bluuebunny/crossref_metadata_2025 huggingface dataset:
Qualitative exploration of pharmacist care for herbal and dietary supplement users in Thai community pharmacies
Authors: Wahab Mohd Shahezwan Abd , Sakthong Phantipa , Winit-Watjana Win
Published: June 2018

Objectives

Herbal and dietary supplements (HDS) can cause adverse effects or interact with diseases and medications. Community pharmacists have a role in ensuring the safe use of HDS, but they have been reported to not being proactive in providing pharmacist care (PCare) for HDS users. The reasons for this warranted investigation. The study aimed to explore pharmacists’ understanding of PCare for HDS users, and to investigate the underlying beliefs or factors influencing its provision by community pharmacists, guided by the theory of planned behaviour.

Methods

A qualitative study using a semi-structured interview guide was conducted in a purposive sample of community pharmacists working in Bangkok, Thailand, from December 2016 to June 2017. All interviews were audio-recorded, transcribed and analysed using qualitative content analysis.

Key findings

Twenty-two pharmacists were interviewed. Several professional pharmacy activities were regarded as PCare for HDS users. The pharmacists reported that the provision of such care was advantageous in terms of promoting rational use of HDS, ensuring safety of users, enhancing own knowledge and promote customers’ loyalty. Facilitators for PCare included the initiation of conversation about HDS by the users, professional training and the availability of reference materials. The reluctance of HDS users to accept pharmacists’ opinions, insufficient education in HDS and limited sources of information were identified as barriers. Most pharmacists believed that PCare for HDS users is part of their responsibilities.

Conclusions

The pharmacists expressed their views on the meaning of PCare for HDS users, and described the beliefs and factors that facilitate or impede its provision. Information from this study can be used to inform strategies that can promote pharmacists to become more proactive in providing PCare for HDS users.
Medication Use and Health Screening in an Ageing Adult Population With Down Syndrome in Ireland: A Descriptive Study
Authors: Belton A. , O'Dwyer M. , Peklar J. , McCallion P. , McCarron M. , Henman M. C.
Published: June 2018

Medications use in adults ageing with Down syndrome (DS) has not been studied extensively. People with DS are at increased risk of hypothyroidism, seizures, and dementia. It is possible that this pattern of multimorbidity is associated with polypharmacy. The aim of this study is to describe the patterns of medical disorders, symptoms, and medications, variation with age and residential setting, and utilization of health screening in an ageing cohort with DS. Data were obtained from wave one (2009/2010) of the Intellectual Disability Supplement to The Irish Longitudinal Study on Ageing. Information on disorders, symptoms, health screening, and medications was gathered using preinterview questionnaires and face to face interviews with participants and/or caregivers. Of the 721 participants answering the questions about medication use and cause of intellectual disability, 20% had DS (n = 144). Descriptive statistics describe the prevalence of disorders and medications and proportion of participants attending health screening for disorders commonly associated with DS. The most commonly reported disorders were eye disease (61.8%), thyroid dysfunction (38.2%), constipation (34.7%) high cholesterol (32.6%), pain (32.1%), and emotional/psychiatric/nervous disorder (25%). The most commonly reported medications were thyroid hormones (43.8%), laxatives (27.1%), pain relievers (27.1%), and lipid modifying agents (26.4%). Polypharmacy, excessive polypharmacy, and multimorbidity were more prevalent among the older group compared to the younger group (37.3% vs. 14.3%; 13.4% vs. 7.8%; 73.1% vs. 58.4%, respectively). Uptake of memory assessments (32.9%), hearing tests (23.8%), and bone density screening (9.2%) was poor, particularly among those living independently, yet general practitioner visits were frequent and extensive. Polypharmacy and excessive polypharmacy are prevalent in this population, yet the provision of health care screening is inadequate. Medications review is needed since the risks posed by multiple medications use have not yet been quantified. As people with DS age, support is necessary for health care professionals, people with DS and their carers to help them optimize the use of medications.
Electroacupuncture treatments for gut motility disorders
Authors: Chen J. D. Z. , Ni M. , Yin J.
Published: June 2018

Functional gastrointestinal (GI) diseases are common and there are patients who are refractory to medical therapies as not all treatments work in all patients. Consequently, a large number of patients with functional GI diseases use complementary and alternative medicine, such as acupuncture or electroacupuncture (EA). In this issue, Zheng et al. reported interesting results of a multi‐center placebo‐controlled clinical study on the use of EA for treating refractory functional dyspepsia; another study reported a multi‐center clinical trial on EA for chronic functional constipation; Liang et al. studied mechanisms of EA involving enteric nervous system and neurotransmitters in treating constipation in rats. While controversial reports are available in the literature, EA with appropriate methodologies as shown in these recent studies is believed to be effective in treating certain functional GI diseases. In this mini‐review, a number of clinical studies, including those included in this issue on the use of EA for treating gastro‐esophageal reflux, functional dyspepsia, irritable bowel syndrome, and constipation are reviewed. Some critically important issues, such as the choice of stimulation parameters for EA, the administration frequency of the therapy, and the appropriate choice of placebo for clinical research are also discussed. Mechanisms of action involved in the therapeutic effects of EA for gut dysmotility and future research directions are also presented.
Inability of infants to push up in the prone position and subsequent development
Authors: Senju Ayako , Shimono Masayuki , Tsuji Mayumi , Suga Reiko , Shibata Eiji , Fujino Yoshihisa , Kawamoto Toshihiro , Kusuhara Koichi
Published: June 2018

Background

During routine health screening, some infants cannot maintain the prone position with extended arm support at 6 months. Little is known, however, about the development of full‐term infants with this developmental deviation. We investigated the developmental course of infants with this characteristic.

