bluuebunny/crossref_metadata_2025 huggingface dataset:
Bullous pemphigoid associated with dipeptidyl peptidase‐4 inhibitors. A case series and analysis of cases reported in the Spanish pharmacovigilance database
Authors: Reolid Alejandra , Muñoz‐Aceituno Ester , Rodríguez‐Jiménez Pedro , González‐Rojano Esperanza , Llamas‐Velasco Mar , Fraga Javier , Daudén Esteban
Published: October 2019

Background

Bullous pemphigoid (BP) has been associated with dipeptidyl peptidase‐4 inhibitors (DPP4i). Clinical features, outcomes, and risk of BP for new DPP4i (linagliptin, saxagliptin, and alopgliptin) are not well established. Comparison of risk of BP appearance for DPP4i and other oral antidiabetic drugs (OADs) such as sodium glucose cotransporter 2 inhibitors has not been studied to date.

Objectives

To describe the prevalence, sociodemographic, clinical, and histopathological characteristics, and outcome after drug withdrawal in DPP‐4i‐associated BP cases from our hospital. To review all Spanish spontaneous notifications of BP where DPP4i or OADs were included as suspected drugs and calculate the reporting odds ratios (RORs).

Methods

A retrospective observational study was performed examining the association between DDP4i and BP. Clinical features and RORs were analyzed. Data from the Spanish Pharmacovigilance System (SEFV) are included.

Results

In our center, 28 of 89 patients with BP (31.5%) were under DPP4i treatment; 53.6% were male, and mean age was 80.8 years. BP debuted the first year after DPP4i in 57.2%. BP control was achieved within 3.7 months after drug withdrawal. Regarding SEFV, 22 of 972 spontaneous notifications were related to BP and DPP4i. RORs were superior for DPP4i compared to other OADs. Vildagliptin had the highest ROR.

Conclusions

We present the largest DPP4i‐induced BP case series in a single center, with a detailed study of the sociodemographic, clinical, and histopathological characteristics of each patient, and their treatment and outcome. Vildagliptin had the highest risk. DPP4i‐associated BP does not seem to have specific clinical characteristics.
Thermal processing of rice grains affects the physical properties of their pregelatinised rice flours
Authors: Ma Mengting , He Meng , Xu Yijuan , Li Peng , Li Zijun , Sui Zhongquan , Corke Harold
Published: October 2019

Waxy, low‐ and high‐amylose rice were cooked at different temperatures (50, 70, 90 °C) for different times (15, 30, 45 min). The microscopic, rheological and gel textural properties of resultant flours were investigated. There was a coarser and discontinuous honeycomb‐like structure with formation of pores in rice flour with greater cooking degree. TGʹmax was positively correlated with cooking temperature and time. As cooking temperature increased, the Gʹ values of pastes first increased and then decreased, whereas the opposite trend was observed for tan δ. Meanwhile, increased cooking temperature was responsible for increases in n values and caused drops in K and hysteresis area. As cooking time increased, the hardness and gumminess of gels from rice cooked were increased at lower temperature, but were decreased at higher temperature. Overall, cooking temperature was more important in determining the processing properties of rice flours than cooking time.
Enhanced electromagnetic wave absorption of Fe‐doped silicon oxycarbide nanocomposites
Authors: Du Bin , Qian Junjie , Hu Ping , He Chao , Cai Mei , Wang Xuan , Shui Anze
Published: October 2019

Polymer‐derived ceramics (PDCs), such as SiOC, SiCN, SiBCN, and SiC are considered the best candidates for designing high‐performance microwave absorber due to their controllable structure, homogeneous element composition at atom level, tunable electromagnetic and electrochemical properties. Herein, Fe ions doped silicon oxycarbide (Fe ions‐SiOC) ceramics have been successfully fabricated via solvothermal method. The electromagnetic absorption performances of the nanocomposites prove to be controllable via tailoring Fe ion contents. The Fe ions effectively enhance both the interfacial polarization of amorphous SiOC, and the dielectric properties of the nanocomposites but barely effect magnetic properties of the nanocomposite. As for 0.16 mol/L‐SiOC ceramics annealed at 1450°C, the effective absorption bandwidth as high as 2.00 GHz and reflection loss of −59.60 dB at 5.40 GHz with the thickness of 4.55 mm are obtained. Such work opens up a novel and simple route to scale up the PDC‐based materials with broadband and excellent microwave absorbing performances.
Identification of insulin gene variants in patients with neonatal diabetes in the Chinese population
Authors: Fu Junling , Wang Tong , Li Mingmin , Xiao Xinhua
Published: October 2019

Aims/Introduction

Neonatal diabetes mellitus is created by alterations in the genes responsible for beta‐cell mass and/or function. The present study aimed to evaluate the genetic variants in the insulin gene (INS) in four Chinese infants aged <12 months with diabetes onset, and to explore the clinical and genetic characteristics of permanent neonatal diabetes mellitus caused by INS mutations.

Materials and Methods

The complete coding sequences of KCNJ11, ABCC8 and INS were detected using Sanger sequencing. The pathogenicity of the mutations was determined based on the American College of Medical Genetics and Genomics, and the structure of wild‐type and mutant proteins was predicted using the web‐based tool, Phyre2.

