bluuebunny/crossref_metadata_2025 huggingface dataset:
Towards an anticipatory public engagement methodology: deliberative experiments in the assembly of possible worlds using focus groups
Authors: Macnaghten Phil
Published: May 2020

Against the background of critique in public engagement scholarship on new and emerging science and innovation, this article engages with the methodological and conceptual challenges of making anticipatory knowledge. Adopting a science and technology studies perspective, a public engagement methodology is presented aimed at anticipating the kinds of possible and plausible worlds that novel science and technology bring into being. Drawing on six empirical social science research projects using focus groups, design criteria are explicated on context, framing, moderation, sampling, analysis and interpretation. A feature of the methodology lies in the assembly of emergent collectives and identities that are constituted to negotiate endogenously public meanings, concerns and priorities. I reflect on the potential of such processes to reconfigure dominant policy narratives, the role of the social scientist in mediating such processes and the politics of making anticipatory knowledge.
Incomplete angle reconstruction algorithm with the sparse optimization and the image optimal criterions
Authors: Jiao Shengxi , Wen Lu , Guo Haitao
Published: May 2020

To solve the problem of artifact and image degradation caused by incomplete angle projection, this article presents an incomplete angle reconstruction algorithm based on sparse optimization and image optimization criterion (SO-IOC). Firstly, the joint objective function model is established based on the projection sparsity and the natural features of images. Secondly, by means of the idea of alternating direction method of multipliers, the augmented Lagrange method is used to decompose the reconstruction model into simple subproblems and the modified genetic algorithm is used for solving those subproblems. Finally, a multiobjective optimization operation is carried out to coordinate and select the candidate solutions to improve the quality of the reconstructed images. The algebraic reconstruction technique algorithm and the Split Bregman algorithm are compared with the SO-IOC algorithm. In the compared process, the mean relative error and the peak signal-to-noise ratio are used. The experimental results show the SO-IOC algorithm is best among the above three algorithms.
Salvation as Cultural Distinction: Religion and Neoliberalism in Urban Africa
Authors: Burchardt Marian
Published: May 2020

Intervening in debates on religion and social inequalities, this article advocates a shift from concerns with economic ethics to a focus on religious belonging as embodying class-based cultural distinctions. In the first part, I critically review the literature that draws inspiration from Weber’s concept of Protestant inner-worldly asceticism and advance two arguments: Pentecostal orientations toward this-worldly salvation thwart rationalising potentials and feed into magic, or “occult,” economies instead. Simultaneously, however, Pentecostalism promotes personal autonomy by emphasising the possibilities for radical personal change through conversion and becoming “born again.” In the second part, I draw on Bourdieu’s cultural sociology and show that personal autonomy and certain images of Pentecostal modernity are increasingly deployed within practices of cultural distinction between the modern Pentecostal and economically successful and the backward who remain locked in the past. The article is based on ethnographic research among Pentecostals in South Africa as well as a review of the literature on other African societies.
Lack of association between clinical and ultrasound measures of disease activity in rheumatoid arthritis remission
Authors: Baker Kenneth F. , Thompson Ben , Lendrem Dennis W. , Scadeng Adam , Pratt Arthur G. , Isaacs John D.
Published: May 2020

Objectives:

The objective of this study was to assess the prevalence of ultrasound (US) abnormalities and association with clinical parameters in rheumatoid arthritis (RA) clinical remission.

Methods:

Patients with established RA in clinical remission (DAS28-CRP < 2.4) taking conventional synthetic disease-modifying anti-rheumatic drugs were recruited as part of the Biomarkers of Remission in Rheumatoid Arthritis (BioRRA) Study. In addition, patients from the Newcastle Early Arthritis Clinic (NEAC) with early active RA (DAS28-CRP > 2.4) or seronegative non-inflammatory arthralgia (NIA) were studied as positive and negative controls, respectively. The association between individual dependent variables (synovial power Doppler and greyscale, tenosynovial greyscale, and erosions) and clinical parameters was assessed by multivariate ordinal logistic regression, with adjustment for multiple testing.

Results:

A total of 294 patients were included: 66 RA in remission, 146 active RA, and 82 NIA. Within the active RA group, significant associations were observed between swollen joint count and higher total synovial greyscale score (OR 1.17 95% CI 1.08–1.26, p < 0.001) and higher total synovial power Doppler score (OR 1.20, 95% CI 1.12–1.30, p < 0.001). No significant associations were observed for the NIA group. In the RA remission group, US abnormalities were frequently observed and comparable for both DAS28-CRP and 2011 ACR/EULAR Boolean remission, with no significant association with clinical parameters identified.

