bluuebunny/crossref_metadata_2025 huggingface dataset:
Problems faced by people living at home with dementia and incontinence: causes, consequences and potential solutions
Authors: Murphy Catherine , De Laine Christine , Macaulay Margaret , Hislop Lennie Kelly , Fader Mandy
Published: November 2020

Background

many people living at home with dementia (PLWD) also have poorly managed toilet-use or incontinence problems with damaging consequences for both people with dementia, unpaid carers and healthcare professionals (HCPs). Currently, there are no theoretically or empirically based interventions to help. The underlying causes and subsequent consequences of these problems need to be fully understood in order to support the development of interventions that have the potential to decrease the impact of these problems on people’s lives.

Aim

to establish the range of causes, consequences and potential solutions of toilet-use and incontinence problems for PLWD and their carers.

Method

a qualitative design was used. Semi-structured interviews were undertaken with PLWD, carers and HCPs (continence or dementia nurses). PLWD and carers were recruited via www.joindementiaresearch.nihr.ac.uk and via dementia/carer groups. Nurses were recruited via their employers. Interviews were digitally recorded and transcribed verbatim. Framework analysis was used to interpret the data to address the goal of the research.

Results

in total, 45 people (26 unpaid carers, 2 people with dementia, 9 continence and 8 dementia HCPs) took part. The causes of toilet-use and incontinence problems were reported to be multi-faceted and complex including those related to dementia (e.g. lack of insight into toileting needs or how to use the toilet), those which are physical (e.g. existing bladder or bowel issues or poor mobility), psychosocial (e.g. inability to ask for help for incontinence) or societal (e.g. fear of stigma), or related to care systems (e.g. lack of expert knowledge) or products (e.g. poor fit or confusing for users). Consequences included harms to physical and mental health, social isolation, increased carer workload and care system resource implications.

Conclusion

this study provides the first detailed characterisation of the causes and consequences of and potential solutions for incontinence problems for PLWD at home and their carers. Multifaceted and complex problems were identified, layering dementia, physical, psychosocial, societal and care system factors and highlighting contextual variation. This new knowledge provides the essential basis for the (now underway) development of urgently needed practical and implementable interventions for this underserved population.
Psychological Distress and Intention to Leave the Profession: The Social and Economic Exchange Mediating Role
Authors: Zychlinski Ester , Lavenda Osnat , Shamir Michal Mahat , Kagan Maya
Published: November 2020

The purpose of the present study was to examine the association between psychological distress among social workers and their intention to leave the profession through the economic and social exchange perspective. The research sample was comprised of 380 Israeli social workers who manually filled in structured questionnaires regarding psychological distress, economic and social exchange between employees and employers in their workplace, self-defined burnout and demographic information. The data analysis showed that higher levels of psychological distress were associated with higher economic exchange and with lower social exchange, which resulted in increased intention to leave. These findings are important for understanding the process that social workers experience regarding the emergence of psychological distress and for clarifying that this process consists of two concurrent components: increasing preoccupation with economic aspects and increasing emotional distancing from the profession. On the basis of the transactional model of stress and coping and the social and economic exchange perspectives, it would be desirable to develop an organisational culture that promotes social exchange (trust, manager support, teamwork), which would allow social workers to cope with active emotional regulation and to strengthen their sense of belonging to the profession and thus reduce their intention to leave.
A fractal concentrator of direct and indirect sunlight
Authors: Katardjiev Ilia
Published: November 2020

A novel concept for concentrating both direct and indirect sunlight employing a combination of waveguiding and refractive optics is presented. More specifically, it is based on both the individual and the collective focusing effects of an array of refractive optical elements of specific geometry. An analytical framework and design principles regarding the geometry of the optical elements taking into account Fresnel reflection and refraction are presented. The principle of operation along with loss mechanisms and acceptance angles are discussed in detail. Ray-tracing simulations of a light concentrator designed accordingly indicate transmittance >90% with acceptance angles of ≤65° at 3 suns for moderate refractive indices. It is further numerically demonstrated that the new approach allows the utilization of the dominant fraction of the solar radiation by harvesting the waste heat in addition to photovoltaic conversion with an operating energy efficiency for diffuse light >70%.
β-blockers in hemodialysis: simple questions, complicated answers
Authors: Hundemer Gregory L , Sood Manish M , Canney Mark
Published: November 2020

In this issue of the Clinical Kidney Journal, Wu et al. present the results of a nationwide population-based study using Taiwanese administrative data to compare safety and efficacy outcomes with initiation of bisoprolol versus carvedilol among patients receiving maintenance hemodialysis for >90 days. The primary outcomes were all-cause mortality and major adverse cardiovascular events over 2 years of follow-up. The study found that bisoprolol was associated with a lower risk for both major adverse cardiovascular events and all-cause mortality compared with carvedilol. While the bulk of the existing evidence favors a cardioprotective and survival benefit with β-blockers as a medication class among dialysis patients, there is wide heterogeneity among specific β-blockers in regard to pharmacologic properties and dialyzability. While acknowledging the constraints of observational data, these findings may serve to inform clinicians about the preferred β-blocker agent for dialysis patients to help mitigate cardiovascular risk and improve long-term survival for this high-risk population.
Metabolic profiling of angiopoietin-like protein 3 and 4 inhibition: a drug-target Mendelian randomization analysis
Authors: Wang Qin , Oliver-Williams Clare , Raitakari Olli T , Viikari Jorma , Lehtimäki Terho , Kähönen Mika , Järvelin Marjo-Riitta , Salomaa Veikko , Perola Markus , Danesh John , Kettunen Johannes , Butterworth Adam S , Holmes Michael V , Ala-Korpela Mika
Published: November 2020

