bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute activation of bronchopulmonary vagal nociceptors by type I interferons
Authors: Patil Mayur J. , Ru Fei , Sun Hui , Wang Jingya , Kolbeck Roland R. , Dong Xinzhong , Kollarik Marian , Canning Brendan J. , Undem Bradley J. 
Published: September 2020

Key points
Type I interferon receptors are expressed by the majority of vagal C‐fibre neurons innervating the respiratory tract
Interferon alpha and beta acutely and directly activate vagal C‐fibers in the airways.
The interferon‐induced activation of C‐fibers occurs secondary to stimulation of type 1 interferon receptors
Type 1 interferons may contribute to the symptoms as well as the spread of respiratory viral infections by causing coughing and other defensive reflexes associated with vagal C‐fibre activation
AbstractWe evaluated the ability of type I interferons to acutely activate airway vagal afferent nerve terminals in mouse lungs. Using single cell RT‐PCR of lung‐specific vagal neurons we found that IFNAR1 and IFNAR2 were expressed in 70% of the TRPV1‐positive neurons (a marker for vagal C‐fibre neurons) and 44% of TRPV1‐negative neurons. We employed an ex vivo vagal innervated mouse trachea‐lung preparation to evaluate the effect of interferons in directly activating airway nerves. Utilizing 2‐photon microscopy of the nodose ganglion neurons from Pirt‐Cre;R26‐GCaMP6s mice we found that applying IFNα or IFNβ to the lungs acutely activated the majority of vagal afferent nerve terminals. When the type 1 interferon receptor, IFNAR1, was blocked with a blocking antibody the response to IFNβ was largely inhibited. The type 2 interferon, IFNγ, also activated airway nerves and this was not inhibited by the IFNAR1 blocking antibody. The Janus kinase inhibitor GLPG0634 (1 μm) virtually abolished the nerve activation caused by IFNβ. Consistent with the activation of vagal afferent C‐fibers, infusing IFNβ into the mouse trachea led to defensive breathing reflexes including apneas and gasping. These reflexes were prevented by pretreatment with an IFN type‐1 receptor blocking antibody. Finally, using whole cell patch‐clamp electrophysiology of lung‐specific neurons we found that IFNβ (1000 U ml−1) directly depolarized the membrane potential of isolated nodose neurons, in some cases beyond to action potential threshold. This acute non‐genomic activation of vagal sensory nerve terminals by interferons may contribute to the incessant coughing that is a hallmark of respiratory viral infections.
Blood Flow Manipulation in the Aorta With Coarctation and Arch Narrowing for Pediatric Subjects
Authors: Jia Yuxi , Punithakumar Kumaradevan , Noga Michelle , Hemmati Arman 
Published: September 2020

Abstract
The characteristics of blood flow in an abnormal pediatric aorta with an aortic coarctation and aortic arch narrowing are examined using direct numerical simulations and patient-specific boundary conditions. The blood flow simulations of a normal pediatric aorta are used for comparison to identify unique flow features resulting from the aorta geometrical anomalies. Despite flow similarities compared to the flow in normal aortic arch, the flow velocity decreases with an increase in pressure, wall shear stress, and vorticity around both anomalies. The presence of wall shear stresses in the trailing indentation region and aorta coarctation opposing the primary flow direction suggests that there exist recirculation zones in the aorta. The discrepancy in relative flowrates through the top and bottom of the aorta outlets, and the pressure drop across the coarctation, implies a high blood pressure in the upper body and a low blood pressure in the lower body. We propose using flow manipulators prior to the aortic arch and coarctation to lower the wall shear stress, while making the recirculation regions both smaller and weaker. The flow manipulators form a guide to divert and correct blood flow in critical regions of the aorta with anomalies.
Adding a Detrital Actor to Increase System of System Resilience: A Case Study Test of a Biologically Inspired Design Heuristic to Guide Sociotechnical Network Evolution
Authors: Watson Bryan C. , Malone Stephen , Weissburg Marc , Bras Bert 
Published: September 2020

