bluuebunny/crossref_metadata_2025 huggingface dataset:
Achieving energy balance with a high‐fat meal does not enhance skeletal muscle adaptation and impairs glycaemic response in a sleep‐low training model
Authors: Areta José L. , Iraki Juma , Owens Daniel J. , Joanisse Sophie , Philp Andrew , Morton James P. , Hallén Jostein
Published: August 2020

New Findings

What is the central question of this study?

Does achieving energy balance mainly with ingested fat in a ‘sleep‐low’ model of training with low muscle glycogen affect the early training adaptive response during recovery?

What is the main finding and its importance?

Replenishing the energy expended during exercise mainly from ingested fat to achieve energy balance in a ‘sleep‐low’ model does not enhance the response of skeletal muscle markers of early adaptation to training and impairs glycaemic control the morning after compared to training with low energy availability. These findings are important for optimizing post‐training dietary recommendations in relation to energy balance and macronutrient intake.

Training with low carbohydrate availability (LCHO) has been shown to acutely enhance endurance training skeletal muscle response, but the concomitant energy deficit (ED) in LCHO interventions has represented a confounding factor in past research. This study aimed at determining if achieving energy balance with high fat (EB‐HF) acutely enhances the adaptive response in LCHO compared to ED with low fat (ED‐LF). In a crossover design, nine well‐trained males completed a ‘sleep‐low’ protocol: on day 1 they cycled to deplete muscle glycogen while reaching a set energy expenditure (30 kcal (kg of fat free mass (FFM))−1). Post‐exercise, low carbohydrate, protein‐matched meals completely (EB‐HF, 30 kcal (kg FFM)−1) or partially (ED‐LF, 9 kcal (kg FFM)−1) replaced the energy expended, with the majority of energy derived from fat in EB‐HF. In the morning of day 2, participants exercised fasted, and skeletal muscle and blood samples were collected and a carbohydrate–protein drink was ingested at 0.5 h recovery. Muscle glycogen showed no treatment effect (P < 0.001) and decreased from 350 ± 98 to 192 ± 94 mmol (kg dry mass)−1 between rest and 0.5 h recovery. Phosphorylation status of the mechanistic target of rapamycin and AMP‐activated protein kinase pathway proteins showed only time effects. mRNA expression of p53 increased after exercise (P = 0.005) and was higher in ED‐LF at 3.5 h compared to EB‐HF (P = 0.027). Plasma glucose and insulin area under the curve (P < 0.04) and peak values (P ≤ 0.05) were higher in EB‐HF after the recovery drink. Achieving energy balance with a high‐fat meal in a ‘train‐low’ (‘sleep‐low’) model did not enhance markers of skeletal muscle adaptation and impaired glycaemia in response to a recovery drink following training in the morning.
Oxidative stress in the medullary respiratory neurons contributes to respiratory dysfunction in the 6‐OHDA model of Parkinson's disease
Authors: Falquetto Bárbara , Thieme Karina , Malta Marília B. , e Rocha Karina C. , Tuppy Marina , Potje Simone R. , Antoniali Cristina , Rodrigues Alice C. , Munhoz Carolina D. , Moreira Thiago S. , Takakura Ana C.
Published: August 2020

Key points

Parkinson's disease (PD) is associated with respiratory dysfunction. In the 6‐OHDA rat model of PD this is seen as a reduction in respiratory frequency and minute ventilation during normoxia and hypercapnia stimulus.

Respiratory dysfunction is caused by neuronal death of medullary respiratory nuclei in the 6‐OHDA model of PD.

Oxidative stress can be considered a strong candidate for neurodegeneration via miR‐34c downregulation and pro‐apoptotic signalling in respiratory neurons, preceding the functional impairment observed in the 6‐OHDA model of PD.

Parkinson's disease (PD) is a neurodegenerative disease caused by dopaminergic neuron death in the substantia nigra (SN). New evidence has revealed that this neurodegeneration is the result of complex interactions between genetic abnormalities, environmental toxins, mitochondrial dysfunction and disruption of the blood–brain barrier (BBB) in the SN. In addition to classic symptoms, PD patients also exhibit respiratory failure. Here, we investigated whether oxidative stress was associated with neurodegeneration in a respiratory group (RG) of 6‐OHDA‐treated rats, which act as a model of PD. We analysed how oxidative stress affected apoptotic signalling in the RG 30 days after 6‐OHDA treatment, shortly before commencement of breathing impairment (40 days). After 30 days, a dihydroethidium assay showed increased oxidative stress in the RG, anti‐apoptotic signalling, as shown by an increase in p‐Akt and BcL‐2 and a decrease in Bax in the caudal aspect of the nucleus of the solitary tract (cNTS), and a decrease in p‐p38 and Bax levels in the retrotrapezoid nucleus (RTN); pro‐apoptotic signalling was indicated by a decrease in p‐Akt and BcL‐2 and an increase in Bax in the rostral ventral respiratory group (rVRG) and pre‐Botzinger complex (preBotC). miR‐34c, a known oxidative stress protector, was downregulated in 6‐OHDA animals in the RC. After 40 days of 6‐OHDA, the NTS, rVRG, preBotC and RTN exhibited reduced NeuN immunoreactivity, no BBB disruption and an increase in thiobarbituric acid reactivity. We conclude that in the 6‐OHDA model of PD, oxidative stress contributes to neurodegeneration in medullary respiratory neurons.
Influence of Land Use and Coverage Change on Continental Surface Temperature in the Urban Area of Belem-PA
Authors: Margalho Eduardo Da Silva , Silva Madson Tavares , Cardoso Letícia Karyne Da Silva , Olinda Ricardo Alves de , Menezes José Felipe Gazel
Published: August 2020

