bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of El Niño drought on seedling dynamics in a seasonally dry tropical forest in Northern Thailand
Authors: Nutiprapun Prapawadee , Hermhuk Sutheera , Nanami Satoshi , Itoh Akira , Kanzaki Mamoru , Marod Dokrak
Published: October 2022

As El Niño is predicted to become stronger and more frequent in the future, it is crucial to understand how El Niño‐induced droughts will affect tropical forests. Although many studies have focused on tropical rainforests, there is a paucity of studies on seasonally dry tropical forests (SDTFs), particularly in Asia, and few studies have focused on seedling dynamics, which are expected to be strongly affected by drought. Seedlings in SDTFs are generally more drought‐tolerant than those in the rainforests, and the effects of El Niño‐induced droughts may differ between SDTF and tropical rainforests. In this study, we explored the impact of El Niño‐induced drought at an SDTF in northern Thailand by monitoring the seedling dynamics at monthly intervals for 7 years, including a period of strong El Niño. The effects were compared between two forest types in an SDTF: a deciduous dipterocarp forest (DDF), dominated by deciduous species, and an adjacent lower montane forest (LMF) with more evergreen species. El Niño‐induced drought increased seedling mortality in both the forest types. The effect of drought was stronger in evergreen than in the deciduous species, resulting in higher mortality in the LMF during El Niño. However, El Niño increased seedling recruitment only in the DDF, mainly because of the massive recruitment of the deciduous oak,Quercus brandisiana(Fagaceae), which compensated for the mortality of seedlings in the DDF. As a result, El Niño increased seedling density in the DDF and decreased it in the LMF. This is the first long‐term study to identify the differences in the impacts of El Niño on seedlings between the two forest types, and two leaf habits, evergreen and deciduous, in Southeast Asia. Our findings suggest that future climate change may alter the species composition and spatial distribution of seedlings in Asian SDTFs.
A biased random‐key genetic algorithm for the home health care problem
Authors: Kummer Alberto F. , de Araújo Olinto C.B. , Buriol Luciana S. , Resende Mauricio G.C.
Published: October 2022

Home health care problems consist in scheduling visits to home patients by health professionals while following a series of requirements. This paper studies the Home Health Care Routing and Scheduling Problem, which comprises a multi‐attribute vehicle routing problem with soft time windows. Additional route inter‐dependency constraints apply for patients requesting multiple visits, either by simultaneous visits or visits with precedence. We apply a mathematical programming solver to obtain lower bounds for the problem. We also propose a biased random‐key genetic algorithm, and we study the effects of additional state‐of‐the‐art components recently proposed in the literature for this genetic algorithm. We perform computational experiment using a publicly available benchmark dataset. Regarding the previous local search‐based methods, we find results up to 26.1% better than those of the literature. We find improvements from around 0.4% to 6.36% compared to previous results from a similar genetic algorithm.
Calciphylaxis and its co‐occurrence with connective tissue diseases
Authors: Zhou Yueyuan , Chen Yuehong , Yin Geng , Xie Qibing
Published: October 2022

Calciphylaxis, also known as calcific uremic arteriopathy, is a rare calcification syndrome that presents as ischemic skin necrosis and severe pain. It has a high mortality rate and is characterised by calcification of the small and medium arteries and micro‐thrombosis. Calciphylaxis mainly occurs in patients with end‐stage renal disease. In recent years, there have been an increasing number of cases of calciphylaxis associated with connective tissue diseases. Given the absence of clear diagnostic criteria for calciphylaxis thus far, an early diagnosis is crucial for designing an effective multidisciplinary treatment plan. In this article, we review the research progress on calciphylaxis and describe its characteristics in the context of connective tissue diseases.
Association between circulating 25‐hydroxyvitamin D metabolites and periodontitis: Results from the NHANES 2009–2012 and Mendelian randomization study
Authors: Li Wenjing , Zheng Qiwen , Xu Mingming , Zeng Changqing , Deng Xuliang
Published: October 2022

Aim

This study sought to investigate associations of 25‐hydroxyvitamin D (25(OH)D) metabolites with periodontitis and to assess causality using Mendelian randomization (MR).

Materials and Methods

This study included 7246 participants of the National Health and Nutrition Examination Survey, 2009–2012. The association of periodontitis with 25(OH)D metabolites was assessed using multivariable logistic regression analysis. Two‐sample MR for 25(OH)D, 25(OH)D3, and C3‐epi‐25(OH)D3 with periodontitis (n = 17,353 cases/28,210 controls) was conducted. The principal analysis employed the inverse‐variance‐weighted (IVW) approach. We controlled for horizontal pleiotropy using five additional methods.

Results

Based on the observational study, each 1‐point increase in standard deviation of 25(OH)D lowered the risk of periodontitis by 15% (OR = 0.85, 95% confidence interval [CI]: 0.78–0.93, p = .006) after multivariable adjustment. A similar relationship was observed between 25(OH)D3 and periodontitis (OR = 0.88, 95% CI: 0.80–0.97, p = .031). Furthermore, a potential non‐linear association was found between periodontitis and both 25(OH)D and 25(OH)D3. However, C3‐epi‐25(OH)D3 was not found to be associated with periodontitis risk. IVW‐MR showed that periodontitis risk was not significantly associated with genetically increased levels of 25(OH)D (OR = 1.02, 95% CI: 0.90–1.16, p = .732), 25(OH)D3 (OR = 1.04, 95% CI: 0.93–1.17, p = .472), or C3‐epi‐25(OH)D3 (OR = 1.11, 95% CI: 0.87–1.41, p = .400). The pleiotropy‐robust MR approaches yielded similar results after we had eliminated the variants with horizontal pleiotropy risk.