Methods

We enrolled 2,020 full‐term infants who had been recruited at a regional center for the Japan Environment and Children's Study. Their development was measured using the Ages and Stages Questionnaire, third edition, at 0.5, 1, 1.5, 2, 2.5, and 3 years. The children were grouped according to their ability to stay prone on extended arms at 6 months, and their development was compared.

Results

A total of 1,625 infants could stay prone on extended arms and 179 could not. We excluded 212 infants who could stay prone on extended arms only sometimes, and four who did not have a questionnaire response. In the gross motor domain, significant difference in questionnaire scores was observed between the “could” and “could‐not” groups at 6 months (Hedges’ g, 1.83) and persisted until 3 years (Hedges’ g, 0.33). Significant differences were also observed in the communication, fine motor, problem solving, and personal–social domains at 6 months (Hedges’ g, 0.20–0.58) and persisted until 1, 2, 2, and 1.5 years, respectively (Hedges’ g, 0.21–0.25).

Conclusions

Infants who cannot maintain the prone position on extended arms lag behind those who can, although the effect sizes become relatively small after 1.5 years of age. Early intervention may be considered if delay is problematic or persistent.
Hyperbilirubinemia in preterm infants in Japan: New treatment criteria
Authors: Morioka Ichiro
Published: June 2018

In 1992, Kobe University proposed treatment criteria for hyperbilirubinemia in newborns using total serum bilirubin and serum unbound bilirubin reference values. In the last decade, chronic bilirubin encephalopathy has been found to develop in preterm infants in Japan because it can now be clinically diagnosed based on an abnormal signal of the globus pallidus on T2‐weighted magnetic resonance imaging and abnormal auditory brainstem response with or without apparent hearing loss, along with physical findings of kinetic disorders with athetosis. We therefore revised the Kobe University treatment criteria for preterm hyperbilirubinemic infants in 2017. The three revised points are as follows: (i) newborns are classified under gestational age at birth or corrected gestational age, not birthweight; (ii) three treatment options were created: standard phototherapy, intensive phototherapy, and albumin therapy and/or exchange blood transfusion; and (iii) initiation of standard phototherapy, intensive phototherapy, and albumin therapy and/or exchange blood transfusion is decided based on the total serum bilirubin and serum unbound bilirubin reference values for gestational weeks at birth at <7 days of age, and on the reference values for corrected gestational age at ≥7 days of age. Studies are needed to establish whether chronic bilirubin encephalopathy can be prevented using the 2017 revised Kobe University treatment criteria for preterm infants in Japan.
Seed dormancy and control of germination in Sisymbrella dentata (L.) O.E. Schulz (Brassicaceae)
Authors: Puglia G. , Carta A. , Bizzoca R. , Toorop P. , Spampinato G. , Raccuia S. A.
Published: June 2018

Seed germination responsiveness to environmental cues is crucial for plant species living in changeable habitats and can vary among populations within the same species as a result of adaptation or modulation to local climates. Here, we investigate the germination response to environmental cues of Sisymbrella dentata (L.) O.E. Schulz, an annual endemic to Sicily living in Mediterranean Temporary Ponds (MTP), a vulnerable ecosystem.

Germination of the only two known populations, Gurrida and Pantano, was assessed over a broad range of conditions to understand the role of temperatures, nitrate, hormones (abscisic acid – ABA and gibberellins – GA) and after‐ripening in dormancy release in this species.

Seed germination responsiveness varied between the two populations, with seeds from Gurrida germinating under a narrower range of conditions. Overall, this process in S. dentata consisted of testa and endosperm rupture as two sequential events, influenced by ABA and GA biosynthesis. Nitrate addition caused an earlier testa rupture, after‐ripening broadened the thermal conditions that allow germination, and alternating temperatures significantly promoted germination of non‐after‐ripened seeds.

Primary dormancy in S. dentata seeds likely allows this plant to form a persistent seed bank that is responsive to specific environmental cues characteristic of MTP habitats.
Understanding Compound, Interconnected, Interacting, and Cascading Risks: A Holistic Framework
Authors: Pescaroli Gianluca , Alexander David
Published: June 2018

In recent years, there has been a gradual increase in research literature on the challenges of interconnected, compound, interacting, and cascading risks. These concepts are becoming ever more central to the resilience debate. They aggregate elements of climate change adaptation, critical infrastructure protection, and societal resilience in the face of complex, high‐impact events. However, despite the potential of these concepts to link together diverse disciplines, scholars and practitioners need to avoid treating them in a superficial or ambiguous manner. Overlapping uses and definitions could generate confusion and lead to the duplication of research effort. This article gives an overview of the state of the art regarding compound, interconnected, interacting, and cascading risks. It is intended to help build a coherent basis for the implementation of the Sendai Framework for Disaster Risk Reduction (SFDRR). The main objective is to propose a holistic framework that highlights the complementarities of the four kinds of complex risk in a manner that is designed to support the work of researchers and policymakers. This article suggests how compound, interconnected, interacting, and cascading risks could be used, with little or no redundancy, as inputs to new analyses and decisional tools designed to support the implementation of the SFDRR. The findings can be used to improve policy recommendations and support tools for emergency and crisis management, such as scenario building and impact trees, thus contributing to the achievement of a system‐wide approach to resilience.
Common gamma chain cytokines promote regulatory T cell development and survival at the CD4+ CD8+ stage in the human thymus
Authors: Vanhanen Reetta , Tuulasvaara Anni , Mattila Joonatan , Pätilä Tommi , Arstila T. Petteri
Published: June 2018

