bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Different Types Strength Exercises with Thera-Band® on Oxidative Stress and DNA Damage
Authors: Agirbas Ozturk
Published: January 2019

The aim of this study is to determine the effects of both static and dynamic strength trainings on oxidative stress and DNA damage in elite boxers. 19 elite male boxers participated in the study. Boxers were instructed to perform strength exercises 3 days a week for 8 weeks. Blood samples were taken before exercises (resting), after the first exercise (acute) and after 8 weeks following the last exercise (chronic). MDA, SOD, GPx and 8-OHdG levels of blood were examined. Statistical analyses were carried out using the SPSS 22 for Windows. The data were found to not be distributed normally. Thus, Friedman, Wilcoxon and Mann-Whitney U tests were used. The results were evaluated using an alpha level of .05. In the dynamic strength exercise group, there was no significance at GPx, however MDA, SOD and 8-OHdG levels decreased in 8 weeks. In static strength exercise group, although there was no significance at SOD, GPx and 8-OHdG, MDA levels decreased both after a single session and in 8 weeks. In addition, significant difference was found between dynamic and static exercise groups at SOD, GPx and 8-OHdG levels in pre-exercise and at 8-OHdG levels after 8 weeks.  Dynamic strength exercises with Thera-Band are effective on MDA, SOD and 8-OHdG chronically, static strength exercises are effective on MDA both acutely and chronically. Neither dynamic nor static strength exercises are not effective on GPx both acutely and chronically.
Evaluating the Impact of Idea Dissemination Methods on Information Loss
Authors: Victoria Zhao Zixuan , Lopez Christian E. , Tucker Conrad S.
Published: January 2019

Information is transferred through a process consisting of an information source, a transmitter, a channel, a receiver, and its destination. Unfortunately, during the engineering design process, there is a risk of a design idea or solution being incorrectly transferred and interpreted due to the nonlinearity of the process, and many ways to communicate and disseminate ideas or solutions. The objective of this work is to explore the amount of relevant design information transmitted by different idea dissemination methods and how the receiver's familiarity with the idea impacts the effectiveness of the methods. First, this work explores the advantages and disadvantages of different dissemination methods in engineering design. Next, an experiment is conducted with engineering and nonengineering participants in order to quantify the information transmitted by different idea dissemination methods. This work also quantifies the effect that receivers' familiarity with a design artifact has on the amount of information transmitted by different dissemination methods. Finally, the results obtained from the experiments are compared with a previous theoretical model for validation. The results indicate that while certain methods are perceived as more informative and are able to convey more information than others (e.g., linguistic textual description versus virtual three-dimensional (3D) models), the effectiveness of the methods depends on a receiver's familiarity with the ideas being transmitted. Knowledge gained from this work can aid designers in selecting a suitable dissemination method needed to effectively communicate ideas and achieve a design solution.
Atlatl Internal Ballistics
Authors: Denny Mark
Published: January 2019

An atlatl or spearthrower is perhaps humanity’s oldest technology for accelerating projectiles. The dynamics prior to launch of the dart projectile have been much discussed in the literature. In this article we present a simple new model of launch dynamics and show that dart flex is not an important factor in determining launch speed, but it increases accuracy. The atlatl is a lever but only indirectly; the significant parameters for increasing launch speed are applied energy, and angular difference between force direction and dart direction. This study exhibits some instructive elements of Newtonian mechanics.
Investigating Torricelli’s Law (and More) with a 19th-Century Bottle
Authors: Pavesi Laura
Published: January 2019

The phenomenon of emerging water jets from the holes of containers has been extensively studied; nevertheless, it continues to inspire researchers and teachers. The main aspects of the recent studies concern: the range of the jets trajectories; the extension of Bernoulli’s equation, of which Torricelli’s expression represents an ideal situation, to real fluids; and the measure of the jets’ speed and the drainage time in dependence on the fluid system geometry and wetting conditions. The focus of this paper is to discuss Torricelli’s relation between jet speed and hole depth in the case of a 19th-century glass bottle featuring three lateral holes. Measurements of the free water level displacements and jet speed from the holes have been carried out with 11th-grade students.
Use smartphones to measure Brewster’s angle
Authors: Chiang Chun-Ming , Cheng Han-Yang
Published: January 2019

This study aims to measure Brewster’s angle of glass and acrylic brick with an easy-to-obtain mobile application (app) by changing the tungsten light source to a red laser. The popularization of the smartphone has inspired many to use its various built-in sensors to carry out general physics experiments. Many others have adopted both a laser and a light sensor to perform such measurements. In Refs. 10 and 11, the devices required specific software and are not widely available in physics laboratories. In this paper, we present a similar study, but one that has the advantage that it uses the ambient light sensor of the smartphone. In this work, a simple and inexpensive experimental setup is proposed to quantitatively measure Brewster’s angle.
Did neurons arise from an early secretory cell?
Authors: Pennisi Elizabeth
Published: January 2019

Cell lineage studies of comb jellies and other creatures may suggest a single ancient origin of the nervous system.
An amygdalar neural ensemble that encodes the unpleasantness of pain
Authors: Corder Gregory , Ahanonu Biafra , Grewe Benjamin F. , Wang Dong , Schnitzer Mark J. , Scherrer Grégory
Published: January 2019

The emotional dimension of pain

The unpleasantness of pain is an emotional phenomenon distinct from pain's sensory qualities. To study how the brain processes pain-related emotions, Corder
et al.
used in vivo neural calcium imaging in freely behaving mice. They identified brain circuits that respond to pain and directly tested their causal role in motivational behaviors associated with acute and chronic pain.

