–31 July 2017 of all deliveries at the Centenary Hospital for Women and Children to determine compliance with antenatal pertussis vaccination. The single difference between time points was changing the interface so the antenatal pertussis vaccination field became compulsory.

Results

275 and 299 women delivered in the audit periods. Vaccination rates almost doubled (52.7% vs 91.4%, p<0.0001).

Conclusion

Small interface changes increase compliance. Interface change could be considered for key quality outcomes in patient care.
Reliability of comorbidity scores derived from administrative data in the tertiary hospital intensive care setting: a cross-sectional study
Authors: Hua-Gen Li Michael , Hutchinson Anastasia , Tacey Mark , Duke Graeme
Published: June 2019

Background

Hospital reporting systems commonly use administrative data to calculate comorbidity scores in order to provide risk-adjustment to outcome indicators.

Objective

We aimed to elucidate the level of agreement between administrative coding data and medical chart review for extraction of comorbidities included in the Charlson Comorbidity Index (CCI) and Elixhauser Index (EI) for patients admitted to the intensive care unit of a university-affiliated hospital.

Method

We conducted an examination of a random cross-section of 100 patient episodes over 12 months (July 2012 to June 2013) for the 19 CCI and 30 EI comorbidities reported in administrative data and the manual medical record system. CCI and EI comorbidities were collected in order to ascertain the difference in mean indices, detect any systematic bias, and ascertain inter-rater agreement.

Results

We found reasonable inter-rater agreement (kappa (κ) coefficient ≥0.4) for cardiorespiratory and oncological comorbidities, but little agreement (κ<0.4) for other comorbidities. Comorbidity indices derived from administrative data were significantly lower than from chart review: −0.81 (95% CI − 1.29 to − 0.33;p=0.001) for CCI, and −2.57 (95% CI −4.46 to −0.68;p=0.008) for EI.

Conclusion

While cardiorespiratory and oncological comorbidities were reliably coded in administrative data, most other comorbidities were under-reported and an unreliable source for estimation of CCI or EI in intensive care patients. Further examination of a large multicentre population is required to confirm our findings.
Lessons learned from a comprehensive electronic patient record procurement process—implications for healthcare organisations
Authors: Priestman W , Collins R , Vigne H , Sridharan S , Seamer L , Bowen D , Sebire N J
Published: June 2019

Background

This study describes learning from procurement of a comprehensive electronic patient record (EPR/electronic health record (EHR)), system for a specialist clinical academic institution.

Method

Retrospective review of procurement process in addition to evaluation of peer-reviewed literature in the field.

Results

Main lessons learned include the importance of detailed preparation of organisational requirements/specifications and organisational ‘readiness’. Early staff involvement, resulting in ownership of the selected system by the organisation was a key achievement. The scoring process used required significant resource commitment but, despite being extensive in scope, provided relatively poor distinction between suppliers, despite significant variation in supplier self-scoring. Other elements, such as demonstrations and site visits, provided superior evaluation of functional abilities, and specification requirements should be regarded as threshold evaluation.

Conclusion

While principles should be followed, the procurement process must be modified to meet the needs of the specific organisation, in terms of its clinical activities, digital maturity, existing infrastructure and budget.
Interventions to improve the use of EMRs in primary health care: a systematic review and meta-analysis
Authors: Hamade Noura , Terry Amanda , Malvankar-Mehta Monali
Published: June 2019

Background

Electronic medical record (EMR) adoption in primary care has grown exponentially since their introduction in the 1970s. However, without their properusebenefits cannot be achieved. This includes: 1) the complete and safe documentation of patient information; 2) improved coordination of care; 3) reduced errors and 4) more involved patients. Theuseof EMRs is defined by practitioners using EMRs and their features to perform daily practice functions.

Objective

The purpose of this systematic review was to identify interventions aimed at improving EMR use in primary healthcare settings.

Methods

Ten online databases were searched to identify studies conducted in primary healthcare settings aimed at implementing interventions to observe the use of EMRs and directly measure the use of EMR functions or outcomes effected by the use of EMR functions.

Results

Of 2098 identified studies, 12 were included in the review. Results showed that interventions focused on the use of EMR functions, including referrals, electronic communication, reminders, use of clinical decision support systems and workflow management support functions, were five times more likely to show improvements in EMR use compared with controls. Interventions focused on data quality were five and a half times more likely to show improvements in EMR use compared with controls.

Conclusions

Individuals in primary healthcare settings aiming to improve EMR use would benefit from implementing interventions focused on EMR feature add-ons such as clinical decision support systems and customised referral templates, and provisions of educational materials, or financial incentives targeted at improving the use of EMR functions and data quality.
Large retrospective analysis on frailty assessment in primary care: electronic Frailty Index versus frailty coding
Authors: Millares-Martin Pablo
Published: June 2019

Background

Primary care in UK is expected to use tools such as the electronic Frailty Index (eFI) to identify patients with frailty, which should be then validated and coded accordingly.

