bluuebunny/crossref_metadata_2025 huggingface dataset:
Reported transfusion‐related acute lung injury associated with solvent/detergent plasma – A case series
Authors: Klanderman Robert B. , Bulle Esther B. , Heijnen Josephine W. M. , Allen Judith , Purmer Ilse M. , Kerkhoffs Jean‐Louis H. , Wiersum‐Osselton Johanna C. , Vlaar Alexander P. J.
Published: February 2022

Background

Antibody‐mediated transfusion‐related acute lung injury (TRALI) is caused by donor HLA or HNA antibodies in plasma‐containing products. In the Netherlands 55,000 units of solvent/detergent plasma (SDP), a pooled plasma product, are transfused yearly. It's produced by combining plasma from hundreds of donors, diluting harmful antibodies. Due to a lack of reported cases following implementation, some have labeled SDP as “TRALI safe”.

Study design and methods

Pulmonary transfusion reactions involving SDP reported to the Dutch national hemovigilance network in 2016–2019 were reviewed. Reporting hospitals were contacted for additional information, cases with TRALI and imputability definite, probable, or possible were included and informed consent was sought.

Results

A total of three TRALI and nine TACO cases were reported involving SDP. The imputability of one TRALI case was revised from possible to unlikely and excluded; in one case no informed consent was obtained. We present a case description of TRALI following SDP transfusion in a 69‐year‐old male, 3 days following endovascular aortic aneurysm repair. The patient received one unit of SDP to correct a heparin‐induced coagulopathy, prior to removal of a spinal catheter post‐operatively. Within five hours he developed hypoxemic respiratory failure requiring intubation, hypotension, bilateral chest infiltrates, and leucopenia. The patient made a full recovery.

Conclusion

This case of TRALI, following transfusion of a single unit of SDP to a patient without ARDS risk factors, demonstrates that TRALI can occur with this product. Clinicians should remain vigilant and continue to report suspected cases, to help further understanding of SDP‐associated TRALI.
Validación de constructo de la escala Zung en pacientes con falla cardíaca
Authors: Rojas Sánchez Lyda Zoraya , Trujillo-Cáceres Silvia Juliana , Hernández Vargas Juliana Alexandra , Jurado Adriana Milena , Echeverría Luis Eduardo , Gómez-Ochoa Sergio Alejandro , Roa-Díaz Zayne Milena
Published: February 2022

Introducción: La escala Zung para depresión ha sido previamente utilizada en pacientes con falla cardíaca; sin embargo, en nuestro conocimiento no se encuentra evidencia de su validez para la versión en español y su uso en población adulta con falla cardíaca en Colombia. Objetivo: Determinar la validez de constructo de la escala Zung para depresión en su versión original y proponer una versión abreviada para pacientes adultos con falla cardíaca. Materiales y Métodos: Estudio de corte transversal, realizado en 200 pacientes de una clínica de falla y trasplante cardiaco, en quienes se aplicó Zung Self-Rating Depression Scale. Se evaluó la consistencia interna por medio del alfa de Cronbach y el  análisis factorial fue utilizado para identificar las dimensiones del instrumento. Resultados: La consistencia interna de la versión original de la escala (20 ítems) fue de α=0.811. El análisis de factores mostró una estructura compuesta por tres factores que explican el 51.59% de la varianza total. La nueva versión abreviada (13 ítems) obtuvo un α=0.819 y los ítems correlacionaron con un único factor que explicó el 33.54% de la varianza total. Discusión: Nuestros hallazgos son similares a los encontrados por otros autores en diferentes poblaciones a la estudiada. Conclusiones: Se evidenció validez de constructo tanto para la escala Zung para depresión en su versión original como para la abreviada creada en la población estudiada. Sin embargo, se requieren estudios adicionales que verifiquen estos hallazgos en una muestra representativa y que otros aspectos de la psicometría sean evaluados.
Effective polymerization technique for plasma-treated multiwalled carbon nanotubes to maximize wear resistance of composite polyurethane
Authors: Ogawa Daisuke , Morimune-Moriya Seira , Nakamura Keiji
Published: February 2022

In this study, we examined a technique for maximizing the wear resistance of a polyurethane film composited with plasma-treated carbon nanotubes (CNTs). In our previous work, we showed that adding plasma-treated CNTs enhanced the wear resistance of off-the-shelf polyurethane. Here, we also investigated the chemical reactions between polyurethane and plasma-treated CNTs. The result showed that plasma-treatment modified isocyanate groups on CNTs possibly react with polyols to form urethane. However, the off-the-shelf polyurethane was supposed to have limited polyols because urethane reactions were mostly finished. In the present study, we synthesized polyurethane ourselves in order to compare how the timing of synthesis of plasma-treated CNTs into polyurethane (either before or after urethane reactions occur) impacts resulting films. Five polyurethane films were prepared, including a film composited with plasma-treated CNTs synthesized before urethane reactions (in situ polymerized CNT-composite polyurethane film). A wear-resistance test was then conducted to evaluate the mechanical properties of the composite films. The results showed that the plasma-treated CNTs enhanced wear resistance by a factor of two. Next, we conducted a tensile test to examine how the wear resistance was enhanced in polyurethane films composited with plasma-treated CNTs. The tensile test showed that in situ polymerized plasma-treated CNTs significantly improved Young’s modulus of CNT-composite polyurethane. These combined results suggested that plasma-treated CNTs should be composited into polyurethane before urethane reactions occur to maximize the wear resistance of composite polyurethane.
The crane operator's trick and other shenanigans with a pendulum
Authors: Schlamminger Stephan , Chao Leon , Lee Vincent , Newell David B. , Speake Clive C.
Published: February 2022

