bluuebunny/crossref_metadata_2025 huggingface dataset:
Moisture behavior of external insulated precast concrete wall panels
Authors: Sekki Pauli , Karvinen Timo , Vinha Juha
Published: June 2020

Excess moisture in concrete structures is a major problem in building industry. It is claimed that degradation of the finishing materials of concrete slabs is the largest source of volatile organic compound in the building stock in the Nordic countries. Considering concrete wall panels, the choice of the insulation material influences concrete drying considerably and causes a risk for moisture accumulation on the interior surface, if vapor tight finishing materials are used or if finishing materials are installed prematurely. Mineral wool insulation, which has predominately been used in Finland, is a vapor open material. However, vapor tight plastic foam insulation materials are nowadays more commonplace. Here we show that the overall rate of drying of the concrete panel with a vapor open insulation material is higher in comparison to the concrete panel with vapor tight insulation materials. However, relative humidity distribution near the inner surface of the concrete panel at the end of the drying phase is almost identical irrespective of the insulation material and the water vapor resistance of the interior surface material has a greater impact on the relative humidity level on the inner concrete surface. Moisture behavior of concrete panel walls is studied under a certain building schedule in Finnish environment and building conditions by numerical simulation. The model for drying of concrete is calibrated based on laboratory measurements. According to our study, self-desiccation and changing diffusivity due to the hydration process of the concrete cannot be ignored when evaluating the moisture behavior of the concrete wall panel structure with a low water binder ratio ( w/ b < 0.5). Measurements indicate that the early age humidity drop is by up to 10 percentage points.
The virtual fracture clinic improves quality of care for patients with hand and wrist injuries: an assessment of 3709 patients
Authors: Little Max , Huntley Daniel , Morris James , Jozsa Felix , Hardman John , Anakwe Raymond E.
Published: June 2020

Fracture clinic services are under significant pressures to meet patients' expectations of a high-quality service. The virtual fracture clinic has shown early promise in helping to reduce such pressures. We used the virtual fracture clinic for hand and wrist injuries treated in the orthopaedic fracture clinic and used key quality indicators to measure improvement. Over the first 21 months, key patient outcome measures and satisfaction scores for patients discharged from the virtual fracture clinic with education to self-care were excellent. Our results show that a virtual fracture clinic model can be applied to provide high-quality care for hand and wrist injuries. The main advantage of the virtual fracture clinic is its ability to direct patients to the right person for timely treatment. We conclude from our 21-month experience that this model of care allows safe, effective, patient-centred, efficient and equitable care to the patients with hand and wrist fractures.

Level of evidence: IV
A biomechanical field testing approach in snow sports: Case studies toward a detailed analysis of joint loading
Authors: Kurpiers Nicolas , McAlpine Paul , Kersting Uwe G
Published: June 2020

In this study, kinematic and kinetic measurements were combined to assess the effects of removing the stiff shaft from a ski boot. It was hypothesized that joint flexion at the ankle, knee and hip increase and reduce joint loading specifically at the knee. A previously developed force sensor was combined with a high-speed camera system for data collection of 6 degrees of freedom ground reaction forces and three-dimensional marker data in the field on a wave slope. The collected data were used as input to a musculoskeletal model for the estimation of joint kinematics and joint moments and contact forces in the ankle and knee. The force sensor, which was previously used for skiing, had experienced wear and tear and was thus prone to breakage. As a result, joint loading could only be analyzed for two skiers. These two skiers did not use the added range of ankle flexion to its full extent, but showed substantial reductions in joint moments and joint contact forces (e.g. knee compression force from 85 to 57 N/kg). Only one of the five experienced skiers tested was able to adopt the anticipated movement pattern by substantially increased maximum ankle joint flexion angle (from 10° to 37°) and knee joint flexion angle (from 93° to 105°) and the respective ranges of motion when skiing through a wave course. The study provides information on possible individual adaptations to ski boot modifications. The mechanical construction of the force sensor will need to be modified to withstand the high forces expected during freestyle skiing. The study also supports the future use of this measurement setup for comprehensive studies in snow sports, provided that a sufficient training period is given.
Health literacy
Authors: Reilly Johanna
Published: June 2020

Health literacy has been defined by the World Health Organisation as ‘The cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health.’ Doctors need to assess and take into account a patient’s health literacy when communicating information. Poor health literacy is more common than doctors may appreciate, and health information is often produced at a level that many people may struggle to understand.
Comparative Tissue Distribution of 6 Major Polyphenolic Compounds in Normal and Myocardial Ischemia Model Rats After Oral Administration of the Polygonum orientale L. Extract
Authors: Li Na , Lv Ting , Pan Jie , Liu Chunhua , Sun Jia , Lan Yanyu , Wang Aimin , Li Yongjun , Wang Yonglin , Lu Yuan
Published: June 2020

