bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between the clinical disability and T1 hypointense lesions’ volume in cerebral magnetic resonance imaging of multiple sclerosis patients: A systematic review and meta‐analysis
Authors: Valizadeh Amir , Moassefi Mana , Barati Elham , Ali Sahraian Mohammad , Aghajani Faezeh , Fattahi Mohammad‐Reza
Published: October 2021

Background

To evaluate the correlation between T1 hypointense lesions’ mean volume on cerebral MRI with disability level of patients with multiple sclerosis.

Methods

We included studies testing the desired outcome in adult patients diagnosed with RRMS or SPMS. In Feb 2021, we searched PubMed, Embase, CENTRAL, and Web of Science to find relevant studies. All included studies were assessed for the risk of bias using a tailored version of the Quality in Prognosis Studies (QUIPS) tool. Extracted correlation coefficients were converted to the Fisher's z scale, and a meta‐analysis using a random‐effects model was performed on the results.

Results

We included 27 studies (1919 participants). Meta‐analysis revealed a correlation coefficient of 0.32 (95% CI 0.26–0.37) between T1 hypointense lesions’ mean volume and EDSS score.

Discussion

The correlation between T1 hypointense lesions’ mean volume and EDSS was interpreted as low to slightly moderate. The certainty of the evidence was judged to be high.
Huawei, 5G and Security: Technological Limitations and Political Responses
Authors: Friis Karsten , Lysne Olav
Published: October 2021

How did Chinese 5G providers, such as Huawei, become a security concern in the USA and Europe? Were the security concerns related to 5G and Chinese suppliers based upon technological features of the systems, or were they a product of geopolitical rivalry? How did European approaches to 5G distinguish themselves from those of the USA? This article addresses these questions using an interdisciplinary approach via the framework of securitization theory. The authors argue that the technological features of 5G made securitization more likely compared to 4G, and that screening and control of software was unlikely to defuse securitization concerns. They also show how Europe chose its own path for the securitization of 5G. In short, the article argues that the American macrosecuritization of China largely failed in Europe, whereas the niche securitization of 5G was more successful.
The Externalization of China's Technical Standardization Approach
Authors: Rühlig Tim Nicholas , ten Brink Tobias
Published: October 2021

International technical standardization has always been shaped by the externalization of the domestic standard systems of the most technologically advanced countries. China's growing technological footprint is no exception, and it has the potential to significantly reshape international technical standard setting. In contrast particularly to European standardization, which is realized through coordinated private self‐regulation, China has adopted a state‐centric approach. Based on the international and comparative political economy literature on China's global externalization, and through research on technical standardization, this article investigates 5G standard setting within formal international standard‐developing organizations and de facto standardization of railways within the Belt and Road Initiative. By triangulating data from interviews, policy documents and other primary and secondary sources, the article systematically analyses China's standardization practices, which also affords insight into the implications for international standardization.
Hidden in Plain Sight: Chinese Development Finance in Central and Eastern Europe
Authors: Jepson Nicholas
Published: October 2021

China's bilateral loans have been the subject of much controversy. Most recently, an influential paper by Horn, Reinhart and Trebesch claimed that a large proportion of Chinese overseas lending is ‘hidden’ and not reported to any of the institutions which monitor global financial flows. This article examines this proposition in relation to Central and Eastern Europe, through an analysis of official Chinese lending to four countries (Belarus, Montenegro, North Macedonia and Ukraine). It finds that the most recent estimates of emerging markets’ and developing economies’ debts to China tend to be exaggerated, at least with respect to Central and Eastern Europe, and so are claims of hidden loans. In line with trends elsewhere, in three of the four cases private capital market debts outweigh debts to China. Although a lack of centralized data sources makes it challenging to form a full picture of Chinese lending, there seems to be less secrecy involved than is often suggested. Concerns remain regarding the apparent readiness of Chinese creditors to finance projects of dubious viability, as well as related issues of waste, corruption and environmental impact.
Respiratory Complex I dysfunction in cancer: from a maze of cellular adaptive responses to potential therapeutic strategies
Authors: Sollazzo Manuela , De Luise Monica , Lemma Silvia , Bressi Licia , Iorio Maria , Miglietta Stefano , Milioni Sara , Kurelac Ivana , Iommarini Luisa , Gasparre Giuseppe , Porcelli Anna Maria
Published: October 2021

