bluuebunny/crossref_metadata_2025 huggingface dataset:
Game jams for cultural safety training in Colombian medical education: a pilot randomised controlled trial
Authors: Pimentel Juan , Cockcroft Anne , Andersson Neil
Published: May 2021

Objectives

Explore the acceptability and feasibility of a randomised controlled trial (RCT) to assess game jams—participatory events to cocreate digital or board games in a time-constrained environment—in cultural safety training of medical students. The pilot tests methods and procedures and explores the validity and reliability of our research instrument.

Design

Two-arm parallel-group pilot RCT with a 1:1 allocation ratio.

Setting

Faculty of Medicine in Chia, Colombia.

Participants

79 final-year medical students completed the baseline questionnaire. 64 completed the assessment immediately after the intervention: 31 in the intervention group (20 female) and 33 in the control group (18 female). 35 completed the final assessment (18 control and 17 intervention) 4 months after the intervention.

Interventions

The intervention group joined a 5-hour game jam composed of a 1-hour lecture and a 4-hour session to create and to play educational games about cultural safety. The control group had a 1-hour conventional lesson, followed by a 4-hour study session of selected readings on cultural safety.

Primary and secondary outcome measures

The instrument, an online self-administered Likert-type questionnaire, assessed a self-reported cultural safety results chain based on a planned behaviour theory. Student recruitment, retention and perception of the activity determined acceptability. The methodological and logistical factors for a full-scale study determined feasibility.

Results

After the intervention, students randomised to that arm reported a slightly higher cultural safety score (26.9) than those in the control group (25.9) (difference −1, 95% CI −3.0 to 1.0). Students described game jam learning in favourable terms and considered cultural safety training relevant. The university authorised the conduct of the full-scale trial.

Conclusion

Game jam learning is feasible and acceptable for cultural safety training of Colombian medical students. Researchers and educators may find our results informative in the design of RCTs assessing educational interventions.

Trial registration number

ISRCTN14261595(stage: pilot study results)
Disease and demography: a systems-dynamic cohort-component population model to assess the implications of disease-specific mortality targets
Authors: Husain Muhammad Jami , Datta Biplab Kumar , Kostova Deliana
Published: May 2021

Introduction

The 2015 Sustainable Development Goals include the objective of reducing premature mortality from major non-communicable diseases (NCDs) by one-third by 2030. Accomplishing this objective has demographic implications with relevance for countries’ health systems and costs. However, evidence on the system-wide implications of NCD targets is limited.

Methods

We developed a cohort-component model to estimate demographic change based on user-defined disease-specific mortality trajectories. The model accounts for ageing over 101 annual age cohorts, disaggregated by sex and projects changes in the size and structure of the population. We applied this model to the context of Bangladesh, using the model to simulate demographic outlooks for Bangladesh for 2015–2030 using three mortality scenarios. The ‘status quo’ scenario entails that the disease-specific mortality profile observed in 2015 applies throughout 2015–2030. The ‘trend’ scenario adopts age-specific, sex-specific and disease-specific mortality rate trajectories projected by WHO for the region. The ‘target’ scenario entails a one-third reduction in the mortality rates of cardiovascular disease, cancer, diabetes and chronic respiratory diseases between age 30 and 70 by 2030.

Results

The status quo, trend and target scenarios projected 178.9, 179.7 and 180.2 million population in 2030, respectively. The cumulative number of deaths during 2015–2030 was estimated at 17.4, 16.2 and 15.6 million for each scenario, respectively. During 2015–2030, the target scenario would avert a cumulative 1.73 million and 584 000 all-cause deaths compared with the status quo and trend scenarios, respectively. Male life expectancy was estimated to increase from 71.10 to 73.47 years in the trend scenario and to 74.38 years in the target scenario; female life expectancy was estimated to increase from 73.68 to 75.34 years and 76.39 years in the trend and target scenarios, respectively.

Conclusion

The model describes the demographic implications of NCD prevention and control targets,estimating the potential increase in life expectancy associated with achieving key NCD reduction targets. The results can be used to inform future health system needs and to support planning for increased healthcare coverage in countries.
Rural family physician perspectives on communication with urban specialists: a qualitative study
Authors: Wilson Margo M , Devasahayam Augustine Joshua , Pollock Nathaniel J , Dubrowski Adam , Renouf Tia
Published: May 2021

Objective

Communication is a key competency for medical education and comprehensive patient care. In rural environments, communication between rural family physicians and urban specialists is an essential pathway for clinical decision making. The aim of this study was to explore rural physicians’ perspectives on communication with urban specialists during consultations and referrals.

Setting

Newfoundland and Labrador, Canada.

Participants

This qualitative study involved semistructured, one-on-one interviews with rural family physicians (n=11) with varied career stages, geographical regions, and community sizes.

Results

Four themes specific to communication in rural practice were identified. The themes included: (1) understanding the contexts of rural care; (2) geographical isolation and patient transfer; and (3) respectful discourse; and (4) overcoming communication challenges in referrals and consultations.