Conclusions

Cross‐sectional observational analysis identified significant relationships between periodontitis with 25(OH)D metabolites, while findings based on MR study did not support a causal role.
Stronger legacy effects of cropland than of meadows or pastures on soil conditions and plant communities in French mountain forests
Authors: Mollier Sylvain , Dupouey Jean‐Luc , Kunstler Georges , Montpied Pierre , Bergès Laurent
Published: October 2022

Question

Differences in understorey vegetation between ancient and recent forests have been thoroughly explored; however, few studies have investigated the legacies of different former land uses in recent forests. Indeed, due to more intense agricultural practices (tillage and fertilisation), legacy effects are expected to be stronger in former cropland or meadows than in former pastures. Our objectives were to compare soil conditions, taxonomic composition and functional composition of understorey plant communities in recent forests located on former pastures, meadows or cropland, with ancient forests as a reference.

Location

Tarentaise Valley, Savoy, France.

Methods

Based on land‐use maps surveyed between 1862 and 1864, we selected 82 forest sites with different former land uses in mountain forests in the French Alps and carried out soil sampling and botanical surveys. To account for potential confounding factors (altitude, canopy cover, tree species composition), we applied multiple linear regressions to analyse soil properties, canonical correspondence analysis to analyse plant taxonomic composition and multispecies generalised linear mixed‐effects models to analyse relationships between plant functional composition and former land uses.

Results

The soils of former cropland were richer in nutrients and more alkaline compared to other past land uses, while soils on former pastures and meadows differed only slightly from ancient forests. Ancient forests were characterised by acidophilic, shade‐tolerant, low‐stature, forest‐dependent species, whereas former cropland was characterised by calcicolous non‐forest species. Former pasture and meadow communities displayed a distinct taxonomic composition compared to other past land uses, but a functional composition closer to ancient forest than to former cropland.

Conclusion

Former cropland has a stronger legacy effect than former pastures or meadows. This could explain small differences between ancient and recent forests observed in previous studies conducted in mountain landscapes where former cropland was rare.
The strength of gender norms and gender‐stereotypical occupational aspirations among adolescents
Authors: Kuhn Andreas , Wolter Stefan C.
Published: October 2022

We empirically test the hypothesis that adolescents' occupational aspirations are more gender‐stereotypical if they live in a region where the societal norm towards gender equality is weaker. For our analysis, we combine rich survey data describing a sample of 1,434 Swiss adolescents who attended 8th grade in 2013 with municipal voting results dealing with gender equality and policy. We find that occupational aspirations predominantly follow gender stereotypes and that adolescents living in municipalities with a stronger norm towards gender equality are significantly less likely to aspire for a gender‐stereotypical occupation, even after controlling for individual‐level controls. At the same time, we also find that the association is surprisingly weak – in the sense that adolescents tend to aspire for gender‐stereotypical occupations even in the most gender‐progressive municipalities. Moreover, a more detailed analysis shows that the association mainly reflects the intergenerational transmission of occupations from parents to their children and/or regional differences in the prevailing occupational structure. We discuss the implications of these findings and several mechanisms that are consistent with the evidence from our analysis.
Mergers and acquisitions in supply bases
Authors: Hu Wenjin , Skowronski Keith , Dong Yan , Shou Yongyi
Published: October 2022

Mergers and acquisitions (M&As) by first‐tier suppliers, referred to as the supply base, are dynamic and drastic changes in supply chain structure and relationships that affect focal firm performance. In particular, the impact of M&As in a supply base depends on the concentration and differentiation of the supply base, which affects power–dependence relationships in the supply chain. This study examines the effect of supply base M&As on focal firms’ cost of goods sold (COGS). In addition, this study explores the role of power relationships by investigating the moderating effects of supply base concentration and differentiation. Using secondary panel data assembled from four different data sources, this study constructs econometric models and empirically examines the relationship between supply base M&As and focal firm cost efficiency. Our findings indicate that supply base M&As are positively associated with focal firm COGS. This result suggests that potential efficiency gains from M&As in supply bases may not translate to benefits for the focal firm because suppliers may also gain bargaining power from M&As. However, the effect of supply base M&As on focal firm COGS is attenuated when the supply base is less concentrated in terms of their transaction percentage with suppliers and more differentiated in terms of industry and business scopes. These are situations where suppliers less effectively obtain or employ bargaining power from M&As. These findings make important contributions to the operations management literature.
Quid pro quo
Authors: Yao Zhiyong , Huang Yao
Published: October 2022

