bluuebunny/crossref_metadata_2025 huggingface dataset:
Ministry of Recovery and Discovery
Authors: Wright Peter
Published: June 2020

Am I the only one who thinks that perhaps some of our technology has come too far, too fast? And are we really better off as a result of this? Whenever I bring up the subject among friends and colleagues it invariably results in my being told to “get back to the dark ages” (which I’m old enough to remember).
Gamma rays shed light on dark matter
Authors: Cartlidge Edwin
Published: June 2020

An analysis of nine years’ worth of data from NASA’s Fermi craft opens the possibility of studying dark-matter particle models with gamma rays, as Edwin Cartlidge reports
Sneezes could spread viruses up to 8m
Authors: Cockbill Louisa
Published: June 2020

Research on the fluid dynamics of respiratory emissions indicates that people infected with COVID-19 could spread viral particles up to 8 m away when they cough or sneeze
Solar wind and extreme heat creates ice on Mercury
Authors: Jarman Sam
Published: June 2020

Some of the ice on Mercury is created by chemical reactions triggered by the planet’s extreme daytime heat. That is according to Brant Jones and Thomas Orlando from the Georgia Institute of Technology and ASA’s Menelaos Sarantos
Effects of Prophylactic Lipofilling After Radiotherapy Compared to Non–Fat Injected Breasts: A Randomized, Objective Study
Authors: Gentilucci Marika , Mazzocchi Marco , Alfano Carmine
Published: June 2020

Background

Patients who are suffering from invasive breast cancer may require post-mastectomy radiation therapy (PMRT). PMRT improves outcomes in breast cancer patients in terms of locoregional recurrence. Preliminary studies indicate that fat injections reduce post-radiation damage of soft tissue and implants.

Objectives

The aim of this study was to demonstrate the safety and effectiveness of prophylactic fat injections on radiated implanted breasts.

Methods

The authors randomly assigned 60 female patients to either Group A or B. Group A patients received 3 breast fat injections, according to Coleman’s technique, after radiotherapy and before expander removal with definitive implant insertion. Group B patients underwent surgery without lipofilling. At each surgical operation, skin biopsies were performed in a specific breast area to evaluate adipose tissue thickness, and a statistical analysis of the thickness variations was performed with the Wilcoxon’s sum test. Disability was assessed according to the Late Effects of Normal Tissues-Subjective Objective Management Analytic scale.

Results

The study demonstrates a qualitative and quantitative improvement about tissues after fat injection. This is highlighted by the significant increase in thickness after lipofilling.

Conclusions

The study, which is based on both clinical and histological findings and is supported by the comparison of a control group with a 1-year follow-up, demonstrates that fat injections reduce tissue radio damage, improving reconstructive surgery outcomes and quality of life.

Level of Evidence: 2
Stuck inside the urban with the dialectical blues again: abstraction and generality in urban theory
Authors: Addie Jean-Paul D
Published: June 2020

This article discusses how critical urban theory understands generalisation and particularity by unpacking the process of abstraction. It develops an urban interpretation of dialectics through the philosophy of internal relations to: (i) heuristically examine conceptual and political fissures within contemporary urban studies and (ii) critically recalibrate neo-Marxist planetary urban theorising. Examining the conceptual extension, levels of generality and vantage points of our abstractions can assist in constructively negotiating relations between urban difference and generality. The challenge is not which assertions are true based on a given epistemological position, but which abstractions are appropriate to address specific issues, given the range of politics and possibilities each establishes.
Safety and performance of a novel transventricular beating heart mitral valve repair system: 1-year outcomes
Authors: Gammie James S , Bartus Krzysztof , Gackowski Andrzej , Szymanski Piotr , Bilewska Agata , Kusmierczyk Mariusz , Kapelak Boguslaw , Rzucidlo-Resil Jolanta , Duncan Alison , Yadav Rashmi , Livesey Steve , Diprose Paul , Gerosa Gino , D’Onofrio Augusto , Pittarello Demetrio , Denti Paolo , La Canna Giovanni , De Bonis Michele , Alfieri Ottavio , Hung Judy , Kolsut Piotr , D’Ambra Michael N
Published: June 2020

OBJECTIVES

The objective of this study was to evaluate the safety and performance of a novel, beating heart procedure that enables echocardiographic-guided beating heart implantation of expanded polytetrafluoroethylene (ePTFE) artificial cords on the posterior mitral leaflet of patients with degenerative mitral regurgitation.

METHODS

Two prospective multicentre studies enrolled 13 (first-in-human) and 52 subjects, respectively. Patients were treated with the HARPOON beating heart mitral valve repair system. The primary (30-day) end point was successful implantation of cord(s) with mitral regurgitation reduction to ≤moderate. An independent core laboratory analysed echocardiograms.

RESULTS

Of 65 patients enrolled, 62 (95%) achieved technical success, 2 patients required conversion to open surgery and 1 procedure was terminated. The primary end point was met in 59/65 (91%) patients. Among the 62 treated patients, the mean procedural time was 2.1 ± 0.5 h. Through discharge, there were no deaths, strokes or renal failure events. At 1 year, 2 of the 62 patients died (3%) and 8 (13%) others required reoperations. At 1 year, 98% of the patients with HARPOON cords were in New York Heart Association class I or II, and mitral regurgitation was none/trace in 52% (n = 27), mild in 23% (n = 12), moderate in 23% (n = 12) and severe in 2% (n = 1). Favourable cardiac remodelling outcomes at 1 year included decreased end-diastolic left ventricular volume (153 ± 41 to 119 ± 28 ml) and diameter (53 ± 5 to 47 ± 6 mm), and the mean transmitral gradient was 1.4 ± 0.7 mmHg.