The objective of this work is to examine the spatial distribution of Continental Surface Temperature (CST) of the urban area of Belem / PA and the influence of the change of use and soil cover from remote sensing techniques. Products from Thematic Mapper (TM) and Thermal Infrared Sensor (TIRS) sensors coupled, respectively, to Landsat 5 and 8 satellites were used. The images acquired from the years 1994, 2008 and 2017 were processed, resampled (spatial resolution of 120 meters) and, finally, centroids were extracted with a total of 1252 points, using the Quantum GIS software. Subsequently, spectral indices, NDVI, NDBI and albedo were calculated, which represent, respectively, the presence of vegetation, exposed soil or built area and reflectivity rate. The results showed that CST showed an increase in all sectors of the study area, mainly between the years 2008 and 2017. The sector with the highest elevation of the CST was the urban center, as it presented values below 25.0 ºC in the image of 1994 and above 35.0 ºC in the 2017 image. In contrast, the ecological park sector showed the lowest increase in CST, from 20.0 ºC (1994) to 25.0 ºC (2017). According to the analysis of the spectral indices, the intensification of CST is directly associated with the strong territorial expansion, since from the NDVI values the degradation of the vegetation cover was noted. This degradation is observed in the comparisons of the images, in which it is possible to verify the decrease in the NDVI values in the entire study area, whose values represent the decrease in the vegetation cover. The sector with the greatest withdrawal of green areas was the northern zone, as it showed a drop in NDVI values, from 0.7 in 1994 to 0.3 in the 2017 image. It was also observed that the density of the constructed area was intensified, presenting increasing values of NDBI. Added to these NDVI and NDBI values, higher reflectivity rate values were noted, whose values in the urban center of Belem in 1994 were 0.1% and which exceeded 0.5% in the image for the year 2017, ratifying the impact of changes in land cover and the direct association between changes in the environment and CST. In general, the results indicate that the uncontrolled expansion of the urban process and the change in land cover cause the intensification of CST.
Explorando Causas Próximas dos Padrões de Uso e Cobertura da Terra na Região Metropolitana de Santarém – PA
Authors: Corrêa Jéssica Ariana de Jesus , Silva Julio Tota da
Published: August 2020

Este estudo explora os fatores determinantes do padrão de uso e cobertura da terra na Região Metropolitana de Santarém (RMS), no estado do Pará. A análise empírica foi baseada na regressão logística para verificar as relações que levam em consideração explicitamente as interações espaciais das causas fundamentais do padrão espacial. Um banco de dados contendo as classes “urbano”, “floresta primária”, “vegetação secundária”, “agricultura”, “pastagem”, e os fatores determinantes precipitação pluvial do trimestre chuvoso, precipitação pluvial do trimestre seco, altitude, declividade, temperatura de superfície do trimestre mais seco, distância a rodovias, distância a núcleos urbanos, presença de estradas, presença de corpos d’água, população por distrito, presença de projeto de assentamentos e presença de áreas protegidas, foram compilados em uma grade regular de 1 km x 1 km. Apesar do crescimento de 52,58 km² e 420, 98 km² das classes “urbano” e “agricultura”, respectivamente, no período analisado, a classe dominante na área de estudo pertence à “floresta primária” com aproximadamente 17.000 km². Os padrões de “agricultura”, “pastagem”, “urbano” e “vegetação secundária” podem ser explicados principalmente pela presença de estradas. Enquanto os fatores biofísicos como a declividade assim como políticos como unidades de conservação têm uma influência importante nos padrões de floresta primária. Mais notavelmente, verificou-se que unidades de conservação atuaram como bloqueadores para o avanço da agricultura mecanizada. Por fim, os resultados mostraram empiricamente os efeitos dos fatores determinantes sobre os padrões, os quais podem ser utilizados no desenvolvimento de modelos integrados de mudança de uso da terra para geração de cenários futuros na região do estudo.
Avaliação Multitemporal da Cobertura do Solo da Bacia Hidrográfica do Rio Mororó em Jaru, Rondônia
Authors: Santana Paulo Cézar de , Pagani Caio Henrique Patrício , Mascarenhas Adriano Reis Prazeres
Published: August 2020

Na Amazônia, com o incentivo de programas de colonização ocorreram danos aos recursos ambientais de forma extensa e diversa, com destaque aos municípios do estado de Rondônia, onde a BR-364 proporcionou maior influência socioambiental. Objetivou-se com o presente trabalho caracterizar a bacia hidrográfica do rio Mororó na cidade de Jaru - RO quanto ao uso e ocupação do solo entre os anos de 1975 e 2018. A bacia hidrográfica do rio Mororó, passou por vários processos de alteração da sua cobertura vegetal desde a década de 1970 início da colonização da região. Essas alterações promoveram a perda de floresta de 66,94%, acarretando vários problemas de perda da quantidade e qualidade da água, assoreamento dos rios entre outros. A análise multitemporal de cobertura do solo verificou-se o grande índice de desmatamento na região da bacia desde a colonização (1975) até recentemente (2018) e assim reduzindo a qualidade ambiental dos recursos naturais desse local.
Validação de Estimativas de Precipitação por Radar Meteorológico em uma Bacia Hidrológica na Região Central do Estado de São Paulo, Brasil
Authors: Miguel Bárbara Hass , Rennó Camilo Daleles
Published: August 2020