Conclusions

Communication between rural family physicians and urban specialists is a critical task in providing care for rural patients. Rural physicians see value in conveying unique aspects of rural clinical practice during communication with urban specialists, including context and the complexities of patient transfers.
Use of carnosine in the prevention of cardiometabolic risk factors in overweight and obese individuals: study protocol for a randomised, double-blind placebo-controlled trial
Authors: Menon Kirthi , Cameron James D , de Courten Maximilian , de Courten Barbora
Published: May 2021

Introduction

Carnosine, an over the counter food supplement, has been shown to improve glucose metabolism as well as cardiovascular risk factors in animal and human studies through its anti-inflammatory, antioxidative, antiglycating and chelating properties. The aim of this study is to establish if carnosine supplementation improves obesity, insulin sensitivity, insulin secretion, cardiovascular risk factors including arterial stiffness and endothelial function, and other risk factors related to diabetes and cardiovascular disease in the overweight and obese population.

Methods and analysis

Fifty participants will be recruited to be enrolled in a double-blind randomised controlled trial. Eligible participants with a body mass index (BMI) between 25 and 40 kg/m2will be randomly assigned to the intervention or placebo group. Following a medical review and oral glucose tolerance test to check eligibility, participants will then undergo testing. At baseline, participants will have anthropometric measurements (BMI, dual X-ray absorptiometry and peripheral quantitative CT scan), measurements of glucose metabolism (oral glucose tolerance test, intravenous glucose tolerance test and euglycaemic hyperinsulinaemic clamp), cardiovascular measurements (central blood pressure, endothelial function and arterial stiffness), a muscle and fat biopsy, physical activity measurement, liver fibroscan, cognitive function and questionnaires to assess dietary habits, sleep quality, depression, and quality of life. Following baseline assessments, participants will be randomised to either 2 g carnosine or placebo for 15 weeks. In the 15th week, all assessments will be repeated. The preplanned outcome metric is the change between baseline and follow-up measures.

Ethics and dissemination

This study is approved by the Human Research Ethics Committee of Monash Health and Monash University, Australia.

Trial registration number

NCT02686996.
Learning needs, preferred learning methods and learning challenges of first five general practitioners in NHS Scotland: a qualitative study
Authors: Cunningham David E , Ward Caroline , Kyle John , Yeoman Lynsey
Published: May 2021

Objectives

To identify the learning needs and preferred learning methods of First5 general practitioners (GPs) in National Health Service (NHS) Scotland.

Design

Qualitative research study using grounded theory methods. First5 GPs were interviewed in small focus groups or individual interviews in-person, or over the telephone depending on their preference.

Setting

General practice in NHS Scotland.

Participants

GPs, within the first 5 years of completion of GP training, who were working in NHS Scotland.

Results

Thirty-eight First5s were recruited to the study. Participants recognised that gaps in their GP training became apparent in independent practice. Some of this related to NHS appraisal and revalidation, and with the business of general practice. They were interested in learning from an older generation of GPs but perceived that preferred learning methods differed. First5 GPs were less reliant on reading journals to change their practice, preferring to find learning resources that allowed them to gain new knowledge quickly and easily. There were considerations about resilience and of the challenges of learning in remote and rural areas of NHS Scotland. This related to travel costs and time, and to accessibility of learning courses. Participants appreciated collective learning and commented about the logistics and costs of learning.

Conclusions

Preferred learning methods and learning resources differ with First5 GPs compared with those who have been in practice for some years. Learning providers need to recognise this and take these differences into account when planning and preparing learning in the future.
The Young Disability Questionnaire-Spine: item development, pilot testing and conceptualisation of a questionnaire to measure consequences of spinal pain in children
Authors: Meldgaard Emilie , Lauridsen Henrik Hein , Hestbaek Lise
Published: May 2021

Objective

The objective of the present study was to develop a questionnaire to measure the consequences of neck, midback and low back pain, relevant for schoolchildren aged 9–12 years.

Design

The development of the questionnaire was carried out in three phases: (1) generation of items, (2) pilot testing and (3) conceptualisation.

Setting

Danish primary schools.

Participants

Children aged 9–12 years from a local school were invited for completion of questionnaires and subsequent interviews.

Methods

In phase 1 an extensive literature search identified items from existing questionnaires measuring musculoskeletal disability in children. These were added to items from a previously conducted qualitative study and constituted the basis for the new questionnaire. In phase 2 two consecutive pilot tests were performed to test for comprehension and feasibility of the questionnaire. Phase 3 consisted of a categorisation of the newly developed items according to the WHO’s International Classification of Functioning, Disability and Health (ICF).

Results

The combination of the previously conducted qualitative study and the literature review resulted in an item pool of 35 items. Through the process of item formulation and pilot testing, these were reduced to 28 items in the final questionnaire, which represented all categories in the ICF model. The qualitative study identified codes giving relative weight to four important domains. These were not included in any of the existing questionnaires but were added to the new questionnaire.

Conclusions

We developed the first version of a questionnaire to measure the consequences of back or neck pain in children. The process showed the importance of combining research methods, each adding important contributions to the final product. Subsequent work will finalise the questionnaire, allowing various options for use of the questionnaire.
Maternal healthcare utilsation and complete childhood vaccination in sub-Saharan Africa: a cross-sectional study of 29 nationally representative surveys
Authors: Budu Eugene , Ahinkorah Bright Opoku , Aboagye Richard Gyan , Armah-Ansah Ebenezer Kwesi , Seidu Abdul-Aziz , Adu Collins , Ameyaw Edward Kwabena , Yaya Sanni
Published: May 2021

Objective

The objective of the study was to examine the association between maternal healthcare utilisation and complete childhood vaccination in sub-Saharan Africa.

