bluuebunny/crossref_metadata_2025 huggingface dataset:
Nature, formation, and distribution of carbonates on Ceres
Authors: Carrozzo Filippo Giacomo , De Sanctis Maria Cristina , Raponi Andrea , Ammannito Eleonora , Castillo-Rogez Julie , Ehlmann Bethany L. , Marchi Simone , Stein Nathaniel , Ciarniello Mauro , Tosi Federico , Capaccioni Fabrizio , Capria Maria Teresa , Fonte Sergio , Formisano Michelangelo , Frigeri Alessandro , Giardino Marco , Longobardo Andrea , Magni Gianfranco , Palomba Ernesto , Zambon Francesca , Raymond Carol A. , Russell Christopher T.
Published: March 2018

Hydrated carbonates indicate that the surface of Ceres is recent and dehydration is ongoing, implying a still-evolving body.
Past and future drought in Mongolia
Authors: Hessl Amy E. , Anchukaitis Kevin J. , Jelsema Casey , Cook Benjamin , Byambasuren Oyunsanaa , Leland Caroline , Nachin Baatarbileg , Pederson Neil , Tian Hanqin , Hayles Laia Andreu
Published: March 2018

Mongolian tree rings indicate that recent moisture extremes, although unusual, are not unprecedented in the last 2060 years.
Divergence in problem-solving skills is associated with differential expression of glutamate receptors in wild finches
Authors: Audet Jean-Nicolas , Kayello Lima , Ducatez Simon , Perillo Sara , Cauchard Laure , Howard Jason T. , O’Connell Lauren A. , Jarvis Erich D. , Lefebvre Louis
Published: March 2018

Wild birds that vary in their problem-solving capacity were found to express different neurotransmitter receptor densities.
Response to comment on “Climate legacies drive global soil carbon stocks in terrestrial ecosystem”
Authors: Delgado-Baquerizo Manuel , Eldridge David J. , Maestre Fernando T. , Karunaratne Senani B. , Trivedi Pankaj , Reich Peter B. , Singh Brajesh K.
Published: March 2018

We discuss possible mechanisms to explain paleoclimate as a predictor of the current distribution of global soil C content.
An origami-inspired, self-locking robotic arm that can be folded flat
Authors: Kim Suk-Jun , Lee Dae-Young , Jung Gwang-Pil , Cho Kyu-Jin
Published: March 2018

A self-locking foldable mechanism enables a robotic arm to be folded flat and to maintain high stiffness when deployed.
Astromechs for NASA
Authors: Verdeyen W. Kris
Published: March 2018

NASA’s space robots will need the repair capabilities and intelligence of R2D2 and BB-8 but may resemble C3PO and K-2SO.
The long(er) road from brain to meninges
Authors: Attenello Frank J.
Published: March 2018

Medulloblastoma spreads from the cerebellum to the leptomeninges via blood in addition to cerebrospinal fluid.
Dieting bacteria cure fatty liver disease
Authors: Houtkooper Riekelt
Published: March 2018

Lowering carbohydrate intake treats fatty liver disease in humans by changing gut microbial composition and metabolism.
Distressing microbial consequences of smoking
Authors: Segal Leopoldo N.
Published: March 2018

Changes in lung microbiota associated with smoking might contribute to the development of acute respiratory distress syndrome in subjects with blunt trauma.
Pili Assembled by the Chaperone/Usher Pathway in
Escherichia coli
and
Salmonella
Authors: Werneburg Glenn T. , Thanassi David G.
Published: March 2018

Gram-negative bacteria assemble a variety of surface structures, including the hair-like organelles known as pili or fimbriae. Pili typically function in adhesion and mediate interactions with various surfaces, with other bacteria, and with other types of cells such as host cells. The chaperone/usher (CU) pathway assembles a widespread class of adhesive and virulence-associated pili. Pilus biogenesis by the CU pathway requires a dedicated periplasmic chaperone and integral outer membrane protein termed the usher, which forms a multifunctional assembly and secretion platform. This review addresses the molecular and biochemical aspects of the CU pathway in detail, focusing on the type 1 and P pili expressed by uropathogenic
Escherichia coli
as model systems. We provide an overview of representative CU pili expressed by
E. coli
and
Salmonella
, and conclude with a discussion of potential approaches to develop antivirulence therapeutics that interfere with pilus assembly or function.
Complete Genome Sequence of the Environmental Burkholderia pseudomallei Sequence Type 131 Isolate MSHR1435, Associated with a Chronic Melioidosis Infection
Authors: Sahl Jason W. , Mayo Mark , Price Erin P. , Sarovich Derek S. , Kaestli Mirjam , Pearson Talima , Williamson Charles H. D. , Nottingham Roxanne , Sheridan Krystal , Wagner David M. , Currie Bart J. , Keim Paul
Published: March 2018

The
Burkholderia pseudomallei
isolate MSHR1435 is a fully virulent environmental sequence type 131 (ST131) isolate that is epidemiologically associated with a 17.5-year chronic melioidosis infection. The completed genome will serve as a reference for studies of environmental ecology, virulence, and chronic
B. pseudomallei
infections.
Metagenomic Exploration of Microbial Signatures on Periyar River Sediments from the Periyar Tiger Reserve in the Western Ghats
Authors: Chakkamadathil Rajeev Aparna , Sahu Nishi , Deori Maushumi , Arun Dev Suma , Pal Yadav Vijay , Ghosh Ilora
Published: March 2018

