bluuebunny/crossref_metadata_2025 huggingface dataset:
Chronisch-obstruktive Lungenerkrankungen: Die wichtigsten Änderungen im GOLD-Update 2019
Authors: Spielmanns Marc , Pantev Strahil
Published: December 2019

Der jüngste Report der Global Initiative for Chronic Obstructive Lung Disease (GOLD) aus 2019 beinhaltet die letzten Empfehlungen zur Früherkennung, Differenzialdiagnose sowie Initial- und Folgetherapie der COPD. Der Schwerpunkt des Reports liegt auf den aktualisierten therapeutischen Algorithmen für COPD im Zusammenhang mit dem Schweregrad und der Risikogruppe der Erkrankung. Neu wird die Eosinophilenzahl im Blut als wichtiger biochemischer Marker für Therapieentscheidungen bei vorbehandelten Patienten definiert. So wird die Indikation zur inhalativen Kortikosteroidtherapie (ICS) bei einer Eosinophilenzahl >300 Zellen/µl gestellt. Hingegen wird ein ICS-Versuch bei einer Eosinophilenzahl <100 Zellen/µl nicht empfohlen, auch wenn die Patienten exazerbieren.
Antihypertensive Medication Adherence and Confirmation of True Refractory Hypertension
Authors: Siddiqui Mohammed , Judd Eric K. , Dudenbostel Tanja , Gupta Pankaj , Tomaszewski Maciej , Patel Prashanth , Oparil Suzanne , Calhoun David A.
Published: December 2019

Refractory hypertension (RfHTN) is a phenotype of antihypertensive treatment failure defined as uncontrolled BP despite the use of effective doses of ≥5 antihypertensive medications including a long-acting thiazide-like diuretic (chlorthalidone) and a mineralocorticoid receptor antagonist. The degree of medication nonadherence is unknown among patients with RfHTN. In this prospective evaluation, 54 patients with apparent RfHTN were recruited from the University of Alabama at Birmingham Hypertension Clinic after having uncontrolled BP at 3 or more clinic visits. All patients’ BP was evaluated by automated office BP and 24-hour ambulatory BP monitoring (n=49). Antihypertensive medication adherence was determined by measuring 24-hour urine specimens for antihypertensive medications and their metabolites by high-performance liquid chromatography-tandem mass spectrometry (n=45). Of the 45 patients who completed 24-hour ambulatory BP monitoring, 40 (88.9%) had confirmed RfHTN based on an elevated automated office BP (≥130/80 mm Hg), mean 24-hour ABP (≥125/75 mm Hg), and mean awake (day-time) ABP (≥130/80 mm Hg). Out of the 40 fully evaluated patients with RfHTN, 16 (40.0%) were fully adherent with all prescribed medications. Eighteen (45.0%) patients were partially adherent and 6 (15.0%) had none of the prescribed agents detected in their urine. Of 18 patients who were partially adherent, 5 (12.5%) were adherent with at least 5 medications, including chlorthalidone and the mineralocorticoid receptor antagonist, consistent with true RfHTN. Of patients identified as having apparent RfHTN, 52.5% were adherent with at least 5 antihypertensive medications, including chlorthalidone and a mineralocorticoid receptor antagonist, confirming true RfTHN. These findings validate RfHTN as a rare, but true phenotype of antihypertensive treatment failure.
Brain Natriuretic Peptide and Discovery of Atrial Fibrillation After Stroke
Authors: Wasser Katrin , Weber-Krüger Mark , Gröschel Sonja , Uphaus Timo , Liman Jan , Hamann Gerhard F. , Kermer Pawel , Seegers Joachim , Binder Lutz , Gelbrich Götz , Gröschel Klaus , Wachter Rolf
Published: December 2019

Background and Purpose—

Diagnosing paroxysmal atrial fibrillation (pAF) can be challenging after acute ischemic stroke. Enhanced and prolonged Holter-ECG monitoring (EPM) improves the detection rate but is not feasible for all patients. We hypothesized that brain natriuretic peptide (BNP) may help to identify patients with stroke at high risk for pAF to select patients for EPM more effectively.

Methods—

Patients with acute cerebral ischemia ≥60 years presenting in sinus rhythm and without history of AF were included into a prospective, randomized multicenter study to receive either EPM (3× 10-day Holter-ECG) or usual stroke care diagnostic work-up. BNP plasma levels were measured on randomization and 3 months thereafter. Levels were compared between patients with and without pAF detected by means of EPM or usual care. Furthermore, the number needed to screen for EPM depending on BNP cut offs was calculated.

Results—

A total of 398 patients were analyzed. In 373 patients (93.7%), BNP was measured at baseline and in 275 patients (69.1%) after 3 months. pAF was found in 27 patients by means of EPM and in 9 patients by means of usual care (
P
=0.002). Median BNP was higher in patients with pAF as compared to patients without AF in both study arms at baseline (57.8 versus 28.3 pg/mL in the EPM arm,
P
=0.0003; 46.2 versus 27.7 pg/mL,
P
=0.28 in the control arm) and after 3 months (74.9 versus 31.3 pg/mL,
P
=0.012 in the EPM arm, 99.3 versus 26.3 pg/mL,
P
=0.02 in the control arm). Applying a cut off of 100 pg/mL, the number needed to screen was reduced from 18 by usual care to 3 by EPM.

