bluuebunny/crossref_metadata_2025 huggingface dataset:
Keeping Up With the Novaks? Income Distribution as a Determinant of Household Debt in CESEE
Authors: Hake Mariya , Poyntner Philipp
Published: November 2021

This paper constitutes an initial attempt to shed light on the role of income distribution for household debt in Central, Eastern, and Southeastern Europe (CESEE). Using household‐level data from the OeNB’s Euro Survey for the period 2008–2018, we address the question whether interpersonal comparisons (“Keeping up with the Novaks”) are associated with the probability of having a loan and planning to take out a loan. Applying multilevel probit modeling to consider the hierarchical structure of the data, our results support the notion that higher income inequality is negatively correlated with the probability of having a loan at the bottom of the distribution, and positively at the top. We show this impact for almost all components of household debt, but evidence is strongest for mortgage and foreign currency loans. Loan plans are associated with income inequality at the very top of the income distribution.
A multicenter evaluation of hepatitis B reactivation with and without antiviral prophylaxis after kidney transplantation
Authors: Shaikh Suhail A , Kahn Jeffrey , Aksentijevic Andraea , Kawewat‐Ho Pnada , Bixby Alexandra , Rendulic TrisAnn , Park Jeong M
Published: November 2021

Background

Hepatitis B virus (HBV) reactivation in hepatitis B surface antigen (HBsAg)‐negative and hepatitis B core antibody (anti‐HBc)‐positive kidney transplant recipients ranges between 1.4% and 9.6%. Limited evidence is available regarding routine antiviral prophylaxis and identifiable risk factors for HBV reactivation in this population.

Methods

In this multicenter retrospective study, we evaluated the prevalence of HBV reactivation in HBsAg‐negative anti‐HBc‐positive kidney transplant recipients who did or did not receive antiviral prophylaxis. The primary outcome assessed the prevalence of HBV reactivation, defined as a positive HBV DNA by PCR of any viral load at or above the minimal detection level. The principal safety outcomes assessed 1‐year graft survival, 1‐year all‐cause mortality, biopsy‐proven acute rejection, and antibody‐mediated rejection.

Results

One hundred and sixty‐one patients met inclusion criteria and comprised two groups, antiviral prophylaxis (n = 14) and no antiviral prophylaxis (n = 147). Of patients who did not receive prophylaxis, only five (3.4%) experienced HBV reactivation, whereas one (7.1%) patient in the prophylaxis group experienced reactivation over a median follow‐up of 1103 days (p = .43). Furthermore, there were no differences with respect to all secondary outcomes. Statistical analysis demonstrated delayed graft function to be a significant factor associated with HBV reactivation.

Conclusion

These study results suggest that the prevalence of HBV reactivation in HBsAg‐negative anti‐HBc‐positive kidney transplant recipients is low, regardless of antiviral prophylaxis. Furthermore, there were no significant graft‐related outcomes among those that did experience reactivation.
Babesia blood testing: the first‐year experience
Authors: Tonnetti Laura , Dodd Roger Y. , Foster Gregory , Stramer Susan L.
Published: November 2021

Background

Babesia is an intraerythrocytic parasite responsible for hundreds of cases of transfusion‐transmitted babesiosis in the past 50 years. In May of 2020, blood testing for Babesia was implemented at the American Red Cross (ARC) for all donations in endemic areas of the northeastern and midwestern regions of the United States.

Methods

Between May 2020 and May 2021, 1,816,669 donations from 13 states and DC were tested for Babesia by the ARC. Testing was performed in pools of 16 whole blood lysates using a licensed nucleic acid test (NAT) targeting Babesia 18S rRNA. Reactive donations were tested for B. microti antibody by immunoglobulin G immunofluorescence. Suspected cases of transfusion‐transmitted babesiosis (TTB) were investigated if reported.

Results

The first 13 months of Babesia screening identified 365 NAT‐reactive donations. Antibodies for B. microti were detected in 79% (287) of reactive donations; negative serology samples were prevalent between May and July. Follow‐up donations were collected from 142 donors, and 86% (122), collected up to 74 days after index, remained NAT reactive. Reactive donations were mainly collected in MA (77), CT (68), NY (49), NJ (47), and PA (44), but were identified in all states except Delaware. Most reactive blood donors were male (65%) aged between 40 and 80 years. Since the beginning of Babesia testing, no case of TTB was identified.

Conclusions

The absence of TTB cases since implementation of Babesia screening for blood donations collected in endemic areas suggests testing is an effective strategy to eliminate TTB.
Electrochemical Bioelectronics in Drug Delivery: Effect of the Initial Gas Volume
Authors: Avila Raudel , Ciatti Joanna L. , Vázquez-Guardado Abraham , Wu Yixin , Zhang Yamin , Garziera Rinaldo , Rogers John A. , Huang Yonggang
Published: November 2021

Implantable bioelectronic devices with drug delivery capabilities have emerged as suitable candidates for biomedical applications focusing on localized drug delivery. These classes of miniaturized bioelectronics offer wireless operation and refillable designs that can be used for repeated animal behavioral studies without restricting their motion. The pumping mechanisms of these bioelectronic devices features soft materials, microfluidics, and electrochemical subsystems that can be scaled from behavioral studies in small animals to delivery of life-saving medication in humans. Here, we study the refillable aspect of these bioelectronic systems using an analytic model for the drug delivery time established from the ideal gas law when an initial gas volume is present in the device electrolyte reservoirs. The effect of the initial gas volume in delaying the drug delivery time is captured via a non-dimensional parameter identified as the normalized initial gas volume. An analytical solution is derived from the perturbation method, which agrees well with the numerical solution. These results have relevance in the reusability aspect of these bioelectronic systems since modifying the amount of initial gas in the device reservoirs for different experiments affects the total delivery time and can serve as a tunable parameter to ensure timely and successful delivery of the drug in the target region.
Modelling binaural unmasking and the intelligibility of speech in noise and reverberation for normal-hearing and hearing-impaired listeners
Authors: Vicente Thibault , Buchholz Jörg M. , Lavandier Mathieu
Published: November 2021