We report here targeted deep-sequencing metagenomic data that reveal a high level of diversity in the microbiota residing in the sediment of the Periyar River in a reserve forest of the Western Ghats. Of the 4,674 operational taxonomic units discovered, the dominant phyla represented were
Proteobacteria
(33.12%),
Actinobacteria
(14.58%),
Acidobacteria
(12.81%), and
Bacteroidetes
(9.89%).
First Complete Genome Sequence of Cucurbit aphid-borne yellows virus from Papua New Guinea
Authors: Maina Solomon , Barbetti Martin J. , Edwards Owain R. , Minemba David , Areke Michael W. , Jones Roger A. C.
Published: March 2018

Analysis of an RNA-Seq library from cucumber leaf RNA revealed the first complete genome sequence of
Cucurbit aphid-borne yellows virus
(CABYV) from Papua New Guinea. We compared it with 36 complete CABYV genomes from other world regions. It most resembled the genome of South Korean isolate GS6.
A protocol for an economic evaluation of a polypill in patients with established or at high risk of cardiovascular disease in a UK NHS setting: RUPEE (NHS) study
Authors: Crossan Catriona , Dehbi Hakim-Moulay , Williams Hilarie , Poulter Neil , Rodgers Anthony , Jan Stephen , Thom Simon , Lord Joanne
Published: March 2018

Introduction

The ‘Use of a Multi-drug Pill in Reducing cardiovascular Events’ (UMPIRE) trial was a randomised controlled clinical trial evaluating the impact of a polypill strategy on adherence to indicated medication in a population with established cardiovascular disease (CVD) of or at high risk thereof. The aim of Researching the UMPIRE Processes for Economic Evaluation in the National Health Service (RUPEE NHS) is to estimate the potential health economic impact of a polypill strategy for CVD prevention within the NHS using UMPIRE trial and other relevant data. This paper describes the design of a modelled economic evaluation of the impact of increased adherence to the polypill versus usual care among the UK UMPIRE participants.

Methods and analysis

As recommended by the International Society for Pharmacoeconomics and Outcomes Research and the Society for Medical Decision Making modelling guidelines, a review of published CVD models was undertaken to identify the most appropriate modelling approach and structure. The review was carried out in the electronic databases, MEDLINE and EMBASE. 40 CVD models were identified from 57 studies, the majority of economic models were health state transition cohort models and individual-level simulation models. The findings were discussed with clinical experts to confirm the approach and structure. An individual simulation approach was identified as the most suitable method to capture the heterogeneity in the population at CVD risk. RUPEE-NHS will use UMPIRE trial data on adherence to estimate the long-term cost-effectiveness of the polypill strategy.

Dissemination

The evaluation findings will be presented in open-access scientific and healthcare policy journals and at national and international conferences. We will also present findings to NHS policy makers and pharmaceutical companies.
Postpartum urinary tract infection by mode of delivery: a Danish nationwide cohort study
Authors: Gundersen Tina Djernis , Krebs Lone , Loekkegaard Ellen Christine Leth , Rasmussen Steen Christian , Glavind Julie , Clausen Tine Dalsgaard
Published: March 2018

Objectives

To examine the association between postpartum urinary tract infection and intended mode of delivery as well as actual mode of delivery.

Design

Retrospective cohort study.

Setting and participants

All live births in Denmark between 2004 and 2010 (n=450 856). Births were classified by intended caesarean delivery (n=45 053) or intended vaginal delivery (n=405 803), and by actual mode of delivery: spontaneous vaginal delivery, operative vaginal delivery, emergency or planned caesarean delivery in labour or prelabour.

Primary and secondary outcome measures

The primary outcome measure was postpartum urinary tract infection (n=16 295) within 30 days post partum, defined as either a diagnosis of urinary tract infection in the National Patient Registry or redemption of urinary tract infection-specific antibiotics recorded in the Register of Medicinal Product Statistics.

Results

We found that 4.6% of women with intended caesarean delivery and 3.5% of women with intended vaginal delivery were treated for postpartum urinary tract infection.

Women with intended caesarean delivery had a significantly increased risk of postpartum urinary tract infection compared with women with intended vaginal delivery (OR 1.33, 95% CI 1.27 to 1.40), after adjustment for age at delivery, smoking, body mass index, educational level, gestational diabetes mellitus, infection during pregnancy, birth weight, preterm delivery, preterm prelabour rupture of membranes, pre-eclampsia, parity and previous caesarean delivery (adjusted OR 1.24, 95% CI 1.17 to 1.46).

Using actual mode of delivery as exposure, all types of operative delivery had an equally increased risk of postpartum urinary tract infection compared with spontaneous vaginal delivery.

Conclusions

Compared with intended vaginal delivery, intended caesarean delivery was significantly associated with a higher risk of postpartum urinary tract infection. Future studies should focus on reducing routine catheterisation prior to operative vaginal delivery as well as improving procedures related to catheterisation.
Psychological interventions for positive symptoms in schizophrenia: protocol for a network meta-analysis of randomised controlled trials
Authors: Bighelli Irene , Salanti Georgia , Reitmeir Cornelia , Wallis Sofia , Barbui Corrado , Furukawa Toshi A , Leucht Stefan
Published: March 2018

Introduction

There is rising awareness that we need multidisciplinary approaches integrating psychological treatments for schizophrenia, but a comprehensive evidence based on their relative efficacy is lacking. We will conduct a network meta-analysis (NMA), integrating direct and indirect comparisons from randomised controlled trials (RCTs) to rank psychological treatments for schizophrenia according to their efficacy, acceptability and tolerability.

