bluuebunny/crossref_metadata_2025 huggingface dataset:
The influence of social relationships and activities on the health of adults with obesity: A qualitative study
Authors: Serrano‐Fuentes Nestor , Rogers Anne , Portillo Mari Carmen
Published: June 2022

Background

Obesity in adults is a leading health challenge that causes millions of deaths worldwide and represents a risk factor for developing long‐term conditions. Social relationships are one of the multiple drivers shaping obesity and obesity‐related practices. However, there is still little evidence as to the processes by which relationships influence the adoption of positive and negative obesity health‐related practices—eating, physical activity and alcohol intake. This study aims first to identify the types of relationships relevant to the adoption of practices in adults with obesity and, second, to explore the type of activities these relationships engage with or promote to produce those practices and their potential health consequences.

Methods

Nineteen adults who have or had a history of obesity living in the United Kingdom were interviewed between May 2020 and March 2021. Experiences were explored through semi‐structured interviews and network mapping via videoconferencing. Data were analysed using a hermeneutic phenomenology informed thematic analysis.

Results

Three main themes were identified: (1) everyday familial routines matter, (2) chasing healthier lifestyles: comparing, modelling and connecting emotionally with friends and (3) healthcare professionals as negative influencers.

Discussion and Conclusions

Findings show how different types of relationships might shape the risk of developing and losing weight. They uncover the power of informal networks (family and friends) and highlight the potentially negative impact of formal ones (healthcare professionals). Our exploration could add to arguments about the need for stakeholders confronting obesity to be aware of the relevance of everyday social relationships in health and well‐being strategies for tackling the issue, in creating collective and individual person‐centred long‐term sustainable actions.

Patient and Public Contribution

Feedback on the tone/content of the interview questions was provided by the two first participants. The results were checked and received feedback from one of the interviewees.
Tumor shrinkage patterns of nivolumab monotherapy in metastatic renal cell carcinoma
Authors: Hamada Kosuke , Fujiwara Ryo , Takemura Kosuke , Komai Yoshinobu , Oguchi Tomohiko , Numao Noboru , Yamamoto Shinya , Yonese Junji , Yuasa Takeshi
Published: June 2022

Objectives

To investigate the tumor shrinkage patterns of patients with metastatic renal cell carcinoma treated with nivolumab monotherapy.

Methods

Forty‐four consecutive patients with metastatic renal cell carcinoma treated with nivolumab monotherapy (81 metastatic and four primary lesions) between September 2013 and December 2020 were retrospectively analyzed. The tumor shrinkage rate of individual visceral and lymph node metastatic lesions and the primary site lesions treated with nivolumab monotherapy, as well as the association between overall survival and pretreatment tumor size, were statistically assessed.

Results

Pretreatment tumor size for the total and individual target lesions, which included kidneys, lungs, pancreas, and lymph nodes, were not correlated with tumor shrinkage rate. The tumor shrinkage rate was found to have no significant association with pretreatment tumor size between any organ. In addition, there is no significant difference in tumor shrinkage rate between larger (>median value) and smaller (<median value) pretreatment tumor size in any organ. Finally, there was no significant difference in overall survival between larger and smaller pretreatment tumor size.

Conclusions

Pretreatment tumor size was not associated with the tumor shrinkage rate and overall survival in nivolumab monotherapy.
Kidney impairment and outcomes in acute ischaemic stroke
Authors: Nagaraja Nandakumar , Farooqui Amreen , Ballur Narayana Reddy Varalakshmi , Shukla Ashutosh M.
Published: June 2022

Background

Chronic kidney disease (CKD) is associated with increased risk of stroke and mortality.

Aims

To evaluate the clinical and imaging features and outcomes of patients with and without kidney impairment among t admitted for acute ischaemic stroke (AIS).

Methods

AIS patients with brain magnetic resonance imaging (MRI) were included in the study. Kidney impairment was defined by an admission estimated glomerular filtration rate < 60 mL/min/1.73 m2. Cerebral microbleeds (CMB) and white matter hyperintensities (WMH) were evaluated using the Microbleed Anatomical Rating Scale and Fazekas scales, respectively. Primary outcomes were defined by modified Rankin Scale (mRS) and discharge disposition. Multivariate logistic regression analysis was performed to evaluate factors associated with the presence of kidney impairment and poor discharge outcomes.

Results

Of the 285 patients with AIS, 80 had kidney impairment on admission. Patients with kidney impairment were older (mean age ± standard deviation: 74.7 ± 12.9 vs 64.4 ± 13.8 years, P < 0.0001) and had more neurological deficits on National Institutes of Health Stroke Scale (NIHSS) score (median 8.5 vs 5, P = 0.02). In unadjusted analysis, patients with kidney impairment were less likely to have a good functional outcome (mRS 0–2: 36% vs 57%, P = 0.002) and good discharge outcome (home or inpatient rehabilitation: 68% vs 82%, P = 0.008). On multivariate analysis, kidney impairment was associated with higher NIHSS score (odds ratio (OR) = 1.04; 95% confidence interval (CI) = 1.002–1.08) and severe WMH (OR = 1.99; 95% CI = 1.06–3.77) suggestive of small vessel disease, but kidney impairment was not associated with poor discharge outcome (OR = 1.62; 95% CI = 0.75–3.53).