Design

Our study was a cross-sectional study that used pooled data from 29 countries in sub-Saharan Africa.

Participants

A total of 60 964 mothers of children aged 11–23 months were included in the study.

Outcome variables

The main outcome variable was complete childhood vaccination. The explanatory variables were number of antenatal care (ANC) visits, assistance during delivery and postnatal care (PNC).

Results

The average prevalence of complete childhood vaccination was 85.6%, ranging from 67.0% in Ethiopia to 98.5% in Namibia. Our adjusted model, children whose mothers had a maximum of three ANC visits were 56% less likely to have complete vaccination, compared with those who had at least four ANC visits (adjusted OR (aOR)=0.44, 95% CI 0.42 to 0.46). Children whose mothers were assisted by traditional birth attendant/other (aOR=0.43, 95% CI 0.41 to 0.56) had lower odds of complete vaccination. The odds of complete vaccination were lower among children whose mothers did not attend PNC clinics (aOR=0.26, 95% CI 0.24 to 0.29) as against those whose mothers attended.

Conclusion

The study found significant variations in complete childhood vaccination across countries in sub-Saharan Africa. Maternal healthcare utilisation (ANC visits, skilled birth delivery, PNC attendance) had significant association with complete childhood vaccination. These findings suggest that programmes, interventions and strategies aimed at improving vaccination should incorporate interventions that can enhance maternal healthcare utilisation. Such interventions can include education and sensitisation, reducing cost of maternal healthcare and encouraging male involvement in maternal healthcare service utilisation.
Cost-effectiveness analysis of 3 months of weekly rifapentine and isoniazid compared to isoniazid monotherapy in a Canadian arctic setting
Authors: Pease Christopher , Alvarez Gonzalo , Mallick Ranjeeta , Patterson Mike , Finn Sandy , Habis Yahya , Schwartzman Kevin , Kilabuk Elaine , Mulpuru Sunita , Zwerling Alice
Published: May 2021

Objective

To assess the cost effectiveness of once weekly rifapentine and isoniazid for 12 weeks (3HP) to the current standard care for latent tuberculosis (TB) infection (LTBI) in Iqaluit, Nunavut.

Design

A cost-effectiveness analysis using a Markov model reflecting local practices for LTBI treatment.

Setting

A remote Canadian arctic community with a high incidence of TB.

Participants

Hypothetical patients with LTBI.

Interventions

The cost effectiveness of 3HP was compared with the existing standard of care in the study region which consists of 9 months of twice weekly isoniazid (9H) given by directly observed therapy.

Outcome measures

Effectiveness was measured in quality-adjusted life years (QALYs) with model parameters were derived from historical programmatic data, a local implementation study of 3HP and published literature. Costs from the perspective of the Nunavut healthcare system were measured in 2019 US dollars and were obtained primarily from local, empirically collected data. Secondary health outcomes included estimated TB cases and TB deaths averted using 3HP versus 9H. One way and probabilistic sensitivity analyses were performed.

Results

The 3HP regimen was dominant over 9H: costs were lower (US$628 vs US$924/person) and health outcomes slightly improved (20.14 vs 20.13 QALYs/person). In comparison to 9H, 3HP treatment resulted in fewer TB cases (27.89 vs 30.16/1000 persons) and TB deaths (2.29 vs 2.48/1000 persons). 3HP completion, initiation and risk of fatal adverse events were the primary drivers of cost effectiveness.

Conclusion

In a remote Canadian arctic setting, using 3HP instead of 9H for LTBI treatment may result in cost savings and similar or improved health outcomes.
When COVID-19 enters in a community setting: an exploratory qualitative study of community perspectives on COVID-19 affecting mental well-being
Authors: Ali Naureen Akber , Feroz Anam Shahil , Akber Noshaba , Feroz Ridah , Nazim Meghani Salima , Saleem Sarah
Published: May 2021

Objective

The COVID-19 pandemic has resulted in an increased level of anxiety and fear among the general population related to its management and infection spread. Considering the relevance of present circumstances, we explored perceptions and attitudes of community members towards their mental well-being during the COVID-19 pandemic.

Setting

We conducted an exploratory qualitative study using a purposive sampling approach, at two communities of Karachi, Pakistan.

Participants

In-depth interviews were conducted with community members including, young adults, middle-aged adults and older adults of both genders. Study data were analysed manually using the thematic analysis technique.

Primary outcome

The primary outcome is assessing community perception towards their mental well-being amidst the COVID-19 pandemic.

Results

A total of 27 in-depth interviews were conducted, between May and June 2020. Three overarching themes were identified: (1) impact of COVID-19 on the mental health of the general communities; (2) current coping mechanisms to adapt to the new reality and (3) recommendations to address the mental health of communities. Generally, community members underwent increased anxiety and fear due to the contagious nature of the virus. Alongside, social, financial and religious repercussions of the pandemic have also heightened psychological distress among community members. However, community members were able to point out some of the coping mechanisms such as getting closer to God, connecting with family, participating in mental health sessions and resetting lives by indulging in diverse activities. Simultaneously, they also recommended the need for remote mental health services for elders and continuous efforts by the government to address the mental health needs of the community.