The dynamics of a swinging payload suspended from a stationary crane, an unwanted phenomenon on a construction site, can be described as a simple pendulum. However, an experienced crane operator can deliver a swinging payload and have it stop dead on target in a finite amount of time by carefully modulating the speed of the trolley. Generally, a series of precisely timed stop and go movements of the trolley are implemented to damp out the kinetic energy of the simple harmonic oscillator. Here, this mysterious crane operator's trick will be revealed and ultimately generalized to capture the case where the load is initially swinging. Finally, this modus operandi is applied to a torsion balance used to measure G, the universal gravitational constant responsible for the swinging of the crane's payload in the first place.
A new microscopic look into pressure fields and local buoyancy
Authors: Meneses João S. , Santos Pires J. P. , Viana Parente Lopes J. M.
Published: February 2022

Defining local pressures is pivotal to understanding phenomena such as buoyancy and atmospheric physics, which always require space-varying pressure fields to be considered. Such fields have precise definitions within the frameworks of hydro-thermodynamics and the kinetic theory of gases, but a pedagogical approach based on standard statistical mechanics techniques is still lacking. In this paper, we propose a new microscopic definition of local pressure inside a classical fluid, relying upon a local barometer potential that is built into the many-particle Hamiltonian. This setup allows pressure to be locally defined as an ensemble average of the radial force exerted by the barometer potential on the gas' particles. Moreover, this same framework is also employed in a microscopic derivation of buoyancy of immersed bodies in the presence of arbitrary external fields. As instructive examples, buoyant forces are calculated for ideal fluids in the presence of a uniform force field, in the presence of a spherical harmonic confinement field and in rotation with a constant angular velocity.
The Prevalence and Impact of Debilitative Psychological and Behavioral Responses to Long-Term Injury in Athletes
Authors: Gervis Misia , Pickford Helen , Nygârd Hanna , Goldman Aura
Published: February 2022

Injuries, and their psychological and maladaptive behavioral consequences, are an inevitable by-product of sport participation. This study sought to investigate the prevalence of maladaptive behaviors and psychological corollaries of long-term injury in order to understand if these are universal experiences of long-term injured athletes. Competitive athletes (n = 187; average time spent injured =43 weeks), across a range of sports completed an online questionnaire developed to investigate the psychological and behavioral consequences of long-term injury. Results indicated that negative symptoms after injury were a universal experience and are the “normal” response to injury, not the “exception.” The most prevalent psychological consequences were rumination (97.9%), boredom (94.7%), and fear of reinjury (93.6%). Furthermore, indicators of suicidal ideation were reported by more than 50% of participants. Factor analysis revealed a six-factor model: (a) self-sabotaging behavior, (b) daily functioning, (c) addictive behavior, (d) clinical issues, (e) fixation on injury, and (f) compromised athletic identity. All factors significantly correlated with debilitating impact. Thus, this study calls for a change to the support of long-term injured athletes to include routine psychological care.
Lysosomal cystine mobilization shapes the response of TORC1 and tissue growth to fasting
Authors: Jouandin Patrick , Marelja Zvonimir , Shih Yung-Hsin , Parkhitko Andrey A. , Dambowsky Miriam , Asara John M. , Nemazanyy Ivan , Dibble Christian C. , Simons Matias , Perrimon Norbert
Published: February 2022

Adaptation to nutrient scarcity involves an orchestrated response of metabolic and signaling pathways to maintain homeostasis. We find that in the fat body of fasting
Drosophila
, lysosomal export of cystine coordinates remobilization of internal nutrient stores with reactivation of the growth regulator target of rapamycin complex 1 (TORC1). Mechanistically, cystine was reduced to cysteine and metabolized to acetyl-coenzyme A (acetyl-CoA) by promoting CoA metabolism. In turn, acetyl-CoA retained carbons from alternative amino acids in the form of tricarboxylic acid cycle intermediates and restricted the availability of building blocks required for growth. This process limited TORC1 reactivation to maintain autophagy and allowed animals to cope with starvation periods. We propose that cysteine metabolism mediates a communication between lysosomes and mitochondria, highlighting how changes in diet divert the fate of an amino acid into a growth suppressive program.
Demographic implications of lead poisoning for eagles across North America
Authors: Slabe Vincent A. , Anderson James T. , Millsap Brian A. , Cooper Jeffrey L. , Harmata Alan R. , Restani Marco , Crandall Ross H. , Bodenstein Barbara , Bloom Peter H. , Booms Travis , Buchweitz John , Culver Renee , Dickerson Kim , Domenech Robert , Dominguez-Villegas Ernesto , Driscoll Daniel , Smith Brian W. , Lockhart Michael J. , McRuer David , Miller Tricia A. , Ortiz Patricia A. , Rogers Krysta , Schwarz Matt , Turley Natalie , Woodbridge Brian , Finkelstein Myra E. , Triana Christian A. , DeSorbo Christopher R. , Katzner Todd E.
Published: February 2022