Conclusion

Presence of kidney impairment at the time of stroke presentation, regardless of previous renal function, is associated with more neurological deficits and severe WMH on MRI.
Effect of diabetes and prediabetes on the development of disability and mortality among middle‐aged Japanese adults: A 22‐year follow up of NIPPON DATA90
Authors: Tran Ngoc Hoang Phap , Kadota Aya , Yano Yuichiro , Harada Akiko , Hayakawa Takehito , Okamoto Shohei , Miyagawa Naoko , Kondo Keiko , Okukda Nagako , Kita Yoshiuni , Okayama Akira , Fujita Yukihiro , Maegawa Hiroshi , Miura Katsuyuki , Okamura Tomonori , Ueshima Hirotsugu ,   NIPPON DATA90 Research Group
Published: June 2022

Aims/Introduction

To examine the association between diabetes and prediabetes at baseline, and disability, mortality over a 22‐year period among middle‐aged Japanese adults.

Materials and Methods

Participants consisted of 1,788 adults aged 45–64 years at baseline from the cohort study National Integrated Project for Prospective Observation of Non‐communicable Disease and its Trends in the Aged 1990 (NIPPON DATA90). Disability, defined as having a decline in activities of daily living (ADL), was assessed by a modified Katz questionnaire at four time points. Disability and death without disability for 22‐year follow up were used as outcomes to test the association with a diagnosis of diabetes or prediabetes at baseline, using multinomial logistic regression. Adjusted odds ratios (ORs) were obtained from four models that contained appropriate adjustment factors, such as age, sex, smoking status, drinking status, body mass index and cardiovascular risk factors (hypertension, hypercholesterolemia, triglycerides, low serum high‐density lipoprotein), at baseline.

Results

In the present study, 334 participants (18.7%) reported at least one disability, and 350 (19.6%) were reported dead without observation of disability during follow up. Adjusting sex and other risk factors, participants with diabetes and prediabetes had a higher risk for disability (OR 1.43, 95% confidence interval [CI] 1.07–1.91 and OR 1.66, 95% CI 1.10–2.50, respectively) and for mortality (OR 1.56, 95% CI 1.16–2.08 and OR 1.77, 95% CI 1.18–2.65, respectively) than individuals with normal glucose tolerance.

Conclusions

In middle‐aged Japanese adults, individuals with diabetes and prediabetes were more likely to be associated with disability and mortality. Our findings suggest that prediabetes and diabetes in middle‐aged adults should be paid more attention, and requires more intervention to prevent disability and mortality in later life.
Neuroimaging in cerebellar ataxia in childhood: A review
Authors: Serrallach Bettina L. , Orman Gunes , Boltshauser Eugen , Hackenberg Annette , Desai Nilesh K. , Kralik Stephen F. , Huisman Thierry A. G. M.
Published: June 2022

Ataxia is one of the most common pediatric movement disorders and can be caused by a large number of congenital and acquired diseases affecting the cerebellum or the vestibular or sensory system. It is mainly characterized by gait abnormalities, dysmetria, intention tremor, dysdiadochokinesia, dysarthria, and nystagmus. In young children, ataxia may manifest as the inability or refusal to walk. The diagnostic approach begins with a careful clinical history including the temporal evolution of ataxia and the inquiry of additional symptoms, is followed by a meticulous physical examination, and, depending on the results, is complemented by laboratory assays, electroencephalography, nerve conduction velocity, lumbar puncture, toxicology screening, genetic testing, and neuroimaging. Neuroimaging plays a pivotal role in either providing the final diagnosis, narrowing the differential diagnosis, or planning targeted further workup. In this review, we will focus on the most common form of ataxia in childhood, cerebellar ataxia (CA). We will discuss and summarize the neuroimaging findings of either the most common or the most important causes of CA in childhood or present causes of pediatric CA with pathognomonic findings on MRI. The various pediatric CAs will be categorized and presented according to (a) the cause of ataxia (acquired/disruptive vs. inherited/genetic) and (b) the temporal evolution of symptoms (acute/subacute, chronic, progressive, nonprogressive, and recurrent). In addition, several illustrative cases with their key imaging findings will be presented.
Influenza vaccine administration in a paediatric intensive care unit
Authors: Elia Sonja , Moore Yvette , Duke Trevor , Crawford Nigel W , Tosif Shidan
Published: June 2022

Aim

We describe the clinical profile of children and outcomes of influenza immunisation for patients in a paediatric intensive care unit (PICU).

Methods

Over two influenza seasons: 19/04/2018 to 07/08/2018 and 02/05/2019 to 10/10/2019, an immunisation nurse and PICU nurse coordinator met weekly and identified patients to receive the influenza vaccine. An inpatient list of PICU patients was screened for eligible patients: greater than 6 months of age, did not have imminent procedures (e.g. surgery) or were not critically unwell, as determined by the treating team, to receive the influenza vaccine. Patients were excluded if they had undergone surgery in the previous 24 hours or were being treated palliatively.

Results

Sixty patients in PICU were identified, with 43% (26/60) receiving the vaccine while in PICU and 17% (10/60) once discharged from PICU to the general ward environment. The majority of patients immunised were in PICU due to cardiac surgery/cardiology or general medical conditions, such as cerebral palsy or RSV bronchiolitis. There were no reported adverse events following immunisation.