Conclusion:

We observed widespread subclinical US findings in RA patients in clinical remission, even when remission is defined using the stringent ACR/EULAR Boolean criteria. In contrast to active disease, synovial power Doppler failed to show significant association with any of the clinical parameters in RA remission. Our results suggest that clinical and US examinations are non-overlapping in evaluating RA remission, challenging the proposition of US-driven management strategies in this setting.
Spontaneous expulsion of a submucosal uterine fibroid without embolization in a pre-menopausal woman
Authors: Rios Salete da Silva , Ribeiro Jaqueline Santos , Mota Marco Antonio de Souza , Chen Ana Carolina Rios , Chen Juliana Rios , Resende Ceres Nunes de
Published: May 2020

Uterine leiomyomas are benign tumors that develop from smooth muscle tissue and are present in up to 77% of women in menacme. They are often asymptomatic but can cause pelvic pain, compression, abnormal uterine bleeding, and degeneration. We present the first case report of a perimenopausal woman who exhibited complete and spontaneous expulsion of uterine fibroids without embolization or use of medication. She complained of a mass extruding from the vaginal orifice associated with bleeding and pain for a couple of hours. The anatomopathological findings showed a myomatous lesion. Complete expulsion of a uterine fibroid is a rare condition that may be associated with profuse hemorrhage and can pose a risk to the patient. When it occurs during perimenopause, it can mimic several clinical conditions. Therefore, gynecologists must remain alert to make the correct diagnosis and treatment.
Epifluorescent microscopy of edge-trimmed carbon fibre-reinforced polymers: An alternative to computed tomography scanning
Authors: Ashworth S , Fairclough JPA , Monoranu M , Ghadbeigi H , Meredith J , Takikawa Y , Kerrigan K
Published: May 2020

X-Ray computed tomography (XCT) can be used to detect edge-milled carbon fibre-reinforced polymer (CFRP) defects. Significantly this method is able to show subsurface defects that cannot be captured by traditional methods such as stylus-based or more novel areal methods of surface quality measurement. While useful, this method can be prohibitive due to high equipment cost, scanning time and image resolution. XCT can often produce artefacts which falsely predict damage or obscure damage and depending on machine X-ray power often cannot resolve damage to fibre diameter which is critical when observing milled quality of the surface/subsurface. This study utilises epifluorescent (EF) optical microscopy to provide high-quality optical images as an alternative to XCT to observe through-depth damage of CFRP materials. The method of computing the novel damage criteria is presented, as well as the validation of the method which compares EF to XCT. Subsurface damage of fabric and unidirectional (UD) materials in 0°, 45°, 90° and −45° orientations to the cutting edge is observed to demonstrate typical defects. A novel metric resulting from the EF method provides a total area of damage when compared to a theoretically straight cut across the face of the edge-milled CFRP. The method shows that different subsurface damage exists for different fibre orientations to the cutting edge, highlighting the clear need for through-depth analysis of machined edges. In addition, the method is shown to be a suitable alternative to XCT with scope for further development of industrial aerospace and automotive quality control of machined CFRP parts.
Phase 1 study of CWP232291 in patients with relapsed or refractory acute myeloid leukemia and myelodysplastic syndrome
Authors: Lee Je-Hwan , Faderl Stefan , Pagel John M. , Jung Chul Won , Yoon Sung-Soo , Pardanani Animesh D. , Becker Pamela S. , Lee Howard , Choi Jeongeun , Lee Kyoungjune , Kim Minkyoung , Cortes Jorge E.
Published: May 2020

CWP232291 (CWP291) is a small-molecule inhibitor of Wnt signaling that causes degradation of β-catenin via apoptosis induction through endoplasmic reticulum stress activation. This first-in-human, open-label, dose-escalation study to evaluate the safety, maximum tolerated dose (MTD), and preliminary efficacy of CWP291 enrolled 69 patients with hematologic malignancies (acute myeloid leukemia [AML], n = 64; myelodysplastic syndrome, n = 5) in 15 dose-escalation cohorts of 4 to 334 mg/m2 using a modified 3+3 design and 1 dose-expansion cohort. CWP291 was administered IV daily for 7 days every 21 days. The most common treatment-emergent adverse events (TEAEs) were nausea (n = 44, 64%), vomiting (n = 32, 46%), diarrhea (n = 25, 36%), and infusion-related reactions (n = 20, 29%). Grade ≥3 TEAEs in >3 patients (5%) were pneumonia (n = 8, 12%); hypophosphatemia (n = 6, 8%); leukocytosis, nausea, cellulitis, sepsis, and hypokalemia (n = 5 each, 7% each); and hypertension (n = 4, 6%). Dose-limiting toxicities included nausea (n = 3) and abdominal pain, anaphylactic reaction, myalgia, and rash (n = 1, each); the MTD was defined at 257 mg/m2. CWP232204, the active metabolite of CWP291, showed pharmacokinetic linearity on both days 1 and 7, and a terminal half-life of ∼12 hours. Among 54 response-evaluable AML patients, there was one complete response at a dose of 153 mg/m2 and one partial response at 198 mg/m2; bone marrow blast percentage reduced from a median of 58.3% to 3.5% and 15.0% to 4.2%, respectively. Future studies will explore CWP291, with a mechanism of action aimed at eradication of earlier progenitors via Wnt pathway blockade, as combination therapy. This trial was registered at www.clinicaltrials.gov as #NCT01398462.
Screening for comorbidities in COPD
Authors: Natali Delphine , Cloatre Georges , Hovette Philippe , Cochrane Belinda
Published: May 2020

