bluuebunny/crossref_metadata_2025 huggingface dataset:
Global Differences in Heart Failure With Preserved Ejection Fraction
Authors: Tromp Jasper , Claggett Brian L. , Liu Jiankang , Jackson Alice M. , Jhund Pardeep S. , Køber Lars , Widimský Jiří , Boytsov Sergey A. , Chopra Vijay K. , Anand Inder S. , Ge Junbo , Chen Chen-Huan , Maggioni Aldo P. , Martinez Felipe , Packer Milton , Pfeffer Marc A. , Pieske Burkert , Redfield Margaret M. , Rouleau Jean L. , Van Veldhuisen Dirk J. , Zannad Faiez , Zile Michael R. , Rizkala Adel R. , Inubushi-Molessa Akiko , Lefkowitz Martin P. , Shi Victor C. , McMurray John J.V. , Solomon Scott D. , Lam Carolyn S.P. ,   on behalf of the PARAGON-HF Investigators
Published: April 2021

Background:

Heart failure with preserved ejection fraction (HFpEF) is a global public health problem with important regional differences. We investigated these differences in the PARAGON-HF trial (Prospective Comparison of Angiotensin Receptor Neprilysin Inhibitor With Angiotensin Receptor Blocker Global Outcomes in HFpEF), the largest and most inclusive global HFpEF trial.

Methods:

We studied differences in clinical characteristics, outcomes, and treatment effects of sacubitril/valsartan in 4796 patients with HFpEF from the PARAGON-HF trial, grouped according to geographic region.

Results:

Regional differences in patient characteristics and comorbidities were observed: patients from Western Europe were oldest (mean 75±7 years) with the highest prevalence of atrial fibrillation/flutter (36%); Central/Eastern European patients were youngest (mean 71±8 years) with the highest prevalence of coronary artery disease (50%); North American patients had the highest prevalence of obesity (65%) and diabetes (49%); Latin American patients were younger (73±9 years) and had a high prevalence of obesity (53%); and Asia-Pacific patients had a high prevalence of diabetes (44%), despite a low prevalence of obesity (26%). Rates of the primary composite end point of total hospitalizations for HF and death from cardiovascular causes were lower in patients from Central Europe (9 per 100 patient-years) and highest in patients from North America (28 per 100 patient-years), which was primarily driven by a greater number of total hospitalizations for HF. The effect of treatment with sacubitril-valsartan was not modified by region (interaction
P
>0.05).

Conclusions:

Among patients with HFpEF recruited worldwide in PARAGON-HF, there were important regional differences in clinical characteristics and outcomes, which may have implications for the design of future clinical trials.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT01920711.
Medullary breast carcinoma: a pathogenic review and immunohistochemical study using tissue microarray
Authors: Lee Ming , Jara-Lazaro Ana Richelia , Cheok Poh Yian , Thike Aye Aye
Published: April 2021

Introduction:

Medullary breast carcinomas (MBCs) are distinguished by circumscribed, high-grade morphology with dense chronic inflammation; they are associated with the basal phenotype but have a relatively good prognosis.

Methods:

This study aimed to review the clinicopathological features of MBCs diagnosed at the Department of Pathology, Singapore General Hospital and correlate them with immunohistochemical expression of hormonal markers and c-erbB-2, the basal markers p53, cytokeratin (CK) 14, epidermal growth factor receptor (EGFR) and 34BE12, and the follow-up outcome.

Results:

Using Ridolfi’s criteria for histologic reviews, 62 patients previously diagnosed as having ‘typical MBC’ (n = 26), ‘atypical MBC’ (n = 32) and ‘invasive carcinoma with focal medullary-like features’ (n = 4) were re-classified as follows: ‘typical MBC’ (n = 6; 9.7%), ‘atypical MBC’ (n = 46; 74.2%), and ‘non-medullary infiltrating carcinoma’ (n = 10; 16.1%). Clinicopathological parameters, including ethnicity, age, tumour size and concurrent ductal carcinoma in situ (DCIS), showed no statistically significant correlation with review diagnoses and immunohistochemical findings. Presence of lymphovascular invasion and nodal stage were significantly correlated with recurrence and breast cancer-related deaths, respectively. ER negativity was significantly correlated with triple positivity for basal markers CK14, EGFR and 34BE12, which comprised patients who showed a significantly decreased disease-free survival rate within a 10–15-year follow-up period.

Conclusions:

Lymphovascular invasion and high nodal stage as well as triple negativity among typical and atypical MBCs that have basal-like phenotype represent a portion of invasive carcinomas with medullary features that may have poor outcomes in this otherwise relatively good prognostic group.
Caregiver burden and its prevalence, measurement scales, predictive factors and impact: a review with an Asian perspective
Authors: Loo Yu Xian , Yan Shi , Low Lian Leng
Published: April 2021

Caregiver burden is a well-recognised global phenomenon. The primary aim of this review is to summarise the prevalence of caregiver burden and its measurement scales, predictive factors and impact in Singapore. PubMed® and Scopus® databases were searched using the key terms ‘caregiver’, ‘burden’, ‘stress’, ‘strain’ and ‘Singapore’. A total of 206 papers were retrieved and 20 were included. This review showed that a significant proportion of caregivers in Singapore experience caregiver burden. Caregiving experiences and outcomes are affected by cultural, behavioural and socioeconomic factors. Being a Malay caregiver appears to be a protective factor for caregiver burden, whereas having negative coping strategies and care recipients with functional, cognitive and behavioural impairments are positive risk factors. As for outcomes, caregiver burden is associated with poorer self-rated health and reduced quality of life. Multiple instruments have been used to measure caregiver burden, and the Zarit Burden Interview is the most widely used.
Integrated hip fracture care pathway (IHFCP): reducing complications and improving outcomes
Authors: Heyzer Louise , Ramason Rani , Molina Joseph Antonio De Castro , Chan William Wai Lim , Loong Chen Yi , Kwek Ernest Beng Kee
Published: April 2021

Introduction:

Hip fractures in elderly people are increasing. A five-year Integrated Hip Fracture Care Pathway (IHFCP) was implemented at our hospital for seamlessly integrating care for these patients from admission to post discharge. We aimed to evaluate how IHFCP improved process and outcome measures in these patients.