Science
, this issue p.
276
Prediction of higher-selectivity catalysts by computer-driven workflow and machine learning
Authors: Zahrt Andrew F. , Henle Jeremy J. , Rose Brennan T. , Wang Yang , Darrow William T. , Denmark Scott E.
Published: January 2019

Predicting catalyst selectivity

Asymmetric catalysis is widely used in chemical research and manufacturing to access just one of two possible mirror-image products. Nonetheless, the process of tuning catalyst structure to optimize selectivity is still largely empirical. Zahrt
et al.
present a framework for more efficient, predictive optimization. As a proof of principle, they focused on a known coupling reaction of imines and thiols catalyzed by chiral phosphoric acid compounds. By modeling multiple conformations of more than 800 prospective catalysts, and then training machine-learning algorithms on a subset of experimental results, they achieved highly accurate predictions of enantioselectivities.

Science
, this issue p.
eaau5631
Resolution of asthmatic symptoms following successful endoscopic resection of tracheal mucoepidermoid carcinoma
Authors: Hanif Khan Abdul , Faisal Mohamed , Mohd Ali Razana , Abdul Rahaman Jamalul Azizi
Published: January 2019

Mucoepidermoid carcinoma (MEC) is a rare tumour of the trachea accounting for up to 0.2% of reported primary lung malignancy. We report a case of a 54-year-old man, ex-smoker, whose presentation mimicked adult onset asthma with cough and wheezing, which did not respond to conventional treatment. He had occasional haemoptysis and weight loss in which CT scan performed for malignancy screening showed a protruding mass in the distal trachea causing endobronchial obstruction. Bronchoscopic intervention was performed to relieve the obstruction that resulted in resolution of asthmatic symptoms. Histological diagnosis confirmed MEC. This case emphasised the importance of a high index of suspicion in an unusual presentation of a common disease and the pivotal role of bronchoscopic intervention in malignant central airway obstruction.
Paediatric presentation of intracranial haemorrhage due to thrombosis of a developmental venous anomaly
Authors: Entezami Pouya , Boulos Alan , Yamamoto Junichi , Adamo Matthew
Published: January 2019

Developmental venous anomalies (DVAs) are the most commonly encountered cerebral malformations. While generally asymptomatic and discovered as incidental findings, there is a small number that can cause intracranial haemorrhage, usually attributed to associated cavernomas; however, venous thrombosis of the draining vein is a rare cause. A 10-year-old woman presented with seizure episodes. Angiographic evaluation revealed a collection of vessels draining into the superior sagittal sinus via the vein of Trolard, concerning for a DVA. The patient improved clinically with supportive care and antiepileptic treatment. Anatomically, DVAs represent dysplasia of primary capillary beds and smaller cerebral veins, resulting in abnormal venous drainage of the affected parenchyma. Several distinguishing radiological findings can help differentiate a DVA from other pathologies. Early radiological identification can help in the initiation of appropriate therapy and prevent incorrect surgical management leading to further neurological demise.
Estimation of impact of RPE65-mediated inherited retinal disease on quality of life and the potential benefits of gene therapy
Authors: Lloyd Andrew , Piglowska Natalia , Ciulla Thomas , Pitluck Sarah , Johnson Scott , Buessing Marric , O’Connell Thomas
Published: January 2019

Background/aims

In rare diseases, health-related quality of life (HRQL) data can be difficult to capture. Given the ultrarare nature of RPE65-mediated inherited retinal disease (IRD), it was not feasible to recruit a patient sample and collect HRQL data prospectively. The objectives of this study were to develop health state descriptions of RPE65-mediated IRD, and to estimate associated patient utilities.

Methods

Vignette descriptions of IRD states were developed and then assessed to elicit utilities. The vignettes ranged from moderate vision loss through to hand motion to no light perception (NLP). Six retina specialists with additional expertise in IRDs provided a proxy valuation of the vignettes using generic measures of health—the 5-level version of EQ-5D-5L and Health Utility Index 3 (HUI3). The data were then scored using standard methods for each instrument.

Results

Weights from both HRQL measures revealed a large decline in scores with vision loss. The EQ-5D-5L weights ranged from 0.709 for moderate vision loss to 0.152 for hand motion to NLP. The HUI3 weights ranged from 0.519 to − 0.039, respectively. A decline was seen on both measures, and the degree of decline from moderate vision loss to NLP was identical on both (−0.56).

Conclusion

This is the first study to report HRQL weights (or utilities) for health states describing different levels of vision loss in patients with IRD, specifically those with RPE65-mediated disease. The parallel decline in scores from the EQ-5D and HUI3 corroborates the substantial impact of progressive vision loss on HRQL.
Normative pattern and determinants of outer retinal thickness in an Asian population: the Singapore Epidemiology of Eye Diseases Study
Authors: Dai Wei , Tham Yih-Chung , Chee Miao-Li , Majithia Shivani , Tan Nicholas Y Q , Wong Kah-Hie , Neelam Kumari , Cheung Ning , Sabanayagam Charumathi , Cheung Carol Y , Wong Tien-Yin , Cheng Ching-Yu
Published: January 2019

Background/aims

To evaluate the distribution and determinants of outer retinal thickness in eyes without retinal diseases, using spectral-domain optical coherence tomography (SD-OCT).