Conclusions

We have demonstrated the suitability and acceptability of children in the PICU receiving the seasonal influenza vaccine and tailored interventions to follow‐up once discharged from PICU to optimise protection.
Instrumental texture assessment of IDDSI texture levels for dysphagia management. Part 1: Thickened fluids
Authors: Hadde Enrico Karsten , Prakash Sangeeta , Chen Wei , Chen Jianshe
Published: June 2022

Thickened fluids are commonly used in the medical management of individuals who suffer from swallowing difficulty (known as dysphagia). International Dysphagia Diet Standardization Initiative (IDDSI) developed a standardized terminology and description for texture‐modified foods and thickened fluids to allow dysphagia patients to receive the correct consistency of food/drink. Syringe flow test and fork drip test are suggested by IDDSI to identify the drink category (IDDSI Levels 1–4). These practical methods are widely welcomed by carers and patients because of their simplicity. However, these methods are not most feasible for industrial applications, where objective measurements are required for industry for the purpose of quality control of such products. Therefore, our aim in this work was to develop quantitative and objective measurements that best describe IDDSI level category for use as an objective framework. Two measuring techniques, syringe flow test and fork drip test, recommended by IDDSI were evaluated in two different sets of experiment. Participants were recruited to categorize fluid samples of known texture parameters using syringe flow test and fork drip test techniques. The apparent stress measured from Ball‐Back Extrusion (BBE) technique for each of the fluid category (IDDSI Levels 1–4) was calculated. Bands of apparent stress for each of the fluid category were developed from two measuring techniques, syringe flow test and fork drip test. An inconsistency was observed between these two measuring techniques for IDDSI Level 3 fluid due to different dominating factors in the two tests. However, we proposed to combine the results from the two experiments to develop a quantitative range for each IDDSI Level as objective complements to the IDDSI Framework. Thickened fluid manufacturers are encouraged to follow the proposed guidelines presented once they are clinically validated and use them fine‐tune their products, thus enhancing the safety of individuals with dysphagia.
Viral hepatitis in pregnancy
Authors: Shata Mohamed Tarek M. , Hetta Helal F. , Sharma Yeshika , Sherman Kenneth E.
Published: June 2022

Viral hepatitis is caused by a heterogenous group of viral agents representing a wide range of phylogenetic groups. Many viruses can involve the liver and cause liver injury but only a subset are delineated as ‘hepatitis viruses’ based upon their primary site of replication and tropism for hepatocytes which make up the bulk of the liver cell population. Since their discovery, beginning with the agent that caused serum hepatitis in the 1960s, the alphabetic designations have been utilized. To date, we have five hepatitis viruses, A through E, though it is postulated that others may exist. This chapter will focus on those viruses. Note that hepatitis D is included as a subset of hepatitis B, as it cannot exist without concurrent hepatitis B infection. Pregnancy has the potential to affect all aspects of these viral agents due to the unique immunologic and physiologic changes that occur during and after the gestational period. In this review, we will discuss the most common viral hepatitis and their effects during pregnancy.
Pharmacokinetics of meloxicam in laying hens after single intravenous, oral, and intramuscular administration
Authors: Shao Hao‐Tian , Yang Fang , Chen Jun‐Cheng , Zhang Mei , Song Zhe‐Wen , Yang Fan
Published: June 2022

The objective of this study was to determine the pharmacokinetics of meloxicam after a single intravenous (IV), intramuscular (IM), and oral (PO) dose at 1 mg/kg body weight in Jing Hong laying hens. Blood samples were collected at predetermined time points. Plasma meloxicam concentrations were determined using a validated high‐performance liquid chromatography (HPLC) assay method and then subjected to a non‐compartmental analysis. After IV administration, meloxicam had a mean (±SD) volume of distribution at steady‐state (Vdss) of 206.50 ± 25.23 ml/kg, a terminal half‐life (t1/2λ) of 5.45 ± 0.53 h, and a total body clearance (Cl) of 26.48 ± 4.13 ml/h/kg. After PO and IM administration, meloxicam was absorbed relatively rapidly: the peak concentrations (Cmaxs) of 3.04 ± 0.56 and 8.94 ± 2.31 μg/ml were observed at 3.08 and 0.80 h, respectively. After PO and IM administration, the absolute bioavailability (F) was determined as 70.13% and 125.50%, respectively. Assuming that hens shared the same analgesic threshold of meloxicam (0.5 μg/ml) with humans, the plasma concentrations after three different routes (PO, IM, and IV) of administration were above this value for 16.7, 19.2, and 14.9 h, respectively.
Treatment of hepatitis delta and HIV infection
Authors: Soriano Vicente , de Mendoza Carmen , Treviño Ana , Ramos‐Rincón José Manuel , Moreno‐Torres Víctor , Corral Octavio , Barreiro Pablo
Published: June 2022