Methods:

A study was conducted over a five-year period on patients with acute fragility hip fracture who were managed on IHFCP. The evaluation utilised a descriptive design, with outcomes analysed separately for each of the five years of the programme. First-year results were treated as baseline.

Results:

The main improvements in process and outcome measures over five years, when compared to baseline, were: (a) increase in surgeries performed within 48 hours of admission from 32.5% to 80.1%; (b) reduced non-operated patients from 19.6% to 11.9%; (c) reduced average length of stay at acute hospital among surgically (from 14.0 ± 12.3 days to 9.9 ± 1.0 days) and conservatively managed patients (from 19.1 ± 22.9 to 11.0 ± 2.5 days); (d) reduced 30-day readmission rate from 3.2% to 1.6%; and (e) improved Modified Functional Assessment Classification of VI to VII at six months from 48.0% to 78.2%.

Conclusion:

The IHFCP is a standardised care path that can reduce time to surgery, average length of stay and readmission rates. It is distinct from other orthogeriatric care models, with its ability to provide optimal care coordination, early transfer to community hospitals and post-discharge day rehabilitation services. Consequently, it helped to optimise patients’ functional status and improved their overall outcome.
A diverse crinoid fauna (Echinodermata, Crinoidea) from the Lower Eocene of the Gulf of Languedoc (Corbières, Aude, southern France)
Authors: ROUX MICHEL , MARTINEZ ALAIN , VIZCAÏNO DANIEL
Published: April 2021

Detailed studies of the middle Ilerdian (lower Ypresian) blue marls of the Gulf of Languedoc (Corbières, Aude, France), belonging to the north Pyrenean foreland basin, have revealed a more abundant and diverse crinoid fauna than previously documented from the Lower Eocene. Here we describe five species of stalked crinoids in the family Rhizocrinidae (Cherbonniericrinus requiensis n. sp., ?Democrinus elongatus, Globulocrinus amphoraformis n. gen., n. sp., Pseudoconocrinus doncieuxi and P. lavadensis n. sp.), one barnacle-like species in the stalkless family Holopodidae (Holopus plaziati n. sp.) and a single feather star in the family Conometridae (Amphorometra atacica). Several sites have yielded brachials and rhizoids in addition to abundant aboral cups and columnals indicating in situ fossilisation of the dissociated skeletal elements. P. lavadensis n. sp. and ?D. elongatus have been collected only from outcrops located in the upper part of the middle blue marls, while P. doncieuxi predominates, with a wide range of morphological variation, in the lower blue marls. The fossil assemblage at the locality of Réqui near Montlaur differs from the others in the smaller size of most individuals and the presence of H. plaziati n. sp., C. requiensis n. sp., G. amphoraformis n. gen., n. sp., and P. doncieuxi suboblongus n. subsp. This particular association with high juvenile mortality corresponds to an unstable environment with mixed substrates (muddy and rocky). The crinoid fauna of the Corbières appears to be the most diverse of Early Eocene age known to date. With the fauna of the London Clay, a boreal formation of the same age, it shares the presence of the genera Democrinus and Amphorometra in an open-sea environment. A comparison with extant faunas allows the depth of deposition at the Ypresian sites in the Gulf of Languedoc to be estimated between from 100 and 140 meters.
Erratum: on the correct name of Scolocerca thomasi Massa, 2021 (Orthoptera, Tettigoniidae, Phaneropterinae) from Côte d’Ivoire
Authors: MASSA BRUNO
Published: April 2021

N/A
Contribution to the knowledge of the Prioninae (Coleoptera, Cerambycidae) from the Mizoram State (India), with the first report of the genus Megobaralipton Lepesme & Breuning and new records from the country
Authors: MAJUMDER AMITAVA , DRUMONT ALAIN , JÁKL STANISLAV , TAVAKILIAN GÉRARD , MANJUNATHA HASAHOLALU BOREGOWDA , CHANDRA KAILASH
Published: April 2021

Five species of Prioninae from the Indian state of Mizoram were studied: Megobaralipton kalimantanum (Komiya & Makihara, 2001); Nepiodes bowringi (Gahan, 1894); Anomophysis hainana (Gressitt, 1940); Eurypoda (Eurypoda) nigrita Thomson, 1865 and Eurypoda (Neoprion) batesi Gahan, 1894. New country records are provided to: Megobaralipton kalimantanum (Komiya & Makihara, 2001); Anomophysis hainana (Gressitt, 1940); Eurypoda (Eurypoda) nigrita Thomson, 1865; Eurypoda (Neoprion) batesi Gahan, 1894. Nepiodes bowringi (Gahan, 1894) is record for the first time from the Indian state of Mizoram. Detailed taxonomic position of all species, their host plant, and images of dorsal habitus are provided.
Solsticial Hadley Cell ascending edge theory from supercriticality
Authors: Hill Spencer A. , Bordoni Simona , Mitchell Jonathan L.
Published: April 2021

