bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between alcohol consumption/alcohol use disorders and patient complexity: a cross-sectional study
Authors: Sugiyama Yoshifumi , Matsushima Masato , Yoshimoto Hisashi
Published: August 2020

Objectives

The objective was to clarify the relationship between alcohol consumption/alcohol use disorders and patient complexity.

Design

Cross-sectional study.

Setting

A clinic located on a remote island in Okinawa, Japan, providing general outpatient practices and round-the-clock emergency services.

Participants

Patients who lived on the island, visited Tarama Clinic from 1 April 2018 to 30 June 2018, were aged ≥20 years and had decision-making capacity were judged to be eligible for this study.

Main outcome measures

Alcohol consumption/alcohol use disorders as measured by the Alcohol Use Disorders Identification Test (AUDIT) and patient complexity as scored by the Patient Centered Assessment Method (PCAM).

Results

During the 3-month study period, 355 patients (163 women and 192 men) with mean (SD) age of 66.4 (13.6) years were included. Multiple regression analysis of PCAM scores showed that, after adjusting for age, sex, education, occupation, physical activity, smoking, annual medical expenses and number of family members living with the patient, AUDIT scores classified as ‘dependence likely’ were associated with PCAM scores (p value=0.040).

Conclusions

Alcohol consumption and alcohol use disorders classified as dependence likely are associated with patient complexity.
Acupuncture for patients with chronic pruritus: protocol of a systematic review and meta-analysis
Authors: Zhang Leixiao , Deng Yanli , Yao Junpeng , Xiao Xianjun , Yu Siyi , Shi Yunzhou , Zheng Hui , Zheng Qianhua , Zhou SiYuan , Cao Wei , Liu Ying , Hao Pingsheng , Li Ying
Published: August 2020

Introduction

Chronic pruritus (CP) frequently occurs in many skin and systemic diseases, and adversely affects quality of life. This systematic review aims to evaluate treatment effects of acupuncture on CP.

Methods and analysis

An electronic and manual search will be conducted for all acupuncture treatments for CP, from the inception date of predefined database up to 28 February 2020. Databases include PubMed, Embase, Springer, Web of Science, the Cochrane Library, the World Health Organization International Clinical Trial Registration Platform, the Chinese Medicine Database, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the China Science Journal Database and the Wanfang Database. Other sources, including existing systematic reviews, conference proceedings and reference lists of identified publications will also be searched. Additionally, any clinical randomised controlled trials related to acupuncture treatment for CP, regardless of the publication status and language limitations, will be included. Study selection, data extraction and research quality assessments will be conducted independently by two researchers. The primary outcome measures include the Visual Analogue Scale, Urdu 5D-Itch Scale or other validated scales implemented after at least 2 weeks of treatment. Secondary outcomes include the effective rate, Quality of Life Scale (eg, the EQ-5D third level, the Dermatology Life Quality Index, etc.), Pittsburgh Sleep Quality Index, recurrence rate during the follow-up period and adverse events. If possible, meta-analyses will be performed using RevMan V.5.3 statistical software; otherwise, a descriptive analysis or subgroup analysis will be conducted. The results will be presented as the risk ratio of the binary data and the mean difference (MD) or standardised MD of the continuous data.

Ethics and dissemination

This systematic review protocol does not require formal ethical approval because the data are not personalised. It will be published in peer-reviewed journals and presented at international academic conferences.

PROSPERO registration number

CRD42019136727.
Gender and other potential biases in peer review: cross-sectional analysis of 38 250 external peer review reports
Authors: Severin Anna , Martins Joao , Heyard Rachel , Delavy François , Jorstad Anne , Egger Matthias
Published: August 2020

Objectives

To examine whether the gender of applicants and peer reviewers and other factors influence peer review of grant proposals submitted to a national funding agency.

Setting

Swiss National Science Foundation (SNSF).

Design

Cross-sectional analysis of peer review reports submitted from 2009 to 2016 using linear mixed effects regression models adjusted for research topic, applicant’s age, nationality, affiliation and calendar period.

Participants

External peer reviewers.

Primary outcome measure

Overall score on a scale from 1 (worst) to 6 (best).

Results

Analyses included 38 250 reports on 12 294 grant applications from medicine, architecture, biology, chemistry, economics, engineering, geology, history, linguistics, mathematics, physics, psychology and sociology submitted by 26 829 unique peer reviewers. In univariable analysis, male applicants received more favourable evaluation scores than female applicants (+0.18 points; 95% CI 0.14 to 0.23), and male reviewers awarded higher scores than female reviewers (+0.11; 95% CI 0.08 to 0.15). Applicant-nominated reviewers awarded higher scores than reviewers nominated by the SNSF (+0.53; 95% CI 0.50 to 0.56), and reviewers from outside of Switzerland more favourable scores than reviewers affiliated with Swiss institutions (+0.53; 95% CI 0.49 to 0.56). In multivariable analysis, differences between male and female applicants were attenuated (+0.08; 95% CI 0.04 to 0.13) whereas results changed little for source of nomination and affiliation of reviewers. The gender difference increased after September 2011, when new evaluation forms were introduced (p=0.033 from test of interaction).