Hepatitis delta virus (HDV) is a defective agent that only infects individuals with hepatitis B virus (HBV). Around 5–10% of chronic hepatitis B patients worldwide are superinfected with HDV, which means 15–25 million people. Hepatitis delta is the most severe of all chronic viral hepatitis, leading to cirrhosis, liver cancer and/or transplantation in most patients. Despite it, many HDV patients remain undiagnosed. The only treatment available until recently was peginterferon alfa, with poor results and significant side effects. The recent approval of bulevirtide, a lipopeptide that blocks HBV/HDV entry, has revolutionized the field. Another drug, lonafarnib, already approved to treat progeria, is expected to be available soon as HDV therapy. Since there is no cell reservoir for the HDV RNA genome, hypothetically viral clearance could be achieved if complete blocking of viral replication occurs for a minimum time frame. This is what happens in hepatitis C using direct‐acting antivirals, with the achievement of cure in nearly all treated patients. We envision the cure of hepatitis delta using combination antiviral therapy. Given that sexual and parenteral transmission routes are the most frequent for the acquisition of HBV and HDV, shared with HIV infection and HBV/HDV and HIV coinfection. The clinical outcome of hepatitis delta is worst in the HIV setting, with more frequent liver complications. Since most persons infected with HIV are on regular health care follow‐up, we propose that HIV‐HDV patients should be prioritized for moving forward new and potentially curative treatments for hepatitis delta.
A pathologically confirmed case of combined amyotrophic lateral sclerosis with C9orf72 mutation and multiple system atrophy
Authors: King Andrew , Lee Yuan Kai , Jones Shalmai , Troakes Claire
Published: June 2022

Hexanucleotide repeat expansions in C9orf72 account for a large proportion of cases of amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration. There have been occasional reported cases associated with this expansion but also additional extrapyramidal clinical features. However, only very rarely has there been pathological confirmation of a parkinsonian syndrome associated with a C9orf72 repeat expansion. To date, as far as we are aware, there have been no reported pathologically confirmed cases of ALS with C9orf72 mutation and multiple system atrophy (MSA). We report a case of a man who initially presented with extrapyramidal features, including cogwheel rigidity, and, therefore, was clinically considered likely to have Parkinson's disease or a parkinsonian syndrome. Subsequent examination six months later revealed additional abnormal upper and lower motor neuron signs, raising the strong possibility of ALS. He had a rapid clinical decline and died 16 months after the first presentation. It was noted that his father also had ALS, and that his mother had a parkinsonian syndrome, suggestive of progressive supranuclear palsy. The macroscopic and microscopic examination of the brain and spinal cord revealed ALS pathology with neuronal loss, especially of the anterior horns of the cord and the motor cortex. This was associated with numerous neuronal cytoplasmic inclusions immunoreactive for phosphorylated transactivation response DNA‐binding protein of 43 Da (TDP43). There were additional pathological features, including p62‐immunoreactive cerebellar neuronal cytoplasmic inclusions, fully in keeping with a C9orf72 repeat expansion, and this was confirmed on molecular analysis. However, there was also α‐synuclein pathology in the form of oligodendroglial cytoplasmic inclusions in the basal ganglia, cerebellum, and brainstem, indicative of MSA. To our knowledge, this is the first reported case of pathologically confirmed combined ALS‐C9orf72 and MSA.
Nursing students' motivational and self‐regulated learning during the COVID‐19 pandemic: A cross‐sectional study
Authors: Cho Sunhee , Jang Sun Joo
Published: June 2022

On‐site clinical training, which has been greatly hindered during the COVID‐19 pandemic, is essential in nursing practicum. This study aimed to identify the predictors of nursing students' motivational and self‐regulated learning in clinical nursing practicum during the pandemic. This cross‐sectional study aimed to identify the predictors of motivational and self‐regulated learning among nursing students in clinical nursing practicum during the COVID‐19 pandemic. An online survey was completed by 195 nursing students in Korea in 2021. Students' moral sensitivity and motivational and self‐regulated learning were assessed using the Moral Sensitivity Questionnaire and the Motivated Strategies for Learning Questionnaire. Multiple regression analysis revealed that moral sensitivity was the most potent predictor of motivational and self‐regulated learning, followed by online clinical practicum experience, determination to become a nurse, and online practicum type; these factors explained 21.0% of the variance. Practicum courses using a tailored hybrid model, combining online and in‐person approaches for imparting nursing practices and inspiring moral sensitivity, can enhance nursing students' motivational and self‐regulated learning. Modules to enhance nursing students' moral sensitivity should be included in online practicum curricula.
Research Deserts and Oases: Evidence from 27 Thousand Economics Journal Articles on Africa*
Authors: Porteous Obie
Published: June 2022

The distribution of economics research across Africa's 54 countries is highly uneven. I use a simple conceptual model and reduced‐form regressions with cross‐sectional, panel, and subnational data to explore the determinants of this distribution. Of the variation in research across countries, 93% can be explained by peacefulness, political institutions, international tourist arrivals, having English as an official language, and population. Within countries, research is concentrated in regions with higher income and large urban areas. Most research on African countries is context‐specific, so the lack of research in many countries and regions means a smaller potential evidence base for local policymakers.
Microcystic lymphatic malformation presenting as firm, skin‐colored papules of the lips
Authors: Edminister John R. , Zarbo Allison , Seale Lauren , Friedman Ben J. , Shwayder Tor
Published: June 2022