Due to growing recognition of comorbidities, COPD is no longer considered a disease affecting only the respiratory system. Its management now entails the early diagnosis and treatment of comorbidities. However, although many studies have examined the impact of comorbidities on the evolution of COPD and patients’ quality of life, very few have explored the means to systematically identify and manage them. The aims of this article are to summarise the state of current knowledge about comorbidities associated with COPD and to propose a possible screening protocol in the outpatient setting, emphasising the areas needing further research.
A 180 nm Self-biased Bandgap Reference with High PSRR Enhancement
Authors: Shi Yue , Li Shilei , Cao Jianwen , Zhou Zekun , Ling Weiwei
Published: May 2020

In this paper, an improved self-biased bandgap reference (BGR) with high power supply rejection ratio (PSRR) is presented. An operational amplifier constructing feedback loop is multiplexed with the generation of positive temperature coefficient (TC) voltage for lower power consumption, where an offset voltage is adopted to achieve proportional to absolute temperature (PTAT) voltage. With the temperature-independent reference generation, two feedback loops are realized at the same time for PSRR enhancement, which form a local negative feedback loop (LNFL) and a global self-biased loop (GSBL). The proposed BGR is implemented in a 180 nm BCD technology, whose results show that the generated reference voltage is 2.506 V, and the TC is 25 ppm/°C in the temperature range of −55 to 125 °C. The line sensitivity (LS) is 0.08 ‰/V. Without any filter capacitor, the PSRR is 76 dB at low frequencies, over 46 dB up to 1 MHz.
The use of clinical decision rules for pulmonary embolism in the emergency department: a retrospective study
Authors: Al Dandan Omran , Hassan Ali , Alnasr Afnan , Al Gadeeb Mohammed , AbuAlola Hossain , Alshahwan Sarah , Al Shammari Malak , Alzaki Alaa
Published: May 2020

Background

Pulmonary embolism (PE) is a common and life-threatening medical condition with non-specific clinical presentation. Computed tomography pulmonary angiography (CT-PA) has been the diagnostic modality of choice, but its use is not without risks. Clinical decision rules have been established for the use of diagnostic modalities for patients with suspected PE. This study aims to assess the adherence of physicians to the diagnostic algorithms and rules.

Methods

A retrospective observational study examining the utilization of CT-PA in the Emergency Department of King Fahd Hospital of Imam Abdulrahman Bin Faisal University for patients with suspected PE from May 2016 to December 2019. The electronic health records were used to collect the data, including background demographic data, clinical presentation, triage vital signs, D-dimer level (if ordered), risk factors for PE, and the CT-PA findings. The Wells score and pulmonary embolism rule-out (PERC) criteria were calculated retrospectively without knowledge of the results of D-dimer and the CT-PA.

Results

The study involved a total of 353 patients (125 men and 228 women) with a mean age of 46.7 ± 18.4 years. Overall, 200 patients (56.7%) were classified into the “PE unlikely” group and 153 patients (43.3%) in the “PE likely” group as per Wells criteria. Out of all the CT-PA, 119 CT-PA (33.7%) were requested without D-dimer assay (n = 114) or with normal D-dimer level (n = 5) despite being in the “PE unlikely” group. Only 49 patients had negative PERC criteria, of which three patients had PE.

Conclusions

The study revealed that approximately one-third of all CT-PA requests were not adhering to the clinical decision rules with a significant underutilization of D-dimer assay in such patients. To reduce overutilization of imaging, planned interventions to promote the adherence to the current guidelines seem imperative.
Management of upper calyceal stone by percutaneous nephrolithotomy through lower calyx access: prone versus supine position
Authors: Soliman Tarek , Khalil Mostafa , Omar Rabea , Mohey Ahmed , Ahmed Shabieb , Sherif Hammoda , Abdelazim Mohamed
Published: May 2020

Background

The best way in the management of calyceal stone by percutaneous nephrolithotomy (PCNL) is to go directly into the desired calyx. However, in upper calyx, this direct entry may be associated with undesired complications, and through lower calyx is limited in prone PCNL. Recently, there is another option about reaching it through the lower calyx in supine position with more accessibility and better manipulation. This study aimed to evaluate the management of the upper calyceal stone by PCNL through lower calyx access in prone versus supine position.

Methods

A total of 38 patients with upper calyceal stone (≥ 2 cm) were randomly divided into two groups; the first group included 18 patients managed by PCNL in the prone position, and the second group included 20 patients managed in supine position. All data of both procedures were collected and statistically analyzed to compare between both groups.

Results

There is no statistically significant difference between groups as regards demographic and stone characters. The angle between the access to the lower calyx and access of the upper calyx was significantly wider in the supine group versus prone group (130.2° ± 23.46° vs. 89.67° ± 14.56°, respectively). The mean operative and fluoroscopy time was significantly longer in the prone group. There is no significant difference in intraoperative or postoperative morbidity. The stone-free rate was significantly higher in the supine group than the prone group (85% vs 38.9%, respectively). Also stone approachability was higher in the supine group than prone group (95% vs. 66.7%, respectively).