Conclusions—

BNP measured early after ischemic stroke identifies a subgroup of patients with stroke at increased risk for AF, in whom EPM is particularly efficacious.

Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT01855035.
A new subspecies of Jodina rhombifolia (Santalales: Cervantesiaceae), with taxonomical considerations

Authors: ARANA MARCELO D. , LUNA MARÍA LUJÁN
Published: December 2019

The monotypic genus Jodina is endemic from central to south-eastern South America, where it grows from southern Bolivia and Brazil, Uruguay, to northern and central Argentina. The only species included in the genus is Jodina rhombifolia, a small hemiparasitic tree about 4–8 m high that is characteristic of the chacoan environments of the Neotropical region and Monte from the South American transition zone. As part of the floristic updates in the Neotropical and Andean regions of South America, the nomenclature of taxa related to Jodina rhombifolia was re-examined. Owing to the morphological and anatomical differences observed, and the well-delimited geographical distribution patterns that suggest the existence of two distinguishable subspecific entities, a new subspecies of Jodina rhombifolia is proposed here. Two lectotypes are designated and the nomenclature is clarified. An identification key, complete descriptions of the taxa and geographical distribution of the subspecies are also provided.
Cupressaccus nomen novum: a replacement name for the illegitimate Middle Jurassic coniferous pollen genus Cupressacites Reyre

Authors: HERNÁNDEZ JOSÉ AMET RIVAZ
Published: December 2019

Reyre (1973) erected the monospecific genus Cupressacites Reyre (1973: 156) for a Middle Jurassic fossil gymnosperm pollen, Cupressacites oxycedroides Reyre (1973: 157), from the southern Tunisia. This genus was included within the informal pollen group Inaperturatae. Thus, Cupressacites oxycedroides Reyre (1973: 157) collected in the strata of Callovian-Kimmeridgian age was the type species by monotypy.
Two new scale insect species (Hemiptera: Coccomorpha: Acanthococcidae and Pseudococcidae) and a new country record from protected areas in Iran
Authors: MOGHADDAM MASUMEH
Published: December 2019

A new mealybug species, Phenacoccus poae sp. n. (Hemiptera: Coccomorpha: Pseudococcidae) and a new felt scale species, Rhizococcus asperulae sp. n. (Hemiptera: Coccomorpha: Acanthococcidae) are described and illustrated based on adult females; both were collected from Iran, Markazi province, Arak, Haftad-Gholleh Protected Area. A new country record of Rhizococcus istresianus Goux, 1989 (Hemiptera: Coccomorpha: Acanthococcidae) from Kermanshah province, Eslamabad -e Gharb, Ghallajeh Protected Area, is illustrated and some of its morphological variations are discussed. Identification keys to the Iranian species of Phenacoccus and Rhizococcus are provided.
Establishment of rapid diagnostic method for the identification of Staphylococcus aureus in bacterial conjunctivitis
Authors: Li Wei , Nie Aiqin , Li Qiang , Xie Ning , Ling Yunzhi
Published: December 2019

Staphylococcus aureus is the most frequent cause of conjunctivitis and may lead to severe visual impairment. However, the tools available for the diagnosis, such as bacterial culture and cytology, are often inadequate. Therefore, the goal of the present work was to establish
a rapid detection method for S. aureus in the secretions of the conjunctival sac to provide a basis for the early diagnosis of acute bacterial conjunctivitis. The study included 32 patients with acute bacterial conjunctivitis, 30 patients with viral conjunctivitis, and 28 control subjects.
Extracted DNA was analyzed by conventional PCR and RT-PCR using primers specific for S. aureus DNA and two antibiotic resistance genes, mecA and femB. By this technique, S. aureus was found in 37.5% of patients with bacterial conjunctivitis, 20% of patients with
viral conjunctivitis, and in 7.1% normal control subjects. Except for the control group in which the femB gene was not found, in most other cases S. aureus carried mecA and femB genes. The developed molecular biology approach is faster and more sensitive than the
methods requiring bacterial cultures and is uniquely suited for the detection of an S. aureus infection in the eye.
Preparation of ZnS quantum dot photocatalyst and study on photocatalytic degradation of antibiotics
Authors: Wei Maobin , Yang Lili , Yan Yongsheng , Ni Liang
Published: December 2019

In this paper, ZnS quantum dot nanomaterials were prepared by means of hydrothermal method and the structure and morphology of the prepared samples were characterized by XRD and transmission electron microscopy (TEM). At the same time, the photocatalytic properties of ZnS quantum dots
were studied using antibiotic contaminants ciprofloxacin (CIP) in the environment as the object of degradation. The study showed that the successfully prepared ZnS quantum dot has good photocatalytic property under UV irradiation, it can effectively degrade the antibiotic contaminant ciprofloxacin
in the environment, but its catalytic performance under visible light is not high and its degradation efficiency is only 45.75%.
Design, simulation, and performance-evaluation-based validation of a novel RFID-based automatic parking system
Authors: Salah Bashir
Published: December 2019

