bluuebunny/crossref_metadata_2025 huggingface dataset:
Brain oscillatory activity associated with switch and mixing costs during reactive control
Authors: Capizzi Mariagrazia , Ambrosini Ettore , Arbula Sandra , Vallesi Antonino
Published: July 2020

Task‐switching paradigms, which involve task repetitions and between‐task switches, have long been used as a benchmark of cognitive control processes. When mixed and single‐task blocks are presented, two types of costs usually occur: the switch cost, measured by contrasting performance on switch and repeat trials during the mixed‐task blocks, and the mixing cost, calculated as the performance difference between the all‐repeat trials from the single‐task blocks and the repeat trials from the mixed‐task blocks. Both costs can be mitigated by informational cues that signal the upcoming task switch beforehand. Recent electroencephalographic studies have started unveiling the brain oscillatory activity underlying the switch cost during the preparatory cue‐target interval, thus, targeting proactive control processes. Less attention has instead been paid to the mixing cost and, importantly, to the oscillatory dynamics involved in switch and mixing costs during reactive control. To fill this gap, here, we analyzed the time‐frequency data obtained during a task‐switching paradigm wherein the simultaneous presentation of task cues and targets increased the need for reactive control. Results showed that while alpha and beta bands were modulated by switch and mixing costs in a similar gradual fashion, with greater suppression going from switch to repeat and all‐repeat trials, theta power was sensitive to the switch cost with increased power for switch than repeat trials. Together, our findings join previous studies underlining the importance of theta, alpha and beta oscillations in task‐switching and extend them by depicting the oscillations involved in switch and mixing costs during reactive control processes.
Parent‐early adolescent relationship quality and problem behavior in Hungary, the Netherlands, India, and Iceland
Authors: Hillekens Jessie , Buist Kirsten L. , Horváth Lili O. , Koper Natasha , Ólafsdóttir Jóna , Karkdijk Esther , Balázs Judit
Published: July 2020

Higher parent‐child relationship quality has been associated with less internalizing and externalizing problem behavior. However, it remained less clear whether these associations are universal or depend on the country under investigation. Furthermore, fathers are still understudied, even though there is increasing evidence of their important role in early adolescent development. Our study compared the association of mother‐child as well as father‐child relationship quality with early adolescents’ problem behavior in four culturally different countries, namely Hungary (N = 293; Mage = 11.22; 53% boys), the Netherlands (N = 242; Mage = 11.20; 48% boys), India (N = 230; Mage = 10.68; 61% boys), and Iceland (N = 261; Mage = 10.90; 53% boys). Early adolescents filled out questionnaires in their classroom, assessing warmth and conflict with fathers and mothers and internalizing and externalizing problem behavior. Stepwise multi‐group path analysis demonstrated no cross‐cultural differences in associations between quality of the parent‐child relationship and problem behavior. We did not find any effects of maternal or paternal warmth. However, across samples conflict with mothers was associated with more internalizing and externalizing problem behavior, and conflict with fathers was associated with more externalizing problem behavior. Our findings highlight the need to target conflict with both fathers and mothers in interventions across different countries, especially when addressing externalizing problem behavior.
A typology of household livelihood changes in rural coastal areas of the Vietnamese Mekong Delta—Capturing the heterogeneity and complexity of the social‐ecological context
Authors: Pham Thi Thanh Hoai , Revilla Diez Javier , Garschagen Matthias
Published: July 2020

Over the last decades, the Vietnamese Mekong Delta (VMD) has experienced drastic political, socio‐economic, and ecological changes. On a conceptual level, numerous studies started to emphasize that livelihood shifts are driven by not only climate but also socio‐economic and institutional changes. Nevertheless, on an analytical and operational level, research taking up both aspects of social and ecological changes in analysing the dynamics of livelihood is still lacking. This paper therefore is to present a typology of livelihood transitions to capture complex sets and interactions of environmental and non‐environmental drives for livelihood changes. The paper thus aims at providing a valid representation of the shifts on the ground that can also be used in policy‐making and future research. Using data from a household survey conducted in three provinces (n = 524), we propose a typology of six livelihood‐change trends that reflects the level of intensity of agrarian adjustments, particularly system‐shift versus diversification, as well as the role of non‐agricultural income changes. The typology allows further analysis of characteristics of the six household groups respectively, thereby facilitating the identification of enabling factors and barriers to sustainable livelihood improvements. This classification method can also be transferred to develop similar household livelihood‐change typologies in other contexts.
Capability for suicide: Discrimination as a painful and provocative event
Authors: Brooks Jasmin R. , Hong Judy H. , Cheref Soumia , Walker Rheeda L.
Published: July 2020

Objective

Developing the capability to die by suicide, and overcoming one's natural instinct of self‐preservation, is thought to occur as a result of habituation to the fear and pain surrounding suicide. However, investigations of suicide capability have yet to examine whether perceived discrimination serves as a painful and provocative event that contributes to capability for suicide. The purpose of the current study was to examine the association of perceived discrimination and suicide capability for Black and White adults.

Method

The study sample included 173 Black adults (67.6% female; Mage = 23.18, SD = 5.74) and 272 White adults (60.7% female; Mage = 22.80, SD = 5.90). Participants completed a questionnaire battery that included measures of perceived discrimination, depression, and suicide ideation.