Methods and analysis

We will include all RCTs comparing a psychological treatment aimed at positive symptoms of schizophrenia with another psychological intervention or with a no treatment condition (waiting-list and treatment as usual). We will include studies on adult patients with schizophrenia, excluding specific subpopulations (eg, first-episode patients or patients with psychiatric comorbidities). Primary outcome will be the change in positive symptoms on a published rating scale. Secondary outcomes will be acceptability (dropout), change in overall and negative symptoms of schizophrenia, response, relapse, adherence, depression, quality of life, functioning and adverse events. Published and unpublished studies will be sought through database searches, trial registries and websites. Study selection and data extraction will be conducted by at least two independent reviewers. We will conduct random-effects NMA to synthesise all evidences for each outcome and obtain a comprehensive ranking of all treatments. NMA will be conducted in Stata and R within a frequentist framework. The risk of bias in studies will be evaluated using the Cochrane Risk of Bias tool and the credibility of the evidence will be evaluated using an adaptation of the Grading of Recommendations Assessment, Development and Evaluation framework to NMA, recommended by the Cochrane guidance. Subgroup and sensitivity analyses will be conducted to assess the robustness of the findings.

Ethics and dissemination

No ethical issues are foreseen. Results from this study will be published in peer-reviewed journals and presented at relevant conferences.

PROSPERO registration number

CRD42017067795.
Prevalence and factors associated with exposure to secondhand smoke (SHS) among young people: a cross-sectional study from the Gambia
Authors: Jallow Isatou K , Britton John , Langley Tessa
Published: March 2018

Background

Annually, 600 000 deaths are attributed to exposure of non-smokers to secondhand smoke (SHS). These include 165 000 among children, about 60% of which occur in Africa and Southeast Asia. As of 2017, only seven countries in the African region had comprehensive smoke-free legislation covering all public places. Given the increasing prevalence of smoking in many low-income countries, preventing exposure to SHS is an urgent public health priority, particularly in Sub-Saharan Africa.

Objectives

The objective of this study is to obtain a reliable and nationally representative estimate of the prevalence of exposure to SHS and to identify the major risk factors among young people in The Gambia.

Settings and methods

We used a two-stage cluster random sampling to select students in secondary schools throughout The Gambia and a self-administered questionnaire to collect data on demographic characteristics and detailed indicators of exposure to SHS.

Results

Of the 10 392 eligible students, 10 289 (99%; 55% girls and 44% boys, age 12–20 years) participated. The proportion of students reporting any exposure to SHS was 97.0% (enclosed public places 59.2%, outdoor public places 61.4%, school 21.3% and home 38.2%), with 96.4% reporting some exposure outside the home. Exposure to SHS in the home was more common in girls and among older students. Parental education, living with parents and being sent to purchase cigarettes were associated with exposure to SHS both within and outside the home. More than 50% of students supported public smoking ban in both enclosed and outdoor public places. About 35% of students were unaware of the harmful effects of exposure to SHS.

Conclusions

Exposure to SHS is highly prevalent among students in The Gambia and occurs mostly outside of the home. Interventions to reduce SHS exposure in students are urgently needed.
What are healthcare providers’ understandings and experiences of compassion? The healthcare compassion model: a grounded theory study of healthcare providers in Canada
Authors: Sinclair Shane , Hack Thomas F , Raffin-Bouchal Shelley , McClement Susan , Stajduhar Kelli , Singh Pavneet , Hagen Neil A , Sinnarajah Aynharan , Chochinov Harvey Max
Published: March 2018

Background

Healthcare providers are considered the primary conduit of compassion in healthcare. Although most healthcare providers desire to provide compassion, and patients and families expect to receive it, an evidence-based understanding of the construct and its associated dimensions from the perspective of healthcare providers is needed.

Objectives

The aim of this study was to investigate healthcare providers’ perspectives and experiences of compassion in order to generate an empirically derived, clinically informed model.

Design

Data were collected via focus groups with frontline healthcare providers and interviews with peer-nominated exemplary compassionate healthcare providers. Data were independently and collectively analysed by the research team in accordance with Straussian grounded theory.

Setting and participants

57 healthcare providers were recruited from urban and rural palliative care services spanning hospice, home care, hospital-based consult teams, and a dedicated inpatient unit within Alberta, Canada.

Results

Five categories and 13 associated themes were identified, illustrated in the Healthcare Provider Compassion Model depicting the dimensions of compassion and their relationship to one another. Compassion was conceptualised as—a virtuous and intentional response to know a person, to discern their needs and ameliorate their suffering through relational understanding and action.

Conclusions

An empirical foundation of healthcare providers’ perspectives on providing compassionate care was generated. While the dimensions of the Healthcare Provider Compassion Model were congruent with the previously developed Patient Model, further insight into compassion is now evident. The Healthcare Provider Compassion Model provides a model to guide clinical practice and research focused on developing interventions, measures and resources to improve it.
Tools for assessing risk of reporting biases in studies and syntheses of studies: a systematic review
Authors: Page Matthew J , McKenzie Joanne E , Higgins Julian P T
Published: March 2018

Background

Several scales, checklists and domain-based tools for assessing risk of reporting biases exist, but it is unclear how much they vary in content and guidance. We conducted a systematic review of the content and measurement properties of such tools.

