bluuebunny/crossref_metadata_2025 huggingface dataset:
Mud‐rich delta‐scale compound clinoforms in the Triassic shelf of northern Pangea (Havert Formation, south‐western Barents Sea)
Authors: Rossi Valentina Marzia , Paterson Niall William , Helland‐Hansen William , Klausen Tore Grane , Eide Christian Haug
Published: March 2019

In recent years it has become clear that many shallow‐marine heterolithic and mudstone‐dominated successions are deposited as mud belts forming part of subaqueous deltas that are related to major fluvial sources either upstream or along shore. Here the Havert Formation is presented as an ancient example of this kind of system. The Havert Formation in the south‐western Barents Sea represents shelf margin clinoforms consisting predominantly of heterolithic deposits. Sediments were mainly derived from the east (Ural Mountains), but a smaller system prograded northward from Fennoscandia. The Havert Formation holds a lot of interest due to: (i) its stratigraphic position, directly above the Permo–Triassic boundary and contemporaneous to the emplacement of the Siberian Traps; (ii) the fact that it represents the first siliciclastic input in the south‐western Barents Sea and it shows interaction between Uralian‐derived and Fennoscandian‐derived sediments; and (iii) its hydrocarbon potential. This study is focused on a detailed sedimentological analysis of cored intervals of the (Ural‐derived) Havert Formation, in combination with seismic interpretation, well‐log correlations and palynological analysis of the Havert and overlying Klappmyss formations. The cored intervals belong to the shelf environment of the Havert shelf‐margin clinoforms (300 to 500 m thick). This sedimentological analysis distinguishes six facies associations, spanning from tidally‐influenced channels at the shoreline to mud‐rich subaqueous platform and foresets of the subaqueous delta. Seismic lines and well‐log correlations show the larger‐scale evolution of the Ural‐derived Havert Formation, characterized by episodes of low‐accommodation and high‐accommodation. The palynological analyses provide the first detailed study of the Havert Formation in the Nordkapp Basin, revising its depositional age in the region as Induan to early Olenekian (Smithian). Furthermore, they strengthen the environmental interpretation; palynofacies present on the shelf record flora of tidally‐influenced coastal plains, whereas the palynofacies in the deep‐water slope contain only amorphous organic matter.
Host‐parasite life‐histories of the diurnalvs. nocturnal chronotypes ofSchistosoma mansoni: adaptive significance
Authors: Mouahid Gabriel , Mintsa Nguema Rodrigue , Al Mashikhi Khalid M. , Al Yafae Salem A. , Idris Mohamed A. , Moné Hélène
Published: March 2019

Objectives

To optimise host‐to‐host transmission, digenean trematodes (parasites) synchronise their cercarial emission patterns with the aquatic activities of their vertebrate hosts.Schistosoma mansonihas two different circadian chronotypes: a diurnal shedding pattern with a mean peak occurring at 11:00 h, and a nocturnal shedding pattern with a mean peak occurring at 20:00 h. We analysed the life‐history variations between these two chronotypes at the levels of the parasite and its hosts.

Methods

For each chronotype, we quantified three life‐history traits related to the parasite (prepatent period, infection rate and cercarial production) and analysed the morphometry and the morphology of the parasite eggs; we also quantified three life‐history traits related to the snail intermediate host (shell diameter, fecundity and survival rate) and one life‐history trait related to the experimental definitive host (survival rate). A phylogeny based on the mitochondrial cytochrome‐oxidase gene was made on samples of both chronotypes.

Results

Life‐history analysis revealed significant variations between the two chronotypes. Life‐history traits were optimal for both the parasite and the snail host for the diurnal chronotype compared to the nocturnal one. The new chronotype behaved like an allopatric population towards its snail host. Phylogenetic analysis supports the hypothesis of a lateral transfer ofS. mansonifrom humans toRattus rattus. These results were interpreted in terms of an ongoing sympatric speciation.

Conclusion

The nocturnal chronotype ofS. mansonishowed non‐adapted life‐history traits in its relation with the snail intermediate hostBiomphalaria pfeifferi. The emergence of this new phenotype is probably linked to divergent natural selection.
TsHD1 and TsNAC1 cooperatively play roles in plant growth and abiotic stress resistance of Thellungiella halophile
Authors: Liu Can , Ma Haizhen , Zhou Jie , Li Zhaoxia , Peng Zhenghua , Guo Fei , Zhang Juren
Published: March 2019