Mitochondria act as key organelles in cellular bioenergetics and biosynthetic processes producing signals that regulate different molecular networks for proliferation and cell death. This ability is also preserved in pathologic contexts such as tumorigenesis, during which bioenergetic changes and metabolic reprogramming confer flexibility favoring cancer cell survival in a hostile microenvironment. Although different studies epitomize mitochondrial dysfunction as a protumorigenic hit, genetic ablation or pharmacological inhibition of respiratory complex I causing a severe impairment is associated with a low‐proliferative phenotype. In this scenario, it must be considered that despite the initial delay in growth, cancer cells may become able to resume proliferation exploiting molecular mechanisms to overcome growth arrest. Here, we highlight the current knowledge on molecular responses activated by complex I‐defective cancer cells to bypass physiological control systems and to re‐adapt their fitness during microenvironment changes. Such adaptive mechanisms could reveal possible novel molecular players in synthetic lethality with complex I impairment, thus providing new synergistic strategies for mitochondrial‐based anticancer therapy.
ForestTemp – Sub‐canopy microclimate temperatures of European forests
Authors: Haesen Stef , Lembrechts Jonas J. , De Frenne Pieter , Lenoir Jonathan , Aalto Juha , Ashcroft Michael B. , Kopecký Martin , Luoto Miska , Maclean Ilya , Nijs Ivan , Niittynen Pekka , van den Hoogen Johan , Arriga Nicola , Brůna Josef , Buchmann Nina , Čiliak Marek , Collalti Alessio , De Lombaerde Emiel , Descombes Patrice , Gharun Mana , Goded Ignacio , Govaert Sanne , Greiser Caroline , Grelle Achim , Gruening Carsten , Hederová Lucia , Hylander Kristoffer , Kreyling Jürgen , Kruijt Bart , Macek Martin , Máliš František , Man Matěj , Manca Giovanni , Matula Radim , Meeussen Camille , Merinero Sonia , Minerbi Stefano , Montagnani Leonardo , Muffler Lena , Ogaya Romà , Penuelas Josep , Plichta Roman , Portillo‐Estrada Miguel , Schmeddes Jonas , Shekhar Ankit , Spicher Fabien , Ujházyová Mariana , Vangansbeke Pieter , Weigel Robert , Wild Jan , Zellweger Florian , Van Meerbeek Koenraad
Published: October 2021

Ecological research heavily relies on coarse‐gridded climate data based on standardized temperature measurements recorded at 2 m height in open landscapes. However, many organisms experience environmental conditions that differ substantially from those captured by these macroclimatic (i.e. free air) temperature grids. In forests, the tree canopy functions as a thermal insulator and buffers sub‐canopy microclimatic conditions, thereby affecting biological and ecological processes. To improve the assessment of climatic conditions and climate‐change‐related impacts on forest‐floor biodiversity and functioning, high‐resolution temperature grids reflecting forest microclimates are thus urgently needed. Combining more than 1200 time series of in situ near‐surface forest temperature with topographical, biological and macroclimatic variables in a machine learning model, we predicted the mean monthly offset between sub‐canopy temperature at 15 cm above the surface and free‐air temperature over the period 2000–2020 at a spatial resolution of 25 m across Europe. This offset was used to evaluate the difference between microclimate and macroclimate across space and seasons and finally enabled us to calculate mean annual and monthly temperatures for European forest understories. We found that sub‐canopy air temperatures differ substantially from free‐air temperatures, being on average 2.1°C (standard deviation ± 1.6°C) lower in summer and 2.0°C higher (±0.7°C) in winter across Europe. Additionally, our high‐resolution maps expose considerable microclimatic variation within landscapes, not captured by the gridded macroclimatic products. The provided forest sub‐canopy temperature maps will enable future research to model below‐canopy biological processes and patterns, as well as species distributions more accurately.
Mobilization of soil phosphate after 8 years of warming is linked to plant phosphorus‐acquisition strategies in an alpine meadow on the Qinghai‐Tibetan Plateau
Authors: Zhou Jun , Li Xiao‐Long , Peng Fei , Li Chengyang , Lai Chimin , You Quangang , Xue Xian , Wu Yanhong , Sun Hongyang , Chen Yang , Zhong Hongtao , Lambers Hans
Published: October 2021

Phosphorus (P) is essential for productivity of alpine grassland ecosystems, which are sensitive to global warming. We tested the hypotheses that (1) mobilized ‘calcium‐bound inorganic P’ (Ca‐Pi) is a major source of plant‐available P in alpine meadows with alkaline soils after long‐term warming, (2) mobilization of Ca‐Pi is linked to effective plant carboxylate‐releasing P‐acquisition strategies under warming, and (3) the mobilization is also related to plant nitrogen (N)‐acquisition. We conducted an 8‐year warming experiment in an alpine meadow (4635 m above sea level) on the Qinghai‐Tibetan Plateau. A significant increase in P concentration in both aboveground and belowground biomass indicates an increased mobilization and assimilation of P by plants under warming. We observed a significant decrease in Ca‐Pi, no change in moderately‐labile organic P, and an increase in highly resistant organic P after warming. There was no increase in phosphatase activities. Our results indicate that Ca‐Pi, rather than organic P was the major source of plant‐available P for alpine meadows under warming. Higher leaf manganese concentrations of sedges and forbs after warming indicate that carboxylates released by these plants are a key mechanism of Ca‐Pi mobilization. The insignificant increase in Rhizobiales after warming and the very small cover of legumes show a minor role of N‐acquisition strategies in solubilizing phosphate. The insignificant change in relative abundance of mycorrhizal fungi and bacteria related to P cycling after warming shows a small contribution of microorganisms to Ca‐Pi mobilization. The significant increase in leaf N and P concentrations and N:P ratio of grasses and no change in sedge leaf N:P ratio reflect distinct responses of plant nutrient status to warming due to differences in P‐acquisition strategies. We highlight the important effects of belowground P‐acquisition strategies, especially plant carboxylate‐releasing P‐acquisition strategies on responses of plants to global changes in alpine meadows.
The impact of land‐use change emissions on the potential of bioenergy as climate change mitigation option for a Brazilian low‐carbon energy system
Authors: Lap Tjerk , Daioglou Vassilis , Benders René , van der Hilst Floor , Faaij André
Published: October 2021