Conclusion

COVID-19-associated mental health consequences have hit every individual in society. The study finding has the potential to guide the development of context-specific innovative mental health programmes to overcome the pandemic repercussions.
Maintenance of non-pharmacological strategies 6 months after patients with chronic obstructive pulmonary disease (COPD) attend a breathlessness service: a qualitative study
Authors: Luckett Tim , Roberts Mary , Swami Vinita , Smith Tracy , Cho Jin-Gun , Klimkeit Ester , Wheatley John R
Published: May 2021

Objectives

This study aimed to explore the degree to which non-pharmacological strategies for chronic breathlessness are sustained 6 months after completing a breathlessness service in patients with chronic obstructive pulmonary disease (COPD), and patient perceptions regarding the need for ongoing support.

Design

A qualitative approach was taken using semistructured telephone interviews. Thematic analysis used an integrative approach.

Setting

The Westmead Breathlessness Service (WBS) trains patients with COPD to self-manage chronic breathlessness over an 8-week programme with multidisciplinary input and home visits.

Participants

Patients with moderate to very severe COPD who had completed the WBS programme 6 months earlier.

Results

Thirty-two participants were interviewed. One or more breathlessness self-management strategies were sustained by most participants, including breathing techniques (n=22; 69%), the hand-held fan (n=17; 53%), planning/pacing and exercise (n=14 for each; 44%) and strategic use of a four-wheeled walker (n=8; 25%). However, almost a third of participants appeared to be struggling psychologically, including some who had refused psychological intervention. A ‘chaos narrative’ appeared to be prevalent, and many participants had poor recall of the programme.

Conclusions

Self-management strategies taught by breathlessness services to patients with moderate to very severe COPD have potential to be sustained 6 months later. However, psychological coping may be more challenging to maintain. Research is needed on ways to improve resilience to set-backs and uptake of psychological interventions, as well as to understand and address the implications of poor recall for self-management.

Trial registration number

ACTRN12617000499381
Multiple rib fractures: does flail chest matter?
Authors: Daskal Yaakov , Paran Maya , Korin Alexander , Soukhovolsky Vladislav , Kessel Boris
Published: May 2021

Background

Recent studies have reported significant morbidity and mortality in patients with multiple rib fractures, even without flail chest. The aim of this study was to compare the clinical outcome and incidence of associated chest injuries between patients with and without flail chest, with three or more rib fractures.

Methods

This study included patients with blunt trauma with at least three rib fractures, hospitalised during 2010–2019 in the Hillel Yaffe Medical Center in central Israel (level II trauma centre). Patients with and without radiologically defined flail chest were compared with regard to demographics, Injury Severity Score (ISS), GCS, systolic blood pressure (SBP) on admission, radiological evidence of flail chest, associated chest injuries, length of stay in intensive care unit, length of hospitalisation and mortality.

Results

The study included 407 patients, of which 79 (19.4%) had flail chest. Overall, pneumothorax and haemothorax were more common among patients with flail chest (p<0.05). When comparing patients with three to five rib fractures, there was no difference in length of intensive care and length of hospitalisation or mortality; however, there was a higher incidence of pneumothorax (24.6% vs 50.0%, p<0.05). When comparing patients with six or more rib fractures, no difference was found between patients with and without flail chest.

Conclusion

In patients with three to five rib fractures, pneumothorax is more common among patients with flail chest. Clinical significance of flail chest in patients with more than six rib fractures is questionable and flail chest may not be a reliable marker for severity of chest injury in patients with more than six fractures.
Multicentre derivation and validation of a colitis-associated colorectal cancer risk prediction web tool
Authors: Curtius Kit , Kabir Misha , Al Bakir Ibrahim , Choi Chang Ho Ryan , Hartono Juanda L , Johnson Michael , East James E ,   Oxford IBD Cohort Study Investigators, Lindsay James O , Vega Roser , Thomas-Gibson Siwan , Warusavitarne Janindra , Wilson Ana , Graham Trevor A , Hart Ailsa
Published: May 2021

Objective

Patients with ulcerative colitis (UC) diagnosed with low-grade dysplasia (LGD) have increased risk of developing advanced neoplasia (AN: high-grade dysplasia or colorectal cancer). We aimed to develop and validate a predictor of AN risk in patients with UC with LGD and create a visual web tool to effectively communicate the risk.

Design

In our retrospective multicentre validated cohort study, adult patients with UC with an index diagnosis of LGD, identified from four UK centres between 2001 and 2019, were followed until progression to AN. In the discovery cohort (n=246), a multivariate risk prediction model was derived from clinicopathological features using Cox regression. Validation used data from three external centres (n=198). The validated model was embedded in a web tool to calculate patient-specific risk.

