bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis and Experimental Research on the Fluid–Solid Coupled Heat Transfer of High-Speed Motorized Spindle Bearing Under Oil–Air Lubrication
Authors: Gao Feng , Jia Weitao , Li Yan , Zhang Dongya , Wang Zhengliang
Published: October 2020

For high-speed motorized spindle bearing, temperature rise is the primary factor that restricts the maximum speed of spindle and affects the stability of system. This paper addresses the lubrication and cooling of spindle bearing by exploiting the precise oil control and high cooling efficiency of oil–air lubrication. Enlightened by the bearing tribology and two-phase flow theory, a numerical model of oil–air two-phase flow heat transfer inside bearing cavity is created, with which the effects of operating condition and nozzle structure parameters on the temperature rise are studied. As the results show, with the elevation in speed, the heat generation increases rapidly, and despite the somewhat enhanced heat transfer effect, the temperature still tends to rise. Given the higher volume fraction of air than oil in the two-phase flow, the temperature rise of bearing is suppressed greatly as the air inlet velocity increases, revealing a remarkable cooling effect. When a single nozzle is used, the bearing temperature increases from the inlet to both sides, which peaks on the opposite side of the inlet. In case multiple evenly distributed nozzles are used, the high-temperature range narrows gradually, and the temperature distributions in the inner and outer rings tend to be consistent. With the increase in the nozzle aspect ratio, the airflow velocity drops evidently, which affects the heat dissipation, thereby resulting in an aggravated temperature rise. Finally, the simulation analysis is verified through experimentation, which provides a theoretical basis for selecting optimal parameters for the oil–air lubrication of high-speed bearing.
Comparison of Dry Sliding Tribological Behavior of Nanostructured Al2O3–13 wt% TiO2 Coatings Prepared by High-Efficiency Supersonic Plasma Spraying and Atmospheric Plasma Spraying
Authors: Jin Zi-ang , Ma Jian-long , Zhu Li-na , Wang Hai-dou , Li Guo-lu , Liu Ming
Published: October 2020

Plasma-sprayed ceramic coatings have been widely used in friction and wear protection of mechanical parts. In this paper, the nanostructured Al2O3–13 wt% TiO2 coatings were prepared by high-efficiency supersonic plasma spraying (HESP) and atmospheric plasma spraying (APS), respectively. The surface and section morphology of the coatings were observed by scanning electron microscopy (SEM). The phase composition of the coatings was analyzed by X-ray diffraction (XRD). The dry sliding friction properties of the coatings were tested on UMT-3 friction and wear testing machine. The results show that after plasma spraying, a large amount of γ-Al2O3 phase appears, while the TiO2 phase almost disappears in the coatings; compared with APS, the coatings sprayed by HESP have fewer defects and better coating quality; under dry friction condition, the steady-state friction coefficient of the coatings sprayed by HESP and APS all decreases with the increase of load, and the wear volume all increases with the increase of load. When the load is more than 40 N, wear volume of the coatings sprayed by APS is basically twice that of HESP; the wear mechanism of the coatings sprayed by HESP is the laminar cracking, peeling off and the adhesive wear.
Optimal Geometry for Cable Wrapping to Minimize Dynamic Impacts on Cable-Harnessed Beam Structures
Authors: Cao Shilei , Agrawal Pranav , Qi Naiming , Salehian Armaghan
Published: October 2020

Power and cable carrier systems have been shown to significantly impact the dynamic behavior of lightweight space structures. The goal of this paper is to obtain an optimal cable placement geometry for cable-harnessed beam structures by minimizing the impact of added cables on the system dynamics. The cable is harnessed to the beam in a periodic pattern, which forms several repeating fundamental elements within the structure. An analytical model for the cable-harnessed beam, using an energy-equivalence homogenization method, is employed for the purpose of optimization. The natural frequencies of the cable-harnessed beam are then matched with the bare beam (when no cables attached) using an optimization algorithm to find the optimal cable placement solution for the given system parameters. Subsequently, the system parameters’ effects on the optimal solutions are investigated and discussed. Experimental modal analysis is then performed to further validate the optimal solutions found using the model. The test results further validate findings from the model, and the frequency response functions from the bare and optimally wrapped beams align really well.
Natural Frequencies and Band Gaps of Periodically Corrugated Beams
Authors: Bachour Rhamy Salim , Nicoletti Rodrigo
Published: October 2020

Structures with geometric periodicity can present interesting dynamic properties like stop and pass frequency bands. In this case, the geometric periodicity has the effect of filtering the propagating waves in the structure, in a similar way to that of phononic crystals and metamaterials (non-homogeneous materials). Hence, by adopting such structures, we can design systems that present dynamic characteristics of interest, e.g., with minimum dynamic response in a given frequency range with large bandwidth. In the present work, we show that corrugated beams also present the dynamic properties of periodic structures due to their periodic geometry only (no need of changing mass or material properties along the beam). Two types of corrugated beams are studied analytically: beams with curved bumps of constant radii and beams with bumps composed of straight segments. The results show that, as we change the proportions of the bump, the natural frequencies change and tend to form large band gaps in the frequency spectrum of the beam. Such shifting of the natural frequencies is related to the coupling between longitudinal and transverse waves in the curved beam. The results also show that it is possible to predict the position and the limits of the first band gap (at least) as a function of the fundamental frequency of the straight beam (without bumps), irrespective of the total length of the corrugated beam.
Spinning Wave Scattering From a Flow Pipe With Serrations
Authors: Jiang Hanbo , Huang Xun
Published: October 2020