How far the Hadley circulation’s ascending branch extends into the summer hemisphere is a fundamental but incompletely understood characteristic of Earth’s climate. Here, we present a predictive, analytical theory for this ascending edge latitude based on the extent of supercritical forcing. Supercriticality sets the minimum extent of a large-scale circulation based on the angular momentum and absolute vorticity distributions of the hypothetical state were the circulation absent. We explicitly simulate this latitude-by-latitude radiative-convective equilibrium (RCE) state. Its depth-averaged temperature profile is suitably captured by a simple analytical approximation that increases linearly with sinφ, where φ is latitude, from the winter to the summer pole. This, in turn, yields a one-third power-law scaling of the supercritical forcing extent with the thermal Rossby number. In moist and dry idealized GCM simulations under solsticial forcing performed with a wide range of planetary rotation rates, the ascending edge latitudes largely behave according to this scaling.
Observational estimates of turbulent mixing in the southeast Indian Ocean
Authors: Cyriac Ajitha , Phillips Helen E. , Bindoff Nathaniel L. , Mao Huabin , Feng Ming
Published: April 2021

This study investigates the spatio-temporal variability of turbulent mixing in the eastern South Indian Ocean using a collection of data from EM-APEX profiling floats, shipboard CTD and microstructure profilers. The floats collected 1566 profiles of temperature, salinity and horizontal velocity data down to 1200 m over a period of about four months. A fine-scale parameterization is applied to the float and CTD data to estimate turbulent mixing. Elevated mixing is observed in the upper ocean, over bottom topography and in mesoscale eddies. Mixing is enhanced in the anticyclonic eddies due to trapped near-inertial waves within the eddy. We found that cyclonic eddies contribute to turbulent mixing in the depth range of 500 – 1000 m, which is associated with downward propagating internal waves. The mean diapycnal diffusivity over 250 – 500 m depth is O(10−6) m2 s−1 and it increases to O(10−5) m2 s−1 in 500 – 1000 m in cyclonic eddies. The turbulent mixing in this region has implications for watermass transformation and large-scale circulation. Higher diffusivity (O(10−5) m2 s−1) is observed in the Antarctic Intermediate Water (AAIW) layer in cyclonic eddies whereas weak diffusivity is observed in the Subantarctic Mode Water (SAMW) layer (O(10−6) m2 s−1). Counter-intuitively, then, the SAMW watermass properties are strongly affected in cyclonic eddies whereas the AAIW layer is less affected. Comparatively high diffusivity at the location of the South Indian Countercurrent (SICC) jets suggests there are wave-mean flow interactions in addition to the wave-eddy interactions that warrant further investigation.
Adaptive event-triggered fault detection for Markovian jump systems with network time-delays
Authors: Liu Mengmeng , Yu Jinyong , Sun Yiming , Li Jiahao
Published: April 2021

In this paper, the adaptive event-triggered fault detection (FD) problem is investigated for Markovian jump systems (MJSs) with network time-delays and data package dropouts. First, a novel event-triggered communication strategy with an adaptive threshold is introduced to screen the sampled signals and reduce the data releasing frequency. Consequently, the limited communication resources and network bandwidth are saved as much as possible. Second, since communication links between the plant and filter are considered to be unreliable, the effects of intermittent package dropouts phenomenon and network time-delays are taken into account simultaneously. By using time-delay system method, the network-induced phenomena, adaptive event-triggered strategy and MJSs are unified into a networked MJSs time-delay system. Then, sufficient conditions are developed such that the resulting residual system is mean-square exponentially stable with the desired [Formula: see text] performance. Finally, a numerical example of the F-404 aircraft engine system is provided to illustrate the effectiveness and potential of the proposed design method.
Estimation and rejection of sinusoidal disturbance with unknown frequency using cascade disturbance observer
Authors: Xinyu Wen , Junjie Zhang , Xiuming Yao
Published: April 2021

A disturbance rejection approach is presented for a class of uncertain systems subject to sinusoidal disturbance with unknown frequency. The proposed disturbance estimation method includes two types of observers that are connected in cascade form. The disturbance property is excited through an auxiliary filter, and then a frequency factor observer is constructed to generate the information required by full-order state observer. Thus, with the disturbance and system state estimation values, the composite control structure including a cascade disturbance observer (CDO) and a robust feedback controller is designed. As a result, the uncertain system with unknown-frequency sinusoidal component can be controlled within the disturbance observer-based control (DOBC) framework, where the asymptotic stability performance can be guaranteed.
Detection of Domestic Violence and Abuse by Community Mental Health Teams Using the BRAVE Intervention: A Multicenter, Cluster Randomized Controlled Trial
Authors: Ruijne Roos , Mulder Cornelis , Zarchev Milan , Trevillion Kylee , van Est Roel , Leeman Eva , Willems Willemien , Gaag Mark van der , Garofalo Carlo , Bogaerts Stefan , Howard Louise , Kamperman Astrid
Published: April 2021