A simple, rapid, and selective ultra-performance liquid chromatography-mass spectrometry (MS)/MS method was established to investigate tissue distribution of 6 polyphenolic compounds of Polygonum orientale L. extract in normal and myocardial ischemia (MI) model rat tissues, including isoorientin, orientin, vitexin, quercitrin, astragalin, and protocatechuic acid. An Agilent Eclipse Plus C18 column was used. The mobile phase consisted of acetonitrile and water, both with 0.1% formic acid. Quantification was performed in negative ion multiple reaction monitoring mode. All the analysts had good linearity with r ≥ 0.9912. Accuracy ranged from 12.49% to −13.98% for the 6 compounds; within-day variation (precision) was ≤9.98% and interday precision was ≤11.88%. Extraction recovery of the analysts ranged from 80.55% to 99.92%; the matrix was 81.00%–98.73%. The analyst preparations were stable throughout. The 6 compounds were rapidly distributed in various tissues after oral administration, without accumulation over 12 hours. Compared with normal rats, distributions of 6 compounds in the heart, liver, spleen, lung, kidney, brain, stomach, and intestine in MI model rats were different from those in the normal group. The study provides an insight for further research of P. orientale L.
The Role of Home Fungal Exposure in Allergic Fungal Rhinosinusitis
Authors: Rowan Nicholas R. , Storck Kristina A. , Schlosser Rodney J. , Soler Zachary M.
Published: June 2020

Background

Allergic fungal rhinosinusitis (AFRS) is disproportionately identified in patients of low socioeconomic status living in warm, humid climates, and is thought to occur in response to environmental fungal species.

Objective

We hypothesized that micro-geographic differences in fungal exposure contribute to the pathogenesis of AFRS, and compared home fungal exposure of patients with AFRS to normative data and controls.

Methods

Comprehensive prospective enrollment and data capture was completed in 70 patients. Patients with AFRS were compared to a control population with chronic rhinosinusitis with nasal polyposis (CRSwNP) and comorbid atopy. Comprehensive demographics, 22-item sino-nasal outcomes test (SNOT-22) questionnaires, and endoscopy scores were compiled. Using a test strip collection system, a home fungal assessment was completed for each patient, along with detailed questions related to home condition.

Results

Patients with AFRS were more likely to be younger (p<.001), African American (p<.001), from a lower income bracket (p < .012), and less likely to own their home (p < .001). There were no differences in prior surgeries (p=.432), endoscopy scores (p = .409) or SNOT-22 scores (p = .110) between the groups. There were no differences in overall fungal counts between patients with AFRS and controls (p = .981). AFRS patients had a higher prevalence of Basidiospores than controls (p = .034).

Conclusion

This study failed to detect differences in total home fungal exposure levels between those with AFRS and atopic CRSwNP, despite differences in socioeconomic status. This suggests that absolute fungal levels may not be the primary driver in development of AFRS, or that the fungal detection strategies utilized were not representative of patients’ overall fungal exposure.
Case report: Minimal change disease and acute interstitial nephritis in a patient with Hodgkin’s lymphoma treated with nivolumab
Authors: Chemaly Elie R , Sandoval Sus Jose , Hussain Faizul , Mogollon-Duffo Francis , Laber Damian A , Durr Jacques A , Khalighi Mazdak A , Lopez del Valle Ramon
Published: June 2020

Programmed cell death receptor-1 blocking antibodies and cytotoxic T-lymphocyte–associated antigen-4 blocking antibodies are referred to as checkpoint inhibitors and are used in cancer immunotherapy. While enhancing T-cell antitumor immunity, checkpoint inhibitors can also cause immune-mediated nephrotoxicities, manifesting mostly in acute kidney injury. Cytotoxic T-lymphocyte–associated antigen-4 blockade was associated with acute interstitial nephritis with variable degrees of podocyte effacement, minimal change disease, and membranous nephropathy. Conversely, programmed cell death receptor-1 blockade has mostly been associated with acute interstitial nephritis, with or without various glomerular diseases. In particular, cases of minimal change disease were reported with programmed cell death receptor-1 blockade, including two cases of minimal change disease reported in Hodgkin’s lymphoma and one with mesothelioma, in addition to one case of focal segmental glomerulosclerosis after treatment of renal cell carcinoma. We report a case of acute interstitial nephritis and minimal change disease in a patient with Hodgkin’s lymphoma treated with nivolumab and discuss pathophysiological hypotheses. The association of minimal change disease with Hodgkin’s lymphoma is well-recognized and may be related to c-mip protein and/or CD80. The checkpoint pathway likely triggers the auto-immune, T-cell-mediated, minimal change disease associated with Hodgkin’s lymphoma; however, this pathogenic process may also involve a programmed cell death receptor-1– fyn-c-mip interaction or a PD-L1–CD80 cross-talk at both T-cell and podocyte level.
RGS10 and RGS18 differentially limit platelet activation, promote platelet production, and prolong platelet survival
Authors: DeHelian Daniel , Gupta Shuchi , Wu Jie , Thorsheim Chelsea , Estevez Brian , Cooper Matthew , Litts Kelly , Lee-Sundlov Melissa M. , Hoffmeister Karin M. , Poncz Mortimer , Ma Peisong , Brass Lawrence F.
Published: June 2020

