bluuebunny/crossref_metadata_2025 huggingface dataset:
Utility of mobile learning in Electrocardiography
Authors: Viljoen Charle André , Millar Rob Scott , Hoevelmann Julian , Muller Elani , Hähnle Lina , Manning Kathryn , Naude Jonathan , Sliwa Karen , Burch Vanessa Celeste
Published: February 2021

Aims

Mobile learning is attributed to the acquisition of knowledge derived from accessing information on a mobile device. Although increasingly implemented in medical education, research on its utility in Electrocardiography remains sparse. In this study, we explored the effect of mobile learning on the accuracy of electrocardiogram (ECG) analysis and interpretation.

Methods and results

The study comprised 181 participants (77 fourth- and 69 sixth-year medical students, and 35 residents). Participants were randomized to analyse ECGs with a mobile learning strategy [either searching the Internet or using an ECG reference application (app)] or not. For each ECG, they provided their initial diagnosis, key supporting features, and final diagnosis consecutively. Two weeks later, they analysed the same ECGs, without access to any mobile device. ECG interpretation was more accurate when participants used the ECG app (56%), as compared to searching the Internet (50.3%) or neither (43.5%, P = 0.001). Importantly, mobile learning supported participants in revising their initial incorrect ECG diagnosis (ECG app 18.7%, Internet search 13.6%, no mobile device 8.4%, P < 0.001). However, whilst this was true for students, there was no significant difference amongst residents. Internet searches were only useful if participants identified the correct ECG features. The app was beneficial when participants searched by ECG features, but not by diagnosis. Using the ECG reference app required less time than searching the Internet (7:44 ± 4:13 vs. 9:14 ± 4:34, P < 0.001). Mobile learning gains were not sustained after 2 weeks.

Conclusion

Whilst mobile learning contributes to increased ECG diagnostic accuracy, the benefits were not sustained over time.
Delivering an integrated sexual reproductive health and rights and HIV programme to high-school adolescents in a resource-constrained setting
Authors: Shaikh Najma , Grimwood Ashraf , Eley Brian , Fatti Geoffrey , Mathews Catherine , Lombard Carl , Galea Sandro
Published: February 2021

Southern Africa remains the epicentre of the human immunodeficiency virus (HIV) epidemic with AIDS the leading cause of death amongst adolescents. Poor policy translation, inadequate programme implementation and fragmentation of services contribute to adolescents’ poor access to sexual and reproductive health and rights (SRHR) services. This study assessed an integrated, school-based SRHR and HIV programme, modelled on the South African Integrated School Health Policy in a rural, high HIV-prevalence district. A retrospective cohort study of 1260 high-school learners was undertaken to assess programme uptake, change in HIV knowledge and behaviour and the determinants of barrier-methods use at last sexual intercourse. Programme uptake increased (2%–89%; P�<�0.001) over a 16-month period, teenage-pregnancy rates declined (14%–3%; P�<�0.050) and accurate knowledge about HIV transmission through infected blood improved (78.3%–93.8%; P�<�0.050), a year later. Post-intervention, attending a clinic perceived as adolescent-friendly increased the odds of barrier-methods use during the last sexual encounter (aOR=1.85; 95% CI: 1.31–2.60), whilst being female (aOR=0.69; 95% CI: 0.48–0.99), <15 years (aOR=0.44; 95% CI: 0.24–0.80), or having >5 sexual partners in the last year (aOR=0.59; 95% CI: 0.38–0.91) reduced the odds. This study shows that the unmet SRHR needs of under-served adolescents can be addressed through integrated, school-based SRHR programmes.
Fluoroethylnormemantine, A Novel Derivative of Memantine, Facilitates Extinction Learning Without Sensorimotor Deficits
Authors: Chen Briana K , Le Pen Gwenaëlle , Eckmier Adam , Rubinstenn Gilles , Jay Therese M , Denny Christine A
Published: February 2021

Background

Memantine, a noncompetitive N-methyl-D-aspartate receptor antagonist, has been approved for use in Alzheimer’s disease, but an increasing number of studies have investigated its utility for neuropsychiatric disorders. Here, we characterized a novel compound, fluoroethylnormemtantine (FENM), which was derived from memantine with an extra Fluor in an optimized position for in vivo biomarker labeling. We sought to determine if FENM produced similar behavioral effects as memantine and/or if FENM has beneficial effects against fear, avoidance, and behavioral despair.

Methods

We administered saline, FENM, or memantine prior to a number of behavioral assays, including paired-pulse inhibition, open field, light dark test, forced swim test, and cued fear conditioning in male Wistar rats.

Results

Unlike memantine, FENM did not produce nonspecific side effects and did not alter sensorimotor gating or locomotion. FENM decreased immobility in the forced swim test. Moreover, FENM robustly facilitated fear extinction learning when administered prior to either cued fear conditioning training or tone reexposure.