Thymic commitment of human FOXP3+ regulatory T cells begins at the double‐positive (DP) CD4+ CD8+ stage. In the current study, we show that interleukin‐2 promotes the development of FOXP3+ thymocytes and enhances their survival at the DP phase. IL‐2 increases the frequency of FOXP3+ cells and promotes the Treg phenotype after TCR‐mediated positive selection at the most mature DP stage. However, it has no effect on FOXP3+ cells at the earlier maturation steps before positive selection. DP FOXP3+ thymocytes are highly susceptible to cell death but IL‐2 promotes their survival. The anti‐apoptotic protein BCL‐2 (B Cell Lymphoma 2) is also upregulated by IL‐2 at the most mature DP stage. In addition to IL‐2, we identify IL‐15 to have a significant role in the upregulating FOXP3 and survival of Tregs at the DP phase. IL‐7 also increases the expression of BCL‐2 in the DP FOXP3+ thymocytes. Our results indicate that common gamma chain cytokines IL‐2, IL‐7 and IL‐15 promote the development of regulatory T cells at the most mature DP stage after TCR‐mediated positive selection through suppressing cell death.
Geographies of heteroactivism: Resisting sexual rights in the reconstitution of Irish nationhood
Authors: Browne Kath , Nash Catherine J. , Gorman‐Murray Andrew
Published: June 2018

Legislative and cultural changes have produced significant shifts in sexual and gender rights. Although this has been extensively studied in relation to those who have “won” and in relation to the normalisations that these changes create, there is little scholarship on the emergence of new resistances to Lesbian, Gay, Bisexual and Trans equalities. We employ the term heteroactivism to name the ways that resistances to sexual and gender rights have moved from vilifying “the homosexual,” towards more subtle and nuanced resistances in places with sexual and gender equalities legislation. Geography is key because legislation and its enactment varies spatially, and national legislations and imaginings recreate distinctive, place‐based heteroactivism. Paying attention to the ideologies of those who opposed same‐sex marriage in Ireland's 2015 referendum, this paper explores how the boundaries of Irishness were central to heteroactivist campaigns, drawing on specific invocations of relatedness between a female child and her mother, the quintessential Irish Mammy. Using a close reading of the textual and visual elements of a “Vote No” poster, the paper elucidates the presences and silences of new forms of resistances that seek to recuperate what was once not only “common sense” heterosexuality, but also seen as the essence of Irishness. In doing so, the paper extends understandings of sexuality–gender–nation–state nexus by critically interrogating the ideologies of those who contest progressive state sexual and gender legislation.
Evaluation of pulse pressure variation and pleth variability index to predict fluid responsiveness in mechanically ventilated isoflurane‐anesthetized dogs
Authors: Sano Hiroki , Seo Joonbum , Wightman Paul , Cave Nick J. , Gieseg Mike A. , Johnson Craig B. , Chambers Paul
Published: June 2018

Objective

To evaluate whether pulse pressure variation (PPV) and pleth variability index (PVI) are more accurate than central venous pressure (CVP) for predicting fluid responsiveness in mechanically ventilated isoflurane‐anesthetized dogs after premedication with acepromazine.

Design

Prospective experimental trial.

Setting

University teaching hospital.

Animals

Twelve Harrier hound dogs.

Interventions

Each dog was anesthetized and had a fluid challenge performed. This was repeated 4 weeks later for a total of 24 fluid challenges. After premedication with intramuscular acepromazine, anesthesia was induced with propofol and maintained with isoflurane. The dogs were mechanically ventilated with constant settings. The fluid challenge consisted of 10 mL/kg of 6% hydroxyethyl starch intravenously over 13 minutes.

Measurements and Main Results

Before and after the fluid challenge, PPV, PVI, CVP, and other hemodynamics were recorded. Change in velocity time integral of pulmonary arterial blood flow by echocardiography was calculated as an indication of change in stroke volume. A fluid responder was defined as an increase in velocity time integral ≥ 15%. Receiver operator characteristic (ROC) curves were used to determine cutoff values. Areas under ROC curve were calculated and compared. Dogs responded on 14 fluid challenges and did not on 10. Cutoff values for PPV and PVI were 11% (sensitivity 79%; specificity 80%) and 9.3% (sensitivity 86%; specificity 70%), respectively. The areas under the ROC curve of PPV [0.85, 95% confidence interval (CI): 0.70–1.00, P = 0.038] and PVI (0.84, 95% CI: 0.68–1.00, P = 0.043) were significantly higher than CVP (0.56, 95% CI: 0.32–0.81).

