bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of asthma exacerbation in children during the coronavirus disease pandemic with strict mitigative countermeasures
Authors: Fan Hui‐Feng , He Chun‐Hui , Yin Gen‐Quan , Qin Yi , Jiang Nan , Lu Gen , Li Xing
Published: March 2021

Background

Strict countermeasures for coronavirus disease (COVID‐19) were undertaken in China without knowing their influence on asthma.

Objective

To investigate the associations between the frequencies of asthma exacerbations and respiratory infections and air pollutants before and during the COVID‐19 pandemic, which were direct consequences of countermeasures undertaken for the pandemic.

Methods

Asthma exacerbations and respiratory infections among hospitalized children in the permanent population of Guangzhou City, China, from February to June 2016–2019 (before the pandemic) to February to June 2020 (during the pandemic) were collected in this cross‐sectional study in Guangzhou.

Results

The number of asthma exacerbation cases per month documented in the Guangzhou Women and Children's Hospital before (median: 13.5; range: 0–48) and during (median: 20; range: 0–34) the mitigative response to the COVID‐19 pandemic was similar. The frequency of severe asthma exacerbation cases per month decreased, whereas that of mild asthma exacerbation cases per year increased (p = .004). The number of patients hospitalized with infectious respiratory diseases decreased from 146 (range: 90–172) per month before the pandemic to 42 (range: 33–57) per month during the pandemic (p = .004). Most pathogens and air pollutants decreased during the COVID‐19 pandemic. The frequency of severe asthma exacerbations positively correlated to that of respiratory infections in children, but did not correlate to air pollutants.

Conclusion

Strict countermeasures undertaken for the pandemic were associated with a decreased the frequency of infectious respiratory diseases and severe asthma exacerbations among urban children.
Pharmacokinetics, safety, and immunogenicity of HLX03, an adalimumab biosimilar, compared with reference biologic in healthy Chinese male volunteers: Results of a randomized, double‐blind, parallel‐controlled, phase 1 study
Authors: Zhang Hong , Wu Min , Sun Jixuan , Zhu Xiaoxue , Li Cuiyun , Ding Yanhua , Zhang Xiaodi , Chai Katherine , Li Xiaojiao
Published: March 2021

The primary objective of this randomized, double‐blind, parallel‐controlled study (from December 2016 to October 2018) was to evaluate pharmacokinetic (PK) equivalence of adalimumab biosimilar HLX03 and reference adalimumab in healthy volunteers, and to assess safety, and immunogenicity of HLX03. The primary PK endpoints were maximum observed plasma concentration (Cmax) and area under the concentration curve from time zero to the last quantifiable concentration (AUC0–t). Equivalence was determined if the 90% confidence interval (CI) of geometric least square mean ratio between the two treatment groups were within the predefined range of 80%–125%. Safety and immunogenicity were monitored during the study. Healthy Chinese males (N = 220) were randomized 1:1 to receive a single subcutaneous 40 mg dose of HLX03 or China (CN)‐sourced adalimumab. The ratios of the geometric mean of Cmax and AUC0–t were 102.2% and 105.7%, respectively, with corresponding 90% CIs falling in the predefined margins, which demonstrated PK equivalence between HLX03 and CN‐adalimumab. The incidence of treatment‐emergent adverse events (TEAEs) was similar in the two groups (73.8% and 66.0% in the HLX03 and CN‐adalimumab groups, respectively). Grade 3–4 TEAEs were reported in 7.5% and 5.7% of participants, respectively. The incidences of participants with antidrug antibodies (HLX03: 96.2%; CN‐adalimumab: 93.4%) or neutralizing antibodies (HLX03: 40.6%, CN‐adalimumab: 41.4%) were comparable between groups. This study demonstrated PK bioequivalence between HLX03 and CN‐adalimumab, with similar safety and immunogenicity profiles. These data support further clinical development of HLX03 as an adalimumab biosimilar.
Evidence for Conical Magnetic Structure in M‐Type BaFe12O19 Hexaferrite: A Combined Single‐Crystal X‐ray Magnetic Circular Dichroism and Neutron Diffraction Study
Authors: Kumar Keshav , Mishra Shrawan Kumar , Singh Sanjay , Baev Ivan , Martins Michael , Orlandi Fabio , Manuel Pascal , Pandey Dhananjai
Published: March 2021

The magnetic ground state of BaFe12O19 (BFO) is investigated using X‐ray absorption spectra (XAS), X‐ray magnetic circular dichroism (XMCD), and neutron diffraction studies at 1.2 and 1.5 K, respectively. The XMCD measurements on single‐crystals of BFO in grazing‐incidence geometry reveal canting of the spins away from the c‐axis of the hexagonal unit cell. Single‐crystal neutron diffraction studies reveal magnetic satellite peaks along the 00l reciprocal lattice row around the forbidden l = 2n ± 1 positions confirming the conical‐type magnetic structure in the ground state of BFO. The observation of the conical magnetic structure of BFO opens the possibility of type‐II multiferroicity in undoped BFO.
New pneumothorax complicating successful treatment of persistent air leak by endobronchial valves
Authors: Yeung Yiu Cheong , Chan Yu Hong , Ho Man Ying , Chan Ming Chiu , Kwok Hau Chung , Yu Wai Cho
Published: March 2021

