bluuebunny/crossref_metadata_2025 huggingface dataset:
Street‐levelbureaucrats' emotional intelligence and its relation with their performance
Authors: Eshuis Jasper , de Boer Noortje , Klijn Erik Hans
Published: February 2022

This article analyses whether the emotional intelligence (EI) of street‐level bureaucrats, in this case inspectors, predicts their individual performance. It explores whether EI predicts the aggression that inspectors face and whether this explains the relation between EI and performance. Our survey among 547 inspectors, measuring their (self) perceptions, shows that inspectors' ability to appraise others' emotions and use their emotions intelligently (i.e., motivating themselves and maintaining a positive attitude) is significantly associated with inspectors' performance. Ability to appraise others' emotions predicts increases encountered aggression (as perceived by inspectors), and capacity to regulate one's emotions correlates with decreased perceived encountered aggression. The paper contributes to street‐level bureaucracy literature by identifying affective factors that help explain performance, and to EI literature by theorizing and testing succedents of various dimensions of EI rather than assuming that EI is unidimensional.

Dit artikel verkent of de emotionele intelligentie (EI) van inspecteurs hun individuele prestaties voorspelt. Er wordt onderzocht of EI verklarend is voor de agressie waarmee inspecteurs te maken krijgen, en of deze ondervonden agressie vervolgens de prestaties verklaart. Uit dit onderzoek waarin we de (zelf)perceptie van 547 inspecteurs hebben gemeten, blijkt dat het vermogen van inspecteurs om emoties van anderen in te schatten en hun eigen emoties intelligent te gebruiken (d.w.z. zichzelf te motiveren en een positief te blijven) significant samenhangt met de prestaties van inspecteurs. Het vermogen om emoties van anderen in te schatten voorspelt een toename van agressie die inspecteurs ondervinden, en het vermogen om hun eigen te emoties te reguleren correleert met een afname van ondervonden agressie. Het artikel draagt bij aan de literatuur over contactambtenaren (street‐level bureaucracy) door affectieve factoren te identificeren die prestaties helpen verklaren, en aan de EI‐literatuur door verschillende dimensies van EI te theoretiseren en te testen in plaats van aan te nemen dat EI eendimensionaal is.
The cell‐type specific role of Arabidopsis bZIP59 transcription factor in plant immunity
Authors: Song Zhiqiang , Zhang Cheng , Jin Pinyuan , Tetteh Charles , Dong Xueshuo , Luo Sheng , Zhang Siyi , Li Xinyuan , Liu Yingjun , Zhang Huajian
Published: February 2022

Stomatal movement participates in plant immunity by directly affecting the invasion of bacteria, but the genes that regulate stomatal immunity have not been well identified. Here, we characterised the function of the bZIP59 transcription factor from Arabidopsis thaliana, which is constitutively expressed in guard cells. The bzip59 mutant is partially impaired in stomatal closure induced by Pseudomonas syringae pv. tomato strain (Pst) DC3000 and is more susceptible to Pst DC3000 infection. By contrast, the line overexpressing bZIP59 enhances resistance to Pst DC3000 infection. Furthermore, the bzip59 mutant is also partially impaired in stomatal closure induced by flagellin flg22 derived from Pst DC3000, and epistasis analysis revealed that bZIP59 acts upstream of reactive oxygen species (ROS) and nitric oxide (NO) and downstream of salicylic acid signalling in flg22‐induced stomatal closure. In addition, the bzip59 mutant showed resistance and sensitivity to Sclerotinia sclerotiorum and Tobacco mosaic virus that do not invade through stomata, respectively. Collectively, our results demonstrate that bZIP59 plays an important role in the stomatal immunity and reveal that the same transcription factor can positively and negatively regulate disease resistance against different pathogens.
The microbial controls on the deposition of Pb‐Zn minerals in carbonate‐hosted Tunisian ore deposits
Authors: Abidi Riadh , Slim‐Shimi Najet , Marignac Christan , Somarin Alireza K. , Renac Christophe , Deloule Etienne , Hatira Nouri , Gasquet Dominique
Published: February 2022

The Ain Allega, Mjar Hannech and Sidi Driss Pb‐Zn‐Ba‐Sr‐As‐(Hg) deposits in northern Tunisia are hosted in a post‐nappe anticline with a core of a Triassic evaporite diapir affected by the NE–SW‐trending Ghardimaou‐Cap Serrat and E‐W lineament. The ore minerals show different styles; particularly, impregnation in dolomite, cement of breccias, replacement ore and open space filling in the dissolution cavities and fractures. Ore minerals include sphalerite, galena, marcasite, pyrite and cinnabar. Principal gangue minerals are composed of barite, celestine, calcite, dolomite and quartz. The orebodies are hosted by Triassic carbonate rocks (Ain Allega ore deposits), Cretaceous carbonate rocks (Mjar Hannech ore deposits) and by the volcanoclastic layers (Sidi Driss ore deposits). These host rocks show hydrothermal alteration, dissolution and brecciation. Sphalerite in the carbonate‐hosted Zn‐Pb deposits in Tunisia occurs as nano‐size microglobular blebs and peloids and forms finely‐laminated bands with wavy and even ripped up features. Peloids are present in collapse breccias of karst cavities. Peloids (5–100 μm) and bacterial filaments (1 μm long) locally form the common micro‐texture of the sulfide mineralization. The core and the shell of peloids are composed of different minerals; there are 1–3 shells and each shell is 1–1.5 μm thick, commonly with coarse crystals. These textures probably represent fossil microbial mats as in‐situ sulfate‐reducing bacteria products and are similar to nano‐textures observed in bacterial biofilms. Electron microscopy, combined with major element changes (Zn, Pb, As, Fe, and Cd) and sulfur isotope values suggest that sphalerite nano‐textures and nano‐spheres are associated with fossilized bacterial‐mat. The δ34S values of sphalerite (−43.9 to +22.38‰) show that the microbial production of H2S controlled sphalerite precipitation. The biogenic nano‐ to macro‐textured sphalerite and sulfur isotope data suggest that microbes had an important role in the genesis of carbonate‐hosted Zn‐Pb deposits in Tunisia during the Miocene.
Oophorectomy or ovarian conservation at the time of hysterectomy for benign disease
Authors: Asfour Victoria , Jakes Adam D , McMicking Jess , Szetho Wei Zian , Sayasneh Ahmad , Diab Yasser , Mascarenhas Lawrence , Rymer Janice
Published: February 2022

