bluuebunny/crossref_metadata_2025 huggingface dataset:
Is marijuana use associated with decreased use of prescription opioids? Toxicological findings from two US national samples of drivers
Authors: Li Guohua , Chihuri Stanford
Published: February 2020

Background

State governments in the United States are increasingly viewing marijuana legalization as a policy option for controlling the opioid epidemic under the premise that marijuana is a less harmful substitute for opioids. The purpose of this study is to assess whether marijuana use is associated with decreased odds of prescription opioid use.

Methods

A cross-sectional study design was applied to toxicological testing data from two national samples of drivers: 1) the 2011–2016 Fatality Analysis Reporting System (FARS) and 2) the 2013–2014 National Roadside Survey of Alcohol and Drug Use by Drivers (NRS). Adjusted odds ratios (ORs) and 95% confidence intervals (CIs) estimated from multivariable logistic regression models were used to assess the associations of marijuana use with prescription opioid use and alcohol use.

Results

Among the 47,602 drivers from the FARS, 15.7% tested positive for marijuana and 6.9% positive for prescription opioids. Compared with drivers testing negative for marijuana, those testing positive for marijuana were 28% more likely to test positive for prescription opioids (adjusted OR = 1.28, 95% CI = 1.15–1.42). Among the 7881 drivers from the NRS, 7.9% tested positive for marijuana and 4.5% positive for prescription opioids. Relative to drivers testing negative for marijuana, those testing positive for marijuana were twice as likely to test positive for prescription opioids (adjusted OR = 2.03, 95% CI = 1.29–3.20). In both study samples, marijuana use was associated with significantly increased odds of alcohol positivity.

Conclusions

Drivers who test positive for marijuana are significantly more likely to test positive for prescription opioids. Longitudinal studies with rigorous designs and toxicological testing data are needed to further address the substitution hypothesis between marijuana and prescription opioids.
The opioid mortality epidemic in North America: do we understand the supply side dynamics of this unprecedented crisis?
Authors: Fischer Benedikt , Pang Michelle , Jones Wayne
Published: February 2020

While there has been extensive attention to the ‘demand side’ – or use and adverse consequences, including mortality – of the ‘opioid crisis’ presently unfolding across North America, few considerations have focused on the supply side. This paper examines the supply side dynamics of this unprecedented public health phenomenon. We provide evidence for several interrelated supply-side elements that have contributed to the present public health crisis. We observe that initially, persistently high levels of prescription opioid availability and use exposed large proportions of the North American population to opioids, resulting in correspondingly high levels of medical and non-medical use (e.g., involving diversion). While various intervention measures to control prescription opioid availability and use have been implemented in recent years, leading to eventual reductions in opioid dispensing levels, these occurred late in the crisis’s evolution. Moreover, these supply reductions have not been met by corresponding reductions in opioid use or demand levels. These growing discrepancies between opioid demand and prescription-based sources have left major gaps in opioid supplies. In response to such supply gaps, highly potent and toxic illicit opioid products have rapidly proliferated across North America, and become a core driver of the dramatic spikes in opioid overdose fatality levels in recent years. These supply-related interrelations are corroborated by a corresponding increase in illicit opioid-related fatalities, which arose just as medical opioid supplies began to decrease in many jurisdictions. Improved analyses and understanding of the supply-side dynamics of the opioid crisis are urgently needed in order to inform future intervention and policy development. Meanwhile, the high mortality toll related to illicit, highly toxic opioid exposure requires sustained solutions, including supply-oriented measures (e.g., safer opioid distribution for at–risk users) towards improved public health protection.
Acoustic diagnosis of elastic properties of human tooth by 320 MHz scanning acoustic microscopy after radiotherapy treatment for head and neck cancer
Authors: Demirkan Irem , Yaprak Gokhan , Ceylan Cemile , Algul Emriye , Tomruk Ceyda Ozcakir , Bilen Bukem , Unlu Mehmet Burcin
Published: February 2020

Background

On the elastic profiles of human teeth after radiotherapy for head and neck cancers, generation of dental complications, which may bring several side effects preventing the quality of life, has not well clarified. Thus, we aimed to show the applicability of using 320 MHz Scanning Acoustic Microscopy (SAM) in the evaluation of the tooth damage acoustically at the micrometer level following radiation therapy, and also in the determination of the safe dose limits to impede severe dental damage.

Methods

This prospective study was performed by SAM employed at 320 MHz by an azimuthal resolution of 4.7 μm resolving enamel and dentin. A total of 45 sound human third molar teeth collected between September 2018 and May 2019 were used for the acoustic impedance measurements pre- and post irradiation. Nine samples for each group (control, 2 Gy, 8 Gy, 20 Gy, 30 Gy and 60 Gy) were evaluated to acquire the acoustic images and perform a qualitative analysis. Scanning Electron Microscopy (SEM) images were obtained to establish a relationship between micromechanical and morphological characteristics of the teeth. Statistical analysis was conducted using the Student t-test succeded by Mann-Whitney U investigation (p < .05), while SEM images were assessed qualitatively.

