bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of levetiracetam in the treatment of Sydenham chorea
Authors: Direk Meltem , Epcacan Serdar , Epcacan Zerrin , Yildirim Didem Derici , Okuyaz Cetin
Published: May 2020

Background

To study the effect of levetiracetam in treating Sydenham chorea.

Methods

We retrospectively collected the data of 140 patients diagnosed with Sydenham chorea in the pediatric neurology and pediatric cardiology outpatient clinics of Van Training and Research Hospital between January 2010 and December 2018.

Results

There were 140 patients, 102 (70%) of whom were girls, with mean age of onset 11.8 ± 2.7 years. Symptomatic treatment was initiated in all patients at the time of diagnosis; this medication was changed during follow up in 15 patients. The most frequently prescribed drugs were haloperidol and sodium (Na) valproate, and the most frequently discontinued one was haloperidol, due to side effects. The second‐choice drug was most often levetiracetam. Clinical response often began within the first 2 weeks, with Na valproate (P = 0.002), within 4 weeks with carbamazepine (P = 0.037) but 1–6 months with haloperidol (P = 0.018) and levetiracetam (P = 0.008). Time to full remission was similar with Na valproate, carbamazepine, haloperidol, and levetiracetam (P = 0.276). Our study indicated that levetiracetam was as effective as the other commonly used drugs in the symptomatic treatment of Sydenham chorea.

Conclusion

Levetiracetam might be an option in the treatment of Sydenham chorea because of its acceptable effect and safety profile. This observation needs further support with evidence obtained through controlled and blinded trials.
Social Distancing during the COVID‐19 Pandemic: Who Are the Present and Future Noncompliers?
Authors: Pedersen Mogens Jin , Favero Nathan
Published: May 2020

Social distancing is an effective means of containing the spread of COVID‐19, but only if we all participate. Who are the individuals who are least likely to adhere to social distancing recommendations, presently and in the long term? Such knowledge is important for policy makers looking to sustain the public's buy‐in to social distancing. Using survey data from a sample of U.S. residents (n = 1,449), the authors show that some demographic factors (gender, age, race, political party) help predict intent to adhere to social distancing. Yet demographic factors are relatively poor predictors compared with individual attitudes and media diets. Public officials should make efforts to inform and persuade the public of the importance of social distancing, targeting media such as television and radio, where audiences are less likely to currently engage in social distancing or are less likely to envision themselves sustaining strict social distancing for several weeks or months.
Comparison of Norwegian health and welfare regulatory frameworks in salmon and chicken production
Authors: Gismervik Kristine , Tørud Brit , Kristiansen Tore S. , Osmundsen Tonje , Størkersen Kristine Vedal , Medaas Christian , Lien Marianne Elisabeth , Stien Lars Helge
Published: May 2020

The health and welfare of farmed fish are often regarded with less concern than for other production animals. This review compares the Norwegian legal health and welfare frameworks for broiler chickens and farmed salmon, with the aim of improving regulations for salmon farming in Norway. Highlighting differences in laws, regulations and governmental organisation are also highly relevant in general, especially in developing welfare regulations for farmed fish in other countries. Norwegian chicken farmers must comply with two main laws, the Norwegian Animal Welfare Act and the Food Act, governed by the same ministry and governmental agency. The salmon farmers must in addition relate to the Aquaculture Act, different ministries and several agencies with different objectives. Compared to the regulation of chicken farming, the regulation of salmon farming is more complex, has potentially conflicting aims and uses less positive welfare phrasings. Thus, the regulation may be perceived as focusing on profitability over welfare. Despite having many similar paragraphs to regulation for chicken farming, salmon farming regulation is less strict in the daily securing of animals and recordings of mortality. There is no specified slaughterhouse control of high‐density productions, as there is for broiler chickens. There are also differences in the mandatory welfare courses, one being that infection prevention is a stated topic for chickens. The Norwegian Animal Welfare Act has no possibility of dispensation, meaning exceptions, and treats fish and other animals equally. Future regulatory frameworks for farmed fish production should avoid unintended downgrading of fish health and welfare.
Characterization of the novel HLA allele: HLA‐B*15:437 in a Chinese bone marrow donor
Authors: Wang Fang , You Xuan , Zhang Wei , He Ji , Zhu Faming
Published: May 2020

HLA‐B*15:437 shows one nucleotide difference with B*15:02 at position 814 G>A.
Tourism land use simulation for regional tourism planning using POIs and cellular automata
Authors: Shi Hong , Li Xia , Yang Zhenzhi , Li Taohong , Ren Yun , Liu Tingting , Yang Ningdong , Zhang Hang , Chen Guangzhao , Liang Xun
Published: May 2020

Previous studies on tourism land use primarily focus on the spatial distribution, and its related impacts on the environment. Here, we propose a future tourism land use simulation model for mountain vacations based on the cellular automata and Markov chain methods, having verified and simulated tourism land use in Emeishan city at a spatial resolution of 30 × 30 m using remote sensing and GIS. In addition, we introduced a tourism land use intensity index to study the spatial expansion mode of tourism land use. The results have confirmed the validity of the model and demonstrated its ability to simulate future tourism land use. The average growth rate of tourism land use from 2010 to 2015 is 33.36%, and tourism land use will rise from 1.26% of Emeishan city’s land area in 2015 to 2.95% in 2030. Tourism land use shows a spatial expansion pattern along channels from scenic spots to the urban area. The growth of tourism land use in the protected area has an increasing trend when there is no restriction on development, especially in the Eshan region. The simulation results can provide useful implications and guides for regional tourism planning and management.
Comparison of serologic status of Toxoplasma gondii infection in pre‐ and post‐heart transplantation in a pediatric population: A preliminary study
Authors: Orang Elahe , Sayyahfar Shirin , Mahdavi Mohammad , Khanaliha Khadijeh , Amiri Mehri
Published: May 2020

Background

Toxoplasmosis is an important opportunistic infection in immunocompromised children, especially in heart transplant recipients. This study aimed to investigate pre‐ and post‐transplant serology for toxoplasmosis along with post‐transplant PCR in pediatric heart transplant patients.

