bluuebunny/crossref_metadata_2025 huggingface dataset:
Karl Kraus, Walter Benjamin y la crítica
Authors: Rico Sandoval Ronald Zuleyman
Published: October 2021

En este texto proveemos algunas claves para comprender el críptico ensayo “Karl Kraus” de Walter Benjamin. Para esto, destacamos la importancia de Kraus para la crítica periodística y política que le interesaba a Benjamin, introducimos al lector en las tres partes del ensayo y hacemos una breve reflexión sobre la construcción del concepto de crítica en Benjamin a partir de la obra de Kraus.
Balancing inverted pendulum cart on inclines using accelerometers
Authors: Woods Cole , Vikas Vishesh
Published: October 2021

The balance of inverted pendulum on inclined surfaces is the precursor to their control in unstructured environments. Researchers have devised control algorithms with feedback from contact (encoders - placed at the pendulum joint) and non-contact (gyroscopes, tilt) sensors. We present feedback control of Inverted Pendulum Cart (IPC) on variable inclines using non-contact sensors and a modified error function. The system is in the state of equilibrium when it is not accelerating and not falling over (rotational equilibrium). This is achieved when the pendulum is aligned along the gravity vector. The control feedback is obtained from non-contact sensors comprising of a pair of accelerometers placed on the inverted pendulum and one on the cart. The proposed modified error function is composed of the dynamic (non-gravity) acceleration of the pendulum and the velocity of the cart. We prove that the system is in equilibrium when the modified error is zero. We present algorithm to calculate the dynamic acceleration and angle of the pendulum, and incline angle using accelerometer readings. Here, the cart velocity and acceleration are assumed to be proportional to the motor angular velocity and acceleration. Thereafter, we perform simulation using noisy sensors to illustrate the balance of IPC on surfaces with unknown inclination angles using PID feedback controller with saturated motor torque, including valley profile that resembles a downhill, flat and uphill combination. The successful control of the system using the proposed modified error function and accelerometer feedback argues for future design of controllers for unstructured and unknown environments using all-accelerometer feedback.
Global determinants and conservation of evolutionary and geographic rarity in land vertebrates
Authors: Murali Gopal , Gumbs Rikki , Meiri Shai , Roll Uri
Published: October 2021

Analysis of vertebrate’s phylogenetic endemism highlights that unique regions of conservation concern face several threats.
Why is mechanical fatigue different from toughness in elastomers? The role of damage by polymer chain scission
Authors: Sanoja Gabriel E. , Morelle Xavier P. , Comtet Jean , Yeh C. Joshua , Ciccotti Matteo , Creton Costantino
Published: October 2021

Tough elastomers that resist fracture at high loads are not optimum for sustaining many cycles at low loads.
Climate models generally underrepresent the warming by Central Africa biomass-burning aerosols over the Southeast Atlantic
Authors: Mallet Marc , Nabat Pierre , Johnson Ben , Michou Martine , Haywood Jim M. , Chen Cheng , Dubovik Oleg
Published: October 2021

Underestimates of smoke absorption by climate models limits their ability to reproduce positive forcing and low-cloud feedback.
Maximizing efficiency of dipolar recoupling in solid-state NMR using optimal control sequences
Authors: Tošner Zdeněk , Brandl Matthias J. , Blahut Jan , Glaser Steffen J. , Reif Bernd
Published: October 2021

Highly efficient optimal control experiments for routine studies of solid proteins by NMR using various MAS frequencies.
Preparing for “Disease X”
Authors: Van Kerkhove Maria D. , Ryan Michael J. , Ghebreyesus Tedros Adhanom
Published: October 2021

The past 30 years have exposed the global public health and economic threats posed by the emergence of infectious pathogens with epidemic and pandemic potential. Severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS), influenza, Ebola, Marburg, Lassa, Nipah, Zika, and now SARS coronavirus 2 (SARS-CoV-2) each have been the “Disease X” of their time. The risk of future emergence is driven by multiple forces, including climate change, ecosystem changes, and increasing urbanization. The next Disease X could appear at any time, and the world needs to be better prepared.
Macrophage-tumor chimeric exosomes accumulate in lymph node and tumor to activate the immune response and the tumor microenvironment
Authors: Wang Shuang , Li Feng , Ye Tong , Wang Jianghua , Lyu Chengliang , Qing Shuang , Ding Zhaowen , Gao Xiaoyong , Jia Rongrong , Yu Di , Ren Jun , Wei Wei , Ma Guanghui
Published: October 2021

Macrophage-tumor chimeric exosomes inhibit tumor growth in multiple mouse models by stimulating the immune response and tumor microenvironment.
Zinc Finger Protein ZFP36L1 Inhibits Flavivirus Infection by both 5′-3′ XRN1 and 3′-5′ RNA-Exosome RNA Decay Pathways
Authors: Chiu Han , Chiu Hsin-Ping , Yu Han-Pang , Lin Li-Hsiung , Chen Zih-Ping , Lin Yi-Ling , Lin Ren-Jye
Published: October 2021

Cellular RNA-binding proteins are among the first lines of defense against various viruses, particularly RNA viruses. ZFP36L1 belongs to the CCCH-type zinc-finger protein family and has RNA-binding activity; it has been reported to bind directly to the AU-rich elements (AREs) of a subset of cellular mRNAs and then lead to mRNA decay by recruiting mRNA-degrading enzymes.
A Pilot Study To Establish an
In Vitro
Model To Study Premature Intestinal Epithelium and Gut Microbiota Interactions
Authors: Gibbons Justin , Yoo Ji Youn , Mutka Tina , Groer Maureen , Ho Thao T. B.
Published: October 2021