Aims 

Angiopoietin-like protein 3 (ANGPTL3) and 4 (ANGPTL4) inhibit lipoprotein lipase (LPL) and represent emerging drug targets to lower circulating triglycerides and reduce cardiovascular risk. To investigate the molecular effects of genetic mimicry of ANGPTL3 and ANGPTL4 inhibition and compare them to the effects of genetic mimicry of LPL enhancement.

Methods and results 

Associations of genetic variants in ANGPTL3 (rs11207977-T), ANGPTL4 (rs116843064-A), and LPL (rs115849089-A) with an extensive serum lipid and metabolite profile (208 measures) were characterized in six cohorts of up to 61 240 participants. Genetic associations with anthropometric measures, glucose-insulin metabolism, blood pressure, markers of kidney function, and cardiometabolic endpoints via genome-wide summary data were also explored. ANGPTL4 rs116843064-A and LPL rs115849089-A displayed a strikingly similar pattern of associations across the lipoprotein and lipid measures. However, the corresponding associations with ANGPTL3 rs11207977-T differed, including those for low-density lipoprotein and high-density lipoprotein particle concentrations and compositions. All three genotypes associated with lower concentrations of an inflammatory biomarker glycoprotein acetyls and genetic mimicry of ANGPTL3 inhibition and LPL enhancement were also associated with lower C-reactive protein. Genetic mimicry of ANGPTL4 inhibition and LPL enhancement were associated with a lower waist-to-hip ratio, improved insulin-glucose metabolism, and lower risk of coronary heart disease and type 2 diabetes, whilst genetic mimicry of ANGPTL3 was associated with improved kidney function.

Conclusions 

Genetic mimicry of ANGPTL4 inhibition and LPL enhancement have very similar systemic metabolic effects, whereas genetic mimicry of ANGPTL3 inhibition showed differing metabolic effects, suggesting potential involvement of pathways independent of LPL. Genetic mimicry of ANGPTL4 inhibition and LPL enhancement were associated with a lower risk of coronary heart disease and type 2 diabetes. These findings reinforce evidence that enhancing LPL activity (either directly or via upstream effects) through pharmacological approaches is likely to yield benefits to human health.
Long-term observation of catheter ablation vs. pharmacotherapy in the management of persistent and long-standing persistent atrial fibrillation (CAPA study)
Authors: Wu Gang , Huang He , Cai Lin , Yang Yanzong , Liu Xu , Yu Bo , Tang Yanhong , Jiang Hong , Huang Congxin ,   for the CAPA Study Investigators
Published: November 2020

Aims 

The roles of radiofrequency catheter ablation (RFCA) and pharmacotherapy in treating persistent and long-standing persistent atrial fibrillation (AF) have not been sufficiently investigated. We conducted a multicentre, randomized, controlled trial to compare the effects of RFCA and pharmacotherapy on the prognosis of these patients.

Methods and results 

A total of 648 patients with persistent and long-standing persistent AF were enrolled from 30 centres and randomized to either the ablation group (n = 327) or the pharmacotherapy group (n = 321). After 54.2 ± 10.6 months of follow-up, the primary endpoints occurred significantly more rarely in the ablation group than in the pharmacotherapy group (10.4% vs. 17.4%; hazard ratio 0.59, 95% confidence interval 0.48–0.75; P < 0.001). The incidence of stroke/transient ischaemic attack (TIA) was significantly lower in the ablation group (4.2% vs. 7.2%, P < 0.001). Likewise, the incidence of new-onset congestive heart failure (CHF) was lower in the ablation group (2.8% vs. 7.2%, P < 0.001). More patients had sinus rhythm in the ablation group than in the pharmacotherapy group (60.6% vs. 20.9%, P < 0.001), but fewer patients were on antiarrhythmic drugs (24.4% vs. 41.6%, P < 0.001) and warfarin (60.8% vs. 83.9%, P = 0.001). Both the 6-min walk distance and the quality of life (QoL) were improved in the ablation group at the end of follow-up.

Conclusion 

In patients with persistent and long-standing persistent AF, RFCA-based treatment was superior to pharmacotherapy in decreasing stroke/TIA and new-onset CHF and improving QoL.
Carbapenemase-producing Enterobacteriaceae in transplant patients
Authors: Giannella Maddalena , Bartoletti Michele , Conti Michela , Righi Elda
Published: November 2020