Conclusion

Management of upper calyceal stone by PCNL through the lower calyx is safe, but it is more effective in the supine position than in prone position.
MEPHAS: an interactive graphical user interface for medical and pharmaceutical statistical analysis with R and Shiny
Authors: Zhou Yi , Leung Siu-wai , Mizutani Shosuke , Takagi Tatsuya , Tian Yu-Shi
Published: May 2020

Background

Even though R is one of the most commonly used statistical computing environments, it lacks a graphical user interface (GUI) that appeals to students, researchers, lecturers, and practitioners in medicine and pharmacy for conducting standard data analytics. Current GUIs built on top of R, such as EZR and R-Commander, aim to facilitate R coding and visualization, but most of the functionalities are still accessed through a command-line interface (CLI). To assist practitioners of medicine and pharmacy and researchers to run most routines in fundamental statistical analysis, we developed an interactive GUI; i.e., MEPHAS, to support various web-based systems that are accessible from laptops, workstations, or tablets, under Windows, macOS (and IOS), or Linux. In addition to fundamental statistical analysis, advanced statistics such as the extended Cox regression and dimensional analyses including partial least squares regression (PLS-R) and sparse partial least squares regression (SPLS-R), are also available in MEPHAS.

Results

MEPHAS is a web-based GUI (https://alain003.phs.osaka-u.ac.jp/mephas/) that is based on a shiny framework. We also created the corresponding R package mephas (https://mephas.github.io/). Thus far, MEPHAS has supported four categories of statistics, including probability, hypothesis testing, regression models, and dimensional analyses. Instructions and help menus were accessible during the entire analytical process via the web-based GUI, particularly advanced dimensional data analysis that required much explanation. The GUI was designed to be intuitive for non-technical users to perform various statistical functions, e.g., managing data, customizing plots, setting parameters, and monitoring real-time results, without any R coding from users. All generated graphs can be saved to local machines, and tables can be downloaded as CSV files.

Conclusion

MEPHAS is a free and open-source web-interactive GUI that was designed to support statistical data analyses and prediction for medical and pharmaceutical practitioners and researchers. It enables various medical and pharmaceutical statistical analyses through interactive parameter settings and dynamic visualization of the results.
Physiological effects of the combined stresses of freezing-thawing, acid precipitation and deicing salt on alfalfa seedlings
Authors: Bao Guozhang , Tang Wenyi , An Qirui , Liu Yaoxin , Tian Jiaqi , Zhao Nan , Zhu Saning
Published: May 2020

Background

Frequent freeze-thaw phenomena, together with widely used deicing salt and intense acid precipitation, often occur in northeastern China, causing damage to various aspects of plants, such as the permeability of biological membranes, osmotic adjustment, and photosystems. Aiming to explore the resistance of alfalfa to freezing-thawing (F), acid precipitation (A) and deicing salt (D), this study used Medicago sativa cv. Dongmu-70 as the experimental material, and the contents of malondialdehyde (MDA), soluble protein, soluble sugars, proline and chlorophyll were evaluated.

Results

As the temperature decreased, the MDA content in the seedlings of the group under combined stress (A-D-F) increased and was significantly higher than that of group F (by 69.48 ~ 136.40%). Compared with those in the control (CK) group, osmotic substances such as soluble sugars and proline in the treatment groups were higher, while the soluble protein content was lower. The chlorophyll contents in the seedlings of the treatment groups were lower than those of the CK group; however, the chlorophyll content displayed a non-significant change during the free-thaw cycle.

Conclusion

Injury to the permeability of the biological membranes and photosystems of alfalfa results from stress. Moreover, alfalfa maintains osmotic balance by adaptively increasing the potential of osmotic substances such as soluble sugars and proline. Furthermore, the influence of stress from freezing-thawing and deicing salt is highly substantial, but the combined stresses of acid precipitation with the two factors mentioned above had little effect on the plants.
Retrospective evaluation of pain in patients with coccydynia who underwent impar ganglion block
Authors: Sagir Ozlem , Demir Hafize Fisun , Ugun Fatih , Atik Bulent
Published: May 2020

Background

We aimed to evaluate pain scores one year after impar ganglion block in patients with coccydynia who did not benefit from conservative treatment.

Methods

The medical records of 29 patients with coccydynia were reviewed. Patients who were referred to the algology clinic and underwent impar ganglion blocks were retrospectively evaluated. Demographic data, time to the onset of pain, causes of pain, X-ray findings, administered invasive procedures, and visual analog scale (pain) scores were recorded.

Results

A total of 29 patients were included in the study, 10 males (34%) and 19 females (66%). The average age and body mass index were 53.45 ± 9.6 and 29.55 ± 4.21 respectively. In 21 patients, the onset of pain was associated with trauma. Nineteen patients (65.5%) had anterior coccygeal angulation. The average visual analog scale score before undergoing an impar ganglion block was 7.4 ± 1. After the procedure, the scores at < 3 months, 3–6 months and 6 months-1 year follow-up intervals were significantly lower (p < 0.05). Furthermore, visual analog scale scores at the 3–6 months and 6 months-1 year periods were significantly lower in patients who received diagnostic blocks plus pulse radiofrequency thermocoagulation than in patients who underwent a diagnostic block only.