It is well known that trailing-edge serrations, which are also known as chevrons, are able to reduce the turbulent mixing noise from an aeroengine. The study of the associated control capability of the scattering of incident waves from the rotor–stator assembly is rare. To address this issue, a theoretical model is proposed to predict sound wave scattering from a cylindrical pipe with trailing-edge serrations in the presence of plug flows. The model incorporates Fourier series expansion into the Wiener–Hopf method and, therefore, is a natural extension of the previous aerofoil work by Huang (2017, “Theoretical Model of Acoustic Scattering From a Flat Plate With Serrations,” J. Fluid Mech., 819, pp. 228–257). The nature of the flow duct problem, however, leads to a much more complicated matrix kernel, and the associated factorization method is given in this article. The proposed model is validated by comparison with the numerical simulations at certain representative setups, which show the overall agreements to be satisfactory. The comparisons also show that the proposed model is so efficient that it can enable rapid predictions. A series of parametric studies are performed to study the two mechanisms behind the noise reduction of a serrated flow duct. One is the redistribution of acoustic energy to new higher cutoff modes. The other is the destructive interference due to multiple scattering from serrations. Overall, the proposed model should be helpful in offering deep physical insights and would be able to assist the aeroacoustic design and optimization of new low-noise aeroengines and flow duct systems after considering the tradeoff with aerodynamic impacts.
Implications of Nonsub-Wavelength Resonator Spacing on the Sound Transmission Loss Predictions of Locally Resonant Metamaterial Partitions
Authors: Van Belle Lucas , Claeys Claus , Deckers Elke , Desmet Wim
Published: October 2020

Locally resonant metamaterials have recently emerged and gained attention in the field of noise control engineering. The addition of resonant structures to a flexible partition on a sub-wavelength scale enables a targeted frequency range of strongly reduced vibration and sound transmission. These structures have been widely studied and are typically analyzed using infinite periodic structure theory. The implications of nonsub-wavelength resonator spacing on the sound transmission loss of metamaterial partitions as well as on the representativeness of the infinite periodic structure modeling are, however, less well known. In this technical brief, it is shown that, although a shifted sound transmission loss peak can be predicted for partitions with nonsub-wavelength resonator spacing when using infinite periodic structure modeling, the sound transmission loss enhancement is not guaranteed for their finite structure counterparts.
Psychological Factors Predicting Sedentary Behavior of Older Adults: A Cross-Sectional Study in Brazil
Authors: de Oliveira Daniel Vicentini , do Nascimento Matheus Amarante , Branco Bráulio Henrique Magnani , de Oliveira Rogéria Vicentini , do Nascimento Júnior José Roberto Andrade , Freire Gabriel Lucas Morais , Bertolini Sônia Maria Marques Gomes
Published: October 2020

This cross-sectional study aimed to investigate the psychological factors that might predict the sedentary behavior of 654 older adults from the South Region of Brazil. The participants were evaluated by the International Physical Activity Questionnaire; Mini-Mental State Exam; Geriatric Anxiety Scale; and the scales Geriatric Depression, Purpose in Life, Perceived Stress, Rosenberg Self-Esteem, and Satisfaction with Life. Data analysis was conducted through Pearson correlation and multiple regression analysis (p < .05). No significant (p > .05) correlation was found between the sedentary behavior variables with self-esteem. Multiple regression analysis revealed that psychological variables explained 6% of the variance of sitting time during the week (R2 = .06; F = 11.546; p < .01). Depression showed a positive prediction (β = −0.10; p = .040), while life satisfaction (β = −0.16; p = .001) and purpose in life (β = −0.10; p = .026) showed negative prediction. Psychological variables predicted only 3% of the variance of sitting time during the weekend (R2 = .03; F = 5.629; p < .01), showing that life satisfaction had significant (p = .007) and negative (β = −0.13) association. Life satisfaction and purpose in life can be considered protector factors to sedentary behavior, while depression is a potentiating factor.
In new strategy, Wellcome Trust takes on global health concerns
Authors: Kupferschmidt Kai
Published: October 2020

Giant philanthropy will focus on infectious disease, mental health, and the health effects of global warming.
Proximal colon–derived O-glycosylated mucus encapsulates and modulates the microbiota
Authors: Bergstrom Kirk , Shan Xindi , Casero David , Batushansky Albert , Lagishetty Venu , Jacobs Jonathan P. , Hoover Christopher , Kondo Yuji , Shao Bojing , Gao Liang , Zandberg Wesley , Noyovitz Benjamin , McDaniel J. Michael , Gibson Deanna L. , Pakpour Sepideh , Kazemian Negin , McGee Samuel , Houchen Courtney W. , Rao Chinthalapally V. , Griffin Timothy M. , Sonnenburg Justin L. , McEver Rodger P. , Braun Jonathan , Xia Lijun
Published: October 2020

So much more to mucus

Mammals accommodate a dense community of metabolically active microorganisms in their gut. This is not a passive relationship, and host and microbe have antagonistic as well as mutualistic responses to each other. Using a whole-colon imaging method in mice, Bergstrom
et al.
looked at the role of colonic mucus in segregating the microbiota from host cells during elimination of feces (see the Perspective by Birchenough and Johansson). Host goblet cells synthesize two forms of mucin that differ in branched chain O-glycosylation and the site of production in the colon. A “thick” mucus in the proximal, ascending colon wraps the microbiota to form fecal pellets. Transit along the distal, descending colon is lubricated by “thin” mucus that transiently links with the thick mucus. Normal mucus encapsulation prevents inflammation and hyperplasia and thus is important for maintenance of a healthy gut.