Conclusions

Peer review of grant applications at SNSF might be prone to biases stemming from different applicant and reviewer characteristics. The SNSF abandoned the nomination of peer reviewers by applicants. The new form introduced in 2011 may inadvertently have given more emphasis to the applicant’s track record. We encourage other funders to conduct similar studies, in order to improve the evidence base for rational and fair research funding.
Caste, religion and regional differentials in life expectancy at birth in India: cross-sectional estimates from recent National Family Health Survey
Authors: Kumari Meena , Mohanty Sanjay K
Published: August 2020

Objective

Though estimates of longevity are available by states, age, sex and place of residence in India, disaggregated estimates by social and economic groups are limited. This study estimates the life expectancy at birth and premature mortality by caste, religion and regions of India.

Design

This study primarily used cross-sectional data from the National Family Health Survey (NFHS-4), 2015–2016 and the Sample Registration System (SRS), 2011–2015. The NFHS-4 is the largest ever demographic and health survey covering 601 509 households and 811 808 individuals across all states and union territories in India.

Measures

The abridged life table is constructed to estimate the life expectancy at birth, adult mortality (45q15) and premature mortality (70q0) by caste, religion and region.

Results

Life expectancy at birth was estimated at 63.1 years (95% CI 62.60 -63.64) for scheduled castes (SC), 64.0 years (95% CI 63.25 - 64.88) for scheduled tribes (ST), 65.1 years (95% CI 64.69 - 65.42) for other backward classes (OBC) and 68.0 years (95% CI 67.44 - 68.45) for others. The life expectancy at birth was higher among o Christians 68.1 years (95% CI 66.44 - 69.60) than Muslims 66.0 years (95% CI 65.29 - 66.54) and Hindus 65.0 years (95% CI 64.74 -65.22). Life expectancy at birth was higher among females than among males across social groups in India. Premature mortality was higher among SC (0.382), followed by ST (0.381), OBC (0.344) and others (0.301). The regional variation in life expectancy by age and sex is large.

Conclusion

In India, social and religious differentials in life expectancy by sex are modest and need to be investigated among poor and rich within these groups. Premature mortality and adult mortality are also high across social and religious groups.
Role of endoscopic ultrasonography in the diagnostic work-up of idiopathic acute pancreatitis (PICUS): study protocol for a nationwide prospective cohort study
Authors: Umans Devica S , Timmerhuis Hester C , Hallensleben Nora D , Bouwense Stefan A , Anten Marie-Paule GF , Bhalla Abha , Bijlsma Rina A , Boermeester Marja A , Brink Menno A , Hol Lieke , Bruno Marco J , Curvers Wouter L , van Dullemen Hendrik M , van Eijck Brechje C , Erkelens G Willemien , Fockens Paul , van Geenen Erwin J M , Hazen Wouter L , Hoge Chantal V , Inderson Akin , Kager Liesbeth M , Kuiken Sjoerd D , Perk Lars E , Poley Jan-Werner , Quispel Rutger , Römkens Tessa EH , van Santvoort Hjalmar C , Tan Adriaan CITL , Thijssen Annemieke Y , Venneman Niels G , Vleggaar Frank P , Voorburg Annet MCJ , van Wanrooij Roy LJ , Witteman Ben J , Verdonk Robert C , Besselink Marc G , van Hooft Jeanin E
Published: August 2020

Introduction

Idiopathic acute pancreatitis (IAP) remains a dilemma for physicians as it is uncertain whether patients with IAP may actually have an occult aetiology. It is unclear to what extent additional diagnostic modalities such as endoscopic ultrasonography (EUS) are warranted after a first episode of IAP in order to uncover this aetiology. Failure to timely determine treatable aetiologies delays appropriate treatment and might subsequently cause recurrence of acute pancreatitis. Therefore, the aim of the Pancreatitis of Idiopathic origin: Clinical added value of endoscopic UltraSonography (PICUS) Study is to determine the value of routine EUS in determining the aetiology of pancreatitis in patients with a first episode of IAP.

Methods and analysis

PICUS is designed as a multicentre prospective cohort study of 106 patients with a first episode of IAP after complete standard diagnostic work-up, in whom a diagnostic EUS will be performed. Standard diagnostic work-up will include a complete personal and family history, laboratory tests including serum alanine aminotransferase, calcium and triglyceride levels and imaging by transabdominal ultrasound, magnetic resonance imaging or magnetic resonance cholangiopancreaticography after clinical recovery from the acute pancreatitis episode. The primary outcome measure is detection of aetiology by EUS. Secondary outcome measures include pancreatitis recurrence rate, severity of recurrent pancreatitis, readmission, additional interventions, complications, length of hospital stay, quality of life, mortality and costs, during a follow-up period of 12 months.

Ethics and dissemination

PICUS is conducted according to the Declaration of Helsinki and Guideline for Good Clinical Practice. Five medical ethics review committees assessed PICUS (Medical Ethics Review Committee of Academic Medical Center, University Medical Center Utrecht, Radboud University Medical Center, Erasmus Medical Center and Maastricht University Medical Center). The results will be submitted for publication in an international peer-reviewed journal.

Trial registration number

Netherlands Trial Registry (NL7066). Prospectively registered.
Meanings and senses of being a health professional with tuberculosis: an interpretative phenomenological study
Authors: Santos Marcandra Nogueira Almeida , Sá Antonia Margareth Moita , Quaresma Juarez Antonio Simões
Published: August 2020

Objective

The aim of the study was to analyse and understand meanings and senses of living with tuberculosis for health professionals.