Conclusions

The impar ganglion block provides effective analgesia without complications in patients with coccydynia. Pulse radiofrequency thermocoagulation combined with a diagnostic block prolongs the analgesic effect of the procedure.
Experiences of maternity care in New South Wales among women with mental health conditions
Authors: Corscadden L. , Callander E. J. , Topp S. M. , Watson D. E.
Published: May 2020

Background

High quality maternity care is increasingly understood to represent a continuum of care. As well as ensuring a positive experience for mothers and families, integrated maternity care is responsive to mental health needs of mothers. The aim of this paper is to summarize differences in women’s experiences of maternity care between women with and without a self-reported mental health condition.

Methods

Secondary analyses of a randomized, stratified sample patient experience survey of 4787 women who gave birth in a New South Wales public hospital in 2017. We focused on 64 measures of experiences of antenatal care, hospital care during and following birth and follow up at home. Experiences covered eight dimensions: overall impressions, emotional support, respect for preferences, information, involvement, physical comfort and continuity. Multivariable logistic regression was used to compare experiences of women with and without a self-reported longstanding mental health condition.

Results

Compared to women without a condition, women with a longstanding mental health condition (n = 353) reported significantly less positive experiences by eight percentage points on average, with significant differences on 41 out of 64 measures after adjusting for age, education, language, parity, type of birth and region. Disparities were pronounced for key measures of emotional support (discussion of worries and fears, trust in providers), physical comfort (assistance, pain management) and overall impressions of care. Most women with mental health conditions (75% or more) reported positive experiences for measures related to guidelines for maternity care for women with mental illness (discussion of emotional health, healthy behaviours, weight gain). Their experiences were not significantly different from those of women with no reported conditions.

Conclusions

Women with a mental health condition had significantly less positive experiences of maternity care across all stages of care compared to women with no condition. However, for some measures, including those related to guidelines for maternity care for women with mental illness, there were highly positive ratings and no significant differences between groups. This suggests disparities in experiences of care for women with mental health conditions are not inevitable. More can be done to improve experiences of maternity care for women with mental health conditions.
Severity and prevalence of various types of mental ill-health in a general adult population: age and sex differences
Authors: Höglund Per , Hakelind Camilla , Nordin Steven
Published: May 2020

Background

Taking a broad approach, the aim of this study was to better understand severity and prevalence of various types of mental ill-health across age and sex groups in the general adult population. A first objective was to determine symptom severity of anxiety, depression, insomnia, burnout and somatization in combinations of different age groups and sex. A second objective was to determine prevalence of caseness of these types of mental ill-health in both absolute and relative terms in the combinations of age groups and sex.

Methods

Cross-sectional data based on validated questionnaire instruments were used from the Västerbotten Environmental Health Study in Sweden. In total, 3406 participants, aged 18 to 79 years, constituted a random sample stratified for age and sex.

Results

Severity and prevalence of anxiety, insomnia and burnout were high in women, in particular young women, and lower in older age groups. The prevalence rates for insomnia, burnout and somatization were particularly high based on the used cut-off scores. Men aged 30–49 years had the highest prevalence of mental ill-health compared to other age groups among men. Men and women aged 60–69 years had generally the lowest symptom severity and caseness. The prevalence of depression was similar in men and women in all age groups, whereas sex-related differences in extent in general were largest in the youngest age group, and gradually decreased with age.

Conclusion

The results suggest that focus in primary healthcare regarding mental ill-health should to be directed more towards insomnia, burnout and somatization, in particular in young women.
Chronic obstructive pulmonary disease, lung function and risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies
Authors: Peng Yang , Zhong Guo-Chao , Wang Lingxiao , Guan Lijuan , Wang Ao , Hu Kai , Shen Jing
Published: May 2020

Background

The association between chronic obstructive pulmonary disease (COPD), lung function and risk of type 2 diabetes mellitus (T2DM) remains controversial. We performed a meta-analysis to clarify this issue.

Methods

The PubMed and EMBASE databases were searched. Cohort studies on COPD, lung function and risk of T2DM in adults were included. A random effects model was adopted to calculate the summary risk ratio (RR) and 95% confidence interval (CI). Dose-response analysis was conducted where possible.

Results

A total of 13 eligible cohort studies involving 307,335 incident T2DM cases and 7,683,784 individuals were included. The risk of T2DM was significantly higher in patients with COPD than those without COPD (RR = 1.25, 95% CI 1.16–1.34). Compared to the highest category of percentage forced vital capacity (FVC%), the lowest category of FVC% was associated with a higher risk of T2DM (RR = 1.43, 95% CI 1.33–1.53). Similarly, the summary RR of T2DM for the lowest versus highest category of percentage forced expiratory volume in 1 s (FEV1%) was 1.49 (95% CI 1.39–1.60). Significant linear associations of FVC% and FEV1% with risk of T2DM were found (Pnon-linearity > 0.05); the RR of T2DM was 0.88 (95% CI 0.82–0.95) and 0.87 (95% CI 0.81–0.94) per 10% increase in FVC% and FEV1%, respectively. There was a non-significant relationship between the FEV1/FVC ratio and the risk of T2DM.

Conclusions

Both COPD and impaired lung function, especially restricted ventilation dysfunction, could increase the risk of T2DM. However, these findings should be interpreted with caution due to the limited number of studies, and need to be validated by future studies.
The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis
Authors: Almeida Marcela , Kosman Katherine A. , Kendall Mark C. , De Oliveira Gildasio S.
Published: May 2020

Background

Previous studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, however the association between adequate intrapartum pain control and the development of postpartum depression is not clear. The purpose of the study was to examine the effects of labor epidural analgesia and postpartum depression.