Automated parking systems play an important role in improving the utilization of parking facilities, particularly in busy public areas that receive many visitors, such as airports, government buildings, and shopping malls. The current parking facilities of airports in Saudi Arabia use barrier gates and ticket-issuing machines. Such parking facilities increase the waiting time at every circulation point, especially at the entry and exit terminals, and when a large number of vehicles are waiting in the queue. In this study, we address this problem by applying an automated technology at the entry/exit terminals of the current parking facilities. In particular, we introduce a parking system that uses radio-frequency identification (RFID) technology for the entry and exit terminals. The basic components of the current entry/exit system and the proposed one (i.e., using RFID technology) are described in detail. Subsequently, a simulation model for the entry/exit system using Arena 14.7 is developed to evaluate the current and proposed entry/exit systems. The evaluation is based on two performance metrics: average waiting time and average number of waiting vehicles. The developed simulation model is validated using actual data through a systematic procedure. The outcome of this study shows that the proposed RFID-based entry/exit system significantly outperforms the current system. Similarly, the validated results confirm the robustness of the simulation model. Thus, it can be concluded that an RFID-based parking system will provide an effective solution for parking facilities.
The Relationship between Tour Guide Humor and Tourists’ Behavior Intention: A Cross-Level Analysis
Authors: Tu HongWei , Guo WeiFeng , Xiao XinNi , Yan Ming
Published: December 2019

This study investigated how tour guide humor could influence tourists’ behavioral intentions in tour groups. Drawing on affective events theory, we explored the mediating role of positive emotion and the moderating role of the personality trait of openness on the influence of tour guide humor on behavioral intentions. Data were collected from 888 tourists nested within 52 tour groups. Findings clearly indicated that tour guide humor influenced tourists’ behavioral intentions directly, and indirectly through positive emotion. Furthermore, tourists’ openness significantly moderated the effects of tour guide humor on tourists’ positive emotion. Specifically, tourists with low openness were more likely to experience positive emotion as a result of tour guide humor. Additionally, tourists’ openness weakened the indirect relationship between tour guide humor and tourists’ behavioral intentions through positive emotion.
The association between professional stratification and use of online sources: Evidence from the National Dental Practice-Based Research Network
Authors: Rosenblum Simone , Isett Kimberley R , Melkers Julia , Funkhouser Ellen , Hicks Diana , Gilbert Gregg H. , Melkers Michael J , McEdward Deborah , Buchberg-Trejo Meredith ,   National Dental PBRN Collaborative Group
Published: December 2019

The use of online information sources in most professions is widespread, and well researched. Less understood is how the use of these sources vary across the strata within a single profession, and how question context affects search behaviour. Using the dental profession as a case of a highly stratified discipline, we examine search preferences for sources by professional strata among dentists in a practice-based network. Results show that variation exists in information search behaviour across professional strata of dental clinicians. This study highlights the importance of addressing information literacy across different levels of a profession. Findings also underscore that search behaviour and source preference vary with perceived question relevance.
Protecting Breastfeeding From Conflicts of Interest
Authors: Lhotska Lida , Richter Judith , Arendt Maryse
Published: December 2019

In order to maximize profits from sales of breastmilk substitutes, manufacturers use a whole gamut of strategies to interfere with the effective implementation of policies that protect, promote, and support breastfeeding (e.g., the International Code of Marketing of Breastmilk Substitutes with its subsequent World Health Assembly resolutions and the Global Strategy on Infant and Young Child Feeding). Their strategies create, among other problems, personal and institutional conflicts of interest. Effective Conflict of Interest policies are therefore needed for ensuring that governments, international organizations, non-governmental organizations, and health professionals can protect their independence, integrity, and credibility in order to work in the best interests of children. Conflicts of interest are discussed by Dr Lida Lhotska and Dr Judith Richter, who have been actively involved in these issues internationally. Lida Lhotska holds a BSc in Biology and a PhD in Anthropology. Her international work spans over 25 years. She headed the Infant Feeding and Care team for UNICEF and subsequently joined the IBFAN-Geneva Infant Feeding Association team, always focusing on advancing the protection of breastfeeding through legal and other policy measures. Judith Richter has a multidisciplinary background combining knowledge in the humanities with health sciences (PhD Social Sciences; MA Development Studies; MSc Pharmaceutical Sciences). Her work as a freelance researcher for United Nations agencies, governments, and civil society organizations and networks has centered on safeguarding their capacity to hold transnational corporations accountable. In her interview, Judith Richter explains why conflict of interest regulation matters to health professionals working in the field of lactation.