Aim

To assess the influence of organisation and software on how eFI score and direct clinical validation occurs across practices in Leeds.

Method

The ‘minimum necessary’ anonymised patient data required for the study (recorded eFI scores and frailty codes – mild, moderate or severe – with their dates of entry) was requested to the Health and Care Hub of the NHS Leeds Clinical Commissioning Group. Data from 44 185 patients from 104 practices using two different clinical software were collected. Descriptive statistics was carried out using SPSS software.

Results

42 593 patients had a frailty code, 8881 had an eFI code. 7341 had both types of entry, and correlation between eFI and coded level of frailty was as expected high (85.3%), but there was statistically significant variation depending on practice and software used. When results did not match, there was a tendency to overstate, to code a level of frailty above the value to be assigned based on the numeric value of eFI, and it was more so on those practices using SystmOne software compared with those using EMIS Web.

Conclusions

Although correlation was generally good, the variability encountered would indicate the need for training and also for software improvements to reduce current disparity and facilitate validation, so frailty level is adequately recorded.
Short-term adoption rates for a web-based portal within the intranet of a hospital information system
Authors: Kotoulas Athanasios , Stratis Ioannis , Goumenidis Theodoros , Lambrou George , Koutsouris Dimitrios - Dionysios
Published: June 2019

Objective

An intranet portal that combines cost-free, open-source software technology with easy set-up features can be beneficial for daily hospital processes. We describe the short-term adoption rates of a costless content management system (CMS) in the intranet of a tertiary Greek hospital.

Design

Dashboard statistics of our CMS platform were the implementation assessment of our system.

Results

In a period of 10 months of running the software, the results indicate the employees overcame ‘Resistance to Change’ status. The average growth rate of end users who exploit the portal services is calculated as 2.73 every 3.3 months.

Conclusion

We found our intranet web-based portal to be acceptable and helpful so far. Exploitation of an open-source CMS within the hospital intranet can influence healthcare management and the employees’ way of working as well.
Effectiveness of the eCARE programme: a short message service for asthma monitoring
Authors: Prabhakaran Lathy , Chun Wei Yap
Published: June 2019

Objective

To evaluate the effectiveness of the upgraded eCARE monitoring system on asthma control in discharged emergency department (ED) patients.

Methods

A multicentre randomised controlled study (randomised controlled trial) was done for patients with a primary diagnosis of asthma seen at the EDs in Singapore between 1 March 2013 and 28 February 2015. Those who met the inclusion criteria were randomised into a control group (routine care, n=212) and intervention group (eCARE, n=212). Patients in the intervention group received short message service (SMS) messages according to a structured workﬂow, while patients in the control group did not receive SMS support.

Results

For patients with poorly controlled asthma at recruitment, the results at 5 weeks showed no statistical difference in the proportion of patients who attained well-controlled asthma between the eCARE and routine care groups. At 3 months, the routine care group had a higher proportion of patients with well-controlled asthma but this was not statistically significant after adjustment for baseline differences using logistic regression. Approximately 95% of patients under the eCARE programme were satisfied with the SMS service.

Discussion

Patients in the eCARE programme did not have better asthma control than those receiving routine care. Conversely, patients in the eCARE programme appeared to have poorer asthma control, though a larger sample size will be required to confirm this finding.
An auditory brainstem implant for treatment of unilateral tinnitus: protocol for an interventional pilot study
Authors: van den Berge Minke J C , van Dijk Marc J M C , Metzemaekers Jan D M , Maat Bert , Free Rolien H , van Dijk Pim
Published: June 2019

Introduction

Tinnitus may have a very severe impact on the quality of life. Unfortunately, for many patients, a satisfactory treatment modality is lacking. The auditory brainstem implant (ABI) was originally indicated for hearing restoration in patients with non-functional cochlear nerves, for example, in neurofibromatosis type II. In analogy to a cochlear implant (CI), it has been demonstrated that an ABI may reduce tinnitus as a beneficial side effect. For tinnitus treatment, an ABI may have an advantage over a CI, as cochlear implantation can harm inner ear structures due to its invasiveness, while an ABI is presumed to not damage anatomical structures. This is the first study to implant an ABI to investigate its effect on intractable tinnitus.

Methods and analysis

In this pilot study, 10 adults having incapacitating unilateral intractable tinnitus and ipsilateral severe hearing loss will have an ABI implanted. The ABI is switched on 6 weeks after implantation, followed by several fitting sessions aimed at finding an optimal stimulation strategy. The primary outcome will be the change in Tinnitus Functioning Index. Secondary outcomes will be tinnitus burden and quality of life (using Tinnitus Handicap Inventory and Hospital Anxiety and Depression Scale questionnaires), tinnitus characteristics (using Visual Analogue Scale, a tinnitus analysis), safety, audiometric and vestibular function. The end point is set at 1 year after implantation. Follow-up will continue until 5 years after implantation.

