bluuebunny/crossref_metadata_2025 huggingface dataset:
Beta-blockeRs tO patieNts with CHronIc Obstructive puLmonary diseasE (BRONCHIOLE) – Study protocol from a randomized controlled trial
Authors:   the BRONCHIOLE investigators, Sundh Josefin , Magnuson Anders , Montgomery Scott , Andell Pontus , Rindler Gustaf , Fröbert Ole
Published: January 2020

Background

Observational studies indicate that beta-blockers are associated with a reduced risk of exacerbation and mortality in patients with chronic obstructive pulmonary disease (COPD) even without overt cardiovascular disease, but data from randomized controlled trials (RCT) are lacking. The aim of this RCT is to investigate whether beta-blocker therapy in patients with COPD without diagnosed cardiovascular disease is associated with a decreased 1-year risk of the composite endpoint of death, exacerbations, or cardiovascular events.

Methods

The Beta-blockeRs tO patieNts with CHronIc Obstructive puLmonary diseasE (BRONCHIOLE) study is an open-label, multicentre, prospective RCT. A total of 1700 patients with COPD will be randomly assigned to either standard COPD care and metoprolol at a target dose of 100 mg per day or to standard COPD care only. The primary endpoint is a composite of death, COPD exacerbations, and cardiovascular events. Major exclusion criteria are ischemic heart disease, left-sided heart failure, cerebrovascular disease, critical limb ischemia, and atrial fibrillation/flutter. Study visits are an inclusion visit, a metoprolol titration visit at 1 month, follow-up by telephone at 6 months, and a final study visit after 1 year. Outcome data are obtained from medical history and record review during study visits, as well as from national registries.

Discussion

BRONCHIOLE is a pragmatic randomized trial addressing the potential of beta-blockers in patients with COPD. The trial is expected to provide relevant clinical data on the efficacy of this treatment on patient-related outcomes in patients with COPD.

Trial registration

ClinicalTrials.gov, ID: NCT03566667. Registered on 25 June 2018.
Randomised, double-blind, placebo controlled multi-centre study to assess the efficacy, tolerability and safety of Enterosgel® in the treatment of irritable bowel syndrome with diarrhoea (IBS-D) in adults
Authors: Kemppinen Anu , Howell Carol , Allgar Victoria , Dodd Matthew , Gregson John , Knowles Charles , McLaughlin John , Pandya Preeti , Whorwell Peter , Markaryan Elena , Yiannakou Yan
Published: January 2020

Background

Irritable bowel syndrome (IBS) with diarrhoea (IBS-D) is a common and chronic condition that can significantly impair quality of life. The emergence of new drugs for IBS-D has been slow and there is a need for new treatments, including drug-free treatments, which are easy to use and suitable for different patient groups. Currently available drug-free treatments include Enterosgel®, an intestinal adsorbent approved for use in IBS-D and acute diarrhoea and available over-the-counter in the UK and 30 countries worldwide. The aim of this randomised, double-blind, placebo-controlled, multi-centre study is to test the efficacy and safety of Enterosgel® compared to placebo in symptomatic treatment in IBS-D.

Methods/design

We will recruit 430 participants with IBS-D from approximately 30 primary and secondary care sites in England. Participants meeting the required abdominal pain and stool consistency criteria over a 2-week screening period will be randomly allocated to receive blinded treatment (Enterosgel® or placebo) for 8 weeks. This will be followed by an 8-week open-label treatment phase with Enterosgel®. Participants will be allowed to adjust their daily dosage during both phases based on their symptoms. Participants will then return to standard care and those who responded to treatment will receive a follow-up call 8 weeks later. Co-medication with loperamide will be permitted and use recorded. The primary outcome measure is the percentage of participants defined as responders for abdominal pain and stool consistency during at least 4 weeks in the 8-week blinded phase. Secondary outcome measures include stool frequency, stool consistency, abdominal pain, bloating, urgency, adequate relief, questionnaire scores and rescue medication use. Exploratory outcomes will be assessed in subsets of participants including qualitative and quantitative data on faecal microorganisms and biomarkers and gut-related measurements from magnetic resonance imaging data.

Discussion

This is the first large scale randomised controlled trial investigating Enterosgel® in IBS-D. A study design with blinded phase followed by an open-label phase was chosen to encourage participation and study completion. Demonstrating that Enterosgel® is effective and safe in IBS-D could encourage adoption by patients and healthcare professionals and foster future clinical trials assessing its use in related conditions.

Trial registration

ISRCTN17149988. Prospectively registered on 14 November 2017.
Exploring why sodium lignosulfonate influenced enzymatic hydrolysis efficiency of cellulose from the perspective of substrate–enzyme adsorption
Authors: Zheng Wenqiu , Lan Tianqing , Li Hui , Yue Guojun , Zhou Haifeng
Published: January 2020

Background

Cellulase adsorbed on cellulose is productive and helpful to produce reducing sugars in enzymatic hydrolysis of lignocellulose; however, cellulase adsorbed on lignin is non-productive. Increasing productive adsorption of cellulase on cellulose would be beneficial in improving enzymatic hydrolysis. Adding lignin that was more hydrophilic in hydrolysis system could increase productive adsorption and promote hydrolysis. However, the effect mechanism is still worth exploring further. In this study, lignosulfonate (LS), a type of hydrophilic lignin, was used to study its effect on cellulosic hydrolysis.