G protein–coupled receptors are critical mediators of platelet activation whose signaling can be modulated by members of the regulator of G protein signaling (RGS) family. The 2 most abundant RGS proteins in human and mouse platelets are RGS10 and RGS18. While each has been studied individually, critical questions remain about the overall impact of this mode of regulation in platelets. Here, we report that mice missing both proteins show reduced platelet survival and a 40% decrease in platelet count that can be partially reversed with aspirin and a P2Y12 antagonist. Their platelets have increased basal (TREM)-like transcript-1 expression, a leftward shift in the dose/response for a thrombin receptor–activating peptide, an increased maximum response to adenosine 5′-diphosphate and TxA2, and a greatly exaggerated response to penetrating injuries in vivo. Neither of the individual knockouts displays this constellation of findings. RGS10−/− platelets have an enhanced response to agonists in vitro, but platelet count and survival are normal. RGS18−/− mice have a 15% reduction in platelet count that is not affected by antiplatelet agents, nearly normal responses to platelet agonists, and normal platelet survival. Megakaryocyte number and ploidy are normal in all 3 mouse lines, but platelet recovery from severe acute thrombocytopenia is slower in RGS18−/− and RGS10−/−18−/− mice. Collectively, these results show that RGS10 and RGS18 have complementary roles in platelets. Removing both at the same time discloses the extent to which this regulatory mechanism normally controls platelet reactivity in vivo, modulates the hemostatic response to injury, promotes platelet production, and prolongs platelet survival.
MoSe2-Ni3Se4 Hybrid Nanoelectrocatalysts and Their Enhanced Electrocatalytic Activity for Hydrogen Evolution Reaction
Authors: Wu Pengyuan , Sun Gangyong , Chen Yuanzhi , Xu Wanjie , Zheng Hongfei , Xu Jin , Wang Laisen , Peng Dong-Liang
Published: June 2020

Combining MoSe2 with other transition metal dichalcogenides to form a hybrid nanostructure is an effective route to enhance the electrocatalytic activities for hydrogen evolution reaction (HER). In this study, MoSe2-Ni3Se4 hybrid nanoelectrocatalysts with a flower-like morphology are synthesized by a seed-induced solution approach. Instead of independently nucleating to form separate nanocrystals, the Ni3Se4 component tends to nucleate and grow on the surfaces of ultrathin nanoflakes of MoSe2 to form a hybrid nanostructure. MoSe2–Ni3Se4 hybrid nanoelectrocatalysts with different Mo:Ni ratios are prepared and their HER catalytic activities are compared. The results show that the HER activities are affected by the Mo:Ni ratios. In comparison with pure MoSe2, the MoSe2-Ni3Se4 hybrid nanoelectrocatalysts having a Mo:Ni molar ratio of 2:1 exhibit enhanced HER properties with an overpotential of 203 mV at 10 mA/cm2 and a Tafel slope of 57 mV per decade. Improved conductivity and increased turnover frequencies (TOFs) are also observed for the MoSe2-Ni3Se4 hybrid samples.
Genome re-sequencing and reannotation of the Escherichia coli ER2566 strain and transcriptome sequencing under overexpression conditions
Authors: Zhou Lizhi , Yu Hai , Wang Kaihang , Chen Tingting , Ma Yue , Huang Yang , Li Jiajia , Liu Liqin , Li Yuqian , Kong Zhibo , Zheng Qingbing , Wang Yingbin , Gu Ying , Xia Ningshao , Li Shaowei
Published: June 2020

Background

TheEscherichia coliER2566 strain (NC_CP014268.2) was developed as a BL21 (DE3) derivative strain and had been widely used in recombinant protein expression. However, like many other current RefSeq annotations, the annotation of the ER2566 strain was incomplete, with missing gene names and miscellaneous RNAs, as well as uncorrected annotations of some pseudogenes. Here, we performed a systematic reannotation of the ER2566 genome by combining multiple annotation tools with manual revision to provide a comprehensive understanding of theE. coliER2566 strain, and used high-throughput sequencing to explore how the strain adapted under external pressure.

Results

The reannotation included noteworthy corrections to all protein-coding genes, led to the exclusion of 190 hypothetical genes or pseudogenes, and resulted in the addition of 237 coding sequences and 230 miscellaneous noncoding RNAs and 2 tRNAs. In addition, we further manually examined all 194 pseudogenes in the Ref-seq annotation and directly identified 123 (63%) as coding genes. We then used whole-genome sequencing and high-throughput RNA sequencing to assess mutational adaptations under consecutive subculture or overexpression burden. Whereas no mutations were detected in response to consecutive subculture, overexpression of the human papillomavirus 16 type capsid led to the identification of a mutation (position 1,094,824 within the 3′ non-coding region) positioned 19-bp away from thelacI gene in the transcribed RNA, which was not detected at the genomic level by Sanger sequencing.