Results

Regression analyses revealed for Black adults (but not White adults), perceived discrimination was associated with an increased capability for suicide after accounting for depressive symptomatology, suicide ideation, non‐discriminatory painful and provocative events experienced, age, and gender (β = .226, t = 3.154, p = .002).

Conclusions

These findings provide preliminary evidence that perceived discrimination may play a role in suicide capability for Black adults and highlight the importance of considering contextual experiences when examining suicidality in underserved groups.
Pre‐ and post‐natal factors and physical activity in childhood: The Norwegian Mother, Father and Child Cohort study
Authors: Bernhardsen Guro Pauck , Stensrud Trine , Nystad Wenche , Ekelund Ulf
Published: July 2020

Few studies have examined the possibility that pre‐ and post‐natal factors may be non‐linearly associated with later physical activity. We used data from the Norwegian Mother, Father and Child Cohort study (MoBa) and the Medical Birth Registry of Norway (MBRN), including 48 672 children with available data on leisure time physical activity (LTPA) at child's age 7 years. Restricted cubic and linear splines or linear regression was used to examine the associations between maternal pre‐pregnancy BMI, birth weight for gestational age, and infant weight gain from birth to 1 year with LTPA (frequency/wk) in 7‐year‐old children. The results suggest no associations between maternal pre‐pregnancy BMI, birth weight, and infant weight gain on subsequent LTPA in girls. Maternal pre‐pregnancy BMI and birth weight may be non‐linearly associated with LTPA in 7‐year‐old boys. Infant weight gain (change in weight z‐score from birth to 1 year) may be weakly linearly associated with LTPA in boys. Pre‐ and post‐natal factors may therefore influence LTPA in childhood differently in boys and girls. Maternal pre‐pregnancy BMI and birth weight are positively associated with LTPA at the lower ends of the maternal pre‐pregnancy BMI and birth weight continuums in boys. The negative associations at the higher ends of the continuums and the positive association between infant weight gain and LTPA in boys may not be important and needs further replication.
Why Parfit Can Rebut JohnstonʼsReductio
Authors: Ehring Douglas
Published: July 2020

Abstract

Henry Pollock, in “Parfit's Fission Dilemma: Why Relation R Doesn't Matter”, examines the options available to Parfit for defending his “argument from below” from Johnstonʼsreductioobjection. Pollock argues that Parfitʼs proposed defence against Johnston fails. In this article, I argue that Pollockʼs objections to Parfitʼs defence can be resisted.
Thawed solvent/detergent‐treated plasma demonstrates comparable clinical efficacy to thawed plasma
Authors: Racine‐Brzostek Sabrina E. , Canver Matthew C. , DeSimone Robert A. , Zdravkova Milena , Lo Dian T. , Crowley Kathleen M. , Hsu Yen‐Michael S. , Vasovic Ljiljana V. , Hill Shanna Sykes , Cushing Melissa M.
Published: July 2020

Background

Thawed Plasma (TP), plasma thawed and refrigerated for up to 5 days, is a commonly transfused plasma product. This pilot study was conducted to determine whether Thawed Solvent/Detergent‐treated Plasma stored refrigerated for up to 5‐days post‐thaw (T‐S/D) was as efficacious as TP.

Study Design and Methods

This single institution retrospective cohort analysis evaluated the efficacy of T‐S/D in reversing coagulopathies in comparison to TP. Utilizing the institution's electronic medical records, transfusion data were collected in adult patients who received either TP or T‐S/D. The primary outcome was the incidence of subsequent transfusions within 24 hours after first dose of either type of plasma. Secondary outcomes included the number of blood products transfused within 24 hours of first‐dose plasma, correction of pre‐transfusion coagulation laboratory values, volume transfused, and clinical outcomes.

Results

TP was received by 301 patients and 137 received T‐S/D during the first 32 months post‐implementation of T‐S/D. There was no difference in incidence of subsequent transfusions or number of blood products given. The median pre‐INR of both the TP and T‐S/D cohorts was 1.9, with a similar decrease in INR of 0.2 and 0.3 (p = 0.36), respectively, post plasma transfusion. There was no difference in correction of PT/aPTT, mortality, transfusion reactions, readmission rates, length of stay, or inpatient deep venous thrombosis. The median volume of T‐S/D plasma transfused for the first dose was 126 mL less than TP (p = .0001).

Conclusion

T‐S/D was as efficacious as TP for the treatment of coagulopathies and the reversal of coagulation laboratory values.
Humour-Supported Instructional Approach: A Method for Generating and Maintaining Interest in Mathematics for Secondary School Students in South Sudan Re-settled Communities
Authors: Tap William D. , Mtetwa David K. , Vere Joseph C.
Published: July 2020

This article reports the findings from the main study that investigated relative effects of an instructional approach aimed at generating and maintaining interest in mathematics for secondary school students living in South Sudan’s displaced and re-settled communities. The study compared interest-generating effects of two different instructional approaches on two groups of Grade 11 students over a twelve-week period. While the Humour-supported Instructional Approach (H-SIA) was applied to the experimental group (E-group; n = 53), the control group (C-group; n = 59) was taught using Regular Instructional Approach (RIA). No significant differences were found in the two approaches’ effects in generating and maintaining interest. A four (4) week pilot study conducted prior to the main study produced similar results. However, some new insights from the main study suggest that teachers’ teaching traits play a heavier and more central role in both methods than had been initially realised. This led to the conclusion that the two methods (H-SIA and RIA) have similar effects on learner interest. The equivalence appears strongly dependent on the teachers’ teaching traits, characteristics and teaching qualities for marshalling teachers’ teaching techniques or strategies which include humour into their pedagogical toolkit. H-SIA method, however, is more recommended because the literature indicates-and this is confirmed in this study-that the use of humour in the classroom setting provides students with additional reason, motivation and inspiration to learn.
Influence of blood flow occlusion on muscular recruitment and fatigue during maximal‐effort small muscle‐mass exercise
Authors: Hammer Shane M. , Alexander Andrew M. , Didier Kaylin D. , Barstow Thomas J.
Published: July 2020

Key points

The heavy‐to‐severe intensity exercise threshold (i.e. critical force) distinguishes between steady‐state and progressive metabolic and neuromuscular responses to exercise.

