bluuebunny/crossref_metadata_2025 huggingface dataset:
Vigilance for carcinoid heart disease is still required in the era of somatostatin analogues: Lessons from a case series
Authors: Chan David L. , Pavlakis Nick , Crumbaker Megan , Lawrence Ben , Barber Camilla , Price Timothy J. , Michael Michael , Oberg Kjell
Published: April 2021

Aim

Carcinoid heart disease (CHD) is a well‐documented complication of neuroendocrine tumors (NETs) due to secreted hormones causing fibrosis. Somatostatin analogues (SSAs) can decrease hormonal secretion and inhibit tumor growth. The reported incidence of CHD has decreased as SSA use has increased. We describe a series of patients who have developed CHD even though they were treated with SSA therapy.

Methods

Nine patients were seen in four centers in Australia and New Zealand. The average duration of follow‐up from diagnosis was 39 months.

Results

Three patients had Grade 1 and six Grade 2 disease by World Health Organization 2010 criteria. All patients had no CHD symptoms at baseline and started SSA therapy soon after diagnosis, yet developed significant, symptomatic cardiac dysfunction in their disease course. The median time from NET diagnosis to SSA initiation was 1 month, and median time from NET diagnosis to CHD diagnosis was 23 months (range 4–52). All patients who were tested had persistently increased hormonal levels (chromogranin A, urinary 5‐hydroxyindolacetic acid).

Conclusions

The good symptomatic control afforded by SSAs should not lead to reduced vigilance in screening for CHD, especially in patients with persistently elevated hormonal assays. Clinicians should consider regular echocardiographic screening in patients with a secretory syndrome.
Acute ketosis inhibits appetite and decreases plasma concentrations of acyl ghrelin in healthy young men
Authors: Vestergaard Esben Thyssen , Zubanovic Natasa Brkovic , Rittig Nikolaj , Møller Niels , Kuhre Rune Ehrenreich , Holst Jens J. , Rehfeld Jens F. , Thomsen Henrik Holm
Published: April 2021

Aim

To investigate the acute effect of ketone ester (KE) ingestion on appetite and plasma concentrations of acyl ghrelin (AG), unacylated ghrelin (UAG) and glucagon‐like peptide‐1 (GLP‐1) secretion, and to compare responses with those elicited by isocaloric glucose (GLU) administration.

Methods

We examined 10 healthy young men on three separate occasions using a placebo (PBO)‐controlled crossover design. A KE versus taste‐matched isovolumetric and isocaloric 50% GLU and taste‐matched isovolumetric PBO vehicle was orally administered. Our main outcome measures were plasma concentrations of AG, UAG, glucose‐dependent insulinotropic polypeptide (GIP) and GLP‐1 along with appetite sensation scores assessed by visual analogue scale.

Results

KE ingestion resulted in an average peak beta‐hydroxybutyrate concentration of 5.5 mM. AG and UAG were lowered by approximately 25% following both KE and GLU intake compared with PBO. In the case of AG, the differences were −52.1 (−79.4, –24.8) for KE and −48.4 (−75.4, −21.5) pg/mL for GLU intake (P < .01). Concentrations of AG remained lower with KE but returned to baseline and were comparable with PBO levels after GLU intake. GLP‐1, GIP, gastrin and cholecystokinin were not affected by KE ingestion.

Conclusion

Our results suggest that the suppressive effects on appetite sensation scores associated with hyperketonaemia are more probable to be mediated through reduced ghrelin concentrations than by increased activity of cholecystokinin, gastrin, GIP or GLP‐1.
Pressure ulcer prevention—Results of a multicentre cross‐sectional survey on hospital infrastructures and processes in acute hospitals and accident and emergency departments
Authors: Strube‐Lahmann Sandra , Lahmann Nils A.
Published: April 2021

Aims and objectives

Pressure ulcers (PUs) are a serious health problem. They can be considered as an indicator of the quality of health care and are associated with considerable cost increases for the health care system. The prevention of PUs is a major concern in hospital care. The aim of the study was to reveal the current PU prevention‐related processes and structures with a specific focus on the Accident and Emergency (A&E) Department.

Method

In late 2018/early 2019, all German hospitals were invited to participate in a nationwide cross‐sectional survey. One standardized questionnaire was assigned to a representative of each hospital. The representative was asked to state what PU‐related structures and processes are implemented in their hospital, in general and specific to the A&E department. Besides mostly descriptive analysis, PU‐related processes were analysed on PU incidence in a multivariate linear regression model.

Results

Two hundred seventy‐six hospitals participated in the survey. 63.4% (n = 175) of the participating hospitals had at least one PU manager. Skin inspection was the most frequently performed procedure. Although not recommended, 1.3% (2.1%) of the facilities still use sheepskins quite often (very often). In the regression model on PU incidence, only the process ‘mobilization in bed’ was statistically significantly associated. Although the risk of developing a PU in the emergency department is high, more than half of the facilities had no PU guidelines.