Science
, this issue p.
467
; see also p.
402
Oxygen-sensing mechanisms across eukaryotic kingdoms and their roles in complex multicellularity
Authors: Hammarlund Emma U. , Flashman Emily , Mohlin Sofie , Licausi Francesco
Published: October 2020

Origins and evolution of hypoxia response

In our current oxygen-rich atmosphere, the ability of eukaryotic cells to sense variation in oxygen concentrations is essential for adapting to low-oxygen conditions. However, Earth's atmosphere has not always contained such high oxygen concentrations. Hammarlund
et al.
discuss oxygen-sensing systems across both plants and animals and argue that the systems are functionally convergent and that their emergence in an initially hypoxic environment shaped how they operate today.

Science
, this issue p.
eaba3512
Orderly compartmental mapping of premotor inhibition in the developing zebrafish spinal cord
Authors: Kishore Sandeep , Cadoff Eli B. , Agha Moneeza A. , McLean David L.
Published: October 2020

Spinal circuit development

Motor neuron circuits in the zebrafish spinal cord support both the rapid evasion response and the leisurely swimming response. Kishore
et al.
now follow the development of inhibitory interneurons as these circuits are assembled in the larva. Interneurons generated early in development drive different sorts of circuits and synapse onto different subcellular sections of the motor neurons than interneurons generated later in development. Thus, both rapid evasion and slower swimming are supported by the same cellular components assembled in different ways. The authors suggest that development follows an opportunistic rule in which interneurons synapse onto what is available to them at that moment in development.

Science
, this issue p.
431
Metasurface-driven OLED displays beyond 10,000 pixels per inch
Authors: Joo Won-Jae , Kyoung Jisoo , Esfandyarpour Majid , Lee Sung-Hoon , Koo Hyun , Song Sunjin , Kwon Young-Nam , Song Seok Ho , Bae Jun Cheol , Jo Ara , Kwon Myong-Jong , Han Sung Hyun , Kim Sung-Han , Hwang Sungwoo , Brongersma Mark L.
Published: October 2020

Metasurface-based microdisplays

Organic light-emitting diodes (OLEDs) have found wide application in high-resolution, large-area televisions and the handheld displays of smartphones and tablets. With the screen located some distance from the eye, the typical number of pixels per inch is in the region of hundreds. For near-eye microdisplays—for example, in virtual and augmented reality applications—the required pixel density runs to several thousand pixels per inch and cannot be met by present display technologies. Joo
et al.
developed a full-color, high-brightness OLED design based on an engineered metasurface as a tunable back-reflector. An ultrahigh density of 10,000 pixels per inch readily meets the requirements for the next-generation microdisplays that can be fabricated on glasses or contact lenses.

Science
, this issue p.
459
Design of higher valency in covalent organic frameworks
Authors: Gropp Cornelius , Ma Tianqiong , Hanikel Nikita , Yaghi Omar M.
Published: October 2020

Higher-valency ligands for COFs

Metal-organic frameworks (MOFs) have exhibited more extensive connectivity (valency) and topological diversity than covalent organic frameworks (COFs), mainly because MOF linkers can connect from 3 to 24 discrete units or even infinity for one-dimensional rods. For COFs, linkers generally have a valency of 3 or 4 that reflect the valency of organic carbon. Gropp
et al.
created cubane-like linkers from 1,4-boronophenylphosphonic acid that could condense to make COFs with a valency of 8 or, by adding acid, could form large, single crystals with an infinite-rod topology.

Science
, this issue p.
eabd6406
The engines of SARS-CoV-2 spread
Authors: Lee Elizabeth C. , Wada Nikolas I. , Grabowski M. Kate , Gurley Emily S. , Lessler Justin
Published: October 2020

Fighting SARS-CoV-2 requires a clear framework for understanding epidemic spread
A case for “we” in an “I” country
The Upswing
Robert D. Putnam with Shaylyn Romney Garrett
Simon and Schuster, 2020. 480 pp.
Authors: Morone James A.
Published: October 2020

An eerily similar era gave way to social progress in the United States—will it happen again?
Science, politics, and public health
Authors: Roper William
Published: October 2020

There is an idea on the part of scientists that politics is dirty, and a companion idea on the part of politicians that science, by its continual qualifications and revisions, is, if not irrelevant, then at least out of touch with the constraints of a democracy: What seems optimal from the perspective of science may be impossible to implement in the political arena.
Systematic Investigation of Resistance Evolution to Common Antibiotics Reveals Conserved Collateral Responses across Common Human Pathogens
Authors: Rodriguez de Evgrafov Mari C. , Faza Marius , Asimakopoulos Konstantinos , Sommer Morten O. A.
Published: October 2020

As drug resistance continues to grow, treatment strategies that turn resistance into a disadvantage for the organism will be increasingly relied upon to treat infections and to lower the rate of multidrug resistance. The majority of work in this area has investigated how resistance evolution toward a single antibiotic effects a specific organism’s collateral response to a wide variety of antibiotics. The results of these studies have been used to identify networks of drugs which can be used to drive resistance in a particular direction.
Prediction of Vancomycin Levels Using Cystatin C in Overweight and Obese Patients: a Retrospective Cohort Study of Hospitalized Patients
Authors: Teaford Hilary R. , Stevens Ryan W. , Rule Andrew D. , Mara Kristin C. , Kashani Kianoush B. , Lieske John C. , O’Horo John , Barreto Erin F.
Published: October 2020