The gut bacterial flora influences the development of the immune system and long-term health outcomes in preterm infants. Studies of the mechanistic interactions between the gut bacteria and mucosal barrier are limited to clinical observations, animal models, and
in vitro
cell culture models for this vulnerable population.
Cervical Squamous Intraepithelial Lesions Are Associated with Differences in the Vaginal Microbiota of Mexican Women
Authors: Nieves-Ramírez M. E. , Partida-Rodríguez O. , Moran P. , Serrano-Vázquez A. , Pérez-Juárez H. , Pérez-Rodríguez M. E. , Arrieta M. C. , Ximénez-García C. , Finlay B. B.
Published: October 2021

Human papillomavirus (HPV) plays a critical role in cervical carcinogenesis but is not sufficient for cervical cancer development, indicating the involvement of other factors. The vaginal microbiota is an important factor in controlling infections caused by HPV, and, depending on its composition, it can modulate the microenvironment in vaginal mucosa against viral infections.
Genome and Ecology of a NovelAlteromonasPodovirus, ZP6, Representing a New Viral Genus,Mareflavirus
Authors: Wang Ziyue , Zhang Fang , Liang Yantao , Zheng Kaiyang , Gu Chengxiang , Zhang Wenjing , Liu Yundan , Zhang Xinran , Shao Hongbing , Jiang Yong , Guo Cui , He Hui , Wang Hualong , Sung Yeong Yik , Mok Wen Jye , Wong Li Lian , He Jianfeng , McMinn Andrew , Wang Min
Published: October 2021

Alteromonasis an important symbiotic bacterium of phytoplankton, but research on its bacteriophages is still at an elementary level. Our isolation and genome characterization of a novelAlteromonaspodovirus, ZP6, identified a new viral genus of podovirus andGammaproteobacteriaphages, namely,Mareflavirus.
Shared Mutations in Emerging SARS-CoV-2 Circulating Variants May Lead to Reverse Transcription-PCR (RT-PCR)-Based Misidentification of B.1.351 and P.1 Variants of Concern
Authors: Losada Carmen , Rico-Luna Carla , Otero-Sobrino Álvaro , Molero-Salinas Andrea , Buenestado-Serrano Sergio , Candela Ana , Pérez-Lago Laura , Muñoz Patricia , Catalán Pilar , de Viedma Darío García
Published: October 2021

Reverse transcription-PCRs (RT-PCRs) targeting SARS-CoV-2 variant of concern (VOC) mutations have been developed to simplify their tracking. We evaluated an assay targeting E484K/N501Y to identify B.1.351/P1. Whole-genome sequencing (WGS) confirmed only 72 (59.02%) of 122 consecutive RT-PCR P.1/B.1.351 candidates. Prescreening RT-PCRs must target a wider set of mutations, updated from WGS data from emerging variants.
Phylogenetic Differentiation of Rickettsia parkeri Reveals Broad Dispersal and Distinct Clustering within North American Strains
Authors: Allerdice Michelle E. J. , Paddock Christopher D. , Hecht Joy A. , Goddard Jerome , Karpathy Sandor E.
Published: October 2021

Since 1937, when
Rickettsia parkeri
was originally identified in
Amblyomma maculatum
group ticks, the recognized range and associated vectors for this pathogen have expanded significantly. In recent years,
R. parkeri
has been identified in 12 tick species from seven countries in the Americas.
Ulungarat Basin: Record of a major Middle Devonian to Mississippian syn-rift to post-rift tectonic transition, eastern Brooks Range, Arctic Alaska
Authors: Anderson Arlene V. , Meisling Kristian E.
Published: October 2021

The Ulungarat Basin of Arctic Alaska is a unique exposed stratigraphic record of the mid-Paleozoic transition from the Romanzof orogeny to post-orogenic rifting and Ellesmerian passive margin subsidence. The Ulungarat Basin succession is composed of both syn-rift and post-rift deposits recording this mid-Paleozoic transition. The syn-rift deposits unconformably overlie highly deformed Romanzof orogenic basement on the mid-Paleozoic regional angular unconformity and are unconformably overlain by post-rift Endicott Group deposits of the Ellesmerian passive margin. Shallow marine strata of Eifelian age at the base of the Ulungarat Formation record onset of rifting and limit age of the Romanzof orogeny to late Early Devonian. Abrupt thickness and facies changes within the Ulungarat Formation and disconformably overlying syn-rift Mangaqtaaq Formation suggest active normal faulting during deposition. The Mangaqtaaq Formation records lacustrine deposition in a restricted down-faulted structural low. The unconformity between syn-rift deposits and overlying post-rift Endicott Group is interpreted to be the result of sediment bypass during deposition of the outboard allochthonous Endicott Group. Within Ulungarat Basin, transgressive post-rift Lower Mississippian Kekiktuk Conglomerate and Kayak Shale (Endicott Group) are older and thicker than equivalents to the north. North of Ulungarat Basin, deformed pre-Middle Devonian rocks were exposed to erosion at the mid-Paleozoic regional unconformity for ∼50 m.y., supplying sediments to the rift basin and broader Arctic Alaska rifted margin beyond. Although Middle Devonian to Lower Mississippian chert- and quartz-pebble conglomerates and sandstones across Arctic Alaska share a common provenance from the eroding ancestral Romanzof highlands, they were deposited in different tectonic settings.
Intravenous ketamine for rapid treatment of major depressive disorder in the general medical hospital
Authors: Gee Siobhan Helen , Wratten Camille , Cairns Ruth , Santhouse Alastair , Taylor David
Published: October 2021