(MA = Maryse Arendt; LL = Lida Lhotska; JR = Judith Richter)
Evaluation of bone excision effects on a human skull model—II: Finite element analysis
Authors: Franceskides Constantinos , Gibson Michael , Zioupos Peter
Published: December 2019

Patient-specific computational models are powerful tools which may assist in predicting the outcome of invasive surgery on the musculoskeletal system, and consequently help to improve therapeutic decision-making and post-operative care. Unfortunately, at present the use of personalized models that predict the effect of biopsies and full excisions is so specialized that tends to be restricted to prominent individuals, such as high-profile athletes. We have developed a finite element analysis model to determine the influence of the location of an ellipsoidal excision (14.2 mm × 11.8 mm) on the structural integrity of a human skull when exposed to impact loading, representing a free fall of an adult male from standing height. The finite element analysis model was compared to empirical data based on the drop-tower testing of three-dimensional-printed physical skull models where deformations were recorded by digital image correlation. In this bespoke example, we found that the excision site did not have a major effect on the calculated stress and strain magnitudes unless the excision was in the temporal region, where the reduction in stiffness around the excision caused failure within the neighboring area. The finite element analysis model allowed meaningful conclusions to be drawn for the implications of using such a technique based on what we know about such conditions indicating that the approach could be both clinically beneficial and also cost-effective for wider use.
Exact tests using binary data in adaptive two or multi-stage designs
Authors: Yin Huan , Wang Weizhen , Zhang Zhongzhan
Published: December 2019

When establishing an effective treatment with binary data in a two-stage design, one-sided tests for a proportion p are employed. Researchers use the parameter configuration at the boundary of the null hypothesis space to determine a rejection region and an optimal design. However, it is unclear whether the (maximum) Type I error rate is achieved at the boundary especially when the sample size in stage 2 varies. In this paper, we first prove that this is true for a large family of tests in adaptive two-stage designs by showing that any test in the family has a nondecreasing power in p and then derive optimal designs. Second, similar results are established for m-stage designs with m >  2. Supplementary materials for this article are available online.
An Analysis of the Decision-Making Process After “Decision not to Operate” in Acutely Unwell, High-Risk General Surgery Patients
Authors: Pinto-Lopes Rui , Thahir Azeem , Halahakoon V. Chandima
Published: December 2019

Objectives:

The purpose of this study was to analyze the decision-making process in emergency general surgery in an attempt to ascertain whether surgeons make the correct decision when decisions not to operate in high-risk acutely unwell surgical patients are taken.

Background:

A decision not to operate is sometimes associated with a certain degree of uncertainty as to the accuracy of the decision. Difficulty lies with the fact that the decisions are made on assumptions, and the tools available are not fool proof.

Methods:

We retrospectively evaluated “decisions not to operate” over a period of 32 months from April 2013 to August 2015 in a district general hospital in United Kingdom and compared with consecutive similar number of patients who had an operation as recorded in the National Emergency Laparotomy Audit (NELA) database (from January 2014 to August 2015). We looked at the demographics, American Society of Anesthesiologists grade, Portsmouth–Physiological and Operative Severity Score for enumeration of Mortality and Morbidity (P-POSSUM) score, functional status, and 30-day mortality.

Results:

Two groups (operated [n = 43] and conservative [n = 42]) had similar characteristics. Patients for conservative management had a higher P-POSSUM score ( P < .001) and a poorer functional status ( P < .001) at the time of decision-making compared to those who had surgery. Mortality at 30 days was significantly higher for patients decided for conservative management when compared with those who had surgery (76.2% and 18.6%, respectively).

Conclusions:

Elderly patients with poorer functional status and predicted risks more often drive multidisciplinary discussions on whether to operate. Within the limitations of not knowing the outcome otherwise, it appears surgeons take a reasonable approach when deciding not to operate.
Applied Behavior Analysis: Dispelling Associated Myths
Authors: Demchak MaryAnn , Sutter Chevonne , Grumstrup Brianna , Forsyth Andrea , Grattan Jill , Molina Leslie , Fields C. J.
Published: December 2019

Applied behavior analysis (ABA) is a widely studied and often used approach to working with human behavior. However, there are numerous myths surrounding what ABA is, who is it for, and how it is implemented. The purpose of this article is to identify, explain origins of, and dispel seven common myths about ABA.
Results of Tibia and Fibula Osteotomies Performed Concomitant to Total Ankle Replacement
Authors: Adams Samuel B. , Steele John R. , Demetracopoulos Constantine A. , Nunley James A. , Easley Mark E. , DeOrio James K.
Published: December 2019

Background:

Neutral ankle alignment along with medial and lateral support are paramount to the success of total ankle replacement (TAR). Fibula, intra-articular medial malleolus, and supramalleolar tibia osteotomies have been described to achieve these goals; however, the literature is scant with outcomes and union rates of these osteotomies performed concomitant to TAR. The purpose of this study was to describe our results.

Methods:

A retrospective review was performed to identify patients who had a concomitant tibia, fibula, or combined tibia and fibula osteotomy at the same time as TAR. Routine radiographs were used to assess osteotomy union rates and changes in alignment. Outcomes questionnaires were evaluated preoperatively and at most recent follow-up. Twenty-six patients comprising 4% of the total TAR cohort were identified with a mean follow-up of 3.9 years.

