bluuebunny/crossref_metadata_2025 huggingface dataset:
Probation Revocation
Authors: Mitchell Kelly Lyn
Published: February 2021

Probation revocation is an event in which the court, after finding that one or more probation violations have been proven, rescinds an individual’s probation sentence and executes a jail or prison sentence. Probation is a community-based sanction for criminal behavior, often represented as an alternative to incarceration. A person who is placed on probation serves a defined period in the community, during which the individual is subject to the supervision of a probation officer and must comply with and complete multiple conditions of probation. Probation conditions are requirements an individual is ordered to follow or complete during the period of probation. Conditions can include administrative requirements, such as reporting regularly to one’s probation officer; public safety requirements, such as no contact with the victim; and required programming or services, such as substance abuse treatment. If an individual fails to comply with or complete any of the conditions of probation, the probation officer can allege a probation violation to the court, detailing the noncompliant behavior. There are two main types of probation violations: new crimes and technical violations. When an individual commits a new offense while serving a term of probation, the offense can serve both as the basis for a probation violation and as a charge in a new criminal case. Violations of probation conditions that do not involve new criminal behavior are commonly referred to as “technical violations.” With the recognition of mass incarceration in the United States, attention has more recently been paid to the parallel growth of mass probation and the contribution of probation revocations to prison and jail populations. The Council of State Governments estimates that in 2017, 45 percent of prison admissions were due to probation and parole violations. Thus, more research and attention is being paid to determining how to reduce probation revocations. This article identifies points of discretion leading to probation revocation, discusses issues in defining probation outcomes, summarizes common predictors of probation revocation and recidivism, and discusses the impact of the form and intensity of probation on probation outcomes.
Spanish American Port Cities
Authors: Díaz Ceballos Jorge
Published: February 2021

Following medieval political traditions, the conquest of America led by the Spanish crown was a highly urbanized enterprise. Cities defined the spaces of colonial America in terms of organization of the territory, control of the population, and the negotiation of political sovereignty on the ground. Early city foundation in the Antilles after 1492 was followed by the major occupation of continental America, when more than two hundred cities were founded over the 16th century. In the 17th and 18th centuries, cities in Spanish America became the hub of social integration, moving from ‘Spanish cities’ to what has been labeled ‘creole metropolises.’ During the age of revolution and independence, the late 18th and early 19th centuries, cities played a major role as the seats of national sovereignty. Typically struggles for independence would start with the rising of creole elites in the capital cities of each viceroyalty. Historiography on Spanish American cities has evolved in the last decades from an institutionally driven or urban growth approach to urban experiences, to an exploration of the multiple facets of urban life: commercial, economic, political, social, and cultural. In the renewal of urban history, the study of port cities has gained significance especially—although not exclusively—in connection to their commercial role, contributing thus to the development of new trends on Atlantic, global, and connected histories. Ports were also spaces for scientific development with shipyards and arsenals as main centers of technological innovation. Studies on port cities, however, have not been systematic and are notably disproportionate among regions and periods within the Spanish Atlantic. There are a considerably greater number of studies related to the first half of the 16th century and late 18th century and to the Caribbean and River Plate regions. Acknowledging this imbalance, this article will prioritize a geographical approach by focusing on particular cities within four main regions in the Atlantic—the Greater Antilles, Northern Mainland Caribbean, Southern Mainland Caribbean and the Southern Atlantic and River Plate Region—as a way to address the complexity of port experiences within those regions during different chronologies. A section on Pacific Connections ports is included to underline the connected nature of Spanish American port cities and their global outreach. Although local examples of port cities will be the core of this article, it opens with an updated review on the main urban history literature, with a section on primary sources following, and a general overview of regional or thematic works on ports, to move then to the geographical sections.
Food Studies and Communication
Authors: Parasecoli Fabio
Published: February 2021

Food is much more than fuel for our bodies. It is an essential part of human cultures, and as such it carries meanings that shape and reflect individual and communal identities in terms of race, ethnicity, class, age, social class, and status, among others. It is both deeply physical and highly symbolic. Challenging the fundamental opposition between inside and outside, eating requires ingestion, bringing the outside inside, which is both exciting and terrifying. For this reason, food is both a source of pleasure and comfort and a cause for anxieties and concerns ranging from purity to propriety, heath, and wellness, just to mention a few. All food communicates meaning. We are implicitly trained to get cues from the world that surrounds us, and food is not excluded from these dynamics. We can obtain information from products and ingredients; from dishes and recipes; from the material objects that surround the act of eating, from tableware to furniture, interior design, built environments such as markets, stores, and supermarkets; from urban design and landscapes; from performative acts that include selling, cooking, serving, and eating food, as well as even disposing of leftovers; from every component of food systems, from agricultural production to manufacturing, packaging, transportation, distribution, trade, retail, and consumption; invisible infrastructures such as supply chains, cold chains, and more recently electronic traceability and blockchain. This bibliographical article focuses on the study of the intentional forms of communication that revolve around material, visual, and textual representations of food, and how they reflect, shape, or at times even problematize the explicit and implicit meanings food is able to generate. Research on these matters has grown in recent years with the emergence and growth of food studies as an interdisciplinary academic field. However, scholars from other disciplines, from literary studies to art history, media studies, gender studies, and politics, have engaged with the role of food in communication, often embracing multidisciplinary approaches in dialogue with food studies. The article is divided in two parts. The first part examines publications that look at food in different means of communication, from TV to fine arts and digital media, investigating the specificities of each means in its relationship with food discourse and practices. The second part instead explores research on food representations in the communication that involves different aspects of cultural and social life, from gender to politics. Some overlapping between the two sections is inevitable, but nevertheless the organization of the bibliographical entries in these two large sections can help the reader better navigate the content of the article and the rapidly expanding literature.
Language Policy and Planning
Authors: Romaine Suzanne
Published: February 2021