Lead poisoning occurs worldwide in populations of predatory birds, but exposure rates and population impacts are known only from regional studies. We evaluated the lead exposure of 1210 bald and golden eagles from 38 US states across North America, including 620 live eagles. We detected unexpectedly high frequencies of lead poisoning of eagles, both chronic (46 to 47% of bald and golden eagles, as measured in bone) and acute (27 to 33% of bald eagles and 7 to 35% of golden eagles, as measured in liver, blood, and feathers). Frequency of lead poisoning was influenced by age and, for bald eagles, by region and season. Continent-wide demographic modeling suggests that poisoning at this level suppresses population growth rates for bald eagles by 3.8% (95% confidence interval: 2.5%, 5.4%) and for golden eagles by 0.8% (0.7%, 0.9%). Lead poisoning is an underappreciated but important constraint on continent-wide populations of these iconic protected species.
Engineered Wnt ligands enable blood-brain barrier repair in neurological disorders
Authors: Martin Maud , Vermeiren Simon , Bostaille Naguissa , Eubelen Marie , Spitzer Daniel , Vermeersch Marjorie , Profaci Caterina P. , Pozuelo Elisa , Toussay Xavier , Raman-Nair Joanna , Tebabi Patricia , America Michelle , De Groote Aurélie , Sanderson Leslie E. , Cabochette Pauline , Germano Raoul F. V. , Torres David , Boutry Sébastien , de Kerchove d’Exaerde Alban , Bellefroid Eric J. , Phoenix Timothy N. , Devraj Kavi , Lacoste Baptiste , Daneman Richard , Liebner Stefan , Vanhollebeke Benoit
Published: February 2022

The blood-brain barrier (BBB) protects the central nervous system (CNS) from harmful blood-borne factors. Although BBB dysfunction is a hallmark of several neurological disorders, therapies to restore BBB function are lacking. An attractive strategy is to repurpose developmental BBB regulators, such as Wnt7a, into BBB-protective agents. However, safe therapeutic use of Wnt ligands is complicated by their pleiotropic Frizzled signaling activities. Taking advantage of the Wnt7a/b-specific Gpr124/Reck co-receptor complex, we genetically engineered Wnt7a ligands into BBB-specific Wnt activators. In a “hit-and-run” adeno-associated virus–assisted CNS gene delivery setting, these new Gpr124/Reck-specific agonists protected BBB function, thereby mitigating glioblastoma expansion and ischemic stroke infarction. This work reveals that the signaling specificity of Wnt ligands is adjustable and defines a modality to treat CNS disorders by normalizing the BBB.
Self-assembled monolayers direct a LiF-rich interphase toward long-life lithium metal batteries
Authors: Liu Yujing , Tao Xinyong , Wang Yao , Jiang Chi , Ma Cong , Sheng Ouwei , Lu Gongxun , Lou Xiong Wen (David)
Published: February 2022

High–energy density lithium (Li) metal batteries (LMBs) are promising for energy storage applications but suffer from uncontrollable electrolyte degradation and the consequently formed unstable solid-electrolyte interphase (SEI). In this study, we designed self-assembled monolayers (SAMs) with high-density and long-range–ordered polar carboxyl groups linked to an aluminum oxide–coated separator to provide strong dipole moments, thus offering excess electrons to accelerate the degradation dynamics of carbon-fluorine bond cleavage in Li bis(trifluoromethanesulfonyl)imide. Hence, an SEI with enriched lithium fluoride (LiF) nanocrystals is generated, facilitating rapid Li
+
transfer and suppressing dendritic Li growth. In particular, the SAMs endow the full cells with substantially enhanced cyclability under high cathode loading, limited Li excess, and lean electrolyte conditions. As such, our work extends the long-established SAMs technology into a platform to control electrolyte degradation and SEI formation toward LMBs with ultralong life spans.
How does a lizard shed its tail?
Authors: Ghatak Animangsu
Published: February 2022

Hierarchical microstructures help a lizard self-amputate its tail when needed
Richard Leakey (1944—2022)
Authors: Kahumbu Paula
Published: February 2022

Renowned conservationist and advocate for African scientists
Empower with evidence
Authors: Amara Susan G.
Published: February 2022

This week (17 to 20 February), the virtual annual meeting of the American Association for the Advancement of Science (AAAS, the publisher of
Science
) will address the challenges of building the public’s trust and understanding of science by illuminating both great science and innovative initiatives in advocacy, education, and policy. The theme, “Empower with Evidence,” speaks to the critical importance of decision-making, policy-making, and interventions that are grounded in knowledge and facts, not opinions—or worse, misinformation.
The calorie counter
Authors: Gibbons Ann
Published: February 2022

Evolutionary anthropologist Herman Pontzer busts myths about how humans burn calories—and why
Transgenic fish invades Brazilian streams
Authors: Moutinho Sofia
Published: February 2022

Fluorescent aquarium curiosity has escaped from fish farms and may threaten local biodiversity
Europe proposes drastic cut of endocrine disruptor in plastic
Authors: Stokstad Erik
Published: February 2022

Food safety agency adopts cautious approach in calling for 100,000-fold cut in allowable exposure to bisphenol A
Draft Genome Sequences from Two Gram-Negative Bacteria,
Serratia
sp. Strain EWG9 and
Leclercia
sp. Strain EMC7, Isolated from the Earthworm Eisenia fetida
Authors: Barman Partha , Mondal Nibendu , Sen Subhajit , Chatterjee Sumit , Sinha Shilpa , Ghosh Wriddhiman , Chakraborty Ranadhir
Published: February 2022

We present the draft genome sequences of two bacterial strains that are putatively unique species and belong to two different Gram-negative genera:
Serratia
sp. EWG9 and
Leclercia
sp. EMC7, recovered from the gut and cast, respectively, of the compost worm
Eisenia fetida
.
Sequencing and Analysis of the Entire Genome of the Mycoparasitic Bioeffector Fungus Trichoderma asperelloides Strain T 203 (Hypocreales)
Authors: Gortikov Maggie , Wang Zheng , Steindorff Andrei S. , Grigoriev Igor V. , Druzhinina Irina S. , Townsend Jeffrey P. , Yarden Oded
Published: February 2022