Results

The effect of LS on the enzymatic hydrolysis of pure cellulose (Avicel) and lignocellulose [dilute acid (DA) treated sugarcane bagasse (SCB)] was investigated by analyzing enzymatic hydrolysis efficiency, productive and non-productive cellulase adsorptions, zeta potential and particle size distribution of substrates. The result showed that after adding LS, the productive cellulase adsorption on Avicel reduced. Adding LS to Avicel suspension could form the Avicel–LS complexes. The particles were charged more negatively and the average particle size was smaller than Avicel before adding LS. In addition, adding LS to cellulase solution formed the LS–cellulase complexes. For DA-SCB, adding LS decreased the non-productive cellulase adsorption on DA-SCB from 3.92 to 2.99 mg/g lignin and increased the productive adsorption of cellulase on DA-SCB from 2.00 to 3.44 mg/g cellulose. Besides, the addition of LS promoted the formation of LS–lignin complexes and LS–cellulase complexes, and the complexes had more negative charges and smaller average sizes than DA-SCB lignin and cellulase particles before adding LS.

Conclusions

In this study, LS inhibited Avicel’s hydrolysis, but enhanced DA-SCB’s hydrolysis. This stemmed from the fact that LS could bind cellulase and Avicel, and occupied the binding sites of cellulase and Avicel. Thus, a decreased productive adsorption of cellulase on Avicel arose. Regarding DA-SCB, adding LS, which enhanced hydrolysis efficiency of DA-SCB, increased the electrostatic repulsion between DA-SCB lignin and cellulase, and therefore, decreased non-productive adsorption of cellulase on DA-SCB lignin and enhanced productive adsorption of cellulase on DA-SCB cellulose.

Graphical abstract
Maternal survival in a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe
Authors: Ngwenya Solwayo , Nleya Faith , Mwembe Desmond
Published: January 2020

Objectives

Maternal mortality is an important global subject. This dataset was generated from a retrospective cross-sectional study carried out at Mpilo Central Hospital, covering the period January 1, 2015 to December 31, 2018. The aim of the study was to compare how frequently the exposure to a risk factor was related to maternal death. Maternal deaths that were recorded during the study period were considered as cases. Controls were selected randomly from women of child-bearing age who survived during the study period. Low-resourced countries contribute significantly to global maternal deaths. Understanding risk factors could help reduce maternal mortality.

Data description

The dataset contains data of 387 pregnant women who were included in the study. Data were collected as secondary data using a data collection sheet, as recorded by the hospital staff that gave all necessary demographic details in birth and mortality registers. The data collected included socio-demographic and clinical data. The independent variables were maternal age, gravidity, parity, antenatal visits, booking status, marital status, educational status, days spent in hospital, mode of delivery, fetal outcomes, and maternal complications. The dependent variable was maternal mortality. The data can be used to determine the relationship between the independent variables and maternal death.
Inside the system-wide cultural district: a new relational and organisational taxonomy of cultural districts based on the sector policies by Italian Regions (2000–2015)
Authors: Colavitti Anna Maria , Usai Alessia
Published: January 2020

A considerable environmental turbulence pushes cultural and creative firms to cluster and to adopt new forms of cross-integration. An issue common also to wider entrepreneurial ecosystems (EEs) of SMEs. This evolutionary trend has given birth to a new generation of cultural districts defined as system-wide cultural districts (SWCDs) in which culture acts like a lever for all production sectors and not merely the cultural one, as in the past. The paper investigates the internal nested geographies of SWCDs through a comparative analysis of the district policies implemented by Italian Regions from 2000 to 2015 providing a new classification of cultural districts that updates the existing ones and reflecting on the links between SWCDs, urban policies and landscape planning.
Everything in moderation: ICT and reading performance of Dutch 15-year-olds
Authors: Gubbels Joyce , Swart Nicole M. , Groen Margriet A.
Published: January 2020

Previous research on the relationship between students’ home and school Information and Communication Technology (ICT) resources and academic performance has shown ambiguous results. The availability of ICT resources at school has been found to be unrelated or negatively related to academic performance, whereas the availability of ICT resources at home has been found to be both positively and negatively related to academic performance. In addition, the frequency of use of ICT is related to students’ academic achievement. This relationship has been found to be negative for ICT use at school, however, for ICT use at home the literature on the relationship with academic performance is again ambiguous. In addition to ICT availability and ICT use, students’ attitudes towards ICT have also been found to play a role in student performance. In the present study, we examine how availability of ICT resources, students’ use of those resources (at school, outside school for schoolwork, outside school for leisure), and students’ attitudes toward ICT (interest in ICT, perceived ICT competence, perceived ICT autonomy) relate to individual differences in performance on a digital assessment of reading in one comprehensive model using the Dutch PISA 2015 sample of 5183 15-year-olds (49.2% male). Student gender and students’ economic, social, and cultural status accounted for a substantial part of the variation in digitally assessed reading performance. Controlling for these relationships, results indicated that students with moderate access to ICT resources, moderate use of ICT at school or outside school for schoolwork, and moderate interest in ICT had the highest digitally assessed reading performance. In contrast, students who reported moderate competence in ICT had the lowest digitally assessed reading performance. In addition, frequent use of ICT outside school for leisure was negatively related to digitally assessed reading performance, whereas perceived autonomy was positively related. Taken together, the findings suggest that excessive access to ICT resources, excessive use of ICT, and excessive interest in ICT is associated with lower digitally assessed reading performance.
Determination of the increased risk of developing atrial fibrillation in fibromyalgia syndrome
Authors: Akkaya Hasan , Güntürk Ertuğrul Emre , Kaydok Ercan , Özdemir Betül
Published: January 2020