CONCLUSIONS

This initial clinical experience with the HARPOON beating heart mitral valve repair system demonstrates encouraging early safety and performance.

Clinical registration numbers

NCT02432196 and NCT02768870.
Effects of Fortetropin on the Rate of Muscle Protein Synthesis in Older Men and Women: A Randomized, Double-Blinded, Placebo-Controlled Study
Authors: Evans William , Shankaran Mahalakshmi , Nyangau Edna , Field Tyler , Mohammed Hussein , Wolfe Robert , Schutzler Scott , Hellerstein Marc
Published: June 2020

Background

Fortetropin is a proteo-lipid complex made from fertilized egg yolk and, in young men, has been shown to increase lean body mass.

Methods

The purpose of this study was to examine the effects of 21 days of Fortetropin supplementation on the fractional synthetic rate (FSR) of muscle protein in 10 healthy, older men and 10 women (66.4 ± 4.5 y). We used 2H2O labeling to measure FSR of multiple muscle protein ontologies. D3-creatine dilution was used to determine muscle mass at baseline. Subjects ingested 70% 2H2O for 21 day and saliva samples were collected to determine body 2H2O enrichment. A microbiopsy was obtained from the m. vastus lateralis on Day 21. Subjects were randomly assigned to Fortetropin (19.8 g/d) or placebo (cheese powder, 19.8 g/d).

Results

Restricting kinetic data to proteins with ≥2 peptides measured in at least 4 subjects per group resulted in 117 proteins meeting these criteria. The mean FSR for a majority of proteins in several muscle gene ontologies was higher in the Fortetropin group compared to placebo (32/38 myofibril proteins, 33/44 sarcoplasmic proteins, and 12/17 mitochondrial proteins) and this proportion was significantly different between groups using a binomial test and were independent of sex or baseline muscle mass.

Conclusions

The overall magnitude of the difference in muscle protein FSR of Fortetropin from placebo was 18%, with multiple gene ontologies affected. While these results should be confirmed in larger cohorts, they suggest that Fortetropin supplementation is effective for promoting muscle protein synthesis in older people.
Unequal Impact of Structural Health Determinants and Comorbidity on COVID-19 Severity and Lethality in Older Mexican Adults: Considerations Beyond Chronological Aging
Authors: Bello-Chavolla Omar Yaxmehen , González-Díaz Armando , Antonio-Villa Neftali Eduardo , Fermín-Martínez Carlos A , Márquez-Salinas Alejandro , Vargas-Vázquez Arsenio , Bahena-López Jessica Paola , García-Peña Carmen , Aguilar-Salinas Carlos A , Gutiérrez-Robledo Luis Miguel
Published: June 2020

Background

COVID-19 has had a disproportionate impact on older adults. Mexico’s population is younger, yet COVID-19’s impact on older adults is comparable to countries with older population structures. Here, we aim to identify health and structural determinants that increase susceptibility to COVID-19 in older Mexican adults beyond chronological aging.

Methods

We analyzed confirmed COVID-19 cases in older adults using data from the General Directorate of Epidemiology of Mexican Ministry of Health. We modeled risk factors for increased COVID-19 severity and mortality, using mixed models to incorporate multilevel data concerning healthcare access and marginalization. We also evaluated structural factors and comorbidity profiles compared to chronological age for COVID-19 mortality risk prediction.

Results

We analyzed 20 804 confirmed SARS-CoV-2 cases in adults aged 60 and older. Male sex, smoking, diabetes, and obesity were associated with pneumonia, hospitalization, and intensive care unit (ICU) admission in older adults, CKD and COPD were associated with hospitalization. High social lag indexes and access to private care were predictors of COVID-19 severity and mortality. Age was not a predictor of COVID-19 severity in individuals without comorbidities and combination of structural factors and comorbidities were better predictors of COVID-19 lethality and severity compared to chronological age alone. COVID-19 baseline lethality hazards were heterogeneously distributed across Mexican municipalities, particularly when comparing urban and rural areas.

Conclusions

Structural factors and comorbidity explain excess risk for COVID-19 severity and mortality over chronological age in older Mexican adults. Clinical decision-making related to COVID-19 should focus away from chronological aging onto more a comprehensive geriatric care approach.
Structure-preserving discretizations of gradient flows for axisymmetric two-phase biomembranes
Authors: Garcke Harald , Nürnberg Robert
Published: June 2020

The form and evolution of multi-phase biomembranes are of fundamental importance in order to understand living systems. In order to describe these membranes, we consider a mathematical model based on a Canham–Helfrich–Evans two-phase elastic energy, which will lead to fourth-order geometric evolution problems involving highly nonlinear boundary conditions. We develop a parametric finite element method in an axisymmetric setting. Using a variational approach it is possible to derive weak formulations for the highly nonlinear boundary value problems such that energy decay laws, as well as conservation properties, hold for spatially discretized problems. We will prove these properties and show that the fully discretized schemes are well posed. Finally, several numerical computations demonstrate that the numerical method can be used to compute complex, experimentally observed two-phase biomembranes.
A Parliamentary Perspective on the Implementation of the Judgments of the European Court of Human Rights
Authors: Le Borgn’ Pierre-Yves
Published: June 2020