Method/design

This is an interpretative phenomenological study conducted from in-depth interviews to analyse how health professionals understand their personal experience of tuberculosis.

Scenario

Two reference health institutions for tuberculosis diagnosis and treatment located in a municipality of the Eastern Brazilian Amazon.

Participants

Intentional sample of 15 health professionals with the disease or with a recent history of tuberculosis.

Results

Regarding the personal experience of tuberculosis of the participating health professionals, four superordinate themes were identified: (1) experiencing tuberculosis, (2) experiencing the diagnosis of tuberculosis, (3) facing the treatment of tuberculosis and (4) signifying tuberculosis.

Conclusion

This study verified that health professionals live the experience of tuberculosis similar to other people: with fear, anguish, frustration, prejudice and health needs not always met by the services and programmes for the control of the disease. The lived experience has an important impact on the health professionals’ ways of understanding the kind of empathic and sensitive care that should be provided to people with tuberculosis. In addition, it is concluded that specific governmental strategies are needed for tuberculosis prevention, diagnosis and treatment among health professionals.
Agreement between ranking metrics in network meta-analysis: an empirical study
Authors: Chiocchia Virginia , Nikolakopoulou Adriani , Papakonstantinou Theodoros , Egger Matthias , Salanti Georgia
Published: August 2020

Objective

To empirically explore the level of agreement of the treatment hierarchies from different ranking metrics in network meta-analysis (NMA) and to investigate how network characteristics influence the agreement.

Design

Empirical evaluation from re-analysis of NMA.

Data

232 networks of four or more interventions from randomised controlled trials, published between 1999 and 2015.

Methods

We calculated treatment hierarchies from several ranking metrics: relative treatment effects, probability of producing the best valuep(BV)and the surface under the cumulative ranking curve (SUCRA). We estimated the level of agreement between the treatment hierarchies using different measures: Kendall’s τ and Spearman’s ρ correlation; and the YilmazτAPand Average Overlap, to give more weight to the top of the rankings. Finally, we assessed how the amount of the information present in a network affects the agreement between treatment hierarchies, using the average variance, the relative range of variance and the total sample size over the number of interventions of a network.

Results

Overall, the pairwise agreement was high for all treatment hierarchies obtained by the different ranking metrics. The highest agreement was observed between SUCRA and the relative treatment effect for both correlation and top-weighted measures whose medians were all equal to 1. The agreement between rankings decreased for networks with less precise estimates and the hierarchies obtained frompBVappeared to be the most sensitive to large differences in the variance estimates. However, such large differences were rare.

Conclusions

Different ranking metrics address different treatment hierarchy problems, however they produced similar rankings in the published networks. Researchers reporting NMA results can use the ranking metric they prefer, unless there are imprecise estimates or large imbalances in the variance estimates. In this case treatment hierarchies based on both probabilistic and non-probabilistic ranking metrics should be presented.
Study protocol: effects, costs and distributional impact of digital primary care for infectious diseases—an observational, registry-based study in Sweden
Authors: Wilkens Jens , Thulesius Hans , Arvidsson Eva , Lindgren Anna , Ekman Bjorn
Published: August 2020

Introduction

The ability to provide primary care with the help of a digital platform raises both opportunities and risks. While access to primary care improves, overuse of services and medication may occur. The use of digital care technologies is likely to continue to increase and evidence of its effects, costs and distributional impacts is needed to support policy-making. Since 2016, the number of digital primary care consultations for a range of conditions has increased rapidly in Sweden. This research project aims to investigate health system effects of this development. The overall research question is to what extent such care is a cost-effective and equitable alternative to traditional, in-office primary care in the context of a publicly funded health system with universal access. Three specific areas of investigation are identified: clinical effect; cost and distributional impact. This protocol describes the investigative approach of the project in terms of aims, design, materials, methods and expected results.

Methods and analysis

The research project adopts a retrospective study design and aims to apply statistical analyses of patient-level register data on key variables from seven regions of Sweden over the years 2017–2018. In addition to data on three common infectious conditions (upper respiratory tract infection; lower urinary tract infection; and skin and soft-tissue infection), information on other healthcare use, socioeconomic status and demography will be collected.

Ethics and dissemination

This registry-based study has received ethical approval by the Swedish Ethical Review Authority. Use of data will follow the Swedish legislation and practice with regards to consent. The results will be disseminated both to the research community, healthcare decision makers and to the general public.
What do children, parents and staff think about a healthy lifestyles intervention delivered in primary schools? a qualitative study
Authors: Goldthorpe Joanna , Epton Tracy , Keyworth Chris , Calam Rachel , Brooks Joanna , Armitage Chris
Published: August 2020

Objective

Primary schools are crucial settings for early weight management interventions but effects on children’s weight are small and evidence shows that deficiencies in intervention implementation may be responsible. Very little is known about the roles of multiple stakeholders in the process of implementation. We used a multiple-stakeholder qualitative research approach to explore the implementation of an intervention developed to improve the diet and increase the levels of physical activity for children living in some of the most deprived areas of England.

Design

For this qualitative study, interviews and focus groups were carried out using semi-structured topic guides. Data were analysed thematically.

Setting

Seven primary schools (pupils aged 4 to 11) in Manchester, England.

