bluuebunny/crossref_metadata_2025 huggingface dataset:
The muscle anabolic effect of protein ingestion during a hyperinsulinaemic euglycaemic clamp in middle‐aged women is not caused by leucine alone
Authors: van Vliet Stephan , Smith Gordon I. , Porter Lane , Ramaswamy Raja , Reeds Dominic N. , Okunade Adewole L. , Yoshino Jun , Klein Samuel , Mittendorfer Bettina
Published: July 2018

Key points

It has been suggested that leucine is primarily responsible for the increase in muscle protein synthesis after protein ingestion because leucine uniquely activates the mTOR‐p70S6K signalling cascade.

We compared the effects of ingesting protein or an amount of leucine equal to that in the protein during a hyperinsulinaemic‐euglycaemic clamp (to eliminate potential confounding as a result of differences in the insulinogenic effect of protein and leucine ingestion) on muscle anabolic signalling and protein turnover in 28 women.

We found that protein, but not leucine, ingestion increased muscle p‐mTORSer2448 and p‐p70S6KThr389, although only protein, and not leucine, ingestion decreased muscle p‐eIF2αSer51 and increased muscle protein synthesis.

It has been suggested that leucine is primarily responsible for the increase in muscle protein synthesis (MPS) after protein ingestion because leucine uniquely activates the mTOR‐p70S6K signalling cascade. We tested this hypothesis by measuring muscle p‐mTORSer2448, p‐p70S6KThr389 and p‐eIF2αSer51, as well as protein turnover (by stable isotope labelled amino acid tracer infusion in conjunction with leg arteriovenous blood and muscle tissue sampling), in 28 women who consumed either 0.45 g protein kg−1 fat‐free mass (containing 0.0513 g leucine kg−1 fat‐free mass) or a control drink (n = 14) or 0.0513 g leucine kg−1 fat‐free mass or a control drink (n = 14) during a hyperinsulinaemic‐euglycaemic clamp procedure (HECP). Compared to basal conditions, the HECP alone (without protein or leucine ingestion) suppressed muscle protein breakdown by ∼20% and increased p‐mTORSer2448 and p‐p70S6KThr389 by >50% (all P < 0.05) but had no effect on p‐eIF2αSer51 and MPS. Both protein and leucine ingestion further increased p‐mTORSer2448 and p‐p70S6KThr389, although only protein, and not leucine, ingestion decreased (by ∼35%) p‐eIF2αSer51 and increased (by ∼100%) MPS (all P < 0.05). Accordingly, leg net protein balance changed from negative (loss) during basal conditions to equilibrium during the HECP alone and the HECP with concomitant leucine ingestion and to positive (gain) during the HECP with concomitant protein ingestion. These results provide new insights into the regulation of MPS by demonstrating that leucine and mTOR signalling alone are not responsible for the muscle anabolic effect of protein ingestion during physiological hyperinsulinaemia, most probably because they fail to signal to eIF2α to initiate translation and/or additional amino acids are needed to sustain translation.
Synergistic Activity of Colistin-Containing Combinations against Colistin-Resistant Enterobacteriaceae
Authors: Brennan-Krohn Thea , Pironti Alejandro , Kirby James E.
Published: July 2018

Resistance to colistin, a polypeptide drug used as an agent of last resort for the treatment of infections caused by multidrug-resistant (MDR) and extensively drug-resistant (XDR) Gram-negative bacteria, including carbapenem-resistant
Enterobacteriaceae
(CRE), severely limits treatment options and may even transform an XDR organism into one that is pan-resistant. We investigated the synergistic activity of colistin in combination with 19 antibiotics against a collection of 20 colistin-resistant
Enterobacteriaceae
isolates, 15 of which were also CRE.
Mode of Action of the Monobactam LYS228 and Mechanisms Decreasing
In Vitro
Susceptibility in Escherichia coli and Klebsiella pneumoniae
Authors: Dean Charles R. , Barkan David T. , Bermingham Alun , Blais Johanne , Casey Fergal , Casarez Anthony , Colvin Richard , Fuller John , Jones Adriana K. , Li Cindy , Lopez Sara , Metzger Louis E. , Mostafavi Mina , Prathapam Ramadevi , Rasper Dita , Reck Folkert , Ruzin Alexey , Shaul Jacob , Shen Xiaoyu , Simmons Robert L. , Skewes-Cox Peter , Takeoka Kenneth T. , Tamrakar Pramila , Uehara Tsuyoshi , Wei Jun-Rong
Published: July 2018

The monobactam scaffold is attractive for the development of new agents to treat infections caused by drug-resistant Gram-negative bacteria because it is stable to metallo-β-lactamases (MBLs). However, the clinically used monobactam aztreonam lacks stability to serine β-lactamases (SBLs) that are often coexpressed with MBLs.
Mechanisms of Bacterial Tolerance and Persistence in the Gastrointestinal and Respiratory Environments
Authors: Trastoy R. , Manso T. , Fernández-García L. , Blasco L. , Ambroa A. , Pérez del Molino M. L. , Bou G. , García-Contreras R. , Wood T. K. , Tomás M.
Published: July 2018

Pathogens that infect the gastrointestinal and respiratory tracts are subjected to intense pressure due to the environmental conditions of the surroundings. This pressure has led to the development of mechanisms of bacterial tolerance or persistence which enable microorganisms to survive in these locations.
Recent intimate partner violence against women and health: a systematic review and meta-analysis of cohort studies
Authors: Bacchus Loraine J , Ranganathan Meghna , Watts Charlotte , Devries Karen
Published: July 2018

Objective

We reviewed cohort studies to determine the magnitude and temporal direction of the association between recent intimate partner violence (IPV) and a range of adverse health outcomes or health risk behaviours.