Methods

Participants were recruited from the Singapore Epidemiology of Eye Diseases Study, a population-based study among Chinese, Malays and Indians in Singapore. A total of 5333 participants underwent SD-OCT imaging in which a 6×6 mm2 measurement area centred at the fovea. Outer retinal thickness was defined as the distance from the outer plexiform layer to the retinal pigment epithelium layer boundary.

Results

7444 eyes from 4454 participants were included in final analysis. Of them, mean age was 58.4 years (SD 8.3), and 2294 (51.5%) were women. Women (121.0±8.1 µm) had thinner average outer retinal thickness than men (125.6±8.2 µm) (p<0.001). Malays (121.4±8.7 µm) had thinner average outer retinal thickness than Indians (124.3±8.6 µm) and Chinese (123.7±7.9 µm) (both p<0.001). In multivariable models, thinner average outer retinal thickness was associated with older age (per decade, β=−1.02, p<0.001), hypertension (β=−0.59, p=0.029), diabetes (β=−0.73, p=0.013), chronic kidney disease (β=−1.25, p=0.017), longer axial length (per mm, β=−0.76, p<0.001), flatter corneal curvature (per mm, β=−2.00, p<0.001) and higher signal strength (β=−1.46, p<0.001).

Conclusion

In this large sample of Asian population, we provided normative SD-OCT data on outer retinal thickness in eyes without retinal diseases. Women had thinner outer retina than men. For the first time, these findings provide fundamental knowledge on normative profile of outer retinal thickness in Asians.
Association of visual acuity with educational outcomes: a prospective cohort study
Authors: Jan Catherine , Li Shi-Ming , Kang Meng-Tian , Liu Luoru , Li He , Jin Ling , Qin Xuezheng , Congdon Nathan , Wang Ningli
Published: January 2019

Background/aim

To quantify the impact of baseline presenting visual acuity (VA), refractive error and spectacles wear on subsequent academic performance among Chinese middle school children.

Methods

A prospective, longitudinal, school-based study on grade 7 Chinese children (age, mean±SD, 12.7±0.5 years, range=11.1–15.9) at four randomly selected middle schools in Anyang, China. Comprehensive eye examinations including cycloplegic autorefraction were performed at baseline, and information on demographic characteristics, known risk factors for myopia and spectacle wear was collected. Academic test scores for all subjects in the curriculum were obtained from the local Bureau of Education. Main outcome measure was total test scores for five subjects at the end of grade 9, adjusted for total scored at the beginning of grade 7.

Results

Among 2363 eligible children, 73.1% (1728/2363) had seventh grade test scores available. 93.9% (1623/1728) completed eye examinations, and 98.5% (1599/1623) of these had ninth grade test scores. Adjusting only for baseline test score, the following were significantly associated with higher ninth grade scores: younger age, male sex, less time outdoors, better baseline presenting VA, higher parental education and income and parental myopia, but refractive error and spectacle wear were not. In the full multivariate model, baseline test score (p<0.001), presenting VA (p<0.01), age (p<0.001), quality of life (p<0.05) and parental education (p<0.001) and myopia (either: p<0.05; both: p<0.05) remained significantly associated with better ninth grade scores.

Conclusions

In this longitudinal study, better presenting VA, but not cycloplegic refractive error or spectacle wear, was significantly associated with subsequent academic performance.
Protocol for a feasibility randomised controlled trial of targeted oxygen therapy in mechanically ventilated critically ill patients
Authors: Martin Daniel S , Brew-Graves Chris , McCartan Neil , Jell Gavin , Potyka Ingrid , Stevens Jia , Williams Norman R , McNeil Margaret , O’Driscoll B Ronan , Mythen Monty , Grocott Michael P W
Published: January 2019

Introduction

Oxygen is the most commonly administered drug to mechanically ventilated critically ill adults, yet little is known about the optimum oxygen saturation (SpO2) target for these patients; the current standard of care is an SpO2of 96% or above. Small pilot studies have demonstrated that permissive hypoxaemia (aiming for a lower SpO2than normal by using a lower fractional inspired oxygen concentration (FIO2)) can be achieved in the critically ill and appears to be safe. This approach has not been evaluated in a National Health Service setting. It is possible that permissive hypoxaemia may be beneficial to critically ill patients thus it requires robust evaluation.

Methods and analysis

Targeted OXygen therapY in Critical illness (TOXYC) is a feasibility randomised controlled trial (RCT) to evaluate whether recruiting patients to a study of permissive hypoxaemia is possible in the UK. It will also investigate biological mechanisms that may underlie the links between oxygenation and patient outcomes. Mechanically ventilated patients with respiratory failure will be recruited from critical care units at two sites and randomised (1:1 ratio) to an SpO2target of either 88%–92% or ≥96% while intubated with an endotracheal tube. Clinical teams can adjust FIO2and ventilator settings as they wish to achieve these targets. Clinical information will be collected before, during and after the intervention and blood samples taken to measure markers of systemic oxidative stress. The primary outcome of this study is feasibility, which will be assessed by recruitment rate, protocol adherence and withdrawal rates. Secondary outcomes will include a comparison of standard critical care outcome measures between the two intervention groups, and the measurement of biomarkers of systemic oxidative stress. The results will be used to calculate a sample size, likely number of sites and overall length of time required for a subsequent large multicentre RCT.