Language policy and planning (hereafter LPLP) is a relatively new multi- and interdisciplinary field, but by no means a new phenomenon. The term ‘language planning’ (preceded by the term ‘language engineering’) emerged in the late 1950s and then developed as part of and in tandem with sociolinguistics and the sociology of language in the 1960s and 1970s. LPLP was initially preoccupied with language problems of developing nations emerging from the breakup of European colonial empires after World War II (see Foundational Works). Multilingualism in newly independent states posed problems to which planners believed they had solutions in the form of deliberate interventions into language, typically imposed top-down by governments and government-authorized agencies and institutions. Although regulation of languages—their status, functions, and linguistic form on a national level—still forms a central part of LPLP (see Areal Studies), its scope has increasingly widened. Scholars recognized that similar problems and issues applied not just to developing nations and were not confined to the nation state, or other macro-level polity, but were also relevant at the supranational as well as meso- and micro-level of individuals, families, multinational corporations, and other organizations. The 1980s and 1990s witnessed a more critical turn. LPLP underwent a series of paradigmatic shifts as the association of language planning with westernized notions of modernization, progress, and democratization was regarded as simplistic and overoptimistic. After having developed one or more ‘official’ languages, some emerging nations realized that their plan not only did not solve political and social problems but instead created new ones. The idea that language could be planned and imposed top-down became increasingly unworkable and ethically questionable. Even in totalitarian regimes LPLP has been less than fully effective or successful. Researchers began to scrutinize some of the hidden or covert agendas and unintended consequences of LPLP, particularly the ways in which top-down LPLP serves the interest of elite groups and marginalizes others. With the collapse of communism and the end of the Cold War, a resurgence of interest in LPLP has occurred amidst a new world order characterized by reemergence of small nations and minority and regional languages, along with development of supranational political frameworks, like the European Union, and the increasing influence of corporations and limitations in the autonomy of nation states. In the 21st century LPLP has been increasingly concerned with internationalization and globalization, especially the role of English as a world language, language endangerment, and migration. A perennial challenge is how to make connections between macro- and micro- levels.
Vietnam War in Hollywood Feature Films
Authors: Luhrssen David
Published: February 2021

Vietnam was the focal point of a larger set of conflicts that broke out in Indo-China in 1945 and resulted by 1975 with Cambodia and Laos as well as Vietnam falling under the rule of various Communist parties. The first Vietnam War (1945–1954) pitted French colonists and their local allies against Vietnamese Communist rebels. It ended with the French withdrawal from Indo-China and the partition of Vietnam into two states, Communist North Vietnam and pro-Western South Vietnam. In the second Vietnam War (1955–1975), North Vietnam and Communist rebels in the south fought against the US-backed South Vietnamese regime. No conflict in American history since the Civil War was as divisive as Vietnam, yet the war was widely supported until US ground forces entered the fray (1965). Mounting casualties and the threat of conscription fueled a growing antiwar movement that forced Washington to find a way out of the war. After the United States withdrew in 1973, Communist forces overran South Vietnam and reunited the country under their rule in 1975. Films about the Vietnam War were produced in both North and South Vietnam, the Soviet Union (which armed the North) and South Korea and Australia (both dispatched troops to support the South). With few exceptions, many were seldom seen outside their lands of origin. With Hollywood’s dominance of movie markets in much of the world, American stories about the war dominated the imagination of moviegoers in the United States and most other countries. Hollywood took only slight interest in Vietnam during the war’s early years. The first major motion picture about American combat in Vietnam, John’s Wayne’s pro-war The Green Berets (1968), was a box-office hit but universally derided by critics. With the war’s increasing unpopularity and unsuccessful conclusion, the subject was deemed “box-office poison” by the studios for several years. By the late 1970s a rising generation of filmmakers embraced Vietnam as material for displaying American heroism, explaining the US defeat or exploring the ethical basis for war. The commercial breakthrough for Vietnam War movies was achieved by director Sidney Furie’s The Boys in Company C (1978), Michael Cimino’s The Deer Hunter (1978), and Francis Ford Coppola’s Apocalypse Now (1979). Each reflected in different ways America’s disillusionment and the physical and psychological toll charged to the men who served in the conflict. The theme continued with Platoon (1986), directed by a Vietnam combat veteran, Oliver Stone. A counter-trend appeared with Sylvester Stallone’s Rambo series (1982–2019), which amplified the resurgent nationalism that began under the Reagan administration. Providing a third perspective, Stanley Kubrick’s Full Metal Jacket (1987) presented the war unemotionally as a fact of history. In the 21st century, movies on the Vietnam War continue to be made, if in diminished number. Characteristic of recent films, We Were Soldiers (2002) validates the experience of US servicemen while honoring the heroism of the enemy.
The Epic Tradition
Authors: Hurst Isobel
Published: February 2021