T. HALOPHILA HOMEOBOX PROTEIN 1(TsHD1) cloned from the halophyte Thellungiella halophila is a homeodomain (HD) transcription factor gene and functions as a collaborator of TsNAC1. TsHD1 can form heterodimers with TsNAC1 via the interaction between its zinc finger (ZF) domain and the A subdomain of TsNAC1. The overexpression of TsHD1 improved the heat stress resistance of T. halophila and retarded its vegetative growth slightly. The co‐overexpression of TsHD1 and TsNAC1 highly improved heat and drought stress resistance by increasing the accumulation of heat shock proteins and enhancing the expression levels of drought stress response genes, such as MYB DOMAIN PROTEIN 77 and MYB DOMAIN PROTEIN 96 (MYB77and MYB96) and SALT TOLERANCE ZINC FINGER 10 and SALT TOLERANCE ZINC FINGER 18 (ZAT10 and ZAT18), but seriously retarded the vegetative growth of T. halophila by restraining cell expansion. The heterodimer of TsHD1 and TsNAC1 has higher transcriptional activation activity and higher stability compared with the homodimer of TsHD1 or TsNAC1. The binding sites of the TsHD1 and TsNAC1 heterodimers were found to exist in the promoters of most upregulated genes in Cauliflower mosaic virus 35S promoter (P35S)::TsHD1 and P35S::TsNAC1 transgene lines compared with the wild type using RNA‐seq and genomic data analyses. Moreover, the binding sites in the promoter region of the most downregulated genes were located in the vicinity of the TATA‐box. This study reveals that TsNAC1 and TsHD1 play roles in plant growth and abiotic stress resistance synergistically, and the effects depend on the heterodimer binding to the specific target sites in the promoter region.
Distributed Flow Estimation for Autonomous Underwater Robots Using Proper Orthogonal Decomposition-Based Model Reduction
Authors: Dang Fengying , Zhang Feitian
Published: March 2019

Flow estimation plays an important role in the control and navigation of autonomous underwater robots. This paper presents a novel flow estimation approach that assimilates distributed pressure measurements through coalescing recursive Bayesian estimation and flow model reduction using proper orthogonal decomposition (POD). The proposed flow estimation approach does not rely on any analytical flow model and is thus applicable to many and various complicated flow fields for arbitrarily shaped underwater robots, while most of the existing flow estimation methods apply only to those well-structured flow fields with simple robot geometry. This paper also analyzes and discusses the flow estimation design in terms of reduced-order model accuracy, relationship with conventional flow parameters, and distributed senor placement. To demonstrate the effectiveness of the proposed distributed flow estimation approach, two simulation studies, one with a circular-shaped robot and one with a Joukowski-foil-shaped robot, are presented. The application of flow estimation in closed-loop angle-of-attack regulation is also investigated through simulation.
A Robust Visual Tracking Method for Unmanned Mobile Systems
Authors: Yi Xiongfeng , Chen Zheng
Published: March 2019

This paper introduces a robust visual tracking of objects in complex environments with blocking obstacles and light reflection noises. This visual tracking method utilizes a transfer matrix to project image pixels back to real-world coordinates. During the image process, a color and shape test is used to recognize the object and a vector is used to represent the object, which contains the information of orientation and body length of the object. If the object is partially blocked by the obstacles or the reflection from the water surface, the vector predicts the position of the object. During the real-time tracking, a Kalman filter is used to optimize the result. To validate the method, the visual tracking algorithm was tested by tracking a submarine and a fish on the water surface of a water tank, above which three pieces of blur glass were blocking obstacles between the camera and the object. By using this method, the interference from the reflection of the side glass and the fluctuation of the water surface can be also avoided.
On the Passive Control of Friction-Induced Instability Due to Mode Coupling
Authors: Niknam Alborz , Farhang Kambiz
Published: March 2019

This study investigates a passive controller for a coupled two degrees-of-freedom (DOFs) oscillator to suppress friction-induced mode-coupling instability. The primary system is acted upon by a friction force of a moving belt and static coupling of the oscillator provided with an oblique spring. The combined system, original system plus absorber, response is governed by two sets of differential equations to include contact and loss of contact between the mass and the belt. Therefore, the model accounts for two sources of nonlinearity in the system: (1) discontinuity in the friction force and (2) intermittent loss of contact. Friction coefficient and absorber orientation are used to define planar parameter space for stability analysis. For various mass ratios, the parameter space is divided into stable and unstable zones by defining stability boundaries. In general, an absorber expands the stability region and provides a significant reduction in transient response overshoot and settling time. Incorporation of the absorber also prevents mass-belt separation, thereby suppressing the belt-speed-overtake by the primary mass.
To Play or Not to Play? An Analysis of Dispositions, Gambling, and Daily Fantasy Sport
Authors: Dwyer Brendan , Drayer Joris , Shapiro Stephen L.
Published: March 2019

Following a mega-advertising blitz in the late summer of 2015, daily fantasy sports (DFSs) entered a maturing fantasy sports market as a new, highly accessible, and potentially lucrative alternative to traditional, season-long fantasy sports. The two activities share a name but represent substantially different business models. In the view of some policy makers and state legislatures, DFS appeared to resemble a new form of sports wagering and as a result, several U.S. states banned the activity. The current study examined the consumption behavior differences and gambling-related dispositions of those fantasy participants who play DFS and those who do not. A total of 314 fantasy football participants were surveyed, and the results contribute to what we know about gambling and DFS participation. Although distinct differences were found between the two groups, the overall assessment of the findings suggest DFS participation appears to align more with highly involved traditional, season-long fantasy sports participation than other forms of gambling.
Acute Effects of Interrupting Prolonged Sitting With Intermittent Physical Activity on Blood Pressure in Preadolescent Children
Authors: Weston Emma , Nagy Matthew , Ajibewa Tiwaloluwa A. , O’Sullivan Molly , Block Shannon , Hasson Rebecca E.
Published: March 2019

