bluuebunny/crossref_metadata_2025 huggingface dataset:
Sexual minority status and suicidal behaviour among Chinese adolescents: a nationally representative cross-sectional study
Authors: Huang Yeen , Li Pengsheng , Guo Lan , Gao Xue , Xu Yan , Huang Guoliang , Deng Xueqing , Lu Ciyong
Published: August 2018

Objectives

Suicidality among sexual minority adolescents has generated worldwide concern in recent decades, and previous Western studies have demonstrated that sexual minority status is associated with adolescent suicidality. However, whether this association exists in Chinese adolescents remains largely unknown. This study aimed to estimate the associations between sexual minority status and suicidal behaviour among Chinese adolescents.

Design

Cross-sectional survey.

Setting

A total of 506 high schools in 7 provinces of China.

Participants

A total of 150 822 students in grades 7–12 who completed the questionnaires (response rate of 95.9%) were included.

Main outcome measures

Suicidal ideation and suicide attempts were used to measure suicidal behaviour, and sexual attraction (opposite sex, same sex or both sex) was used as a measure for sexual minority status.

Results

Of the 150 822 adolescents analysed, 4.1% self-reported as sexual minorities and 17.3% were unsure. Compared with heterosexual and unsure adolescents, same-sex romantic attraction (SSA) and both-sex romantic attraction (BSA) adolescents reported a higher prevalence of past-year suicidal ideation (SSA: 21.6% for males and 30.4% for females; BSA: 34.7% for males and 42.3% for females) and suicide attempts (SSA: 6.9% for males and 8.9% for females; BSA: 12.2% for males and 10.9% for females). After adjustment for covariates, SSA and BSA adolescents were more likely to have past-year suicidal ideation and suicide attempts than their heterosexual and unsure peers. BSA adolescents reported the highest risk of suicidal ideation (males: adjusted OR (AOR) 2.42, 95% CI 2.03 to 2.88; females: AOR 2.61, 95% CI 2.41 to 2.82) and suicide attempts (males: AOR 3.83, 95% CI 2.85 to 5.14; females: AOR 2.59, 95% CI 2.19 to 3.06).

Conclusions

Our study suggested that Chinese sexual minority adolescents were at increased risk of suicidality, and those with BSA had an especially high risk in this population. These findings emphasised the urgent need to develop targeted interventions to effectively address suicide-related problems among Chinese sexual minority adolescents.
Development of a simple, practice-based tool to assess quality of paediatric emergency care delivery in resource-limited settings: identifying critical actions via a Delphi study
Authors: Daftary Rajesh Kirit , Murray Brittany Lee , Reynolds Teri Ann
Published: August 2018

Objective

Provision of timely, high-quality care for the initial management of critically ill children in African hospitals remains a challenge. Monitoring the completion of critical actions during resuscitations can inform efforts to reduce variability and improve outcomes. We sought to develop a practice-based tool based on contextually relevant actions identified via a Delphi process. Our goal was to develop a tool that could identify gaps in care, facilitate identification of training and standardised assessment to support quality improvement efforts.

Design

Six sentinel conditions were selected based on disease epidemiology and mortality at rural and urban African emergency departments. Potential critical actions were identified through focused literature review. These actions were evaluated within a three-round modified Delphi process. A set of logistical filters was applied to the candidate list to derive a practice-based tool.

Setting and participants

Attendees at an international emergency medicine conference comprised an expert panel of 25 participants, with 84% working primarily in African settings. Consensus rounds allowing novel responses were conducted via online and in-person surveys.

Results

The expert panel generated 199 actions that apply to six conditions in emergently ill children. Application of appropriateness criteria refined this to 92 candidate actions across the following seven categories: core skills, active seizure, altered mental status, diarrhoeal illness, febrile illness, respiratory distress and polytrauma. From these, we identified 28 actions for inclusion in a practice-based tool contextually relevant to the initial management of critically ill children in Africa.

Conclusions

A group consensus process identified critical actions for severely ill children with select sentinel conditions in emergency paediatric care in an African setting. Absence of these actions during resuscitation might reflect modifiable gaps in quality of care. The resulting practice-based tool is context relevant and can serve as a foundation for training and quality improvement efforts in African hospitals and emergency departments.
Mixed methods process evaluation of an enhanced community-based rehabilitation intervention for elderly patients with hip fracture
Authors: Roberts Jessica Louise , Pritchard Aaron W , Williams Michelle , Totton Nikki , Morrison Val , Din Nafees Ud , Williams Nefyn H
Published: August 2018

Objectives

To describe the implementation of an enhanced rehabilitation programme for elderly hip fracture patients with mental capacity, in a randomised feasibility study compared with usual rehabilitation. To compare processes between the two and to collect the views of patients, carers and therapy staff about trial participation.

Design

Mixed methods process evaluation in a randomised feasibility study.

Setting

Patient participants were recruited on orthopaedic and rehabilitation wards; the intervention was delivered in the community following hospital discharge.

Participants

Sixty-one older adults (aged ≥65 years) recovering from surgical treatment (replacement arthroplasty or internal fixation) following hip fracture, who were living independently prior to fracture and had mental capacity and 31 of their carers.

Interventions

Usual care (control) or usual care plus an enhanced rehabilitation package (intervention). The enhanced rehabilitation consisted of a patient-held information workbook, goal-setting diary and up to six additional therapy sessions.