Conclusion

Even if recommended procedures (skin inspection, 30° positioning) have been used frequently, regular training could help to bring new scientific findings such as the use of local skin protection dressings into clinical practice. Prevention guidelines should be established in all areas of care even for A&E as well as when patients are transferred inside or out of the hospital, where the risk of PU development was considered low.
Experimentar el paso de Dios: diálogo entre exégesis, teología y tradición en Ex 33,12-23
Authors: Triana Rodríguez Jorge Yecid , Méndez Paniagua Ivonne Adriana
Published: April 2021

En este trabajo se indagan los resultados obtenidos de la exégesis diacrónica aplicados en la perícopa de Éx 33,12-33, y se resalta el aporte teológico de la crítica de las redacciones en el contexto de la unidad literaria del Pentateuco; esto, como propuesta metodológica que favorece la comprensión de la perícopa desde la mirada holística de las fuentes antiguas y otros materiales preexílicos diferentes que componen este bloque literario. Estos resultados son considerados además como la base o el fundamento para obtener las claves teológicas de la perícopa desde las categorías conceptuales de la Ley y el culto, en los que se tienen en cuenta las dos unidades redaccionales de la misma, ubicadas así: la primera, del v. 12 al v. 17; y la segunda, del v. 18 al v. 23. Es así como las teologías emergentes del culto y la Ley son clave de lectura en el marco teológico de la alianza que les da los rasgos y características propias en el relato bíblico. A su vez, los aportes que las tradiciones interpretativas de origen halakitas y haggaditas, propias del midrás rabínico y sus middot, son referentes teológicos que permiten nuevas categorías de estudio, análisis y actualización de los contenidos bíblicos, presentes en la perícopa de estudio y en toda la obra del Pentateuco. Este proceso de exégesis, teología e interpretación bíblica se propone como alternativa investigativa y pedagógica para un mayor y mejor acercamiento al estudio integral y la comprensión más amplia de los cinco primeros libros del canon bíblico, el cual proporciona e incorpora herramientas de actualización del mensaje revelado, tanto en las perspectivas éticas, jurídicas y litúrgicas propias de la experiencia de fe judía como de la fe cristiana.
Perderse para ser ganada. Realización de la mujer, bajo el símbolo del alma esposa en el Cántico espiritual de Juan de la Cruz
Authors: Pinilla A. Juan Francisco
Published: April 2021

Este artículo indaga sobre la especificidad de la realización de la mujer, latente en la figura de la esposa del Cántico espiritual de Juan de la Cruz. En el último verso de la Canción 20, la esposa declara: “Me hice perdidiza, y fui ganada”. Esta expresión, de cuño evangélico (Mt 16,25) y paulino (Flp 1,21), constituye un rasgo específico del amor de la amada y abre el camino para la comprensión de su paradójica realización, lo cual se verifica en el análisis de los demás textos del Cántico relativos al alma esposa. Este estudio privilegia el orden de la primera versión del Cántico sanjuanista, cuya estrofa 20 corresponde además al protocántico y expresa de manera más armoniosa los desplazamientos hacia la interioridad y al “entrambos”. Sin embargo, la transmutación de los amantes del drama, en el dinamismo simbólico, parece desdibujar toda especificidad del amor y de la realización personal consecuente. La unión de amor articula, no sin conflicto, los símbolos relativos a lugares para la esposa y de movimiento para el esposo. El drama comienza con la salida de la esposa en búsqueda del Amado, para un nuevo ingresar en lo más interior de sí misma, donde mora el Esposo. La alternancia movilidad y estabilidad recorre todo el poema. La repentina presencia del Espíritu Santo en el drama, como “aposentador del Verbo en el alma”, explicita un tercero en la relación de amor y elimina cualquier intento de comprenderlo en términos lineales. El Espíritu sostiene y enriquece la reciprocidad en la alteridad propia del amor, cuya matriz es la encarnación y, finalmente, revela en aquel amor esponsal dialógico, el misterio del amor trinitario. Lo específico de la realización de la mujer trasciende como disponibilidad al Espíritu, al cual todo amor que no suprime la dolorosa paradoja, se equipara.
The use of interprofessional simulation interventions in medical student education: A scoping review
Authors: Langton Victoria , Dounas Dimitra , Moore Abby , Bacchi Stephen , Thomas Josephine
Published: April 2021

Introduction: Simulation is commonly used by health and education institutions to facilitate interprofessional learning (IPL). The use of simulation in IPL is resource intensive. Evidence of what works, and with whom, is important to inform practice, policymaking and further research. The aim of this scoping review was to summarise the existing literature on IPL involving medical students, where simulation was the teaching modality. This review examined a variety of simulation-based interventions used to teach IPL to medical students and identified key features and outcomes. Methods: The databases Pubmed, Medline, EMBASE and PsychINFO were searched using the terms related to medical student and simulation combined with interprofessional. Included articles involved medical students alongside a student or practitioner from at least one other health profession taking part in at least one simulation session. Data extraction was performed by two authors using a standardised form. Results: It emerged that simulations of medical emergencies were the most common format to deliver IPL interventions. Most studies evaluated the success of their IPL intervention using the Readiness for Interprofessional Learning Scale (RIPLS). Conclusion: All studies were successful in improving student attitudes towards IPL and interprofessional collaboration when these were measured outcomes. Formal team training prior to simulation is effective in improving teamwork skills. IPL interventions with participants from a greater mix of professions have more positive results.
Characterization of TMexCD3-TOprJ3, an RND-Type Efflux System Conferring Resistance to Tigecycline in Proteus mirabilis, and Its Associated Integrative Conjugative Element
Authors: Wang Qian , Peng Kai , Liu Yuan , Xiao Xia , Wang Zhiqiang , Li Ruichao
Published: April 2021