As a member of the Assemblée nationale, the lower house of the French Parliament, from 2012 to 2017, the author was part of the French delegation to the Parliamentary Assembly of the Council of Europe (PACE), where he was entrusted with preparing, as a rapporteur for the Committee on Legal Affairs and Human Rights, a report on the implementation of the judgments of the European Court of Human Rights. This practice note underscores that it is the responsibility of PACE as an institution, and of its members individually, to follow closely the issue of the implementation of European Court judgments, even if the primary responsibility for supervising implementation, or ‘execution’, lies with the Committee of Ministers of the Council of Europe. PACE can provide useful solutions where the implementation of judgments pertaining to long-standing or systemic problems is stalled or protracted, notably through field missions carried out by members and in particular by its rapporteur, which can complement the efforts deployed by the Committee of Ministers.
Circulating Folate and Folic Acid Concentrations: Associations With Colorectal Cancer Recurrence and Survival
Authors: Geijsen Anne J M R , Ulvik Arve , Gigic Biljana , Kok Dieuwertje E , van Duijnhoven Fränzel J B , Holowatyj Andreana N , Brezina Stefanie , van Roekel Eline H , Baierl Andreas , Bergmann Michael M , Böhm Jürgen , Bours Martijn J L , Brenner Hermann , Breukink Stéphanie O , Bronner Mary P , Chang-Claude Jenny , de Wilt Johannes H W , Grady William M , Grünberger Thomas , Gumpenberger Tanja , Herpel Esther , Hoffmeister Michael , Huang Lyen C , Jedrzkiewicz Jolanta D , Keulen Eric T P , Kiblawi Rama , Kölsch Torsten , Koole Janna L , Kosma Katharina , Kouwenhoven Ewout A , Kruyt Flip M , Kvalheim Gry , Li Christopher I , Lin Tengda , Ose Jennifer , Pickron T Bartley , Scaife Courtney L , Schirmacher Peter , Schneider Martin A , Schrotz-King Petra , Singer Marie C , Swanson Eric R , van Duijvendijk Peter , van Halteren Henk K , van Zutphen Moniek , Vickers Kathy , Vogelaar F Jeroen , Wesselink Evertine , Habermann Nina , Ulrich Alexis B , Ueland Per M , Weijenberg Matty P , Gsur Andrea , Ulrich Cornelia M , Kampman Ellen
Published: June 2020

Background

Folates, including folic acid, may play a dual role in colorectal cancer development. Folate is suggested to be protective in early carcinogenesis but could accelerate growth of premalignant lesions or micrometastases. Whether circulating concentrations of folate and folic acid, measured around time of diagnosis, are associated with recurrence and survival in colorectal cancer patients is largely unknown.

Methods

Circulating concentrations of folate, folic acid, and folate catabolites p-aminobenzoylglutamate and p-acetamidobenzoylglutamate were measured by liquid chromatography-tandem mass spectrometry at diagnosis in 2024 stage I-III colorectal cancer patients from European and US patient cohort studies. Multivariable-adjusted Cox proportional hazard models were used to assess associations between folate, folic acid, and folate catabolites concentrations with recurrence, overall survival, and disease-free survival.

Results

No statistically significant associations were observed between folate, p-aminobenzoylglutamate, and p-acetamidobenzoylglutamate concentrations and recurrence, overall survival, and disease-free survival, with hazard ratios ranging from 0.92 to 1.16. The detection of folic acid in the circulation (yes or no) was not associated with any outcome. However, among patients with detectable folic acid concentrations (n = 296), a higher risk of recurrence was observed for each twofold increase in folic acid (hazard ratio = 1.31, 95% confidence interval = 1.02 to 1.58). No statistically significant associations were found between folic acid concentrations and overall and disease-free survival.

Conclusions

Circulating folate and folate catabolite concentrations at colorectal cancer diagnosis were not associated with recurrence and survival. However, caution is warranted for high blood concentrations of folic acid because they may increase the risk of colorectal cancer recurrence.
Navigating by Stars: Using CMS Star Ratings to Choose Hospitals for Complex Cancer Surgery
Authors: Papageorge Marianna V , Resio Benjamin J , Monsalve Andres F , Canavan Maureen , Pathak Ranjan , Mase Vincent J , Dhanasopon Andrew P , Hoag Jessica R , Blasberg Justin D , Boffa Daniel J
Published: June 2020

Background

The Centers for Medicare and Medicaid Services (CMS) developed risk-adjusted “Star Ratings,” which serve as a guide for patients to compare hospital quality (1 star = lowest, 5 stars = highest). Although star ratings are not based on surgical care, for many procedures, surgical outcomes are concordant with star ratings. In an effort to address variability in hospital mortality after complex cancer surgery, the use of CMS Star Ratings to identify the safest hospitals was evaluated.

Methods

Patients older than 65 years of age who underwent complex cancer surgery (lobectomy, colectomy, gastrectomy, esophagectomy, pancreaticoduodenectomy) were evaluated in CMS Medicare Provider Analysis and Review files (2013-2016). The impact of reassignment was modeled by applying adjusted mortality rates of patients treated at 5-star hospitals to those at 1-star hospitals (Peters-Belson method).

Results

There were 105 823 patients who underwent surgery at 3146 hospitals. The 90-day mortality decreased with increasing star rating (1 star = 10.4%, 95% confidence interval [CI] = 9.8% to 11.1%; and 5 stars = 6.4%, 95% CI = 6.0% to 6.8%). Reassignment of patients from 1-star to 5-star hospitals (7.8% of patients) was predicted to save 84 Medicare beneficiaries each year. This impact varied by procedure (colectomy = 47 lives per year; gastrectomy = 5 lives per year). Overall, 2189 patients would have to change hospitals each year to improve outcomes (26 patients moved to save 1 life).