Process evaluation components

Recruitment of sites and rehabilitation teams, response of rehabilitation teams, recruitment and reach in patient and carer participants, intervention delivery, delivery to individuals, response of individual patients to the enhanced intervention or usual rehabilitation, response of carer participants, unintended consequences and testing intervention theory and context.

Results

Usual rehabilitation care was very variable. The enhanced rehabilitation group received a mean of five additional therapy sessions. All of the returned goal-setting diaries had inputs from the therapy team, and half had written comments by the patients and carers. Focus group themes: variation of usual care and its impact on delivering the intervention; the importance of goal setting; the role of the therapist in providing reassurance about safe physical activities; and acceptability of the extra therapy sessions.

Conclusions

Lessons learnt for a future definitive RCT include how to enhance recruitment and improve training materials, the workbook, delivery of the extra therapy sessions and recording of usual rehabilitation care.

Trial registration number

ISRCTN22464643; Post- results.
Determinants of patient choice for hospital readmission after township hospitalisation: a population-based retrospective study in China
Authors: Zhang Yan , Niu Yadong , Zhang Liang
Published: August 2018

Objective

The lack of coordinated and appropriate healthcare across sectors has produced more patients for county hospitals in China. This study examined differences in patient choice between township and county hospitals for readmission after a first township hospitalisation, and the determinants that influenced this choice.

Design

A retrospective study of readmissions across hospitals after a first admission in township hospital. A township–township (TT) inpatient group and a township–county (TC) inpatient group were compared. A two-level logistic regression model was used to examine the determinants of choice for hospital readmission.

Setting

Data were drawn from a population-based health utilisation database for Qianjiang District, China, from 1 January 2008 to 31 December 2013.

Participants

This study focused on readmitted patients whose first admission was in a township hospital. Readmission cases were identified as the same diagnosis (International Classification of Diseases, Tenth Revision) in a subsequent hospitalisation within 30 days. In total, 6764 readmissions had first admissions in township hospitals.

Primary outcome measures

Patient choice for hospital readmission after a first township hospitalisation.

Results

The TT group accounted for 62.5% (4225) and the TC group for 37.5% (2539) of readmissions in 6 years, and the proportion of TC readmissions in total inpatients increased from 1.66% to 1.89%. Readmission rates varied among towns (p<0.001). Differences between the TC and TT groups included: length of stay (LOS) of first admission (6.96 days vs 9.23 days), average interval between admissions (6.03 days vs 14.95 days) and disease category. Admission year, age, travel time to county hospital, interval between admissions, first admission LOS and disease category were determinants of choice for hospital readmission.

Conclusions

Patients whose first admission was in a township hospital were more likely to be readmitted to a county hospital. A combination of first LOS and interval between admissions may be an effective identification index for TC readmission.

Trial registration number

ChiCTR-OOR-14005563.
Maternal anemia and underweight as determinants of pregnancy outcomes: cohort study in eastern rural Maharashtra, India
Authors: Patel Archana , Prakash Amber Abhijeet , Das Prabir Kumar , Gupta Swarnim , Pusdekar Yamini Vinod , Hibberd Patricia L
Published: August 2018

Objectives

To study the trend in the prevalence of anaemia and low BMI among pregnant women from Eastern Maharashtra and evaluate if low BMI and anaemia affect pregnancy outcomes.

Design

Prospective observational cohort study.

Setting

Catchment areas of 20 rural primary health centres in four eastern districts of Maharashtra State, India.

Participants

72 750 women from the Nagpur site of Maternal and Newborn Health Registry of NIH’s Global Network, enrolled from 2009 to 2016.

Main outcome measures

Mode of delivery, pregnancy related complications at delivery, stillbirths, neonatal deaths and low birth weight (LBW) in babies.

Results

Over 90% of the women included in the study were anaemic and over a third were underweight (BMI <18 kg/m2) and with both conditions. Mild anaemia at any time during delivery significantly increased the risk (Risk ratio; 95% confidence interval (RR;(95% CI)) of stillbirth (1.3 (1.1–1.6)), neonatal deaths (1.3 (1–1.6)) and LBW babies (1.1 (1–1.2)). The risks became even more significant and increased further with moderate/severe anaemia any time during pregnancy for stillbirth (1.4 (1.2–1.8)), neonatal deaths (1.7 (1.3–2.1)) and LBW babies (1.3 (1.2–1.4)).,. Underweight at anytime during pregnancy increased the risk of neonatal deaths (1.1 (1–1.3)) and LBW babies (1.2;(1.2–1.3)).The risk of having stillbirths (1.5;(1.2–1.8)), neonatal deaths (1.7;(1.3–2.3)) and LBW babies (1.5;(1.4–1.6)) was highest when - the anaemia and underweight co-existed in the included women. Obesity/overweight during pregnancy increased the risk of maternal complications at delivery (1.6;(1.5–1.7)) and of caesarean section (1.5;(1.4–1.6)) and reduced the risk of LBW babies 0.8 (0.8–0.9)).

Conclusion

Maternal anaemia is associated with enhanced risk of stillbirth, neonatal deaths and LBW. The risks increased if anaemia and underweight were present simultaneously.