Carbapenemase-producing Enterobacteriaceae (CPE) are a serious public health concern and represent a major threat to immunocompromised hosts, including solid organ (SOT) and stem cell transplant (HSCT) recipients. Transplant patients are at particular risk of developing CPE colonization and/or infection due to their frequent exposure to prolonged courses of broad-spectrum antibiotics, altered immunocompetence and exposure to invasive procedures and immunosuppressive drugs. Gut colonization with CPE, in particular carbapenem-resistant Klebsiella pneumoniae, may occur before or after SOT in 2%–27% of patients and among 2%–9% of HSCT and has been associated with increased risk of developing CPE infections. In endemic areas, CPE infections occur in up to 18% of SOT, and HSCT patients can account for 5%–18% of all patients with CPE bacteraemia. Mortality rates up to 70% have been associated with CPE infections in both patient populations. The rapid initiation of an active therapy against CPE is advocated in these infections. Therapeutic options, however, are limited by the paucity of novel compounds that are currently available and by potential antibiotic-associated toxicities. Therefore, a multidisciplinary approach involving infection control and antimicrobial stewardship programmes still represents the mainstay for the management of CPE infections among transplant patients. The evidence for the use of prevention strategies such as CPE-targeted perioperative prophylaxis or gut decolonization is still scarce. Large, multicentre trials are required to better define prevention strategies and to guide the management of CPE infections in the transplant setting.
Architectural Distortion on Screening Digital Breast Tomosynthesis: Pathologic Outcomes and Indicators of Malignancy
Authors: Wadhwa Anubha , Majidi Shadie S , Cherian Solomon , Dykstra Daniel S , Deitch Sarah G , Hansen Colin , Bhave Sampada , Koch Kevin M
Published: November 2020

Objective

Digital breast tomosynthesis (DBT) has significantly improved cancer detection capabilities through its identification of subtle findings often imperceptible on 2D digital mammography, particularly architectural distortion (AD). The purpose of this study was to analyze of suspicious AD detected on screening DBT to evaluate the incidence of malignancy and to determine other patient or imaging characteristics in these cases as possible predictors of malignancy.

Methods

This was an IRB approved retrospective analysis of subjects with AD detected on DBT screening mammography who were given a biopsy recommendation between January 1, 2016, and June 30, 2018. Univariate analysis of various imaging characteristics and patient high-risk factors was performed for statistical correlation with diagnosis of malignancy.

Results

In the 218 DBT-detected AD findings with a final BI-RADS assessment of 4 or 5 on diagnostic workup, 94 (43.1%) yielded malignancy, 57 (26.2%) were classified as high-risk, and 67 (30.7%) were benign. There was a strong statistically significant association with malignancy in the cases with an US correlate (P < 0.0001). There was a statistically significant inverse correlation between malignancy and one-view findings (P = 0.0002). The presence of AD on 2D (P = 0.005) or synthetic 2D views (P = 0.002) showed statistically significant correlations with malignancy, whereas breast density or high-risk factors (P = 0.316) did not.

Conclusion

AD detected on DBT that persists on further workup and has no explainable cause should be considered suspicious for malignancy. Identification of the AD on both standard mammographic views and the presence of an US correlate significantly increase the probability of malignancy.
Probing Saraswati’s heart: evaluating the dynamical state of the massive galaxy cluster A2631 through a comprehensive weak-lensing and dynamical analysis
Authors: Monteiro-Oliveira R , Soja A C , Ribeiro A L B , Bagchi J , Sankhyayan S , Candido T O , Flores R R
Published: November 2020

In this work, we investigate the dynamical state of the galaxy cluster Abell 2631, a massive structure located at the core of the Saraswati supercluster. To do this, we first solve a tension found in the literature regarding the weak-lensing mass determination of the cluster. We do this through a comprehensive weak-lensing analysis, exploring the power of the combination of shear and magnification data sets. We find $M_{200}^{\rm wl} = 8.7_{-2.9}^{+2.5} \times 10^{14}$ M⊙. We also determined the mass based on the dynamics of spectroscopic members, corresponding to $M_{200}^{\rm dy} = 12.2\pm 3.0 \times 10^{14}$ M⊙, consistent within a 68 per cent CL with the weak-lensing estimate. The scenarios provided by the mass distribution and dynamics of galaxies are reconciled with those provided by X-ray observations in a scenario where A2631 is observed at a late stage of merging.
Individual dynamical masses of DENIS J063001.4−184014AB reveal a likely young brown dwarf triple
Authors: Sahlmann J , Dupuy T J , Burgasser A J , Filippazzo J C , Martín E L , Bardalez Gagliuffi D C , Hsu C , Lazorenko P F , Liu Michael C
Published: November 2020

The binary nature of the M8.5 dwarf DENIS J063001.4−184014AB (DE0630−18) was discovered with astrometric monitoring from the ground, which determined the unresolved photocentric orbit and the trigonometric parallax of the system. Here we present radial velocity monitoring and resolved observations in the near-infrared with Keck aperture masking that allows us to measure the system’s relative separation and brightness. By combining all available information, we determine the individual dynamical masses of the binary components to be $M_1 = 0.052^{+0.009}_{-0.008}$MSun and $M_2 = 0.052^{+0.005}_{-0.004}$MSun, both firmly in the substellar regime. These masses are surprising, given the object’s M8.5 optical spectral type and equivalent absolute magnitude, and the significant difference in brightness between the components (ΔK = 1.74 ± 0.06 mag). Our results suggest that DE0630−18 is a relatively young system (∼200 Myr) with a secondary component that is itself a potentially unresolved binary.
Direct imaging of sub-Jupiter mass exoplanets with James Webb Space Telescope coronagraphy
Authors: Carter Aarynn L , Hinkley Sasha , Bonavita Mariangela , Phillips Mark W , Girard Julien H , Perrin Marshall , Pueyo Laurent , Vigan Arthur , Gagné Jonathan , Skemer Andrew J I
Published: November 2020