High levels of skeletal muscle sensory feedback related to peripheral fatigue development are thought to restrict motor unit activation and limit exercise tolerance.

Utilizing limb blood flow occlusion, we demonstrate that critical force reflects an oxygen‐delivery‐dependent balance between motor unit activation and peripheral fatigue development.

Our findings suggest that mechanisms which determine the total force‐producing capacity of exercising skeletal muscle are significantly altered during blood flow occlusion.

These findings may have widespread implications for exercise tolerance in patient populations who experience partial vascular occlusion or altered neuromuscular reflexes.

High levels of muscle sensory feedback restrict motor unit activation and limit exercise tolerance. The roles of muscle fatigue development and motor unit activation in determining the heavy‐ to severe‐intensity threshold (critical force; CF) remain unclear. This study utilized blood flow occlusion (OCC) to determine relationships between muscle fatigue development and motor unit activation during the determination of CF. We hypothesized that (1) OCC would exacerbate peripheral fatigue development and increase the rate of motor unit deactivation, and (2) blood flow reperfusion (REP) would result in muscle recovery and re‐recruitment of motor units despite continuous maximal effort, (3) resulting in an end‐exercise force not different from CF. Seven young, healthy subjects performed maximal‐effort rhythmic handgrip exercise for 5 min under control conditions (CON) and during OCC and REP. Peripheral fatigue development and motor unit activation were measured via electrical stimulation and electromyography, respectively, during each test. OCC resulted in significantly greater peripheral fatigue development than CON (54.3 ± 34.8%; P < 0.001). Motor unit deactivation was only observed during OCC (P < 0.001). REP resulted in significant peripheral recovery (P < 0.001) and the re‐recruitment of motor units (P < 0.001) to levels not different from CON. While OCC resulted in a significantly greater reduction in force production compared to CON (65.7 ± 35.6%; P < 0.001), REP resulted in the restoration of maximal‐effort force production (266 ± 19 N; P < 0.001) to levels not different from CF (276 ± 55 N). These data suggest that CF reflects an oxygen‐delivery‐dependent balance between motor unit activation and peripheral fatigue development. Furthermore, this study established that mechanisms which determine the total force‐producing capacity of exercising skeletal muscle are altered during OCC.
Physical Activity Measured by Accelerometry in Mozambican Older Adult Women Attending a Regular Exercise Program
Authors: Daca Timóteo , Prista António , Tchonga Francisco , Crochemore-Silva Inacio , Reichert Felipe F. , Farinatti Paulo , Tani Go
Published: July 2020

Time spent in different Physical Activity (PA) Intensities of 72 Mozambican older adult women (67 ± 7 years old) was assessed by means of triaxial accelerometers for 7 consecutive days, and participants were stratified based on their body mass index, as being normal weight (NW, n = 23); overweight (n = 16); or obese (OB, n = 33). Overall, most daily time was spent in sedentary activities (614 ± 111 min or 69.1%) and light PA (181 ± 56 min or 20.2%). On average, moderate to vigorous PA (MVPA) was performed during 10.6% of the day (93 ± 44 min). Time spent in MVPA was significantly higher in the NW compared to OB category (112.8 ± 51.5 vs. 81.0 ± 36.3; p = .021). The overweight group did not differ in time spent in MVPA when compared to NW and OB group. Overall, 75% of the participants spent more than 60 min a day in MVPA (NW: 83%; overweight: 81%; OB: 67%). Pearson’s correlation between body mass index and total MVPA controlling for age was −.39 (p < .001). It was concluded that Mozambican older adult women living in urban and rural areas of Maputo province engaged in relatively high Physical Activity Intensities compared with individuals of similar ages in high-income countries, regardless of their nutritional status.
Recreational Therapy to Promote Mobility in Long-Term Care: A Scoping Review
Authors: Yang Yijian , van Schooten Kimberley S. , McKay Heather A. , Sims-Gould Joanie , Hoang Raymond A. , Robinovitch Stephen N.
Published: July 2020

The objective of this study was to explore and synthesize evidence on the effectiveness and implementation of recreational therapy programs to enhance mobility outcomes (e.g., balance, functional performance, fall incidence) for older adults in long-term care. The authors conducted a scoping review of 66 studies following the PRISMA guidelines. Two independent reviewers evaluated each article, and a third reviewer resolved discrepancies. Randomized controlled studies provided strong to moderate evidence that tai chi programs, walking, dancing, and ball games improve flexibility, functional mobility, and balance. Studies assessing program implementation highlighted that program delivery was facilitated by clear instruction, encouragement, attendance documentation, and minimal equipment. This review elucidated the benefit of recreational therapy programs on mobility. It also identified the need for customized programs based on individuals’ interests and their physical and mental abilities. These findings and recommendations will assist practitioners in designing effective and feasible recreational therapy programs for long-term care.
A dynamic mouse peptidome landscape reveals probiotic modulation of the gut-brain axis
Authors: Zhang Pei , Wu Xiaoli , Liang Shan , Shao Xianfeng , Wang Qianqian , Chen Ruibing , Zhu Weimin , Shao Chen , Jin Feng , Jia Chenxi
Published: July 2020