The emergence and transmission of novel antimicrobial resistance genes pose a great threat to public health globally. Recently, the plasmid-encoding RND efflux pump TMexCD1-TOprJ1 in
Klebsiella pneumoniae
was reported to reduce the sensitivity of multiple antimicrobials.
Aggressive progression of a facial super giant basal cell carcinoma
Authors: Yoham Athina Lidia , Sinawe Hadeer , Schnur Jack , Casadesus Damian
Published: April 2021

Super giant basal cell carcinoma (BCC) is a rare oncological entity. A 52-year-old man with a history of a left upper facial lesion for 11 years was transferred to our facility seeking an evaluation. He frequented multiple hospitals where he was treated with antibiotics for this condition. He reported having the Mohs procedure 8 months prior to this hospital visit but he did not follow-up with the other institution. The physical examination revealed an ulcer involving the upper left orbito-fronto-parieto-temporal area with bone exposure. Both CT and MRI of the face and the brain demonstrated dehiscence of the left lateral orbital roof and left frontal bone. The biopsy confirmed advanced BCC. He was discharged against medical advice and lost to follow-up. He returned 1 month later with left eye discharge and vision loss. He was diagnosed with cerebral abscess, treated with antibiotics and discharged to hospice.
Development of national physical activity recommendations in 18 EU member states: a comparison of methodologies and the use of evidence
Authors: Tcymbal Antonina , Gelius Peter , Abu-Omar Karim , Foster Charlie , Whiting Stephen , Mendes Romeu , Titze Sylvia , Dorner Thomas Ernst , Halbwachs Christian , Duclos Martine , Toussaint Jean-Francois , Wendel-Vos Wanda , Baxter Beelin , Ferschl Susanne , Breda Joao Joaquim
Published: April 2021

Objectives

The aim of the study is to compare how member states of the European Union (EU) develop their national physical activity (PA) recommendations and to provide an overview of the methodologies they apply in doing so. Information was collected directly from the physical activity focal points of EU member states in 2018. Five countries were chosen for detailed case study analysis of development processes.

Design

Cross-sectional survey.

Participants

The representatives of the 28 EU member state governments to the EU physical activity Focal Point Network.

Outcome measures

From national documents we extracted data on (1) the participants of the development process, (2) the different methods used during development, and (3) on which sources national PA recommendations were based. An additional survey for case study countries provided details on (1) anonymised information on the participants of development process, (2) methods employed and rationale for choosing them, (3) development process and timeline, and (4) main source documents used for recommendation development.

Results

Eighteen national documents on PA recommendations contained information about development process. The results showed that countries used different approaches to develop national recommendations. The main strategies were (1) adoption of WHO 2010 recommendations or (2) a combination of analysis and adoption of other national and international recommendations and literature review. All of the five case study countries relied on review processes rather than directly adopting WHO recommendations.

Conclusions

While there are arguments for the use of particular strategies for PA recommendation development, there is currently no evidence for the general superiority of a specific approach. Instead, our findings highlight the broad spectrum of potential development methods, resources utilisation and final recommendations design currently available to national governments. These results may be a source of inspiration for other countries currently planning the development or update of national PA recommendations.
Frailty and driving status associated with disability: a 24-month follow-up longitudinal study
Authors: Doi Takehiko , Tsutsumimoto Kota , Ishii Hideaki , Nakakubo Sho , Kurita Satoshi , Shimada Hiroyuki
Published: April 2021

Objectives

To examine the relationship of driving status and frailty with disability in older adults.

Design

A prospective study.

Setting and participants

The study included 8533 participants (mean age: 72.0±6.1 years (range: 60–98 years), women: 54.1%) in a community setting.

Measures

Driving status and frailty were assessed at baseline. The clinical definition of frailty was used according to the Japanese Cardiovascular Health Study index. Disability was prospectively determined using a record of Japanese long-term care insurance (LTCI).

Results

During the follow-up period (mean duration: 23.5 months), 58 (0.7%) participants were regarded as moving out of the city, 80 (0.9%) participants had died and 311 (3.6%) participants were certified by LTCI. The proportion of disability was 1.3% among the not-frail group and 5.3% among the frail group. The proportion of disability was 2.5% in participants who were currently driving and 7.5% in those not driving. Based on frailty status and driving, participants were further classified into four groups: not frail and currently driving (n=2945), not frail and not driving (n=642), frail and currently driving (n=3598) and frail and not driving (n=1348). Compared with older adults who are not frail and driving, the combined status of frail and not driving (adjusted HR: 2.28; 95% CI: 1.47 to 3.52) and frail and driving (HR: 1.91; 95% CI: 1.30–2.81) were risk factors for disability.

