bluuebunny/crossref_metadata_2025 huggingface dataset:
Perspectives of Adult Rheumatologists Regarding Family Planning Counseling and Care: A Qualitative Study
Authors: Birru Talabi Mehret , Clowse Megan E. B. , Blalock Susan J. , Hamm Megan , Borrero Sonya
Published: March 2019

Objective

Little is known about whether and how rheumatologists provide family planning counseling and reproductive health care (FPCC) to reproductive‐age women with rheumatic diseases. This qualitative study sought to assess rheumatologists’ perspectives, attitudes, and practices regarding FPCC.

Methods

Semistructured interviews were conducted with a geographically diverse US sample of rheumatologists (n = 12). Interviews were transcribed verbatim, and a code book was inductively developed based on transcript content. Two coders applied the code book to all transcripts, and coding differences were adjudicated to full agreement. The finalized coding was used to conduct a thematic analysis.

Results

Six themes were identified across interviews. Rheumatologists said that they 1) feel responsible for providing some FPCC to patients, 2) experience tension between respecting patients’ autonomy and their own anxieties about managing high‐risk pregnancies, 3) view patient‐initiated conversations as FPCC facilitators, and they regard lack of guidelines and the presence of competing clinical priorities as barriers to FPCC, 4) are reluctant to prescribe contraception, 5) desire greater access to resources to help guide FPCC, and 6) recognize the benefits of multidisciplinary collaboration with gynecologists.

Conclusion

Rheumatologists feel a sense of responsibility to provide some aspects of FPCC to reproductive‐age female patients. However, their own apprehensions about managing complicated pregnancies may negatively influence how they advise patients about pregnancy planning or avoidance. Rheumatologists do not prescribe contraception but rarely refer patients to gynecologists for contraceptive care. Future work should focus on eliminating barriers and identifying solutions that support rheumatologists’ efforts to provide high‐quality FPCC to patients.
Sex Differences in the Achievement of Remission and Low Disease Activity in Rheumatoid Arthritis
Authors: Maynard Carson , Mikuls Ted R. , Cannon Grant W. , England Bryant R. , Conaghan Philip G. , Østergaard Mikkel , Baker Daniel G. , Kerr Gail , George Michael D. , Barton Jennifer L. , Baker Joshua F.
Published: March 2019

Objective

In rheumatoid arthritis, whether women are less likely to achieve low disease activity is unclear. We evaluated sex differences in remission and low disease activity, comparing different clinical and imaging measures.

Methods

We used data from the Veterans Affairs Rheumatoid Arthritis (VARA) registry and from 2 clinical trials. Remission and low disease activity were defined using composite scores, individual items (tender joints, swollen joints, erythrocyte sedimentation rate [ESR], C‐reactive protein [CRP] level, and evaluator/patient global assessment), and magnetic resonance imaging (MRI). In the VARA registry, we assessed the likelihood of point remission at any time during follow‐up using logistic regression, and time to sustained remission (2 consecutive visits) using Cox proportional hazards models. In the clinical trials, logistic regression models evaluated the likelihood of low clinical and MRI activity at 52 weeks.

Results

Among 2,463 patients in VARA, women (10.2%) were less likely to be in Disease Activity Score in 28 joints (DAS28)–ESR remission in follow‐up (odds ratio [OR] 0.71 [95% confidence interval (95% CI) 0.55–0.91]; P < 0.01) and had a longer time to sustained DAS28‐ESR remission. This difference was not observed for DAS28‐CRP, Clinical Disease Activity Index, or Routine Assessment of Patient Index Data 3. Women were more likely to achieve favorable individual components except for an ESR <30 mm/hour (OR 0.72 [95% CI 0.57–0.90]; P < 0.01). Among 353 trial participants (83.7% women), women had reduced rates of DAS28‐ESR remission (OR 0.39 [95% CI 0.21–0.72]; P = 0.003) but similar rates of low MRI synovitis and osteitis.

Conclusion

The comparison of remission rates between men and women varies based on the disease activity measure, with sex‐specific differences in ESR resulting in reliably lower rates of remission among women. There were no differences in MRI measures.
Development of a Modified Psoriatic Arthritis Disease Activity Score Using the Medical Outcomes Study Short Form 12 as a Measure of Quality of Life
Authors: Perruccio Anthony V. , Got Matthew , Li Suzanne , Ye Yang , Gladman Dafna D. , Chandran Vinod
Published: March 2019

Objective

The Psoriatic Arthritis Disease Activity Score (PASDAS) is a composite measure of psoriatic arthritis (PsA) disease activity. The length of its patient‐reported components raises concern about questionnaire burden. The PASDAS includes the Medical Outcomes Study Short Form 36 (SF‐36) health survey. We undertook this study to investigate the agreement between the PASDAS and a modified PASDAS (mPASDAS), which substituted the SF‐36 with the shortened SF‐12.

Methods

A total of 100 patients who fulfilled the criteria of the Classification of Psoriatic Arthritis Study Group for PsA were consecutively recruited. All of the PASDAS‐required variables were collected. The 12 item responses for SF‐12 were extracted from the SF‐36 questionnaire. The PASDAS and the mPASDAS were calculated using the SF‐36 and SF‐12 scores, respectively. A Bland‐Altman plot of the mean differences in PASDAS and mPASDAS scores was generated to evaluate agreement. Construct validity was assessed by examining correlations of the PASDAS and the mPASDAS with the Health Assessment Questionnaire, the Functional Assessment of Chronic Illness Therapy–Fatigue subscale, the EuroQol 5‐domain instrument (health‐related quality of life), and pain scores (range 0–10, visual analog scale). The kappa statistic was used to measure agreement between disease activity states as determined by the PASDAS and mPASDAS.