Introduction

Atrial fibrillation (AF) is the leading cause of ischemic stroke and is one of the most common arrhythmias. Previous studies have shown that impaired diastolic functions, P wave dispersion (Pd), and prolonged atrial conduction times (ACT) are associated with increased incidence of atrial fibrillation (AF). The aim of this study was to evaluate diastolic functions, Pd, and ACT in fibromyalgia syndrome (FMS) patients to determine whether there is an increase in the risk of developing AF.

Methods

The study included a total of 140 female patients (70 FMS group, 70 healthy control group). Pd was evaluated using 12 lead electrocardiography (ECG), and diastolic functions and ACT with echocardiography. The ECG and echocardiographic evaluations were performed by different cardiologists blinded to the clinical information of the subjects.

Results

There was no difference between the two groups in laboratory and clinical parameters. Patients with FMS had significantly higher echocardiographic parameters of ACT known as left-sided intra-atrial (13.9 ± 5.9 vs. 8.1 ± 1.8, p < 0.001), right-sided intra-atrial (21.9 ± 8.2 vs. 10.4 ± 3.5, p < 0.001) and interatrial [40 (25–64) ms vs. 23 (14–27) ms p < 0.001] electromechanical interval (EMI) compared with the control group. Pd was significantly greater in the FMS group compared with the control group [46 (29–62) ms vs. 32 (25–37) ms, p < 0.001]. In the FMS group, there was no significant relationship of the echocardiographic parameters of ACT, Pmax and Pd with age, E/A ratio and deceleration time (DT); while all these five parameters were significantly correlated with left atrial dimension, isovolumetric relaxation time (IVRT), fibromyalgia impact questionnaire (FIQ) and visual analogue scale (VAS). There was a strong correlation between FIQ and VAS and echocardiographic parameters of ACT, Pmax and Pd.

Conclusions

Impaired diastolic functions, an increase in Pd, and prolongation of ACT were observed in FMS. Current disorders are thought to be associated with an increased risk of AF in FMS. The risk of developing AF increases with the severity of FMS and clinical progression.
Neutrophil/lymphocyte and platelet/lymphocyte ratios as potential markers of disease activity in patients with Ankylosing spondylitis: a case-control study
Authors: Al-Osami Mohammed Hadi , Awadh Nabaa Ihsan , Khalid Khalid Burhan , Awadh Ammar Ihsan
Published: January 2020

Background

The neutrophil/ lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) have the potential to be inflammatory markers that reflect the activity of many inflammatory diseases. The aim of this study was to evaluate the NLR and PLR as potential markers of disease activity in patients with ankylosing spondylitis.

Methods

The study involved 132 patients with ankylosing spondylitis and 81 healthy controls matched in terms of age and gender. Their sociodemographic data, disease activity scores using the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), erythrocyte sedimentation rate (ESR), and white blood cell, neutrophil, lymphocyte and platelet counts were recorded. The patients with ankylosing spondylitis were further divided according to their BASDAI scores into patients with inactive disease (BASDAI < 4) and patients with active disease (BASDAI ≥4). The correlations between the NLR, PLR and disease activity were analysed.

Results

There was a statistically significant difference in the NLR and PLR between the active and inactive ankylosing spondylitis patients (2.31 ± 1.23 vs. 1.77 ± 0.73, p = 0.002), (142.04 ± 70.98 vs. 119.24 ± 32.49, p <  0.001, respectively). However, there was no significant difference in both the NLR and PLR between the healthy control group and ankylosing spondylitis patients (p > 0.05). In addition, the PLR was significantly higher in both the active and inactive groups compared to those in the healthy control group (142.04 ± 70.98 vs. 99.32 ± 33.97, p = 0.014), (119.24 ± 32.49 vs. 99.32 ± 33.97, p = 0.019). The BASDAI scores were positively correlated with the PLR (r = 0.219, p = 0.012) and the NLR, but they were not statistically significant with the later (r = 0.170, p = 0.051). Based on the ROC curve, the best NLR cut-off value for predicting severe disease activity in ankylosing spondylitis patients was 1.66, with a sensitivity of 61.8% and a specificity of 50.6%, whereas the best PLR cut-off value was 95.9, with a sensitivity of 70.9% and a specificity of 55.5%.

Conclusion

The PLR may be used as a useful marker in the assessment and monitoring of disease activity in AS together with acute phase reactants such as the ESR.
Is gap balancing superior to measured resection technique in total knee arthroplasty? A meta-analysis
Authors: He Qiang , Sun Caihong , Ma Jianbing , Guo Jianbing
Published: January 2020

Background

Measured resection and gap balancing are two distinct methods for proper femoral component alignment in total knee arthroplasty. Decision-making between the two techniques is controversial. The aim of this systematic review and meta-analysis was to compare measured resection and gap balancing with regard to the radiological and clinical benefits, and to examine whether this change the conclusions from previous trails.