The use of the kidney function biomarker cystatin C (cysC) can improve the accuracy of vancomycin dosing for target trough attainment in nonobese patients. It is unknown whether cysC can also improve vancomycin target trough attainment in overweight and obese patients. We conducted a retrospective observational study of overweight or obese hospitalized adults with stable renal function administered intravenous vancomycin between January 2011 and July 2019. Linear regression models were used to predict initial steady-state vancomycin troughs using several factors, including various cysC- and serum creatinine (SCr)-based estimates of kidney function.
B-scan ultrasound, visual electrophysiology and perioperative videoendoscopy for predicting functional results in keratoprosthesis candidates
Authors: Silva Luzia Diegues , Santos Albert , Hirai Flavio , Allemann Norma , Berezovsky Adriana , Salomão Solange Rios , Oliveira Paulo Ricardo Chaves de , Andrade Gabriel , Maia André , Sousa Luciene Barbosa de , Oliveira Lauro Augusto de
Published: October 2020

Background/Aims

We analysed the ability of B-scan ultrasound, ocular electrophysiology testing and videoendoscopic examination for predicting visual prognosis in Boston Type 1 keratoprosthesis (KPro-1) candidates. Indirect anatomical and electrophysiological findings and results from direct endoscopic evaluations were correlated with postoperative functional data.

Methods

In this prospective and interventional study, we included 13 individuals who had previously been indicated for Kpro-1 surgery. All subjects underwent preoperative screening, including ophthalmic evaluation, B-scan ultrasound, electrophysiological testing, and perioperative intraocular videoendoscopic evaluation (VE). B-scan ultrasound, electrophysiological testing, and VE evaluation results were categorised as favourable or unfavourable predictors of postoperative functional results according to predefined criteria. The predictability values of B-scan ultrasound, electrophysiological testing, and VE prognostication were calculated based on the visual acuity level achieved.

Results

All surgeries and perioperative VEs were uneventful. Preoperative best-corrected visual acuity (BCVA) ranged from light perception to counting fingers. The 1-year postoperative BCVA was better than 20/200 (satisfactory visual acuity result) in 10 eyes (76.9%) and 20/40 or better in 5 eyes (38.5%). B-scan ultrasound presented a positive predictive value (PPV) of 85.7% for satisfactory postoperative visual acuity, electroretinography showed a PPV of 66.7%, and visual evoked potential presented a PPV of 66.7%. The perioperative VE PPV of a negative finding for satisfactory visual acuity was 100%.

Conclusions

Fundoscopic visualisation by intraocular VE is a minimally invasive procedure that can be used to predict functional outcomes in keratoprosthesis candidates. This technique demonstrated better prognostication in keratoprosthesis candidates than B-scan ultrasound and electrophysiological testing.
Comparison of intraocular lens calculation methods after myopic laser-assisted in situ keratomileusis and radial keratotomy without prior refractive data
Authors: Patel Priyanka , Ashena Zahra , Vasavada Viraj , Vasavada Shail A , Vasavada Vaishali , Sudhalkar Aditya , Nanavaty Mayank A
Published: October 2020

Aim

To compare intraocular lens (IOL) calculation methods not requiring refraction data prior to myopic laser-assisted in situ keratomileusis (LASIK) and radial keratotomy (RK).

Methods

In post-LASIK eyes, the methods not requiring prior refraction data were Hagis-L; Shammas; Barrett True-K no-history; Wang-Koch-Maloney; ‘average’, ‘minimum’ and ‘maximum’ IOL power on the American Society of Cataract and Refractive Surgeons (ASCRS) IOL calculator. Double-K method and Barrett True-K no-history, ‘average’, ‘minimum’ and ‘maximum’ IOL power on ASCRS IOL calculator were evaluated in post-RK eyes. The predicted IOL power was calculated with each method using the manifest postoperative refraction. Arithmetic and absolute IOL prediction errors (PE) (implanted–predicted IOL powers), variances in arithmetic IOL PE and percentage of eyes within ±0.50 and ±1.00 D of refractive PE were calculated.

Results

Arithmetic or absolute IOL PE were not significantly different between the methods in post-LASIK and post-RK eyes. In post-LASIK eyes, ‘average’ showed the highest and ‘minimum’ showed the least variance, whereas ‘average’ and ‘minimum’ had highest percentage of eyes within ±0.5 D and ‘minimum’ had the highest percentage of eyes within ±1.0 D. In the post-RK eyes, ‘minimum’ had highest variance, and ‘average’ had the least variance and highest percentage of eyes within ±0.5 D and ±1.0 D.