AbstractNetworking complex sociotechnical systems into larger Systems of Systems (SoS) typically results in improved performance characteristics including sustainability, efficiency, and productivity. The response, or lack thereof, of many SoS to unexpected constituent system failures undermines their effectiveness in many cases. SoS performance after faults can be improved by improving the SoS’s hard (physical design) or soft (human intervention) resilience. The current approaches to increase resilience are limited due to the cost and necessary of human response increasing non-linearly with SoS scale. The limitations of current approaches require a novel design approach to improve SoS network resilience. We hypothesize that biologically inspired network design can improve SoS resilience. To illustrate this, a systems dynamics model of a Forestry Industry is presented and an optimization search over potential hard and soft resilience approaches is compared to a biologically inspired network improvement. SoS network resilience is measured through the newly developed System of System Resilience Measurement (SoSRM). Our first result provides evidence that biologically inspired network design provides an approach to increase SoS resilience beyond hard and soft resilience improvements alone. Second, this work provides evidence that having a SoS constituent fulfill the ecosystem role of detrital actor increases resilience. Third, this paper documents the first case study using the new SoSRM metric to justify a design decision. Finally, this case study provides a counter-example to the theory that increased sustainability always results in increased resilience. By comparing biologically inspired network redesign and optimized traditional resilience improvements, this paper provides evidence that biologically inspired intervention may be the needed strategy to increase sociotechnical SoS network resilience, improve SoS performance, and overcome the limitations of traditional resilience improvement approaches.
Inter-rater reliability of paediatric emergency assessment: physiological and clinical features
Authors: Heal Calvin , Cotterill Sarah , Rowland Andrew Graeme , Garratt Natalie , Long Tony , Brown Stephen , O'Connor Grainne , Rishton Chloe , Woby Steve , Roland Damian 
Published: September 2020

ObjectiveThe Paediatric Admission Guidance in the Emergency Department (PAGE) score is an assessment tool currently in development that helps predict hospital admission using components including patient characteristics, vital signs (heart rate, temperature, respiratory rate and oxygen saturation) and clinical features (eg, breathing, behaviour and nurse judgement). It aims to assist in safe admission and discharge decision making in environments such as emergency departments and urgent care centres. Determining the inter-rater reliability of scoring tools such as PAGE can be difficult. The aim of this study was to determine the inter-rater reliability of seven clinical components of the PAGE Score.DesignInter-rater reliability was measured by each patient having their clinical components recorded by two separate raters in succession. The first rater was the assessing nurse, and the second rater was a research nurse.SettingTwo emergency departments and one urgent care centre in the North West of England. Measurements were recorded over 1 week; data were collected for half a day at each of the three sites.PatientsA convenience sample of 90 paediatric attendees (aged 0–16 years), 30 from each of the three sites.Main outcome measuresTwo independent measures for each child were compared using kappa or prevalence-adjusted bias-adjusted kappa (PABAK). Bland-Altman plots were also constructed for continuous measurements.ResultsInter-rater reliability ranged from moderate (0.62 (95% CI 0.48 to 0.74) weighted kappa) to very good (0.98 (95% CI 95 to 0.99) weighted kappa) for all measurements except ‘nurse judgement’ for which agreement was fair (0.30, 95% CI 0.09 to 0.50 PABAK). Complete information from both raters on all the clinical components of the PAGE score were available for 73 children (81%). These total scores showed good’ inter-rater reliability (0.64 (95% CI 0.53 to 0.74) weighted kappa).ConclusionsOur findings suggest different nurses would demonstrate good inter-rater reliability when collecting acute assessments needed for the PAGE score, reinforcing the applicability of the tool. The importance of determining reliability in scoring systems is highlighted and a suitable methodology was presented.
Incidence of retinopathy of prematurity in Germany: evaluation of current screening criteria
Authors: Larsen Petra P , Müller Andreas , Lagrèze Wolf A , Holz Frank G , Stahl Andreas , Krohne Tim U 
Published: September 2020