Methods

This cross‐sectional study was performed on 38 heart transplant recipients aged 1‐17 years, by the end of 2018. Pre‐ and post‐transplant IgM and IgG titrations were measured using ELISA method. Nested PCR of B1 gene was performed to identify Toxoplasma gondii (T gondii) infection after transplant.

Results

Totally, 11.4% of patients had positive IgG and 91.4% had negative IgM for toxoplasmosis before heart transplantation. The mean of pre‐transplant IgG titration for seropositive and seronegative patients was 22.32 ± 15.30 IU/mL and 1.49 ± 1.15 IU/mL, respectively (P < .001). All cases were on chemoprophylaxis with trimethoprim‐sulfamethoxazole (TMP/SMX). The mean of post‐transplant IgG titration was 1.62 ± 1.87 IU/mL, which was negative for all cases. Investigating pre‐transplant, IgM titration, 5.7% were positive, 91.4% were negative, and 2.9% were borderline. All cases were post‐transplant IgM negative. The mean of post‐transplant IgG titrations was significantly higher in the first 6 months (3.26 ± 2.68 IU/mL) compared to 6‐12 (1.30 ± 1.34 IU/mL; P = .039) and > 12 months (1.07 ± 1.27 IU/mL; P = .004) time periods. The result of PCR for B1 gene in all cases was negative.

Conclusions

Chemoprophylaxis with TMP/SMX seems to be effective in prevention of T gondii infection or reactivation among pediatric heart transplantation population. Anti‐T. gondii‐IgG level alone may not be sensitive enough for evaluation of the infection at least after 6 months post‐transplantation.
Surveillance strategies for the detection of disease outbreaks in the Pacific islands: meta‐analysis of published literature, 2010–2019
Authors: Craig Adam T. , Kaldor John , Schierhout Gill , Rosewell Alexander E.
Published: May 2020

Objective

Due to their tropical location, development status and the limited capacity of health systems, Pacific island counties and territories are particularly susceptible to infectious disease outbreaks; but evidence as to the optimal way in which outbreaks are detected is scarce. In this review, we synthesise evidence from literature about how outbreaks are detected in Pacific island countries and territories and critique factors identified as inhibiting surveillance practice.

Method

For this systematic review, we searched electronic databases Embase, Global Health, MEDLINE and MEDLINE Epub from 1 January 2010 and 31 March 2019 for reports describing infectious disease outbreaks occurring in the Pacific islands. Reports were included if they reported the method by which an outbreak was detected or the time between an outbreak’s onset and its detection. We extracted information about the report type and authors, the outbreak and its method/s of detection, and pertinent issues inhibiting surveillance practice.

Results

Of 860 articles identified, 37 reports describing 39 outbreaks met the inclusion criteria. Most outbreaks (n = 30) were identified through formal event‐based surveillance; six through syndromic surveillance; and two by ad hoc notification from the community. Barriers to early outbreak detection included population isolation; lack of resources and infrastructure to support surveillance implementation and signal investigation; and broader health system factors such as preparedness planning and availability of laboratory services.

Conclusion

Most surveillance‐related gain in the Pacific islands may be made through building formal event‐based surveillance systems and streamlining reporting processes to facilitate outbreak notification. This observation is pertinent given the focus on establishing and expanding syndromic surveillance approaches for outbreak detection in the islands over the last decade.
Direct and indirect targets of the arabidopsis seed transcription factor ABSCISIC ACID INSENSITIVE3
Authors: Tian Ran , Wang Fangfang , Zheng Qiaolin , Niza Venus M. A. G. E. , Downie A. Bruce , Perry Sharyn E.
Published: May 2020

Arabidopsis thaliana ABSCISIC ACID INSENSITIVE3 (ABI3) is a transcription factor in the B3 domain family. ABI3, along with B3 domain transcription factors LEAFY COTYLEDON2 (LEC2) and FUSCA3 (FUS3), and LEC1, a subunit of the CCAAT box‐binding complex, form the so‐called LAFL network to control various aspects of seed development and maturation. ABI3 also contributes to the abscisic acid (ABA) response. We report on chromatin immunoprecipitation‐tiling array experiments to map binding sites for ABI3 globally. We also assessed transcriptomes in response to ABI3 by comparing developing abi3‐5 and wild‐type seeds and combined this information to ascertain direct and indirect responsive ABI3 target genes. ABI3 can induce and repress its transcription of target genes directly and some intriguing differences exist in cis motifs between these groups of genes. Directly regulated targets reflect the role of ABI3 in seed maturation, desiccation tolerance, entry into a quiescent state and longevity. Interestingly, ABI3 directly represses a gene encoding a microRNA (MIR160B) that targets AUXIN RESPONSE FACTOR (ARF)10 and ARF16 that are involved in establishment of dormancy. In addition, ABI3, like FUS3, regulates genes encoding MIR156 but while FUS3 only induces genes encoding this product, ABI3 induces these genes during the early stages of seed development, but represses these genes during late development. The interplay between ABI3, the other LAFL genes, and the VP1/ABI3‐LIKE (VAL) genes, which are involved in the transition to seedling development are examined and reveal complex interactions controlling development.
Arabidopsis JMJ29 is involved in trichome development by regulating the core trichome initiation gene GLABRA3
Authors: Hung Fu‐Yu , Chen Jian‐Hao , Feng Yun‐Ru , Lai You‐Cheng , Yang Songguang , Wu Keqiang
Published: May 2020