Ethics and dissemination

This study was approved by the London - Harrow Research Ethics Committee on 2 November 2017 (REC Reference 17/LO/1334) and received HRA approval on 13 November 2017. Results from this study will be disseminated in peer-reviewed journals, at medical and scientific meetings, in the NIHR Journals Library and patient information websites.

Trial registration number

NCT03287466; Pre-results.
Evaluation of the performance of nucleic acid amplification tests (NAATs) in detection of chlamydia and gonorrhoea infection in vaginal specimens relative to patient infection status: a systematic review
Authors: Rönn Minttu M , Mc Grath-Lone Louise , Davies Bethan , Wilson Janet D , Ward Helen
Published: January 2019

Objective

We evaluated the performance of nucleic acid amplification tests (NAATs) using vaginal specimens in comparison to specimens from the cervix or urine in their ability to detect chlamydia and gonorrhoea infection in women based on patient infection status (PIS).

Design

Systematic review.

Data sources

EMBASE and Ovid MEDLINE databases were searched through 3 October 2017.

Eligibility criteria for selecting studies

We included studies that tested samples from the vagina and ≥1 other site (cervix and/or urine) with ≥2 NAATs for chlamydia and ≥2 NAATs or 1 NAAT and culture for gonorrhoea for each site.

Data extraction and synthesis

Performance is defined as the sensitivity of a NAAT using a specimen site and PIS of the patient. We assessed risk of bias using modified QUADAS-2.

Results

Nine publications met the inclusion criteria (eight for chlamydia; six for gonorrhoea) and were narratively reviewed. Pooled summary estimates were not calculated due to the variable methodology and PIS definitions. Tests performed on vaginal specimens accomplished similar performance to cervical and urine specimens for chlamydia (range of performance estimates: vaginal 65%–100%, cervical 59%–97%, urine 57%–100%) and gonorrhoea (vaginal 64%–100%, cervical 85%–100%, urine 67%–94%). Vaginal specimens were estimated to have a performance >80% for chlamydia and gonorrhoea infections in all but one study.

Conclusions

Performance of the NAATs for chlamydia and gonorrhoea detection using vaginal specimens was similar to that of cervical and urine specimens relative to PIS. As vaginal samples have a higher acceptability and lower cost, the study can support clinical testing guidelines by providing evidence that vaginal samples are a suitable alternative to traditionally used specimens.
Effect of work schedule on prospective antidepressant prescriptions in Sweden: a 2-year sex-stratified analysis using national drug registry data
Authors: Hall Amy L , Kecklund Göran , Leineweber Constanze , Tucker Philip
Published: January 2019

Introduction

Depression-related mood disorders affect millions of people worldwide and contribute to substantial morbidity and disability, yet little is known about the effects of work scheduling on depression. This study used a large Swedish survey to prospectively examine the effects of work schedule on registry-based antidepressant prescriptions in females and males over a 2-year period.

Methods

The study was based on an approximately representative sample (n=3980 males, 4663 females) of gainfully employed participants in the Swedish Longitudinal Occupational Survey of Health. Sex-stratified analyses were conducted using logistic regression. For exposure, eight categories described work schedule in 2008: ‘regular days’ (three categories of night work history: none, ≤3 years, 4+ years), ‘night shift work’, ‘regular shift work (no nights)’, ‘rostered work (no nights)’, ‘flexible/non-regulated hours’ and ‘other’. For the primary outcome measure, all prescriptions coded N06A according to the Anatomical Therapeutic Chemical System were obtained from the Swedish National Prescribed Drug Register and dichotomised into ‘any’ or ‘no’ prescriptions between 2008 and 2010. Estimates were adjusted for potential sociodemographic, health and work confounders, and for prior depressive symptoms.

Results

In 2008, 22% of females versus 19% of males worked outside of regular daytime schedule. Registered antidepressant prescription rates in the postsurvey period were 11.4% for females versus 5.8% for males. In fully adjusted models, females in ‘flexible/non-regulated’ schedules showed an increased OR for prospective antidepressant prescriptions (OR=2.01, 95% CI=1.08 to 3.76). In males, odds ratios were most increased in those working ‘other’ schedules (OR=1.72, 95% CI=0.75 to 3.94) and ‘Regular days with four or more years’ history of night work’ (OR=1.54, 95% CI=0.93 to 2.56).

Conclusions

This study’s findings support a relationship between work schedule and prospective antidepressant prescriptions in the Swedish workforce. Future research should continue to assess sex-stratified relationships, using detailed shift work exposure categories and objective registry data where possible.
Association between spinal curvature disorders and injury: a nationwide population-based retrospective cohort study
Authors: Kuo Yen-Liang , Chung Chi-Hsiang , Huang Tsai-Wang , Tsao Chang-Huei , Chang Shan-Yueh , Peng Chung-Kan , Cheng Wei-Erh , Chien Wu-Chien , Shen Chih-Hao
Published: January 2019

Objectives

Injury is an important issue in public health. Spinal curvature disorders are deformities characterised by excessive curves of the spine. The prevalence of spinal curvature disorders is not low, but its relationship with injury has not been studied. The aim of this study is to investigate whether spinal curvature disorders increase the risk of injury.

Design

Population-based retrospective cohort study.

Setting

Using data from the Taiwan National Health Insurance Research Database from 2000 to 2010.