ObjectiveTo evaluate current screening criteria for retinopathy of prematurity (ROP) by investigating the incidence of ROP requiring treatment in infants with gestational age (GA) ≥30 weeks or postmenstrual age (PMA) <32 weeks in Germany.MethodsThree patient databases were analysed, that is, the German Quality Assurance Procedure in Neonatology (years 2011–2017; n=52 461 infants screened for ROP, 1505 infants treated for ROP), the German Retina.net ROP Registry (years 2011–2018; n=281 treated infants) and the ROP screening programme of two German university hospitals (years 2012–2016; n=837 screened infants).ResultsIn the analysed cohorts, infants with GA ≥30 weeks represented 33.1%–38.5% of the screening populations but only 1.40%–1.42% of the cases requiring ROP treatment. In a cohort of 281 infants treated for ROP, all 4 infants with GA ≥30 weeks had additional risk factors for ROP including prolonged oxygen supplementation and/or significant comorbidities. Five infants (1.8%) were treated at 32 weeks PMA and none at PMA <32 weeks.ConclusionsIn the investigated cohorts, preterm infants with GA ≥30 weeks carried a very low or no risk for developing treatment-requiring ROP unless additional risk factors were present, and no treatment was performed earlier than 32 weeks PMA. These findings are of relevance for the ongoing re-evaluation of ROP screening criteria.
Efficacy of heel lifts versus calf muscle eccentric exercise for mid-portion Achilles tendinopathy (HEALTHY): a randomised trial
Authors: Rabusin Chantel L , Menz Hylton B , McClelland Jodie A , Evans Angela M , Malliaras Peter , Docking Sean I , Landorf Karl B , Gerrard James M , Munteanu Shannon E 
Published: September 2020

Objective(s)To compare the efficacy of in-shoe heel lifts to calf muscle eccentric exercise in reducing pain and improving function in mid-portion Achilles tendinopathy.MethodsThis was a parallel-group randomised superiority trial at a single centre (La Trobe University Health Sciences Clinic, Discipline of Podiatry, Melbourne, Victoria, Australia). One hundred participants (52 women and 48 men, mean age 45.9, SD 9.4 years) with clinically diagnosed and ultrasonographically confirmed mid-portion Achilles tendinopathy were randomly allocated to either a (1) heel lifts (n=50) or (2) eccentric exercise (n=50) group. The primary outcome measure was the Victorian Institute of Sport Assessment-Achilles (VISA-A) questionnaire at 12 weeks. Differences between groups were analysed using intention to treat with analysis of covariance.ResultsThere was 80% follow-up of participants (n=40 per group) at 12 weeks. The mean VISA-A score improved by 26.0 points (95% CI 19.6 to 32.4) in the heel lifts group and by 17.4 points (95% CI 9.5 to 25.3) in the eccentric exercise group. On average, there was a between-group difference in favour of the heel lifts for the VISA-A (adjusted mean difference 9.6, 95% CI 1.8 to 17.4, p=0.016), which approximated, but did not meet our predetermined minimum important difference of 10 points.ConclusionIn adults with mid-portion Achilles tendinopathy, heel lifts were more effective than calf muscle eccentric exercise in reducing pain and improving function at 12 weeks. However, there is uncertainty in the estimate of effect for this outcome and patients may not experience a clinically worthwhile difference between interventions.Trial registration numberACTRN12617001225303.
Role of resistin, IL-6 and NH2-terminal portion proBNP in the pathogenesis of cardiac disease in type 2 diabetes mellitus
Authors: Ghanem Samar Ebrahim , Abdel-Samiee Mohamed , Torky Mohamed Hamdy , Gaafar Ahmed , Mohamed Somia Mokabel , Salah Eldin Ghada Mohamed Mohamed , Awad Samah Mohammed , Diab Karema A , ELsabaawy Dalia M , Yehia Sania Ali , Abdelaziz Elbasyouni Hany Abdelbary , Elshormilisy Amr Aly 
Published: September 2020