Results

The analysis included 45 sound teeth collected from men and women 18 to 50 years old. Post irradiation micromechanical variations of human teeth were significant only in the radiation groups of 30 Gy and 60 Gy compared to pre-irradiation group for enamel (7.24 ± 0.18 MRayl and 6.49 ± 028 MRayl; p < 0.05, respectively). Besides, the teeth subjected to radiation doses of 20, 30 and 60 Gy represented significantly lower acoustic impedance values relative to non-irradiated group for dentin (6.52 ± 0.43 MRayl, 5.71 ± 0.66 MRayl and 4.82 ± 0.53 MRayl p < 0.05), respectively.

Conclusions

These results are evidence for a safe acoustic examination device which may be a useful tool to visualize and follow the safe dose limits to impede severe dental damage through the radiation therapy treatment for head and neck cancers.
Changing soil carbon: influencing factors, sequestration strategy and research direction
Authors: Xu Shangqi , Sheng Chunlei , Tian Chunjie
Published: February 2020

Soil carbon (C) plays a critical role in the global C cycle and has a profound effect on climate change. To obtain an in-depth and comprehensive understanding of global soil C changes and better manage soil C, all meta-analysis results published during 2001–2019 relative to soil C were collected and synthesized. The effects of 33 influencing factors on soil C were analyzed, compared and classified into 5 grades according to their effects on soil C. The effects of different categories of influencing factors, including land use change (LUC), management and climate change, on soil C and the underlying mechanism were compared and discussed. We propose that natural ecosystems have the capacity to buffer soil C changes and that increasing C inputs is one of the best measures to sequester C. Furthermore, a comparison between the meta-analyses and previous studies related to soil C based on bibliometric analysis suggested that studies on wetland soil C, soil C budgets and the effects of pollution and pesticides on soil C should be strengthened in future research.
The effect of TLR4 on the growth and local inflammatory microenvironment of HPV-related cervical cancer in vivo
Authors: Jiang Ninghong , Xie Feng , Chen Limei , Chen Fang , Sui Long
Published: February 2020

Background

Cervical cancer is the most common malignancy of the female lower genital tract. In our previous study, we found that TLR4 promotes cervical cancer cell growth in vitro. The aim of this study was to further explore the role of TLR4 in HPV-related cervical cancer in vivo by using a nude mouse xenograft model.

Methods

Cervical cancer-derived HeLa and CaSki cells (5 × 107/mL) were either stimulated with an optimal concentration of LPS for the appropriate time (HeLa cells were treated with 1 μg/mL LPS for 1 h, and CaSki cells were treated with 2 μg/mL LPS for 1.5 h) or transfected with TLR4 shRNA and then injected subcutaneously into the dorsal right posterior side of nude mice. The shortest width and longest diameter of the transplanted tumors in the nude mice were measured every 3 days.TLR4, IL-6,iNOS, IL-8,COX-2, MIP-3α, TGF-β1 and VEGF expression levels in the transplanted tumor tissue were detected by immunohistochemistry.

Results

The tumor formation rate was 100% in both HeLa and CaSki nude mouse groups. The tumors grew faster, and the cachexia symptoms were more serious in the LPS groups than in the control group. In contrast, the tumors grew slower, and the cachexia symptoms were milder in the TLR4-silenced groups. TLR4, iNOS, IL-6, MIP-3α and VEGF were highly expressed in the transplanted tumor tissues from the LPS groups, and their expression levels were decreased in the TLR4-silenced groups.

Conclusion

TLR4 expression is closely associated with the tumorigenesis and growth of HPV-positive cervical cancer; TLR4 promotes HPV-positive cervical tumor growth and facilitates the formation of a local immunosuppressive microenvironment. Eventually, these conditions may lead to cervical cancer development.
Retrospective analysis of the clinical features of 172 patients with BCR-ABL1-negative chronic myeloproliferative neoplasms
Authors: Lin Xiaolan , Huang Huifang , Chen Ping
Published: February 2020

Background

To explore the clinical features of the patients with BCR-ABL1-negative chronic myeloproliferative neoplasms (MPNs) in our hospital and to reveal the unique features of BCR-ABL1-negative MPNs patients in our center.

Methods

Retrospective analysis of routine karyotype analysis results, driver gene mutations and other related clinical parameters of 172 patients with newly diagnosed BCR-ABL1-negative MPNs who were admitted to our hospital between October 2013 and June 2018.

Results

(1) The rate of karyotypic abnormalities were 25, 6.3 and 2.9% in primary myelofibrosis (PMF), polycythemia vera (PV) and essential thrombocythemia (ET) patients, respectively. (2) The mutation rate of JAK2-V617F was 62.5%, and that of the CALR, MPL and EZH2 genes was 4.2% in PMF. The mutation rates of JAK2-V617F and JAK2-12exon were 91.3 and 1.3% in PV, respectively. The mutation rates of JAK2-V617F and CALR were 69.1 and 11.8% in ET, respectively. (3) Patients with JAK2-V617F mutation than with the wild-type gene were more often female in PMF (P = 0.027); had higher peripheral blood white blood cell (WBC) counts (P = 0.006), platelet (PLT) count (P = 0.001) and splenomegaly (P < 0.05) in PV; and had higher WBC (P = 0.001), hemoglobin concentrations (P = 0.001), lower PLT (P = 0.037), splenomegaly and endogenous coagulopathy (P < 0.05) in ET. (4) Among the PV and ET patients, those with thrombus were older than those in the nonthrombotic group.