Conclusions

Mortality after complex cancer surgery is associated with CMS Star Rating. However, the use of CMS Star Ratings by patients to identify the safest hospitals for cancer surgery would be relatively inefficient and of only modest impact.
Excision of metastatic breast cancer from sternum and reconstruction in two patients with solitary metastatic spread
Authors: Mohamed Saifullah , Mazhar Khurum , Osman Ahmed , Patel Akshay , Srinivasan Lakshmi , Ghosh Shilajit
Published: June 2020

Metastatic breast carcinoma is a relatively common clinical entity. However, the prognosis of oligometastatic and polygometastatic disease differs considerably pertaining to five-year survival. Metastatic breast carcinoma to the sternum has been described as early as 1988. We describe two cases in our institution who presented with solitary sternal metastases with a previous history of treated breast cancer. In both cases, there had been a history of previous left breast cancer treated aggressively with surgical resection and adjuvant oncological therapy and maintenance hormonal therapy. Partial sternectomy or total sternectomy for solitary metastatic sternal deposits is well established with relatively low morbidity and mortality and improvement in quality of life and possible improvement in long-term survival. Furthermore, reconstructive options are inherently dependent on extent of resection performed. These techniques can incorporate the use of sternal plates in order to approximate defects and reinforce the sternum in the setting of partial sternectomy.
Discounting for Uncertainty in Health
Authors: Cotton-Barratt Owen
Published: June 2020

When modeling future health outcomes, there are several reasons one might apply a discount function. Setting aside questions of whether health is intrinsically or instrumentally preferred at different times, one can still use a discount function to account for various unmodeled factors. Since it is infeasible to track all possible future trajectories for society, this could be a good pragmatic approach. How this should be done in a health context can be explored; in particular there is a reasonable case that a higher discount rate should be used for years lived with disability than years of life lost. Discounting for uncertainty adds robustness and can be used to dissolve the “eradication paradox” and “research paradox.”
Common Programming Strategies for Deep Brain Stimulation
Authors: Salinas Meagen R.
Published: June 2020

Deep brain stimulation (DBS) has improved the quality of life for many patients with select movement disorders. Since its first approval in the United States for thalamic stimulation as a potential treatment for essential and parkinsonian tremors in 1997, advances in neurostimulation technology have helped propel an expansion of research into other indications for DBS, including dystonia, obsessive compulsive disorder, epilepsy, and Tourette syndrome. The evolving approach to programming is based on optimizing symptomatic benefits while minimizing stimulation-induced side effects, neurotoxicity, and energy inefficiency. A solid foundation in the basics of programming is critical to approaching the now more complex neurostimulation systems. Advances such as segmented leads, multiple independent current sources, and pulse shaping are quickly changing the landscape of programming options. This chapter provides an overview of common DBS programming strategies.
Healthy living
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle
Published: June 2020

This chapter in the Oxford Handbook of General Practice explores how to give healthy living advice to patients. It looks at prevention and screening, including prevention of travel-related illness. It discusses the effect of diet, obesity, exercise, smoking, insomnia, and alcohol on general health, as well as the management of alcohol misuse and the assessment and management of drug misuse.
Gastrointestinal medicine
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle
Published: June 2020

This chapter in the Oxford Handbook of General Practice explores gastrointestinal medicine in general practice. It covers assessment of abdominal pain, vomiting and diarrhoea, gastroenteritis and food poisoning, constipation, and other abdominal symptoms and signs. It examines dyspepsia and Helicobacter pylori, oesophageal conditions, gastro-oesophageal reflux and gastritis, peptic ulceration, and gastro-oesophageal malignancy. It discusses hernias, appendicitis and small bowel disease, colorectal cancer, and other large bowel conditions. It describes anal and perianal conditions, patients with ostomies, malabsorption, faecal incontinence, coeliac disease, inflammatory bowel disease, and irritable bowel syndrome. It also explores jaundice and abnormal liver function, fatty liver disease, hepatitis, liver failure and portal hypertension, gallbladder disease, pancreatitis, and pancreatic tumours.
Sexual health and contraception
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle
Published: June 2020

This chapter in the Oxford Handbook of General Practice explores sexual health and contraception in general practice. It covers assessment of sexual health, vaginal discharge, sexually transmitted infection, chlamydia, trichomonas, gonorrhoea, hepatitis B and C, and HIV infection. It explores contraceptive choices, combined hormonal contraception, progestogen-only contraceptives, and intrauterine contraceptive devices. It discusses teenagers and women over 40, termination of pregnancy, infertility, sexual problems, erectile dysfunction, gender dysphoria, and gender reassignment.
Mental health
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle
Published: June 2020

This chapter in the Oxford Handbook of General Practice explores mental health in general practice. It covers mental health assessment, symptoms and signs, and psychological therapies. It discusses anxiety and anxiety-type disorders, chronic stress, depression, psychosis, schizophrenia, mania, acute delirium, dementia, and eating disorders.
Cancer care
Authors: Simon Chantal , Everitt Hazel , van Dorp Françoise , Hussain Nazia , Nash Emma , Peet Danielle
Published: June 2020