O objetivo do presente trabalho foi validar as estimativas de precipitação do radar meteorológico do Centro de Meteorologia de Bauru (IPMet/UNESP) para a bacia hidrográfica do Rio Jacaré Guaçu, localizada na região central do Estado de São Paulo/Brasil. Para isso, foram utilizados dados de 2013 de 18 estações pluviométricas. A quantificação da precipitação da bacia foi realizada através dos polígonos de Thiessen. Para a validação do radar, foram testadas 3 relações Z-R: Calheiros, Jones e Marshall-Palmer. Os melhores resultados da validação foram obtidos por Marshall-Palmer. Para o ajuste dos dados subestimados do radar meteorológico, utilizou-se um método de otimização nos dados das estações, encontrando o fator de correção de 3,135. Após o ajuste, observou-se uma semelhança entre a média da precipitação observada pelos pluviômetros e a precipitação estimada pelo radar. Sem as devidas correções, a chuva acumulada em 2013 na bacia hidrográfica de acordo com os pluviômetros foi de 1252,26 mm, enquanto que as obtidas pelas relações Z-R de Calheiros, Jones e Marshall-Palmer foram 512,63, 218,6 e 358,37 mm, respectivamente. Com esse estudo pudemos confirmar que ainda há muita dificuldade em se utilizar estimativas de chuva de radar meteorológico integrados a uma rede pluviométrica. Sugere-se realizar outros estudos semelhantes em escalas temporais diferentes.
F0-related head movement in blind versus sighted speakers
Authors: Liu Yadong , Shamei Arian , Chow Una Y. , Soo Rachel , Pineda Mora Gina , de Boer Gillian , Gick Bryan
Published: August 2020

This study investigated the relationship between head movement and fundamental frequency (F0) during speech by comparing continuous speech of congenitally blind and sighted speakers from YouTube videos. Positive correlations were found between F0 (measured in semitones) and vertical head movement for both speaker groups, with a stronger correlation for blind speakers. In addition, larger head movements and larger head movement per semitone ratios were observed for sighted speakers. These results suggest that physiological processes may account for part of the F0-related head movement and that sighted speakers use the visual modality to communicate F0 information through augmented head movement.
Bias-preserving gates with stabilized cat qubits
Authors: Puri Shruti , St-Jean Lucas , Gross Jonathan A. , Grimm Alexander , Frattini Nicholas E. , Iyer Pavithran S. , Krishna Anirudh , Touzard Steven , Jiang Liang , Blais Alexandre , Flammia Steven T. , Girvin S. M.
Published: August 2020

Noise asymmetry in the quantum operations with cat-qubits is exploited for efficient fault-tolerant quantum error correction.
Laser writing of nitrogen-doped silicon carbide for biological modulation
Authors: Nair Vishnu , Yi Jaeseok , Isheim Dieter , Rotenberg Menahem , Meng Lingyuan , Shi Fengyuan , Chen Xinqi , Gao Xiang , Prominski Aleksander , Jiang Yuanwen , Yue Jiping , Gallagher Charles T. , Seidman David N. , Tian Bozhi
Published: August 2020

Laser-assisted synthesis yields silicon carbide–elastomer composite for bioelectric modulation of cells and tissues.
Negative resistance state in superconducting NbSe
2
induced by surface acoustic waves
Authors: Yokoi Masahiko , Fujiwara Satoshi , Kawamura Tomoya , Arakawa Tomonori , Aoyama Kazushi , Fukuyama Hiroshi , Kobayashi Kensuke , Niimi Yasuhiro
Published: August 2020

A negative resistance state is realized in a superconducting gap of NbSe
2
by irradiating surface acoustic waves.
Aircraft observations since the 1990s reveal increases of tropospheric ozone at multiple locations across the Northern Hemisphere
Authors: Gaudel Audrey , Cooper Owen R. , Chang Kai-Lan , Bourgeois Ilann , Ziemke Jerry R. , Strode Sarah A. , Oman Luke D. , Sellitto Pasquale , Nédélec Philippe , Blot Romain , Thouret Valérie , Granier Claire
Published: August 2020

Recent aircraft observations show that tropospheric ozone increased above many Northern Hemisphere regions since the mid-1990s.
Synthetic lethal combination targeting BET uncovered intrinsic susceptibility of TNBC to ferroptosis
Authors: Verma Nandini , Vinik Yaron , Saroha Ashish , Nair Nishanth Ulhas , Ruppin Eytan , Mills Gordon , Karn Thomas , Dubey Vinay , Khera Lohit , Raj Harsha , Maina Flavio , Lev Sima
Published: August 2020

Synthetic lethal combination induces ferroptosis.
The motor cortex uses active suppression to sculpt movement
Authors: Griffin Darcy M. , Strick Peter L.
Published: August 2020

The motor cortex sculpts complex spatiotemporal patterns of output by actively turning off muscles, as well as by turning them on.
DELTEX2 C-terminal domain recognizes and recruits ADP-ribosylated proteins for ubiquitination
Authors: Ahmed Syed Feroj , Buetow Lori , Gabrielsen Mads , Lilla Sergio , Chatrin Chatrin , Sibbet Gary J. , Zanivan Sara , Huang Danny T.
Published: August 2020

The C-terminal domain of DELTEX E3s binds ADP-ribose and promotes ubiquitination of poly-ADP-ribosylated substrates.
Functionalized lipid-like nanoparticles for in vivo mRNA delivery and base editing
Authors: Zhang Xinfu , Zhao Weiyu , Nguyen Giang N. , Zhang Chengxiang , Zeng Chunxi , Yan Jingyue , Du Shi , Hou Xucheng , Li Wenqing , Jiang Justin , Deng Binbin , McComb David W. , Dorkin Robert , Shah Aalok , Barrera Luis , Gregoire Francine , Singh Manmohan , Chen Delai , Sabatino Denise E. , Dong Yizhou
Published: August 2020

