bluuebunny/crossref_metadata_2025 huggingface dataset:
Iris colour in relation to myopia among Chinese school‐aged children
Authors: Pan Chen‐Wei , Qiu Qin‐Xiao , Qian Deng‐Juan , Hu Dan‐Ning , Li Jun , Saw Seang‐Mei , Zhong Hua
Published: December 2017

Purpose

Understanding the association of iris colour and myopia may provide further insights into the role of the wavelength of lights in the pathophysiology of myopia. We aim to assess the association of iris colour and myopia in a school‐based sample of Chinese students.

Methods

Two thousand three hundred and forty‐six Year 7 students from 10 middle schools (93.5% response rate) aged 13–14 years in Mojiang, a small county located in Southwestern China, participated in the study. We obtained standardised slit lamp photographs and developed a grading system assessing iris colour (higher grade denoting a darker iris). Refractive error was measured after cycloplegia using an autorefractor by optometrists or trained technicians. An IOLMaster (www.zeiss.com) was used to measure ocular biometric parameters including axial length (AL).

Results

Of all the study participants, 693 (29.5%) were affected by myopia with the prevalence estimates being higher in girls (36.8%; 95% confidence interval [CI]: 34.0, 39.6) than in boys (22.8%; 95% CI: 20.4, 25.1) (p < 0.001). After adjusting for gender, height, parental history of myopia, time spent on computer, time spent watching TV, time spent outdoors, and time spent reading and writing, participants with a darker iris colour tended to have a higher prevalence of myopia, a more myopic refraction and a longer AL. Dose‐response relationships were observed in all regression models (p for trend <0.05).

Conclusions

Darker iris colour was associated with more myopic refractive errors and longer ALs among Chinese school‐aged children and this association was independent of other known myopia‐related risk factors.
The reading accessibility index and quality of reading grid of patients with central vision loss
Authors: Tarita‐Nistor Luminita , González Esther G. , Mandelcorn Mark S. , Brent Michael H. , Markowitz Samuel N. , Steinbach Martin J.
Published: December 2017

Purpose

In this study we evaluated the reading accessibility index (ACC) and a quality of reading grid as assessment tools for reading and as outcome measures for reading rehabilitation of patients with central vision loss.

Methods

Reading performances on the MNRead chart (www.precision-vision.com) were reviewed from our research database. Participants were 24 controls with normal vision [mean age: 34 (SD, 14) years] and 61 patients with bilateral central vision loss [mean age: 81 (SD, 9) years] among which a subgroup of 18 patients [mean age, 76 (SD, 13) years] had undergone perceptual learning training for reading rehabilitation. The outcome measures were maximum reading speed, reading acuity, critical print size, ACC, and the reading quality. A reading quality grid that classified reading speed as spot, slow, functional, or fluent and print size as small, regular, medium, or large was used. All reading speed values were normalised (i.e., divided by 200, the average reading speed in young adults with normal vision measured with the MNRead).

Results

The ACC was associated perfectly with the maximum reading speed in the control group (r22 = 0.99, P < 0.001) and strongly with all parameters of reading in the patient group (smallest r value: r59 = −0.66, P < 0.001). For patients with central vision loss, reading was functional for large print, but slow for medium print and spot for regular print. For some patients with the same ACC values, the quality of reading grid revealed important performance differences. For the subgroup (n = 18) of patients who were trained, the ACC revealed a greater effect of training than the other three parameters of reading, and although there were statistically significant improvements across all print size categories, a qualitative improvement in reading was noticed only for the medium print sizes.

Conclusions

The ACC is a good measure of reading performance in patients with central vision loss. Examining reading quality for different print size categories can provide a more detailed picture of reading impairment and should be considered as an outcome for rehabilitation in addition to the ACC.
Transcoronary cell infusion with the stop‐flow technique in children with single‐ventricle physiology
Authors: Eitoku Takahiro , Baba Kenji , Kondou Maiko , Kurita Yoshihiko , Fukushima Yousuke , Hirai Kenta , Ohtsuki Shinichi , Ishigami Shuta , Sano Shunji , Oh Hidemasa
Published: December 2017

Background

Almost all reports on cardiac regeneration therapy have referred to adults, and only a few have focused on transcoronary infusion of cardiac progenitor cells using the stop‐flow technique in children.

Methods

Intracoronary autologous cardiosphere‐derived cell (CDC) transfer was conducted at Okayama University as a phase 1 clinical trial for seven patients with hypoplastic left heart syndrome between January 2011 and December 2012, and as a phase 2 clinical trial for 34 patients with single‐ventricle physiology between July 2013 and March 2015.

Results

A total of 41 patients with single‐ventricle physiology underwent transcoronary infusion of CDC with the stop‐flow technique. The median age was 33 months (range, 5–70 months) and the median weight was 10.1 kg (range, 4.1–16.0 kg). Transient adverse events occurred during the procedure, including ST‐segment elevation or depression, hypotension, bradycardia, and coronary artery vasospasm. All patients completely recovered. There were no major procedure‐related adverse events. In this study, transcoronary infusion of CDC using the stop‐flow technique was successfully completed in all patients.