Epic occupied a prominent position as the highest test of poetic genius, yet any poet imprudent enough to attempt an epic would be faced with a daunting challenge. For a Victorian poet the attempt to rival Homer or Virgil involved complex considerations of form, theme, and history. The genre was traditionally associated with heroism and masculine strength, mythology, and the shaping of national identity, religion, and war, and with the poet’s own desire to compete with and surpass his predecessors much as epic heroes seek to prove their own supremacy. The reception of ancient epic was an ongoing concern in the period, since Homer in particular was cited as a model in literature, politics, and morality. Matthew Arnold’s prescriptions for translating Homer conveyed a sense of the responsibility involved in disseminating classical texts to a new readership. The Iliad was appropriated in debates on divorce, masculinity, authorship, and the historical criticism of the Bible. The Odyssey offered an alternative, novelistic version of Homeric epic, one which prioritized domesticity and highlighted the poem’s female characters. Some of the most influential creative responses to the epic tradition were not poems in twelve or twenty-four books but verse novels, dramatic monologues, or theatrical burlesques. Others took up the challenge of writing at epic length and addressing national concerns. For aspiring epic poets, there were many choices to be made: should poetry inhabit a mythological world, whether Arthurian (Tennyson’s Idylls of the King or Swinburne’s Tristram of Lyonesse) or Norse (William Morris’s Sigurd the Volsung), or a contemporary domain like that of Elizabeth Barrett Browning’s Aurora Leigh? Might the epic be used to intervene in religious controversies or political conflicts such as Chartism? Could a modern poet be the Virgil of the British Empire? Facing strong competition from the novel, ambitious Victorian poets chose to approach such questions and an astonishing range of themes in a form which evoked vast expanses of time and space, extraordinary physical and intellectual achievement, and literary renown. Yet to achieve recognition as an epic poet remains an unusual distinction. Despite recent critical attention to the proliferation of Victorian poems with epic aspirations, a small number of poems by Tennyson, Barrett Browning, and William Morris have continued to dominate accounts of the genre.
Frank O'Connor
Authors: Delaney Paul
Published: February 2021

“O’Connor was, above all, a short story writer,” Maurice Sheehy proposed in the first extended bibliography of the writer’s work (Sheehy 1969, 168). Criticism over the last fifty years has generally endorsed this claim and has concentrated on O’Connor’s work as a practitioner and critic of the genre. Frank O’Connor (b. 1903–d. 1966) was the author of six volumes of short stories, the first of which, Guests of the Nation, appeared in 1931; his last volume, Domestic Relations, was published in 1957. He edited several collections of his own work, beginning with The Stories of Frank O’Connor in 1952, and additional collections were published posthumously; he was also the author of an influential study of short fiction, The Lonely Voice (1962) (see introduction to O’Connor as Short-Story Writer). Broadly speaking, O’Connor’s stories can be grouped into the following clusters: His stories of the 1930s engage with the fight for Irish independence and the subsequent disappointments of life in the newly emergent Free State; they also explore the uneasy relationship between traditional practices and modernizing values. His stories of the 1940s continue this concern with cultural clashes, intensifying the themes of frustration, provincialism, and loneliness, and dramatizing the power and the habitus of the Catholic Church in Ireland. In the late 1940s, O’Connor began writing for the New Yorker, and the impact of this magazine’s style can be seen in his short fiction of the 1950s and early 1960s; a number of stories from this period are narrated from the perspective of a child, many are nostalgic or whimsical, and some carry an autobiographical element. In addition to his short fiction, O’Connor was a novelist, dramatist, essayist, and literary critic; he had varying levels of success in each of these genres. Largely self-taught, he was fluent in Irish, and he was a distinguished translator of texts from the 7th and 8th centuries through to the modern period; his most famous translations include The Lament for Art O’Leary (1940) and The Midnight Court (1945). He was also a memoirist of note, and his first volume of autobiography, An Only Child (1961) is justly acclaimed. O’Connor wrote under the name “Frank O’Connor” throughout his life; this was a pseudonym of sorts, derived from his middle name (Francis) and his mother’s maiden name (O’Connor). His birth name was Michael O’Donovan.
Post-Copulatory Sexual Selection
Authors: Brennan Patricia L.R. , Orbach Dara N.
Published: February 2021