This study investigated the effect of hearing loss on binaural unmasking (BU) for the intelligibility of speech in noise. Speech reception thresholds (SRTs) were measured with normal-hearing (NH) listeners and older mildly hearing-impaired (HI) listeners while varying the presentation level of the stimuli, reverberation, modulation of the noise masker, and spatial separation of the speech and noise sources. On average across conditions, the NH listeners benefited more (by 0.6 dB) from BU than HI listeners. The binaural intelligibility model developed by Vicente, Lavandier, and Buchholz [J. Acoust. Soc. Am. 148, 3305–3317 (2020)] was used to describe the data, accurate predictions were obtained for the conditions considering moderate noise levels [50 and 60 dB sound pressure level (SPL)]. The interaural jitters that were involved in the prediction of BU had to be revised to describe the data measured at a lower level (40 dB SPL). Across all tested conditions, the correlation between the measured and predicted SRTs was 0.92, whereas the mean prediction error was 0.9 dB.
An oral SARS-CoV-2 M
pro
inhibitor clinical candidate for the treatment of COVID-19
Authors: Owen Dafydd R. , Allerton Charlotte M. N. , Anderson Annaliesa S. , Aschenbrenner Lisa , Avery Melissa , Berritt Simon , Boras Britton , Cardin Rhonda D. , Carlo Anthony , Coffman Karen J. , Dantonio Alyssa , Di Li , Eng Heather , Ferre RoseAnn , Gajiwala Ketan S. , Gibson Scott A. , Greasley Samantha E. , Hurst Brett L. , Kadar Eugene P. , Kalgutkar Amit S. , Lee Jack C. , Lee Jisun , Liu Wei , Mason Stephen W. , Noell Stephen , Novak Jonathan J. , Obach R. Scott , Ogilvie Kevin , Patel Nandini C. , Pettersson Martin , Rai Devendra K. , Reese Matthew R. , Sammons Matthew F. , Sathish Jean G. , Singh Ravi Shankar P. , Steppan Claire M. , Stewart Al E. , Tuttle Jamison B. , Updyke Lawrence , Verhoest Patrick R. , Wei Liuqing , Yang Qingyi , Zhu Yuao
Published: November 2021

Path to another drug against COVID-19

The rapid development of vaccines has been crucial in battling the ongoing COVID-19 pandemic. However, access challenges remain, breakthrough infections occur, and emerging variants present increased risk. Developing antiviral therapeutics is therefore a high priority for the treatment of COVID-19. Some drug candidates in clinical trials act against the viral RNA-dependent RNA polymerase, but there are other viral enzymes that have been considered good targets for inhibition by drugs. Owen
et al
. report the discovery and characterization of a drug against the main protease involved in the cleavage of polyproteins involved in viral replication. The drug, PF-07321332, can be administered orally, has good selectivity and safety profiles, and protects against infection in a mouse model. In a phase 1 clinical trial, the drug reached concentrations expected to inhibit the virus based on in vitro studies. It also inhibited other coronaviruses, including severe acute respiratory syndrome coronavirus 1 and Middle East respiratory syndrome coronavirus, and could be in the armory against future viral threats. —VV
Plasmodium falciparum Calcium-Dependent Protein Kinase 4 is Critical for Male Gametogenesis and Transmission to the Mosquito Vector
Authors: Kumar Sudhir , Haile Meseret T. , Hoopmann Michael R. , Tran Linh T. , Michaels Samantha A. , Morrone Seamus R. , Ojo Kayode K. , Reynolds Laura M. , Kusebauch Ulrike , Vaughan Ashley M. , Moritz Robert L. , Kappe Stefan H. I. , Swearingen Kristian E.
Published: November 2021

Transmission of the malaria parasite to the mosquito vector is critical for the completion of the sexual stage of the parasite life cycle and is dependent on the release of male gametes from the gametocyte body inside the mosquito midgut. In the present study, we demonstrate that PfCDPK4 is critical for male gametogenesis and is involved in phosphorylation of proteins essential for male gamete emergence.
Hepatitis C Virus-Induced Exosomal MicroRNAs and Toll-Like Receptor 7 Polymorphism Regulate B-Cell Activating Factor
Authors: Liao Tsai-Ling , Chen Yi-Ming , Hsieh Shie-Liang , Tang Kuo-Tung , Chen Der-Yuan , Yang Ying-Ying , Liu Hung-Jen , Yang Sheng-Shun
Published: November 2021