Methods

A systematic literature search of the medical literature from January 1990 to February 2015 was performed. We selected six randomized controlled trials and five prospective cohort studies comparing gap balancing and measured resection in patients undergoing primary total knee arthroplasty. Data from included studies were pooled with use of fixed-effects and random-effects models with standard mean differences and risk ratios for continuous and dichotomous variables, respectively. Heterogeneity across studies was assessed with calculation of the I2statistic.

Results

A total of 857 knees from 11 trials were included. Four hundred and forty-one knees were treated with gap balancing and 416 were treated with measured resection. In contrast to previous studies, we found that gap balancing demonstrated better patient-reported outcomes with regard to Knee Society score for pain (WMD 2.75,p = 0.004) and Knee Society score for function (WMD 5.47,p < 0.0001) at two-year follow-up. Gap balancing showed more precise limb alignment in terms of post-operative value of mechanical axis (WMD 0.40°,p = 0.01) and risk of mechanical alignment outliers (RR 0.350,p < 0.0001). However, gap balancing was associated with more joint line elevation (WMD 1.27 mm,p < 0.0001) and longer operative time (WMD 16.18 min,p < 0.0001). No significant difference was observed in rotation of the femoral component (p = 0.07).

Conclusions

The meta-analysis demonstrated that gap balancing was able to achieve more precise coronal alignment with better short-term patient-reported outcomes compared with measured resection. Measured resection was more desirable than gap balancing with regard to restoration of the joint line and operative time. Comparable femoral rotational alignment was observed.
Single blastocyst transfer yields similar pregnancy rates compared with multiple cleavage embryo transfer, with reduced twin rate, in patients with low number of fertilized oocytes
Authors: Smeltzer Stephanie , Acharya Kelly , Truong Tracy , Pieper Carl , Muasher Suheil
Published: January 2020

Background

In patients with low numbers of embryos, there is not yet consensus on whether to extend culture to the blastocyst stage, especially due to the risk that some or all of the embryos will not make it to the blastocyst stage. The objective of our study was to evaluate pregnancy outcomes in patients with a low number of fertilized oocytes (< 4), comparing single blastocyst transfer to one or more cleavage embryo transfer.

Results

We analyzed 6795 cycles from the 2014–2105 Society for Assisted Reproductive Technology (SART) registry. All patients were ≤ 38 years old, had less than four fertilized oocytes, and were undergoing first fresh in vitro fertilization (IVF) transfer. Primary outcomes were clinical pregnancy (CP), live birth (LB), and miscarriage rate in both cleavage stage transfer and single blastocyst transfer. A secondary outcome was the rate of twin gestation. The comparison of interest in day of transfer included (1) single blastocyst vs single cleavage and (2) single blastocyst vs multiple cleavage stage. The association between day of transfer and primary outcome was investigated using logistic regression, controlling for the age, race/ethnicity, BMI, smoking, gravidity, parity, infertility diagnoses, and assisted hatching.

Single blastocyst transfer was associated with an increased odds of CP (adjusted OR 2.03) and LB (adjusted OR 1.86) when compared to single cleavage transfer, and no statistically significant association was observed when comparing single blastocyst transfer to multiple cleavage embryo transfer for CP (adjusted OR 0.94) and LB (adjusted OR = 0.88). The odds of having twins among single blastocyst transfer was significantly lower compared to those odds that among multiple cleavage stage transfer (unadjusted OR 0.09).

Conclusions

While pregnancy outcomes are similar between single blastocyst and multiple cleavage embryo transfer, the twin rate is reduced significantly among the single blastocyst transfers in patients with a low number of fertilized oocytes.
An empirical study of the earnings–returns association: an evidence from China’s A-share market
Authors: Alduais Fahd
Published: January 2020

This paper aims to investigate the returns–earnings association in the context of the Chinese capital market. Previously, the investigations brought about disputable outcomes concerning the handiness of models utilizing earnings levels or earnings changes as the informative factors. In this investigation we create theories from the slack structure between stock returns and earnings and perform an empirical test. In an introductory context, this study examines the above relationship applying three models using data from CSMAR database of Chinese listed companies A shares over the sample period of 10 years 2007–2016. The results demonstrated a significant value relevancy of accounting earnings. Specially, in the Chinese stock market the change in the earnings model interprets the stock returns less than earnings level model. Furthermore, the use of cross-sectional accumulated data results in a enormous increase in the explanatory power of earnings for returns yielding more significant earnings response coefficients. The explanatory power of the model that included both variables was (1.17%) that is more than the result of using one explanatory variable in the model implemented for all years and all companies, whether the variable was the earning level (1.03%) or the change in earning (0.75%). The findings recommend that future research should control for the impacts of the temporal increase in market returns before making value relevance inferences from the debilitating association between earnings and returns. The paper contributes to the incomplete framework of research on returns–earnings association as the main driver for the temporal reduction in value relevance of earnings.
Sweating Disorders
Authors: Coon Elizabeth A. , Cheshire William P.
Published: January 2020

PURPOSE OF REVIEW

This article reviews disorders of sweating, including hyperhidrosis and anhidrosis due to central or peripheral autonomic nervous system causes.

