bluuebunny/crossref_metadata_2025 huggingface dataset:
Trends in the prevalence of airflow limitation in a general Japanese population: two serial cross-sectional surveys from the Hisayama Study
Authors: Ogata Hiroaki , Hirakawa Yoichiro , Matsumoto Koichiro , Hata Jun , Yoshida Daigo , Fukuyama Satoru , Inoue Hiromasa , Kitazono Takanari , Ninomiya Toshiharu , Nakanishi Yoichi
Published: March 2019

Objectives

Chronic obstructive airway disease, which is characterised by airflow limitation, is a major burden on public health. Reductions in environmental pollution in the atmosphere and workplace and a decline in the prevalence of smoking over recent decades may have affected the prevalence of airflow limitation in Japan. The present epidemiological study aimed to evaluate trends in the prevalence of airflow limitation and in the influence of risk factors on airflow limitation in a Japanese community.

Design

Two serial cross-sectional surveys.

Setting

Data from the Hisayama Study, a population-based prospective study that has been longitudinally conducted since 1961.

Participants

A total of 1842 and 3033 residents aged ≥40 years with proper spirometric measurements participated in the 1967 and 2012 surveys, respectively.

Main outcome measures

Airflow limitation was defined as forced expiratory volume in 1 s/forced vital capacity <70% by spirometry. For each survey, the age-adjusted prevalence of airflow limitation was evaluated by sex. ORs and population attributable fractions of risk factors on the presence of airflow limitation were compared between surveys.

Results

The age-standardised prevalence of airflow limitation decreased from 1967 to 2012 in both sexes (from 26.3% to 16.1% in men and from 19.8% to 10.5% in women). Smoking was significantly associated with higher likelihood of airflow limitation in both surveys, although the magnitude of its influence was greater in 2012 than in 1967 (the multivariable-adjusted OR was 1.63 (95% CI 1.19 to 2.24) in 1967 and 2.26 (95% CI 1.72 to 2.99) in 2012; p=0.007 for heterogeneity). Accordingly, the population attributable fraction of smoking on airflow limitation was 33.5% in 2012, which was 1.5-fold higher than that in 1967 (21.1%).

Conclusions

The prevalence of airflow limitation was decreased over 45 years in Japan, but the influence of smoking on airflow limitation increased with time.
The Experience of people with rheumatoid arthritis living with fatigue: a qualitative metasynthesis
Authors: Primdahl Jette , Hegelund Annette , Lorenzen Annette Gøntha , Loeppenthin Katrine , Dures Emma , Appel Esbensen Bente
Published: March 2019

Objectives

To identify, appraise and synthesise qualitative studies on the experience of living with rheumatoid arthritis (RA)-related fatigue.

Methods

We conducted a qualitative metasynthesis encompassing a systematic literature search in February 2017, for studies published in the past 15 years, in PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, SveMed, PsychINFO and Web of Science. To be included, the studies had to report the experience of living with fatigue among adults with RA. The analysis and synthesis followed Malterud’s systematic text condensation.

Results

Eight qualitative articles were included, based on 212 people with RA (69% women) and aged between 20 and 83 years old. The synthesis resulted in the overall theme ‘A vicious circle of an unpredictable symptom’. In addition, the synthesis derived four subthemes: ‘being alone with fatigue’; ‘time as a challenge’; ‘language as a tool for increased understanding’ and ‘strategies to manage fatigue’. Fatigue affects all areas of everyday life for people with RA. They strive to plan and prioritise, pace, relax and rest. Furthermore, they try to make use of a variety of words and metaphors to explain to other people that they experience that RA-related fatigue is different from normal tiredness. Despite this, people with RA-related fatigue experience feeling alone with their symptom and they develop their own strategies to manage fatigue in their everyday life.

Conclusions

The unpredictability of RA-related fatigue is dominant, pervasive and is experienced as a vicious circle, which can be described in relation to its physical, cognitive, emotional and social impact. It is important for health professionals to acknowledge and address the impact of fatigue on the patients’ everyday lives. Support from health professionals to manage fatigue and develop strategies to increase physical activity and maintain work is important for people with RA-related fatigue.
Psychological and psychosocial interventions offered to forensic mental health inpatients: a systematic review
Authors: MacInnes Douglas , Masino Serena
Published: March 2019

Objective

To examine the evidence for the use of psychological and psychosocial interventions offered to forensic mental health inpatients.

Design

CINAHL, MEDLINE, PsycINFO, ScienceDirect and Web of Science databases were searched for research published in English between 1 January 1990 and 31 May 2018.

Outcome measures

Disturbance, mental well-being, quality of life, recovery, violence/risk, satisfaction, seclusion, symptoms, therapeutic relationship and ward environment. There were no limits on the length of follow-up.

Eligibility criteria

We included randomised controlled trial (RCT) studies of any psychological or psychosocial intervention in an inpatient forensic setting. Pilot or feasibility studies were included if an RCT design was used.

We restricted our search criteria to inpatients in low, medium and high secure units aged over 18. We focused on interventions considered applicable to most patients residing in forensic mental health settings.