Land‐use change (LUC)‐related greenhouse gas (GHG) emissions determine largely whether bioenergy is a suitable option for climate change mitigation. This study assesses how LUC emissions influence demand for bioenergy to mitigate GHG emissions, and how this affects the energy mix, using Brazil as a case study. A methodological framework is applied linking bioenergy supply curves, with associated costs and spatially explicit LUC emissions, to a bottom‐up energy system model. Furthermore, the influence of four key determining parameters is assessed: agricultural productivity, time horizon, natural succession (NS), and the use of dynamic emission factors (EFs). Demand for new bioenergy plantations range from 0.5 to 6.7 EJ in 2050, and is avoided when its EF reaches above 15 kg CO2/GJbiomass. Dynamic EFs result in earlier and larger use of bioenergy. Static EFs attenuate all emissions evenly over time, resulting in relative high emissions around 2050 when the carbon budget is most stringent. This in contrast to dynamic EFs, having early high peaks because of clearance of natural vegetation, but relatively small long‐term emissions when the carbon budget is most stringent. Exclusion of NS, in combination with spared agricultural land, results in a demand of 6.7 EJ, because of its low carbon penalty. Assuming that land is spared due to continuous yield increase (which is the reason to include NS as and EF component), bypasses the fact that yield improvements (that make those lands available) take place because of demand for bioenergy. When low‐carbon biomass is in limited availability, increasing electrification is observed, leading to electric capacity increase of 62% (mainly wind and solar energy), and a 12% energy system costs increase. Inclusion of spatiotemporal explicit supply potential and LUC emissions leads to improved bioenergy deployment pathways that come closer to the real situation as the dynamic nature of LUC emissions is included.
Pressure injury prevalence and incidence in acute inpatient care and related risk factors: A cross‐sectional national study
Authors: Tervo‐Heikkinen Tarja Anita , Heikkilä Anniina , Koivunen Marita , Kortteisto Tiina‐Riitta , Peltokoski Jaana , Salmela Susanne , Sankelo Merja , Ylitörmänen Tuija Sinikka , Junttila Kristiina
Published: October 2021

The aim of this national cross‐sectional study was to explore the prevalence of pressure injuries and incidence of hospital‐acquired pressure injuries, and the relating factors in somatic‐specialised inpatient care in Finland. The study was conducted in 16 (out of 21) Finnish health care organisations offering specialised health care services. Data were collected in 2018 and 2019 from adult patients (N = 5902) in inpatient, emergency follow‐up, and rehabilitation units. Pressure injury prevalence (all stages/categories) was 12.7%, and the incidence of hospital‐acquired pressure injuries was 10%. Of the participants, 2.6% had at least one pressure injury at admission. The risk of hospital‐acquired pressure injuries was increased for medical patients with a higher age, the inability to move independently, mode of arrival, being underweight, and the absence of a skin assessment or pressure injury risk assessment at admission. For surgical patients, the risk was associated with the inability to move independently, mode of arrival, and lack of skin assessment at admission, while being overweight protected the patients. Overall, medical patients were in greater risk of hospital‐acquired pressure injuries than the surgical patients. An assessment of the pressure injury risk and skin status should be carried out more systematically in Finnish acute care hospitals.
A review of epidemic investigation on cold‐chain food‐mediatedSARS‐CoV‐2 transmission and food safety consideration duringCOVID‐19 pandemic
Authors: Lu Li‐Che , Quintela Irwin , Lin Cheng‐Han , Lin Tzu‐Ching , Lin Chao‐Hsu , Wu Vivian C. H. , Lin Chih‐Sheng
Published: October 2021

COVID‐19 has brought speculations on potential transmission routes of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), the causal agent of the pandemic. It is reported that the main route of virus transmission to be person‐to‐person by respiratory droplets; however, people have raised concerns on the possible transmission of SARS‐CoV‐2 to humans via food and packaging and its potential effects on food safety. This review discusses food safety issues in the COVID‐19 pandemic and reveals its possible transmission in cold‐chain food. The first outbreak of COVID‐19 in late 2019 was associated with a seafood market in Wuhan, China, while the second outbreak of COVID‐19 in June 2020 was also related to a seafood market in Beijing, China. As of 2020, several frozen seafood products linked with SARS‐CoV‐2 have been reported in China. According to the current survey and scientific studies, the risk of infection by SARS‐CoV‐2 from cold‐chain food, food products, and food packaging is thought to be very low. However, studies on food cold chain contamination have shown that SARS‐CoV‐2 remained highly stable under refrigerated (4°C) and even in freezing conditions (−10 to −80°C). Since one mode of SARS‐CoV‐2 transmission appears to be touching contaminated surfaces, it is important to clean and sanitize food contact surfaces properly. Understanding food safety hazard risks is essential to avoid potential negative health effects and SARS‐CoV‐2 transmission in the food supply chain during the COVID‐19 pandemic.
Eucrite‐type achondrites: Petrology and oxygen isotope compositions†
Authors: Mittlefehldt David W. , Greenwood Richard C. , Berger Eve L. , Le Loan , Peng Zhan X. , Ross D. Kent
Published: October 2021