This paper attempts to shed some new light on two puzzles about Chinese economy: Rapid economic growth despite pandemic corruption; dramatic development of the private sector despite ‘ownership discrimination' in financial resource allocation. In our model, the productive bribe facilitates the more efficient private firm to obtain the scarce financial resource, either from the bank or from the state‐owned enterprise, and corrects the initial allocation distortion. Meanwhile, our model also generates the distortionary and the predatory bribes which hurt the economy.
The load borne by the Achilles tendon during exercise: A systematic review of normative values
Authors: Demangeot Yoann , Whiteley Rod , Gremeaux Vincent , Degache Francis
Published: October 2022

The Achilles tendon (AT) can be exposed to considerable stress during athletic activities and is often subject to pathologies such as tendinopathies. When designing a prevention or rehabilitation protocol, mechanical loading is a key factor to consider. This implies being able to accurately determine the load applied to the AT when performing exercises that stress this tendon. A systematic review was performed to synthesize the load borne by the AT during exercises/activities. Three databases (Pubmed, Embase and Cochrane) were searched for articles up to May 2021, and only the studies assessing the AT load in newtons relative to body‐weight (BW) on humans during activities or exercises were included. Most of the 11 included studies assessed AT load when running or walking (N = 10), and only three tested exercises were usually performed during rehabilitation. The load on the tendon ranged from 2.7 to 3.95 BW when walking, from 4.15 to 7.71 BW when running, and from 0.41 to 7.3 BW according to the strengthening exercise performed. From the collected data, a progression of exercises progressively loading the Achilles tendon, as well as the possible connections with walking and running activities, could be defined. However, the trends highlighted in the relationship between tendon loading and walking or running speeds present some inconsistencies. Further research is still needed to clarify them, but also to complete the data set in healthy and injured people.
Identification of three novel HLA class I alleles: HLA‐A*02:1008, ‐A*24:553 and ‐C*12:350
Authors: Moya‐Quiles María Rosa , Muro Manuel
Published: October 2022

Characterization of three new HLA class I alleles, HLA‐A*02:1008, ‐A*24:553 and ‐C*12:350, identified in Spanish hematopoietic stem cell donors.
The identification of three novel HLA‐A alleles: HLA‐A*03:390:02, ‐A*26:112:02 and ‐A*26:221
Authors: Ananeva Anastasiia , Elvira Ziyatdinova , Ryzhkova Tatiana , Shagimardanova Elena
Published: October 2022

Three novel HLA‐A alleles HLA‐A*03:390:02, ‐A*26:112:02, and ‐A*26:221 alleles detected during routine next generation sequencing.
Identification of the novel HLA‐C*07:02:01:184 allele in an Indian individual from a Kshatriya family
Authors: Tambe Manisha , D'Silva Selma Z. , Pinto Andrea S. , Singh Meenakshi
Published: October 2022

The novel allele HLA‐C*07:02:01:184 as compared with HLA‐C*07:02:01:03 displays polymorphism at position; gDNA 2896 (G > C).
The novel HLA‐A*11:416 allele was identified during high‐resolution HLA typing
Authors: Ananeva Anastasiia , Gulnaz Akhmetshina , Ryzhkova Tatiana , Gaifullina Raushania , Shagimardanova Elena
Published: October 2022

HLA‐A*11:416 has one non‐synonymous nucleotide change from A*11:01:01:01 in codon 39.
Somatic mutations show no clear association with red blood cell or human leukocyte antigen alloimmunization in de novo or therapy‐related myelodysplastic syndrome
Authors: Adkins Brian D. , Mehta Ajay , Selesky Margaret , Vittitow Stephany , Smolkin Mark E. , Ratcliffe Sarah J. , Luckey Chance J.
Published: October 2022

Background

Myelodysplastic syndrome (MDS) is a marrow failure disease. As patients often require chronic transfusion, many develop red blood cell (RBC) alloimmunization or immune‐mediated platelet refractoriness. MDS represents a spectrum of diseases with specific categorizations and genetic abnormalities, and we set out to determine if these characteristics predispose patients to antibody formation.

Study Design and Methods

A natural language search identified MDS patients with pre‐transfusion testing from 2015 to 2020. Marrow reports, cytogenetic results, and next‐generation sequencing panels were gathered. Transfusion history and testing were collected from the laboratory information system.

Results

The group consisted of 226 biopsy‐proven MDS patients. The prevalence of RBC alloimmunization was 11.1% (25 of 226). Half (23 of 46) of all RBC alloantibodies were against Rh (C, c, E, e) and Kell (K) antigens. There was a relative enrichment for JAK2 positivity among the RBC alloimmunized group. A total of 7.1% (16 of 226) of patients had immune‐mediated platelet refractoriness and had increased transfusion requirements (p ≤ 0.01). No disease type or genetic abnormality was significantly associated with alloimmunization or immune‐mediated platelet refractoriness.