Conclusion

PMF patients have more chromosomal abnormalities than PV and ET patients, and the effect of driver mutations on the clinical features of patients with MPNs differs among the three subtypes.
Outpatient balloon catheter vs inpatient prostaglandin for induction of labour (OBLIGE): a randomised controlled trial
Authors: Wise Michelle R. , Marriott Joy , Battin Malcolm , Thompson John M. D. , Stitely Michael , Sadler Lynn
Published: February 2020

Background

Approximately one in four pregnant women undergo an induction of labour. The purpose of this study is to investigate the clinical effectiveness, safety, and cost-effectiveness for mothers and babies of two methods of cervical ripening – inpatient care for women starting induction with vaginal prostaglandin E2 hormones, or allowing women to go home for 18 to 24 h after starting induction with a single-balloon catheter.

Methods/design

This is a multi-centre randomised controlled trial in New Zealand. Eligible pregnant women, with a live singleton baby in a cephalic presentation who undergo a planned induction of labour at term, will be randomised to outpatient balloon-catheter induction or in-hospital prostaglandin induction. The primary outcome is caesarean section rate. To detect a 24% relative risk reduction in caesarean rate from a baseline of 24.8%, with 80% power and 5% type 1 error, will require 1552 participants in a one to one ratio.

Discussion

If outpatient balloon-catheter induction reduces caesarean section rates, has additional clinical benefits, and is safe, cost-effective, and acceptable to women and clinicians, we anticipate change in induction of labour practice around the world. We think that home-based balloon-catheter induction will be welcomed as part of a patient-centred labour-induction care package for pregnant women.

Trial registration

Australia New Zealand Clinical Trials Registry (ANZCTR), ACTRN: 12616000739415. Registered on 6 June 2016.
Smartphone-based secondary prevention intervention for university students with unhealthy alcohol use identified by screening: study protocol of a parallel group randomized controlled trial
Authors: Bertholet Nicolas , Schmutz Elodie , Grazioli Véronique S. , Faouzi Mohamed , McNeely Jennifer , Gmel Gerhard , Daeppen Jean-Bernard , Cunningham John A.
Published: February 2020

Background

Unhealthy alcohol use is a leading cause of morbidity and mortality among young people, including university students. Delivering secondary prevention interventions against unhealthy alcohol use is challenging. Information technology has the potential to reach large parts of the general population. The present study is proposed to test a proactive secondary prevention smartphone-based intervention against unhealthy alcohol use.

Methods

This is a parallel-group, randomized controlled trial (1:1 allocation ratio) among 1696 university students with unhealthy alcohol use, identified by screening and followed up at 3, 6, and 12 months. Participants will be randomized to receive access to a smartphone-based intervention or to a no intervention control condition.

The primary outcome will be self-reported volume of alcohol drunk over the past 30 days, reported as the mean number of standard drinks per week over the past 30 days, measured at 6 months. Secondary outcomes will be number of heavy drinking days over the past 30 days, at 6 months. Additional outcomes will be maximum number of drinks on any day over the past 30 days, alcohol-related consequences (measured using the Short Inventory of Problems (SIP-2R), and academic performance.

Discussion

The aim of this trial is to close the evidence gap on the efficacy of smartphone-based secondary prevention interventions. If proven effective, smartphone-based interventions have the potential to reach a large portion of the population, completing what is available on the Internet.

Trial registration

ISRCTN, 10007691. Registered on 2 December 2019. Recruitment will start in April 2020.
Expression of gynoecium patterning transcription factors in Aristolochia fimbriata (Aristolochiaceae) and their contribution to gynostemium development
Authors: Peréz-Mesa Pablo , Ortíz-Ramírez Clara Inés , González Favio , Ferrándiz Cristina , Pabón-Mora Natalia
Published: February 2020

Background

InAristolochia(Aristolochiaceae) flowers, the congenital fusion of the anthers and the commissural, stigmatic lobes forms a gynostemium. Although the molecular bases associated to the apical–basal gynoecium patterning have been described in eudicots, comparative expression studies of the style and stigma regulatory genes have never been performed in early divergent angiosperms possessing a gynostemium.

Results

In this study, we assess the expression of five genes typically involved in gynoecium development inAristolochia fimbriata. We found that all five genes (AfimCRC,AfimSPT,AfimNGA,AfimHEC1andAfimHEC3) are expressed in the ovary, the placenta, the ovules and the transmitting tract. In addition, onlyAfimHEC3,AfimNGAandAfimSPTare temporarily expressed during the initiation of the stigma, while none of the genes studied is maintained during the elaboration of the stigmatic surfaces in the gynostemium.