Design

Systematic review and meta-analysis.

Methods

Medline, EMBASE and PsycINFO were searched from the first record to November 2016. Recent IPV was defined as occurring up to and including the last 12 months; all health outcomes were eligible for inclusion. Results were combined using random-effects meta-analysis.

Results

35 separate cohort studies were retrieved. Eight studies showed evidence of a positive association between recent IPV and subsequent depressive symptoms, with a pooled OR from five estimates of 1.76 (95% CI 1.26 to 2.44, I2=37.5%, p=0.172). Five studies demonstrated a positive, statistically significant relationship between depressive symptoms and subsequent IPV; the pooled OR from two studies was 1.72 (95% CI 1.28 to 2.31, I2=0.0%, p=0.752). Recent IPV was also associated with increased symptoms of subsequent postpartum depression in five studies (OR=2.19, 95% CI 1.39 to 3.45, p=0.000), although there was substantial heterogeneity. There was some evidence of a bidirectional relationship between recent IPV and hard drug use and marijuana use, although studies were limited. There was no evidence of an association between recent IPV and alcohol use or sexually transmitted infections (STIs), although there were few studies and inconsistent measurement of alcohol and STIs.

Conclusions

Exposure to violence has significant impacts. Longitudinal studies are needed to understand the temporal relationship between recent IPV and different health issues, while considering the differential effects of recent versus past exposure to IPV. Improved measurement will enable an understanding of the immediate and longer term health needs of women exposed to IPV. Healthcare providers and IPV organisations should be aware of the bidirectional relationship between recent IPV and depressive symptoms.

PROSPERO registration number

CRD42016033372.
Developing a new clinical governance framework for chronic diseases in primary care: an umbrella review
Authors: Buja Alessandra , Toffanin Roberto , Claus Mirko , Ricciardi Walter , Damiani Gianfranco , Baldo Vincenzo , Ebell Mark H
Published: July 2018

Objectives

Our goal is to conceptualise a clinical governance framework for the effective management of chronic diseases in the primary care setting, which will facilitate a reorganisation of healthcare services that systematically improves their performance.

Setting

Primary care.

Participants

Chronic Care Model by Wagneret aland Clinical Governance statement by Scallyet alwere taken for reference. Each was reviewed, including their various components. We then conceptualised a new framework, merging the relevant aspects of both.

Interventions

We conducted an umbrella review of all systematic reviews published by the Cochrane Effective Practice and Organisation of Care Group to identify organisational interventions in primary care with demonstrated evidence of efficacy.

Results

All primary healthcare systems should be patient-centred. Interventions for patients and their families should focus on their values; on clinical, professional and institutional integration and finally on accountability to patients, peers and society at large. These interventions should be shaped by an approach to their clinical management that achieves the best clinical governance, which includes quality assurance, risk management, technology assessment, management of patient satisfaction and patient empowerment and engagement. This approach demands the implementation of a system of organisational, functional and professional management based on a population health needs assessment, resource management, evidence-based and patient-oriented research, professional education, team building and information and communication technologies that support the delivery system. All primary care should be embedded in and founded on an active partnership with the society it serves.

Conclusions

A framework for clinical governance will promote an integrated effort to bring together all related activities, melding environmental, administrative, support and clinical elements to ensure a coordinated and integrated approach that sustains the provision of better care for chronic conditions in primary care setting.
Stability of home-based care arrangements for people living with dementia: protocol of a meta-study on mixed research
Authors: Dreyer Jan , Köhler Kerstin , Hochgraeber Iris , Holle Bernhard , von Kutzleben Milena
Published: July 2018

Introduction

Worldwide, most people with dementia live at home and are cared for by informal carers. During the dementia care trajectory, creating and maintaining a stable care situation is a guiding principle of informal carers and a desirable outcome of contemporary healthcare policies. However, though there is an extensive body of research focusing on the course of dementia care trajectories, it remains unclear how stability of home-based care arrangements is constituted and what are the essential factors that influence this stability. This paper outlines a protocol of a systematic review that aims to address these gaps in knowledge.

Methods and analysis

To theorise the complex phenomenon of stability of home-based care arrangements for people with dementia, we will conduct a meta-study. Meta-studies include three analytical components (meta-data analysis, meta-method and meta-theory) that are combined and finally culminate in an integrative knowledge synthesis. Originally, meta-study was designed to include qualitative studies only. To capture relevant contributions to our target phenomenon from all types of evidence, we will extend the original methodology and apply it to studies with qualitative, quantitative and mixed-methods designs and to (systematic) reviews. Eligible studies will be identified by systematic database searches (PubMed, CINAHL and PsycINFO), backward/forward citation tracking, snowballing and theoretical sampling. All identified studies will be screened against predefined inclusion criteria. The main analytical approach for all analyses is thematic synthesis. The meta-study will generate a more comprehensive understanding of dementia care trajectories and will be used to identify research gaps, develop future research questions and define relevant outcomes.