Conclusions

These results suggest that FENM is a promising, novel compound that robustly reduces fear behavior and may be useful for further preclinical testing.
Breaking the waves: asymmetric random periodic features for low-bitrate kernel machines
Authors: Schellekens Vincent , Jacques Laurent
Published: February 2021

Many signal processing and machine learning applications are built from evaluating a kernel on pairs of signals, e.g., to assess the similarity of an incoming query to a database of known signals. This nonlinear evaluation can be simplified to a linear inner product of the random Fourier features (RFFs) of those signals: random projections followed by a periodic map, the complex exponential. It is known that a simple quantization of those features (corresponding to replacing the complex exponential by a different periodic map that takes binary values, which is appealing for their transmission and storage) distorts the approximated kernel, which may be undesirable in practice. Our take-home message is that when the features of only one of the two signals are quantized, the original kernel is recovered without distortion; its practical interest appears in several cases where the kernel evaluations are asymmetric by nature, such as a client-server scheme. Concretely, we introduce the general framework of asymmetric random periodic features, where the two signals of interest are observed through random periodic features—random projections followed by a general periodic map, which is allowed to be different for both signals. We derive the influence of those periodic maps on the approximated kernel and prove uniform probabilistic error bounds holding for all pair of signals picked in an infinite low-complexity set. Interestingly, our results allow the periodic maps to be discontinuous, thanks to a new mathematical tool, i.e., the mean Lipschitz smoothness. We then apply this generic framework to semi-quantized kernel machines (where only one of the signals has quantized features and the other has classical RFFs), for which we show theoretically that the approximated kernel remains unchanged (with the associated error bound) and confirm the power of the approach with numerical simulations.
Patterns of virus growth across the diversity of life
Authors: Jin Tianyi , Yin John
Published: February 2021

Although viruses in their natural habitats add up to less than 10% of the biomass, they contribute more than 90% of the genome sequences [1]. These viral sequences or ‘viromes’ encode viruses that populate the Earth’s oceans [2, 3] and terrestrial environments [4, 5], where their infections impact life across diverse ecological niches and scales [6, 7], including humans [8–10]. Most viruses have yet to be isolated and cultured [11–13], and surprisingly few efforts have explored what analysis of available data might reveal about their nature. Here, we compiled and analyzed seven decades of one-step growth and other data for viruses from six major families, including their infections of archaeal, bacterial and eukaryotic hosts [14–191]. We found that the use of host cell biomass for virus production was highest for archaea at 10%, followed by bacteria at 1% and eukarya at 0.01%, highlighting the degree to which viruses of archaea and bacteria exploit their host cells. For individual host cells, the yield of virus progeny spanned a relatively narrow range (10–1000 infectious particles per cell) compared with the million-fold difference in size between the smallest and largest cells. Furthermore, healthy and infected host cells were remarkably similar in the time they needed to multiply themselves or their virus progeny. Specifically, the doubling time of healthy cells and the delay time for virus release from infected cells were not only correlated (r = 0.71, p < 10−10, n = 101); they also spanned the same range from tens of minutes to about a week. These results have implications for better understanding the growth, spread and persistence of viruses in complex natural habitats that abound with diverse hosts, including humans and their associated microbes.
Informatics response to address the COVID-19 pandemic in a safety net healthcare system
Authors: Sadasivaiah Shobha , Shaffer Eric , Enanoria Wayne , Su George , Goldman Seth , Scarafia Jeff , Lee Tina , Yu Albert , Goldman L Elizabeth , Ratanawongsa Neda
Published: February 2021

In service of particularly vulnerable populations, safety net healthcare systems must nimbly leverage health information technology (IT), including electronic health records (EHRs), to coordinate the medical and public health response to the novel coronavirus (COVID-19). Six months after the San Francisco Department of Public Health implemented a new EHR across its hospitals and citywide clinics, California declared a state of emergency in response to COVID-19. This paper describes how the IT and informatics teams supported San Francisco Department of Public Health’s goals of expanding the safety net healthcare system capacity, meeting the needs of specific vulnerable populations, increasing equity in COVID-19 testing access, and expanding public health analytics and research capacity. Key enabling factors included critical partnerships with operational leaders, early identification of priorities, a clear governance structure, agility in the face of rapidly changing circumstances, and a commitment to vulnerable populations.
Coverage of the hospital-based cancer registries and the designated cancer care hospitals in Japan
Authors: Okuyama Ayako , Tsukada Yoichiro , Higashi Takahiro
Published: February 2021

Background

Hospital-based cancer registries were developed to describe and improve clinical care for cancer patients. We described the hospital-based cancer registry coverage as a reference for the users, including researchers, policymakers and clinicians.

Methods

The hospital-based cancer registry coverage was defined as the proportion of new cases registered in the hospital-based cancer registry to the National Cancer Registry as the denominator. To examine the coverage of respective cancer types, age groups and prefecture in the hospital-based cancer registry, cases were grouped based on the 10th International Statistical Classification of Diseases and Related Health Problems and were compared with the published report of the National Cancer Registry in 2017.

Results

The overall hospital-based cancer registries coverage was 71.7%, and 52.5% of patients were treated at designated cancer care hospitals. The hospital-based cancer registries coverage and treatment rates at designated cancer care hospitals varied per cancer type, age group, and prefecture. The hospital-based cancer registries covered over 80% of the patients with cancers of the larynx, uterus, oesophagus, lip, oral cavity, pharynx and skin, whereas patients’ coverage with thyroid cancer was relatively low. The hospital-based cancer registry coverage of young patients (<15 years) was >80%, whereas that for elderly patients (≥85 years) was <55%. The range of coverage in each prefecture was from 43.0 to 89.7%. Over 70% of the patients with cancers of the larynx, lip, oral cavity and pharynx were treated at designated cancer care hospitals.