Data extraction and synthesis

Two independent reviewers extracted data and assessed risk of bias.

Results

17 232 citations were identified with 195 full manuscripts examined in detail. Nine papers were included in the review. The heterogeneity of the identified studies meant that meta-analysis was inappropriate. The results were presented in table form together with a narrative synthesis. Only 7 out of 91 comparisons revealed statistically significant results with no consistent significant findings. The most frequently reported outcomes were violence/risk and symptoms. 61% of the violence/risk comparisons and 79% of the symptom comparisons reported improvements in the intervention groups compared with the control groups.

Conclusions

Current practice is based on limited evidence with no consistent significant findings. This review suggests psychoeducational and psychosocial interventions did not reduce violence/risk, but there is tentative support they may improve symptoms. More RCTs are required with: larger sample sizes, representative populations, standardised outcomes and control group interventions similar in treatment intensity to the intervention.

PROSPERO registration number

CRD42017067099.
Cross-sectional study estimating the psychosocial impact of genital warts and other anogenital diseases in South Korea
Authors: Lee Taek Sang , Kothari-Talwar Smita , Singhal Puneet K , Yee Karen , Kulkarni Amit , Lara Nuria , Roset Montserrat , Giuliano Anna R , Garland Suzanne M , Ju Woong
Published: March 2019

Objectives

To estimate self-reported human papillomavirus (HPV) disease-related psychosocial impact among male and female patients in South Korea.

Design

In this multicentre cross-sectional study, psychosocial impacts were estimated using a one-time survey capturing HPV Impact Profile (HIP) results, CuestionarioEspecifico en Condilomas Acuminados (CECA; in Spanish)—‘Specific questionnaire for Condylomata Acuminata’ and the EuroQol-5 Dimension (EQ-5D) surveys. Student’s t-tests or Mann-Whitney U tests were used for continuous comparisons; χ2or Fisher’s exact tests were applied for categorical comparisons.

Setting

5098 clinics throughout Seoul, Busan, Daegu, Kwangju and Daejeon (South Korea).

Participants

Patients with and without genital warts (GW) (males) and selected HPV diseases (females) visiting primary care physicians, obstetricians/gynaecologists, urologists and dermatologists with 2–30 years experience.

Results

Of 150 male and 250 female patients, HIP scores showed 85.3% of male patients with GW and 32.0% without reported moderate psychological impact (p<0.0001). In categorised total scores, 88.5% of female patients with and 66.0% without selected HPV-related diseases reported moderate or high psychological impacts (p=0.0004). In the CECA questionnaire, male patients had mean (SD) scores of 10.51 (3.79) in ‘emotional health’ and 15.90 (6.13) in ‘sexual activity’. Female patients with GW reported lower scores in both dimensions with mean scores of 7.18 (4.17) in ‘emotional health’ and 10.97 (5.80) in ‘sexual activity’ (p<0.0001), indicating worse health-related quality of life (HRQoL). For the EQ-5D, male patients with GW reported lower mean Visual Analogue Scale (VAS) scores than those without (75.1 vs 81.13, p<0.0135). Mean VAS score and utility values were lower for females with HPV-related diseases than those without (72.18 vs 76.86 and 0.90 vs 0.94, respectively).

Conclusion

In South Korea, GW in men and HPV-related diseases in women negatively impact patient well-being and HRQoL scores. Among women, those with GW suffered a greater psychosocial impact than those with other selected HPV-related diseases.
A cross-sectional study to assess prevalence and factors associated with mild cognitive impairment among older adults in an urban area of Kerala, South India
Authors: Mohan Devi , Iype Thomas , Varghese Sara , Usha Anuja , Mohan Minu
Published: March 2019

Objectives

To assess the prevalence and factors associated with mild cognitive impairment (MCI) among older adults in an urban area of South India.

Setting

The study was conducted in the capital city of Thiruvananthapuram in the South Indian state of Kerala.

Participants

The study participants were community-dwelling individuals aged 60 years and above.

Primary outcome measure

MCI was the primary outcome measure and was defined using the criteria by European Alzheimer’s Disease Consortium. Cognitive assessment was done using the Malayalam version of Addenbrooke’s Cognitive Examination tool. Data were also collected on sociodemographic variables, self-reported comorbidities like hypertension and diabetes, lifestyle factors, depression, anxiety and activities of daily living.

Results

The prevalence of MCI was found to be 26.06% (95% CI of 22.12 to 30.43). History of imbalance on walking (adjusted OR 2.75; 95 % CI of 1.46 to 5.17), presence of depression (adjusted OR 2.17, 95 % CI of 1.21 to 3.89), anxiety (adjusted OR 2.22; 95 % CI of 1.21 to 4.05) and alcohol use (adjusted OR 1.99; 95 % CI of 1.02 to 3.86) were positively associated with MCI while leisure activities at home (adjusted OR 0.33; 95 % CI of 0.11 to 0.95) were negatively associated.