Conclusions

PPV and PVI predicted fluid responsiveness more accurately than CVP and may be useful to guide fluid administration in mechanically ventilated isoflurane‐anesthetized dogs after premedication with acepromazine.
Deep-biosphere methane production stimulated by geofluids in the Nankai accretionary complex
Authors: Ijiri Akira , Inagaki Fumio , Kubo Yusuke , Adhikari Rishi R. , Hattori Shohei , Hoshino Tatsuhiko , Imachi Hiroyuki , Kawagucci Shinsuke , Morono Yuki , Ohtomo Yoko , Ono Shuhei , Sakai Sanae , Takai Ken , Toki Tomohiro , Wang David T. , Yoshinaga Marcos Y. , Arnold Gail L. , Ashi Juichiro , Case David H. , Feseker Tomas , Hinrichs Kai-Uwe , Ikegawa Yojiro , Ikehara Minoru , Kallmeyer Jens , Kumagai Hidenori , Lever Mark A. , Morita Sumito , Nakamura Ko-ichi , Nakamura Yuki , Nishizawa Manabu , Orphan Victoria J. , Røy Hans , Schmidt Frauke , Tani Atsushi , Tanikawa Wataru , Terada Takeshi , Tomaru Hitoshi , Tsuji Takeshi , Tsunogai Urumu , Yamaguchi Yasuhiko T. , Yoshida Naohiro
Published: June 2018

Scientific drilling at a submarine mud volcano shows that geofluid migration stimulates methanogenesis in the deep biosphere.
Methane emissions partially offset “blue carbon” burial in mangroves
Authors: Rosentreter Judith A. , Maher Damien T. , Erler Dirk V. , Murray Rachel H. , Eyre Bradley D.
Published: June 2018

Water and sediment methane emissions have the potential to offset “blue carbon” burial in mangrove coastal ecosystems.
Oxygen-deficient triple perovskites as highly active and durable bifunctional electrocatalysts for oxygen electrode reactions
Authors: Kim Nam-In , Sa Young Jin , Yoo Tae Sup , Choi Sung Ryul , Afzal Rana Arslan , Choi Taekjib , Seo Young-Soo , Lee Kug-Seung , Hwang Jun Yeon , Choi Woo Seok , Joo Sang Hoon , Park Jun-Young
Published: June 2018

Triple perovskite, Nd
1.5
Ba
1.5
CoFeMnO
9−δ
, enriched with oxygen defects shows high activity and durability as a bifunctional oxygen electrocatalyst.
Sequencing conjugated polymers by eye
Authors: Warr Daniel A. , Perdigão Luís M. A. , Pinfold Harry , Blohm Jonathan , Stringer David , Leventis Anastasia , Bronstein Hugo , Troisi Alessandro , Costantini Giovanni
Published: June 2018

Electrospray deposition and STM as a new analytical technique to sequence conjugated polymers and reveal polymerization defects.
Elastic properties of 2D Ti
3
C
2
T

x

MXene monolayers and bilayers
Authors: Lipatov Alexey , Lu Haidong , Alhabeb Mohamed , Anasori Babak , Gruverman Alexei , Gogotsi Yury , Sinitskii Alexander
Published: June 2018

Nanoindentation experiments show that Ti
3
C
2
T

x

MXenes have a higher elastic modulus than other solution-processed 2D materials.
Viscoelastic properties of vimentin originate from nonequilibrium conformational changes
Authors: Block Johanna , Witt Hannes , Candelli Andrea , Danes Jordi Cabanas , Peterman Erwin J. G. , Wuite Gijs J. L. , Janshoff Andreas , Köster Sarah
Published: June 2018

Hierarchical molecular architecture renders intracellular vimentin a high-performance, shock-absorbing material.
Biomimetic enzyme cascade reaction system in microfluidic electrospray microcapsules
Authors: Wang Huan , Zhao Ze , Liu Yuxiao , Shao Changmin , Bian Feika , Zhao Yuanjin
Published: June 2018

Biomimetic enzyme cascade reaction systems in microcapsules are developed for mimicking biocatalysis of organelles.
Ultra-confined mid-infrared resonant phonon polaritons in van der Waals nanostructures
Authors: Tamagnone Michele , Ambrosio Antonio , Chaudhary Kundan , Jauregui Luis A. , Kim Philip , Wilson William L. , Capasso Federico
Published: June 2018

Resonant polaritonic nanoantennas allow manipulation of light and optical forces at the nanoscale for sensing applications.
NEDD9 targets
COL3A1
to promote endothelial fibrosis and pulmonary arterial hypertension
Authors: Samokhin Andriy O. , Stephens Thomas , Wertheim Bradley M. , Wang Rui-Sheng , Vargas Sara O. , Yung Lai-Ming , Cao Minwei , Brown Marcel , Arons Elena , Dieffenbach Paul B. , Fewell Jason G. , Matar Majed , Bowman Frederick P. , Haley Kathleen J. , Alba George A. , Marino Stefano M. , Kumar Rahul , Rosas Ivan O. , Waxman Aaron B. , Oldham William M. , Khanna Dinesh , Graham Brian B. , Seo Sachiko , Gladyshev Vadim N. , Yu Paul B. , Fredenburgh Laura E. , Loscalzo Joseph , Leopold Jane A. , Maron Bradley A.
Published: June 2018

TGF-β–independent oxidative modification of NEDD9 at Cys
18
promotes vascular fibrosis and the pathobiology of pulmonary arterial hypertension.
A live vaccine rapidly protects against cholera in an infant rabbit model
Authors: Hubbard Troy P. , Billings Gabriel , Dörr Tobias , Sit Brandon , Warr Alyson R. , Kuehl Carole J. , Kim Minsik , Delgado Fernanda , Mekalanos John J. , Lewnard Joseph A. , Waldor Matthew K.
Published: June 2018

An engineered cholera vaccine candidate mediates colonization resistance and disease protection within 1 day in an infant rabbit model.
Human milk as a protective factor for bronchopulmonary dysplasia: a systematic review and meta-analysis
Authors: Huang Jinglan , Zhang Li , Tang Jun , Shi Jing , Qu Yi , Xiong Tao , Mu Dezhi
Published: June 2018

Objective

To summarise current evidence evaluating the effects of human milk on the risk of bronchopulmonary dysplasia (BPD) in preterm infants.