Conclusion

In post-LASIK and post-RK eyes, there are no significant differences in IOL PE between the methods not requiring prior refraction data. ‘Minimum’ showed least variance in PEs and more chances of eyes to be within ±1.0 D postoperatively in post-LASIK eyes. ‘Average’ had least variance and more chance of eyes within ±1.0 D in post-RK eyes.
Gestational diabetes status and dietary intake modify maternal and cord blood allostatic load markers
Authors: Jack-Roberts Chauntelle , Maples Patricia , Kalkan Betul , Edwards Kaydine , Gilboa Ella , Djuraev Ikhtiyor , Zou Shuli , Hoepner Lori , Fordjour Lawrence , Lee Wen-Ching , Kral John , Dalloul Mudar , Jiang Xinyin
Published: October 2020

Introduction

Allostatic load (AL) defines cardiometabolic, inflammatory, and neuroendocrine changes in the body in response to internal and external stressors. It is largely unknown whether gestational diabetes mellitus (GDM) alters maternal and fetal AL, which in turn affects GDM outcomes. Whether dietary intakes and quality can modify AL and thus influence GDM progression is also unknown.

Research design and methods

In this study, we recruited 35 GDM and 30 non-GDM women in gestational week 25–33. Fasting blood samples were collected at enrollment, and cord venous blood samples were collected at delivery for the measurement of a series of AL biomarkers to calculate the composite AL index. Three-day dietary recalls were conducted at enrollment.

Results

Results suggest that GDM women had 60% higher composite AL index scores (p value=0.01). Maternal AL index was associated with shorter duration of gestation (β=−0.33, p value=0.047) and higher fetal AL index (β=0.47, p value=0.006) after adjusting for GDM status. Dietary intake of monounsaturated fatty acids was negatively associated with maternal AL index (β=−0.20, p value=0.006). GDM women had lower total caloric intake and dietary glycemic load, yet their linolenic acid, vitamin C and E intakes were also decreased (all p value<0.05). These dietary differences were not related to birth outcomes measured.

Conclusions

In this study, GDM status and dietary intakes modify AL in this population. AL may serve as an indicator of GDM control. Future research on dietary interventions that can improve maternal AL markers during GDM is warranted.
Prevalence, incidence and predictors of cardiovascular risk factors: longitudinal data from rural and urban South India and comparison with global data
Authors: Vasan Senthil K , Antonisamy Belavendra , Gowri Mahasampath , Selliah Hepsy Y , Geethanjali Finney S , Jebasingh Felix S , Paul Thomas V , Thomas Nihal , Karpe Fredrik , Johnson Matthew , Osmond Clive , Fall Caroline H D
Published: October 2020

Introduction

India has high mortality rates from cardiovascular disease (CVD). Understanding the trends and identifying modifiable determinants of CVD risk factors will guide preventive strategies and policy making.

Research design and methods

CVD risk factors (obesity, central obesity, and type 2 diabetes (T2D), hypertension, hypercholesterolemia and hypertriglyceridemia) prevalence and incidence were estimated in 962 (male 519) non-migrant adults from Vellore, South India, studied in: (1) 1998–2002 (mean age 28.2 years) and (2) 2013–2014 (mean age 41.7 years). Prevalence was compared with the Non-Communicable Disease Risk Collaboration (global) data. Incidence was compared with another Indian cohort from New Delhi Birth Cohort (NDBC). Regression analysis was used to test baseline predictors of incident CVD risk factors.

Results

The prevalence at 28 and 42 years was 17% (95% CI 14% to 19%) and 51% (95% CI 48% to 55%) for overweight/obesity, 19% (95% CI 17% to 22%) and 59% (95% CI 56% to 62%) for central obesity, 3% (95% CI 2% to 4%) and 16% (95% CI 14% to 19%) for T2D, 2% (95% CI 1% to 3%) and 19% (95% CI 17% to 22%) for hypertension and 15% (95% CI 13% to 18%) and 30% (95% CI 27% to 33%) for hypertriglyceridemia. The prevalence of T2D at baseline and follow-up and hypertension at follow-up was comparable with or exceeded that in high-income countries despite lower obesity rates. The incidence of most risk factors was lower in Vellore than in the NDBC. Waist circumference strongly predicted incident T2D, hypertension and hypertriglyceridemia.

Conclusions

A high prevalence of CVD risk factors was evident at a young age among Indians compared with high and upper middle income countries, with rural rates catching up with urban estimates. Adiposity predicted higher incident CVD risk, but the prevalence of hypertension and T2D was higher given a relatively low obesity prevalence. Preventive efforts should target both rural and urban India and should start young.
Referrals to secondary care in an outpatient primary care walk-in clinic for refugees in Germany: results from a secondary data analysis based on electronic medical records
Authors: Schäfer Ingmar , Oltrogge Jan Hendrik , Pruskil Susanne , Mews Claudia , Schlichting Dana , Jahnke Martin , Wagner Hans-Otto , Lühmann Dagmar , Scherer Martin
Published: October 2020

Objectives

The aims of our study were to describe the disease spectrum of refugees, to analyse to what extent their healthcare needs could be met in an outpatient primary care walk-in clinic and which cases required additional services from secondary care (ie, outpatient specialists or hospitals).

Design

Retrospective longitudinal observational study.

Setting

The study was based on routine data from a walk-in clinic in the largest central first reception centre in Hamburg, Germany between 4 November 2015 and 21 July 2016.

Participants

1467 asylum seekers with 4006 episodes of care (ie, distinctive health problems) resulting in 5545 consultations. The patients were 60% men and had a mean age of 23.2 years. About 90% of the patients were from Central Asia or from the Middle East and North Africa.

Primary and secondary outcome measures

The endpoint of our analyses was referral to secondary care. Time to event was defined as days under treatment until the first referral. Predictor variables were the patients’ diagnoses grouped in 46 categories. The data set was analysed by Cox regression allowing for multiple failure times per patient. This analysis was adjusted for age, sex and country of origin.