Purpose: To compare the acute effects of intermittent physical activity (PA) across 4 different intensities on blood pressure. Methods: Thirty children (12 males and 18 females; aged 7–11 y; 33% overweight/obese; 53% nonwhite) completed 4 experimental conditions in random order: 8 hours sitting interrupted with 20, 2-minute low-, moderate-, high-intensity PA breaks, or sedentary screen-time breaks. PA intensity corresponded with 25%, 50%, and 75% of heart rate reserve. Blood pressure was measured during each condition in the morning (0800 h), noon (1200 h), and afternoon (1600 h). Results: There were no significant differences across conditions for systolic blood pressure (SBP; all Ps > .05). There was a significant effect of time with SBP decreasing throughout the day for all conditions (average morning SBP: 106 [1] mm Hg, average noon SBP: 101 [2] mm Hg, average afternoon SBP: 103 [1] mm Hg; P = .01). There were no significant effects of condition or time on diastolic blood pressure (all Ps > .05). Conclusion: While sedentary behavior is known to be associated with hypertension in both adults and children, a single bout of prolonged sitting may be insufficient to produce hypertensive effects in otherwise healthy children. Future research should examine the appropriate dose of intermittent PA to accrue hypotensive responses in preadolescent children.
Enantioselective fragmentation of an achiral molecule in a strong laser field
Authors: Fehre K. , Eckart S. , Kunitski M. , Pitzer M. , Zeller S. , Janke C. , Trabert D. , Rist J. , Weller M. , Hartung A. , Schmidt L. Ph. H. , Jahnke T. , Berger R. , Dörner R. , Schöffler M. S.
Published: March 2019

Prochiral formic acid has been enantioselectively driven to chiral fragmentation, leading to photoion circular dichroism in the molecular frame.
Direct imaging of ultrafast lattice dynamics
Authors: Brown S. Brennan , Gleason A. E. , Galtier E. , Higginbotham A. , Arnold B. , Fry A. , Granados E. , Hashim A. , Schroer C. G. , Schropp A. , Seiboth F. , Tavella F. , Xing Z. , Mao W. , Lee H. J. , Nagler B.
Published: March 2019

We image a previously unidentified ultrafast lattice response in silicon, providing insight into deformation kinetics.
Generation and persistence of human tissue-resident memory T cells in lung transplantation
Authors: Snyder Mark E. , Finlayson Michael O. , Connors Thomas J. , Dogra Pranay , Senda Takashi , Bush Erin , Carpenter Dustin , Marboe Charles , Benvenuto Luke , Shah Lori , Robbins Hilary , Hook Jaime L. , Sykes Megan , D’Ovidio Frank , Bacchetta Matthew , Sonett Joshua R. , Lederer David J. , Arcasoy Selim , Sims Peter A. , Farber Donna L.
Published: March 2019

Human tissue-resident memory T cells persist long term in transplanted lungs and develop from infiltrating recipient T cells.
Bilateral herpes simplex keratitis: lactation a trigger for recurrence!
Authors: Agarwal Rinky , Maharana Prafulla Kumar , Titiyal Jeewan S , Sharma Namrata
Published: March 2019

A young lactating woman presenting to us with simultaneous bilateral corneal lesions was clinically diagnosed to have herpes simplex keratitis, which was confirmed by herpes simplex virus (HSV) PCR. The patient was administered topical and systemic acyclovir therapy and therapeutic penetrating keratoplasty was done in right eye. She was advised to continue breast feeding under strict hygienic conditions. Diagnosis and management of HSV keratitis in a lactating patient can be particularly challenging for both clinician and patient and adoption of a multidisciplinary approach is necessary to ensure safety of mother and child. At 3 months follow-up, the baby was clinically healthy, there were no side effects of acyclovir therapy in the mother or the baby and the patient showed no evidence of recurrence in either eye.
Idiopathic omental infarction: managed conservatively
Authors: McMillen Brock , Hekman Daniel Paul , Nguyen Michelle Thuy Tien , Grewal Dennis
Published: March 2019

We report a case of a 49-year-old woman who presented with acutely worsening episodic abdominal pain. Workup was negative but CT of the abdomen showed right upper quadrant omental fat stranding, suggestive of fat necrosis or infarct. Treatment for the patient was largely supportive with pain management and fluid resuscitation.
Primary small cell carcinoma of the vagina: a rare instance of prolonged survival
Authors: Kombathula Sri Harsha , Rapole Pragna Sagar , Prem Shyama Sudha , Badhe Bhawana
Published: March 2019

Small cell carcinoma (SmCC) of the vagina is a rare and aggressive tumour. It comprises only 1% –2% of all gynaecological malignancies 85% of the patients with SmCC vagina die within a year of diagnosis. Here we report the case of a 65-year-old woman with stage III primary neuroendocrine carcinoma of vagina who was treated with chemoradiotherapy. The patient survived 1 year and 10 months after the initial presentation. SmCC of the vagina is very rare and despite being aggressive, the local disease can be controlled with a chemoradiation regimen.
Systemic sarcoidosis presenting as complete heart block in a patient with normal chest radiography
Authors: Saad Shaukat Muhammad Hamza , Fahad Fadi , Weinreb David , Torosoff Mikhail
Published: March 2019