Probiotic treatment alters the abundance of neuropeptides in the brain.
Effect of Vancomycin-Associated Acute Kidney Injury on Incidence of 30-Day Readmissions among Hospitalized Veterans Affairs Patients with Skin and Skin Structure Infections
Authors: Patel Nimish , Stornelli Nicholas , Sangiovanni Ryan J. , Huang David B. , Lodise Thomas P.
Published: July 2020

Among hospitalized adults who received vancomycin for their skin and skin structure infection (SSSI), patients who experienced acute kidney injury (AKI) had considerably higher 30-day readmission rates. Nearly half of the observed 30-day readmissions were due to non-SSSI-related reasons, which is consistent with the persistent organ dysfunction observed among patients with AKI.
The Challenges of Using Oropharyngeal Samples To Measure Pneumococcal Carriage in Adults
Authors: Boelsen Laura K. , Dunne Eileen M. , Gould Katherine A. , Ratu F. Tupou , Vidal Jorge E. , Russell Fiona M. , Mulholland E. Kim , Hinds Jason , Satzke Catherine
Published: July 2020

Streptococcus pneumoniae
(the pneumococcus) is a significant global pathogen. Accurate identification and serotyping are vital. In contrast with World Health Organization recommendations based on culture methods, we demonstrate that pneumococcal identification and serotyping with molecular methods are affected by sample type. Results from oropharyngeal samples from adults were often inaccurate. This is particularly important for assessment of vaccine impact using carriage studies, particularly in low- and middle-income countries where there are significant barriers for disease surveillance.
Implementation of Antibody Rapid Diagnostic Testing versus Real-Time Reverse Transcription-PCR Sample Pooling in the Screening of COVID-19: a Case of Different Testing Strategies in Africa
Authors: Nyazika Tinashe K. , Kaela Rabelani , Mugoni Mathias , Musomekwa Kudakwashe , Kyei-Baafour Eric , Chiwanda Simbarashe , Mapondera Prichard T. , Makawa Tatenda S. , Sithole Elliot M. , Mavunganidze George , Manasa Justen , Jambo Kondwani C. , Musarurwa Cuthbert
Published: July 2020

Coronavirus disease 2019 (COVID-19) has wreaked havoc across the globe; although the number of cases in Africa remains lower than in other regions, it is on a gradual upward trajectory. To date, COVID-19 cases have been reported in 54 out of 55 African countries. However, due to limited severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-PCR (rRT-PCR) testing capacity and scarcity of testing reagents, it is probable that the total number of cases could far exceed published statistics.
The life cycle of subcontinental peridotites: From rifted continental margins to mountains via subduction processes
Authors: Vannucchi Paola , Morgan Jason P. , Polonia Alina , Molli Giancarlo
Published: July 2020

Serpentinization greatly affects the physical and chemical properties of lithospheric mantle. Here we address the fate of serpentinized peridotites and their influence over an entire Wilson cycle. We document the near-surface journey of serpentinized subcontinental peridotites exhumed during rifting and continental breakup, reactivated as buoyant material during subduction, and ultimately emplaced as “ophiolite-like” fragments within orogenic belts. This life cycle is particularly well documented in former Tethys margins, where recent studies describe the ongoing incorporation of Mesozoic serpentinized subcontinental peridotites that diapirically rise from a subducting lower plate’s mantle to be emplaced into the accretionary prism in front of a continental arc. This newly recognized mode of subduction-linked serpentine diapirism from the downgoing lithospheric slab is consistent with the origin of some exhumed serpentinized subcontinental peridotites in the Apennines (Italy), these assemblages reaching their present locations during Alpine orogenesis. Transfer of serpentinized subcontinental peridotites from the downgoing to the overriding plate motivates the concept of a potentially “leaky” subduction channel. Weak serpentine bodies may in fact rise into, preferentially migrate within, and eventually leave the intraplate shear zone, leading to strong lateral heterogeneities in its composition and mechanical strength.
Supplemental Material: Late Miocene contourite channel system reveals intermittent overflow behavior
Authors: De Weger Wouter , al. et
Published: July 2020

Table S1 (facies and facies association scheme with example pictures from the outcrops).
Does not compute: challenges and solutions in managing computable biomedical knowledge
Authors: Wong David , Peek Niels
Published: July 2020

Computers can potentially play a key role in resolving knowledge mobilisation bottlenecks in health and care through decision support at the point of care based on computable biomedical knowledge (CBK). But the management of CBK comes with a range of significant computer science challenges. Some of these have been suitably addressed through the development of CBK methods and tools, while others require further research and development. We review the main challenges associated with creating, reasoning with and sharing CBK, and describe current state-of-the-art solutions as well as outstanding issues. We argue that a radical approach, in which all evidence generation is suitable for computation at the outset, is ultimately needed to take full advantage of CBK.
Decision support for Scotland’s health and social care: learning from an outcomes-focused approach
Authors: Wales Ann
Published: July 2020