Key content

Bilateral salpingo‐oophorectomy is indicated for patients with suspected or confirmed gynaecological malignancy.

Risk reduction surgery is indicated in patients with a significant family history or a genetic predisposition to developing breast or ovarian cancer.

Bilateral salpingectomy with ovarian conservation reduces the risk of ovarian cancer, whilst preserving ovarian function.

Oophorectomy prior to the menopause is associated with increased all‐cause mortality and significant menopause related morbidity.

Conservative measures such as weight loss, family planning and lifestyle advice could reduce the overall lifetime risk of ovarian cancer.

Learning objectives

To understand the rationale of the decision‐making process for bilateral salpingo‐oophorectomy or bilateral salpingectomy with ovarian conversation at the time of hysterectomy for benign disease.

To understand the risk–benefit balance of performing oophorectomy in the context of risk reduction of high‐risk patients compared with patients with no genetic predisposition or family history.

To consider conservative risk reduction measures that do not involve oophorectomy.

Ethical issues

In the absence of family history or genetic predisposition to ovarian or breast cancer, is it ethical to perform routine oophorectomy in perimenopausal or even postmenopausal women?

Is it ethical to reduce the risk of ovarian cancer while increasing all‐cause mortality and menopause‐related morbidity?

Is it ethical to offer bilateral salpingectomy as a female sterilisation procedure?
A case report of the beneficial effect of oclacitinib in a dog with pemphigus vulgaris
Authors: Martinez Nicola , McDonald Beth , Crowley Ann
Published: February 2022

Pemphigus vulgaris is a rare immune‐mediated skin disorder of the dog, usually treated with immunosuppressive medications such as oral glucocorticoids, azathioprine or ciclosporin. Herein we report the successful treatment of pemphigus vulgaris in a dog, using oclacitinib and a topical product containing fucidic acid (0.5 % w/w) and betamethasone valerate.
Comparing diagnostic findings and cost of whole body computed tomography to traditional diagnostic imaging in polytrauma patients
Authors: Sepuya Rebecca G. , Dozeman Emily T. , Prittie Jennifer E. , Fischetti Anthony J. , Weltman Joel G.
Published: February 2022

Objective

To compare the diagnostic utility of traditional diagnostic tests (ie, radiographs and focused assessment using sonography for trauma [FAST] scans) to whole‐body computed tomography (WBCT) for characterizing injuries in polytrauma patients. A secondary objective was to compare costs of traditional diagnostic tests to WBCT.

Design

Prospective, observational study.

Setting

Private, level 1 veterinary trauma center.

Animals

Convenience sample of 21 client‐owned cats and dogs presenting with polytrauma.

Interventions

Abdominal and thoracic FAST were performed by the primary clinician, if indicated. Radiographs were performed on areas concerning for trauma at the primary clinician's discretion. A WBCT was performed on each patient within 24 h of presentation and was blindly interpreted by a board‐certified radiologist. Patients were only placed under anesthesia if further procedures were planned. IV contrast administration was employed at the discretion of the primary clinician and radiologist.

Measurements and Main Results

Twenty‐one patients (14 dogs and 7 cats) were enrolled. Sources of trauma included blunt force (80%), penetrating wounds (10%), and unknown sources (10%). Twelve injuries were missed on traditional diagnostics tests. Injuries missed on traditional diagnostic workup included pneumothorax, pneumomediastinum, pulmonary contusions, pleural effusion, traumatic bulla, peritoneal effusion, and an appendicular skeleton fracture. A distal metacarpal fracture was missed on WBCT. Traditional diagnostic tests misdiagnosed a diaphragmatic hernia and a ruptured urinary bladder, whereas WBCT was able to rule out these injuries. There were no adverse outcomes associated with missed injuries. The median cost of traditional diagnostic tests was significantly less than the cost of WBCT (P < 0.001).