Endobronchial one‐way valves (EBV) have been proposed as a treatment option for persistent air leak (PAL) complicating spontaneous pneumothorax when surgical intervention is considered not feasible. Published case series showed this form of treatment to be generally safe. We report two such cases in which both achieved immediate cessation of air leak and post‐procedural chest radiograph showed significant collapse of the treated lobe, but developed sudden onset of shortness of breath within 24 h after EBV insertion. Chest radiograph showed continued collapse of the treated lobes with enlarged ipsilateral pneumothorax in one patient and new contralateral pneumothorax in the other. Pulmonologists and thoracic surgeons inserting EBV for treatment of PAL should be aware of this possible and important complication.
Self‐assembled fullerene (C60)‐pentacene superstructures for photodetectors
Authors: Tang Qin , Zhang Guangpu , Jiang Bohong , Ji Deyang , Kong Huihui , Riehemann Kristina , Ji Qingmin , Fuchs Harald
Published: March 2021

Fullerene assembling with specific donor molecules would yield multifunctional metamaterials via the collective behavior, wherein linear acenes are widely used as donor molecules to construct the charge‐transfer heterojunction structure with fullerene. However, they are generally prepared by vacuum deposition due to the insoluble property of high‐performance linear acenes molecules in common solvents, which makes the construction of fullerene with insoluble donor molecules still be a big challenge in the solution‐processed method. To this end, chemical modification provides an effective solution‐processed strategy to construct donor and acceptor systems. Here, the C60‐pentacene is assembled into controllable flower‐like superstructures by the surface grafting method. It is found that the nanofeatures of the microflowers could be regulated by temperature, resulting in dense‐flakes morphology at room temperature and loose flakes at high temperatures. Furthermore, the dense‐flakes microflowers structures with less mass but better crystalline structure exhibit better optoelectronic properties. Our results reveal an effective control on the nanofeatures of the self‐assembled fullerenes complex superstructures and their role for the optoelectronic performance, which may promote the exploring of fullerene superstructures as photodetectors.
Effect of self‐compacting concrete infill on the flexural behavior of hollow channel sections: Experimental and numerical studies
Authors: P.S kumar , G Dhamodhara kannan
Published: March 2021

Use of hollow cold‐formed steel (CFS) sections has gained popularity in the construction of light industrial and commercial structures. However, their overall load carrying capacity under flexure can be severely affected due to the possible buckling failure modes. Addition of concrete as an infill material for hollow CFS sections can significantly improve their overall performance by resisting their inward local buckling. In this paper, the effectiveness of self‐compacting concrete (SCC) as an infill material for hollow channel sections (HCS) is investigated under flexure. In total, nine full‐scale hollow channel sections with and without SCC infill are tested to understand the effect of different parameters namely (i) width to depth ratio, (ii) section thickness, and (iii) developed length. In addition, a detailed nonlinear finite element (FE) modeling was performed using the software ABAQUS. Moreover, an analytical investigation was performed to determine the ultimate moment capacity of SCC infilled sections using the strain compatibility procedure. Test results revealed that the addition of SCC infill helped in increasing the ultimate moment resistance by more than 100% when compared to the specimens with no infill. Moreover, the local buckling resistance of HCS is significantly improved due to the addition of SCC infill. The validated analytical and finite element models were used for performing an extensive parametric investigation.
Perfluorotridecanoic acid inhibits fetal Leydig cell differentiation after in utero exposure in rats via increasing oxidative stress and autophagy
Authors: Li Changchang , Zou Cheng , Yan Haoni , Li Zengqiang , Li Yang , Pan Peipei , Ma Feifei , Yu Yige , Wang Yiyan , Wen Zina , Ge Ren‐Shan
Published: March 2021

Perfluorotridecanoic acid (PFTrDA) is a long‐chain perfluoroalkyl substance, and its effect on the differentiation of fetal Leydig cells remains unclear. The objective of this study is to explore the effect of in utero PFTrDA exposure on the differentiation of fetal Leydig cells and investigate its underlying mechanisms. Pregnant Sprague–Dawley female rats were daily administered by gavage of PFTrDA at doses of 0, 1, 5, and 10 mg/kg from gestational day 14 to 21. PFTrDA had no effect on the body weight of dams, but significantly reduced the body weight and anogenital distance of male pups at birth at a dose of 10 mg/kg. PFTrDA significantly decreased serum testosterone levels as low as 1 mg/kg. PFTrDA did not affect fetal Leydig cell number, but promoted abnormal aggregation of fetal Leydig cells at doses of 5 and 10 mg/kg. PFTrDA down‐regulated the expression of Insl3, Lhcgr, Scarb1, Star, Hsd3b1, Cyp17a1, Nr5a1, and Dhh as well as their proteins. PFTrDA lowered the levels of antioxidants (SOD1, CAT, and GPX1), induced autophagy as shown by increased levels of LC3II and beclin1, and reduced the phosphorylation of mTOR. In conclusion, PFTrDA inhibits the differentiation of fetal Leydig cells in male pups after in utero exposure mainly through increasing oxidative stress and inducing autophagy.
Erratum to: Relations between elliptic modular graphs
Authors: Basu Anirban
Published: March 2021

This rectifies a typo in the published version.
Electrochemiluminescence immunosensor for cytokeratin fragment antigen 21-1 detection using electrochemically mediated atom transfer radical polymerization
Authors: Jian Lihe , Wang Xiaolan , Hao Lulu , Liu Yanju , Yang Huaixia , Zheng Xiaoke , Feng Weisheng
Published: March 2021