Results

Four clinicopathological variables were significantly associated with AN progression in the discovery cohort: endoscopically visible LGD >1 cm (HR 2.7; 95% CI 1.2 to 5.9), unresectable or incomplete endoscopic resection (HR 3.4; 95% CI 1.6 to 7.4), moderate/severe histological inflammation within 5 years of LGD diagnosis (HR 3.1; 95% CI 1.5 to 6.7) and multifocality (HR 2.9; 95% CI 1.3 to 6.2). In the validation cohort, this four-variable model accurately predicted future AN cases with overall calibration Observed/Expected=1.01 (95% CI 0.64 to 1.52), and achieved 100% specificity for the lowest risk group over 13 years of available follow-up.

Conclusion

Multicohort validation confirms that patients with large, unresected, multifocal LGD and recent moderate/severe inflammation are at highest risk of developing AN. Personalised risk prediction provided via the Ulcerative Colitis-Cancer Risk Estimator (www.UC-CaRE.uk) can support treatment decision-making.
Biochemical assessment of adequate levothyroxine replacement in primary hypothyroidism differs with different TSH assays: potential clinical implications
Authors: Kalaria Tejas R , Sanders Anna , Ford Clare , Buch Harit , Fenn Jonathan Samuel , Ashby Helen L , Mohammed Pervaz , Gama Rousseau Mariano
Published: May 2021

Aim

Thyroid stimulating hormone (TSH) assays provided by Abbott Laboratories and Roche Diagnostics are used by approximately 75% of laboratories in the UK. We assessed the potential impact of Abbott and Roche TSH assay differences on the biochemical assessment of levothyroxine replacement in primary hypothyroidism.

Method

Samples from 100 consecutive primary care patients (83 women, median age 64 years, IQR 51–73 years) with primary hypothyroidism on adequate levothyroxine based on an Abbott Architect TSH in the reference range were analysed for TSH on Roche cobas within 24 hours. The Abbott and Roche TSH results were compared. Over 1 year, TSH results from patients in primary care from the laboratories with Abbott and Roche methods were compared.

Results

The median (IQR) Roche TSH (2.5 (1.3–3.6) mIU/L) was 30%±10% higher (p<0.001) than Abbott TSH (1.9 (1.1–2.6) mIU/L). Although all Abbott TSH results were in the Abbott specific reference range, 14 patients (14%) had Roche TSH results above the Roche specific reference range. In the 1 year gather, Roche TSH (1.9 (1.3–2.9) mIU/L, n=103 932) results were higher (p<0.001) than Abbott TSH (1.5 (1.0–2.2) mIU/L, n=1 10 544) results. The TSH results were above their assay-specific upper reference limit in 10.7% of Roche results and 4.2% of Abbott results.

Conclusion

Biochemical assessment of levothyroxine replacement may be dependent on the type of TSH assay. Laboratorians and clinicians should be aware that the lack of harmonisation between TSH methods and their assay-specific reference ranges may potentially lead to different patient management decisions. We suggest lot verification in laboratories should include processes to identify cumulative drift in assay performance.
How does income affect mental health and health behaviours? A quasi-experimental study of the earned income tax credit
Authors: Shields-Zeeman Laura , Collin Daniel F. , Batra Akansha , Hamad Rita
Published: May 2021

Background

Although research has repeatedly demonstrated the association between poverty, mental health, and health behaviours, there is limited evidence on the effects of interventions to improve these outcomes by addressing poverty directly. Moreover, most prior studies are often confounded by unobserved characteristics of individuals, making it difficult to inform possible interventions. We addressed this gap in the literature by leveraging quasi-random variation in the earned income tax credit (EITC)—the largest US poverty alleviation programme for families with children—to examine the effects on overall health, psychological distress, smoking, and alcohol consumption.

Methods

We used a large diverse national sample drawn from the Panel Study of Income Dynamics (N=34 824). We first conducted ordinary least squares (OLS) models to estimate the association of income and the EITC with the outcomes of interest. We subsequently employed a quasi-experimental instrumental variables (IV) analysis—in which EITC refund size was the instrument—to estimate the effect of income itself.

Results

In OLS models, higher income was associated with reductions in psychological distress, increased drinking, increased smoking, and more cigarettes per day, and larger EITC refunds were associated with reductions in psychological distress. In IV models, higher income was associated with decreased psychological distress.

Conclusion

These results suggest that typical correlational studies of the health effects of income may be confounded, although results may not generalise to income distributed in different ways than the EITC. The findings also provide valuable information for policymakers and researchers seeking to address socioeconomic disparities in mental health.
Long-term exposure to ambient fine particulate matter originating from traffic and residential wood combustion and the prevalence of depression
Authors: Allaouat Sara , Yli-Tuomi Tarja , Tiittanen Pekka , Turunen Anu W , Siponen Taina , Kukkonen Jaakko , Kangas Leena , Kauhaniemi Mari , Aarnio Mia , Ngandu Tiia , Lanki Timo
Published: May 2021

Introduction

Air pollution has been suggested to be associated with depression. However, current evidence is conflicting, and no study has considered different sources of ambient particulate matter with an aerodynamic diameter below 2.5 µm (PM2.5). We evaluated the associations of long-term exposure to PM2.5from road traffic and residential wood combustion with the prevalence of depression in the Helsinki region, Finland.