Conclusions

The hospital-based cancer registry coverage is ~70% of all cancers. Because the coverage differed across cancers and age groups, the respective target groups’ analysis should consider this factor.
Histone acetylation: a requirement for petunia floral scent
Authors: Vlachonasios Konstantinos E
Published: February 2021

This article comments on:

Patrick RM, Huang X-Q, Dudareva N, Li Y. 2021. Dynamic histone acetylation in floral volatile synthesis and emission in petunia flowers. Journal of Experimental Botany 72, 3704–3722.
The environment of QSO triplets at 1 ≲ z ≲ 1.5
Authors: Vicentin Marcelo C , Araya-Araya Pablo , Sodré Laerte , Overzier Roderik , Carrasco Eleazar R , Cuevas Hector
Published: February 2021

We present an analysis of the environment of six QSO triplets at 1 ≲ z ≲ 1.5 by analysing multiband (r, i, z, or g, r, i) images obtained with Megacam at the CFHT telescope, aiming to investigate whether they are associated or not with galaxy protoclusters. This was done by using photometric redshifts trained using the high-accuracy photometric redshifts of the COSMOS2015 catalogue. To improve the quality of our photometric redshift estimation, we included in our analysis near-infrared photometry (3.6 and 4.5$\, \mu$m) from the unWISE survey available for our fields and the COSMOS survey. This approach allowed us to obtain good photometric redshifts with dispersion, as measured with the robust σNMAD statistics (which scales as (1 + z)−1), of ∼0.04 for our six fields. Our analysis setup was reproduced on lightcones constructed from the Millennium Simulation data and the latest version of the L-GALAXIES semi-analytic model to verify the protocluster detectability in such conditions. The density field in a redshift slab containing each triplet was then analysed with a Gaussian kernel density estimator. We did not find any significant evidence of the triplets inhabiting dense structures, such as a massive galaxy cluster or protocluster.
Dark energy survey internal consistency tests of the joint cosmological probes analysis with posterior predictive distributions
Authors: Doux C , Baxter E , Lemos P , Chang C , Alarcon A , Amon A , Campos A , Choi A , Gatti M , Gruen D , Jarvis M , MacCrann N , Park Y , Prat J , Rau M M , Raveri M , Samuroff S , DeRose J , Hartley W G , Hoyle B , Troxel M A , Zuntz J , Abbott T M C , Aguena M , Allam S , Annis J , Avila S , Bacon D , Bertin E , Bhargava S , Brooks D , Burke D L , Carrasco Kind M , Carretero J , Cawthon R , Costanzi M , da Costa L N , Pereira M E S , Desai S , Diehl H T , Dietrich J P , Doel P , Everett S , Ferrero I , Fosalba P , Frieman J , García-Bellido J , Gerdes D W , Giannantonio T , Gruendl R A , Gschwend J , Gutierrez G , Hinton S R , Hollowood D L , Honscheid K , Huff E M , Huterer D , Jain B , James D J , Krause E , Kuehn K , Kuropatkin N , Lahav O , Lidman C , Lima M , Maia M A G , Menanteau F , Miquel R , Morgan R , Muir J , Ogando R L C , Palmese A , Paz-Chinchón F , Plazas A A , Sanchez E , Scarpine V , Schubnell M , Serrano S , Sevilla-Noarbe I , Smith M , Suchyta E , Swanson M E C , Tarle G , To C , Tucker D L , Varga T N , Weller J , Wilkinson R D ,   (DES Collaboration), Alarcon Alex , Compos Andresa , Park Youngsoo
Published: February 2021

Beyond ΛCDM, physics or systematic errors may cause subsets of a cosmological data set to appear inconsistent when analysed assuming ΛCDM. We present an application of internal consistency tests to measurements from the Dark Energy Survey Year 1 (DES Y1) joint probes analysis. Our analysis relies on computing the posterior predictive distribution (PPD) for these data under the assumption of ΛCDM. We find that the DES Y1 data have an acceptable goodness of fit to ΛCDM, with a probability of finding a worse fit by random chance of p = 0.046. Using numerical PPD tests, supplemented by graphical checks, we show that most of the data vector appears completely consistent with expectations, although we observe a small tension between large- and small-scale measurements. A small part (roughly 1.5 per cent) of the data vector shows an unusually large departure from expectations; excluding this part of the data has negligible impact on cosmological constraints, but does significantly improve the p-value to 0.10. The methodology developed here will be applied to test the consistency of DES Year 3 joint probes data sets.
Unveiling the planet population at birth
Authors: Rogers James G , Owen James E
Published: February 2021

The radius distribution of small, close-in exoplanets has recently been shown to be bimodal. The photoevaporation model predicted this bimodality. In the photoevaporation scenario, some planets are completely stripped of their primordial H/He atmospheres, whereas others retain them. Comparisons between the photoevaporation model and observed planetary populations have the power to unveil details of the planet population inaccessible by standard observations, such as the core mass distribution and core composition. In this work, we present a hierarchical inference analysis on the distribution of close-in exoplanets using forward models of photoevaporation evolution. We use this model to constrain the planetary distributions for core composition, core mass, and initial atmospheric mass fraction. We find that the core-mass distribution is peaked, with a peak-mass of ∼4M⊕. The bulk core-composition is consistent with a rock/iron mixture that is ice-poor and ‘Earth-like’; the spread in core-composition is found to be narrow ($\lesssim 16{{\ \rm per\ cent}}$ variation in iron-mass fraction at the 2σ level) and consistent with zero. This result favours core formation in a water/ice poor environment. We find the majority of planets accreted a H/He envelope with a typical mass fraction of $\sim 4{{\ \rm per\ cent}}$; only a small fraction did not accrete large amounts of H/He and were ‘born-rocky’. We find four times as many super-Earths were formed through photoevaporation, as formed without a large H/He atmosphere. Finally, we find core-accretion theory overpredicts the amount of H/He cores would have accreted by a factor of ∼5, pointing to additional mass-loss mechanisms (e.g. ‘boil-off’) or modifications to core-accretion theory.
Intron exon boundary junctions in human genome have in-built unique structural and energetic signals
Authors: Mishra Akhilesh , Siwach Priyanka , Misra Pallavi , Dhiman Simran , Pandey Ashutosh Kumar , Srivastava Parul , Jayaram B
Published: February 2021