Results

One novel mutation (p.I99_C100insSI) and three previously reported variants (p.G32S, p.R89C and p.C96R) in INS were identified in four infants with early‐onset diabetes. All the mutations in the four patients were de novo. Except for mutation R89C, which causes permanent neonatal diabetes mellitus through the addition of an additional cysteine residue at the cleavage site of the A chain and C‐peptide, the other three mutations affected disulfide bonds. The patients had diabetes with marked hyperglycemia or diabetic ketoacidosis, and were then treated with exogenous insulin. Mutations in crucial regions of the INS might give rise to diabetes with varying severity.

Conclusions

This study enriches our awareness of the mutant spectrum in INS, and suggests the important role of INS in the development of permanent neonatal diabetes mellitus.
Associations of anemia and hemoglobin with hemoglobin A1c among non‐diabetic workers in Japan
Authors: Sakamoto Nobuaki , Hu Huanhuan , Nanri Akiko , Mizoue Tetsuya , Eguchi Masafumi , Kochi Takeshi , Nakagawa Tohru , Honda Toru , Yamamoto Shuichiro , Ogasawara Takayuki , Sasaki Naoko , Nishihara Akiko , Imai Teppei , Miyamoto Toshiaki , Yamamoto Makoto , Okazaki Hiroko , Tomita Kentaro , Uehara Akihiko , Hori Ai , Shimizu Makiko , Murakami Taizo , Kuwahara Keisuke , Fukunaga Ami , Kabe Isamu , Sone Tomofumi , Dohi Seitaro
Published: October 2019

Aims/Introduction

We examined the association between hemoglobin A1c (HbA1c) and anemia, which was categorized into three groups according to mean corpuscular volume (MCV), as well as the association between hemoglobin in the non‐anemic range and HbA1c.

Materials and Methods

We used the 2016 health checkup data from 36,422 workers without diabetes. Anemic people were divided into three groups based on MCV: <80, 80–90 and >90 fL. Non‐anemic people were divided into four groups based on their hemoglobin levels. We carried out multiple linear regression models to estimate the means and 95% confidence intervals (CIs) of HbA1c.

Results

For men, 0.2% had anemia with MCV <80 fL, 0.5% had anemia with MCV 80–90 fL, 0.9% had anemia with MCV >90 fL and 98.4% had no anemia. For women, the corresponding values were 6.1, 6.4, 2.8 and 84.7%, respectively. The adjusted mean HbA1c (%) values for men with anemia with MCV <80, 80–90 and >90 fL were 5.67 (95% CI 5.60–5.74), 5.58 (95% CI 5.54–5.62) and 5.41 (95% CI 5.37–5.44), respectively. Among men without anemia, HbA1c (%) increased from 5.36 (95% CI 5.34–5.39) in those with hemoglobin ≥17.5 mg/dL to 5.45 (95% CI 5.45–5.46) in those with hemoglobin 13.0 to <14.5 mg/dL (P for trend <0.001). The HbA1c values were higher in men with anemia with MCV <80 fL or MCV 80–90 fL, but lower in men with MCV >90 fL, compared with non‐anemic men with hemoglobin 13.0 to <14.5 mg/dL (All P < 0.001). Similar findings were observed in women.

Conclusions

We observed elevated HbA1c among anemic people with MCV <80 fL or MCV 80–90 fL, and decreased HbA1c among anemic people with MCV >90 fL, suggesting that different types of anemia might influence HbA1c differently. In addition, non‐anemic people with lower hemoglobin levels had higher HbA1c levels, suggesting that hemoglobin levels are in need of consideration when interpreting HbA1c values among non‐anemic people.
Self‐esteem change during the transition from university to work
Authors: Reitz Anne K. , Shrout Patrick E. , Denissen Jaap J. A. , Dufner Michael , Bolger Niall
Published: October 2019

Objective

The current study examined whether the transition from university to work, a major developmental milestone in young adulthood, was related to stability and change in self‐esteem.

Method

Self‐esteem was assessed in the last year of their master's program (T1) of 163 27‐year old students and 14 months later, when they had graduated and half of them had started a full‐time job (T2). Daily diaries were used to assess the occurrence of achievement‐ and affiliation‐related experiences on 14 consecutive days at T1 and T2. We compared the full‐time job beginners and a comparison group without a full‐time job with regard to their mean‐level change, rank‐order stability and correlated change of self‐esteem and daily experiences.

Results

First, job beginners increased in self‐esteem, but the difference to the mean‐level change of the comparison group was only small. Second, self‐esteem was less stable among job beginners than among the comparison group. Third, the changes in achievement‐related daily experiences and self‐esteem correlated positively in the job‐beginner group but not in the comparison group.