Plant trichomes are large single cells that are organized in a regular pattern and play multiple biological functions. In Arabidopsis, trichome development is mainly governed by the core trichome initiation regulators, including the R2R3 type MYB transcript factor GLABRA 1 (GL1), bHLH transcript factors GLABRA 3/ENHANCER OF GLABRA 3 (GL3/EGL3), and the WD‐40 repeat protein TRANSPARENT TESTA GLABRA 1 (TTG1), as well as the downstream trichome regulator GLABRA 2 (GL2). GL1, GL3/EGL3, and TTG1 can form a trimeric activation complex to activate GL2, which is required for the trichome initiation and maintenance during cell differentiation. Arabidopsis JMJ29 is a JmjC domain‐containing histone demethylase belonging to the JHDM2/KDM3 group. Members of the JHDM2/KDM3 group histone demethylases are mainly responsible for the H3K9me1/2 demethylation. In the present study, we found that the trichome density on leaves and inflorescence stems is significantly decreased in jmj29 mutants. The expression of the core trichome regulators GL1, GL2, and GL3 is decreased in jmj29 mutants as well. Furthermore, JMJ29 can directly target GL3 and remove H3K9me2 on the GL3 locus. Collectively, we found that Arabidopsis JMJ29 is involved in trichome development by directly regulating GL3 expression. These results provide further insights into the molecular mechanism of epigenetic regulation in Arabidopsis trichome development.
Electroelastic Response of Isotropic Dielectric Elastomer Composites with Deformation-Dependent Apparent-Permittivity Matrix
Authors: Lefèvre Victor
Published: May 2020

This paper puts forth an approximate yet accurate free energy for the elastic dielectric response—under finite deformations and finite electric fields—of non-percolative dielectric elastomer composites made out of a non-Gaussian dielectric elastomer matrix with deformation-dependent apparent permittivity isotropically filled with nonlinear elastic dielectric particles that may exhibit polarization saturation. While the proposed free energy applies in its most general form to arbitrary isotropic non-percolative microstructures, closed-form specializations are recorded for the practically relevant cases of rigid or liquid-like spherical particles. The proposed free energy is exact by construction in the asymptotic context of small deformations and moderate electric fields and is shown to remain accurate for arbitrary large deformations and electric fields via comparisons with full-field finite-element simulations. The proposed constitutive model is deployed to probe the electrostriction response of these dielectric elastomer composites and corresponding results reveal that their elastic dielectric response strongly depends on the deformation-dependent apparent permittivity of the matrix they comprise.
Micromechanics Study on Actuation Efficiency of Hard-Magnetic Soft Active Materials
Authors: Zhang Rundong , Wu Shuai , Ze Qiji , Zhao Ruike
Published: May 2020

Hard-magnetic soft active materials have drawn significant research interest in recent years due to their advantages of untethered, rapid and reversible actuation, and large shape change. These materials are typically fabricated by embedding hard-magnetic particles in a soft matrix. Since the actuation is achieved by transferring the microtorques generated on the magnetic particles by the applied magnetic field to the soft matrix, the actuation depends on the interactions between the magnetic particles and the soft matrix. In this paper, we investigate how such interactions can affect the actuation efficiency by using a micromechanics approach through the representative volume element simulations. The micromechanics reveals that particle rotations play an essential role in determining the actuation efficiency, i.e., the torque transmission efficiency. In particular, a larger local particle rotation in the matrix would reduce the effective actuation efficiency. Micromechanics simulations further show that the efficiency of the torque transmission from the particles to the matrix depends on the particle volume fraction, the matrix modulus, the applied magnetic field strength, as well as the particle shape. Based on the micromechanics simulations, a simple theoretical model is developed to correlate the torque transmission efficiency with the particle volume fraction, the matrix modulus, as well as the applied magnetic field strength. We anticipate this study on the actuation efficiency of hard-magnetic soft active materials would provide optimization and design guidance to the parameter determination for the material fabrication for different applications.
Description and Characterization of a 114-kWe High-Flux Solar Simulator
Authors: Chu Shunzhou , Bai Fengwu , Nie Fuliang , Wang Zhifeng
Published: May 2020

