bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebral blood volume index as a predictor of functional independence after basilar artery thrombectomy
Authors: Karamchandani Rahul R. , Strong Dale , Rhoten Jeremy B. , Prasad Tanushree , Selig Jacob , Defilipp Gary , Asimos Andrew W.
Published: September 2021

Background and Purpose

The role of CT perfusion (CTP)in the evaluation of acute basilar artery occlusion (aBAO) patients undergoing endovascular thrombectomy (EVT) is unclear. We investigated the association of individual CTP parameters with functional outcomes in aBAO patients undergoing EVT.

Methods

A health system's prospectively collected code stroke registry was used in this retrospective analysis of aBAO patients treated with EVT presenting between January 2017 and February 2021 with pre‐EVT CTP. The primary outcome measure was modified Rankin Scale (mRS) score 0‐2 at 90 days. Factors with a univariate association (p < .05) with mRS 0‐2 were combined in a multivariable regression model to determine independent predictors of 90‐day favorable functional outcome.

Results

Forty‐six subjects, with median age 67 years and median National Institutes of Health Stroke Scale 16, were included, of whom 17 (37%) achieved mRS 0‐2 at 90 days. In the multivariable logistic regression model, CTP cerebral blood volume (CBV) index (per 0.1‐point increase, odds ratio = 1.843; 95% confidence interval: 1.039, 3.268; p‐value .0365) was independently associated with a favorable 90‐day outcome.

Conclusions

CBV index was independently associated with a favorable 90‐day outcome in aBAO patients treated with EVT, a novel finding in this patient population. CBV index may assist in treatment and prognosis discussions and inform future studies investigating the role of CTP in aBAO.
Comparative outcomes of Riata and Fidelis lead management strategies: Results from the NCDR‐ICD Registry
Authors: Zeitler Emily P. , Wang Yongfei , Pokorney Sean D. , Curtis Jeptha , Prutkin Jordan M.
Published: September 2021

Background

The Medtronic Sprint Fidelis® and Abbott Riata®/Riata ST® leads are at risk of failure and are subject to FDA recall. Comparative risks of various lead management strategies during elective generator change in a multi‐center population are unknown. We aim to describe patients with functional, recalled ICD leads undergoing elective generator replacement and report outcomes according to lead management strategies.

Methods

Using data from the NCDR ICD Registry, patients with a functioning Riata® or Fidelis® lead undergoing generator replacement are described according to lead management: reuse, abandon/replace, and extract/replace. Adjusted rates of death and pre‐discharge complications are reported.

Results

There were 13,144 generator replacement procedures involving a functioning, non‐infected Riata® or Fidelis® lead (extraction n = 414, abandonment n = 427). Extraction patients were younger (mean 58 vs. 67 years) with fewer comorbidities than the reuse group. Maximum lead dwell time was similar between groups with average 94, 90, and 99 months in the extraction, abandonment, and reuse groups, respectively. In‐hospital complications or mortality were more common in the extraction group (10.14%, 4.35%) compared with abandonment (1.64%, 0.47%) and reuse (0.22%, 0.07%). Compared with reuse, the adjusted odds of death or pre‐discharge complication were significantly higher in the extraction group (OR 7.77 95% CI 2.42–24.95, p < .001) but not the abandonment group (OR 1.70 95% CI 0.52–5.61, p = .38).

Conclusions

In this real‐world population, extraction of functional recalled ICD leads was associated with significant risk of in‐hospital mortality and complications. Additional work is needed to clarify whether longer term outcomes balance these peri‐procedural risks.
The first case of gastric leiomyosarcoma developed through malignant transformation of leiomyoma
Authors: Yamamoto Amane , Tateishi Yoko , Aikou Susumu , Seto Yasuyuki , Ushiku Tetsuo
Published: September 2021

Malignant transformation of gastric leiomyoma has not been reported, and therefore it is considered to have virtually no malignant potential. We report a case of gastric leiomyosarcoma arising from leiomyoma. The patient is a 72‐year‐old man with a submucosal mass measuring 20 mm in diameter, which was incidentally identified by an endoscopic surveillance. A biopsy suggested a diagnosis of leiomyosarcoma, and local excision was performed. Pathological examination revealed that the tumor was composed of two distinct components: typical leiomyoma‐like area in the periphery and leiomyosarcoma component exhibiting higher cellularity, prominent nuclear atypia, necrosis, and increased mitosis. Immunohistochemically, in the latter, p53 overexpression, increased Ki‐67 labeling index, and attenuated expression of smooth muscle markers were noted. This is the first report to demonstrate the presence of leiomyoma–leiomyosarcoma sequence in the stomach that is well recognized in the uterus. Our observation highlights the potential occurrence of malignant transformation of gastrointestinal leiomyoma.
How physical activity, fitness, and motor skills contribute to math performance: Working memory as a mediating factor
Authors: Syväoja Heidi J. , Kankaanpää Anna , Hakonen Harto , Inkinen Virpi , Kulmala Janne , Joensuu Laura , Räsänen Pekka , Hillman Charles H. , Tammelin Tuija H.
Published: September 2021

Purpose

The purpose of this study was to examine whether physical activity, fitness, and motor skills have an indirect association with math performance via cognitive outcomes and if so, through which aspects of cognition?