Precise identification of correct exon–intron boundaries is a prerequisite to analyze the location and structure of genes. The existing framework for genomic signals, delineating exon and introns in a genomic segment, seems insufficient, predominantly due to poor sequence consensus as well as limitations of training on available experimental data sets. We present here a novel concept for characterizing exon–intron boundaries in genomic segments on the basis of structural and energetic properties. We analyzed boundary junctions on both sides of all the exons (3 28 368) of protein coding genes from human genome (GENCODE database) using 28 structural and three energy parameters. Study of sequence conservation at these sites shows very poor consensus. It is observed that DNA adopts a unique structural and energy state at the boundary junctions. Also, signals are somewhat different for housekeeping and tissue specific genes. Clustering of 31 parameters into four derived vectors gives some additional insights into the physical mechanisms involved in this biological process. Sites of structural and energy signals correlate well to the positions playing important roles in pre-mRNA splicing.
aniFOUND: analysing the associated proteome and genomic landscape of the repaired nascent non-replicative chromatin
Authors: Stefos Georgios C , Szantai Eszter , Konstantopoulos Dimitris , Samiotaki Martina , Fousteri Maria
Published: February 2021

Specific capture of chromatin fractions with distinct and well-defined features has emerged as both challenging and a key strategy towards a comprehensive understanding of genome biology. In this context, we developed aniFOUND (accelerated native isolation of factors on unscheduled nascent DNA), an antibody-free method, which can label, capture, map and characterise nascent chromatin fragments that are synthesized in response to specific cues outside S-phase. We used the ‘unscheduled’ DNA synthesis (UDS) that takes place during the repair of UV-induced DNA lesions and coupled the captured chromatin to high-throughput analytical technologies. By mass-spectrometry we identified several factors with no previously known role in UVC-DNA damage response (DDR) as well as known DDR proteins. We experimentally validated the repair-dependent recruitment of the chromatin remodeller RSF1 and the cohesin-loader NIPBL at sites of UVC-induced photolesions. Developing aniFOUND-seq, a protocol for mapping UDS activity with high resolution, allowed us to monitor the landscape of UVC repair-synthesis events genome wide. We further resolved repair efficacy of the rather unexplored repeated genome, in particular rDNA and telomeres. In summary, aniFOUND delineates the proteome composition and genomic landscape of chromatin loci with specific features by integrating state-of-the-art ‘omics’ technologies to promote a comprehensive view of their function.
Police and Crime Commissioners: A Dislocated Expectation?
Authors: Cooper Simon
Published: February 2021

The calls in 2019 and 2020 for a Royal Commission, combined with the launch of The Strategic Review by The Police Foundation and the recommendation by Her Majesty’s Inspector of Constabulary and Fire & Rescue Services for ‘profound and far reaching police reform’, evidence a thirst for refinement, and potentially, significant change to the governance of policing. Using new empirical data obtained through elite research interviews with some of the most senior stakeholders in policing at a regional and national level, this article explores the ability of Police and Crime Commissioners (PCCs) to hold Chief Constables to account. Attention is drawn to how the accountability of Chief Constables to PCCs may have significant strengths, such as enhanced visibility, increased frequency, and improved scrutiny. However, the accountability of Chief Constables may also be frustrated and possibly compromised. Indeed, accountability might be exercised inconsistently, susceptible to significant variance and contingent on the calibre and vagaries of PCCs. As such, recommendations are made to strengthen governance arrangements to ensure Chief Constables are robustly held to account. Specifically, the Home Secretary is encouraged to review The Policing Protocol Order and issue an Accountability Code of Practice.
Meta-analysis of alcohol consumption and venous thromboembolism
Authors: Zhang Xingxia , Chen Xinrong , Yang Jie , Du Liang , Zhou Yong , Li Ka
Published: February 2021

Background

The associations of alcohol consumption and venous thromboembolism (VTE) have been investigated widely, but the conclusions were inconsistent.

Objective

To summarize the relationship of alcohol consumption and VTE.

Methods

This study has been registered in PROSPERO (ID: CRD42020164567). We searched the PubMed, Embase, Web of Science and the Cochrane Library databases from inception to September 2019 and reviewed the reference list of relevant articles to identify studies assessing the association between alcohol consumption and risk of VTE.

Results

Fourteen cohorts and four case-control studies were included in the meta-analysis. Compared with non-drinkers, the risk of VTE was decreased (RR: 0.93; 95% confidence interval [CI] 0.88–0.99) for alcohol drinkers. The pooled RRs of VTE were 0.91 (95% CI 0.84–0.99) for low to moderate alcohol intake (0.1–14.0 drinks/week) and 0.91 (95% CI 0.78–1.06) for high alcohol intake (>14.0 drinks/week) compared with non-drinker. Subgroup analysis showed liquor intake might slightly increase the risk of VTE (1.01; 95% CI 0.85–1.21) although the difference was not significant.