Design

We searched for studies on human milk and BPD in English and Chinese databases on 26 July 2017. Furthermore, the references of included studies were also screened. The inclusion criteria in this meta-analysis were the following: (1) preterm infants (<37 weeks); (2) human milk; (3) comparing with formula feeding; (4) the outcome included BPD; and (5) the type of study was randomised controlled trial (RCT) or cohort study.

Result

A total of 17 cohort studies and 5 RCTs involving 8661 preterm infants met our inclusion criteria. The ORs and 95% CIs of six groups were as follows: 0.78 (0.68 to 0.88) for exclusive human milk versus exclusive formula group, 0.77 (0.68 to 0.87) for exclusive human milk versus mainly formula group, 0.76 (0.68 to 0.87) for exclusive human milk versus any formula group, 0.78 (0.68 to 0.88) for mainly human milk versus exclusive formula group, 0.83 (0.69 to 0.99) for mainly human milk versus mainly formula group and 0.82 (0.73 to 0.93) for any human milk versus exclusive formula group. Notably, subgroup of RCT alone showed a trend towards protective effect of human milk on BPD but no statistical significance.

Conclusion

Both exclusive human milk feeding and partial human milk feeding appear to be associated with lower risk of BPD in preterm infants. The quality of evidence is low. Therefore, more RCTs of this topic are needed.
Oral diabetes medication monotherapy and short-term mortality in individuals with type 2 diabetes and coronary artery disease
Authors: Raghavan Sridharan , Liu Wenhui G , Saxon David R , Grunwald Gary K , Maddox Thomas M , Reusch Jane E B , Berkowitz Seth A , Caplan Liron
Published: June 2018

Objective

To determine whether sulfonylurea use, compared with non-sulfonylurea oral diabetes medication use, was associated with 2-year mortality in individuals with well-controlled diabetes and coronary artery disease (CAD).

Research design and methods

We studied 5352 US veterans with type 2 diabetes, obstructive CAD on coronary angiography, hemoglobin A1c ≤7.5% at the time of catheterization, and taking zero or one oral diabetes medication (categorized as no medications, non-sulfonylurea medication, or sulfonylurea). We estimated the association between medication category and 2-year mortality using inverse probability of treatment-weighted (IPW) standardized mortality differences and IPW multivariable Cox proportional hazards regression.

Results

49%, 35%, and 16% of the participants were on no diabetes medications, non-sulfonylurea medications, and sulfonylureas, respectively. In individuals on no medications, non-sulfonylurea medications, and sulfonylureas, the unadjusted mortality rates were 6.6%, 5.2%, and 11.9%, respectively, and the IPW-standardized mortality rates were 5.9%, 6.5%, and 9.7%, respectively. The standardized absolute 2-year mortality difference between non-sulfonylurea and sulfonylurea groups was 3.2% (95% CI 0.7 to 5.7) (p=0.01). In Cox proportional hazards models, the point estimate suggested that sulfonylurea use might be associated with greater hazard of mortality than non-sulfonylurea medication use, but this finding was not statistically significant (HR 1.38 (95% CI 1.00 to 1.93), p=0.05). We did not observe significant mortality differences between individuals on no diabetes medications and non-sulfonylurea users.

Conclusions

Sulfonylurea use was common (nearly one-third of those taking medications) and was associated with increased 2-year mortality in individuals with obstructive CAD. The significance of the association between sulfonylurea use and mortality was attenuated in fully adjusted survival models. Caution with sulfonylurea use may be warranted for patients with well-controlled diabetes and CAD, and metformin or newer diabetes medications with cardiovascular safety data could be considered as alternatives when individualizing therapy.
Effects of a 12-week running programme in youth and adults with complex mood disorders
Authors: Keating Laura E , Becker Suzanna , McCabe Katie , Whattam Jeff , Garrick Laura , Sassi Roberto B , Frey Benicio N , McKinnon Margaret C
Published: June 2018

Objective

Although numerous studies suggest a salutary effect of exercise on mood, few studies have explored the effect of exercise in patients with complex mental illness. Accordingly, we evaluated the impact of running on stress, anxiety and depression in youth and adults with complex mood disorders including comorbid diagnoses, cognitive and social impairment and high relapse rates.

Methods

Participants were members of a running group at St Joseph Healthcare Hamilton’s Mood Disorders Program, designed for clients with complex mood disorders. On a weekly basis, participants completed Cohen’s Perceived Stress Scale, Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) questionnaires, providing an opportunity to evaluate the effect of running in this population.

Results

Data collected for 46 participants from April 2012 to July 2015 indicated a significant decrease in depression (p<0.0001), anxiety (p<0.0001) and stress (p=0.01) scores. Whereas younger participant age, younger age at onset of illness and higher perceived levels of friendship with other running group members (ps≤0.04) were associated with lower end-of-study depression, anxiety and stress scores, higher attendance was associated with decreasing BDI and BAI (ps≤0.01) scores over time.