IntroductionEpidemiological and genetic studies have recorded the association between proinflammatory cytokines and the development of insulin resistance, diabetes, and cardiovascular disease. The role of interleukin 6 (IL-6), NH2-terminal portion pro-brain natriuretic peptide (NT-proBNP) and resistin in the pathogenesis of heart disease in type 2 diabetes mellitus (T2DM) is still a matter of controversy. The current study aimed to evaluate the role of these biomarkers in the development of left ventricular systolic dysfunction and the ability to use them as non-invasive test in the prediction of left ventricular hypertrophy and systolic dysfunction in T2DM.Research design and methods150 participants were included in this case–control study. Patients were divided into two subgroups according to echocardiographic findings: group 1a included 46 patients with type 2 diabetes mellitus and echocardiographic evidence of abnormal systolic function; group 1b included 54 patients with type 2 diabetes mellitus and with normal echocardiogenic study; and group 2 included 50 apparently healthy controls. Routine laboratory investigations such as complete blood count, liver and renal function tests, and lipid profile, serum IL-6, NT-proBNP, and resistin were measured in all participants. Conventional echocardiography was done with special concern on the assessment of left ventricular systolic function (ejection fraction).ResultsThere was a significant increase in the level of resistin, NT-proBNP and IL-6 in group 1a patients compared with group 1b and in healthy controls. Echocardiographic parameters showed a significant increase in left ventricular mass index, left ventricle posterior wall thickness, interventricular septum thickness, and left ventricle mass in group 1a compared with group 1b and the control group. The increased left ventricular mass index was associated with higher levels of IL-6, NT-proBNP and resistin.ConclusionsProinflammatory cytokines had a clear relation with left ventricular systolic dysfunction and hypertrophy and can be used as early non-invasive markers for detection of left ventricular remodeling and systolic dysfunction in patients with T2DM.
Multicentre, single-blind randomised controlled trial comparing MyndMove neuromodulation therapy with conventional therapy in traumatic spinal cord injury: a protocol study
Authors: Anderson Kim D , Wilson James R , Korupolu Radha , Pierce Jacqueline , Bowen James M , O'Reilly Daria , Kapadia Naaz , Popovic Milos R , Thabane Lehana , Musselman Kristin E 
Published: September 2020

IntroductionThis protocol is describing a multicentre, single-blind randomised controlled trial. The objective is to compare the efficacy of MyndMove therapy versus conventional therapy (CT) in improving upper extremity function in individuals with C4–C7 traumatic, incomplete spinal cord injury (SCI). It is being conducted in two US and two Canadian SCI rehabilitation centres.Methods and analysisSixty people aged 18 years or older with a C4–C7 incomplete (AIS B-D) SCI between 4 months and 8 years postinjury are randomised to receive 40 sessions of MyndMove neuromodulation therapy or CT within a 14-week period of time. Therapy sessions are 1 hour in duration with a dose of 3–5 sessions per week. Assessments occur prior to randomisation, after 20 sessions, after 40 sessions and 10 weeks after the last session. The primary outcome measure is the efficacy of MyndMove therapy versus CT in improving upper extremity function as measured by Spinal Cord Independence Measure III: Self-Care subscore after 40 sessions. Secondary outcomes include: (1) improvements in the SCIM mobility subscore; (2) upper limb functions measured by Graded Redefined Assessment of Strength, Sensibility and Prehension and (3) Toronto Rehab Institute Hand Function Test; (4) To assess safety as measured by serious and non-serious adverse events recorded for participants in both groups of the study population over the duration of the study; (5) to compare the change in quality of life as measured by the Spinal Cord Injury-Quality of Life; and (6) to evaluate the impact on healthcare resource utilisation.Ethics and disseminationAll ethical approvals were obtained prior to enrolling any participants. Dissemination of the results of the study will be made at peer-reviewed academic meetings and through peer-reviewed medical journalsTrial registration numberNCT03439319
Emergency medicine response to the COVID-19 pandemic in England: a phenomenological study
Authors: Walton Henry , Navaratnam Annakan Victor , Ormond Martyn , Gandhi Vanita , Mann Clifford 
Published: September 2020

BackgroundThe COVID-19 pandemic has stretched EDs globally, with many regions in England challenged by the number of COVID-19 presentations. In order to rapidly share learning to inform future practice, we undertook a thematic review of ED operational experience within England during the pandemic thus far.MethodsA rapid phenomenological approach using semistructured telephone interviews with ED clinical leads from across England was undertaken between 16 and 22 April 2020. Participants were recruited through purposeful sampling with sample size determined by data saturation. Departments from a wide range of geographic distribution and COVID-19 experience were included. Themes were identified and included if they met one of three criteria: demonstrating a consistency of experience between EDs, demonstrating a conflict of approach between emergency departments or encapsulating a unique solution to a common barrier.ResultsSeven clinical leads from type 1 EDs were interviewed. Thematic redundancy was achieved by the sixth interview, and one further interview was performed to confirm. Themes emerged in five categories: departmental reconfiguration, clinical pathways, governance and communication, workforce and personal protective equipment.ConclusionThis paper summarises learning and innovation from a cross-section of EDs during the first UK wave of the COVID-19 pandemic. Common themes centred around the importance of flexibility when reacting to an ever-changing clinical challenge, clear leadership and robust methods of communication. Additionally, experience in managing winter pressures helped inform operational decisions, and ED staff demonstrated incredible resilience in demanding working conditions. Subsequent surges of COVID-19 infections may occur within a more challenging context with no guarantee that there will be an associated reduction in A&E attendance or cessation of elective activity. Future operational planning must therefore take this into consideration.
Prospective cohort study of elderly patients with coronary artery disease: impact of frailty on quality of life and outcome
Authors: Qayyum Shouaib , Rossington Jennifer Ann , Chelliah Raj , John Joseph , Davidson Benjamin J , Oliver Richard M , Ngaage Dumbor , Loubani Mahmoud , Johnson Miriam J , Hoye Angela 
Published: September 2020