Methods

We searched for potentially relevant articles in Ovid MEDLINE, Ovid Embase, Ovid PsycINFO and Google Scholar from inception to February 2017. One author screened all titles, abstracts and full text articles, and collected data on tool characteristics.

Results

We identified 18 tools that include an assessment of the risk of reporting bias. Tools varied in regard to the type of reporting bias assessed (eg, bias due to selective publication, bias due to selective non-reporting), and the level of assessment (eg, for the study as a whole, a particular result within a study or a particular synthesis of studies). Various criteria are used across tools to designate a synthesis as being at ‘high’ risk of bias due to selective publication (eg, evidence of funnel plot asymmetry, use of non-comprehensive searches). However, the relative weight assigned to each criterion in the overall judgement is unclear for most of these tools. Tools for assessing risk of bias due to selective non-reporting guide users to assess a study, or an outcome within a study, as ‘high’ risk of bias if no results are reported for an outcome. However, assessing the corresponding risk of bias in a synthesis that is missing the non-reported outcomes is outside the scope of most of these tools. Inter-rater agreement estimates were available for five tools.

Conclusion

There are several limitations of existing tools for assessing risk of reporting biases, in terms of their scope, guidance for reaching risk of bias judgements and measurement properties. Development and evaluation of a new, comprehensive tool could help overcome present limitations.
Cost-effectiveness of enhanced recovery in hip and knee replacement: a systematic review protocol
Authors: Murphy Jacqueline , Pritchard Mark G , Cheng Lok Yin , Janarthanan Roshni , Leal José
Published: March 2018

Introduction

Hip and knee replacement represents a significant burden to the UK healthcare system. ‘Enhanced recovery’ pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways.

Methods and analysis

A systematic review will be conducted using MEDLINE, EMBASE, Econlit and the National Health Service Economic Evaluations Database. Separate search strategies were developed for each database including terms relating to hip and knee replacement/arthroplasty, economic evaluations, decision modelling and quality of life measures.

We will extract peer-reviewed studies published between 2000 and 2017 reporting economic evaluations of preoperative, perioperative or postoperative enhanced recovery interventions within hip or knee replacement. Economic evaluations alongside cohort studies or based on decision models will be included. Only studies with patients undergoing elective replacement surgery of the hip or knee will be included. Data will be extracted using a predefined pro forma following best practice guidelines for economic evaluation, decision modelling and model validation.

Our primary outcome will be the cost-effectiveness of enhanced recovery (entire pathway and individual components) in terms of incremental cost per quality-adjusted life year. A narrative synthesis of all studies will be presented, focussing on cost-effectiveness results, study design, quality and validation status.

Ethics and dissemination

This systematic review is exempted from ethics approval because the work is carried out on published documents. The results of the review will be disseminated in a peer-reviewed academic journal and at conferences.

PROSPERO registration number

CRD42017059473.
Understanding and scaffolding Danish schoolteachers’ motivation for using classroom-based physical activity: study protocol for a mixed methods study
Authors: Knudsen Louise Stjerne , Skovgaard Thomas , Bredahl Thomas
Published: March 2018

Introduction

The benefits of physical activity for children’s health, both mental and physical, and its positive effects on academic achievement are well established. Research also emphasises that schools could provide a natural setting for regular physical activity. There is, however, a limited amount of knowledge about teachers’ views when it comes to integrating physical activity as part of teaching. The aim of this study is to understand teachers’ motivation for integrating physical activity as part of teaching and to assess their need for guidance and support.

Methods and analysis

The study uses an explanatory sequential mixed-methods design. Schools from across Denmark are included in the sample. The design comprises two separated phases—a quantitative and qualitative phase. The quantitative phase is guided by the self-determination theory where teachers’ motivation will be measured using the Work Task Motivation Scale for Teachers. The theory of scaffolding guides the qualitative phase, which consists of in-depth interviews with participants selected from the quantitative phase based on levels of motivation and on demographic information. In accordance with the study aims, the analysis of data will identify teachers’ internal and external levels of motivation. The purpose of the qualitative phase is to enhance understanding of teachers’ motivation and of their need for support in the use of physical activity in teaching.

Ethics and dissemination

All relevant ethics approvals have been acquired. All participants in this study will provide written informed consent prior to data collection. All data emerging from the quantitative and qualitative phase will be anonymised for analysis. Ethics approval was requested from the Regional Committee on Health Research Ethics for Southern Denmark approval ID S-20162000–40 and the Danish Data Protection Agency approval ID 16/15491). The study was deemed not notifiable by both authorities.