Conclusion

Transcoronary infusion of CDC using the stop‐flow technique in children is a feasible and safe procedure.
Service outsourcing: The home, the host and the provider
Authors: Grover Goswami Arti
Published: December 2017

Although offshoring service providers have grown meteorically in the last two decades, the phenomenon is still primarily analyzed through the lens of a home country and its firms. This paper presents a framework for explaining some of the stylized facts of the offshore service provider industry. The model characterizes the service choice of offshore service providers under alternative skill distribution and also explains why complex service providers employ more skilled workers, pay higher wages, and have a lower scale of provision. Finally, it sheds light on the relationship between partnering country sizes and wage inequality.
Relations between close friendships and adolescent aggression: Structural and behavioral friendship features
Authors: Andrews Naomi C. Z. , Hanish Laura D. , DeLay Dawn , Martin Carol Lynn , Updegraff Kimberly A.
Published: December 2017

Friendships have the potential to perpetuate or mitigate youth's aggressive behavior. We investigated concurrent and longitudinal effects of friendships on aggression by examining both structural (size and interconnectedness of the local friendship network) and behavioral (friends' aggression) friendship features. Participants were 868 sixth to eighth grade middle‐school students (M = 12.10 years; 49.9% girls; 44% Latina/o) who completed questionnaires at two time points. Participants nominated their friends; reciprocal friendship nominations were used to calculate structural friendship group features (size and interconnectedness). Peer nominations were also used to measure youth's and their friends' aggression. Having more reciprocal friends was associated with more aggression concurrently (particularly for youth whose friends were highly aggressive), and having an interconnected friendship group was associated with decreased aggression over time. Given that findings were different for group size and interconnectedness, we discuss the unique importance of each of these structural friendship features. Practical implications regarding the potential to decrease aggressive behavior based on specific friendship features are also discussed.
Prognostic significance of clinical presentation, induction and rescue treatment in 42 cases of canine centroblastic diffuse large B‐cell multicentric lymphoma in the United Kingdom
Authors: Davies O. , Szladovits B. , Polton G. , Garden O. A. , Leo C. , Lara‐Garcia A.
Published: December 2017

Canine lymphoma is a heterogeneous group of diseases and many previous studies have evaluated the response of a mixed population of lymphoma cases to one specific treatment protocol. The aim of this retrospective study was to describe the outcome and prognostic factors in 42 cases of multicentric centroblastic diffuse large B‐cell lymphoma treated with either a COP‐type (35%) or CHOP‐type (64%) induction chemotherapy. The objective response rate to induction therapy was 94%; entire dogs had a greater rate of complete vs partial remissions than neutered dogs (P= .017). Median progression‐free survival for the first remission (PFS1) was 182 days; absence of anaemia at diagnosis (P= .002) and pretreatment neutrophil:lymphocyte ratio (NLR) below 9.44 (P= .015) were independently predictive of longer PFS1. Fifty‐eight percent of dogs received rescue protocols with an objective response rate of 81%; 31% of dogs received further rescue protocols (up to a total of 5) and the median number of protocols administered were 2. Median overall survival (OS) was 322 days, the 1‐year survival rate was 38% and the 2‐year survival rate was 9%. Lymphocyte:monocyte ratio above 1.43 (P= .031), NLR below 11.44 (P= .009), the combination of induction and rescue therapy (P= .030) and the total number of doxorubicin doses used (P= .002) were independently predictive of longer OS. Use of a COP‐type protocol induction compared with CHOP did not undermine OS providing doxorubicin was used as rescue therapy.
Evaluation of an Intervention With Nurses for Delirium Detection After Cardiac Surgery
Authors: Fraser Vanessa , Cossette Sylvie , Mailhot Tanya , Brisebois Anie , Dubé Véronique
Published: December 2017

Background

Completion of a delirium detection tool allows rapid management, which alleviates complications. However, these tools are often underused.

Aims

To assess the effect of a knowledge transfer (KT) intervention on the completion of a delirium detection tool by nurses working with cardiac surgery patients. Secondary aims included describing completion rates per work shift, and patient characteristics associated with higher rates.

Methods

In a pre‐post study, the intervention included a survey and focus groups to identify barriers to use of a delirium detection tool (Intensive Care Delirium Screening Checklist [ICDSC]). Nurses’ suggestions for a KT activity and its implementation were also included. Using chi‐square analysis and medical charts from 242 patients, we compared the pre‐ and postintervention rates of completion of the ICDSC.

Results

The majority of nurses who completed the survey (n = 30) felt they had the knowledge, skills, and intention to complete the ICDSC. During the focus groups (n = 4), a need for information on delirium symptoms and its management was raised as a barrier. This barrier was addressed with the selected KT activity (clinical capsule and aide‐memoire handed out to nurses [n = 24]). Across all work shifts, the completion rate was similar pre‐ and postintervention. Overall, the completion rate was lower during the day shift than the night and evening shifts. A higher rate was associated with the first three postoperative days, and longer hospital and intensive care unit stays.