Participants

We conducted 14 focus groups with children aged 5 to 10 years and interviews with 19 staff members and 17 parents.

Intervention

Manchester Healthy Schools (MHS) is a multicomponent intervention, developed to improve diet and physical activity in schools with the aim of reducing and preventing childhood obesity.

Results

Three themes were developed from the data: common understandings of health and health behaviours; congruence and consistency of messages; negotiations of responsibility.

Conclusion

All participant groups had a common conceptualisation of health as having physical and psychological components and that action could be taken in childhood to change behaviours that protect long-term health. When parents and staff felt a shared sense of responsibility for children’s health and levels of congruence between home and school norms around diet and physical activity were high, parents and children were more likely to accept the policies implemented as part of MHS. Effective two-way communication between home and school is therefore vital for successful implementation of this intervention.
Intervention elements to reduce inappropriate prescribing for older adults with multimorbidity receiving outpatient care: a scoping review
Authors: Lee Jia Qi , Ying Kate , Lun Penny , Tan Keng Teng , Ang Wendy , Munro Yasmin , Ding Yew Yoong
Published: August 2020

Objective

Polypharmacy occurs in approximately 30% of older adults aged 65 years or more, particularly among those with multimorbidity. With polypharmacy, there is an associated risk of potentially inappropriate prescribing (PIP). The aims of this scoping review were to (1) identify the intervention elements that have been adopted to reduce PIP in the outpatient setting and (2) determine the behaviour change wheel (BCW) intervention functions performed by each of the identified intervention elements.

Design

Scoping review

Data sources

PubMed, Cumulative Index to Nursing and Allied Health Literature, EMBASE, Web of Science and Cochrane Library databases, grey literature sources, six key geriatrics journals and the reference lists of review papers.

Study selection

All studies reporting an intervention or strategy that addressed PIP in the older adult population (age ≥65) with multimorbidity in the outpatient setting and in which the primary prescriber is the physician.

Data extraction

Data extracted from the included studies can be broadly categorised into (1) publication details, (2) intervention details and (3) results. This was followed by data synthesis and analysis based on the BCW framework.

Results

Of 8195 studies yielded, 80 studies were included in the final analysis and 14 intervention elements were identified. An average of two to three elements were adopted in each intervention. The three most frequently adopted intervention elements were medication review (70%), training (26.3%) and tool/instrument(s) (22.5%). Among medication reviews, 70% involved pharmacists. The 14 intervention elements were mapped onto five intervention functions: ‘education’, ‘persuasion’, ‘training’, ‘environmental restructuring’ and ‘enablement’.

Conclusion

PIP is a multifaceted problem that involves multiple stakeholders. As such, interventions that address PIP require multiple elements to target the behaviour of the various stakeholders. The intervention elements and their corresponding functions identified in this scoping review will serve to inform the design of complex interventions that aim to reduce PIP.
Clinical prediction models to diagnose neonatal sepsis: a scoping review protocol
Authors: Neal Samuel R , Musorowegomo David , Gannon Hannah , Cortina Borja Mario , Heys Michelle , Chimhini Gwen , Fitzgerald Felicity
Published: August 2020

Introduction

Neonatal sepsis is responsible for significant morbidity and mortality worldwide. Diagnosis is often difficult due to non-specific clinical features and the unavailability of laboratory tests in many low-income and middle-income countries (LMICs). Clinical prediction models have the potential to improve diagnostic accuracy and rationalise antibiotic usage in neonatal units, which may result in reduced antimicrobial resistance and improved neonatal outcomes. In this paper, we outline our scoping review protocol to map the literature concerning clinical prediction models to diagnose neonatal sepsis. We aim to provide an overview of existing models and evidence underlying their use and compare prediction models between high-income countries and LMICs.

Methods and analysis

The protocol was developed with reference to recommendations by the Joanna Briggs Institute. Searches will include six electronic databases (Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, Global Index Medicus and the Cochrane Library) supplemented by hand searching of reference lists and citation analysis on included studies. No time period restrictions will be applied but only studies published in English or Spanish will be included. Screening and data extraction will be performed independently by two reviewers, with a third reviewer used to resolve conflicts. The results will be reported by narrative synthesis in line with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guidelines.

Ethics and dissemination

The nature of the scoping review methodology means that this study does not require ethical approval. Results will be disseminated through peer-reviewed publications and conference presentations, as well as through engagement with peers and relevant stakeholders.
Retrospective analysis of reported suicide deaths and attempts on veterans health administration campuses and inpatient units
Authors: Mills Peter D , Soncrant Christina , Gunnar William
Published: August 2020

Introduction

Suicide is the 10th leading cause of death in the USA. Inpatient suicide is the fourth most common sentinel event reported to the Joint Commission. This study reviewed root cause analysis (RCA) reports of suicide events by hospital unit to provide suicide prevention recommendations for each area.

Methods

This is a retrospective analysis of reported suicide deaths and attempts in the US Veterans Health Administration (VHA) hospitals. We searched the VHA National Center for Patient Safety RCA database for suicide deaths and attempts on inpatient units, outpatient clinics and hospital grounds, between December 1999 and December 2018.