Results

The mean ± SD PASDAS and mPASDAS was 3.29 ± 1.39 and 3.24 ± 1.27, respectively. The correlation between the 2 scores was 0.998 (P < 0.0001), and the mean difference was –0.05 (95% confidence interval [95% CI] –0.07, –0.03). Construct validity was found, with nearly identical correlations of the PASDAS and mPASDAS with each of the external health measures. The misclassification rate with the mPASDAS was only 6%. The weighted κ = 0.90 (95% CI 0.82, 0.97).

Conclusion

The mPASDAS may replace the PASDAS in disease activity assessment given the excellent agreement, validity, and low misclassification rate.
Increased Incidence of Resistant Hypertension in Patients With Systemic Lupus Erythematosus: A Retrospective Cohort Study
Authors: Gandelman Jocelyn S. , Khan Omair A. , Shuey Megan M. , Neal Jacquelyn E. , McNeer Elizabeth , Dickson Alyson , Barnado April , Wang Li , Anandi Prathima , Dupont William D. , Stein C. Michael , Chung Cecilia P.
Published: March 2019

Objective

To compare the risk of resistant hypertension (RHTN) in patients with systemic lupus erythematosus (SLE) and in controls without SLE, and to define factors associated with RHTN in patients with SLE.

Methods

We studied 1,044 patients with SLE and 5,241 control subjects using de‐identified electronic health records from a tertiary care center. SLE was defined as ≥4 International Classification of Diseases, Ninth Revision codes for SLE and antinuclear antibody titer ≥1:160. RHTN was defined as uncontrolled blood pressure on 3 antihypertensive medications or requiring 4 or more antihypertensives to attain control. First, we compared the risk of RHTN between groups. Second, we examined the association between RHTN and all‐cause mortality in patients with SLE.

Results

RHTN was nearly twice as prevalent in patients with SLE compared to control subjects (10.2% and 5.3%, respectively), with an incidence rate of 10.2 versus 6.1 cases per 1,000 person‐years of observation (hazard ratio [HR] 1.72 [95% confidence interval 1.28–2.30]; P < 0.001, adjusted for age, sex, race, baseline end‐stage renal disease [ESRD], creatinine, and calendar year). In patients with SLE, we found associations between RHTN and black race, lower renal function, hypercholesterolemia, and increased inflammatory markers. RHTN was associated with a significantly higher mortality risk (HR 2.91, P = 0.0005) after adjustment for age, sex, race, calendar year, creatinine, baseline ESRD, and number of visits.

Conclusion

Patients with SLE have a higher risk of RHTN compared to frequency‐matched controls, independent of multiple covariates. RHTN is an important comorbidity for clinicians to recognize in SLE, because it is associated with a higher risk of mortality.
Chemical Characterization of Euphorbia heterophylla L. Essential Oils and Their Antioxidant Activity and Allelopathic Potential on Cenchrus echinatus L.
Authors: Elshamy Abdelsamed I. , Abd‐ElGawad Ahmed M. , El Gendy Abd El‐Nasser G. , Assaeed Abdulaziz M.
Published: March 2019

The genus Euphorbia attracted the attention of many researchers worldwide from natural products, bioactivity, and ecological perspective. The essential oils (EOs) of Euphorbia heterophylla are poorly studied. Therefore, the present study aimed to provide a detailed profile of the E. heterophylla EOs as well as to determine their antioxidant and allelopathic activities. The EOs from aerial parts of E. heterophylla were extracted using hydrodistillation and analyzed via GC/MS. The antioxidant activity was determined based on scavenging of the free radical, 1,1‐diphenyl‐2‐picrylhydrazyl and H2O2. Various concentrations of the EOs were tested against the noxious weed, Cenchrus echinatus. Thirty‐five compounds were identified representing 100 % of the total mass. Four classes of components were characterized, among which terpenoids were the main components (88.70 %). Monoterpenes represented the main class (69.48 %), followed by sesquiterpenes (18.63 %), and only one diterpenoid, kaur‐16‐ene, was identified. 1,8‐Cineole (32.03 %), camphor (16.54 %), β‐elemene (5.92 %), endo‐borneol (4.94 %), limonene (4.27 %), pentatriacontane (3.91 %), and α‐pinene (3.89 %) were the major compounds. The EOs composition of Egyptian E. heterophylla ecospecies was comparable to that of other reported Euphorbia species, although it showed no correlation with Nigerian E. heterophylla ecospecies. The EOs from E. heterophylla aerial parts exhibited significant antioxidant activity. Moreover, a concentration of 100 μL L−1 of the EOs reduced the germination, root, and shoot growth of C. echinatus by about 93.95 %, 84.6 %, and 57.8 %, respectively. Therefore, the EOs from E. heterophylla could be integrated into the control of this weed, as eco‐friendly biocontrol method. Further study is needed to characterize their allelopathic activity under field conditions as well as to evaluate their durability and biosafety.
“Click” Silica‐Supported Sulfonic Acid Catalysts with Variable Acid Strength and Surface Polarity
Authors: Kasinathan Palraj , Lang Charlotte , Radhakrishnan Sambhu , Schnee Josefine , D'Haese Cécile , Breynaert Eric , Martens Johan A. , Gaigneaux Eric M. , Jonas Alain M. , Fernandes Antony E.
Published: March 2019