Linking Evidence to Action

A tailored intervention based on preidentified barriers and facilitators, using the Determinants of Implementation Behavior Questionnaire, and in collaboration with participants, has the potential to promote evidence‐based practice.
The Effects of Different Strength Training on Static and Dynamic Balance Ability of Volleyball Players
Authors: Eylen Mehmet Ali , Daglioglu Onder , Gucenmez Erkan
Published: December 2017

The aim of this study is to examine the effect of different strength training on the static and dynamic balance ability of volleyball players. A total of 20 male volleyball players, aged between 18 and 25, are participated in the study who has been playing in national volleyball competition in Gaziantep. The subjects were divided into two groups according to the randomized method as experimental group (n=10, age:21.60±2.06) and control group (n=10, age:20.50±1.77). The experimental group was given a different strength training program for 3 days a week for 8 weeks. Both groups continued their regular volleyball practice. Leg strength, static and dynamic balance measurements were made before starting the different strength training in both groups and after the training was finished. Takei Leg Dynamometer used for leg strength measurement and Biodex Balance SD Isokinetic Balance Test for balance measurement. Paired Sample t test was used for intra-group comparisons and Independent Sample t test was used for statistical analysis of the data. When the pre-test and post-test measurements of the experimental group were compared, there were significant differences in leg strength, static (Double leg-Overall Postural Stability Index (OPSI), Right Leg-OPSI, Left Leg-OPSI) and dynamic (Right Leg- Overall Stability Index (OSI), Left Leg-OSI) balance scores (p<0.05). The control group showed significant significance in the Double leg-OPSI score (p<0.05). No other significance was found in the other data (p>0.05). As a result, it is considered that the different strength training applied to the volleyball players has a positive effect on the static and dynamic balance ability. It can be said that static and dynamic balance abilities of regular strength training may increase.
High fat diet blunts the effects of leptin on ventilation and on carotid body activity
Authors: Ribeiro Maria J. , Sacramento Joana F. , Gallego‐Martin Teresa , Olea Elena , Melo Bernardete F. , Guarino Maria P. , Yubero Sara , Obeso Ana , Conde Silvia V.
Published: December 2017

Key points

Leptin plays a role in the control of breathing, acting mainly on central nervous system; however, leptin receptors have been recently shown to be expressed in the carotid body (CB), and this finding suggests a physiological role for leptin in the regulation of CB function.

Leptin increases minute ventilation in both basal and hypoxic conditions in rats. It increases the frequency of carotid sinus nerve discharge in basal conditions, as well as the release of adenosine from the CB. However, in a metabolic syndrome animal model, the effects of leptin in ventilatory control, carotid sinus nerve activity and adenosine release by the CB are blunted.

Although leptin may be involved in triggering CB overactivation in initial stages of obesity and dysmetabolism, resistance to leptin signalling and blunting of responses develops in metabolic syndrome animal models.

Leptin plays a role in the control of breathing, acting mainly on central nervous system structures. Leptin receptors are expressed in the carotid body (CB) and this finding has been associated with a putative physiological role of leptin in the regulation of CB function. Since, the CBs are implicated in energy metabolism, here we tested the effects of different concentrations of leptin administration on ventilatory parameters and on carotid sinus nerve (CSN) activity in control and high‐fat (HF) diet fed rats, in order to clarify the role of leptin in ventilation control in metabolic disease states. We also investigated the expression of leptin receptors and the neurotransmitters involved in leptin signalling in the CBs. We found that in non‐disease conditions, leptin increases minute ventilation in both basal and hypoxic conditions. However, in the HF model, the effect of leptin in ventilatory control is blunted. We also observed that HF rats display an increased frequency of CSN discharge in basal conditions that is not altered by leptin, in contrast to what is observed in control animals. Leptin did not modify intracellular Ca2+ in CB chemoreceptor cells, but it produced an increase in the release of adenosine from the whole CB. We conclude that CBs represent an important target for leptin signalling, not only to coordinate peripheral ventilatory chemoreflexive drive, but probably also to modulate metabolic variables. We also concluded that leptin signalling is mediated by adenosine release and that HF diets blunt leptin responses in the CB, compromising ventilatory adaptation.
Scar-Like Self-Reinforced and Failure-Tolerant Dielectric Elastomer Actuator With AgNWs Electrode
Authors: Zhang Mingqi , Xie Yuhan , Yao Tingge , Cao Xunuo , Zhang Zhen , Li Guorui , Ma Zipeng , Mao Jie , Yang Tao , Luo Yingwu , Li Tiefeng
Published: December 2017

Scar structures of natural animals can reinforce the wounds both mechanically and biologically to maintain the functions of the injured muscle and skin. Inspired by the scar structure, we present a dielectric elastomer (DE) with silver nanowire electrodes possessing the scar-like ability. This DE membrane can tolerate the failures by both electric breakdown and mechanical rupture. The DE actuator (DEA) can maintain their performances of force and displacement output after multiple failures. Scanning electronic microscope (SEM) images show that the scar-like structures accumulate around the electromechanical failure locations on the DE membrane as the stiffened and insulated regions, which prevent further short current and membrane rupture. J-integrals and stress distribution around the failure location have been calculated by finite element analysis to verify the mechanical reinforcements of the scar-like structures over crack propagation.
Inverse Design of Single- and Multi-Rotor Horizontal Axis Wind Turbine Blades Using Computational Fluid Dynamics
Authors: Moghadassian Behnam , Sharma Anupam
Published: December 2017