Methods

We performed a quantitative systematic review in compliance with the PRISMA statement. We conducted a search of PubMed, Embase, the Cochrane Database of Systematic Reviews and Google Scholar databases. The primary outcome was a positive screen of postpartum depression among women who received labor epidural analgesia up to 3 months into the postpartum period. Meta-analysis was performed using the random effect model.

Results

Of the 148 studies available, 9 studies with 4442 patients were included in the analysis. The use of labor analgesia on positive depression screen compared to control revealed no significant effect, OR (95% CI) of 1.02 (0.62 to 1.66, P = 0.94).

Conclusion

Based on current literature, the use of epidural analgesia for pain relief during labor doesn’t appear to affect the likelihood of postpartum depression. Future studies are warranted to further investigate these findings and identity other possible preventative interventions that reduce postpartum depression.
Should I stay or should I go? The role of leadership and organisational context for hospital physicians’ intention to leave their current job
Authors: Martinussen Pål E. , Magnussen Jon , Vrangbæk Karsten , Frich Jan C.
Published: May 2020

Background

Physician turnover is a concern in many health care systems globally. A better understanding of physicians’ reasons for leaving their job may inform organisational policies to retain key personnel. The aim of this study was to investigate hospital physicians’ intention to leave their current job, and to investigate if such intentions are associated with how physicians assess their leaders and the organisational context.

Methods

Data was derived from a survey of 971 physicians working in public hospitals in Norway in 2016. The data was analysed using descriptive statistics and multivariate analysis.

Results

We found that 21.0% of all hospital physicians expressed an intention to leave their current job for another job. An additional 20.3% of physicians had not made up their mind whether to stay or leave. Physicians’ perceptions of their leaders and the organisational context influence their intention to leave their hospital. Respondents who perceived their leaders as professional-supportive had a significantly lower probability of reporting an intention to leave their job. The analysis suggests that organisational context, such as department mergers, weigh in on physicians’ considerations about leaving their current job. Social climate and commitment are important reasons why physician stay.

Conclusions

A professional-supportive leadership style may have a positive influence on retention of physicians in public hospitals. Further research should investigate how retention of physicians is associated with performance related to organisational and leadership style.
High frequency of benzimidazole resistance alleles in trichostrongyloids from Austrian sheep flocks in an alpine transhumance management system
Authors: Hinney Barbara , Schoiswohl Julia , Melville Lynsey , Ameen Vahel J. , Wille-Piazzai Walpurga , Bauer Karl , Joachim Anja , Krücken Jürgen , Skuce Philip J. , Krametter-Frötscher Reinhild
Published: May 2020

Background

Infections of small ruminants with trichostrongyloid nematodes often result in reduced productivity and may be detrimental to the host. Anthelmintic resistance (AR) against most anthelmintic drug classes is now widespread amongst the trichostrongyloids. Baseline establishment, followed by regular monitoring of the level of AR, is necessary for farmers and veterinarians to make informed decisions about parasite management. The detection of single nucleotide polymorphisms (SNPs) is a sensitive method to detect AR against benzimidazoles (BZs), one of the most widely used anthelmintic classes. Alpine transhumance constitutes a special type of pasturing of sheep from many different farms, the aim of this study was to investigate the prevalence of benzimidazole resistance alleles in this particular management system.

Results

Sixteen sheep flocks in Styria and Salzburg in Austria were examined by pyrosequencing for SNPs at codons 167, 198 and 200 of the isotype-1 β-tubulin gene. The frequency of the resistance-associated exchange F200Y was 87–100% for H. contortus, 77–100% for T. colubriformis and <  5–66% for T. circumcincta. Additionally, the F167Y polymorphism was detected in T. colubriformis from two farms at a frequency of 19 and 23% respectively.

Conclusions

The high resistance allele frequency in H. contortus and T. colubriformis in the examined sheep population urgently calls for the development of new treatment strategies to sustainably control trichostrongyloid infections for this kind of pasturing, since the frequent mixing of flocks during the alpine summer grazing must be considered an important risk factor for the spread of resistant nematodes to a large number of farms.
Secretion of a low and high molecular weight β-glycosidase by Yarrowia lipolytica
Authors: Swietalski Paul , Hetzel Frank , Seitl Ines , Fischer Lutz
Published: May 2020

Background

The secretory production of recombinant proteins in yeast simplifies isolation and purification but also faces possible complications due to the complexity of the secretory pathway. Therefore, correct folding, maturation and intracellular transport of the recombinant proteins are important processing steps with a higher effort needed for complex and large proteins. The aim of this study was to elucidate the secretion potential of Yarrowia lipolytica for low and high molecular weight β-glycosidases in a comparative cultivation approach.