Conclusion

The prevalence of MCI is high in Kerala. It is important that the health system and the government take up urgent measures to tackle this emerging public health issue.
Multimodal neuronavigation-guided precision bypass in adult ischaemic patients with moyamoya disease: study protocol for a randomised controlled trial
Authors: Lu Junlin , Zhao Yahui , Ma Li , Chen Yu , Li Mingtao , Ye Xun , Wang Rong , Chen Xiaolin , Zhao Yuanli
Published: March 2019

Introduction

Revascularisation surgery is an important treatment of moyamoya disease (MMD). Several general methods of revascularisation had been used: direct, indirect and combined techniques. However, there had been no reports about the criteria of recipient arteries selection in bypass surgery for MMD. Surgeons usually choose the recipient arteries by their own experiences. Their choices of the recipient arteries are various and may contribute the different outcome of patients. The purpose is to identify utility and efficacy of precision bypass guided by multimodal neuronavigation of MMD in a prospective randomised controlled trial.

Method and analysis

This study is a prospective randomised controlled clinical trial. This study will enrol a total of 100 eligible patients. These eligible patients will be randomised to the empirical bypass group and the multimodal neuronavigation-guided precision bypass group in a 1:1 ratio. Patient baseline characteristics and MMD characteristics will be described. In the multimodal neuronavigation-guided group, the blood velocity and blood flow of the recipient arteries will be identified. Surgical complications and outcomes at pretreatment, post-treatment, at discharge and at 3 month, 6 month, 12 month and end of trial will be analysed with CT perfusion, MRI, digital subtraction angiography, modified Rankin Scale, National Institute of Health Stroke Scale and modified Barthel Scale. This trial will determine whether multimodal neuronavigation-guided precision bypass is superior to empirical bypass in patients with MMD and identify the safety and efficacy of multimodal neuronavigation-guided precision bypass.

Ethics and dissemination

The study protocol and written informed consent were reviewed and approved by the Clinical Research Ethics Committee of Peking University International Hospital. Study findings will be disseminated in the printed media. The study started in August, 2018 and expected to be completed in December, 2020.

Trial registration number

NCT03516851; Pre-results.
Nursing students’ interprofessional educational experiences in the clinical context: findings from an Italian cross-sectional study
Authors: Palese Alvisa , Gonella Silvia , Brugnolli Anna , Mansutti Irene , Saiani Luisa , Terzoni Stefano , Destrebecq Anne , Zannini Lucia , Grassetti Luca , Dimonte Valerio
Published: March 2019

Objective

To explore nursing students’ interprofessional educational (IPE) experiences during their most recent clinical rotation and to explore the factors supporting IPE experiences.

Design

National cross-sectional study on data collected in 2016.

Setting

95 Bachelor of Nursing Sciences programmes; 27 Italian Universities.

Participants

Students who (a) were attending or just completed their clinical rotations lasting at least 2 weeks in the same unit, and (b) willing to participate in the study.

Primary and secondary outcomes

First to measure the occurrence of IPE experiences in the most recent clinical rotation; the secondary outcome was to discover factors associated with IPE occurrence.

Measures

The primary outcome was measured using questions based on a 4-point Likert scale (from 0=‘never’ to 3=‘always’). Explanatory variables were collected at both individual and regional levels with items included in the same questionnaire.

Results

9607 out of 10 480 students took part in the study. Overall, 666 (6.9%) perceived not having had any IPE experience, while 3248 (33.8%), 3653 (38%) and 2040 (21.3%) reported having experienced IPE opportunities ‘only a little’, to ‘some extent’ or ‘always’, respectively. From the multilevel analysis performed using the generalised linear mixed model, factors promoting the occurrence of IPE experiences were mainly set at (a) the clinical learning environment level (high: learning environment quality, self-directed learning encouragement, learning opportunities, quality of safety and nursing care and quality of tutorial strategies); and (b) the regional level, where significant differences emerged across regions. In contrast, male gender was negatively associated with the perception of having had IPE experiences.

Conclusions

A large number of nursing students experienced either ‘never’ or ‘only a little’ IPE opportunities, thus suggesting that nursing education tends to remain within the nursing profession. Limiting students’ interprofessional exposure during education can prevent future collaborative approaches that have been shown to be essential in providing best patient care. In order to increase IPE exposure, it is necessary to develop strategies designed both at the singular unit and regional levels.
Self-management and blood pressure control in China: a community-based multicentre cross-sectional study
Authors: Qu Zhan , Parry Monica , Liu Fang , Wen Xiulin , Li Jieqiong , Zhang Yanan , Wang Duolao , Li Xiaomei
Published: March 2019

Objectives

This study explored the relationship between self-management and blood pressure (BP) control in China.

Design

A cross-sectional study.

Setting

Eight community health centres from four cities in the Northeast (Shenyang), Northwest (Xi’an), Southwest (Chengdu) and South (Changsha) of China.

Participants

A total of 873 adults with hypertension, including 360 men and 513 women. Hypertension was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg.