The field of post-copulatory sexual selection investigates how female and male adaptations have evolved to influence the fertilization of eggs while optimizing fitness during and after copulation, when females mate with multiple males. When females are polyandrous (one female mates with multiple males), they may optimize their mating rate and control the outcome of mating interactions to acquire direct and indirect benefits. Polyandry may also favor the evolution of male traits that offer an advantage in post-copulatory male-male sperm competition. Sperm competition occurs when the sperm, seminal fluid, and/or genitalia of one male directly impacts the outcome of fertilization success of a rival male. When a female mates with multiple males, she may use information from a number of traits to choose who will sire her offspring. This cryptic female choice (CFC) to bias paternity can be based on behavioral, physiological, and morphological criteria (e.g., copulatory courtship, volume and/or composition of seminal fluid, shape of grasping appendages). Because male fitness interests are rarely perfectly aligned with female fitness interests, sexual conflict over mating and fertilization commonly occur during copulatory and post-copulatory interactions. Post-copulatory interactions inherently involve close associations between female and male reproductive characteristics, which in many species potentially include sperm storage and sperm movement inside the female reproductive tract, and highlight the intricate coevolution between the sexes. This coevolution is also common in genital morphology. The great diversity of genitalia among species is attributed to sexual selection. The evolution of genital attributes that allow females to maintain reproductive autonomy over paternity via cryptic female choice or that prevent male manipulation and sexual control via sexually antagonistic coevolution have been well documented. Additionally, cases where genitalia evolve through intrasexual competition are well known. Another important area of study in post-copulatory sexual selection is the examination of trade-offs between investments in pre-copulatory and post-copulatory traits, since organisms have limited energetic resources to allocate to reproduction, and securing both mating and fertilization is essential for reproductive success.
The T-cell response to SARS-CoV-2: kinetic and quantitative aspects and the case for their protective role
Authors: Bertoletti Antonio , Tan Anthony T , Le Bert Nina
Published: February 2021

Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2), the etiological agent of Coronavirus Diseases 2019 (COVID-19), triggers an adaptive immunity in the infected host that results in the production of virus-specific antibodies and T cells. Although kinetic and quantitative aspects of antibodies have been analyzed in large patient cohorts, similar information about SARS-CoV-2-specific T cells are scarce. We summarize the available knowledge of quantitative and temporal features of the SARS-CoV-2 T-cell response in this review. Currently, most of the data are derived only from the analysis of the circulatory compartment. Despite this limitation, early appearance, multi-specificity and functionality of SARS-CoV-2-specific T cells are associated with accelerated viral clearance and with protection from severe COVID-19.
Genetic variation in the promoter of an R2R3−MYB transcription factor determines fruit malate content in apple (Malus domestica Borkh.)
Authors: Jia Dongjie , Wu Peng , Shen Fei , Li Wei , Zheng Xiaodong , Wang Yongzhang , Yuan Yongbing , Zhang Xinzhong , Han Zhenhai
Published: February 2021

Deciphering the mechanism of malate accumulation in apple (Malus domestica Borkh.) fruits can help to improve their flavor quality and enhance their benefits for human health. Here, we analyzed malate content as a quantitative trait that is determined mainly by genetic effects. In a previous study, we identified an R2R3−MYB transcription factor named MdMYB44 that was a candidate gene in qtl08.1 (quantitative trait locus mapped to chromosome 8) of fruit malate content. In the present study, we established that MdMYB44 negatively regulates fruit malate accumulation by repressing the promoter activity of the malate-associated genes Ma1 (Al-Activated Malate Transporter 9), Ma10 (P-type ATPase 10), MdVHA-A3 (V-type ATPase A3), and MdVHA-D2 (V-type ATPase D2). Two single-nucleotide polymorphisms (SNPs) in the MdMYB44 promoter, SNP A/G and SNP T/−, were experimentally shown to associate with fruit malate content. The TATA-box in the MdMYB44 promoter in the presence of SNP A enhances the basal activity of the MdMYB44 promoter. The binding of a basic-helix–loop–helix transcription factor MdbHLH49 to the MdMYB44 promoter was enhanced by the presence of SNP T, leading to increased MdMYB44 transcript levels and reduced malate accumulation. Furthermore, MdbHLH49 interacts with MdMYB44 and enhances MdMYB44 activity. The two SNPs could be used in combination to select for sour or non-sour apples, providing a valuable tool for the selection of fruit acidity by the apple breeding industry. This research is important for understanding the complex molecular mechanisms of fruit malate accumulation and accelerating the development of germplasm innovation in apple species and cultivars.
Reward Responsiveness in Patients with Opioid Use Disorder on Opioid Agonist Treatment: Role of Comorbid Chronic Pain
Authors: Finan Patrick H , Letzen Janelle , Epstein David H , Mun Chung Jung , Stull Samuel , Kowalczyk William J , Agage Daniel , Phillips Karran A , Pizzagalli Diego A , Preston Kenzie L
Published: February 2021

Objective

Evidence suggests that blunted reward responsiveness may account for poor clinical outcomes in both opioid use disorder (OUD) and chronic pain. Understanding how individuals with OUD and comorbid chronic pain (OUD+CP) respond to rewards is, therefore, of clinical interest because it may reveal a potential point of behavioral intervention.

Methods

Patients with OUD (n = 28) and OUD+CP (n = 19) on opioid agonist treatment were compared on: 1) the Probabilistic Reward Task (an objective behavioral measure of reward response bias) and 2) ecological momentary assessment of affective responses to pleasurable events.

Results

Both the OUD and the OUD+CP groups evidenced an increase in reward response bias in the Probabilistic Reward Task. The rate of change in response bias across blocks was statistically significant in the OUD group (B = 0.06, standard error [SE] = 0.02, t = 3.92, P < 0.001, 95% confidence interval [CI]: 0.03 to 0.09) but not in the OUD+CP group (B = 0.03, SE = 0.02, t = 1.90, P = 0.07, 95% CI: −0.002 to 0.07). However, groups did not significantly differ in the rate of change in response bias across blocks (B = 0.03, SE = 0.02, t = 1.21, P = 0.23, 95% CI: −0.02 to 0.07). Groups did not significantly differ on state measures of reward responsiveness (P’s ≥0.50).