RECENT FINDINGS

Disorders of thermoregulation and sweating may manifest with hyperhidrosis or hypohidrosis/anhidrosis. Primary disorders of hyperhidrosis may significantly impact quality of life yet tend to be benign. Many sweating disorders present with compensatory hyperhidrosis due to areas of anhidrosis. Anhidrosis may occur due to either central or peripheral damage to the autonomic nervous system. The thermoregulatory control of sweating involves central pathways from the hypothalamus to the brainstem and then spinal cord as well as projections to peripheral structures, including the sympathetic chain ganglia, peripheral nerves, and eccrine sweat glands. Disruption at any point of this pathway may lead to impaired sweating. Characterization of sweating dysfunction helps localize different autonomic disorders to guide diagnosis and may allow for evaluation of treatment effect.

Sweating dysfunction manifests in myriad ways, including essential hyperhidrosis, complete anhidrosis with heat intolerance, and compensatory hyperhidrosis due to anhidrosis, and often indicates involvement of underlying central or peripheral autonomic dysfunction.
Skin Biopsy in Evaluation of Autonomic Disorders
Authors: Gibbons Christopher H. , Wang Ningshan , Kim Jee Young , Campagnolo Marta , Freeman Roy
Published: January 2020

PURPOSE OF REVIEW

This article provides an up-to-date assessment of the role of skin biopsy in the evaluation of autonomic disorders. The standard methodology for completing a skin biopsy, the anatomic structures of interest detected within a skin biopsy, and the disease states in which skin biopsies may provide valuable information are reviewed.

RECENT FINDINGS

Several recent advances in the studies of hereditary amyloidosis and the various degenerative synucleinopathies have demonstrated that simple skin biopsies can provide valuable pathologic evidence of neurologic disease. In addition to diagnosis of the underlying disorder, skin biopsies provide a quantitative structural measurement of the associated autonomic damage.

Skin biopsies are making great inroads into the study of autonomic and peripheral nerve disorders. Complex immunohistochemical staining protocols are challenging to complete, but the rich data derived from these studies in the diagnosis and monitoring of different disease states suggest that the role of skin biopsies in the study of the autonomic nervous system will continue to expand in the years to come.
Autonomic Peripheral Neuropathy
Authors: Freeman Roy
Published: January 2020

PURPOSE OF REVIEW

This article provides a summary of the autonomic neuropathies, including neuropathies associated with diabetes mellitus, neuropathies due to amyloid deposition, immune-mediated autonomic neuropathies (including those associated with a paraneoplastic syndrome), inherited autonomic neuropathies, and toxic autonomic neuropathies. The presenting features, diagnostic investigations, and natural history of these neuropathies are discussed.

RECENT FINDINGS

Recent findings in autonomic peripheral neuropathy include data on the epidemiology and atypical presentations of diabetic autonomic neuropathy, treatment-induced neuropathy of diabetes mellitus, the presentation of immune-mediated neuropathies, and advances in hereditary neuropathy associated with amyloidosis and other hereditary neuropathies.

Knowledge and recognition of the clinical features of the autonomic neuropathies, combined with appropriate laboratory and electrophysiologic testing, will facilitate accurate diagnosis and management.
Connective Tissue
Authors: Cooppan Vilashini
Published: January 2020

This essay explores the interlinked discourses of memory that put slavery, indenture, colonization, and apartheid into comparison. The term connective tissue, with its connotations of organic and inorganic interweavings (fabrics, bodies and their microstructures, societies and their networks), elaborates memory that is composed through entanglement and expressed through distinctly networked technologies. These technologies include textuality’s semiotic weave (Barthes, Derrida), the nonlinearity of Glissant’s Relation, and the affective intensities, sensory experience, and inherited memory of diasporic identity, here given shape through critical memoir. Connective tissue models an approach to a comparative memory studies animated by entanglement rather than competitive hierarchization of the events of racialized historical violence.
DEVELOPING A LIFELONG RESISTANCE TRAINING PROGRAM
Authors: Kravitz Len R.
Published: January 2020

Pulled Quotes:

“Humans have evolved and adapted for a wide range of unique physical activities, such as long-distance running and walking in the heat, carrying, digging, and throwing projectiles.”

“Higher levels of exercise intensity are associated with greater improvements in A1c.”

“In boys and girls, resistance training may also lead to a positive attitude by increasing self-esteem and confidence levels.”

“For lifelong progression in resistance training, variation, or a systematic alternation of the program, is needed.”

“Importantly, data now show that youth with low muscular fitness are at increased risk of maintaining a low muscular fitness level into adulthood.”

Apply It!
Pro-opiomelanocortin Neurons and the Transcriptional Regulation of Motivated Exercise
Authors: Good Deborah J. , Zhang Haiyan , Grange Robert W. , Braun Thomas
Published: January 2020

Hypothalamic pro-opiomelanocortin (POMC) neurons are key sensory neurons for energy balance. The basic helix-loop-helix transcription factor NHLH2 is expressed in POMC neurons, and Nhlh2 knockout mice show adult-onset obesity with low exercise behavior. Evidence is presented to explore the hypothesis that NHLH2 transcriptional activity within POMC neurons is crucial for maintaining motivated spontaneous activity and enforced exercise.
CT-pathologic correlation of non-calcified atherosclerotic arterial plaques: a study using carotid endarterectomy specimens
Authors: Higashi Masahiro , Yamada Naoaki , Imakita Satoshi , Yutani Chikao , Ishibashi-Ueda Hatsue , Iihara Koji , Naito Hiroaki
Published: January 2020

Objective:

Pathologic features of atherosclerotic plaques on CT are not established. We compared CT values among pathologically confirmed plaque constituents and evaluated their ability to distinguish plaque constituents.