Outcome measurements

BP control was the primary outcome variable. This was categorised as good control if individuals with hypertension reduced their BP to <140/90 mm Hg, otherwise, it was categorised as poor control. Secondary outcomes included self-management, defined as: (1) context or condition-specific factors or physical/social environments (eg, age, sex, marital status, education, personal income and health insurance) and (2) process or knowledge/beliefs, self-regulation skills/abilities and social facilitation (eg, treatment, diet, exercise and risk factor management). Data were analysed using logistic regression models using SPSS V.20.

Results

A total of 67.1% (n=586) participants had poor BP control. Limited outpatient care benefits in mainly rural residents (OR 2.26, 95% CI 1.06 to 4.81) and longer disease duration (OR 1.03, 95% CI 1.01 to 1.04) were associated with poor BP control. Self-management practices reduced the odds of having poor BP control (OR 0.98, 95% CI 0.97 to 0.99).

Conclusions

The individual and family self-management theory can serve as an effective theory for understanding the key contexts, processes and outcomes essential for BP control in China. Future research should evaluate the effect of a self-management intervention (eg, self-monitoring, medication adherence, regular and routine doctor visits, and social supports) for BP control in China using a multisite cluster randomised controlled trial. Sex and gender difference, cost and patient-reported outcomes should also be examined.
International multiphase mixed methods study protocol to develop a cross-cultural patient-reported outcome and experience measure for hand conditions (HAND-Q)
Authors: Sierakowski Kyra , Dean Nicola R , Pusic Andrea L , Cano Stefan J , Griffin Philip A , Bain Gregory I , Klassen Anne , Lalonde Donald
Published: March 2019

Introduction

patient-reported outcome measures (PROMs) are instruments used to measure outcomes and experiences of healthcare from the patient perspective. The specific methodology used to develop a PROM should be communicated to establish the quality of the instrument. This mixed methods protocol describes the development of a cross-cultural, internationally applicable PROM for hand conditions, the HAND-Q.

Methods and analysis

The multiphase approach used for this study has been previously used with the development of other PROMs by our team (eg, BODY-Q, BREAST-Q, CLEFT-Q, FACE-Q). In Phase I, we establish what important concepts matter to patients with hand conditions. A conceptual framework is developed from a systematic review of existing PROMs in the field and an extensive international qualitative study. Interpretive description is the qualitative approach used. Item generation is based on the qualitative data. The preliminary scales will be created for each theme identified in the conceptual framework. These scales will be refined by cognitive debriefing interviews with participants and expert input. Phase II involves a large international sample of patients with varied hand conditions completing the field-test version of the HAND-Q. The scales will be refined using the modern psychometric approach of Rasch Measurement Theory. Analysis will result in a shortened set of clinically meaningful and scientifically robust HAND-Q scales.

Ethics and dissemination

This study is coordinated at Flinders University (Adelaide, Australia) where it has ethics board approval for phase I and phase II. Findings will be published in peer-reviewed journals and presented at local, national and international conferences.
Recognition and response to life-threatening situations among women with perinatal mental illness: a qualitative study
Authors: Easter Abigail , Howard Louise Michelle , Sandall Jane
Published: March 2019

Objective

Mental illness has persistently been found to be a leading cause of death during pregnancy and the year after birth (the perinatal period). This study aims to explore barriers to detection, response and escalation of mental health-related life-threatening near miss events among women with perinatal mental illness.

Design

Qualitative study.

Participants

Healthcare professionals (HCP) working in psychiatry, maternity and primary care (n=15) across community and hospital maternity and perinatal services within the UK.

Methods

In-depth semistructured interviews were conducted with a range of healthcare professionals working with women during the perinatal period. An iterative process of inductive and deductive thematic analysis, informed by systems theories of healthcare and the Three Delays model, was employed to analyse the data.

Results

Three overarching themes were identified: recognition of severity, communication of risk and service provision and access to treatment. Differing perspectives of mental illness severity influenced how life-threatening situations among women with perinatal mental illness were described, recognised and communicated between teams. Under-resourced mental health service provision, particularly within emergency and specialist perinatal mental health services, unclear thresholds for escalating care and poor infrastructure for sharing information all contributed to delays in a timely response to crisis situations. Reluctance to prescribe medication or admit women to psychiatric hospital, stigma and missed appointments created further delays.

Conclusions

Response and escalation of care for life threatening near miss events among women with mental illness is strongly influenced by professional culture and understandings of mental illness embedded within different healthcare disciplines. Focusing on how differences in organisational and professional culture contribute to the recognition of severe mental illness and interdisciplinary communication may help facilitate clearer co-ordination between teams.
Does cigarette demand respond to price increases in Uganda? Price elasticity estimates using the Uganda National Panel Survey and Deaton’s method
Authors: Chelwa Grieve , van Walbeek Corne
Published: March 2019

Objective

To provide the first published estimates of the price elasticity of demand for cigarettes in Uganda and thereby contribute to growing the evidence base of the likely impact of excise taxes on cigarette consumption and tax revenues in Sub-Saharan Africa.

Method

We use a linear approximation of the Almost Ideal Demand System along with expenditure data from the Uganda National Panel Survey and exploit the fact that prices of cigarettes vary across geographical space in Uganda.