Conclusions

Overall, findings across objective and subjective measures were mixed, necessitating follow-up with a larger sample. The results suggest that although there is a reward response bias in patients with OUD+CP treated with opioid agonist treatment relative to patients with OUD without CP, it is modest and does not appear to translate into patients’ responses to rewarding events as they unfold in daily life.
The Space of Traces in Symmetric Monoidal Infinity Categories
Authors: Steinebrunner Jan
Published: February 2021

We define a tracelike transformation to be a natural family of conjugation invariant maps $T_{x,\mathtt{C}}:\hom_\mathtt{C}(x, x) \to \hom_\mathtt{C}(𝟙,𝟙)$ for all dualizable objects x in any symmetric monoidal $\infty$-category $\mathtt{C}$. This generalizes the trace from linear algebra that assigns a scalar $\operatorname{Tr}(\,f\,) \in k$ to any endomorphism f : V → V of a finite-dimensional k-vector space. Our main theorem computes the moduli space of tracelike transformations using the one-dimensional cobordism hypothesis with singularities. As a consequence, we show that the trace $\operatorname{Tr}$ can be uniquely extended to a tracelike transformation up to a contractible space of choices. This allows us to give several model-independent characterizations of the $\infty$-categorical trace. By restricting the aforementioned notion of tracelike transformations from endomorphisms to automorphisms one can in particular recover a theorem of Toën and Vezzosi. Other examples of tracelike transformations are for instance given by $f \mapsto \operatorname{Tr}(\,f^{\,n})$. Unlike for $\operatorname{Tr}$, the relevant connected component of the moduli space is not contractible, but rather equivalent to $B\mathbb{Z}/n\mathbb{Z}$ or BS1 for n = 0. As a result, we obtain a $\mathbb{Z}/n\mathbb{Z}$-action on $\operatorname{Tr}(\,f^{\,n})$ as well as a circle action on $\operatorname{Tr}(\operatorname{id}_x)$.
Incentivising biodiversity net gain with an offset market
Authors: Simpson Katherine , Hanley Nick , Armsworth Paul , de Vries Frans , Dallimer Martin
Published: February 2021

Most programmes that incentivise the supply of public goods such as biodiversity conservation on private land in Europe are financed through the public purse. However, new ideas for how to fund biodiversity conservation are urgently needed, given recent reviews of the poor state of global biodiversity. In this paper, we investigate the use of private funding for biodiversity conservation through an offset market. The environmental objective is to increase some measure of biodiversity in a region (‘net gain’) despite the loss of land for new housing. Farmers create biodiversity credits by changing their land management and then sell these credits to housing developers who are required to more than offset the impacts of new housing development on a specific indicator of biodiversity. Combining an economic model of market operation with an ecological model linking land management to bird populations, we examine the operation, costs, and biodiversity impacts of such a (hypothetical) market as the target level of net gain is increased. A general result is established for the impacts on price and quantity in the offset market as the net gain target is made more ambitious. For a case-study site in Scotland, we find that as the net gain target is increased, the number of offsets traded in equilibrium falls, as does the market-clearing offset price. Changes in the spatial pattern of gains and losses in our biodiversity index also occur as the net gain target is raised.
‘It is good to have a target in mind’: qualitative views of patients and parents informing a treat to target clinical trial in juvenile-onset systemic lupus erythematosus
Authors: Smith Eve M D , Gorst Sarah L , Al-Abadi Eslam , Hawley Daniel P , Leone Valentina , Pilkington Clarissa , Ramanan Athimalaipet V , Rangaraj Satyapal , Sridhar Arani , Beresford Michael W , Young Bridget
Published: February 2021

Objective

We sought to explore patient and parental views on treatment targets, outcome measures and study designs being considered for a future JSLE treat-to-target (T2T) study.

Methods

We conducted topic-guided, semistructured interviews with JSLE patients and parents and analysed the audio recorded interviews using thematic approaches.

Results

Patients and parents differed regarding symptoms they felt would be tolerable, representing ‘low disease activity’. Patients often classed symptoms that they had previously experienced, were ‘invisible’ or had minimal disruption on their life as signs of low disease activity. Parents were more accepting of visible signs but were concerned about potential organ involvement and symptom severity. Overall, patients and parents preferred that children were entirely asymptomatic, with no ongoing treatment side effects. They regarded fatigue as particularly challenging, requiring proper monitoring using a fatigue patient-reported outcome measure. Most families felt that reducing corticosteroids would also be a good treatment target. Overall, families liked the concept of T2T, commenting that it could help to improve disease control, help structure treatment and improve communication with clinicians and treatment compliance. They were concerned that T2T might increase the frequency of hospital visits, thus impacting upon schooling, parental employment and finances. Families made suggestions on how to modify the future trial design to mitigate such effects.