Major depressive disorder (MDD) is common in general medical settings, and can usually be treated with conventional oral antidepressants. For some patients, however, oral treatment is refused or not possible, and the untreated symptoms can have a significant impact on the treatment of the acute medical problem. Use of intravenous ketamine has been widely reported in mental health settings for the treatment of MDD. We describe use of intravenous ketamine in a general medical hospital for the treatment of MDD in an 83-year-old male patient who refused food, fluid and medical investigations following a stroke.
Severe fetal anaemia caused by congenital cytomegalovirus infection
Authors: Salazar-Sanchez Claudia , Llancarí Pedro , Novoa Rommy H , Ventura Walter
Published: October 2021

A 22-year-old pregnant woman was referred to our fetal medicine unit due to severe fetal growth restriction at 26 weeks of gestation. An extensive detailed ultrasound revealed signs of bilateral periventricular hyperechogenicity, suggesting fetal infection potentially due to cytomegalovirus (CMV). Doppler ultrasound showed a high peak systolic velocity in the middle cerebral artery. Percutaneous umbilical cord blood sampling confirmed fetal CMV infection and severe fetal anaemia. We present this case to highlight the importance of fetal anaemia, which can be fatal regardless of whether it is associated with generalised oedema or hydrops fetalis.
Murmur on top of the head: bioprosthetic mitral valve insufficiency
Authors: Malik Albahi , Saif Aneeqa , Al-Ani Awsse , Haas Christopher
Published: October 2021

In 1961, K Merendino ‘in pure curiosity’, while tracking the murmur of mitral regurgitation, placed his stethoscope ‘on the vertex of the head’, and ultimately led to a medical curiosity and exam finding that not only bears his name, but awes medical learners at all stages of their careers. Merendino and colleagues collected seven such cases of the ‘Murmur on Top of the Head’ building on the work of others who provided a detailed description of mitral regurgitation and noted murmur radiation to the neck and cervical/lumbosacral spine. The majority of patients suffered from rheumatic heart disease or subacute bacterial endocarditis in native heart valves. Here, we report on a case of the ‘Murmur on Top of the Head’ and provide the reader/listener with a direct recording of the ‘Merendino murmur’ (as well as its spinal correlate) in an elderly woman with a bioprosthetic mitral valve.
Laparoscopic transdiaphragmatic approach to a thoracic paravertebral hydatid cyst presenting with compression myelopathy
Authors: Kumar Saket , Kumar Abhay , Kumar Mukesh , Parween Rana
Published: October 2021

An elderly gentleman presented with heaviness over the right side of the chest, lower back pain and difficulty in walking for the last 6 months. He also reported of progressive weakness of the left leg associated with tingling and numbness for 2 months. Imaging studies revealed a large hydatid cyst in the right thoracic cavity compressing the spinal cord. The patient was prescribed a 14-day course of albendazole therapy. He underwent laparoscopic transdiaphragmatic deroofing and evacuation of the cyst. Postoperative recovery was uneventful. The patient started showing symptom relief from day 1 of surgery and by day 3, his right leg strength and sensation recovered remarkably. Echinococcal cyst is a zoonotic disease that can affect any part of the body. Vertebral involvement and spinal cord compression is a rare manifestation of echinococcal disease. Such cases pose diagnostic and therapeutic challenges and require a multidisciplinary approach to treat them successfully.
Use of extracorporeal blood purification therapy (ECBPT) as an adjuvant to high-dose corticosteroids in a severely ill COVID-19 patient with concomitant bacterial infection
Authors: Lim Min Xian , Fong Kean Khang , Yeap Tat Boon
Published: October 2021

COVID-19 presents with a spectrum of severity, ranging from asymptomatic or mild symptoms to those with acute respiratory distress syndrome. Corticosteroids are widely used for their efficacy in reducing inflammatory responses. However, its use may be limited to patients with immunosuppression. An adjunct therapy for cytokine storm in COVID-19 is extracorporeal blood purification therapies using high adsorptive filters, such as oXiris, to remove cytokines. We share our experience in using continuous renal replacement therapy with oXiris haemofilter as a temporising measure to high-dose corticosteroids in managing cytokine storm in a deteriorating COVID-19 patient with concomitant bacterial infection.
Odontogenic choristoma embedded in the cheek of an old patient
Authors: Gabriele Guido , Benedetti Simone , Rossi Fabiola , Gennaro Paolo
Published: October 2021

Odontogenic choristomas are a rare and recently classified entity, defined as neoplasms containing tissues of odontogenic derivation, found in abnormal locations and usually diagnosed in the early age. The authors report a unique case of a 79-year-old patient who presented to our attention for a skin lesion in the right cheek with no history of trauma or recent dental procedures, that underneath presented an indolent tooth-like structure inside the soft tissue of the right cheek, which at the histological study resulted to be an odontogenic choristoma. This rare histopathological diagnosis should be considered when a hard lesion is present in the head and neck region.
Plasma proteinN-glycosylation is associated with cardiovascular disease, nephropathy, and retinopathy in type 2 diabetes
Authors: Memarian Elham , 't Hart Leen M , Slieker Roderick C , Lemmers Roosmarijn F L , van der Heijden Amber A , Rutters Femke , Nijpels Giel , Schoep Emma , Lieverse Aloysius G , Sijbrands Eric J G , Wuhrer Manfred , van Hoek Mandy , Dotz Viktoria
Published: October 2021

Introduction

Although associations of total plasmaN-glycome (TPNG) with type 2 diabetes have been reported, little is known on the role of TPNG in type 2 diabetes complications, a major cause of type 2 diabetes-related morbidity and mortality. Here, we assessed TPNG in relation to type 2 diabetes complications in subsamples of two Dutch cohorts using mass spectrometry (n=1815 in DiaGene and n=1518 in Hoorn Diabetes Care System).