A high-flux solar simulator is essential for evaluating solar thermal components under controlled and adjustable flux input conditions. This study presents a newly built high-flux solar simulator composed of 19 individual units. Each unit includes a xenon short-arc lamp (each consuming up to 6 kW electricity power) coupled with a truncated ellipsoidal reflector, a cooling blower, and a power module. The power module yields a current in the range of 50–160 A. The number of lamps in use is flexible, which allows for a wide range of radiation flux (10%–100%) on the focal plane. The radiation power, peak value, flux distribution on the circular target plane, and conversion efficiency are evaluated based on a flux mapping method. The results indicate that the proposed solar simulator is capable of achieving thermal power of 23.3 kW, peak flux in excess of 1.78 MW/m2, a stagnation temperature exceeding 2360 °C, and average irradiance of 773.4 kW/m2 on the focal plane (diameter of 260 mm). The electro-thermal conversion efficiency of the simulator is 35.7%. A ray-tracing method was employed, and the simulation results were found to be in good agreement with those in the experiments. An experimental test of a volumetric ceramic receiver was conducted, and the results indicate the availability and applicability of the high-flux solar simulator when carrying out studies about solar receivers.
Compliant Hydrostatic Bearings Utilizing Functionally Graded Materials
Authors: Nijssen Joep P. A. , van Ostayen Ron A. J.
Published: May 2020

Deformability of hydrostatic bearings could potentially increase their application range significantly. When a bearing is made compliant, the film pressure starts to influence the deformation of the support itself. This effect, called compliant-hydrostatic pre-loading, is especially crucial to take into account when designing highly deformable hydrostatic bearings. This work introduces the principle of pressure profile matching to minimize the effect of this pre-loading. A two-dimensional design model is introduced to determine the performance of such an elastic bearing utilizing stiffness profile matching. Additionally, an extension to the model is presented to analyze the basic performance of these type of bearings over small counter surface eccentricities. Finally, an embodiment of such a material distribution is presented utilizing functionally graded materials. These embodiments are analyzed with respect to their failure behavior, showing an improved shear stress and strain energy density distribution with the functionally graded supports when compared with conventional elastic supports.
Effects of Pyrolysis Conditions on Organic Fractions and Heat Values of Olive Mill Wastes Pyrolysis Liquid
Authors: Dinc Gamze , Isik Ferda , Yel Esra
Published: May 2020

Pyrolysis liquids can be evaluated in energy and material recovery. However, its characteristics and recovery potential highly depend on pyrolysis conditions. Olive pomace is lignocellulosic biomasses widely studied in the production of renewable energy and bio-based materials through pyrolysis, but there are no comprehensive studies about changes of pomace pyrolysis liquids' characteristics by pyrolysis conditions. Therefore, in this study, pyrolysis of olive pomace and various combinations of olive pomace with olive mill wastes at different heating rates, temperatures, and retention times was conducted to reveal effects of pyrolysis conditions on pyrolysis liquids' organic fractions. Moreover, heating values of organic compounds in pyrolysis liquids at different pyrolysis conditions were evaluated. All bio-oils comprises of aliphatic compounds (alkanes, alkenes, and alkynes), oxygenated compounds (acids, aldehydes, alcohols, esters, and ketones), and aromatic compounds (phenols and benzenes). The highest percentages of aliphatic compounds in olive pomace bio-oils were obtained at 600 °C, 5 °C/min heating rate with retention. A pyrolysis temperature increment leads to a decrement in H-type phenols and an increment in S-type and G-type phenolic compounds. Mixing pomace with olive mill wastes resulted in aliphatic compounds increment and oxygenated compounds decrement. Heating values of all bio-oils obtained under different pyrolysis conditions were found important for energy production. When pomace pyrolysis liqiuids' heating values changed between 2831 and 5100 cal/g, heating values of pomace-olive mill waste mixtures' bio-oils were found between 3300 and 5500 cal/g. Consequently, organic compounds in both pomace and pomace-olive mill bio-oils are valuable feedstocks and energy source in the number of product productions in various industrial processes.
A Comparative Life Cycle Assessment on Nuclear-Based Clean Ammonia Synthesis Methods
Authors: Karaca Ali Erdogan , Dincer Ibrahim , Gu Junjie
Published: May 2020

This paper evaluates the impacts of nuclear ammonia synthesis options on the environment through the life cycle assessment (LCA) technique. Ammonia is synthesized via the mature Haber–Bosch technique that combines hydrogen and nitrogen with 3:1 ratio to yield ammonia. For hydrogen production from water, five different hydrogen production methods are used, namely, conventional electrolysis (CE), high-temperature electrolysis (HTE), and 3-, 4-, and 5-step Cu–Cl cycles. The nitrogen required for ammonia synthesis is extracted from the air by the cryogenic air separation technique. The thermal and electrical energy need of production processes is supplied from a pressurized water reactor type nuclear power plant (NPP). The simapro software is utilized for LCA in the present study. The environmental impacts of nuclear ammonia are investigated through five impact categories, namely, abiotic depletion potential, acidification potential, global warming potential (GWP), ozone depletion potential, and human toxicity potential. According to LCA results, ammonia synthesis via HTE corresponds to the lowest environmental impact in all selected impact categories. Furthermore, the GWP for ammonia production via HTE is 0.1832 kg CO2 eq/kg ammonia, followed by CE (0.2240 kg CO2 eq/kg ammonia), 4-step Cu–Cl (0.3113 kg CO2 eq/kg ammonia), 3-step Cu–Cl (0.3323 kg CO2 eq/kg ammonia), and 5-step Cu–Cl (0.3370 kg CO2 eq/kg ammonia).
Visualizing Interactions Between Liquid Propane and Heavy Oil
Authors: Athar Khan Sameem , Yassin Mahmood Reza , Dehghanpour Hassan
Published: May 2020