Ethics and dissemination

The protocol was reviewed and approved by the Institutional Review Board of the University Medical Centre Groningen, The Netherlands (METc 2015/479). The trial is registered atwww.clinicialtrials.govand will be updated if amendments are made. Results of this study will be disseminated in peer-reviewed journals and at scientific conferences.

Trial registration number

NCT02630589.

Trial status

Inclusion of first patient in November 2017. Data collection is in progress. Trial is open for further inclusion. The trial ends at 5 years after inclusion of the last patient.
Six versus two weeks treatment with doxycycline in Lyme neuroborreliosis: the protocol of a multicentre, non-inferiority, double-blinded and randomised controlled trial
Authors: Solheim Anne Marit , Ljøstad Unn , Mygland Åse
Published: June 2019

Introduction

Current treatment guidelines for European Lyme neuroborreliosis (LNB) recommend cephalosporins, penicillin or doxycycline for 14–28 days but evidence for optimal treatment length is poor. Treatment lengths in clinical practice tend to exceed the recommendations. Most patients experience a rapid improvement of symptoms and neurological findings within days of treatment, but some report long-term complaints. The underlying mechanisms of remaining complaints are debated, and theories as ongoing chronic infection withBorrelia burgdorferi, dysregulated immune responses, genetic predisposition, coinfection with multiple tick-borne pathogens, structural changes in CNS and personal traits have been suggested. The main purpose of our trial is to address the hypothesis of improved outcome after long-term antibiotic treatment of LNB, by comparing efficacy of treatment with 2 and 6 weeks courses of doxycycline.

Methods and analysis

The trial has a multicentre, non-inferiority, double-blinded design. One hundred and twenty patients diagnosed with LNB according to European Federation of Neurological Societies (EFNS)guidelines will be randomised to 6 or 2 weeks treatment with oral doxycycline. The patients will be followed for 12 months. The primary endpoint is improvement on a composite clinical score (CCS) from baseline to 6 months after inclusion. Secondary endpoints are improvements in the CCS 12 months after inclusion, fatigue scored on Fatigue Severity Scale, subjective symptoms on the Patient Health Questionnaire-15 scale, health-related quality of life scored on RAND 36-item short form health survey and safety as measured by side effects of the two treatment arms. Blood and cerebrospinal fluid (CSF) are collected from inclusion and throughout the follow-up and a biobank will be established. The study started including patients in November 2015 and will continue throughout December 2019.

Ethics and dissemination

The study is approved by the Norwegian regional committees for medical and health research ethics and the Norwegian Medicines Agency. Data from the study will be published in peer-reviewed medical journals.

Trial registration number

2015-001481-25
Change in prevalence and severity of metabolic syndrome in the Sami and non-Sami population in rural Northern Norway using a repeated cross-sectional population-based study design: the SAMINOR Study
Authors: Michalsen Vilde L , Kvaløy Kirsti , Svartberg Johan , Siri Susanna R A , Melhus Marita , Broderstad Ann R
Published: June 2019

Objective

To examine the change in both the prevalence and severity of metabolic syndrome (MetS) in the Sami and non-Sami in Northern Norway due to a lack of knowledge regarding the development of MetS in this population.

Design

Repeated cross-sectional study.

Setting

The study is based on data from the SAMINOR 1 Survey (2003–2004, n=6550) and the SAMINOR 2 Clinical Survey (2012–2014, n=6004), conducted in 10 municipalities in Northern Norway.

Participants

Men and women aged 40–79 years were invited. We excluded participants not handing in the questionnaire and with missing information concerning ethnicity questions or MetS risk factors resulting in a final sample of 6308 (36.0% Sami) subjects in SAMINOR 1 and 5866 (40.9% Sami) subjects in SAMINOR 2.

Outcome measures

MetS prevalence was determined using the harmonised Adult Treatment Panel III (ATP-III) criteria, and severity was assessed with the MetS severity Z-score. Generalised estimating equations with an interaction term (survey × ethnicity) were used to compare prevalence and severity between the two surveys while accounting for partly repeated measurements.

Results

The overall, age-standardised ATP-III-MetS prevalence was 31.2% (95% CI: 29.8 to 32.6) in SAMINOR 1 and 35.6% (95% CI: 34.0 to 37.3) in SAMINOR 2. Both the ATP-III-MetS prevalence and the mean MetS severity Z-score increased between the surveys in all subgroups, except the ATP-III-MetS prevalence in non-Sami women, which remained stable. Over time, Sami men showed a slightly larger increase in MetS severity than non-Sami men (p<0.001): the score increased by 0.20 (95% CI: 0.14 to 0.25) and 0.06 (95% CI: 0.01 to 0.10) in Sami and non-Sami men, respectively. Abdominal obesity increased markedly between the surveys in all subgroups.