Conclusions

Although cost is higher, WBCT is a single test that can provide more comprehensive information and may help decrease the risk of missed injuries compared to traditional diagnostic tests. WBCT may be considered as a first‐line diagnostic in severely traumatized patients.
Heat Transfer Analysis of Cu–Water Nanofluid in a District Cooling Chilled Water Loop
Authors: Abdellatif Yasser M. , Okonkwo Eric C. , Beitelmal AbdlMonem H. , Al-Ansari Tareq
Published: February 2022

Nanofluids consist of nanoparticles made of materials with high thermal conductivity suspended in a base fluid such as water. In theory, the presence of thermally conductive nanoparticles in a base fluid improves the heat transfer performance of the resulting nanofluid. This article numerically investigates the impact of nanoparticles on the energy performance of a district cooling system. The current work focuses on using Cu–water nanofluid as the working fluid for the secondary chilled water loop. It examines the effect of varying the nanoparticles concentration, nanofluid flowrate, and return temperature on the system energy performance. The numerical model is built using the engineering equation solver (EES) and validated using operational data obtained from the McQuay chilled water system operating in one of the university central facility plants. In the current numerical model, the Reynolds number in the shell side of the heat exchanger is varied between 2200 and 8800 at a volume fraction of 0.02. The result shows that for a fixed cooling capacity of 280 kW, the Cu–water nanofluid reduced the mass flowrate by 4.8% and the corresponding pump work input by 33.6%. This improved energy performance of the circulating water reduced the overall chiller system work input by 3.8% and increased the corresponding system coefficient of performance (COP) by 3.9%. The current findings reveal the potential impact and opportunity of nanofluids on the effectiveness of the district cooling system chiller water loop and the associated overall energy performance.
Passive acoustic tracking of an unmanned underwater vehicle using bearing-Doppler-speed measurements
Authors: Kita Kristen Railey , Randeni Supun , DiBiaso Dino , Schmidt Henrik
Published: February 2022

Tracking unmanned underwater vehicles (UUVs) in the presence of shipping traffic is a critical task for passive acoustic harbor security systems. In general, vessels can be tracked by their unique acoustic signature caused by machinery vibration and cavitation noise. However, cavitation noise of UUVs is quiet relative to that of ships. Furthermore, tracking a target with bearing-only measurements requires the observing platform to maneuver. In this work, it is demonstrated that it is possible to passively track an UUV from its high-frequency motor noise using a stationary array in a shallow-water experiment with passing boats. The motor noise provides high signal-to-noise ratio measurements of the bearing, range rate, and speed, which we combined in an unscented Kalman filter to track the target. First, beamforming is applied to estimate the bearing. Next, the range rate is calculated from the Doppler effect on the motor noise. The propeller rotation rate can be estimated from the motor signature and converted to speed using a pre-identified model of the robot. The bearing-Doppler-speed measurements outperformed traditional bearing-Doppler target motion analysis: the bearing, bearing rate, range, and range rate accuracy improved by a factor of 2×, 16×, 3×, and 6×, respectively. Finally, the robustness of the tracking solution to an unknown vehicle model is evaluated.
Underlying mechanism of shear-banding in soft glasses of charged colloidal rods with orientational domains
Authors: Parisi D. , Vlassopoulos D. , Kriegs H. , Dhont J. K. G. , Kang K.
Published: February 2022

Soft glasses of colloidal rods (fd-virus particles) with orientational domains were recently shown to exhibit inhomogeneous flow profiles [Dhont et al., Phys. Rev. Fluids 2, 043301 (2017)]: fracture and accompanied plug flow at small shear rates, which transits to gradient shear-banding on increasing the shear rate, while a uniform flow profile develops at sufficiently high shear rates. These flow profiles coexist with Taylor-vorticity bands. The texture of such glasses under flow conditions consists of domains with varying orientations. The observed gradient shear-banding was solely attributed to the strong shear thinning behavior of the material inside the domains (henceforth abbreviated as domain-interior), without considering the texture stress that is due to interactions between the glassy domains. Here, we present new experiments on the shear-banding transition to assess the role played by the texture stress in comparison to the domain-interior stress. For a large concentration, well into the glassy state, it is found that both texture stress and domain-interior stress contribute significantly to the gradient shear-banding transition in the shear-rate region where it occurs. On the other hand, for a small concentration close to the glass-transition concentration, the domains are shown to coalesce within the shear-rate range where gradient shear-banding is observed. As a result, the texture stress diminishes and the domain-interior stress increases upon coalescence, leading to a stress plateau. Thus, a subtle interplay exists between the stresses arising from the structural order on two widely separated length scales from interactions between domains and from the rod-rod interactions within the domain-interior for both concentrations.
Postmatch Recovery Practices Carried Out in Professional Football: A Survey of 56 Portuguese Professional Football Teams
Authors: Querido Sérgio M. , Brito João , Figueiredo Pedro , Carnide Filomena , Vaz João R. , Freitas Sandro R.
Published: February 2022

Background: In football (ie, soccer), the effectiveness of recovery practices is critical to maintain high levels of performance, prevent residual fatigue, and reduce injury risk. However, the recovery methods that professional football teams put in place up to 72 hours postmatch are widely unknown. Purpose: This study aimed to characterize the postmatch recovery practices in Portuguese football teams in different postmatch periods and match locations. Methods: Portuguese football teams (total, N = 56; male: first league [n = 17], second league [n = 16], under-23 league [n = 12]; female: first league, n = 11) participated in the study. The practitioners in charge of recovery strategies in each team filled out the online questionnaire in the middle of the 2019–20 season. The questions focused on the type of recovery methods to be used at different times after home and away matches. Results: After home matches, stretching, electrostimulation, active recovery, and massage were used with higher frequency (P < .017) in later postmatch periods (ie, 12–24, and 24–72 h) compared with immediately postmatch. After away matches, several differences were found (P < .017) for the stretching, electrostimulation, active recovery, cold-water immersion, massage, nutrition, and sleep between postmatch periods. Regarding match location, stretching (r = .19), active recovery (r = .39), cold-water immersion (r = .46), and massage (r = .29) showed a higher frequency of use immediately after home matches. Conversely, the use of compression garments (r = .27) was higher immediately after away matches. Conclusions: It was concluded that in professional football, recovery methods are not applied uniformly along postmatch periods and differ depending on the match location.
Trained ILC3 responses promote intestinal defense
Authors: Serafini Nicolas , Jarade Angélique , Surace Laura , Goncalves Pedro , Sismeiro Odile , Varet Hugo , Legendre Rachel , Coppee Jean-Yves , Disson Olivier , Durum Scott K. , Frankel Gad , Di Santo James P.
Published: February 2022