A method for inverse design of horizontal axis wind turbines (HAWTs) is presented in this paper. The direct solver for aerodynamic analysis solves the Reynolds-averaged Navier–Stokes (RANS) equations, where the effect of the turbine rotor is modeled as momentum sources using the actuator disk model (ADM); this approach is referred to as RANS/ADM. The inverse problem is posed as follows: for a given selection of airfoils, the objective is to find the blade geometry (described as blade twist and chord distributions) which realizes the desired turbine aerodynamic performance at the design point; the desired performance is prescribed as angle of attack (α) and axial induction factor (a) distributions along the blade. An iterative approach is used. An initial estimate of blade geometry is used with the direct solver (RANS/ADM) to obtain α and a. The differences between the calculated and desired values of α and a are computed and a new estimate for the blade geometry (chord and twist) is obtained via nonlinear least squares regression using the trust-region-reflective (TRF) method. This procedure is continued until the difference between the calculated and the desired values is within acceptable tolerance. The method is demonstrated for conventional, single-rotor HAWTs and then extended to multirotor, specifically dual-rotor wind turbines (DRWT). The TRF method is also compared with the multidimensional Newton iteration method and found to provide better convergence when constraints are imposed in blade design, although faster convergence is obtained with the Newton method for unconstrained optimization.
A Propeller Model for Steady-State and Transient Performance Prediction of Turboprop and Counter-Rotating Open Rotor Engines
Authors: Silva Vinícius Tavares , Bringhenti Cleverson , Tomita Jesuino Takachi , Fontes Anderson Frasson
Published: December 2017

This paper describes a methodology used for propeller performance estimation, which was implemented in an in-house modular program for gas turbine performance prediction. A model based on subsonic generic propeller maps and corrected for compressibility effects, under high subsonic speeds, was proposed and implemented. Considering this methodology, it is possible to simulate conventional turboprop architectures and counter-rotating open rotor (CROR) engines in both steady-state and transient operating conditions. Two simulation scenarios are available: variable pitch angle propeller with constant speed; or variable speed propeller with constant pitch angle. The simulations results were compared with test bench data and two gas turbine performance commercial software packages were used to fulfill the model validation for conventional turboprop configurations. Furthermore, a direct drive CROR engine was simulated using a variable inlet guide vanes (VIGV) control strategy during transient operation. The model has shown to be able to provide several information about propeller-based engine performance using few input data, and a comprehensive understanding on steady-state and transient performance behavior was achieved in the obtained results.
Identification of an Empirical Equation for Predicting Free Surface Roughness Evolution in Thin Sheets of Aluminum Alloy and Pure Copper
Authors: Furushima Tsuyoshi , Sato Hideki , Manabe Ken-ichi , Alexandrov Sergei
Published: December 2017

This paper deals with the identification of an empirical equation for predicting free surface roughness evolution. The equation has been proposed elsewhere, and, in contrast to widely used equations, assumes that the evolution of free surface roughness is controlled by two kinematic variables, the equivalent strain, and the logarithmic strain normal to the free surface. Therefore, an experimental program is designed to account for the effect of the mode of deformation on free surface roughness evolution. Thin sheets of aluminum alloy A5052-O and pure copper C1220P-O alloys are used to conduct the experimental program. In addition, numerical simulation is performed to calculate the evolution of free surface roughness under the same conditions. Comparison of experimental and numerical results shows that the accuracy of the numerical results is good enough. Then, numerical simulation is extended to the domain in which no experimental results are available. Discrete functions so found are fitted to polynomials. As a result, continuous functions that represent the empirical equation for predicting free surface roughness evolution for A5052-O and C1220P-O alloys are determined. These equations can be used in conjunction with solutions to boundary value problems in plasticity for predicting the evolution of free surface roughness in metal forming processes.
Thermal Hydraulic Safety Assessment of LLCB Test Blanket System in ITER Using Modified relap/scdapsim/mod4.0 Code
Authors: Saraswat S. P. , Munsh P. , Khanna A. , Allison C.
Published: December 2017

This work attempts to investigate the thermal hydraulic safety of lithium lead ceramic breeder (LLCB) test blanket system (TBS) in International Thermonuclear Experimental Reactor (ITER) with the help of modified thermal hydraulic code relap/scdapsim/mod4.0. The design basis accidents, in-vessel and ex-vessel loss of coolant of first wall (FW) of test blanket module (TBM) are analyzed for this safety assessment. The sequence of accidents analyzed was started with postulated initiating events (PIEs). A detailed modeling of first wall helium cooling system (FWHCS) loop and lithium lead cooling system (LLCS) is presented. The analysis of steady-state normal operation along with 10 s power excursion before the accident is also discussed in order to better understanding of initial condition of accidents. The analysis discusses a number of safety concerns and issues that may result from the TBM component failure, such as vacuum vessel (VV) pressurization, TBM FW temperature profile, passive decay heat removal capability of TBM structure, pressurization of port cell and Tokomak cooling water system vault annex (TCWS-VA) and to check the capability of passive safety system (vacuum vessel pressure suppression system (VVPSS)). The analysis shows that in these accident scenarios, the critical parameters have reasonable safety margins.
Mental Fatigue Impairs Physical Performance in Young Swimmers
Authors: Penna Eduardo Macedo , Filho Edson , Wanner Samuel Penna , Campos Bruno Teobaldo , Quinan Gabriel Resende , Mendes Thiago Teixeira , Smith Mitchell Robert , Prado Luciano Sales
Published: December 2017

