bluuebunny/crossref_metadata_2025 huggingface dataset:
Haplotype analysis of key genes governing grain yield and quality traits across 3K RG panel reveals scope for the development of tailor‐made rice with enhanced genetic gains
Authors: Abbai Ragavendran , Singh Vikas Kumar , Nachimuthu Vishnu Varthini , Sinha Pallavi , Selvaraj Ramchander , Vipparla Abhilash Kumar , Singh Arun Kumar , Singh Uma Maheshwar , Varshney Rajeev K. , Kumar Arvind
Published: January 2019

Though several genes governing various major traits have been reported in rice, their superior haplotype combinations for developing ideal variety remains elusive. In this study, haplotype analysis of 120 previously functionally characterized genes, influencing grain yield (87 genes) and grain quality (33 genes) revealed significant variations in the 3K rice genome (RG) panel. For selected genes, meta‐expression analysis using already available datasets along with co‐expression network provided insights at systems level. Also, we conducted candidate gene based association study for the 120 genes and identified 21 strongly associated genes governing 10‐grain yield and quality traits. We report superior haplotypes upon phenotyping the subset of 3K RG panel, SD1‐H8 with haplotype frequency (HF) of 30.13% in 3K RG panel, MOC1‐H9 (HF: 23.08%), IPA1‐H14 (HF: 6.64%), DEP3‐H2 (HF: 5.59%), DEP1‐H2 (HF: 37.53%), SP1‐H3 (HF: 5.05%), LAX1‐H5 (HF: 1.56%), LP‐H13 (3.64%), OSH1‐H4 (5.52%), PHD1‐H14 (HF: 15.21%), AGO7‐H15 (HF: 3.33%), ROC5‐H2 (31.42%), RSR1‐H8 (HF: 4.20%) and OsNAS3‐H2 (HF: 1.00%). For heading date, Ghd7‐H8 (HF: 3.08%), TOB1‐H10 (HF: 4.60%) flowered early, Ghd7‐H14 (HF: 42.60%), TRX1‐H9 (HF: 27.97%), OsVIL3‐H14 (HF: 1.72%) for medium duration flowering, while Ghd7‐H6 (HF: 1.65%), SNB‐H9 (HF: 9.35%) were late flowering. GS5‐H4 (HF: 65.84%) attributed slender, GS5‐H5 (HF: 29.00%), GW2‐H2 (HF: 4.13%) were medium slender and GS5‐H9 (HF: 2.15%) for bold grains. Furthermore, haplotype analysis explained possible genetic basis for superiority of selected mega‐varieties. Overall, this study suggests the possibility for developing next‐generation tailor‐made rice with superior haplotype combinations of target genes suiting future food and nutritional demands via haplotype‐based breeding.
Long‐term plant community trajectories suggest divergent responses of native and non‐native perennials and annuals to vegetation removal and seeding treatments
Authors: Copeland Stella M. , Munson Seth M. , Bradford John B. , Butterfield Bradley J. , Gunnell Kevin L.
Published: January 2019

Land managers frequently apply vegetation removal and seeding treatments to restore ecosystem function following woody plant encroachment, invasive species spread, and wildfire. However, the long‐term outcome of these treatments is unclear due to a lack of widespread monitoring. We quantified how vegetation removal (via wildfire or management) with or without seeding and environmental conditions related to plant community composition change over time in 491 sites across the intermountain western United States. Most community metrics took over 10 years to reach baseline conditions posttreatment, with the slowest recovery observed for native perennial cover. Total cover was initially higher in sites with seeding after vegetation removal than sites with vegetation removal alone, but increased faster in sites with vegetation removal only. Seeding after vegetation removal was associated with rapidly increasing non‐native perennial cover and decreasing non‐native annual cover. Native perennial cover increased in vegetation removal sites irrespective of seeding and was suppressed by increasing non‐native perennial cover. Seeding was associated with higher non‐native richness across the monitoring period as well as initially higher, then declining, total and native species richness. Several cover and richness recovery metrics were positively associated with mean annual precipitation and negatively associated with mean annual temperature, whereas relationships with weather extremes depended on the lag time and season. Our results suggest that key plant groups, such as native perennials and non‐native annuals, respond to restoration treatments at divergent timescales and with different sensitivities to climate and weather variation.
Testing the Measurement Invariance of Nativism*
Authors: Zhao Yikai
Published: January 2019

Objective

Survey questions regarding immigration have been frequently used to compare how mass publics think about nativism, but it remains unclear whether the resulting nativism measures are comparable across countries. In this article, we empirically examine whether nativism achieves scalar invariance—an important measurement feature for valid instrumentation—across very different country contexts.

Method

We examine measurement invariance of a nativism scale using survey data from 22 countries representing 16,096 individual respondents. To test for invariance, we utilize multigroup confirmatory factor analysis (MG‐CFA).

Results

While the nativism scale fails to achieve full scalar invariance, we are able to establish partial scalar invariance, indicating the nativism scale is valid across many national contexts. Though highly correlated, the means of the latent nativist variable also provide different rankings than the means of an additive scale.