Solid acid catalysts are central in our chemical industry and are major players in the valorization of bioresources. However, there is still a need to develop solid acid catalysts with enhanced acid strength and improved, or tunable, physicochemical profile to enhance the efficiency and sustainability of chemical processes. Here, a modular approach to tune the acid strength and surface polarity of silica‐supported sulfonic acid catalysts, based on a versatile copper‐catalyzed azide–alkyne cycloaddition (CuAAC)‐based anchoring scheme, is presented. The CuAAC‐formed triazole link was used to enhance the activity of the grafted sulfonic acids and to pair the acid sites with secondary hydrophobic functions. The beneficial effects of both the triazolium link and the paired hydrophobic site, as well as the optimal positioning of the sulfonic moiety on the triazole ring, are discussed in model esterification reactions.
3D Heterocycles from Sulfonimidamides by Sequential C−H Bond Alkenylation/Aza‐Michael Cyclization
Authors: Bachon Anne‐Katrin , Hermann Alina , Bolm Carsten
Published: March 2019

Starting from NH‐sulfonimidamides, rhodium‐catalyzed C−H bond alkenylation followed by aza‐Michael cyclization leads to unprecedented benzoisothiazole 1‐oxides. The applicability and robustness of the method is demonstrated in 25 examples with yields up to 95 %. The resulting scaffolds are partly saturated, 3D heterocycles with potential significance for medicinal and agricultural chemistry.
Back Cover: Electrochemical Radical Borylation of Aryl Iodides (Chin. J. Chem. 4/2019)
Authors: Hong Junting , Liu Qianyi , Li Feng , Bai Guangcan , Liu Guoquan , Li Man , Nayal Onkar S. , Fu Xuefeng , Mo Fanyang
Published: March 2019

The back cover picture shows an electrochemical strategy for the borylation of aryl iodides via a radical pathway using current as a driving force. This method features mild reaction conditions, good functional groups tolerance, and prompt reaction time. EPR, CV and DPV experiments verified the formation of aryl radicals in this electrochemical borylation reaction, and the current plays an important role in the generation of radical intermediate. More details are discussed in the article by Mo et al. on page 347–351.

image
Assessing Blood Clotting and Coagulation Factors in Mice
Authors: Brake Marisa A. , Ivanciu Lacramioara , Maroney Susan A. , Martinez Nicolas D. , Mast Alan E. , Westrick Randal J.
Published: March 2019

The mammalian blood coagulation system was designed to restrict blood loss due to injury as well as keep the blood fluid within the blood vessels of the organism. Blood coagulation activity in inbred mouse strains varies widely among strains, suggesting that many genomic variants affect hemostasis. Some of these molecules have been discovered and characterized; however, many are still unknown. Genetically modified mouse technologies are providing a plethora of new mouse models for investigating the regulation of blood coagulation. Here we provide a protocol for the tail bleeding time as a primary assessment of in vivo blood coagulation, as well as in vitro methods such as the prothrombin time, activated partial thromboplastin time, and thrombin generation assay. We also provide protocols for the assessment of the activities of specific known factors involved in blood coagulation. © 2019 by John Wiley & Sons, Inc.
Synthesis and Characterization of Ag‐Delafossites AgBO2 (B: Al, Ga, In) from a Rapid Hydrothermal Process
Authors: Zwiener Leon , Jones Travis , Wolf Elisabeth Hannah , Girgsdies Frank , Plodinec Milivoj , Klyushin Alexander Yu. , Willinger Elena , Rosowski Frank , Schlögl Robert , Frei Elias
Published: March 2019

A single‐step rapid hydrothermal low‐temperature process for the formation of high purity polycrystalline Ag‐based delafossite oxides 3R‐AgBO2 (B: Al, Ga, In) is reported. For the synthesis process reusable and widely available PTFE‐lined pressure vessels are used. The presence of an elemental Ag by‐phase is traced back to the metastability of the Ag‐delafossite under the reaction conditions. High‐purity products were obtained by decreasing the synthesis time requirements by up to 90 %. The effect of the isoelectronic B‐site atoms on the structure and bonding situation were comparatively studied experimentally and by ab‐initio calculations. Distorted coordination environments are observed in all cases, and the nature of the chemical bond changes qualitatively along the series of group 13 B‐site atoms Al, Ga, and In. This is reflected in systematic changes of the (optical) band gap, the contactless conductivity, the thermal stability, and the energetic position of Raman modes, which are strongly affected and decrease with increasing atomic number. The establishment of a facile synthesis strategy allows the application of these Ag‐delafossite systems in many disciplines, i.e. in heterogeneous catalysis and as optoelectronic devices.
Exploring perceptions, motivations, and practices regarding outsourcing support services by general hospitals in Uganda: A mixed methods study
Authors: Mujasi Paschal N. , Nkosi Zerish Z.
Published: March 2019

Research on outsourcing in a developing country using a mixed methods approach can provide insights on outsourcing decisions and practices. This study investigated motivations, practices, perceived benefits, and barriers to outsourcing by general hospitals in Uganda.

An explanatory sequential mixed methods design was used. Quantitative data were collected using a self‐administered questionnaire from managers in 32 randomly selected hospitals. Qualitative data were latter collected from eight purposively selected managers using an interview guide. Quantitative data were statistically analyzed using SAS 9.3. Qualitative data were managed using ATLAS ti 7 and coded manually, and content analysis was conducted.