Results:

There were 12 combined tibia and fibula osteotomies, 9 isolated tibia osteotomies, and 5 isolated fibula osteotomies. The union rate for these osteotomies was 92%, 100%, and 100%, respectively. Mean coronal alignment improved from 15.2 to 2.1 degrees ( P < .001). There was significant improvement in patient-reported outcome scores, including Short Form-36, Short Musculoskeletal Function Assessment, and visual analog scale pain. There was 1 failure in the study.

Conclusion:

These data demonstrate successful use of tibia, fibula, or combined tibia and fibula osteotomies at the same time as TAR in order to gain neutral ankle alignment. The overall union rate was 96% with significant improvement in alignment, pain, and patient-reported outcomes. We believe concomitant osteotomies can be considered a successful adjunctive procedure to TAR.

Level of Evidence:

Level III, retrospective comparative series.
Free vibration analysis of hybrid laminated composite cylindrical shells reinforced with shape memory alloy fibers
Authors: Nekouei Morteza , Raghebi Mehdi , Mohammadi Meisam
Published: December 2019

In the present paper, vibration behavior of hybrid laminated composite cylindrical shells reinforced with shape memory alloy fibers is investigated. Material properties of shape memory alloy fibers and composites are accurately considered temperature dependent. Thermo-mechanical properties of shape memory alloy fibers with uniform temperature change are calculated using Brinson’s one-dimensional constitutive law. Love’s first approximation and first-order shear deformation theory of shells with the von Kármán type of geometrical non-linearity are used in conjunction with Hamilton’s principle for deriving the equations of motion. The generalized differential quadrature method is employed to solve the coupled partial differential equations. The effects of pre-strain, volume fraction, phase transformation, location of shape memory alloy fibers, boundary conditions and temperature on the fundamental frequency of the hybrid laminated composite cylindrical shells are studied. Results indicate that a small amount of shape memory alloy fibers significantly increases the fundamental frequency and vibration control of the hybrid laminated composite reinforced with shape memory alloy hybrid laminated composite cylindrical shells.
High order differential feedback controller design and implementation for a Stewart platform
Authors: Ayas Mustafa S , Sahin Erdinc , Altas Ismail H
Published: December 2019

Stewart platform or other parallel manipulators with a Stewart structure are commonly used in flight simulators, surgical operations, medical rehabilitation processes, machine tools, industrial applications, etc. Therefore, researchers have paid attention to position control of these manipulators in addition to their design and development process. In this study, a developed Stewart platform and its inverse kinematic analysis are presented first. Then, a model-free control scheme called a high order differential feedback controller scheme is designed for the Stewart platform in order to improve its trajectory tracking performance and robustness against to different reference trajectories. Real-time trajectory tracking experiments with varied reference trajectories are carried out to show the robustness and effectiveness of the high order differential feedback controller scheme compared to the traditional proportional–integral–derivative controller of which the parameters are optimally tuned. The obtained visual trajectory tracking results and numerical performance results based on error-based performance measurement metrics such as integral of absolute error, integral of squared error, and integral of time-weighted absolute error are provided for both the proposed high order differential feedback controller scheme and the optimal tuned proportional–integral–derivative controller. Experimental results show that the proposed high order differential feedback controller scheme is more robust than the proportional–integral–derivative controller. Furthermore, the high order differential feedback controller scheme has superiority in both transient and steady-state responses and even the parameters of the proportional–integral–derivative controller are optimally tuned.
Measuring Health Promotion in Sports Club Settings: A Modified Delphi Study
Authors: Johnson Stacey , Vuillemin Anne , Geidne Susanna , Kokko Sami , Epstein Jonathan , Van Hoye Aurélie
Published: December 2019

Settings-based approaches have become an increasing health promotion focus since the World Health Organization’s 1986 Ottawa Charter. While schools, cities, and prisons have implemented this approach, its development within sports environments is recent. Sports are a popular leisure-time activity, requiring validated tools to measure health promotion activity. This study’s aim was to develop a measurement tool based on international consensus that measures perceptions of health promotion within sports clubs. It is grounded in the settings-based approach and builds on theory from previous works expanding their context and knowledge. An online, three-round international Delphi study was conducted, inviting experts in sports and health fields to participate in designing the tool. Round 1 created a collaborative list of items; Round 2 validated items based on relevance, importance, and feasibility; and the final round classified items into one determinant category—social, cultural, environmental, or economic. Panelists (69 experts) from 13 countries participated, creating a final list of 62 items at 3 organizational levels; the sports club level included 23 items, the officials level retained 20 items, and the coaching level contained 19 items. This study provides several innovations: (1) applying the settings-based approach to health promotion within sports clubs, (2) defining each club level (sports club, official, coaching) and determinants (social, cultural, environmental, economic) within 3-levels, (3) creating a tool that measures perceptions of health-promotion activities per level and determinant, and (4) obtaining expert consensus on included items. These advancements allow further research on promoting health within sports clubs.
Patients Prescribed Anakinra for Acute Gout Have Baseline Increased Burden of Hyperuricemia, Tophi, and Comorbidities, and Ultimate All-Cause Mortality
Authors: Sharma Ena , Pedersen Brian , Terkeltaub Robert
Published: December 2019

Objective:

The interleukin-1 (IL-1) receptor antagonist anakinra is an effective, off-label option in acute gout flares, when conventional therapy options are narrowed. We performed a retrospective, randomized, case-controlled study to gain clinical insight on baseline factors for gout patients most likely to receive anakinra, and ultimate mortality of those who received anakinra.