A previously healthy 44-year-old Caucasian man presented with recurrent syncope and was found to have a complete heart block with a ventricular rate of 24 bpm. No biochemical abnormalities were identified. Tick borne illnesses were ruled out. Paced echocardiogram revealed left ventricular systolic dysfunction with septal hypokinesis. Chest radiography and subsequent CT scan did not reveal adenopathy. However, a positron emission tomography scan demonstrated increased fluorodeoxyglucose uptake in the spleen, a right retro-clavicular lymph node, right ventricle and the interventricular septum of the heart. Excision biopsy of the retro-clavicular lymph node revealed non-caseating granulomas consistent with sarcoidosis. Complete heart block persisted despite steroid treatment. A pacemaker/biventricular implantable cardioverter defibrillator was placed for complete heart block and primary prevention of ventricular tachycardia and sudden cardiac death.
Extranodal NK/T cell lymphoma, nasal type, with retrobulbar extraconal phlegmon and naso-oral fistula
Authors: Wong Daniel Jun Yi , Parry Louise Ann , Bloch Aaron Elijah , Agar Nicholas
Published: March 2019

Extranodal natural killer (NK-)/T cell lymphoma, nasal type (ENKL),1is a rare disease that often mimics rheumatological and infectious conditions and can therefore be difficult to diagnose. The authors present a case of a 55-year-old Vietnamese woman who was misdiagnosed with severe atrophic rhinitis and chronic sinus osteitis. Over a period of 8 months from initial referral, she underwent multiple biopsies and was treated with various antimicrobial regimens until the histopathological diagnosis of ENKL was finally made. Her presentation was complicated by bacterial dacrocystitis, preseptal cellulitis and a retrobulbar extraconal phlegmon requiring surgical drainage. She also subsequently developed a naso-oral fistula on treatment. This case highlights the importance of repeated biopsies, in particular from non-necrotic regions of the sinonasal tract when a patient does not respond to therapy and clinical suspicion of neoplastic pathology remains. This is the first case of ENKL to describe significant orbital complication.
Multiple basal cell carcinomas in a patient with myotonic dystrophy type 1
Authors: Feng Jessica , LaChance Avery , Sinclair David A , Asgari Maryam M
Published: March 2019

A man in his early 60s with myotonic dystrophy type 1 (DM1) and an extensive history of non-melanoma skin cancer presented with multiple pearly, erythematous papules on his face, head, trunk and extremities, clinically consistent with basal cell carcinoma (BCC). Due to the numerous BCC and history of multiple and early-onset BCC, examination was concerning for a hereditary BCC syndrome. Subsequent histopathology confirmed BCC. Genetic testing was negative for basal cell nevus syndrome and clinical findings were inconsistent with other known hereditary BCC syndromes. There have been reports of an association between DM1 and BCC, however, it is not well known among clinicians. We hope to raise awareness among clinicians about this association.
Shrinking of a Tarlov cyst
Authors: Murphy Kieran P , Ryan Susannah
Published: March 2019

A 65-year-old patient presenting with left labial and perirectal pain was diagnosed with bilateral Tarlov cysts. Upon treatment of the left Tarlov cyst (the right was asymptomatic) using image-guided aspiration and subsequent injection of the cyst with fibrin sealant, the cyst reduced in size. To our knowledge, there are currently no other documented cases in which the Tarlov cyst reduced in size following this procedure. This case would seem to suggest that clinicians are poorly informed with regard to Tarlov cysts. These cysts are more common in Caucasian women, many of whom are told their cysts are not responsible for their pain or that they are not treatable. However, there is clear evidence that some Tarlov cysts are symptomatic and minimally invasive procedures have been developed to treat them. As they primarily occur in women, it is possible gender bias may also play a role in the delayed diagnosis of the patient’s pain.
Schistosoma haematobiumcausing pulmonary schistosomiasis in a returning traveller
Authors: Massie Jonathan , Howling Sarah
Published: March 2019

Schistosomiasis is infrequently seen in the UK, but remains an important cause of haematuria in endemic areas. It may also be complicated by systemic illness, and can affect multiple organs, including the bladder, liver and lungs. We discuss a case of haematuria associated with lower abdominal discomfort and dry cough/wheeze in a returning traveller diagnosed as pulmonary and urinary schistosomiasis, caused bySchistosomahaematobium. This case was particularly notable for the radiological findings seen on CT scan of the chest (figure 2A,B), as well as the characteristic sago nodules discovered within the bladder. It is also unusual to see pulmonary schistosomiasis associated withS. haematobium, an organism more typically characterised by bladder involvement. It is important to consider schistosomiasis and its complications, while rare in the western world, it remains an important differential diagnosis in at-risk groups with considerable morbidity if untreated.
Anaphylaxis probably induced by transfer of amoxicillin via oral sex
Authors: Gómez Caballero Nazaret , Almenara Susana , Tévar Terol Antonia , Horga de la Parte José Francisco
Published: March 2019

We present a case of a possible amoxicillin-induced anaphylaxis in a sensitive woman triggered by an instance of oral sexual contact with a man who was taking amoxicillin-clavulanic acid treatment.

To our knowledge, this is the first case reported of a suspicion of amoxicillin-induced anaphylaxis in a woman after a sexual contact with a man who was taking the drug, we hypothesised an oral drug transfer through semen.