Conclusions

Expression patterns suggest thatCRC,HEC,NGAandSPThomologs establish ovary and style identity inAristolochia fimbriata.OnlyNGA,HEC3andSPTgenes may play a role in the early differentiation of the stigmatic lobes, but none of the genes studied seems to control late stigma differentiation in the gynostemium. The data gathered so far raises the possibility that such transient expression early on provides sufficient signal for late stigma differentiation or that unidentified late identity genes are controlling stigma development in the gynostemium. Our data does not rule out the possibility that stigmas could correspond to staminal filaments with convergent pollen-receptive surfaces.
Segmentation-based image defogging using modified dark channel prior
Authors: Sabir Aneela , Khurshid Khawar , Salman Ahmad
Published: February 2020

Image acquisition under bad weather conditions is prone to yield image with low contrast, faded color, and overall poor visibility. Different computer vision applications including surveillance, object classification, tracking, and recognition get effected due to degraded hazy images. Dehazing can significantly improve contrast, balance luminance, correct distortion, remove unwanted visual effects/ and therefore enhance the image quality. As a result, image defogging is imperative pre-processing step in computer vision applications. Previously, dark channel prior-based algorithms have proven promising results over the available techniques. In this paper, we have proposed a modified dark channel prior that uses fog density and guided image-filtering technique to estimate and refine transmission map, respectively. Guided image filter speeds up the refinement of transmission map, hence reduces the overall computational complexity of algorithm. We have also incorporated segmentation of the foggy image into sky and non-sky regions, after which, the modified dark channel prior and atmospheric light is computed for each segment. Then, the average value of atmospheric light for each segment is used to estimate transmission map. We have performed quantitative and subjective comparison for effective evaluation of our proposed algorithm against the current state-of-the-art algorithms on natural and synthetic images. Different quality metrics, such as saturation, mean square error, fog density, peak signal to noise ratio, structural similarity index metric, dehazing algorithm index (DHQI), full-reference image quality assessmen (FR-IQA), and naturalness of dehazed images have shown the proposed algorithm to be better than existing techniques.
A scale-adaptive object-tracking algorithm with occlusion detection
Authors: Yuan Yue , Chu Jun , Leng Lu , Miao Jun , Kim Byung-Gyu
Published: February 2020

The methods combining correlation filters (CFs) with the features of convolutional neural network (CNN) are good at object tracking. However, the high-level features of a typical CNN without residual structure suffer from the shortage of fine-grained information, it is easily affected by similar objects or background noise. Meanwhile, CF-based methods usually update filters at every frame even when occlusion occurs, which degrades the capability of discriminating the target from background. A novel scale-adaptive object-tracking method is proposed in this paper. Firstly, the features are extracted from different layers of ResNet to produce response maps, and then, in order to locate the target more accurately, these response maps are fused based on AdaBoost algorithm. Secondly, to prevent the filters from updating when occlusion occurs, an update strategy with occlusion detection is proposed. Finally, a scale filter is used to estimate the target scale. The experimental results demonstrate that the proposed method performs favorably compared with several mainstream methods especially in the case of occlusion and scale change.
A study of coupled systems of mixed order fractional differential equations and inclusions with coupled integral fractional boundary conditions
Authors: Ntouyas Sotiris K. , Al-Sulami Hamed H.
Published: February 2020

In this work we investigate existence and uniqueness of solutions for new coupled systems of mixed order fractional differential equations and inclusions supplemented with coupled nonlocal fractional boundary conditions. We apply the Leray–Schauder alternative and the Banach contraction mapping principle to obtain the existence and uniqueness results, while in the multi-valued case we use the nonlinear alternative for Kakutani maps and Covitz and Nadler’s fixed point theorem.
Iterative algorithms for solutions of Hammerstein equations in real Banach spaces
Authors: Chidume Charles E. , Adamu Abubakar , Okereke Lois C.
Published: February 2020

LetBbe a uniformly convex and uniformly smooth real Banach space with dual space$B^{*}$B∗. Let$F:B\to B^{*}$F:B→B∗,$K:B^{*} \to B$K:B∗→Bbe maximal monotone mappings. An iterative algorithm is constructed and the sequence of the algorithm is proved to converge strongly to a solution of the Hammerstein equation$u+KFu=0$u+KFu=0. This theorem is a significant improvement of some important recent results which were proved in real Hilbert spaces under the assumption thatFandKare maximal monotonecontinuousandbounded. The continuity and boundedness restrictions onKandFhave been dispensed with, using our new method, even in the more general setting considered in our theorems. Finally, numerical experiments are presented to illustrate the convergence of the sequence of our algorithm.
Flies from a tertiary hospital in Rwanda carry multidrug-resistant Gram-negative pathogens including extended-spectrum beta-lactamase-producing E. coli sequence type 131
Authors: Heiden Stefan E. , Kurz Mathis S. E. , Bohnert Jürgen , Bayingana Claude , Ndoli Jules M. , Sendegeya Augustin , Gahutu Jean Bosco , Eger Elias , Mockenhaupt Frank P. , Schaufler Katharina
Published: February 2020

Multidrug-resistant gram-negative (MRGN) bacteria are a serious threat to global health. We used genomics to study MRGN obtained from houseflies in a tertiary Rwandan hospital. Our analysis revealed a high abundance of different MRGN including E. coli pathogenic lineage ST131 suggesting the important role of flies in disseminating highly virulent pathogens in clinical settings and beyond.
A socio-psychological model of laser levelling impacts assessment
Authors: Tohidyan Far Somayeh , Rezaei-Moghaddam Kurosh
Published: February 2020