Research design and methods

Blood plasma samples and technical replicates were pipetted into 96-well plates in a randomized manner. Peptide:N-glycosidase F (PNGase F) was used to releaseN-glycans, whereafter sialic acids were derivatized for stabilization and linkage differentiation. After total area normalization, 68 individual glycan compositions were quantified in total and were used to calculate 45 derived traits which reflect structural features of glycosylation. Associations of glycan features with prevalent and incident microvascular or macrovascular complications were tested in logistic and Cox regression in both independent cohorts and the results were meta-analyzed.

Results

Our results demonstrated similarities between incident and prevalent complications. The strongest association for prevalent cardiovascular disease was a high level of bisection on a group of diantennary glycans (A2FS0B; OR=1.38, p=1.34×10−11), while for prevalent nephropathy the increase in 2,6-sialylation on triantennary glycans was most pronounced (A3E; OR=1.28, p=9.70×10−6). Several other TPNG features, including fucosylation, galactosylation, and sialylation, firmly demonstrated associations with prevalent and incident complications of type 2 diabetes.

Conclusions

These findings may provide a glance on how TPNG patterns change before complications emerge, paving the way for future studies on prediction biomarkers and potentially disease mechanisms.
Longitudinal associations between family conflict, parent engagement, and metabolic control in children with recent-onset type 1 diabetes
Authors: Case Hannah , Williams David D , Majidi Shideh , Ferro Diana , Clements Mark Allen , Patton Susana R
Published: October 2021

Introduction

We prospectively investigated the associations between diabetes-related family conflict, parent engagement in child type 1 diabetes (T1D) care, and child glycated hemoglobin (HbA1c) in 127 families of school-age children who we recruited within the first year of their T1D diagnosis.

Research design and methods

Parents completed the Diabetes Family Conflict Scale-Revised (DFCS-R) to assess for diabetes-related family conflict and the Diabetes Self-Management Questionnaire-Brief (DSMQ-Brief) to assess parent engagement in child T1D care at the initial study visit (T1) and at 12 (T2) and 27 (T3) months later. We also collected child HbA1c at these time points. Our analyses included Pearson correlations and repeated measures linear mixed models controlling for child age, sex, and T1D duration at T1.

Results

Parents’ DFCS-R scores negatively correlated with DSMQ-Brief scores (r=−0.13, p<0.05) and positively correlated with children’s HbA1c (r=0.26, p<0.001). In our linear mixed models, parents’ DSMQ-Brief scores were unchanged at T2 (β=−0.71, 95% CI −1.59 to 0.16) and higher at T3 (β=8.01, 95% CI 6.89 to 9.13) compared with T1, and there was an association between increasing DFCS-R and decreasing DSMQ-Brief scores (β=−0.14, 95% CI −0.21 to −0.06). Child HbA1c values were significantly higher at T2 (β=0.66, 95% CI 0.38 to 0.94) and T3 (β=0.95, 95% CI 0.63 to 1.27) compared with T1, and there was an association between increasing DFCS-R scores and increasing child HbA1c (β=0.04, 95% CI 0.02 to 0.06).

Conclusions

Increasing diabetes-specific family conflict early in T1D may associate with decreasing parent engagement in child T1D care and increasing child HbA1c, suggesting a need to assess and intervene on diabetes-specific family conflict.

Trial registration numberNCT03698708.
Use of metformin following a population-level intervention to encourage people with pre-diabetes to enroll in the National Diabetes Prevention Program
Authors: Hurst Thomas E , McEwen Laura N , Joiner Kevin L , Herman William H
Published: October 2021

Introduction

The National Diabetes Prevention Program (NDPP) and metformin are interventions to slow progression from pre-diabetes to type 2 diabetes. When coverage for the NDPP was offered by a public research university’s health insurance plan, proactive strategies were used to combat historically low enrollment. Although not specifically targeted by these strategies, metformin use was higher than expected, leading to this evaluation.

Research design and methods

We used insurance enrollment, claims, pharmacy, and laboratory data for 64 131 adult employees, dependents, and retirees to identify individuals with pre-diabetes and invite them to enroll in the NDPP at no out-of-pocket cost. The characteristics of individuals with pre-diabetes who used metformin before and after their invitation were compared with NDPP enrollees.

Results

8131 individuals with pre-diabetes were identified. Of these, 776 (9.5%) enrolled in a NDPP and 802 (9.9%) used metformin. Metformin users were younger, had higher body mass index, were more likely to have comorbidities, and had higher baseline hemoglobin A1c levels than non-users. Timing of metformin use varied with 107 (13%) discontinuing, 426 (53%) continuing, and 269 (34%) initiating metformin use after their NDPP invitation. Of NDPP enrollees, 13 (2%) discontinued, 56 (7%) continued, and 34 (4%) initiated metformin use when they enrolled.