Biodegradable nanomaterials effectively deliver long messenger RNAs in animal models.
Nutrient-supplying ocean currents modulate coral bleaching susceptibility
Authors: DeCarlo Thomas M. , Gajdzik Laura , Ellis Joanne , Coker Darren J. , Roberts May B. , Hammerman Nicholas M. , Pandolfi John M. , Monroe Alison A. , Berumen Michael L.
Published: August 2020

Nutrients become a death knell 5 for corals as the ocean warms.
Efficient high-throughput SARS-CoV-2 testing to detect asymptomatic carriers
Authors: Shental Noam , Levy Shlomia , Wuvshet Vered , Skorniakov Shosh , Shalem Bar , Ottolenghi Aner , Greenshpan Yariv , Steinberg Rachel , Edri Avishay , Gillis Roni , Goldhirsh Michal , Moscovici Khen , Sachren Sinai , Friedman Lilach M. , Nesher Lior , Shemer-Avni Yonat , Porgador Angel , Hertz Tomer
Published: August 2020

Single-stage group testing uses compressed sensing for efficient high-throughput SARS-CoV-2 testing.
Heterogeneity and clonal relationships of adaptive immune cells in ulcerative colitis revealed by single-cell analyses
Authors: Boland Brigid S. , He Zhaoren , Tsai Matthew S. , Olvera Jocelyn G. , Omilusik Kyla D. , Duong Han G. , Kim Eleanor S. , Limary Abigail E. , Jin Wenhao , Milner J. Justin , Yu Bingfei , Patel Shefali A. , Louis Tiani L. , Tysl Tiffani , Kurd Nadia S. , Bortnick Alexandra , Quezada Lauren K. , Kanbar Jad N. , Miralles Ara , Huylebroeck Danny , Valasek Mark A. , Dulai Parambir S. , Singh Siddharth , Lu Li-Fan , Bui Jack D. , Murre Cornelis , Sandborn William J. , Goldrath Ananda W. , Yeo Gene W. , Chang John T.
Published: August 2020

Single-cell sequencing analyses reveal changes in B and T cell transcriptional states in the context of ulcerative colitis.
Targeting Piezo1 unleashes innate immunity against cancer and infectious disease
Authors: Aykut Berk , Chen Ruonan , Kim Jacqueline I. , Wu Dongling , Shadaloey Sorin A. A. , Abengozar Raquel , Preiss Pamela , Saxena Anjana , Pushalkar Smruti , Leinwand Joshua , Diskin Brian , Wang Wei , Werba Gregor , Berman Matthew , Lee Steve Ki Buom , Khodadadi-Jamayran Alireza , Saxena Deepak , Coetzee William A. , Miller George
Published: August 2020

Blockade of the Piezo1 mechanoreceptor decreases myeloid cell suppression of immune responses to cancer and polymicrobial sepsis.
Natural killer cell immunotypes related to COVID-19 disease severity
Authors: Maucourant Christopher , Filipovic Iva , Ponzetta Andrea , Aleman Soo , Cornillet Martin , Hertwig Laura , Strunz Benedikt , Lentini Antonio , Reinius Björn , Brownlie Demi , Cuapio Angelica , Ask Eivind Heggernes , Hull Ryan M. , Haroun-Izquierdo Alvaro , Schaffer Marie , Klingström Jonas , Folkesson Elin , Buggert Marcus , Sandberg Johan K. , Eriksson Lars I. , Rooyackers Olav , Ljunggren Hans-Gustaf , Malmberg Karl-Johan , Michaëlsson Jakob , Marquardt Nicole , Hammer Quirin , Strålin Kristoffer , Björkström Niklas K. ,   The Karolinska COVID-19 Study Group
Published: August 2020

The NK cell activation landscape in acute SARS-CoV-2 infection is associated with COVID-19 disease severity.
The Evolutionary Conservation of Escherichia coli Drug Efflux Pumps Supports Physiological Functions
Authors: Teelucksingh Tanisha , Thompson Laura K. , Cox Georgina
Published: August 2020

Bacteria harness an impressive repertoire of resistance mechanisms to evade the inhibitory action of antibiotics. One such mechanism involves efflux pump-mediated extrusion of drugs from the bacterial cell, which significantly contributes to multidrug resistance. Intriguingly, most drug efflux pumps are chromosomally encoded components of the intrinsic antibiotic resistome. In addition, in terms of xenobiotic detoxification, bacterial efflux systems often exhibit significant levels of functional redundancy. Efflux pumps are also considered to be highly conserved; however, the extent of conservation in many bacterial species has not been reported and the majority of genes that encode efflux pumps appear to be dispensable for growth. These observations, in combination with an increasing body of experimental evidence, imply alternative roles in bacterial physiology. Indeed, the ability of efflux pumps to facilitate antibiotic resistance could be a fortuitous by-product of ancient physiological functions. Using Escherichia coli as a model organism, we here evaluated the evolutionary conservation of drug efflux pumps and we provide phylogenetic analysis of the major efflux families. We show the E. coli drug efflux system has remained relatively stable and the majority (∼80%) of pumps are encoded in the core genome. This analysis further supports the importance of drug efflux pumps in E. coli physiology. In this review, we also provide an update on the roles of drug efflux pumps in the detoxification of endogenously synthesized substrates and pH homeostasis. Overall, gaining insight into drug efflux pump conservation, common evolutionary ancestors, and physiological functions could enable strategies to combat these intrinsic and ancient elements.
Age constraints on surface deformation recorded by fossil shorelines at Cape Range, Western Australia
Authors: Sandstrom Michael R. , O’Leary Michael J. , Barham Milo , Cai Yue , Rasbury E. Troy , Wooton Kathleen M. , Raymo Maureen E.
Published: August 2020