Discussion

While JAK2 specific mutations were enriched among RBC alloimmunized patients, this association failed to reach statistical significance in our single‐center cohort. Further study using larger patient cohorts is warranted. Overall, this cohort of MDS patients had very similar RBC alloimmunization prevalence and anti‐RBC antibody specificities as other recent literature. Our data reinforce the finding that MDS patients are at greater risk for alloimmunization and support the use of extended phenotype matching for these at‐risk patients.
SiO2 etching and surface evolution using combined exposure to CF4/O2 remote plasma and electron beam
Authors: Lin Kang-Yi , Preischl Christian , Hermanns Christian Felix , Rhinow Daniel , Solowan Hans-Michael , Budach Michael , Edinger Klaus , Oehrlein G. S.
Published: October 2022

Electron-based surface activation of surfaces functionalized by remote plasma appears like a flexible and novel approach to atomic scale etching and deposition. Relative to plasma-based dry etching that uses ion bombardment of a substrate to achieve controlled material removal, electron beam-induced etching (EBIE) is expected to reduce surface damage, including atom displacement, surface roughness, and undesired material removal. One of the issues with EBIE is the limited number of chemical precursors that can be used to functionalize material surfaces. In this work, we demonstrate a new configuration that was designed to leverage flexible surface functionalization using a remote plasma source, and, by combining with electron beam bombardment to remove the chemically reacted surface layer through plasma-assisted electron beam-induced etching, achieve highly controlled etching. This article describes the experimental configuration used for this demonstration that consists of a remote plasma source and an electron flood gun for enabling electron beam-induced etching of SiO2 with Ar/CF4/O2 precursors. We evaluated the parametric dependence of SiO2 etching rate on processing parameters of the flood gun, including electron energy and emission current, and of the remote plasma source, including radiofrequency source power and flow rate of CF4/O2, respectively. Additionally, two prototypical processing cases were demonstrated by temporally combining or separating remote plasma treatment and electron beam irradiation. The results validate the performance of this approach for etching applications, including photomask repair and atomic layer etching of SiO2. Surface characterization results that provide mechanistic insights into these processes are also presented and discussed.
Physical Activity Measured by Pedometer in a Peri-Urban Mozambican Population
Authors: Macicame Ivalda , Katzmarzyk Peter T. , Lauchande Carlos , Uate Jorge , Cavele Nílzio , Manhiça Cremildo , Saathoff Elmar , Parhofer Klaus G. , Prista António
Published: October 2022

Aim: This study was performed to describe physical activity behavior and its demographic associations in a peri-urban population from Mozambique, using device-based data. Methods: Physical activity was assessed by pedometers in a sample of 15- to 64-year-old subjects from Maputo, Mozambique. Participants wore a pedometer for 7 consecutive days, and physical inactivity was classified using a variety of approaches: sedentary (<5000 steps/d), physically inactive (<7500 steps/d), and no moderate-to-vigorous physical activity (MVPA < 1 min/d). Results: The percentage of sedentary subjects was 17.8%, and the percentage who were physically inactive was 41.8%. A total of 9.0% of participants participated in no MVPA (<1 min/d). Logistic regression analysis showed that females had a higher odds of being sedentary or inactive and having no MVPA compared with males. Unemployed participants were more sedentary and inactive than those who were employed. Socioeconomic status and body mass index did not show any significant association with physical activity. Conclusions: Findings suggest that physical activity levels of this peri-urban African city population are insufficient relative to the amount of activity recommended to improve health. Moreover, being sedentary and inactive was associated with occupation and gender but not with other sociodemographic characteristics and body mass index.
Supplemental Material: Sponge-rich sediment recycling in a Paleozoic continental arc driven by mélange melting
Authors: Liu Huichuan , al. et
Published: October 2022

Detailed analytical methods, Tables S1–S5, and Figures S1–S5. 
One-Dimensional Inverse Problem of Passive Acoustic Thermometry Using the Heat Conductivity Equation: Computer and Physical Simulation
Authors: Anosov A. A.
Published: October 2022

An algorithm for reconstructing the time-varying one-dimensional distribution of the deep temperature of the human body under local heating is proposed and experimentally tested on a model. The algorithm requires that the temperature obey the heat conduction equation, the integration of which with a weight that takes into account absorption in the object, makes it possible to obtain the time dependence of the acoustic brightness temperature (measured signal), which in turn is determined by the parameters of the equation. The desired temperature is obtained by solving the heat conduction equation with the found parameters. The algorithm reconstructs two parameters: blood flow and the amplitude of the heating source, which are not determined each time anew, but only refined. In this case, the integration time increases, but the temporal resolution does not suffer: new results can be obtained after any period of time. After 2 min of heating, it is possible to reconstruct the temperature and size of the heated region with an accuracy acceptable for medical applications: 0.5°C and 0.5 mm, respectively.
Evaluations of the Annoyance Effects of Noise
Authors: Rimskaya-Korsakova L. K. , Pyatakov P. A. , Shulyapov S. A.
Published: October 2022