We report petrologic studies and oxygen isotope analyses of normal and anomalous eucrites, termed eucrite‐type achondrites. Petrologically anomalous eucrite‐type achondrites can have normal oxygen isotope compositions, and vice versa. Two basaltic eucrites with normal oxygen isotope compositions contain pyroxenes with anomalous Fe/Mn engendered by parent body processes acting on normal eucrites: solid‐state reduction by S gas in EET 87542, and reduction during crystallization by magmatic S in QUE 94484. Cataclastic basaltic breccias PCA 82502 and PCA 91007 are paired (petrology, anomalous oxygen). Although isotopically like Pasamonte, they are petrologically distinct. We confirm the petrological and isotopic anomalies of cumulate gabbro EET 92023; likely formed by impact melting of mixed cumulate and basaltic materials. Many main group eucrites include plagioclases that retain near‐liquidus compositions despite metamorphic overprinting. Stannern group eucrites contain more sodic plagioclase, which is consistent with the melt hybridization hypothesis for Stannern group magma formation. The lack of more calcic plagioclase suggests reactive exchange of the anorthite component of the primary melt with the albitic component of the crust. Asteroids that are modestly different in composition can produce virtually indistinguishable basalts, providing a ready explanation for the eucrite‐type achondrite suite. Small stochastic variations in petrologic evolution can cause substantial differences in rocks produced on an asteroid.
Comparison of 3‐D mandibular surfaces generated by MRI and CT
Authors: Maeda Jun , Tanikawa Chihiro , Nagata Namiki , Lim Jaeyeon , Kreiborg Sven , Murakami Shumei , Yamashiro Takashi
Published: October 2021

Objective

The purpose of this study was to evaluate the errors of three‐dimensional mandibular surfaces generated using magnetic resonance imaging (MRI) when computed tomography (CT) was set as the gold standard.

Settings and sample population

Seven patients with orthognathic deformities who had undergone CT and MRI scans were included in the study.

Materials and Methods

Mandibular surfaces were generated on each CT and MR image by the surface‐rendering method. Intra‐individual reliability between CT and MRI was statistically tested by the confidence limits of agreement (LOA) for systematic error, 95% confidence interval minimal detectable change (MDC95) for random error and intra‐class correlation coefficient (ICC).

Results

The average total error was 1.6 mm. The greatest MDC95 was observed in the coronoid region in all directions. The other regions showed MDC95 values of < 1.8 mm (transvers direction), 3.5 mm (vertical direction) and 1.7 mm (antero‐posterior direction). ICCs showed ‘almost perfect’ agreement with respect to all regions.

Conclusion

Random errors were quantified for 3‐D rendering of the mandible from MRI data. Although the coronoid region showed the greatest errors, the other regions of the mandibular surfaces generated using MRI were able to be evaluated.
Tocilizumab administration for the treatment of hospitalized patients with COVID‐19: A systematic review and meta‐analysis
Authors: Kyriakopoulos Christos , Ntritsos Georgios , Gogali Athena , Milionis Haralampos , Evangelou Evangelos , Kostikas Konstantinos
Published: October 2021

Tocilizumab has been repurposed against the ‘cytokine storm’ in the setting of coronavirus disease 2019 (COVID‐19). Our aim was to evaluate the efficacy of tocilizumab in the management of hospitalized COVID‐19 patients. We searched MEDLINE, CENTRAL and medRxiv for studies of tocilizumab in hospitalized COVID‐19 patients. Primary objective was the effectiveness of tocilizumab on mortality. Secondary objectives included the need for invasive mechanical ventilation (IMV), composite endpoints of mortality or IMV and intensive care unit (ICU) admission or IMV, length of hospitalization and differences in mortality in subgroups (ICU and non‐ICU patients and patients receiving or not receiving concomitant corticosteroids). We included 52 studies (nine randomized controlled trials [RCTs] and 43 observational) with a total of 27,004 patients. In both RCTs and observational studies, the use of tocilizumab was associated with a reduction in mortality; 11% in RCTs (risk ratio [RR] 0.89, 95% CI 0.82 to 0.96) and 31% in observational studies (RR 0.69, 95% CI 0.58 to 0.83). The need for IMV was reduced by 19% in RCTs (RR 0.81, 95% CI 0.71 to 0.93), while no significant reduction was observed in observational studies. Both RCTs and observational studies showed a benefit from tocilizumab on the composite endpoint of mortality or IMV. Tocilizumab improved mortality both in ICU and non‐ICU patients. Reduction in mortality was evident in observational studies regardless of the use of systemic corticosteroids, while that was not the case in the RCTs. Tocilizumab was associated with lower mortality and other clinically relevant outcomes in hospitalized patients with moderate‐to‐critical COVID‐19.
Respiratory viral infections do not explain the winter peak in heart failure
Authors: Chang Catherina L. , Hancox Robert J. , Mansell Chris , Fairweather Sarah M. , Shafuddin Eskandarain
Published: October 2021

See related editorial.
Promoting awareness of donation‐related iron depletion among high risk blood donors
Authors: France Janis L. , France Christopher R. , Rebosa Mark , Shaz Beth H. , Kessler Debra A.
Published: October 2021

Background

The potential for iron deficiency is a known blood donor health concern and suggests the need to inform donors about the potential risks of low iron levels as well as strategies to address these risks.