This short report shares learning from the research and development phase of the national decision support programme in NHS Scotland. It outlines how the programme has adopted an outcomes-focused approach which has guided critical decisions on solution design, engagement of policy sponsors, clinical and management leaders, implementation and evaluation approach, technical architecture and technology development. It discusses how this outcomes-led approach positions decision support as catalyst for a learning health and care system that continuously refreshes the healthcare knowledge base through new insights generated by evaluating impact and outcomes.
A NICE perspective on computable biomedical knowledge
Authors: Mitchell Andrew
Published: July 2020

Introduction

The National Institute for Health and Care Excellence (NICE) plays a central role in the NHS. We distill knowledge of best practice from the best available sources of evidence and share this across the health and care system, typically in the form of recommendations. We want to ensure that this knowledge is shared in a form that supports improved decision making by professionals working together with patients, leading to improved outcomes. Understanding the role of computable knowledge in the context of a learning health system is therefore of deep interest to NICE.

Methods

The Agency for Healthcare Research and Quality (AHRQ) 4 levels of knowledge have been used as a framework to review current NICE products and services and envisage how they may need to evolve.

Discussion

NICE is mostly still at level 1 of the AHRQ knowledge hierarchy but aspires to work towards structured and computable products. The NHS Long Term Plan makes clear that the wider health and care system is seeking to drive up interoperability with standards for data exchange at the heart of this. NICE Connect is the name given to NICE’s ambition to change in order to keep pace with changing technologies, advances in guideline development and analytical methods and the shifting needs of the system, and to ensure that it can sustainably and efficiently manage its portfolio of guidance. It is seen as crucial that NICE Connect and the wider Mobilising Computable Biomedical Knowledge (MCBK) agenda align for either of them to truly succeed.
PROMISE (Program Refinements to Optimize Model Impact and Scalability based on Evidence): a cluster-randomised, stepped-wedge trial assessing effectiveness of the revised versus original Ryan White Part A HIV Care Coordination Programme for patients with barriers to treatment in the USA
Authors: Irvine Mary K , Levin Bruce , Robertson McKaylee M , Penrose Katherine , Carmona Jennifer , Harriman Graham , Braunstein Sarah L , Nash Denis
Published: July 2020

Introduction

Growing evidence supports combining social, behavioural and biomedical strategies to strengthen the HIV care continuum. However, combination interventions can be resource-intensive and challenging to scale up. Research is needed to identify intervention components and delivery models that maximise uptake, engagement and effectiveness. In New York City (NYC), a multicomponent Ryan White Part A-funded medical case management intervention called the Care Coordination Programme (CCP) was launched at 28 agencies in 2009 in order to address barriers to care and treatment. Effectiveness estimates based on >7000 clients enrolled by April 2013 and their controls indicated modest CCP benefits over ‘usual care’ for short-term and long-term viral suppression, with substantial room for improvement.

Methods and analysis

Integrating evaluation findings and CCP service-provider and community-stakeholder input on modifications, the NYC Health Department packaged a Care Coordination Redesign (CCR) in a 2017 request for proposals. Following competitive re-solicitation, 17 of the original CCP-implementing agencies secured contracts. These agencies were randomised within matched pairs to immediate or delayed CCR implementation. Data from three 9-month periods (pre-implementation, partial implementation and full implementation) will be examined to compare CCR versus CCP effects on timely viral suppression (TVS, within 4 months of enrolment) among individuals with unsuppressed HIV viral load newly enrolling in the CCR/CCP. Based on current enrolment (n=933) and the pre-implementation outcome probability (TVS=0.54), the detectable effect size with 80% power is an OR of 2.75 (relative risk: 1.41).

Ethics and dissemination

This study was approved by the NYC Department of Health and Mental Hygiene Institutional Review Board (IRB, Protocol 18–009) and the City University of New York Integrated IRB (Protocol 018–0057) with a waiver of informed consent. Findings will be disseminated via publications, conferences, stakeholder meetings, and Advisory Board meetings with implementing agency representatives.

Trial registration number

Registered with ClinicalTrials.gov under identifier:NCT03628287, V.2, 25 September 2019; pre-results.
Implementation of blood glucose self-monitoring among insulin-dependent patients with type 2 diabetes in three rural districts in Rwanda: 6 months open randomised controlled trial
Authors: Ng'ang'a Loise , Ngoga Gedeon , Dusabeyezu Symaque , Hedt-Gauthier Bethany L , Ngamije Patient , Habiyaremye Michel , Harerimana Emmanuel , Ndayisaba Gilles , Rusangwa Christian , Niyonsenga Simon Pierre , Bavuma Charlotte M , Bukhman Gene , Adler Alma J , Kateera Fredrick , Park Paul H.
Published: July 2020

Introduction

Most patients diagnosed with diabetes in sub-Saharan Africa (SSA) present with poorly controlled blood glucose, which is associated with increased risks of complications and greater financial burden on both the patients and health systems. Insulin-dependent patients with diabetes in SSA lack appropriate home-based monitoring technology to inform themselves and clinicians of the daily fluctuations in blood glucose. Without sufficient home-based data, insulin adjustments are not data driven and adopting individual behavioural change for glucose control in SSA does not have a systematic path towards improvement.