In this study, we use a custom-designed visual cell to investigate nonequilibrium interactions between liquid propane (C3(l)) and a heavy oil sample (7.2 deg API) at varying experimental conditions. We inject C3(l) into the visual cell containing the heavy oil sample (pressure-buildup process) and allow the injected C3(l) to interact with the oil sample (soaking process). We measure visual-cell pressure and visualize the C3/heavy oil interactions during the pressure-buildup and soaking processes. Nonequilibrium interactions occurring at the interfaces of C3(l)/heavy oil and C3(l)/C3(g) are recorded with respect to time. The results show that the complete mixing of heavy oil with C3(l) occurs in two stages. First, upward extracting flows of oil components from bulk heavy oil phase toward C3(l) phase form a distinguished layer (L1) during the soaking process. The extracted oil components become denser over time and move downward (draining flows) toward the C3(l)/heavy oil interface due to gravity. The gradual color change of L1 from colorless (color of pure C3(l)) to black suggests the mixing of oil components with C3(l). After L1 appears to be uniform, a second layer (L2) is formed above L1 in the bulk C3(l) phase. Extracting and draining flows become active once again, leading to the mixing of oil components from L1 into L2. At final conditions, heavy oil and C3(l) appear to be mixed and form a single uniform phase.
Young victims of youth violence: using youth workers in the emergency department to facilitate ‘teachable moments’ and to improve access to services
Authors: Wortley Elizabeth , Hagell Ann
Published: May 2020

There have been rising concerns in the UK about the levels of serious violence between young people, especially serious physical violence and knife crime. Interactions with young people in the emergency department (ED) at the time of injury provide an opportunity for screening and intervention in order to reduce the risk of repeat attendances. However, paediatricians and other healthcare workers can feel unsure about the best way to intervene. Embedding youth workers in EDs has started in some UK hospitals, making use of a potential ‘teachable moment’ in the immediate aftermath of an event to help change behaviour. Based on a rapid review of the literature, we summarise the evidence for these types of interventions and present two practice examples. Finally, we discuss how EDs could approach the embedding of youth workers within their department and considerations required for this.
Association of alcohol intake with incidence and progression of diabetic
retinopathy
Authors: Gupta Preeti , Fenwick Eva K , Sabanayagam Charumathi , Gan Alfred Tau Liang , Tham Yih-Chung , Thakur Sahil , Man Ryan Eyn Kidd , Mitchell Paul , Wong Tien Yin , Cheng Ching-Yu , Lamoureux Ecosse Luc
Published: May 2020

Purpose

We examined the longitudinal association of baseline alcohol intake and
frequency with the 6-year incidence and progression of diabetic retinopathy
(DR) in a population-based cohort of Singaporean Indians.

Methods

We included 656 participants with diabetes mellitus, gradable retinal
photographs from baseline (2007–2009) and follow-up (2013–2015) examinations,
information on alcohol intake and other relevant data from the Singapore Indian
Eye Study were included. Incident DR was defined using the Modified Airlie
House Classification as no DR at baseline and at least minimal
non-proliferative DR at follow-up; and DR progression as at least a one-step
worsening in DR at follow-up from minimal or worse status at baseline,
excluding those with proliferative DR.

Results

The mean age (SD) of our participants (n=656) was 58.8 (9.2) years, and
54.4% were male. At follow-up, 82 of 510 (16%) participants developed DR, and
45 of 146 (30.8%) had DR progression. 65 (12.7%) and 28 (19.1%) participants
consumed alcohol in incident DR and progression categories, respectively. In
multivariable analyses, those who consumed alcohol had nearly two-thirds
reduced odds of incident DR (OR (95% CI): 0.36 (0.13 to 0.98)) compared with
those who did not. Participants with infrequent consumption of alcohol also had
a reduction in odds of incident DR (0.17 (0.04 to 0.69)), compared with
non-drinkers. No association was found between alcohol consumption and DR
progression.

Conclusions and relevance

In our longitudinal population of Singapore Indians, baseline alcohol
intake, particularly infrequent consumption, was associated with lower risk of
developing DR, compared with non-drinkers, in line with previous
cross-sectional findings.
Potential survivability of prehospital injury deaths in New Zealand: a cross-sectional study
Authors: Kool Bridget , Lilley Rebbecca , Davie Gabrielle , de Graaf Brandon , Reid Pararangi , Branas Charles , Civil Ian , Dicker Bridget , Ameratunga Shanthi N
Published: May 2020

Introduction

Acknowledging a notable gap in available evidence, this study aimed to assess the survivability of prehospital injury deaths in New Zealand.

Methods

A cross-sectional review of prehospital injury death postmortems (PM) undertaken during 2009–2012. Deaths without physical injuries (eg, drownings, suffocations, poisonings), where there was an incomplete body, or insufficient information in the PM, were excluded. Documented injuries were scored using the AIS and an ISS derived. Cases were classified as survivable (ISS <25), potentially survivable (ISS 25–49) and non-survivable (ISS >49).

Results

Of the 1796 cases able to be ISS scored, 11% (n=193) had injuries classified as survivable, 28% (n=501) potentially survivable and 61% (n=1102) non-survivable. There were significant differences in survivability by age (p=0.017) and intent (p<0.0001). No difference in survivability was observed by sex, ethnicity, day of week, seasonality or distance to advanced-level hospital care. ‘Non-survivable’ injuries occurred more commonly among those with multiple injuries, transport-related injuries and aged 15–29 year. The majority of ‘survivable’ cases were deceased when found. Among those alive when found, around half had received either emergency medical services (EMS) or bystander care. One in five survivable cases were classified as having delays in receiving care.