Dissemination

The findings of the meta-study will be published in a series of articles in peer-reviewed scientific journals and will be presented at national and international scientific conferences.

PROSPERO registration number

CRD42016041727.
Prevalence, associated factors and reasons for sickness presenteeism: a cross-sectional nationally representative study of salaried workers in Spain, 2016
Authors: Navarro Albert , Salas-Nicás Sergio , Moncada Salvador , Llorens Clara , Molinero-Ruiz Emilia
Published: July 2018

Objectives

The aim of this study was to estimate the prevalence of sickness presenteeism (SP), its associated factors and the reasons given for SP episodes, among the overall salaried population and excluding the ‘healthy’ workers.

Design

Population-based cross-sectional study.

Setting

Salaried population in Spain.

Participants

Data were obtained from the third Spanish Psychosocial Risks Survey (2016), carried out between October and December 2016, n=1615.

Main outcome measures

Self-reported episodes of SP and their reasons.

Results

23.0% (95% CI 19.2 to 26.8) of the workers exhibit SP, whereas among those manifesting having had some health problem in the preceding year, the figure was 53.0% (95% CI 46.9 to 59.1). The factors associated with SP when we study all workers are age, seniority, salary structure, working more than 48 hours, the contribution of worker’s wage to the total household income and downsizing; factors among the ‘unhealthy’ workers are working more than 48 hours and not having a contract. The most common reason for SP is ‘did not want to burden my colleagues’, 45.7% (95% CI 37.3 to 54.4), whereas ‘I could not afford it for economic reasons’ ranked third, 35.9% (29.4% to 42.9%), and 27.5% (21.3% to 34.6%) of the workers report ‘worried about being laid off’ as a reason for going to work despite being ill.

Conclusions

The estimated frequency of SP in Spain is lower than certain other countries, such as the Scandinavian countries. The factors associated vary depending on the population analysed (all workers or excluding ‘healthy’ workers). The reason ‘I was worried about being laid off’ was much more common than the estimates for Sweden or Norway.
Balancing the risk of the evacuation and sheltering-in-place options: a survival study following Japan’s 2011 Fukushima nuclear incident
Authors: Shimada Yuki , Nomura Shuhei , Ozaki Akihiko , Higuchi Asaka , Hori Arinobu , Sonoda Yuki , Yamamoto Kana , Yoshida Izumi , Tsubokura Masaharu
Published: July 2018

Objective

The decision to evacuate or shelter-in-place is fundamental to emergency response, especially for a vulnerable population. While an elevated risk of mortality due to a hasty, unplanned evacuation has been well documented, there is little research on and knowledge about the health consequences of sheltering-in-place in disaster contexts. We compared hospital mortality in patients who sheltered-in-place (non-evacuees) after the incident with the baseline preincident mortality and articulated postincident circumstances of the hospital while sheltering-in-place.

Participants

We considered all 484 patients admitted to Takano Hospital (located 22 km South of the Fukushima Daiichi nuclear power plant) from 1 January 2008 to 31 December 2016.

Methods

Significant differences in mortality rates between preincident baseline and three postincident groups (evacuees, non-evacuees (our major interest) and new admittees) were tested using the Bayesian survival analysis with Weibull multivariate regression and survival probability using the Kaplan-Meier product limit method. All the analyses were separately performed by the internal and psychiatry department.

Results

After adjusting for covariates, non-evacuees in the internal department had a significantly higher mortality risk with an HR of 1.57 (95% credible intervals 1.11 to 2.18) than the baseline preincident. Of them, most deaths occurred within the first 100 days of the incident. No significant increase in mortality risk was identified in evacuees and new admittees postincident in the department, which were adjusted for covariates. In contrast, for the psychiatry department, statistical difference in mortality risk was not identified in any groups.

Conclusions

The mortality risk of sheltering-in-place in a harsh environment might be comparable to those in an unplanned evacuation. If sheltering-in-place with sufficient resources is not guaranteed, evacuation could be a reasonable option, which might save more lives of vulnerable people if performed in a well-planned manner with satisfactory arrangements for appropriate transportation and places to safely evacuate.
Metagenomic analysis of gut microbial communities from a Central Asian population
Authors: Kushugulova Almagul , Forslund Sofia K , Costea Paul Igor , Kozhakhmetov Samat , Khassenbekova Zhanagul , Urazova Maira , Nurgozhin Talgat , Zhumadilov Zhaxybay , Benberin Valery , Driessen Marja , Hercog Rajna , Voigt Anita Yvonne , Benes Vladimir , Kandels-Lewis Stefanie , Sunagawa Shinichi , Letunic Ivica , Bork Peer
Published: July 2018

Objective

Changes in the gut microbiota are increasingly recognised to be involved in many diseases. This ecosystem is known to be shaped by many factors, including climate, geography, host nutrition, lifestyle and medication. Thus, knowledge of varying populations with different habits is important for a better understanding of the microbiome.