Conclusion

This study provides guidance from patients and parents on T2T targets and study designs. Complementary quantitative studies assessing the achievability and impact of different targets (e.g. lupus low disease activity state or remission) are now warranted to inform an international consensus process to develop treatment targets.
Changes in Default-Mode Network Associated With Childhood Trauma in Schizophrenia
Authors: Dauvermann Maria R , Mothersill David , Rokita Karolina I , King Sinead , Holleran Laurena , Kane Ruan , McKernan Declan P , Kelly John P , Morris Derek W , Corvin Aiden , Hallahan Brian , McDonald Colm , Donohoe Gary
Published: February 2021

Background

There is considerable evidence of dysconnectivity within the default-mode network (DMN) in schizophrenia, as measured during resting-state functional MRI (rs-fMRI). History of childhood trauma (CT) is observed at a higher frequency in schizophrenia than in the general population, but its relationship to DMN functional connectivity has yet to be investigated.

Methods

CT history and rs-fMRI data were collected in 65 individuals with schizophrenia and 132 healthy controls. Seed-based functional connectivity between each of 4 a priori defined seeds of the DMN (medial prefrontal cortex, right and left lateral parietal lobes, and the posterior cingulate cortex) and all other voxels of the brain were compared across groups. Effects of CT on functional connectivity were examined using multiple regression analyses. Where significant associations were observed, regression analyses were further used to determine whether variance in behavioral measures of Theory of Mind (ToM), previously associated with DMN recruitment, were explained by these associations.

Results

Seed-based analyses revealed evidence of widespread reductions in functional connectivity in patients vs controls, including between the left/right parietal lobe (LP) and multiple other regions, including the parietal operculum bilaterally. Across all subjects, increased CT scores were associated with reduced prefrontal-parietal connectivity and, in patients, with increased prefrontal-cerebellar connectivity also. These CT-associated differences in DMN connectivity also predicted variation in behavioral measures of ToM.

Conclusions

These findings suggest that CT history is associated with variation in DMN connectivity during rs-fMRI in patients with schizophrenia and healthy participants, which may partly mediate associations observed between early life adversity and cognitive performance.
Candidate Factors Maintaining Social Anxiety in the Context of Psychotic Experiences: A Systematic Review
Authors: Aunjitsakul Warut , McGuire Nicola , McLeod Hamish J , Gumley Andrew
Published: February 2021

Social anxiety is common in psychosis and associated with impaired functioning, poorer quality of life, and higher symptom severity. This study systematically reviewed factors maintaining social anxiety in people with attenuated, transient, or persistent psychotic experiences. Other correlates of social anxiety were also examined. MEDLINE, Embase, CENTRAL, and PsycINFO were searched for relevant literature up to October 19, 2020. Forty-eight articles were eligible for narrative synthesis: 38 cross-sectional studies, 8 prospective studies, 1 uncontrolled trial, and 1 qualitative study. From 12060 participants, the majority was general population (n = 8771), followed by psychosis samples (n = 2532) and those at high risk of psychosis (n = 757). The methodological quality and risk of bias were assessed using the Mixed Methods Appraisal Tool. Ninety percent of studies were rated as high to very-high quality. Poorer quality studies typically failed to adequately control for confounds and provided insufficient information on the measurement validity and reliability. Prominent psychological factors maintaining social anxiety included self-perceptions of stigma and shame. Common correlates of social anxiety included poorer functioning and lower quality of life. In conclusion, stigma and shame could be targeted as a causal mechanism in future interventional studies. The integration of findings from this review lead us to propose a new theoretical model to guide future intervention research.
Efficacy and Safety of Levetiracetam vs. Phenytoin as Second Line Antiseizure Medication for Pediatric Convulsive Status Epilepticus: A Systematic Review and Meta-Analysis of Randomized Controlled Trials
Authors: Angurana Suresh Kumar , Suthar Renu
Published: February 2021

Objective

To evaluate the efficacy and safety of levetiracetam (LEV) in comparison to phenytoin (PHT) as second line antiseizure medication (ASM) for Pediatric convulsive status epilepticus (SE).

Data source

PubMed, Embase, Google scholar/Google, Scopus, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane Database of Systematic Reviews and Cochrane Central Register of Controlled Trials.

Study selection

Randomized controlled trials (RCTs) assessing LEV and PHT as second line agent for convulsive SE in children <18 years published between 1 January 2000 and 30 November 2020.

Data extraction

The data were pooled regarding the proportion of children achieving seizure cessation within 5–60 min of completion of study drug infusion (primary outcome); and seizure cessation within 5 min, time to achieve seizure cessation, seizure recurrence between 1 to 24 h, intubation and cardiovascular instability (secondary outcomes). Data were analyzed using RevMan version 5.4 and quality analysis was done using Cochrane risk-of-bias tool. The study protocol was registered with PROSPERO.

Data synthesis

Twelve RCTs with 2293 children were included. Seizure cessation within 5–60 min was similar with both the drugs [82% in LEV vs. 77.5% in PHT, risk ratio (RR) = 1.04, 95% confidence interval (95% CI) 0.97–1.11, p = 0.30]. Seizure recurrences within 1–24 h was higher with PHT in comparison to LEV (16.6% vs. 9.7%, RR = 0.63, 95% CI 0.44–0.90, p = 0.01). Higher proportion of children in PHT group required intubation and mechanical ventilation (21.4% vs. 14.2%, RR = 0.54, 95% CI 0.30–0.98, p = 0.04). Seizure cessation within 5 min, time to achieve seizure cessation, and cardiovascular instability were similar with both the drugs. Three RCTs were at low risk of bias and nine were at high risk of bias.