The filamentous mycoparasitic fungus
Trichoderma asperelloides
(Hypocreales, Ascomycota, Dikarya) strain T 203 was isolated from soil in Israel by the Ilan Chet group in the 1980s. As it has been the subject of laboratory, greenhouse, and field experiments and has been incorporated into commercial agricultural preparations, its genome has been sequenced and analyzed.
Genome Sequence of Bacteriophage Infecting a Rare Pathogen, Pseudomonas luteola
Authors: Rathor Nisha , Sachdeva Pooja , Chaudhry Rama
Published: February 2022

This is a report of genome characterization of
Pseudomonas
phage AIIMS-Plu-RaNi infecting
Pseudomonas luteola
. The phage belonged to the family Siphoviridae with icosahedral head and tail with a genome of 46.6 kb, 64.45% GC with 68 open reading frames.
Complete Genome Sequence of “
Candidatus
Hydrogeosomobacter endosymbioticus,” an Intracellular Bacterial Symbiont of the Anaerobic Ciliate Scuticociliate GW7
Authors: Shiohama Yasuo , Takeshita Kazutaka , Hirakata Yuga , Nobu Masaru K. , Ito Michihiro , Shinzato Naoya
Published: February 2022

The bacterium “
Candidatus
Hydrogenosomobacter endosymbioticus” is an intracellular symbiont of anaerobic scuticociliate GW7, which is associated with hydrogenosome together with methanogenic archaea. Here, we report a complete genome sequence of the symbiont consisting of 827 kbp. Knowing this sequence would contribute to the understanding of the metabolic interactions and evolution of the tripartite symbiosis.
Rate and severity of radiological features of physical abuse in children during the first UK-wide COVID-19 enforced national lockdown
Authors: Stivaros Stavros , Paddock Michael , Rajai Azita , Cliffe Helen , Connolly Daniel JA , Dineen Robert A , Dixon Rachel , Edwards Harriet , Evans Emily , Halliday Katherine , Jackson Kandise , Landes Caren , Oates Adam J , Stoodley Neil , Offiah Amaka C
Published: February 2022

Rate and severity of radiological features of physical abuse in children during the first UK-wide COVID-19 enforced national lockdown.

Objective

To assess the number, type and outcome of radiological investigations for children presenting to hospital with suspected physical abuse (SPA; including abusive head trauma) during the first national COVID-19 enforced lockdown compared with the prelockdown period.

Design

Multicentre, retrospective, observational, interrupted time series analysis.

Setting

Eight secondary/tertiary paediatric centres between January 2018 and July 2020 inclusive.

Participants

1587 hospital assessed children undergoing radiographic skeletal surveys (SkS) and head CT imaging performed for SPA/child protection concerns.

Main outcome measures

Incidence and severity of fractures identified on SkS; head injury (composed of incidence rates and ratios of skull fracture, intracranial haemorrhage (ICH) and hypoxic ischaemic injury (HII)) on head CT imaging; and ratio of antemortem and postmortem SkS.

Results

1587 SkS were performed: 1282 (81%) antemortem, 762 (48%) male, and positive findings in 582 (37%). Median patient age was 6 months. There were 1.7 fractures/child prelockdown versus 1.1 fractures/child during lockdown. There was no difference between positive/negative SkS rates, the absolute ratio of antemortem/postmortem SkS or absolute numbers of head injury occurring between January 2018 and February 2020 and the lockdown period April–July 2020. Likewise, prelockdown incidence and rates of skull fracture 30/244 (12%), ICH 28/220 (13%) and HIE 10/205 (5%) were similar to lockdown, 142/1304 (11%), 171/1152 (15%) and 68/1089 (6%), respectively.

Conclusion

The first UK COVID-19 lockdown did not lead to an increase in either the number of antemortem or postmortem radiological investigations performed for SPA, or the number or severity of fractures and intracranial injuries identified by these investigations.
Early identification of patients admitted to hospital for covid-19 at risk of clinical deterioration: model development and multisite external validation study
Authors: Kamran Fahad , Tang Shengpu , Otles Erkin , McEvoy Dustin S , Saleh Sameh N , Gong Jen , Li Benjamin Y , Dutta Sayon , Liu Xinran , Medford Richard J , Valley Thomas S , West Lauren R , Singh Karandeep , Blumberg Seth , Donnelly John P , Shenoy Erica S , Ayanian John Z , Nallamothu Brahmajee K , Sjoding Michael W , Wiens Jenna
Published: February 2022

Objective

To create and validate a simple and transferable machine learning model from electronic health record data to accurately predict clinical deterioration in patients with covid-19 across institutions, through use of a novel paradigm for model development and code sharing.

Design

Retrospective cohort study.

Setting

One US hospital during 2015-21 was used for model training and internal validation. External validation was conducted on patients admitted to hospital with covid-19 at 12 other US medical centers during 2020-21.

Participants

33 119 adults (≥18 years) admitted to hospital with respiratory distress or covid-19.

Main outcome measures

An ensemble of linear models was trained on the development cohort to predict a composite outcome of clinical deterioration within the first five days of hospital admission, defined as in-hospital mortality or any of three treatments indicating severe illness: mechanical ventilation, heated high flow nasal cannula, or intravenous vasopressors. The model was based on nine clinical and personal characteristic variables selected from 2686 variables available in the electronic health record. Internal and external validation performance was measured using the area under the receiver operating characteristic curve (AUROC) and the expected calibration error—the difference between predicted risk and actual risk. Potential bed day savings were estimated by calculating how many bed days hospitals could save per patient if low risk patients identified by the model were discharged early.