Results

We found 847 RCA reports of suicide attempts (n=758) and deaths (n=89) in VHA hospitals, hanging accounted for 71% of deaths on mental health units and 50% of deaths on medical units. Overdose accounted for 55% of deaths and 68% of attempts in residential units and the only method resulting in death in emergency departments. In VHA community living centres, hanging, overdose and asphyxiation accounted for 64% of deaths. Gunshot accounted for 59% of deaths on hospital grounds and 100% of deaths in clinic areas. All inpatient locations cited issues in assessment and treatment of suicidal patients and environmental risk evaluation.

Conclusions

Inpatient mental health and medical units should remove anchor points for hanging where possible. On residential units and emergency departments, assessing suicide risk, conducting thorough contraband searches and maintaining observation of suicidal patients is critical. In community living centres, suicidal patients should be under supervision in an environment free of anchor points, medications and means of asphyxiation. Suicide prevention on hospital grounds and outpatient clinics can be achieved through the control of firearms.
CIC de novo loss of function variants contribute to cerebral folate deficiency by downregulating FOLR1 expression
Authors: Cao Xuanye , Wolf Annika , Kim Sung-Eun , Cabrera Robert M. , Wlodarczyk Bogdan J. , Zhu Huiping , Parker Margaret , Lin Ying , Steele John W. , Han Xiao , Ramaekers Vincent Th , Steinfeld Robert , Finnell Richard H. , Lei Yunping
Published: August 2020

Background Cerebral folate deficiency (CFD) syndrome is characterised by a low concentration of 5-methyltetrahydrofolate in cerebrospinal fluid, while folate levels in plasma and red blood cells are in the low normal range. Mutations in several folate pathway genes, including FOLR1 (folate receptor alpha, FRα), DHFR (dihydrofolate reductase) and PCFT (proton coupled folate transporter) have been previously identified in patients with CFD.

Methods In an effort to identify causal mutations for CFD, we performed whole exome sequencing analysis on eight CFD trios and identified eight de novo mutations in seven trios.

Results Notably, we found a de novo stop gain mutation in the capicua (CIC) gene. Using 48 sporadic CFD samples as a validation cohort, we identified three additional rare variants in CIC that are putatively deleterious mutations. Functional analysis indicates that CIC binds to an octameric sequence in the promoter regions of folate transport genes: FOLR1, PCFT and reduced folate carrier (Slc19A1; RFC1). The CIC nonsense variant (p.R353X) downregulated FOLR1 expression in HeLa cells as well as in the induced pluripotent stem cell (iPSCs) derived from the original CFD proband. Folate binding assay demonstrated that the p.R353X variant decreased cellular binding of folic acid in cells.

Conclusion This study indicates that CIC loss of function variants can contribute to the genetic aetiology of CFD through regulating FOLR1 expression. Our study described the first mutations in a non-folate pathway gene that can contribute to the aetiology of CFD.
Compulsory medical intervention versus external constraint in pandemic control
Authors: Douglas Thomas , Forsberg Lisa , Pugh Jonathan
Published: August 2020

Would compulsory treatment or vaccination for COVID-19 be justified? In England, there would be significant legal barriers to it. However, we offer a conditional ethical argument in favour of allowing compulsory treatment and vaccination, drawing on an ethical comparison with external constraints—such as quarantine, isolation and ‘lockdown’—that have already been authorised to control the pandemic in this jurisdiction. We argue that,ifthe permissive English approach to external constraints for COVID-19 has been justified, then there is a case for a similarly permissive approach to compulsory medical interventions.
An intellectual history of suffering in the Encyclopedia of Bioethics, 1978–2014
Authors: Duffee Charlotte
Published: August 2020

Suffering is an important theme in many bioethical debates, yet little historical research is available to contextualise ideas about it. My article proposes a preliminary intellectual history of suffering in bioethics using the field’s most trusted tertiary work, the four editions of theEncyclopedia of Bioethics(1978–2004), later renamedBioethics(2014). In the first edition, I find suffering roughly conceptualised as either the negation of a good or as a pain. The former acquired a technical connotation beginning in the second edition, when physician Eric Cassell refined the negative aspects of suffering into a full-fledged theory. Now, suffering no longer marked the loss of just any good but instead threatened one’s purpose in relation to that good. Cassell also strongly distinguished suffering from pain which, when combined with his theory of suffering, hardened earlier distinctions between pain and suffering that were present but weak in the first encyclopedia. Both Cassell’s theory and his strong distinction impacted how other contributors moralised suffering in the later encyclopedias, although his influence was not total: utilitarians continued to moralise suffering in ways that still roughly construed it as pain. Consequently, Cassell and the utilitarians conflicted conceptually. Nevertheless, this tension went unfelt in the encyclopedias for reasons I describe. I close by suggesting areas for further historical research and argue for their relevance to bioethical enquiries into suffering.
Beta-blocker use and acute exacerbations of COPD following myocardial infarction: a Danish nationwide cohort study
Authors: Rasmussen Daniel B , Bodtger Uffe , Lamberts Morten , Torp-Pedersen Christian , Gislason Gunnar , Lange Peter , Jensen Magnus T
Published: August 2020

Introduction

Patients with chronic obstructive pulmonary disease (COPD) are undertreated with beta-blockers following myocardial infarction (MI), possibly due to fear for acute exacerbations of COPD (AECOPD). Is beta-blocker use associated with increased risk of AECOPD in patients following first-time MI?