Conclusions

With a few limitations, nativist sentiments can be meaningfully measured across political contexts. Across 19 of the 22 countries, respondents answered survey items on nativism in ways that suggest their answers reflect the same underlying latent construct.
Young People are the Future? Comparing Adults’ and Young People’s Perceptions and Practices of Diversity in a Highly Diverse Neighbourhood
Authors: Visser Kirsten , Tersteeg Anouk K.
Published: January 2019

As today’s cities are becoming more diverse, scholars and policy makers have become increasingly interested in the impacts of living in diverse neighbourhoods on people’s perceptions of diversity. While adults’ and young people’s perceptions have been studied separately, we know little about how different age groups living in the same neighbourhood encounter and experience diversity. In this paper we explore how adults (aged 35–65) and young people (aged 12–19) in Feijenoord, Rotterdam perceive neighbourhood diversity and how this is related to encounters with differences in public, semi‐public and private neighbourhood spaces. We argue for combining generational and spatial approaches when studying perceptions of diversity by showing that these perceptions cannot be explained by age and the time people grew up in alone, but are also shaped by the different ways in which age groups use neighbourhood spaces and encounter others in these spaces.
Probable transmission of hepatitis E virus (HEV) via transfusion in the United States
Authors: Ticehurst John R. , Pisanic Nora , Forman Michael S. , Ordak Carly , Heaney Christopher D. , Ong Edgar , Linnen Jeffrey M. , Ness Paul M. , Guo Nan , Shan Hua , Nelson Kenrad E.
Published: January 2019

BACKGROUND

Hepatitis E virus (HEV) can inapparently infect blood donors. To assess transfusion transmission of HEV in the United States, which has not been documented, a donor‐recipient repository was evaluated.

STUDY DESIGN AND METHODS

To identify donations that contained HEV RNA and were linked to patient‐recipients with antibody evidence of HEV exposure, we assayed samples from the Retrovirus Epidemiology Donor Study (REDS) Allogeneic Donor and Recipient repository that represents 13,201 linked donations and 3384 transfused patients. Posttransfusion samples, determined to contain IgG anti‐HEV by enzyme‐linked immunosorbent assay, were reassayed along with corresponding pretransfusion samples for seroconversion (incident exposure) or at least fourfold IgG anti‐HEV increase (reexposure). HEV‐exposed patients were linked to donations in which HEV RNA was then detected by reverse‐transcription quantitative polymerase chain reaction, confirmed by transcription‐mediated amplification, and phylogenetically analyzed as subgenomic cDNA sequences.

RESULTS

Among all patients, 19 of 1036 (1.8%) who had IgG anti‐HEV before transfusion were reexposed; 40 of 2348 (1.7%) without pretransfusion IgG anti‐HEV seroconverted. These 59 patients were linked to 257 donations, 1 of which was positive by reverse‐transcription quantitative polymerase chain reaction and transcription‐mediated amplification. Plasma from this donation contained 5.5 log IU/mL of HEV RNA that grouped with HEV genotype 3, clade 3abchij. The patient‐recipient of RBCs from this donation had a greater than eightfold IgG increase; however, clinical data are unavailable.

CONCLUSIONS

This is the first report of probable HEV transmission via transfusion in the United States, although it has been frequently observed in Europe and Japan. Additional data on the magnitude of the risk in the United States are needed.
Hermite-Hadamard's inequalities for conformable fractional integrals
Authors: Sarıkaya Mehmet Zeki , Akkurt Abdullah , Budak Hüseyin , Yıldırım Merve Esra , Yıldırım Hüseyin
Published: January 2019

In this paper, we establish the Hermite-Hadamard type inequalities forconformable fractional integral and we will investigate some integralinequalities connected with the left and right-hand side of theHermite-Hadamard type inequalities for conformable fractional integral. Theresults presented here would provide generalizations of those given inearlier works and we show that some of our results are better than the otherresults with respect to midpoint inequalities.
Unmanned Aerial Vehicle Surveillance Under Visibility and Dwell-Time Constraints
Authors: Peters Jeffrey R. , Surana Amit , Taylor Grant S. , Turpin Terry S. , Bullo Francesco
Published: January 2019

A framework is introduced for planning unmanned aerial vehicle (UAV) flight paths for visual surveillance of ground targets, each having particular viewing requirements. Specifically, the framework is designed for instances in which each target is associated with a set of imaging parameters, including a desired: (i) tilt angle, (ii) azimuth, with the option of a 360 deg view, and (iii) dwell-time. Tours are sought to image the targets, while minimizing both the total mission time and the time required to reach the initial target. An ϵ-constraint scalarization is used to pose the multi-objective problem as a constrained optimization, which, through careful discretization, can be approximated as a discrete graph-search. It is shown that, in many cases, this approximation is equivalent to a generalized traveling salesperson problem (GTSP). A heuristic procedure for solving the discrete approximation and recovering solutions to the full routing problem is presented and illustrated through numerical studies.
Backlash Identification in Two-Mass Systems by Delayed Relay Feedback
Authors: Ruderman Michael , Yamada Shota , Fujimoto Hiroshi
Published: January 2019

Backlash, also known as mechanical play, is a piecewise differentiable nonlinearity which exists in several actuated systems, comprising, e.g., rack-and-pinion drives, shaft couplings, toothed gears, and other machine elements. Generally, the backlash is nested between the moving parts of a complex dynamic system, which handicaps its proper detection and identification. A classical example is the two-mass system which can approximate numerous mechanisms connected by a shaft (or link) with relatively high stiffness and backlash in series. Information about the presence and extent of the backlash is seldom exactly known and is rather conditional upon factors such as wear, fatigue, and incipient failures in the components. This paper proposes a novel backlash identification method using one-side sensing of a two-mass system. The method is based on the delayed relay operator in feedback that allows stable and controllable limit cycles to be induced and operated within the (unknown) backlash gap. The system model, with structural transformations required for the one-side backlash measurements, is given, along with the analysis of the delayed relay in velocity feedback. Experimental evaluations are shown for a two-inertia motor bench that has coupling with backlash gap of about 1 deg.
Fault Detection and Isolation for Complex Thermal Management Systems
Authors: Tannous Pamela J. , Alleyne Andrew G.
Published: January 2019