HCV remains an important cause of liver disease worldwide. Accumulating evidence has demonstrated that HCV infection is associated with B cell lymphoproliferative disorders such as MC.
Identification and Development of Therapeutics for COVID-19
Authors: Rando Halie M. , Wellhausen Nils , Ghosh Soumita , Lee Alexandra J. , Dattoli Anna Ada , Hu Fengling , Byrd James Brian , Rafizadeh Diane N. , Lordan Ronan , Qi Yanjun , Sun Yuchen , Brueffer Christian , Field Jeffrey M. , Ben Guebila Marouen , Jadavji Nafisa M. , Skelly Ashwin N. , Ramsundar Bharath , Wang Jinhui , Goel Rishi Raj , Park YoSon ,   COVID-19 Review Consortium Vikas Bansal, John P. Barton, Simina M. Boca, Joel D. Boerckel, Christian Brueffer, James Brian Byrd, Stephen Capone, Shikta Das, Anna Ada Dattoli, John J. Dziak, Jeffrey M. Field, Soumita Ghosh, Anthony Gitter, Rishi Raj Goel, Casey S. Greene, Marouen Ben Guebila, Daniel S. Himmelstein, Fengling Hu, Nafisa M. Jadavji, Jeremy P. Kamil, Sergey Knyazev, Likhitha Kolla, Alexandra J. Lee, Ronan Lordan, Tiago Lubiana, Temitayo Lukan, Adam L. MacLean, David Mai, Serghei Mangul, David M, Boca Simina M. , Gitter Anthony , Greene Casey S.
Published: November 2021

The COVID-19 pandemic is a rapidly evolving crisis. With the worldwide scientific community shifting focus onto the SARS-CoV-2 virus and COVID-19, a large number of possible pharmaceutical approaches for treatment and prevention have been proposed.
Acute and repeated haemoperitoneum: a challenging case of lymphangioleiomyomatosis with uterine PEComa
Authors: Xholli Anjeza , Kratochwila Chiara , Vellone Valerio Gaetano , Schiaffino Maria Giulia
Published: November 2021

A 39-year-old woman presented in the emergency ward for abdominal pain and acute anemiation. Abdominal–thoracic CT scan showed haemoperitoneum, with a parauterine mass and a pathological pulmonary pattern suspicious for lymphangioleiomyomatosis (LAM), a systemic disease belonging to perivascular epithelioid cell tumours (PEComas). Gynaecological ultrasound showed a hypoechoic irregular solid mass of the uterine right wall. Ultrasonographic virtual organ computer-aided analysis showed the mass completely formed by arteriovenous vessels, and that allowed distinction from leiomyosarcoma. Repeated haemoperitoneum required uterine artery embolisation. Mass revascularisation occurred in the following 7 days. A laparotomic hysterectomy with removal of the uterus and right parametrium was performed in epidural analgesia. Histological features were consistent with the diagnosis of uterine PEComa of uncertain malignant features, in the presence of coexisting pulmonary LAM. In women with LAM, acute haemoperitoneum may indicate the presence of a uterine PEComa whose diagnosis can be challenging.
Chronic inflammatory demyelinating polyneuropathy evolving to primary CNS lymphoma
Authors: Kajtazi Naim Izet , Khalid Ehtesham , AlGhamdi Juman , Altaf Syed , AlHameed Majed H
Published: November 2021

A 56-year-old woman presented with 3 months history of all four limbs’ numbness in glove and stocking distribution. A week before admission, she developed all four limbs’ weakness and numbness. Brain and whole spine imaging revealed no lesions, and cerebrospinal fluid showed high protein. A nerve conduction study revealed severe sensorimotor polyneuropathy, and she was diagnosed with chronic inflammatory demyelinating polyneuropathy. We treated her with plasma exchange and later developed bilateral pulmonary embolism, deep venous thrombosis and worsening of weakness. The second set of seven sessions of plasma exchange gave her improvement in muscle strength. However, after a chest infection, another neurological deterioration occurred. The third set of plasma exchanges resulted in excellent response. Nineteen months into her illness she developed a headache followed by left upper limb weakness and focal seizures with left side involvement. Brain imaging revealed a right frontal enhancing lesion that required resection, and biopsy showed diffuse large B-cell lymphoma. She was treated with chemotherapy and whole-brain radiation therapy and remained with left-sided weakness.
Acquired growth hormone deficiency in Fanconi-Bickel syndrome
Authors: Scully Kevin J , Wolfsdorf Joseph , Dedekian Michael
Published: November 2021

Fanconi-Bickel syndrome (FBS) is a rare autosomal recessive disease, resulting from mutations in theSLC2A2gene, causing impaired glucose transporter 2 protein transporter protein function, impaired glucose and galactose utilisation, hepatorenal glycogen accumulation and organ dysfunction. Clinical features include failure to thrive, hepatomegaly, rickets, short stature and delayed puberty. Therapy includes electrolyte supplementation and uncooked cornstarch. We present a 15-year-old boy diagnosed with FBS in infancy. Growth velocity was normal on standard treatment until age 8.5 years, at which time growth failure led to a diagnosis of acquired growth hormone (GH) deficiency. Initiation of recombinant human GH (rhGH) replacement of 0.25 μg/kg/week resulted in marked improvement in growth velocity and height. While short stature is expected in FBS, growth velocity that falls below the normal range despite adequate therapy should prompt further evaluation. Our case suggests that acquired GH deficiency can arise in FBS and benefits from rhGH therapy.
Integrating community-based verbal autopsy into civil registration and vital statistics: lessons learnt from five countries
Authors: Firth Sonja Margot , Hart John D , Reeve Matthew , Li Hang , Mikkelsen Lene , Sarmiento Deborah Carmina , Bo Khin Sandar , Kwa Viola , Qi Jin-Lei , Yin Peng , Segarra Agnes , Riley Ian , Joshi Rohina
Published: November 2021