Methods

Danish nationwide study of patients with COPD following hospitalisation for MI from 2003 to 2015. Multivariable, time-dependent Cox regression accounting for varying beta-blocker use based on claimed prescriptions during up to 13 years of follow-up.

Results

A total of 10 884 patients with COPD were discharged after first-time MI. The 1-year rate of AECOPD was 35%, and 65% used beta-blockers at 1 year. Beta-blocker use was associated with a lower risk of AECOPD (multivariable-adjusted HR 0.78, 95% CI 0.74–0.83). This association was independent of the type of MI (HR 0.70, 95% CI 0.59–0.83 in ST-elevation MI (STEMI) and HR 0.80, 95% CI 0.75–0.84 in non-STEMI), presence or absence of heart failure (HR 0.82, 95% CI 0.74–0.90 and HR 0.77, 95% CI 0.72–0.82, respectively), beta-blocker dosage and type, as well as exacerbation severity. Results were similar in 1118 patients with full data on COPD severity and symptom burden (median forced expiratory volume in 1 s as percentage of predicted was 46 and majority had moderate dyspnoea), and in 1358 patients with severe COPD and frequent AECOPD with a high 1-year rate of AECOPD of 70%.

Discussion

Beta-blocker use was not associated with increased risk of AECOPD following MI. This finding was independent of COPD severity, symptom burden and exacerbation history, and supports the safety of beta-blockers in patients with COPD, including high-risk patients with severe disease.
Molecular epidemiology and clinical impact of rhinovirus infections in adults during three epidemic seasons in 11 European countries (2007–2010)
Authors: Zlateva Kalina T , van Rijn Anneloes L , Simmonds Peter , Coenjaerts Frank E J , van Loon Anton M , Verheij Theo J M , de Vries Jutte J C , Little Paul , Butler Christopher C , van Zwet Erik W , Goossens Herman , Ieven Margareta , Claas Eric C J
Published: August 2020

Background

Differences in clinical impact between rhinovirus (RVs) species and types in adults are not well established. The objective of this study was to determine the epidemiology and clinical impact of the different RV species.

Methods

We conducted a prospective study of RVs infections in adults with acute cough/lower respiratory tract infection (LRTI) and asymptomatic controls. Subjects were recruited from 16 primary care networks located in 11 European countries between 2007 and 2010. RV detection and genotyping was performed by means of real time and conventional reverse-transcriptase polymerase chain reaction assays, followed by sequence analysis. Clinical data were obtained from medical records and patient symptom diaries.

Results

RVs were detected in 566 (19%) of 3016 symptomatic adults, 102 (4%) of their 2539 follow-up samples and 67 (4%) of 1677 asymptomatic controls. Genotyping was successful for 538 (95%) symptomatic subjects, 86 (84%) follow-up infections and 62 (93%) controls. RV-A was the prevailing species, associated with an increased risk of LRTI as compared with RV-B (relative risk (RR), 4.5; 95% CI 2.5 to 7.9; p<0.001) and RV-C (RR 2.2; 95% CI 1.2 to 3.9; p=0.010). In symptomatic subjects, RV-A loads were higher than those of RV-B (p=0.015). Symptom scores and duration were similar across species. More RV-A infected patients felt generally unwell in comparison to RV-C (p=0·023). Of the 140 RV types identified, five were new types; asymptomatic infections were associated with multiple types.

Interpretation

In adults, RV-A is significantly more often detected in cases with acute cough/LRTI than RV-C, while RV-B infection is often found in asymptomatic patients.
Arabian nights in Hong Kong: Chinese young adults’ experience of waterpipe smoking
Authors: Lee Jung Jae , Yeung Karly Cheuk Yin , Wang Man Ping , Thorne Sally
Published: August 2020

Background

Waterpipe smoking (WPS) has increased among young adults who may be oblivious to its harmful effects. We explored Chinese young adults’ experiences of using waterpipes.

Methods

Semi-structured interviews with 49 Chinese young adults aged between 18 to 30 years who had smoked waterpipes in the past 30 days were undertaken between May and October 2019. We analysed transcripts using interpretive description that includes an inductive analytical approach and constant comparison strategy.

Results

Six themes on the WPS experience emerged: fostering social connections on weekend nights; bars as a natural setting for waterpipe smoking; providing pleasure; securing social status among young females; growing acceptance and a lack of education; lack of regulation on waterpipe smoking.

Conclusions

We provide the first evidence regarding Chinese young adults’ WPS use. Policy measures to de-normalise false perceptions of WPS are urgently needed to deter use among young adults.
Quasi-normal modes and stability of Einstein–Born–Infeld black holes in de Sitter space
Authors: Lee Chong Oh , Kim Jin Young , Park Mu-In
Published: August 2020