Methods

We conducted a cross-sectional analysis based on the Helsinki Capital Region Environmental Health Survey 2015–2016 (N=5895). Modelled long-term outdoor concentrations of PM2.5were evaluated using high-resolution emission and dispersion modelling on an urban scale and linked to the home addresses of study participants. The outcome was self-reported doctor-diagnosed or treated depression. We applied logistic regression and calculated the OR for 1 μg/m3increase in PM2.5, with 95% CI. Models were adjusted for potential confounders, including traffic noise and urban green space.

Results

Of the participants, 377 reported to have been diagnosed or treated for depression by a doctor. Long-term exposure to PM2.5from road traffic (OR=1.23, 95% CI 0.86 to 1.73; n=5895) or residential wood combustion (OR=0.78, 95% CI 0.43 to 1.41; n=5895) was not associated with the prevalence of depression. The estimates for PM2.5from road traffic were elevated, but statistically non-significant, for non-smokers (OR=1.38, 95% CI 0.94 to 2.01; n=4716).

Conclusions

We found no convincing evidence of an effect of long-term exposure to PM2.5from road traffic or residential wood combustion on depression.
Coexpression of Epha10 and Gli3 Promotes Breast Cancer Cell Proliferation, Invasion and Migration
Authors: Peng Jing , Zhang Danhua
Published: May 2021

This study investigated the influences of EphA10 and Gli3 on breast cancer (BC) cell proliferation, invasion and migration. Immunohistochemistry was used to reveal the expressions of EphA10 and Gli3 in 18 intraductal carcinomas, 124 invasive carcinomas, 50 paracancerous tissues (2 cm away from the tumor, when possible or available), 50 lobular hyperplastic tissues and 30 normal breast tissues. qRT-PCR and Western blotting were applied to detect the expressions of EphA10 and Gli3 in invasive BC cells (MDA-MB-231, BT20 and Hs578T) and normal human mammary epithelial cells (MCF10A). MDA-MB-231 and BT20 cells were transfected with sh-EphA10, sh-Gli3 or sh-EphA10+sh-Gli3. CCK-8 was used to test the proliferation of transfected MDA-MB-231 and BT20 cells. Transwell and scratch assays were used for evaluation of invasion and migration of the transfected cells. EphA10 and Gli3 were highly expressed in invasive carcinomas and invasive BC cells. The expressions of EphA10 and Gli3 were associated with the clinicopathological characteristics and poor prognosis of patients with invasive BC. Knockdown of EphA10 or Gli3 suppressed activities of BC cells. Knockdown of both EphA10 and Gli3 was more effective than knockdown of Gli3 alone. Taken together, coexpression of EphA10 and Gli3 promotes BC cell proliferation, invasion and migration.
Republished: Resolution of an enlarging subdural haematoma after contralateral middle meningeal artery embolisation
Authors: Rutledge Caleb , Baranoski Jacob F , Catapano Joshua S , Jadhav Ashutosh P , Albuquerque Felipe C , Ducruet Andrew F
Published: May 2021

A man in his 50s presented 1 month after an automobile accident with worsening headaches and an enlarging chronic left subdural haematoma (SDH). He underwent left middle meningeal artery (MMA) embolisation. Due to tortuosity at its origin, we were unable to catheterise the MMA distally. Only proximal coil occlusion at the origin was performed. Follow-up interval head CT showed an increase in the size of the SDH with new haemorrhage, worsening mass effect and midline shift. However, he remained neurologically intact. Contralateral embolisation of the right MMA was performed with a liquid embolic agent. His headaches improved, and a follow-up head CT 3 months later showed near-complete resolution of the SDH.
Health transition of the causes of mortality between 2005 and 2015 in Guangdong, China
Authors: Zheng Xue-yan , Yi Qian , Xu Yan-jun , Zeng Xin-ying , Xu Xiao-jun , Chen Ge , Ma Shu-li , Tang Si-li , Lin Li-feng
Published: May 2021

Objectives

To analyse the patterns of transition of health burden for 110 causes of death by stratification of age, sex and geographic regions in Guangdong between 2005 and 2015.

Methods

We analysed the age-specific, sex-specific, region-specific mortality in Guangdong based on assembled databases. County-level surveillance data were calculated to inform city-level changes.

Results

The age-standardised mortality of all causes, non-communicable diseases (NCDs), communicable diseases, maternal diseases, neonatal diseases, malnutrition and injury declined progressively. Despite declining mortality of NCDs, the overall burden of disease was dominated by NCDs (ie, cerebrovascular disease, chronic obstructive pulmonary disease) that still accounted for 86.93% and 88.12% of death in 2005 and 2015, respectively. Considerable variations across geographic regions were observed (lowest in Pearl River Delta and highest in west Guangdong). There was a modest shift to transport injuries at younger ages and unintentional injuries in the elderly.