Conclusions

Aerobic exercise in a supportive group setting may improve mood symptoms in youth and adults with complex mood disorders, and perceived social support may be an important factor in programme’s success. Further research is required to identify specifically the mechanisms underlying the therapeutic benefits associated with exercise-based therapy programmes.
Virtual patient educational programme to teach counselling to clinical pharmacists: development and proof of concept
Authors: Richardson Charlotte Lucy , Chapman Stephen , White Simon
Published: June 2018

Pharmacist–patient counselling can benefit patients and optimise care, but appropriate training is required. A virtual patient (VP) tool to teach pharmacists non-vitamin K oral anticoagulant counselling was developed; the VP may be used for continuing professional development. The objective was to develop and show proof of concept of the VP. A cyclic development approach was adopted whereby the client, developers and a steering group informed VP design, content and aesthetic. This included formal and informal evaluation; ethical approval was not required. The VP received varied feedback. Positive feedback concerned the technology and the high-standard of animations. Negative elements concerned international VP use and differences in practice, also technological comments, regarding VP delivery and usability on various electronic devices. The VP was reported to be ‘valuable’ and realistic with high-quality animations. The steering group commented on VP’s clinical appropriateness, cultural relevance and usability. Areas highlighted for improvement were rectified during development, including the incorporation of printable feedback. European considerations concerned differences in culture and practice. The development process successfully developed the VP and the proof of the concept was demonstrated. This will inform future VP development; a large-scale VP evaluation is underway.
Conflicting duties and restitution of the trusting relationship
Authors: Eriksen Andreas
Published: June 2018

It is often claimed that medical professionals are subject to conflicting duties in their role morality. Some hold that the overridden duty taints the professional and generates a patient claim to a form of moral compensation. This paper challenges such a ‘compensation view’ of conflict and argues that it misleadingly makes the role morality into a personal contract between professional and patient. Two competing views are therefore considered. The ‘unity view’ argues that there are no real conflicts between professional duties. Hence, there can be no residual duties that are impossible to discharge and no special claim on the part of the patient. It is argued that this fails because the institutional nature of the role morality requires us to accept possibility of conflict. The paper articulates and defends a third view, where conflict triggers a professional duty of restitution. This duty is not a matter of making amends for a previous wrong, but rather a matter of rebuilding a trusting relationship that has been damaged due to blameless circumstances.
Effect of rectal douching/enema on rectal gonorrhoea and chlamydia among a cohort of men who have sex with men on HIV pre-exposure prophylaxis
Authors: Hassan Adiba , Blumenthal Jill S , Dube Michael P , Ellorin Eric , Corado Katya , Moore David J , Morris Sheldon R
Published: June 2018

Objectives

Rectal douching/enema (RD) is a common practice among men who have sex with men (MSM) in preparation for sex. RD can break down the rectal mucosal barrier and potentially affect the rectal microbiome. The objective of this study was to understand if RD is associated with acquiring rectal infections (RI) with rectal gonorrhoea (NG) and/or chlamydia (CT).

Methods

From 2013 to 2015, 395 adult HIV-uninfected MSM were enrolled in a randomised controlled study for pre-exposure prophylaxis (PrEP) adherence with routine sexual risk survey and testing. Using data from this cohort, baseline differences by RI were assessed using Pearson’s χ² and Wilcoxon-Mann-Whitney test. Association between RD and RI was modelled using multivariable logistic regression adjusted for potential confounders (sexual behaviour, substance use and age) selected a priori. Effect modification by number of male partners and sensitivity analysis to rule out reverse causality were also conducted.

Results

Of 395 participants, 261 (66%) performed RD and 133 (33%) had at least one NG/CT RI over 48 weeks. Number of condomless anal receptive sex (med: 4, p<0.001), male partners (med:6, p<0.001) and substance use (any of methamphetamine/hallucinogens/dissociative/poppers) (p<0.001) were associated with increased odds of RI. Controlling for potential confounders, odds of prevalent RI were 3.59 (p<0.001, 95% CI 1.90 to 6.78) and incident RI 3.87 (p=0.001, 95% CI 1.78 to 8.39) when douching weekly or more compared with not douching. MSM with more than six male partners had 5.34 (p=0.002, 95% CI 1.87 to 15.31) increased odds of RI when douching weekly or more compared with not douching.

Conclusion

Rectal hygiene with RD is a common practice (66%) among HIV-uninfected MSM on PrEP in this study, which increases the odds of acquiring rectal NG and/or CT independent of sexual risk behaviour, substance use and other factors. This suggests interventional approaches targeting rectal hygiene products and practices could reduce sexually transmitted infections.
Secondhand smoke exposure and asthma outcomes among African-American and Latino children with asthma
Authors: Neophytou Andreas M , Oh Sam S , White Marquitta J , Mak Angel C Y , Hu Donglei , Huntsman Scott , Eng Celeste , Serebrisky Denise , Borrell Luisa N , Farber Harold J , Meade Kelley , Davis Adam , Avila Pedro C , Thyne Shannon M , Rodríguez-Cintrón William , Rodríguez-Santana José R , Kumar Rajesh , Brigino-Buenaventura Emerita , Sen Saunak , Lenoir Michael A , Williams L Keoki , Benowitz Neal L , Balmes John R , Eisen Ellen A , Burchard Esteban G
Published: June 2018

Background

Secondhand smoke (SHS) exposures have been linked to asthma-related outcomes but quantitative dose–responses using biomarkers of exposure have not been widely reported.

Objectives

Assess dose–response relationships between plasma cotinine-determined SHS exposure and asthma outcomes in minority children, a vulnerable population exposed to higher levels of SHS and under-represented in the literature.