Quantitative findings indicate that outsourcing of support services was prevalent (72% of hospitals). The key motivation for outsourcing was to gain access to quality service (68%). Limited availability of service providers was a key challenge during outsourcing (57%). Managers perceive improved productivity and better services as key benefits of outsourcing (90%). The main barrier to outsourcing is limited financing. These findings were confirmed and explained by the qualitative data.

Findings and recommendations from this study are critical in developing interventions to encourage effective outsourcing by hospitals in Uganda and other developing countries.
Globalization and women's HIV
Authors: Kim Yiyeon
Published: March 2019

Women's HIV has been a significant issue for decades. While economic integration has increased, little research has investigated the effects of globalization on women's HIV rate. This study argues that trade and FDI have differently affected women's HIV: While larger volume of trade has had the effect of decreasing female labor participation, thus increasing women's HIV rate, greater FDI inflows have worked to increase female labor participation, thereby decreasing women's HIV rate according to pooled time‐series cross‐sectional data of 89 developing countries. These findings suggest that globalization has both negative and positive effects on women's economic status and their health and that more research should be conducted into how economic integration affects marginalized populations such as children or people with low incomes.
The importance of sewage effluent discharge in the export of dissolved organic carbon from U.K. rivers
Authors: Worrall Fred , Howden Nicholas J.K. , Burt Tim P. , Bartlett Rebecca
Published: March 2019

The flux of fluvial carbon from the terrestrial biosphere to the world's oceans is known to be an important component of the global carbon cycle, but within this pathway, the flux and return of carbon to the river network via sewage effluent has not been quantified. In this study, monitoring data from 2000 to 2016 for the dissolved organic carbon (DOC) concentration, biochemical oxygen demand, and chemical oxygen demand of the final effluent of sewage treatment works from across England were examined to assess the amount of DOC contributing to national‐scale fluvial fluxes of carbon. The study shows that the median concentration of DOC in final effluent was 9.4 compared with 4.8 mg C/L for all surface waters for the United Kingdom over the study period and that the DOC in final effluent significantly declined over the study period from 11.0 to 6.4 mg C/L. Rivers receiving sewage effluent showed a significant, on average 19%, increase in DOC concentration downstream of sewage discharges. At the scale of the United Kingdom, the flux of DOC in final effluent was 31 ktonnes C/year with a per capita export of 0.55 kg C/year and compared with an average annual flux of DOC from the United Kingdom of 859 ktonnes C/year, that is, only 3.6% of national‐scale flux. The lability of this DOC was limited, with only 7.4% loss of final effluent DOC concentration over in‐stream residence times of up to 5 days. The direct decline in DOC concentration from sewage treatment works was not large enough on its own to explain the declines observed in DOC concentration in U.K. rivers at their tidal limit.
Denosumab Treatment Improved Health‐Related Quality of Life in Osteoporosis: A Prospective Cohort Study
Authors: Hayashi Shinya , Fukuda Koji , Maeda Toshihisa , Chinzei Nobuaki , Kihara Shinsuke , Miura Yasushi , Sakai Yoshitada , Hashimoto Shingo , Matsumoto Tomoyuki , Takayama Koji , Niikura Takahiro , Kuroda Ryosuke
Published: March 2019

Improving patient health‐related quality of life (HRQOL) and prevention of bone fracture are important components of the treatment of osteoporosis. Our aim in this study was to evaluate the effect of denosumab treatment in improving HRQOL among patients with osteoporosis. Our analysis was based on 332 patients with osteoporosis, followed for 24 months. All patients received denosumab (60 mg) subcutaneously every 6 months. Bone mineral density (BMD) was assessed at the distal radius, with serum concentration of calcium, phosphate, P1NP, and TRACP5b also measured. HRQOL assessment included pain (visual analogue scale [VAS]) and the EQ‐5D questionnaire. A multivariate analysis was performed to identify the possible confounders associated with deterioration in the EQ‐5D utility score in response to denosumab treatment. Denosumab treatment yielded a 3.4% increase in BMD at 24 months. Serum levels of TRACP5b and P1NP decreased significantly, from baseline, at 6 months, with no effect on calcium and phosphate levels. Pain VAS and EQ‐5D utility score improved significantly, from baseline, at 6 months, with the EQ‐5D utility score correlating with the BMD at all time points of measurement over the 24‐month period of observation. Knee osteoarthritis and multiple comorbidities were significantly associated with a worse HRQOL in response to denosumab treatment. Denosumab treatment increased BMD, with improvements in BMD correlating with improved HRQOL, supporting a possible benefit of using denosumab for the treatment of osteoporosis. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.
Immune and cytokine/chemokine responses of PBMCs in rotavirus‐infected rhesus infants and their significance in viral pathogenesis
Authors: Zhou Yan , Qiao Hongtu , Yin Na , Chen Linlin , Xie Yuping , Wu Jinyuan , Du Jing , Lin Xiaochen , Wang Yi , Liu Yang , Yi Shan , Zhang Guangming , Sun Maosheng , He Zhanlong , Li Hongjun
Published: March 2019