Noise is defined as audible sound that disrupts silence and causes annoyance. Such annoyance is traditionally assessed by the A-weighted sound pressure level of noise, roughly corresponding to the level of perceived loudness. However, the A-weighted scale is inapplicable for analyzing tonal, pulsed, and predominantly low-frequency noise; therefore, methods have been developed for calculating noise loudness in linear units, sones, which take into account not only auditory sensitivity, but also masking properties and auditory temporal effects. The existence of noise reduction limits and their informational significance have led to other methods for assessing noise annoyance. Annoyance, in addition to loudness, is caused by such subjective noise qualities as sharpness, roughness, fluctuation strength, tonality, etc. Units of measurements have been defined for these and calculation methods developed. Taking such qualities into account, a metric of short-term psychoacoustic annoyance (PAA) has been proposed, which is valid for many types of noise. Another method for evaluating PAA includes conducting an auditory examination and constructing a mathematical model that relates the rank of auditory annoyance to the measured subjective qualities of the noise. The resulting model helps to identify the causes of annoyance (subjective annoying qualities); develop work plans aimed at noise suppression, the formation of pleasant noise by machines and mechanisms; and control changes in the rank of annoyance in the implementation of such plans. This paper compares different methods for assessing the annoyance caused by noise recorded in Moscow subway cars.
Zieve syndrome presenting with lipaemia and treated by plasmapheresis
Authors: Sams Lauren Eleonore , Krappe Julia , Czihal Michael , Hoppe John Michael
Published: October 2022

Zieve syndrome is a rare condition which occurs in patients with severe alcohol abuse. It is typically characterised by the triad of jaundice, haemolytic anaemia and transient hyperlipidaemia. In the following report, we present the case of a man in his 30s who was admitted to our emergency department with severe epigastric pain and signs of alcohol intoxication. Blood samples showed signs of severe hyperlipidaemia and jaundice. Due to massive hyperlipidaemia, laboratory measurements of triglycerides were impaired and the blood samples had a ‘yellowish’ and ‘creamy’ texture. In order to prevent pancreatitis, plasmapheresis was performed. Subsequently, triglyceride concentration dropped and the patient was discharged a few days later in significantly improved physical condition. In the following case report, we discuss plasmapheresis as a possible treatment for patients with severe Zieve syndrome in addition to conventional symptomatic therapy.
Subarachnoid haemorrhage in a patient with undiagnosed aortic coarctation
Authors: Karlsen Anders Peder Højer , Schmidt Michael Rahbek , Stavnsgaard Trine , Sørensen Martin Kryspin
Published: October 2022

A man in his mid-30s was admitted with a thunderclap headache. He was conscious and hypertensive. A decade earlier, severe hypertension had been diagnosed and extensively investigated without revealing an underlying cause. Brain imaging showed subarachnoid haemorrhage caused by a ruptured pericallosal aneurysm. Endovascular occlusion was attempted, but as the sheath could not pass the aortic arch, it was converted to surgical aneurismal clipping. Intraoperative blood pressure measurement revealed a peak-to-peak gradient of 100 mm Hg across the aortic arch and an ankle/brachial index of 0.46 (normal range 0.9–1.2). Aortic coarctation was suspected, and angiographic imaging and echocardiography confirmed the diagnosis. Subacute direct stenting was performed, which normalised the peak-to-peak gradient and ankle/brachial index. To minimise the risk of severe complications, early diagnosis of aortic coarctation is important and can be facilitated by ankle/brachial index and echocardiography in the suprasternal view.
Cavitating pulmonary lung lesions with more than one microbiological aetiology
Authors: Borup Maria Bisgaard , Falster Casper , Jacobsen Niels , Davidsen Jesper Rømhild
Published: October 2022

Non-tuberculous mycobacteria (NTM) are one of the predominant microbes observed in immunocompromised patients with structural lung disease. Especially in immunocompromised patients, the treating physician needs to be aware of concurrent lung infections with opportunistic pathogens. In this case report we present a man in his 60s with severe chronic obstructive pulmonary disease (COPD) and bullous emphysema, who was diagnosed withMycobacterium europaeumbut with persistent clinical deterioration despite relevant treatment for NTM. A subsequent bronchoalveolar lavage (BAL) revealed elevatedAspergillusgalactomannan antigen which, when seen in relation to imaging-findings of cavitating opacities with aggravating surrounding consolidation, raised suspicion of concurrent subacute invasive aspergillosis. Antifungal treatment was initiated but due to intolerable side effects was discontinued after only a few weeks. This case highlights the importance of concurrent testing for pulmonary aspergillosis in NTM patients and vice versa before treatment initiation and if the disease and symptoms are progressing despite relevant treatment.
Thrombotic thrombocytopenic purpura following administration of the Moderna booster vaccine
Authors: Herrman Emma , Ghimire Bipin , Chisti Mohammad Muhsin
Published: October 2022

Thrombotic thrombocytopenic purpura (TTP) is a type of thrombotic microangiopathy that is characterized by microangiopathic haemolytic anaemia, consumption thrombocytopenia and organ injury. It is caused by a severe deficiency of ADAMTS13, which can be either congenital or acquired. There is a plethora of things that can cause the acquired form, including medications and infections. Vaccines have also been shown to cause TTP. In the midst of the COVID-19 pandemic, with multiple new vaccines being developed and distributed to the masses, the medical community needs to be aware of adverse events associated with these new vaccines. We present a case of TTP following administration of the Moderna booster vaccine.
Solitary fibrous tumour of the pleura: an incidental finding
Authors: Conti Luca , Buhagiar Tiffany , Farrugia Paul , Pace Bardon Michael
Published: October 2022