Trial registration number

NCT01073475.
Arthroscopic-assisted balloon tibioplasty versus open reduction internal fixation (ORIF) for treatment of Schatzker II–IV tibial plateau fractures: study protocol of a randomised controlled trial
Authors: Wang Ji-Qi , Jiang Bing-Jie , Guo Wei-Jun , Zhang Wei-Jiang , Li A-Bing , Zhao You-Ming
Published: August 2018

Introduction

Arthroscopic-assisted balloon tibioplasty is an emerging technology that has shown advantages in recovering depression of the articular surface. However, studies evaluating clinical outcomes between arthroscopic-assisted balloon tibioplasty and traditional open reduction internal fixation (ORIF) are sparse. This is the first randomised study to compare arthroscopic-assisted balloon tibioplasty with ORIF, and will provide guidance for treating patients with Schatzker types II, III and IV with depression of the medial tibial plateau only.

Methods and analysis

A blinded randomised controlled trial will be conducted and a total of 80 participants will be randomly divided into either the arthroscopic-assisted balloon tibioplasty group or the ORIF group, at a ratio of 1:1. The primary clinical outcome measures are the knee functional scores, Rasmussen radiological evaluation scores and the quality of reduction based on postoperative CT scan. Secondary clinical outcome measures are intraoperative blood loss, surgical duration, visual analogue scale score after surgery, hospital duration after surgery, complications and 36-Item Short-Form Health Survey score.

Ethics and dissemination

This study has been reviewed and approved by the Institutional Review Board of the Second Affiliated Hospital of Wenzhou Medical University (batch: 2017–12). The results will be presented in peer-reviewed journals after completion of the study.

Trial registration number

NCT03327337, Pre-results.
Psychometric properties of the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire
Authors: Chai-Adisaksopha Chatree , Skinner Mark W , Curtis Randall , Frick Neil , Nichol Michael B , Noone Declan , O’Mahony Brian , Page David , Stonebraker Jeffrey , Thabane Lehana , Crowther Mark , Iorio Alfonso
Published: August 2018

Objective

To assess the psychometric properties of the Patient Reported Outcomes, Burdens and Experiences (PROBE) questionnaire.

Methods

This study was a cross-sectional, multinational study. Participants were enrolled if they were more than 10 years old and people with haemophilia A or B or people without a bleeding disorder. Participants were invited through non-governmental patient organisations in 21 countries between 01/27/2016 and 02/23/2017. The following psychometric properties: missing data, floor and ceiling effects, exploratory factor analysis and internal consistency reliability were examined. A PROBE Score was derived and assessed for its convergent and known groups validity.

Results

The study analysed the data on 916 participants with median age of 37.0 (IQR 27.0 to 48.0) years, 74.8% male. In the domain assessing patient-reported outcomes (PROs), more than 15% of participants presented a ceiling effect for all items but two, and a floor effect for one item. Factor analysis identified three factors explaining the majority of the variance. Cronbach’s alpha coefficient indicated good internal consistency reliability (0.84). PROBE items showed moderate to strong correlations with corresponding EuroQol five dimension 5-level instrument (EQ-5D-5L) domains. The PROBE Score has a strong correlation (r=0.67) with EQ-5D-5L utility index score. The PROBE Score has a known groups validity among various groups.

Conclusions

The results of this study suggest that PROBE is a valid questionnaire for evaluating PROs in people with haemophilia as well as control population. The known-group property of PROBE will allow its use in future clinical trials, longitudinal studies, health technology assessment studies, routine clinical care or registries. Additional studies are needed to test responsiveness and sensitivity to change.

Trial registration number

NCT02439710; Results.
Integration of musculoskeletal physical therapy care in the patient-centred medical home (IMPaC): protocol for a single-site randomised clinical trial
Authors: Carvalho Erik , Bettger Janet P , Bowlby Lynn , Carvalho Marissa , Dore Daniel , Corcoran Misty W , Harris Ashley A , Bond Jennifer , Goode Adam P
Published: August 2018

Introduction

Annually, >50% of the US population reports musculoskeletal (MSK) pain to a provider, with direct healthcare costs exceeding $185 billion. The number of MSK complaints and the associated costs are projected to rise, increasing demand for and burden on providers. Establishing new care models to decrease inefficiencies may lower costs and optimise care delivery. The purpose of the Integration of Musculoskeletal Physical Therapy Care in the Patient-Centred Medical Home (IMPaC) study is to compare initial evaluation by a physical therapist (PT) integrated into primary care versus initial evaluation by a primary care provider (PCP) for patients with an MSK complaint.

Methods and analysis

This single-site, randomised clinical trial will test the hypothesis that a PT within a primary care facility as the initial evaluating provider for patients with an MSK complaint will lower costs, improve utilisation (ie, reduced opioid prescriptions, imaging, physical therapy, emergency department visits and missed appointments) and increase patient satisfaction within 90 days of the index visit compared with PCP evaluation in the same location. Participants aged ≥18 years will be randomised with equal allocation and stratified by pain site (ie, back, knee, upper extremity and other). In the initial PT evaluation arm, patients will be assessed, treated and then instructed to complete a home exercise programme. The PCP cohort will undergo a usual PCP evaluation, and if a referral to physical therapy is made, patients will be randomised to onsite versus offsite physical therapy. Differences will be calculated and tested across the two arms.

Ethics and dissemination

Approval was received from the Duke University Institutional Review Board (01 May 2017) and the National Institutes of Health, National Centre for Advancing Translational Sciences (01 January 2017). Findings will be communicated via quarterly reports to funding bodies and disseminated through scientific publications.