Trial registration number

NCT02894346; Pre-results.
Randomised controlled trial protocol to evaluate a fixed dose prothrombin complex concentrate against the variable dose in vitamin K antagonist related bleeding (PROPER3)
Authors: Abdoellakhan Rahat A , Khorsand Nakisa , Van Hest Reinier M , Veeger Nic , Ter Avest Ewoud , Ypma Paula F , Faber Laura M , Meijer Karina
Published: March 2018

Introduction

There is currently little evidence for the optimal dosing strategy of four-factor prothrombin complex concentrates (PCC) in vitamin K antagonist (VKA)-related bleeds. The generally accepted dosing strategy is the use of a variable dose calculated using patient-specific characteristics as per manufacturer’s instruction. However, evidence exists that the use of a fixed low dose of 1000 international units of factor IX (IU fIX) might also suffice. Recent studies indicate that in terms of haemostatic effectiveness, the fixed dosing strategy might be even superior to the variable dosing strategy. The PROPER3 (PROthrombin complex concentrate: Prospective Evaluation and Rationalisation, number 3) study aims to confirm the non-inferiority, and explore superiority, in haemostatic effectiveness of the fixed PCC dosing strategy compared with the variable dosing strategy in VKA-related extracranial bleeding emergencies.

Methods and analysis

The study is designed as a randomised controlled multicentre non-inferiority trial. Eligibility criteria are an indication for PCC due to VKA-related extracranial bleeding in subjects 18 years of age or older. The control group will receive a variable dose, determined by patient-specific bodyweight and international normalised ratio. The intervention group is dosed a fixed 1000 IU fIX PCC. Primary outcome is the haemostatic effectiveness of both treatments, as defined by the 2016 International Society on Thrombosis and Haemostasis (ISTH) criteria. The sample size is set at 155 patients per treatment arm, requiring 310 patients in total. Non-inferiority on the proportion (risk) difference of the primary outcome will be evaluated using the asymptotic Wald test for non-inferiority. The non-inferiority margin is set at 6%. The primary analysis will be based on the per-protocol population.

Ethics and dissemination

Study results will be published in an international journal, communicated to discipline-specific associations and presented at (inter)national meetings and congresses.

Trial registration number

EUCTR2014-000392-33; Pre-results.
Enhancing the performance of gastrointestinal tumour board by improving documentation
Authors: Alsuhaibani Roaa Saleh , Alzahrani Hajer , Algwaiz Ghada , Alfarhan Haneen , Alolayan Ashwaq , Abdelhafiz Nafisa , Ali Yosra , Jazieh Abdul Rahman
Published: March 2018

Tumour board contributes to providing better patient care by using a multidisciplinary team approach. In the efforts of evaluating the performance of the gastrointestinal tumour board at our institution, it was difficult to assess past performance due to lack of proper use of standardised documentation tool. This project aimed at improving adherence to the documentation tool and its recommendations in order to obtain performance measures for the tumour board. A multidisciplinary team and a plan were developed to improve documentation. Four rapid improvement cycles, Plan–Do–Study–Act (PDSA) cycles, were conducted. The first cycle focused on updating the case discussion summary form (CDSF) based on experts’ input and previous identified deficiencies to enhance documentation and improve performance. The second PDSA cycle aimed at incorporating the CDSF into the electronic medical records system and assessing its functionality. The third cycle was to orient and train staff on using the form and launching it. The fourth PDSA cycle aimed at assessing the ability to obtain tumour board performance measures. Adherence to completion of the CDSF improved from 82% (baseline) to 94% after the fourth PDSA cycle. Over 104 consecutive cases discussed in the tumour board between January and July 2016 and 76 cases discussed in 2015, results were as follows: adherence to National Comprehensive Cancer Network guidelines in 2016 was observed in 141 (95%) recommendations, while it was observed in 90 (92%) recommendations in 2015. Changes in the management plans were observed in 37 (36%) cases in 2016 and in 6 (8%) cases in 2015. Regarding tumour board recommendations, 87% were done within 3 months of tumour board discussion in 2016, while 69% were done in 2015. Implementing electronic standardised documentation tool improved communication among the team and enabled getting accurate data about performance measures of the tumour board with positive impact on healthcare process and outcomes.
Are they high on steroids? Tailored interventions help improve screening for steroid-induced hyperglycaemia in hospitalised patients
Authors: Kempegowda Punith , Livesey Alana C , McFarlane-Majeed Laura , Chandan Joht Singh , Smyth Theresa , Stewart Martha , Blackwood Karen , McMahon Michelle , Melapatte Anitha Vijayan , Salahuddin Sofia , Webber Jonathan , Ghosh Sandip
Published: March 2018

Steroid-induced hyperglycaemia (SIH) is a common adverse effect in patients both with and without diabetes. This project aimed to improve the screening and diagnosis of SIH by improving the knowledge of healthcare professionals who contribute to the management of SIH in hospitalised patients. Monitoring and diagnosis of SIH were measured in areas of high steroid use in our hospital from May 2016 to January 2017. Several interventions were implemented to improve knowledge and screening for SIH including a staff education programme for nurses, healthcare assistants and doctors. The Trust guidelines for SIH management were updated based on feedback from staff. The changes to the guideline included shortening the document from 14 to 4 pages, incorporating a flowchart summarising the management of SIH and publishing the guideline on the Trust intranet. A questionnaire based on the recommendations of the Joint British Diabetes Societies for SIH was used to assess the change in knowledge pre-intervention and post-intervention. Results showed an increase in junior doctors’ knowledge of this topic. Although there was an initial improvement in screening for SIH, this returned to near baseline by the end of the study. This study highlights that screening for SIH can be improved by increasing the knowledge of healthcare staff. However, there is a need for ongoing interventions to sustain this change.
Device complications with addition of defibrillation to cardiac resynchronisation therapy for primary prevention
Authors: Barra Sérgio , Providência Rui , Boveda Serge , Duehmke Rudolf , Narayanan Kumar , Chow Anthony W , Piot Olivier , Klug Didier , Defaye Pascal , Gras Daniel , Deharo Jean-Claude , Milliez Paul , Da Costa Antoine , Mondoly Pierre , Gonzalez-Panizo Jorge , Leclercq Christophe , Heck Patrick , Virdee Munmohan , Sadoul Nicolas , Le Heuzey Jean-Yves , Marijon Eloi
Published: March 2018