This paper presents a fault detection and isolation (FDI) approach for actuator faults of complex thermal management systems. In the case of safety critical systems, early fault diagnosis not only improves system reliability, but can also help prevent complete system failure (i.e., aircraft system). In this work, a robust unknown input observer (UIO)-based actuator FDI approach is applied on an example aircraft fluid thermal management system (FTMS). Robustness is achieved by decoupling the effect of unknown inputs modeled as additive disturbances (i.e., modeling errors, linearization errors, parameter variations, or model order reduction errors) from the residuals generated from a bank of UIOs. Robustness is central to avoid false alarms without reducing residual sensitivity to actual faults in the system. System dynamics are modeled using a graph-based approach. A structure preserving aggregation-based model-order reduction technique is used to reduce the complexity of the dynamic model. A reduced-order linearized state space model is then used in a bank of UIOs to generate a set of structured robust (in the sense of disturbance decoupling) residuals. Simulation and experimental results show successful (i.e., no false alarms) actuator FDI in the presence of unknown inputs.
Accurate and Efficient Plate and Rod Microfinite Element Models for Whole Bone Segments Based on High-Resolution Peripheral Computed Tomography
Authors: Wang Ji , Zhou Bin , Jenny Hu Yizhong , Zhang Zhendong , Eric Yu Y. , Nawathe Shashank , Nishiyama Kyle K. , Keaveny Tony M. , Shane Elizabeth , Edward Guo X.
Published: January 2019

The high-resolution peripheral quantitative computed tomography (HR-pQCT) provides unprecedented visualization of bone microstructure and the basis for constructing patient-specific microfinite element (μFE) models. Based on HR-pQCT images, we have developed a plate-and-rod μFE (PR μFE) method for whole bone segments using individual trabecula segmentation (ITS) and an adaptive cortical meshing technique. In contrast to the conventional voxel approach, the complex microarchitecture of the trabecular compartment is simplified into shell and beam elements based on the trabecular plate-and-rod configuration. In comparison to voxel-based μFE models of μCT and measurements from mechanical testing, the computational and experimental gold standards, nonlinear analyses of stiffness and yield strength using the HR-pQCT-based PR μFE models demonstrated high correlation and accuracy. These results indicated that the combination of segmented trabecular plate-rod morphology and adjusted cortical mesh adequately captures mechanics of the whole bone segment. Meanwhile, the PR μFE modeling approach reduced model size by nearly 300-fold and shortened computation time for nonlinear analysis from days to within hours, permitting broader clinical application of HR-pQCT-based nonlinear μFE modeling. Furthermore, the presented approach was tested using a subset of radius and tibia HR-pQCT scans of patients with prior vertebral fracture in a previously published study. Results indicated that yield strength for radius and tibia whole bone segments predicted by the PR μFE model was effective in discriminating vertebral fracture subjects from nonfractured controls. In conclusion, the PR μFE model of HR-pQCT images accurately predicted mechanics for whole bone segments and can serve as a valuable clinical tool to evaluate musculoskeletal diseases.
Cardioid microphones/hydrophones in a collocated and orthogonal triad—A steerable beamformer with no beam-pointing error
Authors: Nnonyelu Chibuzo Joseph , Wong Kainam Thomas , Wu Yue Ivan
Published: January 2019

Cardioid sensors offer low sidelobes/backlobes compared to figure-8 bi-directional sensors (like velocity-sensors). Three cardioid sensors, in orthogonal orientation and in spatial collocation, have recently been proposed by Wong, Nnonyelu, and Wu [(2018). IEEE Trans. Sign. Process. 66(4), 895–906] and such a cardioid-triad's “spatial matched filter” beam-pattern has been analyzed therein. That beam-pattern, unfortunately, suffers pointing error, i.e., the spatial beam's actual peak direction deviates from the nominal “look direction.” Instead, this paper will propose a steerable data-independent beamformer for the above-mentioned cardioidic triad to avoid beam-pointing error. Also analytically derived here (via multivariate calculus) is this beam-pattern's lobes' height ratio, beamwidth, directivity, and array gain.
Inspiratory Muscle Training: Improvement of Exercise Performance With Acute Hypoxic Exposure
Authors: Hursh Daniel G. , Baranauskas Marissa N. , Wiggins Chad C. , Bielko Shane , Mickleborough Timothy D. , Chapman Robert F.
Published: January 2019