Despite increased prevalence of domestic violence and abuse (DVA), victimization through DVA often remains undetected in mental health care. To estimate the effectiveness of a system provider level training intervention by comparing the detection and referral rates of DVA of intervention community mental health (CMH) teams with rates in control CMH teams. We also aimed to determine whether improvements in knowledge, skills and attitudes to DVA were greater in clinicians working in intervention CMH teams than those working in control teams. We conducted a cluster randomized controlled trial in two urban areas of the Netherlands. Detection and referral rates were assessed at baseline and at 6 and 12 months after the start of the intervention. DVA knowledge, skills and attitudes were assessed using a survey at baseline and at 6 and 12 months after start of the intervention. Electronic patient files were used to identify detected and referred cases of DVA. Outcomes were compared between the intervention and control teams using a generalized linear mixed model. During the 12-month follow-up, detection and referral rates did not differ between the intervention and control teams. However, improvements in knowledge, skills and attitude during that follow-up period were greater in intervention teams than in control teams: β 3.21 (95% CI 1.18-4.60). Our trial showed that a training program on DVA knowledge and skills in CMH teams can increase knowledge and attitude towards DVA. However, our intervention does not appear to increase the detection or referral rates of DVA in patients with a severe mental illness. A low detection rate of DVA remains a major problem. Interventions with more obligatory elements and a focus on improving communication between CMH teams and DVA services are recommended.
Police Perceptions of Sex-worker Rape Victims and Their Offenders: A Vignette Study
Authors: Zvi Liza
Published: April 2021

Women who are sex workers are at high risk of being victims of sexual violence. Yet research suggests that their claims of victimization are not taken seriously enough and largely go unbelieved by the police. The current study goes beyond the issue of victim credibility to examine police officer blame attributions and judgments toward rape victims and offenders. Two-hundred and twenty police officers read a description of the rape of a young student who was either a sex worker or not. After reading the description, participants reported their perceptions of blame toward the victim and offender, as well as their perceptions of victim resistance, consequences of rape to the victim, and feelings toward the victim. Deserved punishment for the offender was also reported. The findings indicated that police officer attributions of victim-blaming were more prominent toward the sex working victim, and they assessed the consequences that she suffered as less severe. Male officers were more biased than female officers in blame attributions toward the offender, manifested in lower levels of blaming as well as in supporting more lenient sanctions, and specifically when the victim was a sex worker. Negative sentiment toward the victim was indicated, especially among male officers, which also adhered more than female officers to the idea that the victim could have resisted the attack. The findings are interpreted within the contexts of rape myths and stereotypes and unique characteristics of the police subculture. Possible implications for the investigation of rape victims and cases are discussed. The importance of the findings is highlighted by recent data indicating that sex working may be a relatively common phenomenon among young normative students.
The Impact of COVID-19 on First Nations People Health Assessments in Australia
Authors: Robertson Ross , Mian Mustafa , Sreedharan Subhashaan , Lau Phyllis
Published: April 2021

The COVID-19 (coronavirus disease 2019) pandemic has the potential to worsen existing health inequalities faced by Aboriginal and Torres Strait Islander peoples in Australia. We aimed to assess the impact of the pandemic on First Nations people health assessments using an interrupted time series model utilizing data extracted from the Australian Medicare Benefits Schedule database. Additive triple exponential smoothing was used to model health assessments undertaken between January 2017 and December 2019. The model was used to predict health assessments between January 2020 and June 2020 with 95% confidence ( P < .05). There was no significant difference between observed and predicted First Nations people health assessments in January, February, and June 2020. However, we found a statistically significant decrease in health assessments in March (16.5%), April (23.1%), and May (17.2%) 2020. The proportion of total health assessments delivered via telehealth was 0.5%, 23.6%, 17.6%, and 10.0% for March, April, May, and June 2020, respectively. The decrease in total First Nations people health assessments compounds the risk of poorer health outcomes in this population already vulnerable due to a high burden of chronic disease and considerable social, economic, and health inequalities. Strategies to improve the delivery of telehealth for First Nations people must be considered.
Thinking with complexity in evaluation: A case study review
Authors: Roche Chris , Brown Graham , Clune Samantha , Shields Nora , Lewis Virginia
Published: April 2021

Adopting complexity thinking in the design, implementation and evaluation of health and social development programmes is of increasing interest. Understanding institutional contexts in which these programmes are located directly influences shaping and eventual uptake of evaluations and relevant findings. A nuanced appreciation of the relationship between complexity, institutional arrangements and evaluation theory and practice provides an opportunity to optimise both programme design and eventual success. However, the application of complexity and systems thinking within programme design and evaluation is variously understood. Some understand complexity as the multiple constituent aspects within a system, while others take a more sociological approach, understanding interactions between beliefs, ideas and systems as mechanisms of change. This article adopts an exploratory approach to examine complexity thinking in the relational, recursive interactions between context and project design, implementation and evaluation. In doing so, common terms will be used to demonstrate the nature of shared aspects of complexity across apparently different projects.
Trauma-Informed Parenting Education Support Groups for Mothers in Substance Abuse Recovery
Authors: Sperlich Mickey I. , Bascug Erin W. , Green Susan A. , Koury Samantha , Hales Travis , Nochajski Thomas H.
Published: April 2021

Purpose:

A trauma-informed educational support group pilot addressed traumatic stress, substance use disorders (SUDs), and child-rearing for clients who were pregnant and/or parenting young children.

Methods:

Seeking Safety was adapted with parenting content and delivered at two intensive residential rehabilitation facilities. An explanatory sequential mixed methods approach was used to evaluate the pilot. Forty-eight participants completed starting assessments (intention-to-treat) and 31 graduates completed postgroup surveys (per protocol). Focus group sessions were completed with 19 graduates.