Results

Referrals to secondary care occurred in 15.5% of the episodes. The diagnosis groups with the highest referral rates were ‘eye’ (HR 4.9; 95% CI 3.12 to 7.8; p≤0.001), ‘teeth/gum symptom/complaint or disease’ (3.51; 2.52 to 4.9; p≤0.001) and ‘urological system/female or male genital’ (2.50; 1.66 to 3.77; p≤0.001). Age, sex and country of origin had no significant effect on time until referral.

Conclusions

In most cases, the walk-in clinic physicians could provide first-line medical care for the health problems of patients not integrated in the German healthcare system. Additional resources were needed particularly not only for visual impairment and dental problems but also for psychological disorders, antenatal care and certain infections and injuries.
Protocol for a prospective, observational, hospital-based multicentre study of nosocomial SARS-CoV-2 transmission: NOSO-COR Project
Authors: Saadatian-Elahi Mitra , Picot Valentina , Hénaff Laetitia , Pradel Florence K , Escuret Vanessa , Dananché Cédric , Elias Christelle , Endtz Hubert P , Vanhems Philippe
Published: October 2020

Introduction

The newly identified SARS-CoV-2 can cause serious acute respiratory infections such as pneumonia. In France, mortality rate in the general population was approximately 10% and could reach higher levels at the hospital. In the current context of high incidence rates of SARS-CoV-2 in the community, a significant increase in the rate of nosocomial transmission is expected. The risk of nosocomial transmission could even be higher in low-income countries that have fragile healthcare systems. This protocol is intended to estimate the prevalence and incidence of suspected or confirmed cases of nosocomial SARS-CoV-2 infection, the clinical spectrum and the determinants (risk factors/protective) at participating hospitals.

Methods and analysis

This will be an international multicentre prospective, observational, hospital-based study in adults and children. It will include volunteer patients and healthcare professionals in France and hospitals affiliated with the GABRIEL network. Demographic and clinical data will be collected using case report forms designed especially for the purpose of the project. A nasopharyngeal swab will be collected and tested for SARS-CoV-2 by reverse-transcriptase PCR. Characteristics of the study participants, the proportion of confirmed nosocomial SARS-CoV-2 infections relative to all patients with syndromes suggestive of SARS-CoV-2 infection, will be analysed. Appropriate multivariate modelling will be used to identify the determinants associated with nosocomial onset.

Ethics and dissemination

This study was approved by the clinical research and committee of all participating countries. The findings will be submitted to peer-reviewed journal for publication and shared with national health authorities.

Trial registration number

NCT04290780.
Histopathological features of prostate cancer conspicuity on multiparametric MRI: protocol for a systematic review and meta-analysis
Authors: Norris Joseph M , Carmona Echeverria Lina M , Simpson Benjamin S , Ball Rhys , Freeman Alex , Kelly Daniel , Kirkham Alex , Whitaker Hayley C , Emberton Mark
Published: October 2020

Introduction

Multiparametric MRI (mpMRI) has improved risk stratification for men with suspected prostate cancer. Indeed, mpMRI-visible tumours tend to be larger and of higher pathological grade than mpMRI-invisible tumours; however, concern remains around significant cancer that is undetected by mpMRI. There has been considerable recent interest to investigate whether tumour conspicuity on mpMRI is associated with additional histopathological features (including cellular density, microvessel density and unusual prostate cancer subtypes), which may have important clinical implications in both diagnosis and prognosis. Furthermore, analysis of these features may help reveal the radiobiology that underpins the actual mechanisms of mpMRI visibility (and invisibility) of prostate tumours. Here, we describe a protocol for a systematic review of the histopathological basis of prostate cancer conspicuity on mpMRI.

Methods and analysis

A systematic search of the MEDLINE, PubMed, Embase and Cochrane databases will be conducted. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines will be used to guide screening, thematic reporting and conclusions drawn from all eligible studies. Included papers will be full-text, English-language articles, comparing the histopathological characteristics of mpMRI-visible lesions and mpMRI-invisible tumours. All studies published between January 1950 and January 2020 will be eligible for inclusion. Studies using confirmatory immunohistochemistry for the identification of immune subsets or structural components will be included. Study bias and quality will be assessed using a modified Newcastle-Ottawa scale. To ensure methodological rigour, this protocol is written in accordance with the PRISMA Protocol 2015 checklist. If appropriate, a meta-analysis will be conducted comparing histopathological feature frequency between mpMRI-visible and mpMRI-invisible disease.

Ethics and dissemination

No ethical approval will be required as this is an academic review of published literature. Findings will be disseminated through publications in peer-reviewed journals and presentations at national and international conferences.

PROSPERO registration number

CRD42020176049
Assessing care trajectories of adolescent females seeking early induced abortion in New South Wales: multistage, mixed-methods study protocol
Authors: Assifi Anisa Rojanapenkul , Kang Melissa , Sullivan Elizabeth , Dawson Angela J
Published: October 2020

Introduction

In Australia, New South Wales (NSW), abortion has recently been removed from the criminal code. Previous research from Australia and other high-income countries has focused on adult women’s access to abortion services. This protocol describes a five-stage mixed-methods study to determine the care trajectories and experiences of adolescent females, aged 16–19 years, seeking an early induced abortion in NSW. The aims are to (1) explore the needs and perspectives of adolescent females seeking sexual and reproductive health services in NSW and (2) develop a framework for abortion service provision for adolescents in NSW.