The James Webb Space Telescope (JWST), currently scheduled to launch in 2021, will dramatically advance our understanding of exoplanetary systems with its ability to directly image and characterize planetary-mass companions at wide separations through coronagraphy. Using state-of-the-art simulations of JWST performance, in combination with the latest evolutionary models, we present the most sophisticated simulated mass sensitivity limits of JWST coronagraphy to date. In particular, we focus our efforts towards observations of members within the nearby young moving groups β Pictoris and TW Hya. These limits indicate that whilst JWST will provide little improvement towards imaging exoplanets at short separations, at wide separations the increase in sensitivity is dramatic. We predict JWST will be capable of imaging sub-Jupiter mass objects beyond ∼30 au, sub-Saturn mass objects beyond ∼50 au, and that beyond ∼100 au, JWST will be capable of directly imaging companions as small as 0.1 MJ − at least an order of magnitude improvement over the leading ground-based instruments. Probing this unexplored parameter space will be of immediate value to modelling efforts focused on planetary formation and population synthesis. JWST will also serve as an excellent complement to ground-based observatories through its unique ability to characterize previously detected companions across the near- to mid-infrared for the first time.
Exploring the dust content of galactic haloes with Herschel III. NGC 891
Authors: Yoon J H , Martin Crystal L , Veilleux S , Meléndez M , Mueller T , Gordon K D , Cecil G , Bland-Hawthorn J , Engelbracht C
Published: November 2020

We present deep far-infrared observations of the nearby edge-on galaxy NGC 891 obtained with the Herschel Space Observatory and the Spitzer Space Telescope. The maps confirm the detection of thermal emission from the inner circumgalactic medium (halo) and spatially resolve a dusty superbubble and a dust spur (filament). The dust temperature of the halo component is lower than that of the disc but increases across a region of diameter ≈8.0 kpc extending at least 7.7 kpc vertically from one side of the disc, a region we call a superbubble because of its association with thermal X-ray emission and a minimum in the synchrotron scale height. This outflow is breaking through the thick disc and developing into a galactic wind, which is of particular interest because NGC 891 is not considered a starburst galaxy; the star formation rate surface density, 0.03 M⊙ yr−1 kpc−2, and gas fraction, just $10{{\ \rm per\ cent}}$ in the inner disc, indicate the threshold for wind formation is lower than previous work has suggested. We conclude that the star formation surface density is sufficient for superbubble blowout into the halo, but the cosmic ray electrons may play a critical role in determining whether this outflow develops into a fountain or escapes from the gravitational potential. The high dust-to-gas ratio in the dust spur suggests the material was pulled out of NGC 891 through the collision of a minihalo with the disc of NGC 891. We conclude that NGC 891 offers an example of both feedback and satellite interactions transporting dust into the halo of a typical galaxy.
Resonance sweeping by a decelerating Galactic bar
Authors: Chiba Rimpei , Friske Jennifer K S , Schönrich Ralph
Published: November 2020

We provide the first quantitative evidence for the deceleration of the Galactic bar from local stellar kinematics in agreement with dynamical friction by a typical dark matter halo. The kinematic response of the stellar disc to a decelerating bar is studied using secular perturbation theory and test particle simulations. We show that the velocity distribution at any point in the disc affected by a naturally slowing bar is qualitatively different from that perturbed by a steadily rotating bar with the same current pattern speed Ωp and amplitude. When the bar slows down, its resonances sweep through phase space, trapping, and dragging along a portion of previously free orbits. This enhances occupation on resonances, but also changes the distribution of stars within the resonance. Due to the accumulation of orbits near the boundary of the resonance, the decelerating bar model reproduces with its corotation resonance the offset and strength of the Hercules stream in the local vR-vφ plane and the double-peaked structure of mean vR in the Lz–φ plane. At resonances other than the corotation, resonant dragging by a slowing bar is associated with a continuing increase in radial action, leading to multiple resonance ridges in the action plane as identified in the Gaia data. This work shows models using a constant bar pattern speed likely lead to qualitatively wrong conclusions. Most importantly we provide a quantitative estimate of the current slowing rate of the bar $\dot{\Omega }_{\rm p}= (-4.5 \pm 1.4) \, {\rm km}\, {\rm s}^{-1}\, {\rm kpc}^{-1}\, {\rm Gyr}^{-1}$ with additional systematic uncertainty arising from unmodelled impacts of e.g. spiral arms.
SSSpaNG! Stellar Spectra as Sparse, data-driven, Non-Gaussian processes
Authors: Feeney Stephen M , Wandelt Benjamin D , Ness Melissa K
Published: November 2020