Participants and exposure

Patients with spinal curvature disorders were selected using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. A cohort without spinal curvature was randomly frequency-matched to the spinal curvature disorders cohort at a ratio of 2:1 according to age, sex and index year.

Primary outcome measures

The risk of injury was analysed using Cox’s proportional hazards regression models adjusting for age, sex, comorbidities, urbanisation level and socioeconomic status.

Results

A total of 20 566 patients with spinal curvature disorders and 41 132 controls were enrolled in this study. The risk of injury was 2.209 times higher (95% CI 2.118 to 2.303) in patients with spinal curvature disorders than in the control group. The spinal curvature disorders cohort exhibited higher risk of developing injury compared with the control group, regardless of age, sex, comorbidities, urbanisation level and subgroup of spinal curvature disorders. Based on the subgroup analysis, the spinal curvature disorders cohort had higher risks of unintentional injury and injury diagnoses such as fracture, dislocation, open wound, superficial injury/contusion, crushing and injury to nerves and spinal cord compared with the control cohort.

Conclusions

Patients with spinal curvature disorders have a significantly higher risk of developing injury than patients without spinal curvature disorders. Aggressive detection and management of spinal curvature disorders may be beneficial for injury prevention.
Use of patient-reported outcome measures (PROMs) in clinical diabetes consultations: study protocol for the DiaPROM randomised controlled trial pilot study
Authors: Haugstvedt Anne , Hernar Ingvild , Strandberg Ragnhild Bjarkøy , Richards David A , Nilsen Roy Miodini , Tell Grethe S , Graue Marit
Published: January 2019

Introduction

Although diabetes distress is found to be associated with decreased glycaemic control among adults with type 1 diabetes, the psychological and emotional impact of living with the condition is often not recognised and often under-reported in diabetes care. Therefore, regular assessment of diabetes distress is recommended. Assessment of diabetes distress using patient-reported outcome measures (PROMs) in clinical practice has the potential to enhance care for people with diabetes by identifying problems and improving patient–clinician communication. In this study protocol, we describe a pilot randomised controlled trial (RCT) aiming to test the feasibility of all components of an empowerment-based intervention using PROMs as dialogue support in clinical diabetes consultations, and to address the uncertainties associated with running a fully powered evaluation study.

Methods and analysis

We will undertake a two-arm pilot RCT of an intervention using the Problem Areas In Diabetes (PAID) scale in clinical diabetes consultations in order to conclude whether a fully powered trial is appropriate and/or feasible. The study will also include qualitative indepth interviews with participants and healthcare providers. Our objectives are to (1) evaluate the recruitment procedures and attrition rates; (2) evaluate the performance of the randomisation procedure; (3) evaluate the participants’ mean scores on the outcome measures before and after the intervention; (4) evaluate if the intervention consultations are acceptable and feasible; and (5) explore patients’ and healthcare providers’ experiences with the use of PAID as dialogue support and empowerment-based communication skills in clinical diabetes consultations. The quantitative data analysis includes descriptive statistics (frequencies, percentages, means, SD and CI). For the qualitative data, we will perform thematic analysis.

Ethics and dissemination

Ethical approval has been obtained from the Western Norway Regional Committee for Medical and Health Research Ethics (2017/1506/REC west). We will present the findings from the study phases at national and international conferences and submit manuscripts to peer-reviewed journals and popular science journals.

Trial registration number

NCT03471104; Pre-results.
Health-related quality of life and anxiety in the PAN-CAN lung cancer screening cohort
Authors: Taghizadeh Niloofar , Tremblay Alain , Cressman Sonya , Peacock Stuart , McWilliams Annette M , MacEachern Paul , Johnston Michael R , Goffin John , Goss Glen , Nicholas Garth , Martel Simon , Laberge Francis , Bhatia Rick , Liu Geoffrey , Schmidt Heidi , Atkar-Khattra Sukhinder , Tsao Ming-Sound , Tammemagi Martin C , Lam Stephen C
Published: January 2019

Objectives

The impact of lung cancer screening with low-dose chest CT (LDCT) on participants’ anxiety levels and health-related quality of life (HRQoL) is an important consideration in the implementation of such programmes. We aimed to describe changes in anxiety and HRQoL in a high-risk Canadian cohort undergoing LDCT lung cancer screening.

Methods

2537 subjects who had 2% or greater lung cancer risk over 6 years using a risk prediction tool were recruited from eight centres across Canada in the Pan-Canadian Early Detection of Lung Cancer Study (2008–2010). We compared HRQoL and anxiety levels before and after screening of 1237 participants with LDCT (excluding a subset of 1300 participants who also underwent autofluorescence bronchoscopy screening), as well as after investigations performed because of a positive screening examination. The 12-item short-form Physical and Mental Component Scales (SF-12), EQ-5D-3L scores and State Trait Anxiety Inventory-State anxiety were used at each assessment.

Results

Overall, there were no clinically significant differences in HRQoL outcomes between baseline and each of the survey time points following initial screening. No mean change in anxiety in the overall cohort was noted following baseline LDCT, but more participants had clinically significant increase in anxiety versus decrease after baseline screening (increase >minimal clinically important difference (MCID) (n=180) vs decrease >MCID (n=50), p<0.001). This finding persisted but to a lesser degree at the 12 month time point (increase >MCID (n=146) vs decrease >MCID (n=87), p<0.001).

Conclusions

CT screening for lung cancer has no major overall impact on HRQoL among participants, although a minority of participants (number-needed-to-harm=7 after baseline screening and 18 at 1 year) demonstrated clinically significant increased anxiety levels.