Study design and methods

Frequent (n = 904) and young (n = 629) donors were randomly assigned within risk group to either a control (n = 548) or an intervention (n = 985) group. The control group answered questions at baseline and 6‐month follow‐up regarding their awareness of the risk of donation‐related iron depletion and whether they were taking actions to address their iron status. The intervention group answered the same questions at baseline and follow‐up, but after completing the baseline survey, they received information regarding their risk of iron depletion and behaviors they could adopt to mitigate this risk. Intervention group participants were also offered the opportunity to develop an action plan to help them supplement their iron intake.

Results

The intervention enhanced overall awareness of donation‐related iron loss (OR = 1.5, 95% CI 1.171–1.864, p = .001), with no negative impact on retention. Reported iron health behaviors (iron supplementation, speaking with a doctor) showed significant increases when action planning was paired with the educational information.

Conclusion

These findings suggest that it is possible to increase awareness of donation‐related risk for iron depletion without negatively influencing retention, and combining education with encouragement to develop an action plan may increase the likelihood of both retention and behavioral changes to promote healthy iron levels.
Optical metrology of characterizing wetting states
Authors: Meng Deming , Wang Yifei , Yang Hao , Chen Buyun , Hu Pan , Song Boxiang , Wang Yunxiang , Liu Zerui , Ou Tse-Hsien , Zheng Ximing , Gong Yichen , Wu Wei
Published: October 2021

The unique properties of superhydrophobic surfaces have already been widely introduced into many applications and play a more and more important role in our daily life. However, different wetting states will lead to different properties and performances so that distinguishing the wetting states is essential. Until now, as it lacks an accurate and nondestructive technology to test the wetting states in real time, this prevents the study of superhydrophobic phenomena and their applications. Although this has already caught the attention of the scientific community, there is still no successful solution presented yet. Here, we develop a nondestructive in situ optical technology based on characterizing the transmission spectrum of the superhydrophobic surfaces, which is capable of distinguishing the different wetting states such as the Cassie–Baxter state, the mixed wetting state, and the Wenzel state. By using the finite-difference time-domain method, field distribution and transmission spectrum of the superhydrophobic surfaces can be simulated. The experimental data fit well with simulation data. All the results prove the feasibility of the new optical technology to characterize wetting states.
Angle-dependent sound absorption estimation using a compact microphone array
Authors: Alkmim Mansour , Cuenca Jacques , De Ryck Laurent , Desmet Wim
Published: October 2021

This paper proposes a method for estimating the angle-dependent sound absorption coefficient of a large material sample using a compact microphone array. The method relies on the description of the pressure field as a pair of in-going and out-going waves or using an image source model and stands as a generalization of the classical two-microphone method. The array includes an irregular spacing normal to the surface to avoid spatial aliasing. Furthermore, the benefit of additional microphones parallel to the sample is investigated, while keeping the array compact. The approach is validated against the transfer matrix method as well as against locally and non-locally reactive surface models and compared to the two-microphone method. The sensitivity of the estimation to uncertainties in the microphone positions is evaluated by means of a Monte Carlo approach. Measurements above melamine foam and gravel samples are presented and illustrate the reduced uncertainty in the sound absorption estimation. In particular, the proposed method exhibits improved robustness compared to the two-microphone method, especially at low frequencies.
Electromyographic and Systemic Physiological Thresholds in Single-Joint Elbow Flexion Movements
Authors: Tilp Markus , Kitzberger Lukas , Schappacher-Tilp Gudrun , Birnbaumer Philipp , Hofmann Peter
Published: October 2021

Purpose: Reported relationships between electromyographic (EMG) thresholds and systemic thresholds based on lactate, ventilation, or heart rate are contradictory. This might be related to the complexity of the investigated whole-body movements involving many muscles with different activation patterns. Therefore, the aim of the study was to investigate these relationships during an incremental single-joint exercise. Methods: Eighteen male subjects (29.7 [4.4] y) performed single-arm elbow flexions on a biceps curl machine with loads increasing every minute until exhaustion. EMG signals of the main elbow flexors (short and long head of the biceps brachii, flexor carpi radialis, and brachioradialis) as well as gas exchange variables, blood lactate concentration, and heart rate were measured, and 2 turn points based on a 3-phase model of metabolism were determined for each variable. Results: The first and second turn points for EMG were determined at 32.0% to 33.1% and 64.4% to 66.5% of maximal achieved performance (maximum weight), respectively. Systemic turn points were determined at 33.3% to 34.4% and 65.9% to 66.7% of maximum weight and were not significantly different from EMG turn points. Furthermore, systemic and EMG turn points showed a strong or very strong relationship at the first (ρ = .54–.93, P < .05) and second turn point (ρ = .76–.93, P < .01). Conclusions: A close relationship between EMG and systemic turn points could be confirmed for the applied movement of a small muscle group. The determination of local single muscle thresholds using EMG provides additional muscle-specific information about performance-limiting properties of muscles involved in endurance-type incremental exercise.
The Implementation of a National Strategy to Encourage Injury Prevention Program Uptake in a Community Female Sport in Ireland: A Camogie Case Study
Authors: O’Connor Siobhán , O’Brien Wesley , Lacey Peter
Published: October 2021