Discussion

In New Zealand, the majority of injured people who die before reaching hospital do so from non-survivable injuries. More than one third have either survivable or potentially survivable injuries, suggesting an increased need for appropriate bystander first aid, timeliness of EMS care and access to advanced-level hospital care.
Alcohol and Gastric Motility: Pathophysiological and Therapeutic Implications
Authors: Gonzalez Zorisadday , Herlihy Daniel , Phan Cong , Diaz Jesus , Dominguez Kenneth , McCallum Richard
Published: May 2020

Alcohol has been associated with alterations in gastric motility. The literature identifies that various factors play a role in alcohol's effect on gastric emptying including differences in alcohol concentration, osmolarity, caloric content, amino acids as well as different processing techniques (fermentation vs distillation). Additionally, chronic alcohol consumption has been shown to alter the myenteric nitrergic system resulting in impaired gastrointestinal motor function, and it also has an inhibitory effect on the release of several neurotransmitters that play a key role in gastrointestinal motility, including acetylcholine. Whether social or limited intake of alcohol could have a therapeutic role has not been apparent. Serendipitously, we have identified a therapeutic role for alcohol with a meal in the entity of dumping syndrome (DS) where there is postprandial rapid emptying of voluminous and hyperosmolar gastric contents into the small bowel. In the clinical setting of DS attributed to impaired vagal nerve function, there was normalization of gastric emptying and resolution of accompanying symptoms when drinking a glass of wine before and during meals. We propose that alcohol's anticholinergic effect was augmented in the setting of vagal nerve denervation resulting in slowing of gastric emptying and in alleviation of symptoms of early DS. This review article provides an in-depth analysis of the published literature on alcohol and gastric motility focusing on the accumulated knowledge that may have clinical application and relevance.
Integrated case-control and somatic-germline interaction analyses of soft-tissue sarcoma
Authors: Hu Fulan , Yu Yao , Chen Jiun-Sheng , Hu Hao , Scheet Paul , Huff Chad D.
Published: May 2020

Purpose

The contribution of rare genetic variation in the development of soft-tissue sarcoma (STS) remains underexplored. To address this gap, we conducted a whole-exome case-control and somatic-germline interaction study to identify and characterise STS susceptible genes.

Methods

The study involved 219 STS cases from The Cancer Genome Atlas and 3507 controls. All cases and controls were matched genetically onEuropean ancestry based on the 1000 Genomes project. Cross-platform technological stratification was performed with XPAT and gene-based association tests with VAAST 2.

Results

NF1 exhibited the strongest genome-wide signal across the six subtypes, with p=1×10−5. We also observed nominally significant association signals for three additional genes of interest, TP53 (p=0.0025), RB1 (p=0.0281), and MSH2 (p=0.0085). BAG1, which has not previously been implicated in STS, exhibited the strongest genome-wide signal after NF1, with p=6×10−5. The association signals for NF1 and MSH2 were driven primarily by truncating variants, with ORs of 39 (95% CI: 7.1 to 220) for NF1 and 33 (95% CI: 2.4 to 460) for MSH2. In contrast, the association signals for RB1 and BAG1 were driven primarily by predicted damaging missense variants, with estimated ORs of 12 (95% CI: 2.4 to 59) for RB1 and 20 (95% CI: 1.4 to 300) for BAG1.

Conclusions

Our results confirm that pathogenic variants in NF1, RB1 and TP53 confer large increases in the risk of developing multiple STS subtypes, provide support for the role of MSH2 in STS susceptibility and identify BAG1 as a novel candidate STS risk gene.
Paternal 132 bp deletion affecting KCNQ1OT1 in 11p15.5 is associated with growth retardation but does not affect imprinting
Authors: Eggermann Thomas , Kraft Florian , Lausberg Eva , Ergezinger Katrin , Kunstmann Erdmute
Published: May 2020

Background

The chromosomal region 11p15.5 harbours two imprinting centres (H19/IGF2:IG-DMR/IC1, KCNQ1OT1:TSS-DMR/IC2). Molecular alterations of the IC2 are associated with Beckwith-Wiedemann syndrome (BWS), whereas only single patients with growth retardation and Silver-Russell syndrome (SRS) features have been reported. CNVs in 11p15.5 account for less than 1% of patients with BWS and SRS, and they mainly consist of duplications of both ICs either affecting the maternal (SRS) or the paternal (BWS) allele. However, this correlation does not apply to smaller CNVs, which are associated with diverse clinical outcomes.

Methods and results

We identified a family with a 132 bp deletion within the KCNQ1OT1 gene, associated with growth retardation in case of paternal transmission but a normal phenotype when maternally inherited. Comparison of molecular and clinical data with cases from the literature helped to delineate its functional relevance.