Conclusions

Alcohol consumption in low to moderate was associated with a lower risk of VTE. However, precautions are needed when providing personal drinking advice considering the potential harm of alcohol. Further studies are warranted to determine whether moderate alcohol consumption has a causal role in VTE.
Rules without Commitment: Reputation and Incentives
Authors: Dovis Alessandro , Kirpalani Rishabh
Published: February 2021

This article studies the optimal design of rules in a dynamic model when there is a time inconsistency problem and uncertainty about whether the policy maker can commit to follow the rule ex post. The policy maker can either be a commitment type, which can always commit to follow rules, or an optimizing type, which sequentially decides whether to follow rules or not. This type is unobservable to private agents, who learn about it through the actions of the policy maker. Higher beliefs that the policy maker is the commitment type (i.e. the policy maker’s reputation) help promote good behaviour by private agents. We show that in a large class of economies, preserving uncertainty about the policy maker’s type is preferable from an ex ante perspective. If the initial reputation is not too high, the optimal rule is the strictest one that is incentive compatible for the optimizing type. We show that reputational considerations imply that the optimal rule is more lenient than the one that would arise in a static environment. Moreover, opaque rules are preferable to transparent ones if reputation is high enough.
Analysis of Volatile Profiles for Tracking Asymptomatic Infections of Phytophthora ramorum and Other Pathogens in Rhododendron
Authors: Thompson Cai H. , McCartney Mitchell M. , Roubtsova Tatiana V. , Kasuga Takao , Ebeler Susan E. , Davis Cristina E. , Bostock Richard M.
Published: February 2021

Phytophthora ramorum is an invasive, broad host range pathogen that causes ramorum blight and sudden oak death in forest landscapes of western North America. In commercial nurseries, asymptomatic infections of nursery stock by P. ramorum and other Phytophthora species create unacceptable risk and complicate inspection and certification programs designed to prevent introduction and spread of these pathogens. In this study, we continue development of a volatile organic compound (VOC)-based test for detecting asymptomatic infections of P. ramorum in Rhododendron sp. We confirmed detection of P. ramorum from volatiles collected from asymptomatic root-inoculated Rhododendron plants in a nursery setting, finding that the VOC profile of infected plants is detectably different from that of healthy plants, when measured from both ambient VOC emissions and VOCs extracted from leaf material. Predicting infection status was successful from ambient volatiles, which had a mean area under the curve (AUC) value of 0.71 ± 0.17, derived from corresponding receiver operating characteristic curves from an extreme gradient boosting discriminant analysis. This finding compares with that of extracted leaf volatiles, which resulted in a lower AUC value of 0.51 ± 0.21. In a growth chamber, we contrasted volatile profiles of asymptomatic Rhododendron plants having roots infected with one of three pathogens: P. ramorum, P. cactorum, and Rhizoctonia solani. Each pathogen induced unique and measurable changes, but generally the infections reduced volatile emissions until 17 weeks after inoculation, when emissions trended upward relative to those of mock-inoculated controls. Forty-five compounds had significant differences compared with mock-inoculated controls in at least one host–pathogen combination.
Implementation of Cognitive Behavioral Therapy With Cognitive Restructuring Technique to Reduce Psychosocial Anxiety in the COVID-19 Outbreak
Authors: Fadhli Teuku , Situmorang Dominikus David Biondi
Published: February 2021

Objectives:

Anxiety can cause someone to be counterproductive or experience psychological disorders, causing discomfort in social activities, less active participation in behavior. This study aims to prove the effectiveness of cognitive behavioral therapy (CBT) approach and the cognitive restructuring (CR) technique to reduce individual psychosocial anxiety through group counseling, which covers high school adolescents. The CBT approach with the CR technique for dealing with personal psychosocial anxiety provides valuable space for movement. The CBT approach with the CR technique will change the maladaptive beliefs that arise because of anxiety. This intervention aims to increase self-defense and self-control by stimulating rational problem-solving abilities, social skills, and active participation in social activities.

Methods:

The research method was a nonequivalent group pretest-posttest design with a control or comparison group. On the basis of the paired sample t test, there is a significant difference in the mean. The results showed that the CBT approach with the CR technique effectively reduced psychosocial anxiety in the COVID-19 outbreak.

Conclusions:

The results showed that the CBT approach with the CR technique effectively reduced psychosocial anxiety in the COVID-19 outbreak.
Fatty liver index and left ventricular mass: prospective associations from two independent cohorts
Authors: Li Xiang , Heiskanen Jarkko S. , Ma Hao , Heianza Yoriko , Guo Yajun , Kelly Tanika N. , He Hua , Fonseca Vivian A. , Chen Wei , Harville Emily W. , Ruohonen Saku , Hutri-Kähönen Nina , Bazzano Lydia A. , Raitakari Olli T. , Qi Lu
Published: February 2021

Objectives:

Heart disease is the most common cause of death in patients with nonalcoholic fatty liver disease (NAFLD). Emerging data have shown that NAFLD may affect subclinical myocardial remodeling, mainly left ventricular hypertrophy; however, evidence from the prospective studies is still lacking.