Conclusion

The prevalence and severity of MetS increased over time in rural Northern Norway. Abdominal obesity appeared to drive the increase in ATP-III-MetS prevalence. Sami men had a slightly larger increase in severity than non-Sami.
Vaping cannabis among adolescents: prevalence and associations with tobacco use from a cross-sectional study in the USA
Authors: Kowitt Sarah D , Osman Amira , Meernik Clare , Zarkin Gary A , Ranney Leah M , Martin Jim , Heck Courtney , Goldstein Adam O
Published: June 2019

Objective

Previous research suggests that some adolescents are using e-cigarette devices to vaporise (‘vaping’) cannabis in the form of hash oil, tetrahydrocannabinol (THC) wax or oil, or dried cannabis buds or leaves. However, it is unclear how adolescents who vape cannabis use other tobacco products. This study examined the extent to which adolescents reported ever vaping cannabis and investigated how demographic variables and tobacco behaviours were associated with use.

Design

We used cross-sectional data from adolescents (total response rate 64.5%) who participated in the 2017 North Carolina Youth Tobacco Survey. SAS logistic regression survey procedures were used to account for the complex survey design and sampling weights.

Setting

North Carolina, USA.

Participants

Adolescents in high school (n=2835).

Primary outcome and measure

Adolescents were asked to indicate whether they had ever used an e-cigarette device with marijuana, THC or hash oil, or THC wax.

Results

Approximately 1 in 10 high school students reported ever vaping cannabis in the overall sample (9.6%). In multivariable models, adolescents who reported using cigars (adjusted OR (aOR) 3.76, 95% CI 2.33 to 6.07), waterpipe (aOR 2.32, 95% CI 1.37 to 3.93) or e-cigarettes (aOR 3.18, 95% CI 2.38 to 4.25) in the past 30 days had higher odds of reporting ever vaping cannabis compared with their counterparts. There was no significant association between use of smokeless tobacco (aOR 0.89, 95% CI 0.42 to 1.91) or use of cigarettes (aOR 1.27, 95% CI 0.71 to 2.29) in the past 30 days and odds of reporting ever vaping cannabis.

Conclusions

These findings provide evidence that large numbers of high school students who use tobacco products have vaped cannabis. As tobacco control policies—such as communication campaigns or smoke-free laws—increasingly focus on e-cigarettes, attention to understanding how adolescents use e-cigarettes to vape substances other than nicotine is essential.
Anti-VEGF intervention in neovascular AMD: benefits and risks restated as natural frequencies
Authors: Clearkin Louis , Ramasamy Balasubramanian , Wason James , Tiew Stephenie
Published: June 2019

Objective

Clear information is essential to properly determine preference in medical intervention. In neovascular age-related macular degeneration, patients need to understand the balance of risk and benefit of anti-vascular endothelial growth factor (VEGF) treatment. This balance is altered by the number of injections administered.

Methods

Natural frequencies, displayed as pictographically as icon arrays, are used to show material outcomes from the MARINA and HARBOR (12 months) trials. We also calculated the number needed to treat (NNT) and number needed to harm (NNH).

Results

MARINA 24-month data show the absolute risk reduction is 37% and the NNT is 3; meaning for one patient to benefit three need to be treated.

12 months’ HARBOR data show that compared with as-needed treatment, scheduled monthly injection treatment increases the number of patients achieving a better visual outcome. The number of patients suffering harm is also increased by the additional injections.

Conclusion

Displaying MARINA and HARBOR trial data as natural frequencies, with numbers needed to treat and harm, communicates complimentary information on the positive and negative aspects of anti-VEGF treatment.
Motivating Change: a grounded theory of how to achieve large-scale, sustained change, co-created with improvement organisations across the UK
Authors: Breckenridge Jenna P , Gray Nicola , Toma Madalina , Ashmore Sue , Glassborow Ruth , Stark Cameron , Renfrew Mary J
Published: June 2019

Background

Various theories provide guidance on implementing, sustaining and evaluating innovations within healthcare. There has been less attention given, however, to personal theories drawn from practice and the expertise of managers and front-line staff is a largely untapped resource. In this paper, we share learning from experienced improvement organisations to provide a conceptual level explanation of the conditions necessary to facilitate and sustain improvement at scale.

Methods

Staff (n=42) from three leading change organisations in the UK, spanning health, education and social care, took part in three consultation meetings with the aim of sharing knowledge about sustaining large-scale change. This included one government organisation, one National Health Service Board and one large charity organisation. Using a participatory grounded theory approach, the workshops resulted in a co-created theory.

Results

The theory of Motivating Change describes the psychosocial-structural conditions for large-scale, sustained change from the perspectives of front-line staff. The theory posits that change is more likely to be sustained at scale if there is synergy between staff’s perceived need and desire for improvement, and the extrinsic motivators for change. Witnessing effective change is motivating for staff and positive outcomes provide a convincing argument for the need to sustain improvement activity. As such, evidenceofchange becomes evidenceforchange. This is only possible when there is a flow of trust within organisations that capitalises on positive peer pressure and suppresses infectious negativity. When these conditions are in place, organisations can generate self-proliferating improvement.