Purpose: This study aimed to investigate the impact of mental fatigue on heart rate variability, subjective measures of fatigue, and swimming performance in young athletes. Methods: Sixteen swimmers [15.45 (0.51) y old, 7.35 (2.20) y of swimming experience] performed a 1500-m time trial on 2 occasions separated by an interval of at least 72 hours. The 1500-m swimming was preceded by a 30-minute treatment that consisted of performing the Stroop Color and Word test to induce mental fatigue (experimental trial) or watching an emotionally neutral video (control trial). Results: Participants reported higher ratings of mental fatigue and mental effort following the Stroop test when compared with the control trial, but no differences in motivation were observed. The induction of mental fatigue impaired swimming performance, as evidenced by a slower time (1.2%) to complete the 1500-m trial. No intertrial differences were identified for rating of perceived exertion during the swimming test or in heart rate variability after the Stroop and swimming tests. Conclusion: The results indicate that induction of mental fatigue impairs 1500-m swimming performance without changing heart rate variability.
Seeing real-space dynamics of liquid water through inelastic x-ray scattering
Authors: Iwashita Takuya , Wu Bin , Chen Wei-Ren , Tsutsui Satoshi , Baron Alfred Q. R. , Egami Takeshi
Published: December 2017

We directly observed time-dependent real-space atom-atom dynamic correlations in liquid water using inelastic x-ray scattering.
Origin of the blueshift of water molecules at interfaces of hydrophilic cyclic compounds
Authors: Tomobe Katsufumi , Yamamoto Eiji , Kojić Dušan , Sato Yohei , Yasui Masato , Yasuoka Kenji
Published: December 2017

Molecular mechanism of the blueshift of water molecules.
Prediction of a low-temperature N
2
dissociation catalyst exploiting near-IR–to–visible light nanoplasmonics
Authors: Martirez John Mark P. , Carter Emily A.
Published: December 2017

We propose a promising new method of solar-driven ammonia synthesis with metal nanoparticles.
Impact of complex topology of porous media on phase separation of binary mixtures
Authors: Shimizu Ryotaro , Tanaka Hajime
Published: December 2017

We show how phase separation of a binary mixture is guided topologically in labyrinth-like porous materials.
Aggregation-induced emission in lamellar solids of colloidal perovskite quantum wells
Authors: Jagielski Jakub , Kumar Sudhir , Wang Mingchao , Scullion Declan , Lawrence Robert , Li Yen-Ting , Yakunin Sergii , Tian Tian , Kovalenko Maksym V. , Chiu Yu-Cheng , Santos Elton J. G. , Lin Shangchao , Shih Chih-Jen
Published: December 2017

The first low-dimensional semiconductor nanocrystal system that increases the photoluminescence quantum yield in aggregates.
CD1a presentation of endogenous antigens by group 2 innate lymphoid cells
Authors: Hardman Clare S. , Chen Yi-Ling , Salimi Maryam , Jarrett Rachael , Johnson David , Järvinen Valtteri J. , Owens Raymond J. , Repapi Emmanouela , Cousins David J. , Barlow Jillian L. , McKenzie Andrew N. J. , Ogg Graham
Published: December 2017

Human skin–derived ILC2 express CD1a and present endogenous PLA2G4A-dependent antigens to T cells.
Results of viscobubble deep anterior lamellar keratoplasty after failure of pneumatic dissection
Authors: Scorcia Vincenzo , De Luca Valentina , Lucisano Andrea , Carnevali Adriano , Carnovale Scalzo Giovanna , Bovone Cristina , Busin Massimo
Published: December 2017

Aim

To report the outcomes of bubble formation obtained by means of intrastromal injection of ophthalmic viscoelastic device (OVD) after failure of pneumatic dissection for deep anterior lamellar keratoplasty (DALK).

Methods

DALK was performed in 140 keratoconic eyes of 130 patients by injecting air and OVD only secondarily, after pneumatic dissection had failed; the bubble formation rates after air and OVD injection were recorded; complications, best spectacle-corrected visual acuity (BSCVA) and corneal tomographic parameters were evaluated 3 months, 6 months and 12 months postoperatively, as well as after complete suture removal.

Results

Air injection created a big bubble in 106/140 eyes (75.71%); OVD injection was not attempted in 4 eyes (perforation during cannula insertion n=2; air bubble burst n=2) and created a big bubble in 28 of the remaining 30 eyes (93.33%, 20% of the total). Manual dissection was required in 2/30 eyes (6.66%, 1.42% of the total) after failed OVD-assisted dissection.

Deep folds, interface opacity and reduced BSCVA were noted in both eyes after failed OVD-assisted dissection. BSCVA was statistically better after pneumatic-assisted than after OVD-assisted dissection (P 0.01) only up to 3 months postoperatively; no statistically significant differences were recorded between the two techniques at later examinations.

Conclusion

Intrastromal injection of OVD after failed pneumatic dissection increases considerably the success rate of bubble formation (from 75.71% to 95.71% in our series); however, when bubble formation fails, infiltration of OVD into the residual stroma makes manual dissection particularly challenging and causes severe interface haze resulting in poor visual outcomes.
Rationale and design of the violence, injury and trauma observatory (VITO): the Cape Town VITO pilot studies protocol
Authors: Jabar Ardil , Oni Tolu , Engel Mark E , Cvetkovic Nemanja , Matzopoulos Richard
Published: December 2017

The establishment of violence and injury observatories elsewhere has been found to reduce the burden within a relatively short period. Currently no integrated system exists in South Africa to provide collated data on violence, to allow for targeted interventions and routine monitoring and evaluation.This research seeks to identify if bringing multiple data sources, including but not limited to data from the South African Police Service (SAPS), Forensic Pathology Services (FPS), Emergency Medical Services (EMS) and local hospital clinical databases, together are (1) feasible; (2) able to generate data for action, that is valid, reliable and robust and (3) able to lead to interventions.