Results

9291 covid-19 related hospital admissions at 13 medical centers were used for model validation, of which 1510 (16.3%) were related to the primary outcome. When the model was applied to the internal validation cohort, it achieved an AUROC of 0.80 (95% confidence interval 0.77 to 0.84) and an expected calibration error of 0.01 (95% confidence interval 0.00 to 0.02). Performance was consistent when validated in the 12 external medical centers (AUROC range 0.77-0.84), across subgroups of sex, age, race, and ethnicity (AUROC range 0.78-0.84), and across quarters (AUROC range 0.73-0.83). Using the model to triage low risk patients could potentially save up to 7.8 bed days per patient resulting from early discharge.

Conclusion

A model to predict clinical deterioration was developed rapidly in response to the covid-19 pandemic at a single hospital, was applied externally without the sharing of data, and performed well across multiple medical centers, patient subgroups, and time periods, showing its potential as a tool for use in optimizing healthcare resources.
Risk factors for reflex syncope in the British Army
Authors: Parsons Iain T , Ellwood J , Stacey M J , Gall N , Chowienczyk P , Woods D R
Published: February 2022

Introduction

Reflex syncope in the UK Armed Forces is reportedly higher than comparable militaries and civilian populations and is significantly more common in soldiers who take part in State Ceremonial and Public Duties (SCPD) compared with other British Army service personnel (SP). This study aimed to investigate individual susceptibility factors for syncope in soldiers who regularly take part in SCPD.

Methods

A retrospective cohort study was performed in 200 soldiers who perform SCPD. A questionnaire was undertaken reviewing soldiers’ medical history and circumstances of any fainting episodes. A consented review of participants’ electronic primary healthcare medical record was also performed. Participants were divided into two groups (syncope, n=80; control, n=120) based on whether they had previously fainted.

Results

In the syncope group orthostasis (61%) and heat (35%) were the most common precipitating factors. The most common interventions used by soldiers were to maintain hydration (59%) and purposeful movements (predominantly‘toe wiggling’; 55%). 30% of participants who had previously fainted did not seek definitive medical attention. A history of migraines/headaches was found to increase the risk of reflex syncope (OR 8.880, 1.214–218.8), while a history of antihistamine prescription (OR 0.07144, 0.003671–0.4236), non-white ethnicity (OR 0.03401, 0.0007419–0.3972) and male sex (OR 0.2640, 0.08891–0.6915) were protective.

Conclusion

This is the first study, in the British Army, to describe, categorise and establish potential risk factors for reflex syncope. Orthostatic-mediated reflex syncope is the most common cause in soldiers who regularly perform SCPD and this is further exacerbated by heat exposure. Soldiers do not use evidence-based methods to avoid reflex syncope. These data could be used to target interventions for SP who have previously fainted or to prevent fainting during SCPD.
Prevalence and risk factors of metabolic-associated fatty liver disease during 2014–2018 from three cities of Liaoning Province: an epidemiological survey
Authors: Guan Lin , Zhang Xinhe , Tian Haoyu , Jin Xing , Fan Hang , Wang Ningning , Sun Jing , Li Dan , Li Jia , Wang Xue , Zeng Zilu , Li Yiling
Published: February 2022

Objective

To investigate the incidence and characteristics of metabolic-associated fatty liver disease (MAFLD) in individuals undergoing physical examination in Liaoning Province (China).

Design

Retrospective study.

Setting

Single centre.

Participants

Adults who underwent routine health examination at Xikang Medical Center in Liaoning Province (Shenyang, Dandong and Dalian cities) between January 2014 and December 2018.

Results

Among the 204 394 included subjects, 71 756 were diagnosed with MAFLD, accounting for 35.28%. The total prevalence of MAFLD in Shenyang, Dandong and Dalian cities over the past 5 years was 35.8%, 40.41% and 31.7%, respectively. Men had a prevalence of 46.12%, which was higher than in women (21.80%). The percentage of MAFLD in body mass index (BMI) <23 kg/m2 and ≥23 kg/m2 was 6.49% and 53.23%, respectively. In all subjects, BMI, systolic blood pressure, diastolic blood pressure (DBP), fasting blood glucose (FBG), triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), alanine transaminase, aspartate transaminase (AST), alkaline phosphatase (ALP), γ-glutamyl transferase (GGT), blood urea nitrogen, serum creatinine (SCr), serum uric acid (SUA), haematocrit (HCT), mean corpuscular volume (MCV) and urine protein were independently associated with MAFLD (all p<0.001). In lean subjects, DBP, FBG, TG, TC, LDL-C, HDL-C, AST, ALP, GGT, SCr, SUA, HCT and MCV were independently associated with MAFLD (all p<0.001).

Conclusion

The prevalence of MAFLD in Liaoning Province was found to be associated with sex, cities with different economic statuses, BMI and multiple metabolic indicators.
Criminalisation of suicide and suicide rates: an ecological study of 171 countries in the world
Authors: Wu Kevin Chien-Chang , Cai Ziyi , Chang Qingsong , Chang Shu-Sen , Yip Paul Siu Fai , Chen Ying-Yeh
Published: February 2022

Objective

In the last half of the 20th century, many countries have already abolished antisuicide laws; however, more than 20 countries still adopt them. This paper is the first to systematically explore the association between criminalisation of suicide and national suicide rates in 171 countries/regions to examine the deterring effects of the antisuicide laws.

Design

A cross-sectional ecological study.