Methods

This study comprised 311 6th–9th grade adolescents (12–17 years [M age = 14.0 years], 59% girls) from seven schools throughout Finland in 2015. Math performance was measured via a teacher‐rated math achievement and the Basic Arithmetic test. Cognitive functions were measured by broad cognitive test battery. Physical activity was assessed with a self‐reported questionnaire and a hip‐worn accelerometer. Aerobic fitness was estimated using a maximal 20‐m shuttle run test, muscular fitness with curl‐up and push‐up tests, and motor skills with a 5‐leaps test and a throwing‐catching combination test. Structural equation modeling was applied to examine the associations.

Results

In both boys and girls, motor skills had a positive indirect association with math outcomes through visuospatial working memory. Among girls, muscular fitness had a positive indirect association with math outcomes through visuospatial working memory. Aerobic fitness was positively associated with math achievement, but the indirect path via cognition was not observed. Self‐reported physical activity had a borderline indirect positive association with math outcomes through visuospatial working memory. Accelerometer‐based physical activity did not correlate with math performance.

Conclusion

Motor skills and muscular fitness had indirect positive associations with math performance, mediated by visuospatial working memory. The results give support to the viewpoints that the connections between motor skills, fitness, and physical activity to academic skills are mediated via specific cognitive skills.
Development of synchrony‐dominant expectations in observers
Authors: Meng Xianwei , Kato Masaharu , Itakura Shoji
Published: September 2021

Movement synchrony is an essential feature of rituals and collective displays around the world. Previous studies have shown that synchronous movements increase observers’ perceived group entitativity and fighting capacity in agonistic contexts; however, little is known about the developmental roots of synchrony‐dominant attributions. In this study, adult participants (Exp 1), 5‐ to 6‐year‐old children (Exp 2) and 7‐ to 8‐year‐old children (Exp 3) predicted outcomes of zero‐sum conflicts between two groups of animated agents after each group exhibited either synchronised or non‐synchronised movements. Predictions were made for conflicts between two individual members from different groups (individual‐conflict condition) and between all members of the two groups (group‐conflict condition). Results showed that none of the participant groups showed a synchrony‐dominant preference in the individual‐conflict condition. In the group‐conflict condition, most adult participants expected the groups exhibiting synchronised movements to be socially dominant. Although 5‐ to 6‐year‐old children did not show more biased expectations than can be accounted for by chance, adult‐like synchrony‐dominant preference was found in 7‐ to 8‐year‐old children. Moreover, justifications of the synchrony‐dominant expectation in both adults and 7‐ to 8‐year‐old children showed that this expectation was driven by the perceived entitativity of the synchronous group. These findings show that the expectation of group dominance based on synchronous movements is strongly developed in school‐age children, explaining the developmental origins of intergroup attitudes as well as the cognitive mechanisms children employ when making judgments in intergroup contexts.
The Effects of Parental High Expectations on Middle School Students’ Overall Achievement
Authors: Noursi Omar Al , Daheri Ousha Al
Published: September 2021

Positive influence of parental involvement on their children’s academic performance has been widely reported and proved in a good number of research. However, little attention has been given to the negative influence that the high parental expectations may cause to their children performance and motivation. This current study investigates the parental high expectations on their children academic achievement and motivation. It also attempts to explore the adolescents’ perception of the influence of their parent’ expectations on their motivation. To do this, 160 middle and high school students in a public school were surveyed and seven were interviewed to collect data. The results showed that children achievement did not seem to get noticeably worse at a certain task that were pressured into doing, but rather they got exactly what their parents want from them. They also revealed that parents usually decide the expectations without estimating their children’s abilities and interests. Based on the results analysis, some implications and recommendations are provided for parents and educators to consider supporting adolescents in their academic journey.
Denken over religie. Deel II Van Hugo Winckler tot Clifford Geertz
Authors: Neckebrouck Valeer
Published: September 2021

Het tweede volume Van Hugo Winckler tot Clifford Geertz behandelt de voornaamste stromingen sinds het midden van de 19e eeuw, waaronder het evolutionisme, het intellectualisme, het diffusionisme, het Franse en het Britse functionalisme, de psychoanalytische school, het religionisme en het symbolisme of ‘interpretatieve' antropologie. Iedere theorie die een wezenlijke bijdrage heeft geleverd aan de godsdienstantropologie onderwerpt Neckebrouck daarbij aan een uitvoerige en diepgravende analyse en een vaak originele kritische evaluatie.
Denken over religie. Deel III Hedendaagse perspectieven
Authors: Neckebrouck Valeer
Published: September 2021