Methods:

Of 1451 gout patients seen between January 2003 and January 2015 in a Veterans Affairs (VA) rheumatology group practice, under stringent managed care principles, 13 (100% male), who received anakinra at least once for flares, were compared with 1:4 age- and sex-matched gout controls. Each patient’s first rheumatology encounter was studied by factor analysis for variables associated with later anakinra.

Results:

At baseline, patients that received anakinra had higher urate burden (palpable tophi [10/13] vs controls [16/52], P = .003), serum urate ([10.6 mg/dL] vs controls [7.6 mg/dL], P < .0001), and East Asian descent ([7/13] vs [16/52], P = .041). The anakinra group had higher ultimate all-cause mortality ([6/13] vs controls [7/52], relative risk [RR] = 3.43, 95% confidence interval [CI] = 1.39-8.48, P = .0076). Factor analysis showed baseline visit palpable tophus and statin use to be most strongly associated with later anakinra use. Increased mortality of anakinra users, as per a factorial analysis, was linked more strongly to comorbidities than to anakinra.

Conclusions:

At baseline rheumatology gout encounter, higher urate, palpable tophi, statin prescription, and East Asian descent were associated with later anakinra use for flares. Mortality was more closely associated to the presence of comorbidities at baseline rheumatology visit than to anakinra prescription.
Haemophiliac adolescents’ perspectives of resilience: A qualitative study based on the resilience in illness model
Authors: Parviniannasab Ali Mohammad , Rakhshan Mahnaz , Momennasab Marzieh , Soltanian Mitra , Rambod Masoume , Akbarzadeh Mahdi
Published: December 2019

A qualitative study was conducted to investigate the concept of resilience among Iranian haemophilic adolescents based on the Haase’s Resilience in Illness Model (RIM). Purposive sampling was used to recruit 15 participants comprising haemophilic adolescents and their parents in the study. The data were collected through in-depth semi-structured interviews and analysed using direct content analysis. The themes and categories were defensive coping (emotive coping, evasive coping), courageous coping (optimism, constructive approach, seeking support), derived meaning (spiritual strategy, hope) and social support (support from family, friends and treatment teams). Social support, adopting a spiritual strategy and self-management behaviours played an important role among the adolescents in improving their level of resilience and skills to cope with haemophilia.
Association between body mass index and self-rated health: A Swedish population-based longitudinal study
Authors: Hellgren Margareta I. , Kitsche Emelie , Groot-Zevert Marieke , Lindblad Ulf , Daka Bledar
Published: December 2019

Aims: We aimed to investigate (a) the association between body mass index (BMI) and self-rated health (SRH) and (b) BMI’s predicted value for SRH within a representative population in the Skaraborg Project. Methods: This was a longitudinal observational study. A random population of 2816 individuals were included in the study between 2002 and 2005, and a representative sample of these individuals were invited consecutively for a follow-up visit between 2012 and 2014. At follow-up, data from 1327 participants were collected concerning anthropometric variables, blood samples and validated questionnaires regarding lifestyle factors. Results: A significant inverse association was observed between BMI and SRH both at baseline and at follow-up, with all p-values for trend being ⩽0.001 in both men and women. This association was observed even after adjusting for confounders such as co-morbidity, age, sex, education, marital status and lifestyle factors. In addition, the longitudinal analyses showed that BMI at baseline was inversely associated with SRH at follow-up in both sexes (odds ratio (OR)=1.1, confidence interval (CI) 1.02–1.16, p=0.017 in men; and OR=1.1, CI 1.04–1.14, p=0.001 in women). These findings remained in participants whose weight increased ( p=0.022) or was stable ( p=0.004), while it was not seen in individuals who lost weight over the years ( p=0.340). Conclusions: SRH is inversely associated with BMI in Swedish men and women. High BMI predicted low SRH from a longitudinal perspective, independent of co-morbidities, except for individuals who lost weight over the years. This knowledge emphasises the importance of an understanding and empathetic attitude towards these individuals.
Post-traumatic stress disorder, depression, and anxiety in adult Syrian refugees: What do we know?
Authors: Peconga Emma k. , Høgh Thøgersen Marie
Published: December 2019