Trial registration number

NCT03110211; Pre-results.
Protocol for the avatar acceptability study: a multiperspective cross-sectional study evaluating the acceptability of using patient-derived xenografts to guide personalised cancer care in Australia and New Zealand
Authors: Wakefield Claire E , Doolan Emma L , Fardell Joanna E , Signorelli Christina , Quinn Veronica F , Tucker Kathy F , Patenaude Andrea F , Marshall Glenn M , Lock Richard B , Georgiou Gabrielle , Cohn Richard J
Published: August 2018

Introduction

Patient-derived xenografts (PDXs) have the potential to transform personalised cancer care, however, little is known about the acceptability of using PDXs to guide treatment decision-making. Given that patient and community preferences can influence satisfaction with care as well as the success of new technologies, we will evaluate the acceptability of PDXs in individuals affected by cancer and community comparisons.

Methods and analysis

This comparative cross-sectional study will recruit 323 individuals affected by cancer (cancer survivors (of childhood or adult cancer) and parents of childhood cancer survivors) and 323 community comparisons (adults and parents). We will collect data via structured interviews and questionnaires. To determine the acceptability of PDXs, we will assess five domains: willingness to use PDXs when/if diagnosed with cancer, perceived advantages and disadvantages of PDXs, maximum acceptable out-of-pocket costs per patient, maximum acceptable turnaround time to receive results and maximum acceptable number of mice sacrificed per patient. The primary endpoint will be participants’ decisional balance ratio (calculated as participants’ advantages ratings divided by perceived disadvantages ratings).

Ethics and dissemination

The study protocol has been approved by the South Eastern Sydney Local Health District Human Research Ethics Committee (HREC:12/173) and UNSW Sydney (HC15773). The results will be disseminated in peer-reviewed journals and at scientific conferences. A lay summary will be published on the Behavioural Sciences Unit website.
Long-term outcomes of His bundle pacing in patients with heart failure with left bundle branch block
Authors: Huang Weijian , Su Lan , Wu Shengjie , Xu Lei , Xiao Fangyi , Zhou Xiaohong , Mao Guangyun , Vijayaraman Pugazhendhi , Ellenbogen Kenneth A
Published: August 2018

Objectives

His bundle pacing (HBP) can potentially correct left bundle branch block (LBBB). We aimed to assess the efficacy of HBP to correct LBBB and long-term clinical outcomes with HBP in patients with heart failure (HF).

Methods

This is an observational study of patients with HF with typical LBBB who were indicated for pacing therapy and were consecutively enrolled from one centre. Permanent HBP leads were implanted if the LBBB correction threshold was <3.5V/0.5 ms or 3.0 V/1.0 ms. Pacing parameters, left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV) and New York Heart Association (NYHA) Class were assessed during follow-up.

Results

In 74 enrolled patients (69.6±9.2 years and 43 men), LBBB correction was acutely achieved in 72 (97.3%) patients, and 56 (75.7%) patients received permanent HBP (pHBP) while 18 patients did not receive permanent HBP (non-permanent HBP), due to no LBBB correction (n=2), high LBBB correction thresholds (n=10) and fixation failure (n=6). The median follow-up period of pHBP was 37.1 (range 15.0–48.7) months. Thirty patients with pHBP had completed 3-year follow-up, with LVEF increased from baseline 32.4±8.9% to 55.9±10.7% (p<0.001), LVESV decreased from a baseline of 137.9±64.1 mL to 52.4±32.6 mL (p<0.001) and NYHA Class improvement from baseline 2.73±0.58 to 1.03±0.18 (p<0.001). LBBB correction threshold remained stable with acute threshold of 2.13±1.19 V/0.5 ms to 2.29±0.92 V/0.5 ms at 3-year follow-up (p>0.05).

Conclusions

pHBP improved LVEF, LVESV and NYHA Class in patients with HF with typical LBBB.
Genome-wide systematic characterization and its regulatory expression reprogramming process of the bZIP transcription factors during trauma response in Camellia sinensis
Authors: Xue Yajie , Zhang Zaibao , Wang Lei , Yu Yajun , Xiao Jinbin , Hou Jiajia , Lian Shuaibin , Yuan Hongyu , Cheng Lin
Published: August 2018

Basic leucine zipper (bZIP) transcription factor (TF) genes regulate numerous biological processes, as well as biotic and abiotic responses. Although the genome of the tea tree (Camellia sinensis (L.) Kuntze) has been released, knowledge regarding the bZIP TF family in C. sinensis, e.g., phylogenetic relationship and transcriptional gene expression profiles, remains limited. In this study, we characterized 77 bZIP genes in C. sinensis based on transcriptomic and genomic data and divided them into 11 groups according to their phylogenetic relationship with those in Arabidopsis, which allowed us to identify 14 pairs of orthologous proteins shared by Arabidopsis and C. sinensis and 19 pairs of paralogous proteins in C. sinensis. Conserved motif analysis of CsbZIP proteins showed high group specificity. Our classification was supported by the predicted specificities based on DNA-binding domains, as well as the dimerization property based on characteristic features in the basic and hinge regions and the leucine zipper. Specifically, they indicated that some highly conserved amino acid residues exist across each major group in the tree of land plant life. Expression profiling analyses indicate that the CsbZIP genes are likely involved in response to trauma, and a model was established to display the unique expression of each group during different time intervals after wounding. This work provides useful clues for further functional characterization of the CsbZIP TFs.
I/O-Efficient Generation of Massive Graphs Following the
LFR
Benchmark
Authors: Hamann Michael , Meyer Ulrich , Penschuck Manuel , Tran Hung , Wagner Dorothea
Published: August 2018