Trialregistration number

NCT00751660; Results.
Oral cannabinoids in people living with HIV on effective antiretroviral therapy: CTN PT028—study protocol for a pilot randomised trial to assess safety, tolerability and effect on immune activation
Authors: Costiniuk Cecilia T , Saneei Zahra , Routy Jean-Pierre , Margolese Shari , Mandarino Enrico , Singer Joel , Lebouché Bertrand , Cox Joseph , Szabo Jason , Brouillette Marie-Josée , Klein Marina B , Chomont Nicolas , Jenabian Mohammad-Ali
Published: January 2019

Introduction

Despite antiretroviral therapy (ART), people living with HIV have higher rates of non-infectious chronic diseases. These conditions are driven by relatively high levels of inflammation persisting on ART compared with uninfected individuals. Chronic inflammation also contributes to HIV persistence during ART. Cannabis when taken orally may represent a way to reduce inflammation and strengthen immune responses. Before planning large interventional studies, it is important to ensure that cannabis taken orally is safe and well tolerated in people living with HIV. We propose to conduct a pilot randomised trial to examine the safety and tolerability of cannabis oils containing tetrahydrocannabinol (THC) and cannabidiol (CBD) consumed orally in people living with HIV. We will also measure inflammatory markers, markers of HIV persistence in peripheral blood cells and changes in the gastrointestinal microbiome.

Methods and analysis

Twenty-six people living with HIV having undetectable viral load for at least 3 years will be randomised to receive TN-TC11LM (THC:CBD in 1:1 ratio) or TN-TC19LM (THC:CBD in 1:9 ratio) capsules daily for 12 weeks. Safety and tolerability of these capsules will be assessed through haematological, hepatic and renal blood tests, face-to-face interviews and questionnaires. Proportions of participants without any signs of significant toxicity (grades 0–2 scores on the WHO toxicity scale) and who complete the study, as well as scores on quality of life and mood will be examined using descriptive statistics. The effects on inflammatory markers, markers of peripheral blood reservoir size and effect on the composition of the gastrointestinal microbiome will be assessed before and after study completion.

Ethics and dissemination

This study has been approved by the Research Institute of the McGill University Health Centre. A Data Safety Monitor will review safety information at regular intervals. The final manuscript will be submitted to an open-access journal within 6 months of study completion.

Trial registration number

NCT03550352.
Towards sustainable healthcare system performance in the 21st century in high-income countries: a protocol for a systematic review of the grey literature
Authors: Braithwaite Jeffrey , Zurynski Yvonne , Ludlow Kristiana , Holt Joanna , Augustsson Hanna , Campbell Margie
Published: January 2019

Introduction

There is wide recognition that, if healthcare systems continue along current trajectories, they will become harder to sustain. Ageing populations, accelerating rates of chronic disease, increasing costs, inefficiencies, wasteful spending and low-value care pose significant challenges to healthcare system durability. Sustainable healthcare systems are important to patients, society, policy-makers, public and private funders, the healthcare workforce and researchers. To capture current thinking about improving healthcare system sustainability, we present a protocol for the systematic review of grey literature to capture the current state-of-knowledge and to compliment a review of peer-reviewed literature.

Methods and analysis

The proposed search strategy, based on the Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines, includes Google Advanced Search, snowballing techniques and targeted hand searching of websites of lead organisations such as WHO, Organisation for Economic Cooperation and Development, governments, public policy institutes, universities and non-government organisations. Documents will be selected after reviewing document summaries. Included documents will undergo full-text review. The following criteria will be used: grey literature document; English language; published January 2013–March 2018; relevant to the healthcare delivery system; the content has international or national scope in high-income countries. Documents will be assessed for quality, credibility and objectivity using validated checklists. Descriptive data elements will be extracted: identified sustainability threats, definitions of sustainability, attributes of sustainable healthcare systems, solutions for improvement and outcome measures of sustainability. Data will be analysed using novel text-mining methods to identify common concept themes and meanings. This will be triangulated with the more traditional analysis and concept theming by the researchers.

Ethics and dissemination

No primary data will be collected, therefore ethical approval will not be sought. The results will be disseminated in peer-reviewed literature, as conference presentations and as condensed summaries for policy-makers and health system partners.

PROSPERO registration number

CRD42018103076.
PreImplantation Trial of Histopathology In renal Allografts (PITHIA): a stepped-wedge cluster randomised controlled trial protocol
Authors: Ayorinde John OO , Summers Dominic M , Pankhurst Laura , Laing Emma , Deary Alison J , Hemming Karla , Wilson Edward CF , Bardsley Victoria , Neil Desley A , Pettigrew Gavin J
Published: January 2019

Introduction

Most potential kidney transplant donors in the UK are aged over 60 years, yet increasing donor age is associated with poorer graft survival and function. Urgent preimplantation kidney biopsy can identify chronic injury, and may aid selection of better ‘quality’ kidneys from this group. However, the impact of biopsy on transplant numbers remains unproven. The PreImplantation Trial of Histopathology In renal Allografts (PITHIA) study will assess whether the introduction of a national, 24 hours, digital histopathology service increases the number, and improves outcomes, of kidneys transplanted in the UK from older deceased donors.