Met Deel III. Hedendaagse perspectieven is auteur Valeer Neckebrouck tot het sluitstuk gekomen van de chronologisch opgevatte reeks Denken over religie. Antropologische theorie en godsdienst. De studie van de antropologie van de religie wordt in dit laatste deel vanuit de meest toonaangevende, hedendaagse modellen en perspectieven belicht. De secularisatietheorieën, het postmodernisme, het feminisme, het neodarwinisme en de cognitieve antropologie van de godsdienst worden uitvoerig behandeld, maar ook denkers als René Girard, Walter Burkert, Edward O. Wilson en Richard Dawkins passeren de revue. Met de behandeling van hedendaagse theoretische perspectieven in de antropologische studie van de godsdienst gaat het om onderzoeksterreinen die nog constant in beweging zijn, om inzichten die nog in volle ontwikkeling verkeren. Bijna dagelijks worden in de biologie nieuwe ontdekkingen gedaan waarvan sommige verplichten tot een radicale herziening van inzichten die voordien als vaststaande verworvenheden werden beschouwd. Omdat onze kennis op gebied van biologie en neurologie voortdurend evolueert, dient het bilan ervan steeds weer herschreven te worden. Met dit derde deel uit de reeks Denken over religie heeft Valeer Neckebrouck hiertoe onmiskenbaar een belangwekkende bijdrage geleverd. Neckebrouck brengt de lezer in dit finale volume een grondige analyse en kritische evaluatie van de verschillende theoretische systemen waarmee grote en minder grote geesten uit de recente westerse cultuurgeschiedenis getracht hebben het enigmatische fenomeen “religie” vanuit antropologisch standpunt te verhelderen. Voor eenieder die geïnteresseerd is in het fenomeen “religie” en wil weten hoe antropologen doorheen de geschiedenis over godsdienst hebben gedacht, is deze trilogie een onmisbaar en bijzonder rijk gestoffeerd naslagwerk. Een zo gedetailleerde beschrijving en kritische evaluatie van de behandelde materie was tot nog toe in geen enkel taalgebied voorhanden.
Strategy for Connecting to the IHRF: Case Study for the Tide Gauge of Cananeia-SP
Authors: Albarici Fabio Luiz , Guimarães Gabriel Do Nascimento , Santos Marcelo Carvalho , Trabanco Jorge Luiz Alves
Published: September 2021

In July 2018, IBGE launched the new heights of the Brazilian Geodetic System (BGS), the normal height, which has associated gravity. These new heights are replacing the old normal-orthometric ones, in which there was only the non-parallelism correction. The IBGE informs that the values farther from the origin, have less accuracy. This lower accuracy may interfere in the future, the connection of the local tide gauges to IHRF (International Reference Frame Height). Thus, this paper proposes the integration of the local tide gauge of Cananeia-SP to the IHRF. In order to validate the methodology, the normal, Helmert, and rigorous orthometric heights using two distinct references: the Imbituba-SC tide gauge, as the origin of the BGS and the Cananeia-SP tide gauge, as a local tide gauge to be integrated into the IHRF. Calculating the three heights through these two origins, we analyzed the discrepancies in comparison to the heights calculated by IBGE. Numerical tests indicate that there was an improvement in terms of a mean and standard deviation when using the Cananeia gauge as origin in the calculation of normal, Helmert, and rigorous heights. In the congruence analysis, the calculations indicate that the highest standard deviation is presented when using IBGE normal heights. Thus, we have a new origin that is reliable and functional, can be integrated with the IHRF, where the Helmert and rigorous orthometric heights have the best statistical results.
A Computational Fluid Dynamics Approach for Modeling the Fluid–Structure Interaction of Offshore Aquaculture Cages and Waves
Authors: Martin Tobias , Bihs Hans
Published: September 2021

Open ocean aquaculture cages became a promising alternative to traditional fish cage designs recently. The offshore environment implies larger loads on the structure and thus higher risk for fish loss. Floating rigid aquaculture cages with stiff nets are considered as a possible solution to cope with these new challenges. Their design process requires more advanced tools to account for the non-linear fluid–structure interaction. This paper presents a suitable numerical approach for analyzing the interaction of offshore aquaculture cages and waves using computational fluid dynamics. Here, a numerical wave tank accounts for the accurate propagation of the waves, and dynamic solutions are utilized for the cage system. Two-way coupling is enabled by accounting for the influence of the net on the fluid. The numerical model is validated against measurements for the loads on and the responses of a mobile floating fish farm in waves and current.
Review of synthesis and sensing applications of anisotropic silver and gold nanostructures
Authors: Hegde Hemant Ramakant , Chidangil Santhosh , Sinha Rajeev K.
Published: September 2021

Due to their unique optical properties, anisotropic silver and gold nanostructures are widely studied for applications ranging from catalysis to sensing and imaging. The wet chemical synthesis method provides a convenient route to produce desired nanostructures with good control over the morphology of nanoparticles. Nanostructures prepared in the solutions can be loaded on the substrate to fabricate cost-effective nanoplasmonic substrates at a large scale. This review discusses the various strategies available to synthesize anisotropic silver and gold nanostructures by wet chemical methods. The applications of these nanostructures are also presented, particularly in the context of localized surface plasmon resonance-based refractometric sensing.
Use of the filtered-x least-mean-squares algorithm to adapt personal sound zones in a car cabin
Authors: Vindrola Lucas , Melon Manuel , Chamard Jean-Christophe , Gazengel Bruno
Published: September 2021