Microcystic lymphatic malformation (MiLM), also known as lymphangioma circumscriptum, is a superficial collection of lymphatic vessels measuring <1 cm in the largest diameter, often with a more extensive deeper malformation. It commonly presents as discrete or grouped plaques of clear or hemorrhagic vesicles classically described as “frogspawn”; however, here we describe a case of its unique presentation as firm papules on the lips of a healthy six‐year‐old child. These skin‐colored papules in the absence of vesicles with lymphatic and/or hemorrhagic fluid may not be clinically indicative of MiLM. This case represents a diagnostic challenge due to the unique morphology of pink, fleshy papules as opposed to the clear or hemorrhagic vesicles typically observed in MiLM.
The oxidized cellooligosaccharides confer thermotolerance in Arabidopsis by priming ethylene via heat shock factor A2
Authors: Zarattini Marco , Choaibi Ali , Magri Silvia , Hermans Christian , Cannella David
Published: June 2022

Global climate change, especially heatwaves and aridity, is a major threat to agricultural production and food security. This requires common efforts from the scientific community to find effective solutions to better understand and protect the plant's vulnerabilities to high temperatures. The current study demonstrates the potential of cellooligosaccharides (COS), which are native and oxidized signaling molecules released by lytic polysaccharide monooxygenases (LPMO) enzymes during cell wall degradation by microbial pathogens. The extracellular perception of COS leads to the activation of damage‐triggered immunity, often protecting the plant against biotic stress. However, how these signaling molecules affect abiotic stress tolerance is poorly understood. Here, we show that native COS and oxidized COS (oxiCOS) perception increase the transcript levels of several HEAT SHOCK FACTORS (HSFs) and HEAT SHOCK PROTEINS (HSPs) genes in Arabidopsis plants. However, only oxiCOS treatment triggers ethylene priming and increases thermotolerance. Furthermore, the function of the transcription factor HSFA2 is required for these processes. Altogether, our results indicate that the perception of Damage‐Associated Molecular Patterns (DAMPs) may improve tolerance to adverse abiotic conditions, like exposure to high temperatures.
The role of gastrointestinal pathogen polymerase chain reaction testing in liver transplant recipients hospitalized with diarrhea
Authors: Ching Charlotte K. , Nobel Yael R. , Pereira Marcus R. , Verna Elizabeth C.
Published: June 2022

Background

Diarrhea is a common symptom among liver transplant (LT) recipients and can result in significant morbidity. The utility of PCR‐based multiplex gastrointestinal (GI) pathogen panels in this population is unknown.

Methods

We assessed incidence, predictors, and outcomes of GI PCR positivity among inpatients who underwent stool pathogen testing with the FilmArray multiplex GI PCR panel at our institution within 1 year following LT from April 2015 to December 2019.

Results

A total of 112 patients were identified. Of these, 14 (12.5%) had a positive PCR for any pathogen. Escherichia coli (n = 9) and Norovirus (n = 5) were the most common pathogens detected. Recipients with a positive PCR were significantly further from LT (median 74.5 vs. 15.5 days, p < .01) and tested earlier during hospitalization (median 1.0 vs. 9.0 days, p < .01). C. difficile was positive in 20.0% of patients with a positive PCR and 11.4% with a negative PCR. CMV viremia was observed in 11.6% of patients, all in the negative PCR group. Following a positive PCR, patients were more likely to have a change in antimicrobial regimen (71.4% vs. 28.6%, p = .02), a shorter length of stay (median 7.5 vs. 17.5 days, p < .01), and a trend toward lower rates of readmission and colonoscopy within 30 days.

Conclusions

In hospitalized LT recipients with diarrhea, GI PCR pathogen identification was associated with the use of targeted antimicrobial therapy and a shorter length of stay. GI PCR testing should be considered early during admission and later in the post‐LT period.

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Desirability of outcome ranking and quality life measurement for antimicrobial research in organ transplantation
Authors: Doernberg Sarah B. ,   MAS for the Antibacterial Resistance Leadership Group
Published: June 2022

Background

Current clinical trials of new antibiotics facilitate bringing new drugs to market but often fail to provide useful information for clinical decision making.

Methods

Literature review of desirability of outcome ranking (DOOR) in antibiotic clinical trials and description how DOOR can fit into design, administration, and assessment of clinical trials.

Results

DOOR is an approach that addresses many of the shortcomings of current trials by incorporating efficacy and safety into a single outcome to analyze the patient experience in its entirety. Application of partial credit, tiebreaker strategies including response adjusted for duration of antibiotic risk (RADAR), and DOOR for Management of Antimicrobial Therapy (DOOR MAT) provides additional nuance and granularity. To address pitfalls of DOOR, investigators must develop the DOOR a priori, ideally with input from and incorporation of patient voices, and should perform component analysis to ensure that imbalances in key components are detected.

Conclusion

Inclusion of DOOR in clinical trials will enrich our understanding of how new antibiotics might benefit patients who have had transplantation. Additional work to develop best practices for DOOR selection, analysis, and interpretation must continue, and incorporation of the patient perspective is essential.
Rate of D‐alloimmunization in trauma does not depend on the number of RhD‐positive units transfused: The BEST collaborative study
Authors: Seheult Jansen N. , Callum Jeannie , Delaney Meghan , Drake Rosanna , Dunbar Nancy M. , Harm Sarah K. , Hess John R. , Jackson Bryon P. , Javanbakht Ayda , Moore Sarah A. , Murphy Michael F. , Raval Jay S. , Staves Julie , Tuott Erin E. , Wendel Silvano , Ziman Alyssa , Yazer Mark H. ,   The Biomedical Excellence for Safer Transfusion collaborative
Published: June 2022

Background

Evidence indicates the life‐saving benefits of early blood product transfusion in severe trauma resuscitation. Many of these products will be RhD‐positive, so understanding the D‐alloimmunization rate is important.