Results:

Paired samples t tests of intention-to-treat data showed a statistically significant decrease in self-reported symptoms of stress and substance cravings and increases in positive behaviors and parenting self-efficacy. There were no statistically significant differences on lifestyle behaviors, parenting skill, and parenting confidence. Most participants found the intervention acceptable and felt supported to improve their parenting.

Discussion:

Trauma-informed parenting education support in inpatient rehabilitation settings may offer an important complement to existing SUD and parenting programming.
A Practical Approach to the Evaluation and Diagnosis of Pediatric CNS Tumors
Authors: Cotter Jennifer A , Viaene Angela N , Santi Mariarita , Hawkins Cynthia , Judkins Alexander R
Published: April 2021

Tumor classification in neuropathology is a dynamic and complex topic, with many changes emerging in the past 5 years, up to and including the 2021 publication of the 5th edition of the World Health Organization Classification of Tumours of the Central Nervous System (CNS). For pediatric pathologists who will encounter brain tumors with varying frequency, it is important to understand the principles of these classification updates, particularly the inclusion of molecular genetic features and development of a layered, or integrated, diagnosis. This issue of Perspectives in Pediatric Pathology is dedicated to the examination of pediatric brain tumors, and features articles on intraoperative diagnosis and updated information on molecular-based classification for pediatric glial, glioneuronal, ependymal, and embryonal tumors of the CNS.
Primary Biphasic Hepatic Sarcoma in DICER1 Syndrome
Authors: See Sharlene C , Wadhwani Nitin R , Yap Kai Lee , Arva Nicoleta C
Published: April 2021

DICER1 tumor predisposition syndrome is a rare genetic disorder that predisposes individuals to multiple benign and malignant neoplasms. The phenotype is vast and includes pleuropulmonary blastoma (PPB), thyroid nodules, cystic nephroma, Wilms tumor, ovarian Sertoli–Leydig cell tumor, and medulloepithelioma, among others. Herein, we describe a patient with a DICER1 germline pathogenic variant presenting with two neoplasms that are not commonly encountered in the context of DICER1 syndrome. The first tumor is a multiloculated cystic hepatic lesion with a biphasic pattern, composed of cysts lined by bland biliary type (CK19-positive) epithelium surrounded by a condensation of sarcomatous spindled cell proliferation in a myxoid stroma. This neoplasm resembled PPB or cystic nephroma with malignant transformation. The second tumor is a chest nodule consistent with low-grade hidradenocarcinoma. Although it is difficult to speculate with just a single case, these unusual neoplasms occurring in particular at a young age raises the possibility that they can be inherent to, and thus, be part of the DICER1 tumor predisposition syndrome phenotype.
Disability in multiple sclerosis is related to thalamic connectivity and cortical network atrophy
Authors: Schoonheim Menno M , Pinter Daniela , Prouskas Stefanos E , Broeders Tommy AA , Pirpamer Lukas , Khalil Michael , Ropele Stefan , Uitdehaag Bernard MJ , Barkhof Frederik , Enzinger Christian , Geurts Jeroen JG
Published: April 2021

Background:

Thalamic atrophy is proposed to be a major predictor of disability progression in multiple sclerosis (MS), while thalamic function remains understudied.

Objectives:

To study how thalamic functional connectivity (FC) is related to disability and thalamic or cortical network atrophy in two large MS cohorts.

Methods:

Structural and resting-state functional magnetic resonance imaging (fMRI) was obtained in 673 subjects from Amsterdam (MS: N = 332, healthy controls (HC): N = 96) and Graz (MS: N = 180, HC: N = 65) with comparable protocols, including disability measurements in MS (Expanded Disability Status Scale, EDSS). Atrophy was measured for the thalamus and seven well-recognized resting-state networks. Static and dynamic thalamic FC with these networks was correlated with disability. Significant correlates were included in a backward multivariate regression model.

Results:

Disability was most strongly related (adjusted R2 = 0.57, p < 0.001) to higher age, a progressive phenotype, thalamic atrophy and increased static thalamic FC with the sensorimotor network (SMN). Static thalamus–SMN FC was significantly higher in patients with high disability (EDSS ⩾ 4) and related to network atrophy but not thalamic atrophy or lesion volumes.

Conclusion:

The severity of disability in MS was related to increased static thalamic FC with the SMN. Thalamic FC changes were only related to cortical network atrophy, but not to thalamic atrophy.
Current status of neuroprotective and neuroregenerative strategies in multiple sclerosis: A systematic review
Authors: Allanach Jessica R , Farrell John W. , Mésidor Miceline , Karimi-Abdolrezaee Soheila
Published: April 2021

Background:

Immune-mediated demyelination and consequent degeneration of oligodendrocytes and axons are hallmark features of multiple sclerosis (MS). Remyelination declines in progressive MS, causing permanent axonal loss and irreversible disabilities. Strategies aimed at enhancing remyelination are critical to attenuate disease progression.

Objective:

We systematically reviewed recent advances in neuroprotective and regenerative therapies for MS, covering preclinical and clinical studies.

Methods:

We searched three biomedical databases using defined keywords. Two authors independently reviewed articles for inclusion based on pre-specified criteria. The data were extracted from each study and assessed for risk of bias.

Results:

Our search identified 7351 studies from 2014 to 2020, of which 221 met the defined criteria. These studies reported 262 interventions, wherein 92% were evaluated in animal models. These interventions comprised protein, RNA, lipid and cellular biologics, small molecules, inorganic compounds, and dietary and physiological interventions. Small molecules were the most highly represented strategy, followed by antibody therapies and stem cell transplantation.