One of the main fields of application of personal sound zones (PSZs) is the car industry. PSZ systems are usually designed assuming that the acoustic environment is not changing. However, due to variability in the car cabin's acoustic conditions, it is necessary to design a system capable of adapting to these variations. This paper introduces the use of the filtered-x least-mean-squares algorithm to adapt a PSZ system in a car cabin when the seat positions change. The article focuses on four aspects. First, the effect of the initial coefficients is investigated to help with the convergence of the adaptive algorithm. Second, a study is made on the definition of the desired pressure and its effect on the reproduction. Third, the system's sensitivity to external noise is also evaluated. Last, the possibility to reduce the number of microphones for the adaptive system is considered. The method's performance is evaluated using a two headrest system installed in a car cabin and when moving the seats to different positions. It is shown that the system is capable of maintaining the performance in the different seat positions.
Seal bomb explosion sound source characterization
Authors: Wiggins Sean M. , Krumpel Anna , Dorman LeRoy M. , Hildebrand John A. , Baumann-Pickering Simone
Published: September 2021

Small explosive charges, called seal bombs, used by commercial fisheries to deter marine mammals from depredation and accidental bycatch during fishing operations, produce high level sounds that may negatively impact nearby animals. Seal bombs were exploded underwater and recorded at various ranges with a calibrated hydrophone to characterize the pulse waveforms and to provide appropriate propagation loss models for source level (SL) estimates. Waveform refraction became important at about 1500 m slant range with approximately spherical spreading losses observed at shorter ranges. The SL for seal bombs was estimated to be 233 dB re 1 μPa m; however, for impulses such as explosions, better metrics integrate over the pulse duration, accounting for the total energy in the pulse, including source pressure impulse, estimated as 193 Pa m s, and sound exposure source level, estimated as 197 dB re 1 μPa2 m2 s over a 2 ms window. Accounting for the whole 100 ms waveform, including the bubble pulses and sea surface reflections, sound exposure source level was 203 dB re 1 μPa2 m2 s. Furthermore, integrating the energy over an entire event period of multiple explosions (i.e., cumulative sound exposure level) should be considered when evaluating impact.
Bridging the Gap Between Science and Application: The Use of Cocreation Educational Workshops in Professional Youth Soccer
Authors: Andrew Matthew , Ford Paul R. , Miller Matthew T. , McRobert Allistair P. , Foster Nathan C. , Seerden Guido , Littlewood Martin , Hayes Spencer J.
Published: September 2021

We examined whether practice activities adopted by professional youth soccer coaches are modulated through the implementation of and engagement with cocreative evidence-based programs. Across two experiments, we used systematic observation to identify the practice activities of seven coaches across 134 sessions. In Experiment A, drill-based and games-based activities were recorded and quantified. To encourage behaviour change across the study, the systematic observation data were compared with skill acquisition literature to provide coaches with quantitative feedback and recommendations during workshops. Postworkshop systematic observation data indicated that practice activities used by coaches changed in accordance with the evidenced-based information (increase in games-based activities) delivered within the workshop. Interview data indicated that coaches typically stated that the workshop was a key reason for behaviour change. In a follow-up Experiment B, feedback and recommendations were delivered using an interactive video-based workshop. The systematic observation data indicated that coaches increased the use of soccer activities that contained active decision making with coaches citing the workshop as a key reason for behaviour change. These findings indicate that coaching practice activities can be supported and shaped through the implementation of cocreated workshops wherein coaches collaborate with sport scientists and researchers to bridge the gap between science and application.
The English Style: Figure Skating, Gender, and National Identity
Authors: Thurber B.A.
Published: September 2021

During the second half of the nineteenth century, a unique style of figure skating developed in Great Britain. This style emphasized long, flowing glides at high speed with a stiff, upright body posture. It contrasted with the International style, a type of skating developed on the Continent that favored brisk limb movements and showy tricks, such as jumps and spins. English skaters saw the International style as effeminate, while their own represented their idea of masculinity and allowed them to express their national identity. After the founding of the International Skating Union in 1892, British skaters found it necessary to adopt the International style to be competitive. Women proved better able to do so than men, and Madge Syers won the gold in the 1908 Olympics. Over time, the process of transnational exchange enacted through international competition resulted in the near-disappearance of the English style.
SERINC proteins potentiate antiviral type I IFN production and proinflammatory signaling pathways
Authors: Zeng Cong , Waheed Abdul A. , Li Tianliang , Yu Jingyou , Zheng Yi-Min , Yount Jacob S. , Wen Haitao , Freed Eric O. , Liu Shan-Lu
Published: September 2021

The host restriction factor SERINC5 promotes intracellular innate signaling pathways to inhibit viral infection.
The PdeK-PdeR two-component system promotes unipolar localization of FimX and pilus extension in
Xanthomonas oryzae
pv.
oryzicola
Authors: Wei Chao , Wang Shanzhi , Liu Pengwei , Cheng Shou-Ting , Qian Guoliang , Wang Shuwei , Fu Ying , Qian Wei , Sun Wenxian
Published: September 2021