Application of technologies has an important role in agricultural development. Identifying and assessing the impacts of agricultural technologies is necessary. This study aimed at assessing the impacts of laser levelling economically, socially, environmentally, and technically in the viewpoint of the agricultural experts and identifying factors determining their perception of the impacts. The study samples (151 experts) were selected using multi-stage random sampling in Fars Province, Iran. The results revealed that experts considered uniform distribution of water, using conservation tillage, facilitating agricultural activities, decreased water consumption and decrease of water wasting as the most important technical impacts of laser levelling technology. The most environmentally important impacts were the decrease of soil erosion and retention of crop residues. Experts stated the most significant social impacts as improvement in villages living conditions and sense of belonging to rural areas. Besides, an increase of income and reduction of inputs costs were among the economic impacts of laser levelling technology. According to the results, attitude towards water and soil resources conservation and environmental beliefs had the highest direct effect on individual perception toward impacts. Practical recommendations have been presented based on the results of the study.
TEPA impregnation of electrospun carbon nanofibers for enhanced low-level CO2 adsorption
Authors: Wang Jie , Adelodun Adedeji Adebukola , Oh Jong Min , Jo Young Min
Published: February 2020

The CO2 adsorption selectivity of plain activated carbon nanofibers (ANF) is generally low. For enhancement, nitrogen functionalities favorable for CO2 adsorption are usually tethered to the ANF. In the current study, we adopted chemical impregnation using 0.5 wt% tetraethylenepentamine (TEPA) solution as an impregnant. To enhance the impregnation of TEPA further, preliminary oxidation of the nanofibers with 70% HNO3 was conducted. The effects of HNO3 and TEPA treatments on the modified ANFs were investigated for physical (using N2 monosorb, thermogravimetric analyzer, scanning electron microscopy) and chemical (X-ray photoelectron spectrometer) changes. From the results, we found that although TEPA impregnation reduced the specific surface area and pore volume of the ANFs (from 673.7 and 15.61 to 278.8 m2/g and 0.284 cm3/g, respectively), whereas the HNO3 pre-oxidation increased the number of carboxylic groups on the ANF. Upon TEPA loading, pyridinic nitrogen was tethered and further enhanced by pre-oxidation. The surface treatment cumulatively increased the amine content from 5.81% to 13.31%. Consequently, the final adsorption capacity for low (0.3%) and pure CO2 levels were enhanced from 0.20 and 1.89 to 0.33 and 2.96 mmol/g, respectively. Hence, the two-step pre-oxidation and TEPA treatments were efficient for improved CO2 affinity.
Review of the Phytoneering Research & Experience Summit (PRES) 2019 “building bridges between nature’s healing potential and evidence-based medicine - 20 years of phytoneering”
Authors: Naber Kurt G. , Apolikhin Oleg , Kozlov Vladimir , Kennedy David W.
Published: February 2020

This brief communication summarizes the key highlights presented at the 2019 Phytoneering Research and Experience Summit held at the Palma Convention Centre and the educational finca Sa Canova (Majorca, Spain) from the 25th to the 27th of July 2019.

More than 100 professionals from academia, industry and public services took part. The scientific programme included three dedicated symposium sessions and a moderated poster session. In total, 13 oral communications and 23 posters were presented.

The invite-only conference, entitled: “Phytoneering Research & Experience Summit (PRES) 2019 - Building bridges between nature’s healing potential and evidence-based medicine - 20 years of phytoneering”, had participants from 20 different nations, reflecting the international character of the event. This participant group included researchers as well as clinicians with different fields of interest, e.g. gynaecology, urology, respiratory diseases and paediatrics. They all share an interest in evidence-based phytotherapy and phytoneering, which is the combination of ancient knowledge about medicinal plants and state-of-the-art technology to produce evidence-based herbal medicine. This approach offers solutions to reduce the growing number of unnecessarily prescribed antibiotics in the above-mentioned areas, with the aim of preventing further progression of antibiotic resistance. The conference was sponsored by Bionorica® SE.
Fighting African capital flight: trajectories, dynamics, and tendencies
Authors: Asongu Simplice A. , Uduji Joseph I. , Okolo-Obasi Elda N.
Published: February 2020

This study provides a harmonization framework for common capital flight policies in Africa. It builds on evidence of persistent extreme poverty in the continent to assess how common measures can be adopted by sampled countries on one cause of extreme poverty: capital flight. The dataset is sub-divided into fundamental characteristics of African capital flight based on income levels, legal foundations, natural resources, political stability, regional proximity, and religious domination. The main finding shows that from a projection date of 2010, a feasible timeframe for harmonizing policies is between 2016 and 2023. This timeframe coincides with the beginning of the post-2015 agenda on sustainable development goals.
Another nexus? Exploring narratives on the linkage between EU external migration policies and the democratization of the southern Mediterranean neighbourhood
Authors: Faustini-Torres Luisa
Published: February 2020