Endurance exercise performance in hypoxia may be influenced by an ability to maintain high minute ventilation () in defense of reduced arterial oxyhemoglobin saturation. Inspiratory muscle training (IMT) has been used as an effective intervention to attenuate the negative physiological consequences associated with an increased , resulting in improved submaximal-exercise performance in normoxia. However, the efficacy of IMT on hypoxic exercise performance remains unresolved. Purpose: To determine whether chronic IMT improves submaximal-exercise performance with acute hypoxic exposure. Methods: A total of 14 endurance-trained men completed a 20-km cycling time trial (TT) in normobaric hypoxia (fraction of inspired oxygen [FiO2] = 0.16) before and after either 6 wk of an IMT protocol consisting of inspiratory loads equivalent to 80% of sustained maximal inspiratory pressure (n = 9) or a SHAM protocol (30% of sustained maximal inspiratory pressure; n = 5). Results: In the IMT group, 20-km TT performance significantly improved by 1.45 (2.0%), P = .03, after the 6-wk intervention. The significantly faster TT times were accompanied by a higher average (pre vs post: 99.3 [14.5] vs 109.9 [18.0] L·min−1, P = .01) and absolute oxygen uptake (pre vs post: 3.39 [0.52] vs 3.60 [0.58] L·min−1, P = .010), with no change in ratings of perceived exertion or dyspnea (P > .06). There were no changes in TT performance in the SHAM group (P = .45). Conclusion: These data suggest that performing 6 wk of IMT may benefit hypoxic endurance exercise performance lasting 30–40 min.
Effect of Heavy Resisted Sled Sprint Training During the Competitive Season on Sprint and Change-of-Direction Performance in Professional Soccer Players
Authors: McMorrow Brian J. , Ditroilo Massimiliano , Egan Brendan
Published: January 2019

Purpose: Resisted sled sprinting (RSS) is an effective tool for improving sprint performance over short distances, but the effect on change-of-direction (COD) performance is largely unknown. The present study investigated the effect of heavy RSS training during the competitive season on sprint and COD performance in professional soccer players. Methods: Over 6 wk in-season, an RSS training group (n = 6) performed RSS at a sled load of 30% body mass for a total program running distance of 800 m, whereas an unresisted sprint (URS) training group (n = 7) performed the same distance of unresisted sprinting. A 20-m maximal sprint with split times measured at 5, 10, and 20 m and the sprint 9-3-6-3-9 m with 180° turns COD test were performed before and after the intervention. Results: Sprint performance (mean, 95% confidence limits, qualitative inference) was improved in both groups over 5 m (URS, 5.1%, −2.4 to 12.7, likely moderate; RSS, 5.4%, 0.5–10.4, likely moderate), 10 m (URS, 3.9%, −0.3 to 8.1, very likely moderate; RSS, 5.0%, 1.8–8.0, very likely large), and 20 m (URS, 2.0%, −0.6 to 4.5, likely moderate; RSS, 3.0%, 1.7–4.4, very likely moderate). COD was improved in both groups (URS, 3.7%, 2.2–5.2, most likely large; RSS, 3.3%, 1.6–5.0, most likely moderate). Between-groups differences were unclear. Conclusion: Heavy RSS and URS training matched for running distance were similarly effective at improving sprint and COD performance in professional soccer players when performed in the competitive phase of the season.
Transcriptional regulation of microalgae for concurrent lipid overproduction and secretion
Authors: Li Da-Wei , Balamurugan Srinivasan , Yang Yu-Feng , Zheng Jian-Wei , Huang Dan , Zou Li-Gong , Yang Wei-Dong , Liu Jie-Sheng , Guan Yuanfang , Li Hong-Ye
Published: January 2019

NobZIP1 governs the expression of various key genes, leading to lipid overproduction and secretion in
Nannochloropsis oceanica
.
Mitochondrial DNA and temperature tolerance in lager yeasts
Authors: Baker EmilyClare P. , Peris David , Moriarty Ryan V. , Li Xueying C. , Fay Justin C. , Hittinger Chris Todd
Published: January 2019

Mitochondrial genome origin affects the temperature tolerance of synthetic and industrial lager-brewing yeast hybrids.
Vision-based grasp learning of an anthropomorphic hand-arm system in a synergy-based control framework
Authors: Ficuciello F. , Migliozzi A. , Laudante G. , Falco P. , Siciliano B.
Published: January 2019

A reinforcement learning algorithm associates postural synergies to geometric object features for stable grasps of unknown objects.
SlyA and HilD Counteract H-NS-Mediated Repression on the
ssrAB
Virulence Operon of
Salmonella enterica
Serovar Typhimurium and Thus Promote Its Activation by OmpR
Authors: Banda María M. , Zavala-Alvarado Crispín , Pérez-Morales Deyanira , Bustamante Víctor H.
Published: January 2019

The global regulator H-NS represses the expression of acquired genes and thus avoids possible detrimental effects on bacterial fitness. Regulatory mechanisms are adapted to induce expression of the acquired genes in particular niches to obtain a benefit from the information encoded in the foreign DNA, as for pathogenesis. Here, we show two mechanisms that were integrated for the expression of virulence genes in
Salmonella
Typhimurium. One involves the additive action of the regulators SlyA and HilD, whereas the other involves SlyA, but not HilD, to counteract H-NS-mediated repression on the
ssrAB
operon, thus favoring its activation by the OmpR regulator. To our knowledge, this is the first report involving the coordinated action of two regulators to counteract H-NS-mediated repression.
Depositional architecture and structural evolution of a region immediately inboard of the locus of continental breakup (Liwan Sub-basin, South China Sea)
Authors: Lei Chao , Alves Tiago M. , Ren Jianye , Pang Xiong , Yang Linlong , Liu Jun
Published: January 2019