Methods and analysis

PITHIA is an open, multicentre, stepped-wedge cluster randomised study, involving all UK adult kidney transplant centres. At 4-monthly intervals, a group of 4–5 randomly selected clusters (transplant centres) will be given access to remote, urgent, digital histopathology (total intervention period, 24 months). The trial has two primary end points: it is powered for an 11% increase in the proportion of primary kidney offers from deceased donors aged over 60 years that are transplanted, and a 6 mL/min increase in the estimated glomerular filtration rate of recipients at 12 months post-transplant. This would equate to an additional 120 kidney transplants performed in the UK annually. Trial outcome data will be collected centrally via the UK Transplant Registry held by NHS Blood and Transplant (NHSBT) and will be analysed using mixed effects models allowing for clustering within centres and adjusting for secular trends. An accompanying economic evaluation will estimate the cost-effectiveness of the service to the National Health Service.

Ethics and dissemination

The study has been given favourable ethical opinion by the Cambridge South Research Ethics Committee and is approved by the Health Research Authority. We will present our findings at key transplant meetings, publish results within 4 years of the trial commencing and support volunteers at renal patient groups to disseminate the trial outcome.

Trial registrationnumber

ISRCTN11708741; Pre-results.
Place of death in a small island state: a death certificate population study
Authors: Jennings Nicholas , Chambaere Kenneth , Deliens Luc , Cohen Joachim
Published: January 2019

Objectives

Low/middle-income countries, particularly Small Island Developing States, face many challenges including providing good palliative care and choice in place of care and death, but evidence of the circumstances of dying to inform policy is often lacking. This study explores where people die in Trinidad and Tobago and examines and describes the factors associated with place of death.

Methods

A population-level analysis of routinely collected death certificate and supplementary health data where the unit of analysis was the recorded death. We followed the Reporting of Studies Conducted Using Observational Routinely Collected Health Data reporting guidelines, an extension of Strengthening the Reporting of Observational Studies in Epidemiology, on a deidentified data set on decedents (n=10 221) extracted from International Statistical Classification of Diseases version 10 coded death records for the most recent available year, 2010.

Results

Of all deaths, 55.4% occurred in a government hospital and 29.7% in a private home; 65.3% occurred in people aged 60 years and older. Cardiovascular disease (23.6%), malignancies (15.5%) and diabetes mellitus (14.7%) accounted for over half of all deaths. Dying at home becomes more likely with increasing age (70–89 years (OR 1.91, 95% CI 1.73 to 2.10) and 90–highest (OR 3.63, 95% CI 3.08 to 4.27)), and less likely for people with malignancies (OR 0.85, 95% CI 0.74 to 0.97), cerebrovascular disease (OR 0.61, 95% CI 0.51 to 0.72) and respiratory disease (OR 0.74, 95% CI 0.59 to 0.91).

Conclusion

Place of death is influenced by age, sex, race/ethnicity, underlying cause of death and urbanisation. There is inequality between ethnic groups regarding place of care and death; availability, affordability and access to end-of-life care in different settings require attention.
Electronic cigarettes in Italy: a tool for harm reduction or a gateway to smoking tobacco?
Authors: Liu Xiaoqiu , Lugo Alessandra , Davoli Enrico , Gorini Giuseppe , Pacifici Roberta , Fernández Esteve , Gallus Silvano
Published: January 2019

Introduction

More than a decade after electronic cigarettes (e-cigarette) hit the European market, we are still debating whether they may help or hinder tobacco control. It is therefore useful to explore the potential net effect of e-cigarette use in the general population.

Methods

We annually conduct a face-to-face survey on smoking in Italy on a representative sample of the general population aged 15 years or over (52.4 million). A total of 15 406 subjects were interviewed in 2014–2018. We investigated the consequences of using e-cigarettes on tobacco smoking behaviour among ever and regular e-cigarette users.

Results

In all, 5.7% of our sample reported ever e-cigarette use. Multivariate analyses showed more use by men, ex-smokers and current smokers. E-cigarette use decreased with age and increased with education and calendar year. Only 1.1% of subjects were regular e-cigarette users. This prevalence rose from 0.4% in 2014–2015 to 1.8% in 2016–2017 and was 1.3% in 2018. Among 522 ever users, 13.2% stopped smoking after trying e-cigarettes and 22.2% started smoking or relapsed after using e-cigarettes. The corresponding estimates among regular users were 24.7% and 28.0%, respectively.

Conclusions

Among Italian e-cigarette users, those (re)starting smoking after using e-cigarettes outnumber those who stop smoking after using e-cigarettes. From a public health point of view, e-cigarettes may have an unfavourable net effect. Consequently, if we are not able to prevent sales of e-cigarettes to non-smokers, this product will more likely stimulate smoking tobacco than reduce harm.
Illicit tobacco trade in Georgia: prevalence and perceptions
Authors: Little Megan , Ross Hana , Bakhturidze George , Kachkachishvili Iago
Published: January 2019

Background

In lower-income and middle-income countries, limited research exists on illicit tobacco trade and its responsiveness to taxation. Tobacco taxes are critical in reducing tobacco consumption, thereby improving public health. However, the tobacco industry claims that tax increases will increase illicit tobacco trade. Therefore, research evidence on the size of the illicit cigarette market is needed in Georgia and other low-income and middle-income countries to inform tobacco tax policies.

Methods

In 2017, a household survey using stratified multistage sampling was conducted in Georgia with 2997 smokers, to assess illicit tobacco consumption. Smokers were asked to show available cigarette packs to the surveyors. These were examined for tax stamps and health warnings which allowed for an assessment of illegal cigarette consumption in Georgia.