Setting

171 countries in the world.

Participants

In 2012, 25 countries were identified to carry antisuicide laws. A linear regression analysis was adopted to explore the association between national suicide rates (log transformed) and criminalisation of suicide in the world in 2012, having controlled for the Human Development Index (HDI), majority religious affiliations and the national unemployment rate.

Main outcome measure

Sex-specific age standardised suicide mortality rates.

Results

Criminalisation of suicide was associated with slightly increased national suicide rates (β estimate=0.29, 95% CI −0.04 to 0.61). Stronger association was found in women (β estimate=0.40, 95% CI 0.06 to 0.74), connecting criminalisation of suicide and higher suicide rates. The harmful effect of antisuicide laws on women was particularly prominent in non-Muslim countries and countries with lower HDI.

Conclusions

Laws penalising suicide were associated with higher national suicide rates and even more so in the female population in the low HDI, non-Muslim countries. The non-supportive patriarchal culture with laws penalising suicide may render women vulnerable to suicidality. Instead of criminalising suicide, alternative approaches such as providing good mental healthcare and adjusting the socioeconomic, legal and cultural factors that contribute to suicide should be considered.
Assessing infant cognition in field settings using eye-tracking: a pilot cohort trial in Sierra Leone
Authors: Leppänen Jukka M , Butcher Julius Walker , Godbout Claire , Stephenson Kevin , Hendrixson D Taylor , Griswold Stacy , Rogers Beatrice Lorge , Webb Patrick , Koroma Aminata S , Manary Mark J
Published: February 2022

Objectives

To investigate the feasibility of eye-tracking-based testing of the speed of visual orienting in malnourished young children at rural clinics in Sierra Leone.

Design

Prospective dual cohort study nested in a cluster-randomised trial.

Setting

8 sites participating in a cluster-randomised trial of supplementary feeding for moderate acute malnutrition (MAM).

Participants

For the MAM cohort, all infants aged 7–11 months at the eight sites were enrolled, 138 altogether. For controls, a convenience sample of all non-malnourished infants aged 7–11 months at the same sites were eligible, 60 altogether. A sample of 30 adults at the sites also underwent eye-tracking tests as a further control.

Interventions

Infants with MAM were provided with supplementary feeding.

Outcome measures

The primary outcomes were feasibility and reliability of eye-tracking-based testing of saccadic reaction time (SRT). Feasibility was assessed by the percent of successful tests in the infants. Reliability was measured with intraclass correlation coefficients (ICCs). Secondary outcomes were mean SRT based on nutritional state as well as and changes in mean SRT after supplementary feeding of MAM children.

Results

Infants exhibited consistent orienting to targets on a computer screen (>95% of valid trials). Mean SRTs had moderate stability within visits (ICCs 0.60–0.69) and across the 4-week test–retest interval (0.53) in infants; the adult control group had greater SRT stability (within visit ICC=0.92). MAM infants had a trend toward higher adjusted SRT at baseline (difference=12.4 ms, 95% CI −2 to 26.9, p=0.09) and improvement in SRT 4 weeks thereafter (difference=−14 ms, 95% CI −26.2 to −1.7, p=0.025) compared with age-matched controls.

Conclusions

The results demonstrate the feasibility of eye-tracking-based testing in a resource-poor field setting and suggest eye-tracking measures have utility in the detection of group level effects of supplementary feeding.
How is the organisational settings, content and availability of comprehensive multidisciplinary pulmonary rehabilitation for people with COPD in primary healthcare in Norway: a cross-sectional study
Authors: Frisk Bente , Sundør Ingrid Elise , Dønåsen Mette Ramstad , Refvem Olav Kåre , Borge Christine Råheim
Published: February 2022

Objective

To examine the organisational settings, content and availability of comprehensive multidisciplinary pulmonary rehabilitation (PR) programmes for people with chronic obstructive pulmonary disease (COPD) in primary healthcare in Norway.

Design

This was a cross-sectional survey study examining the content, organisational settings and availability of comprehensive multidisciplinary PR for people with COPD.

Setting and participants

When the survey was conducted, Norway had 436 municipalities/primary healthcare services who were invited to participate.

Outcome measures

The main outcome was the question related to accessibility to a PR programme in primary healthcare. We also examined in what degree the single interventions which are a part of a PR programme were one of the municipalities services and if there were regional differences regarding PR.

Results

Of the 436 municipalities, 158 answered the survey (36% response rate), and the survey covered for 45% of the total population in Norway. Five per cent of the responders reported having multidisciplinary PR for patients with COPD. The most frequently reported single interventions that can be a part of a multidisciplinary PR programme were reported as follows: group exercise training for all diagnoses (27%), reablement (25%) and home-care treatment by a physiotherapist and/or occupational therapist (24%). Southern-Eastern Norway had a significantly lower number of these interventions than Western Norway, Central Norway, and Northern Norway (p<0.001).

Conclusion

Only 5% of the Norwegian primary healthcare services (municipalities) had a multidisciplinary PR programme for patients with COPD. PR is the most important and cost-effective treatment within integrated care of patients with COPD. National strategies are therefore needed to increase the availability of PR for patients with COPD in Norwegian municipalities.
New Zealand Emergency Department COVID-19 Preparedness: a cross-sectional survey and narrative view
Authors: Howard Michael James , Chambers Charlotte N L , Mohr Nicholas M
Published: February 2022

Objective

Our objective was to assess the level of COVID-19 preparedness of emergency departments (EDs) in Aotearoa New Zealand (NZ) through the views of emergency medicine specialists working in district health boards around the country. Given the limited experience NZ hospitals have had with SARS-CoV-2, a comparison of current local practice with recent literature from other countries identifying known weaknesses may help prevent future healthcare worker infections in NZ.