Objective

In patients indicated for cardiac resynchronisation therapy (CRT), the choice between a CRT-pacemaker (CRT-P) versus defibrillator (CRT-D) remains controversial and indications in this setting have not been well delineated. Apart from inappropriate therapies, which are inherent to the presence of a defibrillator, whether adding defibrillator to CRT in the primary prevention setting impacts risk of other acute and late device-related complications has not been well studied and may bear relevance for device selection.

Methods

Observational multicentre European cohort study of 3008 consecutive patients with ischaemic or non-ischaemic dilated cardiomyopathy and no history of sustained ventricular arrhythmias, undergoing CRT implantation with (CRT-D, n=1785) or without (CRT-P, n=1223) defibrillator. Using propensity score and competing risk analyses, we assessed the risk of significant device-related complications requiring surgical reintervention. Inappropriate shocks were not considered except those due to lead malfunction requiring lead revision.

Results

Acute complications occurred in 148 patients (4.9%), without significant difference between groups, even after considering potential confounders (OR=1.20, 95% CI 0.72 to 2.00, p=0.47). During a mean follow-up of 41.4±29 months, late complications occurred in 475 patients, giving an annual incidence rate of 26 (95% CI 9 to 43) and 15 (95% CI 6 to 24) per 1000 patient-years in CRT-D and CRT-P patients, respectively. CRT-D was independently associated with increased occurrence of late complications (HR=1.68, 95% CI 1.27 to 2.23, p=0.001). In particular, when compared with CRT-P, CRT-D was associated with an increased risk of device-related infection (HR 2.10, 95% CI 1.18 to 3.45, p=0.004). Acute complications did not predict overall late complications, but predicted device-related infection (HR 2.85, 95% CI 1.71 to 4.56, p<0.001).

Conclusions

Compared with CRT-P, CRT-D is associated with a similar risk of periprocedural complications but increased risk of long-term complications, mainly infection. This needs to be considered in the decision of implanting CRT with or without a defibrillator.
Prospective associations between sport participation and psychological adjustment in adolescents
Authors: Brière Frédéric N , Yale-Soulière Gabrielle , Gonzalez-Sicilia Daniela , Harbec Marie-Josée , Morizot Julien , Janosz Michel , Pagani Linda S
Published: March 2018

Background

Engaging in sport has been suggested to be mitigate against psychological distress. Using a prospective-longitudinal design, we examine whether sport participation is associated with reduced psychological difficulties in adolescents and whether associations differ by sport and personal characteristics.

Methods

17 550 adolescents from grade 7 to 10 (mean age=14.4 years old) self-reported on sport participation, depressive symptoms, social anxiety symptoms and loneliness in Spring 2007 and 1 year later. Analyses tested the association between sport participation and subsequent psychological difficulties using linear regression, while adjusting for pre-existing psychological and sociodemographic characteristics. Analyses also verified whether associations differed by sport frequency (weekly/more than weekly) and type (team/individual) using Wald tests of parameter constraints, as well as sex, age and pre-existing psychological difficulties using interaction terms.

Results

After adjusting for potential confounders, sport participation predicted lower social anxiety symptoms (beta=−0.02 (−0.04, −0.01)) and loneliness (beta=−0.04 (−0.05, −0.02)), but not depressive symptoms. Moderation analyses showed that sport participation predicted greater reductions in depressive symptoms, social anxiety symptoms and loneliness in adolescents with higher baseline scores on each outcome. Associations did not differ by sport frequency and type, sex and age. Post hoc analyses revealed bidirectional associations between sport participation and social anxiety symptoms and loneliness.

Conclusions

Sport participation predicts small reductions in adolescent psychological distress. Reductions seem most important in youth experiencing greater pre-existing psychological difficulty. Our findings suggest that sport participation represents a protective factor that supports psychological resilience in at-risk youth.
Identification of sarilumab pharmacodynamic and predictive markers in patients with inadequate response to TNF inhibition: a biomarker substudy of the phase 3 TARGET study
Authors: Gabay Cem , Msihid Jérôme , Zilberstein Moshe , Paccard Caroline , Lin Yong , Graham Neil M H , Boyapati Anita
Published: March 2018

Introduction

Interleukin-6 (IL-6) orchestrates formation of an inflammatory pannus, leading to joint damage in rheumatoid arthritis (RA). Sarilumab is a human monoclonal antibody blocking the IL-6Rα. In TARGET (NCT01709578), a phase 3 study in adults with moderate-to-severe RA and inadequate response or intolerance to tumour necrosis factor inhibitors, subcutaneous sarilumab 200 mg or 150 mg every 2 weeks (q2w) plus conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) significantly reduced disease activity versus placebo plus csDMARDs.