Results

We find that cigarettes are price inelastic in Uganda with elasticity estimates ranging between −0.26 and −0.33. That is, we expect that cigarette demand will decline by between 2.6% and 3.3% every time cigarette prices rise by 10%. These elasticity estimates are in line with international evidence and are robust to outliers in the data.

Conclusion

Our estimates of the price elasticity of demand for cigarettes suggest that the authorities in Uganda can reduce cigarette consumption and simultaneously increase tax revenues by increasing the excise taxes on cigarettes.
End-of-life cost and its determinants for cancer patients in urban China: a population-based retrospective study
Authors: Li Zhong , Pan Zijing , Zhang Liang , He Ruibo , Jiang Shan , Xu Chengzhong , Lu Fangfang , Zhang Pei , Li Boyang
Published: March 2019

Objective

This study aimed to define the end-of-life (EOL) healthcare utilisation and its cost and determinants for cancer patients and to proactively inform related strategies in mainland China.

Design

A population-based retrospective study.

Setting and participants

Data from 894 cancer patients were collected in urban Yichang, China from 01 July 2015 to 30 June 2017.

Outcome measures

Emergency department (ED) visits, outpatient and inpatient hospitalisation services, intensive care unit (ICU) admission and total costs were used as the main outcomes.

Results

In this study, 66.8% of the 894 patients were male, and the average age was 60.4 years. Among these patients, 37.6% died at home, and patients had an average of 4.86 outpatient services, 2.23 inpatient hospitalisation services and 1.44 ED visits. Additionally, 5.9% of these patients visited the ICU at least once. During the EOL periods, the costs in the last 6 months, 3 months, 1 month and 1 week were US$18 234, US$13 043, US$6349 and US$2085, respectively. The cost increased dramatically as death approached. The estimation results of generalised linear regression models showed that aggressive care substantially affected expenditure. Patients with Urban Employee Basic Medical Insurance spent more than those with Urban Resident-based Basic Medical Insurance or the New Rural Cooperative Medical Scheme. The place of death and the survival time are also risk factors for increased EOL cost.

Conclusion

The findings suggested that the EOL cost for cancer patients is associated with aggressive care, insurance type and survival time. Timing palliative care is urgently needed to address ineffective and irrational healthcare utilisation and to reduce costs.

Ethics and dissemination

This study was approved by the Ethics Committee of the Tongji Medical College, Huazhong University of Science and Technology (IORG No.: IORG0003571). All the data used in this study were de-identified.
Prelegalisation patterns and trends of cannabis use among Canadian youth: results from the COMPASS prospective cohort study
Authors: Zuckermann Alexandra M E , Battista Katelyn , de Groh Margaret , Jiang Ying , Leatherdale Scott T
Published: March 2019

Objective

Canada federally legalised recreational cannabis use among adults in October 2018. The impact this will have on Canadian youth is cause for concern. The current study examined changes in youth cannabis use over the time prior to legalisation to explore the impact of the beginning federal discourse around legalisation during the 2016/2017 school year.

Design

COMPASS, a prospective cohort study based on annual self-administered questionnaires.

Setting

Ontario and Alberta during the first 6 years of the COMPASS study (2012/2013 to 2017/2018).

Participants

Canadian grade 9–12 students attending secondary schools participating in COMPASS. In total, 2 30 404 questionnaires were included in the analysis (Y1: 2012/2013, n=24 173; Y2: 2013/2014, n=45 298; Y3: 2014/2015, n=42 355, Y4: 2015/2016, n=40 436; Y5: 2016/2017, n=37 060; Y6: 2017/2018, n=34 897).

Primary and secondary outcome measures

Lifetime cannabis use, past-year cannabis use, weekly cannabis use, ease of access to cannabis and age at first cannabis use.

Results

Cannabis never-use decreased between Y5 and Y6. Changes in age at first cannabis use mirrored this trend, with male students consistently starting younger. Cannabis access rates increased from Y4, mainly led by female students. Lifetime and past-year use rates were lowest in Y4 then increased in Y5 and Y6 due to a rise in the occasional use more common among female students, who reported use increases first. Non-white students were more likely use cannabis, with black and Aboriginal students the only two groups consistently reporting more weekly than occasional use, though with opposing trajectories. Overall, Aboriginal students had the highest odds of reporting lifetime, past-year and weekly use among the demographic groups examined.

Conclusion

After a steady decrease in patterns of cannabis among youth over several years, it appears that there has been a gradual increase in cannabis use among youth following the start of discourse around cannabis legalisation, with some populations of youth being at greater risk.
Prevalence and characteristics of psoriasis in Denmark: findings from the Danish skin cohort
Authors: Egeberg Alexander , Andersen Yuki M F , Thyssen Jacob P
Published: March 2019

Background

Wide-ranging psoriasis prevalence estimates have been reported, possibly due to methodological differences.

Objectives

To assess the prevalence of psoriasis in Denmark and to validate the use of questionnaire-based data to identify patients with psoriasis.

Methods

We used data from the Danish Skin Cohort, a prospective cohort comprising general population adults, as well as patients with dermatologist-verified psoriasis and atopic dermatitis, respectively. The general population cohort was interviewed to assess the psoriasis prevalence in Denmark, and validation of the questions was performed.