Community sports play an important role in maintaining sporting participation across all ages, from childhood to adulthood. Maintaining participation for females, however, can be a challenge. Injuries can negatively impact sporting participation, both in the short and long term. Thus, reducing the risk of injuries in community sports is essential. While there are developed injury prevention programs available, the uptake of such programs in community sports can be limited. Here, we outline how a female community sport in Ireland, namely, the Camogie Association, has developed and implemented an evidence-based strategy to improve the uptake of an injury prevention program nationally across all ages of their membership. We use the RE-AIM (Reach, Effectiveness, Adoption, Implementation and Maintenance) sports setting matrix as a guiding tool for evaluating this strategy. Varying settings and levels were targeted in this six-step implementation sequence, including the national sporting organisation, regional sporting organisations, alongside the individual coaches and players. The main outcomes of the strategy were that the Camogie Association formally adopted the developed injury prevention program (the Camogie Injury Prevention Program) and the adapted age appropriate programs from 8 years of age and upward. The Camogie Association also embedded this program within their coaching training course. The developed education workshop successfully improved coaches’ attitudes and perceived ability to implement the Camogie Injury Prevention Program. The majority (72.5%) of coaches, 4 weeks after conducting the workshop, had implemented the program, and 95% felt the program could be maintained over multiple seasons. This program may provide guidance to similar national or regional sporting bodies that want to embed injury prevention programs within their respective governing body and maximise the implementation of an injury prevention program by their coaches and players.
CYP51 Paralogue Structure Is Associated with Intrinsic Azole Resistance in Fungi
Authors: Van Rhijn N. , Bromley M. , Richardson M. , Bowyer P.
Published: October 2021

Azole antifungals are the main treatment for fungal disease in humans. Many species are intrinsically resistant to azoles—in other words all members of the species are resistant without prior exposure—and we do not understand why.
Metagenomic Sequencing Reveals that High-Grain Feeding Alters the Composition and Metabolism of Cecal Microbiota and Induces Cecal Mucosal Injury in Sheep
Authors: Xie Fei , Xu Lei , Wang Yue , Mao Shengyong
Published: October 2021

High-grain (HG) diets are known to alter the rumen microbiome. However, the responses of the hindgut microbiota and its epithelial function need further investigation in ruminants.
Extending the Proteomic Characterization of Candida albicans Exposed to Stress and Apoptotic Inducers through Data-Independent Acquisition Mass Spectrometry
Authors: Amador-García Ahinara , Zapico Inés , Borrajo Ana , Malmström Johan , Monteoliva Lucía , Gil Concha
Published: October 2021

Fungal infections are a worldwide health problem, especially in immunocompromised patients and patients with chronic disorders. Invasive candidiasis, caused mainly by
C. albicans
, is among the most common fungal diseases.
On the Composition and Age of Taphofloras of the Krivorechenskaya Formation (Upper Cretaceous) of the Anadyr River Left Bank, Northeast Asia
Authors: Herman A. B. , Shczepetov S. V.
Published: October 2021

Chineiveem taphoflora from the Krivorechenskaya Formation of the Anadyr River left bank (Northeast Asia) is characterized by a relatively low diversity of plants represented by ginkgoaleans, conifers, and angiosperms. Judging by their systematic composition, this taphoflora is younger than the Grebenka flora from the Krivorechenskaya Formation of the Anadyr River basin. Its closest analog is the Penzhina flora of Northwestern Kamchatka and the Yelistratov Peninsula, the age of which is reliably defined as Turonian, excluding the beginning of the Turonian. Therefore, the age of the Chineiveem floristic assemblage is also Turonian, most probably late Turonian. Such dating of this taphoflora is in agreement with the late Turonian or Coniacian age of marine mollusks from the overlying Dugovskaya Formation layers of the Chineiveem River and with a conformable stratigraphic contact of these layers with the plant-bearing beds. A tectonic contact between these deposits is not supported by our paleobotanical data. The observed succession of taphofloras from the Krivorechenskaya Formation in the Ubiyenka–Chineiveem interfluve suggests that the upper age limit of the Grebenka flora is the beginning of the Turonian.
Management of a misidentified and misnumbered intraocular glass foreign body with an endoscope in a case of endophthalmitis
Authors: Thakur Pratima Singh , Aggarwal David , Takkar Brijesh
Published: October 2021

An endoscope is a useful adjunct for the retinal surgeon to overcome haze of a compromised anterior segment. It allows early surgery in trauma and infections which translates to better results. Intraocular glass foreign body is a challenging condition, demanding highly skilled surgical expertise. We present endoscopic removal of an intraocular foreign glass body in a badly traumatised and infected eye. The surgical challenge was accentuated by an imaging misdiagnosis of ‘twin metallic foreign bodies’.
Single-stage surgical correction of a bilateral acquired coxa vara deformity in a young woman
Authors: Ansari Aabid Husain , Gupta Amit Kumar , Vaish Abhishek , Vaishya Raju
Published: October 2021