Conclusions

The theory of Motivating Change has been co-created with staff and offers a useful explanation and guide for others involved in change work that capitalises on front-line expertise.
Patient safety superheroes in training: using a comic book to teach patient safety to residents
Authors: Maatman Theresa Camille , Prigmore Heather , Williams Joni Strom , Fletcher Kathlyn E
Published: June 2019

Problem

Medical errors are a health burden. Residents must be aware of patient safety threats and have confidence reporting concerns. Creative modalities for teaching such content (eg, simulation) are resource intensive, while lectures do not assimilate clinical practice. Therefore, the objective of this project was to assess the use of a comic book to train Internal Medicine residents to identify patient safety issues. We report acceptability of the teaching tool and awareness and confidence in identifying patient safety issues using a comic book.

Approach

Residents from the Medical College of Wisconsin participated in a 1-hour session to identify 24 safety topics in a comic book. The primary outcomes were awareness and confidence. Engagement and enjoyment were also measured as forms of acceptability of the tool. Comparisons were made using Fisher’s exact tests and paired t-tests for awareness questions and Fisher’s exact tests for confidence questions. Analyses were performed using SAS V.9.4.

Outcomes

Fifty participants were included in the analyses. Proportions in each awareness category were significantly different on post-test in 21 of 24 topics included. The confidence in both identifying safety topics (55.1% precourse to 96% postcourse) and reporting them (35.42%–90%) increased significantly after the curriculum. 90% found the tool enjoyable and 98% found the tool engaging.

Next steps

This curriculum was successful in increasing resident awareness and confidence regarding patient safety. The use of a comic book was acceptable to residents. Future directions include digital conversion of the curriculum and expansion to include multiple settings within the hospital.
Visual assessment of movement quality in the single leg squat test: a review and meta-analysis of inter-rater and intrarater reliability
Authors: Ressman John , Grooten Wilhelmus Johannes Andreas , Rasmussen Barr Eva
Published: June 2019

Single leg squat (SLS) is a common tool used in clinical examination to set and evaluate rehabilitation goals, but also to assess lower extremity function in active people.

Objectives

To conduct a review and meta-analysis on the inter-rater and intrarater reliability of the SLS, including the lateral step-down (LSD) and forward step-down (FSD) tests.

Design

Review with meta-analysis.

Data sources

CINAHL, Cochrane Library, Embase, Medline (OVID) and Web of Science was searched up until December 2018.

Eligibility criteria

Studies were eligible for inclusion if they were methodological studies which assessed the inter-rater and/or intrarater reliability of the SLS, FSD and LSD through observation of movement quality.

Results

Thirty-one studies were included. The reliability varied largely between studies (inter-rater: kappa/intraclass correlation coefficients (ICC) = 0.00–0.95; intrarater: kappa/ICC = 0.13–1.00), but most of the studies reached ‘moderate’ measures of agreement. The pooled results of ICC/kappa showed a ‘moderate’ agreement for inter-rater reliability, 0.58 (95% CI 0.50 to 0.65), and a ‘substantial’ agreement for intrarater reliability, 0.68 (95% CI 0.60 to 0.74). Subgroup analyses showed a higher pooled agreement for inter-rater reliability of ≤3-point rating scales while no difference was found for different numbers of segmental assessments.

Conclusion

Our findings indicate that the SLS test including the FSD and LSD tests can be suitable for clinical use regardless of number of observed segments and particularly with a ≤3-point rating scale. Since most of the included studies were affected with some form of methodological bias, our findings must be interpreted with caution.

PROSPERO registration number

CRD42018077822.
Alterations of gut microbiome in autoimmune hepatitis
Authors: Wei Yiran , Li Yanmei , Yan Li , Sun Chunyan , Miao Qi , Wang Qixia , Xiao Xiao , Lian Min , Li Bo , Chen Yong , Zhang Jun , Li You , Huang Bingyuan , Li Yikang , Cao Qin , Fan Zhuping , Chen Xiaoyu , Fang Jing-Yuan , Gershwin Merrill Eric , Tang Ruqi , Ma Xiong
Published: June 2019

Objective

The significance of the liver-microbiome axis has been increasingly recognised as a major modulator of autoimmunity. The aim of this study was to take advantage of a large well-defined corticosteroids treatment-naïve group of patients with autoimmune hepatitis (AIH) to rigorously characterise gut dysbiosis compared with healthy controls.

Design

We performed a cross-sectional study of individuals with AIH (n=91) and matched healthy controls (n=98) by 16S rRNA gene sequencing. An independent cohort of 28 patients and 34 controls was analysed to validate the results. All the patients were collected before corticosteroids therapy.

Results

The gut microbiome of steroid treatment-naïve AIH was characterised with lower alpha-diversity (Shannon and observed operational taxonomic units, both p<0.01) and distinct overall microbial composition compared with healthy controls (p=0.002). Depletion of obligate anaerobes and expansion of potential pathobionts includingVeillonellawere associated with disease status. Of note,Veillonella dispar, the most strongly disease-associated taxa (p=8.85E–8), positively correlated with serum level of aspartate aminotransferase and liver inflammation. Furthermore, the combination of four patients with AIH-associated genera distinguished AIH from controls with an area under curves of approximately 0.8 in both exploration and validation cohorts. In addition, multiple predicted functional modules were altered in the AIH gut microbiome, including lipopolysaccharide biosynthesis as well as metabolism of amino acids that can be processed by bacteria to produce immunomodulatory metabolites.