Since the beginning of the twenty-first century and after two turning point events – 09-11 terrorist attacks and the ‘Arab spring’ – both migration control and democracy promotion became central issues within EU foreign policy, in particular to what concern its relations with the southern Mediterranean neighbourhood. However, although many authors allude to the relation between these two policy dimensions, little is known about their linkage. On the one hand, the debate about EU external migration policies narratives has revolved mainly around the migration-security and migration-development nexus. On the other, whereas the developmental paradigm has dominated theroot-causesapproach little attention has been given to its political dimension. This article aims to overcome these limitations through exploring these other nexus: the one between these policies and the democratization of southern Mediterranean countries. To investigate this nexus I follow a Narrative Policy Analysis approach - the most suitable for investigating issues of high complexity, uncertainty and polarization, which seems to be precisely the case of EU external migration policies. Hence, drawing on longitudinal and interpretative content analysis of EU official documents covering the period between 1995 and 2018, this study seeks to expose the main narratives casted by the EU on the issue and to identify if there has been consistence or change in the stories and arguments over time and in particular, before and after the ‘Arab spring’. Ultimately, the goal was to confirm the presence of this nexus by exposing its complexity and trying to understand its configuration. This is considered as an important step towards further disentangling the logics and impacts of the externalization of EU migration policies towards its Southern Mediterranean neighbourhood.
Development and validation of a scale for measuring cultural beliefs about psychotherapy patients in southern Chile
Authors: Salinas-Oñate Natalia , Baeza-Rivera María José , Ortiz Manuel , Betancourt Héctor
Published: February 2020

Purpose

Negative cultural beliefs about psychotherapy patients represent one of the barriers in the psychological help-seeking and treatment adherence. In Chile today, there is little research about specific beliefs towards this group, and therefore measuring them represents a challenge. The aim of the present study was to develop and validate an instrument to measure cultural beliefs about psychotherapy patients.

Methods

A mixed method design conducted in four stages was implemented. First, 32 semi-structured interviews were carried out to identify beliefs about psychotherapy patients in southern Chile. Then, a scale of beliefs about psychotherapy patients (SBPP) was developed and piloted in an adult sample (n = 109). Subsequently, the factorial structure of the new scale was explored in patients of primary health centres in La Araucanía Region of Chile (n = 201). Finally, the validity of the construct was assessed in adults who were not undergoing psychotherapy (n = 361).

Results

The results showed the existence of negative cultural beliefs about psychotherapy patients which were included in the construction of the SBPP. The scale had a bifactorial structure (αtransitory situations = 0.81 and αstable characteristics = 0.79), consisting of 15 items with a Likert-type response format, and showed good indicators of validity and reliability on the samples in which were applied.

Conclusions

The present study shows the importance of using mixed methods for the examination of socially shared beliefs by the cultural group under study, in order to construct instruments that are psychometrically robust and culturally pertinent.
Biomarkers and neuromodulation techniques in substance use disorders
Authors: Habelt Bettina , Arvaneh Mahnaz , Bernhardt Nadine , Minev Ivan
Published: February 2020

Addictive disorders are a severe health concern. Conventional therapies have just moderate success and the probability of relapse after treatment remains high. Brain stimulation techniques, such as transcranial Direct Current Stimulation (tDCS) and Deep Brain Stimulation (DBS), have been shown to be effective in reducing subjectively rated substance craving. However, there are few objective and measurable parameters that reflect neural mechanisms of addictive disorders and relapse. Key electrophysiological features that characterize substance related changes in neural processing are Event-Related Potentials (ERP). These high temporal resolution measurements of brain activity are able to identify neurocognitive correlates of addictive behaviours. Moreover, ERP have shown utility as biomarkers to predict treatment outcome and relapse probability. A future direction for the treatment of addiction might include neural interfaces able to detect addiction-related neurophysiological parameters and deploy neuromodulation adapted to the identified pathological features in a closed-loop fashion. Such systems may go beyond electrical recording and stimulation to employ sensing and neuromodulation in the pharmacological domain as well as advanced signal analysis and machine learning algorithms. In this review, we describe the state-of-the-art in the treatment of addictive disorders with electrical brain stimulation and its effect on addiction-related neurophysiological markers. We discuss advanced signal processing approaches and multi-modal neural interfaces as building blocks in future bioelectronics systems for treatment of addictive disorders.
Analytic time-of-flight positron emission tomography reconstruction: three-dimensional case
Authors: Zeng Gengsheng L. , Li Ya , Huang Qiu
Published: February 2020

In a positron emission tomography (PET) scanner, the time-of-flight (TOF) information gives us rough event position along the line-of-response (LOR). Using the TOF information for PET image reconstruction is able to reduce image noise. The state-of-the-art TOF PET image reconstruction uses iterative algorithms. This study introduces an analytic TOF PET algorithm that focuses on three-dimensional (3D) reconstruction. The proposed algorithm is in the form of backprojection filtering, in which the backprojection is performed first by using a time-resolution profile function, and then a 3D filter is applied to the backprojected image. For the list-mode data, the backprojection is carried out in the event-by-event fashion, and the timing resolution determined weighting function is used along the projection LOR. Computer simulations are carried out to verify the feasibility of the proposed algorithm.
Aerodynamics and dynamic stability of micro-air-vehicle with four flapping wings in hovering flight
Authors: Cheng Cheng , Wu Jianghao , Zhang Yanlai , Li Han , Zhou Chao
Published: February 2020