LFR
is a popular benchmark graph generator used to evaluate community detection algorithms. We present
EM-LFR
, the first external memory algorithm able to generate massive complex networks following the
LFR
benchmark. Its most expensive component is the generation of random graphs with prescribed degree sequences which can be divided into two steps: the graphs are first materialized deterministically using the Havel-Hakimi algorithm, and then randomized. Our main contributions are
EM-HH
and
EM-ES
, two I/O-efficient external memory algorithms for these two steps. We also propose
EM-CM/ES
, an alternative sampling scheme using the Configuration Model and rewiring steps to obtain a random simple graph. In an experimental evaluation, we demonstrate their performance; our implementation is able to handle graphs with more than 37 billion edges on a single machine, is competitive with a massively parallel distributed algorithm, and is faster than a state-of-the-art internal memory implementation even on instances fitting in main memory.
EM-LFR
’s implementation is capable of generating large graph instances orders of magnitude faster than the original implementation. We give evidence that both implementations yield graphs with matching properties by applying clustering algorithms to generated instances. Similarly, we analyze the evolution of graph properties as
EM-ES
is executed on networks obtained with
EM-CM/ES
and find that the alternative approach can accelerate the sampling process.
Macrophages from the upper and lower human respiratory tract are metabolically distinct
Authors: Lavrich Katelyn S. , Speen Adam M. , Ghio Andrew J. , Bromberg Philip A. , Samet James M. , Alexis Neil E.
Published: August 2018

The function and cell surface phenotype of lung macrophages vary within the respiratory tract. Alterations in the bioenergetic profile of macrophages may also be influenced by their location within the respiratory tract. This study sought to characterize the bioenergetic profile of macrophages sampled from different locations within the respiratory tract at baseline and in response to ex vivo xenobiotic challenge. Surface macrophages recovered from healthy volunteers by induced sputum and by bronchial and bronchoalveolar lavage were profiled using extracellular flux analyses. Oxygen consumption and extracellular acidification rates were measured at rest and after stimulation with lipopolysaccharide (LPS), phorbol 12-myristate 13-acetate (PMA), or 1,2-naphthoquinone (1,2-NQ). Oxygen consumption and extracellular acidification rates were highly correlated for all macrophage samples. Induced sputum macrophages had relatively higher oxygen consumption and extracellular acidification rates and were largely reliant on glycolysis. In contrast, bronchial fraction and bronchoalveolar macrophages depended more heavily on mitochondrial respiration. Bronchoalveolar macrophages showed elevated LPS-induced cytokine responses. Unlike their autologous peripheral blood monocytes, lung macrophages from any source did not display bioenergetic changes following LPS stimulation. The protein kinase C activator PMA did not affect mitochondrial respiration, whereas the air pollutant 1,2-NQ induced marked mitochondrial dysfunction in bronchoalveolar and bronchial fraction macrophages. The bioenergetic characteristics of macrophages from healthy individuals are dependent on their location within the respiratory tract. These findings establish a regional bioenergetic profile for macrophages from healthy human airways that serves as a reference for changes that occur in disease.
Comparison of the effects of e-cigarette vapor with cigarette smoke on lung function and inflammation in mice
Authors: Glynos Constantinos , Bibli Sofia-Iris , Katsaounou Paraskevi , Pavlidou Athanasia , Magkou Christina , Karavana Vassiliki , Topouzis Stavros , Kalomenidis Ioannis , Zakynthinos Spyros , Papapetropoulos Andreas
Published: August 2018

Electronic cigarettes (e-cigs) are advertised as a less harmful nicotine delivery system or as a new smoking cessation tool. We aimed to assess the in vivo effects of e-cig vapor in the lung and to compare them to those of cigarette smoke (CS). We exposed C57BL/6 mice for either 3 days or 4 wk to ambient air, CS, or e-cig vapor containing 1) propylene glycol/vegetable glycerol (PG:VG-Sol; 1:1), 2) PG:VG with nicotine (G:VG-N), or 3) PG:VG with nicotine and flavor (PG:VG-N+F) and determined oxidative stress, inflammation, and pulmonary mechanics. E-cig vapors, especially PG:VG-N+F, increased bronchoalveolar lavage fluid (BALF) cellularity, Muc5ac production, as well as BALF and lung oxidative stress markers at least comparably and in many cases more than CS. BALF protein content at both time points studied was only elevated in the PG:VG-N+F group. After 3 days, PG:VG-Sol altered tissue elasticity, static compliance, and airway resistance, whereas after 4 wk CS was the only treatment adversely affecting these parameters. Airway hyperresponsiveness in response to methacholine was increased similarly in the CS and PG:VG-N+F groups. Our findings suggest that exposure to e-cig vapor can trigger inflammatory responses and adversely affect respiratory system mechanics. In many cases, the added flavor in e-cigs exacerbated the detrimental effects of e-cig vapor. We conclude that both e-cig vaping and conventional cigarette smoking negatively impact lung biology.
Novel differences in gene expression and functional capabilities of myofibroblast populations in idiopathic pulmonary fibrosis
Authors: Walsh Sinead M. , Worrell Julie C. , Fabre Aurelie , Hinz Boris , Kane Rosemary , Keane Michael P.
Published: August 2018