Laterally continuous terraces along the western flank of Cape Range, Western Australia, record both past sea-level highstands and postdepositional vertical displacement. Four distinct fossil coral reef terraces extend nearly the entire length of the slowly uplifting anticlinal structure (∼100 km), enabling documentation of the timing and degree of deformation-induced elevation contamination of past sea-level estimates from fossil shorelines. Here, we present detailed elevations of the four terraces using differential global positioning system (DGPS) and airborne light detection and ranging (LiDAR) data sets, along with new ages for the three upper terraces. Geochemical dating using strontium isotope stratigraphy techniques revealed, from highest to lowest elevation: a late Miocene reef terrace, a late Pliocene shoreline, and a prominent mid-Pleistocene reef terrace (probably associated with the marine oxygen isotope stage 33–31 interglacial), along with a broad last interglacial (Eemian) reef terrace and lagoon, which terminate at the modern shoreline. Laterally variable elevation data integrated with newly defined ages for the terraces demonstrate a gradual and continuous relative deformation in the region that spans at least the last 6.5 m.y. and constrains the emergence of the Cape Range to sometime prior to the late Miocene. This data set also shows that the most recent interglacial shoreline has undergone <1.3 m of vertical warping, suggesting minimal deformation since deposition. By tracing relative uplift rates over multiple terraces for ∼100 km of coastline, we placed constraints on maximum relative sea level (RSL) for the older terraces. Most notably, we were able to place strict maximum RSL elevations of <+34 m on the Pliocene terrace and <+16.5 m on the mid-Pleistocene terrace, with probable RSL being somewhat lower.
Prognostic value of 12 novel cardiological biomarkers in stable coronary artery disease. A 10-year follow-up of the placebo group of the Copenhagen CLARICOR trial
Authors: Winkel Per , Jakobsen Janus Christian , Hilden Jørgen , Jensen Gorm Boje , Kjøller Erik , Sajadieh Ahmad , Kastrup Jens , Kolmos Hans Jørn , Iversen Kasper Karmark , Bjerre Mette , Larsson Anders , Ärnlöv Johan , Gluud Christian
Published: August 2020

Objective

To assess if 12 novel circulating biomarkers, when added to ‘standard predictors’ available in general practice, could improve the 10-year prediction of cardiovascular events and mortality in patients with stable coronary heart disease.

Design

The patients participated as placebo receiving patients in the randomised clarithromycin for patients with stable coronary artery disease (CLARICOR) trial at a random time in their disease trajectory.

Setting

Five Copenhagen University cardiology departments and a coordinating centre.

Participants

1998 participants with stable coronary artery disease.

Outcomes

Death and composite of myocardial infarction, unstable angina pectoris, cerebrovascular disease and death.

Results

When only ‘standard predictors’ were included, 83.4% of all-cause death predictions and 68.4% of composite outcome predictions were correct. Log(calprotectin) and log(cathepsin-S) were not associated (p≥0.01) with the outcomes, not even as single predictors. Adding the remaining 10 biomarkers (high-sensitive assay cardiac troponin T; neutrophil gelatinase-associated lipocalin; osteoprotegerin; N-terminal pro-B-type natriuretic peptide; tumour necrosis factor receptor 1 and 2; pregnancy-associated plasma protein A; endostatin; YKL40; cathepsin-B), which were all individually significantly associated with the prediction of the two outcomes, increased the figures to 84.7% and 69.7%.

Conclusion

When ‘standard predictors’ routinely available in general practices are used for risk assessment in consecutively sampled patients with stable coronary artery disease, the addition of 10 novel biomarkers to the prediction model improved the correct prediction of all-cause death and the composite outcome by <1.5%.

Trial registration number

NCT00121550.
Measuring shared decision-making and collaborative goal setting in community rehabilitation: a focused ethnography using cross-sectional surveys in Canada
Authors: Manhas Kiran Pohar , Olson Karin , Churchill Katie , Faris Peter , Vohra Sunita , Wasylak Tracy
Published: August 2020

Objective

To describe and measure the shared decision-making (SDM) experience, including goal-setting experiences, from the perspective of patients and providers in diverse community-rehabilitation settings.

Design

Prospective, longitudinal surveys.

Setting

13 primary level-of-care community-rehabilitation sites in diverse areas varying in geography, patient population and provider discipline

341 adult, English-speaking patient-participants, and 66 provider-participants.

Measures

Alberta Shared decision-maKing Measurement Instrument (dyadic tool measuring SDM), WatLX (outpatient rehabilitation experience) and demographic questionnaire. Survey packages distributed at two timepoints (T0=recruitment; T1=3 months later).

Results

We found that among 341 patient–provider dyads, 26.4% agreed that the appointment at recruitment involved high-quality SDM. Patient perceptions of goal-setting suggested that 19.6% of patients did not set a goal for their care, and only 11.4% set goals in functional language that tied directly to an activity/role/responsibility that was meaningful to their life. Better SDM was clinically associated with higher total family income (p=0.045).

Conclusions

These findings provide evidence for the importance of SDM and goal setting in community rehabilitation. Among patients, lower ratings of SDM corresponded with less recognition of their preferences. Actionable strategies include supporting financially vulnerable patients in realising SDM through training of providers to make extra space for such patients to share their preferences and better preparing patients to articulate their preferences. We recommend more research into strategies that advance highly functional goal setting with patients, and that lessen survey ceiling effects.
Evaluating the feasibility of ReWork-SCI: a person-centred intervention for return-to-work after spinal cord injury
Authors: Holmlund Lisa , Guidetti Susanne , Hultling Claes , Seiger Åke , Eriksson Gunilla , Asaba Eric
Published: August 2020

Objectives

To evaluate the feasibility of: (1) ReWork-SCI with regard to adherence and acceptability and (2) a study design for evaluating ReWork-SCI with regard to recruitment, retention and outcome measures.