Conclusion:

While significant strides have been made to develop regenerative treatments for MS, the current evidence illustrates a skewed representation of the types of strategies that advance to clinical trials. Further examination is thus required to address current barriers to implementing experimental treatments in clinical settings.
Populist attitudes and conspiratorial thinking
Authors: Balta Evren , Kaltwasser Cristóbal Rovira , Yagci Alper H
Published: April 2021

What happens to the anti-establishment sentiments of pro-incumbent voters for a populist force that is in government and thus controls the political system? This article examines this question utilizing the case of Turkey, a country in which a populist force has been in power for more than a decade. By analyzing populist attitudes among a nationally representative sample, we demonstrate that while the voters of the incumbent populist party (AKP) are less likely, compared to everyone else, to hold populist sentiments, the same voters are also substantially more likely to endorse conspiracy theories that center on malign foreign powers. This finding is relevant beyond Turkey, because it demonstrates that populist forces might be able to maintain popular support and thus stay in power for a long stretch of time by employing government propaganda to fuel an antagonism against conspiratorial foreign and global forces.
Hot Shots: An Analysis of the “Hot Hand” in NBA Field Goal and Free Throw Shooting
Authors: Lantis Robert , Nesson Erik
Published: April 2021

We investigate the hot hand using detailed data on free throws and field goals attempts for 12 NBA seasons. We find a small hot hand for free throws, which more than doubles for longer streaks of made free throws. Both offenses and defenses respond to field goals, but a made field goal does not change the probability that a player makes his next field goal attempt, and longer streaks of made field goals reduce the probability that a player makes his next field goal attempt. Finally, a made field goal reduces the team’s expected points on their next shot.
Occupational burnout following the first wave of coronavirus disease at a Welsh district general hospital
Authors: Srinivas Gayathri Chinnappa , Whitham Anwen , Rouse Rachel , Hamlyn Vincent , Williams Matthew
Published: April 2021

A survey was conducted to identify the prevalence of occupational burnout amongst health care professionals caring for COVID-19 patients in the Intensive Care Unit (ICU) of a Welsh hospital. The response rate was 79%. Nurses and other staff reassigned to work in the ICU had higher levels of burnout. Working in Personal Protective Equipment was most distressing, followed by direct patient care. There were positive outcomes including learning opportunities, professional development and job satisfaction. The impact of the pandemic on staff burnout may have been mitigated by acknowledging the contribution of staff, improving communication and encouraging them to access support.
Crystallographic orientation relationships between quartz and feldspar in myrmekite: a case study in monzodiorite from Meichuan pluton, China
Authors: Song Yueting , Zhao Shanrong , Xu Chang
Published: April 2021

Myrmekites occurring in monzodiorite from the Meichuan pluton in the Dabie ultrahigh-pressure metamorphic belt were investigated. The petrographic evidence demonstrates a metasomatic origin for myrmekite formation at the scale of individual alkali feldspar grains, and that the myrmekitic quartz and plagioclase matrix are generated simultaneously replacing precursor feldspar. Energy-dispersive X-ray spectroscopy and electron microprobe analysis indicate a low anorthite content in the narrow rim of host plagioclase near the myrmekite–alkali-feldspar interface. The Ca2+, Na+proportion of hydrothermal fluids replacing precursor alkali feldspar is 1:5.4, calculated from the anorthite content of the inner part of the host plagioclase and the neighbouring alkali feldspar. Electron back-scattered diffraction was used to identify the crystallographic orientation of the myrmekitic quartz, plagioclase matrix and the precursor alkali feldspar. The crystallographic orientation relationships (110)Kfs//(11$\bar{2}\bar{1}$)Qtz, (20$\bar{1}$)Kfs//(11$\bar{2}$1)Qtzand [11$\bar{2}3]$Qtz//[001]Kfsbetween myrmekitic quartz and adjacent alkali feldspar were obtained from statistical analysis. No clear crystallographic orientation relationship between quartz and plagioclase was found. The growth of myrmekitic quartz is constrained by the precursor alkali feldspar rather than the simultaneously crystallised plagioclase. This research is helpful for understanding the intergrowth mechanism during metasomatism.
Eye-color and Type-2 diabetes phenotype prediction from genotype data using deep learning methods
Authors: Muneeb Muhammad , Henschel Andreas
Published: April 2021

Background

Genotype–phenotype predictions are of great importance in genetics. These predictions can help to find genetic mutations causing variations in human beings. There are many approaches for finding the association which can be broadly categorized into two classes, statistical techniques, and machine learning. Statistical techniques are good for finding the actual SNPs causing variation where Machine Learning techniques are good where we just want to classify the people into different categories. In this article, we examined the Eye-color and Type-2 diabetes phenotype. The proposed technique is a hybrid approach consisting of some parts from statistical techniques and remaining from Machine learning.

Results

The main dataset for Eye-color phenotype consists of 806 people. 404 people have Blue-Green eyes where 402 people have Brown eyes. After preprocessing we generated 8 different datasets, containing different numbers of SNPs, using the mutation difference and thresholding at individual SNP. We calculated three types of mutation at each SNP no mutation, partial mutation, and full mutation. After that data is transformed for machine learning algorithms. We used about 9 classifiers, RandomForest, Extreme Gradient boosting, ANN, LSTM, GRU, BILSTM, 1DCNN, ensembles of ANN, and ensembles of LSTM which gave the best accuracy of 0.91, 0.9286, 0.945, 0.94, 0.94, 0.92, 0.95, and 0.96% respectively. Stacked ensembles of LSTM outperformed other algorithms for 1560 SNPs with an overall accuracy of 0.96, AUC = 0.98 for brown eyes, and AUC = 0.97 for Blue-Green eyes. The main dataset for Type-2 diabetes consists of 107 people where 30 people are classified as cases and 74 people as controls. We used different linear threshold to find the optimal number of SNPs for classification. The final model gave an accuracy of 0.97%.