Methods:

50 histopathological images of carotid endarterectomy samples from 10 males and 2 females (age 54–74 years, average 65.9 years) were examined. We compared pre-operative CT [pre-contrast (CT-P), early post-contrast phase (CT-E), delayed post-contrast phase (CT-D)] of lipid-rich necrotic core (NC) and fibrous tissue (F) plaque components with pathological images. The ability of features to differentiate plaque components using several discrimination techniques were compared.

Results:

CT values of NC and F were 36 ± 13, 45 ± 11 (mean ± standard deviation, Hounsfield unit, HU), 41 ± 17, 69 ± 18, and 44 ± 16, 70 ± 13 in CT-P (p < 0.01), CT-E (p < 0.0001), and CT-D (p < 0.0001), respectively. The threshold, sensitivity, and accuracy for distinguishing NC from F were 44 HU, 74%, and 68%; 55 HU, 85%, and 85%; and 63 HU, 92%, and 84% in CTP, CT-E, and CT-D, respectively. CT-P had lower accuracy than CT-E and CT-D (both p < 0.05), but CT-E and CT-D were similar. CT-E and CT-D yielded 90 and 91% sensitivity and accuracy, respectively in linear discrimination analysis.

Conclusion:

In both pre- and post-contrast CT, CT values were lower in NC than F. Although values overlapped, using two-phase post-contrast CTs improved discrimination ability.

Advances in knowledge:

Our findings may help to establish computer-aided diagnosis of vulnerable atherosclerotic plaques in future.
Good sex matters: Pleasure as a driver of online sex education for young people
Authors: van Clief Lindsay , Anemaat Elianne
Published: January 2020

Background

There are few documented examples of online sex education platforms that make an impact on young people’s sexual health and wellbeing, yet research shows that new media has enormous potential to be harnessed in this way. The same is true for a pleasure-positive approach to sex education curricula and programmes. This research provides empirical evidence from the Love Matters' websites in Mexico, Kenya, Nigeria, Egypt, and India to highlight the prevalence and importance of talking about pleasure-related topics with young people.

Methodology

Love Matters is an online sex education platform targeting seven countries and attracting 30 million website visits in 2018. We analysed data through Google Analytics to explore the difference between sex education-focused content and pleasure-focused content and how young people engage with different types of sexual health information on the Love Matters platforms.

Results

Pleasure-focused content is 1.5 times more popular than sex education-focused content across all platforms. However, education-focused content attracts more organic traffic, suggesting young people purposefully search for sexual health information online. Users generally spend longer on the site engaging with sex education-focused content than pleasure-focused content.

Conclusion

This research provides empirical evidence from five countries in the Global South to support the notion that young people are actively looking for sexual health information that covers the full scope of sexual experience and pleasure, including – but not limited to – the reduction of health risks. This paper furthers the efforts to adopt a pleasure-positive approach to both online and offline sex education interventions.
Establishing the cascade of care for patients with tuberculous meningitis
Authors: Imran Darma , Hill Philip C. , McKnight Jacob , van Crevel Reinout ,   Tuberculous Meningitis International Research Consortium
Published: January 2020

Meningitis is a relatively rare form of tuberculosis, but it carries a high mortality rate, reaching 50% in some settings, with higher rates among patients with HIV co-infection and those with drug-resistant disease. Most studies of tuberculosis meningitis (TBM) tend to focus on better diagnosis, drug treatment and supportive care for patients in hospital. However, there is significant variability in mortality between settings, which may be due to specific variation in the availability and quality of health care services, both prior to, during, and after hospitalization. Such variations have not been studied thoroughly, and we therefore present a theoretical framework that may help to identify where efforts should be focused in providing optimal services for TBM patients. As a first step, we propose an adjusted cascade of care for TBM and patient pathway studies that might help identify factors that account for losses and delays across the cascade. Many of the possible gaps in the TBM cascade are related to health systems factors; we have selected nine domains and provide relevant examples of systems factors for TBM for each of these domains that could be the basis for a health needs assessment to address such gaps. Finally, we suggest some immediate action that could be taken to help make improvements in services. Our theoretical framework will hopefully lead to more health system research and improved care for patients suffering from this most dangerous form of tuberculosis.
Industrial ecology
Authors: Ksenofontov Boris , Pavlihin Gennadiy , Simakova Elena
Published: January 2020