Studies about amoxicillin concentrations achieved in semen after a drug intake are scarce. There are few cases reported of hypersensitivity reactions induced by drugs transported in semen but we have found some concern in sensitive patients about the possibility of transference of allergens via sexual intercourse. As clinicians, we consider that it is important to be aware of the existence of this possibility both in the diagnosis and in the prevention of anaphylactic reactions.
Severe tricuspid valve destruction secondary to previous non-appropriately treated endocarditis
Authors: Sall Fatouma , Adoubi Anicet , Koffi Nina , Yangni-Angate Herve
Published: March 2019

Tricuspid valve(TV) destruction with a remote history of endocarditis without known risk factors (ie, HIV, intravenous drug use, neoplasm, trauma) is rare. We describe the case of a TVs destruction in a 12-year-old non-HIV boy, with a 4-year history of endocarditis without known risk factors nor evidence regarding previous appropriately management.
Unusual oral presentation of HSV-1 lesions in an adult liver transplant recipient
Authors: Yiu Daniel , Ballabio Michele , Fornoni Gianluca , Maggi Umberto
Published: March 2019

Herpes Simplex Virus (HSV) hepatitis in liver transplant patients is a rarely reported infective complication of HSV with severe consequences, often leading to fulminant hepatitis if left untreated. The clinical signs are often atypical, leading to under-reporting in the literature and potential delays in treatment. Our case report describes such atypical mucocutaneous lesions in a liver transplant recipient. We highlight the need for further reports, especially those with images, in order to aid the diagnosis of HSV infection, and to allow prompt treatment to prevent complications such as HSV hepatitis.
Parkes Weber syndrome presenting as Stewart-Bluefarb acroangiodermatitis
Authors: Sharma Reena , Gupta Mudita , Thakur Suresh , Gupta Archit
Published: March 2019

Parkes Weber syndrome (PWS) is a rare disorder characterised by arteriovenous (AV) fistula, along with capillary, lymphatic, venous malformations and limb hypertrophy. Stewart-Bluefarb syndrome is a variant of acroangiodermatitis, which is associated with congenital AV malformation/fistulas. It usually begins early in life, unilaterally over lower extremities presenting as violaceous to dusky coloured macules, papules or plaques with tendency to ulcerate. We are reporting a case of AV malformation fulfilling the triad of PWS and presenting with acroangiodermatitis.
Dermatobia hominis‘the human botfly’ presenting as a scalp lesion
Authors: Dunphy Louise , Sood Vikas
Published: March 2019

Owing to increasing international travel, physicians will encounter more infectious diseases acquired overseas, which may be bacterial, fungal or parasitic in nature.1Knowledge of the geographic distribution of specific diseases permits the formulation of a differential diagnosis in the context of clinical presentation. Parasitic infestations of the maxillofacial tissues can be caused by a host of different ectoparasites, for example, myiasis, a frequently misdiagnosed disease of tourists returning from exotic locations. For those natives and travellers who are subject to these ‘infestations’, the experience can be both alarming and very distressing.
Mesenchymal chondrosarcoma of maxilla in paediatric patient
Authors: Choo Choon Sean , Wan Abdul Rahman Wan Faiziah , Jaafar Hasnan , Ramli Ramiza Ramza
Published: March 2019

Chondrosarcoma (CS) is a malignant tumour of long and flat bone characterised by the formation of cartilage. Mesenchymal chondrosarcoma (MCS) is a rare subtype of CS that is more aggressive and may lead to erroneous diagnosis in a limited biopsy. The diagnosis is mainly based on the histopathological appearance of biphasic pattern of undifferentiated small round cells separated by islands of well-differentiated hyaline cartilage. We report a case of 13-year-old boy who initially presented with gum swelling and the biopsy result suggested a benign fibrous lesion. Following an extensive lesion shown in radiologic findings, the tumour excision was done and finally was diagnosed as an MCS of the maxilla. The patient was given postoperative chemotherapy (EURO-EWING 99 regimen), and now on regular follow-up for monitoring of local recurrence or tumour metastasis.
Cochrane vertebroplasty review misrepresented evidence for vertebroplasty with early intervention in severely affected patients
Authors: Clark William , Bird Paul , Diamond Terrence , Gonski Peter , Gebski Val
Published: March 2019

The Cochrane vertebroplasty review of April 2018 was replaced with an updated version in November 2018 to address complaints of errors in analysis. The updated version continues to misrepresent the evidence supporting early intervention with vertebroplasty for patients with uncontrolled, severe pain and fracture duration <6 weeks. The VAPOUR trial is the only blinded trial of vertebroplasty restricted to this patient group. It showed the benefit of vertebroplasty over placebo, particularly when the intervention occurred within 3 weeks of fracture. The Cochrane vertebroplasty review has ignored the positive outcomes in the VAPOUR trial. Open randomised trials of fractures <6-week duration support the positive findings of the VAPOUR trial. This is not described in the Cochrane review. The VAPOUR trial is clinically heterogeneous from other blinded trials. Cochrane protocol stipulates that clinically heterogeneous trials be described separately, as independent evidence, and not combined in analysis with dissimilar trials. Failure to observe this represents a serious protocol breach in the Cochrane review.
Systematic review of evidence on public health in the Democratic People’s Republic of Korea
Authors: Park John J , Lim Ah-Young , Ahn Hyung-Soon , Kim Andrew I , Choi Soyoung , Oh David HW , Lee-Park Owen , Kim Sharon Y , Jung Sun Jae , Bump Jesse B , Atun Rifat , Shin Hee Young , Park Kee B
Published: March 2019

Background

Engaging in public health activities in the Democratic People’s Republic of Korea (DPRK, also known as North Korea) offers a means to improve population health for its citizens and the wider region. Such an engagement requires an understanding of current and future needs.