Results

From 3490 general population participants, 7.9% (n=275) were found to have self-reported psoriasis. Of these, 221 (prevalence 6.3%) had their disease diagnosed by a physician (the dermatologist-diagnosed prevalence was 4.3%), whereas 54 (prevalence 1.6%) were not diagnosed by a physician. A total of 176 (5%) had active psoriasis within the last 12 months. More than half of patients had at least one disease flare in the last 12 months, and 44.4% of patients with psoriasis had at least one family member with psoriasis, whereas this was only the case for 13.7% of non-psoriasis individuals. Validation of the psoriasis diagnosis yielded a high sensitivity and specificity, with little incremental value of limiting diagnoses to those diagnosed by a physician.

Conclusion

The lifetime-prevalence of self-reported psoriasis was found to be 7.9%, whereas the 1-year prevalence (ie, currently active psoriasis) was 5.0%. If used appropriately, questionnaire-based data may accurately identify patients with psoriasis.
Systemic pharmacokinetic/pharmacodynamic analysis of intravitreal aflibercept injection in patients with retinal diseases
Authors: Kaiser Peter K , Kodjikian Laurent , Korobelnik Jean-Francois , Winkler Julia , Torri Albert , Zeitz Oliver , Vitti Robert , Ahlers Cristiane , Zimmermann Torsten , Dicioccio A Thomas , Höchel Joachim
Published: March 2019

Objective

Explore relationships between systemic exposure to intravitreal aflibercept injection (IAI) and systemic pharmacodynamic effects via post hoc analyses of clinical trials of IAI for neovascular age-related macular degeneration (nAMD) or diabetic macular oedema (DME).

Methods and analysis

Adults from VGFT-OD-0702.PK (n=6), VGFT-OD-0512 (n= 5), VIEW 2 (n=1204) and VIVID-DME (n=404) studies were included. Validated ELISAs were used to measure concentrations of free and bound aflibercept (reported as adjusted bound) in plasma at predefined time points in each study. Non-compartmental analysis of concentration–time data was obtained with dense sampling in VGFT-OD-0702.PK and VGFT-OD-0512. Sparse sampling was used in VIEW 2 and VIVID-DME. Blood pressure or intrarenal function changes were also investigated.

Results

Following intravitreal administration, free aflibercept plasma concentrations quickly decreased once maximum concentrations were achieved at 1–3 days postdose; pharmacologically inactive adjusted bound aflibercept concentrations increased over a longer period and reached plateau 7 days postdose. Ratios of free and adjusted bound aflibercept decreased over time. There were no meaningful changes in systolic/diastolic blood pressure over the duration of each study at all systemic aflibercept exposure levels. For all treatment arms in VIEW 2, there was no clinically relevant change in mean intrarenal function from baseline at week 52. Overall, incidence of systemic adverse events in VIEW 2 and VIVID-DME was low and consistent with the known safety profile of IAI.

Conclusion

IAI administration was not associated with systemic effects in patients with nAMD or DME as measured by blood pressure or intrarenal function, two known pharmacologically relevant effects of anti-vascular endothelial growth factor.
Prevalence and correlates of diabetes and its comorbidities in four Gulf Cooperation Council countries: evidence from the World Health Survey Plus
Authors: Morgan Sara Afshar , Ali Mohamed Mahmoud , Channon Andrew Amos , Al-Sabahi Sultana , Al Suwaidi Huda , Osman Nabil , Al Salameen Mostafa , Khoja Tawfik
Published: March 2019

Background

The Gulf Cooperation Council countries are witnessing unprecedented changes due to fast economic development and population growth. The aims of this study were twofold: first, to estimate the prevalence of diabetes and its comorbidities; second, to examine the association of sociodemographic risk factors and healthcare service utilisation with diabetes.

Methods

Data from the World Health Survey Plus (WHS+) from Kuwait, Oman, Saudi Arabia and the United Arab Emirates were used. The WHS+ is a nationally representative household survey of the adult population, conducted between 2008 and 2009. Both logistic regression and zero-inflated Poisson models were applied to examine the associations of risk factors, comorbidity and treatment with self-reported diabetes.

Results

The highest level of diabetes was observed in Kuwait, with 40.8% among the oldest age group. High body mass index, older age and low education were all associated with diabetes in all settings. High levels of comorbidity existed within the diabetic population. Over 50% of diabetics in all countries reported having at least one chronic condition. In Kuwait and Saudi Arabia, one in five diabetics reported having two or more comorbidities. Treatment prevalence was above 80% across all sociodemographic categories.

Conclusion

The burden of diabetes, although high, is not uniform across populations in the four Gulf countries. Differential exposure to risk, such as unhealthy lifestyles, may be creating a disadvantage for certain populations and influencing the co-occurrence of chronic conditions. In response, a multifaceted and patient-centred approach is needed at all levels of healthcare to control and prevent non-communicable diseases.
Cross-national comparison of two general population job exposure matrices for physical work exposures
Authors: Evanoff Bradley , Yung Marcus , Buckner-Petty Skye , Baca Matthew , Andersen Johan Hviid , Roquelaure Yves , Descatha Alexis , Dale Ann Marie
Published: March 2019

Objectives

Job exposure matrices (JEMs) are increasingly used to estimate physical workplace exposures. We conducted a cross-national comparison of exposure estimates from two general population JEMs to aid the interpretation of exposure–outcome associations across countries and to explore the feasibility of cross-national application of JEMs to provide workplace physical exposure estimates.