Methods

This was a multicenter, retrospective study whereby injured RhD‐negative patients between 18–50 years of age who received at least one unit of RhD‐positive red blood cells (RBC) or low titer group O whole blood (LTOWB) during their resuscitation between 1 January, 2010 through 31 December, 2019 were identified. If an antibody detection test was performed ≥14 days after the index RhD‐positive transfusion then basic demographic information was collected, including whether the patient became D‐alloimmunized. The overall D‐alloimmunization rate, and the rate stratified by the number of units transfused, were calculated.

Results

Data were collected from nine institutions. Five institutions reported fewer than 10 eligible patients each and were excluded. From the remaining four institutions, all from the USA, there were 235 eligible patients; 77 (random effects estimate: 32.7%; 95% CI: 19.1–50.1%) became D‐alloimmunized. Three of the institutions reported D‐alloimmunization rates ≥38.6%, while the remaining institution's rate was 12.2%. In both random and fixed‐effects models, the rate of D‐alloimmunization was not significantly different between those who received one RhD‐positive unit and those who received multiple RhD‐positive units.

Conclusion

In this large, multicenter study of injured patients, the overall rate of D‐alloimmunization fell within the range previously reported. The rate of D‐alloimmunization did not increase as the number of transfused RhD‐positive units increased. These data can help to inform RhD type selection decisions.
Hypocalcemia as a predictor of mortality and transfusion. A scoping review of hypocalcemia in trauma and hemostatic resuscitation
Authors: Kronstedt Shane , Roberts Nicholas , Ditzel Ricky , Elder Justin , Steen Aimee , Thompson Kelsey , Anderson Justin , Siegler Jeffrey
Published: June 2022

Background

Calcium plays an essential role in physiologic processes, including trauma's “Lethal Diamond.” Thus, inadequate serum calcium in trauma patients exacerbates the effects of hemorrhagic shock secondary to traumatic injury and subsequently poorer outcomes compared to those with adequate calcium levels. Evidence to date supports the consideration of calcium derangements when assessing the risk of mortality and the need for blood product transfusion in trauma patients. This review aims to further elucidate the predictive strength of this association for future treatment guidelines and clinical trials.

Methods

Publications were collected on the relationship between i‐Ca and the outcomes of traumatic injuries from PubMed, Web of Science, and CINAHL. Manuscripts were reviewed to select for English language studies. Hypocalcemia was defined as i‐Ca <1.2 mmol/L.

Results

Using PRISMA guidelines, we reviewed 300 studies, 7 of which met our inclusion criteria. Five papers showed an association between hypocalcemia and mortality.

Conclusions

In adult trauma patients, there has been an association seen between hypocalcemia, mortality, and the need for increased blood product transfusions. It is possible we are now seeing an association between low calcium levels prior to blood product administration and an increased risk for mortality and need for transfusion. Hypocalcemia may serve as a biomarker to show these needs. Therefore, hypocalcemia could potentially be used as an independent predictor for multiple transfusions such that ionized calcium measurements could be used predictively, allowing faster administration of blood products.
Screening platelet function in blood donors
Authors: Pedini Pascal , Baudey Jean‐Baptiste , Pouymayou Katia , Falaise Celine , Ibrahim‐Kosta Manal , Vélier Melanie , Demerle Clémence , Graiet Hajer , Dragutini Catherine , Dombey Anne‐marie , Chiaroni Jacques , Alessi Marie Christine , Picard Christophe
Published: June 2022

Background

Transfusion of defective platelets could contribute to the inefficiency of platelet transfusion in preventing or stopping bleeding.

Study Design and Methods

This single‐center prospective study aimed to determine the prevalence of functional platelet abnormalities in a population of blood donors with a clinical history of bleeding diathesis or with history of hematoma (>4 cm) during blood donation. Donors with positive bleeding screening questionnaire were referred to the reference center for rare platelet diseases at La Timone University Hospital (Marseille) to confirm the bleeding tendency using a more extensive bleeding questionnaire (MCMDMscore) and to assess hemostasis, including a comprehensive platelet analysis.

Results

One hundred and ninety‐five donors identified based on a history of hematoma and 2434 blood donors were included in the study. Eighty‐eight donors (3.6%) had a bleeding score indicating a potential bleeding disorder. Five donors with a history of hematoma (2.5%) and 15 (17%) donors with a confirmed bleeding score underwent hemostatic analysis, including two men and 18 women with average age of 33.9 years. Minor hemostatic abnormalities were observed in three donors. Two donors exhibited accelerated fibrinolysis with reduced euglobulin lysis time and increased D‐dimer levels in serum. Two donors had a platelet granule defect, without identification of genetic abnormality.