Conclusion

The efficacy of LEV is similar to PHT as second line ASM for Pediatric convulsive SE. Seizure recurrences between 1 to24 h and requirement of intubation and mechanical ventilation were significantly higher with PHT in comparison to LEV.
Effect of medications after cardiac surgery on long-term outcomes in patients with cirrhosis
Authors: Chou An-Hsun , Lin Yu-Sheng , Wu Victor Chien-Chia , Chen Fang-Ting , Yang Chia-Hung , Chen Dong-Yi , Chen Shao-Wei
Published: February 2021

The aim of this study was to evaluate the effect of beta-blockers, angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) after cardiac surgery in the liver cirrhosis (LC) patients. We conducted a population-based cohort study using data from the Taiwanese National Health Insurance Research Database (NHIRD) from 2001 to 2013. The outcomes of interest included all-cause mortality, major adverse cardiac and cerebrovascular events (MACCE) and liver and renal outcomes. Among 1470 LC patients, 35.6% (n = 524) received beta-blockers and 33.4% (n = 491) were prescribed ACEIs and/or ARBs after cardiac surgery. The risk of negative liver outcomes was significantly lower in the ARB group compared with the ACEI group (9.6% vs 22.7%, hazard ratio [HR] 0.50, 95% confidence interval [CI] 0.31–0.83). Furthermore, the risk of MACCE (44.2% vs 54.7%, HR 0.79, 95% CI 0.65–0.96), all-cause mortality (35.3% vs 46.4%, HR 0.74, 95% CI 0.60–0.92), composite liver outcomes (9.6% vs 16.5%, HR 0.56, 95% CI 0.38–0.85) and hepatic encephalopathy (2.7% vs 5.7%, HR 0.45, 95% CI 0.21–0.94) were lower in the ARB group than the control group. Our study demonstrated that ARBs provide a greater protective effect than ACEIs in regard to long-term outcomes following cardiac surgery in patients with LC.
Efficacy and safety of traditional Chinese herbal medicine in the treatment of threatened abortion
Authors: Zeng Pengfei , Zhou Hang , Guo Pei , Xia Wanting , Huang Jinzhu , Zeng Qian
Published: February 2021

Background:

Threatened abortion (TA) is the commonest complication that occurs in early pregnancy, especially in 8-12 gestational weeks when the secretion of estrogen and progesterone shifts from corpus luteum to placental. Conventional therapies are little evidence of their value. In China, traditional Chinese herbal medicine has been widely used for the treatment of TA for a long time. The lack of strong scientific evidences make this a priority area for research. We aim to evaluate the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA, provide medical staffs with more useful information, and provide patients with better advises.

Methods:

We will search 8 databases and additional sources, including the Web of Science, PubMed, Cochrane Library, Embase, CBM, Wanfang, VIP, CNKI, and WHO ICTRP, ChiCTR, Clinical Trials, Grey Literature Database, for potentially eligible studies. Literature search, screening and retrieval are performed independently by two researchers. In the event of a dispute, a third party will be consulted to support the judgment. We will use RevmanV.5.3 to perform a fixed-effect meta-analysis for clinical homogeneity study data, and the level of evidence will be assessed using the GRADE method.

Results:

This systematic review and meta-analysis will put a high-quality synthesis of the efficacy and safety of traditional Chinese herbal medicine in the treatment of TA.

Conclusion:

The conclusion of this systematic review will provide evidence to assess traditional Chinese herbal medicine therapy whether is an efficacy and safe intervention to treat TA.

Ethics and dissemination:

Since this article does not contain patient personal information, ethical approval is not required. The contract is distributed by a peer-reviewed journal or conference report.

Registration number:

10.17605/OSF.IO/DG3T8
Association between body mass index and cardio-metabolic risk factors among subjects in Wuhan, China
Authors: Zhang Shijie , Huang Fei , Xu Ranran , Cheng Anying , Wan Zhengce , Lv Yongman , Liu Qingquan
Published: February 2021

The aim of this study is to evaluate the association between body mass index (BMI) and cardio-metabolic risk factors and to determine the optimal BMI cut-off values in male and female subjects in Wuhan, China.

We conducted a retrospective cross-sectional analysis of 20218 adult subjects (aged 18–85 years, 12717 men of them) who had health examinations at the health management center of Tongji Hospital of Wuhan in 2017. Multivariate logistic regression analysis was preformed to calculate the odds ratios (ORs) of cardio-metabolic risk factors. Receiver operating characteristic curve was used to determine the area under the receiver operating characteristic curve and optimal cut-off values for BMI predictive of cardio-metabolic risk factors.