Idiopathic pulmonary fibrosis (IPF), a chronic progressive interstitial pneumonia, is characterized by excessive fibroproliferation. Key effector cells in IPF are myofibroblasts that are recruited from three potential sources: resident fibroblasts, fibrocytes, and epithelial cells. We hypothesized that IPF myofibroblasts from different sources display unique gene expression differences and distinct functional characteristics. Primary human pulmonary fibroblasts (normal and IPF), fibrocytes, and epithelial cells were activated using the profibrotic factors TGF-β and TNF-α. The resulting myofibroblasts were characterized using cell proliferation, soluble collagen, and contractility assays, ELISA, and human fibrosis PCR arrays. Genes of significance in human whole lung were validated by immunohistochemistry on human lung sections. Fibroblast-derived myofibroblasts exhibited the greatest increase in expression of profibrotic genes and genes involved in extracellular matrix remodeling and signal transduction. Functional studies demonstrated that myofibroblasts derived from fibrocytes expressed mostly soluble collagen and chemokine (C-C) motif ligand (CCL) 18 but were the least proliferative of the myofibroblast progeny. Activated IPF fibroblasts displayed the highest levels of contractility and CCL2 production. This study identified novel differences in gene expression and functional characteristics of different myofibroblast populations. Further investigation into the myofibroblast phenotype may lead to potential therapeutic targets in future IPF research.
Low but not high frequency of intermittent hypoxia suppresses endothelium-dependent, oxidative stress-mediated contractions in carotid arteries of obese mice
Authors: Lee Mary Y. K. , Ge Grace , Fung M. L. , Vanhoutte Paul M. , Mak Judith C. W. , Ip Mary S. M.
Published: August 2018

Obstructive sleep apnea is characterized by intermittent hypoxia (IH) during sleep and predisposes to endothelial dysfunction. Obesity is a major risk factor for the occurrence of sleep apnea. The present study compared the functional impact of low- (IH10; 10 hypoxic events/h) and high-frequency (IH60; 60 hypoxic events/h) IH for 4 wk on endothelial function in male C57BL/6 mice with or without high-fat (HF) diet-induced obesity. Mean arterial blood pressure (tail cuff method) was increased in obese mice after IH60 exposure, i.e., HF + IH60 group. The serum levels of the oxidative stress marker malondialdehyde were augmented in lean IH60 and HF groups, with a further increase in HF + IH60 but a reduction in HF + IH10 mice compared with the HF group. Vascular responsiveness was assessed as changes in isometric tension in isolated arteries. Relaxations to the endothelium-dependent vasodilator acetylcholine were impaired in HF + IH60 aortae. Endothelium-dependent contractions (EDC; response to acetylcholine in the presence of the nitric oxide synthase inhibitor l-NAME) in carotid arteries were augmented in the HF group, but this HF-induced augmentation was suppressed by low-frequency IH exposure. The addition of apocynin (antioxidant) reduced EDC in HF and HF + IH60 groups but not in HF + IH10 group. In conclusion, these findings suggest that exposure of obese mice to mild IH exerts preconditioning-like suppression of endothelium-dependent and oxidative stress-mediated contractions. When IH severity increases, this suppression diminishes and endothelial dysfunction accelerates.

NEW & NOTEWORTHY The present study demonstrates, for the first time, that low-frequency intermittent hypoxia may exert a preconditioning-like suppression of oxidative stress-induced endothelium-dependent contractions in mice with diet-induced obesity. This relative suppression was diminished as intermittent hypoxia became more severe, and a deleterious effect on endothelial function emerged.
The Effect of Water on the Tin Electrodeposition from [Bmim]HSO4 Ionic Liquid
Authors: Tang Jie , Lv DongLiang , Xu CunYing , Hua YiXin , Zhang QiBo , Niu PingZhao , Zhu XiaoLin
Published: August 2018

The electrodeposition of tin from SnO in ionic liquid 1-butyl-3-methylimidazolium hydrogen sulfate ([Bmim]HSO4) in the presence of water at different cathodic potential was investigated. With the addition of water to [Bmim]HSO4ionic liquid, the electrochemical window of the electrolyte decreases and the reduction potential of Sn(II) positively shifts. The water content of ionic liquid electrolyte has a distinct effect on morphology of the deposits. As water content increased from 0 to 50% (v/v), the morphology of deposits varies from granular to hexagonal rod-like, then to hollow tubular, and finally to wire-like. The XRD phase analysis showed that both Sn and CuSn alloys were deposited in ionic liquid/water mixtures. However, in dried ionic liquids only Cu3Sn was obtained, surprisingly. The difference in the structure might be attributed to the various interactions of the ions with the Cu substrate. In addition, the deposition potential was found to play a significant role in the morphology of deposits.
Episodic Behavioural Regression in an 8-Year-Old Female: Sequelae of 22q11.2 Duplication Syndrome
Authors: Bahji A. , Khalid-Khan S.
Published: August 2018

22q11.2 duplication syndrome is a recently discovered genetic syndrome with unclear neuropsychiatric sequelae. While its connection to 22q11.2 deletion syndrome is actively investigated, case reports on the neuropsychiatric sequelae of affected individuals have been previously described, largely focusing on comorbid autism spectrum disorder. Here, we present the case of an 8-year-old female experiencing episodes of severe behavioural regression following medical illness. We analyze the case and relate it to the available literature and identify potential risk factors.
λ Phase Transition in Horava Gravity
Authors: Xu Wei
Published: August 2018