Conclusions

We have documented a dramatic change in the overall mortality and age-specific, sex-specific and cause-specific mortality in Guangdong province between 2005 and 2015. The significant burden of NCDs remains a major healthcare issue despite the notable progress in reducing mortality in Guangdong, China. Our findings highlight important unmet needs to refine healthcare services by taking into account the inequity of age, sex and geographic regions. Identification of the ‘treatable’ risk factors and improved disease surveillance should be continuously improved to minimised the overall and cause-specific mortality.
Population transfer in a nonlinear three-level Λ-system by Stark - chirped rapid adiabatic passage
Authors: Saadati-Niari M. , Shirkhanghah N.
Published: May 2021

We propose the use of the Stark-chirped rapid adiabatic passage (SCRAP) method to induce a complete population transfer in a nonlinear three-level Λ-type system (nl-SCRAP). We also use the nl-SCRAP method for creating stable diatomic ground molecular Bose–Einstein condensates (BECs) from atomic BECs. In this three-laser technique the pump and Stokes pulses are slightly detuned from transition frequencies, and a third strong hyperbolic-tangent laser pulse induces dynamic Stark shifts of the relevant transitions and compensates for third-order nonlinearities. If the timing of the three pulses is appropriately chosen, the nonlinear quantum system is prepared to almost complete population inversion between the two lower states in the Λ-like scheme. The paper shows that the efficiency of the nl-SCRAP is higher than the nonlinear stimulated Raman adiabatic passage (nl-STIRAP) technique, and this method can be used in one-photon as well as multi-photon transitions. The transfer process is robust concerning fluctuations of experimental parameters, such as peak Rabi frequencies, the time delay between pulses, and static detunings.
New insights into the biodegradation of polylactic acid: from degradation to upcycling
Authors: Xu Bin , Chen Yinping , He Jie , Cao Shixiang , Liu Jiawei , Xue Rui , Xin Fengxue , Qian Xiujuan , Zhou Jie , Dong Weiliang , Jiang Min
Published: May 2021

Owing to its biosynthetic and biodegradable properties, polylactic acid (PLA) is considered to be a most promising biopolymer that could play a crucial role as a potentially environmentally friendly material for a sustainable bioeconomy. However, its long-life cycle indicates that it cannot be easily degraded in nature. Therefore, understanding the biodegradation mechanism of PLA is important for reducing the impacts of waste plastic and waste disposal. With the recent development of molecular biology techniques, some studies have confirmed that specific groups of microorganisms can facilitate the biodegradation of PLA. Here, recent advances in the biodegradation of PLA (i.e., microbial and enzymatic degradation) and key factors affecting the degradation efficiency were reviewed. In addition, compared with complete degradation through mineralization, upcycling is also proposed as a more recyclable strategy for disposing of waste plastics.
A prescription for projectors to compute helicity amplitudes in D dimensions
Authors: Chen Long
Published: May 2021

This article discusses a prescription to compute polarized dimensionally regularized amplitudes, providing a recipe for constructing simple and general polarized amplitude projectors in D dimensions that avoids conventional Lorentz tensor decomposition and avoids also dimensional splitting. Because of the latter, commutation between Lorentz index contraction and loop integration is preserved within this prescription, which entails certain technical advantages. The usage of these D-dimensional polarized amplitude projectors results in helicity amplitudes that can be expressed solely in terms of external momenta, but different from those defined in the existing dimensional regularization schemes. Furthermore, we argue that despite being different from the conventional dimensional regularization scheme (CDR), owing to the amplitude-level factorization of ultraviolet and infrared singularities, our prescription can be used, within an infrared subtraction framework, in a hybrid way without re-calculating the (process-independent) integrated subtraction coefficients, many of which are available in CDR. This hybrid CDR-compatible prescription is shown to be unitary. We include two examples to demonstrate this explicitly and also to illustrate its usage in practice.
Prediction of new scientific collaborations through multiplex networks
Authors: Tuninetti Marta , Aleta Alberto , Paolotti Daniela , Moreno Yamir , Starnini Michele
Published: May 2021

The establishment of new collaborations among scientists fertilizes the scientific environment, fostering novel discoveries. Understanding the dynamics driving the development of scientific collaborations is thus crucial to characterize the structure and evolution of science. In this work, we leverage the information included in publication records and reconstruct a categorical multiplex networks to improve the prediction of new scientific collaborations. Specifically, we merge different bibliographic sources to quantify the prediction potential of scientific credit, represented by citations, and common interests, measured by the usage of common keywords. We compare several link prediction algorithms based on different dyadic and triadic interactions among scientists, including a recently proposed metric that fully exploits the multiplex representation of scientific networks. Our work paves the way for a deeper understanding of the dynamics driving scientific collaborations, and validates a new algorithm that can be readily applied to link prediction in systems represented as multiplex networks.
Dynamic, Incremental, and Continuous Detection of Cyberbullying in Online Social Media
Authors: Chelmis Charalampos , Zois Daphney-Stavroula
Published: May 2021