Design

We therefore conducted a metagenomic analysis of intestinal microbiota from Kazakh donors, recruiting 84 subjects, including male and female healthy subjects and metabolic syndrome (MetS) patients aged 25–75 years, from the Kazakh administrative centre, Astana. We characterise and describe these microbiomes, the first deep-sequencing cohort from Central Asia, in comparison with a global dataset (832 individuals from five countries on three continents), and explore correlations between microbiota, clinical and laboratory parameters as well as with nutritional data from Food Frequency Questionnaires.

Results

We observe that Kazakh microbiomes are relatively different from both European and East Asian counterparts, though similar to other Central Asian microbiomes, with the most striking difference being significantly more samples falling within thePrevotella-rich enterotype, potentially reflecting regional diet and lifestyle. We show that this enterotype designation remains stable within an individual over time in 82% of cases. We further observe gut microbiome features that distinguish MetS patients from controls (eg, significantly reduced Firmicutes to Bacteroidetes ratio,BifidobacteriaandSubdoligranulum, alongside increasedPrevotella), though these overlap little with previously published reports and thus may reflect idiosyncrasies of the present cohort.

Conclusion

Taken together, this exploratory study describes gut microbiome data from an understudied population, providing a starting point for further comparative work on biogeography and research on widespread diseases.

Trial registration number

ISRCTN37346212; Post-results.
Life after breast cancer: moving on, sitting down or standing still? A prospective study of Canadian breast cancer survivors
Authors: Sabiston Catherine M , Wrosch Carsten , Fong Angela J , Brunet Jennifer , Gaudreau Patrick , O’Loughlin Jennifer , Meterissian Sarkis
Published: July 2018

Introduction

Breast cancer (BC) is associated with serious physical and psychological health sequelae that affect quality and quantity of life. Physical activity (PA) and sedentary behaviour can prevent or diminish these sequelae; yet, little is known about how these lifestyle behaviours change after cancer treatment and if these changes affect post-treatment health. The first aim of this study is to describe natural trends in lifestyle behaviours (ie, PA, sedentary behaviour) in women treated for BC. The second aim is to examine the longitudinal associations between lifestyle behaviour changes and (1) physical health (eg, acute symptoms, chronic conditions, body composition, patient-reported fatigue, pain and functioning), (2) psychological health and illness (eg, depression, stress, affect, post-traumatic growth, cancer worry, mood, body image) and (3) biological functioning (eg, cortisol and C-reactive protein). The third aim is to examine modifiable self-regulation (ie, goal adjustment strategies) and motivation constructs (ie, self-determined regulations) that predict trends in lifestyle behaviours.

Method and analysis

This is a prospective longitudinal study of 201 women treated for BC. Data (eg, surveys, accelerometers, saliva, blood) are collected every 3 months during the first year after women complete systemic treatment for a first diagnosis of BC, and once every year for 4 years thereafter. Data analyses assess trends and changes in PA and sedentary lifestyle behaviours, examine associations between these trends and changes in health outcomes and identify modifiable predictors of PA and sedentary lifestyle behaviours using multilevel modelling.

Ethics and dissemination

Ethical approval was obtained from the University of Toronto (REB# 28180) and has been funded by the Canadian Institutes of Health Research (#186128). Study findings will be disseminated through peer-reviewed publications, academic conferences, local community-based presentations such as the Canadian Cancer Society and similar organisations.
Trial of feasibility and acceptability of routine low-dose aspirin versusEarlyScreeningTest indicated aspirin for pre-eclampsia prevention (TESTstudy): a multicentre randomised controlled trial
Authors: Mone Fionnuala , Mulcahy Cecilia , McParland Peter , Breathnach Fionnuala , Downey Paul , McCormack Dorothy , Culliton Marie , Stanton Alice , Cody Fiona , Morrison John J , Daly Sean , Higgins John , Cotter Amanda , Hunter Alyson , Tully Elizabeth C , Dicker Patrick , Alfirevic Zarko , Malone Fergal D , McAuliffe Fionnuala M
Published: July 2018

Objective

Evaluate the feasibility and acceptability of routine aspirin in low-risk women, compared with screening-test indicated aspirin for the prevention of pre-eclampsia and fetal growth restriction.

Design

Multicentre open-label feasibility randomised controlled trial.

Setting

Two tertiary maternity hospitals in Dublin, Ireland.

Participants

546 low-risk nulliparous women completed the study.

Interventions

Women underwent computerised randomisation to: Group 1—routine aspirin 75 mg from 11 until 36 weeks; Group 2—no aspirin and; Group 3—aspirin based on the Fetal Medicine Foundation screening test.

Primary and secondary outcome measures

(1) Proportion agreeing to participate; (2) compliance with protocol; (3) proportion where first trimester uterine artery Doppler was obtainable and; (4) time taken to issue a screening result. Secondary outcomes included rates of pre-eclampsia and small-for-gestational-age fetuses.

Results

546 were included in the routine aspirin (n=179), no aspirin (n=183) and screen and treat (n=184) groups. 546 of 1054 were approached (51.8%) and enrolled. Average aspirin adherence was 90%. The uterine artery Doppler was obtained in 98.4% (181/184) and the average time to obtain a screening result was 7.6 (0–26) days. Of those taking aspirin, vaginal spotting was greater; n=29 (15.1%), non-aspirin n=28 (7.9%), OR 2.1 (95% CI 1.2 to 3.6). Postpartum haemorrhage >500 mL was also greater; aspirin n=26 (13.5%), no aspirin n=20 (5.6%), OR 2.6 (95% CI 1.4 to 4.8).