This paper describes the lessons from scaling up a verbal autopsy (VA) intervention to improve data about causes of death according to a nine-domain framework: governance, design, operations, human resources, financing, infrastructure, logistics, information technologies and data quality assurance. We use experiences from China, Myanmar, Papua New Guinea, Philippines and Solomon Islands to explore how VA has been successfully implemented in different contexts, to guide other countries in their VA implementation. The governance structure for VA implementation comprised a multidisciplinary team of technical experts, implementers and staff at different levels within ministries. A staged approach to VA implementation involved scoping and mapping of death registration processes, followed by pretest and pilot phases which allowed for redesign before a phased scale-up. Existing health workforce in countries were trained to conduct the VA interviews as part of their routine role. Costs included training and compensation for the VA interviewers, information technology (IT) infrastructure costs, advocacy and dissemination, which were borne by the funding agency in early stages of implementation. The complexity of the necessary infrastructure, logistics and IT support required for VA increased with scale-up. Quality assurance was built into the different phases of the implementation. VA as a source of cause of death data for community deaths will be needed for some time. With the right technical and political support, countries can scale up this intervention to ensure ongoing collection of quality and timely information on community deaths for use in health planning and better monitoring of national and global health goals.
Strengthening public financial management in the health sector: a qualitative case study from South Africa
Authors: Wishnia Jodi , Goudge Jane
Published: November 2021

Introduction

Effective public financial management (PFM) ensures public health funds are used to deliver services in the best way possible. Given the global call for universal health coverage, and concerns about the management of public funds in many low-income and middle-income countries, PFM has become an important area of research. South Africa has a robust PFM framework, that is generally adhered to, and yet financial outcomes have remained poor. In this paper, we describe how a South African provincial department of health tried to strengthen its PFM processes by deploying finance managers into service delivery units, involving service delivery managers in the monthly finance meeting, using a weekly committee to review expenditure requests and starting a weekly managers’ ‘touch-base’ meeting. We assess whether these strategies strengthened collaboration and trust and how this impacted on PFM.

Method

This research used a case study design with ethnographic methods. Semi-structured interviews (n=30) were conducted with participant observations. Thematic analysis was used to identify emergent themes and collaborative public management theory was then used to frame the findings. The authors used reflexive methods, and member checking was conducted.

Results

The deployment of staff and touch-base meeting illustrated the potential of multidisciplinary teams when members share power, and the importance of impartial leadership when trying to achieve consensus on how to prioritise resource use. However, the service delivery and finance managers did not manage to collaborate in the monthly finance meeting to develop realistic budgets, or to reprioritise expenditure when required. The resulting mistrust threatened to derail the other strategies, highlighting how critical trust is for collaboration.

Conclusion

Effective PFM requires authentic collaboration between service delivery and finance managers; formal processes alone will not achieve this. We recommend more opportunities for ‘boundary crossing’, embedding finance managers in service delivery units and impartial effective leadership.
Influence of dysregulated expression of circular RNA on the diagnosis and prognosis of breast cancer in Asia: a meta-analysis study
Authors: Liu Fengyuan , Wu Xinrui , Zhu Huixia , Wang Feng
Published: November 2021

Objective

Recent studies have reported a correlation between non-coding RNAs such as circular RNAs (circRNAs) and clinical value of various cancers. However, the diagnostic and prognostic role of circRNA in breast cancer remains controversial.

Design

Systematic review and meta-analysis.

Methods

Diagnostic efficacy was estimated by sensitivity, specificity and area under the curve (AUC). Pooled HRs with 95% CIs estimated overall survival (OS), and ORs with 95% CIs investigated clinical features.

Results

By searching PubMed, Embase, Web of Science, CNKI and Cochrane Library, we obtained a total of 29 studies with 4405 patients. A shorter survival time was associated with high expression levels of tumour-promoter circRNAs (OS: HR=2.43, 95% CI 2.20 to 2.92, p<0.001), and tumour‐suppressor circRNAs were related to a favourable prognosis (OS: HR=0.32, 95% CI 0.23 to 0.44, p<0.001). Furthermore, high expression levels of oncogenic circRNAs were associated with poor clinical outcomes; tumour-suppressor circRNAs showed the opposite result. As for the diagnostic role, the outcome indicated an AUC of 0.82 (95% CI 0.78 to 0.85), with 85% sensitivity and 86% specificity to distinguish patients with breast cancer from healthy controls.

Conclusion

Dysregulated expression of circRNA was related to diagnosis and prognosis in breast cancer, which indicated it might be a novel biomarker and a target of therapy for breast cancer.

PROSPERO registration number

CRD42020207912.
Importance of accounting for loss to follow-up when comparing mortality between immigrants and long-term residents: a population-based retrospective cohort
Authors: Vyas Manav V. , Fang Jiming , Austin Peter C. , Laupacis Andreas , Cheung Matthew C. , Silver Frank L. , Kapral Moira K
Published: November 2021

Objectives

To evaluate the association between immigration status and all-cause mortality in different disease cohorts, and the impact of loss to follow-up on the observed associations.

Design

Population-based retrospective cohort study using linked administrative health data in Ontario, Canada.

Setting

We followed adults with a first-ever diagnosis of ischaemic stroke, cancer or schizophrenia between 2002 and 2013 from index event to death, loss to follow-up, or end of follow-up in 2018.

Primary and secondary outcome measures

Our outcomes of interest were all-cause mortality and loss to follow-up. For each disease cohort, we calculated adjusted HRs of death in immigrants compared with long-term residents, adjusting for demographic characteristics and comorbidities, with and without censoring for those who were lost to follow-up. We calculated the ratio of two the HRs and the respective CL using bootstrapping methods.