The violence, injury and trauma observatory (VITO) is a planned collaborative, multicentre study of clinical, police and forensic data for violence and injury in the City of Cape Town, where a local context exists of access to multiple source of health and non-health data. The VITO will initially be piloted in Khayelitsha, a periurban community characterised by increased rates of violence, where fatal and non-fatal injury data will be sourced from within the community for the period 2012–2015 and subjected to descriptive statistics and time-trend analyses. Analysed data will be visualised using story maps, data clocks, web maps and other geographical information systems-related products.

This study has been approved by the University of Cape Town’s Human Research Ethics Committee (HREC 861/2016). We intend to disseminate our findings among stakeholders within the local government safety cluster, non-governmental organisations working within the violence prevention sector and the afflicted communities through the SAPS and violence prevention through urban upgrading community forums. Findings from this work will serve to identify important issues and trends, influence public policy and develop evidence-based interventions.
Anticipated health behaviour changes and perceived control in response to disclosure of genetic risk of breast and ovarian cancer: a quantitative survey study among women in the UK
Authors: Meisel Susanne F , Fraser Lindsay Sarah Macduff , Side Lucy , Gessler Sue , Hann Katie E J , Wardle Jane , Lanceley Anne
Published: December 2017

Background

Genetic risk assessment for breast cancer and ovarian cancer (BCOC) is expected to make major inroads into mainstream clinical practice. It is important to evaluate the potential impact on women ahead of its implementation in order to maximise health benefits, as predictive genetic testing without adequate support could lead to adverse psychological and behavioural responses to risk disclosure.

Objective

To examine anticipated health behaviour changes and perceived control to disclosure of genetic risk for BCOC and establish demographic and person-specific correlates of adverse anticipated responses in a population-based sample of women.

Design

Cross-sectional quantitative survey study carried out by the UK Office for National Statistics in January and March 2014.

Setting

Face-to-face computer-assisted interviews conducted by trained researchers in participants’ homes.

Participants

837 women randomly chosen from households across the UK identified from the Royal Mail’s Postcode Address File.

Outcome measures

Anticipated health behaviour change and perceived control to disclosure of BCOC risk.

Results

In response to a genetic test result, most women (72%) indicated ‘I would try harder to have a healthy lifestyle’, and over half (55%) felt ‘it would give me more control over my life’. These associations were independent of demographic factors or perceived risk of BCOC in Bonferroni-corrected multivariate analyses. However, a minority of women (14%) felt ‘it isn’t worth making lifestyle changes’ and that ‘I would feel less free to make choices in my life’ (16%) in response to BCOC risk disclosure. The former belief was more likely to be held by women who were educated below university degree level (P<0.001) after adjusting for other demographic and person-specific correlates.

Conclusion

These findings indicate that women in the UK largely anticipate that they would engage in positive health behaviour changes in response to BCOC risk disclosure.
Prevalence and possible factors associated with anaemia, and vitamin B12and folate deficiencies in women of reproductive age in Pakistan: analysis of national-level secondary survey data
Authors: Soofi Sajid , Khan Gul Nawaz , Sadiq Kamran , Ariff Shabina , Habib Atif , Kureishy Sumra , Hussain Imtiaz , Umer Muhammad , Suhag Zamir , Rizvi Arjumand , Bhutta Zulfiqar
Published: December 2017

Objective

To determine the prevalence and possible factors associated with anaemia, and vitamin B12and folate deficiencies in women of reproductive age (WRA) in Pakistan.

Methods

A secondary analysis was conducted on data collected through the large-scale National Nutrition Survey in Pakistan in 2011. Anaemia was defined as haemoglobin levels <12 g/dL, vitamin B12deficiency as serum vitamin B12levels of <203 pg/mL (150 pmol/L) and folate deficiency as serum folate levels <4 ng/mL (10 nmol/L).

Results

A total of 11 751 blood samples were collected and analysed. The prevalence of anaemia, vitamin B12deficiency and folate deficiency was 50.4%, 52.4% and 50.8%, respectively. After adjustment, the following factors were positively associated with anaemia: living in Sindh province (RR 1.07; 95% CI 1.04 to 1.09) P<0.00, food insecure with moderate hunger (RR 1.03; 95% CI 1.00 to 1.06) P=0.02, four or more pregnancies (RR 1.03; 95% CI 1.01 to 1.05) P<0.00, being underweight (RR 1.03; 95% CI 1.00 to 1.05) P=0.02, being overweight or obese (RR 0.95; 95% CI 0.93 to 0.97) P<0.00 and weekly intake of leafy green vegetables (RR 0.98; 95% CI 0.95 to 1.00) P=0.04. For vitamin B12deficiency, a positive association was observed with rural population (RR 0.81; 95% CI 0.66 to 1.00) P=0.04, living in Khyber Pakhtunkhwa province (RR 1.25; 95% CI 1.11 to 1.43) P<0.00 and living in Azad Jammu and Kashmir (RR 1.50; 95% CI 1.08 to 2.08) P=0.01. Folate deficiency was negatively associated with daily and weekly intake of eggs (RR 0.89; 95% CI 0.81 to 0.98) P=0.02 and (RR 0.88; 95% CI 0.78 to 0.99) P=0.03.