Conclusion

Low-risk nulliparous women are open to taking aspirin in pregnancy and had high levels of adherence. Aspirin use was associated with greater rates of vaginal bleeding. An appropriately powered randomised controlled trial is now required to address the efficacy and safety of universal low-dose aspirin in low-risk pregnancy compared with a screening approach.

Trial registration number

ISRCTN (15191778); Post-results.
JACK trial protocol: a phase III multicentre cluster randomised controlled trial of a school-based relationship and sexuality education intervention focusing on young male perspectives
Authors: Lohan Maria , Aventin Áine , Clarke Mike , Curran Rhonda M , Maguire Lisa , Hunter Rachael , McDowell Clíona , McDaid Lisa , Young Honor , White James , Fletcher Adam , French Rebecca , Bonell Christopher , Bailey Julia V , O’Hare Liam
Published: July 2018

Introduction

Teenage pregnancy remains a worldwide health concern which is an outcome of, and contributor to, health inequalities. The need for gender-aware interventions with a focus on males in addressing teenage pregnancy has been highlighted as a global health need by WHO and identified in systematic reviews of (relationship and sexuality education (RSE)). This study aims to test the effectiveness of an interactive film-based RSE intervention, which draws explicit attention to the role of males in preventing an unintended pregnancy by reducing unprotected heterosexual teenage sex among males and females under age 16 years.

Methods and analysis

A phase III cluster randomised trial with embedded process and economic evaluations.If I Were Jackencompasses a culturally sensitive interactive film, classroom materials, a teacher-trainer session and parent animations and will be delivered to replace some of the usual RSE for the target age group in schools in the intervention group. Schools in the control group will not receive the intervention and will continue with usual RSE. Participants will not be blinded to allocation. Schools are the unit of randomisation stratified per country and socioeconomic status. We aim to recruit 66 UK schools (24 in Northern Ireland; 14 in each of England, Scotland and Wales), including approximately 7900 pupils. A questionnaire will be administered at baseline and at 12–14 months postintervention. The primary outcome is reported unprotected sex, a surrogate measure associated with unintended teenage pregnancy. Secondary outcomes include knowledge, attitudes, skills and intentions relating to avoiding teenage pregnancy in addition to frequency of engagement in sexual intercourse, contraception use and diagnosis of sexually transmitted infections.

Ethics and dissemination

Ethical approval was obtained from Queen’s University Belfast. Results will be published in peer-reviewed journals and disseminated to stakeholders. Funding is from the National Institute for Health Research.

Trial registration number

ISRCTN99459996
Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study
Authors: Martín Lesende Iñaki , Mendibil Crespo Luis Ignacio , Castaño Manzanares Sonia , Otter Anne-Sophie Denise , Garaizar Bilbao Irati , Pisón Rodríguez Jakobe , Negrete Pérez Ion , Sarduy Azcoaga Iraide , de la Rua Fernández María Jesús
Published: July 2018

Objective

To analyse short-term functional decline and associated factors in over 65-year-olds with multimorbidity.

Design and setting

Prospective multicentre study conducted in three primary care centres, over an 8-month period. During this period, we also analysed admissions to two referral hospitals.

Participants

Of the 241 patients ≥65 years included randomly in the study, 155 were already part of a multimorbidity programme (stratified by ‘Adjusted Clinical Groups’) and 86 were newly included (patients who met Ollero’s criteria and with ≥1 hospital admission the previous year). Patients who were institutionalised, unable to complete follow-up or receiving dialysis were excluded.

Outcomes and variables

The primary outcome was the decrease in functional status category (Barthel Index or Lawton Scale). Other variables considered were sociodemographic characteristics, comorbidity, medications, number of admissions and functional status on discharge.

Results

Patients had a median age of 82 years (P7586) and of five selected chronic conditions (IQR 4–6), and took 11 (IQR 9–14) regular medications; 46.9% were women; 38.2% had impaired function at baseline.

Overall, 200 persons completed the follow-up; 10.4% (n=25) of the initial sample died within the 8 months. In 20.5% (95% CI 15.5% to 26.6%) of them we recorded a decrease in functionality, associated with older age (OR 1.1, 95% CI 1.0 to 1.2) and with having ≥1 admission during the follow-up (OR 3.6, 95% CI 1.6 to 7.7). There were 133 hospital admissions in total during the follow-up considering all the patients included, and a functional decline was observed in 35.5% (95% CI 25.7% to 46.7%) of the 76 discharges in which functional status was assessed.

Conclusions

A fifth of patients showed functional decline or loss of independence in just 8 months. These findings are important as functional decline and the increasing care needs are potentially predictable and modifiable. Age and hospitalisation were closely associated with this decline
Changing use of antidiabetic drugs in the UK: trends in prescribing 2000–2017
Authors: Wilkinson Samantha , Douglas Ian , Stirnadel-Farrant Heide , Fogarty Damian , Pokrajac Ana , Smeeth Liam , Tomlinson Laurie
Published: July 2018

Objectives

Guidelines for the use of drugs for type 2 diabetes mellitus (T2DM) have changed since 2000, and new classes of drug have been introduced. Our aim was to describe how drug choice at initiation and first stage of intensification have changed over this period, and to what extent prescribing was in accord with clinical guidelines, including adherence to recommendations regarding kidney function.