Conclusions

Despite no active encouragement, use of metformin was similar to the rate of enrollment in the NDPP. Metformin use was higher for individuals with higher likelihood of responding. With the proven cost-effectiveness of metformin, targeted strategies to increase metformin use in individuals with pre-diabetes who are likely to respond, but not willing to enroll in a lifestyle intervention, are needed.
Association between dietary antioxidant vitamins intake and homocysteine levels in middle-aged and older adults with hypertension: a cross-sectional study
Authors: Peng Xiaolin , Gao Qin , Zhou Juan , Ma Jianping , Zhao Dan , Hao Liping
Published: October 2021

Objectives

Plasma total homocysteine (tHcy) has been implicated in the development of cardiovascular disease. This study aimed to assess the relationship of dietary antioxidant vitamins intake with tHcy levels in middle-aged and older adults with hypertension.

Design

A cross-sectional study.

Setting

The survey was conducted in the Nanshan district of Shenzhen.

Participants

A total of 1465 middle-aged and older adults with hypertension were included between July and September of 2013.

Measurements

Hyperhomocysteinaemia (HHcy) was defined as tHcy ≥15 µmol/L. Some dietary antioxidant vitamins (vitamin C (VC) and vitamin E (VE), carotenes, retinol, lutein) intake was estimated using the Food Frequency Questionnaire. Sociodemographic and potential covariates were evaluated through questionnaires, anthropometric measurements and blood tests. The association between dietary intakes of antioxidant vitamins and tHcy concentration were evaluated by multiple linear regression analyses after napierian logarithm transformed. Multiple logistic regression models were further used to determine ORs and 95% CIs.

Results

The β (95% CIs) of VC intake and tHcy was −0.050 (−0.084 to –0.016). Compared with the lowest quartile in the fully adjusted model, the ORs (95% CIs) for HHcy levels across quartiles of dietary VC intake were 0.82 (0.57 to 1.16), 0.49 (0.33 to 0.74) and 0.40 (0.22 to 0.74) (p for trend=0.001). The β (95% CIs) of retinol intake and tHcy was −0.021 (−0.041 to –0.002) and the ORs (95% CIs) in the third quartile of retinol intake was 0.61 (0.42 to 0.86), while the effect for the highest quartile was not significant (p for trend=0.951). No significant association was observed between dietary VE, carotenes and lutein intake and HHcy.

Conclusions

A linear inverse association between dietary VC intake and HHcy prevalence, and an L-shaped association between dietary retinol intake and HHcy prevalence were found in Chinese middle-aged and older adults with hypertension.
Modified effect of active or passive smoking on the association between age and abdominal aortic calcification: a nationally representative cross-sectional study
Authors: Lv Luyan , Wu Shixian , Yang Yungui , Yue Xiongli
Published: October 2021

Objective

The deleterious effects of smoking on atherosclerosis were well known; however, the interaction among ageing, smoking and atherosclerosis remains unclear. This study tested the hypothesis that the association between age and vascular calciﬁcation, a critical mark of atherosclerosis, was modified by smoking.

Design

Cross-sectional study.

Setting

A nationally representative sample, the National Health and Nutrition Examination Surveys 2013–2014.

Participants

This study included 3140 adults aged 40–80 years with eligible data for abdominal aortic calcification (AAC). Active and passive smoking exposure was identified through self-reports and tobacco metabolites (serum cotinine and urinary 4-methylnitrosamino-3-pyridyl-1-butanol).

Primary outcome measures

AAC score was determined using dual-energy X-ray absorptiometry (DXA) scans. OR was estimated using the logistic regression method to assess the association between age and the presence of severe or subclinical AAC stratified by smoking exposure. The survey-weighted Wald test was used to evaluate potential interactions.

Results

AAC was positively associated with age in the general population. After adjustment for age, sex, race/ethnicity and other cardiovascular risk factors, age was significantly associated with the odds of severe AAC (OR for each 5-year increase in age: 1.66, 95% CI 1.48 to 1.87, p<0.001). As expected, the association between age and vascular calcification was especially stronger in smokers than in never smokers (p value for interaction ≤0.014). According to spline fitting, the progression of vascular calcification was significantly increased after 45 years in smokers compared with that after 60 years in never smokers. Quitting smoking may compromise the deleteriousness of the vascellum especially in younger adults. However, the difference in age-related calcification among never smokers with or without secondhand smoke exposure was minor, regardless of the definition by self-report, serum cotinine, or urinary 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanol.

Conclusions

Smoking significantly accelerated the progression of age-related subclinical atherosclerosis. Early smoking cessation should be encouraged among young smokers. The effect of passive smoking exposure on arteriosclerosis should be assessed further.
Minimising exposure to respiratory droplets, ‘jet riders’ and aerosols in air-conditioned hospital rooms by a ‘Shield-and-Sink’ strategy
Authors: Hunziker Patrick
Published: October 2021

Objectives

In COVID-19, transfer of respiratory materials transmits disease and drives the pandemic but the interplay of droplet and aerosol physics, physiology and environment is not fully understood. To advance understanding of disease transmission mechanisms and to find novel exposure minimisation strategies, we studied cough-driven material transport modes and the efficacy of control strategies.

Design

Computer simulations and real-world experiments were used for integrating an intensive care setting, multiphysics and physiology. Patient-focused airflow management and air purification strategies were examined computationally and validated by submicron particle exhalation imaging in volunteers.

Setting

Hospital setting during a respiratory virus pandemic with transmission by respiratory droplets and aerosols.