Conclusion

Our study establishes compositional and functional alterations of gut microbiome in AIH and suggests the potential for using gut microbiota as non-invasive biomarkers to assess disease activity.
Association between physical multimorbidity, body mass index and mental health/disorders in a representative sample of people with obesity
Authors: Romain Ahmed Jérôme , Marleau Jacques , Baillot Aurelie
Published: June 2019

Background

Obesity is known to be associated with poor mental health. Studies suggested that multimorbidity might explain the consequences of obesity on mental health. The objective of the present study was to examine to what extent physical multimorbidity and the severity of obesity were associated with mental health and with mental disorders.

Methods

Cross-sectional study including a weighted representative sample of individuals in obesity from the province of Quebec included in the 2013–2014 Canadian Community Health Survey (N=1315) and test of the replicability of the association in the three previous cycles (2011–2012, N=1180; 2009–2010, N=1166; 2007–2008, N=1298).

Results

Adjusted logistic regressions showed that when obesity classes and physical multimorbidity were considered, the latter was preferentially associated with poor perceived mental health (OR 3.58, 95% CI 2.07 to 6.22), psychological distress (OR 3.71, 95% CI 2.14 to 6.42), major depressive episode (OR 5.16, 95% CI 2.92 to 9.13), mood disorders (OR 2.31, 95% CI 1.41 to 3.78) and anxiety disorders (OR 2.46, 95% CI 1.46 to 4.16). The same associations were confirmed in the previous cycles. Obesity class was only associated with stress (OR 2.05, 95% CI 1.36 to 3.07), but this association was not confirmed in the other cycles. Both physical multimorbidity and severe obesity were associated with mental multimorbidity.

Conclusion

Among people with obesity, physical multimorbidity is preferentially associated with poor mental health/disorders. There is an existence of a somatic-mental multimorbidity which should be assessed and prevented in the management of obesity.
Cervical diskospondylitis in a Tennessee walking horse mare
Authors: Olivarez Jeff , Graves Meggan T , Morandi Federica
Published: June 2019

A 17‐year‐old Tennessee Walking Horse mare presented for an approximate four‐week history of hindlimb weakness and suspect laminitis, as perceived by the owner. When examined by a veterinarian, no lameness was found; rather significant cervical pain was detected. Cervical radiographs revealed abnormalities consistent with diskospondylitis at C5‐C6. The patient was placed on oral trimethoprim‐sulfamethoxazole (20 mg/kg orally twice a day) to be continued for two to three months, as well as firocoxib (0.3 mg/kg orally once a day). After two days of treatment, gabapentin (10 mg/kg orally twice a day) was added for pain management. Two days following, fentanyl patches (100 mcg/hour every 36 hours) were placed to further alleviate pain. Acupuncture was also used for pain management. The patient was released two weeks after initial presentation, with marked improvement. At the time of this report, two months after admission, the mare continues to show marked improvement in mobility and range of motion.
MiR-19a enhances cell proliferation, migration, and invasiveness through enhancing lymphangiogenesis by targeting thrombospondin-1 in colorectal cancer
Authors: Yin Qian , Wang Pei-Pei , Peng Rui , Zhou Hang
Published: June 2019

Colorectal cancer (CRC) is a devastating disease with high mortality and morbidity, and the underlying mechanisms of miR-19a in CRC are poorly understood. In our study, dual-luciferase reporter assays were used to evaluate the binding of miR-19a with thrombospondin-1 (THBS1). Cell viability, migration, and invasiveness were assessed using MTT, wound healing, and Transwell assays, respectively. Tube-formation assays with human lymphatic endothelial cells (HLECs) were used to evaluate lymphangiogenesis, and tumor xenograft assays were used to measure tumor growth. The results showed that miR-19a was up-regulated and THBS1 was down-regulated in CRC tissues and cells. Applying an inhibitor of miR-19a suppressed survival, migration, and invasiveness, and inhibited the expression of matrix metallopeptidase 9 (MMP-9) and vascular endothelial growth factor C (VEGFC). Further mechanistic study identified that THBS1 is a direct target of miR-19a. THBS1 silencing attenuated the above-mentioned suppressive effects induced with the miR-19a inhibitor. Furthermore, the miR-19a inhibitor suppressed the migration and tube-formation abilities of HLECs via targeting the THBS1–MMP-9/VEGFC signaling pathway. And the inhibition of miR-19a also suppressed tumor growth and lymphatic tube formation in vivo. In conclusion, miR-19a inhibition suppresses the viability, migration, and invasiveness of CRC cells, and suppresses the migration and tube-formation abilities of HLECs, and further, inhibits tumor growth and lymphatic tube formation in vivo via targeting THBS1.
Two sympatric, not externally discernible, and heavily exploited deepwater species with coastal migration during spawning season: implications for sustainable stocks management of Aphanopus carbo and Aphanopus intermedius around Madeira
Authors: Vasconcelos Joana , Sousa Ricardo , Henriques Paulo , Amorim Antonieta , Delgado João , Riera Rodrigo
Published: June 2019