Design

Repeated cross-sectional study.

Setting

UK electronic primary care health records from the Clinical Practice Research Datalink.

Participants

Adults initiating treatment with a drug for T2DM between January 2000 and July 2017.

Primary and secondary outcome measures

The primary outcomes were the proportion of each class of T2DM drug prescribed for initiation and first-stage intensification in each year. We also examined drug prescribing by kidney function and country within the UK.

Results

Of 280 241 people initiating treatment with T2DM drugs from 2000 to 2017, 73% (204 238/280 241) initiated metformin, 15% (42 288/280 241) a sulfonylurea, 5% (12 956/280 241) with metformin and sulfonylurea dual therapy and 7% (20 759/280 241) started other options. Clinicians have increasingly prescribed metformin at initiation: by 2017 this was 89% (2475/2778) of drug initiations. Among people with an estimated glomerular filtration rate of ≤30 mL/min/1.73 m2, the most common drug at initiation was a sulfonylurea, 58% (659/1135). In 2000, sulfonylureas were the predominant drug at the first stage of drug intensification (87%, 534/615) but by 2017 this fell to 30% (355/1183) as the use of newer drug classes increased. In 2017, new prescriptions for dipeptidyl peptidase-4 inhibitors (DPP4i) and sodium/glucose cotransporter-2 inhibitors (SGLT2i) accounted for 42% (502/1183) and 22% (256/1183) of intensification drugs, respectively. Uptake of new classes differs by country with DPP4is and SGLT2is prescribed more in Northern Ireland and Wales than England or Scotland.

Conclusions

Our findings show markedly changing prescribing patterns for T2DM between 2000 and 2017, largely consistent with clinical guidelines.
A cross-sectional survey of awareness of human papillomavirus-associated oropharyngeal cancers among general practitioners in the UK
Authors: Lechner Matt , Vassie Claire , Kavasogullari Cemal , Jones Oliver , Howard James , Masterson Liam , Fenton Tim , Yarbrough Wendell , Waller Jo , Gilson Richard
Published: July 2018

Objectives

To examine the level of awareness of the link between human papillomavirus (HPV) and oropharyngeal cancer (OPC) and epidemiological trends in HPV-related OPC among general practitioners (GPs) in the UK.

Design

Cross-sectional survey.

Participants

384 GPs from England, Scotland, Wales and Northern Ireland.

Setting

The survey was administered at GP training courses and via email to lists of training course attendees.

Primary and secondary outcome measures

Proportion of respondents aware of the link between HPV and OPC; respondents’ self-rated knowledge of OPC; proportion of participants aware of the epidemiological trends in HPV-associated OPC.

Results

384 questionnaires were completed with an overall response rate of 72.9%. 74.0% of participants recognised HPV as a risk factor for OPC, which was lower than knowledge about the role of smoking, chewing tobacco and alcohol consumption (all >90% recognition). Overall, 19.4% rated their knowledge of OPC as very good or good, 62.7% as average and 17.7% as poor or very poor. The majority (71.9%) were aware that rates of HPV-associated OPC have increased over the last two decades. Fewer than half (41.5%) of the participants correctly identified being male as a risk factor of HPV-associated OPC, while 58.8% were aware that patients with HPV-associated OPC tend to be younger than those with non-HPV-associated disease.

Conclusions

The association of HPV infection with OPC is a relatively recent discovery. Although the level of awareness of HPV and OPC among GPs was high, the characteristics of HPV-associated OPC were less well recognised, indicating the need for further education.
Using primary care-based paper and telephone interventions to increase uptake of bowel scope screening in Yorkshire: a protocol of a randomised controlled trial
Authors: McGregor Lesley M , Kerrison Robert S , Green Trish , Macleod Una , Hughes Mark , Gibbins Monica , Morris Stephen , Rees Colin , von Wagner Christian
Published: July 2018

Introduction

Evidence suggests bowel scope screening (BSS) can significantly reduce an individual’s risk of developing colorectal cancer (CRC). BSS for 55 year olds was therefore introduced to the English Bowel Cancer Screening Programme (BCSP) in 2013. However, the benefits are only gained from test completion and uptake is low (43%). Primary care involvement has consistently shown benefits to cancer screening uptake and so this study aims to build on this knowledge and evaluate general practitioner (GP) practice led interventions designed to increase BSS attendance.

Methods and analysis

A three-arm randomised controlled trial will be conducted to evaluate three interventions: one intervention for prospective BSS invitees (primer letter with locally tailored leaflet sent by an individual’s GP practice) and two interventions for those who do not attend their BSS appointment (a self-referral letter sent by an individual’s GP practice and a patient navigation call made on behalf of an individual’s GP practice). The trial will be set in Yorkshire. Individuals soon to receive their invitation to attend BSS at one of the Hull and East Yorkshire Bowel Cancer Screening centre sites, will be randomly assigned to one of three groups: control (usual care; no input from GP practice), Intervention group A (primer letter/leaflet and a self-referral letter), Intervention group B (primer letter/leaflet and a patient navigation call). Attendance data will be obtained from the BCSP database (via National Health Service (NHS) Digital) 3 months after the last intervention. Regression analysis will compare uptake, and additional clinical outcomes, across the three groups. The analysis will be multivariate and adjust for several covariates including gender and area-level deprivation.