Conclusions

Not driving and frail were associated with a risk of disability in community-dwelling older adults.
Real-world effects of medications for stroke prevention in atrial fibrillation: protocol for a UK population-based non-interventional cohort study with validation against randomised trial results
Authors: Powell Emma Maud , Douglas Ian J , Gungabissoon Usha , Smeeth Liam , Wing Kevin
Published: April 2021

Introduction

Patients with atrial fibrillation experience an irregular heart rate and have an increased risk of stroke; prophylactic treatment with anticoagulation medication reduces this risk. Direct-acting oral anticoagulants (DOACs) have been approved providing an alternative to vitamin K antagonists such as warfarin. There is interest from regulatory bodies on the effectiveness of medications in routine clinical practice; however, uncertainty remains regarding the suitability of non-interventional data for answering questions on drug effectiveness and on the most suitable methods to be used. In this study, we will use data from Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation (ARISTOTLE)—the pivotal trial for the DOAC apixaban—to validate non-interventional methods for assessing treatment effectiveness of anticoagulants. These methods could then be applied to analyse treatment effectiveness in people excluded from or under-represented in ARISTOTLE.

Methods and analysis

Patient characteristics from ARISTOTLE will be used to select a cohort of patients with similar baseline characteristics from two UK electronic health record (EHR) databases, Clinical Practice Research Datalink Gold and Aurum (between 1 January 2013 and 31 July 2019). Methods such as propensity score matching and coarsened exact matching will be explored in matching between EHR treatment groups to determine the optimal method of obtaining a balanced cohort.

Absolute and relative risk of outcomes in the EHR trial-analogous cohort will be calculated and compared with the ARISTOTLE results; if results are deemed compatible the methods used for matching EHR treatment groups can then be used to examine drug effectiveness over a longer duration of exposure and in special patient groups of interest not studied in the trial.

Ethics and dissemination

The study has been approved by the Independent Scientific Advisory Committee of the UK Medicines and Healthcare Products Regulatory Agency. Results will be disseminated in scientific publications and at relevant conferences.
Health insurance awareness and its uptake in India: a systematic review protocol
Authors: Reshmi Bhageerathy , Unnikrishnan Bhaskaran , Parsekar Shradha S , Rajwar Eti , Vijayamma Ratheebhai , Venkatesh Bhumika Tumkur
Published: April 2021

Introduction

Health insurance is one of the important approaches that can help in boosting universal healthcare coverage through improved healthcare utilisation and financial protection. This objectives of this review are to identify various interventions implemented in India to promote awareness of health insurance, and to provide evidence for the effectiveness of such interventions on the awareness and uptake of health insurance by the resident Indian population.

Methods and analysis

A systematic review will be carried out based on the Cochrane handbook for systematic reviews of interventions. The review will include experimental and analytical observational studies that have included adult population (>18 years) in India. We will include any intervention, policy or programme that directly or indirectly affects awareness or uptake of health insurance. The following outcomes will be eligible to be included: awareness or health insurance literacy, attitude such as readiness to buy health insurance or decision making, uptake of health insurance, demand-side and supply-side factors for awareness of health insurance, and awareness as a factor for uptake and re-enrolment in health insurance. Databases such as MEDLINE (PubMed), Web of Science, Scopus, 3ie impact evaluation repository and Social Science Research Network will be searched from January 2010 to 15 July 2020. Additionally, important government websites and references of the included studies will be scanned to identify potential records. Three authors, independently, will carry out screening and data extraction. Studies will be categorised into quantitative and qualitative, and mixed-methods synthesis will be employed to analyse the findings.

Ethics and dissemination

This review will be based on published studies and will not recruit human participants directly, therefore, ethical clearance is not applicable. We will disseminate the final review findings in a national or international conference and publish in a peer-reviewed journal.
Prehospital stratification in acute chest pain patient into high risk and low risk by emergency medical service: a prospective cohort study
Authors: Wibring Kristoffer , Lingman Markus , Herlitz Johan , Amin Sinan , Bång Angela
Published: April 2021

Objectives

To describe contemporary characteristics and diagnoses in prehospital patients with chest pain and to identify factors suitable for the early recognition of high-risk and low-risk conditions.

Design

Prospective observational cohort study.

Setting

Two centre study in a Swedish county emergency medical services (EMS) organisation.

Participants

Unselected inclusion of 2917 patients with chest pain contacting the EMS due to chest pain during 2018.

Primary outcome measures

Low-risk or high-risk condition, that is, occurrence of time-sensitive diagnosis on hospital discharge.

Results

Of included EMS missions, 68% concerned patients with a low-risk condition without medical need of acute hospital treatment in hindsight. Sixteen per cent concerned patients with a high-risk condition in need of rapid transport to hospital care. Numerous variables with significant association with low-risk or high-risk conditions were found. In total high-risk and low-risk prediction models shared six predictive variables of which ST-depression on ECG and age were most important. Previously known risk factors such as history of acute coronary syndrome, diabetes and hypertension had no predictive value in the multivariate analyses. Some aspects of the symptoms such as pain intensity, pain in the right arm and paleness did on the other hand appear to be helpful. The area under the curve (AUC) for prediction of low-risk candidates was 0.786 and for high-risk candidates 0.796. The addition of troponin in a subset increased the AUC to >0.8 for both.