A 23-year-old female-treated patient of osteomalacia and secondary hyperparathyroidism with hypophosphatemia presented with a 5-year history of bilateral groin pain and stiffness of both hips and difficulty in walking. Plain radiographs of the pelvis showed bilateral coxa vara deformity. She was managed surgically by a single-stage bilateral subtrochanteric corrective osteotomy with the internal fixation. After the osteotomy healing at 3 months, the patient was pain free and walked comfortably with an increased range of hip motion.
Sustainability of a school-based health intervention for prevention of non-communicable diseases in marginalised communities: protocol for a mixed-methods cohort study
Authors: Arnaiz Patricia , Adams Larissa , Müller Ivan , Gerber Markus , Walter Cheryl , du Randt Rosa , Steinmann Peter , Bergman Manfred Max , Seelig Harald , van Greunen Darelle , Utzinger Jürg , Pühse Uwe
Published: October 2021

Introduction

The prevalence of chronic, lifestyle-related diseases is increasing among adults and children from low-income and middle-income countries. Despite the effectiveness of community-based interventions to address this situation, the benefits thereof may disappear in the long term, due to a lack of maintenance, especially among disadvantaged and high-risk populations. TheKaziBanturandomised controlled trial conducted in 2019 consisted of two school-based health interventions,KaziKidzandKaziHealth. This study will evaluate the long-term effectiveness and sustainability of these interventions in promoting positive lifestyle changes among children and educators in disadvantaged schools in Nelson Mandela Bay, South Africa, in the context of the COVID-19 pandemic.

Methods and analysis

This study has an observational, longitudinal, mixed-methods design. It will follow up educators and children from theKaziBantustudy. All 160 educators enrolled inKaziHealthwill be invited to participate, while the study will focus on 361KaziKidzchildren (aged 10–16 years) identified as having an increased risk for non-communicable diseases. Data collection will take place 1.5 and 2 years postintervention and includes quantitative and qualitative methods, such as anthropometric measurements, clinical assessments, questionnaires, interviews and focus group discussions. Analyses will encompass: prevalence of health parameters; descriptive frequencies of self-reported health behaviours and quality of life; the longitudinal association of these; extent of implementation; personal experiences with the programmes and an impact analysis based on the Reach, Efficacy, Adoption, Implementation, Maintenance framework.

Discussion

In settings where resources are scarce, sustainable and effective prevention programmes are needed. The purpose of this protocol is to outline the design of a study to evaluateKaziKidzandKaziHealthunder real-world conditions in terms of effectiveness, being long-lasting and becoming institutionalised. We hypothesise that a mixed-methods approach will increase understanding of the interventions’ capacity to lead to sustainable favourable health outcomes amid challenging environments, thereby generating evidence for policy.

Trial registration number

ISRCTN15648510
Time trends, sociodemographic and health factors associated with discharge and length of stay of hospitalised patients with sickle cell disease in Ghana: a retrospective analysis of national routine health database
Authors: Narh Clement Tetteh , Der Joyce , Ofosu Anthony , Blettner Maria , Wollschlaeger Daniel
Published: October 2021

Objective

Patients with sickle cell disease (SCD) are prone to multiple episodes resulting in frequent hospital visits. We determined the time trends, sociodemographic and health factors associated with length of stay (LoS) for patients with SCD in Ghana.

Design, participants, setting

We retrospectively analysed SCD hospitalisation records of 22 680 patients from a nationwide database of the Ghana Health Service from 2012 to 2017.

Outcome measures

Factors associated with LoS were estimated using Cox regression, while the cumulative incidence of being discharged alive was estimated with in-hospital death as a competing risk.

Results

Patients admitted for SCD over 6 years constituted 22 680 (0.8%) of nearly 3 million admissions. The median age and LoS for the patients were 16 years (IQR=8–24) and 3 days (IQR=2–4), representing 14 202 (62.6%) of the patients discharged alive by the third day. Patients with sickle cell anaemia (6139, 52.6%) with a crisis were more frequent than those without a crisis. Increasing age was associated with shorter LoS when comparing age groups 10–14 years (HR=1.08, 95% CI 1.01 to 1.14) and 25–29 years (HR=1.27, 95% CI 1.17 to 1.37) to patients aged 0–4 years. Patients with comorbidities had a longer LoS compared with those without (HR=0.88, 95% CI 0.86 to 0.90).

Conclusion

This is the largest study to date documenting factors associated with LoS for patients admitted for SCD. The association of younger age with increased LoS supports recent calls for early SCD screening, especially newborns. The emerging trends and factors accounting for SCD admission require a multisector approach as these patients already experience frequent episodes of pain and hospital visits.
Disease-related knowledge measurement instruments of people affected by multiple sclerosis: protocol for a systematic psychometric review
Authors: Gonzalez-del-Rio Marina , Bertran-Noguer Carme , Ramió-Torrentà Lluís , Zabaleta-del-Olmo Edurne
Published: October 2021

Introduction

Disease-related knowledge is a key component of shared decision making and a relevant outcome to measure the effectiveness of information provision interventions. However, no systematic psychometric reviews have been found that assess the measurement instruments aimed at evaluating the disease-related knowledge of people affected by multiple sclerosis. This review aims to systematically assess the quality of the measurement properties of all available disease-related knowledge measurement instruments of people affected by multiple sclerosis.