Methods:

Prospective analyses were performed to investigate the association of fatty liver index (FLI) with left ventricular mass (LVM) among 1962 participants from the Bogalusa Heart Study (BHS, 1995–2010) and 1547 participants from the Cardiovascular Risk in Young Finns Study (YFS, 2001–2011) free of cardiovascular diseases (CVD) at baseline. LVM was assessed by two-dimensional guided M-mode echocardiography and indexed (LVMI) to body height (m2.7). Multivariable regression models were applied after adjustment for traditional CVD risk factors.

Results:

In both cohorts, we observed significant and positive associations between FLI and LVM (BHS: β=0.59, P < 0.001; YFS: β=0.41, P < 0.001) and LVMI (BHS: β=0.14, P < 0.001; YFS: β=0.09, P < 0.001). In addition, we found that the relationship between FLI and LVMI was stronger in women than men (BHS: P-interaction = 0.01; YFS: P-interaction < 0.01); and the relationship between FLI and LVM/LVMI was stronger in black than white individuals (LVM: P-interaction = 0.02; LVMI: P-interaction = 0.04). Moreover, we found that the associations of FLI with LVM and LVMI were attenuated by high physical activity, especially in BHS (P-interaction = 0.02).

Conclusion:

Our findings from two independent prospective cohorts indicate that FLI is positively associated with LVM/LVMI, independent of traditional cardiovascular risk factors. Such relationships are more pronounced among women and black individuals and are attenuated by high physical activity.
The aortic-femoral arterial stiffness gradient: an atherosclerosis risk in communities (ARIC) study
Authors: Stone Keeron , Fryer Simon , Meyer Michelle L. , Kucharska-Newton Anna , Faulkner James , Zieff Gabriel , Paterson Craig , Credeur Daniel , Matsushita Kunihiro , Hughes Timothy M. , Tanaka Hirofumi , Stoner Lee
Published: February 2021

Background:

The aortic to femoral arterial stiffness gradient (af-SG) may be a novel measure of arterial health and cardiovascular disease (CVD) risk, but its association with CVD risk factors and CVD status, and whether or not they differ from the referent measure, carotid-femoral pulse-wave velocity (cfPWV), is not known.

Method:

Accordingly, we compared the associations of the af-SG and cfPWV with (i) age and traditional CVD risk factors and (ii) CVD status. We evaluated 4183 older-aged (75.2 ± 5.0 years) men and women in the community-based Atherosclerosis Risk in Communities (ARIC) Study. cfPWV and femoral-ankle PWV (faPWV) were measured using an automated cardiovascular screening device. The af-SG was calculated as faPWV divided by cfPWV. Associations of af-SG and cfPWV with age, CVD risk factors (age, BMI, blood pressure, heart rate, glucose and blood lipid levels) and CVD status (hypertension, diabetes, coronary heart disease, heart failure, stroke) were determined using linear and logistic regression analyses.

Results:

(i) the af-SG and cfPWV demonstrated comparable associations with age and CVD risk factors, except BMI. (ii) a low af-SG was associated with diabetes, coronary heart disease, heart failure and stroke, whilst a high cfPWV was only associated with diabetes.

Conclusion:

Although future studies are necessary to confirm clinical utility, the af-SG is a promising tool that may provide a unique picture of hemodynamic integration and identification of CVD risk when compared with cfPWV.
How much oxygen for the injured brain – can invasive parenchymal catheters help?
Authors: Leach Matthew R. , Shutter Lori A.
Published: February 2021

Purpose of review

Each year in the United States there are over 2.5 million visits to emergency departments for traumatic brain injury (TBI), 300,000 hospitalizations, and 50,000 deaths. TBI initiates a complex cascade of events which can lead to significant secondary brain damage. Great interest exists in directly measuring cerebral oxygen delivery and demand after TBI to prevent this secondary injury. Several invasive, catheter-based devices are now available which directly monitor the partial pressure of oxygen in brain tissue (PbtO2), yet significant equipoise exists regarding their clinical use in severe TBI.

Recent findings

There are currently three ongoing multicenter randomized controlled trials studying the use of PbtO2 monitoring in severe TBI: BOOST-3, OXY-TC, and BONANZA. All three have similar inclusion/exclusion criteria, treatment protocols, and outcome measures. Despite mixed existing evidence, use of PbtO2 is already making its way into new TBI guidelines such as the recent Seattle International Brain Injury Consensus Conference. Analysis of high-fidelity data from multimodal monitoring, however, suggests that PbtO2 may only be one piece of the puzzle in severe TBI.

While current evidence regarding the use of PbtO2 remains mixed, three ongoing clinical trials are expected to definitively answer the question of what role PbtO2 monitoring plays in severe TBI.
Acupuncture for behavioral and psychological symptoms of dementia
Authors: Kwon Chan-Young , Lee Boram
Published: February 2021

Background:

Dementia is a major mental health problem worldwide, and an optimal anti-dementia drug that could modify its core symptoms has not been developed yet. Behavioral and psychological symptoms of dementia (BPSD), an important clinical manifestation of dementia, is closely related to disease burden, caregiver burden, and consequent social burden. In general, many experts and international guidelines prefer non-pharmacological interventions, including psychosocial intervention, and complementary and integrative medicine in the management of BPSD. However, in clinical settings, psychotropic drugs are frequently used; therefore, the need to establish and actively use effective non-pharmacological interventions is emphasized. Therefore, in this systematic review, we will evaluate the effectiveness and safety of acupuncture, a promising non-pharmacological complementary and integrative medicine, for BPSD.