Methods and analysis

This study comprises: (1) semistructured qualitative interviews with key informants, individuals with diverse, in-depth experience of providing and/or supporting abortion care in NSW; (2) a cross-sectional online survey of adolescent females residing in NSW; (3) case study interviews with adolescents females who have accessed an abortion service in NSW; (4) a co-design workshop with adolescents who took part in stage 3 to develop relevant knowledge and recommendations and (5) a knowledge dissemination forum with key stakeholders.

Ethics and dissemination

Ethics approval has been received from the University of Technology Sydney Human Research Ethics Committee for this study. Data collection commenced in March 2019 and will continue until the end of 2020. This study aims to develop a deep understanding of adolescent abortion care trajectories and experiences of abortion services in NSW. The study will deliver co-produced recommendations to improve adolescent access to abortion information and services.
Mixed-methods process evaluation of SafeTea: a multimedia campaign to prevent hot drink scalds in young children and promote burn first aid
Authors: Cowley Laura Elizabeth , Bennett C Verity , Brown Isabelle , Emond Alan , Kemp Alison Mary
Published: October 2020

Objectives

SafeTea is a multifaceted intervention delivered by community practitioners to prevent hot drink scalds to young children and improve parents’ knowledge of appropriate burn first aid. We adapted SafeTea for a national multimedia campaign, and present a mixed-methods process evaluation of the campaign.

Methods

We used social media, a website hosting downloadable materials and media publicity to disseminate key messages to parents/caregivers of young children and professionals working with these families across the UK. The SafeTea campaign was launched on National Burns Awareness Day (NBAD), October 2019, and ran for 3 months. Process evaluation measurements included social media metrics, Google Analytics, and quantitative and qualitative results from a survey of professionals who requested hard copies of the materials via the website.

Results

Findings were summarised under four themes: ‘reach’, ‘engagement’, ‘acceptability’ and ‘impact/behavioural change’. The launch on NBAD generated widespread publicity. The campaign reached a greater number of the target audience than anticipated, with over 400 000 views of the SafeTea educational videos. Parents and professionals engaged with SafeTea and expressed positive opinions of the campaign and materials. SafeTea encouraged parents to consider how to change their behaviours to minimise the risks associated with hot drinks. Reach and engagement steadily declined after the first month due to reduced publicity and social media promotion.

Conclusion

The SafeTea campaign was successful in terms of reach and engagement. The launch on NBAD was essential for generating media interest. Future campaigns could be shorter, with more funding for additional social media content and promotion.
The link between unemployment and opioid prescribing. An instrumental variable approach using evidence from England
Authors: Vandoros Sotiris , Gong Xiangpu , Kawachi Ichiro
Published: October 2020

Background

Unemployment has been associated with chronic pain, which is often treated with prescription opioids. Opioid mortality has been included in the so-called category of ‘deaths of despair’ due to the role of lack of opportunity. While previous studies have found an association between unemployment and opioids, the relationship is endogenous and examining any effect is challenging.

Objective

The objective of this paper is to study the association between unemployment and opioid prescribing in England.

Data and Methods

We used data from the GP prescribing database in England for the period 2011–2017 and followed ordinary least squares (OLS) and Instrumental Variable econometric approaches, controlling for other confounders. We used the number of foreign direct investment projects and the number of registered companies as instruments for unemployment, taking population size into account.

Results

The OLS model suggests that an increase in the unemployment rate by 1 percentage point is associated with 0.017 additional opioid defined daily doses per capita—a 0.9% increase compared with the mean of 1.745. According to the instrumental variable model, an increase in unemployment by 1 percentage point leads to an increase in the number of opioid doses prescribed per capita by between 0.315 and 0.437, which constitutes a 18–25% increase compared with the mean of 1.745.

Conclusions

Unemployment appears to have an impact on opioid prescribing volume in England. This reveals yet another negative effect of unemployment on health. Relevant labour market policies may play a protective role with regards to opioid use.
CSF sphingomyelin: a new biomarker of demyelination in the diagnosis and management of CIDP and GBS
Authors: Capodivento Giovanna , De Michelis Chiara , Carpo Marinella , Fancellu Roberto , Schirinzi Erika , Severi Daniele , Visigalli Davide , Franciotta Diego , Manganelli Fiore , Siciliano Gabriele , Beronio Alessandro , Capello Elisabetta , Lanteri Paola , Nobile-Orazio Eduardo , Schenone Angelo , Benedetti Luana , Nobbio Lucilla
Published: October 2020

Objective

To validate sphingomyelin (SM) dosage in the cerebrospinal fluid (CSF) of patients affected by chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and Guillain-Barré syndrome (GBS) as a reliably assessable biomarker.

Methods

We prospectively enrolled 184 patients from six Italian referral centres, in whom CSF SM levels were quantified by a fluorescence-based assay optimised and patented in our laboratory.

Results

We confirmed increased levels of SM in the CSF of patients affected by typical CIDP (n=35), atypical CIDP (n=18) and acute inflammatory demyelinating polyradiculoneuropathy, AIDP (n=12) compared with patients affected by non-demyelinating neurological diseases, used as controls (n=85) (p<0.0001, p=0.0065 and p<0.0001, respectively). In patients with CIDP classified for disease stage, SM was higher in active CIDP compared with both controls and stable CIDP (p<0.0001), applying for a selective tool to treatment tailoring or withdrawal. SM was also increased in AIDP compared with axonal GBS, discerning the demyelinating from axonal variant of the disease. SM did not correlate with CSF protein levels, stratifying patients independently from commonly used CSF indexes, and displaying high specificity to avoid potential misdiagnosis. Finally, SM correlated with the main clinical scores and some neurophysiological parameters in patients with CIDP and AIDP.