Methods

Circulating levels of biomarkers associated with synovial inflammation (matrix metalloproteinase 3 (MMP-3), collagen type I MMP-cleaved fragment (C1M), collagen type III MMP-cleaved fragment (C3M)), myeloid (soluble intercellular adhesion molecule 1 (sICAM-1), IL-8 and calprotectin) and lymphoid activation (chemokine, CXC motif, ligand 13 (CXCL13), CXCL10, B cell-activating factor) and bone remodelling (receptor activator of nuclear factor-κB ligand (RANKL), osteoprotegerin and osteocalcin) were evaluated in patients from a TARGET substudy.

Results

Sarilumab significantly decreased C1M, C3M, CXCL13, MMP-3 and total RANKL levels at week 24 versus placebo; some markers were significantly suppressed at week 2 and normalised to levels in healthy controls. Levels of sICAM-1 were predictive of disease activity score by C-reactive protein and clinical disease activity index low disease activity (LDA) response in the sarilumab 200 mg q2w group at week 12. A trend was observed in which patients with lower sICAM-1 levels at baseline had better response compared with patients with higher sICAM-1.

Conclusions

Sarilumab plus csDMARDs decreased circulating biomarkers of synovial inflammation and bone resorption; sICAM-1 was predictive of achieving LDA with sarilumab.

Trial registration number

NCT01709578; Post-results.
Effects of high-velocity circuit resistance and treadmill training on cardiometabolic risk, blood markers, and quality of life in older adults
Authors: Roberson Kirk B. , Potiaumpai Melanie , Widdowson Kayla , Jaghab Ann-Marie , Chowdhari Sean , Armitage Catherine , Seeley Afton , Jacobs Kevin A. , Signorile Joseph F.
Published: March 2018

The presence of cardiometabolic syndrome (CMS) confers an increased risk for cardiovascular disease (CVD) and mortality and is associated with reduced health-related quality of life (HRQoL). Although the effects of exercise on biomarkers, HRQoL, and future risk have been studied, no study has measured the effects on all three components. The present study compared the effects of steady-state, moderate-intensity treadmill training (TM) and high-velocity circuit resistance training (HVCRT) on biological markers, HRQoL, and overall CVD risk in adults with CMS and CVD risk factors. Thirty participants (22 females, 8 males) were randomly assigned to 1 of 3 groups: HVCRT, TM, or control. Participants in the exercise groups attended training 3 days/week for a total of 12 weeks. Of the 30 participants who began the study, 24 (19 females, 5 males) were included in the final analysis. Primary outcome measures included CMS criteria, hemodynamic measures, Framingham Risk Score (FRS), and HRQoL. All variables were measured pre- and post-intervention. CMS z score significantly decreased for HVCRT (p = 0.03), while there were no significant changes for TM or control. FRS significantly decreased for HVCRT compared with TM (p = 0.03) and control (p = 0.03). Significant decreases in systolic (p < 0.01) and diastolic blood pressures (p < 0.01) for HVCRT accompanied significant increases from baseline in stroke volume (p = 0.03) and end-diastolic volume (p < 0.01). Systemic vascular resistance significantly decreased (p = 0.05) for HVCRT compared with control. Emotional well-being significantly improved following HVCRT and TM compared with control (p = 0.04; p = 0.03). HVCRT represents a novel training modality that improved factors in each of the 3 components assessed.
Comparison of Buck–Boost and Ćuk Converters Based on Time Domain Response
Authors: Rose J. Leema , Sankaragomathi B.
Published: March 2018

This paper presents the design and modeling of power electronic converters such as buck–boost and Ćuk operated under continuous conduction mode (CCM). The open-loop behavior of buck–boost and Ćuk converters needs modeling and simulation using modeled equations. The closed-loop control of these converters has a propositional–integral–derivative (PID) controller. PID controller parameters are obtained from Ziegler–Nichols step response method. These converters can be analyzed using the state equation. The MATLAB/SIMULINK tool is used for simulation of those state equations. Ćuk and buck–boost converters are designed and analyzed. The mathematical model of power Converter for simulation has been carried out using SIMULINK with/without any Sim Power System Elements. The open- and closed-loop results are compared.
A Segmented Ladder-Structured Multilevel Inverter for Switch Count Remission and Dual-Mode Savvy
Authors: Chitrakala G. , Stalin N. , Mohan V.
Published: March 2018

The multilevel inverter (MLI) has ascertained its gravity in high-power applications for the past three decades through perennial topological modifications from the pristine structure and development of apposite modulation strategies. The benefits, including subtle switch voltage stress, reduced output voltage total harmonic distortion (THD), tolerable electromagnetic compatibility (EMC), minimal switching losses and [Formula: see text]/[Formula: see text] stress, have prepared it as a very promising candidate in high-power drives and electric utility applications. Meanwhile, MLI has few drawbacks such as higher number of switches with associated peripherals (gate driver circuits, protection circuits and heat sinks) which makes the overall system complex, bulky and costly. There have been many attempts to curb the component count in MLI structure. In this paper, a new topology is developed with a perspective to wane the switch count, which also has the ability of working in both symmetrical and asymmetrical modes. The performance of the proposed segmented ladder-structured MLI (SLSMLI) topology is substantiated with simulation study and experimentation.
Global bounded variation solutions describing Fanno–Rayleigh fluid flows in nozzles
Authors: Chou Shih-Wei , Hong John M. , Huang Bo-Chih , Quita Reyna
Published: March 2018