The cytokeratin fragment antigen 21-1 (CYFRA 21-1) protein is a critical tumor biomarker tightly related to non-small cell lung cancer (NSCLC). Herein, we prepared an effective electrochemiluminescence (ECL) immunosensor for CYFRA 21-1 detection using electrochemically mediated atom transfer radical polymerization (eATRP). The CYFRA 21-1 antigen was fixed on the electrode surface by constructing a sandwich type antibody-antigen-antibody immune system. The sensitivity of ECL was improved by using the eATRP reaction. In this method, eATRP was applied to CYFRA 21-1 detection antibody with N-acryloyloxysuccinimide as functional monomer. This is the first time that ECL and eATRP signal amplification technology had been combined. Under the optimized testing conditions, the immunosensor showed a good linear relation in the range from 1 fg mL−1 to 1 μg mL−1 at a limit of detection of 0.8 fg mL−1 (equivalent to ~ 134 molecules in a 10 μL sample). The ECL immunosensing system based on eATRP signal amplification technology provided a new way for rapid diagnosis of lung cancer by detecting CYFRA 21-1.

Graphical abstract
A collective investment problem in a stochastic volatility environment: The impact of sharing rules
Authors: Chen An , Nguyen Thai , Rach Manuel
Published: March 2021

It is typical in collectively administered pension funds that employees delegate fund managers to invest their contributions. In addition, many pension funds still need to sustain guarantees (prescribed by law) in spite of the current low interest environment. In this paper, we consider an optimal collective investment problem for a pool of investors who (implicitly) demand minimum guarantees by deriving utility from the wealth exceeding their guarantees in two financial market settings, one with a stochastic and one with a constant volatility. We find that individual investors’ well-being will not be worsened through the collective investment in both financial markets, as individual optimal solutions are attainable if a financially fair state-dependent sharing rule is applied. When more prevailing sharing rules like linear rules are applied, this holds no longer. Furthermore, the degree of sub-optimality imposed by linear sharing rules is more pronounced in the stochastic volatility market than in the constant volatility market.
Effect of seaweed extract application on wine grape yield in Australia
Authors: Arioli Tony , Mattner Scott W. , Hepworth Graham , McClintock David , McClinock Rachael
Published: March 2021

Seaweed extracts are agricultural biostimulants that have been shown to increase the productivity of many crops. The aim of this study was to determine the effect of a seaweed extract from the brown algae Durvillaea potatorum and Ascophyllum nodosum as a soil treatment on the yield of wine grapes grown in Australian production and climate conditions. This study used a series of seven field experiments (2012–2017), across five locations, in three Australian states and four cultivars, and analysed data using a linear mixed model approach. The analysis revealed that recurring soil applications of the seaweed extract significantly increased wine grape yield by an average of 14.7% across multiple growing years that experienced climate extremes. Partial budget analysis showed that the use of the seaweed extract increased profits depending on the grape cultivar. This study is the most extensive investigation of its type in Australian viticulture to understand the effect of a soil-applied seaweed extract on wine grape production.
Aleatoric and epistemic uncertainty in machine learning: an introduction to concepts and methods
Authors: Hüllermeier Eyke , Waegeman Willem
Published: March 2021

The notion of uncertainty is of major importance in machine learning and constitutes a key element of machine learning methodology. In line with the statistical tradition, uncertainty has long been perceived as almost synonymous with standard probability and probabilistic predictions. Yet, due to the steadily increasing relevance of machine learning for practical applications and related issues such as safety requirements, new problems and challenges have recently been identified by machine learning scholars, and these problems may call for new methodological developments. In particular, this includes the importance of distinguishing between (at least) two different types of uncertainty, often referred to as aleatoric and epistemic. In this paper, we provide an introduction to the topic of uncertainty in machine learning as well as an overview of attempts so far at handling uncertainty in general and formalizing this distinction in particular.
A methodological framework for determining an optimal coastal protection strategy against storm surges and sea level rise
Authors: Miura Yuki , Qureshi Huda , Ryoo Chanyang , Dinenis Philip C. , Li Jiao , Mandli Kyle T. , Deodatis George , Bienstock Daniel , Lazrus Heather , Morss Rebecca
Published: March 2021

Interdependent critical infrastructures in coastal regions, including transportation, electrical grid, and emergency services, are continually threatened by storm-induced flooding. This has been demonstrated a number of times, most recently by hurricanes such as Harvey and Maria, as well as Sandy and Katrina. The need to protect these infrastructures with robust protection mechanisms is critical for our continued existence along the world’s coastlines. Planning these protections is non-trivial given the rare-event nature of strong storms and climate change manifested through sea level rise. This article proposes a framework for a methodology that combines multiple computational models, stakeholder interviews, and optimization to find an optimal protective strategy over time for critical coastal infrastructure while being constrained by budgetary considerations.
When “Good Enough” Isn’t Good Enough: Interdisciplinary Perspectives on Caring for Adults Using Substances at the End of Life
Authors: Templeton Lorna , Galvani Sarah , Peacock Marian
Published: March 2021

This paper draws on data from one strand of a six-strand, exploratory study on end of life care for adults using substances (AUS). It presents data from the key informant (KI) strand of the study that aimed to identify models of practice in the UK. Participant recruitment was purposive and used snowball sampling to recruit KIs from a range of health and social care, policy and practice backgrounds. Data were collected in 2016–2017 from 20 KIs using a semi-structured interview approach. The data were analysed using template analysis as discussed by King (2012). This paper focusses on two of seven resulting themes, namely “Definitions and perceptions of key terms” in end of life care and substance use sectors, and “Service commissioning and delivery.” The KIs demonstrated dedicated individual practice, but were critical of the systemic failure to provide adequate direction and resources to support people using substances at the end of their lives.
Integration of First- and Second-generation Bioethanol Production from Beet molasses and Distillery Stillage After Dilute Sulfuric Acid Pretreatment
Authors: Mikulski D. , Kłosowski G.
Published: March 2021