Conclusion

The ER2566 strain was used by both the general scientific community and the biotechnology industry. Reannotation of theE. coliER2566 strain not only improved the RefSeq data but uncovered a key site that might be involved in the transcription and translation of genes encoding the lactose operon repressor. We proposed that our pipeline might offer a universal method for the reannotation of other bacterial genomes with high speed and accuracy. This study might facilitate a better understanding of gene function for the ER2566 strain under external burden and provided more clues to engineer bacteria for biotechnological applications.
Real-time quantitative PCR assay development and application for assessment of agricultural surface water and various fecal matter for prevalence of Aliarcobacter faecis and Aliarcobacter lanthieri
Authors: Miltenburg Mary G. , Cloutier Michel , Craiovan Emilia , Lapen David R. , Wilkes Graham , Topp Edward , Khan Izhar U. H.
Published: June 2020

Background

Aliarcobacter faecis and Aliarcobacter lanthieri are recently identified as emerging human and animal pathogens. In this paper, we demonstrate the development and optimization of two direct DNA-based quantitative real-time PCR assays using species-specific oligonucleotide primer pairs derived from rpoB and gyrA genes for A. faecis and A. lanthieri, respectively. Initially, the specificity of primers and amplicon size of each target reference strain was verified and confirmed by melt curve analysis. Standard curves were developed with a minimum quantification limit of 100 cells mL− 1 or g− 1 obtained using known quantities of spiked A. faecis and A. lanthieri reference strains in autoclaved agricultural surface water and dairy cow manure samples.

Results

Each species-specific qPCR assay was validated and applied to determine the rate of prevalence and quantify the total number of cells of each target species in natural surface waters of an agriculturally-dominant and non-agricultural reference watershed. In addition, the prevalence and densities were determined for human and various animal (e.g., dogs, cats, dairy cow, and poultry) fecal samples. Overall, the prevalence of A. faecis for surface water and feces was 21 and 28%, respectively. The maximum A. faecis concentration for water and feces was 2.3 × 107 cells 100 mL- 1 and 1.2 × 107 cells g− 1, respectively. A. lanthieri was detected at a lower frequency (2%) with a maximum concentration in surface water of 4.2 × 105 cells 100 mL− 1; fecal samples had a prevalence and maximum density of 10% and 2.0 × 106 cells g− 1, respectively.

Conclusions

The results indicate that the occurrence of these species in agricultural surface water is potentially due to fecal contamination of water from livestock, human, or wildlife as both species were detected in fecal samples. The new real-time qPCR assays can facilitate rapid and accurate detection in < 3 h to quantify total numbers of A. faecis and A. lanthieri cells present in various complex environmental samples.
Identification of transcription factors interacting with a 1274 bp promoter of MaPIP1;1 which confers high-level gene expression and drought stress Inducibility in transgenic Arabidopsis thaliana
Authors: Xu Yi , Jin Zhiqiang , Xu Biyu , Li Jingyang , Li Yujia , Wang Xiaoyi , Wang Anbang , Hu Wei , Huang Dongmei , Wei Qing , Xu Zhuye , Song Shun
Published: June 2020

Background

Drought stress can severely affect plant growth and crop yield. The cloning and identification of drought-inducible promoters would be of value for genetically-based strategies to improve resistance of crops to drought.

Results

Previous studies showed that the MaPIP1;1 gene encoding an aquaporin is involved in the plant drought stress response. In this study, the promoter pMaPIP1;1, which lies 1362 bp upstream of the MaPIP1;1 transcriptional initiation site, was isolated from the banana genome..And the transcription start site(A) is 47 bp before the ATG. To functionally validate the promoter, various lengths of pMaPIP1;1 were deleted and fused to GUS to generate pMaPIP1;1::GUS fusion constructs that were then transformed into Arabidopsis to generate four transformants termed M-P1, M-P2, M-P3 and M-P4.Mannitol treatment was used to simulate drought conditions. All four transformants reacted well to mannitol treatment. M-P2 (− 1274 bp to − 1) showed the highest transcriptional activity among all transgenic Arabidopsis tissues, indicating that M-P2 was the core region of pMaPIP1;1. This region of the promoter also confers high levels of gene expression in response to mannitol treatment. Using M-P2 as a yeast one-hybrid bait, 23 different transcription factors or genes that interacted with MaPIP1;1 were screened. In an dual luciferase assay for complementarity verification, the transcription factor MADS3 positively regulated MaPIP1;1 transcription when combined with the banana promoter. qRT-PCR showed that MADS3 expression was similar in banana leaves and roots under drought stress. In banana plants grown in 45% soil moisture to mimic drought stress, MaPIP1;1 expression was maximized, which further demonstrated that the MADS3 transcription factor can synergize with MaPIP1;1.

Conclusions

Together our results revealed that MaPIP1;1 mediates molecular mechanisms associated with drought responses in banana, and will expand our understanding of how AQP gene expression is regulated. The findings lay a foundation for genetic improvement of banana drought resistance.
Videolaryngoscopy versus direct laryngoscopy for double-lumen endotracheal tube intubation in thoracic surgery - a randomised controlled clinical trial
Authors: Risse Joachim , Schubert Ann-Kristin , Wiesmann Thomas , Huelshoff Ansgar , Stay David , Zentgraf Michael , Kirschbaum Andreas , Wulf Hinnerk , Feldmann Carsten , Meggiolaro Karl Matteo
Published: June 2020

Background

Double-lumen tube (DLT) intubation is necessary for thoracic surgery and other operations with the need for lung separation. However, DLT insertion is complex and might result in airway trauma. A new videolaryngoscopy (GVL) with a thin blade might improve the intubation time and reduce complexity as well as iatrogenic airway complications compared to conventional direct laryngoscopy (DL) for DLT intubation.