Methods and analysis

This study explores the feasibility and impact of implementing self-monitoring of blood glucose (SMBG) in patients with type 2 diabetes in rural Rwandan districts. This is an open randomised controlled trial comprising of two arms: (1) Intervention group—participants will receive a glucose metre, blood test strips, logbook, waste management box and training on how to conduct SMBG in additional to usual care and (2) Control group—participants will receive usual care, comprising of clinical consultations and routine monthly follow-up. We will conduct qualitative interviews at enrolment and at the end of the study to assess knowledge of diabetes. At the end of the study period, we will interview clinicians and participants to assess the perceived usefulness, facilitators and barriers of SMBG. The primary outcomes are change in haemoglobin A1c, fidelity to SMBG protocol by patients, appropriateness and adverse effects resulting from SMBG. Secondary outcomes include reliability and acceptability of SMBG and change in the quality of life of the participants.

Ethics and dissemination

This study has been approved by the Rwanda National Ethics Committee (Kigali, Rwanda No.102/RNEC/2018). We will disseminate the findings of this study through presentations within our study settings, scientific conferences and publication in a peer-reviewed journal.

Trial registration number

PACTR201905538846394; pre-results.
Are prolonged sitting and sleep restriction a dual curse for the modern workforce? a randomised controlled trial protocol
Authors: Vincent Grace E , Gupta Charlotte C , Sprajcer Madeline , Vandelanotte Corneel , Duncan Mitch J , Tucker Phil , Lastella Michele , Tuckwell Georgia A , Ferguson Sally A
Published: July 2020

Introduction

Prolonged sitting and inadequate sleep are a growing concern in society and are associated with impairments to cardiometabolic health and cognitive performance. However, the combined effect of prolonged sitting and inadequate sleep on measures of health and cognitive performance are unknown. In addition, the circadian disruption caused by shiftwork may further impact workers’ cardiometabolic health and cognitive performance. This protocol paper outlines the methodology for exploring the impact of simultaneous exposure to prolonged sitting, sleep restriction and circadian disruption on cardiometabolic and cognitive performance outcomes.

Methods and analysis

This between-subjects study will recruit 208 males and females to complete a 7-day in-laboratory experimental protocol (1 Adaptation Day, 5 Experimental Days and 1 Recovery Day). Participants will be allocated to one of eight conditions that include all possible combinations of the following: dayshift or nightshift, sitting or breaking up sitting and 5 hour or 9 hour sleep opportunity. On arrival to the laboratory, participants will be provided with a 9 hour baseline sleep opportunity (22:00 to 07:00) and complete five simulated work shifts (09:00 to 17:30 in the dayshift condition and 22:00 to 06:30 in the nightshift condition) followed by a 9 hour recovery sleep opportunity (22:00 to 07:00). During the work shifts participants in the sitting condition will remain seated, while participants in the breaking up sitting condition will complete 3-min bouts of light-intensity walking every 30 mins on a motorised treadmill. Sleep opportunities will be 9 hour or 5 hour. Primary outcome measures include continuously measured interstitial blood glucose, heart rate and blood pressure, and a cognitive performance and self-perceived capacity testing battery completed five times per shift. Analyses will be conducted using linear mixed models.

Ethics and dissemination

The CQUniversity Human Ethics Committee has approved this study (0000021914). All participants who have already completed the protocol have provided informed consent. Study findings will be disseminated via scientific publications and conference presentations.

Trial registration details

This study has been registered on Australian New Zealand Clinical Trials Registry (12619001516178) and is currently in the pre-results stage.
Characteristics of family meetings for patients with advanced disease in an Australian metropolitan tertiary hospital
Authors: Wang Amy , Thomas Kristina , Weil Jennifer , Hudson Peter
Published: July 2020

Objectives

Family meetings (FMs) between clinicians, patients and family are recommended as a valuable communication and care planning method in the delivery of palliative care. However, there is a dearth of knowledge regarding FM characteristics, with few studies describing the prevalence, circumstances and content of FMs. The aims of this study were to: (1) measure the prevalence of FMs, (2) examine circumstance and timing of FMs, and (3) explore the content of FMs.

Methods

A retrospective medical record audit was conducted of 200 patients who died in an Australian hospital of an expected death from advanced disease. Details of FMs were collected using an audit tool, along with patient demographics and admission data.

Results

33 patients (16.5%) had at least one FM during their inpatient stay. The majority of FMs occurred for patients admitted to an inpatient palliative care unit (59.5%) and were most commonly facilitated by doctors (81.0%). Patient attendance was frequent (40.5%). FM content fell into six categories: medical information, supportive communication behaviours of clinicians, psychosocial support for patients and families, end-of-life discussions, discharge planning and administrative arrangements.