Conclusions

The findings underline the role of daily experiences during life transitions for individual differences in self‐esteem change. The discussion calls for accounting for unique transition experiences to advance theory and research on self‐esteem development.
Insights into the genetic architecture of sexual dimorphism from an interspecific cross between two diverging Silene (Caryophyllaceae) species
Authors: Baena‐Díaz Fernanda , Zemp Niklaus , Widmer Alex
Published: October 2019

The evolution of sexual dimorphism in species with separate sexes is influenced by the resolution of sexual conflicts creating sex differences through genetic linkage or sex‐biased expression. Plants with different degrees of sexual dimorphism are thus ideal to study the genetic basis of sexual dimorphism. In this study we explore the genetic architecture of sexual dimorphism between Silene latifolia and Silene dioica. These species have chromosomal sex determination and differ in the extent of sexual dimorphism. To test whether QTL for sexually dimorphic traits have accumulated on the sex chromosomes and to quantify their contribution to species differences, we create a linkage map and performed QTL analysis of life history, flower and vegetative traits using an unidirectional interspecific F2 hybrid cross. We found support for an accumulation of QTL on the sex chromosomes and that sex differences explained a large proportion of the variance between species, suggesting that both natural and sexual selection contributed to species divergence. Sexually dimorphic traits that also differed between species displayed transgressive segregation. We observed a reversal in sexual dimorphism in the F2 population, where males tended to be larger than females, indicating that sexual dimorphism is constrained within populations but not in recombinant hybrids. This study contributes to the understanding of the genetic basis of sexual dimorphism and its evolution in Silene.
Cross‐cultural Adaptation and Psychometric Properties of the Greek Version of the Central Sensitization Inventory
Authors: Bilika Paraskevi , Neblett Randy , Georgoudis George , Dimitriadis Zacharias , Fandridis Emmanouil , Strimpakos Nikolaos , Kapreli Eleni
Published: October 2019

Objectives

Recent studies support the opinion that central sensitization (CS) plays an important role in the pathophysiology of many chronic pain conditions. CS refers to hyperexcitability of the central nervous system, which can result in pain hypersensitivity and other somatosensory symptoms. Recognition of CS‐related symptomology is crucial in chronic pain evaluation and rehabilitation. The Central Sensitization Inventory (CSI) was created to evaluate symptoms that have been found to be associated with CS. The aim of the current study was the cross‐cultural adaptation of the CSI into Greek (CSI‐Gr).

Methods

To evaluate discriminate validity, 200 patients with chronic pain and 50 healthy control subjects participated. The sample was divided into 4 diagnostic groups (fibromyalgia, single pain complaints, multiple pain complaints, and a control group) and into 5 CSI severity subgroups, from subclinical to extreme. Convergent validity was determined by evaluation of the relationship between the CSI‐Gr and the Pain Catastrophizing Scale (PCS). Additionally, 30 patients completed the CSI a second time for the purpose of a test/retest analysis.

Results

The results showed high internal consistency (Cronbach's alpha = 0.994) and test‐retest reliability (intraclass correlation coefficient = 0.993). The standard error of measurement was 2.1. The CSI‐Gr correlated moderately with the PCS (r = 0.68). Statistically significant differences were found among the 3 comparison groups, with patients who had fibromyalgia reporting the highest CSI severity and healthy control subjects reporting the lowest severity.

Conclusions

As determined in the present study, the CSI‐Gr was found to be a reliable and valid tool for recognition of CS‐related symptomology.
Use of pediatric donor en bloc kidneys along with bladder segment in pediatric liver‐kidney and multivisceral‐kidney transplantation
Authors: Kunzler de Oliveira Maia Filipe , Tekin Akin , Nicolau‐Raducu Ramona , Beduschi Thiago , Selvaggi Gennaro , Vianna Rodrigo , Ammar Al Nuss Mohamad , González Javier , Gaynor Jeffrey J. , Ciancio Gaetano
Published: October 2019

The combination of pediatric multivisceral and kidney transplantation leads to additional recipient risks due to the number of anastomoses and to the small sizes of donor structures. The inclusion of donor kidneys, ureters, and a bladder patch en bloc with multivisceral organs decreases the number and complexity of anastomoses and has not yet been reported. Four patients were transplanted in this fashion; three underwent multivisceral‐kidney and one underwent liver‐kidney transplantation. The first patient was a 3‐year‐old male with polycystic kidney disease and congenital hepatic fibrosis. The second was a 7‐year‐old female with complications from necrotizing enterocolitis. The third was a 12‐month‐old male with megacystis microcolon intestinal hypoperistalsis syndrome and secondary hydronephrosis, and the fourth was a 3‐year‐old male with multiple intestinal resections secondary to incarcerated hernia. The third patient developed a right ureteral stenosis with an intact bladder patch. The fourth child expired from maintained abdominal sepsis. The first 3 patients maintained normal graft function. There were no cases of thrombosis, arterial stenosis, or urinary leakages. These reported cases demonstrate that small pediatric en bloc transplantation of the multivisceral organs and dual kidneys with a bladder patch anastomosis is a feasible and less complex alternative to the standard procedure.
Appointment Scheduling for a Health Care Facility with Series Patients
Authors: Yu Siyun , Kulkarni Vidyadhar G. , Deshpande Vinayak
Published: October 2019