Methods

We conducted a systematic search of five English and eight Korean language databases to identify available literature published between 1988 and 2017. A narrative review of evidence was conducted for five major categories (health systems, communicable diseases (CDs), non-communicable diseases (NCDs), injuries, and reproductive, maternal, newborn and child health (RMNCH) and nutrition).

Findings

We found 465 publications on the DPRK and public health. Of the 253 articles that addressed major disease categories, we found under-representation of publications relative to proportion of disease burden for the two most significant causes: NCDs (54.5% publications vs 72.6% disability adjusted life years (DALYs)) and injuries (0.4% publications vs 12.1% DALYs), in comparison to publications on the third and fourth largest disease burdens, RMNCH and nutrition (30.4% publications vs 8.6% DALYs) and CDs (14.6% publications vs 6.7% DALYs) which were over-represented. Although most disease category articles were on NCDs, the majority of NCD articles addressed mental health of refugees. Only 165 articles addressed populations within the DPRK and among these, we found publication gaps on social and environmental determinants of health, CDs, and NCDs.

Conclusion

There are gaps in the public health literature on the DPRK. Future research should focus on under-studied, significant burdens of disease. Moreover, establishing more precise estimates of disease burden and their distribution, as well as analysis on health systems responses aimed at addressing them, can result in improvements in population health.
HeART of Stroke: randomised controlled, parallel-arm, feasibility study of a community-based arts and health intervention plus usual care compared with usual care to increase psychological well-being in people following a stroke
Authors: Ellis-Hill Caroline , Thomas Sarah , Gracey Fergus , Lamont-Robinson Catherine , Cant Robin , Marques Elsa M R , Thomas Peter W , Grant Mary , Nunn Samantha , Paling Thomas , Thomas Charlotte , Werson Alessa , Galvin Kathleen T , Reynolds Frances , Jenkinson Damian
Published: March 2019

Introduction

People often experience distress following stroke due to fundamental challenges to their identity.

Objectives

To evaluate (1) the acceptability of ‘HeART of Stroke’ (HoS), a community-based arts and health group intervention, to increase psychological well-being; and (2) the feasibility of a definitive randomised controlled trial (RCT).

Design

Two-centre, 24-month, parallel-arm RCT with qualitative and economic components. Randomisation was stratified by centre and stroke severity. Participant blinding was not possible. Outcome assessment blinding was attempted.

Setting

Community.

Participants

Community-dwelling adults ≤2 years poststroke recruited via hospital clinical teams/databases or community stroke/rehabilitation teams.

Interventions

Artist-facilitated arts and health group intervention (HoS) (ten 2-hour sessions over 14 weeks) plus usual care (UC) versus UC.

Outcomes

The outcomes were self-reported measures of well-being, mood, capability, health-related quality of life, self-esteem and self-concept (baseline and 5 months postrandomisation). Key feasibility parameters were gathered, data collection methods were piloted, and participant interviews (n=24) explored the acceptability of the intervention and study processes.

Results

Despite a low recruitment rate (14%; 95% CI 11% to 18%), 88% of the recruitment target was met, with 29 participants randomised to HoS and 27 to UC (57% male; mean (SD) age=70 (12.1) years; time since stroke=9 (6.1) months). Follow-up data were available for 47 of 56 (84%; 95% CI 72% to 91%). Completion rates for a study-specific resource use questionnaire were 79% and 68% (National Health Service and societal perspectives). Five people declined HoS postrandomisation; of the remaining 24 who attended, 83% attended ≥6 sessions. Preliminary effect sizes for candidate primary outcomes were in the direction of benefit for the HoS arm. Participants found study processes acceptable. The intervention cost an estimated £456 per person and was well-received (no intervention-related serious adverse events were reported).

Conclusions

Findings from this first community-based study of an arts and health intervention for people poststroke suggest a definitive RCT is feasible. Recruitment methods will be revised.

Trial registration number

ISRCTN99728983.
Ethnic variations in risk of preterm birth in an ethnically dense socially disadvantaged area in the UK: a retrospective cross-sectional study
Authors: Puthussery Shuby , Li Leah , Tseng Pei-Ching , Kilby Lesley , Kapadia Jogesh , Puthusserry Thomas , Thind Amardeep
Published: March 2019

Objective

To investigate ethnic variations in risk of preterm birth (PTB), including extreme preterm birth (EPTB) and moderately preterm birth (MPTB), among mothers in an ethnically dense, socially disadvantaged area, and to examine whether any variations were dependent of area deprivation and maternal biological and behavioural factors.

Design

Retrospective cross-sectional study using routinely collected data.

Setting

A large UK National Health Service maternity unit.

Participants

46 307 women who gave singleton births between April 2007 and March 2016.

Outcome measures

PTB defined as <37 weeks of gestation and further classified into EPTB (<28 weeks of gestation) and MPTB (28 to <37 weeks of gestation).