Conclusions

A majority of patients with chest pain cared for by the EMS suffer from a low-risk condition and have no prognostic reason for acute hospital care given their diagnosis on hospital discharge. A smaller proportion has a high-risk condition and is in need of prompt specialist care. Building models with good accuracy for prehospital identification of these groups is possible. The use of risk stratification models could make a more personalised care possible with increased patient safety.
Rehabilitation following flexor tendon injury to the hand in African countries: a study protocol for a scoping review
Authors: Marume Martin , De Klerk Susan , Khuabi Lee-Ann Jacobs-Nzuzi
Published: April 2021

Quality of life is enhanced by engagement in meaningful activities and participation using our hands. In African countries, people rely predominantly on the use of their hands to engage in economic productive activities, including agricultural, fishing, mining and construction, that are largely performed by machines in high-income contexts. Anecdotal evidence suggests a high incidence of flexor tendon injuries that are managed using protocols that were adopted from high-income countries and implemented without considering contextual differences. African therapists use discretion in selecting protocols thereby presenting inconsistency in tendon management. This result in challenges with ascertaining the most effective protocol, factors that influence protocols and the extent of evidence about flexor tendon rehabilitation in Africa. Therefore, this scoping review aims to provide evidence currently available on the rehabilitation of flexor tendons in African countries. This will synthesise the advantages and disadvantages of the current protocols and make proposals that are contextually relevant and cost-effective for rehabilitation of tendon injuries.

Methods and analysis

The research will follow the scoping review methodological framework developed by Arksey and O’Malley (2005). The search strategy was developed and will be used to retrieve articles from eight databases. Further literature will be searched in the bibliography of the identified eligible articles. Grey literature will be searched in scientifically reliable websites, organisations and other sources. Articles will be reviewed by two independent researchers and opinion will be sought from a third reviewer when disagreement prevails on the inclusion quality of an article. All relevant articles that meet the criteria will be analysed using Weft QDA.

Ethics and dissemination

The scoping review paper will be discussed with local therapists. Thereafter, findings will be published in the year 2021 and sent to rehabilitation associations in respective African countries.
Changes in quality of life (QoL) and other patient-reported outcome measures (PROMs) in living-donor and deceased-donor kidney transplant recipients and those awaiting transplantation in the UK ATTOM programme: a longitudinal cohort questionnaire survey with additional qualitative interviews
Authors: Gibbons Andrea , Bayfield Janet , Cinnirella Marco , Draper Heather , Johnson Rachel J , Oniscu Gabriel C , Ravanan Rommel , Tomson Charles , Roderick Paul , Metcalfe Wendy , Forsythe John L R , Dudley Christopher , Watson Christopher J E , Bradley J Andrew , Bradley Clare
Published: April 2021

Objective

To examine quality of life (QoL) and other patient-reported outcome measures (PROMs) in kidney transplant recipients and those awaiting transplantation.

Design

Longitudinal cohort questionnaire surveys and qualitative semi-structured interviews using thematic analysis with a pragmatic approach.

Setting

Completion of generic and disease-specific PROMs at two time points, and telephone interviews with participants UK-wide.

Participants

101 incident deceased-donor (DD) and 94 incident living-donor (LD) kidney transplant recipients, together with 165 patients on the waiting list (WL) from 18 UK centres recruited to the Access to Transplantation and Transplant Outcome Measures (ATTOM) programme completed PROMs at recruitment (November 2011 to March 2013) and 1 year follow-up. Forty-one of the 165 patients on the WL received a DD transplant and 26 received a LD transplant during the study period, completing PROMs initially as patients on the WL, and again 1 year post-transplant. A subsample of 10 LD and 10 DD recipients participated in qualitative semi-structured interviews.

Results

LD recipients were younger, had more educational qualifications and more often received a transplant before dialysis. Controlling for these and other factors, cross-sectional analyses at 12 months post-transplant suggested better QoL, renal-dependent QoL and treatment satisfaction for LD than DD recipients. Patients on the WL reported worse outcomes compared with both transplant groups. However, longitudinal analyses (controlling for pre-transplant differences) showed that LD and DD recipients reported similarly improved health status and renal-dependent QoL (p<0.01) pre-transplant to post-transplant. Patients on the WL had worsened health status but no change in QoL. Qualitative analyses revealed transplant recipients’ expectations influenced their recovery and satisfaction with transplant.

Conclusions

While cross-sectional analyses suggested LD kidney transplantation leads to better QoL and treatment satisfaction, longitudinal assessment showed similar QoL improvements in PROMs for both transplant groups, with better outcomes than for those still wait-listed. Regardless of transplant type, clinicians need to be aware that managing expectations is important for facilitating patients’ adjustment post-transplant.
Protocol of a 12-month multifactorial eHealth programme targeting balance, dual-tasking and mood to prevent falls in older people: theStandingTall+ randomised controlled trial
Authors: van Schooten Kimberley S , Callisaya Michele L , O"Dea Bridianne , Lung Thomas , Anstey Kaarin , Lord Stephen R , Christensen Helen , Brown Alicia , Chow Jessica , McInerney Garth , Miles Lillian , Ngo Michelle , Perram Amy , Delbaere Kim
Published: April 2021

Introduction

Falls have a multifactorial aetiology, which may limit the effectiveness of the common approach of exercise as the sole intervention strategy. Multifactorial interventions could be more effective in people at high risk of falling; however, the focus of such interventions has traditionally been quite narrow. This paper describes the design of a randomised controlled trial that will evaluate the effectiveness of an eHealth programme, which addresses cumulative effects of key fall-risk factors across the triad of physical, affective and cognitive functions on falls in older people.