Methods

A randomised, controlled trial was conducted in 70 patients undergoing elective thoracic surgery using DLT for lung separation. Primary endpoint was time to successful intubation. The secondary endpoints of this study were number of intubation attempts, the assessment of difficulty, any complications during DLT intubation and the incidence of objective trauma of the oropharynx and supraglottic space and intubation-related subjective symptoms.

Results

65 patients were included (DL group [n  =  31], GVL group [n  =  34]). Median intubation time (25th–75th percentiles) in GVL group was 93 s (63–160) versus 74 (58–94) in DL group [p = 0.044]. GVL resulted in significantly improved visualisation of the larynx (Cormack and Lehane grade of 1 in GVL group was 97% vs. 74% in DL Group [p = 0.008]). Endoscopic examinations revealed significant differences in GVL group compared to DL group showing less red-blooded vocal cord [p = 0.004], vocal cord haematoma [p = 0.022] and vocal cord haemorrhage [p = 0.002]. No significant differences regarding the postoperative subjective symptoms of airway were found.

Conclusions

Videolaryngoscopy using the GlideScope®-Titanium shortly prolongs DLT intubation duration compared to direct laryngoscopy but improves the view. Objective intubation trauma but not subjective complaints are reduced.

Trial registration

German Clinical Trial Register DRKS00020978, retrospectively registered on 09. March 2020.
The relationship of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension
Authors: Liu Yang , Lin Yao , Zhang Ming-Ming , Li Xiao-Hui , Liu Yan-Yan , Zhao Jing , Shi Lin
Published: June 2020

Background

To investigate the relationships of plasma renin, angiotensin, and aldosterone levels to blood pressure variability and target organ damage in children with essential hypertension.

Methods

A case-control study was conducted on 132 children diagnosed with essential hypertension (103 males and 29 females with the mean age of 11.8 ± 2.4 years). The plasma RAAS levels were measured using the enhanced chemiluminescence method, the ambulatory blood pressure was monitored for 24 h, and then the average real variability (ARV) was calculated. Data on indicators were used for assessing cardiac and renal damages. The correlations of plasma renin, angiotensin, and aldosterone (RAAS) levels to blood pressure variability (BPV) and target organ damage (TOD) were studied. A comparison between the groups was conducted using SPSS 20.

Results

Among the 132 children, 55 cases had target organ damage. The 24-h ARV and the daytime ARV of the systolic blood pressure of the high angiotensin II (AT II) group was significantly higher than that of the normal AT II group (t = 2.175, P = 0.031; t = 2.672, P = 0.009). Plasma AT II and aldosterone levels were significantly associated with the left ventricular mass index (r = 0.329, P = 0.0001; r = 0.175, P = 0.045). Linear regression analysis showed that AT II [β ± s.e. = 0.025 ± 0.006, 95% CI (0.013–0.038), P = 0.0001] and aldosterone [β ± s.e. = 0.021 ± 0.007, 95% CI (0.008–0.034), P = 0.002] were risk factors for LVH.

Conclusions

The AT II level in children with essential hypertension affected the variability of the 24-h and the daytime SBP. Plasma AT II and aldosterone levels were associated with cardiac damage. Results from this study indicated that AT II and aldosterone are risk factors for LVH in childhood hypertension and are of great significance for improving the clinical prognosis of pediatric patients with hypertension.
Coronary angiography video segmentation method for assisting cardiovascular disease interventional treatment
Authors: Liang Dongxue , Qiu Jing , Wang Lu , Yin Xiaolei , Xing Junhui , Yang Zhiyun , Dong Jiangzeng , Ma Zhaoyuan
Published: June 2020

Background

Coronary heart disease is one of the diseases with the highest mortality rate. Due to the important position of cardiovascular disease prevention and diagnosis in the medical field, the segmentation of cardiovascular images has gradually become a research hotspot. How to segment accurate blood vessels from coronary angiography videos to assist doctors in making accurate analysis has become the goal of our research.

Method

Based on the U-net architecture, we use a context-based convolutional network for capturing more information of the vessel in the video. The proposed method includes three modules: the sequence encoder module, the sequence decoder module, and the sequence filter module. The high-level information of the feature is extracted in the encoder module. Multi-kernel pooling layers suitable for the extraction of blood vessels are added before the decoder module. In the filter block, we add a simple temporal filter to reducing inter-frame flickers.

Results

The performance comparison with other method shows that our work can achieve 0.8739 in Sen, 0.9895 in Acc. From the performance of the results, the accuracy of our method is significantly improved. The performance benefit from the algorithm architecture and our enlarged dataset.

Conclusion

Compared with previous methods that only focus on single image analysis, our method can obtain more coronary information through image sequences. In future work, we will extend the network to 3D networks.
Minimum accelerometer wear-time for reliable estimates of physical activity and sedentary behaviour of people receiving haemodialysis
Authors: Prescott Sean , Traynor Jamie P. , Shilliday Ilona , Zanotto Tobia , Rush Robert , Mercer Thomas H.
Published: June 2020

Background

Low levels of physical activity are implicated in low life expectancies of people receiving maintenance haemodialysis. Accelerometers are increasingly being used to quantify activity behaviours of this population but guidance to quality-assure such data is lacking. The objective of this study was to provide data processing and reduction recommendations to ensure accelerometer-derived outcomes are sufficiently reliable for interpretative analysis.