Group 3 innate lymphoid cells (ILC3s) are innate immune effectors that contribute to host defense. Whether ILC3 functions are stably modified after pathogen encounter is unknown. Here, we assess the impact of a time-restricted enterobacterial challenge to long-term ILC3 activation in mice. We found that intestinal ILC3s persist for months in an activated state after exposure to
Citrobacter rodentium
. Upon rechallenge, these “trained” ILC3s proliferate, display enhanced interleukin-22 (IL-22) responses, and have a superior capacity to control infection compared with naïve ILC3s. Metabolic changes occur in
C. rodentium
–exposed ILC3s, but only trained ILC3s have an enhanced proliferative capacity that contributes to increased IL-22 production. Accordingly, a limited encounter with a pathogen can promote durable phenotypic and functional changes in intestinal ILC3s that contribute to long-term mucosal defense.
Rethinking the A cation in halide perovskites
Authors: Lee Jin-Wook , Tan Shaun , Seok Sang Il , Yang Yang , Park Nam-Gyu
Published: February 2022

The A cation in ABX
3
organic-inorganic lead halide perovskites (OLHPs) was conventionally believed to hardly affect their optoelectronic properties. However, more recent developments have unraveled the critical role of the A cation in the regulation of the physicochemical and optoelectronic properties of OLHPs. We review the important breakthroughs enabled by the versatility of the A cation and highlight potential opportunities and unanswered questions related to the A cation in OLHPs.
Losing sleep with age
Authors: Jacobson Laura H. , Hoyer Daniel
Published: February 2022

Hypocretin neuron hyperexcitability underlies disrupted sleep quality associated with age
Supplemental Material: Greenland tidewater glacier advanced rapidly during era of Norse settlement
Authors: Pearce Danni M. , Mair Douglas W.F. , al. et
Published: February 2022

Detailed methods, Figures S1–S4, and Table S1.
SARS-CoV-2 antigen lateral flow tests for detecting infectious people: linked data analysis
Authors: Deeks Jonathan J , Singanayagam Anika , Houston Hamish , Sitch Alice J , Hakki Seran , Dunning Jake , Lalvani Ajit
Published: February 2022

Objectives

To investigate the proportion of lateral flow tests (LFTs) that produce negative results in those with a high risk of infectiousness from SARS-CoV-2, to investigate the impact of the stage and severity of disease, and to compare predictions made by influential mathematical models with findings of empirical studies.

Design

Linked data analysis combining empirical evidence of the accuracy of the Innova LFT, the probability of positive viral culture or transmission to secondary cases, and the distribution of viral loads of SARS-CoV-2 in individuals in different settings.

Setting

Testing of individuals with symptoms attending NHS Test-and-Trace centres across the UK, residents without symptoms attending municipal mass testing centres in Liverpool, and students without symptoms screened at the University of Birmingham.

Participants

Evidence for the sensitivity of the Innova LFT, based on 70 individuals with SARS-CoV-2 and LFT results. Infectiousness was based on viral culture rates on 246 samples (176 people with SARS-CoV-2) and secondary cases among 2 474 066 contacts; distributions of cycle threshold (Ct) values from 231 497 index individuals attending NHS Test-and-Trace centres; 70 people with SARS-CoV-2 detected in Liverpool and 62 people with SARS-CoV-2 in Birmingham (54 imputed).

Main outcome measures

The predicted proportions who were missed by LFT and viral culture positive and missed by LFT and sources of secondary cases, in each of the three settings. Predictions were compared with those made by mathematical models.

Results

The analysis predicted that of those with a viral culture positive result, Innova would miss 20% attending an NHS Test-and-Trace centre, 29% without symptoms attending municipal mass testing, and 81% attending university screen testing without symptoms, along with 38%, 47%, and 90% of sources of secondary cases. In comparison, two mathematical models underestimated the numbers of missed infectious individuals (8%, 10%, and 32% in the three settings for one model, whereas the assumptions from the second model made it impossible to miss an infectious individual). Owing to the paucity of usable data, the inputs to the analyses are from limited sources.

Conclusions

The proportion of infectious people with SARS-CoV-2 missed by LFTs is substantial enough to be of clinical importance. The proportion missed varied between settings because of different viral load distributions and is likely to be highest in those without symptoms. Key models have substantially overestimated the sensitivity of LFTs compared with empirical data. An urgent need exists for additional robust well designed and reported empirical studies from intended use settings to inform evidence based policy.
Efficacy of a meal sequence in patients with type 2 diabetes: a systematic review and meta-analysis
Authors: Okami Yukiko , Tsunoda Hideki , Watanabe Jun , Kataoka Yuki
Published: February 2022

Introduction

This systematic review investigated the efficacy of a meal sequence, the carbohydrate-later meal pattern (CL), on type 2 diabetes mellitus (T2DM).