Conclusions

Despite the benefits FMs confer, FMs appear to be infrequently used at the end of life. When FMs are used, there is a strong medical focus on both facilitation and content. Available FM documentation tools also appear to be underused. Clinicians are encouraged to have a greater understanding of FMs to optimise their use and adopt a proactive and structured approach to the conduct and documentation of FMs.
Anti-Mycobacterium paratuberculosis(MAP) therapy for Crohn’s disease: an overview and update
Authors: Honap Sailish , Johnston Emma , Agrawal Gaurav , Al-Hakim Bahij , Hermon-Taylor John , Sanderson Jeremy
Published: July 2020

The role ofMycobacterium aviumsubspeciesparatuberculosis(MAP) in the pathogenesis of Crohn’s disease (CD) has been strongly debated for many years. MAP is the known aetiological agent of Johne’s disease, a chronic enteritis affecting livestock. At present, due to the paucity of high-quality data, anti-MAP therapy (AMT) is not featured in international guidelines as a treatment for CD. Although the much-quoted randomised trial of AMT did not show sustained benefits over placebo, questions have been raised regarding trial design, antibiotic dosing and the formulation used. There are several lines of evidence supporting the CD and MAP association with uncontrolled and controlled trials demonstrating effectiveness, including a retrospective review of cases treated at our own institution. Here, we provide an overview of the evidence supporting and refuting AMT in CD before focussing on updates of the current research in the field, including the ongoing trials with the novel RHB-104 formulation and the MAP vaccine trial. While controversial, gastroenterologists are often asked about long-term combination antibiotic therapy for CD. There has been broadcast and social media coverage surrounding this, particularly with regard to current trials. Although patients should not be deterred from treatments of proven effectiveness, this review aims to help with commonly asked questions and highlights our own approach for the use of anti-MAP in specific circumstances.
Predictors and outcomes of acute respiratory failure in hospitalised patients with acute pancreatitis
Authors: Gajendran Mahesh , Prakash Bharat , Perisetti Abhilash , Umapathy Chandraprakash , Gupta Vineet , Collins Laura , Rawla Prashanth , Loganathan Priyadarshini , Dwivedi Alok , Dodoo Christopher , Unegbu Fortune , Schuller Dan , Goyal Hemant , Saligram Shreyas
Published: July 2020

Background and aim

Acute pancreatitis (AP) is associated with organ failures and systemic complications, most commonly acute respiratory failure (ARF) and acute kidney injury. So far, no studies have analysed the predictors and hospitalisation outcomes, of patients with AP who developed ARF. The aim of this study was to measure the prevalence of ARF in AP and to determine the clinical predictors for ARF and mortality in AP.

Methods

This is a retrospective cohort study using the Nationwide Inpatient Sample database from the year 2005–2014. The study population consisted of all hospitalisations with a primary or secondary discharge diagnosis of AP, which is further stratified based on the presence of ARF. The outcome measures include in-hospital mortality, hospital length of stay and hospitalisation cost.

Results

In our study, about 5.4% of patients with AP had a codiagnosis of ARF, with a mortality rate of 26.5%. The significant predictors for ARF include sepsis, pleural effusion, pneumonia and cardiogenic shock. Key variables that were associated with a higher risk of mortality include mechanical ventilation, age more than 65 years, sepsis and cancer (excluding pancreatic cancer). The presence of ARF increased hospital stay by 8.3 days and hospitalisation charges by US$103 460.

Conclusion

In this study, we demonstrate that ARF is a significant risk factor for increased hospital mortality, greater length of stay and higher hospitalisation charges in patients with AP. This underlines significantly higher resource utilisation in patients with a dual diagnosis of AP-ARF.
ABC score: a new risk score that accurately predicts mortality in acute upper and lower gastrointestinal bleeding: an international multicentre study
Authors: Laursen Stig Borbjerg , Oakland Kathryn , Laine Loren , Bieber Vered , Marmo Riccardo , Redondo-Cerezo Eduardo , Dalton Harry R , Ngu Jeffrey , Schultz Michael , Soncini Marco , Gralnek Ian , Jairath Vipul , Murray Iain A , Stanley Adrian J
Published: July 2020

Objectives

Existing scores are not accurate at predicting mortality in upper (UGIB) and lower (LGIB) gastrointestinal bleeding. We aimed to develop and validate a new pre-endoscopy score for predicting mortality in both UGIB and LGIB.

Design and setting

International cohort study. Patients presenting to hospital with UGIB at six international centres were used to develop a risk score for predicting mortality using regression analyses. The score’s performance in UGIB and LGIB was externally validated and compared with existing scores using four international datasets. We calculated areas under receiver operating characteristics curves (AUROCs), sensitivities, specificities and outcome among patients classified as low risk and high risk.

Participants and results

We included 3012 UGIB patients in the development cohort, and 4019 UGIB and 2336 LGIB patients in the validation cohorts. Age, Blood tests and Comorbidities (ABC) score was closer associated with mortality in UGIB and LGIB (AUROCs: 0.81–84) than existing scores (AUROCs: 0.65–0.75; p≤0.02). In UGIB, patients with low ABC score (≤3), medium ABC score (4–7) and high ABC score (≥8) had 30-day mortality rates of 1.0%, 7.0% and 25%, respectively. Patients classified low risk using ABC score had lower mortality than those classified low risk with AIMS65 (threshold ≤1) (1.0 vs 4.5%; p<0.001). In LGIB, patients with low, medium and high ABC scores had in-hospital mortality rates of 0.6%, 6.3% and 18%, respectively.