Methods

Seventy people receiving maintenance haemodialysis (age 55.9 ± 15.7 years, 34% women, 23% diabetic) from a single outpatient renal unit volunteered for the study. Participants wore Actigraph GT3x and ActivPAL monitors during waking hours over seven days. Reliability of accelerometer output (normalised to wear-time) was assessed via intraclass correlation coefficient (ICC). The Spearman-Brown prophecy formula was subsequently applied to the ICCs to derive the minimum required accelerometer wear-time for each behavioural outcome.

Results

Monitor wear compliance was greater on dialysis compared to non-dialysis days (90% v 77%). Participants were significantly more active on non-dialysis days compared to dialysis days but there were no significant differences in estimated behaviours between days within the same condition. Average measure ICCs for all accelerometer outcomes were high (range 0.76–0.96). Computations indicated that habitual physical activity and sedentary behaviour could be estimated with a minimum reliability level of 0.80 from one dialysis day and two non-dialysis days, and at least eight hours monitor wear per day. Applying this rubric allowed 90% of participant data to be retained for further analysis.

Conclusions

Regardless of accelerometer, one dialysis and two non-dialysis days data with a minimum of eight hours wear each day should enable habitual activity of people receiving maintenance haemodialysis to be characterised with acceptable reliability. These recommendations reconcile the tension between wear-time criteria stringency and retention of an adequately representative sample.
Supporting perinatal anxiety in the digital age; a qualitative exploration of stressors and support strategies
Authors: Harrison Virginia , Moore Donna , Lazard Lisa
Published: June 2020

Background

The period surrounding childbirth is one of profound change, which can often be experienced as stressful and overwhelming. Indeed, around 20% of women may experience significant levels of anxiety in the perinatal period. However, most women experiencing perinatal anxiety (PNA) go unrecognised and untreated. The Internet offers a potentially scalable solution to improve access to support, however a dearth of research in this area means that work is needed to better understand women’s experience of PNA, so that potential targets for intervention can be identified and possible barriers to support overcome. This study aimed to qualitatively explore women’s experience of anxiety triggers and support in the perinatal period; and gain insight into what online support is acceptable for women with PNA.

Methods

Women who were either pregnant or within one-year postpartum were invited to participate in focus groups across the UK. Focus groups were used to allow a diversity of perspectives to be heard, while simultaneously promoting the identification and prioritisation of important support needs and solutions. Interviews were transcribed and thematically analysed.

Results

Five key themes emerged in relation to women’s experience with PNA: holding unrealistic expectations of birth and motherhood; stigma; the importance of peer support; uncertainty and poor maternal confidence; and a lack of mental health support and knowledge. Perinatal women felt under-supported and poorly prepared for motherhood. A mismatch between their expectations and the reality of their experience, alongside a pressure to be the ‘perfect mum’ was the primary source of their anxiety. Furthermore, stigma associated with PNA may have exacerbated these issues and led to help-seeking avoidance. Overall, women felt these issues could be addressed via online support, through the delivery of more realistic information, providing psychoeducation about PNA symptoms and management, and the inclusion of authentic peer experiences. Thus, delivering evidence-based information and interventions online may provide a solution that is acceptable to this cohort.

Conclusions

This work provides unique insight into potential sources of anxiety for women in the perinatal period, while also offering potential internet-based support solutions that are likely to be acceptable and helpful for women with PNA.
Establishment of a serological molecular model for the early diagnosis and progression monitoring of bone metastasis in lung cancer
Authors: Teng Xiaoyan , Wei Lirong , Han Liming , Min Daliu , Du Yuzhen
Published: June 2020

Background

The prognosis is very poor for lung cancer patients with bone metastasis. Unfortunately, a suitable method has yet to become available for the early diagnosis of bone metastasis in lung cancer patients. The present work describes an attempt to develop a novel model for the early identification of lung cancer patients with bone metastasis risk.

Methods

As the test group, 205 primary lung cancer patients were recruited, of which 127 patients had bone metastasis; the other 78 patients without bone metastasis were set as the negative control. Additionally, 106 healthy volunteers were enrolled as the normal control. Serum levels of several cytokines in the bone microenvironment (CaN, OPG, PTHrP, and IL-6) and bone turnover markers (tP1NP, β-CTx) were detected in all samples by ECLIA or ELISA assay. Receiver operating characteristic (ROC) curves and multivariate analyses were performed to evaluate diagnostic abilities and to assess the attributable risk of bone metastasis for each of these indicators; the diagnostic model was established via logistic regression analysis. The prospective validation group consisted of 44 patients with stage IV primary lung cancer on whom a follow-up of at least 2 years was conducted, during which serum bone biochemical marker concentrations were monitored.