Background: The crisis in Syria has resulted in vast numbers of refugees seeking asylum in Syria’s neighboring countries and Europe. Refugees are at considerable risk of developing common mental disorders, including depression, anxiety, and post-traumatic stress disorder. Since the war, no systematic review has been conducted regarding the prevalence of these in the Syrian refugee group. Research is needed to develop strategies to improve the integration of Syrian refugees. Objective: This study provides a systematic review of peer-reviewed articles that feature originally collected data regarding the prevalence of post-traumatic stress, depression, and anxiety in adult Syrian refugees. Methods: The authors searched online databases (PsychInfo, PubMed, PILOTS) for peer-reviewed articles that used validated screening tools to provide mental health prevalence rate estimates in adult Syrian refugees. This article explores potential sources of heterogeneity, including individual risk factors such as demographic and environmental variables. Results: In total, 15 eligible studies provided cross-sectional data for 8176 adult Syrian refugees resettled in 10 countries, with significant variation in assessment and sampling methods. Combined, these studies indicate prevalence rates of 43.0% (range: 23.4–83.4%) for post-traumatic stress, 40.9% (range: 20–44.1%) for depression, and 26.6% (range: 19.30–31.8%) for anxiety morbidity in adult Syrian refugees. Larger and more rigorous surveys reported similar prevalence rates to studies with less rigorous designs, but vast heterogeneity in prevalence of morbidity persisted among all. Conclusions: Syrian refugees could be over 10 times more likely to develop post-traumatic stress and other disorders than the general population. Although there are limitations when comparing studies with different research methodologies, the results of this study suggest increased focus on adequate mental health support is necessary.
Unmet care needs are common among community-dwelling older people with memory problems in Finland
Authors: Aaltonen Mari S. , Van Aerschot Lina H.
Published: December 2019

Aims: Ageing in place has become a policy priority. Consequently, residential care has been reduced, and more older people with multiple care needs reside at home with the help of informal care and home care services. An increasing share of these people has memory disorders. We examined the extent to which memory problems, in addition to other individual characteristics, are associated with unmet care needs among community-dwelling older people. Methods: The study employed cross-sectional survey data from community-dwelling people aged 75+ collected in 2010 and 2015, analysed using binary logistic regression analysis. The study population consisted of people who had long-term illnesses or disabilities that limited their everyday activities ( N = 1928). Nine per cent reported substantial memory problems. Of these, 35.7% had a proxy respondent. Results: People with memory problems have more care needs than those with other types of disability or illness. They receive more care but still have more unmet needs than others. About a quarter of people with memory problems reported that they did not receive enough help. This result did not change significantly when the proxy responses were excluded. Even a combination of informal and formal home care was insufficient to meet their needs. Conclusions: Insufficient care for people with memory problems implies a serious demand for further development of home care services. The care needs of this population are often complex. Unmet needs represent a serious risk to the well-being of people with memory disorders, and may also create an extensive burden on their informal caregivers.
Identifying supportive daytime lighting characteristics for enhancing individuals’ psychophysiological wellbeing in windowless workplace in tropical Malaysia
Authors: Sithravel RatnaKala , Ibrahim Rahinah
Published: December 2019

Inappropriate architectural lighting exposures in workplaces are causing light-induced health and performance-related problems among healthy, urban individuals. This paper presents part one of an integrated tropical architectural lighting design framework for improving dayshift individuals’ psychophysiological wellbeing in windowless workplace in Malaysia. The paper discusses five architectural lighting factors, namely intensity, spectrum, timing, duration, spatial distribution. The daytime lighting characteristics that influence individuals’ psychophysiological wellbeing indicators (IPWI) were analysed. Findings indicated a dearth of literature in the lighting characteristics to support IPWI in the tropics, as evidence was predominantly from seasonal climate contexts. This motivated a critical discussion on the lighting factors and recommendations of alternative design consideration for a tropical Asian context. Potential daytime architectural lighting characteristics likely to support dayshift IPWI in windowless workplace in tropical Malaysia were also recommended for further investigations. These recommendations in the framework are expected to facilitate healthier windowless workplace design in Malaysia.
Interaction rituals in an open drug scene
Authors: Grønnestad Trond E , Sagvaag Hildegunn , Lalander Philip
Published: December 2019

Aims:

Open drug scenes can be found in most major cities in Europe. Despite often being closed down by the police, the drug community continues to exist, and the drug scenes reappear elsewhere. There seem to be forces that hold these communities together, regardless of the substances used. In this study we explore whether interaction rituals have an impact on the decision by people to stay in the drug scene or to return after quitting their drug use.

Method:

In this ethnographic study, one of the researchers spent time in an open drug scene in a Norwegian city over a one-year span and gathered data on the human interactions hosted by this scene. In addition, the researcher interviewed eight people from the scene to obtain greater insight into their lives and perceptions of the scene, drawing on Goffman’s and Collins’s theories about rituals.

Findings:

Three themes emerged. First, drug users bonded as a group and resisted what they called “normal people” passing by. Second, users demonstrated the importance of sharing drugs and services and adhering to the scene’s rules of conduct. The third and final theme is the focus of attention and the production of emotional energy.