Methods and analysis

518 older people aged 65 years and over with high fall risk, defined as having a history of falls in the past 6 months, self-reported fear of falling or being aged 80 years or over, will be recruited via local advertisements, newsletters and presentations, and randomised to an intervention or health education control group. The intervention comprises balance exercise, cognitive-motor exercise and cognitive–behavioural therapy, with their dosage based on participant’s baseline balance, executive function and mood. The primary outcome is the rate of falls in the 12 months after randomisation. Secondary outcomes at 6 and 12 months comprise programme adherence, healthcare use, physical activity, balance and mobility, cognitive function, psychological well-being, quality of life, health literacy and user experience and attitudes towards the programme. Data will be analysed following intention to treat to gauge real-world effectiveness. We will further determine complier averaged causal effects to correct for varying adherence and conduct economic analyses to gain insight into cost-effectiveness and cost–utility.

Ethics and dissemination

Ethical approval was obtained from the University of New South Wales (UNSW) Human Research Ethics Committee in December 2017. Outcomes will be disseminated via peer-reviewed articles, conference presentations, community events and media releases.

Trial registration number

ACTRN12619000540112.
Role of the NO-cGMP-K+ channels pathway in the peripheral antinociception induced by α-bisabolol
Authors: Ortiz Mario I. , Cariño-Cortés Raquel , Muñoz-Pérez Víctor M. , Salas-Casas Andrés , Castañeda-Hernández Gilberto
Published: April 2021

The aim of this study was to examine if the peripheral antinociception of α-bisabolol involves the participation of nitric oxide (NO) and cyclic guanosine monophosphate (cGMP) synthesis followed by K+ channel opening in the formalin test. Wistar rats were injected in the dorsal surface of the right hind paw with formalin (1%). Rats received a subcutaneous injection into the dorsal surface of the paw of vehicles or increasing doses of α-bisabolol (100–300 µg/paw). To determine whether the peripheral antinociception induced by α-bisabolol was mediated by either the opioid receptors or the NO-cGMP-K+ channels pathway, the effect of pretreatment (10 min before formalin injection) with the appropriate vehicles, naloxone, naltrexone, NG-nitro-l-arginine methyl ester (L-NAME), 1H-[1,2,4]-oxadiazolo[4,2-a]quinoxalin-1-one (ODQ), glibenclamide, glipizide, apamin, charybdotoxin, tetraethylammonium, or 4-aminopyridine on the antinociceptive effects induced by local peripheral α-bisabolol (300 µg/paw) were assessed. α-Bisabolol produced antinociception during both phases of the formalin test. α-Bisabolol antinociception was blocked by L-NAME, ODQ, and all the K+ channels blockers. The peripheral antinociceptive effect produced by α-bisabolol was not blocked by the opioid receptor inhibitors. α-Bisabolol was able to active the NO-cGMP-K+ channels pathway to produce its antinoceptive effect. The participation of opioid receptors in the peripheral local antinociception induced by α-bisabolol is excluded.
Are we paying-to-play? A quantitative assessment of Canadian open access research in ecology and evolution
Authors: Shafer Aaron B.A.
Published: April 2021

Open access (OA) allows for peer-reviewed research to be freely accessed and there has been a collective shift from both researchers and publishers towards more OA publishing. OA typically occurs either through article-processing charges (the gold road) or via self-archiving (the green road); the former can be expensive, while the latter has seen minimal uptake. The gold road of OA has led to predatory publishers and, to some, questionable publications. Here, I used publicly available grant information in Canada and combined this with individual publishing statistics to test a variety of factors and their influence on OA publishing. I showed that an individual’s award amount, H-index, and gender did not influence the proportion of OA articles they published, but an individual’s H-index scaled with the number of OA publications. Institute size influenced OA publishing patterns, with researchers at large universities (i.e., >20 000 full-time students) publishing proportionately more OA articles than medium and small institutes. I discuss the potential for this pattern to build on pre-existing systemic biases when it comes to funding and publishing.
THE IMPACT OF THE ANTI-CORRUPTION CAMPAIGN ON INCOME DISTRIBUTION: EVIDENCE FROM CHINA
Authors: GE YING , XUE JINJUN
Published: April 2021

This paper provides the first systematic micro-level evidences on the effectiveness of anti-corruption campaign in disciplining public officials and its impact on income distribution. Based on China Household Income Project (CHIP) survey data 2007 and 2013, we found that party and government officials had significant hidden income and the public–private earnings gap was as high as 8% before the campaign. However, the hidden income become not significant and the earnings gap declined to [Formula: see text]18% in this post-campaign period. The regions inspected by central anti-corruption inspection groups experience larger public earnings penalties compared to the other regions. Overall, our findings suggest that the privilege of public officials declined sharply during this anti-corruption campaign.
Sinusoidal AC-induced electrohydrodynamic direct-writing nanofibers on insulating collector
Authors: Chen Huatan , Kang Guoyi , Jiang Jiaxin , Liu Juan , Wang Xiang , Li Wenwang , Liu Yifang , Zheng Gaofeng
Published: April 2021