Ethics and dissemination

NHS ethical approval has been obtained from London-Harrow Research Ethics Committee. The results will be submitted for publication in a peer-reviewed journal and presented at conferences.

Trial registration number

ISRCTN16252122; Pre-results.
Colloid effect on clogging mechanism of hydraulic reclamation mud improved by vacuum preloading
Authors: Deng Yongfeng , Liu Li , Cui Yu-Jun , Feng Qi , Chen Xianglong , He Ning
Published: July 2018

Many cases of artificial soft clay foundation constructed by hydraulic filling and improved by the vacuum preloading show the clogging phenomenon in the surrounding soil, which compromises the improvement quality. To clarify the clogging mechanism and the formation of soil columns, the vacuum process was tracked from macro to micro by laboratory model tests. Results show that the soil column with higher strength (density) and lower water content was formed surrounding the prefabricated vertical drainage (PVD). Mercury intrusion porosimetry (MIP) tests revealed that the pore-entrance diameter of the soil column after 50 and 43 days of vacuum application ranged from 100 to 600 nm, and that at peak it is 300 nm. However, the mean diameter of the colloidal particles in tail water decreases from 1000 to 100 nm with continuous vacuum application, and then becomes stable at about 100 nm after 43 days. After re-visiting the vacuum process of the hydraulic reclamation mud, the pore-size distribution of surrounding soils and particle-size distribution of the tail water, the clogging was explained by the filling of the pores of the soil column by the colloidal particles in pore water. This mechanism differentiates the artificial foundation improved by vacuum preloading from the natural foundation for the presence of rich colloidal particles in pore water.
Case study of slope failure during construction of an open pit mine in Indonesia
Authors: Wang Wei , Griffiths D.V.
Published: July 2018

This paper presents back-analyses of a failed slope at an open pit lignite mine in Muara Enim, Indonesia. The slope, which was being raised by the dumping of excavated material, failed at a dump height of 24 m, well before reaching the design height of 80 m. The primary cause of failure was determined to be the presence of a previously unknown weak layer in the foundation, combined with high excess pore pressures generated by a relatively fast dumping rate. The failure resulted in significant disruption of the mining operation, in addition to environmental problems and a high cost of remediation. Finite element analyses were performed to gain a better understanding of the influence of the weak layer at the time of the failure. The case history emphasizes the need for a thorough site investigation and the risks associated with fast dumping on saturated weak clay overlain by a stiff residual soil layer with low permeability.
Measuring Tacit Knowledge: A Deliberate Construct Validation Using Structural Equation Modelling
Authors: Puteh Fadilah
Published: July 2018

Tacit knowledge (TK) is an intangible asset of the organisation and forms a major part of organisational knowledge. TK is personal, context-specific knowledge, difficult to formalise, record or articulate and it is stored in the heads of people. TK is part of informal learning components. TK has received growing attention and popularity due to its uniqueness and significant contributions to organisational performance. Despite its crucial role, the effects of TK on employee learning have often been neglected due to the notion of measurement difficulty. As a result, it poses challenges to capture both knowledge and expertise of individuals. This paper presents and discusses the construct validation of TK. Construct validity is a test that measures the intended construct and is particularly important in the social sciences-related disciplines. This paper deliberates how items development for TK is measured and tested for validation. Structural Equation Modelling (SEM) technique was employed for construct validation in terms of convergent and discriminant validities. Pre- and post-validations were also conducted to detect any validation discrepancies using exploratory factor analysis.
Semantic soft segmentation
Authors: Aksoy Yağiz , Oh Tae-Hyun , Paris Sylvain , Pollefeys Marc , Matusik Wojciech
Published: July 2018

Accurate representation of soft transitions between image regions is essential for high-quality image editing and compositing. Current techniques for generating such representations depend heavily on interaction by a skilled visual artist, as creating such accurate object selections is a tedious task. In this work, we introduce
semantic soft segments
, a set of layers that correspond to semantically meaningful regions in an image with accurate soft transitions between different objects. We approach this problem from a spectral segmentation angle and propose a graph structure that embeds texture and color features from the image as well as higher-level semantic information generated by a neural network. The soft segments are generated via eigendecomposition of the carefully constructed Laplacian matrix fully automatically. We demonstrate that otherwise complex image editing tasks can be done with little effort using semantic soft segments.
FEPR
Authors: Dinev Dimitar , Liu Tiantian , Li Jing , Thomaszewski Bernhard , Kavan Ladislav
Published: July 2018

We propose a novel projection scheme that corrects energy fluctuations in simulations of deformable objects, thereby removing unwanted numerical dissipation and numerical "explosions". The key idea of our method is to first take a step using a conventional integrator, then project the result back to the constant energy-momentum manifold. We implement this strategy using
fast projection
, which only adds a small amount of overhead to existing physics-based solvers. We test our method with several implicit integration rules and demonstrate its benefits when used in conjunction with Position Based Dynamics and Projective Dynamics. When added to a dissipative integrator such as backward Euler, our method corrects the artificial damping and thus produces more vivid motion. Our projection scheme also effectively prevents instabilities that can arise due to approximate solves or large time steps. Our method is fast, stable, and easy to implement---traits that make it well-suited for real-time physics applications such as games or training simulators.
Full 3D reconstruction of transparent objects
Authors: Wu Bojian , Zhou Yang , Qian Yiming , Cong Minglun , Huang Hui
Published: July 2018