Results

The serological molecular model for the diagnosis of bone metastasis was logit (p). ROC analysis showed that when logit (p) > 0.452, the area under curve of the model was 0.939 (sensitivity: 85.8%, specificity: 89.7%). Model validation demonstrated accuracy with a high degree of consistency (specificity: 85.7%, specificity: 87.5%, Kappa: 0.770). The average predictive time for bone metastasis occurrence of the model was 9.46 months earlier than that of the bone scan diagnosis. Serum OPG, PTHrP, tP1NP, β-CTx, and the diagnostic model logit (p) were all positively correlated with bone metastasis progression (P < 0.05).

Conclusions

This diagnostic model has the potential to be a simple, non-invasive, and sensitive tool for diagnosing the occurrence and monitoring the progression of bone metastasis in patients with lung cancer.
Effect of hypothermic perfusion on phacoemulsification in cataract patients complicated with uveitis: a randomised trial
Authors: Jiang Lu , Wan Wenjuan , Xun Yan , Xiong Liang , Wu Binge , Xiang Yongguo , Li Zhouyu , Zhu Lu , Ji Yan , Yang Peizeng , Hu Ke
Published: June 2020

Background

To evaluate the effectiveness and safety of hypothermic perfusion in the phacoemulsification of cataract caused by uveitis.

Methods

This was a prospective, single-masked, randomised, controlled clinical trial. One hundred and six patients with uveitis-associated cataract underwent phacoemulsification with perfusion fluid temperature at 4 °C (treatment group) or 24 °C (control group). Anterior chamber inflammation grade, corneal endothelial cell count, corneal thickness, macular fovea thickness, and intraocular pressure (IOP) were observed on the 1st day and 7th day after operation.

Results

The aqueous flare score was 0.83 ± 0.76 in the 4 °C group, which was lower than that in the 24 °C group (1.51 ± 1.02, p = 0.006) on the first day after operation. The aqueous cells score was lower in the 4 °C group (0.17 ± 0.38) than that in the 24 °C group (0.62 ± 0.94, p = 0.025). The mean corneal thickness of incision in the 4 °C group (907.66 ± 85.37 μm) was thinner than that in the 24 °C group (963.75 ± 103.81 μm, p = 0.005). Corneal endothelial cells density, macular fovea thickness, or percentage of transiently increased IOP showed no difference between the two groups (p > 0.05). There was no significant difference in all the main outcome parameters between the two groups on the 7th day after operation (p > 0.05).

Conclusions

Hypothermic perfusion in the phacoemulsification of uveitis-associated cataract is safe, and it can effectively inhibit anterior chamber inflammation and reduce the incisional corneal edema in the early postoperative stage.

Trial registration

The study was registered with the Chinese Clinical Trial Registry. (http://www.chictr.org.cn/, Registration Number: ChiCTR1800016145).
Effect of assertive case management intervention on suicide attempters with comorbid Axis I and II psychiatric diagnoses: secondary analysis of a randomised controlled trial
Authors: Norimoto Kazunobu , Ikeshita Katsumi , Kishimoto Toshifumi , Okuchi Kazuo , Yonemoto Naohiro , Sugimoto Tatsuya , Chida Fuminori , Shimoda Shigero , Hirayasu Yoshio , Kawanishi Chiaki
Published: June 2020

Background

Most suicide attempters suffer from psychiatric disorders, which are often comorbid with personality disorders. The effects of intervention on patients who have attempted suicide with comorbid Axis I and II diagnoses have not been fully elucidated. We evaluated whether assertive case management can reduce the repetition of suicidal behaviours in patients who had attempted suicide with comorbid Axis I and II diagnoses.

Methods

This study was a secondary analysis of a randomised controlled trial investigating whether assertive case management could reduce the repetition of suicide attempts, compared with enhanced usual care. Subjects were divided into those who had comorbid Axis I and II diagnoses (Axis I + II group), and those who had an Axis I diagnosis without Axis II comorbidity (Axis I group). Outcome measures were compared between patients receiving a case management intervention and patients receiving enhanced usual care, as allocated. The primary outcome measure was the incidence proportion of the first episode of recurrent suicidal behaviour at 6 months after randomisation. We calculated risk ratios (RR) with 95% confidence intervals (CI) at 6 months and 12 months after randomisation of patients in the Axis I and Axis I + II groups.

Results

Of 914 enrolled patients, 120 (13.1%) were in the Axis I + II group, and 794 (86.9%) were in the Axis I group. Assertive case management was significantly effective for the Axis I group on the primary outcome at 6 months (risk ratio [RR] 0.51, 95% confidence intervals [CI] 0.31 to 0.84). The RR of the Axis I + II group was 0.44 (95% CI 0.14 to 1.40).

Conclusions

Assertive case management not only had an effect on patients who had attempted suicide with only Axis I disorders but may also have a similar effect on patients with comorbid Axis I and II disorders.
Association between social participation and mental health consultation in individuals with suicidal ideation: a cross-sectional study
Authors: Youn Hin Moi , Kang Soo Hyun , Jang Sung-In , Park Eun-Cheol
Published: June 2020

Background

Suicidal ideation is a significant public health concern worldwide. Although suicides might be preventable through the provision of adequate treatment, mental health consultation is still mostly underutilized. This study thus aimed to examine the association between social participation and utilization of mental health consultations in individuals with suicidal ideation.