Upcoming million-star spectroscopic surveys have the potential to revolutionize our view of the formation and chemical evolution of the Milky Way. Realizing this potential requires automated approaches to optimize estimates of stellar properties, such as chemical element abundances, from the spectra. The sheer volume and quality of the observations strongly motivate that these approaches should be driven by the data. With this in mind, we introduce SSSpaNG: a data-driven non-Gaussian Process model of stellar spectra. We demonstrate the capabilities of SSSpaNG using a sample of APOGEE red clump stars, whose model parameters we infer using Gibbs sampling. By pooling information between stars to infer their covariance, we permit clear identification of the correlations between spectral pixels. Harnessing this correlation structure, we infer the true spectrum of each red clump star, inpainting missing regions and denoising by a factor of at least two for stars with signal-to-noise of ∼20. As we marginalize over the covariance matrix of the spectra, the effective prior on these true spectra is non-Gaussian and sparsifying, favouring typically small but occasionally large excursions from the mean. The high-fidelity inferred spectra produced with our approach will enable improved chemical elemental abundance estimates for individual stars. Our model also allows us to quantify the information gained by observing portions of a star’s spectrum, and thereby define the most mutually informative spectral regions. Using 25 windows centred on elemental absorption lines, we demonstrate that the iron-peak and alpha-process elements are particularly mutually informative for these spectra, and that the majority of information about a target window is contained in the 10-or-so most informative windows. Such mutual information estimates have the potential to inform models of nucleosynthetic yields and the design of future observations. Our code is made publicly available at https://github.com/sfeeney/ddspectra.
Characterization of nuclear mitochondrial insertions in the whole genomes of primates
Authors: Dayama Gargi , Zhou Weichen , Prado-Martinez Javier , Marques-Bonet Tomas , Mills Ryan E
Published: November 2020

The transfer and integration of whole and partial mitochondrial genomes into the nuclear genomes of eukaryotes is an ongoing process that has facilitated the transfer of genes and contributed to the evolution of various cellular pathways. Many previous studies have explored the impact of these insertions, referred to as NumtS, but have focused primarily on older events that have become fixed and are therefore present in all individual genomes for a given species. We previously developed an approach to identify novel Numt polymorphisms from next-generation sequence data and applied it to thousands of human genomes. Here, we extend this analysis to 79 individuals of other great ape species including chimpanzee, bonobo, gorilla, orang-utan and also an old world monkey, macaque. We show that recent Numt insertions are prevalent in each species though at different apparent rates, with chimpanzees exhibiting a significant increase in both polymorphic and fixed Numt sequences as compared to other great apes. We further assessed positional effects in each species in terms of evolutionary time and rate of insertion and identified putative hotspots on chromosome 5 for Numt integration, providing insight into both recent polymorphic and older fixed reference NumtS in great apes in comparison to human events.
Upadacitinib monotherapy improves patient-reported outcomes in rheumatoid arthritis: results from SELECT-EARLY and SELECT-MONOTHERAPY
Authors: Strand Vibeke , Tundia Namita , Wells Alvin , Buch Maya H , Radominski Sebastiao C , Camp Heidi S , Friedman Alan , Suboticki Jessica L , Dunlap Kendall , Goldschmidt Debbie , Bergman Martin
Published: November 2020

Objective

To evaluate the effect of upadacitinib (UPA) monotherapy vs MTX on patient-reported outcomes (PROs) in patients with RA who were MTX-naïve or who had an inadequate response to MTX (MTX-IR).

Methods

PROs from the SELECT-EARLY and SELECT-MONOTHERAPY randomized controlled trials were evaluated at Weeks 2 and 12/14. Patients were ≥18 years of age with RA symptoms for ≥6 weeks (SELECT-EARLY, MTX-naïve) or diagnosed RA for ≥3 months (SELECT-MONOTHERAPY, MTX-IR) and received UPA monotherapy (15 or 30 mg) or MTX. PROs included Patient Global Assessment of Disease Activity (PtGA), pain visual analogue scale, HAQ Disability Index (HAQ-DI), morning stiffness duration/severity, Functional Assessment of Chronic Illness Therapy (FACIT)-Fatigue (SELECT-EARLY), health-related quality of life (HRQOL) by the 36-iem Short Form Health Survey and Work Productivity and Activity Impairment (WPAI; SELECT-EARLY). Least square mean (LSM) changes and proportions of patients reporting improvements greater than or equal to the minimum clinically important differences and normative values were determined.

Results

In 945 MTX-naïve and 648 MTX-IR patients, UPA monotherapy (15 mg, 30 mg) vs MTX resulted in greater reported LSM changes from baseline at Weeks 12/14 in PtGA, pain, HAQ-DI, morning stiffness duration/severity, FACIT-F (SELECT-EARLY), HRQOL and WPAI (SELECT-EARLY). These changes were statistically significant with both doses of UPA vs MTX at Weeks 12/14 in both RCTs. Improvements were reported as early as week 2. Compared with MTX, more UPA-treated MTX-naïve and MTX-IR patients reported improvements greater than or equal to the minimum clinically important differences and scores greater than or equal to normative values.

Conclusion

Among MTX-naïve and MTX-IR patients with active RA, UPA monotherapy at 15 or 30 mg for 12/14 weeks resulted in statistically significant and clinically meaningful improvements in pain, physical function, morning stiffness, HRQOL and WPAI compared with MTX alone.