Conclusions

In contrast to previous scores, ABC score has good performance for predicting mortality in both UGIB and LGIB, allowing early identification and targeted management of patients at high or low risk of death.
Hyperkalaemia during general anaesthesia: six cases
Authors: Louro Luís Filipe , Raszplewicz Joanna , Alderson Briony
Published: July 2020

The objective of this case series is to describe the clinical course, treatment and outcome in six dogs following acute hyperkalaemia during general anaesthesia. A total of six dogs were presented for routine surgical and/or imaging procedures requiring general anaesthesia. All patients developed hyperkalaemia (ranging from 7.0 to 8.7 mmol/L, reference interval: 3.4–4.9 mmol/L), and electrocardiographic changes were seen in all but one case. The prognosis for treatment of hyperkalaemia during general anaesthesia appears to be excellent as all dogs fully recovered following treatment. To the authors’ knowledge, this is the first reported case series of hyperkalaemia during general anaesthesia in dogs. Our objective is to provide further information regarding possible causes for the development of hyperkalaemia in dogs under general anaesthesia.
Effects of electrokinetic phenomena on the load-bearing capacity of different steel and concrete piles: a small-scale experimental study
Authors: Sadeghian Fatemeh , Haddad Abdolhosein , Jahandari Soheil , Rasekh Haleh , Ozbakkaloglu Togay
Published: July 2020

To date, the electrokinetic (EK) method has only been used to increase the bearing capacity of steel piles. This study analysed the impact of EK on the bearing capacity of reinforced cement concrete piles (RCCP), reinforced lime-cement concrete piles (RLCCP), and steel piles located in kaolin clay. The performance of four different cathodes was also evaluated, and the iron electrode was found to be the most effective cathode for use in the EK process. Unlike RLCCP, the bearing capacity of 7 day cured RCCP with 5 day EK decreased due to corrosion in the pile body. However, the addition of lime to RCCP significantly increased the pile bearing capacity by 57.8% with 8 day EK and prevented damage and corrosion in the pile body. It is concluded that EK can effectively increase the bearing capacity of both metallic and even concrete piles.
The role of excess oxygen for modeling high-Mn, low-Ca garnets in metapelites from the northern Central Metasedimentary Belt of the Grenville Province, Ontario, Canada
Authors: Duesterhoeft Erik , Raase Peter , Duguet Manuel , Easton Robert Michael
Published: July 2020

The Bancroft terrane and the associated Central Metasedimentary Belt boundary thrust zone represent the northern part of the Central Metasedimentary Belt (CMB) of the Canadian Grenville Province. Only a few direct pressure and temperature calculations based on phase equilibrium petrology methods exist in the central Bancroft terrane, and this study applies thermodynamic approaches such as garnet isopleth geothermobarometry to fill this gap and investigate the metamorphic history of the northern CMB. Four metapelitic rock samples were collected in the vicinity of the enigmatic Bancroft shear zone, which approximates the border between the Bancroft terrane and the Elzevir terrane to the south. Garnet isopleths for these samples only intersect if a certain amount of excess oxygen is added to the bulk rock composition corresponding to a Fe3+/Fetot ratio of 0.33–0.38. The northernmost sample records metamorphic peak conditions of approximately 1 GPa and 780 °C, whereas the southernmost sample, which is located in the Elzevir terrane, records a peak metamorphic pressure of approximately 0.9 GPa at a temperature of 520 °C. The latter result contradicts previous pressure estimates of the region and the proposed metamorphic field gradient but is based on a poorly constrained sample in terms of thermodynamic modeling. Hence, we conclude that the metamorphic field gradient in the northern CMB conceals two different P–T trajectories. Such a scenario is commonly observed in crustal thickening models and suggests that the cold upper plate (Elzevir terrane) was thrust over the warm lower plate (Bancroft terrane) in a northwesterly direction.
Antifibrotic effects of bezafibrate and pioglitazone against thioacetamide-induced liver fibrosis in albino rats
Authors: Ibrahim Salwa A. , Mohamed Mervat Z. , El-Tahawy Nashwa F. , Abdelrahman Aly M.
Published: July 2020

Activation of hepatic stellate cells is a central event in hepatic fibrogenesis that offers multiple potential sites for therapeutic interventions. Peroxisome proliferator-activated receptors are implicated in liver fibrosis. We aimed to evaluate the effect of bezafibrate and pioglitazone on a thioacetamide (TAA) rat model of liver fibrosis and to clarify the possible underlying mechanisms. Rats received intraperitoneal injections of TAA for 6 weeks. Daily oral treatments with bezafibrate or pioglitazone were started with the first day of TAA intoxication. Serum liver function tests, hepatic malondialdehyde (MDA), total nitrite and nitrate (NOx), superoxide dismutase, and hepatic histopathology were assessed to evaluate hepatic damage. Alpha smooth muscle actin (α-SMA) and tissue inhibitor metalloproteinase-1 (TIMP-1) and caspase-3 were also assessed. The TAA group experienced significant deterioration of liver functions, increased oxidative stress, and increased liver tissue NOx. Administration of bezafibrate or pioglitazone resulted in significant improvement of all liver functions and reduced oxidative stress in hepatic tissues. Only administration of bezafibrate significantly reduced NOx levels. Liver tissues from the TAA-treated group showed disrupted normal architecture. Administration of bezafibrate or pioglitazone attenuated this picture. Stronger α-SMA expression was detected in the TAA group. Treatment with bezafibrate or pioglitazone decreased the α-SMA expression.
Erratum to: Electromagnetic dipole moments of charged baryons with bent crystals at the LHC
Authors: Bagli E. , Bandiera L. , Cavoto G. , Guidi V. , Henry L. , Marangotto D. , Vidal F. Martinez , Mazzolari A. , Merli A. , Neri N. , Vidal J. Ruiz , Sytov A. , Tikhomirov V.
Published: July 2020

In this Erratum, an improved simulation of the channeling efficiency of protons and antiprotons as a function of the particle momentum is shown in for different configurations