Methods

We conducted a cross-sectional survey of NZ emergency specialists in November 2020 to evaluate preparedness of engineering, administrative policy and personal protective equipment (PPE) use.

Results

A total of 137 surveys were completed (32% response rate). More than 12% of emergency specialists surveyed reported no access to negative pressure rooms. N95 fit testing had not been performed in 15 (12%) of respondents. Most specialists (77%) work in EDs that cohort patients with COVID-19, about one-third (34%) do not use spotters during PPE doffing, and most (87%) do not have required space for physical distancing in non-patient areas. Initial PPE training, simulations and segregating patients were widespread but appear to be waning with persistent low SARS-CoV-2 prevalence. PPE shortages were not identified in NZ EDs, yet 13% of consultants do not plan to use respirators during aerosol-generating procedures on patients with COVID-19.

Conclusions

NZ emergency specialists identified significant gaps in COVID-19 preparedness, and they have a unique opportunity to translate lessons from other locations into local action. These data provide insight into weaknesses in hospital engineering, policy and PPE practice in advance of future SARS-CoV-2 endemic transmission.
Is the Parwarish parenting intervention feasible and relevant for young people and parents in diverse settings in India? A mixed methods process evaluation
Authors: Mathias Kaaren , Nayak Prabhudutt , Singh Pratibha , Pillai Pooja , Goicolea Isabel
Published: February 2022

Objective

To assess the feasibility, acceptability and relevance of the Parwarish, a positive parenting intervention (adapted from PLH-Teens) in three diverse settings in India.

Design

This mixed methods study used the Medical Research Council framework for process evaluations of complex interventions.

Setting

This study was set in disadvantaged communities in urban Agra, rural Uttar Pradesh and tribal Jharkhand in India.

Participants

Data were collected from 86 facilitators, implementers, parents and teens who participated in the Parwarish intervention among 239 families.

Intervention

Couples from target communities facilitated groups of parents and teens over the 14-module structured, interactive Parwarish intervention which focused on building communication, reducing harsh parenting and building family budgeting skills.

Outcome measures

We assessed relevance, acceptability and feasibility of the intervention using mixed methods. Qualitative data collected included semistructured interviews and focus group discussions with implementers, facilitators, parents and young people who were transcribed, translated and thematically analysed to develop themes inherent in the data. Quantitative data which assessed attendance, fidelity to the intervention and facilitator training and coaching were analysed descriptively.

Results

Findings were grouped under the three domains of facilitation, community engagement and programme support with the following seven themes: (1) community-based facilitators increased contextual validity of the intervention; (2) gender relations were not only influenced by Parwarish implementation but were also influenced and transformed by Parwarish; (3) facilitator responsiveness to group concerns increased participation; (4) participation gathered momentum; (5) Parwarish’s strong core and porous periphery allowed adaptations to local contexts; (6) technology that included Skype and WhatsApp enhanced implementation and (7) critical reflection with community trained coaches strengthened facilitation quality and programme fidelity.

Conclusion

This study found Parwarish engaging, feasible and acceptable in three diverse, low-income communities, although constrained by patriarchal gender relations. It paves the way for larger-scale implementation in other South Asian settings.
Assessment of global coagulation function under treatment with emicizumab concomitantly with bypassing agents in haemophilia A with inhibitor (UNEBI Study): multicentre open-label non-randomised clinical trial
Authors: Ogiwara Kenichi , Taki Masashi , Suzuki Takashi , Takedani Hideyuki , Matsushita Tadashi , Amano Kagehiro , Matsumoto Masanori , Nishio Kenji , Shima Midori , Kasahara Masato , Nogami Keiji
Published: February 2022

Introduction

Subcutaneous emicizumab prophylaxis substantially reduces bleeding episodes in patients with haemophilia A (PwHA) and factor VIII inhibitor. However, thrombotic events occurred in some PwHA with inhibitor who had received high cumulative doses of activated prothrombin complex concentrates at their breakthrough bleeds, when they were also given prophylactic emicizumab. After that, although the recommended guidance was proposed for bypassing agents (BPAs) therapy under emicizumab prophylaxis for haemostatic management, detailed investigation(s) is(are) required to elucidate the safe and appropriate dose of BPAs to use concomitantly with emicizumab prophylaxis.

Methods and analysis

In the UNEBI Study, 60 PwHA with inhibitor will be enrolled for a maximum duration of 3 years, and samples of 20 events following concomitant use of BPAs with emicizumab will be collected. An ‘event’ is defined as obtaining blood samples before and after administration of BPA when a breakthrough bleed or a surgical procedure occurs. The coagulation potential in the obtained samples will be measured by global coagulation assays. The primary endpoint is the degree of improvement in the maximum coagulation rate by clot waveform analysis (CWA) before and after administration of fixed-dose BPAs. This parameter obtained from CWA, which is triggered with an optimally diluted mixture of prothrombin time/activated partial thromboplastin time-reagents, is reported to be an excellent marker for assessing the degree of improvement in coagulation potential in emicizumab-treated plasma.

Ethics and dissemination

The UNEBI Study was approved by the Japan Certified Review Board of Nara Medical University. The results of the study will be communicated through publication in international scientific journals and presentations at (inter)national conferences.