A two-component system in a plant pathogen degrades c-di-GMP to promote pilus extension and virulence.
MOV10 Helicase Interacts with Coronavirus Nucleocapsid Protein and Has Antiviral Activity
Authors: Wang Li , Sola Isabel , Enjuanes Luis , Zuñiga Sonia
Published: September 2021

Coronaviruses (CoVs) are emerging pathogens causing life-threatening diseases in humans. Knowledge of virus-host interactions and viral subversion mechanisms of host pathways is required for the development of effective countermeasures against CoVs.
The Multitasking Surface Protein of Staphylococcus epidermidis: Accumulation-Associated Protein (Aap)
Authors: Rahmdel Samane , Götz Friedrich
Published: September 2021

The stratum corneum is the outermost layer of the epidermis and is thus directly exposed to the environment. It consists mainly of corneocytes, which are keratinocytes in the last stage of differentiation, having neither nuclei nor organelles.
Distinctive Roles of Two Acinetobactin Isomers in Challenging Host Nutritional Immunity
Authors: Kim Mingi , Kim Do Young , Song Woon Young , Park So Eun , Harrison Simone A. , Chazin Walter J. , Oh Man Hwan , Kim Hak Joong
Published: September 2021

Acinetobacter baumannii
has acquired antibiotic resistance at an alarming rate, and it is becoming a serious threat to society, particularly due to the paucity of effective treatment options. Acinetobactin is a siderophore of
Acinetobacter baumannii
, responsible for active iron supply, and it serves as a key virulence factor to counter host nutritional immunity during infection.
Neutralizing Monoclonal Antibodies That Target the Spike Receptor Binding Domain Confer Fc Receptor-Independent Protection against SARS-CoV-2 Infection in Syrian Hamsters
Authors: Su Wen , Sia Sin Fun , Schmitz Aaron J. , Bricker Traci L. , Starr Tyler N. , Greaney Allison J. , Turner Jackson S. , Mohammed Bassem M. , Liu Zhuoming , Choy Ka Tim , Darling Tamarand L. , Joshi Astha , Cheng Ka Man , Wong Alvina Y. L. , Harastani Houda H. , Nicholls John M. , Whelan Sean P. J. , Bloom Jesse D. , Yen Hui-Ling , Ellebedy Ali H. , Boon Adrianus C. M.
Published: September 2021

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein is the main target for neutralizing antibodies. These antibodies can be elicited through immunization or passively transferred as therapeutics in the form of convalescent-phase sera or monoclonal antibodies (MAbs).
Microbial Communities in a Serpentinizing Aquifer Are Assembled through Strong Concurrent Dispersal Limitation and Selection
Authors: Putman Lindsay I. , Sabuda Mary C. , Brazelton William J. , Kubo Michael D. , Hoehler Tori M. , McCollom Tom M. , Cardace Dawn , Schrenk Matthew O.
Published: September 2021

Microbial communities existing under extreme or stressful conditions have long been thought to be structured primarily by deterministic processes. The application of macroecology theory and modeling to microbial communities in recent years has spurred assessment of assembly processes in microbial communities, revealing that both stochastic and deterministic processes are at play to different extents within natural environments.
Species-Level Resolution of Female Bladder Microbiota from 16S rRNA Amplicon Sequencing
Authors: Hoffman Carter , Siddiqui Nazema Y. , Fields Ian , Gregory W. Thomas , Simon Holly M. , Mooney Michael A. , Wolfe Alan J. , Karstens Lisa
Published: September 2021

Accurate species-level identification from culture-independent techniques is of importance for microbial niches that are less well characterized, such as that of the bladder. 16S rRNA amplicon sequencing, a common culture-independent way to identify bacteria, is often critiqued for lacking species-level resolution. Here, we extensively evaluate classification schemes for species-level bacterial annotation of 16S amplicon data from bladder bacteria.
Resistance and Resilience of Fish Gut Microbiota to Silver Nanoparticles
Authors: Chen Pubo , Huang Jie , Rao Liuyu , Zhu Wengen , Yu Yuhe , Xiao Fanshu , Chen Xiaojuan , Yu Huang , Wu Yongjie , Xu Kui , Zheng Xiafei , Hu Ruiwen , He Zhili , Yan Qingyun
Published: September 2021

Understanding the ecological mechanisms governing the resistance and resilience of microbial communities is a key issue to predict their responses to environmental disturbances. Using the zebrafish model, we wanted to clarify the potential mechanisms governing the resistance and resilience of gut microbiota after exposure to silver nanoparticles (AgNPs).
High-Frequency, High-Throughput Quantification of SARS-CoV-2 RNA in Wastewater Settled Solids at Eight Publicly Owned Treatment Works in Northern California Shows Strong Association with COVID-19 Incidence
Authors: Wolfe Marlene K. , Topol Aaron , Knudson Alisha , Simpson Adrian , White Bradley , Vugia Duc J. , Yu Alexander T. , Li Linlin , Balliet Michael , Stoddard Pamela , Han George S. , Wigginton Krista R. , Boehm Alexandria B.
Published: September 2021