We herein report a relatively rare case of a woman in her 30s with an incidental lung finding. She subsequently underwent resection for what was considered to be a solitary fibrous tumour of the pleura (SFTP). SFTPs are rare, slow-growing neoplasms from mesenchymal origin. These tumours are histologically characterised by proliferation of bland-looking spindled cells, arranged in a patternless pattern, with hypocellular and hypercellular areas set in a hyalinised stroma. Complete en bloc surgical excision (with margin negativity) is the treatment of choice for both benign and malignant SFTPs. Due to the possibility of local recurrence with benign and malignant SFTPs, clinical and radiological follow-up is recommended.
Recurrent macular neurosensory detachment in hypotony maculopathy managed with topical corticosteroids
Authors: Barbosa Renato Correia , Bastos Ricardo , Tenedório Paula
Published: October 2022

A female patient in her late 70s underwent uncomplicated non-penetrating deep sclerectomy surgery. Three years after surgery, she presented with a sudden decrease in visual acuity, intraocular pressure (IOP) of 2 mmHg, macular folding and significant macular subretinal fluid. Assuming hypotony as the cause, topical dexamethasone was started, with complete functional and imagological improvement. Two months after withdrawal, she returned with the same symptoms and imagological findings. The same topical treatment was re-established, with progressive and complete improvement. After 14 months of follow-up and a maintenance dose of topical dexamethasone (1id), the patient remained stable with an IOP of 16 mm Hg. Hypotony maculopathy can, in rare cases, lead to subretinal fluid and neurosensory detachment. Topical corticosteroids can reverse and prevent hypotony in patients who are corticosteroid responsive. In advanced glaucoma, extremely low IOP may be as dangerous as high IOP. Timely normalisation of IOP may restore normal retinal architecture with associated functional improvement.
Hydrocarbon pneumonitis with abscess formation following diesel siphoning
Authors: Rajpoot Akhilesh , Sharma Prakhar , Kumar Arjun , Rathore Suyash Singh
Published: October 2022

A man in his early 40s presented with a 1-month history of fever after accidental diesel aspiration. He had received treatment with intravenous antibiotics, steroids and supportive care. Contrast-enhanced CT of the thorax revealed a right middle lobe lung abscess and bronchoscopy revealed hyperaemia around the middle lobe bronchus. The abscess was initially managed by drainage using a pigtail catheter and intravenous antibiotics. However, only partial drainage of the abscess was achieved and fever persisted. The cardiothoracic surgery team performed drainage of lung abscess through a right posterolateral thoracotomy. Postprocedure, the patient’s symptoms improved and the patient was discharged in good health. This case demonstrates a rare complication of hydrocarbon aspiration pneumonitis and lung abscess. Post acute management of diesel aspiration, patients should be advised to return for medical assessment immediately, should symptoms like persistent fever and chest pain recur or persist as these symptoms may herald the development of post-hydrocarbon-aspiration lung abscess.
Ethical considerations in international clinical trial site selection
Authors: Miller Jennifer , Millum Joseph
Published: October 2022

New medicines and vaccines are predominantly tested in high-income countries. However, as the COVID-19 pandemic highlighted, the populations who can benefit from these interventions are not limited to these wealthier regions. One-third of novel Food and Drug Administration approved drugs, sponsored by large companies, treat infectious diseases like tuberculosis and HIV, which disproportionately affect low-income and middle-income countries (LMICs). The medicines for non-communicable diseases (NCDs) are also relevant to LMIC health needs, as over three-quarters of deaths from NCDs occur in LMICs. There are concerns clinical trial data may not extrapolate across geographical regions, as product effectiveness can vary substantially by region. The pentavalent rotavirus vaccine, for example, had markedly lower efficacy in LMICs. Efficacy variations have also been found for other vaccines and drugs. We argue there are strong ethical arguments for remedying some of this uneven distribution of clinical trial sites by geography and income. Chief among them, is that these disparities can impede equitable access to the benefits of clinical research, such as representation in the evidence base generated to guide prescribing and use of medicines and vaccines. We suggest trial site locations should be made more transparent and for later stage trials their selection should be informed by the global distribution of disease burden targeted by an experimental product. Countries with high prevalence, incidence, severity or infection transmission rates for targeted diseases should have real opportunities to engage in and enrol their populations in trials for novel medicines and vaccines.
Inequities in the deployment of COVID-19 vaccine in the WHO Eastern Mediterranean Region, 2020–2021
Authors: Hasan Q , Elfakki E , Fahmy K , Mere Osama , Ghoniem A , Langar H , Musa N , Attia Rania , Othman M M , Samhouri Dahlia , Chaudhri Irtaza , Abubakar Abdinasir , Hajjeh Rana , Hutin Y J
Published: October 2022