Design

Pre-test and post-test, single group, feasibility study.

Setting

Spinal cord injury (SCI) unit at a regional rehabilitation centre in Sweden.

Participants

Two women and five men (n=7). Eligible criteria: (1) sustained traumatic or non-traumatic SCI; (2) completed the first acute care episode in a hospital; (3) between 18 to 65 years of age; (4) assessed by a physician as approachable for participation in the intervention; (5) history of permanent or temporary employment; (6) self-reported desire to return to work; and (7) ability to communicate in English or Swedish.

Intervention

ReWork-SCI is a person-centred intervention for return-to-work (RTW), developed and evaluated using the Medical Research Council’s guidelines. ReWork-SCI follows a person-centred, structured and coordinated intervention process led by a coordinator within a SCI rehabilitation team.

Outcome measures

The feasibility of ReWork-SCI and a study design was evaluated using a set of outcome measurement tools, vocational data, logbooks and semi-structured interviews.

Results

All eligible participants accepted enrolment and follow-up. All participants had a plan for RTW after 3 months and four participants had initiated part-time work or work trial 6 months after commencement of intervention. Adherence and acceptability were overall good. Challenges of the intervention related to the person-centred follow-up, staff shortage and rootedness in the SCI team.

Conclusions

ReWork-SCI was feasible and can contribute to a systematic design of an individualised plan, facilitate decision-making and build trust in the RTW process after SCI. Core features of the intervention was the systematic structure, use of a person-centred approach and dialogue with the employer. For the effectiveness of ReWork-SCI, modifications and considerations of study design are needed.
What influences allied health clinician participation in research in the public hospital setting: a qualitative theory-informed approach
Authors: Wenke Rachel , Noble Christy , Weir Kelly A , Mickan Sharon
Published: August 2020

Objectives

Using theoretical frameworks from implementation science, we aimed to systematically explore the barriers and enablers to research active allied health professionals (AHP) participating and leading research in the hospital setting.

Design

A qualitative interview study informed by behaviour change theory.

Setting

Single Australian tertiary hospital and health service.

Participants

We recruited a convenience sample of 21 AHPs working within a hospital who were seeking to actively participate in/or lead research within their workplace.

Data collection

Semistructured interviews explored perceived barriers and enablers to research participation, informed by the 14 domains of the theoretical domains framework (TDF). Transcribed interviews were deductively coded and mapped to the TDF. A deeper level of inductive coding was used to identify emergent themes that influenced behaviour change, according to the three key constructs of: capability, opportunity and motivation (COM-B).

Results

Barriers and enablers to research participation were identified within nine predominant domains of the TDF. Most enablers to engaging in research related to the motivation or opportunity constructs of the COM-B. These enablers included positive beliefs about the consequences of research participation, enabling social influences, peer support and motivation for skill development and to inform practice. Predominant barriers related to environmental context and resources (eg, reduced funding or time), emotional responses of being overwhelmed and perceptions of reduced capability.

Conclusion

This study identified key barriers and enablers to behaviour change related to AHPs participating and/or leading research. Motivation and opportunities to participate in research may be enabled by maximising social influence opportunities, reiterating beliefs about positive consequences of research and considering AHP’s emotional responses. Implementation science frameworks may provide a more systematic and holistic understanding of factors which influence research participation including enhancing knowledge, motivation and opportunity.
Can antipoverty programmes save lives? Quasi-experimental evidence from the Earned Income Tax Credit in the USA
Authors: Muennig Peter , Vail Daniel , Hakes Jahn K
Published: August 2020

Objective

To estimate the impact of state-level supplements of the Earned Income Tax Credit (EITC) on mortality in the USA. The EITC supplements the wages of lower-income workers by providing larger returns when taxes are filed.

Setting

Nationwide sample spanning 25 cohorts of people across every state in the USA.

Participants

793 000 respondents within the National Longitudinal Mortality Survey (NLMS) between 1986 and 2011, a representative sample of the USA.

Intervention

State-level supplementation to the EITC programme. Some, but not all, states added EITC supplementation to varying degrees beginning in 1986 (Wisconsin) and most recently in 2015 (California). Participants who were eligible in states with supplementary programmes were compared with those who were not eligible for supplementation. Comparisons were made both before and after implementation of the supplementary programme (a difference-in-difference, intent-to-treat analysis). This quasi-experimental approach further controls for age, gender, marital status, race or ethnicity, educational attainment, income and employment status.

Primary and secondary outcome measures

The primary outcome measure was survival at 10 years. Secondary outcome measures included survival at 5 years and survival to the end of the intervention period.

Results

We find an association between state supplemental EITC and survival, with a HR of 0.973 (95% CI=0.951–0.996) for each US$100 of EITC increase (p<0.05).

Conclusion

State-level supplemental EITC may be an effective means of increasing survival in the USA.
Qualitative factors shaping MS patients’ experiences of infusible disease-modifying drugs: a critical incident technique analysis
Authors: Larsen Janni Lisander , Schäfer Jakob , Nielsen Helle Hvilsted , Vestergaard Rasmussen Peter
Published: August 2020

Objective

To explore factors shaping the experiences of patients with relapsing-remitting multiple sclerosis with infusible disease-modifying drugs in a hospital setting.

Design and settings

The critical incident technique served as a framework for collecting and analysing patients’ qualitative account practices involving infusible disease-modifying drugs. Data were collected through semistructured interviews and one single-case study. Participants were recruited from all five regions in Denmark. Inductive thematic analysis was used to identify and interpret factors shaping patients’ infusion journey over time.