This study focuses on determining the appointment scheduling for healthcare facilities with series patients. “Series” patients are patients who are scheduled for a series of appointments instead of a single appointment. Examples of healthcare services with series patients include radiotherapy/chemotherapy for cancer, physical therapy, kidney dialysis, diabetes treatment, etc. The aim of this study is to design appointment scheduling policies taking into account revenues per service per patient, costs of staffing, overtime, overbooking and delay. The appointment scheduling problem is formulated using an MDP model. However, due to the huge state space, computing the optimal policy is impractical. Hence, we propose the Index Policy (IP) based on a one‐step policy improvement algorithm applied to the MDP model. We study a further simplification obtained by approximating the distribution of the number of patient visits by a Geometric distribution. A key analytical contribution is to prove the MDP to be a uni‐chain, which implies that there exists an optimal policy that maximizes the long‐run average profit. We also find that the IP provides a significant improvement over the other policies. Especially with the Geometric approximation, the IP requires minimal effort in implementing, and works almost as well. To test the effectiveness of our proposed IP in a real‐world setting, we use the data from a local physical therapy center to compare its performance with two other commonly used policies, namely, the Next Available Day Policy and the Shortest Queue Policy. We recommend the IP with Geometric approximation for series patients’ scheduling, which is computationally efficient and can significantly increases profits by incorporating the series feature of the patients’ appointments. Finally, we provide analysis that incorporates several practical considerations such as accounting for patient heterogeneity in number of visits and inter‐visit times, the option to reject new patients when the system is at full capacity, and incorporating patients with known number of visits at the time of the scheduling decision.
Physical capacity, not skeletal maturity, distinguishes competitive levels in male Norwegian U14 soccer players
Authors: Grendstad Halvard , Nilsen Ann‐Kristin , Rygh Cecilie Brekke , Hafstad Arild , Kristoffersen Morten , Iversen Vegard Vereide , Nybakken Tone , Vestbøstad Mona , Algrøy Erling André , Sandbakk Øyvind , Gundersen Hilde
Published: October 2019

The main aim of the present study was to compare skeletal maturity level and physical capacities between male Norwegian soccer players playing at elite, sub‐elite and non‐elite level. Secondary, we aimed to investigate the association between skeletal maturity level and physical capacities. One hundred and two U14 soccer players (12.8‐14.5 years old) recruited from four local clubs, and a regional team were tested for bone age and physical capacities. Bone age was estimated with x‐ray of their left hand and used to indicate maturation of the skeleton. Players went through a comprehensive test battery to assess their physical capacities. Between‐groups analysis revealed no difference in chronological age, skeletal maturity level, leg strength, body weight, or stature. However, elite players were superior to sub‐elite and non‐elite players on important functional characteristics as intermittent‐endurance capacity (running distance: 1664 m ± 367 vs 1197 m ± 338 vs 693 m ± 235) and running speed (fastest 10 m split time: 1.27 seconds ± 0.06 vs 1.33 seconds ± 0.10 vs 1.39 seconds ± 0.11), in addition to maximal oxygen uptake (), standing long jump, and upper body strength (P < .05 for all comparisons). Medium‐to‐large correlations were found between skeletal maturity level and peak force (r = 695, P < .01), power (r = 684, P < .01), sprint (r = −.471, P<.001), and jump performance (r = .359, P < .01), but no correlation with upper body strength, , or intermittent‐endurance capacity. These findings imply that skeletal maturity level does not bias the selection of players, although well‐developed physical capacity clearly distinguishes competitive levels. The superior physical performance of the highest‐ranked players seems related to an appropriate training environment.
Does localized iron loss in venous disease lead to systemic iron deficiency? A descriptive pilot study
Authors: Ferris Amy E. , Harding Keith G.
Published: October 2019

Haemosiderin deposition in the legs of patients with venous leg ulcers is well established, and several theories suggest this stored iron has a role in disease pathophysiology. In this novel pilot study of patients with chronic venous leg ulcers, we aimed to establish the relationship between wound fluid iron levels, serum iron parameters and healing. Fifteen patients with venous ulcers were included in the study. Blood samples were taken for full blood count and iron studies, while simultaneously wound fluid was obtained from the wound surface using filter paper. Wound areas were measured at initial and 4 week (+/− 2 day) follow‐up visits. We found a positive correlation between wound fluid and serum iron (correlation co‐efficient 0.27) and those with the lowest wound fluid iron level were also anemic. No association was found between initial wound area and wound fluid iron level but the largest wound areas were found in patients with anemia. Only 38% of patients demonstrated a reduction in wound area during the 4 week study, and 80% of those were not anemic or iron deficient. Conversely in those patients whose wounds did not reduce in size 88% were anemic or iron deficient. These findings demonstrate a previously unrecognized phenomenon of systemic iron store depletion secondary to leaching out of the body in wound exudate. In addition, these results suggest a high prevalence of anemia in patients with chronic venous ulcers, though whether this is cause or effect requires further research. Our findings also suggest that patients with venous ulcers have a high prevalence of iron deficiency and anemia, which appears to be often undiagnosed, and that diagnostic criteria for iron deficiency in patients with chronic wounds need to be revised to reflect the effect of chronic inflammation on iron metabolism.
Postnatal intermittent hypoxia enhances phrenic and reduces vagal upper airway motor activities in rats by epigenetic mechanisms
Authors: Bittencourt‐Silva Paloma G. , Menezes Miguel Furtado , Mendonça‐Junior Bolival A. , Karlen‐Amarante Marlusa , Zoccal Daniel B.
Published: October 2019

New Findings

What is the central question of this study?

What are the alterations in respiratory motor activity that may underlie ventilatory dysfunctions in juvenile and adult animals exposed to postnatal chronic intermittent hypoxia?

What is the main finding and its importance?