Several artisanal fisheries target deepwater species. These stocks are highly sensitive to overfishing because of their slow growth and late maturation. This vulnerability is higher if species concentrate during spawning season in coastal areas, as occur with scabbardfish (Aphanopus spp.). In this paper, we explore if two Aphanopus species (A. carbo and A. intermedius) that coexist show migration patterns to coastal areas during spawning. We analysed specimens of both species throughout 4 years (2014–2017) in a weekly basis and compare morphological parameters with the distance of the coast (coastal (<12 n.m.; 1 n.m. = 1.852 km) versus offshore (>12 n.m.)). Both species showed coastal patterns of migration during the spawning season (October–December), with 65.90% of total specimens of A. carbo and 51.60% of A. intermedius being caught at <12 n.m. during this season. Fishing events were also more numerous at <12 n.m. to the coast during spawning season (46.6%) relative to nonspawning season (32.6%). A series of management measures (e.g., October–December season) were developed to preserve Aphanopus stocks in the Northeast Atlantic Ocean.
Bias and consequences in attempts to estimate historical salmon abundance
Authors: Cramer Steven P. , Caldwell Lucius
Published: June 2019

Status of salmon populations thought to be at risk is frequently evaluated by comparing estimated abundances in recent decades with approximations of peak abundance in the era when fisheries began. However, spawner escapements of Pacific salmon were generally not surveyed until 1950 or later, so most estimates of salmon abundance before 1950 have been derived from harvest data alone. We investigated historical data on Oregon Coast coho (Oncorhynchus kisutch) to test the reliability of such estimates. In the “Recovery Plan for Oregon Coast Coho” (prepared by National Marine Fisheries Service (NMFS) in 2016), coho abundance was estimated back to 1892 by assuming that in-river landings before 1950 represented a constant 40% of the population. The first mark–recapture studies enabling estimation of harvest rates were completed in the early 1950s, shortly after regulatory action in 1947 sharply curtailed harvesting of coho. We used annual data on fishing licenses sold and length of fishing seasons before 1950 as indices of harvesting effort to reconstruct harvest rates before 1947 and determined in-river landings were near 80%, twice the level postulated by the Recovery Plan. Thus, spawner escapements before 1947 were roughly 20% rather than the 60% of adult recruitment assumed in the Recovery Plan. Actual spawner counts during the first decade of surveys (1945–1955) indicated that coho abundance was much lower and the population trend was opposite of that estimated in the Recovery Plan. However, when spawner abundance was estimated by assuming in-river harvest rates were 80% before 1947, predicted trends in spawner abundance and ocean harvest rates aligned with those from the earliest decade of studies, enabling direct estimates of spawner abundance and ocean harvest rates. Further, the revised simulations indicate that Oregon Coast coho abundance during 1892–1956 probably varied within a range similar to recent decades. We find that use of landings data to speculate about historical salmon abundance is unreliable and can lead to recovery goals that are unattainable, errant interpretation of population limiting factors, and high investment in well-intentioned but misaligned recovery actions. Correct diagnosis of population trends and their causes is best attained with contemporary data for which both precision and accuracy can be validated.
A critical analysis of the Big Bang Nucleosynthesis
Authors: Makki Tahani R. , El Eid Mounib F. , Mathews Grant J.
Published: June 2019

Standard Big Bang Nucleosynthesis (SBBN) represents one of the basic tools to understand the early evolution of the universe. In this paper, we reanalyze this process to focus on the so-called lithium problem. 7Li is overproduced during SBBN compared to its primordial abundance as obtained from observations. For this reason, we extend the scenarios of SBBN in two directions: (i) equating all neutrino chemical potentials and including more neutrino families, (ii) varying neutrino chemical potentials independently. Since the so-called cosmological lithium problem is not resolved on nuclear/astrophysical ground, we argue that this problem should be examined by invoking nonstandard assumptions.
Dynamics of optical solitons incorporating Kerr dispersion and self-frequency shift
Authors: Butt Asma Rashid , Abdullah Muhammad , Raza Nauman
Published: June 2019

This paper deals with the dynamics of optical solitons in nonlinear Schrödinger equation (NLSE) with cubic-quintic law nonlinearity in the presence of self-frequency shift and self-steepening. This type of equation describes the ultralarge capacity transmission and traveling of laser light pulses in optical fibers. Two robust analytical approaches are employed to determine contemporary solutions. Some new explicit rational, periodic and combo periodic soliton solutions are extracted using the extended trial equation method. The Riccati–Bernoulli sub-ODE method provided us with singular and dark soliton solutions. The constraints found are necessary for the existence of solitons.
Comparing the randomized benchmarking figure with the average infidelity of a quantum gate-set
Authors: Qi Jiaan , Ng Hui Khoon
Published: June 2019