Access to reliable, rapid monitoring data is critical to guide response to an infectious disease outbreak. For pathogens that are shed in feces or urine, monitoring wastewater can provide a cost-effective snapshot of transmission in an entire community via a single sample.
Juvenile hafnium isotopic compositions recording a late Carboniferous–Early Triassic retreating subduction in the southern Central Asian Orogenic Belt: A case study from the southern Alxa
Authors: Zheng Rongguo , Li Jinyi , Zhang Jin
Published: September 2021

Two successive and parallel magmatic arcs within the southern Alxa provide an ideal area to examine the influence of tectonic switching on temporal and spatial distribution of magmatism within accretionary orogens. This study presents new geochronological and geochemical data for Yingen and Quagu plutons from the southern Alxa, located in the southern Central Asian Orogenic Belt. Late Permian Yingen granitic dikes (ca. 252 Ma) have depleted whole-rock Nd isotopic compositions, high Sr, low Y and Yb, and high Sr/Y ratios, all of which indicate they were generated by the partial melting of subducted young/hot oceanic slab. The Middle Permian (271 Ma) Yingen hosting granites contain elevated contents of Nb and Zr, and have high 10,000 × Ga/Al ratios, suggesting that they resulted from mixing between Neoproterozoic crust-derived felsic magmas and depleted mantle-derived mafic magmas. The Quagu pluton yields ca. 271–262 Ma zircon U-Pb ages and has an adakitic high-Mg diorite-like geochemical composition, suggesting that it originated from interaction between slab-derived melts and overlying peridotite material. Collectively, these data record the subduction of the Enger Us oceanic slab beneath Mesoproterozoic–Neoproterozoic sialic crust, generating a Japan-type arc within the southern Alxa during Middle–Late Permian. Temporal-spatial variations of zircon Hf isotope for plutons suggest tectonic switching from advancing to retreating subduction during Carboniferous–Early Triassic within the southern Alxa. An advancing subduction resulted from the subduction of the Paleo-Asian Ocean, and a retreating subduction was related to plate boundary reorganization during the assembly of Pangea.
Analysis of Tomographic Images of the Soil Pore Space Structure by Integral Geometry Methods
Authors: Kalnin T. G. , Ivonin D. A. , Abrosimov K. N. , Grachev E. A. , Sorokina N. V.
Published: September 2021

The technique of numerical analysis of three-dimensional tomographic images of the pore space of soil objects has been used in this paper. It applies methods of integral geometry, topology and morphological analysis. To characterize quantitatively the transformation of the pore space structure, tomographic images of four undisturbed soils were analyzed, i.e., heavy loamy agro-gray soil (Retic Phaeozem), agromineral (Sapric Rheic Mineralic Histosols), and hypnum (brown moss Sapric Rheic Histosols) peat soils in dry and wet conditions. For samples of the subplow horizon in agro-gray soil, a decrease in both Betty numbers was observed on wetting, where the zero number (b0) stands for the amount of topologically simple closed pores, and the first number (b1) indicates a decrease in pore connectivity, which varies in a narrower range of pore sizes as compared to b0. When a sample of agromineral peat soil is moistened, the Euler–Poincaré characteristic is negative ​in the pore range of 0.1–0.16 mm, which points to the predominating complicated branched structure of the pore space and high pore connectivity. When hypnum moss is saturated, a lot of tunnel pores get narrower (“collapse”), and the connectivity decreases due to the structural specifics of long-stemmed plant residues. The number of pores and connections between them in peat soils is an order of magnitude higher than those in the subplow horizon A of the agro-gray soil. The provided quantitative changes in the considered parameters of tomographic images of the soil pore space confirm the possibility of applying them for estimating the transformation of the pore space in soils.
Radical treatment of ruptured dissecting aneurysm on the P1 segment with monotherapy using multiple LVIS stents
Authors: Sasaki Natsuhi , Imamura Hirotoshi , Shigeyasu Masashi , Sakai Nobuyuki
Published: September 2021

The standard endovascular treatment for ruptured dissecting aneurysm is a parent artery occlusion. However, this treatment is unsuitable when the artery of the lesion gives off perforating vessels that supply blood to critical regions or when the collateral flow cannot be expected due to the sacrifice of the parent artery. Here, we present an infrequent case of ruptured dissecting aneurysm on P1 segment of the posterior cerebral artery. The aneurysm had little sac for coiling and the artery of the lesion had some perforator branches; thus, we selected the monotherapy with three overlapping low-profile visualised intraluminal support stents as radical treatment, which resulted in prompt obliteration of the aneurysm. The patient was fully recovered at 3 months after the procedure. Previous studies have reported the effectiveness of multiple stents alone for dissecting aneurysms, whereas this case showed that overlapping stents may also be effective on the P1 segment.
Effects of Ocufolin on retinal microvasculature in patients with mild non-proliferative diabetic retinopathy carrying polymorphisms of the MTHFR gene
Authors: Liu Zhiping , Jiang Hong , Townsend Justin H , Wang Jianhua
Published: September 2021

Introduction

To evaluate effects of Ocufolin on retinal microvasculature in mild non-proliferative diabetic retinopathy patients who carried methylenetetrahydrofolate reductase (MTHFR) polymorphisms (DR+MTHFRP).