Results

Immigrants were more likely to be lost to follow-up than long-term residents in all disease cohorts. Not accounting for this loss to follow-up overestimated the magnitude of the association between immigration status and mortality in those with ischaemic stroke (HR of death before vs after accounting for censoring: 0.78 vs 0.83, ratio=0.95; 95% CL 0.93 to 0.97), cancer (0.74 vs 0.78, ratio=0.96; 0.95 to 0.96), and schizophrenia (0.54 vs 0.56, ratio=0.97; 0.96 to 0.98).

Conclusions

Immigrants to Canada have a survival advantage that varies by the disease studied. The magnitude of this advantage is modestly overestimated by not accounting for the higher loss to follow-up in immigrants.
COVID-19 Public Stigma Scale (COVID-PSS): development, validation, psychometric analysis and interpretation
Authors: Nochaiwong Surapon , Ruengorn Chidchanok , Awiphan Ratanaporn , Kanjanarat Penkarn , Ruanta Yongyuth , Phosuya Chabaphai , Boonchieng Waraporn , Nanta Sirisak , Chongruksut Wilaiwan , Thavorn Kednapa , Wongpakaran Nahathai , Wongpakaran Tinakon
Published: November 2021

Objective

Amid the COVID-19 pandemic, social stigma towards COVID-19 infection has become a major component of public discourse and social phenomena. As such, we aimed to develop and validate the COVID-19 Public Stigma Scale (COVID-PSS).

Design and setting

National-based survey cross-sectional study during the lockdown in Thailand.

Participants

We invited the 4004 adult public to complete a set of measurement tools, including the COVID-PSS, global fear of COVID-19, perceived risk of COVID-19 infection, Bogardus Social Distance Scale, Pain Intensity Scale and Insomnia Severity Index.

Methods

Factor structure dimensionality was constructed and reaffirmed with model fit by exploratory and confirmatory factor analyses and non-parametric item response theory (IRT) analysis. Psychometric properties for validity and reliability were tested. An anchor-based approach was performed for classifying the proper cut-off scores.

Results

After factor analysis, IRT analysis and test for model fit, we created the final 10-item COVID-PSS with a three-factor structure: stereotype, prejudice and fear. Face and content validity were established through the public and experts’ perspectives. The COVID-PSS was significantly correlated (Spearman rank, 95% CI) with the global fear of COVID-19 (0.68, 95% CI 0.66 to 0.70), perceived risk of COVID-19 infection (0.79, 95% CI 0.77 to 0.80) and the Bogardus Social Distance Scale (0.50, 95% CI 0.48 to 0.53), indicating good convergent validity. The correlation statistics between the COVID-PSS and the Pain Intensity Scale and Insomnia Severity Index were <0.2, supporting the discriminant validity. The reliability of the COVID-PSS was satisfactory, with good internal consistency (Cronbach’s α of 0.85, 95% CI 0.84 to 0.86) and test–retest reproducibility (intraclass correlation of 0.94, 95% CI 0.86 to 0.96). The proposed cut-off scores were as follows: no/minimal (≤18), moderate (19–25) and high (≥26) public stigma towards COVID-19 infection.

Conclusions

The COVID-PSS is practical and suitable for measuring stigma towards COVID-19 in a public health survey. However, cross-cultural adaptation may be needed.
Effect of aspirin on HIV disease progression among HIV-infected individuals initiating antiretroviral therapy: study protocol for a randomised controlled trial
Authors: Mwakyandile Tosi , Shayo Grace , Mugusi Sabina , Sunguya Bruno , Sasi Philip , Moshiro Candida , Mugusi Ferdinand , Lyamuya Eligius
Published: November 2021

Introduction

An increase in cardiovascular disease (CVD) among people living with HIV infection is linked to platelet and immune activation, a phenomenon unabolished by antiretroviral (ARV) drugs alone. In small studies, aspirin (acetylsalicylic acid [ASA]) has been shown to control immune activation, increase CD4+ count, halt HIV disease progression and reduce HIV viral load (HVL). We present a protocol for a larger ongoing randomised placebo controlled trial on the effect of an addition of ASA to ARV drugs on HIV disease progression.

Methods and analysis

A single-centre phase IIA double-blind, parallel-group randomised controlled trial intends to recruit 454 consenting ARV drug-naïve, HIV-infected adults initiating ART. Participants are randomised in blocks of 10 in a 1:1 ratio to receive, in addition to ARV drugs, 75 mg ASA or placebo for 6 months. The primary outcome is the proportion of participants attaining HVL of <50 copies/mL by 8, 12 and 24 weeks. Secondary outcomes include proportions of participants with HVL of >1000 copies/mL at week 24, attaining a >30% rise of CD4 count from baseline value at week 12, experiencing adverse events, with normal levels of biomarkers of platelet and immune activation at weeks 12 and 24 and rates of morbidity and all-cause mortality. Intention-to-treat analysis will be done for all study outcomes.

Ethics and dissemination

Ethical approval has been obtained from institutional and national ethics review committees. Findings will be submitted to peer-reviewed journals and presented in scientific conferences.

Trial registration number

PACTR202003522049711.
A co-design study to develop supportive interventions to improve psychological and social adaptation among adults with new-onset type 1 diabetes in Denmark and the UK
Authors: Due-Christensen Mette , Joensen Lene Eide , Sarre Sophie , Romanczuk Ewa , Wad Julie Lindberg , Forde Rita , Robert Glenn , Willaing Ingrid , Forbes Angus
Published: November 2021

Objective

To develop supportive interventions for adults with new-onset type 1 diabetes (T1D) to facilitate positive adaptive strategies during their transition into a life with diabetes.