Randomized benchmarking (RB) is a popular procedure used to gauge the performance of a set of gates useful for quantum information processing (QIP). Recently, Proctor et al. [Phys. Rev. Lett. 119 (2017) 130502] demonstrated a practically relevant example where the RB measurements give a number [Formula: see text], very different from the actual average gate-set infidelity [Formula: see text], despite past theoretical assurances that the two should be equal. Here, we derive formulas for [Formula: see text], and for [Formula: see text] from the RB protocol, in a manner permitting easy comparison of the two. We show in general that, indeed, [Formula: see text], i.e. RB does not measure average infidelity, and, in fact, neither one bounds the other. We give several examples, all plausible in real experiments, to illustrate the differences in [Formula: see text] and [Formula: see text]. Many recent papers on experimental implementations of QIP have claimed the ability to perform high-fidelity gates because they demonstrated small [Formula: see text] values using RB. Our analysis shows that such a statement from RB alone has to be interpreted with caution.
Generalized quasi-Einstein GRW space-times
Authors: De Uday Chand , Shenawy Sameh
Published: June 2019

Recently, it is proven that generalized Robertson–Walker space-times in all orthogonal subspaces of Gray’s decomposition except one (unrestricted) are perfect fluid space-times. GRW space-times in the unrestricted subspace are identified by having constant scalar curvature. Generalized quasi-Einstein GRW space-times have a constant scalar curvature. It is shown that generalized quasi-Einstein GRW space-times reduce to Einstein space-times or perfect fluid space-times.
The Effect of Round Flow Path Discharger and Back Panel Open Ratio on a Performance of Open Refrigerating Showcase
Authors: Gong Myung Keun , Kim Gun Woo , Oh Myung Do
Published: June 2019

Numerical study is conducted to confirm the effect of round flow path control and back panel open ratio on a performance of open refrigerating showcase in this study. The rounding control is applied to flow path of air discharger in various radii and the punched panel with various open ratios is applied to back panel of showcase. These structural changes have a significant impact on its aircurtain performance because both changes can affect flow pattern of showcase. To prove it, the two-dimensional steady simulation is performed using [Formula: see text]–[Formula: see text] turbulent model. The performance of showcase is assessed using entrainment factor which is a ratio between cooled air and ambient air at the suction of refrigerating part. As a result of simulation, the curved path at air discharger reduces the entrainment factor by a maximum 9% less than typical design. The curved flow path removes the dead zone at the honeycomb structure of discharger. In addition, it is found that there is an optimal back panel open ratio at the storage space of the showcase. When the back panel open ratio is 0%, the cooled air from the discharge is attached to the cold storage area because of the Cowanda effect. However, the Cowanda effect is eliminated when back panel open ratio increases. Results address that the entrainment factor remains almost the same at back panel open ratio 3.93% or more. Lastly, the simulation of showcase with product in cold storage area is conducted to confirm the structure changes effect on performance of real use showcase according to KS Standard.
Radium and strontium binding by a modified bauxite refinery residue – isotope exchange studies of pH-dependence, reversibility and ageing
Authors: Clark M. W. , Harrison J. J. , Payne T. E. , Comarmond M. J. , Thiruvoth S. , Wong H. , Shahin L. Mokhber
Published: June 2019

The pH-dependence and reversibility of radium (Ra) and strontium (Sr) binding to a modified bauxite refinery residue (MBRR), and the effects of sample ageing, were studied in laboratory uptake/leaching experiments. Natural
226
Ra and stable strontium (Sr
nat
) were placed in contact with the MBRR for an 8-day loading period (equilibrium pH
c
. 8.5). Following the addition of exchange isotopes
228
Ra and
85
Sr, the samples were then leached in pH-dependent experiments, where the pH was decreased incrementally from 9 to 3 over 7 h. A further suite of samples was aged at 4°, 23° and 65°C for 6 months after the initial addition of
226
Ra and Sr
nat
and then studied in a similar set of pH-dependent exchange experiments. The relative concentrations of the Ra and Sr isotope pairs (
226
Ra/
228
Ra and Sr
nat
/
85
Sr) provided insights into the adsorption strength, incorporation, reversibility and ageing effects. The Sr
nat
data showed that the amount of bound Sr released from aged MBRR samples as the pH decreases is substantially lower than the unaged sample, showing that Sr has been incorporated in less accessible phases during the ageing period. It appears that the uptake of
228
Ra by the higher-temperature aged samples is somewhat stronger than the unaged samples; however, Ra isotope exchange plots for aged and unaged samples are similar. Consequently, the stronger binding of
228
Ra by the higher-temperature aged samples is probably driven by translocation to kinetically less-favourable surface sites rather than a significant incorporation of Ra within the mineral solids during ageing.