New 3-D seismic data and regional 2-D seismic profiles from the northern South China Sea, the most extensive data set imaging a distal rifted margin in the world, are used to characterize a region located immediately inboard of the locus of Cenozoic continental breakup. The interpreted data set images a ∼6-km-thick continental crust in which the Moho and the base of syn-rift sediment are observed as clear, well-resolved seismic reflections. This extremely thinned continental crust was offset at its base by a complex detachment fault system from which oceanward-dipping listric faults propagated vertically to bound six separate tilted blocks, in a style akin to tectonic rafts. The seismic reflection data allowed us to investigate the thickness of syn- and post-rift strata above tilt blocks, revealing that the early-middle Eocene syn-rift topography was gradually blanketed in the late Eocene (ca. 38 Ma). After 33 Ma (earliest Oligocene), the main depocenter on the margin migrated to the south of the Liwan Sub-basin, i.e., oceanwards, as recorded by the thickening of strata within a breakup sequence. This work is important as it demonstrates how closely structures and sedimentation within the Liwan Sub-basin were controlled by a basal, rift-related detachment system, which is imaged in detail by 3-D seismic data for the first time on a rifted continental margin. Continental breakup was marked by a shift in the locus of subsidence (and crustal stretching) toward ocean crust, within a time period spanning ∼16 m.y. We extrapolate our findings from the South China Sea to the development of asymmetric passive margins across the world.
Stroke or side effect? dofetilide associated facial paralysis after direct current cardioversion for atrial fibrillation
Authors: Zhang Lane , Steckman David
Published: January 2019

Dofetilide is a class III antiarrhythmic drug that has proven efficacious in maintaining sinus rhythm in up to 60% of patients with persistent atrial fibrillation. Dofetilide’s most concerning adverse effect is QT prolongation and polymorphic VT, but providers should be aware of other rare significant side effects. We report a case of dofetilide associated Bell’s palsy masquerading as stroke that developed shortly after a cardioversion. The patient’s facial weakness, a side effect of dofetilide, resolved relatively quickly after discontinuation of the medication and a short course of oral corticosteroids.
Proximal tibiofibular joint dislocation: a rare entity
Authors: Mamound Aziz , Hoencamp Rigo , Bosman Willem-Maarten , Leijnen Michiel
Published: January 2019

A 37-year-old woman was diagnosed with an isolated proximal tibiofibular joint dislocation (PTJD) after an accident during gymnastic exercise. The dislocation has a low incidence rate and is often missed in the emergency department as physical and radiology signs are subtle. Treatment consists of closed or open reduction and immobilisation. When it is not recognised it is associated with significant peroneal nerve injury.
Areal summed corneal power shift is an important determinant for axial length elongation in myopic children treated with overnight orthokeratology
Authors: Hu Yin , Wen Canhong , Li Zhouyue , Zhao Wenchen , Ding Xiaohu , Yang Xiao
Published: January 2019

Background

The myopia control effect of orthokeratology (OK) varies among individuals. The variation might relate to the proposed ‘areal summation effect’ of lens-induced visual signals. The current study evaluated the areal summed corneal power shift (ASCPS) in myopic children treated with OK lenses and assessed whether the ASCPS achieved at early post-OK visit can predict the lens long-term effect on the axial length (AL) elongation.

Methods

Study participants were 130 myopic children treated with OK lenses (age range, 8 to 15 years) in a prospective study. Corneal topography and AL were measured at baseline and 1, 3, 6, 9 and 12 months after OK lens wear. The ASCPS was derived from corneal topographic measurements and defined as the change in the areal summed corneal relative refraction at the follow-up visit from baseline. The impact of the ASCPS achieved at the 1 month post-OK visit on the 12 months AL elongation was examined using multivariate linear regression analysis.

Results

Baseline age of the study participants was 11.8 ± 1.8 years and their mean spherical equivalent was −3.00±0.92 D. The ASCPS was 6.90±6.09 D*mm at the 1 month visit and remained stable throughout the follow-up period (p=0.5508, repeated-measures analysis of variance). Greater 1 month ASCPS was associated with slower AL elongation at the 12 months visit (β=−0.007, p=0.001).

Conclusions

The ASCPS achieved at early post-OK visit is predictive for the lens long-term effect on the myopic AL elongation. The parameter is potential in guiding the OK lens practice to slow down axial growth in myopic children.
Ziv-aflibercept versus bevacizumab administration prior to diabetic vitrectomy: a randomised and controlled trial
Authors: Aleman Isaac , Castillo Velazquez Javier , Rush Sloan W , Rush Ryan B
Published: January 2019

Purpose

To compare the effectiveness of intravitreal ziv-aflibercept (IVZ) to intravitreal bevacizumab (IVB) administered preoperatively to patients undergoing pars plana vitrectomy (PPV) for severe manifestations of proliferative diabetic retinopathy (PDR).

Design

Randomised clinical trial (RCT).

Methods

Two hundred and six patients with PDR-related complications requiring PPV were randomised into one of two treatment groups: Group A received IVZ (1.25 mg/0.05 mL) 1–10 days before PPV, while Group B received IVB (1.25 mg/0.05 mL) 1–10 days before PPV. The primary outcome was best-corrected visual acuity (BCVA) at 6 months follow-up. Secondary outcome measures were perioperative tractional retinal detachment (TRD) rates, surgical times, intraoperative and postoperative complications and incidence of unplanned PPV during the 6 month study interval.