Design

The study used a co-design approach informed by Design Thinking to stimulate participants’ reflections on their experiences of current care and generate ideas for new supportive interventions. Visual illustrations were used to depict support needs and challenges. Initial discussions of these needs and challenges were facilitated by researchers and people with diabetes in workshops. Data comprising transcribed audio recordings of the workshop discussions and materials generated during the workshops were analysed thematically.

Settings

Specialised diabetes centres in Denmark and the United Kingdom.

Participants

Adults with new-onset T1D (n=24) and healthcare professionals (HCPs) (n=56) participated in six parallel workshops followed by four joint workshops with adults (n=29) and HCPs (n=24) together.

Results

The common solution prioritised by both adults with new-onset T1D and HCP participants was the development of an integrated model of care addressing the psychological and social elements of the diagnosis, alongside information on diabetes self-management. Participants also indicated a need to develop the organisation, provision and content of care, along with the skills HCPs need to optimally deliver that care. The co-designed interventions included three visual conversation tools that could be used flexibly in the care of adults with new-onset T1D to support physical, psychological and social adaptation to T1D.

Conclusion

This co-design study has identified the care priorities for adults who develop T1D, along with some practical conversational tools that may help guide HCPs in attending to the disruptive experience of the diagnosis and support adults in adjusting into a life with diabetes.
Oxford Understanding Relationships, Sex, Power, Abuse and Consent Experiences (OUR SPACE) cross-sectional survey: a study protocol
Authors: Steele Bridget , Degli Esposti Michelle , Mandeville Pete , Hamnett Gillian , Nye Elizabeth , Humphreys David K
Published: November 2021

Introduction

Sexual violence among higher education students is a public health concern, threatening the general safety of students, often with significant physical and mental health implications for victims. Establishing the prevalence estimates of sexual violence at higher education institutions (HEIs) is essential for designing and resourcing responses to sexual violence, including monitoring the effectiveness of prevention initiatives and institutional programmes. Yet, to date, there have been no rigorous studies assessing prevalence of sexual violence at HEIs in the UK.

Methods and analysis

Informed by guidance from Universities UK, the University of Oxford administration and the related student advocacy groups working within the University, Oxford Understanding Relationships, Sex, Power, Abuse and Consent Experiences is a cross-sectional survey of all undergraduate and graduate students over the age of 18 enrolled at the University of Oxford, UK. The survey design uses a complete sampling approach and measures adapted from previous campus climate surveys in the USA as well as the Sexual Experiences Survey (USA). The analysis will estimate the prevalence of sexual harassment and sexual violence perpetration and victimisation, and will examine whether ethnicity, gender identity, and sexual orientation are associated with these primary outcomes.

Ethics and dissemination

Ethical approval was obtained by the Social Sciences and Humanities Interdivisional Research Ethics Committee at the University of Oxford which is a subcommittee of the Central University Research Ethics Committee (ref no.: R73805/RE001). The research team will disseminate findings through peer-reviewed journal articles and conference presentations. A report cowritten by authors and stakeholders will be shared with Oxford University students.
Distribution and specificity of high-sensitivity cardiac troponin T in older adults without acute cardiac conditions: cross-sectional results from the population-based AugUR study
Authors: Dietl Alexander , Zimmermann Martina E , Brandl Caroline , Wallner Stefan , Burkhardt Ralph , Maier Lars S , Luchner Andreas , Heid Iris M , Stark Klaus J
Published: November 2021

Objective

European guidelines recommended a uniform upper reference limit of high-sensitivity cardiac troponin T (hsTnT) to rule out non-ST segment elevation myocardial infarction. Our study aimed to provide a hsTnT reference distribution and to assess the specificity of the 14 ng/L cut-off value in the mobile population ≥70 years of age.

Design

A cross-sectional analysis was performed in the German AugUR study (AltersbezogeneUntersuchungen zurGesundheit derUniversity ofRegensburg).

Setting

Study population was the mobile population aged 70+ years living in the city and county of Regensburg, Germany.

Participants

A random sample was derived from the local population registries of residence. Of the 5644 individuals invited, 1133 participated (response ratio=20.1%). All participants came to the study centre and were mentally and physically mobile to conduct the protocol (face-to-face interview, blood draw and standardised transthoracic echocardiography). None of the participants was in an acute state of myocardial infarction.

Results

Among the 1129 individuals with hsTnT measurements (overall median=10.0 ng/L

(25th, 75th percentile)=(7.0, 15.0 ng/L)), hsTnT was higher among the older individuals and higher among men (men 70–74 years median=9.6 ng/L (7.2, 13.1 ng/L); men 90–95 years median=21.2 ng/L (14.6, 26.0 ng/L); women 70–74 years median=6.3 ng/L (4.7, 8.7 ng/L); and women 90–95 years median=18.0 ng/L (11.0, 21.0 ng/L)). In participants with impaired kidney function (eGFRcrea<60 mL/min/1.73 m2), hsTnT was elevated (median=13.6 ng/L (9.4, 20.6 ng/L)).

Specificity of recommended upper reference limit, 14 ng/L, is 68%. Most false positives were among men aged >79 years (specificity=34%). In a healthy subgroup (n=96, none of the following: overt heart disease, impaired renal function, blood pressure >160/100 mm Hg, left ventricular hypertrophy and diastolic/systolic dysfunction), specificity was 90%.