This chapter in the Oxford Handbook of General Practice explores cancer care in general practice. It covers cancer diagnosis, principles of cancer care, surgery, chemotherapy, immunotherapy, and radiotherapy.
Factorial study of the RNA-seq computational workflow identifies biases as technical gene signatures
Authors: Simoneau Joël , Gosselin Ryan , Scott Michelle S
Published: June 2020

RNA-seq is a modular experimental and computational approach aiming in identifying and quantifying RNA molecules. The modularity of the RNA-seq technology enables adaptation of the protocol to develop new ways to explore RNA biology, but this modularity also brings forth the importance of methodological thoroughness. Liberty of approach comes with the responsibility of choices, and such choices must be informed. Here, we present an approach that identifies gene group-specific quantification biases in current RNA-seq software and references by processing datasets using diverse RNA-seq computational pipelines, and by decomposing these expression datasets with an independent component analysis matrix factorization method. By exploring the RNA-seq pipeline using this systemic approach, we identify genome annotations as a design choice that affects to the same extent quantification results as does the choice of aligners and quantifiers. We also show that the different choices in RNA-seq methodology are not independent, identifying interactions between genome annotations and quantification software. Genes were mainly affected by differences in their sequence, by overlapping genes and genes with similar sequence. Our approach offers an explanation for the observed biases by identifying the common features used differently by the software and references, therefore providing leads for the betterment of RNA-seq methodology.
High-dose methotrexate-based regimens with or without vincristine for the treatment of primary central nervous system lymphoma
Authors: Freeman Tracelyn , Legasto Carlo S , Schickli M Alexandra , McLaughlin Eric M , Giglio Pierre , Puduvalli Vinay , Gonzalez Javier
Published: June 2020

Background

Primary central nervous system lymphoma (PCNSL) is a rare malignancy with few treatment options. One regimen used for induction is rituximab, high-dose methotrexate (HD-MTX), procarbazine, and vincristine (R-MPV). A common institutional practice is removing vincristine (VCR) from this regimen due to its poor CNS penetration and associated toxicities. The aim of this study was to evaluate how the omission of VCR from HD-MTX-based induction impacted clinical outcomes.

Methods

In a retrospective review, patients with PCNSL who received HD-MTX-based induction therapy between January 1, 2010 and May 31, 2018 were evaluated. Patients were stratified according to treatment into 2 groups, VCR-containing therapy versus no VCR. The primary endpoint was complete response (CR) rate following the completion of induction chemotherapy. Secondary endpoints included progression-free survival (PFS), overall survival (OS), and adverse event rate.

Results

Twenty-nine patients were included: 16 patients in the VCR group and 13 in the non-VCR group. A CR was achieved in 7 (44%) and 5 (38%) (odds ratio [OR] = 1.24; 95% confidence interval [CI]: 0.28–5.53) patients, respectively. Median OS was 85.3 (95% CI: 20.2–85.3) versus 67.1 months (95% CI: 10.5–NR) and median PFS was 60.7 (95% CI: 9.4–NR) versus 23.7 months (95% CI: 4.7–NR) in the VCR group versus non-VCR group, respectively. The incidence of any grade peripheral neuropathy was higher in the VCR group.

Conclusions

CR rate, OS, and PFS were similar between groups regardless of VCR inclusion. Adverse events were higher in the VCR group. Larger studies are required to further evaluate the efficacy of VCR in PCNSL induction regimens.
Hybrid solid electrolyte enabled dendrite-free Li anodes for high-performance quasi-solid-state lithium-oxygen batteries
Authors: Wang Jin , Huang Gang , Yan Jun-Min , Ma Jin-Ling , Liu Tong , Shi Miao-Miao , Yu Yue , Zhang Miao-Miao , Tang Ji-Lin , Zhang Xin-Bo
Published: June 2020

The dendrite growth of Li anodes severely degrades the performance of lithium-oxygen (Li-O2) batteries. Recently, hybrid solid electrolyte (HSE) has been regarded as one of the most promising routes to tackle this problem. However, before this is realized, the HSE needs to simultaneously satisfy contradictory requirements of high modulus and even, flexible contact with Li anode, while ensuring uniform Li+ distribution. To tackle this complex dilemma, here, an HSE with rigid Li1.5Al0.5Ge1.5(PO4)3 (LAGP) core@ultrathin flexible poly (vinylidene fluoride-hexafluoropropylene) (PVDF-HFP) shell interface has been developed. The introduced large amount of nanometer-sized LAGP cores can not only act as structural enhancer to achieve high Young's modulus but can also construct Li+ diffusion network to homogenize Li+ distribution. The ultrathin flexible PVDF-HFP shell provides soft and stable contact between the rigid core and Li metal without affecting the Li+ distribution, meanwhile suppressing the reduction of LAGP induced by direct contact with Li metal. Thanks to these advantages, this ingenious HSE with ultra-high Young's modulus of 25 GPa endows dendrite-free Li deposition even at a deposition capacity of 23.6 mAh. Moreover, with the successful inhibition of Li dendrites, the HSE-based quasi-solid-state Li-O2 battery delivers a long cycling stability of 146 cycles, which is more than three times that of gel polymer electrolyte-based Li-O2 battery. This new insight may serve as a starting point for further designing of HSE in Li-O2 batteries, and can also be extended to various battery systems such as sodium-oxygen batteries.
Boron doping-induced interconnected assembly approach for mesoporous silicon oxycarbide architecture
Authors: Zhu Guanjia , Guo Rui , Luo Wei , Liu Hua Kun , Jiang Wan , Dou Shi Xue , Yang Jianping
Published: June 2020