Conclusions

In Pakistan, anaemia, and vitamin B12and folate deficiencies are a severe public health concern among WRA. Our findings suggest that further research is needed on culturally appropriate short-term and long-term interventions within communities and health facilities to decrease anaemia, and vitamin B12and folate deficiencies among Pakistani women.
Subgrouping and TargetEd Exercise pRogrammes for knee and hip OsteoArthritis (STEER OA): a systematic review update and individual participant data meta-analysis protocol
Authors: Holden Melanie A , Burke Danielle L , Runhaar Jos , van Der Windt Danielle , Riley Richard D , Dziedzic Krysia , Legha Amardeep , Evans Amy L , Abbott J Haxby , Baker Kristin , Brown Jenny , Bennell Kim L , Bossen Daniël , Brosseau Lucie , Chaipinyo Kanda , Christensen Robin , Cochrane Tom , de Rooij Mariette , Doherty Michael , French Helen P , Hickson Sheila , Hinman Rana S , Hopman-Rock Marijke , Hurley Michael V , Ingram Carol , Knoop Jesper , Krauss Inga , McCarthy Chris , Messier Stephen P , Patrick Donald L , Sahin Nilay , Talbot Laura A , Taylor Robert , Teirlinck Carolien H , van Middelkoop Marienke , Walker Christine , Foster Nadine E
Published: December 2017

Introduction

Knee and hip osteoarthritis (OA) is a leading cause of disability worldwide. Therapeutic exercise is a recommended core treatment for people with knee and hip OA, however, the observed effect sizes for reducing pain and improving physical function are small to moderate. This may be due to insufficient targeting of exercise to subgroups of people who are most likely to respond and/or suboptimal content of exercise programmes. This study aims to identify: (1) subgroups of people with knee and hip OA that do/do not respond to therapeutic exercise and to different types of exercise and (2) mediators of the effect of therapeutic exercise for reducing pain and improving physical function. This will enable optimal targeting and refining the content of future exercise interventions.

Methodsand analysis

Systematic review and individual participant data meta-analyses. A previous comprehensive systematic review will be updated to identify randomised controlled trials that compare the effects of therapeutic exercise for people with knee and hip OA on pain and physical function to a non-exercise control. Lead authors of eligible trials will be invited to share individual participant data. Trial-level and participant-level characteristics (for baseline variables and outcomes) of included studies will be summarised. Meta-analyses will use a two-stage approach, where effect estimates are obtained for each trial and then synthesised using a random effects model (to account for heterogeneity). All analyses will be on an intention-to-treat principle and all summary meta-analysis estimates will be reported as standardised mean differences with 95% CI.

Ethics and dissemination

Research ethical or governance approval is exempt as no new data are being collected and no identifiable participant information will be shared. Findings will be disseminated via national and international conferences, publication in peer-reviewed journals and summaries posted on websites accessed by the public and clinicians.

PROSPERO registration number

CRD42017054049.
Association between serum uric acid and atrial fibrillation: a cross-sectional community-based study in China
Authors: Chen Yue , Xia Yunlong , Han Xu , Yang Yiheng , Yin Xiaomeng , Qiu Jing , Liu Henghui , Zhou Yong , Liu Ying
Published: December 2017

Objectives

To investigate the effects of gender on the association of serum uric acid (SUA) levels and atrial fibrillation (AF) prevalence in a community-based Chinese population.

Setting

Data were obtained from annual Jidong Oilfield employee and family member health checkups. The Jidong community is geographically located in Tangshan City in northern China.

Participants

A total of 9078 residents were invited to take part in the survey and provided informed consents. Individuals without data of ECG or SUA were excluded, leaving 8937 residents in our study.

Primary and secondary outcome measures

SUA was measured at baseline using the uricase-peroxidase method. Hyperuricaemia was defined as a SUA level >7.0 mg/dL in men and >5.7 mg/dL in women. AF was diagnosed based on ECG findings and/or any medical history of AF from referring physicians. The crude and independent association between SUA levels and AF prevalence was evaluated with logistic regression analysis.

Results

AF prevalence was 0.6% (53/8937). Participants with hyperuricaemia had a higher AF prevalence compared with those with normal SUA levels (1.1% vs 0.5%; P=0.02). Hyperuricaemia was correlated with AF after adjustment for various cardiovascular risk factors in all participants (P=0.03, OR 2.051, 95% CI 1.063 to 3.856). This correlation was particularly stronger in women compared with men (P<0.001, OR 6.366, 95% CI 2.553 to 15.871 in women and P=0.96, OR 1.025, 95% CI 0.400 to 2.626 in men).