Conclusion

Microdeletions within the paternal IC2 affecting the KCNQ1OT1 gene have been described in only five families, and they all include the differentially methylated region KCNQ1OT1:TSS-DMR/IC2 and parts of the KCNQ1 gene. However, these deletions have different impacts on the expression of both genes and the cell-cycle inhibitor CDKN1C. They thereby cause different phenotypes. The 132 bp deletion is the smallest deletion in the IC2 reported so far. It does not affect the IC2 methylation in general and the coding sequence of the KCNQ1 gene. Thus, the deletion is only associated with a growth retardation phenotype when paternally transmitted but not with other clinical features in case of maternal inheritance as observed for larger deletions.
Local anesthetic resistance in a Crohn’s patient undergoing cesarean delivery
Authors: Schutte Soleil S , Euliano Tammy
Published: May 2020

Introduction

Patient resistance to local anesthetics is rarely considered as the cause of regional anesthesia failure.

Case report

We report a case of resistance to local anesthetics in a patient with Crohn’s disease who underwent cesarean section under continuous spinal anesthesia.

Discussion

Resistance to local anesthetics may be more common than we think, especially among patients with chronic pain. Providers should consider local anesthetic resistance when regional anesthesia is unsuccessful. Further research is needed to determine if skin wheal tests and/or a different local anesthetic could improve results.
Regional anesthesia training model for resource-limited settings: a prospective single-center observational study with pre–post evaluations
Authors: Brouillette Mark A , Aidoo Alfred J , Hondras Maria A , Boateng Nana A , Antwi-Kusi Akwasi , Addison William , Singh Sanjeev , Laughlin Patrick T , Johnson Benjamin , Pakala Swetha R
Published: May 2020

Background and objectives

Educational initiatives are a sustainable means to address provider shortages in resource-limited settings (RLS), yet few regional anesthesia curricula for RLS have been described. We sought to design a reproducible training model for RLS called Global Regional Anesthesia Curricular Engagement (GRACE), implement GRACE at an RLS hospital in Ghana, and measure training and practice-based outcomes associated with GRACE implementation.

Methods

Fourteen of 15 physician anesthesiologists from the study location and three from an outside orthopedic specialty hospital consented to be trainees and trainers, respectively, for this prospective single-center observational study with pre–post evaluations. We conducted an initial needs assessment to determine current clinical practices, participants’ learning preferences, and available resources. Needs assessment findings, expert panel recommendations, and investigator consensus were then used to generate a site-specific curriculum that was implemented during two 3-week periods. We evaluated trainee satisfaction and changes in knowledge, clinical skill, and peripheral nerve block (PNB) utilization using the Kirkpatrick method.

Results

The curriculum consisted of didactic lectures, simulations, and clinical instruction to teach ultrasound-guided PNB for limb injuries. Pre–post evaluations showed trainees were satisfied with GRACE, median knowledge examination score improved from 62.5% (15/24) to 91.7% (22/24) (p<0.001), clinical examination pass rate increased from 28.6% (4/14) to 85.7% (12/14) (p<0.01), and total PNB performed in 3 months grew from 48 to 118.

Conclusions

GRACE applied in an RLS hospital led to the design, implementation, and measurement of a regional anesthesia curriculum tailored to institutional specifications that was associated with positive Kirkpatrick outcomes.
Effect of flavour manipulation on ENDS (JUUL) users’ experiences, puffing behaviour and nicotine exposure among US college students
Authors: Vargas-Rivera Mayra , Ebrahimi Kalan Mohammad , Ward-Peterson Melissa , Osibogun Olatokunbo , Li Wei , Brown David , Eissenberg Thomas , Maziak Wasim
Published: May 2020

Significance

Electronic nicotine delivery system (ENDS) use has continued to increase exponentially among young people in the USA, with unique flavours being one of the most cited reasons for use. Yet, controlled studies examining the effects of restricting flavour are lacking. This study evaluates the impact of ENDS flavour manipulation on user’s puffing behaviour, subjective experience, harm perception and nicotine exposure among college-aged ENDS users.

Methods

JUUL users (n=30, age 18 to 24 years) attended two 60 minad libitumENDS use sessions (JUUL preferred flavour vs JUUL classic tobacco flavour) in a cross-over design. Puff topography and plasma nicotine concentration were measured, and participants completed subjective experience questionnaires.

Results

Increases were observed on measures of satisfaction, taste, enjoyment, urges to vape/smoke, pleasure, product appeal and increased concentration following using the preferred flavour pod (p values <0.05). Compared with preferred flavour, participants in the tobacco flavour were less motivated to use it in the future (70.9 vs 19.1 scores, p<0.001), even if it was the only product on the market (75.8 vs 30.7 scores, p<0.001). While nicotine levels significantly increased in both conditions from pre to post session (p values <0.001), no significant differences were observed in nicotine boost levels or on puff topography parameters when comparing both flavour conditions.

Conclusions

This pilot study provides evidence that ENDS flavours have a substantial effect in enhancing young current ENDS users’ experiences, product appeal and motivation to use the product in the future. It highlights that limiting flavours could play a potential role when designing strategic policies to reduce the appeal of ENDS use among young people.
Exposure to JUUL use: cue reactivity effects in young adult current and former smokers
Authors: Vena Ashley , Miloslavich Krista , Howe Meghan , Cao Dingcai , King Andrea C
Published: May 2020

Background

Exposure to the use of first, second and third generations of electronic cigarettes (e-cigarettes) elicits the desire to vape and smoke among observers, as well as facilitates smoking behaviour. Given the rapid rise in the popularity of the pod mod JUUL, we examined whether observing the use of this device would elicit similar responses in smokers. Exploratory analyses were also conducted to determine whether JUUL can act as a smoking cue for former smokers.