The possibility of using waste distillery stillage (first-generation technology) after dilute acid pretreatment, as a medium for the preparation of beet molasses mash, for ethanol production according to the simultaneous saccharification and fermentation (SSF) technology, was assessed. The combination of lignocellulosic hydrolysates made from acid-pretreated stillage with sugar-rich beet molasses is an effective way of utilizing the first-generation ethanol production by-products in the second-generation ethanol production technology. It was demonstrated that the final ethanol concentration could be as high as 90 g/L. The process yield was over 94% of the theoretical yield when the molasses was diluted using acid-pretreated maize distillery stillage. An attempt to increase the pool of fermentable sugars by using cellulases to hydrolyze cellulose failed due to product inhibition in the fermentation medium with a high glucose concentration. A more than threefold increase in the concentration of ethyl acetate (even up to 924.4±11.8 mg/L) was observed in the distillates obtained from the media incubated with cellulases. The use of beet molasses combined with the hydrolysate of pretreated distillery stillage also changed the concentration of other volatile by-products. An increase in the concentration of aldehydes (mainly acetaldehyde to a concentration of above 1500 mg/L), methanol, 1-propanol, and 1-butanol was observed, while the concentration of higher alcohols (isobutanol, 2-methyl-1-butanol, 3-methyl-1-butanol) decreased. Interestingly, the use of cellulases in fermentation media from molasses and stillage hydrolysates resulted in an average fourfold increase in the concentration of this ester to a maximum level of 924.4±11.8 mg/L. Hydrolysates made from acid-pretreated distillery stillage, combined with sugar-rich beet molasses to boost the efficiency of the conversion process, can be successfully used in the production of second-generation fuel ethanol. However, further optimization of the cellulose enzymatic hydrolysis process is required for efficient use of the raw material.
Implementing Ultrasound Imaging for the Assessment of Muscle and Tendon Properties in Elite Sports: Practical Aspects, Methodological Considerations and Future Directions
Authors: Sarto Fabio , Spörri Jörg , Fitze Daniel P. , Quinlan Jonathan I. , Narici Marco V. , Franchi Martino V.
Published: March 2021

Ultrasound (US) imaging has been widely used in both research and clinical settings to evaluate the morphological and mechanical properties of muscle and tendon. In elite sports scenarios, a regular assessment of such properties has great potential, namely for testing the response to training, detecting athletes at higher risks of injury, screening athletes for structural abnormalities related to current or future musculoskeletal complaints, and monitoring their return to sport after a musculoskeletal injury. However, several practical and methodological aspects of US techniques should be considered when applying this technology in the elite sports context. Therefore, this narrative review aims to (1) present the principal US measures and field of applications in the context of elite sports; (2) to discuss, from a methodological perspective, the strengths and shortcomings of US imaging for the assessment of muscle and tendon properties; and (3) to provide future directions for research and application.
Nanoplatforms for Sepsis Management: Rapid Detection/Warning, Pathogen Elimination and Restoring Immune Homeostasis
Authors: Luo Gan , Zhang Jue , Sun Yaqi , Wang Ya , Wang Hanbin , Cheng Baoli , Shu Qiang , Fang Xiangming
Published: March 2021

Sepsis, a highly life-threatening organ dysfunction caused by uncontrollable immune responses to infection, is a leading contributor to mortality in intensive care units. Sepsis-related deaths have been reported to account for 19.7% of all global deaths. However, no effective and specific therapeutic for clinical sepsis management is available due to the complex pathogenesis. Concurrently eliminating infections and restoring immune homeostasis are regarded as the core strategies to manage sepsis. Sophisticated nanoplatforms guided by supramolecular and medicinal chemistry, targeting infection and/or imbalanced immune responses, have emerged as potent tools to combat sepsis by supporting more accurate diagnosis and precision treatment. Nanoplatforms can overcome the barriers faced by clinical strategies, including delayed diagnosis, drug resistance and incapacity to manage immune disorders. Here, we present a comprehensive review highlighting the pathogenetic characteristics of sepsis and future therapeutic concepts, summarizing the progress of these well-designed nanoplatforms in sepsis management and discussing the ongoing challenges and perspectives regarding future potential therapies. Based on these state-of-the-art studies, this review will advance multidisciplinary collaboration and drive clinical translation to remedy sepsis."Image missing"
Correction to: Combined effect of waste glass powder and recycled steel fibers on mechanical behavior of concrete
Authors: Kumar Mavoori Hitesh , Mohanta Nihar Ranjan , Samantaray Sandeep , Kumar Nagarampalli Manoj
Published: March 2021

There were spelling errors in the second author's name in the initial online publication.
Cultivating the City in Early Medieval Italy
Authors: Goodson Caroline
Published: March 2021