Research design and methods

This is a prospective cohort study. Eight DR+MTHFRP (administrated Ocufolin for 6 months) and 15 normal controls (NCs) were recruited. MTHFR polymorphisms were subtyped as normal, C677T, or A1298C. Best-corrected visual acuity (BCVA) was evaluated. Retinal vessel density (VD) and microstructure were evaluated by optical coherence tomography angiography.

Results

BCVA and vascular indices of DR+MTHFRP at baseline were worse than those of NC and improved. Compared with baseline, DR+MTHFRP had significantly improved BCVA during follow-up period (p<0.05). VD of superficial vascular plexus was increased at 4 months (p=0.012), while VD of retinal vascular network did not change (p>0.05). Carriers of A1298C and C677T showed statistically significant increase in VD at all layers by 6 months, while carriers of C677T alone showed no significant change and carriers of A1298C alone showed decreased density from 4 months to 6 months. Microstructure did not change during the follow-up period.

Conclusion

A 6-month intake of Ocufolin is capable of reversing structural changes of microangiopathy in mild non-proliferative DR+MTHFRP. This suggests a novel way to address these impairments prior to catastrophic vision loss.
Open organisational culture: what does it entail? Healthcare stakeholders reaching consensus by means of a Delphi technique
Authors: Malik Romana Fattimah , Buljac-Samardžić Martina , Amajjar Ihsane , Hilders Carina G J M , Scheele Fedde
Published: September 2021

Objectives

Open organisational culture in hospitals is important, yet it remains unclear what it entails other than its referral to ‘open communication’ in the context of patient safety. This study aims to identify the elements of an open hospital culture.

Methods

In this group consensus study with a Delphi technique, statements were constructed based on the existing patient safety literature and input of 11 healthcare professionals from different backgrounds. A final framework consisting of 36 statements was reviewed on inclusion and exclusion, in multiple rounds by 32 experts and professionals working in healthcare. The feedback was analysed and shared with the panel after the group reached consensus on statements (>70% agreement).

Results

The procedure resulted in 37 statements representing tangible (ie, leadership, organisational structures and processes, communication systems, employee attitudes, training and development, and patient orientation) and intangible themes (ie, psychological safety, open communication, cohesion, power, blame and shame, morals and ethics, and support and trust). The culture themes’ teamwork and commitment were not specific for an open culture, contradicting the patient safety literature. Thereby, an open mind was shown to be a novel characteristic.

Conclusions

Open culture entails an open mind-set and attitude of professionals beyond the scope of patient safety in which there is mutual awareness of each other’s (un)conscious biases, focus on team relationships and professional well-being and a transparent system with supervisors/leaders being role models and patients being involved. Although it is generally acknowledged that microlevel social processes necessary to enact patient safety deserve more attention, research has largely emphasised system-level structures and processes. This study provides practical enablers for addressing system and microlevel social processes to work towards an open culture in and across teams.
Assessing treatment effects and publication bias across different specialties in medicine: a meta-epidemiological study
Authors: Schwab Simon , Kreiliger Giuachin , Held Leonhard
Published: September 2021

Objectives

To assess the prevalence of statistically significant treatment effects, adverse events and small-study effects (when small studies report more extreme results than large studies) and publication bias (over-reporting of statistically significant results) across medical specialties.

Design

Large meta-epidemiological study of treatment effects from the Cochrane Database of Systematic Reviews.

Methods

We investigated outcomes from 57 162 studies from 1922 to 2019, and overall 98 966 meta-analyses and 5534 large meta-analyses (≥10 studies). Egger’s and Harbord’s tests to detect small-study effects, limit meta-analysis and Copas selection models to bias-adjust effect estimates and generalised linear mixed models were used to analyse one of the largest collections of evidence in medicine.

Results

Medical specialties showed differences in the prevalence of statistically significant results of efficacy and safety outcomes. Treatment effects from primary studies published in high ranking journals were more likely to be statistically significant (OR=1.52; 95% CI 1.32 to 1.75) while randomised controlled trials were less likely to report a statistically significant effect (OR=0.90; 95% CI 0.86 to 0.94). Altogether 19% (95% CI 18% to 20%) of the large meta-analyses showed evidence for small-study effects, but only 3.9% (95% CI 3.4% to 4.4%) showed evidence for publication bias after further assessment of funnel plots. Adjusting treatment effects resulted in overall less evidence for efficacy.

Conclusions

These results suggest that reporting of large treatment effects from small studies may cause greater concern than publication bias. Incentives should be created so that studies of the highest quality become more visible than studies that report more extreme results.
Reconsidering ‘minimal risk’ to expand the repertoire of trials with waiver of informed consent for research
Authors: Monach Paul A , Branch-Elliman Westyn
Published: September 2021

Background

Progress in therapeutic research is slowed by the regulatory burden of clinical trials, which provide the best evidence for guiding treatment. There is a long delay from evidence generation to adoption, highlighting the need for designs that link evidence generation to implementation.