The rotavirus (RV) is the most important causative agent of severe gastroenteritis in infants and children aged less than 5 years worldwide. However, the response and the roles of peripheral blood mononuclear cell (PBMC) in RV clearance have yet to be fully elucidated. In this study, we established the neonatal rhesus monkey model of RV infection with histopathological changes in the small intestine. Then, we investigated gene expression changes in PBMCs from the monkey model of RV infection. Similar pathways regulated in rhesus monkeys that received intragastric administration of the RV monkey SA11 strain (G3P[2]) and the human wild‐type strain ZTR‐68 (G1P[8]). Gene profiling showed differences in functional genes mainly associated with chemokine signaling pathways and cytokine‐cytokine receptor interactions post RV infection. Transferrin and C‐C motif chemokine ligand 23 (CCL23) gene expression were upregulated in PBMCs of monkeys when stimulated by simian and human RV strains. Monkeys infected with RV had an enhanced and prolonged inflammatory response that was associated with increased levels of CCL20, CCL23, and C‐X‐C motif chemokine ligand 1; while inhibition of major histocompatibility complex class I expression may be important for immune evasion by RV. The RV infection was also characterized by pathological changes in the small intestine with a cytokine and chemokine storm. This study identified the chemokine signaling pathway and immune response genes involved in RV infection in infant rhesus monkeys. The SA11 RV strain is more suitable for establishing a monkey diarrhea model than the ZTR‐68 RV strain.
Cluster adjacency and the four-loop NMHV heptagon
Authors: Drummond James , Foster Jack , Gürdoğn Ömer , Papathanasiou Georgios
Published: March 2019

Abstract

We exploit the recently described property of cluster adjacency for scattering amplitudes in planar

$$ \mathcal{N}=4 $$

N
=
4

super Yang-Mills theory to construct the symbol of the four-loop NMHV heptagon amplitude. We use a manifestly cluster adjacent ansatz and describe how the parameters of this ansatz are determined using simple physical consistency requirements. We then specialise our answer for the amplitude to the multi-Regge limit, finding agreement with previously available results up to the next-to-leading logarithm, and obtaining new predictions up to (next-to)3-leading-logarithmic accuracy.
E9 exceptional field theory. Part I. The potential
Authors: Bossard Guillaume , Ciceri Franz , Inverso Gianluca , Kleinschmidt Axel , Samtleben Henning
Published: March 2019

Abstract

We construct the scalar potential for the exceptional field theory based on the affine symmetry group E
9. The fields appearing in this potential live formally on an infinite-dimensional extended spacetime and transform under E
9 generalised diffeomorphisms. In addition to the scalar fields expected from D = 2 maximal supergravity, the invariance of the potential requires the introduction of new constrained scalar fields. Other essential ingredients in the construction include the Virasoro algebra and indecomposable representations of E
9. Upon solving the section constraint, the potential reproduces the dynamics of either eleven-dimensional or type IIB supergravity in the presence of two isometries.
Holographic entanglement entropy from probe M-theory branes
Authors: Rodgers Ronnie
Published: March 2019

Abstract

We compute the holographic entanglement entropy contribution from planar two-dimensional defects in six-dimensional

$$ \mathcal{N}=\left(2,0\right) $$

N
=

2
0

superconformal field theory, holographically dual to probe M2- and M5-branes in AdS
7 × S
4. In particular, we test the viability of the universal contribution of the defect to entanglement entropy as a candidate C-function. We find that this coefficient is not monotonic under defect renormalization group flows triggered by the vacuum expectation value of a marginal operator. Another candidate C-function, the on-shell action inside the entanglement wedge, monotonically decreases under the flows we study.
Impact Of Vulvovaginal Atrophy Of Menopause In Spanish Women: Prevalence And Symptoms According To The EVES Study
Authors: Palacios Santiago , González Silvia P. , Fernández-Abellán Micaela , Manubens Montserrat , García-Alfaro Pascual , Prieto C.Argudo , Mainar L.Baquedano , Abu-Amshah J.Calleja , Hidalgo M.J.Cancelo , Castelo-Branco i Flores C. , Martin P.Coronado , Rancel M.Correa , Abellán M.Fernández , Moya J.M.Fernández , Alfaro P.García , Fernández M.González , Rodríguez S.González , Bravo E.Iglesias , Coto P.Llaneza , Grau M.Manubens , Sánchez P.Marín , Ladrón de Guevara N.Mendoza , García-Ramos B.Otero , Palacios S. , Lorite J.C.Presa , Borrego R.Sánchez , Méndez S.Sánchez , Fernández F.Vázquez
Published: March 2019

Introduction

The prevalence of menopausal women with confirmed vulvovaginal atrophy (VVA) oscillates between 67–98%.

Aim

To assess the prevalence of postmenopausal women with VVA confirmed by gynecologic clinical assessment among all women attending menopause centers in Spain, as well as to describe the impact of VVA on quality of life and sexual functioning.

Methods

Women aged 45–75 years old with the last menstrual period >12 months before were included in a cross-sectional study.

Main Outcome Measures

Women with ≥1 VVA symptoms filled out a number of questionnaires, including EuroQoL, Day-to-Day Impact of Vaginal Aging, Female Sexual Function Index, and Female Sexual Distress Scale-revised. A gynecologic examination was performed to confirm diagnosis.

Results

1,177 evaluable patients were included. VVA was confirmed in 87.3% of the patients. Almost 80% of women who acknowledged being sexually active (n = 717) presented pain during intercourse. As compared with patients without confirmed VVA (n = 66), patients with confirmed VVA (n = 1,028) were significantly older (P < .0001), had lower rates of sexual activity (P < .05), and used more VVA treatments (P < .05). Severe vaginal atrophy and severe vulvar atrophy were more prevalent in VVA-confirmed women (P < .0001, in both cases). No differences regarding the confirmation of VVA were observed for EuroQoL and Day-to-Day Impact of Vaginal Aging quality-of-life questionnaires. Sexual function measured through the Female Sexual Function Index score was significantly reduced in sexually-active patients with confirmed VVA (P < .05).