Methods

The sample consisted of 82 young adult participants (62 current smokers and 20 former smokers approximately 1 year smoke free). The study examined their response to observing use of bottled water (control cue) and JUUL (active cue) in a controlled laboratory paradigm. Both cues were delivered by a trained study confederate under the guise of a social interaction task, and participants completed mood and desire and urge surveys precue and postcue exposures.

Results

In current smokers, exposure to the JUUL cue increased smoking urge and desire for a cigarette, mod/vape pen and JUUL, and two-thirds chose to smoke in the behavioural analogue task. In former smokers, the JUUL cue evoked modest and transient increases in desire for a cigarette and JUUL.

Conclusions

The use of JUUL affects the user and elicits responses in observers; this study is the first to demonstrate that exposure to JUUL use may act as a smoking cue and exposure to JUUL use may affect tobacco control efforts.
Will 5.6 million current American youth eventually die from smoking? The anatomy of a commonly accepted tobacco control measure
Authors: Warner Kenneth E
Published: May 2020

Background

According to the 2014 Surgeon General’s Report (SGR), ‘5.6 million (American) youth currently aged 0–17 years of age will die prematurely of a smoking-related illness.’ Advocates cite this number as evidence that smoking will exact an enormous toll for decades to come. This paper examines whether the projected toll accurately portrays smoking’s likely future burden.

Methods

The SGR estimate, using 2012 state-specific data, can be closely approximated using national data by multiplying the population ages 0–17 by 2012 smoking prevalence among adults ages 18–30, and multiplying that by 32%, the 1996 estimate by the Centers for Disease Control and Prevention of the probability of future smoking-attributable mortality among young adult smokers. Repeating this process using 2018 data estimates the number of future deaths of youth ages 0–17 in 2018. A hypothetical estimate for 2024 assumes continuation of the 2012–2018 smoking prevalence decrease.

Findings

Based on 2012 data, the estimated number of youth alive in 2012 who will die prematurely from smoking is 5.31 million. With lower young adult smoking prevalence in 2018, the future smoking-related mortality estimate is 3.66 million. For 2024, the estimate is 2.54 million.

Conclusions

The SGR estimate depended on assumptions that no longer held a few years later. Yet advocates for youth smoking prevention cite it frequently today. Considerations such as this paper’s calculations, decreasing smoking initiation rates, increasing cessation, better screening for and treatment of smoking-related diseases, and smoking’s increasing social unacceptability suggest that smoking’s death toll for today’s youth will be far lower than contemporary estimates. How much lower is virtually impossible to estimate.
Cooperate epidemic spreading on multiplex networks with heterogeneous population
Authors: Zhang Tianqiao , Zhang Yang , Ma Jinming , Chen Junliang , Zhu Xuzhen
Published: May 2020

Cooperate epidemic spreading dynamics has attracted much attention from the field of network science. In this paper, we study the cooperate epidemic spreading dynamics on multiplex networks with heterogeneous populations, which induces the heterogeneous coinfection susceptibility. We propose a spreading model to describe the evolution mechanisms. To predict the final state of the epidemic outbreak size, a generalized bond percolation theory is suggested. Through numerical simulations and theoretical analyses, we find that the system exhibits a discontinuous phase transition for large average and small variance of the distribution of coinfection susceptibility on ER–ER multiplex networks, while the phase transition is continuous on SF–SF networks. In addition, the final outbreak size increases with the average coinfection susceptibility and decreases with the variance of the coinfection susceptibility. Our suggested bond percolation theory can well predict the numerical simulations.
Enhancing perpendicular magnetocrystalline anisotropy in Fe ultrathin films by non-noble transition-metal substrate
Authors: Zhou Shanhu , Hu Jun
Published: May 2020

Based on first-principles calculations, we studied the magnetic properties of ultrathin Fe film on a nonmagnetic substrate Ta(001). We found that the perpendicular magnetocrystalline anisotropy (PMA) of Fe/Ta(001) system with only one or two Fe atomic layer(s) can be enhanced significantly, and the corresponding magnetocrystalline anisotropy energy is enlarged tos about 3 times of that in pure ultrathin Fe film. Analysis of electronic properties demonstrates that the magnetic proximity effect at the Fe/Ta interface plays an important role in the enhancement of the PMA. Alternative arrangement of Ta and Fe layers with more Fe/Ta interfaces may further strengthen the PMA.
Effects of Free Trade Zone Policy on China’s Income Disparity
Authors: CHENG HUIFANG , ZHANG YI , LI HONGYI
Published: May 2020

The income gap between the rich and the poor is growing in China. The Free Trade Zone policy has been adopted in China over the past decade. We analyze whether the Free Trade Zone policy contributes to China’s income disparity based on a panel of provincial level data covering the period from 2009 to 2017. The empirical results show that the implementation of the Free Trade Zone policy has significantly reduced China’s income disparity between provinces, but different regions have different effects. The impact of this policy on the distribution of income has significantly narrowed the income gap in the eastern region. Meanwhile, the policy effect is long lasting, with the influence of the policy increasing over time. In particular, the establishment of Free Trade Zones in provinces with relatively low income, low trade dependence and low innovation capability is more conducive to narrowing the income gap. Furthermore, the establishment of Free Trade Zones in provinces with a relatively high unemployment rate has obviously decreased the income gap; however, in provinces with a low unemployment rate, the income gap has increased. Our empirical results are robust with different model specifications.