Conclusion

The bleeding questionnaire proved to be a valuable tool to screen blood donors for potential platelet defects. Platelet dysfunction was rare in the blood donor population assessed. Additional studies are necessary to understand the clinical impact that the transfusion of platelets with qualitative defects has on recipients.
A High-Consolidation Electron Beam-Curing Process for Manufacturing Three-Dimensional Advanced Thermoset Composites
Authors: Rizzolo Robert H. , Walczyk Daniel F. , Montoney Daniel , Simacek Pavel , Mahbub Md Rashef
Published: June 2022

This paper describes the application of a new manufacturing process for low-cost and rapid consolidation and curing of advanced thermoset composites that avoids the use of expensive prepreg, autoclaving, and thermally induced curing. The process, called VIPE, uses a novel tooling design that combines vacuum infusion (VI) of a dry preform with resin, a rigidly backed pressure focusing layer (P) made of an elastomer to consolidate the wet preform with uniform pressure, and high-energy electron beam curing (E). A VIPE tool is engineered and fabricated to manufacture 3D laminate bicycle seats composed of woven carbon fiber textile and an electron beam-curable epoxy acrylate. Details of the tooling design discussed include computational fluid dynamics (CFD) simulation of the vacuum infusion, iterative structural finite element analysis (FEA) to synthesize the pressure focusing layer (PFL), structural FEA to design the top mold made of a composite sandwich structure for electron beam transparency, and Monte Carlo electron absorption simulations to specify the e-beam energy level. Ten parts are fabricated using the matched tool (bottom aluminum mold covered with silicone layer and top mold with carbon/epoxy skins separated by foam core) after the dry textile preform contained within is infused with resin, the tool halves are clamped under load, and a 3.0 MeV e-beam machine bombards the tool for less than 1 min. Part thickness, part stiffness, surface roughness, and fiber and void volume fractions measurements show that aerospace quality parts with low cycle times are achievable, although there is high variability due to the small number of replicates and need for process optimization.
A New Validation Metric for Models With Correlated Responses Using Limited Experimental and Simulation Data
Authors: Hu Weifei , Zhang Tongzhou , Liu Zhenyu , Cheng Jin , Lou Yukun , Deng Xiaoyu , Tan Jianrong
Published: June 2022

Model validation is the process of determining the degree to which a model is an accurate representation of the real object. Most of the existing model verification metrics rely on massive data, which are expensive to obtain in complex engineering problems. This paper first proposes a new enhanced Mahalanobis distance (EMD) metric by multiplying the original Mahalanobis distance with a direction angle to incorporate the correlation information using limited experimental and simulation data. Combining with EMD, an angle metric is developed as an alternative of the area metric to reduce the misjudgment rate of model validation. In order to quantify the uncertainty due to insufficient experimental and simulation data, the angle metric is further extended to a new interval angle metric, namely the interval EMD-pooling angle metric as the ultimate metric, for validating models at multiple sites. The proposed interval EMD-pooling angle metric is compared with other existing metrics through three numerical case studies to demonstrate its advantages when both experimental and simulation data are insufficient. An engineering example regarding ultrasonic welding is also provided to demonstrate the effectiveness of the proposed metric for practical model validation problems.
Effects of Plyometric Training on Sonographic Characteristics of Quadriceps Muscle and Patellar Tendon, Quadriceps Strength, and Jump Height in Adolescent Female Volleyball Players
Authors: Harput Gulcan , Toprak Ugur , Colakoglu Fatma Filiz , Temel Emirhan , Saylisoy Suzan , Baltaci Gul
Published: June 2022

The aim of this study was to investigate the effects of plyometric training on vastus lateralis (VL) and patellar tendon size, quadriceps isokinetic strength, and vertical jump height in adolescent female volleyball players. Thirty players (age mean ± SD: 15.7 ± 1.1 years) participated in a 6-week Sportsmetrics™ plyometric training program. VL thickness, echo intensity, and patellar tendon cross-sectional area were assessed by real-time ultrasound. Isokinetic quadriceps strength and vertical jump were assessed. The VL thickness, quadriceps strength, and VJ height increased and VL–echo intensity decreased after training. We recommended that 6-week Sportmetrics plyometric training program may be implemented in adolescent female volleyball programs especially before the beginning of the volleyball season.
Effects of Dryland Training During the COVID-19 Lockdown Period on Swimming Performance
Authors: Arsoniadis Gavriil G. , Botonis Petros G. , Tsoltos Alexandros I. , Chatzigiannakis Alexandros D. , Bogdanis Gregory C. , Terzis Gerasimos D. , Toubekis Argyris G.
Published: June 2022