Printing orderly patterns on the insulating collector is the key for the development and application of flexible electronics. However, electrospinning on the insulating collector still has the problem of unstable jet due to the charge accumulation. The alternating current (AC)-induced electrohydrodynamic direct-writing (EDW) technology is a good way to decrease the interferences of charge repulsion, which is beneficial to printing orderly micro/nanostructures on the insulating collector. In this work, the sinusoidal AC-induced EDW is used to enhance the stability of charged jet and the deposition behaviors under AC electric field are also studied. The reciprocation transferring of charges induced by the AC electric field decreased the density of the accumulating charges on the insulating collector. The effect of AC electric field parameters on the direct-written micro/nanostructures are investigated to optimize the printing process. As the voltage peak increases, the fiber deposition bandwidth shows a trend of decreasing first and then increasing. Increasing the voltage frequency appropriately is beneficial to decrease the bandwidth of fiber deposition and to increase the stability of the jet. By improving the stability and controllability of the jet printing process, precise micro/nanopatterns can be direct-written on the insulating collector. This research provides a good foundation for expanding the application fields of EDW.
Darboux transformation for the supersymmetric nonisospectral KdV equation
Authors: Chen Li , Deng Shu-Fang
Published: April 2021

Darboux transformation for the supersymmetric nonisospectral KdV equation is investigated. Based on the Lax pair, we successively construct the one-fold, two-fold and three-fold Darboux tansformations for the supersymmetric nonisospectral KdV equation. Moreover, we present the [Formula: see text]-fold Darboux transformation in the form of superdeterminant.
Degree of approximation of Fourier series of functions in Besov space by deferred Nörlund mean
Authors: Padhy Birupakhya Prasad , Nayak Laxmipriya
Published: April 2021

In the present paper, we estimate the rate of convergence of Fourier series of functions by Deferred Nörlund mean in Besov space which is a generalization of [Formula: see text] space.
Prevention of SARS-CoV-2 Proliferation with a Novel and Potent Main Protease Inhibitor by Docking, ADMET, MM-PBSA, and Molecular Dynamics Simulation
Authors: Noorbakhsh Akbar , Askandar Rafee Habib , Alhagh Mohammad Shakib , Farshadfar Chiako , Seyedi Seyed Hamid , Ahmadizad Mehran , Rahimi Arian , Ardalan Noeman , Koushki Elnaz Hosseininezhadian
Published: April 2021

COVID-19 is the last disease caused by SARS-CoV-2 associated with a severe immune response and lung damage. The main protease (Mpro) has a vital role in SARS-CoV-2 proliferation. Moreover, humans lack homologous Mpro, which makes the Mproa suitable drug target for the development of SARS-CoV-2 drugs. The purchasable L5000 library (Selleckchem Inc) includes 99,040 compounds that were used for virtual screening. After molecular docking and ADME studies, we selected a compound (WAY-604395) with a potent binding affinity to the Mproactive site and acceptable ADME properties compared to the reference drug (nelfinavir). Molecular dynamics (MD) simulation outcomes have proved that the Mpro-WAY604395 complex possesses a considerable value of flexibility, stability, compactness and binding energy. Our Molecular Mechanics Poisson–Boltzmann Surface Area (MM-PBSA) calculation demonstrates that WAY-604395 is more potent ([Formula: see text]272.19[Formula: see text]kcal mol[Formula: see text]) in comparison with nelfinavir ([Formula: see text]173.39[Formula: see text]kcal[Formula: see text]mol[Formula: see text]) against SARS-CoV-2 Mpro. In conclusion, we suggest that WAY-604395 has the potential for the treatment of SARS-CoV-2 by inhibition of the Mpro.
Vehicle Ride Comfort Analysis Based on Vehicle‐Bridge Coupled Vibration
Authors: Zhang Yichang , Li Wusheng , Ji Zhe , Wang Guichun
Published: April 2021

The study in this paper aims to evaluate the effects of vehicle‐bridge coupled vibration on the vehicle ride comfort. The mechanical model of both vehicle and bridge subsystems and the vibration differential equations are established, respectively, based on the principle of dynamic balance and finite element method. The APDL command stream for iterative calculation is compiled on the ANSYS platform. The method to evaluate the vehicle ride comfort is established according to the criteria in ISO2631‐1‐1997. The vehicle dynamic responses and ride comfort are analyzed considering different pavement levels while multiple vehicles pass through the cable‐stayed bridge. The analysis results indicate that the dynamic responses of vehicles decrease with the improvement of pavement roughness, resulting in the vehicle ride comfort to be better; the dynamic responses of vehicles increase with the increment of vehicle speed or the decrement of vehicle gravity, resulting in the vehicle ride comfort to be worse. The present research results can provide an insight into the rational design of bridge structure so as to reduce the vehicle‐bridge coupling vibration responses and improve the ride quality of drivers and passengers.
Adrenal and Hepatic Venous Sampling in a Case of Aldosterone-Producing Adrenocortical Carcinoma with Hepatic Metastasis
Authors: Sugiyama Toru , Sasahara Yuriko , Sasano Hironobu , Hayakawa Eri
Published: April 2021