Methods and analysis:

A comprehensive search will be conducted in 13 electronic medical databases. Regardless of its design, original clinical studies, such as randomized controlled clinical trials, nonrandomized controlled clinical trials, and before-after studies, will be included to assess the beneficial effects and safety of acupuncture on BPSD. The severity of BPSD symptoms assessed by the validated tool will be considered as a primary outcome. The secondary outcome included the total effective rate, daily living activities and quality of life of patients, burden and quality of life of caregiver, placement in a long-term care facility from home, and safety data. The study selection, data extraction, and quality assessment process were performed by 2 independent researchers. The methodological quality of the included studies will be assessed using validated tools according to its design, such as the Cochrane Collaboration's risk of bias tool. RevMan version 5.3 will be used to perform the meta-analysis, with mean differences for continuous outcomes and risk ratio for binary outcomes, and 95% confidence intervals. A fixed- or random-effects model will be used according to the heterogeneity and number of included studies.

Ethics and dissemination:

As this protocol is for a systematic review, ethical approval is not required. The results of the systematic review will be disseminated by the publication of a manuscript in a peer-reviewed journal or presentation at a relevant conference.

Registration number:

OSF (URL: https://osf.io/hu5ac), PROSPERO (CRD42020211005) (URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020211005).
Effects of tonifying kidney and strengthen bone therapy on non-dialysis patients with chronic kidney disease-mineral and bone disorder
Authors: Wu Zijian , Li Liang , Wu Guiling , Xie Youqiong , Li Jia , Peng Rui
Published: February 2021

Background:

Correction of calcium (Ca), phosphorus (P), and parathyroid hormone (PTH) disorders is the standard of treatment in non-dialysis patients with chronic kidney disease-mineral and bone disorder (CKD-MBD), but the side effects and adverse reactions brought by western medicine (WM) are still the main problems. More importantly, the lack of protection of kidney function in the treatment greatly affects the health of patients. Although traditional Chinese medicine (TCM), specifically tonifying kidney and strengthen bone (TKSB) therapy is wildly applied for patients with CKD-MBD in China, the evidence of TKSB therapy in the treatment of CKD-MBD is limited. Thus, we pretent to conduct this protocol to evaluate the efficacy and safety of TKSB therapy combined with WM for non-dialysis patients with CKD-MBD.

Methods:

A system research of randomized controlled trials (RCTs) of TKSB therapy for CKD-MBD will be conducted by 2 investigators from 7 electronic databases. Methodological quality evaluations will be performed by using the Cochrane collaboration tool and data analysis will be conducted by RevMan V5.3 software and STATA v15.0.

Results:

The results of this paper will be submitted to a peer-reviewed journal for publication.

Conclusion:

This research will determine the safety and efficacy of TKSB therapy in treating non-dialysis patients with CKD-MBD.

INPLASY registration number:

INPLASY2020120086
Correlation study of CYP2C19 gene polymorphism and clopidogrel resistance in Han Chinese patients with cerebral infarction in Guizhou region
Authors: Shi Guo-Xian , Zhao Zi-He , Yang Xiao-Yan , Lin Mu , Chen Zhou-Xue
Published: February 2021

This study conducts a correlation exploration of CYP2C19 gene polymorphism and clopidogrel resistance in Han Chinese patients with cerebral infarction in Guizhou Region.

A total of 270 Han Chinese patients with cerebral infarction, who were hospitalized in our hospital from January 2016 to January 2018, are selected. These patients were divided into 2 groups, clopidogrel resistance group (n = 60) and clopidogrel sensitive group (n = 210). According to the TEG results, the CYP2C19 gene polymorphism detection was carried out by using the PCR-RFLP method, while IL-6 level in the patient's blood was measured by using the ELISA method.

The resistance group occupies 22.22%. The platelet inhibition ratio of the resistance group was 23 ± 7%, which was significantly lower than that of the sensitive group (65 ± 13%), and the difference was statistically significant (P < .05). The Logisitic regression analysis revealed that the history of diabetes, history of high blood pressure, increase in low density lipoprotein and CYP2C19 mutant gene were independent risk factors of clopidogrel resistance. After treatment, the serum IL-6 level of patients in the resistance group was 17.21 ± 0.98 ng/L, which was significant higher than that of patients in the sensitive group (11.21 ± 0.68 ng/L), and the difference was statistically significant (P < .05).

Patients with cerebral infarction in Guizhou region have a higher occurrence rate of clopidogrel resistance. Clopidogrel resistance not only will weaken the anti-inflammatory action of the drug, but also correlates with the patient's CYP2C19 mutant gene and blood lipid level.
Effect of SGLT inhibitors on weight and lipid metabolism at 24 weeks of treatment in patients with diabetes mellitus
Authors: Chen Mao-bing , Wang Hua , Cui Wei-yan , Xu Hua-lan , Zheng Qi-han
Published: February 2021

Background:

The goals of improving quality of life and increasing longevity are receiving growing amounts of attention. Body weight and lipid metabolism are closely related to various complications of diabetes. The aim of this study was to rank SGLT inhibitors according to their efficacy with regard to weight and evaluate the effect of SGLT inhibitors on lipid metabolism at 24 weeks of treatment.

Methods:

The Web of Science, PubMed, Cochrane Library, Embase, and Clinical Trials databases were electronically searched to collect randomized controlled trials involving patients with type 2 diabetes mellitus through June 2020. Two researchers independently screened and evaluated the selected studies and extracted the outcome indexes. ADDIS 1.16.5 and STATA 16 software were used to perform the network meta-analysis and draw the plots.