Clinical trial registration number

SELECT-EARLY (NCT02706873) and SELECT-MONOTHERAPY (NCT02706951) are registered with ClinicalTrials.gov.
An outbreak of bilateral photokeratitis and eyelid erythema following exposure to an artificial source of ultraviolet radiation, Tamil Nadu, India, 2018
Authors: Rubeshkumar Polani , Ponnaiah Manickam , Prakash S. Varun , Balasubramanian Ramanujam , Somasundaram Shanmugham , Premkumar Balasubramanian , Gounder Kolandaswamy Karumana , Murhekar Manoj V.
Published: November 2020

Background:

Metal halide lights (MHLs) emit ultraviolet radiation (UVR) and should be used with enclosed fixtures. We investigated a cluster of blurred vision in a locality in South India reported among light music event attendees to identify risk factors.

Methods:

We searched for attendees with any eye-related symptoms by door-to-door. We described cases by time, place, and person and inspected the environment to generate a hypothesis. We followed-up the cohort of the attendees to examine the hypothesis of exposure to MHL as the cause of the outbreak. We computed relative risk (RR) and 95% confidence interval (CI) by comparing attack rates among attendees by seating location and duration of exposure.

Results:

Of the total 500 attendees, we could interview 319 (64%) and 89% (284/319) attendees developed bilateral photokeratitis (median age = 24 years [range: 2–80 years]). Attack rate was higher among female (92% [172/189]) than male (85% [110/130]). Attack rate among those seated within 12 meters from dais was higher (95% [241/253]) than the rest (65% [43/66]; RR = 1.5; 95% CI = 1.2, 1.7) and attack rate was higher among those continuously exposed to MHL (97% [268/277]) than others (38% [16/42]; RR = 2.5; 95% CI = 1.7, 3.7). The duration of exposure was associated with increased risk of bilateral photokeratitis (χ2 test for linear trend = 74; P < 0.00001). During the environmental inspection, we identified the use of MHL with a broken outer envelope.

Conclusions:

Photokeratitis was associated with exposure to UVR from MHL with a broken outer envelope. We recommended the usage of MHL along with enclosed fixtures.
Automated Detection of Exercise Sessions in Patients With Peripheral Artery Disease
Authors: Mays Ryan J. , Wesselman Craig W. , White Robin , Creager Mark A. , Amato Antonino , Greenwalt Marilyn , Hiatt William R.
Published: November 2020

Purpose:

Monitoring home exercise using accelerometry in patients with peripheral artery disease (PAD) may provide a tool to improve adherence and titration of the exercise prescription. However, methods for unbiased analysis of accelerometer data are lacking. The aim of the current post hoc analysis was to develop an automated method to analyze accelerometry output collected during home-based exercise.

Methods:

Data were obtained from 54 patients with PAD enrolled in a clinical trial that included a home-based exercise intervention using diaries and an accelerometer. Peak walking time was assessed on a graded treadmill at baseline and 6 mo. In 35 randomly selected patient data sets, visual inspection of accelerometer output confirmed exercise sessions throughout the 6 mo. An algorithm was developed to detect exercise sessions and then compared with visual inspection of sessions to mitigate the heterogeneity in session intensity across the population. Identified exercise sessions were characterized on the basis of total step count and activity duration. The methodology was then applied to data sets for all 54 patients.

Results:

The ability of the algorithm to detect exercise sessions compared with visual inspection of the accelerometer output resulted in a sensitivity of 85% and specificity of 90%. Algorithm-detected exercise sessions (total) and intensity (steps/wk) were correlated with change in peak walking time (r = 0.28; r = 0.43).

Conclusions:

An algorithm to assess data from an accelerometer successfully detected home-based exercise sessions. Algorithm-identified exercise sessions were correlated with improvements in performance after 6 mo of training in patients with PAD, supporting the effectiveness of monitored home-based exercise.
Saffron
Authors: Singletary Keith
Published: November 2020

Saffron is derived from a specific portion of the flowers ofCrocus sativus L. and is one of the most expensive spices in the world. Besides its use in Mediterranean, Middle Eastern, and South Asian cuisines, it also has been a part of Ayurvedic and Persian traditional healing strategies for thousands of years. Recently, human studies have emerged examining the capacity of saffron or its individual bioactive phytochemicals to ameliorate conditions and symptoms related to, for example, depression, neurodegenerative conditions, and symptoms of diabetes and cardiovascular disease. This narrative review presents a summary of human studies assessing these and other potential health benefits of saffron supplementation and highlights issues for future research.
Black flies and Onchocerciasis: Knowledge, attitude and practices among inhabitants of Alabameta, Osun State, Southwestern, Nigeria
Authors: Oluwatoyin Busari Lateef , Ojurongbe O.O , Adeleke M.A , Surakat O.A
Published: November 2020

Background and Objectives

This study reports knowledge of residents of Alabameta community, Osun State, Nigeria on the bioecology and socio-economic burden of black flies and onchocerciasis.

Methods

Using structured questionnaires and Focus Group Discussion (FGD), a total of 150 community respondent participated in the study.

Results

The knowledge of the residents on the existence of black flies in the community was significant (p<0.05) as all the 150 respondents confirmed the presence of black flies with the local name ‘Amukuru’. However, their lack of knowledge of the flies breeding site (104) (69%), prevention (134) (89%), cause (132) (88%), and treatment (133) (89%) of onchocerciasis was profound. Majority 147(98%) of the respondents reported that flies bite more in the wet season as against dry season 3(2%). The flies have a higher affinity (124) (82%) for biting the leg than any other part of the body. A larger percentage (89%) of the respondents are unaware of any medication for the treatment of onchocerciasis while 11% are aware. There had been no sensitization on onchocerciasis according to 89% of the respondents.