Methods

We compared physical exposure estimates from two general population JEMs created from the FrenchCohorte des consultants des Centres d’examens de santé study (27 exposure variables) and the American Occupational Information Network database (21 exposure variables). These exposure variables were related to physical demands or ergonomic risk factors for musculoskeletal disorders. We used a crosswalk to match French Profession et Catégorie Sociale job codes with American Standard Occupational Classification job codes and calculated Spearman’s correlations and Cohen’s kappa values for exposure variable pairs between these French and American JEMs. We defined a priori 50 matched French and American JEM variable pairs that measured similar exposures.

Results

All variable pairs measuring similar physical exposures demonstrated positive correlations. Among the 50 matched pairs, 33 showed high correlation (ρ≥0.70) and 46 showed at least moderate agreement (κ≥0.41). Exposures expected to be mutually exclusive (manual work vs office work) showed strongly negative correlations.

Conclusions

French and American general population physical exposure JEMs were related, sharing moderate to high association and moderate to substantial agreement between the majority of variable pairs measuring similar exposures. These findings will inform cross-national comparisons of study results and support some uses of general population JEMs outside their countries of origin.
Developmental and sex differences in cardiac tolerance to ischemia–reperfusion injury: the role of mitochondria
Authors: Ostadal B. , Drahota Z. , Houstek J. , Milerova M. , Ostadalova I. , Hlavackova M. , Kolar F.
Published: March 2019

Age and sex play an essential role in the cardiac tolerance to ischemia–reperfusion injury: cardiac resistance significantly decreases during postnatal maturation and the female heart is more tolerant than the male myocardium. It is widely accepted that mitochondrial dysfunction, and particularly mitochondrial permeability transition pore (MPTP) opening, plays a major role in determining the extent of cardiac ischemia–reperfusion injury. We have observed that the MPTP sensitivity to the calcium load differs in mitochondria isolated from neonatal and adult myocardium, as well as from adult male and female hearts. Neonatal and female mitochondria are more resistant both in the extent and in the rate of mitochondrial swelling induced by high calcium concentration. Our data further suggest that age- and sex-dependent specificity of the MPTP is not the result of different amounts of ATP synthase and cyclophilin D: neonatal and adult hearts, similarly as the male and female hearts, contain comparable amounts of MPTP and its regulatory protein cyclophilin D. We can speculate that the lower sensitivity of MPTP to the calcium-induced swelling may be related to the higher ischemic tolerance of both neonatal and female myocardium.
New Algorithm of Response Curve for Fitting HDR Image
Authors: Qiu Shi , Li Xuemei , Huang Yongdong , Li Zhengzhou , Chen Xun , Chen Yuyang
Published: March 2019

Based on the process of generating HDR images from LDR image sequences with different light exposures in the same scene, a new fitting method of camera response curves is proposed to solve the problem that the boundary of the fitting algorithm of camera response curves will be blurred and it is difficult to determine and verify the accuracy of the fitting curves. The optimal response curve is fitted by increasing LDR images step by step through considering the pixel value and texture characteristics. In order to validate the fitting effect of curves, we compare the photographed images and the real images in different time intervals on the basis of HDR images and response curves. We use RGB and gray image experiments to compare the current mainstream algorithms and the accuracy of our proposed algorithm can reach 96%, which has robustness.
Automatic Lip Reading Using Convolution Neural Network and Bidirectional Long Short-term Memory
Authors: Lu Yuanyao , Yan Jie
Published: March 2019

Traditional automatic lip-reading systems generally consist of two stages: feature extraction and recognition, while the handcrafted features are empirical and cannot learn the relevance of lip movement sequence sufficiently. Recently, deep learning approaches have attracted increasing attention, especially the significant improvements of convolution neural network (CNN) applied to image classification and long short-term memory (LSTM) used in speech recognition, video processing and text analysis. In this paper, we propose a hybrid neural network architecture, which integrates CNN and bidirectional LSTM (BiLSTM) for lip reading. First, we extract key frames from each isolated video clip and use five key points to locate mouth region. Then, features are extracted from raw mouth images using an eight-layer CNN. The extracted features have the characteristics of stronger robustness and fault-tolerant capability. Finally, we use BiLSTM to capture the correlation of sequential information among frame features in two directions and the softmax function to predict final recognition result. The proposed method is capable of extracting local features through convolution operations and finding hidden correlation in temporal information from lip image sequences. The evaluation results of lip-reading recognition experiments demonstrate that our proposed method outperforms conventional approaches such as active contour model (ACM) and hidden Markov model (HMM).
The generalized Alexander polynomial of periodic virtual links
Authors: Kim Joonoh , Kim Kyoung-Tark , Shin Mi Hwa
Published: March 2019