Numerous techniques have been proposed for reconstructing 3D models for opaque objects in past decades. However, none of them can be directly applied to transparent objects. This paper presents a fully automatic approach for reconstructing complete 3D shapes of transparent objects. Through positioning an object on a turntable, its silhouettes and light refraction paths under different viewing directions are captured. Then, starting from an initial rough model generated from space carving, our algorithm progressively optimizes the model under three constraints: surface and refraction normal consistency, surface projection and silhouette consistency, and surface smoothness. Experimental results on both synthetic and real objects demonstrate that our method can successfully recover the complex shapes of transparent objects and faithfully reproduce their light refraction properties.
P2P-NET
Authors: Yin Kangxue , Huang Hui , Cohen-Or Daniel , Zhang Hao
Published: July 2018

We introduce P2P-NET, a
general-purpose
deep neural network which learns geometric transformations between point-based shape representations from two domains, e.g., meso-skeletons and surfaces, partial and complete scans, etc. The architecture of the P2P-NET is that of a
bi-directional point displacement
network, which transforms a source point set to a prediction of the target point set with the same cardinality, and vice versa, by applying
point-wise
displacement vectors learned from data. P2P-NET is trained on
paired
shapes from the source and target domains, but
without
relying on point-to-point correspondences between the source and target point sets. The training loss combines two uni-directional geometric losses, each enforcing a
shape-wise
similarity between the predicted and the target point sets, and a cross-regularization term to encourage consistency between displacement vectors going in opposite directions. We develop and present several different applications enabled by our general-purpose bidirectional P2P-NET to highlight the effectiveness, versatility, and potential of our network in solving a variety of point-based shape transformation problems.
Analytic spherical harmonic coefficients for polygonal area lights
Authors: Wang Jingwen , Ramamoorthi Ravi
Published: July 2018

Spherical Harmonic (SH) lighting is widely used for real-time rendering within Precomputed Radiance Transfer (PRT) systems. SH coefficients are precomputed and stored at object vertices, and combined interactively with SH lighting coefficients to enable effects like soft shadows, interreflections, and glossy reflection. However, the most common PRT techniques assume distant, low-frequency environment lighting, for which SH lighting coefficients can easily be computed once per frame. There is currently limited support for near-field illumination and area lights, since it is non-trivial to compute the SH coefficients for an area light, and the incident lighting (SH coefficients) varies over the object geometry. We present an efficient closed-form solution for projection of uniform polygonal area lights to spherical harmonic coefficients of arbitrary order, enabling easy adoption of accurate area lighting in PRT systems, with no modifications required to the core PRT framework. Our method only requires computing zonal harmonic (ZH) coefficients, for which we introduce a novel recurrence relation. In practice, ZH coefficients are built up iteratively, with computation linear in the desired SH order. General SH coefficients can then be obtained by the recently developed sparse zonal harmonic rotation method.
Foldsketch
Authors: Li Minchen , Sheffer Alla , Grinspun Eitan , Vining Nicholas
Published: July 2018

While folds and pleats add interest to garments and cloth objects, incorporating them into an existing design manually or using existing software requires expertise and time. We present
FoldSketch
, a new system that supports simple and intuitive fold and pleat design. FoldSketch users specify the fold or pleat configuration they seek using a simple schematic sketching interface; the system then algorithmically generates both the fold-enhanced 3D garment geometry that conforms to user specifications, and the corresponding 2D patterns that reproduce this geometry within a simulation engine. While previous work aspired to compute the desired patterns for a given
target
3D garment geometry, our main algorithmic challenge is that we do not have target geometry to start with. Real-life garment folds have complex profile shapes, and their exact geometry and location on a garment are intricately linked to a range of physical factors such as fabric properties and the garment's interaction with the wearer's body; it is therefore virtually impossible to predict the 3D shape of a fold-enhanced garment using purely geometric means. At the same time, using physical simulation to model folds requires appropriate 2D patterns and initial drape, neither of which can be easily provided by the user. We obtain both the 3D fold-enhanced garment and its corresponding patterns and initial drape via an alternating 2D-3D algorithm. We first expand the input patterns by allocating excess material for the expected fold formation; we then use these patterns to produce an estimated fold-enhanced drape geometry that balances designer expectations against physical reproducibility. We use the patterns and the estimated drape as input to a simulation generating an initial reproducible output. We improve the output's alignment with designer expectations by progressively refining the patterns and the estimated drape, converging to a final fully physically reproducible fold-enhanced garment. Our experiments confirm that FoldSketch reliably converges to a desired garment geometry and corresponding patterns and drape, and works well with different physical simulators. We demonstrate the versatility of our approach by showcasing a collection of garments augmented with diverse fold and pleat layouts specified via the FoldSketch interface, and further validate our approach via comparisons to alternative solutions and feedback from potential users.