Conclusion

VVA signs and symptoms are highly prevalent in Spanish postmenopausal women. Confirmation of VVA diagnosis was associated with impaired sexual function. The early recognition of VVA symptoms should be actively promoted in medical practice, instead of waiting until signs appear to exclude other reasons for VVA and to manage treatment effectively.
Why Does Amazon Precipitation Decrease When Tropical Forests Respond to Increasing CO2?
Authors: Langenbrunner B. , Pritchard M. S. , Kooperman G. J. , Randerson J. T.
Published: March 2019

Earth system models predict a zonal dipole of precipitation change over tropical South America, with decreases over the Amazon and increases over the Andes. Much of this has been attributed to the physiological response of the rainforest to elevated CO2, which describes a basin‐wide reduction in stomatal conductance and transpiration. While robust in Earth system model experiments, details of the underlying atmospheric mechanism—specifically how it evolves in the context of land‐atmosphere interaction and the diurnal cycle—are unresolved. We investigate this using idealized model simulations and find that within 24 hr of a CO2 increase, changes occur over the Amazon that engender synoptic timescale feedbacks. Decreased evapotranspiration from the rainforest throttles near‐surface moisture, inducing a drier, warmer, and deeper boundary layer. Above this, enhanced turbulent diffusivity increases vapor in the lower free troposphere. Together, these processes reduce convective activity and cause immediate decreases in Amazon rainfall. Over the synoptic timescale, these changes leave behind lower tropospheric moisture, which is advected westward by the background jet and increases Andean precipitation. This produces a dipole of precipitation change consistent across global and regional models as well as parameterized and resolved convection, though details are sensitive to model topography and boundary layer formulation. The mechanism reported here stresses the importance of fast timescale processes affecting stability over a period of hours that can influence longer‐term vegetation‐climate interactions. These results help clarify the Amazon's physiological response to rising CO2 and provide insight into possible causes of historical model biases and end‐of‐century uncertainty in this region.
Geodetic Evidence That Mercury Has A Solid Inner Core
Authors: Genova Antonio , Goossens Sander , Mazarico Erwan , Lemoine Frank G. , Neumann Gregory A. , Kuang Weijia , Sabaka Terence J. , Hauck Steven A. , Smith David E. , Solomon Sean C. , Zuber Maria T.
Published: March 2019

Geodetic analysis of radio tracking measurements of the MErcury Surface, Space ENvironment, GEochemistry, and Ranging spacecraft while in orbit about Mercury has yielded new estimates for the planet's gravity field, tidal Love number, and pole coordinates. The derived right ascension (α = 281.0082° ± 0.0009°; all uncertainties are 3 standard deviations) and declination (δ = 61.4164° ± 0.0003°) of the spin pole place Mercury in the Cassini state. Confirmation of the equilibrium state with an estimated mean (whole planet) obliquity ϵ of 1.968 ± 0.027 arcmin enables the confident determination of the planet's normalized polar moment of inertia (0.333 ± 0.005), which indicates a high degree of internal differentiation. Internal structure models generated by a Markov Chain Monte Carlo process and consistent with the geodetic constraints possess a solid inner core with a radius (ric) between 0.3 and 0.7 that of the outer core (roc).
Tropical Cyclone Heat Potential and the Rapid Intensification of Hurricane Harvey in the Texas Bight
Authors: Potter Henry , DiMarco Steven F. , Knap Anthony H.
Published: March 2019

Harvey entered the Gulf of Mexico as a tropical depression on 23 August 2017; two days later it had strengthened to a category 1 hurricane. Over the following 30 hr Harvey rapidly intensified, reaching the Texas Bight as a category 3 storm. This intensification continued while Harvey crossed the shelf, making landfall as a category 4 storm 60 km east of Corpus Christi, TX on 26 August. A hydrographic survey two weeks prior to landfall shows that the tropical cyclone heat potential across the Texas Bight was approximately 35 kJ/cm2, which is 55 kJ/cm2 less than the amount of upper ocean heat normally associated with intensification. Combined with buoy, float, and satellite data, we use hydrographic surveys to study the conditions of the Texas Bight that contributed to Harvey's rapid intensification. We find that, at the time of landfall, the Texas Bight was well mixed with very warm water extending from the surface to bottom. As a consequence, mixing induced by Harvey had a small impact on surface temperatures which remained high and supported continued intensification. The results show that tropical cyclone heat potential is not an effective metric for hurricane intensity prediction in shallow water, and illustrate the need for continuous subsurface monitoring in order to improve hurricane forecasts.
Comment on “Appropriate Boundary Condition for Dupuit‐Boussinesq Theory on the Steady Groundwater Flow in an Unconfined Sloping Aquifer With Uniform Recharge” by Wu et al.
Authors: Kong Jun , Sun Jie , Luo Zhaoyang , Shen Chengji , Hua Guofen , Lu Chunhui
Published: March 2019