Food-growing gardens first appeared in early medieval cities during a period of major social, economic, and political change in the Italian peninsula, and they quickly took on a critical role in city life. The popularity of urban gardens in the medieval city during this period has conventionally been understood as a sign of decline in the post-Roman world, signalling a move towards a subsistence economy. Caroline Goodson challenges this interpretation, demonstrating how urban gardens came to perform essential roles not only in the economy, but also in cultural, religious, and political developments in the emerging early medieval world. Observing changes in how people interacted with each other and their environments from the level of individual households to their neighbourhoods, and the wider countryside, Goodson draws on documentary, archival, and archaeological evidence to reveal how urban gardening reconfigured Roman ideas and economic structures into new, medieval values.
High-entropy dual functions over finite fields and locally decodable codes
Authors: Briët Jop , Labib Farrokh
Published: March 2021

We show that for infinitely many primespthere exist dual functions of orderkover${\mathbb{F}}_p^n$that cannot be approximated in$L_\infty $-distance by polynomial phase functions of degree$k-1$. This answers in the negative a natural finite-field analogue of a problem of Frantzikinakis on$L_\infty $-approximations of dual functions over${\mathbb{N}}$(a.k.a. multiple correlation sequences) by nilsequences.
Conducting global mental health research: lessons learned from Kenya
Authors: Wasil Akash R. , Osborn Tom L. , Venturo-Conerly Katherine E. , Wasanga Christine , Weisz John R.
Published: March 2021

Mental health disorders are prevalent among youth and adolescents in low- and middle-income countries, and access to evidence-based treatments is poor. Although there is a great need for high-quality research to serve young people in low- and middle-income countries, there is limited guidance available for researchers who wish to conduct such work. Here, we describe our process of conducting school-based youth mental health work in Kenya over the last several years. We focus on five key lessons we learned that could guide future global mental health work with youth: (a) reducing stigma with strengths-focused interventions, (b) expanding access by working in schools, (c) generating buy-in from local stakeholders, (d) adapting the intervention via multicultural collaboration, and (e) applying insights from low- and middle-income countries to serve young people in high-income countries. We conclude by discussing how these lessons, and those shared by other teams, can be applied to help reduce the treatment gap for young people around the world.
Nutritional parameters and lifestyle practices of people who use drugs undergoing treatment for recovery in Lebanon: a descriptive study
Authors: Mahboub Nadine , Rizk Rana , de Vries Nanne
Published: March 2021

Drug use disorder is a major public health problem. Once people who use drugs (PWUD) are referred to treatment, addressing their lifestyle practices and improving their quality of life improves treatment outcomes. The present study assessed the nutritional status and lifestyle practices among PWUD undergoing treatment for recovery in Lebanon. Furthermore, it explored significant differences in these parameters depending on the offered treatment modality, namely opioid substitution treatment (OST) and rehabilitation. In total, 187 PWUD undergoing treatment for recovery participated in this cross-sectional study. Nutritional status and anthropometrics, dietary intake, nutrition knowledge, food addiction, biochemical parameters, sleep and physical activity were measured using validated tools. Of the participants, 88⋅8 % were well nourished based on the Subjective Global Assessment. In total, 67 % gained weight during treatment placing them in the overweight category. This increase in weight was significantly higher in the rehabilitation group. It came in parallel with higher protein and energy intakes, higher rate of food addiction, and poor nutrition knowledge. Biochemical parameters, including fasting blood sugar, total protein, lipid profile and white blood cell count, were in the normal ranges. Moreover, the majority of participants exhibited poor quality sleep that was accentuated among the participants undergoing rehabilitation, in addition to activity levels that were mainly low in the OST group. PWUD undergoing treatment for recovery in Lebanon are subject to various vulnerability factors creating challenges to treatment. Longitudinal assessments to better understand health problems arising during treatment and to identify the components of a comprehensive health promotion intervention during treatment for recovery are needed.
Oral nutritional supplement use is weakly associated with increased subjective health-related quality of life in malnourished older adults: a multicentre randomised controlled trial
Authors: Söderström Lisa , Bergkvist Leif , Rosenblad Andreas
Published: March 2021

Malnutrition is common among older adults in health-care settings and is associated with decreased quality of life (QoL). The present study aimed to investigate the effect on health-related QoL (HRQoL) among older adults after 6 months of treatment with individual dietary advice (DA) and/or oral nutritional supplements (ONS), utilising 409 patients included in a multicentre randomised controlled trial of patients ≥ 65 years old, stratified according to nutrition status (malnourished/at risk of malnutrition), admitted to hospital in Sweden 2010–2014. Patients were randomised into four arms: DA, ONS, DA + ONS or routine care (control). The intervention started at discharge from hospital, with HRQoL measured using European QoL five-dimension, three-level (EQ-5D-3L) and European QoL-visual analogue scale (EQ-VAS) at baseline and at 6-month, 1-year and 3-year follow-ups. Data were analysed using the Kruskal–Wallis test and multiple linear regression. Overall, HRQoL increased from baseline to follow-ups, although the magnitude of change in EQ-5D-3L did not differ significantly between the four arms in any of the nutrition groups. However, a significant difference was observed for change in EQ-VAS from baseline to 6-month follow-up in the malnourished group, with mean changes of 22·4 and –3·4 points for the ONS and control groups, respectively (P = 0·009). In the multiple linear regression analyses, participants in the ONS arm had 27·5, 34·4 and 38·8 points larger increases in EQ-VAS from baseline to the 6-month (P = 0·011), 1-year (P = 0·007) and 3-year (P = 0·032), respectively, follow-ups than the control group. The use of ONS improved subjectively assessed HRQoL in these malnourished older adults.
THE BEARERS OF NEWS: PRINT AND POWER IN GERMAN EAST AFRICA
Authors: Krautwald Fabian
Published: March 2021