Objective

To identify clinical trial designs that confer minimal risk above that inherent in clinical care, to obviate the need for cumbersome consenting processes to enrol patients in prospective clinical research studies. These designs extend the scope of the Learning Healthcare System, a framework for leveraging retrospective ‘big data’ to advance clinical research, to include data collected from prospective controlled trials.

Pragmatic trials may use simplified eligibility criteria, unblinded interventions and objective outcome measures that can all be monitored through the electronic health records (EHR), to reduce costs and speed study conduct. Most pragmatic trials continue to suffer from substantial regulatory burden. Written consent to participate in research can be waived only if the research produces minimal risk above what is encountered in everyday life. However, the ‘consent’ processes for prescribing Federal Drug Administration-approved medications in clinical medicine are informal, even when they involve decisions of uncertain benefit and higher levels of risk. We propose that trial designs that mimic clinical decision-making in areas of uncertainty (clinical equipoise) and in which no data are generated outside of usual care (ideally by EHR embedding) confer minimal additional risk. Trial designs meeting this standard could, therefore, be conducted with minimal documentation of consent, even when interventions contain different risks. To align with risk encountered in clinical practice, allocation to treatment arms should change (adaptive randomisation) as data are collected and analysed. Embedding of informatics tools into the EHR has the additional benefit that, as adaptive randomisation progresses, evidence-generation transitions into implementation via decision-support tools—the ultimate realisation of the Learning Healthcare System.
Protein status of people with phenylketonuria: a scoping review protocol
Authors: Firman Sarah , Ramachandran Radha , Whelan Kevin , Witard Oliver C , O’Keeffe Majella
Published: September 2021

Introduction

Phenylketonuria (PKU) is a disorder of protein metabolism resulting in an accumulation of phenylalanine in the body. Dietary management consists of altering the sources of ingested protein to limit phenylalanine intake. Current dietary protein guidelines for PKU are based on limited scientific evidence, thus it remains unclear whether current practice leads to optimal protein status in people with PKU. To date, no attempt has been made to systematically evaluate the protein status of people with PKU, using a combination of validated anthropometric, biochemical and functional measurement tools. Furthermore, factors known to influence protein status in the general population warrant consideration when determining protein status in individuals with PKU, alongside factors unique to PKU such as the type of protein substitute consumed. Understanding the impact of these variables on protein status is crucial to developing a personalised approach to protein recommendations for optimising health and functional outcomes in people with PKU. Therefore, the aim of this scoping review is to examine existing evidence regarding the protein status of people with PKU, and to investigate the nutritional and lifestyle variables that influence protein status.

Methods and analysis

This review will be guided by Arksey and O’Malley’s framework, along with guidance from Levacet al, Pawliuket aland the Joanna Briggs Institute. The following databases will be searched: MEDLINE (Ovid), Embase, CENTRAL, Web of Science and Scopus, alongside grey literature. Identified literature will be assessed by two independent reviewers for inclusion. Descriptive numerical analysis will be performed and a narrative summary will accompany the tabulated results describing how study findings relate to the review questions.

Ethics and dissemination

This review protocol does not require ethical approval. Findings will be disseminated through peer-reviewed publication, presented at relevant conferences, and shared with a patient research advisory group to inform discussions on future research.
Prevalence, duration of exposure and predicting factors for snus use among young Finnish men: a cross-sectional study
Authors: Danielsson Maria , Tanner Tarja , Patinen Pertti , Birkhed Dowen , Anttonen Vuokko , Lammi Anelma , Siitonen Simo , Ollgren Jukka , Pylkkänen Liisa , Vasankari Tuula
Published: September 2021

Objective

The health hazards of tobacco products depend on the level of exposure, but little is known about the characteristics of snus use. The aim of this study was to investigate the duration of daily exposure to snus among occasional and daily users and its associated predictive factors among young Finnish men.

Design

Cross-sectional questionnaire study.

Setting

Three out of 16 Finnish Defence Forces units.

Participants

1280 young Finnish male conscripts starting their military service in 2016 chosen by simple random sampling.

Primary and secondary measures

The prevalence, duration of use and the amount of daily usage of snus and cigarettes were investigated. The attitudes towards perceived harmfulness of snus and the predictive factors affecting the total time of snus consumption were examined.

Results

Almost a fifth (19.5%) of the conscripts reported daily snus use, and a further 16% reported occasional use. Daily snus use was associated with an earlier starting age, longer duration of use and higher daily exposure time compared with occasional use. On average, daily snus users consumed 10 portions and occasional users three portions per day (p<0.001). The daily total exposure time for daily users was 372 min (95% CI 344 to 401) and for occasional users 139 min (95% CI 106 to 171). Respondents with an upper secondary education had significantly less daily total exposure than those with basic comprehensive education (p=0.036). Perceptions of snus as a harmful substance resulted in a significantly lower duration of exposure.

Conclusion

Snus use was very common among young Finnish men. High snus exposure duration was associated with an earlier starting age, a longer history of use and a careless attitude to its health hazards. A higher education level was a protective factor for total exposure time. Studies of the long-term health effects and dependency profile of snus use are needed.