Of the 20218 participants, the percentage of males with overweight and obesity was as twice as that of females and the prevalence of hypertension, diabetes mellitus (DM), dyslipidemia, and hyperuricemia was significantly higher in males than females (27.18% vs 17.69%, 7.88% vs 4.16%, 41.97% vs 15.20%, and 34.50% vs 9.93%, respectively). Multivariate logistic regression analysis showed that higher BMI was a significant risk factor for hypertension (OR:1.27, 95% confidence intervals [CI]: 1.25–1.29), DM (OR:1.25, 95% CI:1.22–1.28), dyslipidemia (OR:1.26, 95% CI:1.25–1.28), and hyperuricemia (OR:1.25, 95% CI:1.23–1.27) after adjusting for age in both sexes. But in overweight or obesity status, females had higher ORs for hypertension and DM, and lower ORs for dyslipidemia than that in males. The optimal cut-off values of BMI for the presence of cardio-metabolic risk factors were among 24.25 to 25.35 kg/m2 in males, which were higher than in females among 22.85 to 23.45 kg/m2.

The association between BMI and cardio-metabolic risk factors is different by gender. It is necessary to determine appropriate threshold for overweight status in men and women separately.
Efficacy and safety of Shenqi Jiangtang Granules plus oral hypoglycemic agent in patients with type 2 diabetes mellitus
Authors: Li Tianli , Li Hongzheng , Wu Yang , Wu Qian , Zhao Guozhen , Cai Zhaolun , Pu Fenglan , Li Bo
Published: February 2021

Objective:

Shenqi Jiangtang Granules (SQJTG) has been widely used to treat patients with type 2 diabetes mellitus (T2DM). But whether there exists sufficient evidence on the efficacy of SQJTG in the treatment of T2DM is unclear. In order to assess the effects of SQJTG for T2DM, a systematic review and meta-analysis of randomized controlled trials (RCTs) were carried out.

Methods:

Eight databases, namely, PubMed, The Cochrane Library, EMBASE, Web of Science, Chinese National Knowledge Infrastructure, Chinese Scientific Journals Full-Text Database, CBM, and Wanfang database were searched up to May 2020. According to the Cochrane standards, the selection of study, the extraction of data, the assessment of study quality, and the analyses of data were carried out strictly. Then a fixed or random effects model was applied to analyze the outcomes.

Results:

Fifteen studies (N = 1392) in total conformed the inclusion criteria to this meta-analysis. Two subgroups were identified, based on different dose of SQJTG: oral hypoglycemic agent (OHA) vs OHA plus SQJTG (1 g); OHA vs. OHA plus SQJTG (1.5–3 g). The pooled results showed that, in comparison with OHA, OHA plus SQJTG significantly reduced fasting plasma glucose in both 1 g subgroup and 1.5–3 g subgroup; 2-hour post-meal blood glucose was also greatly reduced in the SQJTG 1 g subgroup and the SQJTG 1.5–3 g subgroup. Compared with OHA, SQJTG 1 g subgroup significantly reduced levels of glycated hemoglobin A1c, as well as the SQJTG 1.5–3 g subgroup. Homeostasis model-insulin resistance index was also reduced in both SQJTG 1 g subgroup and SQJTG 1.5–3 g subgroup; SQJTG group can also significantly reduce the total adverse events especially in reducing the incidence of hypoglycemia.

Conclusions:

SQJTG is an effective and safe complementary treatment for T2DM patients. This meta-analysis provides an evidence for the treatment in patients with T2DM. While owing to the high heterogeneity and the trials’ small sample size, it's crucial to perform large-scale and strict designed studies.
Early detection of lung cancer in Czech high-risk asymptomatic individuals (ELEGANCE)
Authors: Lambert Lukas , Janouskova Lenka , Novak Matej , Bircakova Bianka , Meckova Zuzana , Votruba Jiri , Michalek Pavel , Burgetova Andrea
Published: February 2021

Background:

Lung cancer screening in high-risk population increases the proportion of patients diagnosed at a resectable stage.

Aims:

To optimize the selection criteria and quality indicators for lung cancer screening by low-dose CT (LDCT) in the Czech population of high-risk individuals. To compare the influence of screening on the stage of lung cancer at the time of the diagnosis with the stage distribution in an unscreened population. To estimate the impact on life-years lost according to the stage-specific cancer survival and stage distribution in the screened population. To calculate the cost-effectiveness of the screening program.

Methods:

Based on the evidence from large national trials - the National Lung Screening Trial in the USA (NLST), the NELSON study, the recent recommendations of the Fleischner society, the American College of Radiology, and I-ELCAP action group, we developed a protocol for a single-arm prospective study in the Czech Republic for the screening of high-risk asymptomatic individuals. The study commenced in August 2020.

Results:

The inclusion criteria are: age 55 to 74 years; smoking: ≥30 pack-years; smoker or ex-smoker <15 years; performance status (0–1). The screening timepoints are at baseline and 1 year. The LDCT acquisition has a target CTDIvol ≤0.5mGy and effective dose ≤0.2mSv for a standard-size patient. The interpretation of findings is primarily based on nodule volumetry, volume doubling time (and related risk of malignancy). The management includes follow-up LDCT, contrast enhanced CT, PET/CT, tissue sampling. The primary outcome is the number of cancers detected at a resectable stage, secondary outcomes include the average cost per diagnosis of lung cancer, the number, cost, complications of secondary examinations, and the number of potentially important secondary findings.

Conclusions:

A study protocol for early detection of lung cancer in Czech high-risk asymptomatic individuals (ELEGANCE) study using LDCT has been described.