Methods

We performed analyses in 1172 Latino and African-American children with asthma from the mainland USA and Puerto Rico. We used logistic regression to assess relationships of cotinine levels ≥0.05 ng/mL with asthma exacerbations (defined as asthma-related hospitalisations, emergency room visits or oral steroid prescription) in the previous year and asthma control. The shape of dose–response relationships was assessed using a continuous exposure variable in generalised additive logistic models with penalised splines.

Results

The OR for experiencing asthma exacerbations in the previous year for cotinine levels ≥0.05 ng/mL, compared with <0.05 ng/mL, was 1.40 (95% CI 1.03 to 1.89), while the OR for poor asthma control was 1.53 (95% CI 1.12 to 2.13). Analyses for dose–response relationships indicated increasing odds of asthma outcomes related with increasing exposure, even at cotinine levels associated with light SHS exposures.

Conclusions

Exposure to SHS was associated with higher odds of asthma exacerbations and having poorly controlled asthma with an increasing dose–response even at low levels of exposure. Our results support the conclusion that there are no safe levels of SHS exposures.
Tobacco industry’s elaborate attempts to control a global track and trace system and fundamentally undermine the Illicit Trade Protocol
Authors: Gilmore Anna B , Gallagher Allen W A , Rowell Andy
Published: June 2018

Background

The Illicit Trade Protocol (ITP) requires a global track and trace (T&T) system to reduce tobacco smuggling. Given the tobacco industry’s (TI) historical involvement in tobacco smuggling, it stipulates that T&T ‘shall not be performed by or delegated to the tobacco industry’. This paper explores the rationale for & nature of the TI’s effors to influence the ITP & its T&T system.

Methods

Analysis of leaked TI documents and publicly available data; ,investigation of front groups, trademark and patent ownership.

Findings

Growing & diverse sources of evidence indicate that the TI remains involved in tobacco smuggling and that TI cigarettes account for around two-thirds of the illicit cigarette market. The TI therefore has a vested interest in controlling the global T&T system aimed to curtail this behaviour. To this end, Philip Morris International (PMI) adapted its pack marker system, Codentify, to meet T&T requirements, licensed it for free to its three major competitors who then collectively promoted it to governments using front groups and third parties including companies claiming to be independent despite clear TI links. PMI also sought to suggest Codentify was independent by selling some parts of its intellectual property on Codentify while retaining others, leaving a complex web of shared interests. In Africa, British American Tobacco used payments to obtain data suggesting its smaller competitor companies were evading taxes and secure influence with tax authorities. Regulatory capture has been enhanced by a public relations effort involving TI funding for conferences, training, research, and international police and anti-corruption organisations. Collectively this has created public messaging and a powerful network of organisations supportive of the TI’s misleading postion on illicit.

Conclusions

Governments should assume the TI seeks to control T&T systems in order to avoid scrutiny and minimise excise tax payments and that any T&T system based on Codentify, on intellectual property currently or previously owned by the TI, or being promoted or implemented by companies with TI links, is incompatible with the ITP and would not serve to reduce illicit trade.
Overview of foot‐and‐mouth disease awareness among farmers and veterinarians in France
Authors: Raut Noémie , Rivière Julie , Hosteing Soline , Collin Eric , Philizot Stéphanie , Debaere Olivier , Zanella Gina
Published: June 2018

Foot‐and‐mouth disease (FMD) is of major concern in most countries including Europe, where no outbreaks have occurred since a decade. Indeed, the risk of FMD introduction from infected countries is not negligible and the awareness of field stakeholders (farmers, veterinarians) is essential to ensure an effective detection of the viral circulation. The French veterinary services launched in 2015 a survey to estimate the awareness of farmers and veterinarians and their knowledge about epidemiological and regulatory aspects of FMD. Official health visits were used to collect information from cattle farmers and veterinarians through two separate questionnaires. The results show that not all cattle farmers were aware of the risk of FMD reintroduction in France and of its routes of infection and speed of dissemination. As for the veterinarians, their promptness to report a suspicion was dependent on the occurrence of FMD cases in European countries. These results highlight key aspectsregarding FMD epidemiology which should be regularly reminded to the field stakeholders in FMD‐free countries to increase their awareness and thus ensure an effective early detection in case of FMD introduction.
Spatial patterns of tree and shrub biomass in a deciduous forest using leaf-off and leaf-on lidar
Authors: Brubaker Kristen M. , Johnson Quincey K. , Kaye Margot W.
Published: June 2018

Understanding patterns of aboveground carbon storage across forest types is increasingly important as managers adapt to threats of global change. We combined field measures of aboveground biomass with lidar to model fine-scale biomass in deciduous forests located in two watersheds; one watershed was underlain by sandstone and the other by shale. We measured tree and shrub biomass across three topographic positions for both watersheds and analyzed biomass using mixed models. The watershed underlain by shale had 60% more aboveground biomass than the sandstone watershed. Although spatial patterns of biomass were different across watersheds, both had higher (between about 40% and 55%) biomass values at the toe-slope position than at the ridge-top position. To model fine-scale spatial patterns of biomass, we tested the effectiveness of leaf-on and leaf-off lidar combined with topographic metrics to develop a spatially explicit random forest model of tree and shrub biomass across both watersheds. Leaf-on variables were more important for modeling shrub biomass, while leaf-off variables were more effective at modeling tree biomass. Our model of tree and shrub biomass reflects the distribution of biomass across both watersheds at a fine scale and highlights the potential of abiotic factors such as topography and bedrock to affect carbon storage.
Urbanization as a driver of taxonomic, functional, and phylogenetic diversity losses in bird communities
Authors: Palacio Facundo X. , Ibañez Lucía M. , Maragliano René E. , Montalti Diego
Published: June 2018