Results

A low sized β-glucosidase from Pyrococcus furiosus (CelB; 55 kDa) and a large sized β-galactosidase isolated from the metagenome (M1; 120 kDa) were integrated into the acid extracellular protease locus using the CRISPR–Cas9 system to investigate the size dependent secretion of heterologous proteins in Y. lipolytica PO1f. The recombinant strains were cultivated in the bioreactor for 78 h and the extra- and intracellular enzyme activities were determined. The secretion of CelB resulted in an extracellular volumetric activity of 187.5 µkatoNPGal/Lmedium, while a volumetric activity of 2.98 µkatoNPGal/Lmedium was measured during the M1 production. However, when the amount of functional intra- and extracellular enzyme was investigated, the high molecular weight M1 (85%) was secreted more efficiently than CelB (27%). Real-time PCR experiments showed a linear correlation between the transcript level and extracellular activity for CelB, while a disproportional high mRNA level was observed regarding M1. Interestingly, mass spectrometry data revealed the unexpected secretion of two endogenous intracellular glycolytic enzymes, which is reported for the first time for Y. lipolytica.

Conclusion

The results of this study provide deeper insights into the secretion potential of Y. lipolytica. A secretion limitation for the low-size CelB was observed, while the large size M1 enzyme was produced in lower amounts but was secreted efficiently. It was shown for the first time that Y. lipolytica is a promising host for the secretion of heterologous high molecular weight proteins (> 100 kDa), although the total secreted amount has to be increased further.
Inhibition of germinal vesicle breakdown using IBMX increases microRNA-21 in the porcine oocyte
Authors: Hale Benjamin J. , Li Yunsheng , Adur Malavika K. , Ross Jason W.
Published: May 2020

Background

Germinal vesicle breakdown (GVBD) occurs during oocyte meiotic maturation, a period when transcriptional processes are virtually inactive. Thus, the maturing oocyte is reliant on processes such as post-transcriptional gene regulation (PTGR) to regulate the mRNA and protein repertoire. MicroRNA (miRNA) are a class of functional small RNA that target mRNA to affect their abundance and translational efficiency. Of particular importance is miRNA-21 (MIR21) due to its role in regulating programmed cell death 4 (PDCD4). The objective of this study was to characterize the abundance and regulation of MIR21 in relation to GVBD.

Methods

Oocytes were collected from aspirated porcine tertiary follicles. Relative abundance of mature MIR21 was quantified at 0, 8, 16, 24, 32, and 42 h of in vitro (IVM) with or without treatment with 3-isobutyl-1-methylxanthine (IBMX).

Results

IBMX increased abundance of MIR21 at 24 h approximately 30-fold compared to control oocytes (P < 0.05), and the induced increase in MIR21 abundance at 24 h was concomitant with premature depletion of PDCD4 protein abundance. To characterize the effect of artificially increasing MIR21 on oocyte competence without inhibiting GVBD, a MIR21 mimic, scrambled microRNA negative control, or nuclease free water was micro-injected into denuded oocytes at 21 h of IVM. The maturation rate of oocytes injected with synthetic MIR21 (63.0 ± 7.5%) was higher than oocytes injected with negative controls (P < 0.05).

Conclusions

Inhibition of nuclear meiotic maturation via IBMX significantly increased MIR21 and decreased its target, PDCD4. Injection of a MIR21 mimic increased oocyte maturation rate. Our results indicate MIR21 is active and important during meiotic maturation of the oocyte.
Learning sites for health system governance in Kenya and South Africa: reflecting on our experience
Authors:   The RESYST/DIAHLS learning site team
Published: May 2020

Background

Health system governance is widely recognised as critical to well-performing health systems in low- and middle-income countries. However, in 2008, the Alliance for Health Policy and Systems Research identified governance as a neglected health systems research issue. Given the demands of such research, the Alliance recommended applying qualitative approaches and institutional analysis as well as implementing cross-country research programmes in engagement with policy-makers and managers. This Commentary reports on a 7-year programme of work that addressed these recommendations by establishing, in partnership with health managers, three district-level learning sites that supported real-time learning about the micro-practices of governance – that is, managers’ and health workers’ everyday practices of decision-making.

Paper focus

The paper’s specific focus is methodological and it seeks to prompt wider discussion about the long-term and engaged nature of learning-site work for governance research. It was developed through processes of systematic reflection within and across the learning sites. In the paper, we describe the learning sites and our research approach, and highlight the set of wider activities that spun out of the research partnership, which both supported the research and enabled it to reach wider audiences. We also separately present the views of managers and researchers about the value of this work and reflect carefully on four critiques of the overall approach, drawing on wider co-production literature.

Conclusions

Ultimately, the key lessons we draw from these experiences are that learning sites offer particular opportunities not only to understand the everyday realities of health system governance but also to support emergent system change led by health managers; the wider impacts of this type of research are enabled by working up the system as well as by infusing research findings into teaching and other activities, and this requires supportive organisational environments, some long-term research funding, recognising the professional and personal risks involved, and sustaining activities over time by paying attention to relationships; and working in multiple settings deepens learning for both researchers and managers. We hope the paper stimulates further reflection about research on health system governance and about co-production as a research approach.
Can consumer wearable activity tracker-based interventions improve physical activity and cardiometabolic health in patients with chronic diseases? A systematic review and meta-analysis of randomised controlled trials
Authors: Franssen Wouter M. A. , Franssen Gregor H. L. M. , Spaas Jan , Solmi Francesca , Eijnde Bert O.
Published: May 2020

Background

To date, it is unclear if consumer wearable activity trackers (CWATs), with or without behaviour multi-component strategies, effectively improve adherence to physical activity and health outcomes under free living conditions in populations with chronic diseases. Therefore, we systematically evaluated the efficacy of CWAT-based interventions to promote physical activity levels and cardiometabolic health in populations with chronic diseases.