Postnatal chronic intermittent hypoxia modifies the motor activity to pumping and upper airway respiratory muscles in rats, mediated by epigenetic DNA hypermethylation, enhancing resting pulmonary ventilation and predisposing to collapse of the upper airways in juvenile and adult life.

Periods of apnoea, commonly observed in prematures and newborns, are an important risk factor for the development of cardiorespiratory diseases in adulthood. In the present study, we evaluated changes in pulmonary ventilation and respiratory motor pattern in juvenile and adult rats exposed to postnatal chronic intermittent hypoxia (pCIH). Newborn male Holtzman rats (P1) were submitted to pCIH (6% O2 for 30 s, every 9 min, 8 h a day (09.30–17.30 h)) during their first 10 days of life, while control animals were maintained under normoxic conditions (20.8% O2). Thereafter, animals of both groups were maintained under normoxia until the experiments. Unanaesthetized juvenile pCIH rats (n = 27) exhibited elevated tidal volume and respiratory irregularities (P < 0.05) compared to control rats (n = 7). Decerebrate, arterially perfused in situ preparations of juvenile pCIH rats (n = 11) displayed augmented phrenic nerve (PN) burst amplitude and reduced central vagus nerve activity in comparison to controls (n = 10). At adulthood, pCIH rats (n = 5) showed enhanced tidal volume (P < 0.05) and increased respiratory variability compared to the control group (n = 5). The pCIH‐induced changes in ventilation and respiratory motor outputs were prevented by treatment with the DNA methyltransferase inhibitor decitabine (1 mg kg−1, i.p.) during the exposure to pCIH. Our data demonstrate that pCIH in rats impacts, in a persistent way, control of the respiratory pattern, increasing PN activity to the diaphragm and reducing the vagal‐related activity to laryngeal muscles, which, respectively, may contribute to improve resting pulmonary ventilation and predispose to collapse of the upper airways during quiet breathing.
Perspectives of health professionals towards deprescribing practice in Asian nursing homes: a qualitative interview study
Authors: Kua Chong-Han , Mak Vivienne SL , Lee Shaun Wen Huey
Published: October 2019

Objective

To examine the determinants of deprescribing among health professionals in nursing homes, focusing on knowledge, practice and attitude.

Design

This was a qualitative study comprising semi-structured face-to-face interviews guided by 10 open-ended questions. Interviews were conducted until data saturation was achieved and no new ideas were formed. The interviews were audio-recorded, transcribed verbatim and analysed for themes. To derive themes, we employed directed content analysis of transcript data. Coding was completed using a combination of open, axial and selective coding.

Setting

Four nursing homes in Singapore.

Participants

The study involved 17 participants (comprising 4 doctors, 4 pharmacists and 9 nurses).

Results

Two key themes were identified, enablers and challenges. These were enablers and challenges faced by doctors, pharmacists and nurses towards deprescribing. The identified subthemes for enablers of deprescribing were: (1) awareness of medications that are unnecessary or could be targeted for deprescribing; (2) improving quality of life for patients with limited life expectancy; (3) improving communication between doctors, pharmacists and nurses; (4) systematic deprescribing practice and educational tools and (5) acknowledgement of possible benefits of deprescribing. The identified subthemes for challenges of deprescribing were: (1) symptoms not acknowledged as possibly drug-related; (2) lack of knowledge in patient’s and family members’ preferences; (3) lack of coordination between health professionals in hospitals and nursing homes and (4) limited tools for deprescribing. The development of a local guideline, mentoring nurses, case discussions, better shared decision-making and improving multidisciplinary communication, may help to support the process of deprescribing.

Conclusion

In conclusion, this study highlighted that deprescribing in the nursing homes is perceived by health professionals to be challenging and future research could assess how routine case studies, mentoring and better multidisciplinary communication could improve deprescribing knowledge and process in the nursing homes.
Which orthopaedic trauma patients are likely to refuse to participate in a clinical trial? A latent class analysis
Authors: O’Hara Nathan N , Degani Yasmin , Marvel Debra , Wells David , Mullins C Daniel , Wegener Stephen , Frey Katherine , Joseph Tara , Hurst Jonathan , Castillo Renan , O’Toole Robert V
Published: October 2019

Objective

The study aimed to assess systematic differences in the characteristics of patients that consented for the trial compared with the broader pool of eligible patients in a large, pragmatic orthopaedic trauma trial.

Design

A retrospective observational study performed from April 2017 to March 2018.

Setting

Academic trauma centre in Baltimore, USA.

Participants

There were 642 eligible adult trial participants with an operative fracture to the appendicular skeleton and were indicated for blood clot prophylaxis. The median age of the sample was 50 years (IQR: 31–63), and 60% were male.

Primary outcome measure

The primary outcome was the refusal to enrol in the trial. Demographic and injury covariates were included in iterations of latent class models. The final model was selected based on a minimum Bayesian information criterion.

Results

The final model identified three clusters with five covariates predictive of cluster membership (age, neighbourhood-based socioeconomic status, alcohol use, multiple fractures, multiple surgeries). The three clusters were associated with 22% (Cluster 1), 38% (Cluster 2) and 62% (Cluster 3) refusal rates, respectively. Members of Cluster 3 (n=84) were most commonly between 66 and 80 years of age (49% vs 6% (Cluster 1) and 21% (Cluster 2)), of high neighbourhood-based socioeconomic status (85% vs 63% (Cluster 1) and 8% (Cluster 2)), with isolated fractures (100% vs 80% (Cluster 1) and 92% (Cluster 2)), and were less likely to have multiple surgeries compared with the other clusters (28% vs 47% (Cluster 1) and 35% (Cluster 2)).