Participants

Healthy volunteers.

Outcome measures

Distribution of, and exposure to, potentially infectious respiratory secretions.

Results

Respiratory materials ejected by cough exhibited four transport modes: long-distance ballistic, short-distance ballistic, ‘jet rider’ and aerosol modes. Interaction with air conditioning driven flow contaminated a hospital room rapidly. Different than large droplets or aerosols, jet rider droplets travelled with the turbulent air jet initially, but fell out at a distance, were not well eliminated by air conditioning and exposed bystanders at larger distance and longer time; their size predisposes them to preferential capture in the nasal mucosa, the primordial COVID-19 infection site. ‘Cough shields’ captured large droplets but induced lateral dispersion of aerosols and jet riders. An air purification device alone had limited efficacy. A‘Shield and Sink’ approach combining cough shields with ‘virus sinks’ minimised exposure to all secretions in modelling and real-life experiments.

Conclusions

Jet riders have characteristics of highly efficient respiratory infection vectors and may play a role in COVID-19 transmission. Exposure to all droplet types can be minimised through an easily implemented Shield and Sink strategy.
Resting-state functional reorganisation in Alzheimer’s disease and amnestic mild cognitive impairment: protocol for a systematic review and meta-analysis
Authors: Lyu Diyang , Li Taoran , Lyu Xuanxin
Published: October 2021

Introduction

The incidence of Alzheimer’s disease (AD) is increasing rapidly, causing a growing burden to health and economic worldwide. Several clinical trials in the past decade failed to find solutions, and there remains a lack of an effective treatment. The evidence suggests that early intervention for neurodegeneration would likely be effective in preventing cognitive decline. Cognitive decline in AD occurs continuously over a long period; however, there remains a lack of simple, rapid and accurate approach for diagnosis of amnestic mild cognitive impairment or subjective cognitive decline due to underlying Alzheimer’s pathology. Resting-state functional MRI (rs-fMRI) determines the functional activities of the human brain non-invasively. The amplitude of low-frequency fluctuation (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo) are rs-fMRI indicators with high repeatability. They have been studied as early diagnostic imaging markers for other diseases and may be promising markers also for AD.

Methods and analysis

The following electronic literature databases will be searched from inception to December 2021: Medline-Ovid, Medline-PubMed, EMBase-Ovid, Cochrane Central and ClinicalTrials.gov. Two independent reviewers will select studies with eligible criteria, extract data and assess the quality of the original studies with our quality assessment tool individually. Missing data will be requested by sending emails to the corresponding authors. Brain regions will be presented for ALFF/fALFF and ReHo by performing activation likelihood estimation with the Seed-baseddMapping-Permutation of subject images V.6.21 software. Meta-regression will be performed to determine the potential brain regions that may strongly correlate with cognitive decline progression. Subgroup analysis, funnel plot, Egger’s test and sensitivity analysis will be conducted to detect and explain potential heterogeneity.

Ethics and dissemination

This study does not require formal ethical approval. The findings will be submitted to a peer-review journal.

PROSPERO registration number

CRD42021229009.
Temporal trends in incidence and mortality rates of laryngeal cancer at the global, regional and national levels, 1990–2017
Authors: Wang Jing-Yuan , Zhang Qiang-Wei , Wen Kaixue , Wang Chen , Ji Xiaolin , Zhang Lixia
Published: October 2021

Objectives

Laryngeal cancer is the most prevalent entity of head and neck cancer. Knowing the trends of incidence and mortality of laryngeal cancer is important for the reduction in related disease burden.

Design

Population-based observational study.

Main outcomes and measures

The incidence and mortality data of laryngeal cancer were retrieved from the Global Burden of Disease study 2017 online database. The estimated average percentage change was used to quantify the trends of laryngeal cancer incidence and mortality at the global, regional and national levels.

Results

Globally, the numbers of incident cases and deaths due to laryngeal cancer increased 58.7% and 33.9%, respectively, from 1990 to 2017. However, the overall age-standardised incidence rate (ASIR) and age-standardised mortality rate decreased by 0.99% (95% CI 0.83% to 1.14%) and 1.62% (95% CI 1.50% to 1.74%) per year, respectively. These decreases were ubiquitous worldwide. However, unfavourable trends in the ASIR of laryngeal cancer were also observed in a total of 51 developing countries.

Conclusions

The incidence and mortality rates of laryngeal cancer have significantly decreased at the global level and in most countries over the past three decades. The regions that showed an increasing incidence trend deserve more attention.
Infant feeding, appetite and satiety regulation, and adiposity during infancy: a study design and protocol of the ‘MAS-Lactancia’ birth cohort
Authors: Ramirez-Silva Ivonne , Pérez Ferrer Carolina , Ariza Ana Carolina , Tamayo-Ortiz Marcela , Barragán Sofía , Batis Carolina , Cantoral Alejandra , Sánchez Marcela , Zambrano Elena , Burguete-García Ana I , Avila-Jimenez Laura , Ramakrishnan Usha , Stein Aryeh D , Martorell Reynaldo , Rivera Juan A
Published: October 2021

Introduction

The prevalence of childhood obesity has risen dramatically in recent years. A proportion of this burden has been attributed to factors that occur during the first 1000 days of life such as genetic predisposition, breast feeding and complementary feeding. Although the mechanisms by which these factors affect weight and adiposity are less well understood, appetite and satiety regulation may be a key to understanding them. This cohort study aims to investigate the role of appetite and satiety regulation as a mediator in the association between infant feeding practices and genetic polymorphisms with children’s growth, adiposity and metabolic risk factors.