We study gravitational perturbations of electrically charged black holes in (3+1)-dimensional Einstein–Born–Infeld gravity with a positive cosmological constant. For the axial perturbations, we obtain a set of decoupled Schrödinger-type equations, whose formal expressions, in terms of metric functions, are the same as those without cosmological constant, corresponding to the Regge–Wheeler equation in the proper limit. We compute the quasi-normal modes (QNMs) of the decoupled perturbations using the Schutz–Iyer–Will’s WKB method. We discuss the stability of the charged black holes by investigating the dependence of quasi-normal frequencies on the parameters of the theory, correcting some errors in the literature. It is found that all the axial perturbations are stable for the cases where the WKB method applies. There are cases where the conventional WKB method does not apply, like the three-turning-points problem, so that a more generalized formalism is necessary for studying their QNMs and stabilities. We find that, for the degenerate horizons with the “point-like” horizons at the origin, the QNMs are quite long-lived, close to the quasi-resonance modes, in addition to the “frozen” QNMs for the Nariai-type horizons and the usual (short-lived) QNMs for the extremal black hole horizons. This is a genuine effect of the branch which does not have the general relativity limit. We also study the exact solution near the (charged) Nariai limit and find good agreements even far beyond the limit for the imaginary frequency parts.
Optical properties of Kerr–Newman spacetime in the presence of plasma
Authors: Babar Gulmina Zaman , Babar Abdullah Zaman , Atamurotov Farruh
Published: August 2020

We have studied the null geodesics in the background of the Kerr–Newman black hole veiled by a plasma medium using the Hamilton–Jacobi method. The influence of black hole’s charge and plasma parameters on the effective potential and the generic photon orbits has been investigated. Furthermore, our discussion embodies the effects of black hole’s charge, plasma and the inclination angle on the shadow cast by the gravity with and without the spin parameter. We examined the energy released from the black hole as a result of the thermal radiations, which exclusively depends on the size of the shadow. The angle of deflection of the massless particles is also explored considering a weak-field approximation. We present our results in juxtaposition to the analogous black holes in General Relativity, particularly the Schwarzschild and Kerr black hole.
IMPACT OF NON-INTERMEDIATION ACTIVITIES OF BANKS ON ECONOMIC GROWTH AND VOLATILITY: AN EVIDENCE FROM OIC
Authors: ALI MOHSIN , IBRAHIM MANSOR H. , SHAH MOHAMED ESKANDAR
Published: August 2020

This paper investigates the impact of non-intermediation activities of banks on economic growth and volatility of OIC. For the purpose, we utilize LSDVC estimation approach using the sample of Organization of Islamic Countries (OIC) member countries for the period of 2001–2013. We find non-intermediation income to be insignificant for both economic growth and volatility of OIC member countries in general though it reduces volatility of Gulf Cooperation Council (GCC) economies. Intermediation activities are found to be insignificantly related with the growth of OIC member countries, but on the other hand, they are found to reduce volatility in OIC member countries. Our results are robust across different specifications and estimators.
On extended thermodynamics: From classical to the relativistic regime
Authors: Salazar J. Felix , Zannias Thomas
Published: August 2020

The recent monumental detection of gravitational waves by LIGO, the subsequent detection by the LIGO/VIRGO observatories of a binary neutron star merger seen in the gravitational wave signal [Formula: see text], the first photo of the event horizon of the supermassive black hole at the center of Andromeda galaxy released by the EHT telescope and the ongoing experiments on Relativistic Heavy Ion Collisions at the BNL and at the CERN, demonstrate that we are witnessing the second golden era of observational relativistic gravity. These new observational breakthroughs, although in the long run would influence our views regarding this Kosmos, in the short run, they suggest that relativistic dissipative fluids (or magnetofluids) and relativistic continuous media play an important role in astrophysical-and also subnuclear-scales. This realization brings into the frontiers of current research theories of irreversible thermodynamics of relativistic continuous media. Motivated by these considerations, we summarize the progress that has been made in the last few decades in the field of nonequilibrium thermodynamics of relativistic continuous media. For coherence and completeness purposes, we begin with a brief description of the balance laws for classical (Newtonian) continuous media and introduce the classical irreversible thermodynamics (CIT) and point out the role of the local-equilibrium postulate within this theory. Tangentially, we touch the program of rational thermodynamics (RT), the Clausius–Duhem inequality, the theory of constitutive relations and the emergence of the entropy principle in the description of continuous media. We discuss at some length, theories of non equilibrium thermodynamics that sprang out of a fundamental paper written by Müller in 1967, with emphasis on the principles of extended irreversible thermodynamics (EIT) and the rational extended irreversible thermodynamics (REIT). Subsequently, after a brief introduction to the equilibrium thermodynamics of relativistic fluids, we discuss the Israel–Stewart transient (or causal) thermodynamics and its main features. Moreover, we introduce the Liu–Müller–Ruggeri theory describing relativistic fluids. We analyze the structure and compare this theory to the class of dissipative relativistic fluid theories of divergent type developed in the late 1990 by Pennisi, Geroch and Lindblom. As far as theories of nonequilibrium thermodynamics of classical media are concerned, it is fair to state that substantial progress has been made and many predictions of the extended theories have been placed under experimental scrutiny. However, at the relativistic level, the situation is different. Although the efforts aiming to the development of a sensible theory (or theories) of nonequilibrium thermodynamics of relativistic fluids (or continuous media) spans less than a half-century, and even though enormous steps in the right direction have been taken, nevertheless as we shall see in this review, still a successful theory of relativistic dissipation is lacking.
Elastodynamic Response of a Three-Phase-Lag Model of Orthorhombic Thermoviscoelastic Material with Reference Temperature Dependent Properties
Authors: Rani Leena
Published: August 2020