Historians have drawn on newspapers to illuminate the origins of modern nationalism and cultures of literacy. The case ofKiongozi(The Guide or The Leader) relates this scholarship to Tanzania's colonial past. Published between 1904 and 1916 by the government of what was then German East Africa, the paper played an ambivalent role. On the one hand, by promoting the shift from Swahili written in Arabic script (ajami) to Latinized Swahili, it became the mouthpiece of an African elite trained in government schools. By reading and writing forKiongozi, thesewaletaji wa habari(bearers of news) spread Swahili inland and transformed coastal culture. On the other hand, the paper served the power of the colonial state by mediating between German colonizers and their indigenous subordinates. Beyond cooptation,Kiongozihighlights the warped nature of African voices in the colonial archive, questioning claims about print's impact on nationalism and new forms of selfhood.
Determinants of patient-reported outcome trajectories and symptomatic recovery in Improving Access to Psychological Therapies (IAPT) services
Authors: Stochl Jan , Soneson Emma , Stuart Freya , Fritz Jessica , Walsh Annabel E. L. , Croudace Tim , Hodgekins Joanne , Patel Ushma , Russo Debra A. , Knight Clare , Jones Peter B. , Perez Jesus
Published: March 2021

Background

Despite evidence for the general effectiveness of psychological therapies, there exists substantial heterogeneity in patient outcomes. We aimed to identify factors associated with baseline severity of depression and anxiety symptoms, rate of symptomatic change over the course of therapy, and symptomatic recovery in a primary mental health care setting.

Methods

Using data from a service evaluation involving 35 527 patients in England's psychological and wellbeing [Improving Access to Psychological Therapies (IAPT)] services, we applied latent growth models to explore which routinely-collected sociodemographic, clinical, and therapeutic variables were associated with baseline symptom severity and rate of symptomatic change. We used a multilevel logit model to determine variables associated with symptomatic recovery.

Results

Being female, younger, more functionally impaired, and more socioeconomically disadvantaged was associated with higher baseline severity of both depression and anxiety symptoms. Being older, less functionally impaired, and having more severe baseline symptomatology was associated with more rapid improvement of both depression and anxiety symptoms (male gender and greater socioeconomic disadvantage were further associated with rate of change for depression only). Therapy intensity and appointment frequency seemed to have no correlation with rate of symptomatic improvement. Patients with lower baseline symptom severity, less functional impairment, and older age had a greater likelihood of achieving symptomatic recovery (as defined by IAPT criteria).

Conclusions

We must continue to investigate how best to tailor psychotherapeutic interventions to fit patients’ needs. Patients who begin therapy with more severe depression and/or anxiety symptoms and poorer functioning merit special attention, as these characteristics may negatively impact recovery.
The spatio-temporal distribution of COVID-19 infection in England between January and June 2020
Authors: Elson Richard , Davies Tilman M. , Lake Iain R. , Vivancos Roberto , Blomquist Paula B. , Charlett Andre , Dabrera Gavin
Published: March 2021

The spatio-temporal dynamics of an outbreak provide important insights to help direct public health resources intended to control transmission. They also provide a focus for detailed epidemiological studies and allow the timing and impact of interventions to be assessed.

A common approach is to aggregate case data to administrative regions. Whilst providing a good visual impression of change over space, this method masks spatial variation and assumes that disease risk is constant across space. Risk factors for COVID-19 (e.g. population density, deprivation and ethnicity) vary from place to place across England so it follows that risk will also vary spatially. Kernel density estimation compares the spatial distribution of cases relative to the underlying population, unfettered by arbitrary geographical boundaries, to produce a continuous estimate of spatially varying risk.

Using test results from healthcare settings in England (Pillar 1 of the UK Government testing strategy) and freely available methods and software, we estimated the spatial and spatio-temporal risk of COVID-19 infection across England for the first 6 months of 2020. Widespread transmission was underway when partial lockdown measures were introduced on 23 March 2020 and the greatest risk erred towards large urban areas. The rapid growth phase of the outbreak coincided with multiple introductions to England from the European mainland. The spatio-temporal risk was highly labile throughout.

In terms of controlling transmission, the most important practical application of our results is the accurate identification of areas within regions that may require tailored intervention strategies. We recommend that this approach is absorbed into routine surveillance outputs in England. Further risk characterisation using widespread community testing (Pillar 2) data is needed as is the increased use of predictive spatial models at fine spatial scales.
Recurrent fibrovascular granulation on PhotoFix® bovine pericardium causing systemic and pulmonary venous obstruction after repair of scimitar syndrome
Authors: Taylor Nikki P. , Long Zsofia , Ma Michael , Arunamata Alisa
Published: March 2021

A young adult with late diagnosis of scimitar syndrome underwent infradiaphragmatic baffling of the scimitar vein to left atrium through an intra-atrial tunnel using PhotoFix® bovine pericardium with recurrent extensive fibrovascular granulation of the patch causing pulmonary and systemic venous obstruction leading to eventual explantation of the bovine pericardium.
Cardiac point of care ultrasound in resource limited settings to manage children with congenital and acquired heart disease
Authors: Muhame Rugambwa M. , Dragulescu Andreea , Nadimpalli Adi , Martinez Daniel , Bottineau Marie-Claude , Venugopal Raghu , Runeckles Kyle , Manlhiot Cedric , Nield Lynne E.
Published: March 2021

Background:

In resource limited settings, children with cardiac disease present late, have poor outcomes and access to paediatric cardiology programmes is limited. Cardiac point of care ultrasound was introduced at several Médecins Sans Frontières sites to facilitate cardiopulmonary assessment. We describe the spectrum of disease, case management and outcomes of cases reviewed over the Telemedicine platform.