Results:

Ultimately, 36 studies were selected and included in this study. We found that all SGLT inhibitors were effective at reducing weight; canagliflozin was the most effective. SGLT inhibitors and placebo were not associated with significantly different serum cholesterol levels. SGLT inhibitors lowered serum triglyceride levels and increased serum high-density and low-density lipoprotein cholesterol levels. SGLT inhibitors also reduced the level of alanine aminotransferase.

Conclusions:

SGLT inhibitors can bring about weight loss in patients with T2DM and can also improve lipid metabolism. Therefore, patients with hyperlipidemia who have been unsuccessful at losing weight should consider taking SGLT inhibitors. In addition, SGLT inhibitors are hepatoprotective and appear to be safe for patients with mild to moderate liver dysfunction.

Trial Registration:

CRD42020198516.
Association of clinical and laboratory variables with in-hospital incidence of deep vein thrombosis in patients after acute ischemic stroke
Authors: Huang Yucai , Guo Cuirong , Song Kun , Li Changluo , Ding Ning
Published: February 2021

Deep vein thrombosis (DVT) is a serious complication in patients with acute ischemic stroke (AIS). Early prediction of DVT could enable physicians to perform a proper prevention strategy. We analyzed the association of clinical and laboratory variables with DVT to evaluate the risk of DVT in patients after AIS.

AIS patients admitted to the Changsha Central Hospital between January 2017 and December 2019 with length of stay in hospital ≥7 days were included. Clinical and laboratory variables for DVT at baseline were collected, and the diagnosis of DVT was confirmed by ultrasonography. Independent factors were developed by Multivariate logistic regression analysis.

A total of 101 patients were included in the study. The in-hospital incidence of DVT after AIS was 19.8%(20/101). The average level of D-dimer when DVT detected was significant increased around 4-fold than that on admission (P < .001). Pulmonary infection (odds ratio [OR] = 5.4, 95%CI:1.10–26.65, P = .037)) and increased muscle tone (OR = 0.11, 95%CI:0.02–0.58, P = .010) as independent relevant factors for DVT were confirmed.

Pulmonary infection as a risk factor and increased muscle tone as a protective factor for DVT were identified in patients after AIS. The level of D-dimer which increased around 4-fold compared to the initial level could be an indicator for DVT occurrence.
The use of forest plot to identify article similarity and differences in characteristics between journals using medical subject headings terms
Authors: Yan Yu-Hua , Chien Tsair-Wei
Published: February 2021

Background:

Comparison of similarity and difference in research types among journals are concerned in literature. However, to date, none display the methodology seen in selecting similar journals related to the target journal, as similar articles did to a given article. Authors need 1 effective method not only to find similar journals for their studies but also to know the difference in methods. This study (1) shows the similar journals for the target journal online displayed, and (2) identifies the effect of similarity odds ratio compared to the counterparts using the forest plots in Meta-analysis and the major medical subject headings (MeSH terms).

Methods:

We downloaded 1000 recent top 20 most similar articles related to the Respiratory Care journal from the PubMed library, plotted the clusters of related journals using social network analysis (SNA), and compared the MeSH terms in differences in an odds ratio unit using the forest plot relevant to Respiratory Care and the most similar journals. Q statistic and I-square (I
2) index were used to evaluate the difference in the proportion of events.

Results:

This study found that (1) the journals related to Respiratory Care are easily presented on Google Maps; (2) 10 journal clusters were identified using SNA; (3) the top 3 MeSH terms are methods, therapy, and physiopathology, and (4) the odds ratios of MeSH terms between journals associated with the Respiratory Care showing different from Int J Chron Obstruct Pulmori Dis and similar to Curr Opin Endocrinol Diabetes Obes within heterogeneity with I
2 = 70.5% (P < 0.001) and 0% (P = 0.803), respectively.

Conclusions:

SNA and forest plots provide deep insight into the relationships between journals in MeSH terms. The results of this research can provide readers with a concept diagram that can be used for future submissions to a given journal.
Circulating microRNAs as candidate biomarkers for the ovarian response during in vitro fertilization
Authors: Zhao Hongjuan , Wang Liyan , Wang Yu
Published: February 2021

MicroRNAs (miRNAs) in the let-7 family have established regulatory roles in pregnancy; in this study, we evaluated whether miRNAs detectable in the circulation are associated with the ovarian response to stimulation.

In total, 25 patients with infertility were divided into 3 groups: poor response (n = 9), moderate response (n = 8), and hyper-response (n = 8). Serum and endometrial tissue samples on the second day of the menstrual phase, serum samples during the mid-luteal phase, and follicular fluid samples were collected from women undergoing in vitro fertilization. The levels of let-7g-5p, let-7f-5p, and let-7i-5p in were evaluated.

The levels of circulating let-7g-5p,7f-5p, and 7i-5p in the basal sera were significantly higher in the moderate ovarian response group than in the poor response group (P < .05). The expression levels of these genes tended to be down-regulated in the mid-luteal phase in the high response group (P < .05). There were no significant differences in expression levels in the endometria and follicular fluid among groups (P > .05).

Circulating let-7g-5p, 7f-5p, and 7i-5p were differentially expressed between the moderate response group and the high and poor response groups. The combination of these serum miRNAs during the menstrual phase might serve as a non-invasive predictive marker for the ovarian response to in vitro fertilization.