Recently, a novel concept of flapping Micro-Air-Vehicles (FMAVs) with four wings has been proposed, which potentially utilizes the clap-and-fling effect for lift enhancement and agile maneuvers through an adjustment of wing kinematics. However, the application of the clap-and-fling effect in the four-winged FMAVs is underexplored and the dynamic stability is still unclear. In this paper, aerodynamics and flight dynamic stability of the four-winged FMAVs are studied experimentally and numerically. Results show that the clap-and-fling effect is observed when the flapping frequency is above 18 Hz. Due to the clap-and-fling effect, the lift generation and aerodynamic efficiency are both improved, which is mainly attributed to the fling phase. Further studies show that the clap-and-fling effect becomes weaker as the wing root spacing increases and is almost absent at a wing root spacing of 1.73 chord length. In addition, a wing with an aspect ratio of 3 can increase both lift generation and efficiency due to the clap-and-fling effect. Finally, according to the dynamic stability analysis of the four-winged FMAV, the divergence speed of the lateral oscillation mode is about 4 times faster than that of the longitudinal oscillation mode. Our results can provide guidance on the design and control of four-winged FMAVs.
Why care about integrated care? Part 2. Integrated care systems: an irresistible force changing mental health services
Authors: Tracy Derek K. , Holloway Frank , Hanson Kara , Kanani Nikita , Trainer Matthew , Dimond Iain , James Adrian , Kalidindi Sridevi , Shergill Sukhwinder S.
Published: February 2020

Part 1 of this three-part series on integrated care discussed the drivers for change in healthcare delivery in England set out in the NHS Long Term Plan. This second part explores the evolution of mental health services within the wider National Health Service (NHS), and describes important relevant legislation and policy over the past decade, leading up to the 2019 Long Term Plan. We explain the implications of this, including the detail of emerging structures such as integrated care systems (ICSs) and primary care networks (PCNs), and conclude with challenges facing these novel systems. Part 3 will address the practical local implementation of integrated care.
Adjustment to short-term imprisonment under low prison staffing
Authors: O'Connor Sarah , Bezeczky Zoe , Moriarty Yvonne , Kalebic Natasha , Taylor Pamela J.
Published: February 2020

Aims and method

To understand experience of early imprisonment in one prison under low staffing levels. A researcher, independent of the prison, interviewed each prisoner soon after reception and 3–4 weeks later. The first question of the second interview was: ‘I’d like to start by asking you about your experience of the last 3–4 weeks in prison'. Data are verbatim answers to this. Narratives were brief, so responses from all 130 participants were analysed, using grounded theory methods.

Results

The core experience was of ‘routine’ – characterised by repetitive acts of daily living and basic work, and little reference to life outside prison – generally resolved passively, towards boredom and ‘entrapment’.

Clinical implications

This ‘routine’ seems akin to the ‘institutionalism’ described in the end days of the 1960s’ mental hospitals. In an earlier study of similar men at a similar stage of imprisonment, under higher staff:prisoner ratios, experience was initially more distressing, but resolved actively and positively, suggesting that staff loss may have affected rehabilitative climate.
Post-flight confusion: does flying affect the brain?
Authors: Rands Gianetta , McCabe Thomas , Imray Chris
Published: February 2020

This paper describes a condition termed post-flight confusion using anecdotal and clinical observations. It reviews research from the fields of aviation and altitude medicine and how this could apply to some physiological changes that happen during commercial flights. The collection of symptoms observed is similar to those of delirium. More research is needed to validate these observations, to identify the risks of flying for older people and to consider not only how to minimise these risks but whether this situation contributes to our knowledge about the aetiologies of delirium and dementias.
Neutrophil-to-lymphocyte ratio: A potential new peripheral biomarker of suicidal behavior
Authors: Velasco Ángela , Rodríguez-Revuelta Julia , Olié Emilie , Abad Iciar , Fernández-Peláez Abel , Cazals Aurélie , Guillaume Sébastien , de la Fuente-Tomás Lorena , Jiménez-Treviño Luis , Gutiérrez Laura , García-Portilla Paz , Bobes Julio , Courtet Philippe , Sáiz Pilar A.
Published: February 2020

Background.

Neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR) have emerged as important peripheral inflammatory biomarkers. Recent data suggest a possible role of the immune system in the pathophysiology of suicidal behavior (SB). The aim of this study is to evaluate the association among NLR, MLR, and PLR and SB in patients with major depressive disorder (MDD), and to test its validity as a biomarker for suicidality.

Methods.

We evaluated 538 patients with MDD (mean age [standard deviation] = 43.87 [14.36] years; females: 68.8%). A logistic regression model was estimated to determine the independent factors associated with suicide risk in patients with and without a history of suicide attempt (SA).

Results.

Three hundred ninety-three patients (74.7%) had a personal history of SA. Patients with a previous SA were more frequently female (71.9% vs. 59.6%; p = 0.007), significantly younger (41.20 vs. 51.77 years; p < 0.001), had lower depression severity at enrolment (15.58 vs. 18.42; p < 0.000), and significantly higher mean NLR and PLR ratios (2.27 vs. 1.68, p = 0.001; 127.90 vs. 109.97, p = 0.007, respectively). In the final logistic regression model, after controlling for age, sex, and depression severity, NLR was significantly associated with SB (β = 0.489, p = 0.000; odds ratio [95% confidence intervals] = 1.631 [1.266–2.102]). We propose a cut-off value of NLR = 1.30 (sensitivity = 75% and specificity = 35%).