Methods and analysis

‘MAS-Lactancia’ (the first word means ‘more’ and is also an acronym in Spanish for ‘Appetite and Satiety Mechanisms’, the second word is ‘breastfeeding’) is an open, ongoing, prospective birth cohort that began the enrolment in 2016 of mother–child pairs affiliated to the Mexican Social Security Institute and that live in the city of Cuernavaca, Mexico. Pregnant women between 16-week and 22-week gestation are followed during the second half of their pregnancies, at birth and throughout their infant’s first 48 months of life (at 1 month, 3 months, 6 months, 9 months, 12 months, 18 months, 24 months, 36 months and 48 months) at the clinic and at-home visits that include questionnaires, anthropometric measurements and biospecimen collection. The main exposure variables are infant feeding (breast feeding and complementary feeding) and genetic polymorphisms (fat mass and obesity-associated, leptin and adiponectin genes). Outcome variables include infant’s growth, adiposity and metabolic risk factors. We will conduct longitudinal models and path analyses to identify the potential mediating role of satiety and appetite indicators (leptin, adiponectin, insulin concentrations, appetite and satiety perception).

Ethics and dissemination

The study protocol, data collection instruments, consent forms and procedures were approved by the institutional review boards of the National Institute of Public Health and the Mexican Social Security Institute in Mexico. Findings will be disseminated through conferences, peer-reviewed publications and meetings with stakeholders.
Gastrointestinal recovery after surgery: protocol for a systematic review
Authors: Kovoor Joshua G , Stretton Brandon , Jacobsen Jonathan Henry W , Gupta Aashray K , Ovenden Christopher D , Hewitt Joseph N , Glynatsis John M , Edwards Suzanne , Campbell Kaitryn , Asokan Gayatri P , Tivey David R , Babidge Wendy J , Rayner Christopher K , Anthony Adrian A , Trochsler Markus I , Horowitz Michael , Hewett Peter J , Jones Karen L , Maddern Guy J
Published: October 2021

Introduction

Gastrointestinal recovery after surgery is of worldwide significance. Postoperative gastrointestinal dysfunction is multifaceted and known to represent a major source of postoperative morbidity, however, its significance to postoperative care across all surgical procedures is unknown. The complexity of postoperative gastrointestinal recovery is poorly defined within gastrointestinal surgery, and even less so outside this field. To inform the clinical care of surgical patients worldwide, this systematic review and meta-analysis will aim to characterise the duration of postoperative gastrointestinal recovery that can be expected across all surgical procedures and determine the associations between factors that may affect this.

Methods and analysis

MEDLINE, Embase, Cochrane Library and CINAHL will be searched for studies reporting the time to first postoperative passage of stool after any surgical procedure. We will screen records, extract data and assess risk of bias in duplicate. Forest plots will be constructed for time to postoperative gastrointestinal recovery, as assessed by various outcome measures. Because of potential heterogeneity, a random-effects model will be used throughout the meta-analysis. Funnel plots will be used to test for publication bias. Meta-regressions will be undertaken where the outcome is the mean time to first postoperative passage of stool, with potential predictors and confounders being patient characteristics, postoperative outcomes and surgical factors.

Ethics and dissemination

This study will not involve human or animal subjects and, thus, does not require ethics approval. The outcomes will be disseminated via publication in peer-reviewed scientific journal(s) and presentations at scientific conferences.

PROSPERO registration number

CRD42021256210.
Outcomes and complications of peripartum cardiomyopathy: protocol for a systematic review and meta-analysis
Authors: Hoevelmann Julian , Muller Elani , Hohlfeld Ameer , Böhm Michael , Sliwa Karen , Engel Mark E , Viljoen Charle André
Published: October 2021

Introduction

Peripartum cardiomyopathy (PPCM) remains a major contributor to maternal morbidity and mortality worldwide. The disease is associated with various complications, which occur predominantly during the early stages of the disease. Adverse outcomes include decompensated heart failure, thromboembolic complications, arrhythmias and death. We present a protocol for a systematic review and meta-analysis to summarise the available data on the complications and outcomes of women with PPCM.

Methods and analysis

A comprehensive search of all articles published between 2000 (the year in which the first universal definition of PPCM was used) and 1 June 2021 will be performed on PubMed/MEDLINE, Web of Science, Scopus and EBSCO Host, including Academic Search Premier, Africa-Wide Information, Cumulative Index to Nursing and Allied Health Literature. All cohort and cross-sectional studies, as well as control arms of randomised control trials (RCTs) reporting on the complications and outcomes of PPCM will be included in the review. Methodological quality assessment of included studies will be done by assessing the risk of bias. Heterogeneity of the data will be tested by visual inspection of the forest plot and I2and χ2tests. This study will report the burden of complications occurring around the time of diagnosis as well as the 6-month or 12-month outcomes of women with PPCM. A summarised description in form of a pooled analysis of across multiple centres, regions and continents would help us to better understand the estimates of complications and outcomes of women with PPCM.

Ethics and dissemination

As this research is a systematic review of published literature, ethical approval is not required. The results will be reported according to the latest guidelines for Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 statement, and will be submitted to a peer-reviewed journal.