Results

Overall prevalence of PTB was higher (8.3%) compared with the national average (7.8%). Black Caribbean (2.2%) and black African (2.0%) mothers had higher absolute risk of EPTB than white British mothers (1.3%), particularly black Caribbean mothers whose relative risk ratio (RRR) was nearly twice after adjustment for all covariates (RRR=1.93[1.20 to 3.10]). Excess relative risk of EPTB among black African mothers became non-significant after adjustment for prenatal behavioural factors (RRR=1.41[0.99 to 2.01]). Bangladeshi mothers had the lowest absolute risk of EPTB (0.6%), substantially lower than white British mothers (1.3%); the difference in relative risk remained significant after adjustment for area deprivation (RRR=0.59[0.36 to 0.96]), but became non-significant after adjustment for maternal biological factors. Changes were evident in the relative risk of EPTB and MPTB among some ethnic groups compared with the white British on adjustment for different covariates.

Conclusions

Higher than national rates of PTB point to the need for evidence-based antenatal and neonatal care programmes to support preterm babies and their families in ethnically dense socially disadvantaged areas. Differential impact of area deprivation and the role of modifiable behavioural factors highlight the need for targeted preventive interventions for groups at risk.
Producing a preference-based quality of life measure for people with Duchenne muscular dystrophy: a mixed-methods study protocol
Authors: Powell Philip A , Carlton Jill , Rowen Donna , Brazier John E
Published: March 2019

Introduction

Preference-based measures (PBMs) of health-related quality of life (HRQoL) are used to generate quality-adjusted life years, which are necessary for cost-effectiveness evaluations of health interventions via cost–utility analysis. These measures of health can be generic (ie, pandiagnostic) or condition specific. No condition-specific PBM of HRQoL in Duchenne muscular dystrophy (DMD) exists, yet there are concerns that standard generic measures lack the specificity to assess aspects of HRQoL that are especially important to people with DMD. This study has been designed to produce a condition-specific PBM of HRQoL in DMD.

Methods and analysis

This mixed-methods study proceeds through three stages. In the first stage (concept elicitation), semistructured interviews will be conducted with boys and men diagnosed with DMD, and analysed with framework to produce a draft health state descriptive system for HRQoL in DMD. In the second stage (refining the descriptive system), patients, clinicians and primary caregivers of people with DMD will assess the face validity of the descriptive system. This will be followed by a quantitative survey on a larger sample of patients, which will be analysed with psychometric analyses to produce a refined descriptive system. In the third stage (valuation and econometric modelling), an online discrete choice experiment with duration will be administered to a general public sample to generate utility values for the new measure.

Ethics and dissemination

This study has received ethical approval from the National Health Service (REC reference: 18/SW/0055). The primary output of this research will be a condition-specific PBM (or ‘bolt-on’ to an existing generic PBM) in people with DMD and an associated value set. Results will be disseminated through international conferences and open-access journals.
Association between adolescent motherhood and maternal and child health indices in Maiduguri, Nigeria: a community-based cross-sectional study
Authors: Oyeyemi Adewale L , Aliyu Salamatu U , Sa’ad Fatima , Rufa’i Adamu Ahmad , Jajere Abdul Rahman M , Oyeyemi Adetoyeje Y
Published: March 2019

Introduction

Adolescent motherhood (childbearing below 18 years of age) is a major global health and social problem. Understanding the impact of early motherhood on maternal and child health indices is important to community and population health promotion in developing countries. This study examined the association between adolescent motherhood and maternal and child health indices in Maiduguri, Nigeria.

Methods

A cross-sectional design method was used to recruit 220 mothers (age=14–25 years) from four communities in the city of Maiduguri, Northeastern Nigeria. Participants were surveyed using a self-developed interviewer-administered questionnaire that assesses maternal and child health indices and sociodemographic characteristics. Logistic regression analysis was used to compute adjusted OR and 95% CI of the associations between motherhood in adolescence (mothers below 18 years old) and maternal and child health indices.

Results

Compared to adult mothers, adolescent mothers were more likely to experience fistula (OR=5.01, 95% CI=3.01 to 14.27), to have postpartum haemorrhage (OR=6.83, 95% CI=2.93 to 15.92), to have sexually transmitted infections (OR=6.29, 95% CI=2.26 to 17.51) and to lose a child within 5 years of birth (OR=3.52, 95% CI=1.07 to 11.60). Children born to adolescent mothers were less likely to have normal weight at birth (OR=0.34, CI=0.15 to 0.73) than those born to adult mothers.

Conclusion

Adolescent motherhood was associated with negative maternal and child health indices. The findings can be used by public health professionals including physiotherapists in this role to inform effective primary healthcare practice and community health advocacy to improve maternal and child health indices among adolescent mothers in Maiduguri. Future studies are needed to confirm the evidence at the regional or national level including the rural population in Nigeria.
Occupational justice and social inclusion in mental illness and HIV: a scoping review protocol
Authors: Nhunzvi Clement , Langhaug Lisa , Mavindidze Edwin , Harding Richard , Galvaan Roshan
Published: March 2019

Introduction

Mental illness and HIV remain prevalent as chronic and stigmatised conditions and a global public health concern. Disability-adjusted life-years due to comorbid neuropsychiatric conditions and HIV are rising. Occupational justice and social inclusion emphasise the importance of equity and the utility of resources and opportunities for all to engage in diverse, healthy and meaningful activities. However, succinct conceptualisation of social inclusion and occupational justice, including the relationship between these concepts is still limited. This hampers their effective utilisation in research and practice. Here, we present our scoping review protocol to appraise literature to describe and explain the state of conceptualisation of occupational justice and social inclusion in relation to mental illness and HIV. We are aiming to review the definitions, current utilisation and relationships between occupational justice and social inclusion to inform further theorisation and practice application.