Research design and methods

We searched the Cochrane Central Register of Controlled Trials, MEDLINE, Embase, WHO International Clinical Trials Registry Platform, and ClinicalTrials.gov until April 2020 to perform meta‐analyses using random-effects models. Primary outcomes were hemoglobin A1c (HbA1c) and quality of life. Secondary outcomes were plasma concentrations of glucose, insulin and incretin 120 min after a meal, and any adverse outcomes. The revised Cochrane risk-of-bias tool and Grading of Recommendations, Assessment, Development, and Evaluation approach were used to assess the quality of individual studies and the body of evidence, respectively. The present study was registered in the UMIN Clinical Trials Registry.

Results

We included 230 participants in eight trials, including both trials that examined long-term changes (more than 2 months and less than 2 years) and short-term changes (in 2-hour postprandial values). CL resulted in a slight to no difference in HbA1c (mean difference (MD), −0.21% in the intervention group; 95% CI −0.44% to+0.03%), plasma glucose (MD,+4.94 mg/dL; 95% CI −8.34 mg/dL to +18.22 mg/dL), plasma insulin (MD, −3.63 μIU/mL; 95% CI −11.88 μIU/mL to +4.61 μIU/mL), plasma GLP-1 (MD, +0.43 pmol/L; 95% CI −0.69 pmol/L to +1.56 pmol/L), and plasma GIP (MD, −2.02 pmol/L; 95% CI −12.34 pmol/L to +8.31 pmol/L). All of these outcomes were of low-certainty evidence or very low-certainty evidence. None of the trials evaluated quality of life or adverse events.

Conclusions

There was no evidence for the potential efficacy of recommending CL beyond standard dietary advice on T2DM.

Trial registration number

UMIN000039979.
Impact of paramedic education on door-to-balloon times and appropriate use of the primary PCI pathway in ST-elevation myocardial infarction
Authors: Mahadevan Kalaivani , Sharma Divyesh , Walker Christopher , Maznyczka Annette , Hobson Alex , Strike Philip , Griffiths Huw , Dana Ali
Published: February 2022

Objective

Evidence supports improved outcomes and reduced mortality with rapid reperfusion through primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). UK national audit data (Myocardial Ischaemia National Audit Project [MINAP]) demonstrates minor improvements in door-to-balloon times (DTB) of <90 min but increasing call-to-balloon times (CTB). We evaluate the effect of a regional Cardiologist delivered paramedic education programme (PEP) on DTB times and appropriate use of the PPCI pathway.

Methods

This was a prospective single-centre study of patients with STEMI brought directly to hospital via ambulance services. Data sources included ambulance charts, in-patient notes, British Cardiovascular Interventional Society (BCIS) database and local MINAP data. All DTB breaches were investigated. A local PEP was implemented with focus on ECG interpretation, STEMI diagnosis and appropriate use of the PPCI pathway. Non-parametric Wilcoxon rank test was used for comparisons of DTB and CTB times between direct versus ED-associated cath lab transfer.

Results

A total of 728 patients with STEMI were admitted directly to our centre via ambulance, 66% (n=484) directly to the Catheterisation Laboratory (Cath Lab) and 34% (n=244) via the Emergency Department (ED). There was a significant increase in median DTB, 83 vs 37 min (p<0.001) and median CTB 144 vs 97.5 min (p<0.001) when transfer to the Cath Lab occurred via the ED versus direct transfer. The PEP increased direct cath lab transfers (52%–85%) and generated annual reductions in median DTB times, with sustained improvement seen throughout the 7-year study period.

Conclusions

Paramedic education increases direct transfer of STEMI patients to the Cath Lab, and reduces DTB times. This is an effective and reproducible intervention to facilitate timely reperfusion in STEMI.
Association between multimorbidity, self-rated health and life satisfaction among independent, community-dwelling very old persons in Japan: longitudinal cohort analysis from the Kawasaki Ageing and Well-being Project
Authors: Ando Takayuki , Nishimoto Yoshinori , Hirata Takumi , Abe Yukiko , Takayama Midori , Maeno Takashi , Fujishima Seitaro , Takebayashi Toru , Arai Yasumichi
Published: February 2022

Objective

This study aimed to identify associations between multimorbidity and subjective health outcomes among the very old persons, after adjusting for coexisting conditions such as frailty and depression.

Study setting and participants

This was an observational cross-sectional study involving 1012 independent, community-dwelling very old persons (507 men, 505 women; aged 85–89 years) in Kawasaki city, Japan.

Outcome measures

The primary outcome was the cross-sectional associations between multimorbidity and poor self-rated health (SRH) and life satisfaction using binary logistic regression. The secondary outcome was the association of subjective health with each chronic condition.

Results

The prevalence of multimorbidity (≥2 conditions) was 94.7%, and the average number of chronic conditions was 4.47±1.9. Multimorbidity was significantly associated with poor SRH in the adjusted model only when six or more chronic conditions were present (OR 4.80; 95% CI 1.34 to 17.11; p=0.016). Cerebrovascular disease, heart disease, respiratory disease, connective tissue disease and arthritis showed significant associations with poor SRH after multivariate adjustment. Sex-specific analysis replicated associations between multimorbidity with six or more conditions and SRH in both men and women, while the diseases with the greatest impact on SRH differed between men and women. Most conditions were not associated with low satisfaction with life scale, with the exception of arthritis (OR 1.92, 95% CI 1.32 to 2.78, p=0.001).