Purpose: To examine the effect of dryland training during an 11-week lockdown period due to COVID-19 on swimming performance. Methods: Twelve competitive swimmers performed 50- and 300-m maximum-effort tests in their preferred stroke and 200-, 400-, and four 50-m front crawl sprints (4 × 50 m) before and after the lockdown period. Critical speed as an index of aerobic endurance was calculated using (1) 50-, 300-, and (2) 200-, 400-m tests. Blood lactate concentration was measured after the 400- and 4 × 50-m tests. To evaluate strength-related abilities, the dryland tests included handgrip and shoulder isometric strength. Tethered swimming force was measured during a 10-second sprint. During the lockdown period, dryland training was applied, and the session rating of perceived exertion training (sRPE) load was recorded daily. Results: sRPE training load during the lockdown was decreased by 78% (16%), and critical speed was reduced 4.7% to 4.9% compared to prelockdown period (P < .05). Performance time in 200, 300, and 400 m deteriorated 2.6% to 3.9% (P < .05), while it remained unaltered in 4 × 50- and 50-m tests (P > .05). Tethered force increased 9% (10%) (P < .01), but handgrip and shoulder isometric force remained unaltered (P > .05). Blood lactate concentration decreased 19% (21%) after the 400-m test and was unchanged following the 4 × 50-m tests (P > .05). Conclusions: Performance deterioration in the 200, 300, and 400 m indicates reduced aerobic fitness and impaired technical ability, while strength and repeated-sprint ability were maintained. When a long abstention from swimming training is forced, dryland training may facilitate preservation in short-distance but not middle-distance swimming performance.
Disentangling the evolutionary drivers of social complexity: A comprehensive test of hypotheses
Authors: Turchin Peter , Whitehouse Harvey , Gavrilets Sergey , Hoyer Daniel , François Pieter , Bennett James S. , Feeney Kevin C. , Peregrine Peter , Feinman Gary , Korotayev Andrey , Kradin Nikolay , Levine Jill , Reddish Jenny , Cioni Enrico , Wacziarg Romain , Mendel-Gleason Gavin , Benam Majid
Published: June 2022

During the Holocene, the scale and complexity of human societies increased markedly. Generations of scholars have proposed different theories explaining this expansion, which range from broadly functionalist explanations, focusing on the provision of public goods, to conflict theories, emphasizing the role of class struggle or warfare. To quantitatively test these theories, we develop a general dynamical model based on the theoretical framework of cultural macroevolution. Using this model and Seshat: Global History Databank, we test 17 potential predictor variables proxying mechanisms suggested by major theories of sociopolitical complexity (and >100,000 combinations of these predictors). The best-supported model indicates a strong causal role played by a combination of increasing agricultural productivity and invention/adoption of military technologies (most notably, iron weapons and cavalry in the first millennium BCE).
Riemann–Cartan Gravity with Dynamical Signature
Authors: Bondarenko S. , Zubkov M. A.
Published: June 2022

Model of Riemann–Cartan gravity with varying signature of metric is considered. The basic dynamical variables of the formalism are vierbein, spin connection, and an internal metric in the tangent space. The corresponding action contains new terms, which depend on these fields. In general case the signature of the metric is determined dynamically. The Minkowski signature is preferred dynamically because the configurations with the other signatures are dynamically suppressed. We also discuss briefly the motion of particles in the background of the modified black hole configuration, in which inside the horizon the signature is that of Euclidean space–time.
Prospects for Membrane Deoxygenation of Alkanolamine CO2 Solvents to Prevent Their Degradation (A Minireview)
Authors: Bazhenov S. D.
Published: June 2022

Absorption by aqueous solutions of alkanolamines is the most mature technology for removing carbon dioxide (СО2) from natural gas, off-gases from power engineering, and other mixtures. The possible presence of oxygen in the gas mixture being treated or air leakage into the absorption treatment system leads to oxidative degradation of the amine and deactivation of the absorption liquid with the formation of a wide range of corrosion-active degradation products. The paper discusses modern views on the effect of dissolved oxygen on the degradation of amine solvents. The main methods for preventing oxidative degradation of alkanolamines and fighting against it are described. Direct removal of oxygen (deoxygenation) from absorption liquids in compact and modular membrane gas–liquid contactors is suggested as an alternative countermeasure. The retrospective and state-of-the-art of membrane deoxygenation of aqueous media are presented. Advanced studies in the field of oxygen removal from amine СО2 solvents used for flue gas treatment are described.
Epidemiology of the first and second waves of COVID-19 pandemic in Djibouti and the vaccination strategy developed for the response
Authors: Elhakim Mohamed , Tourab Saleh Banoita , Salem Fatouma , Van De Weerdt Reinhilde
Published: June 2022

Since the first case of COVID-19 in Djibouti in March 2020 up to the end of May 2021, the country experienced two major epidemic waves of confirmed cases and deaths. The first wave in 2020 progressed more slowly in Djibouti compared with other countries in the Eastern Mediterranean Region. The second wave in 2021 appeared to be more aggressive in terms of the number and severity of cases, as well as the overall fatality rate. This study describes and analyses the epidemiology of these two waves of the COVID-19 pandemic in Djibouti and highlights lessons learnt from the National Plan for Introduction and Deployment of COVID-19 vaccines developed and implemented by the Ministry of Health of Djibouti.

From 17 March 2020 up to 31 May 2021, Djibouti officially reported 11 533 confirmed cases of COVID-19 with 154 related deaths (case fatality rate, CFR: 1.3%), with an attack rate of 1.2%. The first epidemic wave began in epidemiological week 16/2020 (12–18 April) and ended in epidemiological week 25/2020 (14–20 June) with 4274 reported cases and 46 deaths (CFR: 1.1%). The second wave began in epidemiological week 11/2021 (14–20 March) and ended in epidemiological week 18/2021 (2–8 May) with 5082 reported cases and 86 deaths (CFR: 1.7%).

A vaccination campaign was launched by the President of the Republic in March 2021; approximately 1.6% of the population were vaccinated in only two months’ time. Early Preparedness, multisectoral and multicoordinated response, and collaboration with WHO are among the major lessons learnt during the pandemic in Djibouti.