PROSPERO registration number

CRD42021255654.
Public perceptions of eye symptoms and hospital services during the first UK lockdown of the COVID-19 pandemic: a web survey study
Authors: Butt Gibran F , Hodson James , Wallace Graham R , Rauz Saaeha , Murray Philip I
Published: October 2021

Objective

This study aimed to explore the British public’s healthcare-seeking beliefs concerning eye symptoms, and assess how the first COVID-19 lockdown influenced these.

Methods and analysis

An anonymous web-based survey was disseminated through mailing lists and social media between June and August 2020. The survey sought participants’ views on the severity and urgency of the need for medical review for four ophthalmic and two general medical scenarios on a five-point scale. Participants were asked to answer questions twice: once ignoring the COVID-19 pandemic, and once taking this into account, with additional questions asked to identify factors influencing the decision to seek medical attention and ward admission.

Results

A total of 402 participants completed the survey (mean age 61.6 years, 63.1% female and 87.7% of white ethnicity). Scores for symptom severity and urgency of medical review increased significantly with the severity of the clinical scenario (both p<0.001). However, participants gave significantly lower scores for the urgency of medical attention when accounting for the COVID-19 pandemic (compared with no pandemic) for all scenarios (all p<0.001). Younger age, greater deprivation and non-white ethnicity were correlated with a lower perception of seriousness and urgency of medical attention.

Conclusions

During the first UK lockdown of the COVID-19 pandemic, reduced urgency of medical review for ocular and systemic pathologies was reported in response to the pandemic, which represents a barrier to healthcare-seeking behaviour. This has the potential to critically delay medical review and timely management, negatively impacting patient outcomes.
SARS-CoV-2 driving rapid change in adult cystic fibrosis services: the role of the clinical nurse specialist
Authors: Dunk Rachel , Madge Susan
Published: October 2021

Cystic fibrosis (CF) is a genetic, life-limiting disease without a cure; treatment is complex and lifelong. Respiratory failure is the most common cause of death; however, gastrointestinal disease, diabetes and liver disease are common comorbidities. Coronavirus disease (COVID-19) rapidly changed healthcare services across the globe, including redeployment of healthcare professionals. This adult CF service was challenged to continue a patient facing service within severe staffing and structural limitations.

Not only were many members of the CF multidisciplinary team (MDT) redeployed at the start of the first wave, but also both the CF and ambulatory care wards were closed. Fortunately, the CF clinical nurse specialists (CF-CNSs) remained in their role. Rapid change and adaptation of the CF service was required to ensure that patients did not feel abandoned and access to treatment remained available. The role of the CF-CNS was therefore pivotal in this change.

The aim of this project was to use quality improvement methodology to plan an emergency service allowing a reintroduction of ambulatory care services. Success was measured by the number of patients clinically reviewed with or without intervention, and the reasons for patients contacting the CF-CNS via email and phone were recorded.

In weeks 1 and 2 of the emergency service, the CF-CNSs triaged patients by phone, then reviewed face-to-face when necessary. This first step allowed the CF-CNSs to start two patients on home intravenous antibiotics. This service continued to be developed over the following 12 weeks, leading to a total of 36 patient attendances. In March 2020, n=1187 patients made contact (mostly COVID-19, unwell and medication related), in April n=904 and May n=870 (blood test results, unwell and medication related).

The motivation of the CF-CNSs was pivotal to the success of this initiative with the CF MDT available to provide some support and advice. It concluded at week 12, which then saw the opening of the formal ambulatory care ward and returning redeployed ward staff.
Adverse drug reactions of leukotriene receptor antagonists in children with asthma: a systematic review
Authors: Dixon Eleanor Grace , Rugg-Gunn Charlotte EM , Sellick Vanessa , Sinha Ian P , Hawcutt Daniel B
Published: October 2021

Background

Asthma is the most common chronic condition of childhood. Leukotriene receptor antagonists (LTRAs) are included in international guidelines for children and young people (CYP), but there have been highly publicised concerns about potential adverse effects. The aim was to identify and understand the reported frequency of adverse drug reactions (ADRs) attributed to LTRAs in CYP with asthma.

Methods

Embase, MEDLINE, PubMed and CINAHL were searched up to October 2020. Reference lists of eligible papers were manually screened. Eligible studies identified adverse events attributed to an LTRA in individuals aged between 0 and 18 years diagnosed with asthma. Four different tools were used to assess risk of bias or quality of data to accommodate the papers assessed.

Results

The search identified 427 papers after deduplication; 15 were included (7 case reports, 7 case–controlled or cohort studies and 1 randomised control trial (RCT)). 7012 patients were recorded, of which 6853 received an LTRA. 13 papers examined the ADRs attributed to montelukast, one to pranlukast and one to unspecified LTRAs. After language standardisation, 48 ADRs were found, 20 of which were psychiatric disorders. Across all studies, the most commonly reported ADRs were ‘anxiety’, ‘sleep disorders’ and ‘mood disorders’. The frequency of ADRs could be calculated in seven of the eight studies. Applying standardised frequency terms to the prospective studies and RCT, there were 14 ‘common’ and ‘uncommon’ ADRs. ‘Common’ ADRs included ‘agitation/hyperactivity/irritability/nervousness’, ‘aggression’ and ‘headache’. The case reports showed a similar pattern, describing 46 different ADRs experienced by a total of eight patients.

Conclusions

LTRAs have a wide range of suspected ADRs in CYP, predominantly gastrointestinal and neuropsychiatric disorders. Careful monitoring of CYP with asthma is required, both to assess and manage ADRs and to step treatment down when clinically stable.

PROSPERO registration number

CRD42020209627.