A three-phase-lag model of a homogeneous thermally conducting orthorhombic thermoviscoelastic material under the effect of the dependence of reference temperature on all elastic and thermal parameters is investigated. The Laplace and Fourier transform and eigenvalue approach techniques are used to solve the resulting nondimensional coupled equations. As an application of the problem, harmonically varying and sinusoidal pulse functions are considered. Numerical results for the field quantities are given in the physical domain and illustrated graphically. Comparisons are made for thermoviscoelastic temperature dependent, thermoviscoelastic and thermoelastic materials, respectively, for different values of time, for temperature gradient boundary.
Activation of GABAB receptors results in excitatory modulation of calyx terminals in rat semicircular canal cristae
Authors: Ramakrishna Yugandhar , Sadeghi Soroush G.
Published: August 2020

Using in vitro whole cell patch-clamp recordings from calyx terminals in the vestibular end organs, we show that activation of GABAB receptors result in an excitatory effect, with decreased spike-frequency adaptation and shortened first-spike latencies. Our results suggest that these effects are mediated through inhibition of calcium-sensitive potassium channels.
Neuronal Circuits in Barrel Cortex for Whisker Sensory Perception
Authors: Staiger Jochen F. , Petersen Carl C. H.
Published: August 2020

The array of whiskers on the snout provides rodents with tactile sensory information relating to the size, shape and texture of objects in their immediate environment. Rodents can use their whiskers to detect stimuli, distinguish textures, locate objects and navigate. Important aspects of whisker sensation are thought to result from neuronal computations in the whisker somatosensory cortex (wS1). Each whisker is individually represented in the somatotopic map of wS1 by an anatomical unit named a ‘barrel’ (hence also called barrel cortex). This allows precise investigation of sensory processing in the context of a well-defined map. Here, we first review the signaling pathways from the whiskers to wS1, and then discuss current understanding of the various types of excitatory and inhibitory neurons present within wS1. Different classes of cells can be defined according to anatomical, electrophysiological and molecular features. The synaptic connectivity of neurons within local wS1 microcircuits, as well as their long-range interactions and the impact of neuromodulators, are beginning to be understood. Recent technological progress has allowed cell-type-specific connectivity to be related to cell-type-specific activity during whisker-related behaviors. An important goal for future research is to obtain a causal and mechanistic understanding of how selected aspects of tactile sensory information are processed by specific types of neurons in the synaptically connected neuronal networks of wS1 and signaled to downstream brain areas, thus contributing to sensory-guided decision-making.
Association of Nuclear Receptor Coactivators with Hypoxia‐Inducible Factor‐1α in the Serum of Patients with Chronic Kidney Disease
Authors: Zhou Tianbiao , Lin Wenshan , Lin Shujun , Zhong Zhiqing , Luo Yuanyuan , Lin Zhijun , Xie Weiji , Shen Weitao , Hong Kai
Published: August 2020

Nuclear receptor coactivators (NCOAs), consisting of coactivators and corepressors, dramatically enhance the transcriptional activity of nuclear receptors. Hypoxia‐inducible factor‐1α (HIF‐1α) is a transcription factor that plays a major role under hypoxic conditions. This study was performed with the focus on the association of NCOAs with HIF‐1α in the serum of chronic kidney disease (CKD) patients. Sixty patients with stage 5 CKD and 30 healthy controls from The Second Affiliated Hospital of Shantou University Medical College, between March 21, 2019, and October 30, 2019, were recruited in this prospective cohort study. We analyzed the serum levels of NCOAs (NCOA1, NCOA2, and NCOA3), HIF‐1α, vascular endothelial growth factor (VEGF), etc. and assessed whether there was any relationship between these parameters and CKD disease. We found that circulating NCOA1 was positively associated with circulating NCOA2, NCOA3, and HIF‐1α. A positive correlation was also observed between NCOA2 and NCOA1, NCOA3, HIF‐1α, and VEGF. Furthermore, statistically significant correlations between NCOA3 and NCOA1, NCOA2, and HIF‐1α were observed. The serum levels of VEGF in the CKD group were higher than those of the healthy control group. Circulating NCOA1 and circulating NCOA2 were negatively associated with procalcitonin. In conclusion, there was an association between circulating NCOA1, NCOA2, NCOA3, and circulating HIF‐1α, and circulating VEGF was a risk factor for CKD disease. However, more studies should be performed to confirm this hypothesis.
Synthesis and Biological Activity of 2-Arylidene-N-(quinolin-6-yl)hydrazine-1-carboxamides
Authors: Zhao Shengxian , Cao Yin , Cui Zhenzhen , Zhang Jiayun , Pan Zhixiang , Hu Hongyu
Published: August 2020

A series of 2-arylidene-N-(quinolin-6-yl)hydrazine-1-carboxamides 5a–5o were synthesized and characterized. The synthesized compounds (5a–5o) were screened in vitro against three breast cancer cell lines: SKBR3, MDA-MB-231, and MCF-7 cancer cell lines by the MTT assay. According to MTT results, compounds 5k and 5l showed better antiproliferative activities over MCF-7 cell lines with IC50 values of 8.50 and 12.51 μM. Colony formation assay indicated 5k/5l treatment obviously inhibited the growth of MCF-7 cells and 5k/5l-induced cell cycle was arrested in the G2-M phase. Moreover, 5k/5l significantly increased the level of cleaved PARP and induced the apoptosis in MCF-7 cells. In addition, compared to Hela cells, MCF-7 cells were more sensitive to 5k/5l treatment.