Background. Adrenocortical carcinoma (ACC) is a rare and highly aggressive malignancy. ACCs often secrete adrenal steroid hormones including cortisol and androgens; however, aldosterone-producing ACC is very rare. Although adrenal production of aldosterone is assessed by adrenal venous sampling, the use of sampling from the relevant vein to assess aldosterone production from a tumor arising from ACC metastasis has not been previously reported. Case Presentation. We report the case of a 69-year-old Japanese man with aldosterone-producing ACC with hepatic metastasis. He presented with a history of treatment-resistant hypertension and hypokalemia. Endocrinological examination showed markedly increased plasma aldosterone concentration and suppressed plasma renin activity. Serum cortisol concentration was not suppressed by administration of dexamethasone 1 mg, and normal circadian variation of cortisol secretion was disrupted. Abdominal computed tomography showed a large tumor in the left adrenal gland and multiple tumors in the liver. Together, these results strongly suggested ACC with multiple liver metastases causing primary aldosteronism and subclinical Cushing syndrome. Adrenal and hepatic venous sampling showed markedly increased aldosterone concentration in the left adrenal vein but no increase in the hepatic vein, despite a pathological diagnosis of ACC with hepatic metastasis, with immunohistochemical investigation showing both primary and secondary tumors to have synthetic capability for aldosterone. The patient received mitotane but declined combination chemotherapy and died 2 months later. Conclusion. This is the first report of adrenal and hepatic venous sampling in a case of aldosterone-producing ACC with hepatic metastasis. The case suggests that hepatic venous sampling is unable to detect aldosterone production from liver metastases arising from ACC.
Risky Alcohol Drinking Pattern and Its Association with Educational Attainment and Wealth Index among Adult Men Population in Ethiopia: Further Analysis of 2016 Ethiopian Demographic Health Survey
Authors: Diress Gedefaw , Wondim Getinet
Published: April 2021

Risky alcohol drinking is one of the major public health problems and an important health risk factor for premature death and disability worldwide. Identifying the determinants of risky alcohol drinking patterns is crucial for developing and improving intervention on drinking behavior. In Ethiopia, the role of educational attainment and affluence in reducing risky alcohol drinking patterns among men remains unclear. Therefore, this study aimed to assess the association of educational status and affluence with risky alcohol drinking patterns using national representative data in Ethiopia. Secondary data analysis was conducted on 12,688 adult men using data from the 2016 Ethiopia Demographic Health Survey (EDHS). The dependent variable was a risky alcohol drinking pattern which is defined as the consumption of alcohol every day in the last 12 months before the interview. Multivariable logistic regression was employed to assess the association between educational attainment, Ethiopian standard wealth index, and risky alcohol drinking pattern, after adjusting for the potential confounders. The overall magnitude of risky alcohol drinking patterns among men in Ethiopia was 4.5% (95% CI: 3.4–5.9). Of the total men who had ever taken alcohol, 9.7% of men drink almost every day in the last 12 months. The odds of having a risky alcohol drinking pattern were lower among men who completed secondary education (AOR = 0.56 (0.329–0.961)) and men who completed higher education levels (AOR = 0.35 (0.164–0.765)) as compared to men who did not attend any formal education. Adult men in the top two wealth quintiles were twice more likely to have risky alcohol drinking patterns than those in the lowest wealth quintile (AOR = 2.13 (1.254–3.605)). This study showed that from the total adult male population, nearly 5% of Ethiopian men had risky drinking patterns. Individuals with low educational status and greater affluence engaged in high-risk alcohol consumption behavior.
A Feature Fusion Method with Guided Training for Classification Tasks
Authors: Zhang Taohong , Fan Suli , Hu Junnan , Guo Xuxu , Li Qianqian , Zhang Ying , Wulamu Aziguli
Published: April 2021

In this paper, a feature fusion method with guiding training (FGT‐Net) is constructed to fuse image data and numerical data for some specific recognition tasks which cannot be classified accurately only according to images. The proposed structure is divided into the shared weight network part, the feature fused layer part, and the classification layer part. First, the guided training method is proposed to optimize the training process, the representative images and training images are input into the shared weight network to learn the ability that extracts the image features better, and then the image features and numerical features are fused together in the feature fused layer to input into the classification layer for the classification task. Experiments are carried out to verify the effectiveness of the proposed model. Loss is calculated by the output of both the shared weight network and classification layer. The results of experiments show that the proposed FGT‐Net achieves the accuracy of 87.8%, which is 15% higher than the CNN model of ShuffleNetv2 (which can process image data only) and 9.8% higher than the DNN method (which processes structured data only).
Resolution of the Min-Max Optimization Problem Applied in the Agricultural Sector with the Estimation of Yields by Nonparametric Statistical Approaches
Authors: Kouaiba Ghizlane , Mentagui Driss
Published: April 2021

The ultimate objective of the problem under study is to apply the min-max tool, thus making it possible to optimize the default risks linked to several areas: the agricultural sector, for example, which requires the optimization of the default risk using the following elements: silage crops, annual consumption requirements, and crops produced for a given year. To minimize the default risk in the future, we start, in the first step, by forecasting the total budget of agriculture investment for the next 20 years, then distribute this budget efficiently between the irrigation and construction of silos. To do this, Bangladesh was chosen as an empirical case study given the availability of its data on the FAO website; it is considered a large agricultural country in South Asia. In this article, we give a detailed and original in-depth study of the agricultural planning model through a calculating algorithm suggested to be coded on the R software thereafter. Our approach is based on an original statistical modeling using nonparametric statistics and considering an example of a simulation involving agricultural data from the country of Bangladesh. We also consider a new pollution model, which leads to a vector optimization problem. Graphs illustrate our quantitative analysis.