Participants

Twenty-two patients with relapsing-remitting multiple sclerosis receiving infusion with disease-modifying drugs (natalizumab, alemtuzumab and ocrelizumab).

Results

Four time scenarios—preinfusion, day of infusion, long-term infusion and switch of infusion—associated with the infusion of disease-modifying drugs were analysed to reveal how different factors could both positively and negatively affect patient experience. Time taken to make the treatment decision was affected by participants’ subjective perceptions of their disease activity; this may have set off a treatment dilemma in the event of a pressing need for treatment. Planning and routine made infusion practices manageable, but external and internal surroundings, including infusion room ambience and the quality of relationships with healthcare professionals and fellow patients, affected patients’ cognitive state and well-being irrespective of the infusion regimen. Switching the infusion regimen can reactivate worries akin to the preinfusion scenario.

Conclusion

This study provides novel insight into the positive and negative factors that shape patients’ experience of infusion care practices. From a patient’s perspective, an infusion practice is not a solitary event in time but includes planning and routine which become an integral part of their multiple sclerosis management. The quality of space and the ambience of the infusion room, combined with the relationship with healthcare professionals and fellow patients, can be a significant source of knowledge and support people with relapsing-remitting multiple sclerosis in their experience of agency in life.
Community-based newborn care utilisation and associated factors in Geze Gofa rural district, South Ethiopia: a community-based cross-sectional study
Authors: Gebremedhin Tsegaye , Atnafu Asmamaw , Dellie Endalkachew
Published: August 2020

Objective

The community-based newborn care (CBNC) is a newborn care package along the maternal and newborn health continuum of care that has been implemented at the community level in Ethiopia. The utilisation which might be affected by several factors has not been well assessed. Thus, this study aimed to examine the utilisation of CBNC and associated factors among women who delivered recently in Geze Gofa rural district, south Ethiopia.

Design

Cross-sectional study.

Setting

Community-based.

Participants

Three-hundred seventy-one women who had their newborns recently were randomly selected. Then, they were interviewed at their places using an interviewer-administered structured questionnaire.

Methods

A binary logistic regression analysis was done. In the multivariable logistic regression analysis, a p value of <0.05 and adjusted OR (AOR) with 95% CI were used to identify factors statistically associated with CBNC utilisation.

Outcomes

CBNC utilisation.

Results

The findings showed that the overall utilisation of CBNC by women who delivered recently with their newborns was 37.5% (95% CI: 32.6 to 42.6). Factors associated with the utilisation of CBNC included women who attended elementary school (AOR: 1.76, 95% CI: 1.01 to 3.07), college and above (AOR: 3.71, 95% CI: 1.12 to 12.24), farmer women (AOR: 0.35, 95% CI: 0.16 to 0.79), women in the lowest (AOR: 3.76, 95% CI: 1.65 to 8.54) and middle quantile of wealth status (AOR: 1.96, 95% CI: 1.01 to 3.76), and those whose preference was visiting hospital only when they faced any signs of danger (AOR: 0.29, 95% CI: 0.11 to 0.78).

Conclusion

The use of the CBNC programme in the study area was surprisingly low. To increase utilisation and potentially improve the outcomes of these neonates, we need to increase awareness at community levels, make convenient arrangements and increase the availability of services at nearby health facilities that are essential to improve the uptake of CBNC in the rural district.
Efficacy of different surgical approaches on survival outcomes in patients with early-stage cervical cancer: protocol for a multicentre longitudinal study in China
Authors: Chao Xiaopei , Wu Ming , Ma Shuiqing , Tan Xianjie , Zhong Sen , Song Xiaochen , Li Lei
Published: August 2020

Introduction

Recent studies have revealed that the oncological survival outcomes of minimally invasive radical hysterectomy (MIRH) are inferior to those of abdominal radical hysterectomy (ARH) in early-stage cervical cancer, but the potential reasons are unclear.

Methods and analysis

Each expert from 28 study centres participating in a previously reported randomised controlled trial (NCT03739944) will provide successive eligible records of at least 100 patients who accepted radical hysterectomy for early-stage cervical cancer between 1 January 2009 and 31 December 2015. Inclusion criteria consist of a definite pathological evaluation of stages IA1 (with positive lymphovascular space invasion), IA2 and IB1 according to the International Federation of Gynecology and Obstetrics 2009 staging system and a histological subtype of squamous cell carcinoma, adenocarcinoma or adenosquamous carcinoma. The primary endpoint is 5-year disease-free survival between the MIRH and ARH groups. The secondary endpoints include the MIRH learning curves of participating surgeons, 5-year overall survival between the MIRH and ARH groups, survival outcomes according to surgical chronology, surgical outcomes and sites of recurrence and potential risk factors that affect survival outcomes. A subgroup analysis in patients with tumour diameter less than 2 cm will follow the similar flow diagram.

Ethics and dissemination

This study has been approved by the Institutional Review Board of Peking Union Medical College Hospital (registration no. JS-1711), and is also filed on record by all other 27 centres. The results will be disseminated through community events and peer-reviewed journals.

Trial registration number

NCT03738969
The VRIMM study: Virtual Reality for IMMunisation pain in young children—protocol for a randomised controlled trial
Authors: Ellerton Kirrily , Tharmarajah Harishan , Medres Rimma , Brown Lona , Ringelblum David , Vogel Kateena , Dolphin Amanda , McKellar Sue , Bridson Fiona , John-White Marietta , Craig Simon
Published: August 2020

Introduction

Pain caused by routine immunisations is distressing to children, their parents and those administering injections. If poorly managed, it can lead to anxiety about future medical procedures, needle phobia and avoidance of future vaccinations and other medical treatment. Several strategies, such as distraction, are used to manage the distress associated with routine immunisations. Virtual reality (VR), a technology which transports users into an immersive ‘virtual world’, has been used to manage pain and distress in various settings such as burns dressing changes and dental treatments. In this study, we aim to compare the effectiveness of VR to standard care in a general practice setting as a distraction technique to reduce pain and distress in 4-year-old children receiving routine immunisations.