Conclusions

We demonstrated a significant association between increased SUA levels and AF prevalence in a Chinese population. Our data indicate that there is a gender-specific mechanism underlying the relationship between SUA and AF.
Results of physician licence examination and scholarship contract compliance by the graduates of regional quotas in Japanese medical schools: a nationwide cross-sectional survey
Authors: Matsumoto Masatoshi , Takeuchi Keisuke , Owaki Tetsuhiro , Iguchi Seitaro , Inoue Kazuo , Kashima Saori , Tazuma Susumu , Maeda Takahiro
Published: December 2017

Objectives

Responding to the serious shortage of physicians in rural areas, the Japanese government has aggressively increased the number of entrants to medical schools since 2008, mostly as achiikiwaku, entrants filling a regional quota. The quota has spread to most medical schools, and these entrants occupied 16% of all medical school seats in 2016. Most of these entrants were admitted to medical school with a scholarship with the understanding that after graduation they will practise in designated areas of their home prefectures for several years. The quota and scholarship programmes will be revised by the government starting in 2018. This study evaluates the intermediate outcomes of these programmes.

Design

Cross-sectional survey to all prefectural governments and medical schools every year from 2014 to 2017 to obtain data on medical graduates.

Settings

Nationwide.

Participants

All quota and non-quota graduates with prefecture scholarship in each prefecture, and all the quota graduates without scholarship in each medical school.

Primary outcome measures

Passing rate of the National License Examination for Physicians and the percentage of graduates who have not bought out the scholarship contract after graduation.

Results

Most prefectures and medical schools in Japan participated in this study (97.8%–100%). Quota graduates with scholarship were significantly more likely to pass the National License Examination for Physicians than the other medical graduates in Japan at all the years (97.9%, 96.7%, 97.4% and 94.7% vs 93.9%, 94.5%, 94.3% and 91.8%, respectively). The percentage of quota graduates with scholarship who remained in the scholarship contract 3 years after graduation was 92.2% and 89.9% for non-quota graduates with scholarship.

Conclusions

Quota entrants showed better academic performance than their peers. Most of the quota graduates remained in the contractual workforce. The imminent revision of the national policy regarding quota and scholarship programmes needs to be based on this evidence.
Understanding contagious ovine digital dermatitis
Authors: Duncan Jennifer , Grove‐White Dai , Angell Joe
Published: December 2017

Contagious ovine digital dermatitis (CODD) is an emerging disease of sheep that was first reported in the UK in 1997. Since then it has become widespread in the national flock with an estimated 50 per cent of sheep farms affected. There have been several unconfirmed reports of the disease occurring in other parts of the world. Clinically, it presents as an initial proliferative or ulcerative lesion at the coronary band, progressing to separation and eventual avulsion of the hoof capsule. The disease causes severe lameness in sheep and can be difficult to manage. Until recently, there was only a small evidence base for vets and farmers to use in the control of CODD. This article summarises significant recent advances in the understanding of CODD and provides treatment and prevention strategies.
Systematic review of structural and functional brain alterations in psychosis of epilepsy
Authors: Allebone James , Kanaan Richard , Wilson Sarah J
Published: December 2017

This systematic review critically assesses structural and functional neuroimaging studies of psychosis of epilepsy (POE). We integrate findings from 18 studies of adults with POE to examine the prevailing view that there is a specific relationship between temporal lobe epilepsy (TLE) and POE, and that mesial temporal lobe pathology is a biomarker for POE. Our results show: (1) conflicting evidence of volumetric change in the hippocampus and amygdala; (2) distributed structural pathology beyond the mesial temporal lobe; and (3) changes in frontotemporal functional network activation. These results provide strong evidence for a revised conceptualisation of POE as disorder of brain networks, and highlight that abnormalities in mesial temporal structures alone are unlikely to account for its neuropathogenesis. Understanding POE as a disease of brain networks has important implications for neuroimaging research and clinical practice. Specifically, we suggest that future neuroimaging studies of POE target structural and functional networks, and that practitioners are vigilant for psychotic symptoms in all epilepsies, not just TLE.
Epilepsy and psychosis: a practical approach
Authors: Maguire Melissa , Singh Jasvinder , Marson Anthony
Published: December 2017

The psychoses of epilepsy can be classified according to their temporal relationship with seizures, namely as ictal, postictal and interictal psychosis. Interictal psychosis is the most common and may resemble schizophrenia. They can be challenging to diagnose and to manage, especially given the perception that some antipsychotic drugs may exacerbate seizures, while some antiepileptic medications may worsen psychosis. The current uncertainty around their best management means that some patients may not receive appropriate care. We propose a practical stepwise approach to managing psychosis in patients with epilepsy, summarising the key clinical features. We provide a framework for diagnosis, investigation and management of psychosis in the acute and long term. We also summarise the available evidence on the risk of psychosis with current antiepileptic drugs and the risk of seizures with antipsychotic drugs.
Longitudinally extensive transverse myelitis after Campylobacter jejuni enteritis
Authors: Llamas Yudy , Hazel Karl , Nicholson Patrick , Costelloe Lisa
Published: December 2017

Campylobacter jejuni infection is well-known to precipitate Guillain-Barré syndrome through an immune-mediated attack on the peripheral nervous system. Molecular mimicry between C. jejuni lipo-oligosaccharides on the surface of infectious agents and human gangliosides in the peripheral nerves induces cross-reactive immune responses. Although gangliosides also occur in the central nervous system (CNS), autoimmune CNS disorders rarely follow C. jejuni infections. However, longitudinally extensive transverse myelitis commonly has a parainfectious cause, triggered by a wide range of micro-organisms including viruses and bacteria. We report a patient who developed longitudinally extensive transverse myelitis after C. jejuni enteritis associated with antiganglioside antibodies.