Results

One hundred and seventy three subjects underwent PPV and completed the 6-month follow-up interval. Group A subjects had better BCVA at 6 months (p=0.0035), shorter surgical times (p=0.0013) and were less likely to have a recurrence of vitreous haemorrhaging in the postoperative period (p=0.0101) when compared with subjects in Group B. There were no significant differences among the treatment groups with regards to baseline characteristics, perioperative TRD development, intraoperative complications and incidence of unplanned PPV during the 6 month study interval.

Conclusions

This RCT demonstrated better final visual outcomes, shorter operating times and less vitreous haemorrhage recurrences in the postoperative period when subjects received IVZ compared to IVB prior to PPV for the treatment of PDR-related complications.
Classification of disease severity in retinitis pigmentosa
Authors: Iftikhar Mustafa , Lemus Marili , Usmani Bushra , Campochiaro Peter A , Sahel José Alain , Scholl Hendrik P N , Shah Syed Mahmood Ali
Published: January 2019

Aim

To develop a simple and easily applicable classification of disease severity in retinitis pigmentosa (RP).

Methods

This is a retrospective cross-sectional study. Visual acuity (VA), visual field width (VF) and ellipsoid zone width (EZ) were obtained from medical records of patients with RP. A scoring criterion was developed wherein each variable was assigned a score from 0 to 5 depending on its distribution. The cumulative score (from 0 to 15) was used to classify disease severity from grade 0 to 5. The scores were correlated with each other and the final grade. The grades were then correlated with age and disease duration.

Results

The median age (range) of patients (n=93) was 55 (12–87) years, 51% were female, 70% had been diagnosed within 10 years, and 50% had autosomal recessive disease. Most eyes (n=181) at least had a VA of 20/40 (67%), a VF of 20° (75%) and an EZ of 5° (76%). All scores were correlated with each other (r=0.509–0.613; p<0.001 for all) and with the final grade (r=0.790–0.869; p<0.001 for all). Except for grade 0 (5%), all grades were evenly distributed: 21% for grade 1, 23% for grade 2, 22% for grade 3, 17% for grade 4 and 12% for grade 5. Grades were correlated with both age (r=0.252; p<0.001) and disease duration (r=0.383; p<0.001).

Conclusions

We present a simple, objective and easy to use disease severity classification for RP which can be used to categorise and compare patients.
Tuberculosis: treatment failure, or failure to treat? Lessons from India and South Africa
Authors: Padayatchi Nesri , Daftary Amrita , Naidu Naressa , Naidoo Kogieleum , Pai Madhukar
Published: January 2019

Tuberculosis (TB) remains an enormous public health concern globally. India and South Africa rank among the top 10 high TB burden countries with the highest absolute burden of TB, and the second highest rate of TB incidence, respectively. Although the primary drivers of TB transmission vary considerably between these two countries, they do indeed share common themes. In 2017, only 64% of the global estimated incident cases of TB were reported, the remaining 36% of ‘missing’ cases were either undiagnosed, untreated or unreported. These ‘missing TB cases’ have generated much hype for the challenges they present in achieving the End TB Strategy. Although India and South Africa have indeed made significant strides in TB control, analysis of the patient cascade of care clearly suggests that these ‘missed’ patients are not really missing—most are actively engaging the health system—the system, however, is failing to appropriately manage them. In short, quality of TB care is suboptimal and must urgently be addressed, merely focusing on coverage of TB services is no longer sufficient. While the world awaits revolutionary vaccines, drugs and diagnostics, programmatic data indicate that much can be done to accelerate the decline of TB. In this perspective, we compare and contrast these two national epidemics, and explore barriers, with a particular focus on the role of health systems in finding the missing millions.
Assessing global preparedness for the next pandemic: development and application of an Epidemic Preparedness Index
Authors: Oppenheim Ben , Gallivan Mark , Madhav Nita K , Brown Naor , Serhiyenko Volodymyr , Wolfe Nathan D , Ayscue Patrick
Published: January 2019

Introduction

Robust metrics for national-level preparedness are critical for assessing global resilience to epidemic and pandemic outbreaks. However, existing preparedness assessments focus primarily on public health systems or specific legislative frameworks, and do not measure other essential capacities that enable and support public health preparedness and response.

Methods

We developed an Epidemic Preparedness Index (EPI) to assess national-level preparedness. The EPI is global, covering 188 countries. It consists of five subindices measuring each country’s economic resources, public health communications, infrastructure, public health systems and institutional capacity. To evaluate the construct validity of the EPI, we tested its correlation with proxy measures for preparedness and response capacity, including the timeliness of outbreak detection and reporting, as well as vaccination rates during the 2009 H1N1 influenza pandemic.

Results

The most prepared countries were concentrated in Europe and North America, while the least prepared countries clustered in Central and West Africa and Southeast Asia. Better prepared countries were found to report infectious disease outbreaks more quickly and to have vaccinated a larger proportion of their population during the 2009 pandemic.

Conclusion

The EPI measures a country’s capacity to detect and respond to infectious disease events. Existing tools, such as the Joint External Evaluation (JEE), have been designed to measure preparedness within a country over time. The EPI complements the JEE by providing a holistic view of preparedness and is constructed to support comparative risk assessment between countries. The index can be updated rapidly to generate global estimates of pandemic preparedness that can inform strategy and resource allocation.
Intervention to reduce benzodiazepine prescriptions in primary care, study protocol of a hybrid type 1 cluster randomised controlled trial: the BENZORED study
Authors: Vicens Caterina , Leiva Alfonso , Bejarano Ferran , Sempere Ermengol , Rodríguez-Rincón Raquel María , Fiol Francisca , Mengual Marta , Ajenjo Asunción , Do Pazo Fernando , Mateu Catalina , Folch Silvia , Alegret Santiago , Coll Jose Maria , Martín-Rabadán María , Socias Isabel
Published: January 2019

Introduction

Benzodiazepines (BZDs) are mainly used to treat anxiety and sleep disorders, and are often prescribed for long durations, even though prescription guidelines recommend short-term use due to the risk of dependence, cognitive impairment, and falls and fractures. Education of general practitioners (GPs) regarding the prescription of BZDs may reduce the overuse and of these drugs.