By neglecting unsaturated flow, Wu et al. (2018, https://doi.org/10.1029/2018WR023070) claimed that the zero volumetric discharge at the upstream boundary results in two possible boundary conditions of either zero groundwater table or zero seepage velocity based on the original Dupuit‐Boussinesq theory. They further concluded that a steeper and/or shallower aquifer has a zero‐groundwater table if the downstream groundwater table is shallower. Here we point out that the conceptual model adopted by Wu et al. (2018) not reasonable and the results are quite different from those with unsaturated flow considered in the real hillslope aquifer. Specifically, the water table at the upstream boundary could be positive or negative due to the lateral unsaturated flow effect, and hence, the seepage velocity must be set to zero to satisfy the zero discharge boundary condition at the upstream boundary. In addition, the zero groundwater table cannot ensure a zero discharge at the upstream boundary. Furthermore, we argue that the discharge with respect to the groundwater table is linearly distributed along the slope distance only when both saturated and unsaturated flows are considered. The saturated flow discharge itself is not distributed linearly. Our comment highlights the importance of unsaturated flow in studying steady groundwater flow in an unconfined sloping aquifer with uniform recharge using the Dupuit‐Boussinesq theory.
Probing the Origin of a New Celestial Phenomenon
Authors: Cook Terri
Published: March 2019

The first statistical study of STEVE events suggests that the appearance of these narrow ribbons of light is closely correlated with violent disturbances in Earth’s magnetosphere.
Evaluating Operational Hydrodynamic Models for Real‐time Simulation of Evaporation From Large Lakes
Authors: Gronewold A. D. , Anderson E. J. , Smith J.
Published: March 2019

Methods for simulating evaporative water loss from Earth's large lakes have lagged behind advances in hydrodynamic modeling. Here we explore use of oceanographic models to simulate lake evaporation from a long‐term water balance perspective. More specifically, we compare long‐term monthly simulations of latent heat flux from two configurations of a current operational hydrodynamic forecasting system (based on the Finite Volume Community Ocean Model, or FVCOM) for the Laurentian Great Lakes. We then compare these simulations to comparable simulations from a legacy conventional lake thermodynamics model, and from a recently developed statistical water balance model. We find that one of the FVCOM configurations that is currently used in operations for short‐term hydrodynamic forecast guidance is also suitable for real‐time simulation of evaporation from very large lakes. The operational versions of FVCOM should therefore be considered a readily available tool for supporting regional water supply management and, pending further research, extended water supply forecasting.
Output consensus of high‐order linear multi‐agent systems with time‐varying delays
Authors: Jiang Xiangli , Xia Guihua , Feng Zhiguang
Published: March 2019

In this study, the problem of output consensus control for high‐order continuous‐time linear multi‐agent systems with interval time‐varying delays is investigated. The observability decomposition technique is employed to design the output consensus protocols which are the collections of delayed output information from neighbouring agents. On the basis of invertible transformations, output consensus for the concerned dynamical agents is transformed into the problem of asymptotical stability analysis for some lower dimensional subsystems. By introducing the prescribed convergence rate scalar into the constructed delay‐dependent Lyapunov functionals, the framework for output consensus analysis is theoretically derived. Benefitting from the method of slack matrix variables, sufficient conditions are obtained in terms of linear matrix inequalities to design the protocol gain matrices which can guarantee the property of output consensus. Moreover, the output consensus function determined merely by the initial states of dynamic agents and consensus protocol is presented without the influences of time‐varying delays. Numerical examples are exploited to illustrate the effectiveness of the derived results.
Distributed containment control of multi‐agent systems under asynchronous switching and stochastic disturbances
Authors: Liu Quanli , Zhou Tuo , Guo Shixin , Wang Zehua , Wang Dong , Wang Wei
Published: March 2019

Distributed containment control of multi‐agent systems with asynchronous switching and stochastic disturbances under a time‐invariant directed graph is studied. Since both the process of identifying an active subsystem and that of applying a matched controller to the corresponding subsystem need to consume time, the controller switching usually lags behind the subsystem switching. In order to show that the controllers are still effective to tolerate some time delay, a multiple Lyapunov function is selected to present stability conditions. By employing stochastic stabilisation theory and matrix transformation, the problem of containment control is transformed to that of stability analysis of the closed‐loop system and exponential stabilisation in mean square sense is achieved. Finally, two simulation examples are given to verify the effectiveness of the proposed results.
Investigating the impact of distributed energy resources on market power of strategic utility corporation
Authors: Chen Zhi
Published: March 2019

Market participants may employ potential market power improperly in energy trading. On the other hand, integrations of distributed energy resources (DER) are highly complex since it entails the optimal coordination of a diverse portfolio of DER under multiple sources of uncertainty. A large number of possible stochastic realisations that arise can lead to complex operational models that become problematic in real‐time market environments. Although recent works have explored the impacts of DER on numerous aspects of grid operation and planning, its role in imperfect competitive energy markets has not been investigated nonetheless. This article proposes the theoretical and quantitative analysis of the withholding strategies for the utility corporations with the integration of DERs for the first time and the corresponding market power effects on utility corporation's profits and market prices. The quantitative demonstration is supported by a bi‐level model with the optimal company profit for the upper level and the market clearing for the lower level. This bi‐level problem can be solved directly when a single‐level problem is obtained with a mathematical program with equilibrium constraints (MPEC). Numerical studies are implemented on a wholesale market with the day‐ahead horizon and hourly resolution.
State‐space modelling of an interconnected system of renewable energy sources and grid for rural electrification
Authors: Bhamu Swati , Bhatti Terlochan Singh
Published: March 2019