The WHO Eastern Mediterranean Region (EMR) is characterised by a large range in routine immunisation coverage. We reviewed progress in access, deployment efforts, and use of COVID-19 vaccines in the EMR to identify bottlenecks and propose recommendations. We compiled and analysed data reported to WHO regarding the number of vaccines provided emergency use authorisation (EUA) in each country, the number of vaccine doses allocated and delivered by COVAX, the number of vaccine doses received bilaterally, the date of initiation of vaccination, vaccine usage rate and overall vaccination coverage. In June–July and October–November 2021, we conducted two rounds of a regional survey to assess vaccine acceptance and calculated the weighted proportion of individuals who would get vaccinated once a vaccine is available and recommended. We stratified the analysis according to four groups based on their participation status in COVAX, from the highest to lowest income, that is, (1) fully self-financing high-income countries (group 1), (2) fully self-financing upper middle-income countries (group 2), (3) Advance Market Commitment (AMC) countries not eligible to receive Gavi support (group 3) and (4) AMC countries eligible for Gavi support (group 4). As of 31 December 2021, the median number of vaccines provided with EUA was 6 for group 1, 11 for group 2, 8 for group 3 and 9 for group 4. On the same date, COVAX had delivered 179 793 310 doses to EMR countries. Vaccination started on 10 December 2020 in group 1, on 13 December 2020 in group 2, on 30 December 2020 in group 3 and on 20 January 2021 in group 4. The regional acceptance survey (first round) pointed to higher vaccine acceptance in group 1 (96%), than in others, including group 2 (73.9%), group 3 (78.8%) and group 4 (79.3%), with identical patterns in the second round (98%, 78%, 84% and 76%), respectively. Usage of vaccine allocated by COVAX to participating countries was 89% in group 1, 75% in group 2, 78% in group 3 and 42% in group 4. The full dose and partial dose coverage decreased with the income groups of countries, from 70% and 6% in group 1, to 43% and 8% in group 2, to 33% and 11% in group 3, and 20% and 8% in group 4. All 22 EMR countries introduced COVID-19 vaccines by 21 April 2021, but with major inequities in coverage. Additional efforts are needed to address the determinants of unequal vaccine coverage at all stages of the result chain to improve vaccine equity.
Enabling research capacity strengthening within a consortium context: a qualitative study
Authors: Aiyenigba Abiola , Abomo Pierre , Wiltgen Georgi Neele , Bates Imelda , Pulford Justin
Published: October 2022

Introduction

We explore how health research consortia may be better structured to support research capacity strengthening (RCS) outcomes. The primary research questions include: in what ways do consortium members perceive that they and their respective institutions’ research capacity is strengthened from said membership? And, drawing on member experiences, what are the common factors that enable these perceived gains in research capacity to be realised?

Methods

A qualitative study set within the ‘Developing Excellence in Leadership, Training and Science’ (DELTAS) Africa initiative. Semi-structured interviews were completed with 69 participants from seven institutions across six African countries belonging to three DELTAS Africa consortia. Data were analysed thematically via a general inductive approach.

Results

A diverse array of perceived individual and institutional benefits of RCS consortium membership were reported. Individual benefits included access to training, resources and expertise as well as research and research leadership opportunities. Many institutional-level benefits of consortium membership were also driven through investment in individuals. Four enabling factors presented as especially influential in realising these benefits or realising them to a greater extent. These included: (1) access to funding; (2) inclusive and engaging leadership; (3) a diverse array of facilitated interactions for consortium members; and (4) an efficient interface between a consortium and their respective member institutions.

Conclusion

Many reported benefits of RCS consortium membership were realised through funding access, yet attention to the other three enabling factors may further amplify the advantages conferred by funding access or, when funds are insufficient, ensure worthwhile gains in RCS are still achieved.
Association between maternal adversity, DNA methylation, and cardiovascular health of offspring: a longitudinal analysis of the ALSPAC cohort study
Authors: Hyde Natalie K , Dowty James G , Scovelle Anna , Armstrong Gregory , Sutherland Georgina , Olive Lisa , Lycett Kate , O’Neil Adrienne
Published: October 2022

Objectives

Maternal adversity during pregnancy has been shown to be associated with some health outcomes in the offspring. This study investigated the association of maternal adversity during pregnancy and DNA methylation with offspring cardiovascular (CV) health.

Design

Longitudinal observational cohort study

Setting

All pregnant residents in county Avon (∼0.9 million), UK, were eligible to participate if their estimated delivery date was between 1 April 1991 and 31 December 1992.

Participants

Mother–offspring pairs enrolled in the Avon Longitudinal Study of Parents and Children cohort at seven (n=7431) and 17 years of age (n=3143).

Primary and secondary outcome measures

Offspring CV health primary measures were heart rate (HR), blood pressure (BP) and secondary measures were pulse-wave velocity and carotid intima–media thickness.

Results

Overall, there was no association between maternal adversity scores (number or perceived impact) and primary CV measures (Perceived impact; HR: 0.999-fold change 95% CI 0.998 to 1.001; systolic BP (SBP): 1.000-fold change 95% CI 0.999 to 1.001; diastolic BP: 1.000-fold change 95% CI 0.999 to 1.002). Some small offspring sex effects were observed and there was also a small association between methylation of some CpG sites and offspring BP measures.

Conclusions

We found little evidence to support the overall association of maternal adversity during pregnancy and DNA methylation with offspring CV measures. Offspring sex-specific and age-specific associations require further investigation.
Efficacy of education on injection technique for patients diagnosed with diabetes with lipohypertrophy: systematic review and meta-analysis
Authors: Ichikawa Masahiro , Akiyama Tomoaki , Tsujimoto Yasushi , Anan Keisuke , Yamakawa Tadashi , Terauchi Yasuo
Published: October 2022

Objectives

This study aimed to investigate the efficacy of providing education on injection technique to patients with diabetes with lipohypertrophy (LH).