Conclusion

Genotype–phenotype predictions are very useful especially in forensic. These predictions can help to identify SNP variant association with traits and diseases. Given more datasets, machine learning model predictions can be increased. Moreover, the non-linearity in the Machine learning model and the combination of SNPs Mutations while training the model increases the prediction. We considered binary classification problems but the proposed approach can be extended to multi-class classification.
Genome-wide analysis of SET-domain group histone methyltransferases in apple reveals their role in development and stress responses
Authors: Li Wenjie , Yan Jinjiao , Wang Shicong , Wang Qianying , Wang Caixia , Li Zhongxing , Zhang Dehui , Ma Fengwang , Guan Qingmei , Xu Jidi
Published: April 2021

Background

Histone lysine methylation plays an important role in plant development and stress responses by activating or repressing gene expression. Histone lysine methylation is catalyzed by a class of SET-domain group proteins (SDGs). Although an increasing number of studies have shown that SDGs play important regulatory roles in development and stress responses, the functions of SDGs in apple remain unclear.

Results

A total of 67 SDG members were identified in the Malus×domestica genome. Syntenic analysis revealed that most of the MdSDG duplicated gene pairs were associated with a recent genome-wide duplication event of the apple genome. These 67 MdSDG members were grouped into six classes based on sequence similarity and the findings of previous studies. The domain organization of each MdSDG class was characterized by specific patterns, which was consistent with the classification results. The tissue-specific expression patterns of MdSDGs among the 72 apple tissues in the different apple developmental stages were characterized to provide insight into their potential functions in development. The expression profiles of MdSDGs were also investigated in fruit development, the breaking of bud dormancy, and responses to abiotic and biotic stress; the results indicated that MdSDGs might play a regulatory role in development and stress responses. The subcellular localization and putative interaction network of MdSDG proteins were also analyzed.

Conclusions

This work presents a fundamental comprehensive analysis of SDG histone methyltransferases in apple and provides a basis for future studies of MdSDGs involved in apple development and stress responses.
Evaluation of early postoperative intravenous opioid rescue as a novel quality measure in patients who receive thoracic epidural analgesia: a retrospective cohort analysis and prospective performance improvement intervention
Authors: Levy Nadav , Santer Peter , Zucco Liana , Nabel Sarah , Korsunsky Galina , Ramachandran Satya Krishna
Published: April 2021

Background

In this study, we explored the utility of intravenous opioid rescue analgesia in the post anesthesia care unit (PACU-OpResc) as a single marker of thoracic epidural analgesia (TEA) failure and evaluated the resource implications and quality improvement applications of this measure.

Methods

We performed a retrospective analysis of all TEA placements over a three-year period at a single academic medical center in Boston, Massachusetts. The study exposure was PACU-OpResc. Primary outcome was PACU length of stay (LOS). Secondary outcomes included reasons for delayed PACU discharge and intraoperative hypotension. The analyses were adjusted for confounding variables including patient comorbidities, surgical complexity, intraoperative intravenous opioids, chronic opioid use and local anesthetic bolus through TEA catheter. Post analysis chart review was conducted to determine the positive predictive value (PPV) of PACU-OpResc for inadequate TEA. As a first Plan-Do-Study-Act cycle, we then introduced a checkbox for documentation of a sensory level check after TEA placement. Post implementation data was collected for 7 months.

Results

PACU-OpResc was required by 211 (22.1%) patients who received preoperative TEA, was associated with longer PACU LOS (incidence rate ratio 1.20, 95% CI:1.07–1.34, p = 0.001) and delayed discharge due to inadequate pain control (odds ratio 5.15, 95% CI 3.51–7.57, p <  0.001). PACU-OpResc had a PPV of 76.3 and 60.4% for re-evaluation and manipulation of the TEA catheter in PACU, respectively. Following implementation of a checkbox, average monthly compliance with documented sensory level check after TEA placement was noted to be 39.7%. During this time, a reduction of 8.2% in the rate of PACU-OpResc was observed.

Conclusions

This study demonstrates that PACU-OpResc can be used as a quality assurance measure or surrogate for TEA efficacy, to track performance and monitor innovation efforts aimed at improving analgesia, such as our intervention to facilitate sensory level checks and reduced PACU-OpResc.

Trial registration

not applicable.
Association of body mass index and waist circumference with high blood pressure in older adults
Authors: Zhang Wenli , He Kun , Zhao Hao , Hu Xueqi , Yin Chunyu , Zhao Xiaoyan , Shi Songhe
Published: April 2021

Background

The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure.

Methods

We examined data for 126,123 individuals in Xinzheng city aged ≥60 years from a population based study from January to December 2019. Logistic regression and restricted cubic spline models were applied to assess the relationship and the appropriate level of BMI and WC for high blood pressure. An additive interaction analysis was used to test synergistic effects between a higher BMI and WC for high blood pressure.