Despite desirable progress in various assembly tactics, the main drawback associated with current assemblies is the weak interparticle connections limited by their assembling protocols. Herein, we report a novel boron doping-induced interconnection-assembly approach for fabricating an unprecedented assembly of mesoporous silicon oxycarbide nanospheres, which are derived from periodic mesoporous organosilicas. The as-prepared architecture is composed of interconnected, strongly coupled nanospheres with coarse surfaces. Significantly, through delicate analysis of the as-formed boron doped species, a novel melt-etching and nucleation-growth mechanism is proposed, which offers a new horizon for the developing interconnected assembling technique. Furthermore, such unique strategy shows precise controllability and versatility, endowing the architecture with tunable interconnection size, surface roughness and switchable primary nanoparticles. Impressively, this interconnected assembly along with tunable surface roughness enables intrinsically dual (both structural and interfacial) stable characteristics, achieving extraordinary long-term cycle life when used as a lithium-ion battery anode.
Self-reported diseases and their associated risk factors among camp-dwelling conflict-affected internally displaced populations in Nigeria
Authors: Ekezie Winifred , Myles Puja , Murray Rachael L , Bains Manpreet , Timmons Stephen , Pritchard Catherine
Published: June 2020

Background Conflict in Nigeria displaced millions of people, and some settled in camp-like locations within the country. Evidence on the association between living conditions and health outcomes among these populations are limited. This study investigated the risk factors associated with illnesses among camp-dwelling internally displaced persons (IDPs) in northern Nigeria.

Methods A cross-sectional study was conducted in nine camps in 2016. Self-reported data on socio-demography, resource utilization and disease outcomes were collected. Association between health conditions and various factors, including sanitation and healthcare access, was investigated.

Results Data from 2253 IDPs showed 81.1% (CI = 79.5–82.7) experienced one or more health conditions; however, over 20% did not access healthcare services. Most common diseases were malaria, fever, typhoid and diarrhoea. Multivariable logistic regression presented as adjusted odds ratios(aOR) and 95% confidence intervals(CIs) showed factors significantly associated with increased likelihood of illnesses included being female (aOR = 1.53;CI = 1.19–1.96), overcrowding (aOR = 1.07;CI = 1.00–1.36), long-term conditions (aOR = 2.72;CI = 1.88–3.94), outdoor defecation (aOR = 2.37;CI = 1.14–4.94) and presence of disease-causing vectors (aOR = 3.71;CI = 1.60–8.60).

Conclusion Most diseases in the camps were communicable. Modifiable risk factors such as overcrowding and poor toilet facilities were associated with increased poor health outcomes. This evidence highlights areas of high priority when planning humanitarian public health interventions.
The role of spirituality in the COVID-19 pandemic: a spiritual hotline project
Authors: Ribeiro Marcus Renato Castro , Damiano Rodolfo Furlan , Marujo Ricardo , Nasri Fabio , Lucchetti Giancarlo
Published: June 2020

Recent correspondence letters to the editor of this journal pointed out to the need of implementing psychological support during the pandemic and post-pandemic period to both general and frontline workers. Especially, they highlighted the importance of religious/spiritual interventions in order to provide an integral and holistic care. In this perspective, an important consequence of the social isolation is the closure of churches and the suspension of religious meetings in order to avoid agglomeration and contagion. However, although this is a very important approach in terms of public health, a question is raised: how to promote spiritual care and help spiritual/religious individuals to cope with their problems while maintaining compliance with social isolation? To address this question, we report the Spiritual Hotline Project, a project designed by many Brazilian healthcare workers intended to give spiritual and religious assistance to people with different cultural background. So far, the hotline was able to assist people from different parts of the world, including Brazil and Portugal as well as with different religious affiliation, in order to provide a spiritual comfort and care during this public health crisis.
Stratified glucocorticoid monotherapy is safe and effective for most cases of giant cell arteritis
Authors: Karabayas Maira , Dospinescu Paula , Locherty Marc , Moulindu Paul , Sobti Manvi , Hollick Rosemary , De Bari Cosimo , Robinson Susan , Olson John , Basu Neil
Published: June 2020

Objectives

High-dose glucocorticoids anchor standard care in GCA but are associated with significant toxicity. We aimed to evaluate the safety and effectiveness of a stratified approach to glucocorticoid tapering. The strategy aggressively reduced glucocorticoid doses in those manifesting an adequate early response to treatment, with a view to minimizing glucocorticoid complications.

Methods

A retrospective, population-based study of GCA was performed. All cases were confirmed by temporal artery biopsy between November 2010 and November 2015. Baseline and outcome data were extracted from secondary and primary care records at diagnosis and 1 year follow-up. The primary outcome was loss of vision. Secondary outcomes included remission and relapse rates and CS-related complications.

Results

The cohort consisted of 73 patients (76% female; mean age 73.5 years, s.d. 7.6 years). At presentation, a reduction in visual acuity was recorded in 17 patients (22.3%). The median CRP at diagnosis was 69.5 mg/l [interquartile range (IQR) 40.5–101 mg/l], with a median ESR of 80 mm/h (IQR 60–91 mm/h). At 1 year, remission was achieved in 64 patients (87.7%), whereas 10 patients (13.7%) relapsed. A single patient sustained visual loss after initiation of therapy. The median CRP at 1 year was 4 mg/l (IQR 4–9.5 mg/l) and the mean prednisolone dose was 5.4 mg (0–15 mg). CS-related complications were observed in 10 patients (13.7%).