Methods:

Previously ultrasound naïve, remotely placed clinical teams received ultrasound training on focussed image acquisition. The Médecins Sans Frontières Telemedicine platform was utilised for remote case and imaging review to diagnose congenital and acquired heart disease and guide management supported by a remotely situated paediatric cardiologist.

Results:

Two-hundred thirty-three cases were reviewed between 2016 and 2018. Of 191 who underwent focussed cardiac ultrasound, diagnoses included atrial and ventricular septal defects 11%, atrioventricular septal defects 7%, Tetralogy of Fallot 9%, cardiomyopathy/myocarditis 8%, rheumatic heart disease 8%, isolated pericardiac effusion 6%, complex congenital heart disease 4% and multiple other diagnoses in 15%. In 17%, there was no identifiable abnormality while 15% had inadequate imaging to make a diagnosis. Cardiologist involvement led to management changes in 75% of cases with a diagnosis. Mortality in the entire group was disproportionately higher among neonates (38%, 11/29) and infants (20%, 16/81). There was good agreement on independent review of selected cases between two independent paediatric cardiologists.

Conclusion:

Cardiac point of care ultrasound performed by remote clinical teams facilitated diagnosis and influenced management in cases reviewed over a Telemedicine platform. This is a feasible method to support clinical care in resource limited settings.
Provide Access to Information on Assisted Suicide for a Patient with a Diagnosis of Depression?
Authors: Winkler Laura , Wetterauer Charlotte
Published: March 2021

Abstract. Assisted suicide (AS) is one of the most controversially discussed topics, both in bioethical academia and in clinical practice. This is especially true for psychiatric patients. In Switzerland, the organization of AS and patient accompaniment in the dying process is practiced by lay right-to-die societies (RTDS). Despite this demedicalization, healthcare professionals are increasingly encountering AS requests in their institutions and experiencing moral uncertainty. This led to a physician’s request for clinical ethics support when confronted with an elderly patient with depression asking for information on AS: When does “assistance” start and what am I supposed and willing to do? The following clinical case report discusses these ethical questions from the perspective of the clinical ethics consultants involved. By recounting and discussing this clinical ethics case, this article aims to illustrate the difficulties that arise in daily practice, the importance of guidance and support in view of controversy, the possibilities of finding pragmatic, acceptable solutions for all parties involved, and what clinical ethics consultation can contribute.
Ocular surface indicators and biomarkers in chronic ocular graft-versus-host disease: a prospective cohort study
Authors: Pietraszkiewicz Alexandra A. , Payne Debbie , Abraham Maria , Garced Angel , Devarasetty Krishna C. , Wall Megan , Menezes Supriya M. , Ugarte Sveti , Pirsl Filip , Goklemez Sencer , Ferris Frederick L. , Barrett John , Battiwalla Minoo , Childs Richard W. , Pavletic Steven Z. , Bishop Rachel J.
Published: March 2021

This longitudinal cohort study compared ocular surface indicators in forty allogeneic hematopoietic stem cell transplant (HSCT) subjects with twenty healthy controls at baseline and identified changes in ocular graft-versus-host disease (oGVHD). Outcome measures included: Ocular Surface Disease Index (OSDI), tear osmolarity, Schirmer’s test, Oxford corneal staining score, tear break-up time (TBUT), and tear and serum biomarkers (IFN-γ, IL-10, MMP-9, IL-12, IL-13, IL-17α, IL-1β, IL-2, IL-4, IL-6, IL-8, CXCL10, MCP-1, MIP-1α, RANTES, TNF-α). At baseline the HSCT group had higher median Oxford corneal staining score (1.7 vs. 0.0; P < 0.0001), higher tear TNF-α (20.0 vs. 11.2 pg/mL; P < 0.0001), lower tear RANTES (70.4 vs. 190.2 pg/mL; P < 0.0001), higher serum IL-8 (10.2 vs. 4.5 pg/mL; P = 0.0008), and higher serum TNF-α (8.7 vs. 4.2 pg/mL; P < 0.0001). The incidence of oGVHD was 62% and associated changes included increased Oxford corneal staining score (4.6 vs. 1.8, P = 0.0001), decreased Schirmer’s test (3.0 vs. 10.0; P < 0.0001), and decreased TBUT (4.7 vs. 9.0 s; P = 0.0004). Baseline differences in ocular surface indicators suggest a tendency toward ocular dryness in individuals with hematologic disorders preparing for HSCT. Individuals who developed oGVHD showed changes in corneal staining score, Schirmer’s test, and TBUT.
Electrical transport properties and Kondo effect in La1−xPrxNiO3−δ thin films
Authors: Hien-Hoang Van , Chung Nak-Kwan , Kim Heon-Jung
Published: March 2021