Conclusion

In the elderly population without acute myocardial infarction, hsTnT further increases with age showing different levels for men and women. The specificity of the 14 ng/L cut-off is considerably lower than 99%, even in healthy subjects.
Incidence of post-traumatic epilepsy following paediatric traumatic brain injury: protocol for systematic review and meta-analysis
Authors: Mariajoseph Frederick P , Rewell Sarah S , O"Brien Terence J , Semple Bridgette D , Antonic-Baker Ana
Published: November 2021

Introduction

Post-traumatic epilepsy (PTE) is a recognised complication of traumatic brain injury (TBI), and is associated with higher rates of mortality and morbidity when compared with patients with TBI who do not develop PTE. The majority of the literature on PTE has focused on adult populations, and consequently there is a paucity of information regarding paediatric cohorts. Additionally, there is considerable heterogeneity surrounding the reported incidence of PTE following childhood TBI in the current literature. The primary aim of our study is to summarise reported PTE incidences in paediatric populations to derive an accurate estimate of the global incidence of PTE following childhood TBI. Our secondary aim is to explore risk factors that increase the likelihood of developing PTE.

Methods and analysis

A systematic literature search of Embase (1947–2021), PubMed (1996–2021) and Web of Science (1900–2021) will be conducted. Publications in English that report the incidence of PTE in populations under 18 years of age will be included. Publications that evaluate fewer than 10 patients, report an alternative cause of epilepsy, or in which a paediatric cohort is not discernable, will be excluded. Independent investigators will identify the relevant publications, and discrepancies will be adjudicated by a third independent investigator. Data extracted will include incidence of PTE, time intervals between TBI and PTE, seizure characteristics, injury characteristics, patient demographics and clinical data. Data extraction will be performed by two independent investigators and cross-checked by a third investigator. A descriptive analysis of PTE incidence will be conducted and a weighted mean will be calculated. If sufficient data are available, stratified meta-analysis of subgroups will also be conducted.

Ethics and dissemination

Ethics approval was not required for this study. We intend to publish our findings in a high-quality peer-reviewed journal on completion.

PROSPERO registration number

CRD42021245802.
Enhanced airway sensory nerve reactivity in non-eosinophilic asthma
Authors: Ali Hajar , Brooks Collin , Crane Julian , Beasley Richard , Holgate Stephen , Gibson Peter , Pattemore Philip , Tzeng Yu-Chieh , Stanley Thorsten , Pearce Neil , Douwes Jeroen
Published: November 2021

Background

Neural mechanisms may play an important role in non-eosinophilic asthma (NEA). This study compared airway sensory nerve reactivity, using capsaicin challenge, in eosinophilic asthma (EA) and NEA and non-asthmatics.

Methods

Thirty-eight asthmatics and 19 non-asthmatics (aged 14–21 years) underwent combined hypertonic saline challenge/sputum induction, fractional exhaled nitric oxide, atopy and spirometry tests, followed by capsaicin challenge. EA and NEA were defined using a sputum eosinophil cut-point of 2.5%. Airway hyperreactivity was defined as a ≥15% drop in FEV1during saline challenge. Sensory nerve reactivity was defined as the lowest capsaicin concentration that evoked 5 (C5) coughs.

Results

Non-eosinophilic asthmatics (n=20) had heightened capsaicin sensitivity (lower C5) compared with non-asthmatics (n=19) (geometric mean C5: 58.3 µM, 95% CI 24.1 to 141.5 vs 193.6 µM, 82.2 to 456.0; p<0.05). NEA tended to also have greater capsaicin sensitivity than EA, with the difference in capsaicin sensitivity between NEA and EA being of similar magnitude (58.3 µM, 24.1 to 141.5 vs 191.0 µM, 70.9 to 514.0) to that observed between NEA and non-asthmatics; however, this did not reach statistical significance (p=0.07). FEV1was significantly reduced from baseline following capsaicin inhalation in both asthmatics and non-asthmatics but no differences were found between subgroups. No associations with capsaicin sensitivity and atopy, sputum eosinophils, blood eosinophils, asthma control or treatment were observed.

Conclusion

NEA, but not EA, showed enhanced capsaicin sensitivity compared with non-asthmatics. Sensory nerve reactivity may therefore play an important role in the pathophysiology of NEA.
Defining hypoxaemia from pulse oximeter measurements of oxygen saturation in well children at low altitude in Bangladesh: an observational study
Authors: McCollum Eric D , King Carina , Ahmed Salahuddin , Hanif Abu A M , Roy Arunangshu D , Islam ASMD Ashraful , Colbourn Tim , Schuh Holly B , Ginsburg Amy Sarah , Hooli Shubhada , Chowdhury Nabidul H , Rizvi Syed J R , Begum Nazma , Baqui Abdullah H , Checkley William
Published: November 2021

Background

WHO defines hypoxaemia, a low peripheral arterial oxyhaemoglobin saturation (SpO2), as <90%. Although hypoxaemia is an important risk factor for mortality of children with respiratory infections, the optimal SpO2threshold for defining hypoxaemia is uncertain in low-income and middle-income countries (LMICs). We derived a SpO2threshold for hypoxaemia from well children in Bangladesh residing at low altitude.

Methods

We prospectively enrolled well, children aged 3–35 months participating in a pneumococcal vaccine evaluation in Sylhet district, Bangladesh between June and August 2017. Trained health workers conducting community surveillance measured the SpO2of children using a Masimo Rad-5 pulse oximeter with a wrap sensor. We used standard summary statistics to evaluate the SpO2distribution, including whether the distribution differed by age or sex. We considered the 2.5th, 5th and 10th percentiles of SpO2as possible lower thresholds for hypoxaemia.