The potentially detrimental effects of cyberbullying have led to the development of numerous automated, data-driven approaches, with emphasis on classification accuracy. Cyberbullying, as a form of abusive online behavior, although not well-defined, is a repetitive process, i.e., a sequence of aggressive messages sent from a bully to a victim over a period of time with the intent to harm the victim. Existing work has focused on harassment (i.e., using profanity to classify toxic comments independently) as an indicator of cyberbullying, disregarding the repetitive nature of this harassing process. However, raising a cyberbullying alert immediately after an aggressive comment is detected can lead to a high number of false positives. At the same time, two key practical challenges remain unaddressed: (i) detection timeliness, which is necessary to support victims as early as possible, and (ii) scalability to the staggering rates at which content is generated in online social networks. In this work, we introduce
CONcISE
, a novel approach for timely and accurate Cyberbullying detectiON in online social media SEssions.
CONcISE
is a two-stage online approach designed to reduce the time to raise a cyberbullying alert by sequentially examining comments as they become available over time, and minimizing the number of feature evaluations necessary for a decision to be made for each comment. Extensive experiments on a real-world Instagram dataset with

users and

comments demonstrate the effectiveness, scalability, and timeliness of our approach and its benefits over existing methods. Additional experiments using a Twitter dataset offer evidence in support of the potential generalizability of
CONcISE
to other social media platforms.
Approximating Edit Distance in Truly Subquadratic Time: Quantum and MapReduce
Authors: Boroujeni Mahdi , Ehsani Soheil , Ghodsi Mohammad , Hajiaghayi Mohammadtaghi , Seddighin Saeed
Published: May 2021

The
edit distance
between two strings is defined as the smallest number of
insertions
,
deletions
, and
substitutions
that need to be made to transform one of the strings to another one. Approximating edit distance in subquadratic time is “one of the biggest unsolved problems in the field of combinatorial pattern matching” [37]. Our main result is a quantum constant approximation algorithm for computing the edit distance in truly subquadratic time. More precisely, we give an

quantum algorithm that approximates the edit distance within a factor of 3. We further extend this result to an

quantum algorithm that approximates the edit distance within a larger constant factor.

Our solutions are based on a framework for approximating edit distance in parallel settings. This framework requires as black box an algorithm that computes the distances of several smaller strings all at once. For a quantum algorithm, we reduce the black box to
metric estimation
and provide efficient algorithms for approximating it. We further show that this framework enables us to approximate edit distance in distributed settings. To this end, we provide a MapReduce algorithm to approximate edit distance within a factor of

, with sublinearly many machines and sublinear memory. Also, our algorithm runs in a logarithmic number of rounds.
Metatranscriptomics for the Human Microbiome and Microbial Community Functional Profiling
Authors: Zhang Yancong , Thompson Kelsey N. , Branck Tobyn , Yan Yan  , Nguyen Long H. , Franzosa Eric A. , Huttenhower Curtis
Published: May 2021

Shotgun metatranscriptomics (MTX) is an increasingly practical way to survey microbial community gene function and regulation at scale. This review begins by summarizing the motivations for community transcriptomics and the history of the field. We then explore the principles, best practices, and challenges of contemporary MTX workflows: beginning with laboratory methods for isolation and sequencing of community RNA, followed by informatics methods for quantifying RNA features, and finally statistical methods for detecting differential expression in a community context. In thesecond half of the review, we survey important biological findings from the MTX literature, drawing examples from the human microbiome, other (nonhuman) host-associated microbiomes, and the environment. Across these examples, MTX methods prove invaluable for probing microbe–microbe and host–microbe interactions, the dynamics of energy harvest and chemical cycling, and responses to environmental stresses. We conclude with a review of open challenges in the MTX field, including making assays and analyses more robust, accessible, and adaptable to new technologies; deciphering roles for millions of uncharacterized microbial transcripts; and solving applied problems such as biomarker discovery and development of microbial therapeutics.
Social Protection and State–Society Relations in Environments of Low and Uneven State Capacity
Authors: Alik-Lagrange Arthur , Dreier Sarah K. , Lake Milli , Porisky Alesha
Published: May 2021

Grounded in social-contractual ideas about relationships between the governed and those who govern, the provision of social benefits to citizens has historically been predicated on expectations of acquiescence to state authority. However, the rapid expansion of noncontributory social assistance in sub-Saharan Africa, often supported by global donors through technical assistance programs, raises myriad questions about the relationship between social protection and the social contract in fragile and low-capacity contexts. Focusing on sub-Saharan Africa, but drawing on the theoretical and empirical literature on social protection from around the world, this review parses out the redistributive, contractual, and reconstitutive effects of social protection programming on citizen–state relations. We argue that program features—including targeting, conditionality, accountability mechanisms, bureaucratic reach, and the nature and visibility of state–nonstate partnerships—interact dialectically with existing state–society relationships to engender different social contract outcomes for differently situated populations.
Exploring the Application of Artificial Intelligence in Sports Training: A Case Study Approach
Authors: Wei Shiqing , Huang Puquan , Li Rui , Liu Zhiguo , Zou Yuepei
Published: May 2021

With the rapid development of computer science and information technology, artificial intelligence (AI) has been developed from theory to application. As a key technology in the modern society, AI is increasingly affecting all aspects of people’s daily lives, including sports training. AI can be considered as an assistive technology to provide specific support to athletes’ physical education training through various means such as data analysis and simulation of training scenarios. Although research on AI is still in the preliminary stage, it is significant to explore how AI can be applied in sports training since this emerging technology could facilitate people’s physical training to some extent. This paper first reviews the existing research on AI applications. Then, based on the fundamental concept and related research results of AI, this study explores three specific cases of AI application in sports training and explains the main principles. This research focuses on discussing the strong relationship between AI technology and physical education training and highlights the advantages of AI, including utilization, convenience, and innovation.