Methods

Data were collected from the nationwide Community Health Survey (conducted by the Korea Centers for Disease Control and Prevention, 2017). A total of 17,067 individuals (men: 32.9%, women: 67.1%) who reported experiencing suicidal ideation were included in the analysis. The mean age of the study population was 60.1 (±17.8) years old. This study examined social participation; the number of social activities participated in among leisure, volunteer, social, and religion related activities. Multivariate logistic regression was then used to assess the significance of these associations.

Results

Among those experienced suicidal ideation, 1860 (10.9%) reported receiving mental health consultation services (men: 8.8%, women: 11.9%). Overall, an increased social participation was significantly associated with increased odds of using forms of mental health consultation (OR = 1.65, 95% CI: 1.31–2.09).

Conclusions

In this study, significant evidence of the links between social participation and utilization of mental health consultation was discovered among at risk individuals with suicidal ideation. Suicide prevention policies and programs designed to enhance social participation could potentially encourage people at suicide risk to seek the help they need. Further research focusing on social approaches can produce useful information to plan and implement comprehensive and effective strategies.
Diabetic patient assessment of chronic illness care using PACIC+
Authors: Malliarou Maria , Desikou Christina , Lahana Eleni , Kotrotsiou Styliani , Paralikas Theodosios , Nikolentzos Athanasios , Kotrotsiou Evangelia , Sarafis Pavlos
Published: June 2020

Background

The Patient Assessment of Chronic Illness Care plus is used in order to assess whether provided care is congruent with the Chronic Care Model, according to patients. The purpose of this study was to correlate PACIC+ and the revised 5As “ask, advise, agree, assist and arrange” scoring of a sample of DM patients, with their QoL, depressive symptomatology, demographic and disease characteristics, self-management behaviours of healthy eating and physical activity.

Methods

This is a cross-sectional study where data were collected between January and April 2018 by using three questionnaires (PACIC+, SF-36, CES-D) from a sample of 90 DM patients treated at a Public General Hospital of Central Greece. Anonymous self-completed questionnaires were used to collect the data. Data was processed in the Statistical Package for the Social Sciences (SPSS).

Results

The mean age of the participants with DM was 52.8 years (SD = 21.2 years), with cardiovascular disease and arterial hypertension scoring as the most frequently reporting chronic comorbidities. The healthcare received by DM patients has been correlated with their QoL. More specifically SF – 36 and PACIC+ scale scores showed a positive and low correlation in several subscales. The total score of PACIC+ scale as well as the Patient activation score were increased in higher scores of vitality (p = 0.034 & p = 0.028 respectively), hence both scores correlate significantly with latter. In addition, Delivery System / Practice Design score was increased in higher scores of mental health (p = 0.01) and MCS (p = 0.03).

Conclusions

The shift from hospital care focusing on the disease to a more patient-oriented approach puts forward a dynamic holistic approach to chronic diseases and the reduction of their impact. Finding evidence-based and effective strategies to promote health, prevent and manage chronic diseases such as diabetes mellitus is deemed to be crucial and necessary. PACIC+, which is a tool of a patient-level assessment of CCM implementation, can be used by countries which intend to apply changes in the way their health systems provide chronic care and specifically wish to improve the quality of chronic disease care and the QoL of their patients.
Similarities and differences in people accessing prevention and recovery care services and inpatient units in Victoria, Australia
Authors: Sutherland Georgina , Harvey Carol , Tibble Holly , Spittal Matthew J. , Farhall John , Fletcher Justine , Meadows Graham , Newton J. Richard , Vine Ruth , Brophy Lisa
Published: June 2020

Background

There is an emerging international literature demonstrating clinical and cost-effectiveness of sub-acute residential mental health services. To date, however, there is limited information on the profile of consumers accessing these models of care. This study aimed to understand the profile of the population served by adult sub-acute residential mental health services in Victoria, Australia (known as Prevention and Recovery Care; PARC) and to compare PARC service consumers with consumers admitted to psychiatric inpatient units within public hospitals.

Method

Using 5 years (2012–2016) of a state-wide database of routinely collected individual level mental health service data, we describe the socio-demographic and clinical profile of PARC service consumers compared to consumers of psychiatric inpatient units including for primary diagnosis and illness severity. Using admissions as the unit of analysis, we identify the characteristics that distinguish PARC service admissions from psychiatric inpatient admissions. We also examine and compare length of stay for the different admission types.

Results

We analysed 78,264 admissions representing 34,906 individuals. The profile of PARC service consumers differed from those admitted to inpatient units including for sex, age, diagnosis and illness severity. The odds of an admission being to a PARC service was associated with several socio-demographic and clinical characteristics. Being male or in the youngest age grouping (< 20 years) significantly reduced the odds of admission to PARC services. The presence of primary diagnoses of schizophrenia and related disorders, mood, anxiety or personality disorders, all significantly increased the odds of admission to PARC services. Predictors of length of stay were consistent across PARC and inpatient admission types.

Conclusions

Our findings suggest PARC services may serve an overlapping but distinguishably different consumer group than inpatient psychiatric units. Future research on sub-acute mental health services should be cognizant of these consumer differences, particularly when assessing the long-term effectiveness of this service option.