Conclusions.

Our data suggest that NLR may be a valuable, reproducible, easily accessible, and cost-effective strategy to determine suicide risk in MDD.
On growth and force: mechanical forces in development
Authors: Hallou Adrien , Brunet Thibaut
Published: February 2020

The EMBO/EMBL Symposium ‘Mechanical Forces in Development’ was held in Heidelberg, Germany, on 3-6 July 2019. This interdisciplinary symposium brought together an impressive and diverse line-up of speakers seeking to address the origin and role of mechanical forces in development. Emphasising the importance of integrative approaches and theoretical simulations to obtain comprehensive mechanistic insights into complex morphogenetic processes, the meeting provided an ideal platform to discuss the concepts and methods of developmental mechanobiology in an era of fast technical and conceptual progress. Here, we summarise the concepts and findings discussed during the meeting, as well as the agenda it sets for the future of developmental mechanobiology.
Patterns of maternal nutritional status based on mid upper arm circumference
Authors: Bari Attia , Sultana Nighat , Mehreen Sana , Sadaqat Nadia , Imran Izza , Javed Rashida
Published: February 2020

Objective: To determine the patterns of maternal nutrition status by using mid upper arm circumference (MUAC) and to examine the association of maternal nutritional status with the nutritional status of malnourished children under two years of age.

Methods: Descriptive study conducted at the Department of Pediatric Medicine of the Children’s Hospital, Lahore from January 2017 to March 2018. A total of 227 mother accompanying their children admitted for nutritional rehabilitation were included. Demographics of participants along with MUAC of every mother was taken. Data analysis was done by SPSS 22.

Results: Mean maternal age was 28.29±5.30 years and mean age of children was 9.22 ± 6.05 months. Mean maternal MUAC was 25.53±3.63 cm. Normal nutrition was present in only 70 (31%), 35 (15.4%) had moderate to severe under nutrition and 68 (30%) were overweight and 17 (7.5%) were obese. Maternal illiteracy was common 150 (66%) and 203 (89%) belong to poor social class. Majority 150 (75%) children had <-3SD WHZ score. Only 42 (18.5%) children were exclusively breast fed. Maternal malnutrition was significantly associated with severity of child’s undernutrition (p=0.045) and low rates of exclusive breast feeding practices (p=0.049).

Conclusion: Malnutrition, in the form of both under nutrition and obesity is prevalent in mothers of malnourished children belonging to lower social class. Maternal illiteracy and low income are the major contributor in maternal malnutrition which in turn has an impact on child nutrition and breast feeding practices.

doi: https://doi.org/10.12669/pjms.36.3.1331

How to cite this:Bari A, Sultana N, Mehreen S, Sadaqat N, Imran I, Javed R. Patterns of maternal nutritional status based on mid upper arm circumference. Pak J Med Sci. 2020;36(3):382-386. doi: https://doi.org/10.12669/pjms.36.3.1331

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection
Authors: Zhao Yuqin , Dai Xuemei , Ji Jinzhi , Cheng Ping
Published: February 2020

Objective: To investigate the clinical efficacy of bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection.

Methods: One hundred forty eight patients with severe pulmonary infection who were admitted to our hospital from October 2016 to December 2017 were included in this study. According to the random number table method, they were divided into a control group and an observation group with 79 patients each. The control group was given conventional treatment, while the observation group was given bronchoalveolar lavage with fiberoptic bronchoscopy on the basis of the treatment in the control group. The clinical efficacy of the two groups was compared, the duration of mechanical ventilation, antibiotic use and symptoms improvement of the two groups were recorded, and the respiratory mechanics parameters, serum procalcitonin (PCT) and transforming growth factor β (TGF-β) level were measured before and after treatment.

Results: The duration of mechanical ventilation, antibiotic use, respiratory failure correction, body temperature decline and white blood cell recovery in the observation group were significantly shorter than those in the control group (P<0.05). The total efficacy of the observation group was significantly higher than that of the control group (92.4% vs. 74.7%). The respiratory mechanics parameters of the two groups after treatment were higher than those before treatment (P<0.05) and the increase of the observation group was more obvious than that of the control group (P<0.05). The serum PCT and TGF-β levels of the two groups after treatment were lower than those before treatment (P<0.05), and the decrease level in the observation group was more obvious (P<0.05).

Conclusion: Bronchial lavage under fiberoptic bronchoscopy can improve the clinical efficacy, accelerate the improvement of clinical symptoms and respiratory mechanics parameters, significantly reduce the PCT and TGF-β levels, and promote the rapid recovery of patients in the treatment of severe pulmonary infection.

doi: https://doi.org/10.12669/pjms.36.3.1539

How to cite this:Zhao Y, Dai X, Ji J, Cheng P. Bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection. Pak J Med Sci. 2020;36(3):396-401. doi: https://doi.org/10.12669/pjms.36.3.1539

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.