In this paper, we give several simple criteria to detect possible periods and linking numbers for a given virtual link. We investigate the behavior of the generalized Alexander polynomial [Formula: see text] of a periodic virtual link [Formula: see text] via its Yang–Baxter state model given in [L. H. Kauffman and D. E. Radford, Bi-oriented quantum algebras and a generalized Alexander polynomial for virtual links, in Diagrammatic Morphisms and Applications, Contemp. Math. 318 (2003) 113–140, arXiv:math/0112280v2 [math.GT] 31 Dec 2001].
An ergodic algorithm for generating knots with a prescribed injectivity radius
Authors: Chapman Kyle Leland
Published: March 2019

The first provably ergodic algorithm for sampling the space of thick equilateral knots off-lattice, as a function of thickness, will be described. This algorithm is based on previous algorithms of applying random reflections. It is an off-lattice generalization of the pivot algorithm. This move to an off-lattice model provides a huge improvement in power and efficacy in that samples can have arbitrary values for parameters such as the thickness constraint, bending angle, and torsion, while the lattice forces these parameters into a small number of specific values. This benefit requires working in a manifold rather than a finite or countable space, which forces the use of more novel methods in Markov–Chain theory. To prove the validity of the algorithm, we describe a method for turning any knot into the regular planar polygon using only thickness non-decreasing moves. This approach ensures that the algorithm has a positive probability of connecting any two knots with the required thickness constraint which is used to show that the algorithm is ergodic. This ergodic sampling allows for a statistically valid method for estimating probability distributions of arbitrary functions on the space of thick knots.
Cosmology with Type II supernovae
Authors: Wang Deng
Published: March 2019

With the recent progresses on the Type II supernovae, we attempt to investigate whether there does exist new physics beyond the standard cosmological paradigm, i.e. the cosmological constant [Formula: see text] plus cold dark matter ([Formula: see text]CDM). Constraining four alternative cosmological models with a data combination of currently available Type II supernovae calibrated by the standard color method, Type Ia supernovae, baryon acoustic oscillations (BAO), cosmic microwave background (CMB) and cosmic chronometers, at the [Formula: see text] confidence level, we find that (i) a spatially flat universe is supported for the nonflat [Formula: see text]CDM model; (ii) the constrained equation-of-state of dark energy [Formula: see text] is consistent with the [Formula: see text]CDM hypothesis for the [Formula: see text]CDM model, where [Formula: see text] is a free parameter; (iii) for the decaying vacuum model, there is no evidence of interaction between dark matter and dark energy in the dark sector of the universe; (iv) there is also no hint of dynamical dark energy for the dark energy density-parametrization scenario. It is very obvious that a larger Type II supernovae sample is required if we expect to draw definitive conclusions about the formation and evolution of the universe.
Decolonizing Resilience: The Case of Reconstructing the Coffee Region of Puerto Rico After Hurricanes Irma and Maria
Authors: Borges-Méndez Ramón , Caron Cynthia
Published: March 2019

The term resilience has saliency in the scholarship and policy on post-disaster management and disaster-risk reduction. In this paper, we assess the use of resilience as a concept for post-disaster reconstruction in Puerto Rico and offer a critique of the standard definition. This critique focuses on the primacy of Puerto Rico’s colonial relations with the United States meshed with decades of political mismanagement of the island’s economic and natural resources by local authorities and political parties. For resilience to be a useful conceptual device, we argue for decolonizing resilience and show the relevance of such an argument through a case study of the island’s coffee-growing region. Decolonizing resilience exposes power inequities and the individuating nature of post-disaster reconstruction to illustrate how collective action and direct participation of local actors and communities carves out autonomous spaces of engagement. Decolonizing resilience necessitates a contextualized analysis of resilience, taking into account “the politics of resilience” embedded in the island’s colonial history and the policy bottlenecks it creates.
The Manifestation of Climate Injustices: The Post-Hurricane Irma Conflicts Surrounding Barbuda’s Communal Land Tenure
Authors: Baptiste April Karen , Devonish Hubert
Published: March 2019

Hurricane Irma caused significant destruction to the Caribbean during the 2017 Atlantic Hurricane season. In its aftermath, many of these Small Island Developing States (SIDS) are left with the dilemma of seeking ways to rebuild in some cases entire nation states. Using the case study of Antigua and Barbuda, where Barbuda was the first Caribbean island to receive a direct hit from Hurricane Irma, the paper begins to explore the ways in which the global system of exploitation of SIDS exacerbates internal historical conflicts which is a manifestation of climate injustices. Specifically, the Barbudans’ relative privilege in having inherited communal land rights have become, for the government, the barrier standing in the way of the only alternative funding sources for reconstruction, foreign tourism investment. Using the theoretical underpinnings of climate justice, we argue that the causers of climate change, who are generally the inheritors of the historic colonization, exploitation and impoverishment of these states, will effectively benefit from the intensity of Hurricane Irma, given that they will eventually get access to Barbudan land if the communal land rights are revoked.