Methods and analysis

The study is a randomised controlled clinical trial comparing VR with standard care in 100 children receiving routine 4-year-old vaccination. Children attending a single general practice in metropolitan Melbourne, Australia will be allocated using blocked randomisation to either VR or standard care. Children in the intervention group will receive VR intervention prior to vaccination in addition to standard care; the control group will receive standard care. The primary outcome is the difference in the child’s self-rated pain scores between the VR intervention and control groups measured using The Faces Pain Scale-Revised. Secondary outcomes include another measure of self-rated pain (the Poker Chip Tool), parent/guardian and healthcare provider ratings of pain (standard 100 mm visual analogue scales) and adverse effects.

Ethics and dissemination

Ethics approval has been obtained in Australia from the Royal Australian College of General Practitioners National Research and Evaluation Ethics Committee (NREEC 18-010). Recruitment commenced in July 2019. We plan to submit study findings for publication in a peer-reviewed journal and presentation at relevant conferences.

Trial registration number

ACTRN12618001363279.
Electrocardiography for the detection of left ventricular hypertrophy in an elderly population with long-standing hypertension in primary care: a secondary analysis of the CHELLO cohort study
Authors: de Hartog-Keyzer Josephine Madeleine Louise , El Messaoudi Saloua , Harskamp Ralf , Vart Priya , Ringoir Lianne , Pop Victor , Nijveldt Robin
Published: August 2020

Objectives

To investigate: (1) the prevalence of left ventricular hypertrophy (LVH) in elderly primary care patients with long-standing asymptomatic hypertension, and (2) the diagnostic value of ECG as a screening tool in the detection of LVH compared with echocardiography in this specific patient population.

Design and settings

A cross-sectional study in five general practices in the south-east of the Netherlands.

Participants

Patients with primary care-managed hypertension, aged between 60 and 85 years, without known heart failure.

Primary and secondary outcome measures

Between June 2010 and January 2013, the patients underwent structured interviews, blood pressure assessment, laboratory testing, ECGs and echocardiograms. The primary outcome was to investigate the ability of ECG to detect LVH, compared with echocardiography as a reference test (gold standard).

Results

Four hundred and twenty-two patients (44% male; ages 70±7 years) who underwent ECG and echocardiographic assessment to determine LVH were included. The median duration of hypertension was 10 (4–15) years. The overall prevalence of LVH was 44%, which increased with age (p<0.001); up to 60% of patients were ≥75 years. ECG intimated LVH in 47 patients (11%) but in only 26 of those (55%) was LVH confirmed by echocardiography. The sensitivity of ECG for detecting LVH was poor (14%).

Conclusions

Asymptomatic primary care patients with long-standing hypertension have a high prevalence of previously undetected LVH, which increases with age. ECG is inadequate for detecting LVH in these patients. Early detection of LVH could potentially create more awareness for the optimal regulation of hypertension and compliance to therapy. Therefore, echocardiography should be considered a screening device for the detection of LVH in this population.
Impact of comprehensive molecular testing to reduce antibiotic use in community-acquired pneumonia (RADICAP): a randomised, controlled, phase IV clinical trial protocol
Authors: Abelenda-Alonso Gabriela , Rombauts Alexander , Gudiol Carlota , Meije Yolanda , Clemente Mercedes , Ortega Lucía , Ardanuy Carmen , Niubó Jordi , Padullés Ariadna , Videla Sebastian , Tebe Cristian , Carratalà Jordi
Published: August 2020

Introduction

Community-acquired pneumonia (CAP) continues to be a major health problem worldwide and is one of the main reasons for prescribing antibiotics. However, the causative agent is often not identified, resulting in antibiotic overtreatment, which is a key driver of antimicrobial resistance and adverse events. We aim to test the hypothesis that comprehensive molecular testing, compared with routine microbiological testing, would be effective in reducing antibiotic use in patients with CAP.

Methods and analysis

We will perform a randomised, controlled, open-label clinical trial with two parallel groups (1:1) at two tertiary hospitals between 2020 and 2022. Non-severely immunosuppressed adults hospitalised for CAP will be considered eligible. Patients will be randomly assigned to receive either the experimental diagnosis (comprehensive molecular testing plus routine microbiological testing) or standard diagnosis (only microbiological routine testing). The primary endpoint will be antibiotic consumption measured as days of antibiotic therapy per 1000 patient-days. Secondary endpoints will be de-escalation to narrower antibiotic treatment, time to switch from intravenous to oral antibiotics, days to reaching an aetiological diagnosis, antibiotic-related side effects, length of stay, days to clinical stability, intensive care unit admission, days of mechanical ventilation, hospital readmission up to 30 days after randomisation and death from any cause by 48 hours and 30 days after randomisation. We will need to include 440 subjects to be able to reject the null hypothesis that both groups have equal days of antibiotic therapy per 1000 patient-days with a probability >0.8.

Ethics and dissemination

Ethical approval has been obtained from the Ethics Committee of Bellvitge Hospital (AC028/19) and from the Spanish Medicines and Medical Devices Agency, and it is valid for all participating centres under existing Spanish legislation. Results will be presented at international meetings and will be made available to patients, their caregivers and funders.

Trial registration number

ClinicalTrials:NCT04158492. EudraCT: 2018-004880-29.