Conclusion:

The experience of being outsiders and the need to hide some of their activities seemed to make it necessary for persons in the drug scene to have their own rules and rituals. These rules and rituals can be regarded as “interaction rituals”. They provide participants with the symbols of group membership, emotional energy, and group solidarity. This makes it hard to leave the scene and might explain why those who do often return.
Tribological behavior of chrome-deposited SAE9254 grade steel top compression piston ring under lubrication starvation and mild extreme pressure lubrication
Authors: Syed Danish , Wani MF
Published: December 2019

This article reports tribological studies of piston ring/cylinder liner tribo-contact to evaluate the scuffing failure under dry sliding conditions and its minimization with mild extreme pressure lubrication. The tribological conjugation tested employs a piston ring of SAE9254 grade steel substrate with plasma-sprayed chromium coating of 42 µm and ISO R185220 grade gray cast iron cylinder liner. A conformal, cylinder inscribed in cylindrical cavity contact was ensured to simulate actual dead center reciprocating between piston ring–cylinder liner interface. Tribotests were conducted under dry sliding, simulating lubrication starvation and sliding in extreme pressure additivation blend at a temperature of 200 °C with 10 mm stroke length and reciprocating velocity of 0.2 m s–1. The friction characteristics of the piston ring and cylinder liner samples in cited test conditions were studied as a function of load and continuously monitored throughout the tests. Optimal profilometry was employed for evaluating wear attributes. For surface morphology and allied surface characterization, energy-dispersive X-ray spectroscopy integrated scanning electron microscopy was used. For tribo-chemical interactions and film formation, the tribo-surfaces were further investigated with Raman spectroscopy. ASTM E-384 standard Vickers indentation microhardness and its precedence to tribological characteristics were evaluated. The extreme pressure lubrication is intended to potentially improve the scuffing résistance and optimization of coating material in achieving superior tribological characteristics. Superior lubricity, scuffing resistance and enhanced load-bearing capacity attributes were manifested by EP-PAO10 blend lubrication contrasting the surface deteriorations and scuffing failure ascribed to dry sliding.
Education researchers’ perceptions of and experiences with the research ethics application process in Europe and beyond
Authors: Raykov Milosh
Published: December 2019

Research ethics reviews are an integral component of the research process in education, but little is known about educators’ perceptions of and experiences with this process. This exploratory study examines educators’ perceptions of and experiences with the reviews of research ethics and, in this way, it contributes to a better understanding of this significant but often challenging research component. The study is based on the integration of quantitative findings from an online survey and the thematic analysis of open-ended responses. The research findings have revealed a distinct pattern of the participants’ responses related to the issues in the ethics review process concerning purpose, ambiguity, and process-related matters. The study also found that a significant number of educators face difficulties during the preparation of their applications. Analysis of the open-ended responses has provided some insights that enhance the findings of the survey by contributing to a deeper understanding of the researchers’ experience with and attitudes toward research ethics. The results of this study indicate the complexity of the research process and the need for comprehensive preparation and an efficient support system that will facilitate rather than hinder the quality and efficiency of research in education.
Photocatalysis and UV-blocking properties of cotton fabric functionalized with BiPO4 nanorods
Authors: Jin Jiarui , Li Ning , Xie Yun
Published: December 2019

Uniform monoclinite bismuth phosphate (BiPO4) nanorods were fixed on commonly used cotton fabric using two-dip–two-nip technique. Chitosan and acetic acid were applied to act as cross-linking agent in preparing the finishing solution. In this article, BiPO4 nanorods modified cotton fabrics for UV-blocking, as well as photocatalytic degradation of RhB has been studied. This coated fabric was characterized by X-ray diffraction, field-emission scanning electron microscopy equipped with energy-dispersive X-ray spectrometer, X-ray photoelectron spectroscopy, Fourier transform infrared spectroscopy, and UV–Vis diffuse reflection spectroscopy. Furthermore, UV-blocking and photocatalytic properties were also tested. The coated fabric showed better properties compared to uncoated fabric.
Long-term exposure to air pollution and the risk of non-lung cancer: a meta-analysis of observational studies
Authors: Kim H-B , Shim J-Y , Park B , Lee Y-J
Published: December 2019

Aims:

Several meta-analyses of observational studies report a long-term correlation between air pollution and the risk of cancer, particularly lung carcinoma. The aim of this study was to review and quantify evidence for an association between air pollution and the risk of developing non-lung cancers.

Methods:

We searched PubMed, EMBASE, Cochrane Library, and the reference lists of the included studies as well as those recorded in previous meta-analyses conducted before January 2019. A random-effects model was used to derive overall risk estimates per pollutant.

Results:

A total of 20 studies, including 5 case-control and 15 prospective cohort studies, were used in the final analysis. The risk of developing non-lung cancer was 1.09 (95% confidence interval (CI): 1.01–1.18, I2 = 72.9%) per NO2 increases of 10 µg/m3. There was also a significant association between exposure to PM2.5 and PM10 and the risk of non-lung cancer when the male and female populations were combined (pooled odds ratio/relative risk (OR/RR) = 1.22, 95% CI: 1.11–1.34; I2 = 0.0% and pooled OR/RR = 1.26, 95% CI: 1.05–1.52; I2 = 43.9%, respectively). Regarding the type of cancer, significant harmful effects of PM2.5 were observed for liver cancer populations (pooled OR/RR = 1.21, 95% CI: 1.10–1.32; I2 = 0.0%). Different types of cancer were positively associated with the incidence of non-lung cancer and PM10 in the random-effect meta-regression analysis.

Conclusions:

Long-term exposure to air pollutants appears to be associated with an increased risk of non-lung cancer. Care should be taken in interpretation, because the results for specific cancers were restricted.