The aims of this study are to analyse the effectiveness of an intervention targeted to GPs to reduce BZD prescription and evaluate the implementation process.

Methods and analysis

The healthcare centres in three regions of Spain (Balearic Islands, Catalonia and Community of Valencia) will be randomly allocated to receive a multifactorial intervention or usual care (control). GPs in the intervention group will receive a 2-hour workshop about best-practice regarding BZD prescription and BZD deprescribing, monthly feedback about their BZD prescribing practices and access to a support web page. Outcome measures for each GP are the defined daily dosage per 1000 inhabitants per day and the proportion of long-term BZD users at 12 months. Data will be collected from the electronic prescription database of the public health system, and will be subjected to intention-to-treat analysis. Implementation will be evaluated by mixed methods following the five domains of the Consolidated Framework For Implementation Research.

Ethics and dissemination

This study was approved by the Balearic Islands Ethical Committee of Clinical Research (IB3065/15), l’IDIAP Jordi Gol Ethical Committee of Clinical Research (PI 15/0148) and Valencia Primary Care Ethical Committee of Clinical Research (P16/024). The results will be submitted for publication in peer-reviewed journals.

Trial registration number

ISRCTN28272199.
Demographic and clinical characteristics of hospitalised unintentional poisoning in Aboriginal and non-Aboriginal preschool children in New South Wales, Australia: a population data linkage study
Authors: Lee Caroline , Hanly Mark , Larter Natasha , Zwi Karen , Woolfenden Susan , Jorm Louisa
Published: January 2019

Objectives

To investigate differences in demographic and clinical characteristics of Aboriginal and non-Aboriginal children aged 0–4 years hospitalised for unintentional poisoning in New South Wales (NSW), Australia.

Design and setting

Retrospective whole-of-population cohort analysis of linked hospital and mortality data for 2000–2014.

Participants

All children (Aboriginal and non-Aboriginal) under the age of 5 years who were born in a hospital in NSW from 2000 to 2009.

Outcomes

The primary outcome was hospitalisation for unintentional poisoning. Logistic regression was used to estimate odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children. Poisoning agents and clinical outcomes were compared by Aboriginality.

Results

The cohort included 767 119 children, including 28 528 (3.7%) Aboriginal children. Aboriginal children had approximately three times higher rates of hospitalised poisoning (1.34%) compared with non-Aboriginal children (0.41%). Poisoning incidence peaked at 2–3 years of age. Male sex, socioeconomic disadvantage and geographical remoteness were associated with higher odds of poisoning hospitalisation for Aboriginal and non-Aboriginal children, but associations with disadvantage and remoteness were statistically significant only for non-Aboriginal children. Most (83%) poisonings were caused by pharmaceutical agents. Few Aboriginal and non-Aboriginal children had repeat admissions for poisoning; most had a length of stay of 1 day or less. Only 8% of poisoning admissions involved contact with a social worker.

Conclusion

Commonly used medications in the general population contribute to poisonings among both Aboriginal and non-Aboriginal preschool-aged children. This study highlights a need to develop culturally safe poisoning prevention strategies and policies.
Protocol of a scoping review assessing injury rates and their determinants among healthcare workers in western countries
Authors: Bragazzi Nicola Luigi , Dini Guglielmo , Parodi Valentina , Blasi Carlo , Linares Roberta , Mortara Virginia , Toletone Alessandra , Bersi Francesca Maria , D’Amico Beatrice , Massa Emanuela , Montecucco Alfredo , Debarbieri Nicoletta , Durando Paolo
Published: January 2019

Introduction

Healthcare workers (HCWs) are exposed to various risk factors and risky behaviours that may seriously affect their health and ability to work. The aim of this protocol is to detail the steps to follow in order to carry out a scoping review to assess the prevalence/incidence of injuries among HCWs.

Methods and analysis

The study will be carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocols guidelines. Studies will be selected according to the following criteria: P (HCWs), E (exposure to injuries), C (different types of exposure and different categories of HCWs) and O (prevalence/incidence and determinants of injuries). A time filter has been set (literature between 2000 and 2018) to enable updated, direct comparison between the findings and the epidemiological data available at national and local ‘Istituto Nazionale per l’Assicurazione contro gli Infortuni sul Lavoro’ (National Institute for Insurance Against Accidents at Work) centres in Italy. No language restriction will be applied.

Ethics and dissemination

Formal ethical approval is not required; primary data will not be collected, as they have already been published. The results will be disseminated through peer-reviewed publication(s), conference presentation(s) and the press.
An approach to linking education, social care and electronic health records for children and young people in South London: a linkage study of child and adolescent mental health service data
Authors: Downs Johnny M , Ford Tamsin , Stewart Robert , Epstein Sophie , Shetty Hitesh , Little Ryan , Jewell Amelia , Broadbent Matthew , Deighton Jessica , Mostafa Tarek , Gilbert Ruth , Hotopf Matthew , Hayes Richard
Published: January 2019

Objectives

Creation of linked mental health, social and education records for research to support evidence-based practice for regional mental health services.