Trial registration number

jRCTs051190119.
Secondhand smoke exposure for different education levels: findings from a large, nationally representative survey in Turkey
Authors: Alkan Ömer , Ünver Şeyda
Published: February 2022

Objectives

The aim of this study is to determine the factors that influence individuals’ exposure to tobacco smoke in Turkey according to their education level.

Design

Secondary data analysis.

Participants

Altogether, 17 084 individuals aged 15 and over were included in this study.

Settings

Data set of the Turkey Health Survey in 2019.

Methods

Binary logistic regression analysis was used to determine the factors associated with individuals’ exposure to tobacco smoke.

Primary and secondary outcome measures

The variables age, gender, marital status, general health status, employment status, receipt of psychosocial support and tobacco use were found to be correlated with exposure to tobacco smoke.

Results

The study determined that individuals who are illiterate/unschooled were exposed to tobacco smoke at a rate of 32.61%, primary school graduates at a rate of 34.32%, primary education graduates at a rate of 41.75%, high school graduates at a rate of 41.04% and university graduates at a rate of 40.34%.

Conclusion

As a result of the study, it is emphasised that men, young individuals, individuals with moderate and very good general health status, those who use tobacco, those who are unemployed and those who receive psychosocial support should be targeted. In addition, appropriate strategies for reducing secondhand smoke (SHS) exposure should be developed, taking into account public health strategies for increasing awareness of the adverse health effects of SHS exposure and the determinants of tobacco exposure according to the study.
Association of COVID-19 pandemic-related concern and health routine changes with functioning among individuals with systemic lupus erythematosus
Authors: Plantinga Laura C , Hoge Courtney , Dunlop-Thomas Charmayne , Pearce Brad D , Lim S Sam , Drenkard Cristina , Bowling C Barrett
Published: February 2022

Objective

To examine whether pandemic-related issues were associated with physical functioning, community mobility and cognition among individuals with SLE.

Methods

Participants were recruited (6 October 2020–11 November 2021) for this cross-sectional study from a population-based cohort of individuals with validated SLE in metropolitan Atlanta, as part of an ongoing ancillary study. Pandemic-related issues (concern about the pandemic (very vs somewhat/not at all concerned); changes in physical activity and sleep (less vs more/same); difficulty obtaining food and medications and accessing routine care (any vs none)) were self-reported. Self-reported physical functioning and episodic and working memory performance were reported as t-scores (such that a score of 50=population mean and a 10-point difference=1 SD) and community mobility scores ranged from 0 to 120, with higher scores representing better functioning for all domains. Differences in scores were assessed via t-tests and age-adjusted, sex-adjusted and race-adjusted linear regression.

Results

Among 245 participants (mean age, 46 years; 95% female, 77% black), physical functioning t-scores (mean=44) were consistently lower (by 3–5 points) for those who reported concern about the pandemic, less physical activity and sleep, difficulty obtaining food and medications, and accessing routine care. Similarly, community mobility scores (mean=48) were lower (by 10–20 points) for these individuals. There were no substantial differences in episodic memory and working memory t-scores (mean=50 and 47, respectively) by pandemic-related issues.

Conclusion

We found that physical functioning and community mobility, but not cognition, were lower among those who reported more concern about the pandemic or greater disruptions to health routines. Future studies should explore interventions among these vulnerable individuals with SLE, who already disproportionately suffer from functional impairment, to maintain functioning and prevent adverse outcomes during times of crisis.
SIGLEC1 enables straightforward assessment of type I interferon activity in idiopathic inflammatory myopathies
Authors: Graf Manuel , von Stuckrad Sae Lim , Uruha Akinori , Klotsche Jens , Zorn-Pauly Lydia , Unterwalder Nadine , Buttgereit Thomas , Krusche Martin , Meisel Christian , Burmester Gerd R , Hiepe Falk , Biesen Robert , Kallinich Tilmann , Stenzel Werner , Schneider Udo , Rose Thomas
Published: February 2022

Objective

To evaluate sialic acid binding Ig-like lectin 1 (SIGLEC1) expression on monocytes by flow cytometry as a type I interferon biomarker in idiopathic inflammatory myopathies (IIM).

Methods

We performed a retrospective analysis of adult and paediatric patients with the diagnosis of IIM. SIGLEC1 expression was assessed by flow cytometry and was compared with Physician Global Assessment or Childhood Myositis Assessment Scale disease activity scores. Mann Whitney U test and receiver operating characteristic curves were used for cross-sectional data analysis (n=96), two-level mixed-effects linear regression model for longitudinal analyses (n=26, 110 visits). Response to treatment was analysed in 14 patients within 12 months, using Wilcoxon test. SIGLEC1 was compared with interferon-stimulated gene 15/MxA status by immunohistochemical staining of muscle biopsies (n=17).

Results

96 patients with adult (a) and juvenile (j) dermatomyositis (DM, n=38), antisynthetase syndrome (AS, n=19), immune-mediated necrotising myopathy (IMNM, n=8), inclusion body myositis (IBM, n=9) and overlap myositis (n=22) were included. SIGLEC1 distinguished significantly between active and inactive disease with an area under the curve of 0.92 (95% CI 0.83 to 1) in DM and correlated with disease activity longitudinally (aDM: standardised beta=0.54, p<0.001; jDM: standardised beta=−0.70, p<0.001). Response to treatment in DM was associated with a decreasing SIGLEC1 (p<0.01, Wilcoxon test). SIGLEC1 was found upregulated in 8 of 19 patients with AS, 2 of 9 patients with IBM but not in IMNM.

Conclusion

SIGLEC1 is a candidate biomarker to assess type I interferon activity in IIM and proved useful for monitoring disease activity and response to treatment in juvenile and adult DM.