Conclusion

Due to lack of resident’s knowledge on black flies bioecology which may continuously expose them to the bite of the flies and ultimately infection, it is paramount that the Osun State government map out strategizes through orientation and drug administration with a view to onchocerciasis prevention and eradication.
Label-free bone marrow white blood cell classification using refractive index tomograms and deep learning
Authors: Ryu DongHun , Kim Jinho , Lim Daejin , Min Hyun-Seok , You Inyoung , Cho Duck , Park YongKeun
Published: November 2020

In this study, we report a label-free bone marrow white blood cell classification framework that captures the three-dimensional (3D) refractive index (RI) distributions of individual cells and analyzes with deep learning. Without using labeling or staining processes, 3D RI distributions of individual white blood cells were exploited for accurate profiling of their subtypes. Powered by deep learning, our method used the high-dimensional information of the WBC RI tomogram voxels and achieved high accuracy. The results show >99 % accuracy for the binary classification of myeloids and lymphoids and >96 % accuracy for the four-type classification of B, T lymphocytes, monocytes, and myelocytes. Furthermore, the feature learning of our approach was visualized via an unsupervised dimension reduction technique. We envision that this framework can be integrated into existing workflows for blood cell investigation, thereby providing cost-effective and rapid diagnosis of hematologic malignancy.
Dissociable mechanistic contributions of limb and task related errors during human sensorimotor learning
Authors: Oza Anushka , Kumar Adarsh , Sharma Apoorva , Mutha Pratik K.
Published: November 2020

The unpredictable nature of our world can introduce a variety of errors in our actions, including sensory prediction errors (SPEs) and task performance errors (TPEs). SPEs arise when our existing internal models of limb-environment properties and interactions become miscalibrated due to changes in the environment, while TPEs occur when environmental perturbations hinder achievement of task goals. The precise mechanisms employed by the sensorimotor system to learn from such limb- and task-related errors and improve future performance are not comprehensively understood. To gain insight into these mechanisms, we performed a series of learning experiments wherein the location and size of a reach target were varied, the visual feedback of the motion was clamped along fixed directions, and instructions were carefully manipulated. Our findings indicate that the mechanisms employed to compensate SPEs and TPEs are dissociable. Specifically, our results fail to support theories that suggest that TPEs trigger implicit refinement of reach plans, or that their occurrence automatically modulates SPE-mediated learning. Rather, TPEs drive improved action selection, that is, the selection of verbally-sensitive, volitional strategies that reduce future errors. Moreover, we find that exposure to SPEs is necessary and sufficient to trigger implicit recalibration. When SPE-mediated implicit learning and TPE-driven improved action selection combine, performance gains are larger. However, when actions are always successful and strategies are not employed, refinement in behaviour is smaller. Flexibly weighting strategic action selection and implicit recalibration could thus be a way of controlling how much, and how quickly, we learn from errors.
The impact of quality management practices on innovation: an empirical research study of Brazilian manufacturing companies
Authors: Gambi Lillian Do Nascimento , Lizarelli Fabiane Letícia , Junior Alex Ribeiro Rosa , Boer Harry
Published: November 2020

Purpose

The aim of this study is to investigate the effects of soft and hard quality management (QM) practices on innovation performance, considering innovation practices as a contextual variable mediating this relationship.

Design/methodology/approach

Using data from 132 Brazilian manufacturing companies, partial least square–structural equation modeling (PLS–SEM) is employed to test if soft and hard QM practices, directly, affect innovation practices and, indirectly, innovation performance. This investigation also aims to identify whether the relationships are maintained regardless of the size of the company.

Findings

The results suggest that soft QM has a positive effect on hard QM. However, only soft QM, not hard QM, has a significant effect on innovation practices. Additionally, soft QM has a significant positive effect on innovation performance through innovation practices. Company size does not influence the relationships.

Practical implications

The findings can help managers to adjust their managerial practices to enhance the effective impact of QM on innovation performance.

Originality/value

The previous literature presents conflicting results on the relationship between QM and innovation performance. Most studies have proposed a direct relationship between both constructs. This study considers innovation practices as a mediator in this relationship. Furthermore, this paper adds to the scarce literature reporting related studies conducted in developing countries.
Flash flood hazard mapping based on AHP with GIS and satellite information in Kampong Speu Province, Cambodia
Authors: Koem Chhuonvuoch , Tantanee Sarintip
Published: November 2020

Purpose

Cambodia is considered one of the countries that are most vulnerable to adverse effects of climate change, particularly floods and droughts. Kampong Speu Province is a frequent site of calamitous flash floods. Reliable sources of flash flood information and analysis are critical in efforts to minimize the impact of flooding. Unfortunately, Cambodia does not yet have a comprehensive program for flash flood hazard mapping, with many places such as Kampong Speu Province having no such information resources available. The purpose of this paper is, therefore, to determine flash flood hazard levels across all of Kampong Speu Province using analytical hierarchy process (AHP) and geographical information system (GIS) with satellite information.