Conclusion

In this study, the likelihood of refusing to participate in the trial ranged from 22% to 62% in the three identified clusters. Elderly age, high socioeconomic status, and less severe injuries defined the cluster that was most likely to refuse trial participation.

Trial registration number

NCT02984384.
Neutrino masses in an $$SU(4)\otimes U(1)$$-electroweak model with a scalar decuplet
Authors: Ky N. Anh , Hong Van N. T. , Dinh D. Nguyen , Quang Van P.
Published: October 2019

A neutrino mass model is suggested within an $$SU(4)\otimes U(1)$$SU(4)⊗U(1)-electroweak theory. The smallness of neutrino masses can be guaranteed by a seesaw mechanism realized through Yukawa couplings to a scalar SU(4)-decuplet. In this scheme the light active neutrinos are accompanied by heavy neutrinos, which may have masses at different scales, including those within eV–MeV scales investigated quite intensively in both particle physics and astrophysics/cosmology. The flavour neutrinos are superpositions of light neutrinos and a small fraction of heavy neutrinos with the mixing to be determined by the model’s parameters (Yukawa coupling coefficients or symmetry breaking scales). The distribution shape of the Yukawa couplings can be visualized via a model-independent distribution of the neutrino mass matrix elements derived by using the current experimental data. The absolute values of these Yukawa couplings are able to be determined if the symmetry breaking scales are known, and vice versa. With reference to several current and near future experiments, detectable bounds of these heavy neutrinos at different mass scales are discussed and estimated.
“Fragment of What Will Happen”
Authors: Brouwer Rein
Published: October 2019

The Swedish poet Tomas Tranströmer (1931–2015), winner of the 2011 Nobel Prize in Literature, is known for the perceptive metaphors in his poems “couched in deceptively spare language, crystalline descriptions of natural beauty and explorations of the mysteries of identity and creativity.” Although Tranströmer himself never made a secret of the religious tendency in his work, there is some discussion about the importance of the religious dimension in his poems, which are widely acclaimed in Sweden, a predominately secular country. This article discusses several discourses exploring the religious dimensions of Tranströmer’s poetry, and presents a new approach for understanding the religious and spiritual aspects of his art based on the work of philosopher of religion John D. Caputo. Caputo’s “hauntology” is claimed to be conducive in reading Tranströmer’s poetry as a religious text. A “hauntological” reading of the poetry of Tranströmer interprets the event that is haunting the poems, and suggests a new way of conceiving a religious insight in a work of modern art.
Elio Aristide nella scuola tardoantica: commentari e trattati di retorica
Authors: Miletti Lorenzo
Published: October 2019

The article offers an overview of the testimonies about Aelius Aristides’ reception in the didactic context of the late antique schools of rhetoric. After analysing the major issues relating Aristides’ presence in the rhetorical treatises (Hermogenes, Menander rhetor, the ps.-Aristidean ars), the paper focuses in particular on the (lost) commentaries to his mostly widespread works, namely the Panathenaic and the Platonic orations. From the scholia to these speeches it is possible to obtain some information about how these commentaries were, though the annotations which can be attributed with certainty to specific commentators (Metrophanes, Menander, Athanasius, Sopater, and Zosimus) are scarce. In a last section of the paper, some encomia featuring in Libanius’ epistle 1262 and Synesius’ Dio are discussed as far as they resonate with some remarks on Aristides’ style found in scholia, prolegomena, and in rhetorical treatises.
Design and Validation of a New Programmable Current Source for Electrical Impedance Tomography Applications
Authors: Kumar Ramesh , Kumar Sharvan , Sengupta A.
Published: October 2019

This paper proposed an advanced digital voltage-controlled multi-frequency based constant current source, which is a wide range of loads and high SNR ratio for Electrical Impedance Tomography (EIT) application. In EIT a constant current source is required for injecting a sinusoidal
current pulse to the phantom boundary. The boundary potentials are measured by inserting content current from the phantom boundary according to the variation in frequency and current levels. For studying the wide range of tissue conductivity among different type of subjects (the multi-frequency
scanning) is desired in medical Electrical impedance tomography. The proposed Current source, which shows that the simulation has good performance at multi-frequency range with accuracy and stability. In proteus simulation software, the results show that the proposed circuit presents a more
stable impedance output and the obtained boundary data at multi-frequency for the validation of the obtained data has been shown using suitable image reconstruction algorithm and is found suitable for image reconstruction much easier.
Field investigation on operation parameters and performance of air conditioning system in a subway station
Authors: Li Yuan , Zhang Quan , Wang Jiaqiang , Yue Chang , Che Lunfei , Zhao Jianwei , Wang Yanhua , Duan Fei
Published: October 2019