The basic issues of industrial ecology standards environmental quality, pollution of air and water basins, as well as waste production and possible sources of noise, vibration and electromagnetic radiation.
Provides information about the main methods and devices of protection of the environment from various contaminants, special attention is paid to those which are most commonly used in practice. The principles of developing environmentally friendly technologies and industries based on sustainable use of natural resources and conservation, as well as examples of creation of industrial facilities that have minimal impact on the environment. Much attention is paid to ecological expertise, which is one of the most important ways of identifying environmentally unsound technologies used in various industries.
Meets the requirements of Federal state educational standards of higher education of the last generation.
Is intended for preparation of bachelors in all areas of educational technology and technology in the study of professional discipline "life Safety" (module "environment Protection"), and can also be used by students of the faculty training of specialists in various industries.
Modern technologies of preschool education
Authors: Andrianova Elena , Bogomolova Mariya , Grishina Anna , Dormidontova Larisa , Zaharova Larisa , Karabaeva Svetlana , Kotlyakova Tat'yana , Kuznecova Irina , Maydankina Natal'ya , Subbotina Ekaterina
Published: January 2020

Study guide tailored to the needs identified in the GEF PRIOR to the organization of educational process in preschool educational organizations, and areas of development and education of the child. Used experience pre-school educational institutions of Ulyanovsk, Ulyanovsk region, operating in the mode of innovation.
Meets the requirements of Federal state educational standards of higher education of the last generation.
For bachelors of higher educational institutions enrolled in the profile "Primary education" and educators of preschool organizations.
Technical operation of electric ships
Authors: Burkov Aleksey
Published: January 2020

The book investigates the issues related to improving the efficiency of technical operation of ship electric drives, developed their classification. Identified ship's drives, having low reliability, designed and implemented technical solutions to increase their reliability. The appropriateness of the integrated assessment within the tasks of a mathematical and physical modeling. Developed and implemented mathematical and physical models for studies of electric drives. The proposed method, an algorithmic software, and made payments of contactors for work in the proposed technical solutions.
Designed for those who specializiruetsya in the field of the theory and practice of ship electric drives. Useful for the learning process in the system of higher Maritime education.
Taxation of individuals
Authors: Hardikova Lyubov' , Belousova Svetlana , Afanas'eva Lyubov' , Rykunova Valentina , Sevryukova Larisa , Tkacheva Tat'yana , Ciklauri Viktoriya
Published: January 2020

The tutorial discusses the theoretical and practical aspects of the current system of taxation of physical persons in the Russian Federation, legal bases of its formation, the principles and approaches of effective taxation.
Designed to consolidate the theoretical knowledge and the independent work of students enrolled in the specialty 38.05.01 "Economic security" of all forms of learning while studying the discipline "Taxation of individuals", and also students of training areas 38.03.01 "Economics", 38.03.02 "Management", 38.03.04 "State and municipal management". It may be useful to employees of state bodies of all levels, as well as graduate students, undergraduates and everyone interested in the taxation of individuals in the system of economic development and security.
Comprehensive analysis and audit of integrated reporting on sustainable development companies
Authors: Suyc Viktor , Horin Aleksandr , Sheremet Anatoliy
Published: January 2020

The monograph describes theoretical problems of formation of integrated reporting on sustainable development companies, methods of analysis and auditing of this reporting, methods of complex evaluation of the effectiveness and sustainability of ecological and socio-economic development, and modern problems of development of accounting, economic analysis and audit.
For practitioners and teachers in the field of sustainable development.
DO DIAGNÓSTICO GENÉTICO PRÉ-IMPLANTACIONAL PARA A SELEÇÃO DE EMBRIÕES COM FINS TERAPÊUTICOS: UMA ANÁLISE DO BEBÊ-MEDICAMENTO
Authors: Cardin Valéria Silva Galdino , Guerra Marcela Gorete Rosa Maia
Published: January 2020

RESUMO: O direito ao planejamento familiar, consagrado na Constituição Federal de 1988 em seu art. 226, §7º, pode ser exercido de forma livre, desde sejam observados pelo seu titular, concomitantemente, os princípios da dignidade da pessoa humana e da parentalidade responsável. Nos últimos anos, como meio de efetivação deste direito, as técnicas de reprodução humana assistida assumiram um papel fundamental no combate à infertilidade e esterilidade de algumas pessoas. Atualmente, um procedimento especialmente utilizado na procriação artificial é o Diagnóstico Genético Pré-Implantacional que permite uma análise prévia das características do embrião e de sua viabilidade. Além disso, este exame genético possibilitou a criação da técnica denominada de “bebê-medicamento”, que consiste na seleção de embriões com fins terapêuticos, ou seja, na escolha de embriões que sejam livres de doenças e que apresente compatibilidade genética com um irmão já nascido, como forma de propiciar o tratamento de uma doença que já o acomete. Contudo, este procedimento gera inúmeras discussões éticas acerca de sua licitude, bem como se o casal idealizador estaria ou não agindo conforme os princípios da parentalidade responsável e da dignidade da pessoa humana. Desta forma, faz-se imprescindível analisar a referida técnica sob a ótica do bebê-medicamento nascido, e verificar se os seus direitos da personalidade são respeitados.
A EFETIVIDADE DOS DIREITOS SOCIAIS À LUZ DO PARADIGMA NEOCONSTITUCIONAL
Authors: Freitas Carolina
Published: January 2020