Conclusions

Multimorbidity is prevalent in the independent, community-dwelling very old persons and is associated with poor SRH when six or more conditions are present; conditions causing mobility limitations, such as cerebrovascular disease, connective tissue disease and arthritis, have a negative impact on SRH.

Trial registration number

UMIN000026053.
Global prevalence and trends in hypertension and type 2 diabetes mellitus among slum residents: a systematic review and meta-analysis
Authors: Uthman Olalekan Abdulrahman , Ayorinde Abimbola , Oyebode Oyinlola , Sartori Jo , Gill Paramjit , Lilford R J
Published: February 2022

Objective

First, to obtain regional estimates of prevalence of hypertension and type 2 diabetes in urban slums; and second, to compare these with those in urban and rural areas.

Design

Systematic review and meta-analysis.

Eligibility criteria

Studies that reported hypertension prevalence using the definition of blood pressure ≥140/90 mm Hg and/or prevalence of type 2 diabetes.

Information sources

Ovid MEDLINE, Cochrane CENTRAL and EMBASE from inception to December 2020.

Risk of bias

Two authors extracted relevant data and assessed risk of bias independently using the Strengthening the Reporting of Observational Studies in Epidemiology guideline.

Synthesis of results

We used random-effects meta-analyses to pool prevalence estimates. We examined time trends in the prevalence estimates using meta-regression regression models with the prevalence estimates as the outcome variable and the calendar year of the publication as the predictor.

Results

A total of 62 studies involving 108 110 participants met the inclusion criteria. Prevalence of hypertension and type 2 diabetes in slum populations ranged from 4.2% to 52.5% and 0.9% to 25.0%, respectively. In six studies presenting comparator data, all from the Indian subcontinent, slum residents were 35% more likely to be hypertensive than those living in comparator rural areas and 30% less likely to be hypertensive than those from comparator non-slum urban areas.

Limitations of evidence

Of the included studies, only few studies from India compared the slum prevalence estimates with those living in non-slum urban and rural areas; this limits the generalisability of the finding.

Interpretation

The burden of hypertension and type 2 diabetes varied widely between countries and regions and, to some degree, also within countries.

PROSPERO registration number

CRD42017077381.
Identifying the latent classes of modifiable risk behaviours among diabetic and hypertensive individuals in Northeastern India: a population-based cross-sectional study
Authors: Marbaniang Strong P , Lhungdim Hemkhothang , Chungkham Holendro Singh
Published: February 2022

Objective

To identify the latent classes of modifiable risk factors among the patients with diabetes and hypertension based on the observed indicator variables: smoking, alcohol, aerated drinks, overweight or obesity, diabetes and hypertension. We hypothesised that the study population diagnosed with diabetes or hypertension is homogeneous with respect to the modifiable risk factors.

Design

A cross-sectional study using a stratified random sampling method and a nationally representative large-scale survey.

Setting and participants

Data come from the fourth round of the Indian National Family Health Survey, 2015–2016. Respondents aged 15–49 years who were diagnosed with either diabetes or hypertension or both were included. The total sample is 22 249, out of which 3284 were men and 18 965 were women.

Primary and secondary outcome measures

The observed variables used as latent indicators are the following: smoking, alcohol, aerated drinks, overweight or obesity, diabetes and hypertension. The concomitant variables include age, gender, education, marital status and household wealth index. Latent class model was used to simultaneously identify the latent class and to determine the association between the concomitant variables and the latent classes.

Results

Three latent classes were identified and labelled as class 1: ‘diabetic with low-risk lifestyle’ (21%), class 2: ‘high-risk lifestyle’ (8%) and class 3: ‘hypertensive with low-risk lifestyle’ (71%). Class 1 is characterised by those with a high probability of having diabetes and low probability of smoking and drinking alcohol. Class 2 is characterised by a high probability of smoking and drinking alcohol and class 3 by a high probability of having high blood pressure and low probability of smoking and drinking alcohol.

Conclusions

Co-occurrence of smoking and alcohol consumption was prevalent in men, while excess body weight and high blood pressure were prevalent in women. Policy and programmes in Northeastern India should focus on targeting multiple modifiable risk behaviours that co-occur within an individual.
Effect of in utero exposure to SARS-CoV-2 infection on pregnancy outcomes and growth and development of infants: protocol for a multicentre ambispective cohort study in India
Authors: Banerjee Rupsa , Neogi Sutapa B , Grover Ashoo , G S Preetha , Agrawal Usha
Published: February 2022

Introduction

Poor pregnancy and neonatal outcomes in infants born to COVID-19 positive mothers have been reported, but there is insufficient evidence regarding subsequent growth and development of these children. Our study aims to explore the effect of in-utero exposure to SARS-CoV-2 on pregnancy outcomes and growth and development of infants.