Methods

Randomised controlled trials were collected from five bibliographic databases (PubMed, Embase, Web of Science, The Cochrane Central Register of Controlled Trials and CINAHL). Studies were eligible for inclusion if they evaluated a CWAT-based counselling intervention versus control intervention among patients with chronic respiratory diseases, type 2 diabetes mellitus, cardiovascular diseases, overweight/obesity, cognitive disorders, or sedentary older adults. Data were pooled using a random-effects model.

Results

After deduplication 8147 were identified of which 35 studies met inclusion criteria (chronic respiratory diseases: 7, type 2 diabetes mellitus: 12, cardiovascular diseases: 6, overweight/obesity: 3, cognitive disorders: 1, sedentary older adults: 6). Compared to control groups, CWAT-based interventions significantly increased physical activity by 2123 steps per day (95% confidence interval [CI], [1605–2641]; p < 0.001). In addition, CWAT-based interventions in these populations significantly decreased systolic blood pressure (− 3.79 mm Hg; 95% CI: [− 4.53, − 3.04] mm Hg; p < 0.001), waist circumference (− 0.99 cm; 95% CI: [− 1.48, − 0.50] cm; p < 0.001) and low-density lipoprotein cholesterol concentration (− 5.70 mg/dl; 95% CI: [− 9.24, − 2.15] mg/dl; p = 0.002).

Conclusion

CWAT-based interventions increase physical activity and have beneficial effects on important health-related outcomes such as systolic blood pressure, waist circumference and LDL cholesterol concentration in patients with chronic diseases.
The impact of glutamate infusion on postoperative NT-proBNP in patients undergoing coronary artery bypass surgery: a randomized study
Authors: Jiang Huiqi , Holm Jonas , Vidlund Mårten , Vanky Farkas , Friberg Örjan , Yang Yanqi , Svedjeholm Rolf
Published: May 2020

Background

Glutamate, a key intermediate in myocardial metabolism, may enhance myocardial recovery after ischemia and possibly reduce the incidence and severity of postoperative heart failure in coronary artery bypass surgery (CABG). N-terminal pro-B-type natriuretic peptide (NT-proBNP) can be used to assess postoperative heart failure (PHF) after CABG. Our hypothesis was that glutamate enhances myocardial recovery in post-ischemic heart failure and, therefore, will be accompanied by a mitigated postoperative increase of NT-proBNP.

Methods

Substudy of the GLUTAmate for Metabolic Intervention in Coronary Surgery (GLUTAMICS) trial (ClinicalTrials.gov Identifier: NCT00489827) a prospective triple-center double-blind randomized clinical trial on 399 patients undergoing CABG with or without concomitant procedure for acute coronary syndrome at three Swedish Cardiac Surgery centres (Linköping, Örebro, and Karlskrona) from May 30, 2007 to November 12, 2009. Patients were randomly assigned to intravenous infusion of 0.125 M l-glutamic acid or saline (1.65 mL/kg of body weight per hour) intraoperatively and postoperatively. Plasma NT-proBNP was measured preoperatively, the first (POD1) and third postoperative morning (POD3). A Clinical Endpoints Committee, blinded to both intervention and NT-proBNP used prespecified criteria to diagnose PHF. The primary endpoints were the absolute levels of postoperative NT-proBNP and the difference between preoperative and postoperative levels of NT-proBNP.

Results

Overall no significant difference was detected in postoperative NT-proBNP levels between groups. However, in high-risk patients (upper quartile of EuroSCORE II ≥ 4.15; glutamate group n = 56; control group n = 45) glutamate was associated with significantly lower postoperative increase of NT-proBNP (POD3-Pre: 3900 [2995–6260] vs. 6745 [3455–12,687] ng•L−1, p = 0.012) and lower NT-proBNP POD3 (POD3: 4845 [3426–7423] vs. 8430 [5370–14,100] ng•L−1, p = 0.001). After adjusting for significant differences in preoperative demographics, NT-proBNP POD3 in the glutamate group was 0.62 times of that in the control group (p = 0.002). Patients in the glutamate group also had shorter ICU stay (21 [19–26] vs. 25 [22–46] h, p = 0.025) and less signs of myocardial injury (Troponin T POD3 (300 [170–500] vs. 560 [210–910] ng•L−1, p = 0.025).

Conclusions

Post hoc analysis of postoperative NT-proBNP suggests that intravenous infusion of glutamate may prevent or mitigate myocardial dysfunction in high-risk patients undergoing CABG. Further studies are necessary to confirm these findings.

Trial registration Swedish Medical Products Agency 151:2003/70403 (prospectively registered with amendment about this substudy filed March 17, 2007). ClinicalTrials.gov Identifier: NCT00489827 (retrospectively registered) https://clinicaltrials.gov/ct2/show/NCT00489827?term=glutamics&draw=1&rank=1