We present another example of superfluid black hole containing λ phase transition in Horava gravity. After studying the extended thermodynamics of general dimensional Horava-Lifshitz AdS black holes, it is found that only the one with spherical horizon in four and five dimensions has λ phase transition, which is a line of (continuous) second-order phase transitions and was famous in the discussion of superfluidity of liquid He4. The “superfluid” black hole phase and “normal” black hole phase are also distinguished. Particularly, six-dimensional Horava-Lifshitz AdS black holes exhibit infinitely many critical points in P-ν plane and the divergent points for specific heat, for which they only contain the “normal” black hole phase and the “superfluid” black hole phase disappears due to the physical temperature constraint; therefore there is no similar phase transition. In more than six dimensions, there is no P-ν critical behavior. After choosing the appropriate ordering field, we study the critical phenomena in different planes of thermodynamical phase space. We also calculate the critical exponents, which are the same as the van der Waals fluid.
The Curious Case of Cholangiocarcinoma: Opportunities for Environmental Health Scientists to Learn about a Complex Disease
Authors: Suk William A. , Bhudhisawasdi Vajarabhongsa , Ruchirawat Mathuros
Published: August 2018

Deaths from complex, noncommunicable diseases such as cancer are predicted to continue to increase worldwide, with low- and middle-income countries bearing the brunt of the burden. This problem requires a concentrated global effort to avoid devastating losses of life as well as economic losses. Cholangiocarcinoma (CCA) is a readily studied model of complex, noncommunicable disease, but it receives little attention outside of the scientific community in Southeast Asia. Here, we bring attention to the opportunity to study CCA as a model to understand the role of multiple, complex factors in cancer. These factors include allostatic load, individual genetic susceptibility, and environmental exposures such as chemicals, diet, socioeconomic factors, and psychosocial stress. The study of CCA offers a unique opportunity to make novel observations that could advance progress in prevention and intervention approaches for prevalent diseases that involve complex, multifactorial interactions.
A Novel Real‐Time Image Restoration Algorithm in Edge Computing
Authors: Ma Xingmin , Xu Shenggang , An Fengping , Lin Fuhong
Published: August 2018

Owning to the high processing complexity, the image restoration can only be processed offline and hardly be applied in the real‐time production life. The development of edge computing provides a new solution for real‐time image restoration. It can upload the original image to the edge node to process in real time and then return results to users immediately. However, the processing capacity of the edge node is still limited which requires a lightweight image restoration algorithm. A novel real‐time image restoration algorithm is proposed in edge computing. Firstly, 10 classical functions are used to determine the population size and maximum iteration times of traction fruit fly optimization algorithm (TFOA). Secondly, TFOA is used to optimize the optimal parameters of least squares support vector regression (LSSVR) kernel function, and the error function of image restoration is taken as an adaptive function of TFOA. Thirdly, the LLSVR algorithm is used to restore the image. During the image restoration process, the training process is to establish a mapping relationship between the degraded image and the adjacent pixels of the original image. The relationship is established; the degraded image can be restored by using the mapping relationship. Through the comparison and analysis of experiments, the proposed method can meet the requirements of real‐time image restoration, and the proposed algorithm can speed up the image restoration and improve the image quality.
Application of Customer Segmentation for Electronic Toll Collection: A Case Study
Authors: Qian Chao , Yang Meng , Li Peiqi , Li Shuguang
Published: August 2018

Applying big data technology, this study presents a customer segmentation method of Electronic Toll Collection (ETC) based on vehicle behavioral characteristics. A segmentation index system of ETC customers comprising Recency, Frequency, and Monetary is extracted and constructed using ETC data. The whole-sample clustering analysis of ETC customers is accomplished with the Clustering LARge Applications (CLARA) algorithm while overcoming the invalidation problem of big data clustering. A decision tree on ETC customer segmentation is constructed and transformed into a set of segmentation rules. Empirical results indicate that the proposed method is better able to analyze travel characteristics and to present values and appreciation potentials for ETC customer classification. This method provides an innovative idea for implementing precision marketing and establishing hierarchical discount rates for ETC customers. Furthermore, it provides theoretical support to increase the ETC customer scale and payment ratio, thus improving the decision-making level in expressway operation and management.
Clustering Algorithm for Urban Taxi Carpooling Vehicle Based on Data Field Energy
Authors: Qiang Xiao , Shuang-Shuang Yao
Published: August 2018

A clustering algorithm for urban taxi carpooling based on data field energy and point spacing is proposed to solve the clustering problem of taxi carpooling on urban roads. The data field energy function is used to calculate the field energy of each data point in the passenger taxi offpoint dataset. To realize the clustering of taxis, the central point, outlier, and data points of each cluster subset are discriminated according to the threshold value determined by the product of each data point field values and point spacing. The classical algorithm and proposed algorithm are compared and analyzed by using the compactness, separation, and Dunn validity index. The clustering results of the proposed algorithm are better than those of the classical clustering algorithm. In the case of cluster numbers 25, 249, 409, and 599, the algorithm has good clustering results for the taxi trajectory dataset with certain regularity in space distribution and irregular distribution in time distribution. This algorithm is suitable for the clustering of vehicles in urban traffic roads, which can provide new ideas and methods for the cluster study of urban traffic vehicles.
The Utilization of Medical Devices by Traditional Korean Medicine Doctors Investigated through Traditional Korean Medicine Clinical Studies
Authors: Sung Soo-Hyun , Sim Hee-Ju , Kim Eu-Gene , Sung Angela Dongmin , Park Jung-Youn , Shin Byung-Cheul , Park Min-Jung , Han Chang Hyun , Park Jang-Kyung
Published: August 2018