Conclusion

A stratified approach to CS tapering appeared safe and effective in GCA. It was associated with a high rate of remission and promisingly low rates of relapse at 1 year follow-up. These real-world data indicate that glucocorticoid exposure can be minimized safely in some patients with GCA.
Challenges and solutions in developing legitimate online participation for EU biodiversity and ecosystem services policies
Authors: Varumo Liisa , Paloniemi Riikka , Kelemen Eszter
Published: June 2020

To support legitimate European Union (EU) biodiversity policy development, there is a growing momentum to engage society in these policy processes and build meaningful and inclusive dialogue between science, policy, and society in policy deliberation. So far, engagement efforts have been made to encourage citizen participation in knowledge production via, for example, citizen science. At EU level means to encourage public participation have included a variety of online mechanisms for spreading information and promoting public deliberation. Despite these developments, the involvement of the general public in policy-making at the EU level has been rather inconsistent to date. In this article, we evaluate online science cafés as potential means to encourage dialogue between science, policy, and society; we ask what elements in their design and implementation are essential for inclusive dialogue between science, policy, and society. Our findings emphasise iterative dialogue when approaching multi-scalar challenges. This has important implications for developing legitimate participation across Europe.
A dedicated nurse for skin-to-skin care after cesarean birth
Authors: Kjelland Kim , Monroe Martha , Moore Tyra , Cooper Hyewon , Davies Claire C.
Published: June 2020

An evaluation of clinical outcomes and cost
Validity of the Talk Test as a Method to Estimate Ventilatory Threshold and Guide Exercise Intensity in Cardiac Patients
Authors: Sørensen Lotte , Larsen Karoline Stentoft Rybjerg , Petersen Annemette Krintel
Published: June 2020

Purpose:

To determine the relationship between the Talk Test (TT) and ventilatory threshold (VT) in patients with cardiac disease and to compare the TT with exercise intensity guidelines.

Methods:

Twenty cardiac patients, aged 65 ± 8.5 yr, performed 2 exercise tests with identical ramp protocols on a cycle ergometer on the same day. One test was a submaximal effort to assess exercise intensity using the TT. The other was a cardiopulmonary exercise test using breath-by-breath gas analysis to identify VT and cardiorespiratory fitness.

Results:

Oxygen uptake (

) and workload at the last positive stage (TTpos) was significantly lower than at VT.

and workload at the equivocal stage (TTeq) and the first negative stage (TTneg) were not significantly different from VT, but limits of agreement (LoA) were wide. There was no significant difference in heart rate (HR) at TTpos and TTeq compared with VT, but HR at Tneg was significantly higher. The correlations between the TT and VT ranged from 0.37 to 0.60. Intensity at the different TT stages ranged from 58-77% of

. All TT stages were within intensity guidelines of 40-80% of

.

Conclusion:

Although no significant differences were found in

and workload for TTeq and TTneg when compared with VT, LoA demonstrated wide ranges, suggesting poor individual correspondence. The different stages of the TT can be used as a practical method to guide exercise intensity in patients with cardiac disease.
Exercise Training Effects on the Relationship of Physical Function and Health-Related Quality of Life Among Older Heart Failure Patients With Preserved Ejection Fraction
Authors: Brubaker Peter H. , Avis Teagan , Rejeski W. Jack , Mihalko Shannon E. , Tucker Wesley J. , Kitzman Dalane W.
Published: June 2020

Purpose:

Although exercise training (ET) has been shown to improve both physical function and health-related quality of life (HRQOL) in older patients with heart failure and preserved ejection fraction (HFpEF), the relationship between changes in these important patient-centered outcome measures has not been adequately investigated.

Methods:

Patients (n = 116) with HFpEF (from 2 previous randomized controlled trials) were assigned to either 16 wk of endurance ET or attention control (CON). The ET in both trials consisted of ≤ 60 min of moderate-intensity endurance ET 3 time/wk. Peak exercise oxygen uptake (V˙o2peak) and other exercise capacity measures were obtained from a cardiopulmonary exercise test on an electronically braked cycle ergometer and 6-min walk test (6MWT). HRQOL was assessed using the Minnesota Living with Heart Failure (MLHF) Questionnaire and the 36-item Short Form Health Survey (SF-36).

Results:

Compared with CON, the ET group demonstrated significant improvement in measures of physical function (V˙o2peak and 6MWT) at 16 wk of follow-up. There were no significant differences observed between the groups for MLHF scores, but the ET group showed significant improvements on the SF-36. There were no significant correlations between change in any of the physical function and HRQOL measures in the ET group.

Conclusions:

While endurance ET improved both physical function and some domains of HRQOL, the lack of significant correlations between changes in these measures suggests the effects of ET on physical function and HRQOL are largely independent of one another. Since these measures assess important and unique patient-centered outcomes in HFpEF patients, both physical function and HRQOL should be assessed in exercise-based programs and clinical trials.
Nested matched case control study for the Japan Fukushima Health Management Survey's first full-scale (second-round) thyroid examination
Authors: Takahashi Hideto , Yasumura Seiji , Takahashi Kunihiko , Ohira Tetsuya , Ohtsuru Akira , Midorikawa Sanae , Suzuki Satoru , Shimura Hiroki , Ishikawa Tetsuo , Sakai Akira , Suzuki Shinichi , Yokoya Susumu , Tanigawa Koichi , Ohto Hitoshi , Kamiya Kenji
Published: June 2020

Since Fukushima nuclear accident in 2011, thyroid ultrasound examinations have been conducted. The first full-scale examination detected 71 thyroid-cancer cases. This study examined whether radiation exposure was associated with thyroid-cancer incidence.