This study deals with the development of a state‐space model for an interconnected system of renewable energy sources (RES) with grid. The RES technologies considered for power generation in the interconnected system are doubly fed induction generator (DFIG) based wind energy conversion system and biogas genset. A linearised model for DFIG has been developed for the system. For biogas genset, the control of frequency and voltage is taken care by the electronic speed governor and IEEE type‐I excitation system, respectively. The interconnected system takes a fixed feed of power supply from the grid and the rest of the consumer load is taken care by the RES. Finally, state feedback controllers have been developed for this interconnected system which maintains the active and reactive power balance between different sources of RES when small signal perturbations are given in load and input wind power. The comparative analysis has also been performed with the conventional PI controllers in order to demonstrate the superiority of proposed feedback controllers for the interconnected power system.
Power factor adjustment and input current distortion mitigation for three‐phase unidirectional rectifier
Authors: Cheng Hong , Kong Jiayi , Wang Xihua , Wang Penghui , Chen Ting , Wang Cong
Published: March 2019

In order to improve the power quality, many researchers in the worldwide are committed to investigating the feasibility of integrating reactive power compensation (RPC) and harmonic current compensation (HCC) functionalities for unidirectional rectifier, while the capability of RPC for unidirectional rectifier is very limited. Hence, with the aim of enlarging the capability of RPC for unidirectional rectifier, this article introduces a versatile control strategy for three‐phase star‐connected unidirectional rectifier. The operating principle and the reasons that limit the capability of RPC for unidirectional rectifier are analysed in detail. On this basis, a novel criterion for judging input current distortion zone is proposed. Furthermore, the additional focus of this article is to quantify the constraint relationship between the degree of input current distortion compensation and input power factor regulating range. Simulations and experimental results are conducted to verify the feasibility and effectiveness of the proposed control strategy, as well as the correctness of the theoretical analysis on the proposed constraints of the input power factor regulation.
Temperature and trap distribution dependence of electrical tree growth characteristics in polypropylene/elastomer blends for recyclable cable insulation
Authors: Gao Yu , Li Jing , Han Tao , Yuan Yanqiu , Huang Shihao , Liu Yong
Published: March 2019

Polypropylene (PP)/elastomer blends as a promising cable insulation material have to face the challenge of electrical treeing which possibly leads to unexpected insulation failure. In this work, two types of elastomers, i.e. polyolefin elastomer and propylene‐based elastomer, have been blended into isotactic PP. Effects of the elastomer content and type on electrical treeing behaviours have been investigated under different ambient temperatures. Isothermal surface potential decay measurement has been performed to explore the influence of trap distribution on the treeing behaviour, scanning electron microscope and differential scanning calorimetry measurements were performed to characterise the structure of blends. It was found that with the increase of elastomer content, the trap energy level was reduced and the shallow trap density was increased, which resulted in the enhancement of the tree growth rate and the decrease in the breakdown time. With the temperature changing from 20 to 100°C, the growth rate tended to be increased except that an anomalous reduction in the rate occurred at 80°C. It is suggested that the compatibility between PP matrix and elastomer plays an important role in determining the morphology of blends, which in turn influences the trap distribution and the temperature dependent treeing behaviours.
Red Flags erkennen – Unsichtbarer Feind
Authors: Zalpour Christoff , von Piekartz Harry
Published: March 2019

Seit der Trennung von ihrem Freund klagt die 32-jährige Anne über morgendliche Kopfschmerzen, Parästhesien am Hinterkopf, Schwindel und verspannte Kiefermuskeln. Lange bleibt für ihren Hausarzt, die Psychologin und Physiotherapeut Professor Harry von Piekartz unklar, was die Symptome auslöst. Denn der Unruhestifter ist unsichtbar.
Mit Wasserflaschen die obere Extremität trainieren – Erfrischend einfach
Authors: Huber Martin , Horstmann Christine , Huber Martin
Published: March 2019

Reichen, greifen, manipulieren – drei elementare Aktivitäten, die Patienten mit neurologischen Erkrankungen häufig trainieren müssen. Durch alltagsnahes und intensives Üben können sie Schlüsselkomponenten wie die Handgelenkextension und die Flexion im Schultergelenk verbessern. Eine gute und einfache Therapie ist das Training mit Wasserflaschen.
Physiotherapie bei Arthrose – Was die Leitlinien empfehlen
Authors: Kemper Claudia
Published: March 2019

Möchte ein Physiotherapeut Patienten mit Arthrose evidenzbasiert behandeln, lohnt sich für ihn ein Blick in die internationalen Leitlinien. Sie empfehlen aktive Bewegungstherapie, begleitet von Manueller Therapie, Edukation und der Unterstützung des Patienten beim Selbstmanagement. Physiotherapeutin Dr. Claudia Kemper hat die wichtigsten Elemente zusammengetragen.
Neurologische Rehabilitation – Wohin geht die
Reise?
Authors: Langhammer Birgitta , Sunnerhagen Katharina S. , Stanghelle Johan K.
Published: March 2019

In diesem Beitrag liegt der Schwerpunkt auf der Zukunft bzw. den zukünftigen
Herausforderungen der Neurorehabilitation im Zusammenhang mit genetischer
Forschung, Behandlungen, Interventionen und Medikamenten zur Verbesserung der
Ergebnisse sowie auf translationalen Fragen der Leistungserbringung zwischen
spezialisierten und gemeindebasierten Diensten.
Die Zukunft der neurologischen Frührehabilitation in
Deutschland
Authors: Pohl Marcus
Published: March 2019

Die neurologisch-neurochirurgische Frührehabilitation bietet rund 5000
Behandlungsplätze in Deutschland. Sie ist ein wichtiger Baustein im
Gesamtbehandlungskonzept beatmeter neurologischer Patienten. Vor welchem
Hintergrund sie entstand und wie sie arbeitet, beschreibt der folgende
Artikel.