Methods and analysis

A multicentric ambispective cohort study with comparison group (1:1) will be conducted at six sites. A total of 2400 participants (exposure cohort, n=1200; comparison cohort, n=1200), ie, 400 participants from each site (200 retrospectively; 200 prospectively) will be included. Exposure cohort will be infants born to women with documented COVID-19 infection anytime during pregnancy and comparison cohort will be infants born to women who did not test positive for SARS-CoV-2 anytime during pregnancy. All infants will be followed up till 1 year of age. Anthropometric measurement, age of attainment of developmental milestones and clinical examination findings will be recorded at each follow-up. Data regarding possible cofactors affecting the outcomes will be collected from both groups and adjusted for during analysis. The two groups will be compared for prevalence of every variable considered in the study. Relative risk, attributable and population attributable risks will be calculated. All risk factors with p<0.1 on bivariate analysis will be subjected to multiple logistic regression analysis. A final multivariable model will be developed by including the statistically significant risk factors.

Ethics and dissemination

The study has been approved by the Institutional Review Board of IIHMR Delhi (IRB/2021-2022/006) and will be required to be approved at all participating study sites. The study is scheduled from September 2021 to August 2023. Data from retrospective cohort will be reported by August 2022. All participants will provide written informed consent. We plan to publish our results in a peer-reviewed journal and present findings at academic conferences.
Functional changes in the visual cortex in preoperative and postoperative patients with intermittent exotropia: study protocol for a non-randomised case–control clinical trial
Authors: Guo Yanan , Fu Jing , Hong Jie , Liu Zhaohui , He Xueying
Published: February 2022

Introduction

Intermittent exotropia (IXT) is the most common type of divergent squint. IXT is primarily a cortical neurologic dysfunction disorder, occurring as a result of the insufficient maintenance of sensory and motor fusion. Recent reports have demonstrated the relationship between IXT and visual cortical impairment. We planned to assess blood oxygen level-dependent (BOLD)-functional magnetic resonance imaging (fMRI) in patients with IXT during the preoperative and postoperative follow-ups to evaluate the functional changes in the visual cortex.

Methods and analysis

A total of 90 Chinese subjects will be recruited, and their ages will be between 18 and 40 years old. The subjects will include the surgical treatment (ST) group (45 subjects with IXT who will undergo surgery) and the HC group (45 age-matched, sex-matched and education-matched healthy volunteers). The assessments will include the following aspects: fMRI and general ophthalmic examinations, optometry measurements and strabismus-related tests, such as the ocular deviation, binocular vision test and Newcastle Control Score (NCS). Each subject will complete the resting-state BOLD-fMRI, and the sequences will include echo planar imaging (EPI) pulse and 3-dimensional brain volume (3D-BRAVO) to acquire high-resolution images. The follow-up schedule will be 6 and 12 months after the surgery. The primary outcome will be determined by cortex changes in BOLD-fMRI in the ST group before and after surgery. We will also compare the HC group with the preoperative subjects in the ST group. The secondary outcomes will be changes in strabismus-related examinations, such as binocular visual function and NCS.

Ethics and dissemination

Ethical approval was obtained from the Medical Ethics Committee of Beijing Tongren Hospital. We plan to publish the results of this study in a peer-reviewed journal article.

Trial registration number

ChiCTR2100048852
Experience of depression in older adults with and without a physical long-term condition: findings from a qualitative interview study
Authors: Poole Lydia , Frost Rachael , Rowlands Hannah , Black Georgia
Published: February 2022

Objective

To understand how the lived experience of depression differs among patients with a long-term condition (LTC) compared with those without an LTC, and how the experience differs across different types of LTC.

Design

Face-to-face, semistructured interviews.

Setting

Primary care; General Practitioner (GP) surgeries in and around North London.

Participants

41 primary care patients with depression were recruited. Our sample comprised participants aged 55–75 years with depression only (n=12), depression and coronary heart disease (n=5), depression and type 2 diabetes (n=10) and depression and arthritis (n=14).

Results

Interviews were conducted, audio recorded, transcribed and analysed using thematic analysis. The results revealed that the cardinal diagnostic symptoms of depression (anhedonia, sadness) were experienced by all our participants regardless of LTC. However, the LTC did interact with depression by compounding somatic, cognitive and emotional symptoms, increasing disability and reducing independence, and hindering attempts at coping with mental illness. Our findings demonstrate common experiences across patients as well as key differences based on LTC.

Conclusions

We suggest four key implications for future care practices of these patients: (1) not all participants with depression and LTC view their mental and physical health as interconnected; there should be allowances in care plans for separate treatment pathways; (2) key features of depression that affect LTC management are social withdrawal and lack of motivation to self-manage or access healthcare; (3) key features of LTCs that worsen depression are pain, the unpredictability of future health and progressive disability; (4) positive self-management of LTC could improve self-efficacy and therefore mood, and should be encouraged.
Acceptability of a perturbation-based balance training programme for falls prevention in older adults: a qualitative study
Authors: Gerards Marissa H G , Sieben Judith , Marcellis Rik , de Bie Rob A , Meijer Kenneth , Lenssen Antoine F
Published: February 2022

Introduction

Perturbation-based balance training (PBT) is reported to effectively reduce falls in older adults and may even be superior compared with various exercise programmes. Due to the nature of the intervention, requiring unpredictable balance perturbations, the question arises whether acceptability is an issue in PBT.

Objective

To evaluate the acceptability of PBT in older adults with a recent history of falls.

Design, method, participants and setting

This is a qualitative study in which semistructured interviews were conducted in 16 older adults (14 women and 2 men, mean age 73.6±6.0 years) who completed a three-session PBT protocol as part of another study in a university medical centre in the Netherlands. Typical case and purposive sampling strategies were applied. Interviews were based on the theoretical framework of acceptability (TFA) alongside context-specific factors and analysed using a template analysis approach.