Trata-se de um breve estudo sobre a posição ocupada pelos direitos sociais, no quadro mais geral dos direitos fundamentais, à luz das experiências de “constitucionalização” das ordens jurídicas e do paradigma neoconstitucional. Estas teoria e prática vêm demandando uma postura mais proativa dos intérpretes da Constituição, particularmente dos juízes, em sede de controle da constitucionalidade, contra as acções e omissões inconstitucionais do poder político. O principal objetivo deste estudo é apresentar e analisar criticamente as teses que são propostas para, em contextos de crise econômica – a que o Brasil não está imune -, desafiar a jusfundamentalidade dos direitos sociais e o seu caráter juridicamente vinculante. Conclui-se que todos os argumentos que buscam diferenciar os direitos sociais dos demais direitos fundamentais mostram-se inválidos ou frágeis e que, por isso, uma Constituição só será suprema se todo o seu conteúdo for entendido como juridicamente vinculante.
A ROUPA NOVA DO IMPERADOR E O MITO CONTEMPORÂNEO DO ESTADO DEMOCRÁTICO DE DIREITO
Authors: Souza Ana Paula Lemes de , Simioni Rafael Lazzarotto
Published: January 2020

O Estado Democrático de Direito é entendido como o mais recente modelo de afirmação de direitos humanos. Representa, segundo grande parte dos discursos jurídicos contemporâneos, o maior progresso em termos de direitos e garantias fundamentais, a última encarnação na conquista dos direitos humanos historicamente postos, ou, em outros termos, a nova roupagem do imperador, em uma visão progressista ou evolucionista do Estado. Mas, em especial, como se cristalizou a supremacia conceitual do poder, enquanto uma figura emanante do mito do poder do povo, sob o pálio do Estado de Direito? Este artigo objetiva explicitar esse paradigma jurídico, na perspectiva desconstrutivista de Jacques Derrida, de forma a (des)construir o mito do Constitucionalismo e da Democracia. Igualmente, visa explicitar conceitos importantes na obra do autor, identificar os suplementos jurídicos já utilizados em cada momento histórico, apontar a roupagem dos estados e refletir sobre a criação de alegorias no enfrentamento dos problemas sociais. Como resultado, observa-se que ambos os conceitos são suplementos de sentidos, que funcionam como dissimuladores das aporias jurídicas, como tantos outros que já estiveram em tela na história da humanidade.
AUTONOMIA UNIVERSITÁRIA EM TEMPOS DE GUERRA CULTURAL
Authors: Ribeiro Ricardo Lodi
Published: January 2020

A reflexão sobre a autonomia universitária, em seus contornos didático-pedagógico, administrativo e financeiro, é fundamental em um momento de guerra cultural contra as universidades, seus professores e estudantes, a fim de que seja resgatada a democracia interna, o pluralismo de ideias e um ambiente adequado ao desenvolvimento da educação em nível de excelência e da pesquisa necessária ao desenvolvimento social, econômico e cultural do Brasil.
‘What works’ won't do
Authors: Allingham Sue
Published: January 2020

Too much top-down pressure to create early years policy that meets narrow, pre-determined outcomes must be adjusted with a wider focus. This is an international issue, discovers Sue Allingham.
Support your staff to flourish
Authors: Lawson Deborah , Moxley Kate , Baston-Pitt Linda
Published: January 2020

How can staff be fit to support children's well-being if they are not in a healthy mental place themselves? Deborah Lawson introduces this focus on combatting workplace stress by outlining innovative ideas that involve both teams and managers working together to find solutions.

Karen Faux talks to trainer and consultant Kate Moxley who works with settings to help them bring out the unique talents of their staff. It is all about embarking on a journey to create sense of shared values and embedding a commitment to well-being in everyday practice.

As CEO of PurpleBee Learning, a practice-based online training platform for early years professionals, Linda Baston-Pitt is a passionate advocate for motivated, ambitious staff. She outlines how the skills which underpin these qualities can be taught and developed.
All wrung out
Authors: White Hilary
Published: January 2020

Hand washing may seem old-fashioned but it is an eco-friendly alternative to using a washing machine. Get children involved and help them to consolidate their understanding of how a series of steps lead to a successful outcome.
One from the heart
Authors: Hart Karen
Published: January 2020

Karen Hart suggests some Mother's Day card making ideas that involve children making sponge paintings, hand prints and 3D decorations. These are cards which will be treasured for years to come!
Recognising pupils' feelings and emotions
Authors: Knight Shahana
Published: January 2020

Learning to recognise feelings and emotions is an essential part of growing up, but it will not necessarily come naturally. Shahana Knight looks at how we can help support our pupils to spot, identify and manage their feelings
A case study of the EIF
Authors: O'Connell Suzanne
Published: January 2020

Greenmount Primary School was one of the first schools to be visited under Ofsted's new Education Inspection Framework. Headteacher David Griffith speaks with Suzanne O'Connell and shares his experiences of the Section 8 inspection before offering his advice to other schools
The 20th-century South African economy through a development lens
Authors: Padayachee Vishnu
Published: January 2020

Based on Bill Freund’s latest book, this review essay critically reviews the author’s discussion of: the institutional and network fibres underlying the mid-20th-century South African developmental model; how and why it developed; how and why it transformed through the course of that century; and how it was dismantled by the end of that century. The essay also tries to assess the significance of that model for South African development in the post-1994 democratic era, as well as the economic and public policy choices exercised by the African National Congress (ANC)-led government under conditions of fiscal constraint.