Subjects were participants in the baseline screening and newborns during the 2011 fiscal year. Under nested matched case-control study design, 10 controls per each case were selected by matching the age, sex, baseline screening results, and interval between examinations. With 3 dose levels of external radiation: 1.3 + mSv (upper), 0.8 to 1.3 (middle), and 0.0 to 0.8 (reference), we applied 2 logistic models adjusting for 3 participation-proportions (primary, secondary, and fine-needle aspiratory cytology), overweight, and the B-result of baseline screening (Model 1), and past medical history, family history of thyroid cancer, and frequencies of eating seafood and seaweed in addition to the parameters in Model 1 (Model 2). We examined each model in 3 ways: (a) excluding subjects with a missing radiation exposure dose; and substituting (b1) median or (b2) mean dose of the municipality with missing dose.

Odds ratios (ORs) of middle-dose exposure were (a) 1.35 (0.46–3.94), (b1) 1.55 (0.61–3.96), and (b2) 1.23 (0.50–3.03) for Model 1, and (a) 1.18 (0.39–3.57), (b1) 1.31 (0.49–3.49), and (b2) 1.02 (0.40–2.59) for Model 2. For upper-dose exposure, similar results were obtained. Past medical history was significantly associated (odds ratio  = 2.04–2.08) with both (b1) and (b2) in Model 2.

No significant associations were obtained between the external radiation exposure and thyroid-cancer incidence.
Twice-daily vs higher-dose once-daily thoracic radiotherapy for limited-disease small-cell lung cancer
Authors: Yang Lin , Liu Libo , Yang Yanjie , Lei Yao , Wang Tianyi , Wu Xiaocui , Guo Xiaoling
Published: June 2020

Introduction:

The optimal dose and fractionation of thoracic radiotherapy (RT) for limited-disease small-cell lung cancer (LD-SCLC) remain controversial. This meta-analysis was performed to compare the efficacy and RT toxicity between twice-daily thoracic RT (45 Gy with 1.5 Gy twice daily) and higher-dose once-daily RT (60–72 Gy with 1.8 Gy/2 Gy once daily) administered with chemotherapy in LD-SCLC patients.

Methods:

PubMed, EMBASE, Web of Science, and the Cochrane Library were searched up to March 19, 2020 for studies that compared twice-daily thoracic RT (45 Gy with 1.5 Gy twice daily over 3 weeks) with higher-dose once-daily RT (60–72 Gy with 1.8 Gy/2 Gy once daily over 6–8 weeks) in LD-SCLC patients.

Results:

Five studies involving 13,726 patients were included in this analysis. Compared with the once-daily thoracic RT group, the 1-year overall survival (OS) rate (P < .001), the 2-year OS rate (P < .001), the 5-year OS rate (P < .001), the mOS (P < .001), and the 1-year LRFS rate (P = .048) were significantly improved in the twice-daily RT group. The toxic effects of RT (esophagitis: P = .293; pneumonitis: P = .103) were similar in both groups.

Conclusion:

Compared with the higher-dose once-daily regimen, the twice-daily thoracic radiotherapy regimen improved efficacy but did not increase RT toxicity in LD-SCLC patients.
Content and impact of pharmacy services for patients with Parkinson's disease
Authors: Yi Zhan-Miao , Li Ting-Ting , Tang Qi-Yu , Zhang Yuan , Willis Sarah , Zhai Suo-Di
Published: June 2020

Background:

Medicines optimisation is important for the management of Parkinson's disease (PD). As many patients with PD have other long-term conditions, treatment is complex and risk of adverse events for these patients is high.

Objective:

To explore the role of pharmacists and impact of pharmacy interventions for PD patients.

Methods:

We comprehensively searched PubMed, Embase, the Cochrane Library and Chinese databases Sinomed, China National Knowledge Infrastructure to identify studies reporting pharmacist interventions and pharmacy services for PD patients using a predefined search strategy. The search period was from inception to March 2019. We also manually searched the reference list of included studies and ClinicalTrials.gov. We conducted meta-analyses to synthesize the evidence quantitatively.

Results:

A total of 1607 studies were identified by applying the search criteria. After screening, 19 cross-sectional and case-controlled studies with 1458 PD patients from 9 countries were included. Pharmacist interventions for PD patients most commonly related to adverse drug reactions (ADRs) (13 studies), adherence assessment (12 studies), medication review (12 studies), identification of drug interactions (11 studies), monitoring response to medication therapy (11 studies), identification of inappropriate medication (11 studies), and patient education (10 studies). Most pharmacy services were provided in outpatient settings (13 studies). Reported impact measures included adherence (8 studies), quality of life (7 studies), and identification of drug-related problems (6 studies) such as ADRs (393 times out of 1760 times, 22.33%, 6 studies), inappropriate drug choice (349 times, 19.83%, 6 studies), inappropriate dosage (335 times, 19.03%, 6 studies), inappropriate drug use (257 times, 14.60%, 3 studies) and drug-drug interactions (146 times, 8.3%, 4 studies). Pooled results from 3 studies indicated no statistically significant impact of pharmacy services on all subscales of PD Questionnaire-39.

Conclusion:

ADRs were the most widely reported drug-related problems for PD patients; pharmacy services may have a role to play in medication adherence but were not found to impact on quality of life.