Urbanization is one of the most important threats to biodiversity worldwide, as it drives declines in species diversity, functional diversity, and phylogenetic diversity and increases functional redundancy among species. We estimated taxonomic, functional, and phylogenetic diversities, as well as the abundance of several functional groups, in bird communities from a town in east-central Argentina in 1985–1986 and 30 years after (2015–2016). In 1985–1986, we found that taxonomic diversity (abundance, species richness, and alpha diversity), functional richness, and basal phylogenetic diversity were negatively related to building cover, whereas terminal phylogenetic diversity showed a positive relationship with building cover. Moreover, the abundance of specialized functional groups (ground, aerial, and foliage insectivores; nectarivores/insectivores; ground/canopy and ground granivores) decreased with increased building cover, whereas the reverse pattern for the abundance of generalists (medium-sized/large and small omnivores) was found. In 2015–2016, by contrast, taxonomic, functional, and phylogenetic diversities were not related to building cover. Our results not only support the hypothesis that urbanization affects the potential number of ecosystem functions, but also that this relationship may change through time. Given the accelerated rate of urbanization worldwide, an integrative approach between different facets of biodiversity is promoted to gain insight into the response of bird communities in urban environments.
VULCON
Authors: Farris Katheryn A. , Shah Ankit , Cybenko George , Ganesan Rajesh , Jajodia Sushil
Published: June 2018

Vulnerability remediation is a critical task in operational software and network security management. In this article, an effective vulnerability management strategy, called VULCON (VULnerability CONtrol), is developed and evaluated. The strategy is based on two fundamental performance metrics: (1) time-to-vulnerability remediation (TVR) and (2) total vulnerability exposure (TVE). VULCON takes as input real vulnerability scan reports, metadata about the discovered vulnerabilities, asset criticality, and personnel resources. VULCON uses a mixed-integer multiobjective optimization algorithm to prioritize vulnerabilities for patching, such that the above performance metrics are optimized subject to the given resource constraints. VULCON has been tested on multiple months of real scan data from a cyber-security operations center (CSOC). Results indicate an overall TVE reduction of 8.97% when VULCON optimizes a realistic security analyst workforce’s effort. Additionally, VULCON demonstrates that it can determine monthly resources required to maintain a target TVE score. As such, VULCON provides valuable operational guidance for improving vulnerability response processes in CSOCs.
Efficiency and Optimality of Largest Deficit First Prioritization
Authors: Du Yuhuan , Veciana Gustavo De
Published: June 2018

An increasing number of real-time applications with compute and/or communication deadlines are being supported on a shared infrastructure. Such applications can often tolerate occasional deadline violations without substantially impacting their Quality of Service (QoS). This article explores the efficient allocation of shared resources to satisfy such QoS requirements. We study a simple framework which decouples this problem into two subproblems: (1) dynamic prioritization of users based on arbitrary functions of their deficits (difference of achieved vs. required QoS), and (2) priority-based resource allocation on the underlying compute fabric. In this article, we shall assume the solution to the latter is fixed, e.g., as realized in the task prioritization capabilities of current hardware/software, and focus on compatible solutions to the former. We first characterize the set of feasible QoS requirements and show the optimality of max weight-like prioritization. We then consider simple weighted Largest Deficit First (w-LDF) prioritization policies, where users with higher weighted QoS deficits are given higher priority. The article gives an inner bound for the feasible set under w-LDF policies, and, under an additional monotonicity assumption, characterizes its geometry leading to a sufficient condition for optimality. Additional insights on the efficiency ratio of w-LDF policies, the optimality of hierarchical-LDF, and characterization of clustering of failures are also discussed.
Fast Distributed Algorithms for Connectivity and MST in Large Graphs
Authors: Pandurangan Gopal , Robinson Peter , Scquizzato Michele
Published: June 2018

Motivated by the increasing need to understand the algorithmic foundations of distributed large-scale graph computations, we study a number of fundamental graph problems in a message-passing model for distributed computing where
k
≥2 machines jointly perform computations on graphs with
n
nodes (typically,
n
>
k
). The input graph is assumed to be initially randomly partitioned among the
k
machines, a common implementation in many real-world systems. Communication is point-to-point, and the goal is to minimize the number of communication rounds of the computation.

Our main result is an (almost) optimal distributed randomized algorithm for graph connectivity. Our algorithm runs in Õ(
n
/
k
2
) rounds (Õ notation hides a polylog(
n
) factor and an additive polylog(
n
) term). This improves over the best previously known bound of Õ(
n
/
k
) [Klauck et al., SODA 2015] and is optimal (up to a polylogarithmic factor) in light of an existing lower bound of Ω
˜
(
n
/
k
2
). Our improved algorithm uses a bunch of techniques, including linear graph sketching, that prove useful in the design of efficient distributed graph algorithms. Using the connectivity algorithm as a building block, we then present fast randomized algorithms for computing minimum spanning trees, (approximate) min-cuts, and for many graph verification problems. All these algorithms take Õ(
n
/
k
2
) rounds and are optimal up to polylogarithmic factors. We also show an almost matching lower bound of Ω
˜
(
n
/
k
2
) rounds for many graph verification problems by leveraging lower bounds in random-partition communication complexity.