In this paper, we investigate the initial-boundary value problem of compressible Euler equations including friction and heating that model the transonic Fanno–Rayleigh flows through symmetric variable area nozzles. In particular, the case of contracting nozzles is considered. A new version of a generalized Glimm scheme (GGS) is presented for establishing the global existence of entropy solutions with bounded variation. Modified Riemann and boundary Riemann solutions are applied to design this GGS, which is constructed using the contraction matrices acting on the homogeneous Riemann (or boundary-Riemann) solutions. The extended Glimm–Goodman’s type of wave interaction estimates are investigated to determine the stability of the scheme and the positivity of gas velocity that results in the existence of the weak solution. The limit of approximation solutions serves as an entropy solution. Moreover, a quantitative relation between the shape of the nozzle, friction, and heat is proposed for the global existence result in the contracting nozzle. Numerical simulations of the contraction-expansion and expansion-contraction nozzles are presented to validate the scheme.
Initial-boundary value problem for a fractional type degenerate heat equation
Authors: Huaroto Gerardo , Neves Wladimir
Published: March 2018

In this paper, we study a fractional type degenerate heat equation posed in bounded domains. We show the existence of solutions for measurable and bounded non-negative initial data, and homogeneous Dirichlet boundary condition. The nonlocal diffusion effect relies on an inverse of the [Formula: see text]-fractional Laplacian operator, and the solvability is proved for any [Formula: see text].
A domain decomposition method for the polarizable continuum model based on the solvent excluded surface
Authors: Quan Chaoyu , Stamm Benjamin , Maday Yvon
Published: March 2018

In this paper, an efficient solver for the polarizable continuum model in quantum chemistry is developed which takes the solvent excluded surface (the smooth molecular surface) as the solute–solvent boundary. This model requires to solve a generalized Poisson (GP) equation defined in [Formula: see text] with a space-dependent dielectric permittivity function. First, the original GP-equation is transformed into a system of two coupled equations defined in a bounded domain. Then, this domain is decomposed into overlapping balls and the Schwarz domain decomposition method is used. This method involves a direct Laplace solver and an efficient GP-solver to solve the local sub-equations in balls. For each solver, the spherical harmonics are used as basis functions in the angular direction of the spherical coordinate system. A series of numerical experiments are presented to test the performance of this method.
Parametric Resonance of Pipes with Soft and Hard Segments Conveying Pulsating Fluids
Authors: Li Qian , Liu Wei , Zhang Zijun , Yue Zhufeng
Published: March 2018

In this paper, the parametric resonance of pipes with soft and hard segments induced by pulsating fluids is investigated. The lowest six natural frequencies and mode shapes of the soft–hard combination pipe simply supported at both ends are obtained by the modified Galerkin's method. The Floquet method is used to numerically determine the parametric resonance regions, including subharmonic resonance regions and combination resonance regions. The parametric resonance results are verified by comparison with published ones, which confirm the validity of the present model establishment and numerical calculation. Compared with a uniform pipe conveying fluid simply supported at both ends, the soft–hard pipe conveying fluid is found to reveal different dynamical behaviors. Decreasing the length of the soft pipe, while increasing the stiffness ratio of the hard pipe compared to the soft one, can effectively improve the stability of the pipe system. The parametric resonance results show that the mean flow velocity and pulsation amplitude of the fluid have a great influence on the width of the parametric resonance regions. It is advisable that the ratio (the soft pipe/the whole pipe) of the length may be designed to be 0.4–0.5 for a flexural rigidity ratio (the hard pipe/the soft pipe) of 2. As the stiffness ratio (the hard pipe/the soft pipe) increases beyond 26, the hard pipe may be regarded as a rigid pipe. The probability of parametric resonance occurrence will be smallest if the soft–hard combination pipe is supported in a clamped–pinned way. For certain application cases, the safety design length of the two pipes with different materials can be determined through numerical calculation.
On-Line Case-Based Policy Learning for Automated Planning in Probabilistic Environments
Authors: Martínez Moisés , García Javier , Fernández Fernando
Published: March 2018

Many robotic control architectures perform a continuous cycle of sensing, reasoning and acting, where that reasoning can be carried out in a reactive or deliberative form. Reactive methods are fast and provide the robot with high interaction and response capabilities. Deliberative reasoning is particularly suitable in robotic systems because it employs some form of forward projection (reasoning in depth about goals, pre-conditions, resources and timing constraints) and provides the robot reasonable responses in situations unforeseen by the designer. However, this reasoning, typically conducted using Artificial Intelligence techniques like Automated Planning (AP), is not effective for controlling autonomous agents which operate in complex and dynamic environments. Deliberative planning, although feasible in stable situations, takes too long in unexpected or changing situations which require re-planning. Therefore, planning cannot be done on-line in many complex robotic problems, where quick responses are frequently required. In this paper, we propose an alternative approach based on case-based policy learning which integrates deliberative reasoning through AP and reactive response time through reactive planning policies. The method is based on learning planning knowledge from actual experiences to obtain a case-based policy. The contribution of this paper is two fold. First, it is shown that the learned case-based policy produces reasonable and timely responses in complex environments. Second, it is also shown how one case-based policy that solves a particular problem can be reused to solve a similar but more complex problem in a transfer learning scope.