Results

The full-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of an increase of 1 kg/m2 in BMI and 1 cm in WC for high blood pressure were 1.084 (1.080–1.087) and 1.026(1.024–1.027), respectively. Multivariable adjusted restricted cubic spline analyses showed the nonlinear relationships of BMI and WC with high blood pressure in both men and women (all P < 0.001). The risk of high blood pressure increased steeply with increasing BMI from ≥25 kg/m2 and WC ≥ 88 cm or 86 cm for males and females, respectively. And we observed a significant additive interaction between a higher BMI and WC such that the prevalence of high blood pressure was significantly enhanced.

Conclusion

These findings suggest increased high blood pressure prevalence in the older adults with increased BMI and WC. BMI ≤ 25 kg/m2 and WC ≤ 88 cm or 86 cm for males and females may be the best suggestion with regard to primary prevention of high blood pressure in older adults.
COVID-19 in Northeast Bosnia and Herzegovina and patient’s length of hospitalization
Authors: Trnacevic Alma , Mujkanovic Amer , Al-Salloum Noura , Sakusic Amra , Trnacevic Emir , Jusufovic Emir , Hukic Fatima , Jahic Rahima , Stratton Richard
Published: April 2021

Background

Since the outbreak of COVID-19 pandemic, clinical data from various parts of the world have been reported. Up till now, there has been no clinical data with regards to COVID-19 from Bosnia and Herzegovina (B&H). The aim was to report on the first cohort of patients from B&H and to analyze factors that influence COVID-19 patient’s length of hospitalization (LOH).

Methods

This retrospective cohort study was conducted at Tuzla University Clinical Center (UKC), B&H. It involved 25 COVID-19 positive patients that needed hospitalisation between March 28th and April 27th 2020. The LOH was measured from the time of admission to discharge. Factors analyzed induced age, BMI, presence of known comorbidities, serum creatinine and O2saturation upon admission.

Results

The mean age was 52.92 ± 19.15 years and BMI 28.80 ± 4.22.LOH for patients with BMI < 25 was 9 ± SE2.646 days (CI 95% 3.814–14.816) vs 14.182 ± SE .937 (CI 95% 12.346–16.018p < 0.05; HR 5.148 CI95% 1.217 to 21.772p = 0.026) for ≥25 BMI. The mean LOH of patients with normal levels of O2 ≥ 95% was 11.667 ± SE1.202 (CI95% 8.261 to 13.739;p = 0.046), while LOH for patients with < 95% was 14.625 ± SE 1.231 CI95% 12.184 to 16.757p = 0.042; HR 3.732 CI95%1.137–12.251p = 0.03). Patients without known comorbidities had a mean LOH of 11.700 ± SE1.075 (CI 95% 9.592–13.808), while those with comorbidities had a mean of 14.8 ± 1.303 (CI 95% 12.247–17.353;p = 0.029) with HR2.552.

Conclusion

LOH varied among COVID-19 patients and was prolonged when analyzed for BMI ≥25, comorbidities, elevated creatinine, and O2 saturation < 95%. Furthermore, risk factors for COVID-19 patients in B&H do not deviate from those reported in other countries.
Growth patterns and clinical outcomes in association with breastfeeding duration in HIV exposed and unexposed infants: a cohort study in KwaZulu Natal, South Africa
Authors: Pillay Larisha , Moodley Dhayendre , Emel Lynda Marie , Nkwanyana Ntombifikile Maureen , Naidoo Kimesh
Published: April 2021

Background

Exclusive breastfeeding for 6 months and breastfeeding with complementary feeds until 12 months for HIV exposed and uninfected (HEU) infants or 24 months for HIV unexposed (HU) infants is the current World Health Organisation (WHO) recommendation for low and middle income countries (LMICs) to improve clinical outcomes and growth trajectories in infants. In a post-hoc evaluation of HEU and HU cohorts, we examine growth patterns and clinical outcomes in the first 9 months of infancy in association with breastfeeding duration.

Methods

Two cohorts of infants, HEU and HU from a low-socioeconomic township in South Africa, were evaluated from birth until 9 months of age. Clinical, anthropometric and infant feeding data were analysed. Standard descriptive statistics and regression analysis were performed to determine the effect of HIV exposure and breastfeeding duration on growth and clinical outcomes.

Results

Included in this secondary analysis were 123 HEU and 157 HU infants breastfed for a median of 26 and 14 weeks respectively. Median WLZ score was significantly (p < 0.001) lower in HEU than HU infants at 3, 6 and 9 months (− 0.19 vs 2.09; − 0.81 vs 0.28; 0.05 vs 0.97 respectively). The median LAZ score was significantly lower among HU infants at 3 and 6 months (− 1.63 vs 0.91, p < 0.001; − 0.37 vs 0.51, p < 0.01) and a significantly higher proportion of HU was classified as stunted (LAZ < -2SD) at 3 and 6 months (3.9% vs 44.9%, p < 0.001; 4.8% vs 20.9%, p < 0.001 respectively) independent of breastfeeding duration. A higher proportion of HEU infants experienced one or more episodes of skin rash (44.5% vs 12.8%) and upper respiratory tract infection (URTI) (30.1% vs 10.9%) (p < 0.0001). In a multivariable analysis, the odds of occurrence of wasting, skin rash, URTI or any clinical adverse event in HEU infants were 2.86, 7.06, 3.01 and 8.89 times higher than HU infants after adjusting for breastfeeding duration.

Conclusion

Our study has generated additional evidence that HEU infants are at substantial risk of infectious morbidity and decreased growth trajectories however we have further demonstrated that these adverse outcomes were independent of breastfeeding duration.