Setting

The Clinical Record Interactive Search (CRIS) system was used to extract personal identifiers who accessed psychiatric services between September 2007 and August 2013.

Participants

A clinical cohort of 35 509 children and young people (aged 4–17 years).

Design

Multiple government and ethical committees approved the link of clinical mental health service data to Department for Education (DfE) data on education and social care services. Under robust governance protocols, fuzzy and deterministic approaches were used by the DfE to match personal identifiers (names, date of birth and postcode) from National Pupil Database (NPD) and CRIS data sources.

Outcome measures

Risk factors for non-matching to NPD were identified, and the potential impact of non-match biases on International Statistical Classification of Diseases, 10th Revision (ICD-10) classifications of mental disorder, and persistent school absence (<80% attendance) were examined. Probability weighting and adjustment methods were explored as methods to mitigate the impact of non-match biases.

Results

Governance challenges included developing a research protocol for data linkage, which met the legislative requirements for both National Health Service and DfE. From CRIS, 29 278 (82.5%) were matched to NPD school attendance records. Presenting to services in late adolescence (adjusted OR (aOR) 0.67, 95% CI 0.59 to 0.75) or outside of school census timeframes (aOR 0.15, 95% CI 0.14 to 0.17) reduced likelihood of matching. After adjustments for linkage error, ICD-10 mental disorder remained significantly associated with persistent school absence (aOR 1.13, 95% CI 1.07 to 1.22).

Conclusions

The work described sets a precedent for education data being used for medical benefit in England. Linkage between health and education records offers a powerful tool for evaluating the impact of mental health on school function, but biases due to linkage error may produce misleading results. Collaborative research with data providers is needed to develop linkage methods that minimise potential biases in analyses of linked data.
Feasibility and acceptability of telehealth coaching to promote healthy eating in chronic kidney disease: a mixed-methods process evaluation
Authors: Kelly Jaimon T , Warner Molly M , Conley Marguerite , Reidlinger Dianne P , Hoffmann Tammy , Craig Jonathan , Tong Allison , Reeves Marina , Johnson David W , Palmer Suetonia , Campbell Katrina L
Published: January 2019

Objective

To evaluate the feasibility and acceptability of a personalised telehealth intervention to support dietary self-management in adults with stage 3–4 chronic kidney disease (CKD).

Design

Mixed-methods process evaluation embedded in a randomised controlled trial.

Participants

People with stage 3–4 CKD (estimated glomerular filtration rate [eGFR]15–60 mL/min/1.73 m2).

Setting

Participants were recruited from three hospitals in Australia and completed the intervention in ambulatory community settings.

Intervention

The intervention group received one telephone call per fortnight and 2–8 tailored text messages for 3 months, and then 4–12 tailored text messages for 3 months without telephone calls. The control group received usual care for 3 months then non-tailored education-only text messages for 3 months.

Main outcome measures

Feasibility (recruitment, non-participation and retention rates, intervention fidelity and participant adherence) and acceptability (questionnaire and semistructured interviews).

Statistical analyses performed

Descriptive statistics and qualitative content analysis.

Results

Overall, 80/230 (35%) eligible patients who were approached consented to participate (mean±SD age 61.5±12.6 years). Retention was 93% and 98% in the intervention and control groups, respectively, and 96% of all planned intervention calls were completed. All participants in the intervention arm identified the tailored text messages as useful in supporting dietary self-management. In the control group, 27 (69%) reported the non-tailored text messages were useful in supporting change. Intervention group participants reported that the telehealth programme delivery methods were practical and able to be integrated into their lifestyle. Participants viewed the intervention as an acceptable, personalised alternative to face-face clinic consultations, and were satisfied with the frequency of contact.

Conclusions

This telehealth-delivered dietary coaching programme is an acceptable intervention which appears feasible for supporting dietary self-management in stage 3–4 CKD. A larger-scale randomised controlled trial is needed to evaluate the efficacy of the coaching programme on clinical and patient-reported outcomes.

Trial registration number

ACTRN12616001212448; Results.
Living with dementia with Lewy bodies: an interpretative phenomenological analysis
Authors: Larsson Victoria , Holmbom-Larsen Axel , Torisson Gustav , Strandberg Eva Lena , Londos Elisabet
Published: January 2019

Objective

To explore the subjective experience of living with dementia with Lewy bodies (DLB).

Design

A qualitative study of in-depth interviews using interpretative phenomenological analysis.

Setting

A memory clinic in Malmö, southern Sweden.

Participants

A purposive sample of five male participants with DLB between the ages of 78 and 88 years and disease duration of 1.5–7 years.

Results

Three themes were identified in relation to the participants’ experiences of living with DLB: (1) disease impact, in terms of symptom experience and restricted participation and activities; (2) self-perception and coping strategies; (3) importance of others, such as healthcare, family and friends.

Conclusions

This study provides a broad insight into the first-hand experience of living with DLB and how it compares with other dementia types. Findings highlight factors characterising the disease experience and well-being, and how persons with DLB address challenges arising secondary to disease. These findings are important for both research and clinical practice, demonstrating the feasibility of direct involvement of DLB persons in identifying important aspects of care, which include improved healthcare services.