Findings

The packs shown to surveyors suggest illicit cigarette trade is low (1.5%), although with regional differences, as illicit cigarette packs were present in 6% of the households in Zugdidi. Most illicit cigarettes were purchased at kiosks or informal outlets. This estimate might be conservative, as 28% of respondents did not show any packs to the surveyors.

Conclusions

Despite recent tobacco tax increases, illicit cigarette trade in Georgia seems to be negligible. The market is more vulnerable to illicit cigarette trade close to the border with Abkhazia (near Zugdidi). Tighter control or ban of tobacco sales at kiosks and informal outlets may reduce illicit cigarette trade. Further investigation is planned to better understand why a large proportion of survey participants said they had no pack available at home.
Experimental and numerical study of a plastic worm meshed with a steel helical gear
Authors: Liang Dong , Li Chuanshan , Hua Chengli , Luo Tianhong
Published: January 2019

In this paper, the transmission mechanism of a plastic worm meshed with a steel helical gear is applied to achieve power transmission and motion transfer. Tooth profile equations of the gear pair are derived and general meshing conditions are proposed in terms of gear geometry. A mathematical model of the tooth profiles of the gear pair is established. Contact stress analysis and general evolution law of the tooth profiles are discussed using the finite element method. Material characteristics, mesh generation, contact definition, and constraint conditions are given. For comparison, analysis results of a steel worm meshed with a steel helical gear is also provided. Through the hobbing process, injection molding, and machining center, samples of steel helical gears, plastic worm, and steel worm are completed, respectively. A characteristic test of the transmission mechanism of the plastic worm meshed with a steel helical gear is carried out based on the microtransmission experimental platform. The contrasting results show that the plastic worm has better transmission performance.
INFORMATION-THEORETIC ANALYSIS OF STOCHASTIC VOLATILITY MODELS
Authors: PFANTE OLIVER , BERTSCHINGER NILS
Published: January 2019

Stochastic volatility models describe asset prices [Formula: see text] as driven by an unobserved process capturing the random dynamics of volatility [Formula: see text]. We quantify how much information about [Formula: see text] can be inferred from asset prices [Formula: see text] in terms of Shannon’s mutual information in a twofold way: theoretically, by means of a thorough study of Heston’s model; from a machine learning perspective, by means of investigating a family of exponential Ornstein–Uhlenbeck (OU) processes fitted on S&P 500 data.
A Rule-Based Kurdish Text Transliteration System
Authors: Ahmadi Sina
Published: January 2019

In this article, we present a rule-based approach for transliterating two of the most used orthographies in Sorani Kurdish. Our work consists of detecting a character in a word by removing the possible ambiguities and mapping it into the target orthography. We describe different challenges in Kurdish text mining and propose novel ideas concerning the transliteration task for Sorani Kurdish. Our transliteration system, named
Wergor
, achieves 82.79% overall precision and more than 99% in detecting the double-usage characters. We also present a manually transliterated corpus for Kurdish.
MNK1/NODAL Signaling Promotes Invasive Progression of Breast Ductal Carcinoma In Situ
Authors: Guo Qianyu , Li Vivian Z. , Nichol Jessica N. , Huang Fan , Yang William , Preston Samuel E.J. , Talat Zahra , Lefrère Hanne , Yu Henry , Zhang Guihua , Basik Mark , Gonçalves Christophe , Zhan Yao , Plourde Dany , Su Jie , Torres Jose , Marques Maud , Habyan Sara Al , Bijian Krikor , Amant Frédéric , Witcher Michael , Behbod Fariba , McCaffrey Luke , Alaoui-Jamali Moulay , Giannakopoulos Nadia V. , Brackstone Muriel , Postovit Lynne-Marie , del Rincón Sonia V. , Miller Wilson H.
Published: January 2019

The mechanisms by which breast cancers progress from relatively indolent ductal carcinoma in situ (DCIS) to invasive ductal carcinoma (IDC) are not well understood. However, this process is critical to the acquisition of metastatic potential. MAPK-interacting serine/threonine-protein kinase 1 (MNK1) signaling can promote cell invasion. NODAL, a morphogen essential for embryogenic patterning, is often reexpressed in breast cancer. Here we describe a MNK1/NODAL signaling axis that promotes DCIS progression to IDC. We generated MNK1 knockout (KO) or constitutively active MNK1 (caMNK1)-expressing human MCF-10A–derived DCIS cell lines, which were orthotopically injected into the mammary glands of mice. Loss of MNK1 repressed NODAL expression, inhibited DCIS to IDC conversion, and decreased tumor relapse and metastasis. Conversely, caMNK1 induced NODAL expression and promoted IDC. The MNK1/NODAL axis promoted cancer stem cell properties and invasion in vitro. The MNK1/2 inhibitor SEL201 blocked DCIS progression to invasive disease in vivo. In clinical samples, IDC and DCIS with microinvasion expressed higher levels of phospho-MNK1 and NODAL versus low-grade (invasion-free) DCIS. Cumulatively, our data support further development of MNK1 inhibitors as therapeutics for preventing invasive disease.

Significance:

These findings provide new mechanistic insight into progression of ductal carcinoma and support clinical application of MNK1 inhibitors to delay progression of indolent ductal carcinoma in situ to invasive ductal carcinoma.