Ventilation and air conditioning system in subway stations accounts for about 50% of the total energy consumption of the subway stations. The energy consumption ratio of public area to equipment room is about 6.5:3.5. In order to understand the energy saving potential of public areas and equipment rooms, a field measurement for a typical subway station in central China was conducted from 19 to 29 September 2018. The field testing parameters include weather conditions, indoor air temperature and humidity, supply and return air flow rate, chilled water temperature, and flow rate. Meanwhile, some parameters recorded by the system control panel, such as pump frequency, chiller power demand, and energy consumption, were also collected. The paper studied the operating characteristics of the ventilation and air conditioning system and the cooling load pattern of the subway station, focusing on the following three aspects: cooling capacity and power demand of the chiller under different conditions, dynamic cooling capacity of the air handling units, and cooling load characteristics of the equipment rooms. Different operation conditions influence the operation of chiller. It was found that the real power demands under two operation conditions, i.e. minimum and all fresh air modes, are 121 and 77 kW, and the corresponding coefficient of performances are 4.33 and 4.77, respectively. The actual cooling capacity at night is about 80% that of the daytime, and is about 40% of the design value, which indicates that the air handling units operate under partial load. During the testing period, the actual cooling load is about 10–50% of the design load, of which 50–95% is sensible cooling load. These data can help readers understand the overall situation of a typical subway station adequately and provide numerical basis for energy saving optimization of the ventilation and air conditioning system.
Frenchmen in the AIF: French–Australian identities during the First World War
Authors: Georgelin Pauline
Published: October 2019

This article investigates the participation of French-born soldiers in the AIF – Australia’s volunteer army during the First World War. While the AIF counted men from many different ethnic and cultural backgrounds, the experiences of the French-born Diggers is yet to be fully explored. This article analyses the detailed profiles of these men contained in their military files and demonstrates how they are emblematic of the diverse nature of the French community in Australia. French-born residents of Australia were in a unique position, as they were also liable for French military service. This article explores the motivations and implications of their choices. It also draws on French archival sources to provide a transnational perspective, framing the soldiers’ experiences within the broader context of the conflicting demands of the French and Australian governments, and how French identity was expressed from both above and below.
Evaluation of different strain-based damage criteria for predicting the fatigue life of friction stir spot-welded joints under multi-axial loading conditions
Authors: Aghabeigi Mahya , Hassanifard Soran , Hashemi Seyed M
Published: October 2019

In this article, fatigue life of dissimilar friction stir spot welds in Cross-Tension and Lap-Shear specimens is predicted using a number of fatigue damage criteria. The results revealed a relatively good correlation between predicted fatigue crack initiation lives and experimental data. Also, it has been shown that in the whole range of applied load levels, the least discrepancy between predicted fatigue lives and experimental data is related to the Smith–Watson–Topper criterion. Finally, an excellent agreement was found in predicting the location of the crack tips using the Fatemi–Socie criterion in both types of specimens.
The brain and eye: Treating cerebral and retinal ischemia through mitochondrial transfer
Authors: Heyck Matt , Bonsack Brooke , Zhang Henry , Sadanandan Nadia , Cozene Blaise , Kingsbury Chase , Lee Jea-Young , Borlongan Cesar V
Published: October 2019

Stroke remains a devastating disease with limited treatment options, despite our growing understanding of its pathology. While ischemic stroke is traditionally characterized by a blockage of blood flow to the brain, this may coincide with reduced blood circulation to the eye, resulting in retinal ischemia, which may in turn lead to visual impairment. Although effective treatment options for retinal ischemia are similarly scarce, new evidence suggests that deleterious changes to mitochondrial structure and function play a major role in both cerebral and retinal ischemia pathologies. Prior studies establish that astrocytes transfer healthy mitochondria to ischemic neurons following stroke; however, this alone is not enough to significantly mitigate the damage caused by primary and secondary cell death. Thus, stem cell-based regenerative medicine targeting amelioration of ischemia-induced mitochondrial dysfunction via the transfer of functional mitochondria to injured neural cells represents a promising approach to improve stroke outcomes for both cerebral and retinal ischemia. In this review, we evaluate recent laboratory evidence supporting the remedial capabilities of mitochondrial transfer as an innovative stroke treatment. In particular, we examine exogenous stem cell transplants in their potential role as suppliers of healthy mitochondria to neurons, brain endothelial cells, and retinal cells.

Impact statement

Stroke constitutes a global health crisis, yet potent, applicable therapeutic options remain effectively inaccessible for many patients. To this end, stem cell transplants stand as a promising stroke treatment and as an emerging subject of research for cell-based regenerative medicine. This is the first review to synthesize the implications of stem cell-derived mitochondrial transfer in both the brain and the eye. As such, this report carries fresh insight into the commonalities between the two stroke-affected organs. We present the findings of this developing area of research inquiry with the hope that our evaluation may advance the use of stem cell transplants as viable therapeutic alternatives for ischemic stroke and related disorders characterized by mitochondrial dysfunction. Such lab-to-clinic translational advancement has the potential to save and improve the ever increasing millions of lives affected by stroke.
Invasive screening for lower extremity peripheral artery disease: Killing two birds with one stone?
Authors: Celebi Savas , Ozcan Celebi Ozlem , Çetin Serkan , Cetin Elif Hande Ozcan , Diker Erdem , Aydogdu Sinan , Berkalp Berkten , Amasyalı Basri
Published: October 2019

Objectives

There is substantial evidence that the majority of cases of lower extremity peripheral artery disease are undetected. As a result, there is great interest in the detection of lower extremity peripheral artery disease through routine screening. However, routine screening of lower extremity peripheral artery disease is still debated.