Methods and analysis

A systematic psychometric review will be carried out in accordance with the guidelines proposed by the international ‘COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN)’ initiative. Studies that meet the following criteria will be selected: (1) those whose aim is to measure disease-related knowledge, (2) those whose study populations are affected by multiple sclerosis and (3) those whose aims are to develop measurement instruments or evaluate one or more of their measurement properties. The information sources will be MEDLINE (via PubMed), CINAHL, PsycINFO and OpenGrey. The methodological quality will be assessed using the ‘COSMIN Risk of Bias’ checklist. Available evidence will be synthesised and graded using a modified Grading of Recommendations Assessment, Development and Evaluation approach.

Ethics and dissemination

As this is a systematic review, no ethics approval is needed. Study findings will be shared with multiple sclerosis patient support groups and in reports to funders. The results will be submitted to a peer-reviewed journal and will be presented at national and international conferences.

PROSPERO registration number

CRD42019125417.
Community engagement approaches for malaria prevention, control and elimination: a scoping review protocol
Authors: Awasthi Kiran Raj , Jancey Jonine , Clements Archie C A , Leavy Justine E
Published: October 2021

Community engagement (CE) is important for malaria prevention, control and ultimately elimination. As the decline of malaria has plateaued over the last 5 years, strengthening CE approaches will be necessary to enhance health promotion practice and policy to drive malaria transmission down further. Countries have adopted a wide range of public health intervention approaches for malaria prevention and control that best suit their context. This review will examine the existing evidence on the various CE approaches adopted by malaria programmes across the world and their outcomes.

Methodology and analysis

The review methodology will follow the updated Joanna Briggs Institute guide for scoping review, 2017, which is based on the framework developed by Arksey and O’Malley and further developed by Levac Colquhoun and O’Brien. Proquest, Web of Knowledge and Medline will be searched for publications from January 2000 to 31 March 2021 while Google search engine will be used to find any grey literature. The eligibility criteria will be as follows: review will include primary studies written in the English language using appropriate study designs and methods, including quantitative, qualitative and mixed methods designs; and case, programme or project reports. Information on CE approaches designed specifically for malaria prevention, control, elimination and their outcomes will be explored. Subheadings and free text terms for ‘community engagement’ and ‘malaria’ will be used for the search. The article screening and data extraction will be examined by two reviewers after the initial search, and any disputes will be resolved by a third reviewer through discussion. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews guide will be used to present the review methods and the results from the search. The scoping review results will identify and map the available evidences, sources of information and research gaps in the area of CE as one approach for malaria prevention, control and/or elimination.

Ethics and dissemination

This study only aims to review secondary sources and does not require human research ethics committee approval. The findings of the scoping review will be submitted to a peer-reviewed journal for wider dissemination.
Simplifying TREAtment and Monitoring for HIV (STREAM HIV): protocol for a randomised controlled trial of point-of-care urine tenofovir and viral load testing to improve HIV outcomes
Authors: Bardon Ashley R , Dorward Jienchi , Sookrajh Yukteshwar , Sayed Fathima , Quame-Amaglo Justice , Pillay Cheryl , Feutz Erika , Ngobese Hope , Simoni Jane M , Sharma Monisha , Cressey Tim R , Gandhi Monica , Lessells Richard , Moodley Pravi , Naicker Nivashnee , Naidoo Kogieleum , Thomas Katherine , Celum Connie , Abdool Karim Salim , Garrett Nigel , Drain Paul K
Published: October 2021

Introduction

Substantial improvements in viral suppression among people living with HIV (PLHIV) are needed to end the HIV epidemic, requiring extensive scale-up of low-cost HIV monitoring services. Point-of-care (POC) tests for monitoring antiretroviral therapy (ART) adherence and viral load (VL) may be efficient and effective tools for real-time clinical decision making. We aim to evaluate the effects of a combined intervention of POC ART adherence and VL testing compared with standard-of-care on ART adherence, viral suppression and retention at 6 and 18 months post-ART initiation among PLHIV.

Methods and analysis

Simplifying TREAtment and Monitoring for HIV (STREAM HIV) is a two-arm, open-label, randomised controlled superiority trial of POC urine tenofovir (POC TFV) and VL monitoring in PLHIV. We aim to enrol 540 PLHIV initiating a first-line ART regimen at a public HIV clinic in South Africa. Participants will be randomised 1:1 to the intervention or control arm. Intervention arm participants will receive monthly POC TFV testing for the first 5 months and POC VL testing at months 6 and 12. Intervention arm participants will also receive reflex POC TFV testing if viraemic and reflex HIV drug resistance testing for those with viraemia and detectable TFV. Control arm participants will receive standard-of-care, including laboratory-based VL testing at months 6 and 12. Primary outcomes include ART adherence (TFV-diphosphate concentration) at 6 months and viral suppression and retention at 18 months. Secondary outcomes include viral suppression and retention at 6 months, TFV-diphosphate concentration at 18 months, cost and cost-effectiveness of the intervention and acceptability of the intervention among PLHIV and healthcare workers.

Ethics and dissemination

STREAM HIV has received ethical approval from the University of Washington Institutional Review Board (STUDY00007544), University of KwaZulu-Natal Biomedical Research Ethics Committee (BREC/00000833/2019) and Division of AIDS Regulatory Support Center (38509). Findings will be disseminated at international conferences and in peer-reviewed journals.

Trial registration number

NCT04341779.