Results

Our primary analytical sample included 1470 children (mean age 18.6±9.5 months). Median SpO2was 98% (IQR 96%–99%), and the 2.5th, 5th and 10th percentile SpO2was 91%, 92% and 94%. No child had a SpO2<90%. Children 3–11 months had a lower median SpO2(97%) than 12–23 months (98%) and 24–35 months (98%) (p=0.039). The SpO2distribution did not differ by sex (p=0.959).

Conclusion

A SpO2threshold for hypoxaemia derived from the 2.5th, 5th or 10th percentile of well children is higher than <90%. If a higher threshold than <90% is adopted into LMIC care algorithms then decision-making using SpO2must also consider the child’s clinical status to minimise misclassification of well children as hypoxaemic. Younger children in lower altitude LMICs may require a different threshold for hypoxaemia than older children. Evaluating the mortality risk of sick children using higher SpO2thresholds for hypoxaemia is a key next step.
Temporal variability of soil fertility indicators and sampling periods in Québec
Authors: Chelabi Hakima , Khiari Lotfi , Gallichand Jacques
Published: November 2021

An inadequate soil sampling time leads to difficulties in interpreting soil tests, to incorrect recommendations for soil amendments and fertilizers, and to inappropriate environmental protection restrictions. Soil samples may be collected from agricultural fields before, during, or after the crop growth period. Since the time of soil sample collection can affect soil tests results, the objective of this study was to evaluate the effect of sampling time on measurements representativity of 15 fertility indicators in two fields located in La Pocatière (Québec, Canada). The soils were of fine (G1) and medium (G2) textural groups and were sampled weekly for 33 weeks per year during four years. Data analyses included descriptive statistics, time-series decomposition, and time autocorrelation function (ACF). Since results of these analyses showed a clear seasonal effect only for Mehlich-3 extracted phosphorus (PM3), soil phosphorus saturation index (SPS) for both G1 and G2 soils, and for pHW for G1 only, we recommend that the sampling calendar should be restricted to the first five weeks of spring (until the end of May) and to the entire fall period (starting in early September). Also, the temporal autocorrelation was four weeks on average. This implies that, for an initial year, whichever date is chosen for the sampling, the following annual sampling should be done within a four-week time window (i.e., two weeks before until two weeks after the initial sampling date). Time series are an important element to consider in selecting a representative sampling period for soil fertility indicators.
HURRY UP OR WAIT: ARE PRIVATE INVESTMENTS IN CLIMATE CHANGE ADAPTATION DELAYED?
Authors: SIMS CHARLES , NULL SARAH E. , MEDELLIN-AZUARA JOSUE , ODAME AUGUSTINA
Published: November 2021

Adaptation gaps arise when observed adaptation to climate change is slower than perceived adaptation potential. Two common explanations for adaptation gaps are (1) private parties failing to recognize that the climate is changing and (2) the cost of adaptation is higher than commonly believed. This paper shows how these two explanations are linked and that the likelihood and duration of adaptation gaps depend on whether climate change is characterized by stationary or non-stationary dynamics. Using an investment in water-saving irrigation in California’s Central Valley as an illustrative example, we find little evidence that failing to account for climate change would explain adaptation gaps. A more likely explanation for adaptation gaps is a failure to account for the adaptation option value that arises due to the possibility of maladaptation.
Structural damage to carbonate pillar hazardous rock masses subject to long-term water-level fluctuations in the Three Gorges reservoir area, China
Authors: Huang Bolin , Dong Xingchen , Yang Chao , Qin Zhen , Zhang Peng
Published: November 2021

Given the wide distribution of carbonate pillars in the Three Gorges reservoir area, there is a need to investigate the possible structural damage they experience from long-term water-level fluctuations. This study analysed the coupled effects of an improved time-dependent crack propagation pattern and failure modes of structural rock masses under stress-seepage using the Jianchuandong pillar hazardous rock mass (JCD) as a case study. A new crack simulation method based on

FLAC
3D

is proposed in which the interface element is immediately set on the surface of the yielding zone during the calculation step when a zone yields under tensile or shear stress. The two zones are directly separated during the tension or shearing of the bond at the contact surface. The JCD simulations illustrated that fractures and failure zones within the rock mass would propagate along the existing vertical cracks and extend to the base toe. The base rock mass would experience fracturing, finally leading to failure of the entire rock mass. The presented model provides sufficiently accurate predictions and is a suitable method for analysing time-dependent failure of pillar hazardous rock masses subject to water-level fluctuations.

Thematic collection:
This article is part of the Role of water in destabilizing slopes collection available at:
https://www.lyellcollection.org/cc/Role-of-water-in-destabilizing-slopes
Event Graph Neural Network for Opinion Target Classification of Microblog Comments
Authors: Xiang Yan , Yu Zhengtao , Guo Junjun , Huang Yuxin , Xian Yantuan
Published: November 2021

Opinion target classification of microblog comments is one of the most important tasks for public opinion analysis about an event. Due to the high cost of manual labeling, opinion target classification is generally considered as a weak-supervised task. This article attempts to address the opinion target classification of microblog comments through an event graph convolution network (EventGCN) in a weak-supervised manner. Specifically, we take microblog contents and comments as document nodes, and construct an event graph with three typical relationships of event microblogs, including the co-occurrence relationship of event keywords extracted from microblogs, the reply relationship of comments, and the document similarity. Finally, under the supervision of a small number of labels, both word features and comment features can be represented well to complete the classification. The experimental results on two event microblog datasets show that EventGCN can significantly improve the classification performance compared with other baseline models.