Conclusions

CSF SM is a diagnostic and staging wet biomarker for acquired demyelinating neuropathies and may effectively improve the management of patients affected by GBS and CIDP.
Occupational exposure to specific organic solvents and risk of subtypes of breast cancer in a large population of Danish women, 1964–2016
Authors: Pedersen Julie Elbaek , Strandberg-Larsen Katrine , Andersson Michael , Hansen Johnni
Published: October 2020

Objective

To explore associations between occupational exposure to four specific organic solvents, respectively, and female breast cancer, including subtypes.

Methods

Using the Danish Cancer Registry, we identified 38 375 women under age 70 years with primary breast cancer. Five randomly selected breast-cancer-free controls per case matched on year of birth were retrieved from the Danish Civil Registration System . A nationwide pension fund was used to retrieve full employment history, and exposure to 1,1,1-trichloroethane, trichloroethylene (TCE), benzene and toluene was assessed using a job exposure matrix. ORs were estimated using conditional logistic regression with adjustment for reproductive factors and socioeconomic status.

Results

Overall results indicated no noteworthy associations between the specific organic solvents and breast cancer before and after age 50 years, except for a small increased risk after age 50 in women exposed to TCE (OR=1.15, 95% CI: 0.97–1.36). After age 50 years, exposure to TCE was associated with a small increased risk in women with over 20 years of latency (OR=1.26, 95% CI: 1.02–1.56). Further, an increased risk of oestrogen receptor positive (ER+) tumours was also observed (OR=1.21, 95% CI: 1.01–1.47), and high cumulative exposure and longer latency also increased the risk of this subtype.

Conclusion

This study provides limited evidence supporting the association between occupational exposure to each of the four organic solvents and breast cancer. The risk of ER+ breast tumours after age 50 years may be increased in women with TCE exposure, and this possible association therefore needs further attention in future studies.
Bobble-head doll syndrome with supra-sellar arachnoid cyst
Authors: Indira Priya Done , Sugumaran Ramkumar , Sunil K Narayan , Supriya Chauhan
Published: October 2020

A 19-year-old woman reported progressively worsening involuntary head movements since the age of 7. She had visited multiple hospitals and been labelled as having a functional disorder. Detailed evaluation identified a large supra-sellar arachnoid cyst with hydrocephalus. We made a diagnosis of bobble-head doll syndrome, which is only very rarely associated with suprasellar arachnoid cyst. Her symptoms improved rapidly following endoscopic third ventriculostomy with cyst fenestration and gradual decompression of the ventricles. Clearly, not all suppressible movements should be labelled as psychogenic.
Quantile regression of tobacco tax pass-through in the UK 2013–2019. How have manufacturers passed through tax changes for different tobacco products?
Authors: Wilson Luke Brian , Pryce Robert , Hiscock Rosemary , Angus Colin , Brennan Alan , Gillespie Duncan
Published: October 2020

Background

The effectiveness of tax increases relies heavily on the tobacco industry passing on such increases to smokers (also referred to as ‘pass-through’). Previous research has found heterogeneous levels of tax pass-through across the market segments of tobacco products available to smokers. This study uses retail sales data to assess the extent to which recent tax changes have been passed on to smokers and whether this varies across the price distribution.

Methods

We use panel data quantile regression analysis on Nielsen commercial data of tobacco price and sales in the UK from January 2013 to March 2019 combined with official UK tax rates and inflation to calculate the rate of tax pass-through for factory made (FM) cigarettes and roll your own (RYO) tobacco.

Results

Following increases in the specific tax payable on tobacco, we find evidence of overshifting across the price distribution for both FM and RYO. The rate of the overshift in tax increased the more expensive the products were. This was consistent for FM and RYO. Additionally, our findings suggest that the introduction of standardised packaging was not followed by changes in how the tobacco industry responded to tax increases.

Conclusions

Following the repeated introduction of increases in specific tobacco tax as well as standardised packaging, we show that the tobacco industry applies techniques to keep the cheapest tobacco cheaper relative to the more expensive products when passing on tax increases to smokers.
Life‐threatening hyperkalaemia during general anaesthesia in a domestic short‐haired cat
Authors: Felisberto Ricardo , Auckburally Adam , Flaherty Derek
Published: October 2020

There are an increasing number of reports describing the development of hyperkalaemia in healthy veterinary patients during general anaesthesia. While the majority of cases are dogs, it has also been described in large non‐domestic cats under general anaesthesia. To the authors’ knowledge, there are no reported cases of acute hyperkalaemia in healthy domestic cats associated with anaesthesia. This case report describes the development of hyperkalaemia in a nine‐year‐old domestic short‐haired cat, anaesthetised for fracture repair. Hyperkalaemia (8.0 mmol/l) was recognised due to the sudden development of bradycardia, spiked T waves, decreased amplitude of P waves, progressing to atrial standstill on the ECG. Initial treatment was with calcium gluconate, insulin and glucose, which resolved the problem, but the hyperkalaemia recurred during recovery from anaesthesia, necessitating further treatment. Possible causes of the hyperkalaemia are discussed.