The Kondo effect has been a topic of intense study because of its significant contribution to the development of theories and understanding of strongly correlated electron systems. In this work, we show that the Kondo effect is at work in La1−xPrxNiO3−δ (0 ≤ x ≤ 0.6) thin films. At low temperatures, the local magnetic moments of the 3d eg electrons in Ni2+, which form because of oxygen vacancies, interact strongly with itinerant electrons, giving rise to an upturn in resistivity with x ≥ 0.2. Observation of negative magnetoresistance, described by the Khosla and Fisher model, further supports the Kondo picture. This case represents a rare example of the Kondo effect, where Ni2+ acts as an impurity in the background of Ni3+. We suggest that when Ni2+ does not participate in the regular lattice, it provides the local magnetic moments needed to scatter the conduction electrons in the Kondo effect. These results offer insights into emergent transport behaviors in metallic nickelates with mixed Ni3+ and Ni2+ ions, as well as structural disorder.
Author Correction: Validation of Clinical Treatment Score post-5 years (CTS5) risk stratification in premenopausal breast cancer patients and Ki-67 labelling index
Authors: Lee Janghee , Cha Chihwan , Ahn Sung Gwe , Kim Dooreh , Park Soeun , Bae Soong June , Kim Jeeye , Park Hyung Seok , Park Seho , Kim Seung Il , Park Byeong‑Woo , Jeong Joon
Published: March 2021

An amendment to this paper has been published and can be accessed via a link at the top of the paper.
Haplotypes of FOXP3 genetic variants are associated with susceptibility, autoantibodies, and TGF-β1 in patients with systemic lupus erythematosus
Authors: Stadtlober Nicole Perugini , Flauzino Tamires , da Rosa Franchi Santos Lorena Flor , Iriyoda Tatiana Mayumi Veiga , Costa Neide Tomimura , Lozovoy Marcell Alysson Batisti , Dichi Isaias , Reiche Edna Maria Vissoci , Simão Andréa Name Colado
Published: March 2021

The aim of this study was to evaluate the association of rs2232365 (-924 G > A) and rs3761548 (-3279 C > A) FOXP3 variants with systemic lupus erythematosus (SLE) susceptibility, TGF-β1 plasma levels, autoantibodies, and LN nephritis, and SLE disease activity index (SLEDAI). The study included 196 SLE female patients and 157 female controls. FOXP3 variants were determined with polymerase chain reaction-restriction fragment length polymorphism (PCR–RFLP). Plasma levels of TGF-β1 were determined using immunofluorimetric assay. The AA genotype [OR: 2.650, CI 95%(1.070–6.564), p = 0.035] and A allele [OR: 2.644, CI 95%(1.104–6.333), p = 0.029] were associated with SLE diagnosis in the -3279 C > A. The A/A haplotype was associated with SLE [OR: 3.729, CI 95%(1.006–13.820), p = 0.049]. GCGC haplotype patients had higher TGF-β1 levels (p = 0.012) than other haplotypes. Patients with -924 AA genotype showed higher frequency of anti-dsDNA (p = 0.012) and anti-U1RNP (p = 0.036). The A/C haplotype had higher SLEDAI score [OR: 1.119, CI 95%(1.015–1.234), p = 0.024] and ACAC haplotype higher frequency of anti-dsDNA [OR: 3.026, CI 95%(1.062–8.624), p = 0.038], anti-U1RNP [OR: 5.649, CI 95%(1.199–26.610), p = 0.029] and nephritis [OR: 2.501, CI 95%(1.004–6.229), p = 0.049]. Our data demonstrate that the G/C haplotype provides protection for SLE. While the presence of allele A of both variants could favor autoimmunity, disease activity, and LN.
Characterisation, identification, clustering, and classification of disease
Authors: Webster A. J. , Gaitskell K. , Turnbull I. , Cairns B. J. , Clarke R.
Published: March 2021

The importance of quantifying the distribution and determinants of multimorbidity has prompted novel data-driven classifications of disease. Applications have included improved statistical power and refined prognoses for a range of respiratory, infectious, autoimmune, and neurological diseases, with studies using molecular information, age of disease incidence, and sequences of disease onset (“disease trajectories”) to classify disease clusters. Here we consider whether easily measured risk factors such as height and BMI can effectively characterise diseases in UK Biobank data, combining established statistical methods in new but rigorous ways to provide clinically relevant comparisons and clusters of disease. Over 400 common diseases were selected for analysis using clinical and epidemiological criteria, and conventional proportional hazards models were used to estimate associations with 12 established risk factors. Several diseases had strongly sex-dependent associations of disease risk with BMI. Importantly, a large proportion of diseases affecting both sexes could be identified by their risk factors, and equivalent diseases tended to cluster adjacently. These included 10 diseases presently classified as “Symptoms, signs, and abnormal clinical and laboratory findings, not elsewhere classified”. Many clusters are associated with a shared, known pathogenesis, others suggest likely but presently unconfirmed causes. The specificity of associations and shared pathogenesis of many clustered diseases provide a new perspective on the interactions between biological pathways, risk factors, and patterns of disease such as multimorbidity.
Spectral collapse in multiqubit two-photon Rabi model
Authors: Lo C. F.
Published: March 2021

We have shown that the smallest possible singel-qubit critical coupling strength of the N-qubit two-photon Rabi model is only 1/N times that of the two-photon Rabi model. The spectral collapse can thus occur at a more attainable value of the critical coupling. For both of the two-qubit and three-qubit cases, we have also rigorously demonstrated that at the critical coupling the system not only has a set of discrete eigenenergies but also a continuous energy spectrum. The discrete eigenenergy spectrum can be derived via a simple one-to-one mapping to the bound state problem of a particle of variable effective mass in the presence of a finite potential well and a nonlocal potential. The energy difference of each qubit, which specifies both the depth of the finite potential well and the strength of the nonlocal potential, determines the number of bound states available, implying that the extent of the incomplete spectral collapse can be monitored in a straightforward manner.