Results

The results indicate that this PBT protocol is perceived as acceptable by older adults with a recent history of falls and highlight key areas for potential future modifications. Enjoyment of the novel training and technology, being able to feel safe during training, and perceived impact of increased self-efficacy and balance confidence were identified as facilitating factors. Potential issues included initial apprehension or anxiety during training and perceived impact being predominantly psychological instead of physical. Complementary to the TFA one additional theme emerged which described challenges regarding the training setting, such as preference for group training in some participants and travel to the training location.

Conclusions

The results suggest that PBT is perceived acceptable by older adults with a history of falls. Increasing the social aspect of training and sharing the experiences of peers may be considered to enhance acceptability to new participants who initially feel apprehensive or anxious about their ability to participate in future implementation of PBT.

Trial registration number

The article is linked to a randomised clinical trial registered on https://www.trialregister.nl/trial/7680, NL7680; Results.
Sex differences and adverse events of antiretrovirals in people living with HIV/AIDS: a systematic review and meta-analysis protocol
Authors: de Oliveira Jardel Corrêa , Alves Maíra Ramos , Lopes Luis Phillipe Nagem , Iwami Rodrigo Suguimoto , Motter Fabiane Raquel , Bergamaschi Cristiane de Cássia , Silva Marcus Tolentino , Itria Alexander , Scalco Diogo Luis , Lucio Donavan de Souza , Mazzei Lauren Giustti , Derech Rodrigo D’Agostini , Pereira Tiago Veiga , Barreto Jorge Otávio Maia , Lopes Luciane Cruz
Published: February 2022

Introduction

Antiretroviral therapy (ART) for HIV/AIDS is associated with adverse events (AEs). However, little is known about the differences in the risk of AEs between women and men living with HIV/AIDS. This study aims to determine (1) whether there are sex differences in the risk of AEs in people with HIV/AIDS treated with ART and (2) the prevalence of AEs to the reproductive system and bone mineral density in women.

Methods and analysis

This systematic review (SR) will include randomised trials evaluating ART in people living with HIV/AIDS with at least 12 weeks of duration follow-up. Searches will be conducted in Medline, Embase, Cochrane Library, Epistemonikos, Lilacs, trial registries and grey literature databases, without restriction on publication status, year of publication and language. The primary outcome will be the risk of ART discontinuation or drop-outs/withdrawals of ART due to AEs and the number of any treatment-emergent AE. The secondary outcomes are the incidence of serious clinic or laboratory (grade 3 and/or 4) treatment-emergent AEs, hospitalisation, death and AEs specific to the reproductive system and bone mineral density (osteoporosis, osteopenia and fractures) of women. Selection, data extraction and quality assessment will be performed by pairs of reviewers. Cochrane collaboration tools will be used to assess the risk of bias. If appropriate, a meta-analysis will be conducted to synthesise results. The overall quality of the evidence for each outcome will be determined by the Grades of Recommendation, Assessment, Development and Evaluation.

Ethics and dissemination

The results of this SR will assist the formulation of public policies aimed at the management and monitoring of AEs of ART in people living with HIV/AIDS. A deliberative dialogue will be scheduled with the Department of Chronic Conditions and Sexually Transmitted Infections of Brazil’s Ministry of Health to align the project with policymakers’ interests.

PROSPERO registration number

CRD42021251051.
Tranexamic acid versus placebo to reduce perioperative blood transfusion in patients undergoing liver resection: protocol for the haemorrhage during liver resection tranexamic acid (HeLiX) randomised controlled trial
Authors: Karanicolas Paul Jack , Lin Yulia , McCluskey Stuart , Roke Rachel , Tarshis Jordan , Thorpe Kevin E , Ball Chad G , Chaudhury Prosanto , Cleary Sean P , Dixon Elijah , Eeson Gareth , Moulton Carol-Anne , Nanji Sulaiman , Porter Geoff , Ruo Leyo , Skaro Anton I , Tsang Melanie , Wei Alice C , Guyatt Gordon
Published: February 2022

Introduction

Despite use of operative and non-operative interventions to reduce blood loss during liver resection, 20%–40% of patients receive a perioperative blood transfusion. Extensive intraoperative blood loss is a major risk factor for postoperative morbidity and mortality and receipt of blood transfusion is associated with serious risks including an association with long-term cancer recurrence and overall survival. In addition, blood products are scarce and associated with appreciable expense; decreasing blood transfusion requirements would therefore have health system benefits. Tranexamic acid (TXA), an antifibrinolytic, has been shown to reduce the probability of receiving a blood transfusion by one-third for patients undergoing cardiac or orthopaedic surgery. However, its applicability in liver resection has not been widely researched.

Methods and analysis

This protocol describes a prospective, blinded, randomised controlled trial being conducted at 10 sites in Canada and 1 in the USA. 1230 eligible and consenting participants will be randomised to one of two parallel groups: experimental (2 g of intravenous TXA) or placebo (saline) administered intraoperatively. The primary endpoint is receipt of blood transfusion within 7 days of surgery. Secondary outcomes include blood loss, postoperative complications, quality of life and 5-year disease-free and overall survival.

Ethics and dissemination

This trial has been approved by the research ethics boards at participating centres and Health Canada (parent control number 177992) and is currently enrolling participants. All participants will provide written informed consent. Results will be distributed widely through local and international meetings, presentation, publication and ClinicalTrials.gov.

Trial registration number

NCT02261415.