Methods

In our cross-sectional study, we included 200 consecutive patients with symptoms suggestive of angina who were undergoing coronary angiography. Irrespective of intermittent claudication, we subsequently performed peripheral angiography to detect lower extremity peripheral artery disease. The predictors of lower extremity peripheral artery disease were analyzed, and the diagnostic utility of these predictors and their combinations were determined. Additionally, the determinants of the amount of radio-opaque material used and peripheral fluoroscopy time were investigated.

Results

The overall prevalence of lower extremity peripheral disease was 16%. Being older than 65 years, having coronary artery disease and smoking history remained significant predictors after adjusting for other well-known parameters. Having the combination of age  ≥65 and smoking was associated with a positive predictive value of 50% (likelihood ratio 5.06), and having all of the predictors was associated with a positive predictive value of 100% (likelihood ratio >1000).

Conclusions

Routine screening for lower extremity peripheral disease patients undergoing coronary angiography may be useful in selected patients.
Populism, globalisation and social media
Authors: Flew Terry , Iosifidis Petros
Published: October 2019

Since the 2010s, we witness the rise of populism and nationalism as part of a reaction against the global policies of the last 30 years in Western liberal democracies and beyond. This article seeks to unpack the rise of populism and nationalism and its relationship to social media. We review the relevant literature relating to the globalization paradigm and assess how it has influenced communication studies. The rise of the globalization theory coincides with key advancements in the post-Cold War world, such as the growth of international trade, the global movement of people, the increase in the number of international laws and forums, economic liberalism, as well as the rise of the internet and global digital communication networks. But while the global era denotes a cosmopolitan vision, economic insecurity, growing inequality in wealth distribution, as well as cultural change and shifts in traditional values and norms have brought about a broader concern that globalization is associated with a shift of power to transnational elites, whose impact upon common people’s life and experiences is not fully acknowledged. Contemporary populism has been associated with nationalism, but also with the active use of social media platforms as alternative communication sites to mainstream media which is seen as having been captured by elite consensus politics. This complicates the relationship between truth and free expression in an age of social media, meaning that we need to account for the role of such platforms in the rise of populism and ‘post-truth’ politics, as well as its scope to advance the goals and strategies of progressive social movements.
Cardiac reinnervation affects cardiorespiratory adaptations to exercise training in individuals with heart transplantation
Authors: Ciolac Emmanuel G , Castro Rafael E , Marçal Isabela R , Bacal Fernando , Bocchi Edimar A , Guimarães Guilherme V
Published: October 2019

Purpose

The purpose of this study was to investigate the hemodynamic and cardiorespiratory adaptations to exercise in individuals with heart transplantation with evidence of cardiac reinnervation (cardiac reinnervation group) versus without evidence of cardiac reinnervation (no cardiac reinnervation group).

Methods

Sedentary individuals with heart transplantation (age = 45.5 ± 2.2 years; time elapsed since surgery = 6.7 ± 0.7 years) were divided into the cardiac reinnervation ( n = 16) and no cardiac reinnervation ( n = 17) groups according to their heart rate response to cardiopulmonary exercise testing. The 24-hour ambulatory blood pressure, carotid-femoral pulse wave velocity, and cardiorespiratory fitness were assessed before and after 12 weeks of a thrice-weekly exercise program (five minutes of warm-up, 30 min of endurance exercise, one set of 10–15 reps in five resistance exercises, and five minutes of cool-down).

Results

The cardiac reinnervation group had reduced ( p < 0.01) 24-hour systolic/diastolic blood pressure (7/9 mm Hg), daytime systolic/diastolic blood pressure (9/10 mm Hg) and nighttime diastolic blood pressure (6 mm Hg) after training. The no cardiac reinnervation group reduced ( p < 0.05) only 24-hour (5 mm Hg), daytime (5 mm Hg) and nighttime (6 mm Hg) diastolic blood pressure after training. Hourly analysis showed that the cardiac reinnervation group reduced systolic/diastolic blood pressure for 10/21 h, while the no cardiac reinnervation group reduced systolic/diastolic blood pressure for only 3/11 h. The cardiac reinnervation group also improved both maximal oxygen consumption (10.8%) and exercise tolerance (13.4%) after training, but the no cardiac reinnervation group improved only exercise tolerance (9.9%). Pulse wave velocity did not change in both groups.

Conclusion

There were greater improvements in ambulatory blood pressure and maximal oxygen consumption in the cardiac reinnervation than the no cardiac reinnervation group. These results suggest that cardiac reinnervation associates with hemodynamic and cardiorespiratory adaptations to exercise training in individuals with heart transplantation.
Ineffective erythropoiesis of TET2 deficiency
Authors: Wojchowski Don M.
Published: October 2019

Studies by Qu et al1 in this issue of Blood provide new mechanistic insight into the ineffective erythropoiesis of TET2 deficiency including selective colony-forming unit–erythroid (CFU-E) hyperproliferation, heightened expression of KIT and AXL, and the rescue by KIT and AXL inhibitors of faltered late stage erythropoiesis.