Methods and analysis

This scoping review protocol follows existing guidelines for scoping reviews in occupational therapy with particular attention on Arksey and O’Malley’s (2005) scoping review framework. We iteratively developed a search strategy and carried out our search using the following databases: PubMed, Scopus, Academic Search Premier, Cumulative Index to Nursing and Allied Health Literature, Africa-Wide Information, Humanities International Complete, Web of Science, PsychInfo and SocINDEX. To enhance the comprehensiveness of our search and capture all relevant information, we will also search a variety of grey literature sources. Two reviewers will independently screen eligible studies for inclusion. Bibliographic data, abstract content and aspects of the study design and findings will be extracted and thematically analysed.

Ethics and dissemination

As secondary analysis, this scoping review does not require ethics approval. Results will summarise and disseminate existing research related to occupational justice and social inclusion in mental health and HIV/AIDS care, describing the conceptualisation, relationships between concepts and identifying gaps for further research and practical application. We will disseminate the results through peer-reviewed journals and conferences, targeting clinicians, academics, researchers and policy makers.
Serological surveillance of influenza in an English sentinel network: pilot study protocol
Authors: de Lusignan Simon , Borrow Ray , Tripathy Manasa , Linley Ezra , Zambon Maria , Hoschler Katja , Ferreira Filipa , Andrews Nick , Yonova Ivelina , Hriskova Mariya , Rafi Imran , Pebody Richard
Published: March 2019

Background

Rapidly undertaken age-stratified serology studies can produce valuable data about a new emerging infection including background population immunity and seroincidence during an influenza pandemic. Traditionally seroepidemiology studies have used surplus laboratory sera with little or no clinical information or have been expensive detailed population based studies. We propose collecting population based sera from the Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), a sentinel network with extensive clinical data.

Aim

To pilot a mechanism to undertake population based surveys that collect serological specimens and associated patient data to measure seropositivity and seroincidence due to seasonal influenza, and create a population based serology bank.

Methods and analysis

Setting and Participants:We will recruit 6 RCGP RSC practices already taking nasopharyngeal virology swabs. Patients who attend a scheduled blood test will be consented to donate additional blood samples. Approximately 100–150 blood samples will be collected from each of the following age bands – 18– 29, 30– 39, 40– 49, 50– 59, 60– 69 and 70+ years.

Methods

We will send the samples to the Public Health England (PHE) Seroepidemiology Unit for processing and storage. These samples will be tested for influenza antibodies, using haemagglutination inhibition assays. Serology results will be pseudonymised, sent to the RCGP RSC and combined using existing processes at the RCGP RSC secure hub. The influenza seroprevalence results from the RCGP cohort will be compared against those from the annual PHE influenza residual serosurvey.

Ethics and dissemination

Ethical approval was granted by the Proportionate Review Sub- Committee of the London – Camden & Kings Cross on 6 February 2018. This study received approval from Health Research Authority on 7 February 2018. On completion the results will be made available via peer-reviewed journals.
Coital frequency and condom use in age-disparate partnerships involving women aged 15 to 24: evidence from a cross-sectional study in KwaZulu-Natal, South Africa
Authors: George Gavin , Maughan-Brown Brendan , Beckett Sean , Evans Meredith , Cawood Cherie , Khanyile David , Govender Kaymarlin , Kharsany Ayesha BM
Published: March 2019

Objective

This study examines the role of age-disparate partnerships on young women’s HIV risk by investigating coital frequency and condom use within age-disparate partnerships involving women aged 15 to 24.

Design

A community-based, cross-sectional study was conducted.

Setting

Participants were randomly selected using a two-stage random sampling method in uMgungundlovu district, KwaZulu-Natal, South Africa, between June 2014 and June 2015.

Participants

A total of 1306 15–24-year-old women in an ongoing heterosexual partnership were included in the analysis. Participants had to be a resident in the area for 12 months, and able to provide informed consent and speak one of the local languages (Zulu or English).

Primary and secondary outcome measures

Sexual frequency was assessed by asking participants how many times they had sex with each partner in the past 12 months. The degree of condomless sex within partnerships was assessed in the survey by asking participants how often they used a condom with their partners.

Results

Age-disparate partnerships were associated with a higher order category (once, 2–5, 6–10, 11–20, >20) of coital frequency (adjusted OR (aOR) 1.32, p<0.05, 95% CI 1.02 to 1.71) and with sex on more than 10 occasions (aOR 1.48, p<0.01, 95% CI 1.12 to 1.96) compared with age-similar partnerships. Age-disparate partnerships were also more likely to involve sex on more than 10 occasions with inconsistent condom use (aOR 1.43, p<0.05, 95% CI 1.04 to 1.96) in the previous 12 months.

Conclusion

The finding that increased sexual activity is positively associated with age-disparate partnerships adds to the evidence that age-disparate partnerships pose greater HIV risk for young women. Our study results indicate that interventions to reduce risky sexual behaviour within age-disparate partnerships remain relevant to reducing the high HIV incidence rates among adolescent girls and young women.