BackgroundElderly, frail patients are often excluded from clinical trials so there is lack of data regarding optimal management when they present with symptomatic coronary artery disease (CAD).ObjectiveThe aim of this observational study was to evaluate an unselected elderly population with CAD for the occurrence of frailty, and its association with quality of life (QoL) and clinical outcomes.MethodsConsecutive patients aged ≥80 years presenting with CAD were prospectively assessed for frailty (Fried frailty phenotype (FFP), Edmonton frailty scale (EFS)), QoL (Short form survey (SF-12)) and comorbidity (Charlson Comorbidity Index (CCI)). Patients were re-assessed at 4 months to determine any change in frailty and QoL status as well as the clinical outcome.ResultsOne hundred fifty consecutive patients with symptomatic CAD were recruited in the study. The mean age was 83.7±3.2 years, 99 (66.0%) were men. The clinical presentation was stable angina in 68 (45.3%), the remainder admitted with an acute coronary syndrome including 21 (14.0%) with ST-elevation myocardial infarction. Frailty was present in 28% and 26% by FFP and EFS, respectively, and was associated with a significantly higher CCI (7.5±2.4 in frail, 6.2±2.2 in prefrail, 5.9±1.6 in those without frailty, p=0.005). FFP was significantly related to the physical composite score for QoL, while EFS was significantly related to the mental composite score for QoL (p=0.003). Treatment was determined by the cardiologist: percutaneous coronary intervention in 51 (34%), coronary artery bypass graft surgery in 15 (10%) and medical therapy in 84 (56%). At 4 months, 14 (9.3%) had died. Frail participants had the lowest survival. Cardiovascular symptom status and the mental composite score of QoL significantly improved (52.7±11.5 at baseline vs 55.1±10.6 at follow-up, p=0.04). However, overall frailty status did not significantly change, nor the physical health composite score of QoL (37.2±11.0 at baseline vs 38.5±11.3 at follow-up, p=0.27).ConclusionsIn patients referred to hospital with CAD, frailty is associated with impaired QoL and a high coexistence of comorbidities. Following cardiac treatment, patients had improvement in cardiovascular symptoms and mental component of QoL.
Power law plateau inflation potential in the RS II braneworld evading swampland conjecture
Authors: Adhikari Rathin , Gangopadhyay Mayukh R. , Yogesh  
Published: September 2020

AbstractIn the recent time, inflationary cosmology is facing an existential crisis due to the proposed Swampland criterion which aims to evade any (meta-)stable de Sitter construction within the String landscape. It is been realised that a single field slow roll inflation is inconsistent with the Swampland criterion unless the inflationary model is realised in some non-standard scenario such as Warm inflation or the Braneworld scenario. Dimopoulos and Owen (Phys Rev D 94(6): 063518, 2016) introduced a new class of model of inflation dubbed as the power law plateau inflation in the standard cold inflationary scenario. But to realise this model in the standard scenario consistent with observation, they had to introduce a phase of thermal inflation. In this paper we have analysed this model in the braneworld scenario to show that for some choice of the parameters defining the model class, one can have an observationally consistent power law plateau without any phase of thermal inflation. We have also shown that, for the correct choice of model parameters, one can easily satisfy the Swampland criterion. Besides, for correct choice of equation of states ($$w_{re}$$

w

re

), one can also satisfy the recently proposed Trans–Planckian Censorship Conjecture (TCC).