Design/methodology/approach

The integrated AHP–GIS analysis in this study encompasses ten parameters in the assessment of flash flood hazard levels across the province: rainfall, geology, soil, elevation, slope, stream order, flow direction, distance from drainage, drainage density and land use. The study uses a 10 × 10 pairwise matrix in AHP to compare the relative importance of each parameter and find each parameter’s weight. Finally, a flash flood hazard map is developed displaying all areas of Kampong Speu Province classified into five levels, with Level 5 being the most hazardous.

Findings

This study reveals that high and very high flash flood hazard levels are identified in the northwest part of Kampong Speu Province, particularly in Aoral, Phnum Srouch and Thpong districts and along Prek Thnot River and streams.

Originality/value

The flash flood hazard map developed here provides a wealth of information that can be invaluable for implementing effective disaster mitigation, improving disaster preparedness and optimizing land use.
The role of specific heritage among Hispanic-owned banks in America
Authors: Kashian Russ , Kamal Rashiqa , Xue Yuhan
Published: November 2020

Purpose

Specific types of Hispanic-owned banks (HOBs), including those related to Brazilian, Cuban, Mexican or Puerto Rican heritage, have not be analyzed to date. There are important differences between the relevant communities, including geographic location, language barriers, population size and the importance of remittances to foreign nations. The analysis here sheds light on these differences.

Design/methodology/approach

HOBs with the Federal Deposit Insurance Corporation (FDIC)-designated minority-owned depository institution (MDI) designation are identified, along with bank ownership heritage. Financial data, a measure of market competition, and demographics of depositors from 2003 to 2017 are utilized in an exploratory analysis comparing banks by HOB type, with random effects regressions for the pre-collapse (2003–2006) and post-collapse (2009–2017) periods.

Findings

Although each of the four types of HOBs serve Hispanic and poor communities, there are substantial differences. For example, Brazilian and Puerto Rican banks on the island held high levels of nonperforming loans (NPLs) post-collapse, with the Brazilian and Mexican banks expanding levels of risky commercial real estate (CRE) lending post-collapse, while the Cuban banks contracted CRE lending. Differences in terms of return on assets (ROAs), the cost of borrowed funds and the tier-1 risk-based capital ratio are also identified.

Social implications

HOBs, like Latinos in the USA, are culturally heterogeneous and likely operate in different ways depending upon the culture and economic circumstances of the communities where they operate.

Originality/value

Although there is substantial research on MDIs, this is the first analysis which treats HOBs as culturally heterogeneous. Further research of this type is warranted.
Savanna hypothesis in the human–urban nature relationship
Authors: Hartsell Angela Marie
Published: November 2020

Purpose

This paper expounds theoretical reasons behind and practical applications of urban natural space as part of the ontological whole of the city.

Design/methodology/approach

In this paper, nonsecular and secular relationships between humans and nature are explored from an ontological perspective.

Findings

The characteristics of the savanna hypothesis are shown to be tectonic elements that have been used historically in human-defined landscapes and can be implemented in urban planning and design to enhance urban green spaces and improve the overall quality of urban life.

Social implications

The human–nature relationship has morphed and adapted as civilizations and their belief systems have grown and fallen aside. The human–nature relationship has affected the form of cities while human development and technological advancements have affected nature’s representation in the urban realm. Throughout the periods of nonsecular affection for nature and secular applications of nature, one theme has persisted: human innate preference for certain arrangements of certain natural elements. Though existing long before the first human settlements were formed, the savanna hypothesis was not coined until the 20th century.

Originality/value

Ultimately, the savanna hypothesis is exhibited as a joining concept that connects nonsecular affection for nature to secular qualities of urban nature and natural infrastructure.
Examining the effects of workplace well-being and high-performance work systems on health harm: a Sustainable HRM perspective
Authors: Chillakuri Bharat , Vanka Sita
Published: November 2020

Purpose

This paper aims to provide an empirical investigation into the mediating role of high-performance work systems (HPWS) on health harm (HH). The study also examines the negative moderated role of workplace well-being (WW) and its indirect effect on work intensification (WI) and HH. The paper highlights the implications of the HH on individuals, organizations, families and societies and recognizes the need for sustainable human resource management (HRM) practices that drive employee well-being, thereby reducing the HH. More importantly, the study extends the understanding of sustainable goals through sustainable HRM.

Design/methodology/approach

Data was collected using four established scales. The data collected from 324 executives were analyzed using the SPSS 25.0 Version and AMOS 21.0.

Findings

The study results confirmed that WW practices reduce the adverse effects arising out of HPWS and WI. The results proved that WI is positively related to HH, and that WW moderates the relationship between HPWS and HH such that HPWS is more positively associated with HH when the WW is low compared to when WW is high.

Research limitations/implications

The data were collected from executives working in Information Technology (IT) organizations in India. The findings and the implications may not be generalized to other industries, as the data is collected from IT professionals.

Practical implications

The study highlights the need for organizations to develop sustainable HRM practices to minimize the HH of work. Organizations should implement well-being interventions and develop activities that promote an individual’s mental and physical well-being alongside limiting work intensity.

Originality/value

HRM Literature reveals the positive effect of HPWS that it engages employees to achieve a competitive advantage to the firm. However, this study examines and empirically proves the negative impact of HPWS on employee health and well-being.