Objective. The purpose of this study was to investigate the current status of modern medical devices utilized in diagnosis and treatment in traditional Korean medicine (TKM). Methods. We searched the following six Korean electronic databases to collect TKM clinical studies that were published in a five‐year period (January 2012 to December 2016). Clinical studies of TKM when medical devices were used for diagnosis or treatment were investigated. Results. The search generated a total of 3,735 articles, and 1,328 of these were considered to be clinical studies. Of a total of 1,328 clinical studies of TKM, 774 articles (58.3%) used medical devices for diagnosis or treatment, and 554 articles (41.7%) did not use medical devices for diagnosis or treatment. The three most used diagnostic devices were as follows: MRI scanners, which were used in 194 (20.6%) studies; X‐ray machines, which were used in 172 studies (18.3%); and CT scanners, which were used in 139 studies (14.8%). The three most used treatment devices were electroacupuncture equipment (20.3%), transcutaneous electrical nerve stimulation (TENS) equipment (18.4%), and interferential current therapy (ICT) equipment (16.4%). Conclusions. This study suggests that TKM doctors use diagnostic information derived from modern medical devices clinically. It is therefore necessary to institutionalize considering changes to the medical acts of traditional medicine (TM) doctors. Additionally, this information can be utilized as a reference for developing TM policy and education.
Prevalence and Associations of Hypothyroidism in Indian Patients with Type 2 Diabetes Mellitus
Authors: Nair Abilash , Jayakumari C. , Jabbar P. K. , Jayakumar R. V. , Raizada Nishant , Gopi Anjana , George Geena Susan , Seena T. P.
Published: August 2018

Both type 2 diabetes and hypothyroidism are highly prevalent disorders in the community. The existing data regarding prevalence of hypothyroidism in patients with diabetes comes mostly from small studies. There are only two studies with a sample size of more than 1000 diabetic patients, none of which have been done in South Asians. The present study evaluated patients with type 2 diabetes for presence of hypothyroidism and the clinical factors associated with it. The demographic, anthropometric, clinical, and biochemical parameters of consecutively enrolled patients with diabetes were systematically collected and analyzed. A total of 1152 middle aged patients with type 2 diabetes with a mean duration of diabetes of around 10 years were enrolled. Nearly 40 percent of the patients were obese and overweight, respectively, for South Asian standards and abdominal obesity was seen in around 90% patients. Clinical hypothyroidism (TSH>10 mIU/ml) was present in 113 of patients (9.83%) and another 68 patients (5.9%) had subclinical hypothyroidism (TSH 5-10 mIU/ml). Anemia (odds ratio : 2.19), overweight/obese status (odds ratio 2.07), and known dyslipidemia (odds ratio : 1.99) were found to have independent association with clinical hypothyroidism. HbA1c, abdominal obesity, poor control of hypertension, lipid parameters, microalbuminuria, and renal dysfunction showed no difference among patients with hypothyroidism when compared with euthyroid patients. Subclinical hypothyroid patients had no difference in any of the above analyzed parameters when compared to the euthyroid patients. This study shows that a significant proportion of type 2 diabetes patients suffer from clinical or subclinical hypothyroidism and screening for the same may be appropriate.
The Prevalence and Social Determinants of Hypertension among Adults in Indonesia: A Cross-Sectional Population-Based National Survey
Authors: Peltzer Karl , Pengpid Supa
Published: August 2018

Background. Hypertension is the most significant avoidable cause of morbidity and mortality, yet nationally representative adult data on Indonesia have not been available. The study aimed at assessing the prevalence and determinants of hypertension, including sociodemographic variables, weight status, health behaviour, and psychosocial stress and support risk factors. Methods. The Indonesia Family Life Survey (IFLS-5) interviewed and examined in a national population-based cross-sectional study 29965 individuals aged 18 years and older, mean age 43.3 years (SD=15.3). Blood pressure, body height and weight, dietary behaviour, physical activity, tobacco use, and psychosocial variables were measured. Logistic regression analyses were used to estimate determinants of hypertension by gender. Results. The prevalence of hypertension among study participants was 33.4 % (95 % CI: 32.7-34.0), among males 31.0% (95% CI: 30.2, 31.9), and among females 35.4% (95% CI: 34.6, 36.3). Among hypertensives, 42.9% were aware, 11.5% were treated, and 14.3% were controlled. In fully adjusted analyses, in both men and women, older age, no or elementary education, being overweight or obese, and having visited an outpatients health facility in the past 4 weeks were positively associated hypertension. Significant linear relationships of hypertension were found with age (P for trend <0.001) and body mass index (BMI) (P for trend < 0.001). In addition, among men having quit tobacco use and depressive symptoms were positively associated with hypertension, while current tobacco use was negatively associated with hypertension. Moreover, among women lower subjective economic status was associated with hypertension. Conclusions. The prevalence of hypertension was high and awareness was low, and treatment and control were very low. Significant multilevel public health interventions are urgently needed to improve the diagnosis, treatment, and control of hypertension in Indonesia.