Design

We conducted a systematic review and meta-analysis.

Methods

We included patients with diabetes who use insulin and have LH, and excluded patients without LH. We performed a literature search on CENTRAL, MEDLINE, EMBASE, ICTRP and ClinicalTrials.gov in November 2021 for randomised controlled trials (RCTs). We used the revised Cochrane Risk of Bias 2 tool to evaluate the risk of bias in each outcome in each study. We then pooled the data using a random-effects model and evaluated the certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation approach.

Outcome measures

The primary endpoints were change in total daily dose (TDD) of insulin, change in HbA1c levels and prevalence of hypoglycaemia.

Results

We screened 580 records and included three RCTs (637 participants) in the meta-analysis. Education on injection technique may slightly increase the change of TDD of insulin (three studies, 637 participants: mean difference (MD) −6.26; 95% CI −9.42 to –3.10; p<0.001; I2=38%; low certainty of evidence) and may have little to no effect on change in HbA1c but the evidence is very uncertain compared with that in the control group (three studies, 637 participants: MD −0.59; 95% CI −1.71 to 0.54; p=0.31; I2=98%; very low certainty of evidence). Providing education about injection technique may have little to no effect on the prevalence of hypoglycaemia (three studies, 637 participants: risk ratio 0.44; 95% CI 0.06 to 3.13; p=0.41; I2=90%; very low certainty of evidence).

Conclusions

The present meta-analysis suggests that injection technique education may result in a slight reduction in the TDD of insulin. However, the effect of education on HbA1c, hypoglycaemia and cured LH is uncertain.

Protocol registration

DOI:dx.doi.org/10.17504/protocols.io.btiinkce
Meditation and yoga for irritable bowel syndrome: study protocol for a randomised clinical trial (MY-IBS study)
Authors: D'Silva Adrijana , Marshall Deborah A , Vallance Jeffrey , Nasser Yasmin , Rajagopalan Vidya , MacKean Gail , Raman Maitreyi
Published: October 2022

Introduction

When delivered in person, yoga has been shown to be effective in managing irritable bowel syndrome (IBS) symptoms. Research is needed to test the feasibility and effectiveness of yoga as a therapeutic option when delivered virtually. The primary aim of the mind and yoga for IBS randomised controlled trial is to determine the effects of an 8-week virtual meditation and yoga intervention on IBS symptom severity compared with an advice-only active control group.

Methods and analysis

Adults diagnosed with IBS will be randomised to receive either a Upa Yoga intervention or an advice-only control group. The intervention will consist of weekly online classes for 8 weeks delivered by a facilitator using Microsoft Office Teams and daily home practice. Feasibility will be evaluated by examining recruitment and attrition rates, adherence, participant satisfaction with the programme and safety. The primary outcome is IBS symptom severity, and key secondary outcomes include (but not limited to) quality of life, anxiety and depression symptoms, COVID-19-related stress and anxiety, and fatigue. Outcomes will be assessed at baseline, 4 weeks and 8 weeks. An embedded design experimental model substudy will be conducted post intervention using qualitative research methods to identify participants’ experiences in the yoga programme.

Ethics and dissemination

This study has been approved by the Conjoint Health Research Ethics Board (REB ID 20-0084). Findings will be disseminated through peer-reviewed publication, conference presentation and social media.

Trial registration number

NCT04302623.
18F-FDG-PET hypometabolism as a predictor of favourable outcome in epilepsy surgery: protocol for a systematic review and meta-analysis
Authors: Courtney Merran R , Antonic-Baker Ana , Sinclair Benjamin , Nicolo John-Paul , Neal Andrew , Law Meng , Kwan Patrick , O'Brien Terence J , Vivash Lucy
Published: October 2022

Introduction

A substantial proportion of patients who undergo surgery for drug resistant focal epilepsy do not become seizure free. While some factors, such as the detection of hippocampal sclerosis or a resectable lesion on MRI and electroencephalogram-MRI concordance, can predict favourable outcomes in epilepsy surgery, the prognostic value of the detection of focal hypometabolism with18F-fluorodeoxyglucose positive emission tomography (18F-FDG-PET) hypometabolism is uncertain. We propose a protocol for a systematic review and meta-analysis to examine whether localisation with18F-FDG-PET hypometabolism predicts favourable outcomes in epilepsy surgery.

Methods and analysis

A systematic literature search of Medline, Embase and Web of Science will be undertaken. Publications which include evaluation with18F-FDG-PET prior to surgery for drug resistant focal epilepsy, and which report ≥12 months of postoperative surgical outcome data will be included. Non-human, non-English language publications, publications with fewer than 10 participants and unpublished data will be excluded. Screening and full-text review of publications for inclusion will be undertaken by two independent investigators, with discrepancies resolved by consensus or a third investigator. Data will be extracted and pooled using random effects meta-analysis, with heterogeneity quantified using the I2analysis.

Ethics and dissemination

Ethics approval is not required. Once complete, the systematic review will be published in a peer-reviewed journal.

PROSPERO registration number

CRD42022324823.